优质护理模式在手术室护理中的应用效果研究

目的探讨优质护理模式在手术室护理中的应用效果。方法抽选2010年3月~2012年5月在本院行手术治疗的96例患者,随机分为对照组(n=48例,予以常规护理)和观察组(n=48例,采用优质护理模式),比较两组心理状态、生命体征、患者及医生对护理满意度情况差异。结果观察组护理干预后焦虑(SAS)、抑郁(SDS)评分显著低于对照组(P0.05)。观察组术前、术中、术后心率、血压、呼吸等手术应激体征无明显变化波动(P0.05);而对照组术中心率、血压、呼吸等手术应激体征明显高于术前、术后(P0.05)。观察组患者及医生对护理的满意度明显高于对照组(P0.05)。结论对手术室患者实施优质护理,不仅能缓解其焦虑、抑郁情绪,还可减少患者术中的应激反应,同时获得良好的护理满意度。     

手术室护理中应用循证护理和整体护理的效果及对舒适、疼痛程度的影响

目的探讨手术室护理中应用循证护理和整体护理的效果及对舒适、疼痛程度的影响。方法将郑州大学第一附属医院2018年1~12月收治的在手术室手术患者216例按照随机数字法分为对照组和研究组,各108例。对照组予以常规手术护理,研究组予以循证护理和整体护理。比较两组患者的护理质量,术前、术中、术后的舒张压、收缩压、心率变化情况及护理24 h及48 h时的舒适、疼痛情况。结果研究组护理质量各维度评分均显著高于对照组,差异有统计学意义(均P<0.05)。两组患者术前、术后血压及心率比较差异均无统计学意义(均P>0.05)。术中研究组血压及心率均低于对照组;研究组护理24 h及48 h时舒适评分高于对照组,疼痛评分低于对照组,差异均有统计学意义(均P<0.05)。结论循证护理和整体护理在手术室护理中应用可显著降低患者术中生理应激,缓解患者术后疼痛,提高其舒适度,护理质量较高。     

舒适护理在剖宫产产妇护理中的应用

[目的]探讨舒适护理在剖宫产产妇护理中的应用。[方法]将130例行剖宫产产妇随机分为观察组和对照组,每组65例,对照组采用常规护理,观察组在对照组的基础上进行舒适护理。比较两组病人的护理干预效果,包括术后48 h疼痛程度、护理干预前后焦虑自评量表(SAS)评分、病人对护理服务的满意度。[结果]观察组病人术后48 h疼痛程度低于对照组(P<0.05);观察组病人护理干预后SAS评分低于对照组(P<0.05);观察组病人对护理服务的满意度高于对照组(P<0.05)。[结论]舒适护理可减轻剖宫产病人的焦虑程度、术后48 h疼痛程度,提高病人对护理服务的满意度。     

舒适护理在剖宫产产妇护理中的应用

[目的]探讨舒适护理在剖宫产产妇护理中的应用。[方法]将130例行剖宫产产妇随机分为观察组和对照组,每组65例,对照组采用常规护理,观察组在对照组的基础上进行舒适护理。比较两组病人的护理干预效果,包括术后48 h疼痛程度、护理干预前后焦虑自评量表(SAS)评分、病人对护理服务的满意度。[结果]观察组病人术后48 h疼痛程度低于对照组(P<0.05);观察组病人护理干预后SAS评分低于对照组(P<0.05);观察组病人对护理服务的满意度高于对照组(P<0.05)。[结论]舒适护理可减轻剖宫产病人的焦虑程度、术后48 h疼痛程度,提高病人对护理服务的满意度。     

手术室优质护理干预对腹腔镜子宫肌瘤切除患者应激反应、负性情绪及预后的影响

目的分析手术室优质护理干预对腹腔镜子宫肌瘤切除患者应激反应、负性情绪及预后的影响。方法将100例腹腔镜子宫肌瘤切除患者随机分为对照组和观察组,每组50例。对照组进行手术室常规护理干预,观察组进行手术室优质护理。比较两组的应激指标、心理状况及舒适评分、术后并发症发生情况及对手术室护理的满意度。结果观察组术前及术后12 h的HR、E、NE、Cor水平均低于对照组(P<0.05)。术后1 d,两组的SAS及SDS评分均明显降低,且观察组低于对照组(P<0.05)。观察组的GCQ评分和对手术室护理的满意度高于对照组,术后并发症总发生率低于对照组(P<0.05)。结论给予腹腔镜子宫肌瘤切除患者手术室优质护理干预,可明显减轻患者的应激反应,提高舒适度,降低术后并发症发生率,缓解负性情绪,提升护理满意度。     

