目的 探讨实习前护理知识技能评价与实习教学目标相结合的临床护理实习培训效果。方法 选择2018年在我科实习的护理本科实习生40名为对照组,采取传统的带班实习带教方法进行临床带教;2019年在我科实习的40名护理本科实习生为实验组,对实习生在实习前进行护理知识和护理操作能力评估,根据实习生专业知识与护理技术的评估结果,结合实习教学目标进行针对性的临床带教;实习结束对两组同学掌握的护理理论知识、护理操作技术、服务满意度进行评价。结果 实验组掌握的护理知识、护理操作技术得分均高于对照组,两组结果比较差异有统计学意义(P<0.001);服务满意度评价实验组高于对照组,两组结果比较差异有统计学意义(P<0.05);结论 开展实习前护理专业能力评价与教学目标相结合的护理临床实习培训模式管理,有助于带教老师掌握实习生存在的护理知识缺乏和护理技术薄弱问题,利于带教老师制定合理的实习带教计划和带教重点,提高学生临床实习效果和老师的带教质量。

Objective To explore the effect of clinical nursing practice training combined with the evaluation of nursing knowledge and skills and teaching objectives before practice. Methods 40 nursing undergraduates who practiced in our department in 2018 were selected as the control group, and the traditional method of clinical teaching was adopted; 40 nursing undergraduates who practiced in 2019 were selected as the experimental group to evaluate the nursing knowledge and nursing operation ability of the interns before the practice, according to the evaluation results of professional knowledge and nursing technology of the interns, combined with the practice teaching at the end of the internship. The students in the two groups were evaluated on their theoretical knowledge, nursing operation technology and service satisfaction. Results The scores of nursing knowledge and nursing operation technology in the experimental group were higher than those in the control group, and the results of the two groups were statistically significance (P<0.001); the evaluation of service satisfaction in the experimental group was higher than that in the control group, and the results of the two groups were statistically significance (P<0.05); Conclusion To carry out the management of nursing clinical practice training mode combining the evaluation of nursing professional ability with teaching objectives before practice is helpful for the teachers to find out problems of lack of nursing knowledge and weak nursing technology existing in the interns. It helps the teachers to formulate reasonable practice teaching plan and key points, and improves the effect of students' clinical practice and the quality of teaching.

目的 研究疫情下护理人员的情绪障碍和睡眠障碍情况。方法 应用广泛性焦虑障碍量表(GAD-7),病人健康问卷(抑郁)(PHQ-9),病人健康问卷(躯体症状)(PHQ-15)和匹兹堡睡眠质量指数(PSQI)量表对临床一线护理人员进行心理和睡眠问卷调查,统计情绪和睡眠障碍的发病率,以及其相关性。结果 126名完成量表的临床一线护理人员,焦虑,抑郁,躯体症状,睡眠障碍的发病率分别为:41.9%、31.5%、9.5%和30.8%。相关性分析显示学历,年龄,婚育情况及是否为独生子女与上述情绪、睡眠障碍有相关,差异有统计学意义(P <0.05)。结论 临床一线护理人员焦虑和睡眠障碍发病率高,且二者明显相关,存在相互影响。建议医院随时更新知识指南,加强对护理人员的心理疏导和人文关怀,以减轻护理人员的心理压力。

Objective To study the emotional and sleep disorders of nursing staff under the emerging infections diseases. Methods The generalized anxiety disorder scale anxiety (GAD-7), patient health questionnaire 9(depression)(PHQ-9), patient health questionnaire 15 (somatic symptoms)(PHQ-15), and Pittsburgh sleep quality index (PSQI)were used in our investment. Statistics on the incidence of emotional and sleep disorders, and their correlation were done in our study. Results The incidence of anxiety, depression, physical symptoms, and sleep disorders in 126 nurses were 41.9%, 31.5%, 9.5%, and 30.8%, respectively. Correlation analysis showed that education, age, marital status, and whether or not they were the only children in the family were related to the above-mentioned emotions and sleep disorders (P<0.05). Conclusion The incidence of anxiety and sleep disorders in clinical front-line nurses is high. There are high and significant correlation and interaction between mood and sleep disorders. It is recommended that hospital need to update the knowledge and strengthen the psychological counseling and humanistic care of the nursing staff to reduce the psychological pressure of the nursing staff.

