目的:研究清城区基层医院临床一线护士核心能力调查及相关影响因素.方法:调查清城区400位基层医院临床一线注册护士的核心能力,并进一步分析影响护士核心能力的相关因素.结果:本次共计发放调查问卷400份,回收400份,其中有效问卷为377份,有效率为94.25％;清城区基层医院临床一线护士核心能力总评分为(184.22±20.08)分,处于中等水平,其中领导能力评分较高,专业发展和教育/咨询评分较低;清城区基层医院临床一线护士核心能力总评分在年龄、职称、工作年限及用工性质上比较,差异具有统计学意义(P＜0.05);多元回归分析显示年龄为影响清城区基层医院临床一线护士核心能力的独立危险因素(t=6.044,P＜0.05).结论:清城区基层医院临床一线护士核心能力处于中等水平,护士能够胜任临床护理工作,但仍需加强核心能力培养,尤其是专业发展和教育/咨询方面的培养.

Objective To compare the effect of concentrated sodium chloride (10％ sodium chloride,also known as hypertonic saline) and traditional sealing solution on the risk of hemorrhage after heparin-free hemodialysis (HFHD) during the induction period,and to probe more reasonable choice for central venous catheter (CVC) sealing solution after HFHD.Methods 64 patients undergoing HFHD with CVC as dialysis vascular access during the induction period were divided into two groups according to the time.32 cases in control group were given 1:3 heparin saline (1562.5 U/ml) sealing solution after dialysis,while 32 cases in observation group were given concentrated sodium chloride sealing solution after dialysis.Detected coagulative function index 2,4 hours after tube sealing,monitored bleeding,catheter withdrawing patency,infection,and other conditions.Results Coagulative function index [plasma fibrinogen (FIB),PT-INR] of control group 2 hours after tube sealing were more than those of observation group (P＜0.05),there were no statistically significant differences in activated partial thromboplastin time (APTT),thrombin time (TT),prothrombin (PT) between two groups (P＞0.05).The rate of bleeding of observation group was lower than that of control group,with statistically significant difference (P＜0.01).Conclusion Concentrated sodium chloride sealing solution applied in patients undergoing HFHD with CVC as dialysis vascular access during the induction period,can significantly reduce bleeding complications after dialysis,reduce the financial burden of patients,worthy of clinical application.

目的：了解清城区基层医院护士核心能力现状，为制定切实可行的基层医院护士核心能力联合培训模式奠定基础。方法采用刘明编制的《中国注册护士核心能力量表》，对清城区9所一、二级医院及社区卫生服务中心的377名注册护士进行核心能力问卷调查，内容包括评判性思维/科研、临床护理、领导能力、人际关系、法律/伦理实践、专业发展、教育/咨询7个方面。结果一级医院、社区卫生服务中心护士核心能力处于中等水平，二级医院护士核心能力处于中上水平，各级医院在法律/伦理实践、人际关系、临床护理、专业发展能力靠前4位，而评判性思维/科研能力最低，一级医院、社区卫生服务中心护士与二级医院护士核心能力评分差异有统计学意义（P<0.05）。结论基层医院护士核心能力处于中等和中上水平，能胜任目前的护理工作，但各级医院均需进一步加强培训，提高护士核心能力，尤其是评判性思维/科研能力、领导能力、教育/咨询能力的培训。

目的探讨非惩罚性报告制度在护理安全管理中的应用。方法通过建立护理不良事件非惩罚性报告制度、护理不良事件根本原因分析及有效反馈"错误"经验的信息资源共享,形成较为完善的不良事件管理体系,构建非惩罚性护理安全文化氛围。结果护理不良事件的上报率明显上升(P<0.01),不良事件的严重程度显示中度以上伤害有所下降(P<0.01)。结论在护理安全管理中,非惩罚性护理不良事件报告制度是一种能融洽人际关系、较为完善且可以达到持续改善和提高护理质量的管理方法。

护理安全是医院护理管理的重要组成部分,是现代医院保障患者安全的重要职责.随着医学模式的转变,护理安全管理不再局限于护士,而是通过有计划、有组织和系统建立及完善有效的护理质量管理体系,消除或降低负面因素,从而提高护理安全质量,保障患者安全.随着我国法制建设和医疗卫生改革的不断发展,医疗护理安全已成为社会关注的热点和医院发展的基础.

