手术室护理安全隐患风险与防范措施探讨

目的:探讨手术室护理安全隐患风险与防范措施,以提高手术室护理质量,确保手术室护理安全。方法:结合我院手术室情况,回顾性分析当前手术室护理安全隐患风险,并提出相应的防范措施。结果:制定手术室安全防范措施,加强手术室护理人员的专业技能培训,把手术室护理的安全隐患控制在萌芽状态,医疗差错明显减少,患者护理满意度高。结论:查找手术室护理安全隐患风险,实施针对性的防范措施,有利于减少安全隐患的发生率,提高手术室护理质量,保证患者生命安全。     

浅谈消化内科老年患者护理安全隐患

目的:探讨消化内科住院患者的护理中所存在的安全隐患,并采取相应的护理措施,防止差错事故的发生。方法:评估消化内科住院患者的住院期间的安全隐患因素,并进行分析探讨,提出护理安全问题,制定有效防范措施。结果:患者住院期间有效避免和减少了护理差错事故及不安全事件发生。结论:通过采取一些积极有效的护理措施,提高了护理安全,使护理隐患得到大大降低。     

探讨手术室护理不安全因素分析与方法措施

目的分析手术室护理不安全因素和应对措施的实施效果。方法本研究对2013年手术室护理风险事件进行回顾性分析,探讨手术室护理不安全因素,并在2014年的工作中实施应对措施,对比2013年和2014年手术室护理风险事件发生率的差异。结果经过数据统计发现,2014年手术室护理风险事件发生率明显低于2013年,有显著的统计学差异(P0.05)。结论手术室护理不安全因素包括电灼伤、压疮、标本遗失等,通过建立健全并严格执行规章制度、规范化操作可有效预防护理风险。     

关于外科手术室感染控制的问题与护理管理分析

目的:总结外科手术室感染控制存在的问题,并分析相应的护理管理对策。方法:对我院2012年1月-2012年12月手术室感染高危因素进行总结分析,并提出相应的护理管理措施,比较外科手术室实施护理管理前后的感染情况。结果 外科手术室感染高危因素主要包括术前洗手不彻底、器械物品消毒不认真、医护人员流动管理不严格、以及患者自身的因素等;实施护理管理措施后感染率为2.39%(9例/376例),明显低于实施护理管理前的感染率9.52%(35例/368例),差异有统计学意义(P<0.05)。结论:在外科手术室加强护理管理可以明显的降低感染率,为患者在外科手术室的安全提供了保障。     

产科病房安全管理的潜在隐患及防范对策

目的:探讨产科病房安全管理的潜在隐患,并针对隐患采取防范措施,有效的控制产科病室医院感染的发生.方法:针对产科病房的安全隐患进行因素分析,并提出针对性护理预防措施.结果:对存在的护理问题和可能出现的差错苗头及时采取改进措施和效果评价反馈,将差错、事故消灭在萌芽中.结论:产科病房病区需配备具有高度责任心和有爱心的医护人员实施母、婴统一体的护理制度.在护理过程中强化防范意识;在健康教育中强化安全意识,贯彻以母婴为中心的思想,才能保证产科母婴病房的安全、舒适、和谐.     

浅谈手术室护理记录单存在的问题分析及改进策略

目的:分析总结手术室护理记录单存在的问题,查找原因并提出改进策略,以规范手术室护理记录单的书写,减少医疗纠纷,提高护理质量。方法:随机抽取我院手术室护理记录单2000份进行检查,分析存在的质量问题。结果:2000份手术室护理记录单中,检查出不合格护理记录单42份,将存在的问题进行分类总结,分析原因并制定改进措施。结论:针对手术室护理记录单存在的问题,提出了改进措施,维护了医患双方的合法权益,减少了医疗纠纷的发生,提高了手术室护理质量。     

临床用药风险管理常见问题及应对措施

目的：对我院不安全用药行为进行监测与调查,分析临床用药问题中存在的风险因素,探讨医疗机构加强药品风险管理的措施,以减少临床用药的安全隐患。方法：采用调查问卷的方式,对我院部分科室就诊患者的用药情况进行问卷调查;应用“医院用药安全监测与评价”软件对我院医护人员在临床用药管理方面存在的风险因素进行评估,整理并分析调查结果。结果：在本次临床用药风险分析中,各因素所占比例为：医生：30.50%,药师：9.00%,护士：32.00%,患者：28.50%。了解临床用药各环节中存在的临床用药风险的医护人员占83.3%,但只有50.6% 的人员采取基本的防范措施。用药风险警示调查显示：PASS 警示有效率为57.5%;关联因素评价中人员因素的发生率最高55.16%;外界因素次之31.29%;药物因素发生率为26.95%。结论：医疗机构应当加强临床用药管理,识别、分析用药风险因素,强化合理用药意识及知识,努力构建临床用药风险控制系统,为医药护理人员及患者营造良好的医疗安全氛围,从而降低用药风险的发生,保障患者的用药安全。     

