军队官兵艾滋病认知情况调查

目的了解军队官兵对艾滋病的认知水平和态度,为军队开展艾滋病健康教育提供依据。方法采用方便抽样的方法对1069名官兵进行问卷调查。结果①官兵对艾滋病一般知识、传播途径等回答正确率较高,军官高于士兵,差异具有统计学意义(P<0.01)。②84.67%的军官、64.91%的士兵表示同情、关心艾滋病病人。③多数官兵对国家相关艾滋病的政策缺乏了解。结论军队官兵对艾滋病知识及国家相关政策了解不够,艾滋病健康教育工作应增加宣教的范围及深度,并强调针对性和实用性。     

The ability of A&E personnel to demonstrate inhaler technique.

OBJECTIVE: To determine the ability of accident and emergency (A&E) personnel to demonstrate metered dose inhaler technique. METHODS: 25 senior house officers and 25 nurses working in A&E were individually interviewed and assessed on their knowledge of inhaler technique and competence in demonstrating the correct use of a metered dose inhaler. RESULTS: Demonstration of inhaler technique was generally poor by the staff assessed. Although 22 (88%) of the senior house officers were aware of the British Thoracic Society guidelines, only 10 (40%) routinely checked inhaler technique when discharging asthmatic patients. CONCLUSIONS: The A&E department offers an important opportunity for patient assessment and reinforcement of metered dose inhaler technique. Staff should be made aware of the British Thoracic Society guidelines and be competent at assessing and teaching inhaler technique.     

Handling of drug-related inquiries by hospital nurses

Objective: To determine how nurses handled drug-related questions in the work environment of a teaching hospital in Malaysia and the type of information sources they used Method: Questionnaires were distributed in August 1996 to nurses working in various wards. The majority of respondents were staff nurses. They rated their patients as the most common category of individuals with drug-related inquiries Results: About 58% of nurses said the most common source of reference text available at the workplace was the Drug Index of Malaysia and Singapore (DIMS) and that it was the text most of them used to answer drug-related inquiries. Although the majority of them knew the existence of a drug information centre at the hospital, 73% of nurses referred to pharmacists working in satellite pharmacies to solve drug-related inquiries Conclusion: This survey also showed that nurses sought information on drugs from various sources and that satellite pharmacies served an important purpose in this respect.     

三级甲等医院肾脏科医护人员疼痛认知的调查

目的通过调查肾脏科医护人员对疼痛的认知,以探讨提高医护人员疼痛知识的方法。方法选取肾脏科41名医生,51名护士为调查对象,采用MargoMcCaffery设计的“疼痛知识与态度调查问卷”及自行设计问卷对其疼痛知识与态度进行调查。结果92名医护人员总答对率仅为44．20％;护士疼痛评估、止痛方法与药物、疼痛知识总得分分别为（3．29±1．01）,（2．88±1．64）,（7．39±2．09）分,均高于医生（2．59±1．28）,（1．90±1．09）,（5．56±2．20）分,差异均有统计学意义（t分别为2．969,3．277,4．079;P〈0．05）;医护之间对疼痛的态度得分比较,差异无统计学意义（P〉0．05）;不同学历的医护人员疼痛知识得分有差异,差异具有统计学意义（F=4．15,P〈0．05）;92名医护人员在3种不同给药时间中成瘾发生的可能性问题,无一人完全回答正确,且有8名认为急性用药较短期和长期用药更易成瘾;医护人员疼痛知识掌握情况自评中,75％的医护人员认为不太了解,只有2．17％的医护人员认为非常了解。结论管理者应对肾脏科医护人员共同提供疼痛教育及培训,以改善其对疼痛治疗的态度,增强其疼痛管理的能力。     

What do cardiovascular nurses know about the hematological management of patients with Eisenmenger syndrome?

Aim

We investigated the level of knowledge of hematological management of patients with Eisenmenger syndrome among general cardiovascular nurses and nurses who specialize in congenital heart disease (CHD).

Methods

We conducted a survey at two international conferences attended by cardiovascular nurses. Nurses were asked to complete a questionnaire comprising two questions and three clinical case scenarios. Overall, 89 nurses participated (response rate 90.8%), 43 of whom specialized in CHD.

