Nursing care

护理
  • 文章类型: Journal Article
    背景:低资源环境中的新生儿低体温普遍存在,并且与高发病率和高死亡率密切相关。我们检查了易于阅读的温度检测器设备是否可以改善健康状况。
    方法:在一项描述性研究中,利隆韦三级医院新生儿病房住院1009人,马拉维,分析并分为基线组和试验组。将试验前531例接受标准护理(SC)的新生儿的数据与实施该设备(设备护理=DC)期间的478例新生儿进行了比较。工作人员和护理人员接受了使用该设备以及在体温过低的情况下如何反应的培训。数据是从患者档案中收集的,设备文档表,访谈和焦点小组讨论。体温过低定义为体温<36.5°C。
    结果:在试验期间,在整个住院期间获得体温的频率明显更高(p<0.0001).每个新生儿每天的中位温度测量值SC为1.3倍,DC为1.6倍,轻度低温的检测频率更高。在体重最轻的组中避免了中度低温,这可能导致存活新生儿的住院时间明显缩短(p=0.007)。许多护理人员在正确使用和解释设备时遇到困难,报告的颜色中有47%与注册温度不符。与上述相反,与护理人员和卫生工作者进行的问卷调查和焦点小组讨论显示,该装置具有良好的接受度和总体意见.
    结论:随着更频繁的体温检查,出生体重较低的婴儿可能受益于实施易于阅读的连续温度指示器,但是低体温率仍然很高。我们的数据和经验揭示了结构性,沟通和一致性/解释缺陷。虽然专为低资源设置而设计,设备的实施需要一个良好的工作和结构化的环境,特别是关于工作人员和护理人员的沟通。
    BACKGROUND: Neonatal hypothermia in low-resource settings is prevalent and closely associated with high morbidity and mortality. We examined if an easy-to-read temperature detector device improves health outcomes.
    METHODS: In a descriptive study, 1009 admissions to a neonatal ward in a tertiary care hospital in Lilongwe, Malawi, were analysed and divided into a baseline and a trial group. The data of 531 newborns with standard care (SC) before the trial were compared with 478 newborns during the implementation of the device (device care=DC). Staff and caregivers were trained on using the device and how to react in case of hypothermia. Data were collected from patient files, device documentation sheets, interviews and focus group discussions. Hypothermia was defined as a body temperature <36.5°C.
    RESULTS: During the trial, body temperatures throughout the hospital stay were significantly more often obtained (p<0.0001). The median temperature measurements per newborn per day were 1.3 times with SC and 1.6 times with DC, and mild hypothermia was more frequently detected. Moderate hypothermia was avoided in the lightest weight group possibly contributing to significantly shorter hospital stays of surviving newborns (p=0.007). Many caregivers had difficulties using and interpreting the device correctly, and 47% of the reported colours did not match the registered temperatures. Contrary to the above, a questionnaire and focus group discussions with caregivers and health workers showed a high acceptance and the overall opinion that the device was beneficial.
    CONCLUSIONS: With more frequent temperature checks, infants with lower birth weight possibly benefited from implementing an easy-to-read continuous temperature indicator, but hypothermia rates remained high. Our data and experiences reveal structural, communicational and consistency/interpretation deficits. Although specifically designed for low-resource settings, the implementation of the device needs a well-working and structured environment, especially regarding staff and caregiver communication.
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  • 文章类型: Journal Article
    移情在护理中起着重要的作用,可以为患者提供优质的护理并对所提供的服务感到满意。沙特阿拉伯患者互动,包括初步探索,往往不像其他国家那样公式化地启动。在目前的研究中,研究人员旨在强调护士介绍在沙特阿拉伯卫生部医院住院中心创造理想患者体验的关键作用.这项研究是使用国家健康链接/PressesGaney调查对2021年至2022年期间的每一个quint进行的横截面二次数据分析。该方法包括对患者体验管理计划(PXMP)调查的深入分析,该调查是由HealthLinks/PressGaney完成的统一调查。在分析过程中,然而,结果发现有显著差异,因为71.3%的患者对他们的整体患者体验有很好的印象.这是专门为解决个人特征等具体问题而设计的。这项研究的结果有助于理解驱动护士与病人互动的因素,并加强护士向病人介绍的方式,以提高沙特阿拉伯卫生部医院病人的平均满意度。这项研究建议,沙特护士应接受培训,以建立他们与患者的互动融洽关系,因为这促进了以患者为中心,随后患者的体验和护理结果。
    Empathy plays an important role in nursing so that the patients are provided with quality care and are satisfied with the services provided. Saudi Arabian patient interactions, including initial exploring, tend not to be formulaically initiated as in other countries. In this current study, the researcher aimed to highlight the critical role of nurse introductions in creating a desirable patient experience in the inpatient centers of Ministry Of Health hospitals in Saudi Arabia. This study was a cross-sectional secondary data analysis using the National Health Links/Presses Ganey surveys for every quint between the period 2021 and 2022. The methodology comprised an in-depth analysis of the Patient Experience Management Program (PXMP) survey that was involved as the uniform survey concluded by the Health Links/PressGaney. During the analysis, however, the results were found to have significant differences as 71.3% of the patients had a very good impression of their overall patient experience. This was specifically designed to address specific issues such as personal characteristics. The results of this study contribute to the understanding of what drives the nurses-patient interactions and forge the need for enhancing the way nurses are introduced to their patients to increase the average level of satisfaction of patients in the Ministry Of Health hospitals in Saudi Arabia. This study recommends that Saudi nurses should be trained to establish rapport in their interactions with patients as this promotes patient-centeredness and subsequently patients\' experiences and care outcomes.