目的 促进学龄前儿童建立健康的用眼行为,提高家长及老师对儿童视力保健的认识,达到共同保护儿童视力健康的效果.方法 选取辖区范围内6所幼儿园的学龄前儿童420名,其中3所幼儿园210名儿童设为干预组,对其不健康用眼行为进行系统干预,并对其家长及幼儿园老师进行学龄前儿童视力保健知识指导;另外3所幼儿园210名儿童为对照组,按常规由社区中心每年对幼儿园的老师、家长、儿童进行不定期的健康教育.比较两组干预2年后的用眼行为和视力情况,结果干预组的不健康用眼行为明显减少,视力异常情况得到有效控制,与对照组比较,差异均有统计学意义.结论 在幼儿园针对儿童的用眼行为进行社区干预,可纠正学龄前儿童的不健康用眼行为,家长及老师们对儿童视力保健知识增加,使学龄前儿童视力得到有效保护.

儿童视力问题不仅严重影响学习,而且可导致情绪和行为问题。本文通过探讨学龄前儿童视力保健存在的危险因素,提出相应干预措施,为儿童视力保健工作开展提供科学依据。

目的 了解护士的膳食营养状况,分析存在的问题,以便更好地进行膳食指导.方法 采用食物频率问卷方法,调查110名护士日常生活中选择早餐食物时经常考虑的因素、食物种类的搭配、摄入量、开支情况以及进餐所需用的时间等进行膳食调查分析.结果 本组护士从早餐的膳食结构、能量和营养素摄入量、能量来源分布、蛋白质的来源分布、能量餐次比评价等均需要改善.结论 护士对营养知识掌握不足,护士早餐存在不科学的膳食结构,必须要加强膳食指导,以保证各种营养素的均衡摄入,从而促进护士身体健康。

目的了解学龄前儿童家长对儿童视力保健知识和健康教育方式的需求状况,为社区工作人员对学龄前儿童家长进行针对性的健康教育提供参考。方法在清城区范围内选择三所规模较大的幼儿园,对其中3～6岁学龄前儿童的家长264人进行问卷调查,了解其对儿童视力保健知识及健康教育内容和方式的需求。结果学龄前儿童家长对视力问题的防治知识、定期眼检查和用眼卫生的视力保健知识需求率较高;最希望的健康教育方式是阅读健康教育资料,其次是面对面个别咨询。结论对学龄前儿童家长视力保健知识的指导着重点在于视力问题的预防、定期进行视力检查及用眼卫生等方面;健康教育有待于社区工作人员采取多元化和更具针对性的方式进行。

目的了解清城区学龄前儿童的视力状况。方法采用美国伟伦公司suresight视力筛选仪,于2009年对清城区68所幼儿园13755名学龄前儿童进行视力筛查;同时,回顾性总结分析该地区近5年学龄前儿童的视力发展状况。结果各年龄段视力异常检出率差异有统计学意义(2χ=177.44,P<0.05),视力异常随着年龄的增长而降低。2009年486名儿童存在视力不良,其中散光占77.16%,远视+散光占7.61%,远视占9.87%,近视+散光占2.26%,近视占3.08%;各类型视力不良差异有统计学意义(P<0.05)。3734名儿童存在视力问题。结论学龄前儿童的视力异常发生率虽有下降,但仍处于较高水平,必须引起各级地方政府、保健机构、幼儿园老师及家长的重视。

随着医学模式的转变,护理工作开始走出医院,走向社会,走向家庭.为社区居民提供更方便、更优质、更全面的服务[1].我院为进一步提高人性化服务,减轻产妇家庭经济压力,在一般情况下将顺产、无任何并发症产妇的住院时间控制在分娩后1～2 d,本院社区范围内由社区护士上门拆线,社区范围外产妇按规定时间在产后4～5 d回医院拆线或到附近医院拆线.

目的:探讨基层医院护理管理中的存在问题.方法:回顾三年来参加全区七所医院护理管理检查中发现的问题,并分析问题发生的原因.结果:存在的问题;护理管理人员管理素质参差不齐;护理质量检查流于形式;护理质量评价内容的设置与病人需求及基层医院实际情况相矛盾;管理不严格、制度落实不到位等.结论:通过科学、有效的管理方法,加强对各级管理人员的培训,服务理念以人为本,将重视病人心理需求融入质量管理中,规范护理行为,使病人真正从护理管理中受益.

