探究循证护理在急性心肌梗死并发心律失常护理中的应用

目的探究在急性心肌梗死合并心律失常患者中采用循证护理的应用效果。方法选取我院收治的急性心肌梗死合并心律失常患者60例,分成对照组与观察组各30例,对照组采用常规护理,观察组采用循证护理,比较两组护理效果。结果对照组患者住院时间比对照组少,治疗效果明显优于对照组,差异具有统计学意义(P0.05)。结论实施循证护理效果良好,能减少住院时间,值得临床推广。     

Cronicidad y complejidad: nuevos roles en Enfermería. Enfermeras de Práctica Avanzada y paciente crónico

The increase in chronic diseases and the progressive ageing of the population is a source of concern for the different agencies with responsibility for health care. This has led to the creation of many documents focused on the analysis of the current situation and care of chronic diseases, including the WHO recommendations intended to assist countries and health services design and implement strategies that will address the existing demand, control and prevention of chronic diseases.In addition, there is a need to respond to the demand generated by chronic diseases in every sense, and from the different systems it is becoming more difficult to get enough support from multidisciplinary teams where the nurse has a central importance. While chronic diseases are becoming a threat due to the costs they generate, it is also an opportunity for nursing to be at the forefront for advanced care requirements, performed by professionals with recognized advanced clinical skills and ability for case management while monitoring and controlling complex chronic patients. The different services of the National Health System have introduced nurses that play different roles (cases managers, liaison nurses, advanced practice nurses and so on). However, it could be argued that they are not being trained to a desirable development level.It is therefore time for health care authorities to determine the role of the advanced practice nurse in relation to functional positions, and allow them to make an advance in the development of unified skills for the whole National Health System. From our experience we have learned that the advanced practice nurse is a resource that helps in the sustainability of services, thanks to the efficiency shown in the results obtained from the care given to both chronic and complex chronic patients.     

Relate better and judge less: Poverty simulation promoting culturally competent care in community health nursing

The study aim was to evaluate the effectiveness of a poverty simulation in increasing understanding of and attitudes toward poverty and resulting in changes in clinical practice among nursing seniors. A poverty simulation was conducted using a diverse group of nursing professors and staff from local community agencies assuming the role of community resource providers. Students were assigned roles as members of low-income families and were required to complete tasks during a simulated month. A debriefing was held after the simulation to explore students' experiences in a simulated poverty environment. Students' understanding of and attitude toward poverty pre- and post-simulation were examined. Changes in the students' clinical experiences following the simulation were summarized into identified categories and themes. The poverty simulation led to a greater empathy for the possible experiences of low income individuals and families, understanding of barriers to health care, change in attitudes towards poverty and to those living in poverty, and changes in the students' nursing practice. Use of poverty simulation is an effective means to teach nursing students about the experience of living in poverty. The simulation experience changed nursing students' clinical practice, with students providing community referrals and initiating inter-professional collaborations.     

Using interventions to reduce seclusion and mechanical restraint use in adult psychiatric units: an integrative review

The aim of this integrative review was to describe interventions aimed at reducing seclusion and mechanical restraint use in adult psychiatric inpatient units and their possible outcomes. CINAHL, MEDLINE, PsycINFO and Medic databases were searched for studies published between 2008 and 2017. Based on electronic and manual searches, 28 studies were included, and quality appraisal was carried out. Data were analysed using inductive content analysis. Interventions to proactively address seclusion were environmental interventions, staff training, treatment planning, use of information and risk assessment. Interventions to respond to seclusion risk were patient involvement, family involvement, meaningful activities, sensory modulation and interventions to manage patient agitation. Interventions to proactively address mechanical restraint were mechanical restraint regulations, a therapeutic atmosphere, staff training, treatment planning and review of mechanical restraint risks. Interventions to respond to mechanical restraint risks included patient involvement, therapeutic activities, sensory modulation and interventions to manage agitation. Outcomes related to both seclusion and mechanical restraint reduction interventions were varied, with several interventions resulting in both reduced and unchanged or increased use. Outcomes were also reported for combinations of several interventions in the form of reduction programmes for both seclusion and mechanical restraint. Much of the research focused on implementing several interventions simultaneously, making it difficult to distinguish outcomes. Further research is suggested on the effectiveness of interventions and the contexts they are implemented in.     

尘肺合并肺结核136例患者的护理

目的观察并探究尘肺合并肺结核临床护理方法及效果。方法选取我院收治的136例尘肺合并肺结核患者为研究对象,随机分为对照组与实验组,每组68例。给予对照组常规护理,实验组则接受针对性综合护理服务,对两组护理效果及患者满意度进行统计并比较。结果经过一段时间的护理服务后,实验组的总有效率与患者满意度分别为94.1%与100%,对照组分别为85.3%与86.8%,数据差异显著,具备统计学意义(P0.05)。结论在对尘肺合并肺结核患者进行治疗过程中,通过加强对其心理护理及健康宣教等综合护理,大大改善了患者的呼吸功能,促进其痊愈,充分提高了患者的满意度,值得临床推广与应用。