护理模式与医学模式的比较研究

[目的]探讨现在的护理模式是否体现了护理的特色和价值,为护理模式的完善提供参考依据。[方法]应用文献资料法、历史法和比较研究法,从历史的角度将不同阶段的护理模式与医学模式进行比较。[结果]两者构建发展的出发点和终结点、包含内容形式、影响其形成及实践的宏观因素相同,在模式形成时间、产生的背景、产生及转变的动因、模式实践程度、意义和影响方面不同。[结论]护理模式体现了护理的特色,但未充分显现其价值,可借鉴美国的护理发展模式探索出适合我国国情的护理发展之路。     

The role of personality and self-efficacy in the selection and retention of successful nursing students: a longitudinal study

AIM: This paper is a report of a study to examine the role of personality and self-efficacy in predicting academic performance and attrition in nursing students. BACKGROUND: Despite a considerable amount of research investigating attrition in nursing students and new nurses, concerns remain. This particular issue highlights the need for a more effective selection process whereby those selected are more likely to complete their preregistration programme successfully, and remain employed as Registered Nurses. METHOD: A longitudinal design was adopted. A questionnaire, which included measures of personality and occupational and academic self-efficacy, was administered to 384 students early in the first year of the study. At the end of the programme, final marks and attrition rates were obtained from university records for a total of 350 students. The data were collected from 1999 to 2002. FINDINGS: Individuals who scored higher on a psychoticism scale were more likely to withdraw from the programme. Occupational self-efficacy was revealed to be a statistically significant predictor of final mark obtained, in that those with higher self-efficacy beliefs were more likely to achieve better final marks. Extraversion was also shown to negatively predict academic performance in that those with higher extraversion scores were more likely to achieve lower marks. CONCLUSION: More research is needed to explore the attributes of successful nursing students and the potential contribution of psychological profiling to a more effective selection process.     

地震医疗救援中如何做好医院的营养膳食供应体系保障工作

汶川地震医疗救援中，华西医院中央厨房在充分保障生产环境安全和食品安全的前提下，遵照标准化生产、速凉科技、网络化管理、营养指导四大理念，停止了有可能出现控制失效的食品生产，合理计划库存物资量，加强食品原料来源及品质检查；调整菜式结构；针对来自不同地区、不同民族的伤员和家属，制作特别餐；针对伤员和医护人员研发新菜品；保证轻伤员的营养供给、为重伤员提供个体化常规化的营养治疗方案。其间共为灾区70077人次（伤员36330人次，家属33747人次）、一线救护人员36273人次供餐，并完成普通病员及其他院内职工的供餐任务。最高每日供餐18372人次。     

医用三氧对慢性重型肝炎患者肝肾综合征的预防作用

目的观察医用三氧对慢性重型肝炎患者肾素（PRA）、血管紧张素Ⅱ（AngⅡ）、醛固酮（ALD）、肾血流量和肾功能的影响,探讨医用三氧治疗重型肝炎对肝肾综合征的预防作用。方法将98例慢性重型肝炎患者随机分为医用三氧治疗组50例和对照组48例,治疗组为基础治疗加医用三氧治疗系统进行治疗,采用基本自血疗法,抽出患者静脉血100ml,然后与100ml（35μg/ml）的医用三氧混合后再回输到患者体内,隔天一次,疗程20d。对照组用基础治疗。用美国GELOGIQ-7彩色多普勒超声诊断仪作肾血流量的检测,找出肾动脉,电脑自动计算出平均血流速度及血流量,血流量V=π·（D/2）2·V（平均）·HIR（心率）。用放射免疫竞争抑制法检测PRA、AngⅡ、ALD。结果治疗后20d,治疗组PRA、AngⅡ、ALD较治前下降（P〈0.01）,也低于对照组治疗后20d（P〈0.01）,肾血流量较治前升高,也多于对照组治疗后20d（P〈0.01）,肾功能损害（肝肾综合征）的发生少于对照组（P〈0.01）。治疗组存活率高于对照组（P〈0.01）。结论基础治疗加医用三氧治疗慢性重型肝炎,能使PRA、AngⅡ、ALD下降,肾血流量增加,一定程度的防止肝肾综合征的发生,并能提高患者的存活率。     

实习护生法律证据意识的现状调查及对策

目的 了解我省实习护生证据意识现状,完善临床教学对策,促进护理安全.方法 采用自行设计调查问卷对省内各大教学医院的480名初期实习护生进行证据意识现状的问卷调查,并对结果进行分析.结果 新时期下护生证据意识仍然匮乏.结论 有必要加强护生证据意识的规范教育.     

