PDCA循环在提高肿瘤患者输液港护理依从性的应用

目的 探讨PDCA循环在提高肿瘤患者输液港护理依从性的应用效果.方法 选取2018年2～8月我院收治的504例输液港置管的肿瘤患者按随机分配原则分为对照组240例和观察组264例,对照组给予一般治疗和常规管理,观察组在对照组基础上实施PDCA循环管理,观察两组患者的并发症发生情况、输液港护理依从性,并进行统计分析.结果...     

静脉输液患者的心理护理

静脉输液是临床上迅速有效的治疗手段 ,在静脉穿刺中对患者进行的心理护理是减轻患者痛苦 ,提高静脉穿刺成功率的重要环节。为了具体掌握静脉穿刺中的心理护理重点 ,笔者在临床工作中作了一些探索并加以总结。现报告如下。1　临床资料和方法　　随机抽出老、幼、中青年静脉输液患者 43例 ,分为无心理护理组 1 7例 ,有心理护理组 2 6例 ,两组对比观察。　　有心理护理组按如下 5种方法对患者进行护理。 (1 )希望法。直接向患者介绍通过输液治疗后的效果 ,尤如在患者眼前展现一条通往康复的希望之路 ,可对患者说些“对你来说 ,输液的效果最好…     

护理风险管理在小儿头皮静脉输液中的应用效果观察

目的:观察护理风险管理在小儿头皮静脉输液中的应用效果。方法:选择在2011年7月-2012年7月期间在我院进行头皮静脉输液的80例儿童患者,将这80例患者随机地进行分组,分为观察组和对照组各40例。对对照组的40例患者进行常规的儿童输液护理,对观察组40例患者在进行常规护理的基础上再给予护理风险管理。对两组患者在接受不同护理后的护理效果、输液过程中患儿发生不良事件的概率以及患儿家属对护理满意度等情况进行观察对比。结果:经过一段时间观察,观察组40例患儿在接受护理风险管理后,取得了满意效果,患儿的护理效果明显提高,患儿家属对护理的满意程度也明显优于对照组,两组形成的差异大,在统计学方面具有意义(p0.05)。同时,观察组患儿在输液过程中发生不良事件的概率也明显低于对照组,两组比较形成差异大(p0.05)。结论:对需要输液的儿童患者进行护理风险管理,有助于提高护理效果,帮助提高护理的质量以及患儿家属对护理的满意度,在对患儿进行头皮静脉输液的过程中减少不良事件的发生,说明护理风险管理在小儿头皮静脉输液的过程中效果极佳,值得在临床中应用和推广。     

优质护理服务在门诊输液室实施的效果评价

目的探讨门诊输液室开展优质护理服务的实施效果。方法 2011年1～12月在门诊输液室实施优质护理服务,与2010年1～12月未实施优质护理服务进行比较,评价对比实施优质护理服务前后患者的满意度及护理投诉事件发生率。结果实施优护理服务后,患者对输液环境、护士技术水平、服务态度、仪容仪表及健康教育等5个方面的满意度较2010年均有所提高。患者对护理的投诉事件有所下降。结论在门诊输液患者中实施优质护理服务有助于改善服务质量,提高患者及家属的满意度,密切了护患关系,降低护理投诉事件的发生。优质护理服务是提高病人满意度和赢得医疗市场的重要保证。     

护士优化组合在门急诊输液室护理管理中的应用

目的探讨护士优化组合在门急诊输液室护理管理中的实施效果。方法我院于2014年6月~2015年5月以来对输液室护士实行"将点兵"、"兵点将"的双向选择组合方式进行优化组合,并选择2013年6月~2014年5月随机排班护士进行对照观察,并比较两组护理工作效率和患者满意度。结果护士优化组合后患者的等待时间及护理差错和护理投诉的发生率均低于对照组,护士优化组合在技术水平、护理态度和输液室环境等方面的满意率均高于对照组。结论门诊输液室护士实施优化组合管理可降低护理差错,提高护理工作效率,提高患者满意度,值得在护理管理工作中推广应用。     

