品管圈在提高护理非无菌操作中手卫生的应用

目的研究品管圈对提升妇科护理人员在测量生命体征、发放口服药,做微波、红外线治疗等非无菌操作中,手卫生依从性的临床价值。方法选取2018年5月-2018年12月实施品管圈活动期间科室护理人员手卫生依从性数据为研究组,另选取2017年9月-2018年4月未实施品管圈活动期间科室护理人员手卫生依从性数据为对照组,护理人员与研究组为同一组,对照组采用常规护理,研究组实施品管圈活动,比较两组实施效果。结果研究组洗手依从性为72.71%,对照组37.50%,差异有统计学意义(P<0.01)。研究组正确洗手率为81.95%,对照组43.89%,差异有统计学意义(P<0.01);研究组开展品管圈后解决问题能力、凝聚力、QC手法评分高于对照组,差异有统计学意义(P<0.01)。结论品管圈活动开展,有助于提升护理人员对手卫生重要性的认识,获得了较高手卫生依从性。     

Association between first oral examination characteristics and dental treatment needs in privately insured children: A claims data analysis

BackgroundEarly childhood caries (ECC) remains the most common, preventable infectious disease among children in the United States. Screening is recommended after the eruption of the first tooth, but it is unclear how the age at first dental examination is associated with eventual restorative treatment needs. The authors of this study sought to determine how provider type and age at first dental examination are associated longitudinally with caries experience among children in the United States.MethodsDeidentified claims data were included for 706,636 privately insured children aged 0 through 6 years as part of the nationwide IBM Watson Health Market Scan (2012-2017). The authors used Kaplan-Meier survival analysis to describe the association between the age of first visit and restorative treatment needs.ResultsA total of 21% of this population required restorative treatment, and the average age at first dental examination was 3.6 years. A multivariable Cox proportional hazards model showed increased hazard for restorative treatment with age at first dental visit at 3 years (hazard ratio, 2.05; 95% CI, 1.97 to 2.13) and 4 years (hazard ratio, 3.99; 95% CI, 3.84 to 4.16).ConclusionThe high proportion of children requiring restorative treatment and late age at first dental screening show needed investments in educating general dentists, medical students, and pediatricians about oral health guidelines for pediatric patients.Practical ImplicationsCommunicating the importance of children establishing a dental home by age 1 year to parents and health care professionals may help reduce disease burden in children younger than 6 years.     

Evaluating the Effect of an Educational Intervention for Nursing Managers on the Rate of Incidents Reported at University Hospitals of Iran

In this semiexperimental study conducted at the university hospitals in an urban area of Iran, the number of reported incidents—as per the information from offices—was evaluated and recorded for the improvement of the quality of hospitals. Subsequently, an educational intervention was conducted for nursing managers. Three months later, the number of reported incidents was again evaluated and recorded. According to the results, the number of reported incidents increased in the hospitals after the educational intervention. The results of this study could be helpful for hospital personnel, especially nurses, to improve the culture of incident self-reporting.     

极低出生体质量儿早期规范补铁的临床观察

目的探讨早期规范补铁对极低出生体质量儿病情转归的影响,以避免发生不可逆的神经系统损伤。方法选择2014年6月-2015年12月在防城港市第一人民医院住院的极低出生体质量儿76例为研究对象,按数字表法随机分为试验组38例和对照组38例,对照组予常规治疗,按指南补铁;试验组也予常规治疗,同时按血清铁(SI)、血清铁蛋白(SF)和总铁结合力(TIBC)水平早期补铁。观察两组感染控制时间、新生儿神经行为评分(NBNA)恢复情况。结果试验组总有效率为84.21%高于对照组的65.79%,两组比较差异有统计学意义(χ~2=4.047,P<0.05)。试验组感染控制时间、NBNA恢复时间、住院时间、住院费用[(6.71±2.47)d、(77.53±9.11)d、(23.63±8.86)d、(19 829.95±12 855.04)元]等均少于对照组[(10.47±3.68)d、(77.66±8.67)d、(31.03±15.35)d、(28 405.82±15 213.96)元],差异均有统计学意义(t=-5.728、-3.933、-2.615、-2.636,均P<0.05)。结论早期规范补铁对极低出生体质量儿病情转归有较好的促进作用,有助于神经系统的发育,缩短住院时间,降低住院费用。     

无痛人流术的护理配合

目的探讨芬太尼与异丙酚静脉麻醉下无痛人流手术的护理配合.方法对1 957例无痛人流术的孕妇进行术前护理、术中护理配合、术后护理及健康指导.结果患者均能顺利完成手术.结论对无痛人流术患者进行积极有效的护理措施,有助于手术顺利进行,避免并发症和意外事故的发生.     

ICU病人非计划性拔管的原因分析与护理防范

为提高ICU插管病人的护理质量 ,分析非计划性拔管的原因 ,并提出进行相关知识的培训 ,有效固定导管 ,合理使用镇静剂及肢体约束等防范措施。