Effect of comprehensive nursing on the quality of life and swallowing function in individuals diagnosed with ischemic stroke

BACKGROUND Ischemic stroke(IS)is a widely recognized disease characterized by high preva-lence,mortality,morbidity,disability,and recurrence rates.It ranks prominently in terms of mortality,constituting 60%-80%of stroke cases.AIM To explore the impact of comprehensive nursing care on the quality of life and swallowing function in individuals diagnosed with IS.METHODS This study comprised 172 patients with IS admitted to our hospital between February 2018 to March 2021.The participants were divided into two groups,namely the control group(n=80)receiving routine care and the research group(n=92)receiving comprehensive care.Various assessment scales,including the standard swallowing function assessment scale(SSA),National Institutes of Health Stroke scale(NIHSS),European stroke scale(ESS),self-rating anxiety scale(SAS),self-rating depression scale(SDS),Barthel index(BI),and the motor func-tion assessment scale(MAS),were employed to evaluate the improvement in swallowing function,neurological deficits,clinical outcomes,anxiety,depression,daily living activities,and motor function before and after care.Furthermore,the study compared the occurrence of adverse reactions during the nursing period,life quality before and after the intervention,rehabilitation compliance,and nursing satisfaction between the two groups.RESULTS After the nursing intervention,the research group exhibited significantly improved SSA and NIHSS scores compared to the control group(P<0.05).Moreover,both groups demonstrated significant reductions in SAS and SDS scores(P<0.05),with the research group showing more obvious advantages(P<0.05).Compared to the control group,the research group displayed significantly better ESS,BI,and MAS scores(P<0.05),coupled with a lower incidence of adverse reactions(P<0.05).Additionally,the research group demonstrated markedly higher levels of life quality,rehabilitation compliance,and nursing satisfaction compared to the control group(P<0.05).CONCLUSION Comprehensive nursing effectively improved swallowing function,quality of life,and patient satisfaction,high-lighting its clinical significance.

The level of patients’ satisfaction and perception on quality of nursing services in the Renal unit, Kenyatta National Hospital Nairobi, Kenya

Introduction: Renal failure is on the increase and patients have to identify with renal services and centres where services for renal replacement therapies are rendered. This calls for health care workers to offer services that are perceived as quality and satisfying in order to meet the biophysical and psychological needs of the patients. Study design: This was a descriptive cross-sectional study undertaken at the Renal unit of Kenyatta National Hospital (KNH). Purpose: The study aimed at determining the level of satisfaction and perception of the quality of nursing services in the Renal unit. Methodology: The study population included all patients who were seeking dialysis services during one month period of data collection. The sample size was 151 following data collection. Data collection tools consisted of semi-structured questionnaires which were administered with the aid of research assistants as well as checklists which were self administered. Data analysis and results: Analysis of data was performed using the statistical package of social sciences (SPSS) version 16. Results of data analysis were presented in form of descriptive statistics which included mean, standard deviation and percentages. Regression analysis, t-test and ANOVA were conducted to determine demographic predictors of patient satisfaction with the nursing services. The results of the study revealed that patients in the Renal unit were generally satisfied with the nursing services. The aggregate mean score for all patients on Likert scale was 71.2 out of 105, with a standard deviation of 16.8. Level of satisfaction was 67.8%. The findings also showed that there was no association between demographic characteristics with the levels of satisfaction with the nursing services. Recommendation: The hospital should keep the patients’ level of satisfaction high and maintain it through the provision of more dialysis machines and hiring more nurses.

Competency-based management effects on satisfaction of nurses and patients

Purpose:To evaluate the effect of competency-based management in improving nurse and patient satisfaction.Methods:According to the competency-based management objectives and principles,821 nurses were classified into different levels based on clear nurse qualifications and post responsibilities.According to the different levels of nursing staff and training plans with different emphases,the goal was for the nursing staff to gradually achieve the corresponding level.Targeted training programs for different levels of nurses were formulated to enable nurses to gradually increase their competency levels.Results:After implementation of competency-based management,nurse job satisfaction and patient satisfaction increased significantly(P<0.01).Additionally,the reported nurse job burnout decreased(P<0.01).Conclusion:Competency-based management can promote nurses’enthusiasm,reduce job burnout,improve job satisfaction,as well as improve patient satisfaction.