Results

The level of knowledge displayed among cardiovascular nurses is poor. About one-third of nurses not specialized in CHD recognized the definition of Eisenmenger syndrome and knew what normal hematocrit levels are. With respect to the cases presented, less than 10% of the nurses could give a correct answer. The level of knowledge of specialized nurses was significantly higher, but also here, important gaps in the level of knowledge could be observed. Less than two-thirds knew the reference values of hematocrit and knew the appropriate management in two cases. Less than half of the specialized nurses knew about the procedure of isovolumic phlebotomy.

Conclusion

The level of knowledge displayed by cardiovascular nurses regarding the hematological management of patients with Eisenmenger syndrome is poor. Also the knowledge of nurses specialized in CHD could be improved.     

The impact of a respiratory therapy consult service on house officers' knowledge of respiratory care ordering

BACKGROUND: Although available studies show that implementation of respiratory care protocols by respiratory therapists can enhance the allocation of respiratory care services, concern has been expressed that respiratory therapists' involvement in assessing patients and in determining treatment plans may detract from medical trainees' education and experience in ordering respiratory care services. OBJECTIVE: Compare the rates of correct responses to case-based questions about respiratory care ordering in two groups of internal medicine house officers at academic medical centers: one group training at an institution using respiratory care protocols (The Cleveland Clinic Foundation) and the other group training in an institution at which respiratory care protocols have not been used (University of Nebraska). DESIGN: Prospective cohort study. SETTING: Two academic medical centers, one using respiratory protocols and the other not using respiratory care protocols. MEASUREMENTS: Percent of correct responses to questions regarding respiratory care management posed in 5 case studies administered to both groups. RESULTS: Responses were available from 41 and 17 internal medicine house officers at The Cleveland Clinic Foundation and University of Nebraska, respectively. Respondents represented postgraduate years one, two, and three, and constituted a similar percentage of all internal medicine house officers at each institution (33%). The rate of correct responses to the 20 questions posed in the 5 case studies was high overall (76.8%) and similar in the two house staff groups (77.2 +/- 11.6% at The Cleveland Clinic Foundation and 75.8 +/- 12.0% at University of Nebraska, p = 0.69). The 95% confidence interval for the difference straddled zero (-5.4%, 8.1%), making it very unlikely that any important difference exists between the two groups in rate of correct responses. Analysis of covariance also showed no difference between groups, suggesting that postgraduate training level did not affect this conclusion. In one of the 5 case studies, the percent of correct responses was higher among trainees where respiratory care protocols were in use (86.8 +/- 18% at The Cleveland Clinic Foundation vs 69.1 +/- 14% at University of Nebraska, p = 0.0001). CONCLUSIONS: In this comparison of internal medicine house officers' knowledge regarding respiratory care ordering at institutions using versus not using respiratory care protocols, the rates of correct responses by both groups were similar and unlikely to differ significantly. For one of the 5 case studies, respondents from the institution using respiratory care protocols scored significantly higher. Taken together, these results suggest that use of respiratory care protocols implemented by respiratory therapists does not detract from internal medicine trainees' expertise in respiratory care management. Whether these results generalize to other institutions or reflect expertise in actual practice remains uncertain.     

Community health nurses and family planning services for men

Current concerns about sexually transmitted diseases (STDs) and acquired immunodeficiency syndrome (AIDS), as well as unintended pregnancy, have drawn increasing attention to reproductive health services for men. This report presents information about responses by 844 community health nurses (CHNs) to a self-administered mailed questionnaire that included questions about the extent of the nurses' involvement in delivering or administering family planning services to men, their knowledge and attitudes about men and family planning, and their preparation for working with men. Our sample included CHNs in practice in five states and a sample of CHNs belonging to a national organization of public health nursing, in order to gain information about CHNs in practice in the field and CHNs more likely to be in an educational or administrative position and thus able to influence or to set policy. Two thirds of the nurses surveyed work with men in their reproductive years but only 17.8% delivered or administered family planning services to men (23% of the state sample and 12.5% of the organization sample). Deficits in knowledge about male birth control methods were identified; for example, only 32% knew the use-effectiveness rate of the condom. However, 90% of the CHNs knew the condom has to be put on before any genital contact is made. The CHNs' attitudes were positive; more than 90% said they felt men had equal responsibility with their partners in preventing unwanted pregnancies, using contraception, and contraceptive decision making. Yet, only 9.6% of the CHNs felt men have as much knowledge about contraception as women do. Seventy percent of the nurses felt tha sex education in schools was directed more to female students than to male students. More than 90% said they believed that family planning providers have a responsibility to provide services to men; but two thirds felt that nurses are not as well prepared to work with male as with female clients. Increased educational preparation may improve CHNs' knowledge about men and family planning and enable them to feel professionally prepared to deliver and administer the services they feel are necessary for male as well as female clients. There are 101,430 CHNs in the United States, working in public health departments or other service agencies in almost every community across the country. These CHNs are a major resource for the family planning field.     

