关于急诊科新护士心理弹性现状的对策探讨

目的:了解急诊新护士心理弹性状况,分析其主要的影响因素,从心理弹性角度分析职业倦怠并进行对策探讨。方法:采用整群随机抽样,抽取急诊科120名新护士(临床工作1年内护士)进行心理弹性问卷调查,并分析其影响因素。结果:临床工作1年内急诊护士心理弹性总均分为(1.76±0.63)分,从各维度来看,坚韧(1.95±0.72)自强(1.83±0.45)、乐观(1.64±0.57)均处于较偏下水平;急诊新护士不同年龄、学历、医院等级、用工性质、及是否独生子女影响心理弹性总分(P0.001)。结论:临床工作一年内急诊科护士心理弹性处于较低水平,护理管理者应根据急诊科新护士特点进行培训,以提高其心理弹性。     

急诊专科护士培养模式在临床带教中的应用

目的探讨适合护理本科生(以下简称为护生)急救护理的临床带教方法。方法将2012年10月~2013年12月在我院急诊科实习的本科护生40名,按抛币法随机分为实验组与对照组。对照组采用传统带教模式,即临床带教老师与护生实行"一对一"跟班带教,讲解科室常见仪器的使且及参与危重病人的抢救护理,抢救结束后带教老师给予总结。实验组采用急诊专科护士培养模式,在我院急诊科与下属卫校护理实训基地相结合的基础上进行培训,并于急诊科实习结束出科时进行专科理论、专科技术操作考核以及医生满意度及远期效果评价比较。结果实验组在出科时专科理论、专科技术操作考核成绩及医生满意度、远期效果评价均高于对照组。结论急诊专科护士培养模式使护生急救知识、急救技能及急危重病人抢救能力均得到明显提高,为急诊专科护士的培养打下良好的基础。     

急诊科带教实习护士的方法初探

根据急诊科的特点,探讨了实习护士的带教工作,培养实习护士的观察能力、动手能力和分析解决问题的能力,进一步提高护理知识和操作技能水平,为其毕业后从事临床工作奠定良好的基础。     

微格教学法在急诊低年资护士急救技能培训中的应用研究

目的探讨微格教学在急诊低年资护士急救技能培训中的应用效果,以提高急诊低年资护士的急救技能水平。方法将我科40名低年资护士按照抽签法随机分为对照组和实验组,每组20名。对照组采取常规方法进行培训,实验组使用微格教学法进行培训,培训结束后,对两种教学方法进行效果评价。结果与对照组比较,实验组护士急救技能及理论知识评分均显著高于对照组,差异具有统计学意义(P0.05)。结论微格教学法对提高急诊低年资护士的急救技能具有重要意义,值得在急诊科临床教学中推广应用。     

浅谈急诊科护士压力与自我防护调节措施

随着医学模式的转变和医疗卫生事业的发展,护士的自我防护问题越来越受到国内外同行的关注。急诊科作为医院最前沿的医疗阵地,是医院竞争的第一个窗口,因此,对急诊护理工作也提出了更高的要求,同时也给急诊护士带来更大的压力。再有,急诊病人起病急、病情重,此时病人完全无心理     

整合急救医学建立灾难医学长效教育机制

灾难医学起源于西方的灾害医学,开始被称之为急救、灾难医学。其作为医学的一个分支科学,结合其自身的特殊性,对救援人员实施专业的灾难医学教育培训是不可或缺的重要内容。然而,目前我国医学生教育体制中的灾难医学教育培训体系尚不完善。急救医学服务体系(EMSS)涵盖了院前急救、灾害医学、院内急诊及加强治疗等领域,而急救医学     

骨科护士术后疼痛知识和态度的调查研究

目的:了解骨科护士的疼痛管理知识和态度现状,为加强疼痛知识和态度培训,最终提高疼痛控制的质量提供依据。方法:以方便抽样的方法,采用护理人员疼痛知识和态度问卷对58名广州市某三级医院的骨科护士进行调查,内容包括一般资料、术后疼痛管理知识和态度,调查数据采用SPSS13.0软件包进行描述性分析。结果:发放问卷58份,回收58份,有效回收率100%。护士的术后疼痛管理知识和态度(满分32分)平均分数14.67±2.60分。将问卷条目按测试目的不同分为4个部分,护士的疼痛评估(满分2分)得分1.43±0.62,一般知识(满分10分)5.76±1.82,药物镇痛(满分16分)7.09±1.92,综合应用(满分4分)0.40±0.65。结论:调查显示护士缺乏疼痛管理相关知识和存有错误的观念,需针对主要影响因素开展全员的培训、教育与考核,建立疼痛护理专业架构及成立疼痛专科护理小组,制定疼痛控制规章制度和实践指南,提高疼痛控制的质量。     

