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自制护理标识在老年病房中的应用

【摘要】　目的　探讨护理标识在老年病房安全管理中的应用。　方法　自行设计、制作护理标识并在临床中应用，对比使用前后护理不良事件发生率、检查延误率并进行统计学分析。　结果　使用护理标识后护理不良事件发生率、检查延误率明显降低，有统计学意义（Plt;0.05）。　结论　在老年病房应用护理标识，可以预防护理不良事件发生，减少延误检查，提高工作效率，增强安全防范意识，为患者提供安全护理。

Applying Good Care Service via Risk Management to Improve the Safety of Elder In-patients

【摘要】　目的　探讨优质护理活动中应用风险管理措施提高住院老年患者安全的作用和意义。　方法　对2010年2月-2011年3月开展优质护理活动实施风险管理后，其老年住院患者安全事件预防控制情况进行回顾分析。　结果　应用风险管理措施后老年住院患者的护理不良事件发生减少，患者对护理工作的满意度提高。　结论　加强风险管理有助于保障患者安全，提高患者满意度，构建和谐护患关系。【Abstract】　Objective　To investigate the role and the effect of risk management in good care service on the safety of elder in-patients.　Methods　From February 2010 to March 2011, the risk management was carried out during applying good care service. The prevention and control of the poor nursing events for the elder in-patients were retrospectively analyzed.　Results　The poor nursing events for the elder in-patients decreased obviously after the application of risk management, and the patients were pleased with the service of nurses.　Conclusion　Risk management is conducive to prove the safety of the in-patients, improve the degree of satisfaction of the patients, and make the harmonious relations between the nurses and the patients.

门诊乳腺科患者知识问卷调查分析及对策

目的:了解门诊乳腺科患者对乳腺疾病相关知识的知晓率及心理状态,以便在护理工作中为患者做针对性的护理指导。方法:面对面调查法,患者自愿的方式。结果:428例患者中,272例(63%)不知道乳腺疾病相关知识,377例(88%)患者不知道乳腺自我保健,355例(83%)患者不知道乳腺自查的方法及时间;正常心态仅63例(15%),85%的患者存在焦虑、烦躁、恐惧等负性心理,且多数为复合心态。结论:在门诊护理工作中,对门诊乳腺科患者进行乳腺疾病预防保健指导,以提高患者其知识知晓率,减轻患者的负性心理十分必要。

Investigation on the Knowledge Demand among Family Caregivers for the Elderly

ObjectiveTo discuss the demands for nursing knowledge among family caregivers for elderly people, in order to provide a basis for nurses to provide effective education for these people. MethodsBetween May and June 2012, a questionnaire which contained the condition of demands for nursing knowledge and the burden of care was used to investigate 1 600 family caregivers for the elderly people. ResultsThe caregivers had a demand for nursing knowledge, which may include the knowledge on medicine, disease and caregiving. The demand for knowledge was correlated with relationship between the caregivers and care recipients, health condition of the caregivers and care burden. ConclusionThe demands for nursing knowledge are higher in those who have spouse and high burden of care, without disease and symptom; we should pay more attention on them and take measures to reduce their burden of care.

Evidence-based care of an oldman’s bedsore

Objective　To seek evidence based methods to treat bedsore of aged patients. Methods　We raised clinical questions according to the condition of an eighty-year old male patient, and then, with "bedsore" (treatment or prevention) as key words we searched evidences from Cochrane Library (2nd edition 2002), Medline (1996-2002.4), and Sumsearch. Results　We found 3 SR (systematic review) from Cochrane Library, 3 Meta-analyse and 38 RCT (randomized controlled trial) from medline, and 3 SR and 9 RCT from Sumsearch. Conclusion　1 Various types of mattress are useful in prevention the bedsore. 2 There is still not enough evidences of electromagnetic therapy. 3 In state II bedsore, healing is faster in using collagen Dressing than using water-glue Dressing. 4 Local application of antibiotics and Phenytoin sodium can accelerate the growth of new granulation tissue. 5 Nutritional support is necessary for bedsore prevention and healing. According to these evidence, we make the best care plan for this patient. After our treatment, the wound healed 10 days later, and he doesn’t occur bedsore any more.

输血护理记录流程及质量监测表的设计与应用

2014年4月护理部质量控制科对全院各护理单元进行了输血管理专项督查，结果显示各护理单元在输血医嘱开具、输血医嘱执行、输血执行单、输血护理记录、输血袋管理及输血资料管理方面存在缺陷。该研究回顾性分析了2014年1月－4月老年科输血护理病历。经过总结分析，发现老年科输血护理记录存在输血记录单填写不规范、输血医嘱执行记录时间不一致、输血护理记录信息不完整等缺陷。因此，于2014年6月开展头脑风暴，根据讨论结果设计了输血护理记录流程和质量监测表。通过培训学习，输血护士和护理组长掌握了登记表、流程图的使用方法，能遵循流程及时、准确、全面执行输血记录，护士长应用质量监测表对输血护理记录质量实时监控，反馈输血记录亮点和问题，进行持续质量改进。6个月以后，输血护理记录缺陷较前明显较少，有效提高了输血护理记录质量。

i-STAT便携式血气分析仪在连续性肾脏替代治疗中的应用

目的　讨论i-STAT便携式血气分析仪在连续性肾脏替代治疗（CRRT）中的应用。 方法　2012年2月－5月，对92例行CRRT治疗患者采用i-STAT便携式血气分析仪监测分析治疗中各参数变化并及时予以调整。 结果　92例患者治疗中酸碱及电解质的失衡得到及时调整，无意外情况发生。 结论　i-STAT便携式血气分析仪在CRRT治疗中能较好的监测患者的血气及电解质，确保CRRT的安全完成。

弹性门诊在专家门诊管理中的应用

目的:按照专家自愿、量力而行、形式灵活多样的管理原则,营造和谐温馨的服务管理氛围,通过对老专家的人文关怀,尊重专家的个人意愿,实行弹性门诊,从而达到缓解患者就诊难问题。方法:①临时增加座诊时间;②延时门诊;③停诊专家利用业余时间临时补上门诊;④就诊高峰期,临时增加专家座诊时间。以上办法的实施,均以保证门诊质量及专家身体允许为前提。结果:通过上述办法的实施,从2007年底至2008年底,共增加座诊265 人次,延时约10 773小时,增加就诊患者约24 165人次。结论:弹性门诊既保证了专家身体健康和门诊医疗质量,又满足了患者就诊需求,是医院解决患者看病难、看专家门诊更难的行之有效的办法之一。

简易加取液护理托盘的研制

拓展门诊分诊工作，提高门诊医疗服务质量

【摘要】 目的 总结门诊分诊工作模式，以解决患者就诊前挂号咨询、导向服务方式问题，提高患者挂号就诊的准确性，提升医疗服务品质。 方法 于2009年6月成立门诊分诊服务中心，实现分诊、挂号一站式服务。指导患者分层次就诊，合理使用医疗资源，有效遏制“号贩子”、“医托”，保证患者就诊安全和就诊的对症性。 结果 明显提高患者挂号的准确性，实现医疗资源的合理利用，拓展了分诊服务工作内涵，达到了患者、医院双赢的效果。 结论 门诊分诊工作不仅满足患者需求，同时提升了门诊医疗服务质量，是医院门诊工作不可缺少的组成部份。