循证护理在预防颅内多发动脉瘤围手术期并发症中的应用

[目的]探讨循证护理在预防颅内多发动脉瘤围手术期常见并发症中的应用。【方法】对本科2009年1月至2010年12月25例颅内多发动脉瘤围手术期患者通过成立循证护理小组、确定循证问题、寻找循证支持进行循证护理。【结果125例颅内多发动脉瘤围手术期患者,仅一例偏瘫患者出现脑积水现象,余患者恢复良好。【结论】循证护理对颅内多发动脉瘤围手术期常见并发症的预防具有重要作用,而且可丰富护理人员的知识,进一步提高神经外科护理的专业性和技术性。     

循证护理在人工颈椎间盘置换术围术期的应用

[目的]探讨循证护理在人工颈椎间盘置换术围术期的应用.[方法]对7例人工颈椎间盘置换术病人进行围术期循证护理,包括提出循证问题、循证支持、循证观察、循证应用.[结果]实施循证护理能有效地提高护理质量,提高病人对护士的满意度.[结论]在人工颈椎间盘置换术围术期应用循证护理,可保障护理质量,加强医护协作,提高护士的专业素养.     

循证护理在人工颈椎间盘置换术围术期的应用

[目的]探讨循证护理在人工颈椎间盘置换术围术期的应用。[方法]对7例人工颈椎间盘置换术病人进行围术期循证护理,包括提出循证问题、循证支持、循证观察、循证应用。[结果]实施循证护理能有效地提高护理质量,提高病人对护士的满意度。[结论]在人工颈椎间盘置换术围术期应用循证护理,可保障护理质量,加强医护协作,提高护士的专业素养。     

鼻内镜下行垂体瘤摘除术的围手术期的护理

总结我院鼻内镜下行垂体瘤摘除术的围手术期的护理经验,通过对患者进行围手术期的护理,减少术后并发症,促进早日康复。     

34例HIV感染孕妇围手术期护理

总结了34例HIV感染孕妇的围手术期护理,包括护理人员的培训、规范操作以及对HIV感染孕妇的心理护理,认为医院成立HIV母婴阻断小组,将HIV感染孕妇纳入围生期保健,手术室护士开展人性化围手术期护理,有利于帮助患者解除顾虑,以健康的心态接受手术和护理,提高了患者满意度。     

循证护理在升主动脉瘤手术患者围术期中的应用

目的总结循证护理在升主动脉瘤手术患者围术期的应用效果。方法按照循证护理程序提出升主动脉瘤手术患者围术期护理存在的问题,然后检索文献并进行筛选文献,最后根据文献,结合护士的护理经验和患者的实际情况,制定出护理计划并实施。结果11例升主动脉瘤手术患者无1例死亡。结论循证护理是升主动脉瘤手术患者围术期护理的有效方法。     

循证护理在妇科腹腔镜手术围手术期中的应用

综述了循证护理在妇科腹腔镜手术围手术期的应用,主要包括指导腹腔镜手术患者的围手术期护理。掌握护理要点及术后并发症的观察,使患者顺利度过围手术期,保障腹腔镜手术的治疗效果。认为围手术期良好的护理措施是保证手术成功和提高患者生活质量的关键。     

循证护理在胸腰椎骨折伴截瘫病人围手术期护理中的应用

总结了18例胸腰椎骨折伴截瘫病人围手术期的循证护理体会,分别从术前、术后和出院指导方面找出病人存在的护理问题,通过计算机网络检索有关文献,结合临床实际做出具体评价,用以指导临床护理实践。认为循证是临床护理基础,循证护理可促进病人早日康复,回归社会。     

循证护理在肾上腺嗜铬细胞瘤患者围手术期治疗中的应用

目的探讨循证护理在肾上腺嗜铬细胞瘤围手术期治疗的应用效果。方法2001年1月一2008年12月将100例肾上腺嗜铬细胞瘤手术患者按时间顺序配对设为对照组和循证组各50例,对照组按传统护理方法,循证组运用循证护理方法。即提出患者围手术期存在的护理问题,组织护理人员查找国内外证据,通过科学的方法寻找最佳的护理方案．并进行实施及评价验证。比较两组患者围手术期高血压危象、直立性低血压、低血容量休克发生率及患者满意度。结果循证组患者在围手术期间高血压危象、直立性低血压、低血容量休克发生率较对照组明显降低,患者对护理工作满意度明显提高,两组比较,均P〈0．05,差异具有统计学意义。结论循证护理不仅能提高肾上腺嗜铬细胞瘤患者围手术期护理的质量及患者满意度,而且能丰富护理人员的知识,进一步提高护理人员的专业性和技术性的综合素质。     

循证护理在胸腰椎骨折伴截瘫病人围手术期护理中的应用

总结了18例胸腰椎骨折伴截瘫病人围手术期的循证护理体会,分别从术前、术后和出院指导方面找出病人存在的护理问题,通过计算机网络检索有关文献,结合临床实际做出具体评价,用以指导临床护理实践.认为循证是临床护理基础,循证护理可促进病人早日康复,回归社会.     