目的 探讨双侧会阴神经阻滞麻醉配合综合护理在降低单胎初产妇顺产会阴侧切率中的应用效果。方法 选取2019年7月—2019年12月在我院经阴道分娩的顺产初产妇110例为研究对象,按照随机数字表法分成两组,每组各55例,所选产妇对照组产妇给予常规护理模式,给予局部浸润麻,观察组产妇在对照组基础上采用综合护理模式,给予双侧会阴神经阻滞麻醉,比较两组产妇会阴侧切情况、会阴裂伤情况、产程持续时间、VAS评分、新生儿Apgar评分、依从性情况及护理效果等相关指标。结果 和对照组相比,观察组患者会阴侧切发生率少于对照组(P＜0.05),第一、第二产程时间短于对照组(P＜0.05);同对照组相比,观察组产妇在VAS评分、依从性及满意度指标均优于对照组(P＜0.05),而新生儿窒息、产后出血发生情况比较差异无统计学意义(P＞0.05)。结论 双侧会阴神经阻滞麻醉配合综合护理可以有效降低初产妇会阴侧切的发生率,减轻分娩时的疼痛,缩短产程,提高产妇依从性及满意度,具有较高的临床推广价值。

Objective To explore the effect of bilateral perineum nerve block anesthesia combined with comprehensive nursing in reducing the rate of perineum side cutting of primipara. Methods 110 primiparas who delivered vaginally in our hospital from July 2019 to December 2019 were selected as the research objects. According to the random number table method, they were divided into two groups, 55 in each group. The control group was given the routine nursing mode and local infiltration anesthesia. The observation group was given the comprehensive nursing mode and bilateral perineum nerve block anesthesia on the basis of the control group. The perineum side cutting status, perineum laceration, duration of labor, VAS score, Apgar score, compliance and nursing effect of the two groups were compared. Results Compared with the control group, the incidence of perineum side cutting was lower in the observation group than that in the control group (P<0.05).The first and second stages of labor were shorter in the observation group than the control group (P<0.05); compared with the control group, the VAS score, compliance and satisfaction index were better in the observation group than the control group (P<0.05), but there was no significant difference in neonatal asphyxia and postpartum hemorrhage (P>0.05). Conclusion Bilateral perineum nerve block anesthesia combined with comprehensive nursing may effectively reduce the incidence of perineum lateral incision of primipara, reduce the pain during delivery, shorten the labor process, improve the compliance and satisfaction of parturients, and has a high clinical value.

目的 研究伤口护理中延续性护理的应用效果。方法 选取2017年12月—2018年8月为研究阶段,抽取我院收治的130例皮肤擦伤和存在深部皮肤损伤患者作为研究对象,采用均衡分组法分为参照组和研究组,各65例。参照组采用常规伤口护理,研究组采用延续性护理干预。护理1个月后观察效果,包括并发症发生情况、创面愈合时间、疼痛评分及舒适度评分,进一步观察患者护理前后焦虑、抑郁评分变化。结果 研究组并发症发生率1.54%,参照组并发症发生率13.85%,对比有统计学意义(P＜0.05)。研究组创面愈合时间与参照组相比要短,疼痛评分与参照组相比要低,舒适度评分与参照组相比要高,对比差异有统计学意义(P＜0.05)。护理后,研究组患者焦虑、抑郁评分低于参照组及护理前,对比差异有统计学意义(P＜0.05)。结论 伤口护理中延续性护理的应用效果显著,可有效降低并发症发生风险,使其疼痛感及负性心理得到缓解的同时促使其创面恢复时间缩短,具有较高临床推广价值。

目的 探讨集束化护理模式在AECOPD并呼吸衰竭患者初次无创通气中的作用。方法 选我院2016年10月—2018年12月收治AECOPD并呼吸衰竭需初次无创通气的患者为研究对象,随机分为对照组和观察组,对照组予传统护理,观察组予集束化护理,各30例;分别记录两组患者每日无创通气时间、总住院时间、循环呼吸指标(HR、RR)、指尖血氧饱和度、血气分析、并发症、患者满意度和护理质量。结果 观察组患者的每日无创通气时间,指尖血氧饱和度、pH值、氧分压和二氧化碳分压改善均优于对照组,并发症发生率和住院时间低于对照组,满意度和护理质量较高(P<0.01)。结论 集束化护理可以提高AECOPD并呼吸衰竭患者无创通气的疗效,减少并发症、缩短住院天数,改善预后。

