供应室人员手卫生的干预措施及效果

目的:探讨提高供应室人员手卫生的干预措施,并对干预后的效果进行评价.方法:采用自制调查表的方法了解手卫生依从性差的原因,进而制定相应的干预措施.采用隐蔽式现场观察法对比手卫生干预前后手卫生依从性.结果:通过调查掌握了手卫生依从性差的原因,并制定了干预措施.干预前后医务人员手卫生执行水平分别为45.63％和70.26％,其中护士手卫生执行水平分别为49.75％和74.47％,护工手卫生执行水平分别为39.56％和63.97％,差异均有统计学意义.证明干预措施效果显著.结论:本调查显示我科室手卫生干预前医务人员手卫生依从性只有45.63％,其中护士手卫生依从性为49.75％,明显高于护工手卫生依从性(39.56％).且护士掌握正确洗手方法明显高于护工,但二者对洗手指征的掌握均很差.经过调查发现手卫生差的原因主要包括认识不足,知识缺乏;工作繁忙,依从性低;设备不足,操作麻烦;频繁洗手,损伤皮肤;从众心理,缺乏监管这五大方面.我院通过提高认识,增强培训;按劳分配,合理安排;更新用物,改善方法;完善制度,加强监控等干预措施,可以显著提高了全体工作人员手卫生的依从性.     

天津市三级医院医务人员手卫生现状调查

目的 调查天津市三级医院医务人员手卫生知识掌握情况,分析其影响因素。方法 采用问卷调查法,对目标人群开展调查研究。结果 医务人员手卫生知识水平较高,整体情况良好;不同性别、职称的医务人员手卫生知识得分差别有统计学意义（P<0.05）;手卫生设施是影响医务人员手卫生执行的主要因素。结论 手卫生水平的提高是一项长期任务,有关部门和医院管理者应加强管理,加大宣传教育,采取多种措施提高医务人员手卫生水平。     

医学伦理学教育提高医务人员手卫生依从性的效果评价

目的：通过在医务人员中开展医学伦理学教育,提高医务人员的手卫生依从性。方法：在进行常规的手卫生知识培训的基础 上进行医学伦理学教育的内容,通过对实施培训和教育前后收集到的资料进行统计分析,评价干预的效果。结果：通过干预,医务 人员的手卫生依从性提高,手卫生相关的消耗品使用量增加。结论：医学伦理学教育能够显著提高医务人员的手卫生责任意识, 提高手卫生的依从性。     

医务人员手卫生监测结果回顾性分析及对策

目的了解医务人员手部卫生状况,制定改进措施,预防医院感染。方法回顾性分析东南大学附属中大医院2007年1月至2010年12月医务人员手卫生监测资料1586份。结果医护手监测合格率为89．28％,医生手监测合格率为86．94％,护士手监测合格率为93．09％;重点病区医护手监测台格率为91．98％,普通病区医护手监测合格率为87．06％;该院医护手监测合格率为90．64％,进修、实习医护手监测合格率为88．17％,手部检出细菌184株,葡萄球菌属占49．46％,阳性杆菌占14．67％。结论医务人员对手的清洁与消毒仍缺乏足够的认识,应加强医务人员手卫生培训与监督,提高医务人员手卫生合格率。     

黑龙江省手术室专科护士培训需求分析

目的 了解手术室护士专科培训需求,为合理设置手术室专科护士培训内容,探索培训模式提供依据。方法 采用自拟问卷,对参加2013年黑龙江省手术室专科培训的学员进行问卷调查,采用SPSS 18.0进行卡方检验和非参数检验进行统计分析。结果 不同年龄以及不同职称的护士希望得到培训的内容有显著性差异（P ＜ 0.05）,教学方式与考核方式趋于多样化,以临床实际操作为主,OSCE考核被青年护士所接受。在学员培训内容重要性认知评价的9个方面中手术室专科知识最为重要。结论 重视和发展护士分层级核心能力,构建多样化的手术室专科护士培训模式,进一步提升专科护理培训质量。     