Effects of a Care Workshop on Caring Behaviors as Measured by Patients and Patient Satisfaction

Caring is a central focus of nursing, and patient satisfaction is a critical indicator of nursing care quality. The aim of this study was to determine the effects that a care workshop exerted on nurse caring behaviors as perceived by patients and reflected by patient satisfaction. A quasi-experimental, pretest-posttest design without a control group was applied. The intervention consisted of several facets: 1) formal educational sessions twice a week for six weeks, 2) an angel-master mentorship activity, and 3) posts of exemplary caring behavior and stories. A demographic questionnaire, the Modified Nurse Caring Behaviors Inventory, and the Hartford Hospital Satisfaction Survey were used in this study. Descriptive statistics were analyzed to evaluate participant demographic characteristics. Paired t tests were used to determine the effects of a care workshop on nurse caring behaviors as perceived by patients and reflected by patient satisfaction. Of the 236 patients enrolled, 49.6% were women and 57.2% were admitted to medical-surgical units. Female patients rated nurse caring behaviors higher and reported greater patient satisfaction than did male patients on the pretest (p p p p p p = 0.000). Caring educational programs for nurses are commonly regarded to be an essential strategy for promoting care knowledge and practice and improving patient satisfaction. According to the favorable results of this study, care workshops must be provides to nurses in other units or hospitals in future studies.

A Prospective Survey Comparing Patients’ Experience of a Nurse-Led Clinic and Consultant-Led Clinic for Surveillance of Patients with Dilatation of the Intrathoracic Aorta

Background: Increasing workload in consultant-led clinics often means patients to wait a long time for clinic appointments. To address this, there is an increasing trend in developing nurse-led clinics across many specialities in the National Health Service. This study aims to assess whether the implementation of a nurse-led clinic in thoracic aortic surgery will optimise the utilisation of health care services and improve overall patient satisfaction. Methods: 80 follow-up patients were asked to complete a questionnaire following their appointment in an aortic clinic, which was led either by a consultant (n = 40) or an aortic specialist nurse (n = 40). All patients seen by a nurse in the clinic were assessed by a consultant surgeon prior to the clinic for suitability. No new patients were seen by a nurse. Any patient with an aortic dimension of 5 cm or greater was seen by the consultant. If there were any complicated clinical features, the patient was seen in the consultant-led clinic. Patients were asked questions about their time spent with the respective health care professionals across 12 categories (punctuality, preparedness, understanding of concerns, clarity of speech, listening, respect, explaining, letting you talk, putting you at ease, emotional support, advice and advice for next follow-up). Patients rated each category using an ordinal scale from 0 - 10. Results: Patient scores were greater in nurse-led clinics compared to consultant-led clinics across a number of categories although only punctuality reached significance (mean 9.2 vs. 6.8, p 0.05). Conclusion: Patients were highly satisfied with the nurse-led clinic across all categories, with greater satisfaction for punctuality. These findings suggest that a nurse-led clinic can be implemented for the management of carefully selected thoracic aortic surgery patient without reduction in patient satisfaction.

Effect of High-Quality Nursing on Patients with Hemorrhagic Fever with Renal Syndrome

Objective:To explore and analyze the effect of high-quality nursing on patients with epidemic hemorrhagic fever with renal syndrome.Methods:Ninety patients with epidemic hemorrhagic fever with renal syndrome treated in Huyi District People’s Hospital from October 2021 to January 2022 were randomly divided into an experimental group and a control group,with 45 cases in each group.The control group received routine nursing and the experimental group received high-quality nursing.The effect of routine nursing and high-quality nursing were compared and analyzed based on the Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),the degree of satisfaction with nursing care,and the patients’quality of life.Results:Before nursing,there was no significant difference in the patients’psychological state between the two groups(P>0.05);after nursing,there was significant difference in the patients’psychological state between the two groups(P<0.05);the degree of satisfaction with nursing care of the experimental group was significantly higher than that of the control group(P<0.05);comparing the quality of life of the two groups,the quality-of-life score of the control group was significantly lower than that of the experimental group(P<0.05).Conclusion:For patients with epidemic hemorrhagic fever with renal syndrome,high-quality nursing can significantly and effectively improve their psychological state,level of satisfaction with nursing care,and quality of life.

