云南白药敷脐治疗婴幼儿腹泻及护理

目的　探索治疗婴幼儿腹泻简便易行又安全有效的方法及适当的护理措施。方法　随机将 62例腹泻患儿分为治疗组 32例和对照组 30例 ,治疗组用云南白药敷脐法 ,对照组用常规治疗 (给予补液 ,抗菌治疗等 )。结果　总有效率治疗组为 80 % ,对照组为 4 6.88% ,两组比较差异有显著性 ,χ2 =6.62 ,P <0 .0 5。结论　云南白药敷脐治疗婴幼儿腹泻方法简便 ,疗效确切 ,易被患儿接受     

提高成人高护班护理心理学教学效果的探讨

针对护理心理学的学科属性和成人高等护理教育的特点,结合8年来护理心理学的教学经验,总结出了教学应强调专业教育和素质教育相结合,努力提高护理心理学教育的整体水平。     

体外循环术后精神障碍的原因分析及护理

目的;探讨体外循环（CPB）术后精神障碍发生的原因及护理对策。方法：对36例CPB术后精神障碍进行回顾性分析。结果：本组36例CPB术后精神障碍表现为抑郁状态16例,谵妄状态8例、精神分裂样状态2例、神经衰弱综合征10例。CPB术后脑损害、躯体性因素及精神因素是引起精神障碍的主要原因。经过治疗和护理,34例治愈,2例死亡。结论：CPB术后精神障碍严重影响病人的身体健康,进行精神障碍的病因分析及综合护理具有重要意义。     

系统化整体护理模式对肛裂患者术后疼痛及便秘的效果观察

为观察系统化整体护理模式对肛裂患者术后疼痛及便秘的效果,将肛裂手术患者184例随机分为对照组和观察组,每组92例。对照组患者术后采用常规护理,观察组患者术后采用系统化整体护理模式护理;比较2组患者术后疼痛及便秘效果。结果显示,观察组患者术后疼痛评分低于对照组(P <0.05),观察组患者3d未排便、用力排便、排便堵塞、粪便干硬比率低于对照组(P <0.05)。结果表明,系统化整体护理模式能有效缓解肛裂患者术后疼痛,改善肛裂术后患者便秘症状。     

Variability in cesarean delivery rates among individual labor and delivery nurses compared to physicians at three attribution time points

ObjectiveTo examine the variability in the cesarean delivery (CD) rates of individual labor and delivery nurses compared with physicians at three attribution time points.Data SourcesMedical record data from nine hospitals in Washington State from January 2016 through September 2018.Study DesignRetrospective, observational cohort design using an aggregated database of birth records.Data Collection/Extraction MethodsChart‐abstracted clinical data from a subset of nulliparous, term, singleton, vertex births attributed at admission, labor management, and delivery to nurses and physicians. Two classification methods were used to categorize nurse‐ and physician‐level CD rates at three attribution time points and the reliability of these methods compared.Principal FindingsThe sample included 12 556 births, 319 nurses, and 126 physicians. Overall, variation in nurse‐level CD rates did not differ significantly across the three attribution time points, and the extent of variation was similar to that observed in physicians. However, agreement between attribution time points varied between 35 percent and 65 percent when classifying individual nurses into the top and bottom deciles. The average reliability of nurse‐level CD rates was 32 percent at admission (IQR 22.0 percent to 38.7 percent), 32.6 percent at labor (IQR 23.1 percent to 40.9 percent), and 29.3 percent (IQR 20.9 percent to 35.8 percent) at delivery. The average reliability of physician‐level CD rates was higher: 54.2 percent (IQR 38.7 percent to 71.4 percent) at admission, 62.5 percent (IQR 49.0 percent to 79.6 percent) at labor management, and 66.1 percent (IQR 53.7 percent to 81.2 percent) at delivery.ConclusionFeedback on nurse‐level CD rates as part of routine clinical quality audits can provide insight into nurse performance in the context of other individual‐level and unit‐level information. To reliably distinguish individual nurse performance, larger sample sizes are needed.     

