Evaluation of the Effect of Endoscopic High- Frequency Electrocoagulation Electrodesiccation of Intestinal Polyps in the Clinical Nursing Pathway

Objective: To evaluate the effect of endoscopic high-frequency electrocoagulation electrodesiccation (HFEE) of intestinal polyps in the clinical nursing pathway. Method: A total of 120 patients who underwent HFEE of intestinal polyps were randomly divided into two groups of 60 cases. The control group received conventional nursing care while the observation group received the clinical nursing pathway of HFEE. Results: The average length of hospitalization, hospitalization costs, and mastery of the three health education of the observation group was lower than that of the control group (P < 0.01). The satisfaction of care in the observation group was significantly better than the control group (P <0.01). Conclusion: The clinical care path was suitable for HFEE of intestinal polyps, which shortened the patient’s length of hospitalization, improved their awareness of health education, improved their satisfaction with care, reduced medical disputes, and promoted the good development of nurse-patient relationships .

Application of Clinical Nursing Pathway in the Peri-Treatment Period of Immunoadsorption Therapy for Rheumatic Immune Diseases

Objective: The paper aims to investigate the clinical nursing pathway (CNP) in the application of immunosorption therapy in patients with rheumatic immune disease. Methods: Convenience sampling method was used to select inpatients who received immunoadsorption therapy from January 2020 to December 2022 in the rheumatology and Immunology department of a 3A hospital in Jingzhou City. 30 patients from January 2020 to June 2021 were selected as control group, and 30 patients from July 2021 to December 2022 were selected as observation group. The control group was given routine nursing. On the basis of the control group, the observation group used a clinical nursing pathway for intervention during the perioperative period of immunosorbent therapy. The incidence of adverse reactions, patient satisfaction, and nurse satisfaction during immunosorbent therapy between the control group and the observation group were compared. Results: After intervention, the incidence of adverse reactions in the observation group was significantly lower than that in the control group, while patient satisfaction and nurse satisfaction in the observation group were significantly higher than those in the control group. The results are all statistically significant (P Conclusion: Clinical nursing pathway is beneficial to reduce the incidence of adverse reactions in patients with immunoadsorption during peri-treatment and improve the satisfaction of patients and nurses.

Application of Clinical Nursing Pathway Combined with Cluster Nursing Mode in Biologic Treatment of Rheumatoid Immune Disease Patients

Objective: To investigate the effect of clinical nursing pathway (CNP) combined with cluster nursing mode in intravenous biologic treatment of rheumatoid immune disease patients. Methods: Convenience sampling method was used to select inpatients receiving biologics treatment in Rheumatology and Immunology Department of a grade A hospital in Jingzhou city from May 2020 to April 2022. 75 patients from May 2020 to April 2021 were selected as the control group, and 75 patients from May 2021 to April 2022 were selected as the observation group. The control group was given routine care. The observation group was treated with CNP combined with cluster nursing mode on the basis of the control group, and the incidences of adverse infusion reactions, total treatment time, patient satisfaction and nurse satisfaction were compared between the two groups. Results: There were statistically significant differences between the two groups after intervention (P Conclusion: Using CNP combined with cluster nursing mode is beneficial to reduce the incidence of adverse infusion reactions in patients, shorten the total treatment time, and improve the satisfaction of patients and nurses.

Utilization Management:Walking the Line Between Patient Needs and Healthcare Economics-Short Communication

Utilization management plays a crucial role in healthcare by optimizing resource allocation,improving patient outcomes,and effectively controlling costs.By balancing patient needs with economic considerations,healthcare institutions can ensure efficient and sustainable service delivery.Utilization management encompasses various strategies,including prior authorization,concurrent review,and clinical pathways,to enhance care quality,manage expenses,and streamline resource use.The benefits of utilization management include cost containment,improved care standards,and the implementation of consistent treatment guidelines,thereby increasing the overall efficiency and effectiveness of healthcare delivery.