Considerations in Dealing with Ethical Conflict Encountered in Healthcare Reform: Perceptions of Nurse Leaders

With the nursing profession continuing to face an array of ethical issues, the article reports the findings of a survey of members of the American Organization of Nurse Executives conducted in 2012 to determine the extent to which nurse leaders at different organization levels perceive various factors in their personal, professional and organizational environments to be helpful in resolving ethical dilemmas. After their personal values, nurse leaders perceive factors related to their organization to be more helpful than those related to their profession, including, among others, the American Nurses Association Code of Ethics. The two highest rated business-related factors deal with the absence of pressure to compromise one’s own ethical standards which suggests that one way healthcare organizations can assist nurses and their leaders is by neither explicitly nor implicitly pressuring them to go against their own ethical values. Other key factors related to the organization include formal organizational factors such as the existence of an ethics committee or a person to whom unethical activity can be reported as well as more informal factors related to organizational climate such as the actions and responsiveness of one’s immediate boss, the ability to go beyond one’s boss if necessary, the organizational culture, management philosophy, and management’s communication of appropriate ethical behavior. Comparison of the findings of the 2012 survey with those of a similar study conducted in 2000 indicated the four factors perceived as most helpful in both studies were identical with the same rank order and the top-10 factors were identical with some differences in ranking. Further analysis indicated the relative degree of helpfulness of the 17 help factors common to both studies was perceived by responding nurse leaders as quite similar overall. The authors also discuss the implications for the profession and the healthcare industry today and in the future.

Nurses’ Job Satisfaction and Motivation: Patients’ and Nurses’ Perceptions

Background: High quality care is the main concern of healthcare administrators and it was found to be related to nurses’ job satisfaction and motivation. Purpose: The study aimed to compare patients’ and nurses’ perceptions of nurses’ job satisfaction and motivation. Method: In this cross-sectional study the participants were 315 released patients and 329 nurses from eight hospitals in northern Israel. The participants completed three questionnaires: demographics, nursing job satisfaction, and nursing job motivation. Results: Nurses perceived both job satisfaction and motivation higher than the patients. Duration of hospitalization and being accompanied by family, were positively correlated to patients’ perceptions of these variables. Conclusion/Implications for Practice: To optimize care quality, it is important to assess both patients’ and nurses’ perceptions of nurses’ job satisfaction and motivation. Such an assessment may shed light on the nursing experience and on the way that it is reflected in the patients’ experience. A system-wide process is needed to set a national standard for service quality while emphasizing strategies that promote recognition of nurses’ work, for example, compliments and acknowledgment. This could enhance nurses’ sense of work engagement, which, in turn, may increase the patients’ perception of nurses’ job satisfaction and motivation.

The Impact of Health Care Reform Initiatives on Ethical Conflict and Opportunities for Nurses to Improve Quality of Care While Enhancing Their Work Environments

Background: After more than a decade of the nursing profession contending that healthcare reform based almost exclusively on cost cutting was creating an array of serious ethical issues for nurses, healthcare organizations and other providers are now facing increasing demands primarily from payers to demonstrate improvement in both quality of care and patient experience along with continued cost reduction. Research Question: Have efforts by healthcare organizations to comply with these recently imposed requirements influenced the ethical environment faced by nurses and nurse leaders and if so, how? Materials and Methods: Data for assessing the current ethical environment was gathered with a close-ended survey mailed in October 2012 to a random sample of 3000 members of the American Organization of Nurse Executives. Results and Discussion: Statistical analysis of the data and comparison with the findings of a similar study conducted in 2000 indicated that along with five highly rated issues in the earlier study attributed largely to economic constraints imposed by healthcare organizations, the top-10 key ethical issues today included five issues primarily attributable to interprofessional conflict. Conclusion: Given the success of many ongoing efforts aimed at weakening these key sources of ethical conflict that have blocked many proposals to improve the quality of care, opportunities should arise for the nursing profession to more fully achieve its goals of improving the quality of care, safety and patient satisfaction and enhancing nurses’ work environments essential to that effort.

