Objective To review and analyze the statistics of laboratory critical values in the Department of Cardiovascular Surgery in order to improve the procedures of dealing with these values and provide references for the enhancement of the nursing level. Methods We retrospectively analyzed laboratory critical values of 236 inpatients in the Department of Cardiovascular Surgery from April 2013 to April 2014. General data of the patients including the type of critical values, the critical value, distribution, clinical processing time and complications related to the critical values. Results A total of 208 laboratory critical values of 185 inpatients were analyzed including abnormal blood potassium was involved in 99 (47.60%); abnormal blood glucose was involved in 13 (6.25%); abnormal blood sodium was involved in 11 (5.29%); abnormal blood troponin was involved in 13 (6.25%); and 72 cases had other kinds of critical values (34.62%). A total of 136 critical values were closely related to the Department of Cardiovascular Surgery. Among them, 60 cases had a processing time of 15 minutes or shorter. After re-examination, 16 were confirmed to be fake critical values; and 11 critical values did not need to be treated according to the condition of the patients. There were altogether 27 cases of complications related to critical values, including 23 cases of arrhythmia related to abnormal blood potassium, 2 cases of abnormal muscle strength caused by abnormal blood sodium, and 2 cases of hypoglycemia. After the critical values were handled, related complications disappeared without any recurrence. Conclusions Perfect regulatory regime and process of recording and handling laboratory critical values are important for nurses in our department to carry out more accurate measures in treating these critical values including abnormal blood potassium, blood glucose, blood sodium, and blood troponin, etc. In order to continuously improve medical and nursing quality, nurses should pay more attention to the identification and treatment of laboratory critical values.
目的 探讨心脏机械瓣膜置换术后患者出院指导的综合方法，评价其效果。 方法 将2010年9月－2011年1月242例心脏机械瓣膜置换术患者按入院先后顺序随机分成试验组和对照组。试验组患者采用综合出院指导方案，对照组采用常规宣教方法，在6个月后对两组患者进行调查，评价综合指导方案的效果，并进行统计学分析。 结果 试验组患者均未出现不良并发症，对照组有1例出院后未遵医嘱服药及定期复查，死于血管栓塞；有2例出现血管栓塞，2例牙龈出血，经及时治疗后好转。 结论 对心脏机械瓣膜置换术患者出院时，发放健康教育资料及定期随访指导的综合出院指导方案，可以降低术后并发症，提高患者认知水平和满意度，帮助患者提高依从性，提高生存质量。
目的 提高胸心血管外科患者ICU转出交接班质量，避免护理差错和纠纷。 方法 2010年1月－6月，针对患者转运出现的问题，在查阅文献及专家咨询的情况下，设计制定胸心血管外科ICU患者转出交接单，对患者转出ICU时的病情、用药、并发症等信息进行完善，同时规范交接班签字手续。采用调查问卷方式，对交接单运用效果进行评价。 结果 转出交接单的应用，提高了病房护士对ICU护士交接班质量满意度，除“医嘱单正确执行”、“签字和药物交接班清楚”与运用前满意程度无差异外，其余条目满意程度均有所增加，增加率波动在3.7%～33.4%。 结论 转出交接单使用能够提高ICU患者术后转运交接质量，预防护理差错和纠纷，确保证患者安全。