临床浅静脉输液存在问题及改进体会

浅静脉输液是临床治疗中最基本的给药方法,也是护理工作的重要内容之一。能否顺利地给患者进行输液,关系到医护质量,甚至影响到医护患关系。本文探讨了如何将治疗药物准确输入患者体内,顺利完成输液,减少输液导致不良反应的因素。     

情景游戏干预对门诊输液室学龄前儿童输液治疗的影响

目的探讨情景游戏干预对门诊输液室学龄前儿童输液治疗的影响。方法按时间段法将100例门诊输液室学龄前儿童分为对照组和干预组各50例,对照组按门诊儿童输液护理常规进行护理,干预组在对照组基础上实施情景游戏干预,比较两组患儿输液治疗的一次穿刺成功率、依从性、患儿家属对护理工作的满意度。结果干预组患儿输液治疗的一次穿刺成功率、依从性、患儿家属对护理工作满意度均优于对照组,差异均具有统计学意义(均P0.05)。结论情景游戏干预有利于提高门诊输液室学龄前儿童输液依从性、静脉穿刺一次成功率,使输液疗程能顺利完成,同时也提高了患儿家属对护理工作的满意度。     

全程关护护理模式在放射性粒子植入治疗肝癌患者中的应用

目的探讨在B超或CT引导下经皮穿刺组织间植入125I放射性粒子治疗中晚期肝癌的护理方法。方法对2015年1月~2016年12月在我院行B超或CT引导下125I放射性粒子植入治疗的50例患者实施全程关护护理模式,包括术前评估及干预、术中护理、术后护理、营养干预、出院指导。结果 50例患者对放射防护相关知识完全知晓,均能顺利配合治疗及护理,护理满意度达98.0%;本组患者中主要并发症为穿刺部位轻度疼痛6例,穿刺口少量渗血3例。结论 B超或CT引导下经皮穿刺组织间植入125I放射性粒子治疗中晚期肝癌是一种安全、有效的微创介入法,并发症轻、发生率低,通过全程关护护理干预可提高患者对放射性粒子植入防护相关知识知晓率,提高防护意识,从而提高患者满意度及生活质量。     

手术室静脉输液风险的预见性干预研究进展

<正>静脉输液是利用大气压和液体静压原理将大量无菌液体、电解质、药物由静脉输入体内的方法,具有方便、快捷、安全等优点[1],已逐渐成为手术室护理操作中常用的一项治疗方法。基于手术室静脉输液操作过程中涉及的环节较多,持续时间较长,并且关系到患者的生命安全[2],存在的护理风险多。如何有效加强手术室静脉输液治疗的安全管理与护理风险控制是目前临床护理研究的重点和热点,其护理工作质量直接影响患者的病情和医院的声誉[3]。因此,对手术室     

年老体弱患者手背浅静脉穿刺方法的改进与应用

静脉输液是临床护理工作的基本操作．在护理工作中占仃非常重要的地位,在很大程度上决定着护理人员操作水平的高低及患者的治疗效果。在静脉输液的过程中,尤其是对老年、体弱的病人或应用特殊药物时．运刷常规静脉输液的方法常会出现穿刺失败或引发静脉炎而增加病人的痛苦。     

Intrapulmonal dislocation of a totally implantable venous access device

BACKGROUND: Totally implantable venous access devices are widely used for infusion of chemotherapy or parenteral nutrition. Device associated complications include technical operative problems, infections, paravasal infusions and catheter or punction chamber dislocation. CASE PRESENTATION: We present the case of a 49-year-old patient with the rare complication of a intrapulmonal catheter dislocation of a totally implantable venous access system. Treosulfane for chemotherapy of metastatic breast cancer was infused via the catheter causing instant coughing and dyspnoea which lead to the diagnosis of catheter dislocation. The intrapulmonal part of the catheter was removed under thoracoscopic control without further complications. CONCLUSION: Intrapulmonal catheter dislocation is a rare complication of a totally implantable venous access device which can not be avoided by any prophylactic measures. Therefore, the infusion system should be tested before each use and each new symptom, even when not obviously related to the catheter should be carefully documented and evaluated by expert physicians to avoid severe catheter-associated complications.     