Effect of Emergency Care Process Optimization on Rescue Efficiency of Emergency Patients

Objective: This paper discusses the impact of emergency care process optimization on the rescue efficiency of emergency patients. Methods: 102 cases of emergency patients received from January 2017 to February 2018 in our hospital were selected as research objects. According to the order of treatment, they were divided into control group and observation group. The routine nursing process was given to the control group, and the observation group was given an optimized nursing process to compare the rescue efficiency and nursing satisfaction of the two groups. Results: According to the results of the study, the nursing satisfaction of the two groups was compared. Among them, the total satisfaction of the observation group was 49, accounting for 96.07%;the control group was very satisfied with the nursing work, accounting for 82.35%. There was a significant difference in nursing satisfaction between the two groups, which was statistically significant (P<0.05). Comparing the rescue efficiency of the two groups of patients, the observation time, rescue time, infusion time and disease remission time were significantly lower than the control group, the rescue success rate was 94.11%, and the rescue success rate of the control group was 78.43%. The results have statistical significance (P < 0.05). Conclusion: The optimization of emergency nursing process can greatly improve the rescue efficiency of emergency patients, reduce the disability rate and mortality, improve the quality of nursing, and enhance the satisfaction of nursing. It is worthy of clinical promotion practice.

护患沟通技巧联合心理护理在肺功能检查患者中的应用

目的:探讨护患沟通技巧联合心理护理在肺功能检查患者中的应用效果。方法:选取2020年1月1日~2022年12月1日109例行肺功能检查患者为研究对象,随机分为对照组54例和研究组55例,对照组实施常规护理,研究组实施护患沟通技巧联合心理护理;比较两组检查时间、肺通气完成情况,护理前后心理状态[采用焦虑自评量表(SAS)、抑郁自评量表(SDS)]、肺功能[包括第一秒用力呼气容积(FEV_(1))、FEV_(1)/FVC%]、生活质量[采用生命质量测定量表(QLQ-C30)]及护理满意度。结果:研究组检查时间、肺通气完成率优于对照组(P<0.01);护理后,两组SAS、SDS评分低于护理前(P<0.05),且研究组低于对照组(P<0.01);护理后,两组FEV_(1)、FEV_(1)/FVC%、QLQ-C30评分均优于护理前(P<0.05,P<0.01),且研究组优于对照组(P<0.05);研究组护理满意度高于对照组(P<0.05)。结论:将护患沟通技巧联合心理护理应用于肺功能检查患者中,可有效缩短检查时间,提高肺通气完成率,改善患者负性情绪和肺功能,从而提高生活质量和护理满意度。

专病一体化护理联合协同护理模式对老年慢性心力衰竭患者的影响

目的:探讨专病一体化护理联合协同护理模式对老年慢性心力衰竭(CHF)患者的影响。方法:选取2022年2月1日~2023年2月28日收治的98例老年CHF患者作为研究对象,依据入院时间采用抽签法分为对照组和观察组各49例,对照组给予常规护理,观察组在此基础上实施专病一体化护理联合协同护理模式;比较两组入院时、出院时、出院3个月的积极度评分,护理前后生命质量[简明健康状况调查问卷(SF-36)]评分、睡眠质量(明尼苏达心力衰竭睡眠质量量表)评分、自我护理(欧洲心力衰竭自我护理行为量表)评分、汉密顿焦虑量表(HAMA)评分、汉密顿抑郁量表(HAMD)评分,护理满意度。结果:干预后,两组积极度评分逐渐提高(P<0.01),观察组出院时、出院3个月积极度评分高于对照组(P<0.01);护理后,两组生命质量评分高于护理前(P<0.05),且观察组高于对照组(P<0.01);护理后,两组睡眠质量、自我护理评分及HAMA、HAMD评分低于护理前(P<0.05),且观察组低于对照组(P<0.01);观察组护理满意度高于对照组(P<0.01)。结论:专病一体化护理联合协同护理模式能够有效改善CHF患者的不良情绪和积极度,提高睡眠质量和生命质量,提升护理满意度。

