护理程序在临床教学中的应用

把护理程序运用于临床教学中 ,提高护生的综合素质 ,培养实用型高素质护理人才。通过对护生社会心理状态及学习情况的评估 ,确定知识目标、技能目标、素质目标 ,然后分别组织实施 ,最后作出综合评价。结果显示 ,运用护理程序进行带教后 ,护生的专科知识、技能、服务意识都有了全面的提高 ,同时也培养了护理人员运用护理程序实施带教的能力。揭示 :护理程序在临床教学中的应用具有科学性和实用性 ,值得进一步推广。     

浅析中专护生文化休克的护理策略

文化休克(culture shock),又译为文化震撼或文化震惊,是指生活在某一种文化环境中的人初次进入到另一种文化环境,如到了不同的民族、社会群体中或地区甚至国家时所产生的思想混乱与心理上精神紧张综合征。新入校中专护生,由于文化环境的改变,往往会出现孤独、焦虑、无助等文化休克的种种表现,这些现象若不能及时得到解决,将不利于他们的全面健康状态的成长与发展。众所周知,WHO明确规定,健康不但是没有疾病和身体缺陷,还要有完整的生理、心理状态和良好的社会适应能力。因此,新入校中专护生这一特殊群体所产生的文化休克现象应引起学校有…     

Health Care Markets, the Safety Net, and Utilization of Care among the Uninsured

Objective. To quantify the relationship between utilization of care among the uninsured and the structure of the local health care market and safety net.
Data Sources/Study Setting. Nationally representative data from the 1996 to 2000 waves of the Medical Expenditure Panel Survey (MEPS) linked to data from multiple secondary sources.
Study Design. We separately analyze outpatient care utilization and whether an individual incurred any medical expenditure among uninsured adults living in urban and rural areas. Safety net measures include distances between each individual and the nearest safety net providers as well as a measure of capacity based on local government and hospital health expenditures. Other covariates include the managed care presence in the local health care market, the percentage of individuals who are uninsured in the area, and local primary care physician supply. We simulate utilization using standardized predictions.
Principal Findings. Distances between the rural uninsured and safety net providers are significantly associated with utilization. In urban areas, we find that the percentage of individuals in the area who are uninsured, the pervasiveness and competitiveness of managed care, the primary care physician supply, and safety net capacity have a significant relationship with health care utilization.
Conclusions. Facilitating transport to safety net providers and increasing the number of such providers are likely to increase utilization of care among the rural uninsured. Our findings for urban areas suggest that the uninsured living in areas where managed care presence is substantial, and especially where managed care competition is limited, could be a target for policies to improve the ability of the uninsured to obtain care. Policies oriented toward enhancing funding for the safety net and increasing the capacity of safety net providers are likely to be important to ensuring the urban uninsured are able to obtain health care.     

Safety of levocetirizine treatment in young atopic children: An 18-month study

There are more than 40 H(1)-antihistamines available worldwide. Most of these medications have never been optimally studied in prospective, randomized, double-masked, placebo-controlled trials in children. The aim was to perform a long-term study of levocetirizine safety in young atopic children. In the randomized, double-masked Early Prevention of Asthma in Atopic Children Study, 510 atopic children who were age 12-24 months at entry received either levocetirizine 0.125 mg/kg or placebo twice daily for 18 months. Safety was assessed by: reporting of adverse events, numbers of children discontinuing the study because of adverse events, height and body mass measurements, assessment of developmental milestones, and hematology and biochemistry tests. The population evaluated for safety consisted of 255 children given levocetirizine and 255 children given placebo. The treatment groups were similar demographically, and with regard to number of children with: one or more adverse events (levocetirizine, 96.9%; placebo, 95.7%); serious adverse events (levocetirizine, 12.2%; placebo, 14.5%); medication-attributed adverse events (levocetirizine, 5.1%; placebo, 6.3%); and adverse events that led to permanent discontinuation of study medication (levocetirizine, 2.0%; placebo, 1.2%). The most frequent adverse events related to: upper respiratory tract infections, transient gastroenteritis symptoms, or exacerbations of allergic diseases. There were no significant differences between the treatment groups in height, mass, attainment of developmental milestones, and hematology and biochemistry tests. The long-term safety of levocetirizine has been confirmed in young atopic children.     

