胸外科护士对肿瘤患者护理认知现状的调查及对策

目的 了解胸外科护士对肿瘤患者护理的认知现状,探讨提高心胸外科肿瘤患者护理水平的对策及措施.方法 2009年11月至2010年11月,选取某市5家医院的150名心胸外科护士作为研究对象,对其采用自制的心胸外科肿瘤患者护理认知调查表进行调查,统计150名护士对心胸外科肿瘤患者护理中的健康宣教、心理护理、死亡教育、癌痛护理等知识的认知情况.结果 经调查,150名心胸外科护士对肿瘤患者护理知识中的健康宣教相关知识掌握最好,平均得分为(88.6±11.3)分;对死亡教育的相关知识掌握最差,平均得分为(64.5±21.6)分;5家医院的护士对心理护理及癌痛护理相关知识掌握程度差异较大,A医院和C、D医院护士在心理护理相关知识的掌握程度方面差异显著,B医院与A、E、F医院护士在癌痛护理相关知识掌握程度方面差异显著.结论 根据对心胸外科护士对肿瘤患者护理认知现状的调查,采取针对性的理论及实践培训,可使心胸外科护士提高对心胸外科肿瘤患者护理相关知识的认识水平,提高对肿瘤患者针对性的护理质量.     

血液非正常报废的原因分析及预防措施

目的探讨血液非正常报废的原因,为更有利地利用血液资源提供依据。方法全部统计资料均来源于本血站计算机管理系统,计算出不同项目的百分比及不同品种的数量。结果2010年全年在本地区献血人群中,血液制备中常见的5个品种,35858袋的血液。非正常报废率占0．36％,按报废的时间、品种及原因分类整理。统计非正常报废血比例并分析。报废的血液产品中血浆数量最多,而脂肪血是非正常报废的主要原因。结论为减少血液的浪费,主要做好献血前宣教及咨询指导工作,严把体检质量关,同时完善改进骚潮模式,减少不必要的报废,确保血液质量和输血安全。     

综合肺康复对尘肺病患者呼吸机能的影响

目的:观察综合肺康复对尘肺病患者呼吸机能的影响。方法:尘肺病1期患者118例均给予药物和肺灌洗常规治疗,并配合物理疗法、运动训练、针刺推拿及健康教育等综合肺康复,评定治疗前后呼吸功能、运动功能、生活质量和焦虑程度。结果:治疗2个月后,118例患者肺功能检测第1s用力呼气容积(FEVI)、每分钟最大通气量(MVV)评分、运动能力以及呼吸肌耐力均较治疗前明显提高(P<0.05,0.01);生活质量(SGRQ)及焦虑评分均较治疗前明显降低(P<0.01).结论:综合肺康复对改善尘肺病患者呼吸功能、减轻呼吸困难症状、提高生活质量方面均具有促进作用。     

认知心理护理改善脑卒中急性期抑郁症患者认知障碍的作用

目的探讨认知心理护理改善脑卒中急性期抑郁症患者认知障碍的作用。方法将78例诊断为脑卒中后抑郁症的患者随机分为研究组和对照组各39例,对照组进行常规治疗及护理,研究组在对照组的基础上进行认知心理护理,比较两组患者干预前、干预后4和8周的功能失调性状况评分(dysfunctional attitudes scale,DAS)。结果治疗4及8周时,研究组患者DAS评分均低于对照组,差异有统计学意义(P<0.05);研究组治疗8周后,DAS评分也低于治疗前及治疗4周后,差异有统计学意义(P<0.05)。结论认知心理护理能有效改善脑卒中急性期抑郁症患者的认知障碍。     

医院多重耐药菌感染现状分析及预防措施

目的分析医院多重耐药(MDR)菌感染的现状,加强感染的防治.方法回顾性分析2008~2011年912例住院患者MDR菌感染的病历资料.结果 MDR菌在痰液标本中分离率最高,检出率为24.3%;其次为尿液标本,检出率为22.2%;分泌物检出率19.3%;脓液标本检出率8.7%.MDR菌的年份分布:2008年96株(10.5%);2009年183株(20.1%);2010年294株(32.2%);2011年339株(37.2%).MDR菌在临床科室的构成比:呼吸内科13.5%;泌尿外科11.8%;妇产科11.4%;消化内科10.9%;肛肠科9.4%;心内科 7.7%;普通外科6.7%;急诊科 6.5%;骨伤科 6.0%.该院 MDR 菌株以产 ESBLs 的大肠埃希菌为主,检出486株,占总数的53.3%;其次为产ESBLs的肺炎克雷伯菌78株,占8.6%;粪肠球菌59株,占6.5%;其他菌株289株,占31.7%.结论该院MDR菌的感染以产ESBLs的大肠埃希菌居多,患者MDR菌的感染部位以呼吸道为主,感染科室以呼吸内科为主,MDR菌的感染呈逐年上升的趋势.合理应用抗菌药物是控制MDR菌感染产生的关键,MDR菌的感染已日趋严重,应加强监测、预防与控制.     

