【摘要】 目的 探討神經科住院患者發生走失行為的相關因素，并制定相應的護理干預措施。 方法 采用回顧性調查，對2004年1月-2007年7月發生的8例走失神經系統疾患者，從護理角度對年齡、性別、文化程度、診斷、意識狀態、精神狀態等資料進行評估，分析影響因素與走失行為之間的相關性。 結果 影響自知力和易致患者產生幻覺妄想及定向力障礙的疾病更容易導致患者走失，走失行為多發生在夜間，且以男性、老年和低文化水平患者較多。 結論 針對神經科住院患者走失行為的危險因素，應根據具體情況，采取積極的綜合預防及個體化的護理對策。【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.
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.
目的 探討神經科住院患者留置針安全的持續質量管理。 方法 選擇2011年8月－10月100例神經科住院患者，按入院時間先后排序分為對照組和試驗組，每組50例。對照組運用靜脈留置針的常規護理方法進行護理，試驗組在給予常規護理方法的同時實施一系列持續質量管理的措施，包括安排護理業務查房、組織操作示范、應用留置安全健康宣傳小卡片對患者進行宣教、定期不定期的留置質量檢查、將留置針安全作為一項交班內容、強調優質護理指針。留置針留置第3天對兩組患者使用同一自制量表調查留置期間的安全問題及患者對護理的評價，并對兩組調查結果進行統計分析。 結果 試驗組留置期間不良事件發生率為6.0%，對照組為34.0%，兩組差異有統計學意義（χ2=12.250，P=0.000）；試驗組對留置針留置安全知識的4個方面知曉情況均優于對照組（P=0.000）；試驗組對護理滿意度較對照組好（P=0.000）。 結論 持續質量管理增加了神經科住院患者留置針留置安全、增進了患者對相關健康知識的掌握，提高了患者對護理的滿意，值得臨床推廣。
Objectives To investigate the economic burden of percutaneous endoscopic gastrostomy (PEG) in hospitalized patients with amyotrophic lateral sclerosis (ALS) and analyze its influencing factors. Methods Clinical data of ALS patients who underwent PEG between 2014 and 2024 were collected through the inpatient electronic medical record system of West China Hospital of Sichuan University (including age, gender, comorbidities, disease course, daily living abilities, length of hospital stay, hospitalization costs, etc.), and their impact on the total hospitalization expenses were studied. Results A total of 102 patients were included. The median total hospitalization cost for ALS patients undergoing PEG was 12 701.00 (10 412.75, 16 720.00) yuan. The results of multiple linear regression analysis showed that the length of hospital stay and age of patients could affect the total hospitalization cost. Conclusions The total medical expenses for ALS patients undergoing PEG are approximately 10 000 yuan. Early assessment of the disease status in ALS patients, providing individualized management, and optimizing treatment plans to reduce hospital stay and medication costs can effectively control medical expenses.