运用概念图护理查房对提高急诊低年资护士评判性思维能力的体会

目的观察概念图护理查房对急诊低年资护士评判性思维能力的影响。方法将急诊科参加工作3年内的30名护士随机分为实验组和对照组各15名,实验组采用概念图培训,对照组采用常规查房培训方法,并比较两组护士培训前后的考核成绩。结果两组护士培训前考核成绩差异无统计学意义,培训后实验组考核成绩显著优于对照组(P0.01)。结论概念图能帮助年轻护士将新知识与临床实践相结合,能较好的提高急诊低年资护士的评判性思维能力。     

急诊护士职业疲劳与社会支持状况调查分析

目的:了解急诊科护士的职业疲劳程度及社会支持状况并分析两者之间的联系,为临床护理管理提供科学依据。方法:采用疲劳量表以及社会支持量表对150名急诊科护士的疲劳状况及社会支持进行问卷调查。结果:急诊科护士职业疲劳高于非急诊护士,疲劳与社会支持情况呈显著负相关,即社会支持越少的护士疲劳感越强。尤其是主观感觉社会支持少,对社会支持利用度低的护士疲劳感更强。结论:提倡从各方面增加急诊科护士的社会支持水平,并有效引导她们充分合理利用身边的社会支持资源,以减轻职业疲劳,确保护理人员的身心健康,提高工作效率,保障护理质量及安全。     

急诊科低年资护士应急能力培训探讨

随着卫生事业的发展,医疗业务也不断扩展,医院聘用年轻的护理人员也越来越多。如何独立面对工作中的紧急情况,已成为低年资护士的主要工作压力。对急诊科低年资的护士如何培训,使他们尽快提高急救能力,减少护理安全隐患,确保护理质量,是护理管理者肩上的重任。为此,我院急诊科自2009年1月起,根据急诊科特点制定了一套对急诊科低年资护士培训考核的措施,并予以落实,取得较好成效,现总结报告如下。     

Healthcare-Associated Infections and Shanghai Clinicians: A Multicenter Cross-Sectional Study

Literature about healthcare-associated infection (HCAI) in China is scarce. A cross-sectional anonymous survey was conducted on 647 clinicians (199 physicians and 448 nurses) from six Shanghai hospitals (grades A–C) to investigate their cognizance, knowledge, attitude, self-reported practice, and risks regarding HCAI with emphasis on precautions. The mean overall score of HCAI knowledge was 40.89±11.4 (mean±SD; range, 13∼72) out of 100 for physicians and 43.48±9.9 (10∼70) for nurses. The respondents generally received high scores in hand hygiene, HCAI core concept, and healthcare worker safety but low scores in HCAI pathogen identification and isolation precautions. There were substantial variations in the knowledge scores of various demographic groups across individual hospitals and within hospital grades (ps<0.05). Within-hospital comparisons showed that the nurses were better than physicians particularly in hand hygiene knowledge in 4 hospitals (ps<0.05). Multiple linear regression analysis showed that longer work experience was inversely and independently associated with the overall and categorical knowledge of nurses, whereas independent associations between older age or higher education and categorical knowledge were noted for physicians. The respondents'' self-reported practices and adherence to standard precautions were less than satisfactory. This multi-center study reports a high level of cognizance, patchy knowledge, suboptimal adherence to infection control precautions, and self-protective attitudes among the practicing clinicians regarding HCAI, with potential safety risk to patients and healthcare providers. Providing quality learning resources, enforcing knowledge-informed practice, and promoting a healthcare safety culture are recommended as interventions. Future studies are warranted for social and behavioral aspects of healthcare safety with emphasis on infection control.     

