论护士长的管理技巧对团队凝聚力的影响

阐述护士长的自身素质和管理技巧对团队凝聚力的影响及护士长应具备的管理技巧,认为提高护士长的自身素质和管理技巧是充分调动护理人员工作积极性从而提高护理质量的必要条件。     

亚低温治疗高温高湿环境下重型颅脑损伤的临床护理

目的 探讨亚低温治疗高温高湿环境下重型颅脑损伤的护理方法。方法 高温高湿环境下的重型颅脑损伤患者60例，随机分为亚低温治疗组和对照组。规范护理程序，严密观察病人生命体征变化，采取积极护理措施，减少并发症。结果 亚低温治疗24h后颅内压逐渐下降，脑组织PO2逐渐上升，伤后3个月亚低温治疗组的良好率明显高于对照组（P〈0.05），而死亡率明显低于对照组（P〈0．01）。结论 精心护理有助于改善亚低温治疗的高温高湿环境下重型颅脑损伤病人的预后。     

Does Supplementary Prenatal Nursing and Home Visitation Support Improve Resource Use in a Universal Health Care System? A Randomized Controlled Trial in Canada

ABSTRACT: Background: The addition of supplementary prenatal support may improve the health and well‐being of high‐risk women and families. The objective of this randomized controlled trial was to examine the impact of supplementary prenatal care on resource use among a community‐based population of pregnant women. Methods: Pregnant women from three urban maternity clinics were randomized (a) to current standard of physician care, (b) to current standard of care plus consultation with a nurse, or (c) to (b) plus consultation with a home visitor. Participants were 1,352 women who received 3 telephone interviews. The primary outcome was resource use (e.g., attended prenatal classes, used nutritional counseling). Results: Overall, those in the nurse intervention group were more likely to attend an “Early Bird” prenatal class and parenting classes, and to use nutrition counseling and agencies that assist with child care. Women provided with extra nursing and home visitation supports were more likely to use a written resource guide, nutrition counseling, and agencies that assist with child care. Among women at higher risk (e.g., language barriers, young maternal age, low income), the nurse intervention significantly increased use of early prenatal classes, whereas the nurse and home visitor intervention significantly increased use of the written resource guide and nutrition counseling. The intervention substantially increased the amount of information received on numerous pregnancy‐related topics but had little impact on resource use for mental health and poverty‐related needs. Among those with added support, resource use among low‐risk women was generally greater than among high‐risk women. Conclusions: Additional support provided by nurses, or nurses and home visitors, can successfully address informational needs and increase the likelihood that women will use existing community‐based resources. This finding was true even for high‐risk women, although this intervention did not reduce the difference in resource use between high‐ and low‐risk women. (BIRTH 33:3 September 2006)     

三级综合医院护士在社区护理中的角色与作用

笔者分析了三级综合医院开展社区护理的必要性和可行性；阐述了三级综合医院护士在开展社区护理中承担的教育者和咨询者、服务者、协调者和合作者、观察和研究者多种角色；并提出三级综合医院护士在开展社区护理中所发挥的作用，包括：(1)向社区提供经验丰富的专科护士，提高社区护理质量；(2)为社区护士的培养提供师资队伍和培训基地；(3)开设日间病房，为病人提供方便的治疗及护理；(4)建立双向转诊的社区卫生服务网络，为社区提供持续的优质服务；(5)开展社区护理研究。     

Experiences and learning during a graduate nurse program: an examination using a focus group approach

The graduate nurse year requires individuals to make a huge transition from university student to registered nurse as part of the health care workforce. New graduates experience steep learning curves throughout the first year of professional practice. This study sought to explore experiences and learning occurring throughout the graduate nurse program for a group of seven new nurse graduates. Focus group interviews were conducted at six months and 12 months into the program using the same set of guiding questions. The first interview highlighted that graduates early in the graduate year were internalised, concentrating on their own survival in managing workloads, facing practice realities and coming to terms with themselves as nurses. Learning was primarily about survival strategies and performing tasks. By the second interview, graduates were much less focussed on themselves. They understood their place in the health care team, had gained confidence in their relationships, and were showing concern for the next graduates arriving. Learning at this stage involved more higher order skills, including critical thinking.     

