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.
目的:探讨“破窗理论”在手术室护理安全管理中的应用,为构建手术期间质量安全保障体系提 供新的管理依据。方法:于2019年2月至2020年6月组织佛山市三水区人民医院手术室医护人员对 “破窗理论”进行学习,调查分析护理质量、护理满意度以及手术室护理中出现的安全问题,进 而分析“破窗理论”在手术室护理安全管理中的应用效果。结果:实施前不安全事件发生率高于 实施后(16.00% vs 4.00%,P<0.05)。实施后手术室护理安全管理、药物使用规范性、感染控制程 度、基础护理质量评分高于实施前(P<0.05)。与实施前相比,实施后手术医生、医护人员、患者 满意度明显上升(P<0.05)。结论:“破窗理论”在传统护理的基础上提供了一种更为积极的干预 模式,其在护理安全管理中的应用值得进一步推广应用。
Objective: To provide a new management system to increase the quality and safety during the operation through applicating the broken window theory in the operating room nursing quality management. Methods: From February 2019 to June 2020, we organized medical staff in the operating room to study the broken window theory, investigated the nursing quality, nursing satisfaction and safety problems in operating room nursing, and then analyze the application effect of the theory in the nursing safety management. Results: The incidence of unsafe events before implementation of the broken window theory were significantly higher than that after the implementation (16.0% vs 4.0%, P<0.05). After the implementation, the scores of nursing safety management, standardized drug use, infection control and basic nursing quality in the operating room were higher than those before the implementation (P<0.05). The satisfaction of surgeons, medical staff and patients increased significantly after implementation as compared with before implementation (P<0.05). Conclusion: The broken window theory effectively provides a more active intervention model than traditional care, and it deserves further application in nursing safety management.
目的:通过中山大学中山眼科中心眼科互联网护理咨询门诊建设与运营经验,对互联网专科护理服务模式及效果进行分析,为眼科互联网+护理服务提供参考。方法:依托医院优质资源,成立眼科互联网护理咨询门诊;根据眼科患者的实际需求,制订互联网护理咨询门诊服务制度、工作流程,对出诊专家进行资质审核、培训与考核。收集、统计眼科互联网护理咨询门诊接诊量、患者满意度、首诊问题分类及护士职业获益感等数据。结果:2021年6月26日至12月31日累计接诊患者1266人次;接诊时间主要在08:00—22:00;咨询次数最多的问题种类是眼健康知识科普;患者对眼科互联网护理咨询门诊的总体满意度为99.52%;眼科互联网护理咨询门诊运营后,眼科护士职业获益感总分及各维度得分均有提高,差异均有统计学意义(均P<0.05)。结论:眼科互联网护理咨询门诊服务可有效满足各类人群的眼健康护理需求,患者满意度高,亦可提高眼科护理人员的职业获益感,值得进一步推广
Objective: Based on the construction and practice of Internet nurse-led clinic in our hospital, the model and effect of Internet specialized nursing service were analyzed to provide reference for Internet-based nursing service in ophthalmology. Methods: Relying on the hospital’s high-quality resources, the Internet nurse-led clinic in ophthalmology was established. According to the actual needs of ophthalmology patients, the Internet nursing consultation outpatient service system and workflow were formulated, experts’ qualification were reviewed, and training and assessment for the experts were conducted. The data on the number of outpatient visits, patients’ satisfaction, advisory questions and nurses’ perceived professional benefits were collected and analyzed. Results: From 26th June to 31st December 2021, the number of clinical reception was 1 266. The visit time is mainly between 08:00 to 22:00, the most frequently asked questions were eye health knowledge, the overall patients’ satisfaction was 99.52%, and the total score and the score of all dimensions of nurses’ perceived professional benefits were improved, with statistical significance (all P<0.05). Conclusion: Ophthalmic internet nurse-led consultation clinic can effectively meet the health care needs of all kinds of people, with high patient satisfaction, and can also improve nurses’ perceived professional benefits, which is worthy of further promotion.
