Model essay on nursing research paper "Role Skills of Emergency Nurses"
With the development of nursing specialty, nursing work has changed from single disease nursing to holistic comprehensive nursing. That is, the comprehensive nursing mode of biology, psychology and society. The change of nursing mode meets the requirements of society and patients, and expands the role and skills of nurses. As the window image of the hospital, emergency nurses' own roles and skills will directly affect the reputation of the hospital, so they must be paid enough attention.
1. Roles and skills of social workers:
The emergency department is a place to heal the wounded and rescue the dying, and it is also a shrinking social environment. In the face of sudden critical patients, we must also face people with different knowledge, different cultural backgrounds, different living habits and different economic abilities. Therefore, emergency nurses are social workers first, and they should have noble professionalism, rich social work experience and strong organizational and coordination skills. Pay attention to the cooperative relationship with patients' units, patients' families, accident parties, police and insurance personnel.
In the face of a large number of sudden critical patients, we can provide social support from social groups, units, families, relatives and friends in time. It includes two aspects of support:
(1) Spiritual support, that is, the understanding, comfort and encouragement of the above-mentioned groups and personnel to patients, is helpful to relieve or alleviate the emotional tension or mental stress of patients. This is very important for patients who have attempted suicide and suddenly encountered a major accident.
(2) Material and economic support: provide patients with legal, insurance, treatment and other information in a timely manner, assist patients to win material and economic assistance from the above groups and personnel, solve their living difficulties, and raise funds for treatment. Especially for criminal cases, public security injury cases, insured accidental injuries, car accident injuries, etc., it is very important to remind them to report the case in time and collect and save relevant information. It can cooperate with various medical departments in a predictable, orderly and effective way to create an efficient treatment environment and win valuable follow-up treatment time for patients. Emergency nurses must also have a strong awareness of laws and regulations, pay special attention to the influence of their words and deeds on patients and their families in a tense working environment, and avoid unnecessary disputes.
2. The role and skills of professional workers:
In the past, nursing was subordinate to the medical profession. With the development of nursing, it has become an independent subject. Nurses must change their dominant concept, establish the consciousness of professional workers and master their own professional skills, which requires emergency nurses to have the ability to independently judge the condition, identify various danger signals and outstanding contingency ability. Proficient in emergency resuscitation technology, rapid and correct use of various emergency monitoring equipment, familiar with the rescue procedures of critically ill patients in various specialties, have the knowledge and skills to solve specific difficult problems in nursing, and can answer related questions raised by patients and their families. Understand the new progress of emergency specialty. The development of nursing specialty is not only synchronized with medical specialty, but also intersected with many emerging disciplines, marginal disciplines and social humanities. Emergency nursing is at the forefront of nursing reform. Therefore, emergency nurses must also have the skills to acquire and apply multidisciplinary knowledge, constantly update their knowledge structure, explore the application of new technologies, and improve themselves, so as to implement holistic care for patients with more confidence, methods and foresight, and improve the success rate of cooperating with doctors to rescue patients.
3. The role and skills of psychologists:
The job of emergency nurses is to directly face the sudden critical patients. The causes of injuries are complicated, and it is difficult for patients and their families to face the cruel reality, so their emotions are unstable or abnormal. In addition, the rescue work is so busy that sometimes they can't even get off work on time. Therefore, emergency nurses must also be people with good psychological quality and mastered psychological work skills. She should have the spirit of self-sacrifice and selfless dedication, a healthy outlook on life and values, an optimistic and cheerful personality, and the ability to adjust the emotions of patients and their families. Can influence patients, family members, colleagues and other collaborators with their own personality charm, and get their support, trust, support and cooperation. We can respect patients' feelings, express our understanding and recognition of patients' personal feelings through patient explanation, sincere persuasion, enthusiastic encouragement, meticulous care and thoughtful service, and benefit patients physically and mentally. Don't discuss and discuss patients' privacy in public, to prevent the transmission of negative emotions such as command, blame, disclosure and uselessness, and to avoid patients from underestimating their self-worth and helplessness. In addition, emergency nurses should be good at controlling and eliminating negative emotions and pressures from themselves, preventing words and deeds that may unintentionally hurt patients, their families, colleagues and collaborators, and creating a harmonious and orderly treatment atmosphere.
Discussion on the evaluation system of emergency nursing quality, a nursing research paper, model essay 2.
