军地急救比武模式在急诊专科培训中的应用

目的 探讨适合军队中小医院急诊专科护士培训方法.方法 参照军地急救技能比武模式,有针对性地以战伤救护训练及重症监护技能培训为核心培训方法,分析培训前后急诊专科理论与技能的考核成绩、急危重症抢救成功率及医师、患者的满意度.结果 培训后护士的急诊专科理论与技能考核成绩、急危重症抢救成功率及医师、患者满意度比培训前明显提高.结论 通过参加军队卫勤比武及地方急救技能比武,总结急诊专科技能培训方法,切合本院实际情况,提高护士的整体素质,为培养急诊专科护士提供理论依据.     

急诊专科护士培养

急诊科室是体现一个医院综合水平的窗口,急诊护理工作的质量是医院整体护理质量的重要体现。急诊的护理管理要将重点放在“急”、“畅”、“效”的软硬件建设,将急诊作为医院的一个核心窗口,将急诊的护理管理落实到实处,体现出医院的品质,展示出护理的精髓—心灵的高尚、技术的精湛和知识的渊博。无论从国外急诊护理工作的发展趋势,还是国内急诊护理工作的实践来看,培养一支高素质的急诊专科护理队伍成为当务之急。     

急诊护士在急诊绿色通道中的作用

急诊绿色通道的开放为抢救生命赢得了宝贵时间，适应现代急救医学的发展，提高了病人在急诊室中的抢救成功率。     

急诊护士急救技能阶梯式培训的方法探讨

目的探讨急诊护理人员急救技能阶梯式培训的方法。方法对30名急诊护士具体实施以急救技能及急救理论知识、院前急救及急诊分诊、群死群伤及突发卫生事件、综合模拟急救演练等项目的学习和培训;通过理论考试、急救技能及护理技术操作的考核、模拟急救考核并总结护士每次考核的成绩,对护士进行年度综合考评的方法,验证实施阶梯式培训后急诊护士的急救技能及整体素质。结果30名急诊护士考核成绩及护理综合质量考评均有明显提高(p<0.05)。结论实施阶梯式培训,能有效提高急诊护理人员的急救技能和整体素质,也提高危重病人抢救成功率,同时病人安全和护理安全得到有效保证。     

浅谈低年资护士急诊急救能力的培养

目的探讨有效培养低年资护士急诊急救能力的方法。方法结合李美英、李秋菊等人的研究成果,对低年资护士急诊急救能力的培养方法和结果进行分析、总结。结果李美英、李秋菊等人的研究证明采取系统的培训能够快速提高低年资护士急诊急救能力,经过一段时间的进修,低年资护士的综合能力考核成绩、焦虑量值、医生及患者满意度等状况均得到大幅度的改善。结论根据急诊护理特点开展系统的培训考核,有助于低年资护士专业护理能力的快速、持续提高,能够有效培养低年资护理急诊急救能力。     

ICU专科护士在NICU培训基地临床实践的管理

目的:临床实践性教学与管理是培养ICU专科护士运用所学知识解决实际问题能力的关键.方法:对安徽省首批ICU专科护士在NICU培训基地的临床实践管理过程,分成接受带教前准备、入科时进行评估、制定培训内容及计划、培训过程中的质量管理、出科前师生相互评估、总结这几个阶段.结果:33名ICU专科护士通过几个月的临床带教,NICU的理论知识与临床技能均有明显提高,对带教满意度达到97%.结论:通过NICU临床基地培训,能激发学员对新生儿急救知识的学习热情和兴趣,提高了危重新生儿病情观察能力和急救技能,保证了带教质量完成.     

急诊护士在使用急救物品中存在的问题及对策

分析和探讨在临床实践中，急诊护士使用急救物品时存在的几种问题，并针对提出了对策，进而提出了急救物品的组合使用。急诊护士要明确危重患者的抢救与急救物品之间的关系，作好预见性的准备，保有危机意识和采取行之有效的管理方法。     

广东省骨科专科护士工作现状调查与分析

目的了解广东省骨科专科护士的工作现状,为完善专科护士培养制度,加强专科护士管理提供参考依据。方法采用自行设计的调查问卷,对广东省71家医院的84名骨科专科护士进行问卷调查,回收有效问卷77份。结果①骨科专科护士学历职称以本科中级职称为主②骨科专科护士有高级实践的平台,但专科护理成效不明显,护士缺编、缺乏实践导师、未建立专科本底数据是导致专科护理成效不明显的主要因素。③专科护士能积极查阅专科文献,但缺乏撰写论文、科研的能力。④95.5%专科护士认为经常参加专科学术会议能加强专科护士之间的交流分享,提高专科能力。结论发挥专科护士高级临床护理实践作用,科学地使用专科护士,加强专科护士岗位管理,真正使专科护士学有所用,是目前面临的亟待解决的问题。     

护士在创建急诊绿色通道中的管理作用

为了适应现代急救医学的发展，提高患者在急诊室中的抢救成功率。我院急诊科从2006年1月成立急诊绿色通道，由于不断加强绿色通道护理系统的建设及管理，有力的配合了各项抢救工作。至2006年12月共收治危重患者32例，抢救成功率达95％以上。     

PBL查房模式在提高急诊年轻护士急救能力中的应用

随着医学研究的快速发展,护理研究作为其重要内容,提升医护人员的急救能力显得尤为关键.在临床护理中,在掌握基础护理及专科理论知识的前提条件下,利用PBL查房模式的便利优势,将其应用于急诊护理诊治工作,尝试多种角度思考临床护理问题,注重引发护理人员的自主思考能力,对临床患者具有重要辅助作用.基于此,本文围绕PBL查房模式在提升急诊年轻护理急救能力的应用,探究当下急救护理培训方法的实际现状,为其提供几点优化建议,以供相关研究参考.     

