目的:探讨失效模式与效应分析(failure mode and effect analysis,FMEA)在预防老年住院患者噎食发生中的应用效果.方法:选择2018年3月-2020年3月就诊于本院的老年患者86例.按随机数字表法分为对照组和观察组,各43例.对照组采用常规护理,观察组在此基础上实施FMEA干预.比较两组两组噎食发生率、噎食致气道梗阻率和护理满意度.结果:观察组噎食发生率为2.33％、噎食致气道梗阻发生率为0,均低于对照组的18.60％、13.95％,差异有统计学意义(P<0.05).观察组护理满意度中饮食监管(22.54±2.16)分、操作技术(21.49±2.19)分、沟通态度(22.26±2.01)分、健康指导(22.41±2.33)分、总分(88.94±5.29)分,均高于对照组的(20.52±2.21)、(18.64±2.18)、(20.25±3.02)、(20.33±2.30)、(80.07±5.11)分,差异有统计学意义(P<0.05).结论:FMEA能够降低老年住院患者噎食发生风险,有助于保障患者生命安全,促进护理满意度提升.

目的:探讨个性化护理对老年病患者生活质量的影响.方法:选取2017年1月 ～2019年1月阳江市中西医结合医院收治的老年病患者200例按照护理方法的不同分为研究组(采用个性化护理)和对照组(采用常规方法护理)各100例,比较两组患者ADL评分和HAMD评分及护理满意度.结果:干预后研究组患者ADL评分、护理满意度明显高于对照组患者,HAMD评分明显低于对照组患者,两组差异均有统计学意义(P<0.05).结论:个性化护理能提高老年病患者的生活质量,改善患者的心理状态,提高护理满意度,值得推广.

目的:研究持续质量改进在医院供应室院内感染控制中应用.方法:选择2016年1月—2016年12月我院供应室集中管理中实施持续质量改进之后数据作为观察组,2015年1月—2015年12月未开展持续质量改进之前的数据作为对照组,两组均随机抽取500份消毒灭菌样本,并调查相应时段供应室医务人员共计100人次及随机选取科室1000例患者检查各样本的清洗质量、包装质量和灭菌质量,记录常规物品和紧急物品送达科室的时间及院内感染情况.结果:实施后,观察组清洗质量、包装质量、灭菌质量,均优于对照组,差异有统计学意义(P<0.05);实施后,观察组上午常规物品送达时间、下午常规物品送达时间、紧急物品送达时间,均明显短于对照组,差异有统计学意义(P<0.05);实施后,观察组1年内发生院内感染率为0.30％,低于对照组1.20％,差异有统计学意义(P<0.05).结论:医院供应室实施持续质量改进能降低院内感染率,提高物品供应质量,缩短物品供应时间.

Objective:To explore the effect of progressive target nursing combined with rehabilitation training on functional recovery after femoral fracture fixation.Methods:A total of 60 patients with femoral fracture fixation were selected as the study subjects and the patients were divided into observation group and control group according to the random number table.The control group was given routine rehabilitation training, while the observation group was given progressive target nursing based on the routine nursing of the control group.The hip function, self-efficacy and daily living ability of the two groups were observed.Results:The scores of pain, activity, joint function and joint deformity of the two groups were significantly higher than those before nursing (P<0.05), and the scores of the observation group were significantly higher than those of the control group(P<0.05).The expected score, self-efficacy expectation score and overall score of the two groups were significantly higher than those before nursing(P<0.05), and the observation group was significantly higher than the control group(P<0.05).The scores of daily life activities of the two groups were significantly higher than those before nursing (P<0.05), and the observation group was significantly higher than the control group(P<0.05).Conclusion:Progressive target nursing combined with rehabilitation training can effectively promote the functional recovery of patients after femoral fracture fixation.It can improve self-efficacy and daily living ability of the patients.

