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.

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.

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.

The challenges that head nurses confront on financial management today:A qualitative study

Aim: To explore challenges that Chinese head nurses confront on financial management from the perspective of different levels of nursing and non-nursing managers and to provide contemporary nurse managers with suitable supports.Methods: Eighteen nursing leaders in different levels were divided into two groups: Junior Leadership Group (head nurses) and Senior Leadership Group (nurse coordinator, nurse executive, and vice-president of the hospital). All the subjects were invited to participate in a semi-structured interview. The interviews were audio-taped and transcribed, and data were analyzed using a comparative content approach. Results: The four following challenges that head nurses confront on financial management practice were identified from the research findings: 1) lack of intrinsic motivation;2) insufficient training and edu-cation on financial management and nursing economics;3) desires for cross-uniting communication and cooperation;4) insufficient reference managerial tool. Conclusions: The confusion confronted by head nurses in Changsha include three aspects: managerial roles, managerial training, and managerial tools. Cooperative management model, evidence-based management training, and data-driven tools will contribute to improving the financial management capacity of nurse managers.

Effect of PDCA on Nursing Management

Objective:To explore and analyze the effect of the plan-do-check-act(PDCA)cycle method in the nursing management of head nurses.Methods:68 patients who were hospitalized in the general surgery department were used as research subjects.The patients were divided into an experimental group and a reference group,with 34 cases in each group,by drawing lots.The experimental group was managed with the PDCA method.The management satisfaction,nursing quality score,and nursing effect of both groups were compared with each other.Results:The patients in the experimental group were generally more satisfied with the nursing services compared to the reference group(P<0.05),and the difference was statistically significant.Before the intervention,there was no statistically significant difference(P>0.05)in the nursing quality scores such as ward safety management,nursing risk management,nursing document writing,rescue equipment management,and head nurse administrative management between the two groups.After the intervention,the experimental group had higher nursing quality scores.Furthermore,the nursing effects such as disease education,quality control,safety management,humanistic care,and service attitude in the experimental group were significantly better than those in the reference group(P<0.05).Conclusion:The application of the PDCA method in nursing management can improve management satisfaction,nursing quality,and nursing effect.

Evaluation of the Effectiveness of the Competency Model for Nursing Managers in the Training of Newly Appointed Head Nurses

Objective:To explore the effectiveness of the competency model for nursing managers in the training of newly appointed head nurses.Methods:Eighteen newly appointed head nurses from Yichang Central People’s Hospital,selected between August 2023 and July 2024,were chosen as the research subjects.Based on the nursing manager competency model,corresponding training programs were developed,and these 18 head nurses were trained accordingly.Results:After the training,all newly appointed head nurses passed the theoretical assessments,with a pass rate of 100.00%.The pass rates for two rounds of assessment were 100.00%and 94.54%,respectively.There was no significant difference in the performance evaluation scores between new and senior head nurses in terms of standardized services,nursing quality,nursing research and teaching,and patient satisfaction(P>0.05).Conclusion:The competency model for nursing managers has a significant effect on the training of newly appointed head nurses.It effectively enhances management awareness,facilitates role transition,and,to some extent,improves the management and leadership capabilities of head nurses.It holds high value for broader implementation.

Opportunities for nurses in the era of electronic health records

Nursing leaders are currently faced with opportunities to advance nursing’s role in the use of electronic health records (EHRs). Nurse leaders can advance the design of EHRs with nurse informaticists to improve health outcomes of individual and populations of patients.

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.

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。

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.

中国医院临床科主任、护士长胜任力研究现状的循证分析

目的循证分析我国临床科主任和护士长胜任力研究进展与管理现状,为促进临床科主任、护士长管理研究进一步发展和完善我国医院人力资源管理提供可靠参考。方法利用VIP、CNKI、WANFANG中文数据库、网络资源及相关官方网站检索我国临床科主任和护士长胜任力相关文献,并运用文献计量学方法、循证科学的原理和方法,对检索文献进行描述性分析。结果共纳入文献82篇,主要涉及临床科主任、护士长相关概念理论的阐述、胜任力模型的构建、应用研究等内容;我国科主任、护士长胜任力的研究起步较晚且呈先增长后下降的趋势,期刊分布较分散;文献主要来源于各级高校院所和医疗机构;发展停滞于实证研究阶段,未发展向评价研究阶段。结论我国临床科主任和护士长胜任力研究处于应用实践阶段,缺乏系统化研究,主要以高等院所、医疗机构为主导,国家、政府在医院临床科主任、护士长胜任力方面的的关注有待加强。

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。

多学科呼吸管理小组在A型主动脉夹层患者中促肺康复的效果研究

目的探讨基于医护联合的多学科呼吸管理小组在A型主动脉夹层患者中促肺康复的效果。方法选择本院2022年1月至2023年1月收治的A型主动脉夹层患者80例,随机分为对照组和观察组,每组40例。对照组患者给予常规护理,观察组在对照组的基础上实施基于医护联合的多学科呼吸管理小组护理方式。比较2组患者的肺功能指标[氧合指数(OI)、呼吸指数(RI)、动态肺顺序性(Cdyn)、静态肺顺应性(Cst)]、临床指标、对护理工作的满意度。结果T1时2组OI值、RI值、Cdyn水平及Cst水平比较,差异无统计学意义(P>0.05),T2、T3、T4时观察组OI值、Cdyn水平及Cst水平均高于对照组,RI值均低于对照组,观察组CICU时间、机械通气时间、使用高流量氧疗时间及住院总时间均短于对照组,LUS评分低于对照组,对护理工作的满意度高于对照组,差异均有统计学意义(P<0.05)。结论基于医护联合的多学科呼吸管理小组可明显改善A型主动脉夹层患者术后的肺功能,缩短机械通气时间,提高对护理工作的满意度,值得在临床进一步进行推广。

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。

基于莱温守恒模式的护理对急性脑梗死患者自我管理能力及神经功能的干预效果

目的探讨基于莱温守恒模式的护理干预对急性脑梗死患者自我管理能力及神经功能的影响。方法选择医院2021年3月—2022年6月收治的138例急性脑梗死患者,按照组间基线资料可比的原则分为对照组和观察组,各69例。对照组实施常规护理模式干预,观察组在对照组基础上采用基于莱温守恒模式的护理干预,干预6周。比较两组护理满意度、自我管理能力、神经功能[神经功能缺损评分表(NIHSS)]、肢体运动功能[运动功能评分量表(Fugl-Meyer)]及心理状态[焦虑自评量表(SAS)、抑郁自评量表(SDS)]。结果护理干预后,观察组患者护理满意率为92.75%,与对照组的79.71%对比,差异有统计学意义(P<0.05)。护理干预前,两组自我管理能力、神经功能、肢体运动功能及心理状态比较,差异无统计学意义(P>0.05);护理干预后,观察组自我管理能力各维度评分、肢体运动功能评分均高于对照组,差异有统计学意义(P<0.05);而观察组患者神经功能评价量表各项评分、SAS评分、SDS评分则低于对照组,差异有统计学意义(P<0.05)。结论基于莱温守恒模式的护理干预对急性脑横死患者效果更佳,可使患者负性情绪得到有效缓解,自我管理能力得到提高,还可有效改善患者神经功能,提高护理满意度。

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。