Clinical value of precise rehabilitation nursing in management of cerebral infarction

BACKGROUND Cerebral infarction,previously referred to as cerebral infarction or ischemic stroke,refers to the localized brain tissue experiencing ischemic necrosis or softening due to disorders in brain blood supply,ischemia,and hypoxia.The precision rehabilitation nursing model for chronic disease management is a continuous,fixed,orderly,and efficient nursing model aimed at standardizing the clinical nursing process,reducing the wastage of medical resources,and improving the quality of medical services.AIM To analyze the value of a precise rehabilitation nursing model for chronic disease management in patients with cerebral infarction.METHODS Patients(n=124)admitted to our hospital with cerebral infarction between November 2019 and November 2021 were enrolled as the study subjects.The random number table method was used to divide them into a conventional nursing intervention group(n=61)and a model nursing intervention group(n=63).Changes in the nursing index for the two groups were compared after conventional nursing intervention and precise rehabilitation intervention nursing for chronic disease management.RESULTS Compared with the conventional intervention group,the model intervention group had a shorter time to clinical symptom relief(P<0.05),lower Hamilton Anxiety Scale and Hamilton Depression Scale scores,a lower incidence of total complications(P<0.05),a higher disease knowledge mastery rate,higher safety and quality,and a higher overall nursing satisfaction rate(P<0.05).CONCLUSION The precision rehabilitation nursing model for chronic disease management improves the clinical symptoms of patients with cerebral infarction,reducing the incidence of total complications and improving the clinical outcome of patients,and is worthy of application in clinical practice.

Co-word clustering analysis for nursing safety management research focuses by PubMed

Objective： To analyze hot research areas and the present research status of nursing safety management in PubMed. Methods： PubMed was searched using ＂safety management＂ for the literature on nursing safety management. BICOMB 2.0 and SPSS 20.0 software were used to analyze high-frequency keywords and conduct co-word clustering analysis. Results： We searched for totally 2353 articles related to our topic and extracted 19 high-frequency keywords （27.50%）. Five research focuses were concluded, including： study on nursing safety culture; team work to promote nursing safety; practice of nursing safety management; workplace violence against nursing staffs; nursing safety and quality evaluation standard. Conclusion： Analysis of the hotspots of nursing safety management in the past 10 years will contribute to understanding the research emphases and trend of development, and provide reference for the study and practice of nursing safety management.

Common Nursing Safety Problems and Nursing Management Strategies of Tumor Inpatients

Objective:This study aims to analyze the relatively common problems of nursing safety of tumor inpatients and to study the effect of implementing nursing safety management.Methods:The data of reference group are selected from patients admitted to hospital before the nursing safety management were fully implemented in the hospital from March 2015 to September 2015.The experimental group data are selected from patients admitted to hospital after the nursing safety management were fully implemented in the hospital from October 2015 to March 2016.The total number of nursing adverse events,the total rate of nursing disputes and the total satisfaction rate of nursing management of two group of tumor inpatients were calculated.Results:The total nursing adverse events of tumor inpatients in the experimental group were significantly different with the calculated values of the tumor inpatients in the reference group(p<0.05 data comparative statistics).Similarly,the satisfactory total rate of nursing management for tumor inpatients in experimental group were also significantly different with the calculated value of the tumor inpatients in the reference group(p<0.05 data comparative statistics).Conclusion:The findings suggest that nursing safety management to tumor inpatients should be highlighted as such program maybe useful to address the nursing safety problems in the hospitalized patients with tumor.