细节护理在手术室护理服务中的应用

目的:探讨细节护理在手术室护理服务中的应用效果。方法:将120例手术患者随机分为观察组和对照组各60例,对照组给予常规护理,观察组给予细节护理,通过焦虑自评量表(SAS)和患者满意度调查表比较两组焦虑情绪和满意度情况。结果:观察组术后24 h SAS评分低于术前及对照组术后24 h(P0.05),满意度高于对照组(P0.01)。结论:做好细节护理能够减轻手术患者焦虑情绪,提高患者满意度。     

舒适护理在食管癌围手术期的应用价值体会

选取收治的食管癌患者68例,随机均分为对照组与观察组各34例,对照组给予常规护理,观察组给予舒适护理,比较两组术后焦虑抑郁评分(HAD)、舒适度、满意度及并发症发生率。两组术前焦虑抑郁评分无差异(P>0.05),观察组术后24h焦虑抑郁评分明显降低(P<0.05),而对照组无明显下降(P>0.05),且两组术后24h焦虑抑郁评分差异有统计学意义(P<0.05)。观察组舒适度及满意度明显高于对照组,而并发症发生率低于对照组,差异有统计学意义(P<0.05)。舒适护理能改善患者不良心理,提高其舒适度与满意度,并降低并发症。     

舒适护理对手术室患者舒适度及护理满意度的影响

目的:探讨舒适护理对手术室患者舒适度及护理满意度的影响。方法:将100例普外科手术患者分为观察组和对照组各50例,对照组采用常规护理,观察组采用舒适护理,比较两组患者住院期间的舒适度、护理满意度及症状自评量表(SCL-90)评分。结果:术前观察组抑郁、躯体化、焦虑、精神性评分明显低于对照组(P<0.05);术后观察组舒适度与护理满意度均明显高于对照组(P<0.05)。结论:舒适护理能够满足手术室患者的生理、心理需求,提高患者舒适度和护理满意度。     

音乐干预对子宫切除术患者手术室整体护理效果的研究

目的 探讨音乐干预对子宫切除术患者手术室整体护理效果的作用.方法 择期行子宫切除术患者192例,随机分为实验组和对照组.两组均按手术室常规整体护理程序给予术前解释、指导、鼓励、安慰等支持性治疗,实验组再给予音乐治疗.实验组于术前手术室护士接病人至术毕持续听音乐;对照组只戴耳机,不听音乐.手术中记录患者的生命体征、应用Zung氏焦虑自评量表(SAS)对两组病人围手术期焦虑程度进行评估,并调查患者对围手术期满意度.结果 实验组与对照组比较,手术前其焦虑程度无明显差异、而手术中(t=36.449,P＜0.001)及术后1天(t=8.63,P＜0.001)实验组较对照组焦虑程度明显降低.生命体征比较差异无显著性意义(P＞0.05).但术中满意度实验组明显高于对照组(t=9.63,P＜0.001).结论 音乐干预可明显降低子宫切除术患者的围手术焦虑程度,是一种简便易行,可明显提高子宫切除术患者满意度和手术室整体护理效果的方法 .     

集中访视方法在胃肠外科手术患者中的应用及效果

目的探讨集中访视方法在胃肠外科手术患者中的应用及效果。方法将本院2015年1~6月的200例胃肠外科手术患者随机分为两组,每组100例。对照组采用常规术前访视,观察组采用集中访视方法。比较两组术前焦虑程度、访视前和访视后的血压和心率变化以及对手术室护理工作的满意度。结果观察组术前焦虑程度较对照组明显降低(P0.01);术前访视后的血压和心率较对照组明显降低(收缩压,P0.01;舒张压,P0.05;心率,P0.05);访视后患者对手术室护理工作的满意度评分明显高于对照组(P0.05)。结论集中访视方法能更好地降低择期手术患者术前焦虑程度,使其血压、心率等生理应激水平趋于平稳,提高患者对手术室护理工作的满意度,同时减少手术室护士的工作量。     

Putting policy into practice: pre- and posttests of implementing standardized languages for nursing documentation