Application of clinical pathway combined with drawing method in clinical teaching of cardiac surgery nursing

Background Nursing internship is the terminal course in nursing education. However, the long-standing nursing teaching evolves with obvious disadvantages： boring methods, lack of live Demo and unstandardized contents. Therefore, a novel method is urgently in need. Methods In this study, a total of 74 nursing interns rotating in Cardiac Surgery ward of Large Vessel, Cardiac Surgery Department, were included. Of them, 37 included from July 2016 to March 2017 were distributed to the control group trained by the traditional method; while the rest 37 included from July 2017 to March 2018 were distributed to the study group receiving a novel teaching method characteristic of using clinical pathway and drawing. Baseline characteristics such as gender, age, graduation school were matched. Both groups had an internship for 4 weeks and each subject was taught by experienced instructors like nurse practitioner or nurse-in-charge. Comprehensive assessment,including growth assessment of specialty knowledge and examinations of both theory and operation,were applied both in the beginning and by the end of the internship. Results In the growth assessment of specialty knowledge, the study group performed significantly better than the control group in both total score and sub-section score（specialty pharmacy and specialty operation）. In the final examination, the study group had a higher score in specialty operation than the control group, which was statistically significant. Conclusions Application of clinical pathway combined with drawing method significantly improves the quality of cardiac surgery nursing teaching.

Methodology for Developing a Nursing Administration Analysis System

Nursing administration requires a large volume of wide-ranging information, and nurse administrators are limited in their ability to compile and analyze information for nursing administration. The purpose of this study is to create methodology for developing a nursing administration analysis system to aid nurse administrators in performing outcome analysis. In this methodology, information required for nursing administration in the PSYCHOMS? (Psychiatric Outcome Management System, registered trademark) database is analyzed according to the individual needs of nurse administrators. It features a combination of a classification method and an extraction method for obtaining quantitative and qualitative data as information required for nursing administration, and enables nurse administrators to easily obtain analysis results that they directly need. This methodology converts the time required nurse administrators to collect and organize information into time for making considerations in order to devise strategies for improving the quality of nursing care services, and can improve the quality and efficiency of nursing administration. This may lead to an increase of the quality of nursing care services at psychiatric hospitals. This methodology is highly versatile as it can be applied in information management, not only for nursing, but for the entire psychiatric hospital.

基于临床标准病例的混合式教学法在急诊科临床护理教学中的应用

目的探讨基于临床标准病例的混合式教学法在急诊科临床护理教学中的实践效果。方法选取2021年7月至2023年1月在中国医科大学附属盛京医院急诊科实习的本科护生60人为研究对象,按照入科顺序将前30人设为对照组,后30人设为实验组。对照组采用传统教学模式,实验组采用基于临床标准病例的混合式教学法。结果实验组出科考核成绩和实习质量评价均优于对照组。结论基于临床标准病例的混合式教学法有助于提高护生理论考试和操作考核成绩,提升实习质量,具有推广价值。

导师制在血液内科规范化培训护士带教中的应用

目的 探索导师制在血液内科规范化培训护士带教工作中的应用效果。方法 研究以2021年3月—2023年3月轮转到重庆医科大学附属第二医院血液内科的规范化培训护士70名为研究对象,对每轮规范化培训护士采用随机数表法分为对照组和观察组,其中对照组34名,观察组36名。对照组接受传统的带教模式,由资深护士指导学习和实践;观察组实施导师制带教模式,由专业导师负责培养和辅导。通过对比2组护士的理论知识、操作技能、综合素质和教学满意度等指标,评价导师制教学模式在规范化培训护士培训中的应用效果。结果 观察组的理论知识成绩为(93.00±2.28)分、操作技能成绩为(93.36±1.66)分、综合素质考核成绩为(97.11±1.47)分、教学满意度为100%,高于对照组[理论知识成绩(89.65±6.71)分、操作技能成绩(91.44±3.93)分、综合素质考核成绩(94.18±2.89)分、教学满意度83.60%],差异有统计学意义(P <0.05)。结论 对血液科规范化培训护士实施导师制教学模式,可以使规范化培训护士的专科理论知识、操作技能、综合素质等方面的能力得到全面的提高。