Explore the Practice and Application of Nursing Safety and Quality Management

Objective： Explore the practice and application of safety care management and quality management at work. Methods： Establish and improve the nursing management system, safety assurance and quality improvement through the development of clinical nursing assessment standards, supervision, inspection and evaluation of the hospital based nursing quality management to ensure the compliance of the basic quality indicators; raised the nursing quality,to improve with the basic pattern, we prefer both the long and short-term goals, implement and guide the nursing quality, to improve project implementation, quality management training and assessment. Results： Through the implementation of the management of nursing safety and nursing quality, hospital comprehensive nursing quality and service satisfaction has increased significantly. Conclusion： Implementation of nursing safety management and nursing quality management, which ensure the nursing quality of hospital-wide surveillance, improvement and implementation of nursing quality and service satisfaction improved to play a positive role in promoting. Through increased management, nursing quality management more standardized and institutionalized procedures, and enhanced the quality of nurses＇ awareness and sense of competition, play an enhanced role in the promotion of the service concept of ＂patient-centered＂, improve the nursing comprehensive quality, and create a safe and comfortable medical and rehabilitation environment.

The Influence of Nursing Safety Management on the Quality of Hemopurification Nursing

Objective:To study the influence of nursing safety management on the quality of hemopurification nursing.Methods:Fifty-six patients who underwent hemopurification in our hospital from October 2019 to October 2020 were selected and randomly divided into research group(n=28)and control group(n=28),control group patients adopt routine nursing mode,research group patient take nursing safety management mode.Then compare the nursing quality score,the occurrence of adverse events and nursing satisfaction of patients in the two groups after different nursing modes.Results:The service attitude,doctor-patient relationship,medical environment and professional skill scores of the research group were significantly higher than those of the control group(P<0.05),the incidence of adverse events in the research group was significantly lower than that of the control group(P<0.05),and the satisfaction of the patients in the research group was significantly higher than that of the control group(P<0.05).Conclusion:The application of nursing safety management in hemopurification can effectively improve the quality of nursing,reduce the occurrence of adverse events,and improve the patient's nursing satisfaction,the effect is significant and suitable for promotion.

Establishing Patient Safety in Intensive Care—A Grounded Theory

Background: The modern intensive care unit (ICU) is a complex and high-risk environment, and even small adverse events and changes may deteriorate the patient’s conditions and eventually cause harm. Many factors can potentially be associated within an increased amount of errors, leading to adverse events. Nurses, nurse managers, and other leaders all play important roles in establishing patient safety. Aim: This study aimed to obtain a deeper understanding of leaders’ and nurses’ main concerns in establishing patient safety in Swedish intensive care units. Method: A grounded theory methodology was used. Data from 15 interviews with leaders and nurses involved in critical care in Sweden were collected, analysed and constant compared. Findings: The main concern in establishing patient safety was promoting quality of care, work engagement, and staffs well-being in strained ICUs. The core category building trust explained how the leaders’ and nurses’ strove for quality of care and wished a healthy, safe work environment. This is further explained in the categories “Being an accessible and able leader”, “Creating knowledge and understanding”, and “Establishing collaborative practice”. Conclusion: Establishing patient safety in the ICU requires that staffs enjoy going to work, have good work relations, are committed and want to stay at the unit. A healthy, salutogenetic unit with a work environment marked by trust provides a better opportunity to establish patient safety, and various leaders have potential to achieve this.

护士用药安全管理实践现状与思考

用药安全管理是患者安全管理的重要内容。护士作为患者用药的最终执行者,其用药安全管理水平对于保证住院患者的治疗安全至关重要。文章回顾了国内外用药安全管理与实践现状,总结我国护士在用药安全管理实践中取得的进展与成效,为进一步推动住院患者用药安全水平的提升提供参考。

Application of Whole-Process Management in Day Surgery for Endometrial Polyp

Objective:To explore the effect of whole-process management model in nursing management of endometrial polyp day surgery.Methods:266 patients that underwent endometrial polyp day surgery from January to December 2022 were selected for this study,and they were separated into an observation group(131 patients)and a control group(135 patients);the clinical data of the two groups were compared.Results:After intervention,the scores of Hamilton Anxiety Scale(HAM-A)of the patients in the observation group were lower than those in the control group(P<0.05).The rate of postoperative complications in the observation group was lower than that in the control group(P<0.05),and the satisfaction degree of the patients in the observation group was higher than that in the control group(P<0.05).Conclusion:The application of the whole-course management model in endometrial polyp day surgery can alleviate patients’anxiety,ensure the quality and safety of day surgery nursing,and improve patients’satisfaction.

