临床辅导护理程序方法探讨

临床辅导护理程序方法探讨５３０００３南宁铁路医院黄庆文实行责任制护理成功的关键在于运用护理程序，将其有机地结合到现有的功能制护理中来。我国从８０年代初引进责任制护理以来，我院就设立责任病区，开展责任制护理。但由于大多在职护士没有系统学习过护理程序知识...     

护士长如何组织护理查房

护士长如何组织护理查房２１０００２南京军区南京总医院张娟，徐莉责任制护理是一种新的临床护理制度，是以病人为中心，运用护理程序对病人实施系统的、有计划的整体护理。护士长是责任制护理的具体组织者和领导者，除履行护士长原有的职责外，还应做好责任制护理的分工...     

202份责任制护理病历的质量分析与评估

２０２份责任制护理病历的质量分析与评估０７５０００解放军第４７２医院李荣芝，贾秀兰，秦爱萍，张宏护理病历是责任制护理中一项不可缺少的内容，它是由责任护士对自己所管的病人按照护理程序的四个基本步骤，实施护理全过程的记载。正确书写护理病历是责任制护理的中...     

制定护理诊断应注意的问题

制定护理诊断应注意的问题中国医科大学附属二院（１１０００３）丁艳萍，胡敏随着医学模式的转变，责任制护理已广泛深入开展，而计划护理是做好责任制护理的核心。护理计划制定的科学与否，决定于护理诊断的准确性。只有使护理诊断准确、科学、完善，才能提高责任制护理...     

责任制护理病历管理初探

调查了３０所部队和地方医院的责任制护理病历的管理情况。作者针对当前护理病历管理不够统一的实际情况，并结合该院护理病历的管理方法，进行了分析。认为主要问题是对责任制护理病历的重要性认识不够，同时提出三点意见：（ｌ）提高认识，建立制度。（２）责任制护理病历随同医疗病历由病案室统一管理比较好。（３）开展责任制护理和书写护理病历要防止随意性。     

试论责任制护理中的出院指导

试论责任制护理中的出院指导北京师范大学医院（１００７２５）车敬华所谓责任制护理，就是以患者为中心，由专人负责，对患者的全身心的健康施以有计划、有系统、连续的整体护理，而出院指导则是责任制护理制度的一项重要内容，是落实整个护理工作连续性的一个重要环节。...     

系统化整体护理与责任制护理的区别与联系

系统化整体护理是随着现代社会的文明、进步以及护理学科的发展而出现的一种以护理程序为基础的护理工作模式，它是责任制护理的继续与深化，是现代科学管理在护理工作中的具体体现，本文阐述了系统化整体护理与责任制护理区别与联系。1系统化整体护理与责任制护理的区别1．l概念不同责任制护理是指一个病人从入院到出院都由一名责任护土负责，责任护士对她所负责的病人做到8／J‘时在班，24小时负责；系统化整体护理是以现代护理为指导，以护理程序为基础，将护理临床业务和护理管理的各个环节系统化的护理工作模式。它要求护理哲理护士职…     

功能制护理与责任制护理有机结合的探讨

目前，护理队伍人员少，病人多，实施责任制护理有一定难度。而是提高护理质量，以适应现代医学代理模式的转变，满足病人更高层次的需求，就必须采取功能制护理与责任制护理相结合的方法。本文对将功能制护理与责任制护理有机结合而产生的效果进行了探讨。认为二者结合起来是提高护理质量的有效方法。     

责任制护理与系统化整体护理的比较

责任制护理和系统化整体护理分别是我国８０年代和９０年代美国引入的现代先进的护理模式，两种护理式都是以病人为中心的，以护理程序为工作方法，对病人实施系统的，有计划的，整体的护理，责任制护理理自引起后，相继在全国范围内实施，然而经过十多年的实践，尽管其先进性及科学性得到一致认可，实践也证明它答合病人的利益，有利于医疗护理质量的提高，但是在具体的实施过程中在许多问题，使得在很大程度上只是流于形式，在其之     

责任制护理中护士长的管理技巧

责任制护理中护士长的管理技巧３２２０００浙江省义乌市人民医院虞菊芳实行责任制护理是当前护理体制的一个改革．经过几年来的实践，责任制护理面临着许多困难。要使责任制护理进一步得到巩固和发展．已是当前护理学的新课题。作者认为．除护士长自身必须具备良好的思想...     