目标教学法结合PDCA循环在呼吸科规培护士临床教学中的应用

目的探讨目标教学法结合计划(plan)、执行(do)、检查(check)和处理(act)(PDCA)管理模式在呼吸内科规培护士临床教学中的应用价值。方法选取2021年1月—2022年12月进入呼吸内科轮转的64名规培护士作为研究对象,根据入科时间分为对照组和试验组,各32名。对照组采用传统临床教学模式,试验组采用目标教学法结合PDCA管理临床教学模式。对比2组规培护士的考核评分、出科综合素质评分及满意度评分。结果试验组的操作成绩[(96.05±1.57)分],高于对照组[(94.91±1.51)分],差异有统计学意义(P<0.05)。试验组规培护士的沟通协调、专业知识、专业技能、安全意识、解决问题应急能力评分高于对照组,差异均有统计学意义(P<0.05)。试验组满意度平均分为(92.31±1.31)分,高于对照组的(91.07±0.59)分,差异有统计学意义(P<0.05)。结论目标教学法结合PDCA管理临床教学模式有助于提高呼吸内科规培护士的临床操作水平,利于高素质护理人才的培养,同时提升了规培护士的满意度。

全程标准化护理配合在正颌亚专科手术患者中的效果分析

目的:探讨全程标准化护理配合在正颌亚专科手术患者中的应用效果。方法:选取2022年1月至12月来南京医科大学附属口腔医院行正颌手术治疗的97例患者为研究对象,随机分为对照组48例和观察组49例。对照组采用常规护理配合模式,观察组在此基础上采用全程标准化护理配合,通过成立正颌护理管理小组,对专科小组护士进行专业培训,规范护理人员配合标准,比较两组护理配合效果、术中护理缺陷和术后并发症发生率,患者满意度以及医生对护理配合满意度的差异。结果:观察组患者的护理配合效果、护理缺陷和并发症发生率、患者及医生满意度,均高于对照组,差异有统计学意义(P<0.05)。结论:通过对行正颌手术治疗的患者全程给予标准化护理配合,在流程上对护理各环节进行质量控制,可以明显降低护理缺陷及并发症发生,缩短手术时长,减少术中出血量,保证护理质量和患者安全,有效提高医生和患者满意度。

达芬奇机器人辅助下肝癌根治术的临床疗效及围手术期护理路径的构建

目的:探究达芬奇机器人辅助下肝癌根治术的临床疗效以及护理路径在患者围手术期的应用效果。方法:选取2020年1月—2022年12月在四川省人民医院和成都市第三人民医院接受达芬奇机器人辅助下肝癌根治术的80例患者,采用随机数字表法将其分为研究组和对照组,各40例。对照组给予常规护理干预,研究组给予临床护理路径(CNP)。对比两组临床疗效、肝功能指标、生活质量评分、心理状态评分及住院指标。结果:所有手术均顺利完成,仅有1例胆漏,3例肝断面积液,经保守治疗后相关患者症状均消失;随访6~36个月所有患者均无复发或死亡;比较两组术后肝功能指标、各项生活质量评分、心理状态评分,差异具有统计学意义(P>0.05);出院前,两组肝功能指标和心理状态评分均明显降低,两组各项生活质量评分均明显升高,且研究组明显优于对照组,差异具有统计学意义(P<0.05);研究组卧床时间、住院时间、住院费用明显低于对照组,差异具有统计学意义(P<0.05)。结论:达芬奇机器人辅助下肝癌根治术能够取得良好的手术效果。同时与传统护理干预措施相比,临床护理路径构建的标准化护理流程能够改善患者肝功能、提高生活质量、调节不良情绪,具有较高的临床应用和推广价值。

基于OSCE的中医儿科护士规范化培训考核模式的构建

探讨基于客观结构化临床考试(OSCE)的中医儿科护士规范化培训考核模式的构建,为提升儿科新护士临床综合实践能力探索新的思路。OSCE作为一种科学、准确、公正的评价工具,可为临床培训考核提供客观及可量化的标准。根据考核目的设定考站和考核内容,通过6个站点(病情资料收集、辨病辨证分析、护理措施、相应中医护理操作、应急事件处理、健康教育)统一、规范的评分标准,更加突出中医护理特色,直观反映出新护士工作中的弱项与不足,为以后的培训教学指明了方向。OSCE考核模式的构建贴合临床护理预期和需求,能够有效评价新护士的辨证施护能力,并以此为基础制定出具有中医护理特色的规范化培训模式,以期为临床培养出优秀的实用型护理专业人才,进而提高中医儿科临床护理服务质量。