Subcutaneous implantable infusion device for chronic intravenous pulsatile gonadotropin-releasing hormone treatment

Preliminary data indicate the potential utility of an implantable subcutaneous device that facilitates chronic intravenous infusion of pulsatile gonadotropin-releasing hormone (GnRH) for ovulation induction. GnRH distribution curves were congruent in control monkeys and those with implanted devices. Tissue tolerance was good in this brief trial. These findings suggest that use of this or a similar implantable device be considered for chronic GnRH administration in human pulse therapy.     

持续缓慢静脉输注三氧化二砷治疗急性早幼粒细胞白血病的临床护理效应

目的:观察持续缓慢输注三氧化二砷(As_2O_3)治疗急性早幼粒细胞白血病(APL)病人的临床护理效应。方法:对196例急性早幼粒细胞白血病患者(APL)给予持续缓慢静脉输注As_2O_3治疗,每例患者As_2O_3日治疗总量按0.16mg/kg计算,As_2O_3注射液10毫克(10 mg/支),加入5%葡萄糖500毫升(或生理盐水500毫升)静脉滴注,8-10滴/分钟,每次滴注约18-21小时,连续用药28-50天,至完全缓解(CR)。同时,注重心理护理,加强输液管理,在用药过程中严密观察药物的毒副作用和对不良反应的及时对症护理等措施。结果:177例病人完全缓解(CR),完全缓解率达90.3%。结论:应用持续缓慢静脉输注As_2O_3治疗APL,实施积极有效的护理措施是取得显著疗效的重要环节。     

Propofol infusion for sedation in the intensive care unit: preliminary report.

Propofol (2,6,di-isopropylphenol) was given by continuous intravenous infusion to provide sedation after cardiac surgery in 30 patients and its effects compared with those of midazolam given to a further 30 patients. Propofol infusion allowed rapid and accurate control of the level of sedation, which was satisfactory for longer than with midazolam. Patients given propofol recovered significantly more rapidly from their sedation once they had fulfilled the criteria for weaning from artificial ventilation and as a result spent a significantly shorter time attached to a ventilator. There were no serious complications in either group. Both medical and nursing staff considered the propofol infusion to be superior to midazolam in these patients. These findings suggest that propofol is a suitable replacement for etomidate and alphaxalone-alphadolone for sedating patients receiving intensive care.     

Technique for long-term infusion into the inferior mesenteric artery of unrestrained rats

A technique for long-term infusion into the inferior mesenteric artery was developed which allows simple and reliable regional infusion into the colorectal segment of unrestrained rats. The cannulation system consists of an injection port 'In Stoppers' as a flow swivel, connected to an injection needle, which is inserted into a polyethylene tube protected by a steel spiral. During infusion the animals are free to move in the cage with access to food and water ad libitum. The method is suitable for regional chemotherapy as well as for studies of colorectal tumours in rats. In this study 73% of the cannulae remained functional for continuous infusion over a 15 day period.     

Method for measuring long-term function of muscle-powered implants via radiotelemetry.

Long-term remote monitoring of muscle-powered implants has been made possible with development of an adjustable workload that can be remotely monitored to assess device function. This technique obviates the need for percutaneous access lines and allows test animals to remain untethered, eliminating deleterious effects caused by infection, sedation, or animal stress. Hardware components include a latex bladder fixed within a hermetically sealed canister, multichannel implantable telemetry unit, and subcutaneous access port (for pressure charge adjustment). To validate this method, in vitro tests were performed by using a third-generation muscle energy converter designed to function as an implantable hydraulic pump. Two channels of telemetered pressure data were collected and used to calculate six indexes of device function. Calculated parameters were then compared with measured values to determine accuracy. Correlation between measured and calculated parameters was high in all instances, with most estimates yielding errors of <3%. These results demonstrate the utility of this approach and support its use as a means to monitor muscle-powered devices during long-term animal trials.     

