探讨适合现代护理要求的独立早交班模式

目的探讨适合现代护理要求的独立早交班模式,以提高护士的交接班质量与效率,实现护理质量的持续改进。方法选择本科室2003年4月~2004年3月采用传统交班模式设为对照组,选择2004年4月~2005年3月实行护士独立早交班模式设为实验组,根据自制表格对两组各240次晨会交班进行对比性研究。结果实验组在交班时间、环境、效果及夜间护理质量等方面明显优于对照组,科室医生对新的交班方式表示认可。结论实行护士独立早交班,能有效地提高早交班效率与质量,适合现代护理的要求,有利于实现护理质量的持续改进。     

护理交班的实践与体会

目的:探讨护理交班质量评价在护理交接班中的应用及效果.方法:通过实施护理交班量化评价,对交班护士的行为规范、交班前准备、口头交班、床边交班、账物交班、交班记录、终末质量、交班时间8个方面规范护理交接.结果:实施后护士对患者病情知晓及患者对护士护理服务满意度明显优于实施前(P<0.01).结论:应用护理交接班量化评价表评价护理交接班全过程,有利于对护理交接班进行科学的考评和及时有效的监控,规范护理交接班流程,提高护理质量.     

交接班管理新模式对ICU护理质量的影响

目的 探讨床边交接班管理新模式对ICU护理质量的影响.方法 改变传统的办公室集体交班的模式为直接床边书面交班、口头交班、实地查看病人的新模式,并制定相应的具体的标准和细则.结果 新交接班模式所需交接班时间缩短、接班者对病人病情的掌握程度提高.各级护理人员对交接班管理制度的满意度明显提高,全年来发生交接班制度执行不严...     

护士礼仪培训及考核在临床中的应用

目的:探讨和总结系统化护士礼仪培训及考核对提高护理质量的作用.方法:对全院护理人员进行分层次的护士礼仪培训,包括仪容礼仪、举止礼仪、电话礼仪、沟通礼仪、社交礼仪,在此基础上结合操作和流程制定了22个服务剧本,将护理礼仪融入其中.并制定了严格的考核机制.结果:经过系统化的培训与考核后,护士的服务礼仪、沟通能力、患者的满意度较培训前有显著差异,具有统计学意义.结论:系统化的护士礼仪培训与考核可以让护士更好的将礼仪运用于临床,满足患者的身心需要,促进建立良好的护患关系,提高护理质量和患者对护理工作的满意度.     

对危重症患者交接班现状的分析及应对

目的：分析危重症患者护理交接班现状的不足,探讨如何科学规范管理。方法：调查全院31个临床科室60例危重症患者对护理交接班专项的满意度,同时向100名护士发放危重症患者交接班现状调查问卷。结果：危重症患者交接班环节亟待解决的问题有缺乏人文关怀,交接班流于形式、达不到预期效果,交班内容无重点、病情交接不连续,护士位置无序随意、床边交接不规范。结论：需要融入人本观念,运用整体护理、循证护理的思维及工作模式,对危重症患者交接班环节实行科学规范管理。     

强化早交班在手术室管理中的作用及体会

目的：研究探索强化早交班在手术室管理中的作用。方法：随机选取20i3年2月~2014年2月期间不同旱交班情况的手术室，按照是否加强了手术室中的早交班的管理情况，将所选手术室分为对照组与观察组，观察组是强化早交班管理情况的手术室，对照组是未强化早交班管理情况的手术室，将结果进行对比分析。结果：观察组治疗有总效率为100．00％，对照组治疗总有效率为80．00％。两组有效率比较发现，观察组治疗有效率明显高于对照组。结论：强化早交班制度能有效加强院内的物资管理，提高工作闻连续·挂，大大降低纰漏出现的几率，减少医患纠纷，有利于医院的正常运行。     

普外科护理管理中病房早交班风险点评的应用探析

目的：探讨普外科护理管理中病房早交班风险点评的应用效果。方法：选取我院护士34名,随机平均分为两组,对照组19名护士采用传统交班方式,实验组19名护士采用新式交班方法,即进行病房早交班风险点评。结果：实验组采取风险点评交班方式后,患者满意度93．0％,护理质控缺陷率8．0％,医师满意度96．0％;对照组采取传统交班方式后,患者满意度72．0％,护理质控缺陷率22．0％,医师满意度82．0％。实验组护理质量显著高于对照组,对比差异具有统计学意义（P〈0．05）。结论：实验组采用风险点评交班方式,护理质量显著高于对照组,获得了满意的效果,值得应用推广。     