临床用药风险管理常见问题及应对措施 *

摘要 目的： 对我院不安全用药行为进行监测与调查, 分析临床用药问题中存在的风险因素, 探讨医疗机构加强药品风险管理的 措施,以减少临床用药的安全隐患。方法： 采用调查问卷的方式,对我院部分科室就诊患者的用药情况进行问卷调查; 应用 “医院 用药安全监测与评价” 软件对我院医护人员在临床用药管理方面存在的风险因素进行评估, 整理并分析调查结果。结果： 在本次 临床用药风险分析中, 各因素所占比例为： 医生： 30.50%,药师： 9.00%, 护士： 32.00%, 患者： 28.50%。了解临床用药各环节中存在的 临床用药风险的医护人员占 83.3%,但只有 50.6% 的人员采取基本的防范措施。用药风险警示调查显示： PASS 警示有效率为 57.5%; 关联因素评价中人员因素的发生率最高 55.16%;外界因素次之 31.29%; 药物因素发生率为 26.95%。结论： 医疗机构应当 加强临床用药管理, 识别、分析用药风险因素, 强化合理用药意识及知识, 努力构建临床用药风险控制系统,为医药护理人员及患 者营造良好的医疗安全氛围, 从而降低用药风险的发生, 保障患者的用药安全。 关键词：     

风险意识用于手术室护理护理的效果观察

目的:分析手术室护理中行风险意识的护理效果。方法:抽选我院手术室2011年4月-2015年3月收治患者200例作为对象,按入院意愿分成不同组:对照组(基础护理)、干预组(风险意识护理),护理结束后评估总体效果。结果:干预组预后的风险者2例,占比2.0%,和10.0%的对照组相比较低,有区别,P0.05。结论:临床针对手术室患者行风险意识护理作用突出,可降低风险事件,提高护理效果,值得学习。     

手术室非惩罚性护理不良事件报告制度的建立

手术室护理不良事件发生率影响因素较多,建立非惩罚性护理不良事件报告制度是非常有效的控制不良事件的方法。通过在本院手术室建立非惩罚性护理不良事件报告制度,对上报的护理不良事件分析发生的根本原因并提出修正方案及预防措施,提升护理质量,完善护理流程及管理制度。     

On the origin of the Hirudinea and the demise of the Oligochaeta

The phylogenetic relationships of the Clitellata were investigated with a data set of published and new complete 18S rRNA gene sequences of 51 species representing 41 families. Sequences were aligned on the basis of a secondary structure model and analysed with maximum parsimony and maximum likelihood. In contrast to the latter method, parsimony did not recover the monophyly of Clitellata. However, a close scrutiny of the data suggested a spurious attraction between some polychaetes and clitellates. As a rule, molecular trees are closely aligned with morphology-based phylogenies. Acanthobdellida and Euhirudinea were reconciled in their traditional Hirudinea clade and were included in the Oligochaeta with the Branchiobdellida via the Lumbriculidae as a possible link between the two assemblages. While the 18S gene yielded a meaningful historical signal for determining relationships within clitellates, the exact position of Hirudinea and Branchiobdellida within oligochaetes remained unresolved. The lack of phylogenetic signal is interpreted as evidence for a rapid radiation of these taxa. The placement of Clitellata within the Polychaeta remained unresolved. The biological reality of polytomies within annelids is suggested and supports the hypothesis of an extremely ancient radiation of polychaetes and emergence of clitellates.     