哈尔滨市某三级医院介入人员外照射个人剂量现况调查研究

目的:了解哈尔滨市某三级医院介入人员外照射个人剂量现况和本院辐射防护情况,以期为本院介入防护策略提供一定的科学依据。方法:按照《中华人民共和国国家职业卫生标准》(GBZ128-2016)版本要求,在2016年7月8号～2017年7月8号期间,采用双剂量计监测目标人群年外照射个人剂量,x2检验和logistic回归分析介入人员外照射个人剂量的影响因素。结果:年外照射最小个人剂量为0.08mSv,最大个人剂量为3.60mSv,平均个人剂量为0.23mSv,x2检验表明科室(x~2=50.420,P0.001)、职业类别(x~2=32.992,P0.001)、职称(x~2=33.806,P0.001)和学历(x2=9.289,P0.05)有统计学意义;logistic回归分析均表明,职称、工作年限、职业类别进入方程,但只有职称(Wals=4.896,P0.05)和职业类别(Wals=8.424,P0.05)有统计学意义,医务人员职称和职业类别(Wals=8.424,P0.05)是影响个人外照射剂量的因素。结论:本院总体外照射防护措施得当,本院从事介入工作的相关医务人员中,高级职称医务人员外照射个人剂量低于中、低级职称医务人员;技师外照射个人剂量高于护士和医生。根据本研究结果,在医院的外照射防护中应采取一些措施,比如合理分配工作,避免同一工种医务人员长时间暴露于介入相关外照射,避免中低级职称医生长时间接触介入相关外照射,加强医务人员防护意识,适当调整工作岗位,适时进行防护培训。     

肿瘤科护士预防导管相关性血流感染认知行为情况调查

目的调查肿瘤科护士预防导管相关性血流感染(CRSBI)的认知与行为情况。方法采用方便抽样法,应用自行设计的"预防CRSBI认知与行为问卷"对107名肿瘤科在职护士进行调查,并进行结果分析。结果 107名护士预防CRSBI知识得分20~105分,平均得分(54.95±14.77)分,平均正确率52.34%。预防CRSBI操作行为得分25~45分,平均得分(39.72±4.26)分。肿瘤科护士预防CRSBI认知情况与工作年限、技术职称和是否接受过CRSBI的知识培训有关,行为情况与是否接受过CRSBI的知识培训有关。结论应加强肿瘤科护士CRSBI相关知识的培训和考核,加强管控,进一步提高肿瘤科护士预防CRSBI的认知水平。     

外科手消毒前免刷手与刷手两种方法对术中不同时点手带菌情况的影响

比较外科手消毒前免刷手与刷手两种方法对术中不同时间节点手部带菌情况的影响。选取在本院工作的手术室医务人员共96名,使用计算机产生随机数字表将研究对象随机分配为无刷手组和刷手组各48名,无刷手组研究对象在洗手时不刷手,刷手组研究对象正常刷手,比较免刷手和刷手洗手法在使用同种消毒液后及术中不同时间节点的手不消毒效果、手部皮肤菌落种类和医务人员对于手部皮肤的评价。经研究发现,无刷手组和刷手组研究对象术中不同时间节点手部存活菌落数比较无显著统计学差异(p0.05)。两组各时间节点手部皮肤均有细菌检出,主要以凝固酶阴性葡萄球菌、棒状杆菌为主,肠球菌次之,两组比较无显著统计学差异(p0.05)。无刷手组对于手部皮肤的评价要明显高于刷手组(p0.05),差异有统计学意义。外科手消毒时,免刷手能够达到与常规刷手法同样的消毒效果,消毒时效能维持3 h以上,减免刷手步骤,操作简单且使用方便,对手部皮肤刺激较小,可在临床广泛推广使用。     