Emergency nursing is a new specialty to study the emergency nursing of patients with acute diseases, acute trauma, acute attack of chronic diseases and critical illness. It has developed rapidly, but there is not a set of nursing quality evaluation system that reflects the characteristics of specialties, and hospitals still adopt conventional evaluation standards. The standard can not fully reflect the nursing characteristics of various departments, and lacks practicality, professionalism, integrity and scientificity. In order to embody practicality, scientificity, integrity and professionalism, the establishment of emergency nursing quality evaluation system standards should follow the following principles.
1. Based on clinical practice, highlighting practicality.
Emergency patients have the characteristics of sudden onset, strong timeliness, randomness, small controllability and strong professionalism, which puts higher demands on emergency medical staff. Emergency nurses have multiple roles, not only as the main body of medical services, but also as the organizer and coordinator of disaster relief, as well as as as the director, consultant and educator of public first aid education. With the transformation of medical model, the improvement of people's living standards and the reform of medical system, people's demand for emergency services is getting higher and higher, requiring fast diagnosis and treatment time, high efficiency, low fees and complete services. When establishing the evaluation standard of nursing quality, we should start from the work content and clinical actual situation of emergency nursing, highlight the key points of work, reflect practical principles, and the evaluation workflow is simple and easy, and the triage, visit, rescue, diagnosis and treatment and health education are satisfactory.
2. Pay attention to the final evaluation based on link evaluation, and highlight the scientific nature.
At present, the evaluation of nursing quality is still based on the final quality evaluation, which is easy to produce the illusion of generalization, instability and distortion. Nurses often pay attention to the superficial form to cope with the examination, and it is difficult to implement patient-centered holistic nursing.
Combining the link quality evaluation in the process of implementing the final evaluation can give full play to the initiative and innovation of personnel, open up thinking and introduce competition, thus improving quality, reducing costs and promoting the development of disciplines. For example, the same problem can achieve the same result in different ways. These different ways and methods are what link evaluation needs to control. They improve the quality from the cause and essence, and the method is more practical.
Nursing staff is the core of quality evaluation, and link evaluation also requires nursing staff to understand the purpose, methods and standards of quality evaluation, improve the awareness of quality management, so as to know both what it is and why.
3. The evaluation system of nursing quality should be comprehensive and holistic.
The emergency department has both outpatient nature and ward characteristics, and its quality evaluation should also take into account the management standards of general wards and specialist clinics. In addition to standardized facilities and clear responsibilities, ward management should emphasize flexibility and mobility in scheduling; In addition to being objective, standardized, concise and detailed, the writing of medical records also requires the truthfulness and accuracy of time records; Technical operation assessment should be efficient (accurate, timely and standardized); In addition to the conventional hospital infection evaluation criteria, the emergency department should also have corresponding evaluation criteria for the reporting and disinfection and isolation of various infectious diseases; Holistic nursing evaluation should emphasize practicality, innovation, affordability and service, and nursing management should set standards for nurses' self-protection awareness and enhance their legal awareness.
4. Partition management of evaluation system, reflecting specialization.
The urgency and seriousness of the emergency department require every medical staff to have time consciousness and life-saving consciousness. The evaluation focuses on the following aspects: whether the emergency telephone can respond quickly (the time of seeing a doctor, the speed of getting off the bus), whether all measures are appropriate, whether all kinds of first-aid articles are complete and have good functions, whether all kinds of abnormal situations can be found and handled effectively in time, whether the reserve capacity of first-aid materials is large, whether the communication system is smooth and effective, and whether the cooperation system is synchronized. There are many emergency patients, the emergency volume is large, and the medical staff and medical resources are extremely limited, making full use of the limited resources. Partition management is an effective management method. Zoning management is to focus on graded diagnosis and treatment according to the severity of illness, change unplanned and disorderly work into relatively planned and orderly work, highlight the key points of work, and concentrate on rescuing critically ill patients with technical strength and equipment.
At present, the emergency department is divided into initial diagnosis area, observation area, monitoring area and operation area. The first consultation area is mainly responsible for triage, initial diagnosis and treatment, and maintaining the treatment order. According to the principle of giving priority to diseases, it embodies the concept of life first, and also participates in the organization and coordination of early rescue and disaster relief for critically ill patients. Therefore, the evaluation of nursing quality in newly diagnosed areas should reflect the correct rate of triage, the rate of reporting illness, the timely rate of seeing a doctor and the success rate of critical rescue. The observation area is mainly responsible for the observation and treatment of general emergency patients (patients who are not life-threatening and do not need to be hospitalized), which mainly reflects service awareness and multidisciplinary professional skills. Therefore, quality evaluation should be carried out from the aspects of service concept, medical environment, patient satisfaction, basic nursing operation, specialist health education, disease observation and treatment.
