目的 探讨约束患者快速核查单在预防患者非计划性拔管中的应用效果.方法 通过查找约束患者发生非计划拔管的原因,结合文献分析和专家论证编制约束患者快速核查单,比较核查单应用前后身体约束患者非计划拔管发生率并记录护士在应用核查单过程中核查出的风险及不足之处.结果 核查单应用后,约束患者非计划拔管发生率由5.63％(36/639)降至0.72％(2/278),差异有统计学意义(x2=4.315,P<0.05),同时核查出一系列风险及不足之处.结论 约束患者核查单的应用有助于护士快速识别风险环节及不足之处,降低非计划拔管发生率,提高管路安全性,提升护理质量.

目的 总结急诊科应对新型冠状病毒肺炎疫情防控期间的护理管理工作,为护理管理者今后更好地应对突发疫情提供决策依据.方法 根据急诊科工作特点,结合新型冠状病毒肺炎的诊疗及防控方案、医用防护用品使用指引、环境清洁消毒建议等制订一系列急诊科护理管理工作内容,包括诊治区域管理、就诊流程管理、疑似病例管理、环境消毒管理、工作人员和防护物资管理.结果 疫情防控期间,我科平均每日收治抢救患者33例、流水245例、留观45例,急诊病房、监护室有患者32例,医护人员210例,均无感染发生.结论 疫情防控期间,在完成常规危急重症患者救治的基础上,围绕疫情防控做好急诊科的护理管理工作,对保证医务人员、患者及家属的健康安全至关重要.

Introduction: Nocardiosis is a rare kind of opportunistic infections. Because of its insidious onset and atypical clinical manifestations, diagnosis and early treatment are often delayed. Case presentation: Here we present a 60-year-old Chinese female patient with systemic Nocardia infection, who had been diagnosed with idiopathic thrombocytopenic purpura previously and was misdiagnosed for up to 6 months prior to presenting at our hospital and ultimately achieved clinical cure. Discussion: The patient took prednisone because of ITP for several years which led to immunosuppression. Nocardia infection began from the skin rupture and then spread all over the body with multiple system involvement. The pus culture eventually found Nocardia. Sulphonamides have been the standard treatment for decades and there are several other options. Patients with severe Nocardia infection or immunosuppression are suggested a combined therapy. Conclusion: Nocardiosis is an infection that often resulted in delayed diagnosis because of lack of specificity of the clinical profile and the difficulty in culturing the bacteria. It should be included in the differential diagnosis of patients in which there are cutaneous, respiratory or neurological manifestations, especially in immunosuppressed individuals.