Evaluation of programmatic changes to an antimicrobial stewardship program with house officer feedback

Rationale, aims and objectives A collegial relationship between prescribers and antimicrobial stewards, along with an appreciation of the importance of antimicrobial stewardship, is essential for optimal functioning of an antimicrobial stewardship program (ASP). Programmatic adjustments based on feedback may be beneficial to the success of ASPs. The objective of this study is to assess the experience of house officers with the ASP and the effect of programmatic improvements. Methods A survey of house officers at an academic medical centre was conducted assessing their experience with the ASP before (2008) and after (2010) programmatic interventions were instituted. Results Of 225 house officer surveys sent, we received 97 responses (88% from medical doctors). The majority indicated that ASP was either very or somewhat important in fighting antibiotic resistance (100%), improving patient care (97%), preventing medication errors (91%) and containing health care costs (89%). Ninety‐one per cent indicated either a very good or good educational experience with the ASP. The ASP often reminded respondents of a patient's allergy (31%), to adjust for renal function (78%), and 38% were prevented from making a medication error. Comparing 2008 and 2010, a higher proportion of respondents in 2010 said they had a very good or good educational experience with ASP [84% versus 98%, odds ratio (OR) = 8.40, P = 0.022] and a lower proportion of respondents reported confusion about ASP procedures (59% versus 39%, OR = 0.43, P = 0.048). Conclusions House officer feedback resulted in ASP policy changes which improved the ASP experience.     

Should relatives be allowed in the resuscitation room?

OBJECTIVE: To assess doctors' and nurses' views on the presence of relatives in the resuscitation room during cardiac arrest or major trauma. DESIGN: Questionnaires were sent to accident and emergency (A&E) nurses and doctors of all disciplines in a London teaching hospital. Recipients were asked if they would favour the presence of selected relatives in the resuscitation room and to give comments. RESULTS: 103 questionnaires were distributed and 81 returned, a response rate of 78.6%; 33% were senior house officers, 29% consultants, 16% senior registrars/registrars, 12% A&E nurses, and 10% house officers. Of the respondents, 63% were not in favour of relatives being present, and 37% were in favour. The likelihood of being in favour of allowing relatives to be present was high among A&E nurses; among doctors it increased with rising seniority. Most respondents felt that more resuscitation training would be necessary, in addition to counselling for staff and relatives. CONCLUSIONS: Staff with the least experience in dealing with resuscitations and distressed relatives were likely to be opposed to relatives being present in the resuscitation room. As there is evidence that the bereavement process is eased if a partner/relative witnesses the resuscitation, relatives should be offered the opportunity to witness resuscitation if staff training is geared towards the presence of relatives. ALS/ATLS training for all hospital doctors and nurses should include the management of distressed relatives observing a resuscitation.     

新生儿科和产科护士新生儿疼痛知识和态度的调查分析

目的 了解新生儿科和产科护士对新生儿疼痛知识掌握水平和态度,为临床推广新生儿疼痛管理提供指导依据.方法 采用自行设计的调查问卷,以现场填写的方法对新生儿科和产科工作的护理人员107人(其中新生儿科40人,产科67人)进行新生儿疼痛知识和态度的调查.结果 在新生儿疼痛知识的问题中.新生儿科组的平均答对比例是75.5%,高于产科组的66.3%;新生儿科组有7题的答对率超过80%,产科组只有1题的答对率超过80%,有5题的答对率明显低于新生儿科组.所有护理人员都认为非常必要或有必要对护士开展疼痛相关知识的培训;95.0%(38/40)的新生儿科护士认为自己能够正确评估新生儿疼痛的程度,而产科只有83.6%(56/67),2组比较差异明显;97.5%(39/40)的新生儿科护士认为自己可以对新生儿哭声做出正确判断,而产科为85.1%(57,/67),2组比较差异明显.结论 新生儿疼痛已经逐渐被临床一线医务人员所认识和重视,她们都认为有必要接受相关知识的培训,新生儿科护士对新生儿疼痛知识的掌握优于产科护士.     