One Year Later: Evaluating a Changing Delivery System

One year after the introduction of primary nursing on four medical and surgical units in the tertiary hospital, a 23-item survey was distributed to primary and associate nurses on these units to evaluate the nurses' perceptions of the status of this change in nursing care delivery. Lewin's theory of change provided direction for evaluation of the change. The survey assessed improvements in patient care, changes in nursing practice, and interactions with other disciplines. The majority of nurses surveyed reported that patient care had improved under primary nursing; 100% of the primary nurses agreed that care had improved. The nurses identified continuity of care, communications, and awareness of patient problems as specific areas of improvement. They also identified improved interactions with many members of the healthcare team; the greatest were with dietitians, social workers, and physicians. The authors reported both positive and negative perceptions of how practice had changed under primary nursing. Results from the survey provided suggestions for continued support for staff nurses in this change in nursing care delivery within the studied facility, and suggested the need for future assessment and further evaluation.     

基层医院护士对护理科研认知的调查分析

[目的]了解基层医院护士对护理科研的认知情况,分析基层医院开展护理科研的困难及需求,为针时性地实施科研指导提供依据.[方法]对某市6所镇级医院492名护士进行护理科研认知情况的问卷调查.[结果]基层医院护士开展护理科研的意识及能力普遍较差.[结论]需要积极引导基层医院护士进行科研,提高护士科研意识及能力.     

基层医院护士对护理科研认识现状的调查研究

[目的]了解基层医院护士对护理科研的认识现状.[方法]自行设计问卷,对怀化市4所县级医院的在职护士151名进行问卷调查.[结果]基层护士对护理科研缺乏全面正确的认识,未建立实施护理科研的态度.对护理工作的热爱程度、认为科研是医生和专家的工作内容、护士的学识水平及专业能力是影响开展护理科研的主要因素;对护理科研中应承担的角色认识严重不足.[结论]加强继续教育,转变观念及态度,促进基层护士在护理科研工作中应承担研究者、协调者、管理者的角色,是护理教育者、管理者亟待解决的重要课题之一.     

Outcomes of implementing primary nursing in the care of people with chronic lung diseases: the nurses' experience

AIM: This study describes the outcomes of an action research project carried out to implement primary nursing in the care of people with chronic lung diseases at two hospital units in Iceland. METHODS: The methodological approach was the interpretative perspective. Data from transcribed interviews with 21 nurses and a research journal written by the author were analysed. Themes were generated according to dialectical procedures of interpretation. FINDINGS: The following themes were identified: close relationships with patients, continuity of care, reports of satisfied and secure patients, centrality of individual patient's needs, constant refinement of the system, sensitivity to staffing load and ambitious and responsible nurses. CONCLUSIONS: The nurses participating in this study clearly valued the possibilities that primary nursing brought in terms of higher quality of care for their patients. One of the most important components of high quality care is to know and understand patients' experiences, which is the main outcome of this study. This indicates that implementing primary nursing in the care of people with chronic lung diseases was beneficial from the point of view of the nurses. However, concerns were raised that primary nursing is more sensitive to low staffing than the system it was meant to replace.     

Integrating nursing theory, practice and research through collaborative research

The advancement of professional nursing requires integration of theory, practice and research. One realistic mechanism to achieve this integration is collaborative nursing research. A collaborative experience between clinical nurse specialists and faculty researchers is described and evaluated. The collaborative research project focused on contraceptive nursing care and self-care conceptualized within Orem's theory. A major finding was that while job titles and settings of the participants differed markedly, role components were not disparate; rather, they were compatible and complementary. The collaborative project strengthened both the theory base for a primary care nursing practice and the practice base for faculty research and theory development efforts.     

