随着医保改革和精细化管理的不断推进,加大对医疗服务行为的管理、寻求成本管控是必然趋势,DRGs支付改革在影响医疗管理的同时,对护理管理也提出了更高的要求.文章综述了 DRGs 支付改革对护理管理观念、护理经济价值评价、护士执业环境方面的影响.护理管理者应主动探索 DRGs 与护理工作量的关系及其在人力资源配置中的指导作用,包括主动调控,提高护理人力资源效能;多维度探索,合理评价护理经济价值;优化模式,适应医疗体制改革;仔细核查,配合抓好病案首页质量,从而更好地适应DRGs支付改革.
Objective To investigate the status quo of disease acceptance of lung cancer patients and explore its influencing factors,so as to provide references for carrying out intervention.Methods A total of 215 lung cancer patients admitted to a grade-A tertiary hospital in Guangdong province between June and September 2022 were selected by using the convenience sampling method.They were investigated using a general condition questionnaire,a disease acceptance scale,a perceived social support scale and a general self-efficacy scale.Results The total score of disease acceptance was 22.68±4.67.According to the multiple linear regression analysis,gender,family per capita monthly income,pathological type,perceived social support and self-efficacy were independent influencing factors of disease acceptance of lung cancer patients(F=24.605,P＜0.001,R2 =0.650,△R2=0.623).Conclusion Patients with lung cancer are of low disease acceptance,which is affected by gender,family per capita monthly income,pathological type,perceived social support and general self-efficacy.Therefore,medical staff should take targeted measures and guide them to enhance their sense of social support and self-efficacy,so as to improve their disease acceptance and life quality.
The study summarizes the nursing care of a neonate with streptococcus agalactiae infection combined with persistent pulmonary arterial hypertension.The newborn had a history of intrauterine infection,amniotic fluid pollution and premature rupture of membranes before birth.Two hours after birth,his multiple organs were severely involved.After admission,he was treated with extracorporeal membrane oxygenation combined with continuous renal replacement therapy,ventilator-assisted ventilation,anti-infection and plasma exchange.The main nursing points included liquid resuscitation,protective isolation,pipeline care,systematic monitoring of vital signs,blood clotting status,airway care and skin protection,and the symptoms of the child gradually relieved.
肘关节是人体结构较为复杂的关节,肘关节骨折是临床常见损伤[1].手术治疗可以快速纠正关节畸形,复位关节 [2].术后早期进行功能锻炼能有效改善肘关节功能,从而促进肢体的康复,提高生活质量[3].肘关节骨折术后需抬高患肢促进肿胀消退,且在保持肘关节稳定性的同时,需要进行早期功能活动,以恢复肘关节屈伸功能及前臂的旋转功能[4].目前临床上应用的上肢护具多为固定型号,对于腕关节和前臂的保护和限制作用较少,并且没有专门的固定托盘来抬高患肢和维持患侧肢体的体位.针对以上问题,笔者设计了一款肘关节护具,在临床上取得良好的效果.现报道如下.
Objective To systematically evaluate the life experience of adult heart transplant recipients,so as to provide evidence-based basis for making clinical intervention plans.Methods Articles on the life experience of adult heart transplant recipients were searched in Embase,PubMed,Web of Science,ProQuest,Cochrane Library,CINAHL,EBSCO,CNKI,CBM and Wanfang Data,with the time setting until January 2023.The quality of the literature was evaluated according to the evaluation tool for qualitative research of the Australian JBI evidence-based health care center(2016),then integrated by the aggregative integration method.Results A total of 18 articles were included,and 30 results were extracted and summarized into 12 categories of 4 results:challenges in daily life,negative experience,positive experience and needs for rehabilitation.Conclusion Family members,medical staff and society should pay full attention to the post-surgery life of adult heart transplant recipients,provide them with support and care,meet their needs of rehabilitation,so as to promote their life quality.
