老年眼科患者的护理安全隐患分析及预防对策(附74例)

目的?探讨老年眼科患者护理安全隐患及相应预防对策.方法?选取老年白内障住院手术患者140例,随机分为2组,对照组66例,观察组74例,2组患者有可比性.分析老年眼科患者存在的护理安全隐患.对照组患者采取常规护理,观察组患者在对照组基础上给予针对安全隐患的全面护理.对2组患者安全问题发生情况以及护理满意度进行统计和比较.结果?老年眼科患者主要存在的安全隐患包括摔伤碰伤、错用药品、慢性疾病引起猝死、术眼错误或感染、人工晶体突出或术眼出血.经过针对性的护理后观察组患者安全问题发生情况明显低于对照组,观察组约有91.89%的患者未发生安全问题,明显高于对照组56.06%的比例;约有59.46%和93.24%的观察组患者对护理感到非常满意,明显高于对照组39.39%和83.33%的比例.上述比较两组差异有统计学意义(P<0.05).结论?安全护理在老年眼科患者中进行推广应用是十分必要的,在日常工作中,护理人员应对患者安全风险进行恰当评估,将危险因素消灭于萌芽中,保证患者的安全,提高护理质量,融洽护患关系.     

浅谈基层医院护理管理中的安全隐患与对策

目的 分析基层医院影响护理质量的因素,制定相应对策,防止护理差错事故的发生.方法 通过对护理安全隐患的分析,认为主要原因是职能科室和规章制度不健全,护理人员的职业倦怠,流动性大,业务水平低,护理记录不规范等.结果 采取健全科室和规章制度,加强责任心和业务技术的培训,合理调配人力资源,加强护理人员法制观念的教育等措施.提高了护理人员的整体水平,提高了病人的满意度,稳定了护理队伍.结论 通过有效的干预措施,促进了基层医院护理安全,全面提高了护理质量.     

Knowledge,attitudes, and practices regarding seasonal influenza vaccination during pregnancy in Costa Rica: A mixed-methods study

BackgroundInfluenza increases stillbirth risk, morbidity and mortality in pregnant women. Vaccination protects pregnant women against severe disease and indirectly protects their infants, but coverage among pregnant women remains low worldwide. We aimed to describe knowledge, attitudes, and practices (KAP) regarding seasonal influenza vaccination among postpartum women and prenatal care physicians in Costa Rica.MethodsWe conducted cross-sectional KAP surveys to women one to three days after childbirth at Costa Rican Social Security Fund maternity hospitals, and obstetricians and general practitioners who provided prenatal care in 2017. Principal components analysis, multiple imputation, and logistic regression were used to examine associations between influenza vaccination and demographics, prenatal care, and sources of information—separately for postpartum women and physicians. We also held two focus groups of six healthcare workers each to further describe vaccination KAP.ResultsWe surveyed 642 postpartum women and 146 physicians in maternity hospitals in five Costa Rican provinces of whom 85.5 % (95 % CI: 82.6 %-88.0 %) and 57.9 % (95 % CI: 49.6 %-65.7 %) were vaccinated for influenza, respectively. Factors associated with influenza vaccination for postpartum women included tetanus vaccination (aOR: 3.62, 95 % CI: 1.89–6.92); received vaccination recommendations from clinicians during prenatal check-ups (aOR: 3.39, 95 % CI: 2.06–5.59); had other children in household vaccinated for influenza (aOR: 2.25, 95 % CI: 1.08–4.68); and secondary/university education (aOR: 0.15–0.31) with no formal education as reference. For postpartum women, reasons for vaccination were perceived benefits for mother and infant, whereas not being offered vaccines was most cited for non-vaccination. Most prenatal care physicians recommended influenza vaccines during prenatal check-ups but believed vaccination causes flu-like symptoms.ConclusionVaccination campaigns and provisions of free vaccines effectively increased knowledge and coverage among women in Costa Rica. To improve access, women should be offered vaccines during prenatal care appointments. Educating healthcare workers about vaccine benefits for themselves and patients is needed to mitigate safety concerns.     

实现医院X光片共享信息系统的安全策略

随着医院信息化建设的深入发展,为保证医院数据的连续性、完整性和准确性,信息系统需要24h不间断运行。因此,如何保证信息系统正常运行及信息安全,就成为一个重要问题,涉及到网络、环境、人等各方面因素。     

Security of Patient and Study Data Associated with DICOM Images when Transferred Using Compact Disc Media

The transmission of patient and imaging data between imaging centers and other interested individuals is increasingly achieved by means of compact disc digital media (CD). These CDs typically contain, in addition to the patient images, a DICOM reader and information about the origin of the data. While equipment manufacturers attach disclaimers to these discs and specify the intended use of such media, they are often the only practical means of transmitting data for small medical, dental, or veterinary medical centers. Images transmitted by these means are used for clinical diagnosis. This has lead to a heavy reliance on the integrity of the data. This report describes attempts to alter significant patient and study data on CD media and their outcome. The results show that data files are extremely vulnerable to alteration, and alterations are not detectable without detailed analysis of file structure. No alterations to the DICOM readers were required to achieve this; changes were applied only to the data files. CDs with altered data can be readily prepared, and from the point of view of individuals viewing the images, function identically to the original manufacturer’s CD. Such media should be considered unsafe where there is a potential for financial or other gain to be had from altering the data, and the copy cannot be cross-checked with the original data.     

数字化医院信息安全建设与管理策略探讨

信息安全是数字化医院建设的关键环节,决定着以信息化为手段的医院各项业务的顺利开展。随着医院信息化建设的不断深入,信息安全问题的日益凸显,构建立体化的医院安全体系,注重日常安全防范,不断提升自身安全管理水平是医院信息化建设与管理的重中之重。     

急诊强化他汀治疗在急性冠脉综合征患者中的应用安全性效果观察

【】:目的:探讨阿托伐他汀强化降脂应用于急性冠脉综合征患者的治疗效果及其安全性。方法：选取我院2009年1月-2013年1月间收治的急性冠脉综合征患者70例,将其随机分为强化组以及对照组。两组患者均予以阿司匹林、肝素、硝酸酯类、β-受体阻滞剂以及血管紧张素转换酶抑制剂等常规治疗。强化组患者在此基础上加用阿托伐他汀20mg*qn,连续治疗8周。对照组患者在此基础上加用阿托伐他汀10mg*qn,连续治疗8周。比较两组患者治疗前及治疗8周后的血清hs-CRP、IL-10以及MMP-9的变化情况,并观察治疗不良反应。结果：两组治疗前血清hs-CRP、IL-10和MMP-9水平比较无明显差异(P>0.05)。治疗8周后,两组血清hs-CRP和MMP-9水平均较前明显下降,血清IL-10水平较前明显上升(t＝2.44、2.27、2.46、3.05、2.91、2.92,P<0.05或P<0.01),且强化组下降或上升值较对照组更明显(t＝3.27、3.31、6.11,均P<0.05)。强化组治疗有效率为88.6%(31/35),对照组为68.6%(24/35),组间比较差异有统计学意义,(X2=4.16,P<0.05)。两组患者均未发生严重的不良反应事件。结论:急诊强化阿托伐他汀降脂治疗应用于急性冠脉综合征的治疗具有较好的效果,能降低血清hs-CRP和MMP-9水平,提高血清IL-10水平,从而抑制斑块局部炎性反应,提高动脉粥样硬化斑块的稳定性,且药物的安全性好。