目的 了解中西医结合护理专科护士培训后工作真实体验,以期为完善中西医结合护理专科护士临床培训及管理提供依据.方法 采用现象学研究方法,对13名中西医结合护理专科护士进行半结构式访谈,并用Colaizzi分析7个步骤对资料进行分析.结果 归纳出3个主题:职业认同感,职业获益感,职业发展困惑.结论 中西医结合护理专科护士培训后工作中存在多种体验,需要了解心理状况,给予针对性干预.

Objective To Study the present status of job and profession for nursing staff in Zhejiang.Method Study by present status interview and questionnaire.Interview 72nursing staff chosen from 17hospitals.Investigate nursing directors,head nurses and 4411clinical nurses from 217hospitals by self-designed questionnaires for nursing directors,head nurses and clinical nurses.Result Most nursing directors and head nurses feel administrators of hospital pay enough attention on nursing work and hierarchical management and quality nursing care are well developed in hospital.They hope to increase institution establishment nurses,promote reward of service and reflect the value of nursing care.Nurse patient ratio in the hospitals is under the requirements of the National Ministry of Health.In survey,86.7%consider nursing work to be tense.53.6%think that they’ve already fulfilled themselves.57.4% feel title promotion is reasonable.74.3% consider staffing is inadequate.63.4%feel allocation mechanism is unreasonable.56.4%think they have little chance to have continual education.55.9% hope to leave the position of bedside nursing care if possible.Conclusion Most hospitals developed qualified nursing activities well based on Patients-Centered Care and nurses can do their job well.Inadequate staffing,heavy workload,high profession risk and unreasonable allocation are the main problems.Managers should pay attention to nursing human resources,nurses’benefit,title and profession promotion to improve their working enthusiasm.

<正>感染性心内膜炎是指心脏瓣膜、心内膜以及血管内膜的细菌性、真菌性、立克次体或病毒性感染。内科保守治疗效果较差,病死率高达79%~89%。我院2009年2月—2012年9月对19例感染性心内膜炎患者进行瓣膜置换术,取得较好效果,现将临床观察与护理报道如下。

总结糖尿病专科护士培训的方法与体会.为建立高素质糖尿病专科护士队伍,2009年起,浙江省开展了糖尿病专科护士培训项目,采取3家基地医院联合培训的模式,由3家基地医院共同承担培训工作.共开展3期培训,全体学员经基地医院资格审查,完成既定的理论学习、临床实践培训和撰写结业报告,通过专家委员会答辩,获得相应资格证书.浙江省糖尿病专科护士培训项目形成自身特有的模式,培训工作达到了预期目标.

探讨复合心血管疾病射频消融同时联合冠状动脉造影手术前后的护理。具体包括术前心理护理及术前准备,术后生命体征的监测,预防穿刺部位出血及血栓的形成和栓塞,并发症的观察护理及健康教育。32例患者手术均获成功。因此积极的术前准备和术后严密的观察及护理是手术成功的重要保证。

<正>心房颤动(简称房颤)是成人最常见的心律失常之一,长期发作易使心房产生血栓和血栓脱落引起栓塞[1],恢复窦性心律不仅可以改善患者症状、减少血栓栓塞并发症的发生,还可降低病死率。伊布利特是一种新型离子通道活性的Ⅲ类抗

目的 探讨预防股动脉穿刺插管留置导管相关性感染的护理对策.方法 对86例肿瘤患者于插管前后采用有效的预防感染措施,如皮肤、环境、物品的清洁消毒和无菌操作的执行,观察导管相关性感染的发生情况.结果 经过严格的消毒措施的落实和无菌技术原则的执行,本组无一例导管相关性感染发生.结论 预防股动脉穿刺插管留置导管相关性感染应严格落实各项消毒措施和无菌技术原则,保持导管留置期间敷料清洁无菌,感染是可以避免的.

外科手术前剃毛备皮是我国历年来护理常规之一.而改良备皮法是一种主要强调清洁皮肤,而不剃除体毛的外科术前备皮法.国内外的许多研究报道,术前常规剃毛对降低切口感染率无任何意义.我院在普外科、胸外科、骨科、泌尿外科及妇产科临床推广应用9年证明:术前不剃毛对大外科手术切口愈合情况无影响,切口感染率反而下降,现报道如下.

To improve the quality of nursing records,we applied multi-station quality control to quality management of nursing records,including the stations of head nurses,network groups and monitors of medical records.As a result,the quality of nursing records is significantly improved.