Lucian Leape on Patient Safety in U.S. Hospitals

PURPOSE: To describe and discuss the status of patient safety in U.S. hospitals. METHODS: Personal interview. This report is part of a series of discussions with a leading expert on patient safety. FINDINGS AND CONCLUSIONS: Some improvements have been made in the past 10 years. But changes have not been adequate. Continuing barriers include the punitive environment in hospitals, physicians' denial of the scope of the problem, lack of national leadership, and lack of systems thinking.     

早期应用无创性通气治疗老年Ⅱ型呼吸衰竭的护理

目的　探讨应用无创性通气治疗老年Ⅱ型呼吸衰竭的护理。方法　在常规治疗的同时 ,实验组与对照组分别应用无创通气和呼吸兴奋剂治疗 ,观察 2组患者治疗前、后、治疗间歇期动脉血气变化及康复例数。结果　实验组患者治疗后血气明显改善 (P <0 .0 1) ,康复例数明显多于对照组 (P <0 .0 1)。结论　应用无创通气可促进呼吸衰竭患者的康复 ,护士要加强对患者的心理支持 ,严密监测生命体征 ,保持呼吸道通畅 ,熟练掌握无创通气呼吸机的性能、使用方法 ,防止并发症     

宫颈癌放疗后家庭阴道冲洗效果观察

目的:为寻找一种院外阴道冲洗的有效方法,从而帮助一些由于各种原因不能来医院行阴道冲洗术的患者继续完成治疗。方法:对204例宫颈癌放疗结束后的患者随机分实验组与对照组,实验组实施家庭阴道冲洗,对照组未行阴道冲洗,通过放疗结束后1个月、3个月、6个月门诊随访,观察阴道粘膜急性放射反应治疗后消退情况,对家庭阴道冲洗患者和未行阴道冲洗者进行对照研究。结果:行家庭阴道冲洗者在阴道粘膜急性放射反应方面与未冲洗者差异有显著性(P<0.05)。结论:家庭阴道冲洗是对因各种原因出院后不能来医院行阴道冲洗的患者可以采取的一种行之有效的方法。     

机械通气患者的呼吸道护理

目的：探讨机械通气患者呼吸道的护理以及并发症的预防；方法：查阅有关机械通气护理的文献；结果：呼吸衰竭患者在使用机械通气治疗的过程中护理不当可引起呼吸机相关肺炎、气管阻塞、气管损伤、低氧血症等；结论：加强机械通气患者的呼吸道护理可避免呼吸道并发症的发生。     

The Fort McMurray demonstration project in social marketing: health- and safety-related behaviour among oil sands workers

This is the first round in a series of surveys conducted inFort McMurray as part of the Fort McMurray Demonstration Projectin social marketing. This component of the survey was intendedto focus on the most prominent group of employed workers inthe community and to compare their patterns of response withthe community as a whole. Respondents to the survey were overwhelminglymale (96%), married (72.9%) and living in households of twoto five persons (87.9%). They were predominantly aged 30–44(55%) and graduates of high school (53.5%). Younger male workers(below age 30) were more likely to have a high school diploma(78.3%) or some additional technical or vocational training(21.7% compared to 12.5% overall) and to be unmarried or separated.Attitudes toward safety-related behaviours were stronger thanfor respondents from the community as a whole. Approximately70–100% of all age groups and both sexes showed strongagreement with attitudes involving child car seats and the unacceptabilityof drinking and driving. These attitudes include strong advocacyof vigorous enforcement of occupational health and safety standards.However, they showed a variability similar to the communityas a whole in behaviour at home compared to work, generallyreporting more consistent use of personal protection on thejob than in their own homes, particularly hearing protection.Even so, they were much less likely to perform stretching andwarm-up exercises prior to exertion than community residentsin general. The potential may exist to transfer the technologyand attitudes from workplace health and safety to communitysafety. One possible strategy to accomplish this is to involveworkers in this industry directly in community initiatives.This strategy may be generalizable to any community in whichthere are major employers who place a heavy emphasis on riskcontrol and occupational health and safety.