The role of clinical epidemiology in medical practice

Epidemiological research has been carried out traditionally in the field on non-clinical populations and has sought to reveal the aetiology of disease. But in the 1960's a possible role for epidemiology in the study of clinical practice emerged. A series of articles on scientific methodology and clinical medicine argued that much of the reasoning underpinning clinical practice might be expressed in numerical terms. This numerical expression would require the counting of diseases and events in groups of patients and would thus employ similar methods to traditional epidemiology where diseases are counted in populations. Although the term 'clinical epidemiology' was introduced as early as 1938, Sackett was instrumental in promoting the concept in 1969 as the 'application by a physician... of epidemiologic and biometric methods to the study of the diagnostic and therapeutic process in order to effect an improvement in health'. The management of individual patients involves the clinician in a multitude of decisions, concerned with making a diagnosis, ordering tests, prescribing treatment and estimating prognosis. Decisions are often made in a state of uncertainty because no reasonably objective information is available to indicate the best decision in the given circumstances, or because the most appropriate sequence of decisions for an individual patient is not apparent. Although the state of the art does not allow us to do this completely, the role of clinical epidemiology is, by way of clinical research, to provide clinicians with the information to make decisions that are most appropriate for the welfare of their patients, and in combination with information derived from decision theory to make these decisions rapidly and logically.(ABSTRACT TRUNCATED AT 250 WORDS)     

The role of collaborative interactivity in the observational practice of clinical skills

Medical Education 2012: 46 : 409–416 Context Video‐based observational practice can extend simulation‐based learning outside the training space. This study explores the value of collaborative feedback provided during observational practice to the acquisition of clinical skills. Methods Nursing students viewed a video demonstrating the proper ventrogluteal injection technique before performing a videotaped pre‐test trial on a simulator. They were then assigned randomly to one of three observational practice groups: a group that observed the expert demonstration (EO group); a group that viewed the expert demonstration, self‐assessed their individual pre‐test and contrasted their self‐assessments with expert feedback (ESO group), and a group that observed the expert demonstration, self‐assessed and contrasted their assessments with those of an expert, and formed a community that engaged in peer‐to‐peer feedback (ESPO group). The observation of all videos, the provision of assessments and all networking occurred via an Internet‐mediated network. After 2 weeks, participants returned for post‐tests and transfer tests. Results The pre‐test–post‐test analyses revealed significant interactions (global rating scale: F_(2,22) = 4.00 [p = 0.033]; checklist: F_(2,22) = 4.31 [p = 0.026]), which indicated that post‐test performance in the ESPO group was significantly better than pre‐test performance. The transfer analyses revealed main effects for both the global rating scale (F_(2,23) = 6.73; p = 0.005) and validated checklist (F_(2,23) = 7.04; p = 0.004) measures. Participants in the ESPO group performed better on the transfer test than those in the EO group. Conclusions The results suggest that video‐based observational practice can be effective in extending simulation‐based learning, but its effectiveness is mediated by the amount of time the learner spends engaged in the practice and the type of learning activities the learner performs in the observational practice environment. We speculate that increasing collaborative interactivity supports observational learning by increasing the extent to which the educational environment can accommodate learners’ specific needs.     

Clinical sympathy: the important role of affectivity in clinical practice

Medicine, Health Care and Philosophy - Bioethics has begun to see the revaluation of affects in medical practice, but not all of them, and not necessarily in the sense of affects as we know them....     

The role of reflective practice in pharmacy

CONTEXT: There has been a considerable paradigm shift from a product-centred focus towards a patient-centered focus in pharmacy. Pharmaceutical care practice (Cipolle et al., 1998) can be seen as the latest proposal to transform the profession as mandated by most major professional associations in pharmacy. Pharmaceutical care is an innovative way of practicing pharmacy that has the potential to make drug-therapy safer, more effective, and more convenient for the patient. Even though pharmacists' time spent on customer communication has increased over time (Savage, 1999), this alone will not be sufficient to bring about a paradigm shift in view of what the pharmacist actually does to provide quality patient care. It appears equally important to reflect on how pharmacists practice pharmacy. METHODS/OBJECTIVES: It is the aim of this discussion paper to argue for the importance of linking education and practice as a core part of the teaching of pharmaceutical care. CONCLUSION: In order for pharmacists to partake in truly interdisciplinary health care teams and the profession of pharmacy to demonstrate its unique and indispensable contribution to quality health care, pharmacy curricula would teach toward reflective practice, be problem-based, be positioned in collaborative teams, and have an outside (authentic) focus.     

The teacher and the cop: the role of 'private space' in increasingly transparent clinical practice

Education and enforcement have been two contrasting ways of managing clinical performance. Both are needed but recently health policy has placed greater emphasis on the latter, possibly to the detriment of the former. This paper examines the ways in which education and other formative aspects of clinical practice can be conducted. The boundary between education and enforcement involves a distinction between public and private space. Private space is the territory within which clinicians can review their performance and improve it from an educational perspective. The boundary between public and private space is fluid, particularly since the advent of systems to ensure clinicians' competence. The sensitive management of this boundary will determine whether the benefits of transparent clinical practice will be realized in terms of improved patient care.     

The risks of clinical practice

The hospital workplace is changing dramatically, moulded in part by the need to protect medical staff from the increasing physical and mental risks of medical practice today. This article examines the risks and look to the future.