抽查312份外科护理病历,按护理记录评价标准进行检查。护理病历记录合格率最低的是危重病人护理记录单(89.8%)、最高是入院评估单(96.8%),存在主要问题是护理记录完整性、准确性不够及漏签名。提高护士的法律意识、工作责任心及书写水平,加强护理病历书写质量监控,以提高护理病历书写质量。

Objective To promote nursing students' hand hygiene. Methods Trans-theoretical model was used to intervene 182 nursing students. Establishing intervention program according to strategy of behavioral change in different stages of the theory. A series of continuous and progressive intervention program was implemented to promote nursing students' behavior of hand hygiene. Nursing students' hand hygiene knowledge,self-evaluation of behavior,correct rate of handwashing were surveyed before and after intervention. Results After intervention,nursing students' hand hygiene knowledge level,self-evaluation of behavior,correct rate of handwashing had increased remarkably. Conclusions Applying trans-theoretical model of behavior could promote nursing students' hand hygiene.

Objective To discuss and popularise the necessarity of no shaving-skin methoed before operation in clinical praltsce.Methods 3331 patients were divide randomly into experimental Group(1824cases) and contradistinguishly Group(1507cases).Analysis the difference betweenⅠkind kerf infectional rate of two groups after operation.Results Two groups’rate are both in normal range and below 0.5,by statistic it shows no difference. Conclusion clinical application tfter analysising for longtime and the no shaving-skin methoed before operation is considered to be both scientical and greatly practical,which could be used mdinical practice.

目的:探讨经皮肝穿刺胆道金属支架植入术治疗恶性阻塞性黄疸术后护理方法。方法:对83例恶性阻塞性黄疸患者行经皮胆道引流及支架植入术,术后严密观察病情变化,加强皮肤护理,引流管护理,并发症观察和护理。结果:83例胆道金属支架植入术,78例植入成功,成功率93.97%。术后1个月内黄疸缓解率94.87%。术后17例并发穿刺部位疼痛,13例出现穿刺部位胆汁外渗,2例局限性胆汁性腹膜炎,1例腹腔内出血,3例并发胆道感染,均经过对症处理后好转。结论:经皮肝穿刺胆道金属支架植入术,缓解症状快,效果好,且创伤小,并发症少,但术后严密的病情观察,科学有效的护理措施的落实,减少了并发症发生,提高生活质量,延长生命。

目的通过持续管理干预改进,提高护理病历书写质量。方法对2004年188份和2005年196份抽检的现存护理病历存在问题的回顾、对比和统计分析,检视2005年的管理干预对策。结果干预后病历总体质量提高,护士业务水平和书写规范化提高,而其他方面提高不明显。管理干预建议:护士长应加大对护理病历书写改进的重视和管理力度,加强职责落实;提升护理内涵和护士法律意识。结论护理病历书写应综合施治,持续监管,反复分析和评价,进行持续管理干预改进,以提高护理病历书写质量。

1996年1月～2004年9月,我院组织全院性护理业务查房60余次.以护理程序为框架,结合功能性健康形态,有计划、有目的按排查房内容.采取专科为主,介绍治疗与护理新进展.

近年来,中心静脉置管(CVC)技术已广泛应用于临床,它对危重患者的救治、血管刺激性较强的药物的使用、减轻长期输液患者的痛苦等起到了积极的作用.但中心静脉导管相关性血液感染(CRBSI)在医院感染中所占比例有逐渐上升的趋势.为了探讨CRBSI的护理管理干预方法,减少血液感染的发生,对我院532例CVC的患者并发CRBSI的状况进行回顾分析.现报导如下.

目的使用和管理护理标识,降低护理风险。方法在护理服务过程中,系统、规范、科学地使用护理标识。结果护理差错发生率下降了90%,病人满意度保持在95%以上,护理人员的风险意识增强。结论护理标识有助于降低护理风险,提高护理质量。

[目的]了解临床护士的死亡观和临终关怀心态。[方法]选取内科、外科在职临床护士97人,采用藤腹朋子的“护士与死后处置问卷”进行调查。[结果]临床护士对待死亡有较正确的认识,不愿谈论死亡话题的占91.75%,但随着年龄的增长,工作经历的丰富,对待死亡的态度变得积极;大多数临床护士对待临终关怀的态度基本是积极的。[结论]临床护士的生死观深深地影响着护理质量,要有效地应对死亡压力,需多方面的共同努力。

目的为了帮助护生个案护理学习和运用,打下扎实的基本功,真正提高临床解决问题的能力。方法融合目标教学及多种教学方法设计护理个案教学查房,在2005届、2006届护生带教中制订详细的护理个案查房计划,以全院护理个案教学查房作为示范和指引,护生在病区带教老师指导、督促和评价下,分阶段有系统化目标进行护理个案学习训练。结果查房效果反馈调查显示,该方法分解护生学习难点,分次重点解决问题,得到了护生的肯定;护生个案成绩好于上届护生。结论融合目标教学设计护理个案教学查房,采众家之长,在临床个案护理教学中取得较好的效果,提高了护生临床解决问题的能力。

探讨冷冻消融治疗房室结折返性心动过速手术前后的护理.具体包括术前心理护理及术前准备,术后生命体征的监测,穿刺部位出血的预防,并发症的观察、护理和健康指导.30例患者手术均获成功,随访3～12个月无复发.因此积极的术前准备和术后严密的观察及护理是手术成功的重要保证.