The role of continuous monitoring in a 24/7 telecardiology consultation service—a feasibility study

Today's coronary care unit patients include those with complicated and uncomplicated myocardial infarction, decompensated heart failure and frank cardiogenic shock, severe valvular heart disease, high-grade conduction disturbances, and incessant ventricular arrhythmias. Increasingly in modern medicine, these conditions are not seen in isolation but rather in connection with a series of additional medical comorbidities.Increased life expectancy results in an increase in the prevalence of chronic cardiovascular diseases and an increased demand for health care services. Telemedicine is the provision of health care services, through the use of information and communication technology, in situations where the health care professional and the patient, or 2 health care professionals, are not in the same location. It involves the secure transmission of medical data and information, through text, sound, images, or other forms needed for the prevention, diagnosis, treatment, and follow-up of a patient. Telecardiology is one of the oldest applications in telemedicine and has been largely applied during the last 10 to 20 years.This study evaluated the feasibility of remote surveillance of coronary care unit and cardiology ward patient monitoring data by a “telecardiologist” with access to electronic health care record data and digitally stored 12-lead electrocardiograms. The remote access to the hospital intranet proved to be technically feasible. Also, the server applications used over the remote connection proved to be reliable and showed robustness against network performance variations. Extending remote patient surveillance to other hospitals is possible, provided that similar electrocardiogram and electronic health care record applications are available and a remote access can be arranged to them. However, the usability from cardiologist's perspective may be degraded if connecting with multiple applications and hospital networks is needed.The study indicated potential for speeding up the diagnostic and therapeutic processes in the hospital, although the study was limited in that the telecardiologist played a passive role and did not acutely impact patient care. In the future, the system could be expanded to surveillance of smaller hospitals. Telemedicine has the potential to aid in solving the conflict between aging of population, rise in the demand for critical care services, and shortage of professional personnel. This might, however, require a more active remote surveillance than the one tested in this study. Privacy- and security-related aspects are major components of building trust and confidence in telemedicine systems. In telecardiology, the real-time interactive telemedicine model with 24/7 service has potential superior performance compared with a store-and-forward telemedicine model.     

降低CCU抢救护士参与人数

目的 降低CCU抢救护士参与人数.方法 QC小组活动.结果通过改进抢救流程,改进抢救物品供应方式等,使CCU抢救护士参与人数从4人减少到3人,达到了活动目标.     

人文关怀在CCU的应用

目的探讨人文关怀对CCU患者心理状况的影响。方法对2008年1月-2009年1月收治的178名患者施行人文关怀,利用高超的护理技术,营造充满爱心的服务氛围,把心理疏导作为特色医疗手段,建立融洽的治疗环境。结果患者满意度由原来的918％上升到98．4％,一年内护理服务投诉率为零。结论对CCU患者施行人文关怀,提高护理服务的满意度,改善患者的心理状态,使其积极、主动配合治疗计划,促进疾病的恢复。     

颈静脉留置针在CCU患者中的应用

目的探寻冠心病监护病房(CCU)患者最佳外周静脉留置针部位。方法将162例CCU患者随机分成上肢静脉组和颈外静脉组,比较两组患者穿刺时间,留置时间及静脉炎发生情况及穿刺失败次数。结果颈外静脉穿刺时间短,成功率高,留置时间长,两组达统计学差异(P<0.05)。静脉炎发生率无统计学差异(P>0.05)。结论颈外静脉为CCU患者最佳留置针部位,尤其对合并休克及快速性心律失常的急症患者。     

CCU病房急性心梗患者的监测及护理

ＡＭＩ(急性心肌梗死 )是在冠状动脉病变 (硬化、栓塞、炎症、痉挛 )的基础上 ,发生冠脉供血急剧减少或中断 ,使相应的心肌严重而持久地急性缺血而造成的心肌缺血性坏死 ,属冠心病的严重类型。ＣＣＵ应用先进的监测技术 ,对患者病情进行细致动态的观察 ,准确迅速的判断 ,及时施行治疗抢救措施 ,提高治愈率 ,降低死亡率。现将 1 999年 1月 - 2 0 0 1年 1月我院ＣＣＵ收治的 1 98例ＡＭＩ患者的护理体会报告如下。1　临床资料1 98例患者中 ,男性 1 53例 ,女性 45例 ,年龄 1 5 - 76岁 ,平均年龄 45 .5岁 ,其中治愈好转病例 1 88例 ,死亡 1 0例 …     

CCU护理风险因素分析与有效对策的实施

目的 回顾性分析CCU护理风险事件,制定有针对性的护理对策,保证CCU护理质量.方法 贯穿实施排班改革、风险评估记录、人文精神教育措施应对风险事件.结果 通过对策的实施,有效保证了护理安全,实现护理零投诉,患者满意率由95.3%提高到99.2%,激发了护士的工作责任感.结论 有针对性的护理对策确保了CCU的护理质量,能有效防范护理风险事件的发生.     

CCU急性心肌梗死患者失眠原因分析及护理对策

失眠是指入睡障碍和睡眠维持障碍。急性心肌梗死（acute myocardial infarction AMI）患者的睡眠状况直接影响疾病的恢复,充足有效的睡眠对于疾病康复和预防并发症具有重要意义。为改善AMI患者的睡眠质量,对武警总医院CCU住院的AMI患者进行睡眠质量调查,寻求睡眠的相关因素,探索减少失眠的护理措施。     

基于ACE Star循证模式在CCU急性心肌梗死病人中的应用

目的:探讨基于ACE Star循证模式在冠心病监护病房(CCU)急性心肌梗死(AMI)病人中的应用。方法:将2019年1月—2019年12月CCU收治的62例AMI病人设为对照组,将2020年1月—2020年12月收治的65例AMI病人设为观察组,对照组行CCU常规管理,观察组在常规护理基础上行基于ACE Star循证模式护理,比较两组遵医行为、并发症发生率、不良情绪、预后情况及护理满意度评分。结果:观察组遵医行为率(包括合理饮食、合理用药、合理作息、心电监护、情绪管理)高于对照组(P<0.05),观察组心力衰竭发生率、压疮发生率低于对照组(P<0.05),观察组干预后焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分低于对照组(P<0.05),观察组心绞痛缓解时间、住院时间短于对照组(P<0.05),观察组满意度评分高于对照组(P<0.05)。结论:基于ACE Star循证模式能有效减轻CCU AMI病人不良情绪,提高病人遵医行为,从而降低并发症,改善预后,提高护理满意率。     

入住CCU患者的心理状态分析及护理

目的 分析CCU室患者产生各种心理反应的原因,采取有效的护理对策.方法 采取面对面与患者及家属交流,对300例患者观察心理行为的方法 进行心理分析.结果 患者入CCU室表现为紧张、焦虑、恐惧、悲观抑郁、疑惑、孤独等心理,其中以紧张情绪为多.结论 正确的心理状态分析,行有的放失的心理护理,对疾病的转归和预后起到了事半功倍的效果.     

新进CCU轮转护士上岗培训的方法与体会

目的:对新进CCU轮转的护士进行系统规范化上岗培训,使其尽快掌握专业理论和操作,适应CCU工作,保证CCU护理质量。方法:对2003年7月至2008年5月24名新近CCU轮转护士进行为期3个月的专科理论、专科操作以及综合能力等方面的上岗培训,培训结束进行考核评价。结果:24名轮转护士培训前后在专科理论、专科操作以及综合能力等方面的评分均有显著性差异(P0.05)。结论:对新进CCU轮转的护士进行系统的规范化培训后可使护士获得扎实的理论知识与临床实践,提高CCU护理质量。