医学研究生灾难医学知识的初步调查及对策

目的了解医学研究生对灾难医学相关知识的认知情况。方法通过发放调查问卷,对我校2008-2011年入学的458名医学研究生进行灾难医学相关知识调查分析。结果医学研究生对灾难医学的基本概念、基本急救技术、灾后心理援助以及传染病的预防及处理相关知识掌握较好,但对灾难伤员的检伤分类、灾难医学管理相关知识掌握明显不足。结论医学研究生掌握灾难医学相关知识已明显提高,但仍存在不足,应加强医学研究生急救技能培训、开设灾难医学选修课,以提高我国灾难医学救援整体水平。     

医学生突发公共卫生事件应对知信行调查

目的：了解医学生突发公共卫生事件相关知识、态度、行为现状,为制订干预措施提供依据。方法：采用多阶段抽样方法,共抽取某医学院1380名本、专科学生进行突发公共卫生事件知、信、行问卷调查。结果：突发公共卫生事件相关知识平均得分为（35.93±6.98）,总体知晓率为71.54%。其中女生高于男生（P=0.000）,本科生高于专科生（P〈0.000）,外省生源高于本省生源（P=0.001）,年级越高得分有增高的趋势（P=0.000）。40.8%的学生对突发公共卫生事件感到恐惧;80.0%的海医学生愿意了解突发公共卫生事件相关知识,并认为学校有必要开设相关课程及进行应急演练;仅有17.2%的学生曾和家人讨论过如何应对灾害事件,91.5%的学生从未与家人进行过逃生演练。结论：医学生对突发公共卫生事件相关知识掌握不全面,部分学生尚未建立正向的认知态度和健康的行为方式,学校应采取适当的方式加强突发事件知识和技能的训练。     

DISASTER CARE FOR 15 MILLION CALIFORNIANS

The urgency of the crisis following a nuclear attack staggers the imagination. We would have thousands or millions of survivors making a desperate struggle to survive. Safe water supplies and waste-disposal systems would be gone. In some areas, there would be little or no food or shelter.Yet California has already manned a medical arsenal that is second to none in the United States. We have stored 115 emergency hospitals at strategic points, and through the county medical associations we have appointed cadres including physicians, nurses and technicians. Plans have been made for workers who will assist in setting up the hospitals and first aid stations.In our future operations we will continue to place strong emphasis on the medical phase of our program of disaster care.The program would be just as essential in the event of major natural disaster as nuclear war.Our objective is a simple one. We are seeking to preserve the human resources which are necessary for recovery.California''s medical profession, with the allied professions of nursing and technical skills, has a vital interest in continuing operations to the maximum extent even under the most trying conditions.     

DEU教学模式在临床护理教学中的运用

目的探讨实习专用病房(Dedicated education unit,DEU)教学模式在临床护理实习教学过程中的应用效果。方法选择2019年6月17日~2020年3月15日在我科实习的2017级护理大专班实习护生106名,按教学方法的不同进行分组,其中使用传统带教方式的为对照组,采用DEU临床护理教学方法的为实验组。分析比较两组学生实习出科的考核成绩,包括理论知识、综合技能和实际运用能力。结果经过DEU临床护理教学后,实验组护生的理论知识和综合技能得分高于对照组,差异具有统计学意义(均P<0.05)。实验组护生对教学效果的满意度评价高于对照组,差异具有统计学意义(均P<0.05)。结论DEU教学模式在临床护理教学中的效果显著,有助于培养护生的临床综合能力,提高教学质量。     

急诊科护士正念度与心理弹性和职业倦怠的相关性分析

为了探讨急诊科护士正念度与心理弹性和职业倦怠的相关性,本研究采用整群抽样法对34名急诊科护士进行问卷调查,所有护士均接受一般状况调查表、五因子正念度问卷(FFMQ)、Conner-Davidson心理弹性量表(CD-RISC)简化版和职业倦怠问卷修订版(MBI-GS)调查。结果表明,急诊科护士情绪耗竭、去人性化、个人成就感的得分分别为(16.25±8.27)分、(16.84±9.17)分、(26.83±9.05)分。急诊科护士FFMQ得分(99.91±8.14)分,项目均分(2.56±0.57)分。急诊科护士CD-RISC得分(69.14±7.43)分,项目均分(2.77±0.54)分。初步结论表明,急诊科护士职业倦怠感严重,正念度与急诊科护士的心理弹性呈正相关,与职业倦怠感呈负相关,通过正念训练提高心理弹性可影响急诊科护士的职业倦怠感。     

Diabetes related knowledge among residents and nurses: a multicenter study in Karachi, Pakistan