综合护理干预对老年股骨颈骨折患者术后首次排便的影响

目的探讨综合护理干预对老年股骨颈骨折患者术后首次排便的影响。方法便利抽样法选择2010年11月至2011年11月在镇江市第二人民医院住院治疗的84例老年股骨颈骨折需手术的患者为研究对象,按随机数字表法将其分为观察组和对照组,每组42例。观察组患者采用综合护理干预措施,对照组采用骨科常规护理措施,观察比较两组患者术后自觉肠鸣音时间、肛门排气时间、首次排便时间以及首次大便通畅度情况。结果观察组患者术后自觉肠鸣音时间、肛门排气时间、首次排便时间均早于对照组,且首次大便通畅度优于对照组,差异均有统计学意义(均P<0.01)。对照组有24例术后96h仍未排便,给予通便药物或灌肠干预,而观察组仅有1例患者需灌肠干预。结论综合干预措施能明显缩短老年股骨颈骨折患者术后肠功能恢复时间。     

Comprehensive care for haemophilia around the world

Summary.  Comprehensive haemophilia care has been defined as the continuing supervision of all medical and psychosocial factors affecting the person with haemophilia family. Services offered by haemophilia treatment centres (HTCs) adopting the comprehensive care model include establishing prophylaxis and other treatment protocols, development of psychosocial, education and research programme, maintenance of a patient registry, genetic and reference diagnostic services and orchestration and management of a wide variety of multidisciplinary interventions. Most centres practising this model of care are based in developed countries and can meet costs for plentiful treatment products through government or insurance-company funding. Not all the programmes are dependent on the level of product supply, however, and many have been supported in countries with emerging economies as part of national healthcare systems, particularly in relation to blood management. In this paper we present perspectives from different areas of the world on how to adopt, adapt and achieve economically appropriate models of comprehensive care.     

Providing Patients Web-based Data to Inform Physician Choice: If You Build It,Will They Come?

Background Despite growing emphasis on public reporting of health care quality data, available data are often ignored. Objective To evaluate the usefulness of web-based physician-level data for patients choosing a new primary care physician (PCP). Design Patients seeking a new PCP (n = 2225) were invited to view web-based information including PCP credentials, personal characteristics, office location and hours, and patient experience scores. Patient experience scores included validated measures of interpersonal quality, appointment access, care coordination, health promotion, and patient recommendations of the PCP. After viewing the website, participants indicated their preferred PCP and completed a study questionnaire. Results Of the invited participants, 17% visited the website (n = 382). Patient experience scores were cited most frequently as important to physician choice (51%). Among these measures, patients’ highest priorities were interpersonal quality (37%) and patient recommendations of the PCP (41%). For patients citing these priorities, the odds of choosing a highly scored physician after viewing the data was nearly 10 times that of choosing such a physician by chance (odds ratio (OR) = 9.52 and 9.71, respectively). Conclusions Targeting patients known to be making a health care decision appears to promote the use of performance data. Patients particularly valued data concerning other patients’ experiences and, after viewing the data, made choices well-aligned with their priorities.     

鄱阳湖区化疗和灭螺控制血吸虫病边际效果的分析和比较

目的 分析和比较鄱阳湖区日本血吸虫病控制中化疗和灭螺措施的边际效果。方法 以化疗和灭螺药物的投入和其他变量为自变量,人群感染率的自然对数值为因变量,以逐步回归建立回归方程。利用回归方程分析血吸虫病控制中化疗和灭螺的当前和滞后边际效益,用方差分析对其进行比较。结果 经检验回归方程[ln(RATE_(KT))=0.101+0.924×ln(RATE_(KT1))-2.356E-04×PQT_(KT1)/RATE_(KT1)-1.18E-03×NICO_(KT)/RISKAREA_(KT)+1.781E-03×RISKAREA_(KT)+2.964E-02×LIVESTOCK_(KT)]具有统计学显著性意义,R~2=0.735,P<0.01。t检验表明,化疗和灭螺的当前和累积边际效果差异均有显著性。结论 灭螺的边际效益高于化疗,与在化疗上的投入相比,灭螺需要投入更多的资源。