医务人员遭受医院暴力及对媒体作用的认知研究

目的 对医务人员遭受暴力事件的周期、类型、场所进行分析;对媒体医患报道行为方式进行评价,为规范媒体行为,减少医院暴力提供政策依据。方法 通过问卷星软件收集某省医务人员医院暴力发生情况及对媒体作用的认知情况等相关数据。结果 暴力发生频率相对较低,多发生在内科,以语言暴力为主;医务人员有60%以上对媒体的医患报道采取不可信和负面态度,且职称越高这一趋势越明显。结论 应在医患间建立良好的沟通机制,做好医患暴力应急,规范媒体行为,缓和紧张的医患关系。     

西部地区卫生工作者激励机制满意度研究

通过对中国西部较贫困4个省、自治区的卫生人力资源情况进行调查,了解中国西部欠发达地区卫生工作者对激励机制的满意度水平,探索影响满意度的因素,并提出建议。结果为卫生工作人员总体满意度均分为3.04分,其中,满意度最低的是工作回报方面,均分为2.22分,低于3分;满意度最高的是工作关系方面,均分为3.62分,高于3分。卫生工作人员学历和职称都与满意度相关,副高职称和硕士学历的满意度最低。     

Integrated scheduling of elective surgeries and surgical nurses for operating room suites

Facing an acute shortage of surgical nurses, operating room suites in China are more and more aware of the need to use surgical nurses efficiently. This goal is hard to achieve due to the strong interactions between the nurse and the surgery scheduling process. This paper addresses the benefit of integrating elective surgery and surgical nurse scheduling in terms of nurse utilization. First, an integer programming (IP) model is proposed to schedule elective surgeries and surgical nurses simultaneously. Then an efficient genetic algorithm (GA) is proposed based on the IP formulation due to the computational complexity of the integrated scheduling problem. A case study using real-life data is presented to validate the performance of the integrated approaches (the IP model and the GA) by comparing them with a two-stage approach that schedules elective surgeries and surgical nurses sequentially.     

加强手术室管理,控制医院感染

目的加强手术室医院感染的控制与管理,降低医院感染的发生率。方法针对手术室的工作特点,制定并落实各项有效的消毒隔离措施和感染监测制度,严格执行无菌操作规程,创造合格的手术环境。结果制定有效的手术室消毒隔离制度和感染监测制度,并通过医护人员的积极配合,创造合格的手术室环境,使无菌手术切口感染率下降至0.25%,特殊手术无医院感染发生。结论加强手术室医院感染的管理,可有效地防止医院感染的发生,降低无菌手术切口感染率。     

基于"艾宾浩斯理论"骨科实习带教量表的建立及意义

目的：本研究基于艾宾浩斯学习理论,制定一套量化的骨科护理临床教学管理纲要,对临床实习内容进行整理和评估,为实 习人员规范化培训提供参考。方法：通过中国知网数据库检索实习护理人员培训所涵盖的护理操作、心理、教育等方面的内容。采 用德尔菲（Delphi）法进行专家咨询,依据专家意见评估并筛选教学量表内容。基于艾宾浩斯学习理论确定不同科目的权重与频 次,建立临床带教管理量表。结果：临床带教管理量表包括3 项一级项目：基础操作、专科操作和健康宣教;43 项二级项目：静脉输 液、卧换、轴线翻身等。结论：临床带教管理量表的制定为实习人员规范化培训提供了可借鉴的方法,为提升临床带教效果奠定了基础。     

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。     

Nurse therapists in behavioural psychotherapy.