目的 探讨健康教育路径联合集束化护理模式在预防脑卒中患者便秘的效果观察。方法 随机选择神经外科收治的脑卒中患者120例,分为实验组与对照组,各60例,其中对照组给予常规护理,而实验组在常规护理基础上应用健康教育路径联合集束化护理模式。比较两组患者便秘发生率、便秘措施落实率、患者满意度、及患者入院前后的健康教育知识知晓率的比较。结果 实验组便秘发生率明显低于对照组,便秘护理评估率,护理措施落实率,病人满意度明显高于观察组,患者入院后的健康教育知识知晓率明显升高(P<0.05),具有统计学意义。结论 健康教育路径联合集束化护理模式能有效的降低脑卒中患者便秘发生率,提高预防便秘发生护理措施落实率,提高患者满意度,提高患者舒适度。

目的 探讨降低院前病情识别风险的护理研究。方法 对106例患者进行院前急救护理,53例患者使用简单临床评分(SCS)作为对照组,53例患者采用改良早期预警评分(MEWS)模式作为观察组,并按照院前危重患者救治护理模式实施院前急救护理。比较救治结果。结果 观察组患者院前急救总耗时间缩短,转运成活率和满意度提高,转运并发症发生率低于对照组,差异有统计学意义(P<0.05)。MEWS评分评估28 d生存率的AUC为0.861(P＜0. 001),临界值为6.98分,敏感度87.2%,特异度91.6%,优于SCS。结论 早期预警评分模式可以降低院前病情识别风险,提高救治成功率和护理质量,对患者预后有较好的敏感性和准确性。

Objective To explore the nursing in reducing risk of patients' pre-hospital condition recognition. Methods 106 patients were treated by emergency care in pre-hospital period. Among all patients a simple clinical scoring condition assessment(SCS) were given to 53 patients, who were in control group, and other 53 cases were treated by modified early warning score model (MEWS), who were in observation group. Emergency care was given to all critical patients in pre-hospital period. Then we compared the effects. Results The pre-hospital consumed time was significantly less, transportation survival rate and satisfaction rate of patients were both higher, complication rate was lower in observation group than control group(P＜0.05). The AUC was 0.861(P＜0. 001) of MEWS for evaluating survival rate after 28 days by the ROC curve analysis. The score of cutoff value was 6.98, sensitivity was 87.2%, specificity was 91.6%, which were all better than SCS. Conclusion Early warning score model may decrease the risk of condition recognition in pre-hospital period, improve rescue success rate and nursing quality, providing a better sensitivity and accuracy for prognosis evaluation.

目的 探讨分阶段延续护理对改善留置输尿管支架管老年农民患者并发症的效果。方法 按时间顺序将106例患者分为对照组52例和观察组54例,对照组给予常规电话随访,观察组实施三个阶段的延续护理。30天后测评患者并发症持续时间和发生率、自我管理能力。结果 观察组腰痛、血尿、膀胱刺激征持续时间缩短,尿路感染、支架管移位和滞留的发生率下降,自我管理能力各维度评分升高,与对照组比较差异均有统计学意义(P＜0.01)。结论 分阶段延续护理能提高留置输尿管支架管老年农民患者的自我管理能力,增强依从性,减少并发症的发生,促进早日康复。

Objective To investigate the effect of staged continuous nursing on complications in elderly agricultural-workerpatients with indwelling ureteral stent. Methods According to the chronological order, 106 patients were divided into control group (52 cases) and observation group (54 cases). The control group received routine telephone follow-up, and the observation group received three stages of continuous care. 30 days later, the complications' duration, incidence and self-management ability were assessed. Results In the observation group, pain, hematuria and bladder irritation were obviously shorten. Urinary tract infection and the incidence of stent displacement and retention were decreased. Scores in all dimensions of self management ability were increased. Comparing with the control group, it had significant difference (P<0.01). Conclusion The phased continuous nursing may improve the self-management ability of the elderly agricultural-worker with indwelling ureteral stents, strengthen the compliance, reduce the occurrence of complications and promote early rehabilitation.

