SBAR沟通模式在反式护理交班中的应用效果研究

目的:探讨SBAR沟通模式在临床反式护理交班中的应用效果。方法:将标准沟通方式(SBAR)即"现状、背景、评估、建议"应用于科室护士床旁交接班工作中。结果:实施SBAR沟通模式后护士的交班质量、护士综合工作能力及护士对交接班的满意度均明显高于实施前,差异有统计学意义。结论:SBAR沟通模式,护理交班的缺陷项目减少,护士的综合能力提高,保证了护理工作安全,深化了优质护理服务内涵。     

妇产专科医院急诊住院患者转运交接的应用效果评价

<正>急诊住院患者转运交接是急诊安全中的重要内容,急诊患者病情不稳定,检查项目大多需要跨科室,增加了科室与科室之间的转运交接;产科临产患者变化快,给转运交接带来了风险相对更大。转运交接是指急诊住院患者在挂号检查后,急诊医生开具住院单,办理好住院手续后由急诊护士或者转运大队转运至病区,并根据标准化医护沟通模式(SBAR)交班形式进行交接的一个过程[1,2]。转运交接规范了急诊住院患者转运流程,为进一步探明妇     

SBAR 交流模式在 CCU 病房护士晨交接班中的应用

目的：探讨 SBAR 沟通方式在心内科重症监护（CCU）病房护士晨交班中的应用效果。方法选取2013年8~12月的患者80例作为对照组,2014年1~5月的患者80例作为试验组,对照组给予传统沟通模式交班,试验组按照 SBAR 沟通模式交班,比较2组发生缺陷率、满意度及交班时间情况。结果试验组发生缺陷事件率为22.50％低于对照组的33.75％（P ﹤0.05）,满意度为96.25％明显高于对照组的80.00％（P ﹤0.05）,交接时间明显短于对照组,差异有统计学意义（P ﹤0.01）。结论运用 SBAR 沟通方式,可规范年轻护理人员交班流程,确保患者安全,保证护士的工作效率和质量,提高医护人员的满意度。     

SBAR医护沟通模式在危重患者护理管理中的应用

目的探析SBAR医护沟通模式在危重患者护理管理中的应用效果。方法以2017年1～12月我院急诊科收治的187例Ⅰ级危重症患者为主要对象,其中1～6月份98例运用传统交班模式设为对照组,7～12月89例采用SBAR模式设为观察组,对两组的护理管理效果进行对比分析。结果观察组在基础护理、病情观察、健康教育和专科护理上的质量评分均明显高于对照组,差异有统计学意义(P 0.05);观察组的医护满意度对比分析为91.01%,明显高于对照组的80.61%,差异有统计学意义(P 0.05)。结论在急诊危重症病患管理中运用SBAR医护沟通模式,可使医护合作更为密切,有效提高医护合作的满意度和护理质量,值得推广应用。     

改进式SBAR交接模式对护理工作质量影响的研究

目的:探讨改进式SBAR交接模式对护理工作质量的影响。方法:选取2016年4月1日—2016年9月30日109例住院患者和护士20名为对照组,2016年10月1日—2017年3月31日109例住院患者和护士20名为观察组。对照组采取常规护理交班模式,观察组采取改进式SBAR护理交班模式。比较分析两组交接班质量、不良事件发生率、交班时间和交接班的满意度。结果:观察组交班质量与交班满意度均高于对照组,而不良事件发生率与交班时间均低于对照组,两组比较,差异有统计学意义(P<0.05)。结论:改进式SBAR交班模式可以提升交接班质量,降低护理不良事件发生率,缩短交接班时间,提高医护患满意度。     

SBAR标准化沟通模式在急诊危重症患者中的应用效果研究

目的探讨SBAR标准化沟通模式在急诊危重症患者中的应用效果研究。方法选择2018年3月～2019年3月普宁市人民医院神经外科、神经内科、重症监护室、骨科、急诊EICU、心内科6个科室治疗的危重症患者284例作为研究对象,根据随机数字表法分为对照组(n=142)和观察组(n=142)。对照组给予常规沟通,观察组采用SBAR标准化沟通模式干预,1个月后比较两组应用效果、患者满意度、护士对危重患者病情了解度。结果观察组护理后沟通疗效高于对照组(P 0.05);观察组护理后满意度明显高于对照组(P 0.05);观察组护理后护士对危重患者病情了解度高于对照组,差异有统计学意义(P 0.05)。结论将SBAR标准化沟通模式干预用于急诊危重症患者中,能加强护士、医生对患者病情的深入了解,提高患者治疗效果及抢救成功率,使医生、护士、患者三方满意度均得到提升,值得推广应用。     

