手术室绩效管理对提高护理质量的效果观察

目的探讨手术室绩效管理对护理质量的影响。方法 2012年采用传统绩效考核方法（传统组）,即单纯以专业技术职务系数和工作数量进行护士绩效考核;2013年采用改进后的绩效考核方法（改进组）,即综合护士层级系数、工作数量、工作质量、患者和医生满意度、专项奖惩等方面进行护士绩效考核。比较两组手术室护理质量,患者和医生满意度、护士对绩效考核满意度等情况。结果改进组在护理质量、患者和医生满意度、护士对绩效考核满意度等方面均较传统组提高,差异均有统计学意义（P〈0.05）。结论改进后的绩效考核方法能促进护士增强工作责任感和发挥积极性,能提高护理质量、患者和医生满意度、护士对绩效考核满意度等,有利于手术室护理工作的高效开展。     

Comparison of patient reported outcomes after Triathlon? and Kinemax Plus prostheses

INTRODUCTION

The Triathlon^® (Stryker, Kalamazoo, MI, US) total knee replacement was designed to improve patient function and survivorship. The aim of this study was to determine whether the Triathlon^® prosthesis produces better patient reported outcomes than a previous design by the same manufacturer, the Kinemax Plus.

METHODS

The outcome of 233 knees of patients with a mean age of 68 years (range: 40–80 years) who received the Kinemax Plus prosthesis were compared with the outcomes of 220 knees of patients with a mean age of 70 years (range: 42–90 years) who received the Triathlon^® prosthesis. Data were collected via postal questionnaire prior to surgery as well as at 8–12 weeks and at 1 year following surgery. Validated questionnaires were used including the WOMAC^® (Western Ontario and McMaster Universities) pain and function scales, the Knee injury and Osteoarthritis Outcome Score quality of life scale and the self-administered patient satisfaction scale.

RESULTS

This study found that patients who had the Triathlon^® prosthesis had significantly better pain relief (p<0.0001), function (p=0.028), knee related quality of life (p<0.0001) and satisfaction (p=0.0003) at three months after surgery than those who received the Kinemax Plus prosthesis. In addition, knee related quality of life (p=0.002) and satisfaction (p=0.021) were significantly higher at one year after surgery in Triathlon^® patients.

CONCLUSIONS

The findings suggest that return to function and reduction in pain may occur more quickly in patients with a Triathlon^® prosthesis than in those with the Kinemax Plus.     

黑龙江省县级公立医院员工薪酬满意度分析

目的：调查县级公立医院医务人员薪酬满意度水平,为相关政策设计及效果评价提供参考。方法：对8家县级公立医院员工进行现场问卷调查,利用SPSS19.0统计软件进行统计描述与logistic回归分析。结果：调查对象的薪酬总体满意度平均得分54.05±18.04分;福利方面的满意度最低,平均得分7.98±3.51分;logistic回归分析发现学历、科室类别、每周工作时间、周围同事是否存在收红包现象和是否在编是薪酬总体满意度的影响因素。结论：县级公立医院员工薪酬总体满意度水平不高;对福利方面的满意度水平最低。建立合理的薪酬水平、薪酬提升、福利保障等机制是提高县级公立医院医务人员薪酬总体满意度的可行选择。     

医学生基层就业意向及影响因素分析

目的：了解医学生基层就业意向,分析其影响因素,为解决当前医学生就业难与基层人才短缺的结构性矛盾提供参考与建议.方法：采用自行设计的问卷调查表,对杭州师范大学、浙江医学高等专科学校的482名医学生进行调查,通过卡方检验与二分类Logistic多元回归分析医学生基层就业意向的主要影响因素.结果：44.4％的医学生不愿意去基层就业,仅有8.5％表示非常愿意去基层就业.多因素分析结果显示：女医学生的基层就业意向是男生2.5倍（P ＜0.001）;农村户口医学生的基层就业意向是城市户口医学生的2.1倍（P =0.007）;医学生的基层就业意向与政府政策和学校的基层就业指导的效果呈正相关.结论：制定积极的政策、做好宣传与引导工作、探索合理的用人机制、加强学校就业指导和深化教育教学改革是引导医学毕业生面向基层就业的重要措施.     

AIDET沟通模式在基层医院腹腔镜手术术前访视的应用

目的探讨AIDET沟通模式在基层医院腹腔镜手术术前访视的应用效果。方法将65例患者根据时间段分为对照组29例和观察组36例,按术前访视常规方法和流程对对照组患者进行访视,观察组在对照组基础上采用AIDET沟通模式进行术前访视,比较两组患者的焦虑程度和对手术室护理工作的满意度。结果两组患者访视前SAS评分差异无统计学意义,经访视后,观察组患者焦虑程度低于对照组,对手术室护理工作满意度高于对照组,两组比较差异具有统计学意义(P<0.01)。结论采用AIDET沟通模式对患者进行术前访视,有助于减轻患者的焦虑程度,提高患者对护理工作满意度。     