目的 探讨医护合作护理程序教育模式在轻度认知功能障碍血透患者中的应用效果。方法 对65例患者实施医护合作护理程序教育模式,2个月后对患者的健康教育知识掌握程度、自体动静脉内瘘自我护理能力、维持性透析依从性、满意度进行测评。结果 医护合作护理程序教育模式后患者的健康教育知识掌握程度为92.31%、自体动静脉内瘘自我护理能力为27.11±3.26、维持性透析依从性是48.22±4.67、护理满意度是92.31%,均比护理程序教育前提高,护理程序教育前后比较差异均有统计学意义(P＜0.01)。结论 医护合作护理程序教育模式能提高患者的认知能力、自我护理能力和满意度,减少并发症,利于患者生活质量的提高。

Objective To explore the effect of the application of nursing process education model under doctor-nurse cooperation in hemodialysis patients with mild cognitive impairment.Methods 65 patients received nursing process education model under doctor-nurse cooperation. After 2 months, these patients were assessed in terms of the level of knowledge about health education, autologous arteriovenous fistula self-care ability, compliance of maintenance dialysis and satisfaction.Results After the nursing process education model under doctor-nurse cooperation, the percentage of patients who became proficient at knowledge about health education was 92.31%, that of patients who showed autologous arteriovenous fistula self-care ability was 27.11±3.26, that of the patients who became compliant to maintenance dialysis was 48.22±4.67, and nursing satisfaction was 92.31%. These performances improved significantly, comparing to those before the nursing process education model under doctor-nurse cooperation. The differences between before and after the model have statistical significance (P<0.01).Conclusion The nursing process education model under doctor-nurse cooperation may improve patients' cognitive ability, self-care ability and satisfaction. It also reduces complications and helps patients to increase the quality of life.

目的 研究护理干预对慢性阻塞性肺疾病患者抑郁焦虑情绪的效果。方法 选取2015年2月—2017年3月我院收治的慢性阻塞性肺疾病患者84例为观察对象。2015年2月—2016年2月入院患者42例为对照组,遵医嘱给予治疗,同时均予以常规慢性阻塞性肺疾病知识宣教。2016年3月—2017年3月入院患者42例为观察组在对照组基础上予以优质护理干预。分别比较干预前后两组患者抑郁、焦虑及干预前后肺功能变化、患者满意度、生活质量。结果 干预后观察组抑郁自评量表(SDS)、焦虑自评量表(SAS)评分分别为(20.05±5.24)分、(21.57±6.03)分,均低于对照组(28.57±5.29)分、(31.72±6.14)分,差异有统计学意义(P＜0.05)。干预后观察组FEV1水平(2.00±0.33)L,高于对照组的(1.68±0.25)L、观察组FEV1/FVC水平分别为(69.50±7.95)%,高于对照组的(65.18±8.43)%,差异有统计学意义(P＜0.05)。观察组患者满意度为95.24%(40/42),高于对照组的73.81%(31/42),差异有统计学意义(P＜0.05)。观察组患者各项SF-36评分均高于对照组,均P＜0.05差异有统计学意义。结论 优质护理干预可缓解患者负性情绪,改善肺功能,提高满意度及生活质量。

Objective To study effects of nursing intervention in paitents with chronic obstructive pulmonary disease. Methods 84 patients with chronic obstructive pulmonary disease admitted to our hospital from February 2015 to March 2017 were selected as the observation objects. From February 2015 to February 2016, 42 patients admitted to the control group were treated with conventional therapy. From March 2016 to March 2017, 42 patients admitted to the hospital as the observation group were given quality nursing intervention on the basis of the control group. The depression, anxiety, lung function changes, patient satisfaction and quality of life before and after intervention were compared between the two groups before and after intervention. Results After the intervention, the SDS and SAS scores of the observation group were (20.05±5.24), (21.57±6.03), which were lowered than that of the control group (28.57±5.29), (31.72±6.14), the difference was statistical significance (P<0.05). After intervention, the level of FEV1 in the observation group (2+0.33) L was higher than that in the control group (1.68+0.25) L, and the FEV1/FVC level in the observation group was (69.50+7.95)%, which was higher than that in the control group (65.18+8.43)%,the difference was statistical significance (P<0.05). Satisfaction of patients in the observation group was 95.24% (40/42), higher than the control group 73.81% (31/42),the difference was statistical significance (P<0.05). The SF-36 scores of the observation group were higher than those of the control group, P<0.05, the difference was statistical significance. Conclusion High quality nursing intervention may effectively alleviate depression, anxiety and other negative emotions, improve lung function, satisfaction and quality of life.