SBAR沟通模式在急诊病人交接班中的应用

目的:在急诊患者交接班中应用SBAR沟通模式,分析效果。方法:于2018年3月至2018年4月入组我科100例急诊患者,交接班中行SBAR沟通模式。结果:实施SBAR沟通模式后,护理工作质量评分、护理交接班效果均明显更优于实施前,差异显著(P0.05)。结论:在急诊危重患者交接班中应用SBAR沟通模式,效果显著。     

SBAR沟通模式在急诊-ICU病人转运交接中的应用

目的 探讨"现状-背景-评估-建议"沟通模式在急诊-重症加强护理病房患者转运交接中的应用.方法 选取广东省中山市南区医院2019年3月～2020年7月收治的80例急诊-ICU转运交接危重患者,按照随机数字表法分为观察组(40例)与对照组(40例).对照组转运交接以口头交接与填写普通交接表方法;观察转运交接以SBAR沟通...     

PBL教学联合SBAR模式在危重患者床旁交接班中的应用

目的 探讨以问题为导向的教学(PBL)联合标准化沟通模式(SBAR)在危重患者床旁交接班中的应用效果.方法 选取2020年11月至2021年2月江西省萍乡市人民医院收治的120例危重患者作为研究对象,按随机数字表法分为对照组(n=60)和观察组(n=60).对照组采用SBAR模式进行护理交接班管理,观察组采用PBL教学联合SBAR模式进行护理交接班管理.比较两组干预前及干预2个月时护士对危重患者整体情况掌握度;比较干预期两组的交接问题发生率、患者对交接班模式的满意度;比较干预前及干预2个月时两组护士的评判性思维能力[中文版批判性思维能力测量表(CTDI-CV)].结果 干预2个月,观察组护士对危重患者整体情况掌握度评分、CTDI-CV评分高于对照组,差异均有统计学意义(P＜0.05);干预期间,观察组的交接问题发生率略低于对照组,差异无统计学意义(P＞0.05);干预2个月,观察组对交接班的完整性、条理性、时效性和重点突出及总满意评分高于对照组,差异均有统计学意义(P＜0.05).结论 PBL教学联合SBAR模式在危重患者床旁交接班中的应用较好,能提高患者整体情况掌握度与护士评判性思维能力,降低交接问题发生率,提升患者对交接班模式的满意度.     

PBL教学联合SBAR模式在危重患者床旁交接班中的应用

目的 探讨以问题为导向的教学(PBL)联合标准化沟通模式(SBAR)在危重患者床旁交接班中的应用效果.方法 选取2020年11月至2021年2月江西省萍乡市人民医院收治的120例危重患者作为研究对象,按随机数字表法分为对照组(n=60)和观察组(n=60).对照组采用SBAR模式进行护理交接班管理,观察组采用PBL教学联合SBAR模式进行护理交接班管理.比较两组干预前及干预2个月时护士对危重患者整体情况掌握度;比较干预期两组的交接问题发生率、患者对交接班模式的满意度;比较干预前及干预2个月时两组护士的评判性思维能力[中文版批判性思维能力测量表(CTDI-CV)].结果 干预2个月,观察组护士对危重患者整体情况掌握度评分、CTDI-CV评分高于对照组,差异均有统计学意义(P＜0.05);干预期间,观察组的交接问题发生率略低于对照组,差异无统计学意义(P＞0.05);干预2个月,观察组对交接班的完整性、条理性、时效性和重点突出及总满意评分高于对照组,差异均有统计学意义(P＜0.05).结论 PBL教学联合SBAR模式在危重患者床旁交接班中的应用较好,能提高患者整体情况掌握度与护士评判性思维能力,降低交接问题发生率,提升患者对交接班模式的满意度.     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

Comparison of in vitro cell models in predicting in vivo brain entry of drugs

Although several in vitro models have been reported to predict the ability of drug candidates to cross the blood-brain barrier, their real in vivo relevance has rarely been evaluated. The present study demonstrates the in vivo relevance of simple unidirectional permeability coefficient (P(app)) determined in three in vitro cell models (BBMEC, Caco-2 and MDCKII-MDR1) for nine model drugs (alprenolol, atenolol, metoprolol, pindolol, entacapone, tolcapone, baclofen, midazolam and ondansetron) by using dual probe microdialysis in the rat brain and blood as an in vivo measure. There was a clear correlation between the P(app) and the unbound brain/blood ratios determined by in vivo microdialysis (BBMEC r=0.99, Caco-2 r=0.91 and MDCKII-MDR1 r=0.85). Despite of the substantial differences in the absolute in vitro P(app) values and regardless of the method used (side-by-side vs. filter insert system), the capability of the in vitro models to rank order drugs was similar. By this approach, thus, the additional value offered by the true endothelial cell model (BBMEC) remains obscure. The present results also highlight the need of both in vitro as well as in vivo methods in characterization of blood-brain barrier passage of new drug candidates.