目的:了解重度视力损伤和盲患者居家的主要护理问题及护理需求的内容,为医护人员制订居家照护支持计划提供依据。方法:采用描述性质性研究方法,于2020年4至9月对在广州市某三甲眼科专科医院的20例重度视力损伤和盲的住院患者进行面对面的半结构式访谈,采用归纳式内容分析法对访谈资料进行分析。结果:重度视力损伤和盲患者居家的主要护理问题有日常生活自理的能力缺失、外出社交活动受限和难以适应家庭角色的改变;护理需求包括希望医院提供多维度的疾病相关知识和提供多渠道的医疗咨询服务。结论:重度视力损伤和盲患者居家照护存在诸多的护理问题及需求,患者希望得到多维度相关知识和多渠道医疗咨询,医院、社区应该高度重视此类患者,同时给予相应的指导和帮助,从而提高患者的居家生活质量。
Objective: To explore the main nursing problems and demands of patients with severe visual impairment or blindness, so as to provide the basis for health staff to formulate home care support plans of high quality. Methods: By using a descriptive qualitative method, face-to-face semi-structured interviews were conducted among 20 patients with severe visual impairment or blindness who were hospitalized in the top-grade ophthalmic hospital in Guangzhou from April to September 2020. The inductive content analysis method was used to analyze the data. Results: The main nursing problems of these patients were the lack of self-care ability, limited social activities, and difficulty in adapting to changes in family roles. Nursing needs include the hope that hospitals can provide multidimensional disease-related knowledge and multi-channel medical consulting services. Conclusion: Patients with severe visual impairment or blindness have many problems and needs in home care. They would like to obtain multi-dimensional knowledge and receive multi-channel medical consultation. Health staff from hospitals and communities should attach great importance to these patients, as well as provide appropriate guidance and assistance, so as to improve their activities of daily living.
[摘 要] 目的:减轻行角膜移植术的患儿及家属的心理负担,提高患儿对手术的耐受性,减少术后并发症。方法:对45例将进行角膜移植的患儿进行围手术期护理。结果:所有患儿经过精心的治疗和护理后均恢复良好,视力均有提高。结论:术前做好充足的准备、术前心理护理,术后严密观察生命体征和眼部敷料的情况,做好相关的生活和饮食指导,遵医嘱及时有效用药,注意患儿异常的反应及眼部的情况,及时发现并处理并发症,给予细致的出院指导,有利于患儿早日康复。
Abstract Objective: To reduce the psychological burden of the children and families who are scheduled to the corneal transplantation, and to improve the patients’ tolerance and reduce postoperative complications. Methods: The perioperative care was given to 45 patients with corneal transplantation. Results: All children were treated well by careful treatment and care. Conclusion: Before operation, comprehensive preparation and psychological nursing care should be delivered. After operation, the physicians and nurses should guide the patients to live a healthy lifestyle, remind them to take the drugs timely, identify the abnormal symptoms and postoperative complications in children with abnormal responses, implement effective treatment timely to accelerate postoperative recovery
目的:总结大批量白内障扶贫手术的护理安全管理经验。方法:回顾性分析2013至2016年中山大学中山眼科中心医疗队完成大批量白内障扶贫手术的经验、针对下乡扶贫的特殊环境、患者入院时间短、手术量大、接台手术多以及患者自我管理能力差等情况,分析其安全隐患,并在护理过程中采取相应的安全措施。术前充分评估和准备,对患者进行健康指导;术中对手术环境规范管理;指导加强术后患者的自我管理。结果:8批次共1 064例白内障摘除联合人工晶体植入术顺利完成,无1例发生术后感染。结论:建立大批量白内障扶贫手术护理安全质量管理的规范流程是扶贫工作的重要环节,做好术前的评估和准备工作,落实患者的健康教育及术后患者自我管理指导,才能确保手术顺利进行。
To assess the safety of mass volume of cataract surgery and to identify the possible factors with enhanced patients’ safety. Methods: This is a retrospective case series. Clinical data of patients undergoing charity cataract extraction by surgeons from Zhongshan Ophthalmic Center between 2013 and 2016 was reviewed. The following factors were analyzed: safety management peri-operatively, educational interventions, intraoperative sterilization, and self-management after operations. Results: A total of 1064 patients (8 sessions) underwent cataract extraction and intraocular lens implantation. No evidence of endophthalmitis in any cases was observed. Conclusion: Establishment of standardized operation procedures for nursing safety management is essential for safety of mass volume of charity cataract surgery in China. Adequate assessment and peri-operative endeavor, educational interventions, nurse guided self-management should be empowered to enhance patients’ safety.