Nurses working in primary and community care settings in England: problems and challenges in identifying numbers

BACKGROUND: One third of the primary care nursing workforce is aged 50 years and over. Workforce planning is essential if primary care is to ensure that there are appropriate numbers of nurses available to replace the loss of experienced nurses as they approach retirement. INTRODUCTION: As part of an ongoing study to explore the factors influencing retention of female nurses over the age of 50 years in the primary care nursing workforce, a questionnaire survey targeting all community nurses employed in five Primary Care Trusts was undertaken. Accurate statistics on the number and type of community nurse employed in the five Primary Care Trusts were sought to: (i) identify a denominator to accurately identify the response rates to questionnaires in the survey of Primary Care Trusts; and (ii) to compare the Primary Care Trust data with Department of Health statistics to investigate the accuracy of workforce data. A number of problems with locating accurate primary care nursing workforce statistics were identified. AIM: The purpose of this paper is to highlight the difficulties inherent in collating workforce data and the implications for future workforce planning, both locally and nationally. The impact on research is also highlighted. KEY ISSUES: An ageing nursing workforce indicates that primary care nursing will experience significant reductions in its workforce. Local and National workforce statistics for primary care are flawed. There are significant gaps in primary care data for school and practice nurses. There needs to be clarification and a consensus for the term 'community nurse'. The expansion of the public health role for school nurses is seriously challenged because of limited availability of appropriately qualified nurses and an urgent need for an investigation into school nursing statistics. Future workforce planning and development needs to be based on accurate and reliable statistics, to plan for an ageing nursing workforce. The quality of research in primary care is compromised because of the lack of availability of accurate nursing workforce data. CONCLUSIONS: Effective delivery of the NHS Plan requires a thorough understanding of the composition of the primary care nursing workforce and targets need to be based on accurate and reliable workforce statistics.     

Two miracles in one career

Change is everywhere. Some is good, some is not. Some is fun, some is not. The original development of primary nursing was a transformational change process that was almost transcendental in nature. The impact of it was so powerful, it informed the rest of my life, my career, and the careers of hundreds of thousands of nurses. From a staff-driven change on a single unit, primary nursing has become a global movement. It is viewed by nurse leaders around the world as a viable means to strengthening the role of the bedside staff nurse. It is a change that can be made from within the profession. One that does not require a doctor's or administrator's permission.     

Job diagnostic surveys of paediatric nursing: an evaluative tool

Two distinct trends can be identified in the context within which nursing care is planned and delivered. One is the continuous pressure to find ways of increasing efficiency and cost-effectiveness. The second is the widespread expectation that public services in general, and health services in particular, should be monitored and evaluated. In these circumstances, nurses and their managers need a range of evaluative tools so that changes in the organization of nursing care can be evaluated. Hackman and Oldham's Job Diagnostic Survey' (JDS) approach was tested in a Paediatric Unit in which aspects of primary nursing were being introduced. The paper outlines the JDS approach in the Unit in question and offers an assessment of the value of the JDS as an evaluative tool.     

Predictors of nonpharmacological and pharmacological treatments stopped and started among nursing home residents with dementia

The purpose of this study was to describe the nonpharmacological and pharmacological treatments stopped and started over 6 weeks among a sample of nursing home residents with moderate to severe dementia and to identify nurse and resident factors associated with starting new and stopping ineffective/unnecessary nonpharmacological and pharmacological treatments. One hundred thirty-four nursing home residents with dementia and 39 nurses from 12 nursing homes in the Midwest participated in this study. Resident and nursing process data were collected on daily tracking forms completed by the primary nurse over a 6-week period. Both assessment-driven intervention and evaluation-driven follow through significantly predicted treatments stopped and new treatments started. The findings demonstrate that nurses serve an essential role in maintaining resident physiological and psychological homeostasis by vigilantly responding to residents' physical problems and behaviors with assessment-driven intervention and evaluation-driven follow through.     

Of Lillian Wald, Community Health Nursing Education, and Health Care Reform

Abstract A pilot project is described that was initiated to provide a comprehensive clinical experience for community health nursing (CHN) students despite local cutbacks in field nursing services. The project, entitled the Nursing Elementary Education Outreach Project (NEEOP), is used as a basis for discussion on the CHN role in community-focused health care reform. One-third of the CHN students in one school of nursing during one academic year ( n = 16) participated in the NEEOP. One salaried CHN faculty member assumed primary responsibility, and equipment funding was granted by a local corporation. Collaboration was established with the county's proactive school nurses' association. CHN students developed and conducted health education presentations in elementary schools, worked with school nurses, and participated in other community health activities. Three levels of evaluation were utilized: elementary students to nursing students, nursing students to nursing faculty, and school nurses to nursing faculty. The NEEOP was a success by all evaluation criteria, and plans are currently in progress to expand its focus. Innovative clinical placements such as the one described can promote student understanding of CHN practice with its broad-based emphasis on the promotion of healthier communities.