ABSTRACT: BACKGROUND: Assessment of knowledge among resident trainees and nurses is very important since majority of patients admitted in hospital have underlying diabetes which could lead to adverse clinical outcomes if not managed efficiently. Therefore, the purpose of this study was to evaluate and compare the knowledge related to the management of diabetes among registered nurses (RN) and trainee residents of internal medicine (IMR), family medicine (FMR) and surgery (SR) at tertiary care hospitals of Karachi, Pakistan. METHODS: A validated questionnaire consisting of 21 open ended questions related to diabetes awareness was acquired through a study done at Thomas Jefferson University Hospital, Philadelphia with the permission of primary author. RESULTS: 169 IMR, 27 FMR, 86 SR and 99 RN completed a questionnaire that assessed the knowledge related to different aspects of management of diabetes. The results were further stratified by participant's specialty and level of training. The percentage of knowledge based questions answered correctly was found to be low. The overall mean correct percentage among all the participants was 50% +/- 21. There was no statistical difference in terms of knowledge between IMR & FMR residents (64% +/- 14 vs. 60% +/- 16, p = 0.47) respectively. The total scores of SR and RN were quite low (40 % +/- 16 & 31% +/- 15 respectively).SR and RN were found to have profound deficit in both inpatient and outpatient knowledge of diabetes. We did not observe any improvement in level of knowledge of FMR & SR with increase in duration of their training (p = 0.47 & 0.80 respectively). In contrast, improvement in the level of knowledge of IMR was observed from first to second year of their training (p = 0.03) with no further improvement thereafter. RN's didn't respond correctly on most of the items related to in-patient management of diabetes (Mean score 40% +/- 20). CONCLUSION: As there are no prior studies in our setting evaluating knowledge related to diabetes management among residents and nurses, this study is of paramount importance. Based on these results, considerable knowledge gaps were found among trainee residents and nurses pointing towards need of providing additional education to improve the delivery of diabetes care.     

军队医院中患者对医护工作的评价及需求调查

目的：本文通过调查部分军队医院患者对护理工作的评价及需求,为提高军队医院的护理服务质量提供有利资料。方法：随机抽取四所三级甲等军队医院的380名住院患：考进行问卷调查,调查患者对护理工作的满意程度及需求。结果：患者对护理服务技术满意度为43．2％,对态度满意度为37．3％,对环境和健康教育满意度分别为59．5％和55％;患者最需要的知识为康复知识,占46．1％;患者对护理人员热情工作态度的期许和需求最高,达到38．2％;其次为熟练工作技能,占28．4％。结论：从患者角度出发,真正落实以民文本的原则,切实为患者服务,改善护理服务质量已经成为护理领域的核心内容,应得到各个军队医院的重视,落实优质护理服务工作。     

广西新生儿专科护士的现况调查

目的了解并分析广西新生儿专科护士的现况,为广西新生儿专科护士的培训提供客观依据。方法通过查阅文献,结合广西新生儿专科护士培训方案及培训计划,采用自制调查表及自评式问卷对3期共163名广西新生儿专科护士进行培训技能需求调查,并对培训前、培训后的专科技能掌握现况进行自评。结果基本技能需求构成比为80.98%,重症护理需求构成比为93.25,外科护理需求构成比为51.53%,科研指导需求构成比为41.72%。培训前后新生儿专科基本技能和科研能力掌握评分比较,差异有统计学意义(P<0.05);新生儿重症护理技术和新生儿外科护理技术培训前后的评分比较,差异无统计学意义(P>0.05)。结论广西新生儿专科护士在重症护理技术和外科护理技术能力较低,系统、全面、规范的人才培养及培训有助于提高专科护士的专业技术水平。     

A cross-sectional study of the health effects of work schedules on 3212 hospital workers in France: implications for the new French work schedules policy

This study was designed to investigate the effects of work schedules on the health of hospital workers at the Assistance Publique-H?pitaux de Paris (AP-HP). Out of 40 hospitals, 17 volunteered to participate in this study. The Standard Shiftwork Index and a questionnaire concerning physicians' work schedules were used. Ten thousand questionnaires were distributed anonymously to hospital workers between March and April 1999. Professional categories comprised head nurses, nurses, nursing auxiliaries, hospital agents, midwives and full time physicians. Departments included internal and geriatric medicine, general paediatrics, orthopaedic and general surgery, operating and emergency rooms, and anaesthesiology and intensive care units. 3250 questionnaires were returned. Demographics for the respondents were: 79.2% female, average age 38.1 +/- 9.1 years old. Eleven work schedules were identified. One fourth of the personnel had fixed morning work schedules. The highest level of job satisfaction was found in personnel working in paediatrics while dissatisfaction was strongest in the gerontology and, emergency room personnel. General Health Questionnaire (GHQ) scores were high for head nurses, operating room nurses and junior doctors as well as for personnel with rotating and flexible shifts. This study will be used to make recommendations concerning the reduction of working time for French hospital workers.