县级医院护理人员礼仪培训效果初探

目的：探索县级医院护理礼仪培训的有效方法与效果。方法：对某县医院186名护理人员通过系统的礼仪知识讲座、分批集中培训、利用网络课件分散训练等方式进行护理礼仪培训，比较培训前和培训近一年后护士礼仪知识、非护理人员对护士群体综合素质评定、患者及其亲属对护理工作满意度等方面情况。结果：护理人员礼仪知识水平明显提高（P=0．000）；护理人员综合素质的他评值显著提高（P=0．000）；患者及其亲属对护理工作的满意度明显提高（P一0．001）。结论：护士礼仪培训能提高护理人员礼仪知识水平和整体素质，提高患者及其亲属的满意度；医院领导的重视和支持是保证县级医院护士礼仪培训效果的重要前提；全员参与，创设医院整体氛围，可增强培训效果；集中培训与分散训练相结合，注重督促落实，才能确保培训目标的达成；多媒体教学手段和网络设备有助于强化培训效果。     

基层医院护理管理中几个问题的探讨

护士交班报告是工作及其质量的全部体现,其重要性等同于医师的病史和病程记录,是医院医疗文件的重要组成部分。其意义在于①真实反映病人从入院到出院整个病程的演变及疗效;②是从护理角度记录观察病情的原始资料;③在特殊情况下,可为解决医疗纠纷提供法律性依据;④还是督促考评护士工作的重要指标。因此作为一名护理人员,必须充分了解当日交班内容和重点内容,写好交班报告,作好交接班。但是,现在在二级医院甚或个别三级医院,护士交班报告的书写中存在着许多缺陷,必须克服。１　交班报告书写的缺陷１．１　懒惰省力、抄袭照搬　…     

床头交班中存在的问题及对策

<正> 随着整体护理的深入开展,临床护理人员越来越认识到床头交班的重要性,它是护患沟通的重要时机,同时对掌握急危、重症病人的病情也非常重要,在护理工作中具有举足轻重的地位。但实际工作中却并非如此。为此,笔者对本院11个内科病房120名护理人员床头交班情况进行了问卷调查和分析,以求规范床头交班,提高交班质量和护     

“优质护理服务示范工程”中晨间护理与交接班的改进

指出原有晨间护理及晨间交接班模式存在3方面问题：一是时间安排不合理;二是分工、方法不合理;三是内容、形式、程序不合理。并进行了改革：一是明确时间、流程及人员职责;二是改进分工方式及方法;三是改革形式和内容。改革后。晨间护理时间提前,交接班人数减少、时间缩短,满足了患者需求,提高了医生、护士、患者的满意度,提升了护理质量。     

提高晨会交接班工作效率

目的 提高晨会交接班工作效率.方法 QC小组活动.结果 缩短了晨会交接班时间,满足了患者晨间护理及治疗需求,减轻了午间值班护士工作量.结论 通过QC小组活动,改革了晨会交接班模式,提高了工作效率,减少了护患纠纷.     

A-N两班制排班模式在医院优质服务病区的应用效果

目的探讨A-N两班制排班模式在优质病区的运用,使有限的护理人力达到更优化的组合,来提高护理质量和护士排班的满意度。方法将创优病区普外科采用APN排班模式的阶段为对照组,采用改革后A-N两班制排班模式的阶段(即A代表上午班,上班时间8:00～16:30;N代表夜班,双人上班,上班时间16:30～次日08:00,其中22:00～次日02:00时间段可休息1人,02:00～06:00时间段可休息1人)为实验组,评价两组实施前后的护理质量、病人满意度、护士对排班的满意度等效果。结果实施A-N两班制排班模式后创优病区的护理质量、病人满意度、护士排班的满意度明显高于APN连续性排班模式病区(p<0.05,差异有统计学意义)。结论 A-N两班制排班模式能满足当下护士的需要,值得基层医院优质服务病区在排班方面借鉴。     

连续性护理排班模式对护士职业倦怠的影响

目的通过调查排班改革前、后对护士职业倦怠的影响,探讨开展优质护理服务护士的排班模式。方法随机选取某医院优质护理服务示范病房神经内二科和消化内分泌科护理人员30名。采用工作倦怠量表(MBI),调查排班改革前及改革6个月后护士职业倦怠情况。结果护士情感耗竭评分由改革前的中等水平[(22.19±10.21)分]下降为改革后的低水平[(17.59±8.78)分],但差异未见有统计学意义(P0.05);工作成就感评分由改革前的中等水平[(30.86±6.64)分]提高到改革后的低水平[(35.74±6.23)分],差异有统计学意义(P0.01);非人性化评分改革前、后差异无统计学意义(P0.05)。结论时间分段,护士分层、分组及夜班2人连班的连续性护理排班模式在适应优质护理服务开展的同时,能降低护士职业倦怠水平。     