护理本科生实习前后焦虑程度的调查

目的 了解护理本科生（以下简称护生）实习期间的焦虑情况,方法 采用SCL-90症状自评量表和Zung＇s焦虑自评量表对166名护生进行调查。结果 实习前后护生焦虑检出率分别为2．5％和6．6％,两组比较,P〉0．05,差异无统计意义;实习护生焦虑标准分及SCL-90总分均高于实习前,均P〈0．05,差异有统计学意义。实习前后焦虑标准分及SCL-90总分比较,P〉0．05,差异无统计学意义。结论 实习对护生的焦虑程度影响不大,护生焦虑程度与心理健康状态无相关性。     

运用ISO9001标准规范一次性医疗用品的管理

目的规范一次性医疗用品的管理,预防和控制医院感染的发生,杜绝医疗废物外流,防止医疗废物成为社会环境的公害源。方法采用建立文件、保持记录、过程监督的方式对一次性医疗用品的采购、使用、回收过程及其子过程进行控制。结果规范了一次性医疗用品的管理,杜绝了医疗废物的外流及由此引发的院内感染的发生。结论运用ISO9001标准中的过程方法规范一次性医疗用品的管理,可以有效地预防院内感染及环境污染,提高护理管理质量和医院绩效。     

手术室护生发生差错的原因分析及对策

目的防范护生在手术室实习期间发生护理差错。方法对护生发生差错的常见原因进行分析,制定相应的防范措施。结果通过认真分析差错原因,制定相应防范措施,两年来避免了护理教学差错发生,使手术室的护理教学取得明显效果。     

On- Versus Off-Hours Presentation and Mortality of ST-Segment Elevation Myocardial Infarction Patients Treated With Primary Percutaneous Coronary Intervention

ObjectivesThe authors sought to assess the association between admission time with patient’s care, procedure characteristics, and clinical outcomes within a contemporary ST-segment elevation myocardial infarction (STEMI) network of patients referred for primary percutaneous coronary intervention (PCI).BackgroundThe effect of admission time on STEMI patient's outcomes remains controversial when primary PCI is the preferred reperfusion strategy.MethodsCharacteristics and clinical outcomes of 2,167 consecutive STEMI patients admitted in a tertiary PCI-capable center were collected. On-hours were defined as admission from Monday through Friday between 8 am and 6 pm and off-hours as admission during night shift, weekend, and nonworking holidays. In-hospital and 1-year all-cause mortality were assessed as well as key time delays.ResultsA total of 1,048 patients (48.3%) were admitted during on-hours, and 1,119 patients (51.7%) during off-hours. Characteristics were well-balanced between the 2 groups, including rates of cardiac arrest (7.9% vs. 8.8%; p = 0.55) and cardiogenic shock (12.3% vs. 14.7%; p = 0.16). Median symptom-to-first medical contact time and median first medical contact-to-sheath insertion time did not differ according to on- versus off-hours admission (120 min vs. 126 min; p = 0.25 and 90 min vs. 93 min; p = 0.58, respectively), as well as the rate of radial access for catheterization (85.6% vs. 87.5%; p = 0.27). There was no association between on- versus off-hours groups and in-hospital (8.1% vs. 7.0%; p = 0.49) or 1-year mortality (11.0% vs. 11.1%; p = 0.89), respectively.ConclusionsIn a contemporary organized STEMI network, patients admitted in a high-volume tertiary primary PCI center during on-hours or off-hours had similar management and 1-year outcomes.