Relationship between call light use and response time and inpatient falls in acute care settings

Aims and objectives. This exploratory study used archived hospital data to determine whether the call light use rate and the average call light response time contribute to the fall and the injurious fall rates in acute care settings. Background. Inpatients often use call lights to seek nurses’ attention and assistance. Although implied in patient safety, no studies have examined data related to the call light use or the response time to call lights collected via existing tracking mechanisms to monitor nursing practice. Design. The study was conducted in a Michigan community hospital and used archived hospital data for analyses for the period from February 2007–June 2008. The unit of analysis was unit‐week. Method. The call light use rate per patient‐day was calculated based on information retrieved from the call light tracking system. The average response time in seconds was used as generated from the tracking system. The fall and injurious fall rates per 1000 patient‐days were calculated based on the fall incident reports. spss was used for data analyses. One‐way anova and correlation analyses were conducted. Results. More calls for assistance related to less fall‐related patient harm. Surprisingly, longer response time to call lights also related to fewer total falls and less fall‐related patient harm. Generally speaking, more call light use related to longer response times. Conclusions. This study’s findings challenged the appropriateness of targeting the goals of reducing the frequency of call light use and the fall rates as two outcome indicators of conducting hourly patient rounds. Relevance to clinical practice. Encouraging call light use is a key to reducing injurious fall rates. Unit managers should routinely monitor the trend of the call light use rate and ensure that the call light use rate is maintained at least above the mean rate.     

强化理论在长期住院患者护理管理中的应用

综述了强化理论在长期住院患者护理管理中的应用。根据长期住院患者的角色转化与适应及出现的护理管理问题,应用强化理论给予干预,逐渐消减这些患者的不合理要求,弱化患者不良情绪,促使患者恰当的进入患者角色,从而改善医患关系,构建一个和谐、正常的医疗环境,促进患者康复。     

3 508例不同时期住院死亡病例死因分析

对某综合性医院1981-1985年和1991-1995年的住院死亡病例3508例进行了死因比较分析.结果表明:住院死亡病例的死因基本无改变.其前5位死因为:恶性肿瘤,损佃和中毒,循环系统疾病,传染病和寄生虫病以及消化系统疾病.男性死亡病例均明显高于女性,死亡年龄构成35-64岁年龄组的死亡病例所占比重大.提示今后医院的医疗工作重点仍是然是以恶性肿瘤,损伤中毒,心脑血管病为主的疾病,而传染病和寄生虫病的防治也不容忽视,并且应特别注意加强中老年人疾病的防治工作.     

Disabling neurological syndromes: prevalence amongst hospitalized neurological patients

Neurological patient populations are usually described by diagnosis or in terms of functional disability measures but rarely by their clinical syndromes. A point-prevalence study was conducted assessing 349 neurological inpatients to determine the frequency and co-occurrence of disabling neurological syndromes, considering a wider spectrum including pain, emotional, neuropsychological, vegetative and sensorimotor syndromes. Of the study patients, 61% ( n  = 224) had sensorimotor syndromes, 53% ( n  = 185) had neuropsychological disorders, 40% ( n  = 139) of the patients suffered from pain, emotional disorders were found in 36% ( n  = 122) and vegetative disorders in 33% ( n  = 113). Although frequency varied by neurological diagnosis, these disabling conditions were found across all inpatient groups of diagnosis. Similarly, disorders outside the motor domains grouped according to their Barthel Index showed a striking frequency in patients considered as activities of daily living independent, reflecting a wider spectrum of disability that functional measures are not able to capture. Of the study population, 68% ( n  = 237) suffered from co-occurring disorders from different categories (pain, emotional, neuropsychological, vegetative and sensorimotor syndromes). There is a high prevalence and co-occurrence of disabling syndromes in neurological inpatients. These proportions reflect the neurological workload in a patient population and should be considered in future rehabilitation research and allocation of resources.     

原发性肝癌患者1838例预后因素分析

摘 要：［目的］ 探讨影响肝癌患者预后的相关因素,为临床治疗和肝癌预防提供参考依据。［方法］ 选择1989年11月至2007年1月我院的1838例肝癌住院病例的临床及随访资料进行分析,分析筛选影响患者生存期的相关因素。［结果］ 肝癌住院患者1、3、5、10年生存率分别为52%、26%、17%和8%,中位生存期14个月,最长生存期190个月。Cox比例风险回归模型进行多因素分析显示性别、AFP、临床分期、大体分类、组织学分型、治疗方法不同的肝癌病例的生存率差异均有统计学意义(P<0.05)。 ［结论］ 性别、术前AFP量、临床分期、大体分类、组织学分型以及治疗方法对肝癌的预后生存期有显著性影响。     

某院住院病人抗微生物药物应用分析

【目的】了解本院住院病人抗微生物药物应用情况,分析用药的合理性,为临床合理用药提供参考。【方法】从本院药品管理系统提取2008年度住院病人用药信息数据,应用限定日剂量法分析抗微生物药物的使用情况,采用Excel进行统计分析。【结果】本院住院病人抗微生物药物的应用中,注射剂品种占到近50％;医保药品品种占到87．91％;最常用的抗微生物药物分别是头孢菌素类、大环内酯类、青霉素类、喹诺酮类。【结论】本院住院病人抗微生物药物用药结构相对合理,并逐步规范化,但仍存在问题,应进一步规范抗菌药物的应用,使用药更加安全、有效、经济。     

对住院老年高血压患者实施健康教育路径的效果观察

目的 探讨健康教育路径在住院老年高血压患者中的实施效果.方法 随机将200例住院老年高血压患者分为观察组和对照组各100例,对照组采用一般常规宣教,对观察组患者根据健康教育路径图实施健康教育.并对两组患者进行书面测试、自我护理操作考核、服药依从性、血压的控制等方面的比较.结果 观察组患者书面测试、自我护理操作考核及护理满意度得分明显高于对照组,差异有显著性(P<0.001);观察组患者服药依从性、血压的控制率及健康教育达标率明显高于对照组,差异有显著性(P<0.005).结论 实施健康教育路径能够提高患者对高血压健康教育知识及服药依从性,从而使患者的血压得到有效的控制,减少患者的并发症,同时促进了护患沟通,提高了患者及家属对护理工作的满意度,获得良好的护理效果.