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甲型H1N1流感危重症患者急救护理一例

急诊科护士工作倦怠调查研究

目的　调查急诊科护士工作倦怠现状及其影响因素。 方法　2012年2月14日采用方便抽样的方法选取护士职业倦怠量表（NBS）对急诊科117名护士进行问卷调查，采用SPSS 16.0进行数据处理。 结果　急诊科护士普遍存在职业倦怠，轻度34人，中度42人，重度41人，中重度倦怠发生率高达73.6%。经分析发现，急诊科护士的特殊工作特点及工作环境是造成其产生职业倦怠的主要因素；另外，工作量大、人格因素以及应对方式的选择也成为造成护士职业倦怠的影响因素。 结论　急诊科护士普遍存在职业倦怠，存在着多种、复杂、交叉的压力源，这些倦怠及压力源直接影响着急诊护士的心理健康及工作、生活质量，应引起护士自己及医院管理层的关注和重视，并采取积极有效的应对措施。

Accuracy of continuous glucose monitoring system in emergency critically ill patients

Objective To investigate the accuracy of continuous glucose monitoring (CGM) system in emergency critically ill patients. Methods Critically ill patients admitted to the Intensive Care Unit of Department of Emergency Medicine, West China Hospital of Sichuan University between August 2022 and February 2023 were continuously enrolled. Blood glucose monitoring was performed using CGM system, while blood glucose in the patient’s fingertips was monitored every 4 hours. The correlation and consistency of blood glucose values between CGM system and fingertip glucose detection were compared. Results A total of 52 patients were included, and 1 504 matching blood glucose pairs were formed with fingertip blood glucose values. The overall correlation coefficient was 0.874 (P<0.001), the mean absolute relative difference was 14.50%, and the highest mean absolute relative difference (31.76%) was observed in the hypoglycemic range (<3.9 mmol/L). The percentage of CGM system blood glucose within ±15%, ±20% and ±30% of fingertip blood glucose was 56.65%, 75.56% and 94.75%, respectively. The intra-group correlation coefficient between CGM system blood glucose and fingertip blood glucose was 0.85 on the consistency test, and the Bland-Altman plot showed acceptable clinical accuracy. Conclusions The overall accuracy of the application of CGM system in critically ill patients is reasonable, but the accuracy in the range of low blood glucose values is poor. Whether the auxiliary use of CGM system can improve the blood glucose management of critically ill patients and reduce medical costs needs to be further studied.

Empirical study on the response policy to COVID-19 epidemic based on the new public management theory: take the emergency department rescue area of West China Hospital of Sichuan University as an example

With the change of COVID-19, the prevention and control of COVID-19 infection epidemic entered a new stage in December 2022. How to quickly complete the emergency treatment of a large number of patients in a short period of time, and ensure that patients in emergency department can get rapid and effective medical treatment has always been an urgent problem that emergency department need to solve. The Department of Emergency Medicine of West China Hospital of Sichuan University has adopted patient-oriented management measures based on the core idea of the new public management theory, and has achieved remarkable results. Therefore, this article summarizes the workflow and nursing management strategies of the emergency department rescue area of West China Hospital of Sichuan University in dealing with the batch treatment of COVID-19 infected patients, including optimizing and correcting the environment layout of the ward, implementing the “secondary triage” mode in the rescue area, adding an inter-hospital referral platform for critical patients with COVID-19 emergency, building a conventional COVID-19 reserve material repository in the emergency department, setting up a field office for multi-department joint emergency admission service, optimizing emergency transport services for patients with COVID-19, scientific scheduling and reasonable human resource management, and providing humanistic care for employees, in order to provide reference for the management practice of the emergency department.