基于归因理论的护理干预在经鼻高流量氧疗患者中的应用效果

目的探讨基于归因理论的护理干预在经鼻高流量氧疗(HFNC)患者中的应用价值,以期为临床治疗提供参考。方法选取2021年2月-2023年5月于四川大学华西医院接受治疗的144例HFNC患者为研究对象。采用随机数字表法将患者分为观察组和对照组,每组72例。对照组患者给予常规护理干预,观察组患者在对照组基础上联合基于归因理论的护理干预。比较2组患者遵医情况及护理满意度;比较2组患者干预前后疾病感知问卷(BIPQ)、Borg疲劳量表、视觉类比呼吸困难法量表(VAS)、抑郁自评量表(SDS)及焦虑自评量表(SAS)评分。结果观察组患者总遵从率高于对照组,差异有统计学意义(P<0.05)。干预前,2组患者BIPQ中治疗控制、后果、情绪、持续时间、症状、关注、个人控制、疾病了解评分比较,差异无统计学意义(P>0.05)。干预后,2组患者BIPQ中治疗控制、后果、情绪、持续时间、症状、关注、个人控制、疾病了解评分均高于干预前,且观察组高于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者Borg疲劳量表及VAS评分比较,差异无统计学意义(P>0.05)。干预后,2组患者Borg疲劳量表评分均低于干预前,且观察组低于对照组;VAS评分高于干预前,且观察组高于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者SAS、SDS评分比较,差异无统计学意义(P>0.05)。干预后,2组患者SAS、SDS评分均低于干预前,且观察组低于对照组,差异均具有统计学意义(P<0.05)。观察组患者护理总满意度高于对照组,差异有统计学意义(P<0.05)。结论基于归因理论的护理干预能有效强化患者的遵医行为,减轻患者的疾病感知压力,缓解患者的负面情绪,提高患者的护理满意度,值得临床推广应用。

LPCBL联合Seminar教学法在产科护理带教中的应用

目的 探讨应用以授课、问题、案例为基础的教学法(lecture,problem,case-based learning,LPCBL)联合Seminar教学法对于产科护理的带教价值。方法 选取2021年5月—2022年1月南京市妇幼保健院产科接收的106名护理实习生作为研究对象,按照随机数字表法的原则,分成观察组与对照组2组,每组学生均为53名。对照组应用以教师为主体教学方式(lecture-based learning,LBL),观察组采取LPCBL联合Seminar教学法。对比2组实习生在经2个月实习的理论与实践操作考核成绩,实习生对于带教工作满意度。结果 在实习生的考核中,观察组的理论知识考核成绩(92.02±4.28)分、实践操作考核成绩(89.25±4.15)分均要比对照组更高,差异有统计学意义(P <0.001);调查实习生对于教学工作满意度情况,观察组的各个方面满意度得分高于对照组,差异有统计学意义(P <0.001)。结论 在对产科的护理带教工作中,采取LPCBL联合Seminar教学法的教学手段,能够取得良好教学成效,有助于提高实习生对理论知识掌握,并且也对实习生操作水平以及满意度提高有利。

基于患者360视图的护理不良事件管理系统构建与应用

目的构建基于患者360视图的护理不良事件管理系统,优化护理不良事件管理流程。方法护理不良事件管理系统包含可视化安全预警、向导式上报及反馈追踪、分层系统培训3个功能模块,于2021年1月正式应用。结果系统应用后,压力性损伤、给药错误以及不良事件整体发生率均较应用前下降,其中给药错误发生率差异具有统计学意义(P<0.05),而管路滑脱、跌倒/坠床的发生率较应用前略有增加;护理不良事件整改达标率由92.8%提高至95.7%(P<0.05);组织科护士长培训12次,组织全院护士长专项培训20余次,开展护理质量安全管理标准化操作规程工作坊12场次。结论基于患者360视图的护理不良事件管理系统可以提高护理风险识别率,降低护理不良事件发生率。下一步需在充分考虑患者特点与需求的基础上进一步优化系统功能。