护理人员睡眠障碍及其相关因素的调查

为探求导致护理人员睡眠障碍的相关因素,提高护士素质及护理质量,对672名各岗护士进行抽样调查。其结果：护理人员睡眠障碍的发生率为16.96%;各岗之间存在显著性差异。其中发生率较高的是门诊部、五官科、供应室、精神科、妇产科;睡眠障碍的发生率与班制、岗位、烟酒渚好、夜班工作年限等有关;睡眠障碍出现频度较多的症状是“自觉多楚”、“醒后不易入睡”和“醒后感到不适、疲乏”,所以要以科学合理的排班,加强护士保健,改革工作制度和工作环境等为相应的对策。     

降低危重患者晨间床旁交接班缺陷率

目的降低危重患者晨间床旁交接班缺陷率。方法开展品管圈活动,针对真因,从完善流程、加强培训、建立标准3方面进行改进。结果神经外科危重患者晨间床旁交接班缺陷率从37.34%降低到14.45%。结论开展品管圈活动降低了危重患者晨间床旁交接班缺陷发生率,提升了护士对病情的掌握能力,增强了团队合作意识,提升了患者满意度,促进了护理质量持续改进,更好地保障了患者安全。     

Characteristics of wet work in nurses

Background objectives: Nursing is known for its high prevalence of hand dermatitis, mainly caused by the intense exposure to wet work in nursing activities. We aimed to study the characteristics of wet work exposure in nursing. Method: Trained observers monitored the duration and frequency of different wet work activities in 45 randomly chosen nurses from different wards during a morning shift, using a method of continuous observation based on labour-observation techniques. Results: Wet work in intensive care units accounted for 24% of the overall morning shift duration, with a frequency of 49 incidents. This was 16% in dialysis wards, with a frequency of 30 incidents, and 9% on regular wards, with a frequency of 39 incidents. The wet work activities had short mean duration cycles. The mean duration of occlusion by gloves was 3.1 min on regular wards and 6.7 min in intensive care units. Discussion: The characteristics of wet work in nurses differed substantially, depending on the ward. According to the German regulation TRGS 531, our observations classify nursing as a wet work occupation, due to the frequency of wet work rather than its duration. The mean duration of occlusion in our observations was short, which makes an occlusion-induced irritating effect doubtful. Reduction in wet work exposure in nursing on regular wards could focus on the reduction of the frequency of hand-washing and patient-washing. We suggest increasing the use of gloves for patient washing. Although this will increase exposure to occlusion from gloves, it may reduce the frequency of exposure to water and soap by about a quarter.     

Chronobiological aspects of sleep of nurses in a university hospital

This study was aimed at identifying the chronotype of nurses in the morning and evening shifts of a university hospital, how these workshifts influence their sleep and correlate chronotypes with influences of sleep on and off the workplace. Fifteen nurses participated in the study by answering to the questionnaire of Horne&Ostberg and semi-structured interviews between March and July 2010. Data from questionnaires were organized into spreadsheets and the interviews were analyzed by thematic analysis. Nurses worked as follows: five in moderately morning shift, four in indifferent shift, two in moderately evening shift, three in evening shift and one in morning shift. Shift work was found to develop peculiar eating and sleep habits. The chronobiological profile did not translate subjectivities regarding sleep and work shifts. Night nurses demonstrated higher dysfunction in sleep-wake cycle, which had an impact on the daily lives of all nurses.     

Reentrainment of diurnal variation of psychological and physiological performance at the end of a slowly rotated shift system in hospital workers

Summary Eighteen normal male nurses were tested on a battery of simple psychomotor tasks, subjective self-ratings and physiological tests on three weekly occasions, during the 6th day of each shift (morning, afternoon, night) of their actual job rotation pattern.The shift order was assigned according to a fully balanced design and the tests were carried out between the 3rd and the 5th h from the beginning of work (approximately at 10 a.m., 6 p.m., and 2 a.m.). During the night shift, the subjects rated themselves as most tired and reported higher perceived exertion at different work loads performed on a bicycle ergometer. None of the psychological and physiological variables showed significant inter-shift differences except heart rate and blood pressure: both were lower in the night, the former only at rest and after a light effort, the latter only under hardest work loads. A very high correlation was found between perceived exertion and heart rate in all three shift conditions while a negative correlation between perceived exertion and extraversion emerged in the night occasion only. The present results are discussed and the hypothesis of an adaptation of performance, on most of the tests used, to this weekly rotating shift system is suggested.Paper presented at the 4th International Symposium on Night and Shift Work, Dortmund, 14–17 November 1977