采用纱球进行口腔护理的效果观察

目的探寻有效的口腔护理方法,取得更好的清洁口腔及洁牙效果。方法随机对53例有口腔护理适应症、意识清醒的患者,用纱球或棉球分别作左或右侧牙齿及口腔粘膜的清洁护理,并按同一标准进行效果评价。结果53例患者,以纱球擦洗侧,效果好的为42例,一般为11例,差为0例。以棉球擦洗侧,效果好为13例,效果一般为40例,差为0例,两组效果比较有显著性差异(P<0.01)。结论以纱球作口腔护理的清洁效果明显优于棉球的清洁效果。     

EEG enhancement during electrosurgery using an optical fibre

The paper considers the limiting factors in EEG enhancement in the presence of electrosurgery interference and presents a design for a useful fibre-optic EEG monitoring instrument which is free from such problems as electrical shock (micro and macroshock), patient burns and susceptibility to electrosurgery interference associated with conventional EEG monitors.     

Association between HLA and Japanese patients with rheumatoid arthritis

Japanese patients with rheumatoid arthritis (RA) were observed to have a statistical association with HLA-DR4, MT3. Strong association between the clinical severity of RA and HLA was also observed. Male patients had a stronger association with HLA than female patients. Males are more resistant to RA than females. This suggested that the threshold of liability for RA is higher in males than in females. Japanese patients with RA with systemic vasculitis were negative for HLA-Bw44 and had antilymphocytotoxic autoantibody, indicating that RA with systemic vasculitis is different in etiology from RA without systemic vasculitis.     

Younger Nursing Home Residents: A Scoping Review of Their Lived Experiences,Needs, and Quality of Life

ObjectivesThe percentage of younger nursing home (NH) residents (ages 18–64 years) in some countries such as the United States and Canada has been increasing over the years. In fact, it is generally held that younger NH residents are considerably different from the older residents (age ≥65 years). There is a need to understand who they are, why they resided in NHs, and their quality of life (QoL). The aims of the study were to describe the experiences, needs, and QoL among younger residents living in NHs.DesignScoping review.Settings and Participants(Younger) Residents of NHs.MethodsFive databases (PubMed, CINAHL, PsycINFO, Web of Science, and Scopus) and Google Scholar were used to search for relevant studies. PRISMA diagram was used to guide this scoping review.ResultsThe key findings of the study cover 5 themes: (1) Confinement, (2) Lack of socialization, (3) Lack of privacy, (4) Lack of appropriate settings, and (5) Loss of identity, as well as results of QoL were generated.Conclusions and ImplicationsThis scoping review provides a deeper understanding of the lived experiences, needs, and QoL among younger NH residents. The results provide suggestions for future studies regarding new interventions to optimize the QoL of NH residents.     

A Local COVID-19 Support Platform for Nursing Homes: Feedback and Perspectives

The COVID-19 pandemic has had a major impact on nursing homes (NHs), which were not prepared to manage infections among their at-risk patient populations. In order to comply with the French government's guidelines, we rapidly set up a local support platform (LSP) to help NHs manage their cases of COVID-19. The LSP comprised multidisciplinary decision support, a specialist phone hotline, mobile geriatric medicine teams, and videoconferences on COVID-19.We first quantified the LSP's interventions in 63 local NHs since the start of the first wave of COVID-19 (March 2020): 9 instances of multidisciplinary decision support, 275 calls to the specialist phone hotline, 84 interventions by mobile geriatric medicine teams, and 16 videoconferences. The LSP had been used during and between the first and second waves of the epidemic, and all had evolved to meet the NHs' needs.     

Absence of COVID-19 Disease Among Chronically Ventilated Nursing Home Patients

ObjectiveTo describe the experience of COVID-19 disease among chronically ventilated and nonventilated nursing home patients living in 3 separate nursing homes.DesignObservational study of death, respiratory illness and COVID-19 polymerase chain reaction (PCR) results among residents and staff during nursing home outbreaks in 2020.Setting and Participants93 chronically ventilated nursing home patients and 1151 nonventilated patients living among 3 separate nursing homes on Long Island, New York, as of March 15, 2020. Illness, PCR results, and antibody studies among staff are also reported.MeasurementsData were collected on death rate among chronically ventilated and nonventilated patients between March 15 and May 15, 2020, compared to the same time in 2019; prevalence of PCR positivity among ventilated and nonventilated patients in 2020; reported illness, PCR positivity, and antibody among staff.ResultsTotal numbers of deaths among chronically ventilated nursing home patients during this time frame were similar to the analogous period 1 year earlier (9 of 93 in 2020 vs 8 of 100 in 2019, P = .8), whereas deaths among nonventilated patients were greatly increased (214 of 1151 in 2020 vs 55 of 1189 in 2019, P < .001). No ventilated patient deaths were clinically judged to be COVID-19 related. No clusters of COVID-19 illness could be demonstrated among ventilated patients. Surveillance PCR testing of ventilator patients failed to reveal COVID-19 positivity (none of 84 ventilator patients vs 81 of 971 nonventilator patients, P < .002). Illness and evidence of COVID-19 infection was demonstrated among staff working both in nonventilator and in ventilator units.Conclusions and ImplicationsCOVID-19 infection resulted in illness and death among nonventilated nursing home residents as well as among staff. This was not observed among chronically ventilated patients. The mechanics of chronic ventilation appears to protect chronically ventilated patients from COVID-19 disease.     

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.     

Nursing home residents' perceptions of relocation

Summary

• ? The lived experience of relocating to a nursing home is explored from the perspective of 19 residents of Australian nursing homes.
• ? The interpretative research methodology is informed by hermeneutic phenomenology.
• ? In-depth interviews were conducted with 19 nursing home residents living in nursing homes in NSW. Interviews were audiotaped, transcribed and analysed to identify emergent themes.
• ? The themes are described and interpreted to provide an understanding of the relocation experience.

     

护理人员信息管理系统的开发与应用

本文回顾了国内护理人员信息系统研究的背景和现状,介绍了作者自行研制的护理人员信息管理系统的结构和功能,并将其用于护士继续教育和规范化培训的管理过程,已取得较好成果。护理人员信息管理系统的开发与应用旨在适应未来护理的发展需求,促进护理管理的现代化。