6S管理模式在消化内镜中心护理质量控制中的应用效果

目的探讨消化内镜护理质量控制中实施基于整理-整顿-清扫-清洁-素养-安全(6S)管理模式的应用效果。方法选取2023年1—6月绵阳市中心医院内镜中心实施常规管理模式的80件消化内镜、行消化内镜检查的2317例患者作为A组,另选取2023年7月绵阳市中心医院消化内镜中心实施6S管理模式的80件消化内镜,行消化内镜检查的2483例患者作为B组。A组实施常规管理模式,B组在A组基础上实施6S管理模式,比较2组清洗消毒合格率、器械损坏率及患者护理满意度。结果干预后,B组清洗消毒合格率(98.75%)高于A组(81.25%),而器械损坏率(1.25%)低于A组(11.25%),差异有统计学意义(P<0.05)。干预后,与A组患者护理满意度各维度评分比较,B组均偏高(P<0.05)。结论消化内镜护理质量控制中采用基于6S管理模式能有效提高清洗消毒合格率,降低器械损坏率,患者护理满意度较高。此文的研究结果为消化内镜护理后期标准制订提供了借鉴内容。

基于医护患一体化护理模式在急性淋巴细胞白血病患儿化疗期间的应用效果

目的:探讨医护患一体化护理模式在急性淋巴细胞白血病(ALL)患儿中的应用效果。方法:选择2022年1月—2023年7月在南京医科大学附属淮安第一医院收治的80例ALL患儿作为研究对象。随机将其分为对照组(常规健康教育)及观察组(在对照组基础上给予医护患一体化护理模式),各40例。比较两组护理效果、治疗依从性及家属满意度。结果:观察组护理总有效率为95.00%,高于对照组的77.50%,差异有统计学意义(P<0.05)。观察组总依从率为92.50%,高于对照组的75.00%,差异有统计学意义(P<0.05)。观察组家属满意度为95.00%,高于对照组的77.50%,差异有统计学意义(P<0.05)。结论:医护一体化护理模式在ALL患儿化疗期间,可进一步提升临床疗效及依从性,提高家属满意度。

以Cameron适时理论为基础的全程护理模式在烧伤后瘢痕整形患者中的应用

目的:研究以Cameron适时理论为基础的全程护理模式对烧伤后瘢痕整形患者的干预效果。方法:选择2021年9月-2022年6月笔者医院收治的60例烧伤后瘢痕整形患者为研究对象,采用随机数字表法分为对照组(30例)和观察组(30例)。对照组给予常规护理干预,观察组在对照组的基础上采用以Cameron适时理论为基础的全程护理模式进行干预,两组均干预8周。统计比较两组瘢痕恢复效果、并发症发生情况、心理状态、应对方式及护理满意度。结果:干预后,观察组创面渗出持续时间、疼痛持续时间均短于对照组(P<0.05);两组创面愈合时间、色素沉着率比较差异无统计学意义(P<0.05)。干预8周后,观察组瘢痕恢复总有效率显著高于对照组(P<0.05);观察组心理韧性评分高于对照组(P<0.05),焦虑、抑郁、心理困扰评分低于对照组(P<0.05);观察组屈服、回避评分低于对照组(P<0.05),面对评分高于对照组(P<0.05);观察组护理总满意率高于对照组(P<0.05)。干预期间,观察组总并发症发生率低于对照组(P<0.05)。结论:以Cameron适时理论为基础的全程护理模式对烧伤后瘢痕整形患者进行干预,可有效促进患者创面愈合,改善患者心理状态及应对方式,降低并发症发生率,患者满意度高,具有较好的应用价值。