标准化临床情景模拟教学对护理带教质量的提升探讨

目的:探讨标准化临床情景模拟教学对护理带教质量的提升作用。方法:在2022年1月—2023年1月期间选取60名护生,随机分为对照组与研究组,每组30人,对照组采用常规护理带教,研究组采用标准化临床情景模拟教学,记录并对比带教指标。结果:带教后,研究组护生的护理专业素养评分更高,带教配合度和满意度更高(P<0.05)。结论:标准化临床情景模拟教学可以帮助进行护理带教的教师提升教学工作的综合质量,有利于提升护士的护理专业素养,对于我国临床护理人才队伍的培养与建设具有积极价值,值得推广应用。

基于临床护理分类系统的PICC相关性血栓预防护理知识库的构建

目的在PICC相关性血栓预测模型构建完成的基础上,应用循证方法学构建PICC相关性血栓预防护理知识库,为实现PICC相关性血栓预见性风险管理提供决策基础。方法以2020年发表的成人恶性肿瘤患者PICC血栓预防的最佳证据总结为基础,补充检索BMJ、JBI、RNAO、INS以及中国知网等国内外数据库和专业协会网站中关于PICC相关性血栓预防护理的所有证据,检索时限为2019年11月1日—2023年4月1日,对新纳入的文献进行质量评价和证据提取,并与现有最佳证据总结进行汇总、整理,形成知识库初稿,通过专家会议修改初稿,确定知识库终稿。按照临床护理分类系统编码规则,对知识库初稿内容进行编码。结果以PICC相关性血栓预测模型为评估工具,预防护理知识库终稿包括1项护理诊断、18项具体护理措施和4种护理结局。结论PICC相关性血栓预防护理知识库具有专业性、科学性与实用性,为临床护士提供科学决策。

新入职护士心理护理临床实践体验的质性研究

目的通过质性研究的方法探讨新入职护士心理护理临床实践体验,为构建新入职护士心理护理临床培训方案提供实证参考。方法2022年9-12月,采用目的抽样法,选取来自上海市3所三级甲等医院的14名新入职护士进行半结构式深入访谈,采用主题分析法对访谈资料进行整理分析。结果围绕新入职护士心理护理实践体验,提炼出3个主题:基于自身需求体会到心理护理的重要性、在患者照护过程中有意识地观察和实践心理护理、对于规范化培训阶段心理护理能力提升存在多方面的培训需求。结论新入职护士能较好意识到临床心理护理的重要性,能够逐渐将心理护理理念融入临床实践,但其自助能力与助人能力均有待提升。护理管理者可结合临床情境案例等,针对新入职护士开展相关培训,促进其心理护理实践技能的临床转化与迁移。

基于护理临床思维训练模式的构建与实施在护生培训教学中研究分析

目的:探究标准化病人结合情景模拟教学的培训对护理实习生护理临床思维能力的影响.方法:本研究为非同期类试验性研究,采用便利抽样法选取2019年6月至2020年2月浙江大学医学院附属第一医院消化内科的38名本科护理实习生为对照组,实施传统教学模式.2020年6月至2022年2月浙江大学医学院附属第一医院消化内科的39名本科护理实习生为试验组,开展标准化病人结合情景模拟教学的培训.结果:在出科考试中,我们以护理迷你临床演练评估量表(mini-clinical evaluation exercise,Mini-CEX)的评分作为评价指标,试验组的临床思维能力显著高于对照组的临床思维能力(P<0.01).结论:标准化病人结合情景模拟教学模式可以通过减少护生的紧张情绪,进一步激发护生的自主学习能力,并且有利于护生临床思维的形成,从而大大提高了护生的临床思维能力,最终使得培训教学的效果得到了显著的提升.