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  • 文章类型: Journal Article
    在生命的最后阶段和积极的死亡过程中,缺乏对接受姑息治疗(PC)的患者的感染管理的具体研究。与具体护理有关。有临床和社会的重要性,因为患者在PC代表一个脆弱的人群,适当的感染管理对于改善生活质量和舒适体验至关重要。
    这项研究分析了在两个医院的卫生服务机构中,在临终期和主动死亡过程中,接受PC的患者如何管理感染。
    这是一个观测,分析,和回顾性研究。
    在两家医院进行了数据收集,以帮助在PC下住院的个人,位于巴西,在圣保罗州内陆的一个城市。
    样本由113份病历组成,其中肿瘤诊断是最普遍的。根据患者的临床症状进行感染诊断占优势,主要的焦点是肺,在生命终结的个体中。研究样本中的感染管理是通过引起身体不适的护理和程序进行的。然而,旨在缓解症状。这些发现必须记录在案,当他们邀请我们反思我们的实际态度以及让这些人感到舒适意味着什么时,使得有可能将这些信息纳入干预措施的设计,重点是增强舒适度的体验。
    UNASSIGNED: There is a lack of specific studies on the management of infections in patients receiving palliative care (PC) in the final stages of life and during the active process of death, related to specific nursing care. There is clinical and social importance as patients in PC represent a vulnerable population, and adequate management of infections is crucial to improve quality of life and the experience of comfort.
    UNASSIGNED: This study analyzed how infections are managed in patients undergoing PC at the end-of-life and in the active process of death in two hospital health services.
    UNASSIGNED: This is an observational, analytical, and retrospective study.
    UNASSIGNED: Data collection took place in two hospitals that assist individuals who are hospitalized under PC, located in Brazil, in a city in the interior of the state of São Paulo.
    UNASSIGNED: The sample consisted of 113 medical records, in which the oncological diagnosis was the most prevalent. There was a predominance of infection diagnoses based on the patient\'s clinical symptoms, the main focus being the pulmonary, in individuals at the end-of-life. The management of infection in the study sample occurred through care and procedures that generate physical discomfort, however aiming at relieving symptoms. Such findings must be documented, as they invite us to reflect on our practical attitudes and what it means to be comfortable for these people, making it possible to incorporate this information into the design of interventions focused on enhancing the experience of comfort.
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  • 文章类型: Journal Article
    背景:由于各种因素,例如泪液产生减少和保护机制受损,重症监护病房(ICU)患者的眼表损伤风险增加。尽管眼部护理在ICU环境中具有重要意义,对有效的干预措施缺乏共识,导致眼表疾病(OSD)的预防不足。
    目的:本系统综述旨在评估ICU患者眼部护理预防OSD的有效性。次要目标包括确定眼外伤的主要危险因素并检查最有效的预防方法。
    方法:遵循PRISMA指南进行了系统评价,包括文献检索,文章选择,质量评估和数据综合。符合纳入标准的研究是观察性研究和临床试验,重点是在镇静和接受机械通气的ICU入院的成年人。
    结果:在3545篇最初确定的文章中,12项研究符合纳入标准。这些研究共涉及1853名参与者。评估了各种干预措施,包括盐水冲洗,润滑滴,凝胶润滑剂,用聚乙烯敷料闭塞,被动眨眼和眼睑闭合带胶带。每6小时一次的湿室闭塞与凝胶润滑相结合,是预防OSD的最有效方法。
    结论:凝胶润滑与湿室闭塞被证明是预防ICU患者眼部损伤的最有效策略。相反,常规使用生理盐水与角膜病变严重程度增加相关.正确定义的协议和训练有素的护理团队对于减少ICU环境中的眼外伤至关重要。
    结论:研究结果强调了在ICU中实施基于证据的眼部护理方案的重要性,强调使用凝胶润滑和眼表保护来减轻OSD的风险。这凸显了对ICU护理人员进行全面培训计划的必要性,以确保最佳的眼部护理服务。
    BACKGROUND: Intensive care unit (ICU) patients are at an increased risk of ocular surface injuries because of various factors such as reduced tear production and impaired protective mechanisms. Despite the significance of ocular care in ICU settings, there is a lack of consensus on effective interventions, leading to inadequate prevention of ocular surface disease (OSD).