The monitoring area is mainly responsible for rescuing critically ill patients until their lives are stable. With the rapid development of first aid technology in China, a large number of precision instruments and technologies are widely used in clinic. All kinds of ventilators, defibrillators, ECG monitors, bedside laboratory analyzers and cardiopulmonary resuscitators need a group of emergency nurses with high professional level and high technical operation. Therefore, the evaluation of their nursing quality should focus on professional skills, examine the correct use and maintenance of various instruments and equipment, observe and deal with various acute and severe patients, and innovate scientific research consciousness. The operating area is mainly responsible for emergency surgical treatment, and the assessment focuses on the success rate of surgery, postoperative infection rate, proficiency in surgical cooperation, and health education before and after surgery.
In short, nursing managers should update their concepts, grasp the latest trends, and establish management standards that serve emergency nursing practice, so as to promote the development of emergency nursing quality to a high level.
Nursing research paper model essay 3 "Nursing paper on neonatal asphyxia"
Objective To explore the observation and nursing methods of neonatal asphyxia after resuscitation. Methods The clinical nursing data of 42 asphyxiated newborns were analyzed retrospectively. Results Among 42 asphyxiated newborns, 38 cases were cured and discharged except for 2 cases of intracranial hemorrhage who gave up treatment, 65,438+0 cases of intestinal paralysis and renal failure, and 65,438+0 cases of pulmonary hemorrhage. Conclusion In our work, we realize that timely rescue and effective resuscitation, and correct nursing and treatment after resuscitation can improve the success rate of neonatal asphyxia rescue and reduce the occurrence of complications.
Newborns; Asphyxia; Restore; Observe; nurse
1. Clinical data:
From June 2007 to February 2007, 42 newborns born in our hospital and transferred from other hospitals to our department suffered from asphyxia. There were 28 cases of moderate and mild asphyxia (A's score), 4 cases of severe asphyxia 1 case, 5 cases of maternal diabetic asphyxia1case, 5 cases of pregnancy-induced hypertension syndrome, 5 cases of placenta previa, 6 cases of umbilical cord around the neck, 7 cases of fetal distress caused by amniotic fluid meconium pollution, 5 cases of prolonged labor, 2 cases of head-basin asymmetry, 3 cases of abortion, 8 cases of premature delivery and 9 cases of intracranial hemorrhage.
2. Rescue methods:
After the delivery of the fetal head, the midwife must squeeze from the nasal root to the mandible with her left hand, and try to squeeze out the mucus and amniotic fluid in the nose. After the fetus is delivered, let the newborn lie on his back, shoulder pads and head back. Suck mucus and amniotic fluid from nose, throat and mouth with suction tube, and the negative pressure shall not exceed 30mmHg to keep the respiratory tract unobstructed. If the airway mucus is blocked deeply, use laryngoscope to suck it out through tracheal intubation. You can also use the freehand insertion method. The action must be done quickly and in time, within 1 minute after birth, and be careful not to damage the respiratory mucosa. Those who can't breathe after clearing foreign bodies in respiratory tract can be given artificial respiration and oxygen inhalation at the same time. If the heart rate is slower than 60 beats/min, you should first squeeze it with your chest. After the above treatment, the heart rate has not improved, so drug treatment should be carried out and infusion should be ensured during resuscitation. You must keep warm during the whole recovery process. Dry the newborn's wet body immediately after delivery to reduce heat dissipation, and it is best to have far-infrared insulation bed equipment. Cold will accelerate metabolism, increase oxygen consumption and aggravate acidosis.
3. Nursing after asphyxiation:
Timely and effective resuscitation of asphyxiated newborns should first keep the respiratory tract unobstructed, establish effective breathing, increase ventilation and ensure oxygen supply. The second is to maintain effective circulation and drug treatment.
Keep warm:
In the absence of an incubator, you can put your baby in your mother's arms, cover it with a coat, or keep it warm with a hot water bottle. But to prevent accidents and burns, the water temperature should not exceed 50℃.