Five registered mental nurses (R.M.N.s) were trained over two years to become behavioural psychotherapists for adult neurotic disorders. They achieved results comparable to those obtained with similar patients and methods by psychologists and psychiatrists. Similar results were maintained when over a third year the therapists were seconded to work in four hospitals and a general practice. Patients were satisfied at being treated by nurses. After initial teething difficulties nurse therapists became valuable members of treatment teams during both training and secondment, becoming accepted by most nurses, psychologists, and psychiatrists with whom they came into contact. The training of further nurse therapists would facilitate treatment of many disabled neurotics who would otherwise go without effective treatment. Training nurse therapists takes less time and money than training psychologists and psychiatrists because less of their education is redundant to the skills involved. The pool of R.M.N.s suitable for training is much larger than that of psychiatrists and psychologists. The nurse therapists can be integrated relatively easily into treatment teams. The present nursing structure imposes restrictions on the advancement of clinical nurse specialists and a clinical tree is badly needed parallel with present administrative and teaching hierarchies. An 18-month course in adult behavioural psychotherapy has been recognized by the Joint Board of Clinical Nursing Studies for England and Wales so that nurse therapists seem destined to be a lasting feature of future treatment teams.     

Satiation differentially affects performance in a learning assay by nurse and forager honey bees

When not satiated prior to training, there were no differences between foragers and nurse honey bees in the acquisition of an appetitively based conditioned response in an olfactory associative learning assay, but when satiated foragers showed faster acquisition than did nurses. Satiation-related differences between foragers and nurses were more a function of behavioral state than age, because satiated precocious foragers also showed faster acquisition rates than did satiated nurse bees, despite their similar ages. Tests of sucrose responsiveness and retention of conditioned responses indicate that the observed performance differences between nurses and foragers were more likely due to differential sensitivity of sensory and motor processes related to satiation rather than differences in cognitive ability.     

Postpartum women’s perception of antenatal breastfeeding education: a descriptive survey

Mexico has shown a worrisome decrease in breastfeeding indicators, especially in the lowest socioeconomic level. Improving breastfeeding protection, promotion, and support services through workforce development is a key area of intervention. The objective of this study is to assess the influence on breastfeeding knowledge and abilities of a semi-virtual training for primary healthcare providers assisting beneficiaries of PROSPERA in Mexico, which is one of the largest conditional cash-transfer programs in the world. Two independent cross-sectional samples of healthcare providers were drawn at baseline and post-intervention in three states of Mexico. Baseline data were collected among primary physicians, registered nurses and nurse technicians (i.e. unit of analysis) on July 2016 (n = 529) and post-training between March and April 2017 (n = 211). A 19-item telephone questionnaire assessed providers’ general knowledge about breastfeeding, breastfeeding benefits and clinical aspects of breastfeeding, clinical ability to solve problems and abilities to overcome breastfeeding challenges. The effects of the training were assessed through a propensity score matching (PSM) stratified by types of providers (i.e. physicians, registered nurses, nurse technicians). The PSM analysis showed significant improvements among all providers in the general knowledge about breastfeeding (around 20 percentage points [pp]) and knowledge about breastfeeding benefits (approximately 50 pp). In addition, physicians improved their knowledge about clinical aspects of breastfeeding (7 pp), while registered nurses improved in their ability to solve breastfeeding problems (14 pp) and in helping mothers overcome breastfeeding challenges (12 pp). Promoting a breastfeeding enabling environment in Mexico to improve breastfeeding rates will require improving the knowledge and skills of healthcare providers. While a semi-virtual training showed large improvements in knowledge, developing skills among providers may require a more intensive approach.     

Coronary Care Units—The Status in California

In order to determine the status of Coronary Care Unit activity in California hospitals, especially as it pertains to nurse training, a survery was conducted by the California State Department of Public Health. More than 95 percent of hospitals that were questioned responded. Only one-third of the hospitals reported they neither had a unit nor plans to build one. All units in operation were either directed by an individual medical director or by a Coronary Care Unit Committee.The survey indicated that in some hospitals with operational units, nurses were not permitted to perform life-saving resuscitative procedures. All operational units reported in-service education programs of some type. Many hospitals indicated they would like to have Coronary Care Unit training programs to which they could send nurses. The reasons why nurses may not perform important resuscitative procedures are discussed as well as the need for Coronary Care Unit training programs for both physicians and nurses in California.