    OBJECTIVE: This systematic review aimed to assess the effectiveness of nursing eye care in preventing OSD in ICU patients. Secondary objectives included identifying primary risk factors for ocular injuries and examining the most effective preventive methods.
    METHODS: A systematic review following PRISMA guidelines was conducted, encompassing a literature search, article selection, quality assessment and data synthesis. Studies meeting inclusion criteria were observational studies and clinical trials, focusing on adults admitted to ICUs under sedation and receiving mechanical ventilation.
    RESULTS: Of 3545 initially identified articles, 12 studies met inclusion criteria. These studies involved a total of 1853 participants. Various interventions were assessed, including saline rinsing, lubricating drops, gel lubricants, occlusion with polyethylene dressing, passive blinking and eyelid closure with tape. Moist chamber occlusion every 6 h combined with gel lubrication emerged as the most effective method in preventing OSD.
    CONCLUSIONS: Gel lubrication along with moist chamber occlusion proved to be the most effective strategy in preventing ocular injuries in ICU patients. Conversely, the routine use of physiological saline was associated with increased severity of corneal lesions. Properly defined protocols and well-trained nursing teams are crucial for reducing ocular injuries in ICU settings.
    CONCLUSIONS: The findings underscore the importance of implementing evidence-based eye care protocols in ICUs, emphasizing the use of gel lubrication and ocular surface protection to mitigate the risk of OSD. This highlights the need for comprehensive training programmes for ICU nursing staff to ensure optimal ocular care delivery.
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  • 文章类型: Journal Article
    护士使用手机会影响护理质量。本研究旨在探讨医院护士使用手机的后果。采用了定性方法。数据是通过半结构化访谈收集的。护理人员,病人,和他们的亲属参加了这项研究。“无感情护理”类别,“”忽视护理,“”“职业行为受损”和“个人手机是有效护理的障碍”的主题提取。在工作期间使用手机可能会危害患者的安全并破坏护理专业形象。有必要制定有关如何在医院使用手机的指南。
    Using cell phones by nurses can affect the quality of care. This study aimed to explore the consequences of using cell phones by nurses in hospitals. A qualitative approach was used. Data were collected through semi-structured interviews. Nursing staff, patients, and their relatives participated in this study. Categories of \"emotionless care,\" \"neglect in care,\" \"impaired professional behavior\" and a main theme of \"Personal cell phone is a barrier to effective nursing care\" extracted. Using cell phone during work could jeopardize patients\' safety and ruins the nursing profession image. It is necessary to formulate guidelines on how to use cell phones in hospitals.
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  • 文章类型: Journal Article
    膀胱癌在全球癌症患病率中排名第七。根治性膀胱切除术和尿流改道是肌层浸润性膀胱癌的标准治疗方法。家庭照顾者肩负着沉重的照顾负担,影响他们自己的生活质量,影响患者的健康相关生活质量(HRQOL)。
    这篇叙述性综述旨在强调护理人员所关注的主要问题以及护士主导的干预措施在减轻他们的担忧和改善HRQOL方面的功效。
    对PubMed的系统搜索,CINAHL,和ScienceDirect数据库的开展是为了确定过去5年(2018年1月至2023年8月)发表的研究,这些研究评估了膀胱癌尿流改道患者护理人员的担忧和问题.此外,还搜索了评估护士主导的干预措施在缓解这些担忧方面的功效的研究.
