目的:在推广护理标准预防操作流程(standard operation procedure,SOP)前后对护理人员进行操作情况和针刺伤职业暴露水平对比,探索护理SOP的实用性和有效性。方法:在中山大学中山眼科中心推广护理SOP前后,分别对14名责任护士进行操作考核,并对推广护理SOP前后收治的传染病患者数量和针刺伤职业暴露事件数量进行对比。结果:推行护理SOP前后操作考核平均分分别为82.31分、88.23分,差异有统计学意义(P<0.001)。初高级责任护士考核结果差异无统计学意义。推行护理SOP前后病房收治血液传染性疾病患者总数分别为32例、51例,针刺伤职业暴露事件分别为4例、0例,差异有统计学意义(χ2 =6.698,P=0.020)。结论:护理SOP的推广可使护理人员加强自我防护,减少针刺伤职业暴露,有效降低医源性感染率。
Objective: To compare the operation status and occupational exposure to needle stick injuries level of nursing staff before and after the promotion of nursing standard prevention operation procedure (SOP), and to explore the practicability and effectiveness of nursing SOP. Methods: Before and after the promotion of nursing SOPs at Zhongshan Ophthalmology Center of Sun Yat-sen University, 14 responsible nurses were assessed for operation,and the number of infectious diseases and occupational exposures to needle stick injuries before and after the promotion of nursing SOPs were compared. Results: The average scores of operation and evaluation before and after the implementation of nursing SOP were 82.31 points and 88.23 points, with significant statistical difference(P<0.001). There was no statistical difference in the results of the initial senior responsible nurses. The total number of patients with blood infectious diseases before and after the implementation of nursing SOP was 32 cases and 51 cases. The occupational exposure to needle stick injuries events were 4 cases and 0 and the difference was statistically significant (χ2 =6.698, P=0.020). Conclusion: The promotion of standard preventive procedures can enable caregivers to strengthen self-protection, reduce occupational exposure, and effectively reduce the rate of iatrogenic infection.
目的:探讨标准化沟通模式(SBAR)在眼球穿通伤患者护理交班中的应用效果。方法:60例患者作为对照组,使用传统口头方式交班;60例患者作为观察组,使用SBAR沟通模式进行交接。比较两组交班耗时、两组护士对患者病情掌握程度以及患者对护理服务满意度的差异。结果:观察组与对照组比较,上述指标差异具有统计学意义(P<0.05)。结论:采取SBAR沟通模式交班有助于降低在眼球穿通伤护理中的不良事件发生率,保障了护理质量,提高了交接班效率和患者满意度,适宜推广应用。
Objective: To evaluate the SBAR communication model in the nursing care handover of patients with penetration injuries of eyeball. Methods: Transfer time, receivers’ information retention, and patient’s satisfaction were compared between two groups of patients with penetration injuries of eyeball. A total of 60 patients were handled with the traditional oral communication handover as comparison group and other 60 patients were handled with the SBAR handover as intervention group. Results: When comparing intervention group with comparison group, statistically significant improvements (P<0.05) were observed in all three factors tested. Conclusion:Implementing the communication tool SBAR in the nursing care of patients with penetration injuries of eyeball reduces rate of adverse events, improves patient care quality, enhances transfer efficiency, and boosts patient’s satisfaction.
为在眼科日间手术模式下既能满足玻璃体视网膜术后体位需求,又能合理利用有限空间,本研究团队在原有的眼科日间病房座椅的基础上,增加玻璃体手术后体位护理等功能,发明了一种护理座椅[专利号:国家实用新型专利(ZL 2017 2 0942404. 1)]。该座椅采用钢喷塑(或不锈钢)、木板、海绵和人造革皮等材料,其结构主要包括座椅的主体部分、俯卧台、杂物篮、收纳架、输液杆套筒等部分。其制作材料简单,操作方便,安全使用,既能保证临床体位护理需求,又能节省空间,便于病房环境管理。
To meet the needs of the postoperative position nursing after pars plana vitrectomy in the day surgery mode,this research team has designed a nursing chair [patent number: National Uutility Model Patent (ZL 201720942404. 1)] based on the original chair of ophthalmic day ward, adding the functions of postvitreous nursing and so on. The seat is made from steel spray plastic (or stainless steel), wood, sponge and artificial leather, and the structure mainly consists of the main body, the countertop for prone position, the junk basket, the storage rack, and the infusion rod sleeve. The seat can be made by simple materials. The seat is easy to operate and safe to use, which can not only meet the needs of clinical body position nursing care, but also save the ward’ space and facilitate the environmental management of the ward.