Care of HIV-infected patients: nurses' concerns, opinions, and precautions

The purpose of this study was to describe nurses' concerns, opinions, and precautions related to nursing patients infected with the human immunodeficiency virus (HIV). Of special interest was a comparison of responses by nurses who reported exposure to the HIV through broken skin or mucous membranes with the responses of nurses who reported no such exposure. The sample included all staff nurses employed in either the ambulatory/home health care unit or in one of seven inpatient critical care units of a large urban medical center. Of the 323 respondents, 64 (20%) reported HIV exposure, 77 (24%) reported no exposure, and 180 (56%) reported not knowing if they had been exposed. A 15-item Likert-type scale was used. More HIV-exposed nurses than non-exposed nurses reported: (a) worrying about becoming HIV-infected; (b) considering a change of specialty or profession because of the acquired immunodeficiency syndrome (AIDS) risk; and (c) favoring selected HIV-related policies. Of the total sample, nearly all subjects agreed that staff nurses should be involved in developing HIV-related policies affecting nurses; and over one-half said that, if the agency gave them the option, they would refuse assignment to HIV-infected patients. Nearly 30% said that they had considered changing their profession because of the AIDS risk. Some implications are that nursing administrators should involve well-informed staff nurses in formulating HIV-related policies that affect nurses. The HIV-exposed nurses may need support in dealing with their concerns resulting from HIV-exposure, and they may need more information about HIV-infection control and seroconversion rates of HIV-exposed nurses.     

Basic life support: knowledge and attitude of medical/paramedical professionals

BACKGROUND:

Basic life support (BLS), a key component of the chain of survival decreases the arrest – cardiopulmonary resuscitation interval and increases the rate of hospital discharge. The study aimed to explore the knowledge of and attitude towards basic life support (BLS) among medical/paramedical professionals.

METHODS:

An observational study was conducted by assessing response to self prepared questionnaire consisting of the demographic information of the medical/paramedical staff, their personnel experience/attitude and knowledge of BLS based on the 2005 BLS Guidelines of European Resuscitation Council.

RESULTS:

After excluding incomplete questionnaires, the data from 121 responders (27 clinical faculty members, 21 dental and basic sciences faculty members, 29 house officers and 44 nurses and health assistants) were analyzed. Only 9 (7.4%) of the 121 responders answered ≥11, 53 (43%) answered 7-10, and 58 (48%) answered <7 of 15 questions correctly. The clinical faculty members, house officers and nurses/HA had a mean score of 7.4±3.15, 7.37±2.02 and 6.63±2.16 respectively, while dental/basic sciences faculty members attained a least mean score of 4.52 ±2.13 (P<0.001). Those who had received cardiopulmonary resuscitation (CPR) training within 5 years obtained a highest mean score of 8.62±2.49, whereas those who had the training more than 5 years back or no training obtained a mean score of 5.54±2.38 and 6.1±2.29 respectively (P=0.001). Those who were involved in resuscitation frequently had a higher median score of 8 in comparison to those who were seldom involved or not involved at all (P<0.001).

CONCLUSIONS:

The average health personnel in our hospital lack adequate knowledge in CPR/BLS. Training and experience can enhance knowledge of CPR of these personnel. Thus standard of CPR/BLS training and assessment are recommended at our hospital.KEY WORDS: Basic life support (BLS), Cardiopulmonary resuscitation (CPR), Training, Knowledge, Attitude     

边、海防基层军官疗养期间健康教育需求及方法研究

目的 使基层军官树立正确健康观，改善生活及行为方式，恢复并促进健康。方法 通过问卷调查，了解基层军官对健康教育的需求，实施适宜、有效的健康教育方法。结果 4年来，基层军官疗养基地的健康教育覆盖率为99．7％，健康教育知晓率为93．8％。结论 疗养员接受正确的健康观及相关观点，掌握基本健康保健常识，具有纠正不良生活习惯的积极愿望，达到短期疗养、终生受益的预期目的，为保障基层军官的身体健康打下基础。     

妇幼保健院护士对盆底肌锻炼认知的调查及影响因素分析

目的调查护士对盆底肌锻炼的认知及影响因素,为护士进行盆底肌锻炼宣教和指导提供依据。方法采用护士一般资料调查表、盆底肌锻炼知识认知调查表,对杭州市5家妇幼保健院209名护士进行问卷调查,同时对知识部分答对率的人口学因素进行单因素、多因素分析。结果209名护士盆底肌锻炼知识答对率为10.0%~90.0%,平均答对率为(45.20±15.19)%,其中盆底肌锻炼动作答对人数占比最大(95.69%),需要盆底肌锻炼的人群答对人数占比最低(7.66%)。单因素分析显示,不同工作年限与婚育史的护士盆底肌锻炼认知水平差异有统计学意义(P<0.05);多因素分析结果显示,已婚未育与已生育是盆底肌锻炼认知水平的主要影响因素(P<0.05)。结论妇幼保健院护士对盆底肌锻炼理论知识掌握程度不佳,婚育史是其影响因素,应加强相关知识的学习。     