    总的来说,6项研究涉及933名患有UD的BC患者和1042名护理人员被确定为适合纳入本叙述性文献综述。确定的主要问题包括心理健康,医疗援助需求,和同行支持。在以二元方式运作的护理人员中,明显的心理影响很明显。护士主导的造口教育计划在提高护理人员的生活质量方面显示出潜力,尽管他们仍然受到限制。
    强调护理人员的角色和计划的有效性至关重要。我们的审查解决了这些差距,关注护理人员的关注点以及护理教育对改善患者预后的影响。
    整体和协作方法可以提高膀胱癌患者及其护理人员的整体健康状况和生活质量。
    UNASSIGNED: Bladder cancer ranks seventh in global cancer prevalence. Radical cystectomy and urinary diversion are standard for muscle-invasive bladder cancer. Family caregivers shoulder a substantial care burden, affecting their own quality of life, with repercussions extending to patients\' health-related quality of life (HRQOL).
    UNASSIGNED: This narrative review aims to highlight the major concerns perceived by the caregivers and efficacy of nurse-led interventions in alleviating their concerns and improving HRQOL.
    UNASSIGNED: A systematic search of the PubMed, CINAHL, and Science Direct databases was carried out to identify studies published in the last 5 years (from Jan 2018 to Aug 2023) that have evaluated the concerns and problems of caregivers attending bladder cancer patients with urinary diversion. Additionally, studies evaluating the efficacy of nurse-led interventions in alleviating these concerns were also searched.
    UNASSIGNED: Overall, 6 studies involving 933 BC patients with UD and 1042 caregivers were identified as suitable for inclusion in this narrative literature review. Major concerns identified included psychological well-being, medical assistance needs, and peer support. Significant psychological impact was evident in the caregivers which operated in a dyadic manner. Nurse-led stoma education programs have demonstrated potential in enhancing caregivers\' quality of life, although they remain restricted.
    UNASSIGNED: Emphasizing caregivers\' role and program effectiveness is critical. Our review addresses these gaps, focusing on caregivers\' concerns and the impact of nursing education for improved patient outcomes.
    UNASSIGNED: Holistic and collaborative approach could enhance the overall well-being and quality of life of bladder cancer patients and their caregivers.
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  • 文章类型: Journal Article
    本文综述了下肢深静脉血栓形成(DVT)的介入治疗和护理的最新进展。强调重大创新及其临床应用。它讨论了向新型抗凝剂的过渡,如直接口服抗凝剂,与传统疗法相比,它提供了更安全的配置文件和简化的管理。机械干预,包括球囊血管成形术和静脉支架置入术,详细介绍了它们在改善急性DVT病例的即时和长期血管功能中的作用。此外,图像引导技术的使用对于提高DVT干预的准确性和安全性至关重要.此外,这项研究概述了护理策略的进展,强调全面的术前和术后评估,以优化患者预后。这些评估有助于制定量身定制的治疗计划,对于管理DVT患者的复杂需求至关重要。还讨论了长期护理策略,以患者教育为重点,以确保遵守治疗方案并防止复发。该综合旨在向医疗保健专业人员通报DVT管理的前沿实践,促进更深入地了解如何将这些进步融入临床实践。它还强调了正在进行的研究以应对诸如成本效益和患者依从性等挑战的必要性。确保未来的治疗是可获得的和有效的。
    This review examines recent advancements in interventional treatments and nursing care for lower extremity deep vein thrombosis (DVT), highlighting significant innovations and their clinical applications. It discusses the transition to novel anticoagulants such as Direct Oral Anticoagulants, which offer a safer profile and simplified management compared to traditional therapies. Mechanical interventions, including balloon angioplasty and venous stenting, are detailed for their roles in improving immediate and long-term vascular function in acute DVT cases. Furthermore, the use of image-guided techniques is presented as essential for enhancing the accuracy and safety of DVT interventions. Additionally, this study outlines advances in nursing care strategies, emphasizing comprehensive preoperative and postoperative evaluations to optimize patient outcomes. These evaluations facilitate tailored treatment plans, crucial for managing the complex needs of DVT patients. Long-term care strategies are also discussed, with a focus on patient education to ensure adherence to treatment protocols and to prevent recurrence. The synthesis aims to inform healthcare professionals about cutting-edge practices in DVT management, promoting a deeper understanding of how these advancements can be integrated into clinical practice. It also underscores the necessity for ongoing research to address challenges such as cost-effectiveness and patient compliance, ensuring that future treatments are both accessible and effective.
