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1例外伤性眼球脱臼患者的护理体会

老年丧偶住院患者抑郁状况调查及护理干预

目的调查老年丧偶住院患者的抑郁状况，探讨护理干预在改善丧偶老人抑郁状况中的效果。 方法选择2011年8月－2013年8月住院治疗的97例丧偶老年患者，通过老年专用抑郁量表（GDS-30），调查其抑郁状态，提出并实施护理干预措施，3个月后复查DGS-30评分评估护理干预效果。 结果共发放问卷97份，回收97份，回收率100%。97例丧偶住院患者入院时初评，有抑郁症状者82例，占84.5%。有人陪护者抑郁症发生率低于无人陪护的患者；社会支持好的患者抑郁症发生率低于社会支持差者；与家人居住的患者抑郁发生率低于独居的患者，差异均有统计学意义（P＜0.05）。经3个月护理干预后，再次评估GDS-30评分，患者抑郁情况有明显改善（P＜0.05）。 结论老年丧偶住院患者抑郁发生率高，有人陪护、社会支持好、与家人居住的患者抑郁发生率低。而采取积极的心理护理，以及专业的饮食、睡眠指导、加强患者陪护等护理干预措施，可以有效的改善丧偶患者的抑郁状况。

输血护理记录流程及质量监测表的设计与应用

2014年4月护理部质量控制科对全院各护理单元进行了输血管理专项督查，结果显示各护理单元在输血医嘱开具、输血医嘱执行、输血执行单、输血护理记录、输血袋管理及输血资料管理方面存在缺陷。该研究回顾性分析了2014年1月－4月老年科输血护理病历。经过总结分析，发现老年科输血护理记录存在输血记录单填写不规范、输血医嘱执行记录时间不一致、输血护理记录信息不完整等缺陷。因此，于2014年6月开展头脑风暴，根据讨论结果设计了输血护理记录流程和质量监测表。通过培训学习，输血护士和护理组长掌握了登记表、流程图的使用方法，能遵循流程及时、准确、全面执行输血记录，护士长应用质量监测表对输血护理记录质量实时监控，反馈输血记录亮点和问题，进行持续质量改进。6个月以后，输血护理记录缺陷较前明显较少，有效提高了输血护理记录质量。

结膜吸吮线寄生虫患者护理一例

Application of Continuous Quality Improvement to Reduce the Nursing Record Defects for Blood Transfusion

ObjectiveTo analyze and reduce the defects in nursing records for blood transfusion by continuous quality improvement (CQI) method, in order to prevent blood transfusion related medical disputes. MethodsIn October 2014, CQI team was established to analyze the reason for transfusion record defects and make standardized process and quality monitoring forms for nursing record of blood transfusion. Six months after the implementation of CQI, 40 records were randomly selected before the CQI implementation (April to September 2014) and after the implementation (April to September 2015) for comparison and analysis. ResultAfter 6 months of implementation of CQI, nursing record defects of blood transfusion decreased significantly from 228 to 55 items. ConclusionUsing CQI method can effectively reduce nursing record defects of blood transfusion. CQI can also improve the quality of nursing records and prevent medical disputes caused by blood transfusion.

Selenium Supplementation for Treatment of Kashin-Beck Disease: A Network Meta-analysis

ObjectiveTo assess the comparative efficacy of all kinds of selenium supplementation in the treatment of patients with Kashin-Beck disease (KBD) by network meta-analysis. MethodsWe searched seven electronic databases including PubMed, EMbase, The Cochrane Library (Issue 7, 2016), CBM, VIP, WanFang Data and CNKI databases up to July 2016. All randomized controlled trials (RCTs) assessing the effect of selenium supplementation on KBD were included. Two reviewers independently screened literatures, extracted data and assessed the risk bias of included studies, and then meta-analysis was performed by using Stata13.1 software. ResultsA total of 16 RCTs involving 2 883 participants were included. Direct meta-analysis comparison showed that:Compared with placebo or blank group, sodium selenite (OR=5.00, 95%CI 3.21 to 7.78), selenium supplement salt (OR=7.60, 95%CI 2.34 to 24.67), and combination of sodium selenite and vitamin E (OR=11.05, 95%CI 2.61 to 46.80) had higher metaphysis X-ray improvement (P < 0.05). Ranking on efficacy indicated that combination of sodium selenite and vitamin E were highest, followed by selenium supplement salt, sodium selenite, sodium selenite plus vitamin C, vitamin C, and placebo/blank. ConclusionBased on the results of network meta-analysis, selenium supplement (sodium selenite, combination of sodium selenite and vitamin C, combination of sodium selenite and vitamin E, as well as selenium salt) is more effective than placebo or no treatment in promoting the repairement of metaphysis impairment. The effect of combination of sodium selenite and vitamin E are highest.