Objective To explore influences of different methods of nursing perineal incisions on their recovery in parturient women in community nursing.Methods The perineal incisions in 183 parturient women undergoing vaginal delivery from Jun.2006 to May 2007 were cleaned with clean water each time after urination and defecation and altering of childbed mattresses.The healing conditions were observed on the day before discharge,on day 7,day 14,day 28 and day 42 after discharge.The observed results were compared to those disinfected with iodine or potassium permanganate solution in another 150 parturient women undergoing vaginal delivery from Jun.2005 to May 2006.Results The differences were insignificant in the healing conditions at each time point statistically,but 5 cases manifested with local allergic responses and 1 case with skin adustum in the iodine group,while those cleaned with clean water showed no adverse reactions and felt comfortable.Conclusion Those transferred to community nursing can be instructed to clean and care the perineal incisions with clean water.The method is simple,costing less and having no adverse reactions.Meanwhile,such disinfectant-induced adverse reactions as skill allergy and skin adustum can be avoided.

目的:探讨产妇会阴切口消毒与清洁方法的最佳护理效果.方法:把311例自然分娩产妇按分娩顺序随机分为A、B两组,A组为实验组,采用温开水擦洗清洁会阴切口;B组为对照组,采用0.3%碘伏液擦洗消毒后,用0.5%灭滴灵溶液湿敷会阴切口.观察对比两组产妇会阴切口红、肿、热、痛、感染、愈合等情况.结果:产妇会阴切口使用温开水或碘伏液加灭滴灵护理,对切口的影响没有显著差异(P＞0.05),但在皮肤刺激方面有显著性意义(P＜0.05).结论:采用温开水擦洗能保持会阴部及切口清洁,不影响切口愈合,对皮肤无不良刺激,产妇感觉舒适.

Objective:Discuss the role of individual music to reduce the pain of the coloendoscopy.Methods:Classify the 278 cases to two groups:experi- mental and control,uses and likes to the patient music background carrying on theinvestigation and the apwaisal,the formulation individual musicinterven- tion plan.Before inspection 15 min the experimental group choose the individual music until the inspection end,and control group no music.Results:Music background in two groups didn't show significant difference,pop(35.34%)and light(31.20%) music were loved by patients.The experimental group had the obvious difference(P0.01)in the degree of pain,the degree of tensity,contractive pressure,hart rate,the time of coloendoscopy enter.Before diastolic pressure and inspection 15min there were no obvious difference(P0.05).Conclusion:Likes based on the patient carrying on the individual mu- sicintervention,may strengten the patient to listen respectifully musicdedicted,disperse the attention and reduce the degree of pain,eliminate the tensional mentality,keep the balance of the physiological index,reduces the inspection time,promotes the patient to examinethe wish increase the successful rate of the coloendoscopy.

Objective:Discusses the best nurses effect between the parturient women perineum margin disinfection and the clean method.Methods:311 examples easy childbirths parturient women were Stochastically divided into two groups according to the childbirth order,A group for experimental group:uses the warm boiling water to scour the perineum margin.B group for comparison group:after using the 0.3% idodine solution to bend down the disinfection perineum margin,wet spreads the margin with the 0.5% flegal solution.Observes the situations between the two groups of the parturient women perineums margins lipstick,swells,hot,pain,infection,heals and so on.Results:Two groups of parturient women perineums margin not remarkable difference(P〉0.05).Conclusion:lt can be Maintained cleanly with using the warm boiling water to scour the perineum and the margin,does not affect the margin to heal,no bad stimulates to the skin,the parturient woman feels comfortably.

目的分析婴幼儿意外伤害相关因素,提出相应的预防措施。方法对社区卫生服务中心儿童保健室近期检查的0～3岁婴幼儿1 253人,其中对发生71例意外伤害有关数据进行相关性统计分析。结果0～3岁婴幼儿71例,意外伤害主要包括:跌伤、窒息、溺水、烧(烫)伤、割(扎)伤、动物咬伤、中毒、交通意外等。结论婴幼儿意外伤害情况严重,各方面应采取积极有效措施,以减少意外伤害的发生。

Objective To understand problems existing in aid cart management in grass roots hospitals, analyze causes, seek scientific and effective management methods and ensure aid cart kept in good state and ready for emergency. Methods First aid medicine, appliance, apparatus and it's management in ambulant clinic, emergency department room, wards, ICU and operating room of seven grass roots hospitals were checked and analyzed. Results Existing problems were: some unnecessary medicine in the aid cart, medicine expiration could not be judged, some appliances in the aid cart didn't function well, some disposable sterilized appliances were expired, and some forceps rusted. In addition, the management of the aid cart was inadequate and not completely scientific. Conclusion Nurses' sense of responsibility must be improved, the importance of aid cart in nursing should be clear, and nursing quality monitoring must be strengthened.