Objective To construct a patient-centered quality evaluation index system of clinical nursing innovation, and to provide reference for evaluating the clinical nursing innovation quality. Methods Based on the “structure-process-result” three-dimensional quality evaluation model, the draft of the quality evaluation index system was formulated through literature review and semi-structured interviews, and the expert consultation questionnaire was formed. Two rounds of Delphi expert consultation were conducted on 19 experts, and the weight of each index was determined by analytic hierarchy process. Results The expert authority coefficient in the two rounds of consultation was 0.885 and 0.889 respectively. The Kendall harmony coefficient was 0.174 and 0.192,respectively（all P＜0.001）. The final quality evaluation index system of clinical nursing innovation consisted of 3 first-level, 13second-level and 55 third-level indicators. Conclusion The quality evaluation index of clinical nursing innovation is in line with the patient-centered concept, which is scientific and practical, and has guiding significance for evaluating the quality of clinical nursing innovation.

[目的]调查行数字血管造影(DSA)复合手术病人在手术期间病人非投照敏感部位辐射剂量的现状,并分析其影响因素,为相关研究提供依据.[方法]对2016年5月3日 —2016年6月5日69例行DSA复合手术的病人非投照敏感部位的体表布放热释光剂量仪,测得辐射剂量,并现场调查其影响因素,分析其原因.[结果]69例DSA复合手术病人的非投照敏感部位的人均辐射剂量为(24.03±1.08)mGy,在手术过程中防护用品术中移位 、造影剂流速慢致血管显影不充分 、医务人员辐射相关工作知信行掌握程度低是主要影响因素.[结论]DSA复合手术病人在手术过程中病人的非投照敏感部位受到辐射,通过改善防护方法合理设置血管造影参数,对医护人员防护和介入知识的培训,实施防护工作的质量控制可有效降低DSA复合手术病人非投照敏感部位的辐射剂量.

Objective To prevent and control the infection of multi -drug -resistant bacteria in intensive care unit by sur-veillance and management.Methods Department of nosocomial infection management monitored three cases of infection of multi -drug -resistant bacteria in intensive care unit,and investigated and followed it by the “hospital infection real -time mo-nitoring system”.Results Three cases of infection of multi -drug -resistant bacteria in intensive care unit included community infections and nosocomial infections,while the nosocomial infection was not caused by the infection of the community,and 3 ca-ses were not an outbreak of nosocomial infection.Conclusion Through the analysis of infection of multi -drug -resistant bacte-ria,the level of management and monitoring of the nosocomial infection was improved,and the occurrence of infection of multi -drug -resistant bacteria was effectively prevented and controlled.

胎盘支持下产时胎儿手术是指在保持胎儿胎盘循环的同时进行胎儿先天性缺陷矫治的一种产时胎儿手术[1]。这种手术方案的提出最早是为解决宫内胎儿气道梗阻,随着产前诊断技术的提高,手术适应证范围逐渐扩大,包括先天性膈疝、脐膨出、胎儿颈部肿块、肺或纵隔肿瘤等先天性疾病的治疗[2]。先天性巨型脐膨出是一种新生儿期罕见的严重先天畸形,产时手术治疗