新护士基于学习风格的规范化培训效果评价

目的探讨基于学习风格的培训模式在新护士规范化培训中的应用效果。方法将2021年新护士63名设为对照组,2022年新护士61名设为观察组。对照组按照《新入职护士培训大纲(试行)》进行培训;观察组在培训大纲基础上根据学习风格分类匹配带教老师,同时根据新护士的学习方式偏好和学习特点提供相对应的学习环境及相匹配的教学方法。结果培训1年后,观察组自主学习能力总分和各维度评分及临床推理能力得分显著高于对照组(均P<0.05);观察组理论考核成绩、客观结构化临床考试成绩及培训满意度显著高于对照组(均P<0.05)。结论新护士基于学习风格的规范化培训有利于提升新护士自主学习能力、临床推理能力,提高培训效果及培训满意度。

规培护士职业韧性在临床归属感与职业认同感的中介效应分析

目的 探讨规范化培训护士职业韧性在临床归属感与职业认同感间的中介效应。方法 采用临床归属感量表、职业韧性量表和护士职业认同感量表对武汉市四所三级甲等医院的临床护士进行问卷调查。结果 312名规培护士临床归属感得分(106.53±38.37)分,职业韧性得分(66.14±23.57)分,职业认同感得分(105.73±29.90)分;规培护士的临床归属感与职业韧性、职业认同感均呈正相关(r=0.543,P<0.01;r=0.552,P<0.01),职业认同感与职业韧性呈正相关(r=0.665,P<0.01);职业韧性在临床归属感与职业认同感之间起部分中介作用,中介效应对总效应的贡献率为50.92%。结论 规培护士临床归属感对职业认同感有直接预测作用,职业韧性在临床归属感与职业认同感之间起部分中介作用,可通过提高职业韧性与临床归属感来增加规培护士的职业认同感。

阶段性目标教学结合PDCA循环在ICU护士规范化培训中的应用

目的探讨阶段性目标教学结合PDCA循环在重症医学科(intensive care unit,ICU)护士规范化培训临床教学中的应用效果。方法选取2019年2月-2021年2月在重庆市人民医院重症医学科规范化培训的26名护士为对照组,采用传统教学方法。2021年3月-2023年3月在重庆市人民医院重症医学科规范化培训的32名护士为研究组,采用阶段性目标教学结合PDCA循环教学方法。教学3个月后比较2组规培护士理论考核成绩、操作考核成绩、综合能力、教学满意度的情况。结果研究组理论考核成绩(85.87±3.11)分、操作考核成绩(94.28±1.54)分、综合能力(88.59±1.94)分、教学满意度(90.75±2.60)分,对照组理论考核成绩(77.73±4.49)分、操作考核成绩(91.73±1.73)分、综合能力(82.96±1.84)分、教学满意度(85.42±2.80)分,研究组各方面情况均优于对照组,差异有统计学意义(P<0.001)。结论阶段性目标教学结合PDCA循环有助于提高重症医学科规培护士的教学成绩和综合能力,改善临床教学质量,提高教学满意度。

临床护理路径在HFNC标准化管理中的应用研究

目的:探究临床护理路径在经鼻高流量氧疗(HFNC)标准化管理中的应用。方法:选取甘肃省武威市凉州医院2022年7月至2024年3月期间收治的120例HFNC治疗患者,随机均分为对照组和观察组。两组患者均应用HFNC治疗手段,对照组患者采用常规护理方式,观察组患者应用标准化临床护理路径。结果:观察组患者HFNC治疗时间及ICU住院时间均低于对照组,观察组不良事件发生率(5%)低于对照组(11.67%)(P<0.05);观察组治疗依从性与护理满意度更高(P<0.05)。结论:为患者实施HFNC标准化管理时采取临床护理路径,可分别对照治疗前、治疗中和治疗后三个阶段,为患者进行护理干预,有利于缩短患者治疗时间,提升临床护理指标,降低不良事件发生率,患者治疗依从性及护理满意度更高,该治疗护理方法有临床推广应用价值。