The implications of Project 2000 and the formation of links with higher education for the professional and academic needs of nurse teachers in the United Kingdom

A national study was conducted between 1991 and 1994 to explore and describe the changing role of the nurse teacher following the introduction of Project 2000 pre-registration nursing courses. Multiple methods were used to collect data from a wide variety of respondents (nurse teachers, midwife teachers, clinical nurses, health service managers and higher education lecturers). This paper presents the findings relating to the impact of Project 2000 and the move into higher education on the continuing educational needs of nurse teachers. Views on college strategies for staff development, the changing nature of teachers'academic and professional development needs and the problems of the conflicting demands experienced are reported. The research highlights the need for clinical credibility to be clearly defined in relation to nurse teachers and for educational institutions to place more emphasis on teachers'clinical development if the rhetoric of policy is to become a reality.     

护患交流效果及交流技巧分析

目的：探讨护患交流效果及恰当的交流技巧。方法：对300例住院病人进行问卷调查，分析护患交流结果，提出相应的交流技巧。结果：良好的护患交流能增强病人对护理人员的信任感，增强病人战胜疾病的信心，增加病人康复知识。预防和减少护理纠纷的发生。结论：娴熟的护患交流技巧能帮助护理人员达到交流目的，形成良好的护患关系，提高护理质量。     

Advancing Nursing Practice with a Unit-based Clinical Expert

Objective: To explore patterns in the practice of nursing and patient outcomes.
Design: Qualitative field research.
Population, Sample, Setting: Populations were critical care nurses and critically ill adult patients in the 10-bed medical critical care unit of a 900-bed teaching hospital. A convenience-purposive sample of 27 nurses and 31 patients was studied in 1985.
Methods: Six months of participant observation, unstructured interviews, and the constant comparison method of grounded theory.
Findings: Markedly different patterns were found in expert and nonexpert practice. The substantive theory of conversion helped explain how the majority of nonexpert nurses advanced their practice. The metaphor of catalyzed conversion captures how a unit-based expert nurse serves as a catalyst to advance the practice of nonexperts. Presence, defined as the way of being within a given clinical context, differentiated nurses.
Conclusions: (a) Expert and nonexpert practices are substantively different, (b) Expert and nonexpert practice results in different patient outcomes, (c) Conversion helps explain changes in nonexpert practice.
Clinical Implications: A unit-based expert nurse can increase patient-focused care.     

急诊科护士对新发传染病知信行调查问卷的编制

目的 编制急诊科(emergency department,ED)护士对新发传染病(emerging infectious diseases,EID)知信行(knowledge attitude practice,KAP)调查问卷,并进行信效度检验。方法 以KAP理论为基础,通过文献回顾、德尔菲专家函询形成问卷初稿;于2021年5月方便抽样上海市3所三级甲等综合医院293名ED护士进行预调查,完成问卷条目筛选和信效度检验。结果 形成含有34个条目的ED护士对EID知信行调查问卷,其中知识维度12个条目、态度维度10个条目、行为维度12个条目。问卷整体Cronbach's α系数为0.926,各维度Cronbach's α系数为0.617~0.968;问卷整体分半信度为0.846,各维度分半信度为0.614~0.958。问卷水平内容效度指数(scale-level content validity index,S-CVI)为0.99,条目水平内容效度指数(item-level content validity index,I-CVI)为0.99~1.00;探索因子分析显示,知识、态度、行为3个维度分别提取公因子4个、1个、2个,累计方差贡献率分别为50.192%、78.319%、73.341%,问卷整体累计方差贡献率67.242%;验证因子分析显示,问卷整体及各维度拟合度较好。结论 EID知信行调查问卷具有良好的信效度,可作为ED护士对EID KAP的评估工具。