Objective To construct and apply intra-hospital transport checklist for critically ill cardiovascular patients to improve transport safety. Methods The preliminary draft of intra-hospital transport checklist for critically ill cardiovascular patients was developed based on literature review and semi-structured interviews,and the Delphi method was used to conduct 2 rounds of consultation with 12 experts,the final intra-hospital transport checklist for critically ill cardiovascular patients was formed. After evaluating the reliability and validity of the checklist,it was carried out in a cardiovascular surgical ward and a cardiovascular ward of a tertiary class A hospital in Zhejiang Province from September to December 2021. 67 cases of transport from September to October were regarded as control group,72 cases from November to December were experimental group. The experimental group used intra-hospital transport checklist for critically ill cardiovascular patients on the basis of routine transport,while the control group used routine transport nursing. The rate of adverse events and transport time were compared between the two groups. Results The response rate of the 2 rounds of expert consultation were 100%. Expert authority coefficients was 0.811 and 0.856. And expert coordination coefficients were 0.363 and 0.387（P＜0.05）. Kappa value of each item ranged from 0.733 to 1.000, with average of 0.803（P＜0.05）. The content validity index at the level of items ranged from 0.810 to 1.000, and the index of whole checklist was 0.912. The checklist contained 6 firstlevel indicators,22 second-level indicators,and 50 third-level indicators. After application of the checklist,the incidence of some disease/technology-related adverse events, the preparation time and transit time of experimental group were lower than those of control group（P＜0.05）. Conclusion The construction of transport checklist was scientific and reliable. It can shorten the transport time,and is helpful for the effective implementation of the key link of transport,then improve transport safety.

心脏移植是治疗终末期心脏疾病的有效方法。目前,无论是外科手术技术,还是移植术后监护,均趋于成熟 [1] 。然而,心脏移植围术期管理面临诸多挑战,如术前心肺功能衰竭,手术准备环节复杂,术后并发症监护、感染防控、排异反应观察等,均关乎患者安全。医护人员一些不经意的疏忽或错误可能对患者造成伤害,延长住院时间,甚至危及患者生命。查检单可以在短时间内对重要环节进行质量检查,以保证安全,其最早应用于航空业,近年来被医院管理者引进,应用于患者的质量改进 [2] 。

[目的]评价谵妄集束化策略在重症监护病房(ICU)机械通气病人中的应用效果.[方法]将2017年1月-2017年6月ICU收治的≥18岁98例机械通气病人按入科顺序编号分为两组,对照组45例采用常规ABCDE集束化措施,观察组53例在此基础上实施ABCDEF集束化管理.比较两组病人谵妄发生率、机械通气时间及ICU住院时间.[结果]观察组病人谵妄发生率低于对照组,机械通气时间及ICU住院时间短于对照组(P＜0.05).[结论]在ICU机械通气病人中应用谵妄ABCDEF集束化策略可降低谵妄发生率、缩短机械通气时间及ICU住院时间,效果优于常规ABCDE集束化措施.

总结重度家庭毒蕈中毒致多脏器功能衰竭(Multipleorgandysfunctionsyndrome,MODS)患者的抢救及监护要点.毒蕈中毒致MODS患者病情危重,死亡率高.ICU治疗期间联合采用血浆置换、持续性静脉-静脉血液滤过及解毒药物进行抢救,并严密监测患者的意识、呼吸、循环、消化道及凝血功能,及早识别假愈期和脑损伤期的临床表现,防止并发症.结果该组家庭毒蕈中毒患者中,1例救治成功,1例既往罹患乙型肝炎患者死亡.

总结25例非胃镜引导下留置鼻空肠营养管病人的护理体会。操作前充分评估及用物准备，操作中密切配合医生，操作后妥善固定及精心维护，同时操作全程做好心理护理，一旦操作失败及时采取相应的护理措施。

总结了3例应用体外膜肺氧合(ECMO)治疗溺水致急性呼吸窘迫综合征(ARDS)病人的护理经验,即ECMO治疗前给予充分的准备,治疗过程中做好管道维护、病情观察、抗凝及呼吸道监测、基础护理、营养评估、护理及并发症的预防与监护。