Aims and objectives. To describe the change in documentation of the nursing process in all inpatient wards in a 900‐bed university hospital. Major research question was what are the differences between before and after implementation of documentation policy related to the steps of the nursing process? Background. Implementation of standardized languages has been shown to be difficult to accomplish in clinical practice. Patients are the source of data and their conditions, responses and well‐being should be reflected in the nursing record. As such, nursing documentation can create the premises for the development of new knowledge in nursing and the improvement of nursing performance and can provide data and information necessary for nursing researchers to evaluate the quality of interventions and participate in the formulation of healthcare policy. This study is part of longitudinal project to prepare nurses for electronic documentation within the interdisciplinary health record and to improve documentation of nursing using standardized languages. Design and method. A cross‐sectional study design was used: a pretest (n = 355 nursing records) for baseline status of nursing documentation, an intervention and a post‐test (n = 349 nursing records) to obtain data on nursing documentation. The year‐long intervention comprised planned work in groups, and educational and supporting efforts. Results. A statistically significant improvement was found in the use of Functional Health Patterns for documentation of nursing assessment, NANDA for nursing diagnoses and Nursing Interventions Classification for nursing interventions in documentation of daily nursing care for inpatients. Conclusion. At all organizational levels intervention aimed at putting policy regarding documentation into clinical practice considerably improved daily use of standardized nursing languages. Relevance to clinical practice. Nurses need to use standardized language to document patient care data in the electronic health record and to demonstrate contributions to nursing care.     

Structure and content in Norwegian nursing care documentation.

In 1994, the Norwegian Board of Health (NBH) published recommendations for nursing care documentation. The two-fold purpose of the present study was to see if 5 wards in 2 Norwegian hospitals fulfilled the proposed NBH recommendations and guidelines regarding documentation, and to evaluate them in terms of the proposed structure and key words of the VIPS model. Results showed that all nursing records (n = 55) had an admission assessment. A nursing care plan was present in 62% of the records. Nursing goals were lacking in the remaining 38%, diagnosis and planned interventions were absent in 18%, and 45% of the diagnoses lacked information concerning patient progress or outcome. The nursing care plans were updated in only 40% of the records and discharge notes were present in 35%, confirming that NBH recommendations were not met in this sample. The key words of the VIPS model covered all information present in the records, and high interrater reliability was obtained for the majority of key words categorized by two independent researchers. It is suggested that the VIPS model components and key words can contribute to a reliable and uniform model for nursing care documentation and enhance comprehensive and systematic documentation, which is presently lacking in Norwegian records.     

Research and the configuration of nursing services

• ? This paper is concerned with the way in which nursing research has influenced changes in the organization of nursing services, particularly the shift from so-called traditional nursing to new nursing. To this end published research and professional literature are selectively reviewed.
• ? The case is made to support the view that change in nursing has been driven forward by the evangelical zeal of opinion leaders rather than evidence.
• ? It is suggested that holistic care as embodied in new nursing is no longer affordable. Market pressures have precipitated a revisiting of the task basis of nursing. An effective anchor would have been a solid body of research evidence pointing up the value new nursing may have. Regrettably not enough research was done prior to the diffusion of new nursing. What was done was not always adequate, and what was adequate was not effectively deployed by nurse leaders.
• ? Nursing is the largest workforce in the NHS and has attracted a great deal of policy interest. It is suggested that it will become increasingly important for nursing to be more strategic, and develop its own professionally driven research agenda.
• ? The future of the nursing profession is uncertain. It is clear that evidence-based practice is centre stage, and there is a need for nursing to re-negotiate its professional boundaries and to develop intellectual partnerships in order to move the knowledge base of practice forward.

     

Towards an aesthetics of nursing

Towards an aesthetics of nursing This paper re-appraises the work of Barbara Carper on aesthetics and the art of nursing. It identifies serious flaws in Carper's original arguments and the way in which she and subsequent authors have conflated the concepts of art and aesthetics in nursing. The paper explores a broader approach to aesthetics and proposes a way in which a theoretical approach to nursing aesthetics could be developed. The paper concludes that nursing is a fit object of aesthetic appreciation and that aesthetic quality is a necessary attribute of good nursing practice.     

提升护理服务综合价值的研究

目的:研究护理综合价值的提升。方法:分析护理价值研究背景,阐述护理价值研究进展结果:提出护理价值研究途径。结论:有利于达成一种共识,使广大护理人员认识护理价值、研究护理价值、开发护理价值,重视护理综合价值研究和提升。 护理服务价值是护理服务劳动产品的价值和服务本身所创造的价值的总和,即使用价值与价值的统一。目前日本、美国、德国和中国都在加强护理价值研究的探索,但仍存在使用价值与价值研究分离问题。因此,我们应不断加强护理综合价值研究,以适应卫生事业改革对护理管理的挑战。本研究主要在分析国内外护理价值研究的基础上,提出综合护理价值研究途径,以达到合理评价护理价值的目的。     