Objective To explore the abdominal postoperative patients with large bearing gas soup topical CV 8 hole plus TDP irradiation for the effects of abdominal postoperative patients with gastrointestinal functional recovery. Methods Will our abdominal postoperative 120 patients were rando mly divided into 3 groups( Chinese traditional medicine group,the percutaneous drug group take orally,percutaneous drug delivery plus TDP irradiation group),40 cases in each group,including medicines are group of patients in postoperative 6 when I was a child to start taking large bearing gas soup,2 times a day. Percutaneous drug group of 30 min after surgery,patients with routine disinfection rhubarb ointment topical skin after 3 g connection to god fault positions,and the fixed medical tape,1 times a day,24 hours to replace; Percutaneous drug delivery plus TDP irradiation group of patients on the basis of percutaneous drug group,30 min after each replacement drug use TDP irradiation,and observe the local skin of the presence of inflamed hot pain,prevent burns. Comparison of three groups of patients with postoperative gastrointestinal peristalsis,anal exhaust time and defecation time,for the first time and MODS score of three groups of patients before and after the intervention. Results Percutaneous drug delivery plus TDP irradiation specific set of gastrointestinal peristalsis,anal exhaust time after surgery,the first defecation time and MODS score improvement extent were significantly superior to percutaneous drug group and traditional Chinese medicine internal medicine group( P0. 05). Conclusion Percutaneous drug delivery apply CV 8 point plus TDP irradiation on can shorten the recovery time of gastrointestinal tract in patients with abdominal surgery,promote rehabilitation in patients with abdominal surgery,in clinical worthy of further promotion.

<正>急性心肌梗死(AMI)具有起病急、病情重、变化快等临床特点,如不采取相应的干预措施,常引起严重的后果,甚至危及患者的生命[1]。研究显示,除了尽快恢复冠脉血流等临床干预外,护理干预也具有重要的临床意义[2]。综合护理干预是指护理工作人员从不同的角度对患者进行护理,它是根据患者自身的一般情况制定的一种跨学科、综合的、以患者

目的:探索在西医治疗的基础上配合以活血化瘀法为主中药治疗急性期脑挫裂伤的临床疗效。方法:将45例脑挫裂伤病人,随机分为中药治疗组和对照组,分别于服中药后5d、10d及3月观察两组病人的治疗效果。结果:以活血化瘀法为主的25例中药治疗组患者昏迷时间缩短、致残率降低。结论:在西医治疗的基础上配合以"活血化瘀"法为主中药治疗急性期脑挫裂伤对促进早期清醒、降低致残率方面有明显疗效。

目的 探索在西医治疗基础上配合以活血化瘀法为主中药治疗急性期脑挫裂伤的临床效果.方法 将87例脑挫裂伤患者按随机原则分为中药治疗组(46例)和西药治疗对照组(41例).对照组给予常规西药治疗;中药组在西医治疗基础上辨证给予中药治疗.分别于治疗后5d和10d及3个月观察两组患者的治疗效果.结果 治疗5d后中药组清醒28例,昏迷13例,死亡5例,对照组分别为10、25、6例;治疗10d后中药组清醒31例,昏迷9例,死亡6例,对照组分别为17、17、7例;两组清醒和昏迷例数比较差异均有统计学意义(P<0.05或P<0.01).治疗3个月后,中药组恢复良好26例,轻残10例,重残4例,死亡6例,对照组分别为10、22、2、7例,两组恢复良好、轻残例数比较差异均有统计学意义(均P<0.01).结论 在西医治疗的基础上配合以活血化瘀法为主中药治疗急性期脑挫裂伤,对促进患者清醒、降低致残率有明显疗效.

目的比较吸引瓶干燥备用与含氯消毒液保存对消毒效果的影响。方法采集2007年6月至2009年7月本院内科、外科、妇产科、手术室使用后的吸引瓶共600个随机分为两组,实验组(干燥备用)将使用后的吸引瓶、连接管清洗后用1%含氯消毒液浸泡30分钟后倒放在无菌巾上晾干干燥备用;对照组(含氯消毒液保存)将使用后的吸引瓶、连接管清洗后用1%含氯消毒液储存备用。分别于12h、24h、48h、72h和96h严格按照《全国临床检验操作规程》进行采样,比较2组的消毒效果。结果吸引瓶干燥备用与含氯消毒液保存的消毒效果基本相同,差异均无统计学意义(p>0.05)。结论吸引瓶干燥备用是可取的,它不仅可保证消毒效果,又可避免重复消毒的浪费,达到经济节约;减少了含氯消毒液对操作人员黏膜的刺激及间接对患者人体的刺激。

<正>护理记录是护士针对护理对象所进行的一系列护理活动的真实反映,它不仅是衡量护理质量、提供诊疗的依据,同时也是《医疗事故处理条例》所规定的法庭依据[1]。在临床工作中,由于护理人员工作繁忙、疲劳,记录常流于形式,得不