加强护理风险管理的思路和体会

护理风险是指医院内患者在护理过程中有可能发生的一切不安全事件。护理风险始终贯穿在护理工作的各个环节,如何有效识别、衡量、规避风险做到预防护理缺陷、纠纷和护理事故的发生,病区护士长作为一线的管理者责无旁贷。笔者根据自己的工作经验提出一些思路和体会现介绍如下。     

产科常见护理纠纷原因

近年来,由于患者维护自身权力意识增强,而护理人员法制观念淡薄,自我保护意识差等原因,常常发生一些护理纠纷,给工作和生活带来不必要的麻烦,究其原因如下:     

常见护患纠纷分析与对策

随着法律意识的普及,患者的维权和自我保护意识明显增强,对医院护理质量和服务水平的要求日益提高,以致近几年医院的护理纠纷呈上升趋势。严重的纠纷还使医院的正常工作秩序受到极大的干扰,并造成一定的经济损失。笔者对2004年1月-2006年3月的12起护理纠纷的发生原因及防范,从管理的角度进行分析,以寻求有效的控制方法,最大限度的降低其发生率。     

护理投诉的原因分析及防范措施

目的 分析护理投诉的原因,制订有效的防范措施,加强护患关系,提高服务质量,减少护理纠纷的发生. 方法 采用回顾性的方法对本院2007年1月-2011年6月23例病人对护理投诉的原因进行分析.结果 护理投诉服务态度差占26.1％、沟通不到位占21.7％、护理技术操作欠缺占17.4％及医疗费用问题占17.4％.结论 通过转变服务观念、加强护患沟通、树立法制观念、规范医疗收费等措施,预防减少护患纠纷的发生,构建和谐护患关系.     

影响急诊护患关系的相关因素及对策

目的探讨急诊护患纠纷的原因与防范对策。方法对26例急诊医疗纠纷进行分类和原因分析。结果发生急诊医疗纠纷的原因主要是护士业务水平不高、护患沟通不良、责任性不强、医疗费用问题、就医流程不合理、法律意识不强等。结论应加强急救理论和技能的培训、增强服务意识和法律知识、合理收费、规范就医流程、实行人性化管理等措施,能有效防范急诊护理工作中护患纠纷的发生。     

失效模式与效应分析法在护理安全管理中的应用

目的 通过失效模式与效应分析法评估医院血液科护理风险的薄弱环节,探究护理风险的发生原因,并提出有针对性的改进措施。 方法 采用FMEA法对血液科护理风险进行识别。结果 分析得出血液科护理风险由高至低依次为输血风险、用药风险、职业暴露、针刺伤、坠床跌倒、患者投诉、压疮和医疗器械风险。结论 失效模式与效应分析法可以用于血液科护理风险的识别,在识别结果基础上制定改进措施,可以有效地避免护理风险,保证患者安全。

     

对急诊护理操作实施风险管理的探讨

目的:探讨风险管理在防范急诊医疗纠纷和投诉中的作用。方法:对急诊工作中高风险的护理行为制订风险管理制度,并组织全体护士认真学习。管理者随时督导检查讲评制度落实情况。不断完善和修订制度。结果:实施风险管理1年多,密切了护患关系,变"家长制"护理操作模式为"理解配合"型护理操作模式,降低了纠纷和投诉的发生率。结论:在急诊护理操作中实施风险管理体现了尊重病人意愿的"人性化管理"思想,在护士和病人间架起了一座沟通的桥梁,经护患双方共同努力将高风险因素降至最低限度,受益的不仅是病人还有护理人员,达到了降低护理纠纷和投诉发生的目的。     

产科常见护理纠纷原因

近年来,由于患维护自身权力意识增强,而护理人员法制观念淡薄,自我保护意识差等原因,常常发生一些护理纠纷,给工作和生活带来不必要的麻烦,究其原因如下。     

常见护理纠纷的原因分析与防范措施

护理纠纷是指患者在医院就诊,对护理工作不满意而与护理人员发生争执而引起的纠纷.近年来,随着社会的发展,患者及家属法律意识不断增强,护理纠纷发生的频率越来越高,对医院声誉和护理人员的形象造成了不良影响.     

临床护理教学中的护理安全管理

护理安全是指在实施护理的全过程中,患者不发生法律和法规允许范围以外的心理、机体结构或功能上的损害、障碍、缺陷或死亡。临床护理教学是护理工作的一部分,也是培养护理人才的必经之路,然而临床护理教学过程中存在的安全隐患易被忽视,容易导致医疗护理纠纷。如何提高对护理安全重要性的认识,减少教学中护理安全问题的发生,营造带教安全文化环境,是每位教育者应尽的责任。     

六种藓类植物茎的比较解剖学研究

通过对6种藓类植物,即褶叶青藓(Brachythecium salebrosum(Web.et Mohr.)B.S.G.)、湿地匐灯藓(Plagiomnium acutum(Lindb.)Kop.)、侧枝匐灯藓(Plagiomnium maximoviczii(Lindb.)Kop.)、大凤尾藓(Fissidensnobilis Griff.)、大羽藓(Thuidium cymbifolium(Doz.et Molk.)B.S.G.)和大灰藓(Hypnum plumaeforme Wils.)嫩茎和老茎的石蜡切片和显微观察发现,同一藓类植株的嫩茎和老茎,茎结构稳定,不同种藓类植物茎横切面具有不同特征.植物体茎横切面形状、表层细胞的层数、细胞大小和细胞壁厚薄、皮层细胞大小和形状、中轴的有无以及比例等特征可以作为藓类植物的分科分类依据之一.     

