宫颈癌患者手术后尿潴留的综合防护

笔者对1999年3月~2003年10月收治的49例宫颈癌行次广泛子宫切除术和广泛全子宫切除加盆腔淋巴结清扫术患者的临床护理进行回顾性的分析。认为术前心理疏导,术后采取综合防护:膀胱冲洗,1∶5000高锰酸钾溶液坐浴,耻骨上膀胱造瘘等,能有效减少尿潴留的发生。     

Changes, challenges and choices for the primary health care workforce: looking to the future

AIMS: The main aim of this paper is to draw attention to problems facing the primary health care workforce in terms of demand for treatment of minor illness over the next two decades. These predictions have implications for the community nursing workforce in particular and the flexibility of primary health care teams in general. BACKGROUND: Care delivered in the primary care sector influences, and is influenced by, the characteristics of the health care workforce. These characteristics fall into two main groups: firstly, the shape of the present medical and nursing workforce and manpower trends; and secondly, the changes in doctors' and nurses' workloads. DESIGN: This paper draws on two studies, both commissioned by the Department of Health; the first study focusing on skill mix and delegation in primary health care teams and the second addressing the implications of skill mix for medical workforce scenarios in the changing policy environment. FINDINGS: From the first study, general practitioners across ten general practices were prepared to delegate at least one topic from over a third of 836 consultations and a further 17% of entire consultations. This potential delegation fell mainly to practice nurses and nurse practitioners. The second study used data extracted from the National Morbidity Surveys of 1981 and 1991 predicting that minor consultations are set to increase by 11 million from the 1990s to 2020--a minimal estimate. The authors argue that many of these extra predicted consultations will find their way onto practice nurses' and nurse practitioners' caseloads. CONCLUSIONS: Workforce issues and questions of professional roles and boundaries, in the context of the "greying" community nursing workforce, demand solutions if patient/client demand is to be met over the next two decades.     

不同温度与速度的中药保留灌肠对溃疡性结肠炎患者的影响

目的探讨溃疡性结肠炎患者实施中药保留灌肠的最佳温度和速度,以期为中药保留灌肠的中医护理技术规范化研究提供依据。方法选择88例溃疡性结肠炎患者,按不同的灌肠温度、速度干预分为4组,12 d为1个疗程,分别记录测评疗效相关性指标、医院焦虑抑郁量表（HADS）、灌肠后药液保留时间、对温度和速度等的主观感受。结果组1、组3药液保留时间长于组2,组2长于组4;保留时间和医院焦虑、抑郁呈现负相关。组3、组4的温度感觉较好（P〈0.05）;组2、组4的速度感觉较好（P〈0.05）。组3、组4腹痛得分较高,组2、组4即刻便意得分较高（P〈0.05）。结论溃疡性结肠炎脾虚湿蕴证患者灌肠以温度37.0~38.9℃、速度10~14 m L/min为宜,需要加强对患者的心理护理、健康教育。     

2020 Vision – The Year of the Nurse and Midwife

The World Health Organization has designated 2020 as the Year of the Nurse and Midwife. With a predicted shortfall of more than nine million nurses and midwives by 2030, the World Health Organization has recognized the urgency of tackling the approaching workforce issues head on. The activities planned should provide a once in a generation opportunity to promote the nursing profession and address crucial issues, such as recruitment and retention, professional development and pay and conditions. The International Council of Nurses is working closely with its National Nursing Associations around the world and other key nursing and health organizations, to create a long‐lasting legacy that will raise the profile of the profession with the public, boost its professional status, and make it sustainable in the future.