Search

静脉滴注甘露醇注射液所致静脉炎的预防

20%甘露醇是一种高渗透性的利尿脱水剂，由于其起效快，效果显著等优点被广泛运用于临床，在防止脑疝形成、挽救患者生命方面起到了至关重要的作用。但因其渗透压高，加上临床使用中要求甘露醇快速滴注，极易对患者的血管造成刺激，轻者发生局部红肿、刺痛，重者可能发生不可逆性的损伤，不仅增加患者的经济负担，也增加工作人员的工作量。为减少临床静脉输注甘露醇静脉炎的发生，减轻患者痛苦，提高药物治疗的有效率，现作如下综述。

Continuous Quality Administrations of the Safety of Vein Detained Needles for Inpatients in the Department of Neurology

目的　探讨神经科住院患者留置针安全的持续质量管理。 方法　选择2011年8月－10月100例神经科住院患者，按入院时间先后排序分为对照组和试验组，每组50例。对照组运用静脉留置针的常规护理方法进行护理，试验组在给予常规护理方法的同时实施一系列持续质量管理的措施，包括安排护理业务查房、组织操作示范、应用留置安全健康宣传小卡片对患者进行宣教、定期不定期的留置质量检查、将留置针安全作为一项交班内容、强调优质护理指针。留置针留置第3天对两组患者使用同一自制量表调查留置期间的安全问题及患者对护理的评价，并对两组调查结果进行统计分析。 结果　试验组留置期间不良事件发生率为6.0%，对照组为34.0%，两组差异有统计学意义（χ2=12.250，P=0.000）；试验组对留置针留置安全知识的4个方面知晓情况均优于对照组（P=0.000）；试验组对护理满意度较对照组好（P=0.000）。 结论　持续质量管理增加了神经科住院患者留置针留置安全、增进了患者对相关健康知识的掌握，提高了患者对护理的满意，值得临床推广。

Clinical Evidence on Nursing Care for Patients with Pressure Sore

Objective　To investigate the current status of randomized controlled trials (RCTs) and clinical controlled trials (CCTs) on pressure sore in China. Methods　We searched Chinese Journal of Nursing, Chinese Journal of Practical Nursing and Journal of Nurses Training in CNKI and VIP (January 2000 to December 2005) for Chinese articles on pressure sore, using "pressure sore", "bed sore", "nursing", "treatment", "prevention", "evaluation" and "management" as search terms. The retrieved articles were summarized. Results　We identified 16 reports (10 RCTs and 6 CCTs). The studies were judged to be of low quality.There was one study on the evaluation, two on the prevention, and 13 on the treatment of pressure sores. Conclusion　The current studies on pressure sore in China are focusing on treatment. Randomized controlled trials of large sample size of pressure sore are needed to improve nursing quality.

护理核心制度执行情况检查与分析

目的　总结各护理单元贯彻卫生部“医院质量管理年”核心制度执行情况的检查考核方法。 方法　回顾性分析总结2006年1月起医院各科室核心制度执行考核情况，既按照护理核心制度的内容要求，制定考核项目，并采用随机抽样的调查方法进行护理核心制度执行情况检查，考核评价其执行落实状况及效果。 结果　分极护理制度执行情况均达到100%正确率，但诊断卡、床头标识的准确性完整性不高；查对制度执行情况：日查对、周查对正确率均为97.6%，查对后签字正确率为100.0%；医嘱制度执行情况：各病房抗生素输注间隔时间多为6～8 h，抗生素配置正确率97.6%，但药液抽吸正确率不高。 结论　护士和临床护理管理人员核心制度落实好，有效地促进了医院质量管理长效机制的建立。

Isaacs综合征护理一例

真空负压静脉采血的研究进展

【摘要】　真空负压静脉采血法，使血标本在采集、运输、保存环节处于全封闭状态，能最大限度保持血液标本的原始状态，保护医护人员免受职业伤害，可提高一次性采血成功率，是静脉血标本采集的一大改革。由于其具有使实验数据准确可靠、无污染、工作省时省力等优点，已被广泛使用。近年来，研究人员就真空负压采血的临床应用进行了大量的实践，对采血针的选择、压脉带的使用、穿刺技术及方法改进、采血质量控制、护理措施等进行了一系列研究。医务人员加强采血知识的学习可减少采血并发症，保证标本质量，减少医疗资源的浪费和减轻患者痛苦。