目的:探讨应用数字化广域成像系统RetCam3行婴幼儿口服荧光素钠眼底血管荧光造影(fluorescein fundus angiography,FFA)的护理。方法:选择2018年8月至2019年12月在广州中山大学中山眼科中心小儿眼病综合科就诊的眼底疾病婴幼儿78例,应用RetCam3进行口服法FFA检查及护理,将护理要点进行总结。结果:所有患儿安全、顺利完成检查,检查过程中均未发生异常病情变化或与检查、药物相关的并发症。经FFA确诊家族性渗出性玻璃体视网膜病变(familial exudative vitreoretinopathy ,FEVR)26例,早产儿视网膜病变(retinopathy of prematurity ,ROP)23例,色素失禁症患者6例;玻璃体积血患者3例;视网膜母细胞瘤患者3例;牵牛花综合征患者1例;视网膜色素变性患者3例;弓蛔虫眼病患者1例;原始永存玻璃体患者2例;不明原因眼底病变患者5例,单眼视网膜皱襞患者1例,先天性小眼球患者1例,巨细胞病毒感染患者1例,先天性黄斑发育不良患者1例;Coats病患者1例。结论:应用RetCam3行婴幼儿口服法FFA是一种安全、有效的检查方法。规范、恰当的护理配合能够保证检查准确、顺利地完成。
Objective: To share the nursing experience of RetCam3 ultra-widefield oral fluorescein fundus angiography (FFA) in infants with fundus diseases. Methods: Seventy-eight infants with fundus diseases admitted to General Department of Pediatric Ophthalmology in Zhongshan Ophthalmic Center, Sun Yat-sen University from August 2018 to December 2019 were recruited. Oral FFA was carried out using the 130-degree lens of RetCam3, and the key points of nursing were summarized. Results: No complications related to the examination and drugs occurred after oral FFA with an appropriate nursing manner. FFA confirmed 26 cases of familial exudative vitreoretinopathy,23 cases of retinopathy of prematurity and 6 cases of pigment incontinence. Vitreous hematoma was observed in 3 patients, retinoblastoma in 3 patients, Morning Glory syndrome in 1 patient, retinitis pigmentosa in 3 patients,Ascaris lumbricoides eye disease in 1 case, original permanent vitreous body in 2 patients, unexplained fundus lesions in 5 patients, monocular retinal fold in 1 patient, congenital micro-eyeball in 1 patient, cytomegalovirus infection in 1 patient, congenital macular dysplasia 1 patient and Coats disease in 1 patient. Conclusion: Oral FFA with RetCam3 is an effective and safe detection method for infants. Standard and proper nursing can ensure the examination can be performed accurately and smoothly.
目的:探讨折叠式人工玻璃体球囊(foldable capsular vitreous body,FCVB)植入术的护理配合。方法:对2018年6月至12月接受FCVB植入术的33例患者的术中护理配合进行回顾性分析和总结。结果:33例患者的手术均能顺利进行,术后裂隙灯显微镜检查示折叠式人工玻璃体球囊位置均居中;患者均未见球囊排斥、交感性眼炎及其他明显手术并发症。结论:FCVB是全球首创的革命性产品,手术前充分的术前准备,系统规范化的手术巡回配合,是保证手术顺利完成的关键。
Objective: To explore the nursing cooperation of foldable capsular vitreous body implantation. Methods: The intraoperative nursing cooperation of 33 patients who received the operation from June to December 2018 was retrospectively analyzed and summarized. Results: All the 33 patients underwent successfully, and silt lamp microscopy showed that the position of foldable capsular vitreous body was in the center. No foldable capsular vitreous body rejections, sympathetic ophthalmitis or other obvious surgical complications were observed in all cases. Conclusion: Foldable capsular vitreous body is a global innovative product. Adequate preoperative preparation before surgery and systematic and standardized surgical tour coordination are the keys to thesuccessful completion of surgery.