Combined resynchronisation and implantable defibrillator therapy in left ventricular dysfunction: Bayesian network meta-analysis of randomised controlled trials

Objective To review the evidence base from randomised controlled trials of combined cardiac resynchronisation therapy and implantable cardioverter defibrillator therapy in left ventricular impairment and symptomatic heart failure.Design Bayesian network meta-analysis.Data sources Medline, Embase, and Cochrane databases up to June 2006.Review methods Two reviewers independently assessed trial eligibility and quality. Included trials compared cardiac resynchronisation therapy, implantable cardioverter defibrillator therapy, combined resynchronisation and implantable defibrillator therapy, and medical therapy alone, in patients with impaired left ventricular systolic function. Bayesian random effects network models were used to examine overall number of deaths.Results 12 studies including 1636 events in 8307 patients were identified. Combined cardiac resynchronisation and implantable cardioverter defibrillator therapy reduced the number of deaths by one third compared with medical therapy alone (odds ratio 0.57, 95% credible interval 0.40 to 0.80) but did not further improve survival when compared with implantable defibrillator therapy (0.82, 0.57 to 1.18) or resynchronisation (0.85, 0.60 to 1.22) therapy alone.Conclusion Evidence from randomised controlled trials is insufficient to show the superiority of combined cardiac resynchronisation and implantable cardioverter defibrillator therapy over cardiac resynchronisation therapy alone in patients with left ventricular impairment.     

The rabbit as an experimental model for regional chemotherapy. 1. Intra-arterial hindlimb infusion

Regional delivery of chemotherapy to a tumour or tumour-bearing region has pharmacokinetic advantages over the systemic route. The applications of an animal model for regional drug delivery are outlined. The technique for intra-arterial infusion in the rabbit hindlimb is described. The use of the implantable VX2 rabbit carcinoma as a model for solid human tumours may be studied by this method. Pharmacokinetic data obtained with the model allow comparison between systemic and regional routes of delivery. The distribution of the cancerostatic plant toxin ricin following regional delivery has been investigated using this experimental model.     

Long-Acting Subcutaneously Administered Insulin for Glycemic Control Immediately After Cardiac Surgery

ObjectiveTo test the hypothesis that subcutaneous administration of basal insulin begun immediately after cardiac surgery can decrease the need for insulin infusion in patients without diabetes and save nursing time.MethodsAfter cardiac surgery, 36 adult patients without diabetes were randomly assigned to receive either standard treatment (control group) or insulin glargine once daily in addition to standard treatment (basal insulin group). Standard treatment included blood glucose measurements every 1 to 4 hours and intermittent insulin infusion to maintain blood glucose levels between 100 and 150 mg/dL. The study period lasted up to 72 hours.ResultsThere were no differences in demographics or baseline laboratory characteristics of the 2 study groups. Mean daily blood glucose levels were lower in the basal insulin group in comparison with the control group, but the difference was not statistically significant (129.3 ± 9.4 mg/ dL versus 132.6 ± 7.3 mg/dL; P = .25). The mean duration of insulin infusion was significantly shorter in the basal insulin group than in the control group (16.3 ± 10.7 hours versus 26.6 ± 17.3 hours; P = .04). Nurses tested blood glucose a mean of 8.3 ± 3.5 times per patient per day in the basal insulin group and 12.0 ± 4.7 times per patient per day in the control group (P = .01). There was no occurrence of hypoglycemia (blood glucose level < 60 mg/dL) in either group.ConclusionOnce-daily insulin glargine is safe and may decrease the duration of insulin infusion and reduce nursing time in patients without diabetes who have hyperglycemia after cardiac surgery. (Endocr Pract. 2011;17: 558-562)