安全护理管理中应用根本原因分析法的研究

目的探讨在安全护理管理中应用根本原因分析法的效果。方法选取我院60例护理缺陷事件,应用根本问题分析法(RCA法)找出问题发生的根本原因,再针对问题拟定、落实相应的改进措施。结果 60例护理缺陷事件中有43例(71.7%)为系统原因,17例(28.3%)为非系统原因。实施RCA后,病区患者的响铃率显著低于实施前(P<0.05);实施后的患者满意度(97.8%)显著高于实施前(82.2%),P<0.05,差异具有统计学意义。结论在安全护理管理工作中,应用RCA法可有效提高临床护理工作的质量,增强护理安全性,提升患者满意度,值得推广应用。     

Contraception des femmes françaises de 15 à 45 ans : enquête nationale sur un échantillon représentatif de 5963 femmes

ObjectivesTo describe French women's use of contraceptive methods and study their satisfaction and expectations about contraception.Patients and methodsA survey carried out by mail questionnaire filled in by a representative sample group of French women aged 15 to 45 years (Panel Postal Metascope TNS Sofres) in June 2007.ResultsOf 10,000 questionnaires sent out, 6044 questionnaires were returned, of which 5963 were usable. Seventy-three percent of women surveyed used some method of contraception, of which 46% was an oral contraceptive, 15% an IUD and 7% used condoms. A minority used new contraceptive methods (implant, patch, vaginal ring). The average age at first sexual relationship was 17.8 years. It was 18.5 among 40–45-year-olds and gradually reduced to 16.7 in the under 25-year-olds. Twenty-three percent of pregnancies remain unwanted and unplanned. For 96% of patients, the choice of contraception was considered to be important. Thirty-six percent thought that contraception could be harmful to health. Only 63% of women believed themselves to be well informed the first time they used contraception. Satisfaction for contraception method was evaluated from 7.3/10 (condom) to 9.7/10 (sterilization).Discussion and conclusionTwenty-seven percent of women do not use any contraception and 23% of pregnancies are unwanted despite a large offering of contraceptives. Our study enables the drawing of ‘patient-profiles’ for the main methods of contraception in order to better determine women's expectations and to pass the findings on to health professionals.     

Anejaculation: Relevance to Sexual Enjoyment in Men and Women

IntroductionEjaculation and orgasm are important components of sexual response in men. Our understanding of both phenomena is limited. Anejaculation can be a source of substantial distress, even when procreation (ostensibly the only purpose of ejaculation itself) is not a priority.AimTo present an opinion on male perceptions of ejaculation disorders (specifically anejaculation) based on a variety of data sources, including peer-reviewed literature.MethodsA non-systematic review of literature on anejaculation and other impairments of ejaculatory and orgasmic response was conducted. Relevant articles were critically analyzed and reportedMain Outcome MeasureAn opinion is presented, based on existing data sources, on how and why ejaculation is deemed important to men and their sexual partners.ResultsThe peer-reviewed literature on disorders of ejaculation is scant; existing reports oftentimes do not adequately distinguish between orgasm and ejaculation in assessment. Men’s perceptions of ejaculation quality appear to be positively associated with satisfaction with sexual response, particularly regarding orgasm. Based on very limited data, female sexual partners of men appear to often (but not always) value the orgasmic experience of their partner; only a minority prioritize actual ejaculation. There is evidence that disorders of ejaculation may be particularly troublesome for men who have sex with men.Clinical ImplicationsThe influence of medical conditions and treatments on ejaculation should be considered in the clinical context. Psychological adaptations and interventions may be of value in some cases.Strengths & LimitationsData on the clinical relevance of anejaculation outside the context of concomitant orgasmic dysfunction are sparse. Men’s experience of orgasm is at least partially associated with ejaculation-specific variables; whether this association is mediated by psychological, physical, or a combination of factors remains unclear.ConclusionsEjaculation, orgasm, and sexual satisfaction are closely intertwined but distinct phenomena.Shindel AW. Anejaculation: Relevance to Sexual Enjoyment in Men and Women. J Sex Med 2019;16:1324–1327.     