护理人员乳房自检实施及宣教情况的调查

目的了解护理人员乳房自检相关知识的掌握和实施情况,以及对周围人群的宣教情况。方法采用自制问卷对某医院140名护士进行调查,主要包括一般情况、乳房自我检查的相关知识、乳房自检的实施情况及对周围人群进行乳房自检相关知识的宣教情况。结果（1）被调查护士对乳房自检知识的平均掌握程度为59.1%;（2）51.4%的护士知道5个以上的乳腺癌高危因素;（3）50.7%的护士知道乳腺自检的频率和时间,36.4%的护士知道望诊的3~4个步骤,88.6%和61.4%的护士知道触诊手法和按压顺序;（4）仅5.7%的护士每月规律自检;（5）50%的护士曾接受过他人咨询,其中47.1%未给予咨询者指导。结论应加强护理人员乳房自检相关知识的培训,重点是乳腺癌高危因素、乳房自检频率和望诊方法等;同时,作为妇女健康的教育者和咨询者,护理人员应加强责任心,做好对周围人群乳房自检的宣传普及工作,积极维护自身及广大妇女的身心健康。     

北京市海淀区社区护士消毒隔离相关知识和行为调查

目的 了解在职社区护士消毒隔离知识掌握及执行情况,为规范社区消毒隔离工作、保障患者安全提供客观依据.方法 选取北京市海淀区40所社区卫生服务机构,对其中负责消毒隔离工作的65名社区护士进行调查.结果 消毒隔离相关知识方面:社区护士知晓2009年颁布《医院消毒供应中心管理规范》共有3项强制性卫生行业标准的正确率仅为9.2...     

Use of analgesia in severe pain in the accident and emergency department.

The adequate management of severe pain in accident and emergency departments depends on knowledge of the pharmacology of analgesic drugs. To evaluate such a knowledge a study by questionnaire was conducted. Fourteen accident and emergency departments participated and one hundred senior house officers answered the questionnaire. A large percentage of the respondents would use an inappropriate route of administration (intramuscular 50% rather than intravenous 50%), some would use an inappropriate drug and often wait too long (90 min) before giving a further dose of analgesic should the patient continue to be in severe pain after the initial dose. These results suggest that there is need for further teaching on pain relief at medical schools, casualty officers need to be taught about analgesia when they start working in accident and emergency departments, and it may be beneficial for accident and emergency departments to have an analgesic policy.     

To lead or not to lead? Prospective controlled study of emergency nurses' provision of advanced life support team leadership

Background and objectives: In many emergency departments advanced life support (ALS) trained nurses do not assume a lead role in advanced resuscitation. This study investigated whether emergency nurses with previous ALS training provided good team leadership in a simulated cardiac arrest situation. Methods: A prospective study was conducted at five emergency departments and one nurses'' association meeting. All participants went through the same scenario. Details recorded included baseline blood pressure and pulse rate, time in post, time of ALS training, and subjective stress score (1 = hardly stressed; 10 = extremely stressed). Scoring took into account scenario understanding, rhythm recognition, time to defibrillation, appropriateness of interventions, and theoretical knowledge. Results: Of 57 participants, 20 were ALS trained nurses, 19 were ALS trained emergency senior house officers (SHOs), and 18 were emergency SHOs without formal ALS training. The overall mean score for doctors without ALS training was 69.5%, compared with 72.3% for ALS trained doctors and 73.7% for ALS trained nurses. Nurses found the experience less stressful (subjective stress score 5.78/10) compared with doctors without ALS training (6.5/10). The mean time taken to defibrillate from the appearance of a shockable rhythm on the monitor by the nurses and those SHOs without ALS training was 42 and 40.8 seconds, respectively. Conclusion: ALS trained nurses performed as well as ALS trained and non ALS trained emergency SHOs in a simulated cardiac arrest situation and had greater awareness of the potentially reversible causes of cardiac arrest. Thus if a senior or middle grade doctor is not available to lead the resuscitation team, it may be appropriate for experienced nursing staff with ALS training to act as ALS team leaders rather than SHOs.