耐高压PICC影像检查质量开展现状调查与分析

目的调查全国二级以上医院和科室耐高压经外周静脉置入中心导管(peripherally inserted central venous catheters,PICC)影像检查开展现状,为耐高压PICC影像检查规范制定与推广提供依据。方法2023年2月19日至11月7日期间,通过便利抽样法对全国25个省、自治区、直辖市的70所二级以上医院使用造影剂科室的护理负责人进行问卷调查。应用SPSS 27.0进行数据统计分析。结果来自68所医院的100份问卷被纳入,其中42所医院(61.76%)46个科室(46.00%)开展了耐高压PICC影像检查。不同等级的医院与耐高压PICC患者数量呈显著正相关(r=0.417,P<0.05),即随着医院等级升高,耐高压PICC患者数量呈增加趋势。但不同类型(r=-0.149,P>0.05)与地理区域(r=-0.130,P>0.05)的医院与耐高压PICC影像检查开展数量之间不具备相关性。耐高压PICC影像检查操作标准并不统一,且开展受限的主要原因是缺乏耐高压PICC患者(62.96%)和医患担心耐高压PICC检查潜在风险(18.52%)。结论耐高压PICC影像检查开展范围小,发展较缓慢,流程欠规范,亟待指南规范操作流程,完善专业培训,推动耐高压PICC影像检查规范化管理。

强化儿科护理人员风险防范意识的管理策略分析

目的探讨强化儿科护理人员风险防范意识的管理策略及效果。方法将2021年1—12月、2022年3月—2023年2月这2个阶段在山东大学附属儿童医院小儿呼吸内科从事护理工作的30名护士作为研究对象,分别设为对照组、研究组。对照组阶段实施常规护理管理,研究组阶段在护理管理中实施风险管理。对2组护士的职业暴露伤害发生率进行统计和对比,调查并对比2组护士对于自身安全防护的满意度,并对于2组护士的自我防护知信行评分、疲劳评分、工作压力评分、职场正念评分、职业满意度评分作比较。结果研究组护士的职业暴露伤害总发生率为6.67%,低于对照组的26.67%(P<0.05)。研究组护士对于自身安全防护的总满意度高于对照组(P<0.05)。研究组护士的自我防护知信行评分、职场正念评分、职业满意度评分均高于对照组(P<0.05);研究组护士的疲劳评分、工作压力评分均低于对照组(P<0.05)。结论在小儿呼吸内科护理管理中实施风险管理,可提高护士的自我防护认知、信念,有利于减少护士在护理工作中的职业暴露伤害风险,使其对于自身安全防护更加满意,还可减轻护士的疲劳感、压力,增强其职场正念和职业满意度。

住院患者护理行为轨迹闭环管理平台的构建与应用

护士操作行为的规范性直接关系到患者治疗效果和医疗安全。聚焦住院患者护理行为的关键节点,系统化串联护理、医疗、管理等信息系统,构建包含给药、检验和护理巡视行为轨迹追踪、外出检查行为轨迹追踪及手术转运交接行为轨迹追踪三大功能模块的住院患者护理行为轨迹闭环管理平台。应用后,提升了给药准时性,优化了夜间护理巡视方式,缩短了手术患者转运交接耗时,从而保障了患者安全。