Cause of Senescence of Nine Sorts of Flowers

The levels of endogenous phytohormones and respiratory rate in nine sorts of flowers such as Cymbidium faberi Rolfe, Nopalxochia ackermannii Kunth and others were investigated both at full bloom and senescence and meanwhile the effect of exogenous phytohormones on prolonging the blossoms and promoting ethylene production were tested. There is a high content of endogenous ethylene in all the long-lived flowere, about 3–16 folds higer than the short-lived ones. There is a high level of ABA at full blooming flowers of short-lived flowers, in which there is no or only some cytokinins in it, but the ratio of CTK (6BA+zeatin)/ABA is smaller(l.7). The endogenous ABA reached a much higher level at senescence in all nine sorts of flowers, so it is reasonable to consider that it is ABA which plays an important role of regulation in controlling flower's senescence. There is a much higher level of GA3 and zeatin in the long-lived flowers which is not demonstrated in the shortlived ones. The respiratory rate is one of the factors controtling the longevity of flowers, but it does not play a decided role. Application of 6BA and zeatin prolongs distinctly orchid’s longevity, however exogenous IAA through the promotive action on ethylene production, evidently extends the longevity of the flowers of the Nopalxochia ackermannii Kunth.     

龙胆科药用植物化学成分的研究现状

龙胆科植物在我国的分布范围很广,且多数为药用植物,其多数种属的药用植物,至今其化学成分尚未被系统研究。综述了目前龙胆科药用植物的化学成分的研究现状及一般提取方法,对近年来发现的环烯醚萜及裂环烯醚萜类化合物进行了总结,为本科药用植物的更深入研究提供了参考。     

真菌类遗传学分析的知识结构教学

本文以认知结构理论为指导,讨论了真菌类遗传分析与高等动植物遗传分析的内在联系,认为利用这种内在联系进行教学可收到好的效果并说明了作者的具体教学过程。 Abstract:In the paper, the relationship between genetic analysis of Fungi and genetic analysis of high animal and plant was discussed.A good results were obtained when we adopted this method in the teaching.     

The effects of glutamine of the maintenance of embryogenic cultures of Cryptomeria japonica

Summary Embryogenic tissues of sugi (Cryptomeria japonica) were induced on a modified Campbell and Durzan (CD) medium containing 1 μM 2,4-dichlorophenoxyacetic acid (2,4-D) and 600 mg l⁻¹ glutamine, and subcultured in the medium of the same composition for over 1 yr. This resulted in a mixed culture of embryogenic and non-embryogenic cells. When embryogenic cells were isolated and cultured independently, their capacity to form embryogenic aggregates was lost. Thus, the non-embryogenic cells present within a mixed culture system were essential to the formation of embryogenic aggregates. When embryogenic tissues were isolated and cultured independently on a high glutamine-containing (2400 mg l⁻¹) medium, dry weights and endogenous levels of glutamine increased, and the tissue could generate a large number of embryogenic aggregates. Amino acid analysis of embryogenic and non-embryogenic cells from the maintenance culture indicated a higher level of glutamine was present in the latter. The high endogenous level of glutamine in the non-embryogenic portion of mixed cell masses may be the supplier of glutamine for maintaining the embryogenic property of the tissues.     

Specificity of action of piperidylcholine derivatives as substrates of cholinesterases of various origin

The review deals with study of enzymologic properties of a novel highly specific acetylcholinesterase substrate, N-(β-acetoxyethyl) piperidinium iodomethylate (“piperidylcholine”), and its 30 derivatives that were tested as effectors of cholinesterases of mammals and various species of Pacific squids. It was proven for the first time that responsible for specificity of action was structure of cyclic ammonium grouping of the alcohol part of molecule of the ester substrate. Analysis of specificity is performed based on enzymatic hydrolysis parameters—activity of catalytic center of cholinesterases and bimolecular constant of the reaction rate that are determined at optimal and low substrate concentrations. Among the specially synthesized group of thioester compounds there is revealed one more highly specific acetylcholinesterase substrate—N-(β-acetoxyethyl) piperidinium.     

医疗机构合理用药评价模型的构建研究

目的 针对医疗机构的合理用药水平进行评价研究。方法 根据医疗机构合理用药的具体要求,构建医疗机构合理用药评价指标体系,采用基于模糊群决策的方法和多指标评价分析法构建医疗机构合理用药评价模型。结果 构建了基于模糊群决策的医疗机构合理用药评价模型,并通过实例分析证明了评价模型的可行性。结论 建立的基于模糊群决策的医疗机构合理用药评价模型能够对医疗机构的合理用药水平进行科学评价,为提高医疗机构合理用药水平奠定基础。     

Photoregulation of seed germination of wild-type and of an aurea-mutant of tomato

Seed germination of an aurea mutant of tomato ( Lycopersicon esculentum Mill.) is promoted by continuous irradiation with red, far-red or long-wavelength far-red (758 nm) light as well as by cyclic irradiations (5 min red or 5 min far-red/25 min darkness). Far-red light applied immediately after each red does not change the germination behaviour. Seed germination of the isogenic wild-type, cv. UC-105, is promoted by continuous and cyclic red light while it is inhibited by continuous and cyclic far-red light and by continious 758 nm irradiation. Far-red irradiation reverses almost completely the promoting effect of red light. The promoting effect (in the aurea mutant) and the inhibitory effect (in the wild-type) of continuous far-red light do not show photon fluence rate dependency above 20 nmol m⁻² s⁻¹. It is concluded that phytochrome controls tomato seed germination throgh low energy responses in both the wild type and the au mutant. The promoting effect of continuous and cyclic far-red light in the au mutant can be attributed to a greater sensitivity to P_fr.