目的:探讨急救护理技能规范化培训考核在眼科护士中的应用效果。方法:对暨南大学附属深圳眼科医院142名眼科护士实施急救护理技能的规范化培训考核,比较培训前后急救理论考核成绩及急救技能操作考核成绩的差异,并采用自制调查问卷进行培训评价的调查。结果:在实施急救护理技能规范化培训后,眼科护士的急救理论与技能操作考核成绩均高于培训前,差异有统计学意义(P<0.05);90%以上的眼科护士对急救培训持肯定意见。结论:急救护理技能规范化培训考核提高了眼科护士的临床急救护理水平,培养了良好的急救护理意识和团队协作精神,同时增加了护士的自我价值及职业认同感,获得了较好的培训效果。
Objective: To explore the application effect of standardized training and assessment of emergency nursing skills in ophthalmology nurses. Methods: We implemented standardized training and assessment of emergency nursing skills for 142 ophthalmology nurses in our hospital, compared the difference between the first aid theory and the first aid skill operation before and after the training, and used a self-made questionnaire to conduct training evaluation surveys. Results: After implementing the standardized training of emergency nursing skills, the assessment scores of first aid theory and skill operation of ophthalmology nurses were higher than those of the pre-training assessment. And the difference was statistically significant (P<0.05). More than 90% of ophthalmology nurses had a positive opinion on first aid training. Conclusion: Standardized training and assessment of emergency nursing skills have improved the clinical emergency nursing level of ophthalmology nurses and cultivated a good emergency nursing awareness and teamwork spirit. At the same time, they have strengthened nurses’ self-worth and professional identity, and achieved better training results.
干眼为最常见的眼表疾病之一,以泪膜稳态丢失及伴随眼部症状为特征。干眼的治疗以消除病因、缓解症状和保护视功能为目标,而其中的心理护理、眼睑物理治疗、健康宣教和院外管理尤为重要。优质的整体护理方案有助于干眼患者的治疗。本团队在参考干眼诊疗共识的基础上,结合自身护理经验,为干眼患者制定了个性化、涵盖全面的整体护理方案并运用。
Dry eye is one of the most common ocular surface diseases, characterized by a loss homeostasis of tear film,and accompanied by ocular symptoms. The treatment of dry eye aims to eliminate the cause of disease, relieve symptoms, and protect the visual function, among which psychological care, physical treatment of eyelid, health education and management outside the hospital are particularly important. High quality holistic nursing plan is helpful to the treatment of dry eye patients. Based on the consensus of the diagnosis and treatmen of dry eye,combined with our nursing experience, our team has developed and applied a personalized and comprehensive holistic nursing plan for dry eye patients.
目的:分析眼科护理对人工智能技术应用的内在需求,为眼科医院临床的人工智能技术开发及应用提供导向与依据。方法:采用整群抽样和单纯随机抽样相结合的方法,于2019年7月至2019年8月,对抽取的中山大学中山眼科中心,中山大学附属第一医院、珠海市人民医院、无锡人民医院、新疆维吾尔族自治区人民医院等目标医院其中的眼科护理人员进行问卷调查,内容包括一般资料及人工智能需求等。结果:调查对象绝大部分来自三级甲等医院(89.2%),以华南地区为主(87.2%),人工智能在眼科临床护理应用的需求多种多样,其中以健康教育、接诊与分诊、患者回访领域需求最强烈,分别占比95.7%、93.5%、93.2%。结论:人工智能在眼科临床护理应用有较强及多样化的需求,应结合实际需求为导向,重点推进人工智能在眼科患者健康教育等相关应用的研发。
Objective: To analyze the internal demands of the application of artificial intelligence technology to ophthalmic care, and provide guidance and basis for the development and application of artificial intelligence technology in ophthalmic hospitals. Methods: Using the method of combining cluster sampling with simple random sampling, a questionnaire survey was conducted on the ophthalmic nursing staff in the selected target hospitals from July to August 2019, which included general information and artificial intelligence needs. Results: Most of the respondents came from the third-class hospitals (89.2%), and hospitals in South China account for 87.2% of them. There are diverse demands of artificial intelligence in ophthalmology clinical nursing applications, including health education, clinical reception and triage, patients return visits, which have the strongest demand for the artificial intelligence, accounting for 95.7%, 93.5%, and 93.2%, respectively. Conclusion: The application of artificial intelligence in ophthalmic clinical nursing has strong and diversified demands, and the research and development of artificial intelligence in the health education of ophthalmic patients and other related applications should be promoted according to the actual demands.
