目的 探讨手术室全程护理对中低位直肠癌患者术后早期恢复的影响.方法 本研究为回顾性分析,选择邯郸市中心医院2016年3月至2019年12月收治的120例行腹腔镜全直肠系膜切除术(TME)的中低位直肠癌患者为研究对象,根据手术室护理方式的不同分为观察组(实施手术室全程护理)和对照组(实施手术室常规护理),每组各60例.比较两组手术相关指标、术后早期肠道功能恢复情况及术后并发症发生率.结果 观察组手术时间、术后住院时间短于对照组,术中出血量少于对照组,差异均有统计学意义(均P<0.05),两组淋巴结清扫数目比较差异无统计学意义(P>0.05).观察组术后首次肛门排气时间、首次进食时间、首次排粪时间较对照组提前,差异均有统计学意义(均P<0.05).观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05).结论 对接受腹腔镜TME术的中低位直肠癌患者施予手术室全程护理有助于患者术后早期恢复,减少术后并发症.

目的 了解三级医院护理人员护理科研产出现状及其影响因素,为管理者制定管理策略提供参考.方法 以计划行为理论为依据设计在线调查问卷,对909名三级医院护理人员进行调查.结果 调查对象中近5年已发表文章者占12.3％,有护理专业科研立项者占4.7％,结题者占3.4％,科研获奖者占1.87％;每天阅读文献者仅占3.1％.不同年龄、学历、职务、职称、工作年限以及不同的文献阅读频次的护理人员发表科技论文、已有科研立项与结题的人数不同,差异均有统计学意义(P＜0.05);不同科室护士已发表科技论文的人数不同,差异有统计学意义(P＜0.05).多因素分析结果显示,学历、职称、职务对科技论文与科研结题均有影响;学历、职称、阅读文献情况对科研立项有影响.学历与护理人员主观规范、科研能力自评有相关性,职称仅与主观规范有相关性,差异有统计学意义(P＜0.05);英语水平限制、工作太忙、没有专人指导是制约护士开展护理科研的主要原因.结论 科研产出数量少、被认可度不高;护理人员科研态度积极,但学习科研知识的行为执行力低;学历、技术职称、职务、阅读文献情况是促进护理科研产出的主要影响因素.建议管理者针对不同层次护士设置科研进阶课程,建立“帮带”课题组,激励护士积极开展护理科研活动.

目的 构建基于岗位管理的三级医院临床科室综合评价指标体系.方法 采用德尔菲法,对32名专家进行两轮有效函询,获得专家一致性意见,确立临床科室综合评价指标.结果 两轮函询问卷有效回收率分别为94.12％、100％,最终构建的指标体系包含8个一级指标,64个二级指标.结论 基于岗位管理的临床科室综合评价指标体系构建方法具有科学性,可为提升护理工作,实现目标化管理提供依据.

目的 了解某三级甲等综合医院医护一体化协作对降低医护人员职业倦怠的效果.方法 采用便利抽样法选择某三级医院4个临床科室的65名医生和护士作为研究对象;采用历史对照法,对照组按照常规工作的方法,试验组采取医护一体化协作,职业倦怠感采用MBI-GS量表.结果 医生、护士均存在职业倦怠,护士职业倦怠感更强,差异有统计学意义(P＜0.01).试验组和对照组职业倦怠不同,对照组医护人员职业倦怠感更强,差异有统计学意义;试验组医护人员职业倦怠感随着医护一体化协作实施时间的延长而逐渐降低,护士职业倦怠感降低程度较医生更明显.结论 采用医护一体化协作可以降低医护人员职业倦怠感,尤其是降低护士职业倦怠程度,有利于提高护理队伍的稳定性.

目的：探讨 FOCUS-PDCA 法在促进压疮管理中的效果。方法：采用 Braden 评分表对分管科室的住院患者进行压疮评估，最高23分，最低6分。对Braden评分13分以下的病人作为压疮高危患者，分别采用压疮常规管理和PDCA循环进行管理，其中PDCA循环组按一季度（3个月）为一个循环周期实施PDCA循环。结果：两组患者基线资料无统计学差异（P>0.05，X2>0.05）；压疮管理后， PDCA循环管理组患者压疮braden评分较常规组高（T=7.725， P<0.01），压疮发生率较常规组低（X2=5.79，P<0.05），差异有统计学意义，即两组压疮发生结局有统计学差异（P<0.05）结论：PDCA 循环法是一种有效管理和预防压疮发生的重要手段。

目的：了解我院住院患者压疮发生、上报情况。方法：成立压疮管理组，对住院患者进行横断面调查研究。结果：压疮发生率处于高发水平，压疮上报率低。结论：通过对压疮管理小组分层管理，加强护理人员质量控制知识培训考核，提高了压疮患者管理成效。

目的：探讨提高低年资护士护理质量的管理方法，提升科室护理质量。方法：实行医院三级质控管理体系下的“科室三级质控”。结果：低年资护士的科室护理质量逐步得到提高。结论：科室三级质控可以提高了护士积极性和护理质控意识，提升护理质量，同时促进科室管理文化的建立和完善。

Objective To study the research status of clinical pathway trend and development in our country in recent years , so as to provide a reference for the further research and development of clinical pathway.Methods The CMB, CNKI,VIP, Wanfang academic database were searched as the platform and related literatures research on clinical path were collected .Results A total of 4 811 literatures were identified , of which 1 929 studies were published in core jourals .Although the number of literatures had an increasing tendency year by year , the core documents of studies had a decreasing tendency .The study content were about clinic, nursing, hospital management , training and so on, and the largest published volume research was related to clinical nursing pathway which had 1 567 (32.57%) studies.Conclusions Clinical pathway study is in a high rapid development and in wide and deep expand on contents , but the development of research area is not balanced , supporting systems , information management facilities , and effect evaluation system on clinical pathway is lacking .

Objective To investigate the effect of psychological intervention on negative emotion ,sleep in patients with gastric cancer and prognosis . Methods Patients were randomly divided into 2 groups ,the intervention group 40 psychological intervention group and 40 in non-intervention .The two groups of patients were performed operation ,chemotherapy and other conventional treatment .The control group received the routine nursing mode ,nursing , intervention group received psychological intervention based on routine nursing mode .Comparison of two groups of patients before and after the intervention of negative mood ,sleep ,pain and variation of survival rate .Results After the intervention the intervention group patients with anxiety and inhibition of all scores were lower than the control group .The intervention group than in the control group of sleep time increased significantly .But the intervention group than in control group significantly reduced pain scores .Significantly increase the survival rate of group intervention .There are significant differences (P<0.05) .Conclusion The psychological intervention can reduce negative emotion of patients with gastric cancer undergoing operation ,increase the sleep time of patients and reduce the pain of patients ,improve patient survival .