责任制整体护理在结直肠外科病房的实现

目的：探讨责任制整体护理在结直肠外科病房的实施的可能性及实施效果。方法：总结责任制整体护理在某三级甲等医院结直肠外科病房的试验实施方案，调查执行该护理模式前后出院患者的满意程度和临床护理质量，并进行统计学分析。结果：试验执行责任制整体护理后，患者对临床护理的满意程度大幅提高，科室的临床护理质量也有显著提升，但是在护理文件整理方面仍有待调整。结论：责任制整体护理模式在结直肠外科病房可以实现，且能提高患者的满意程度和护理质量，深入实施后，能为患者提供更优质的临床护理服务。     

积极主动为贫困人口服务--上海市北站医院平价病房的案例调查

目的:对上海市一所国有民营医院的平价病房进行案例调查,了解运行状况、经验及存在问题。方法:相关人员访谈和现场观察。结果:该院设立了14张床位的平价病房,收治对象是低保户、特困户及经济困难的外来务工人员。对医保病人和自费病人设定不同的减免优惠方案,包括减免50.0%的床位费和10.0%的护理、检查、治疗及手术等劳务费用(药费除外)。以收治急性病为主,住院时间原则上不超过2周。出院病人总费用的实际减免率约为6.0%￣10.0%。结论:创办平价病房的方向应予肯定。是民营机构委托管理医院的一种公益性(非营利性)的表现,对其他公立医疗机构具有促进作用。     

《中华骨科杂志》2002-2004年引文分析

目的研究《中华骨科杂志》文献引用规律及我国骨科学研究领域科研人员的文献利用与需求特征。方法利用引文计量分析法,统计《中华骨科杂志》2002-2004年间刊载的614篇论文所引用的参考文献。结果614篇论文中,有引文的论文共565篇,引文率为92.02%,篇均引文11.66条;引文中期刊6672条(93.22%),图书451条(6.30%);普赖斯指数45.44%,期刊自引361条,自引率5.04%。被引用频次居前20位的中、外文期刊的引文量占总引用期刊引文量的53.30%。结论《中华骨科杂志》涉猎文献范围广,引文类型以期刊为主,语种以英文文献为主,引文的外文语种结构较为单一,研究引用文献比较滞后,文献半衰期较长,专业人员利用近5年内新文献的能力有待于进一步提高。     

干部病房护生静脉穿刺遭拒的原因分析及对策

目的调查和分析干部病房实习护生静脉穿刺遭拒的原因,提出对策。方法对52名干部病房实习护生148次遭拒情况进行分析。结果实习护生静脉穿刺遭拒与患者及家属的认知有关,与实习护生自身素质有关。结论实习护生应尊重患者及家属的选择,努力提高穿刺技术,学习并熟练掌握静脉穿刺方法,技巧等,不断总结经验,力争取得更高的成功率。     

运用人力资源管理策略 改革病房护理管理

从发展成功管理的共同文化,创建优质服务病房;建立有效的护理人力资源管理支持系统,创建适合于专业护理的工作环境,确保护理质量;以病人为中心,以病人满意度作为衡量护理工作优劣的标准三个方面介绍了乐山市人民医院运用护理人力资源管理策略,改革病房护理管理,创建优质服务病房的实践经验及其效果。     

病房医生工作站信息系统的功能与应用

病房医生工作站面向病房临床医生，实现了医生日常工作的各种需求，提供填写首页、下达医嘱、书写病历、开申请单、查询报告单、查询体温单、病历检索等功能。系统的应用可以规范医疗文书，减少差错发生，提高工作效率，培养医师的临床工作经验。     

Social climate within secure inpatient services for people with intellectual disabilities

Background The social climate of inpatient facilities is thought to be an important contributor to treatment outcome. However, little research has focused on this construct within secure forensic services for people with intellectual disabilities (ID). Therefore, the objective of this study was to investigate the social climate of two different types of secure units (‘low’ secure vs. ‘medium’ secure) contained within the same facility for offenders with ID. Two hypotheses were generated: (1) residents would rate the social climate of the whole facility in a more negative direction than staff, and (2) residents and staff would rate the social climate of the ‘low’ secure unit in a more positive direction than that of the ‘medium’ secure unit. Method Using a 2 (factor ‘Participant’ = Staff or Resident) × 2 (factor ‘Unit’ = ‘Low’ or ‘Medium’ Secure Unit) between‐subjects design, 18 residents and 37 staff members were recruited and completed the Correctional Institutions Environment Scale (CIES), a measure of social climate. Results Residents tended to rate the units in a more positive direction than staff on some sub‐scales. Participants rated the ‘low’ secure unit in a more positive direction than the ‘medium’ secure unit on two sub‐scales of the CIES. However, on selected sub‐scales there were differences. The findings of this study suggest that the CIES may be a valid instrument for use within forensic services for people with ID, and further suggests that residents and staff have different perceptions of the shared social climate, which may have implications for service development.     

Destination after discharge from a senile dementia therapy ward before and after the implementation of long-term care insurance in Japan

Background: In Japan a new long‐term care insurance (LTCI) system, the so‐called ‘Kaigo‐Hoken’, was started in April 2000. The present study analyzes the change in the type of destination after discharge from a senile dementia therapy ward before and after the implementation of LTCI at Fukuoka Prefectural Onga Hospital, Japan. Methods: The present study examines data from 199 inpatients discharged from the Fukuoka Prefectural Onga Hospital that had been diagnosed with dementia and met the DSM IV criteria for Alzheimer's type, vascular dementia or other type of dementia. For the purposes of comparison two periods were defined, ‘the first period’ was defined as the period from 1 April 1999 to 31 March 2000, before LTCI was implemented, while ‘the second period’ was defined as the period from 1 April 2000 to 31 March 2001, after LTCI had started. Subject data was analyzed on the basis of where the subject had resided pre‐admission and their destination after discharge using the following classifications: nursing home or geriatric care facility, hospitalization, home and death. Results: While the certification rate of inpatients regarding long‐term care increased slightly in the second period, no significant change was observed based on where the subject had resided pre‐admission and their destination after discharge between the first and second periods. Conclusions: While LTCI is essential for Japan, it is necessary that people with dementia in senile dementia therapy wards are encouraged to return to their homes under the care and support of LTCI.     

The patient's daily activities in acute psychiatric care

The patient's daily activities in acute psychiatric care
This study is part of a research project entitled:'Towards patient-focused nursing on an acute psychiatric ward'. The aim of the project is to describe the changes taking place in nursing activities during a research project. This paper is a qualitative analysis of the patient's daily activities in acute psychiatric care. The data were collected by observing, selectively, seven patients for 61 h. The constant comparative method was used in data analysis. On the basis of the data analysis, the categories listed below were identified.
1 The core category of the patient's daily activities was'being a patient'.
2 Being a patient mainly consisted of being alone without meaningful activities.
3 Participating in the daily routines of the ward consisted of being alone while being together with others.
4 Being together was initiated by either the patient or the nurse. The aim of being together was to satisfy the acute basic needs of the patients.
5 Being together on the initiative of the nurse meant participating in the daily routines of the ward.
Because the data were collected by observation, no insight into the patients'desires, expectations and thoughts could be presented. The findings challenged the nursing staff to develop a more therapeutic daily routine in acute psychiatric care. It was also of importance to change the patients'meaningless existence into a meaningful participation in the daily activities on the ward.