目的:建立眼科专科护理门诊及探讨其实施效果。方法:调查2020年7月开展眼科护理门诊以来至2022年3月就诊的206例患者满意度和健康知识知晓率,并由医生、护士对眼科专科护理门诊的实践效果进行评价。结果:206例患者满意度较好,总分在90以上;眼科专科护理门诊针对患者问题提供个体化护理服务,进行眼部检查206人次,健康教育206人次,滴眼药水、涂眼药膏操作示范184人次,术后特殊体位指导38人次,滤过泡按摩26人次,为患者提供了多元化护理服务;同行评价显示眼科护理门诊体现了护士的专业价值;患者就诊后的健康知识知晓率明显高于就诊前,差异有统计学意义(P<0.001)。结论:眼科专科护理门诊的开设满足了患者多元化护理服务需求,提高了患者满意度和健康知识知晓率,提升了护士的自我价值感,为专科护士提供了职业发展平台,促进了眼科专科护理的发展。
Objective: To explore the establishment and effect of ophthalmology specialist nursing clinic. Methods: To Investigate the satisfaction and the awareness rate of health knowledge of 206 patients who visited ophthalmology specialist nursing clinic from July 2020 to March 2022. Doctors and nurses were investigated for evaluation of the clinic. Results: A total of 206 patients were satisfied with a total score of 90 points or more; the ophthalmology specialist nursing clinic provided individualized nursing services for patients’ problems, conducted 206 eye examinations and 206 health education, and demonstrated the operation of eye drops and eye ointment 184 times. 38 patients received post-operative special posture guidance and 26 patients received filter bubble massages. The clinic provided patients with diversified nursing services. Peer reviews showed that the ophthalmological care clinic reflects the professional value of nurses; the awareness rate of health knowledge after the patient’s visit was significantly higher than that before the visit, and the difference was statistically significant (P<0.001). Conclusion: The establishment of ophthalmology specialist nursing clinic meets patients for diversified nursing services, improves patients’ satisfaction and health knowledge awareness rate, and improves nurses’ sense of self-worth. Furthermore, it provides a career development platform for specialist nurses and promotes the development of ophthalmic specialist nursing.
目的:探讨外伤性视神经病变(traumatic optic neuropathy,TON)患者内镜下经蝶筛径路视神经管减压术(endoscopic trans-ethmosphenoid optic canal decompression,ETOCD)的整体护理。方法:选取中山大学中山眼科中心2020年1月至2021年3月收治的80例TON患者,回顾总结患者 ETOCD期间的护理措施及手术疗效。结果:所有患者经过综合护理后均顺利完成手术,未发生感染,出血、疼痛情况经治疗和护理后均改善,68.8%患者术后视力有提高。结论:针对TON患者ETOCD的特点,采取个体化的整体护理具有重要意义,有利于帮助患者顺利完成手术,降低并发症的发生率,促进患者康复。
Objective: To investigate the holistic nursing care of patients with traumatic optic neuropathy undergoing endoscopic trans-ethmosphenoid optic canal decompression (ETOCD). Methods: A total of 80 patients with traumatic optic neuropathy admitted to Zhongshan Ophthalmology Center of Sun Yat-sen University from Jan 2020 to Mar 2021 were selected as the subjects, and the nursing measures and surgical effect during ETOCD were reviewed and summarized. Results: All 80 surgical patients successfully completed the operation after comprehensive nursing without infection. The bleeding and pain were improved after treatment and nursing, and 68.8% patients presented with vision improvement. Conclusion: According to the characteristics of ETOCD in patients with traumatic optic neuropathy, it is of great significance to take individualized overall care, which is beneficial to help patients successfully complete the operation, reduce the incidence of complications, and promote the recovery of the patient’s healthy.