On the ontogeny of the haptor and the evolution of the Monogenea

Data on the ontogeny of the posterior haptor of monogeneans were obtained from more than 150 publications and summarised. These data were plotted into diagrams showing evolutionary capacity levels based on the theory of a progressive evolution of marginal hooks, anchors and other attachment components of the posterior haptor in the Monogenea (Malmberg, 1986). 5 + 5 unhinged marginal hooks are assumed to be the most primitive monogenean haptoral condition. Thus the diagrams were founded on a 5 + 5 unhinged marginal hook evolutionary capacity level, and the evolutionary capacity levels of anchors and other haptoral attachement components were arranged according to haptoral ontogenetical sequences. In the final plotting diagram data on hosts, type of spermatozoa, oncomiracidial ciliation, sensilla pattern and protonephridial systems were also included. In this way a number of correlations were revealed. Thus, for example, the number of 5 + 5 marginal hooks correlates with the most primitive monogenean type of spermatozoon and with few sensillae, many ciliated cells and a simple protonephridial system in the oncomiracidium. On the basis of the reviewed data it is concluded that the ancient monogeneans with 5 + 5 unhinged marginal hooks were divided into two main lines, one retaining unhinged marginal hooks and the other evolving hinged marginal hooks. Both main lines have recent representatives at different marginal hook evolutionary capacity levels, i.e. monogeneans retaining a haptor with only marginal hooks. For the main line with hinged marginal hooks the name Articulon-choinea n. subclass is proposed. Members with 8 + 8 hinged marginal hooks only are here called Proanchorea n. superord. Monogeneans with unhinged marginal hooks only are here called Ananchorea n. superord. and three new families are erected for its recent members: Anonchohapteridae n. fam., Acolpentronidae n. fam. and Anacanthoridae n. fam. (with 7 + 7, 8 + 8 and 9 + 9 unhinged marginal hooks, respectively). Except for the families of Articulonchoinea (e.g. Acanthocotylidae, Gyrodactylidae, Tetraonchoididae) Bychowsky's (1957) division of the Monogenea into the Oligonchoinea and Polyonchoinea fits the proposed scheme, i.e. monogeneans with unhinged marginal hooks form one old group, the Oligonchoinea, which have 5 + 5 unhinged marginal hooks, and the other group form the Polyonchoinea, which (with the exception of the Hexabothriidae) has a greater number (7 + 7, 8 + 8 or 9 + 9) of unhinged marginal hooks. It is proposed that both these names, Oligonchoinea (sensu mihi) and Polyonchoinea (sensu mihi), will be retained on one side and Articulonchoinea placed on the other side, which reflects the early monogenean evolution. Except for the members of Ananchorea [Polyonchoinea], all members of the Oligonchoinea and Polyonchoinea have anchors, which imply that they are further evolved, i.e. have passed the 5 + 5 marginal hook evolutionary capacity level (Malmberg, 1986). There are two main types of anchors in the Monogenea: haptoral anchors, with anlages appearing in the haptor, and peduncular anchors, with anlages in the peduncle. There are two types of haptoral anchors: peripheral haptoral anchors, ontogenetically the oldest, and central haptoral anchors. Peduncular anchors, in turn, are ontogenetically younger than peripheral haptoral anchors. There may be two pairs of peduncular anchors: medial peduncular anchors, ontogentically the oldest, and lateral peduncular anchors. Only peduncular (not haptoral) anchors have anchor bars. Monogeneans with haptoral anchors are here called Mediohaptanchorea n. superord. and Laterohaptanchorea n. superord. or haptanchoreans. All oligonchoineans and the oldest polyonchoineans are haptanchoreans. Certain members of Calceostomatidae [Polyonchoinea] are the only monogeneans with both (peripheral) haptoral and peduncular anchors (one pair). These monogeneans are here called Mixanchorea n. superord. Polyonchoineans with peduncular anchors and unhinged marginal hooks are here called the Pedunculanchorea n. superord. The most primitive pedunculanchoreans have only one pair of peduncular anchors with an anchor bar, while the most advanced have both medial and lateral peduncular anchors; each pair having an anchor bar. Certain families of the Articulonchoinea, the Anchorea n. superord., also have peduncular anchors (parallel evolution): only one family, the Sundanonchidae n. fam., has both medial and lateral peduncular anchors, each anchor pair with an anchor bar. Evolutionary lines from different monogenean evolutionary capacity levels are discussed and a new system of classification for the Monogenea is proposed.In agreeing to publish this article, I recognise that its contents are controversial and contrary to generally accepted views on monogenean systematics and evolution. I have anticipated a reaction to the article by inviting senior workers in the field to comment upon it: their views will be reported in a future issue of this journal. EditorIn agreeing to publish this article, I recognise that its contents are controversial and contrary to generally accepted views on monogenean systematics and evolution. I have anticipated a reaction to the article by inviting senior workers in the field to comment upon it: their views will be reported in a future issue of this journal. Editor