垂体腺瘤术后尿崩症的护理预见性探讨

目的通过垂体腺瘤与尿崩症关系的分析研究,预测尿崩症发生的可能性,找出其规律,探讨垂体腺瘤术后尿崩症的护理预见性.方法采用回顾性研究方法,对1997年5月至1999年11月收治的56例垂体腺瘤病人进行统计学处理,包括垂体微腺瘤、大腺瘤、巨大腺瘤三种类型,分析垂体腺瘤手术后发生尿崩症的相关因素.结果56例垂体腺瘤病人术后发生尿崩症者37例,经资料分析表明垂体腺瘤体积大小与术后尿崩症的发生率呈负相关.x2检验具有显著性差异(P＜0.05).结论不同体积的垂体腺瘤术后尿崩症的发生率不同;在临床护理过程中,通过对术后尿崩症发生的预测,推断护理侧重点,提高垂体腺瘤的临床护理预见性,减少垂体腺瘤术后并发症的发生,促进患者早日康复.     

Using holistic interpretive synthesis to create practice‐relevant guidance for person‐centred fundamental care delivered by nurses

Nursing policy and healthcare reform are focusing on two, interconnected areas: person‐centred care and fundamental care. Each initiative emphasises a positive nurse–patient relationship. For these initiatives to work, nurses require guidance for how they can best develop and maintain relationships with their patients in practice. Although empirical evidence on the nurse–patient relationship is increasing, findings derived from this research are not readily or easily transferable to the complexities and diversities of nursing practice. This study describes a novel methodological approach, called holistic interpretive synthesis (HIS), for interpreting empirical research findings to create practice‐relevant recommendations for nurses. Using HIS, umbrella review findings on the nurse–patient relationship are interpreted through the lens of the Fundamentals of Care Framework. The recommendations for the nurse–patient relationship created through this approach can be used by nurses to establish, maintain and evaluate therapeutic relationships with patients to deliver person‐centred fundamental care. Future research should evaluate the validity and impact of these recommendations and test the feasibility of using HIS for other areas of nursing practice and further refine the approach.     

单鼻孔蝶窦入路显微手术治疗垂体腺瘤56例护理体会

目的:探讨单鼻孔经蝶入路显微手术治疗垂体腺瘤的护理方法.方法:对2000年9月～2006年9月收治的56例垂体腺瘤患者,术前均行冠状TC、MRI扫描,并行内分泌学检查,肿瘤全切47例,次全切7例,部分切除2例,均行单鼻孔蝶窦入路显微手术治疗.并给予精心护理,采用综合医院焦虑/抑郁(HAD)情绪测定量表评估护理前后患者的心理状态.术后随访6～36个月.结果:术后症状及内分泌检查改善54例,5例出现鼻中隔穿孔、鼻黏膜感染、脑脊液漏等并发症.经积极有效护理,患者心理状态得到改善.2例1年后复发.结论:经蝶窦入路显微手术治疗垂体腺瘤,并给予积极精心护理可取得满意效果,降低住院费用,促进患者心理健康.     

经鼻中隔黏膜下入路垂体瘤切除术后嗅觉改变的影响因素

目的探讨经鼻中隔黏膜下入路垂体瘤切除术后患者嗅觉改变的影响因素及护理对策。方法选取2019年1—12月在医院行经鼻中隔黏膜下入路垂体瘤切除术患者90例作为研究对象,将发生嗅觉改变的13例患者作为改变组,未发生嗅觉改变的77例患者作为正常组。采用单因素分析筛选影响经鼻中隔黏膜下入路垂体瘤切除术后患者嗅觉改变的相关危险因素,对有统计学意义的纳入因素进行多因素Logistic回归分析,确定影响经鼻中隔黏膜下入路垂体瘤切除术后患者嗅觉改变的独立危险因素。结果13例出现嗅觉改变的患者中,9例轻度嗅觉减退,3例中度嗅觉减退,1例重度嗅觉减退。单因素分析结果显示,性别、手术时间、保留中鼻甲、消毒液浓度、鼻窦炎、脑脊液鼻漏、鼻腔粘连及鼻出血是影响经鼻中隔黏膜下入路垂体瘤切除术后患者嗅觉改变的相关因素(P<0.05);多因素Logistic回归分析结果显示,保留中鼻甲、脑脊液鼻漏及鼻窦炎是影响经鼻中隔黏膜下入路垂体瘤切除术后患者嗅觉改变的独立危险因素(P<0.05)。结论保留中鼻甲、鼻窦炎及脑脊液鼻漏是影响经鼻中隔黏膜下入路垂体瘤切除术后患者嗅觉改变的独立危险因素。提示医护人员应针对以上危险因素,制定相应护理对策,尽量避免对患者鼻腔正常生理结构与鼻腔黏膜的损害,加强术后鼻腔护理,减少相关并发症的发生,指导患者坚持,以促进患者术后嗅觉功能的恢复。     