帕金森病合并痛风致关节溃疡护理一例

医学期刊发表灾害护理文献的分析

【摘要】 目的 分析国内医学期刊发表的灾害护理文献，为灾害护理证据的生产和传播提供参考。 方法 检索中国知网CNKI全文数据库医药卫生专辑（1991~2010.01），收集灾害护理相关文献，进行分类和描述性统计分析。 结果 207篇文献中，2008年前发表32篇（15.47%），2008年及以后发表175篇（85.53%）。文献分布于67种医学期刊，其中护理类17种98篇（47.34%），非护理类50种109篇（52.66%）。统计源期刊137篇（66.18%），其他期刊70篇（33.72%）。护理类统计源期刊收录79篇，占护理类期刊刊发数的80.61%。以经验类128篇（61.84%），理论类60篇（28.98%），研究类19篇（9.18%）；内容以医疗救护类94篇（61.84%），管理类 72篇（28.98%），教育类31篇（14.98%），其他类10篇（4.83%）；医疗救护类文献中，未见慢性病相关文献。 结论 2008年是灾害护理文献增长的分界点，统计源期刊是证据的主要来源。灾害护理文献以经验类为主，涵盖灾害医疗救护、管理及教育，需要开发灾害慢性病护理证据。【Abstract】 Objective To analyze the literature on disaster nursing published in medical journals and provide reference for the development and dissemination of evidence on disaster nursing. Methods Papers on disaster nursing were get from the CNKI database (1991 to January 2010). After classification, they were inputted to excel and descriptive analysis was applied. Results There were totally 207 papers, among which 32 (15.47%) were published before 2008 and 175 (85.53%) were published in and after 2008. Papers were published in 67 medical journals, for which 17 (98 papers, 47.34%) were nursing Journals, while 50 (109 papers, 52.66%)were not nursing. one hundred and thirty-seren papers (66.18%) were published in Source Journals for Chinese Scientific and Technical Papers and Citations, 70 (33.72%) were not. Seventy-nine papers were published in nursing journals for Chinese Scientific and Technical Papers and Citations. On the type, 128 papers (61.84%) were experience ones, 60 (28.98%) were theoretical papers and 19 (9.18%) were research papers. On the content, 94 (61.84%) were about nursing and rescue practice, 72 (28.98%) were about disaster nursing management, 31 (14.98%) were on disaster nursing education and 10 (4.83%) were others. No literature on chronic disease was found among papers on nursing and rescue practice. Conclusion The year 2008 is apoint for the development of disaster nursing evidence. The evidence were published in kinds of medical journals. The Source Journals for Chinese Scientific and Technical Papers and Citations were the main source for the evidence. The evidence were mainly experience ones. The evidence covered in the fields of nursing and rescue practice, disaster nursing management and disaster nursing education, literature on disaster amp; chronic disease was needed.

汶川地震伤员焦虑状况调查分析

目的:调查汶川地震伤员焦虑状况。方法:采用Zung氏自评焦虑量表(SAS)对2008年5月住院的81例汶川地震伤员的焦虑状况进行调查,有效问卷79例。结果:地震伤员焦虑水平(50.25±11.40)显著高于国内常模(29.78±0.46)(P=0.000lt;0.05),存在焦虑的共38例,占受试者的48.10％(38/79),其中中至重度焦虑共13例,占16.45％(13/79);焦虑水平与文化程度(P=0.270gt;0.05)、伤情(P=0.846gt;0.05)及性别(P＝0.139gt;0.05)差异无统计学意义。结论:在应激情况下地震伤员存在明显的焦虑心理问题,医护人员要重视伤员的心理问题,加强心理护理,促进康复。

Operation and Management of New Neurology Wards in New Cooperative Hospital

Based on the situation of healthcare reform, new cooperative hospitals with private assets invested came into being. Our hospital carried out such practice and established the first new type hospital in the southwest of China in 2012. In the new cooperative mode, a new neurology ward was established. A series of unique and innovative means of operation and quality control were applied, including introduction of brand marketing strategy, promoting advantageous sub-professions, and pay special attention on talents and quality control. This article is aimed to share the management experiences.