模糊评价法分析护士对中心药房药品配送模式的满意度

目的:了解护士对中心药房药品配送模式的满意度,提高中心药房为临床配送药品的服务水平。方法:随机向149名病房护士发放调查问卷,采用模糊评价法确定因素集、评价集和权重集,构建评判矩阵,对收集的有效问卷就配送模式中3个一级指标(药师服务、配送情况、临床影响)、10个二级指标的满意度进行测评,并对测评结果进行分析。结果与结论:护士对上述3个方面的评价和整体评价均为优秀(评分均达到93分,满分100分),主要不满意表现在对病房药品科学管理水平方面;建议中心药房应进一步加强统筹管理、拓宽服务项目、提升专业服务水平等。模糊评价法可将因素定量化并从多个因素进行综合性评价,将其运用于满意度评价较为合理。     

舒适护理在剖宫产术患者中的应用效果

目的探讨舒适护理在剖宫产手术患者中的应用效果。方法将124例剖宫产产妇随机分为观察组和对照组,每组各62例,对照组给予常规护理,观察组在常规护理的基础上给予舒适护理干预,观察两组患者的心理状况、舒适度及护理满意率等相关情况。结果观察组患者产后24h的SAS评分及SDS评分均显著低于对照组（P〈0．01）;观察组患者的舒适度为98．39％,显著高于对照组的41．94％（P〈0．01）;观察组患者的护理满意率为100．OO％,显著高于对照组的72．58％（P〈0．01）。结论舒适护理可改善剖宫产产妇的心理状态,提高住院期间的舒适度。     

人文关怀护理在喉癌手术患者中的应用效果

目的：探讨人文关怀护理在喉癌手术患者中的应用效果。方法选取本院2010年1月~2014年6月收治的68例喉癌手术患者作为研究对象,随机分为观察组和对照组,各34例。观察组给予人文关怀护理,对照组给予常规医疗护理。比较两组的不良心理状态发生率及护理满意度。结果观察组的不良心理状态发生率为20.58%,显著低于对照组的52.94%,差异有统计学意义（P<0.05）。观察组的护理满意度为94.11%,显著高于对照组的61.76%,差异有统计学意义（P<0.05）。结论人文关怀护理在喉癌手术患者中的应用效果显著,能有效降低患者的焦虑、抑郁等不良心理状况,提高患者的护理满意度,值得临床推广应用。     

人文护理模式在临床护理人员培训中的应用研究

目的：探讨人文护理模式在临床护理人员培训中的应用效果。方法选择本院80名护理人员作为研究对象,于2014年4~6月对其进行人文护理模式培训。采用关怀能力评价量表(CAI)评估并比较培训前后护理人员的人文关怀能力改变情况,采用患者满意度问卷调查表对患者进行满意度调查。结果经过3个月的培训,护理人员的人文关怀能力较培训前显著提高(P<0.05),患者对医院的满意度也高于培训前,差异有统计学意义(P<0.05)。结论在临床护理人员培训中应用人文护理模式能有效地改善护理人员的综合素质,提高临床护理质量及患者的满意度,取得更好的培训效果。     

Efficacy of i-Port Advance system on patients satisfaction and glycemic control among patients with type 1 diabetes in Saudi Arabia

Background and aimsTo determine the efficacy of i-Port Advance system on patients satisfaction and glycemic control among patients with type 1 diabetes (T1D).MethodsThis prospective study was performed among 73 patients with T1D (13–29 years) at Prince Sultan Military Medical City, Riyadh, Saudi Arabia. Demographic data were collected at baseline and clinical characteristics were collected at baseline and 12 weeks. Patients’ responses to Morisky Medication Adherence Scale (MMAS-8) and Insulin Delivery Satisfaction Survey (IDSS) were recorded at baseline and 12 weeks after initiating the i-Port Advance system.ResultsAt 12 weeks, significant improvement was evident in the IDSS subscales, which comprises the IDSS effective (p = 0.048), burdensome (p = 0.032), and IDSS inconvenient (p = 0.001), with the total baseline IDSS score being 2.6 ± 0.42, and at 12 weeks being 3.7 ± 0.72 (p = 0.037). The MMAS total score at baseline was 4.6 ± 1.2, and at 12 weeks, it increased to 6.4 (p = 0.028). HbA1c level was 8.4% at baseline and decreased to 7.9% (p = 0.001) at 12 weeks. The total daily dose of insulin at baseline registered 0.9 ± 0.13, which declined to 0.8 ± 0.12 (p = 0.048) at 12 weeks. Fasting blood sugar value was 197 ± 23.4 at baseline, which dropped to 182 ± 24.5 at 12 weeks (p = 0.01); and the postprandial glucose at baseline was 195 ± 21.4 and declined to 177 ± 19.2 at 12 weeks (p = 0.01). The hypoglycemic episodes revealed a noteworthy reduction after the i-Port Advance system usage.ConclusionUse of i-Port Advance system was found to raise the patients’ satisfaction levels and lower both the hypoglycemic episodes as well as the HbA1c levels.