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  • 文章类型: Journal Article
    目标:在过去的二十年里,机器人手术在心脏手术中的应用越来越普遍.通常,机器人辅助手术的患者结果评估集中在患者的发病率和死亡率,手术并发症,和住院时间。然而,关于患者对机器人辅助手术的感知的研究有限。因此,这项研究旨在确定接受机器人辅助心脏手术的患者的经验。
    方法:本研究采用定性设计。
    方法:这项研究是对12名在教育和研究医院接受机器人辅助心脏手术的患者进行的。在研究前获得伦理批准和书面知情同意书。
    结果:66.7%的参与者是男性,平均年龄为38.25±16.06岁。对定性数据的分析确定了三个主题:机器人手术,手术后的经验,和返校节。
    结论:患者对机器人手术表示满意,并推荐给其他接受手术的患者。根据调查结果,我们可能会建议护士进行个性化的机器人手术教育计划,并制定计划以在家中对患者进行随访。
    OBJECTIVE: Over the last two decades, the use of robotic surgery in cardiac procedures has become increasingly prevalent. Typically, assessments of patient outcomes for robot-assisted surgery concentrate on patient morbidity and mortality, surgical complications, and length of hospital stay. However, there is limited research on patients\' perceptions of robot-assisted surgery. Therefore, this study aims to determine the experiences of patients undergoing robot-assisted cardiac surgery.
    METHODS: The study used a qualitative design.
    METHODS: The study was conducted with 12 patients who underwent robot-assisted heart surgery at an educational and research hospital. Ethical approval and written informed consent were obtained before the study.
    RESULTS: 66.7% of the participants were male with an average age of 38.25 ± 16.06 years. The analysis of qualitative data identified three themes: Robotic surgery, Post-Surgical Experience, and Homecoming.
    CONCLUSIONS: Patients expressed satisfaction with robotic surgery and recommended it to others undergoing surgery. Based on the findings, we may suggest that nurses may conduct personalized education programs about robotic surgery and develop programs to follow up with patients at home.
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  • 文章类型: Journal Article
    背景:由于老年人的预期寿命较高,当前的人口结构变化对国家护理系统提出了挑战。很大程度上与社会隔绝,疗养院的居民面临暴力的风险,疏忽,以及其他潜在的侵犯人权行为。这项研究旨在调查疗养院的医疗保健脆弱性,并评估奥地利国家预防机制(NPM)。
    方法:在2017年至2019年之间,在32个疗养院进行了55次监测访问。来自两个奥地利省份的研究结果包括基础设施数据,占用,人员配备,居民的人口统计和医疗条件,以及与NPM运作相关的措施。
    结果:使用助行器的可达性在87%中足够,但仅在20-40%的机构中为视觉或听觉障碍人士提供援助。护理助理人员不足(卡林西亚-5.2全职相当于)和家庭佣工(卡林西亚和施蒂里亚州-1.6)。不到20%的人员接受了与痴呆症和神经精神护理相关的高级培训。虽然50%的居民被诊断出患有精神疾病,大约36%的人得到了指定法定监护人的支持.在监测访问中,有58.1%是由于匿名投诉和紧急转介而进行的。NPM和省政府的处理时间中位数超过250天。
    结论:人权监测揭示了家庭护理的关键方面,包括可达性不足,人员不足和培训不足。尽管当局的处理时间阻碍了迅速的回应,NPM可能会促进疗养院内部的系统性改善和问责制。
    BACKGROUND: Current demographic changes bear challenges for national care systems due to higher life expectancy of older citizens. Largely cut off from society, nursing home residents are at risk for violence, neglect, and other potential human rights violations. This study aimed to investigate healthcare vulnerabilities in nursing homes and evaluate the Austrian National Preventive Mechanism (NPM).
    METHODS: Between 2017 and 2019, 55 monitoring visits were conducted in 32 nursing homes. Study outcomes from two Austrian provinces included data on infrastructure, occupancy, staffing, resident\'s demographics and medical conditions, as well as measures related to the functioning of the NPM.
    RESULTS: Accessibility with mobility aids was sufficient in 87%, but assistance for persons with visual or hearing impairments solely in 20-40% of the institutions. An understaffing with nursing assistants (-5.2 full-time equivalents in Carinthia) and home helpers (-1.6 in Carinthia and Styria) was present. Less than 20% of the personnel received advanced training related to dementia and neuropsychiatric care. While 50% of the residents were diagnosed with a psychiatric disorder, approximately 36% received support from an appointed legal guardian. Of the monitoring visits 58.1% were conducted due to anonymous complaints and urgent referrals. The median processing times of the NPM and the provincial governments exceeded 250 days.
    CONCLUSIONS: Human rights monitoring reveals critical aspects in nursing home care, including insufficient accessibility, understaffing and inadequate training. Although the authorities\' handling times hinder prompt responses, the NPM may foster systemic improvements and accountability within nursing homes.
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