【摘要】 目的 探讨神经科住院患者发生走失行为的相关因素，并制定相应的护理干预措施。 方法 采用回顾性调查，对2004年1月-2007年7月发生的8例走失神经系统疾患者，从护理角度对年龄、性别、文化程度、诊断、意识状态、精神状态等资料进行评估，分析影响因素与走失行为之间的相关性。 结果 影响自知力和易致患者产生幻觉妄想及定向力障碍的疾病更容易导致患者走失，走失行为多发生在夜间，且以男性、老年和低文化水平患者较多。 结论 针对神经科住院患者走失行为的危险因素，应根据具体情况，采取积极的综合预防及个体化的护理对策。【Abstract】 Objective To investigate the countermeasure of nursing towards patients straying from neurological ward by analyzing the associated stray factors. Methods The medical records of 8 patients that went astray from our neurological ward between January 2004 to July 2007 were retrospectively analyzed.The patients’ age, sex, educational level, clinical diagnosis, state of consciousness, and mental status were evaluated and analyzed to determine their correlation with the patients’ straying behavior. Results Patients with self-cognitive disorders, hallucination, delusion and disorientation were more likely to go astray. Male, senior age, and low education level patients were the dominant population engaging in the straying behavior, which mostly happened at night time. Conclusion Preventative nursing measures should be individualized to specific patients with special risky factors of straying in neurological ward.
目的 探讨神经科住院患者留置针安全的持续质量管理。 方法 选择2011年8月－10月100例神经科住院患者，按入院时间先后排序分为对照组和试验组，每组50例。对照组运用静脉留置针的常规护理方法进行护理，试验组在给予常规护理方法的同时实施一系列持续质量管理的措施，包括安排护理业务查房、组织操作示范、应用留置安全健康宣传小卡片对患者进行宣教、定期不定期的留置质量检查、将留置针安全作为一项交班内容、强调优质护理指针。留置针留置第3天对两组患者使用同一自制量表调查留置期间的安全问题及患者对护理的评价，并对两组调查结果进行统计分析。 结果 试验组留置期间不良事件发生率为6.0%，对照组为34.0%，两组差异有统计学意义（χ2=12.250，P=0.000）；试验组对留置针留置安全知识的4个方面知晓情况均优于对照组（P=0.000）；试验组对护理满意度较对照组好（P=0.000）。 结论 持续质量管理增加了神经科住院患者留置针留置安全、增进了患者对相关健康知识的掌握，提高了患者对护理的满意，值得临床推广。
Objective To investigate the current status of randomized controlled trials (RCTs) and clinical controlled trials (CCTs) on pressure sore in China. Methods We searched Chinese Journal of Nursing, Chinese Journal of Practical Nursing and Journal of Nurses Training in CNKI and VIP (January 2000 to December 2005) for Chinese articles on pressure sore, using "pressure sore", "bed sore", "nursing", "treatment", "prevention", "evaluation" and "management" as search terms. The retrieved articles were summarized. Results We identified 16 reports (10 RCTs and 6 CCTs). The studies were judged to be of low quality.There was one study on the evaluation, two on the prevention, and 13 on the treatment of pressure sores. Conclusion The current studies on pressure sore in China are focusing on treatment. Randomized controlled trials of large sample size of pressure sore are needed to improve nursing quality.