基层医院整体护理的实施与对策

目的:总结实施整体护理的经验,提高护理质量。方法:全面综合分析实施整体护理的对策和措施。结果:经验:领导的高度重视和大力支持,是实现整体护理模式转变的坚实基础;提高人员整体素质,确保整体护理的有效开展;多做少写,以点带面,实行非模式病房开展整体护理工作;积极开展健康教育,巩固整体护理效果;实施整体护理质量管理的措施。体会:领导的重视和支持,是开展整体护理工作的根本保证;提高了社会公众对护理工作的认可程度和护士的社会地位;显示了护士的自身价值;改善了护患关系,提高了病人满意度,同时也密切了医护关系;护理队伍整体素质提高,敬业精神增强。结论:实施整体护理,促进了护理学科的发展。     

我国护理行业的改革与发展

从我国护理行业的现状、卫生体制改革以及基本国情出发 ,着重探讨护理管理、护理教育、护理环境、护理经济与管理体系、护理立法等方面的发展途径     

整体护理病房三级护理查房的体会

我院自1999年7月开始在整体护理模式病房中实施三级护理查房。1年多来,对800例危重病人进行了护理查房,查房的形式为责任护士每天查,主管护师或护士长每周查,副主任护师以上或科护士长每月抽查,护理部主任每季抽查。通过查房,明显提高了危重病人的护理质量,病人得到了更为优质的服务,护理服务满意率提高;对护理人员来说,提高了业务水平,锻炼了口头表达能力;对护理管理来说,及时了解护士对护理程序的应用情况,掌握危重病人的护理质量,对护理中存在的不足及时提出指导意见。     

Innovations in United States genetics nursing: Practice and research

Aim: Clinical and research applications from human genome discoveries are growing and creating both opportunities and challenges to the integration of genetic concepts into practice and research. Nurses have a long history of caring for individuals, families, and groups with genetic conditions. In the past two decades, a small group of nurses in the USA have used a variety of strategies to further develop the field of genetics nursing. In this paper we identify innovative approaches to identifying genetics‐related nursing roles and opportunities, as well as successful collaborative efforts beyond nursing to address the emerging health and societal challenges related to human genetics discoveries. Methods: The information presented here comes from a variety of sources where the authors or genetics nurses directly participated, including: (i) a systematic literature review of genetics nursing; (ii) a comprehensive research study of models of delivering clinical genetics services and the roles of health professionals; and (iii) participation in numerous national research, planning, programmatic, and advisory groups involved with clinical genetics‐related health services, research, education, and public policy. Results: Genetics nurses in the US have developed innovative responses to genetics‐related challenges within and beyond the profession of nursing. These include: (i) establishing an organization for nurses in genetics and gaining formal recognition of genetics as a specialty of nursing; (ii) defining the scope of genetics nursing practice and developing a new genetics nursing credential; (iii) establishing a multiprofessional genetics education coalition and defining genetic competency for health‐care practice; (iv) creating new clinical practice roles for nurses that integrate emerging genetics concepts and skills into diverse clinical practice areas; (v) expanding nursing involvement in genetics‐related research; and (vi) participation in high‐level genetics advisory groups. Conclusions: The US experience shows that nurses have made substantial progress in expanding their involvement in genetic services through visionary leadership, innovative approaches to challenges, establishing support with nurse colleagues, and engaging in multiprofessional efforts. The most important first step is developing a supportive environment for nurse advancement. In the US, the genetics nurses’ organization known as the International Society of Nurses in Genetics (ISONG) has provided this base.     

晨间护理缺陷分析及对策

目的提高晨间护理质量。方法通过向住院病人和护士发放问卷调查及每周不定期检查各病区晨间护理质量,了解晨间护理工作中存在的缺陷,提出整改的措施。结果晨间护理工作中存在的主要缺陷:51.8%的病人认为护士与病人的沟通少,进病房时未向病人问好,整理病房时未向病人解释,口腔清洁率70.3%,头发清洁率45.3%,皮肤清洁率69.5%,病房安静整洁率67.3%,床单位整洁率86.5%,病情关注情况67.9%,健康教育执行情况48.6%,协助生活不能自理的病人进食、入厕、更衣、床上排便等占75.4%,时间安排满意度75.6%,护士认为晨间护理重要的占30%,晨间护理内容知晓率占60.9%,认为工作量大来不及做的占56.7%。结论提高护士对晨间护理的认识,规范晨间护理内容和程序,加强与病人的沟通,提供符合个体化需要的晨间护理,合理安排护理人员、工作重点和时间,持续质量改进,有助于提高晨间护理质量。