Incorporating peer-to-peer facilitation with a mid-level fidelity student led simulation experience for undergraduate nurses

BackgroundThe aim of this study was to evaluate peer-to-peer facilitated student led mid-level fidelity simulation experiences.MethodsSecond and third year nursing students (N = 637) were invited to complete a 16-item 6-point Likert scale questionnaire after the simulation experience.ResultsStudents reported high self-confidence in their nursing skills (M = 4.14, SD = 0.92) and a high level of satisfaction in the learning they received during the peer-to-peer facilitated student led simulation experience (M = 4.42, SD = 0.93).ConclusionUsing peer-to-peer teaching strategies during student led simulation experience is an effective approach for ensuring active engagement of all learners during midlevel fidelity group-based simulations and has the potential for broad applicability.     

Validation of the Hebrew Birth Satisfaction Scale – Revised (BSS-R) and its relationship to perceived traumatic labour

ABSTRACT

Objective and background: The Birth Satisfaction Scale-Revised (BSS-R) is a multi-dimensional measure which is recommended by international clinical guidelines for global use as the birth satisfaction outcome measure of choice. The current investigation sought to develop a Hebrew version of the BSS-R for use in the Jewish–Israeli context and examine the relationship between BSS-R domains and the perception of the experience of labour as traumatic.

Methods: Following review, translation, and back-translation for linguistic equivalence, a Hebrew version of the BSS-R (H-BSS-R) was prepared and psychometrically evaluated using key indices of validity and reliability. Complete multivariate normal data from 288 first-time Jewish Israeli mothers within two years after childbirth was entered into the analysis.

Results: The H-BSS-R was found to have a good fit to the BSS-R tridimensional measurement model, excellent internal consistency, divergent and known-group discriminant validity. Moreover, women who experienced their labour as traumatic had significantly lower H-BSS-R subscale scores than women who reported that their birth experience was non-traumatic.

Conclusion: The H-BSS-R is a robust and valid measure suitable for use with Jewish–Israeli women, as well as for investigating the relationship between traumatic labour and birth satisfaction.     

支气管肺泡灌洗术（ＢＡＬ）用于难治性肺部 感染的疗效分析

探讨支气管肺泡灌洗术（ＢＡＬ）用于难治性肺部感染的治疗效果。方法　选取２０１２年１月— ２０１４年１月入我院就诊的难治性肺部感染患者１６０例，随机分为观察组和对照组，各８０例，对照组采取常规抗 菌、雾化吸入、体位引流等治疗，观察者在此基础上进行支气管肺泡灌洗术。分析比较两组患者治疗效果以及患 者满意度情况。结果　观察组患者治疗效果明显优于对照组（９７５％ ＞６５０％），两组相比较差别具有统计学 意义（Ｐ＜００５）；观察组患者满意度为９６３％，对照组为５６３％，两组相比较差别具有统计学意义（Ｐ＜００５）。 结论　通过研究可知，支气管肺泡灌洗术用于难治性肺部感染效果显著，明显改善患者病情，提高满意度，值得 临床推荐应用。     

开展疼痛评估对提高住院患者护理服务满意度的调查分析

目的：探讨开展疼痛评估对住院患者的护理服务满意度的影响。方法对2935例住院患者进行护理服务满意度调查，按开展疼痛评估前后进行分组，其中2012年7～12月开展疼痛评估前所获得的1463例病人为对照组，2013年1～6月开展疼痛评估后所获得的1472例病人为实验组，对两组病人的护理服务满意度调查结果进行比较。结果住院患者对护理服务的满意度，开展疼痛评估后明显高于开展疼痛评估前（P＜0．05）。结论开展疼痛评估可提高住院患者对护理服务的满意度。