湖北省医疗机构日间手术开展与管理现状调查

目的:调查湖北省医疗机构日间手术的开展与管理现状,为进一步推进日间手术的发展、建立日间手术规范化管理策略提供指导。方法:采用方便抽样法,于2023年6月对湖北省24所医疗机构使用编制的问卷进行调查。调查内容包括医疗机构基本信息、日间手术开展现状、日间手术管理制度与规范实施情况、日间手术管理的模式、日间手术的组织管理、限制日间手术开展过程中的难点等。结果:17所医院开展了日间手术,各医疗机构开展日间手术量排名前三的专科分别为骨科(58.8%)、泌尿外科(52.9%)、普外科或眼科(47.1%);各机构在14项有关管理制度与规范指标的实施情况不均衡,部分管理体系建设欠完善;日间手术管理的模式以集中管理为主(52.9%);13所(76.5%)医疗机构设置了专门运行管理团队,而担任日间手术管理决策者的主要是外科医师(88.2%)与医务处(76.5%);限制日间手术发展的难点主要集中在日间手术安全风险(70.6%)和信息系统缺乏支持(58.8%)。结论:各医疗机构日间手术需健全管理建设,完善医疗机构日间手术管理体系,优化日间手术管理制度,以促进日间手术管理水平向科学精细化和规范化发展,提高日间手术护理管理同质化,推动日间手术医疗服务质量提升。

妇产科护理管理中安全文化理念的运用效果分析

目的分析妇产科护理管理中安全文化理念的运用效果。方法选取2022年1月—2023年12月湖南省脑科医院妇产科40名护士为研究对象,2022年1—12月开展常规护理管理,选取此时的20名护士作为对比组;2023年1—12月开展安全文化理念管理,选取此时的20名护士作为观察组。比较两组的护理管理质量、纠纷事件发生情况。结果观察组的护理管理质量高于对比组,差异有统计学意义(P<0.05);观察组未发生纠纷事件,对比组发生1起纠纷事件。结论在为妇产科护士进行护理管理时,常规护理管理与安全文化理念管理均可发挥一定管理作用,但后者更能改善护士护理管理质量,防范纠纷事件的发生。

手术室护理管理中应用护理安全风险管理防御机制对于提升护理质量的影响

目的分析手术室护理管理中融入护理安全风险管理防御机制的效果。方法从2020年3月至2021年3月实施手术室常规护理管理的手术患者中随机抽取50例纳入患者A组,选择同期手术室护理人员20名纳入护理A组;从2021年4月至2022年4月融入护理安全风险管理防御机制的手术患者中随机抽取50例纳入患者B组,选择同期手术室护理人员20名纳入护理B组,对比两组手术室护理质量。结果患者B组手术风险事件发生率、护理投诉率均低于患者A组,差异均有统计学意义(P<0.05)。护理B组护理质量指标评分高于护理A组,差异具有统计学意义(P<0.05)。患者B组护理满意度评分高于患者A组,差异具有统计学意义(P<0.05)。护理B组风险管理认知评分高于护理A组,差异具有统计学意义(P<0.05)。患者B组心理状态评分低于患者A组,差异具有统计学意义(P<0.05)。结论手术室护理工作中融入护理安全风险管理防御机制,能显著提升护理人员的风险意识,提升护理工作质量及患者对护理的满意度,同时能帮助患者改善心理状态。

围手术期患者院内转运护理质量评价指标的构建

目的构建围手术期患者院内转运护理质量评价指标,为评价与监测围手术期患者院内转运护理质量提供评价工具。方法基于结构-过程-结果三维结构质量模型,通过文献回顾法、半结构式访谈法形成指标初稿,采用德尔菲专家函询法和层次分析法,筛选指标并确定各级指标的权重。结果2轮专家函询问卷有效回收率为88.89%、100%,专家权威程度系数为0.928、0.931,专家意见的肯德尔和谐系数分别为0.275、0.314(均P<0.05)。形成的评价指标包括3项一级指标,11项二级指标和57项三级指标。结论构建的围手术期患者院内转运护理质量评价指标内容全面、具备可靠性和实用性,经验证后可作为围手术期患者院内转运护理质量的评价工具。

