目的 探讨应用根本原因分析法(RCA)在过氧化氢等离子灭菌循环终止原因分析中的应用,提高消毒、灭菌质量,以便更好地为临床服务.方法 应用根本原因分析法分析厦门市妇幼保健院供应室过氧化氢等离子灭菌循环终止的原因,制订相关措施,并进行考核整改,对整改前后的规章管理制度、消毒灭菌知识、机器设备工作原理和日常维护、无菌技术规范操作进行考核.并采用简单随机抽样法抽取整改前后180件和90件清洗、灭菌及包装后的医疗器械进行细菌培养,比较其清洗、灭菌及包装的合格率.并将整改前(2018年6月至2019年6月)及整改后(2019年7月至2020年12月)的资料进行比较分析,比较整改前后规章管理制度、消毒灭菌知识、机器设备工作原理和日常维护、无菌技术规范操作的考核结果,比较医疗器械清洗、灭菌及包装的合格率,过氧化氢等离子灭菌循环终止的次数,以及造成灭菌循环终止原因的次数.结果 整改后科室工作人员规章管理制度(85.60±4.55)分、消毒灭菌知识(91.20±3.30)分、机器设备工作原理和日常维护(87.67±3.48)分、无菌技术规范操作(87.40±3.50)分,均高于整改前,医疗器械清洗、灭菌及包装合格率分别为96.67％、98.89％、98.89％,均高于整改前,差异均有统计学意义(P<0.05).整改前后过氧化氢等离子消毒、灭菌895及765舱次,灭菌循环终止53次及15次,取消率为5.92％及1.96％,整改后降压期压力检查失败、过氧化氢浓度低、低等离子功率发生次数分别为7、4、3次,均低于整改前,差异有统计学意义(P<0.05).而操作者误操作、设备故障发生0、1次,低于整改前,差异无统计学意义(P>0.05).结论 将根本原因分析法引入供应室消毒、灭菌的管理过程,能有效提高科室工作人员整体业务水平,减少过氧化氢等离子灭菌循环取消次数,及其造成的原因次数,提高消毒、灭菌成功率,进而减少院内感染率,提高医院的整体医疗质量.

目的 探讨生物反馈电刺激联合综合运动治疗产后盆底功能障碍的效果.方法 回顾性分析厦门大学附属妇女儿童医院2021年6—12月收治的95例产后盆底功能障碍患者,按照治疗方式不同分为对照组和观察组,对照组47例予以综合运动疗法治疗,观察组48例在对照组基础上予以生物反馈电刺激治疗.观察两组患者盆底肌肌力、尿失禁、盆腔脏器脱垂情况以及盆底组织状态.结果 干预2个月后,观察组肌力分级高于对照组,差异有统计学意义(P<0.05);观察组尿失禁程度轻于对照组,差异有统计学意义(P<0.05);观察组盆腔脏器脱垂情况优于对照组,差异有统计学意义(P<0.05);观察组膀胱颈旋转角(θ)、压力状态下尿道膀胱后角(AS)和静息状态下尿道膀胱后角(Ar)角度小于对照组,差异有统计学意义(P<0.05).结论 对产后盆底功能障碍患者予以生物反馈电刺激联合综合运动干预,可提高盆底肌肌力和盆底组织状况,改善尿失禁以及盆腔脏器脱垂情况.

Objective:To observe the influence of empathic nursing on coping style and self-care ability of breastfeeding mother with allergic constitution.Method:A total of 100 breastfeeding mothers with allergic constitution in our hospital from July 2015 to September 2017 were selected.According to the random number table method, they were divided into observation group and control group, 50 cases in each group.The control group received routine nursing intervention, while observation group received empathic nursing.The coping styles (CSQ scale) and self-care ability (ESCA scale) before and after nursing, and nursing satisfaction between two groups were compared.Result:After nursing, the scores of each dimension of CSQ scale in observation group were better than those of control group, the differences were statistically significant (P<0.05).After nursing, the scores of each dimension of ESCA scale in observation group were higher than those of control group, the differences were statistically significant (P<0.05).The satisfaction of nursing in observation group was significantly better than that of control group (P<0.05).Conclusion:Empathic nursing can improve the coping style and self-care ability of breastfeeding mother with allergic constitution, and it is suitable for this kind of mothers.

目的 探讨循证干预措施对降低老年妇女患者盆底重建术后导尿管相关泌尿系感染(CAUTI)发病率的效果评价.方法 选取2015年1月-2017年12月在该院实施全盆底重建术的140例患者作为观察组,实施循证干预措施,另选取2012年1月-2014年12月在该院实施相同手术的112例患者作为对照组,比较两组围术期相关情况及CAUTI发生率,并进行统计学处理.结果 两组患者的年龄、体质指数、术前住院天数和ASA评分比较,差异均无统计学意义(均P＞0.05);观察组CAUTI总发病率(0.65‰)低于对照组的(5.05‰),差异有统计学意义(P＜0.05),术后尿管留置时间、重置尿管次数、术后尿潴留发生率均低于对照组,差异有统计学意义(P＜0.05).结论 实施循证干预措施可有效缩短尿管留置时间,减少留置尿管的重置次数及尿潴留的发生,降低盆底重建术后CAUTI发生率.

Objective:To use the existing research results scientifically and effectively,to provide the high quality of entire diet nursing care for gestational diabetes patients and improve maternal and child safety.Method:The method of convenient sampling was adopted,100 patients with gestational diabetes mellitus who were diagnosed by obstetric clinic from January 2012 to December 2012were selected,the patients were randomly divided into the observation group for 50 cases and the control group for 50 cases,the control group was given conventional diet control,the observation group was given diet nursing care plans based on routine diet control,according to evidence-based nursing principles,meal plans were set by nutritionists,processing nutritious meals were provided by the hospital canteen and nursing was executed,diet nursing care plans were completed by cooperating.Result:The observation group in the incidence of complications and cesarean section rate,aware of knowledge about diet and eating behavior in the correct were better than those of control group,the differences were statistically significant(P<0.05).Conclusion:The evidence-based nursing in patients with gestational diabetes mellitus is applied,it is helpful to promote maternal and child health,is feasible.

目的观察比较自控硬膜外镇痛与笑气分娩镇痛的临床效果,加强分娩镇痛的护理。方法选择无产科及麻醉禁忌症拟阴道分娩初产妇90例,随机分为3组,罗哌卡因+芬太尼硬膜外自控镇痛组30例(A组);50%笑气(N2O)吸入组30例(B组);未行分娩镇痛组30例为对照组(C组)以自然方式分娩。比较3组产妇的疼痛程度、产程、分娩方式及新生儿情况。结果90例产妇分娩期生命体征平稳,VAS评分A、B组较对照组明显降低(p<0.01),A组较B组亦有统计学意义(p<0.05);器械助产率及剖宫产率,A、B组较对照组低(p<0.05),A组较B组无显著意义的降低(p>0.05)。结论自控硬膜外镇痛和笑气均可用于分娩镇痛,对产妇、新生儿均无影响,是较理想的分娩镇痛方法;自控硬膜外镇痛效果较50%笑气吸入镇痛效果佳。