HIV/AIDS and its impact on student nurses

This article describes components surrounding British nursing students' (n=138) knowledge base, attitudes towards HIV/AIDS, homophobia level, willingness to care for individuals with HIV/AIDS and attitudes to sexual risk behaviours. The data were collected by questionnaire and analysed by statistical methods. Out of the 33 knowledge questions, the mean value of correct answers was 22.2 (Min 13, Max 29, SD 3.27). Students who had taken care of people with AIDS and who were willing to take care of these people showed more positive attitudes to the disease and people with AIDS. Older age and reluctance to care for a person with AIDS were associated with a high level of homophobic attitudes. Students demonstrated a positive approach to carrying out general nursing tasks for a person with HIV/AIDS. Having been asked to care or having cared for a patient with HIV/AIDS, and being single were associated with a higher level of willingness to care for these patients. Female sex, older age and having children were associated with more cautious attitudes to sexual risk behaviours. The results underline the importance of providing education about HIV/AIDS and supporting student nurses who are afraid they might contract the disease in nursing tasks.     

经蝶垂体瘤术后低钠血症的循证护理

目的 探讨循证护理模式在经蝶垂体瘤术后发生低钠血症患者的应用效果.方法 对33例经蝶垂体瘤术后发生低钠血症患者应用循证护理模式,即确定需要循证的护理问题,检索相关文献,对相关文献进行分析、探讨,制订最佳护理方案,提高经蝶垂体瘤术后低钠血症患者的救治率和护理质量.结果 33例经蝶垂体瘤术后发生低钠血症患者全部痊愈出院.结论 循证护理为经蝶垂体瘤术后发生低钠血症患者临床护理实践的决策提供了可靠的科学依据,提高了护理质量.     

Developing and establishing an expanded and more comprehensive HIV/AIDS nursing practice

Developing and establishing an advanced nursing practice is an essential step toward future-oriented nursing care. An action research process was initiated to establish advanced nursing practice at the HIV clinic of the outpatient department at the University Hospital Basel with the goal to offer advanced nursing care to patients. Participatory action research allows generating knowledge about a social system while at the same time tempts to promote social change. The most important goal is to constantly analyse, improve, and evaluate nursing care for patients and family caregivers. Advanced nursing practice in HIV/AIDS is based on solid knowledge regarding the illness and current therapies. Central concepts are caring, clinical experiences, evidence based practice, and patient preferences. Through a systematic step-by-step process, the nurses at the HIV clinic are being better educated and more experienced in these concepts. An essential aspect of advanced nursing practice is the specialization of each nurse in a self selected topic within HIV/AIDS care. These nurses now offer new services such as medication management and adherence support, health maintenance and prevention, and symptom management. This ongoing process of learning while establishing advanced nursing practice in HIV/AIDS, enables the nurses to face future changes in health care in a proactive way.     

23例局部麻醉下经鼻内窥镜行垂体腺瘤切除术患者的围手术期护理

目的：针对经鼻内窥镜垂体腺瘤切除患者围手术期面临的相关问题进行分析、总结。方法：回顾性分析我科3年来出院的23例局部麻醉下经鼻内窥镜行垂体腺瘤切除术治疗患者的病例资料。围手术期主要需关注患者的以下几点重要信息：头痛、视力障碍、感冒或鼻炎等前期基础疾病,术后重点观察神经系统症状、尿量、鼻腔渗血渗液情况,及时发现并处理并发症。结果：本组23例患者术前精神状态良好,如期进行手术,术后效果理想,无1例病情恶化,均满意出院。结论：做好患者术前护理及术前准备,术后采取正确体位,加强意识状态、瞳孔、生命体征及并发症的观察及护理,重视术后病情的观察及早期发现术后并发症,是保证垂体腺瘤手术成功的关键。     

Nursing care of dead bodies: a discursive analysis of last offices

BACKGROUND: Nurses care for patients before they are born, after they have died and during the lifetime in between. This paper explores nursing care of the patient after they have died including the actions by nurses in preparation of the body, the covering with a shroud, and the transfer to the mortuary. AIMS: The analysis of a procedure manual excerpt Last Offices, which directs care of the dead patient aims to explore nursing care practices in regard to dead patients, as well as the impact of the health care institution and society at large on these care practices. METHOD: An acute care teaching hospital located in a major Australian city was approached and permission was granted to access their procedure and policy manuals. The Last Offices excerpt of the procedure manual was discursively analysed. FINDINGS: It is the contention of this paper that, through their care, nurses enact the transition between life and death, and from person to corpse. Furthermore, nurses mediate the move from embodied person to becoming dead, and in so doing traverse the cultural, ontological and epistemological breaks that death entails.     

冷循环射频消融术治疗晚期肺癌的护理

目的：探讨冷循环射频消融术治疗晚期肺癌的护理方法。方法：对40例CT引导镇痛麻醉下行冷循环射频消融术治疗的晚期肺癌患者进行全面细致的护理,包括术前健康教育、术中配合护理、术后并发症观察护理和心理护理。结果：40例患者在镇痛麻醉下进行冷循环射频消融术,全部完成治疗,1例发生术口灼伤,余未发生严重并发症。结论：术前做好心理护理、术中密切配合、术后注意观察并及时处理并发症,对于提高成功率,减少并发症发生有重要意义。