Patients' and family members' perspectives on the benefits and working mechanisms of family nursing conversations in Dutch home healthcare

The aim of this study is to propose a model of the benefits and working mechanisms of family nursing conversations in home healthcare from the perspective of participating patients and their family members. Family nursing conversations in this study are intended to optimise family functioning, improve collaboration between family and professional caregivers and ultimately prevent or reduce overburden of family caregivers. In a qualitative grounded theory design, data were collected in 2017 using intensive interviewing with participants of family nursing conversations in home healthcare. A total of 26 participants (9 patients and 17 family members) from 11 families participated in a family nursing conversation and the study. Seven nurses who received extensive education in family nursing conversations conducted them as part of their daily practice. Interviews occurred 4–6 weeks after the family nursing conversation. The model that was constructed in close collaboration with the families consists of three parts. The first part outlines working mechanisms of the conversation itself according to participants, i.e. structured and open communication about the care situation and the presence of all of the people who are involved. The second part consists of the benefits that participants experienced during and immediately after the conversation – an increased sense of overview and improved contact among the people involved – and the related working mechanisms. The last part consists of benefits that emerged in the weeks after the conversation – reduced caregiver burden and improved quality of care – and the related working mechanisms. Insight into the benefits and working mechanisms of family nursing conversations may assist healthcare professionals in their application of the intervention and provides directions for outcomes and processes to include in future studies.     

综合护理干预对急性左心衰患者的影响

目的 探究基于自我调节理论的综合性护理干预对急性左心衰患者无创呼吸机治疗依从性的影响。方法 选取来我院就诊的急性左心衰患者83例,随机分成对照组41例和观察组42例。对照组采用常规护理模式,观察组采用基于自我调节理论的综合性护理。比较两组患者干预前后使用无创呼吸机依从性,比较干预后两组患者对无创呼吸机耐受情况、出院3个月后生活质量及干预过程中并发症发生率。结果 两组患者干预后,观察组依从性指数(85.18±4.13)高于对照组(80.45±3.68)(t=5.512,P=0.000);经干预后,观察组无创呼吸机耐受率(92.68%)与对照组(83.33%)无差异(χ2=1.711,P=0.190);两组患者出院3个月后,观察组在生活质量评分中社会功能(83.23±13.45,75.35±12.7,t=2.736,P=0.007)、情绪职能(74.31±13.64,65.34±8.45,t=3.611,P=0.001)、精神健康(76.38±10.24,68.23±11.53,t=3.402,P=0.001)方面分数高于对照组;干预期间,观察组并发症发生率(26.83%)低于对照组(59.52%)(χ2=9.029,P=0.002)。结论 基于自我调节理论的综合性护理干预能提高急性左心衰患者无创呼吸机治疗依从性,适当改善患者对无创呼吸机的耐受性,减轻并发症发生率,改善患者出院后生活质量。     

基于共享理念的急诊CTA应急平台构建与效果评价

目的基于共享理念的急诊CTA应急平台构建与效果评价。方法选取2019年1—9月急诊CTA检查患者为对照组,2019年11月—2020年8月急诊CTA检查患者为观察组。对照组采用常规急诊值班制,观察组建立急诊CTA应急平台。对申请检查科室、检查项目进行描述性统计,比较两组CTA检查时间及入院患者预后转归情况。结果申请科室以急诊内科为主,检查项目以头颅、胸腹部为主,急诊CTA检查时间对照组中位数为46 min,观察组中位数为20 min,两组对比差异有统计学意义(P<0.05),对照组37例患者中有8例(21.7%)致残,观察组103例患者中有8例(7.8%)致残,两组对比差异有统计学意义(P<0.05)。结论组建急诊CTA应急平台能缩短急诊CTA影像学检查时间,降低致残率,提高患者生活质量,优化护理人力资源,值得临床推广。     

基于ISD模型的福建省医养护理员培训体系设计探索

目的:本研究针对福建省当前医养护理员的现状,基于医养结合背景下养老服务的需求,设计一个较为科学、系统、规范的医养护理员培训体系,为福建省养老护理人才的培养提供借鉴,从而提高福建省医养护理员的整体素质。方法:通过文献研究法,结合养老护理员国家职业技能标准以及医疗护理员培训与规范服务和管理标准,并基于实地调查法和深入访谈法,对医养护理员现状进行调查,拟定医养护理员的培训体系框架。结果:教学系统设计(ISD)作为一种常用的培训体系设计模型,针对目前福建省医养护理员及其培训的实际情况,提出了基于ISD模型的养老护理员培训体系。结论:基于ISD培训体系设计模型,从分析、设计、开发、实施、评价五个环节,构建了医养护理员培训体系,并详细介绍每个环节可操作的实施策略。