护理人员对脑卒中吞咽障碍病人经口进食护理安全管理质量评价的质性研究

目的:了解护理人员对脑卒中吞咽障碍病人经口进食护理安全管理质量评价的认知,为构建脑卒中吞咽障碍病人经口进食护理安全管理质量评价指标体系提供参考。方法:2023年3月-6月采用目的抽样法选取贵阳市4所三级综合性医院13名护理人员进行半结构式深度访谈,利用Colaizzi 7步分析法对访谈结果进行整理、提取主题。结果:共提取8个主题,包括与经口进食护理安全管理结构质量评价相关的3个主题(人力资源配置、护理管理制度与规范、培训考核管理)、与经口进食护理安全管理过程质量评价相关的3个主题(护理评估、专科护理实践、健康教育)、与经口进食护理安全管理结局质量评价相关的2个主题(病人结局、护士结局)。结论:基于护理人员视角提取的脑卒中吞咽障碍病人经口进食护理安全管理质量评价相关主题,能够为构建科学、合理、全面的脑卒中吞咽障碍病人经口进食护理安全管理质量评价指标体系提供参考。

事项清单联合SOAP交班模式在全科医学科的应用

目的探讨事项清单联合SOAP交班模式在全科医学科床边交班中的应用效果。方法构建事项清单联合主观-客观-评价-计划(SOAP)结构化交班模式,用于全科医学科患者床边交接班;比较交班模式改进前(587例次的传统口头交班)、后(605例次的事项清单联合SOAP交班)的床边交班效果、交班缺陷情况。结果交班模式改进后护士床边交接班效果显著优于改进前、交班缺陷率显著降低(均P<0.05)。结论采用事项清单联合SOAP交班模式行患者床边交班,可提高床边交班质量,有利于保障患者护理安全。

用药护理中断事件风险评价指标体系的构建及应用研究

目的构建护士用药护理中断事件风险评价指标体系并临床应用。方法2023年1月—10月,以“基于安全信息流的事故致因概念模型”为理论基础,采用文献分析、质性访谈、德尔菲法及层次分析法,确定用药护理中断事件风险评价指标体系内容及各指标权重。应用该指标体系对湖南省某三级甲等医院440名护士进行评价。结果2轮函询问卷有效回收率为100%,专家权威系数为0.922和0.894,变异系数为0~0.240和0~0.188,肯德尔和谐系数为0.151和0.171。最终确定一级指标6项、二级指标17项、三级指标56项。指标体系的Cronbach'sα系数为0.746,平均内容效度指数为0.969。秩和检验结果显示,不同科室护士总分差异无统计学意义(P>0.05),但在管理和环境因素方面,差异具有统计学意义(P<0.05)。结论用药护理中断事件风险评价指标体系信效度好,指标科学合理、内容全面、专业性强,可为用药安全管理策略提供依据。

医务人员安全建言行为的研究进展

对安全建言行为概念的源起和发展、医务人员安全建言行为的评估方式(包括问卷调查法、访谈法、行为观察法)与分类方式、行为反应类别、前因和后果进行综述。未来研究可在概念化医务人员安全建言行为基础上,拓展该领域研究的深度和广度,以期为我国医务人员安全建言管理提供指导。

临床护士感知用药环境对用药安全能力影响的研究

目的调查临床护士用药安全能力现状,并分析感知用药环境对其用药安全能力的影响,为提高临床护士用药安全能力提供参考依据。方法采用便利抽样法,选取湖南省某三级甲等医院484名临床护士为研究对象,应用一般资料问卷、临床护士用药安全能力量表、用药环境感知量表进行调查分析。结果护士用药安全能力总分为(165.46±23.13)分,标准得分率为91.92%;用药环境感知总分为(143.80±20.37)分,标准得分率为89.88%。用药安全能力与用药环境感知的总分及各维度得分呈正相关(P<0.01),回归分析结果显示,在控制人口学资料后,用药环境感知对护士用药安全能力的解释增加了38.0%。结论用药环境感知中的物理工作环境和护士自身是用药安全能力的影响因素,且呈正向预测,因此改善临床护士用药环境能提高其用药安全能力水平。