If conditions permit, you can put the child in an incubator. The temperature of the incubator should be adjusted according to the child's weight. Children's skin temperature should be kept at a neutral temperature of about 36.5℃ to reduce oxygen consumption.
Monitoring vital signs:
Breathing is the focus of monitoring. If the breathing frequency lasts more than 60 times/min, and the apnea is more than 15s ~ 20s/ min, accompanied by decreased heart rate, cyanosis around lips and limbs, and frequent exhalation and groaning, children often need oxygen. Generally, the hood is used to supply oxygen for 4 ~ 5 liters/minute. The oxygen concentration should be adjusted according to the results of blood gas analysis, because hypoxia will cause irreversible damage to important organs, and long-term high-concentration oxygen inhalation will cause oxygen poisoning.
Monitor your heart rate and blood pressure, which often change with your breathing. In monitoring, it is mainly to measure the heart rate, pay attention to the strength of heart sounds and the uniformity of heart rhythm. If the heart rate is lower than 80 beats/min, chest compressions or drugs that excite the heart should be taken. If the heart rate is higher than 180 beats/min, accompanied by hepatomegaly, heart failure may occur, and cardiotonic drugs can be used according to the doctor's advice. If you have ECG, echocardiography and other equipment, you can find abnormalities as early as possible, notify doctors in time, and cooperate with rescue, which will play a positive role in improving the survival rate of children. Blood pressure systolic pressure is about 45 ~ 80 mmhg.
Observe the change of illness:
Neonatal asphyxia can cause a series of complications, in order to prevent complications and have a good prognosis. Be sure to closely observe the child's bad performance, such as crying size, screaming, limb muscle tension, peripheral circulation, skin temperature and color, whether various reflexes are normal, whether consciousness is barrier-free, defecation and so on. If the above abnormalities are found, active measures should be taken to prevent the illness from getting worse and affecting the life of the children.
Due to the relaxation of anal sphincter, meconium can be partially discharged before birth, but after birth, there is no stool or less stool due to the decrease of intestinal peristalsis, and blood redistribution can also cause intestinal ischemia due to asphyxia and hypoxia. Abdominal distension and bloody stool occurred a few days after birth, and at the same time, due to kidney damage caused by hypoxia and ischemia, urination also decreased. Therefore, it is of great significance to observe and record the frequency, quantity, color and character of defecation.
Prevention of infection:
Because the newborn's body resistance is low, pathogenic bacteria are easy to invade the body and cause infection, so antibiotics can be used appropriately. Newborns are required to live in single rooms or with children with the same disease to reduce the number of visitors. Staff should wash their hands, wear masks, work clothes and clean shoes before and after touching children. Don't touch children with respiratory infections. Articles used by children must be clean and used after autoclaving if necessary. The ward is disinfected with ultraviolet rays once a day, and the child's skin, buttocks and navel are well cared for.
Feeding:
Newborns with mild asphyxia can breastfeed directly if they respond well and suck well. If the sucking ability is poor, you can feed it with a dropper or a stomach tube. If the recovery of severe asphyxia is not good, the time of starting milk should be delayed appropriately to prevent vomiting and inhalation from causing asphyxia again. If feeding cannot ensure the nutrition provider, intravenous rehydration is given. Generally, intravenous drip of 10% glucose first, and then add compound amino acids, neutral fat and plasma as needed for intravenous hypernutrition treatment.
Quiet:
Children with asphyxia must keep quiet, reduce moving, concentrate nursing and operation as much as possible, and move gently. Lift the head slightly to reduce intracranial hemorrhage.
4. Experience:
In this paper, 42 cases of asphyxiated newborns were treated in time after birth. Except for intracranial hemorrhage in 2 cases, intestinal paralysis, renal failure 1 case and pulmonary hemorrhage 1 case, the remaining 38 cases were cured and discharged. It is suggested that effective resuscitation techniques should be carried out to monitor the changes of vital signs in time when newborns are asphyxiated. Because hypoxia can cause multiple organ damage, especially when the brain is hypoxic for more than four minutes, irreversible damage will occur. The intellectual abnormality and complications of asphyxiated children are closely related to the hypoxia time. Therefore, it is of great significance to deal with it correctly and effectively, strive for recovery as soon as possible, reduce the occurrence of sequelae, reduce the perinatal mortality rate and give birth to good children. The treatment and nursing of neonatal asphyxia do not need expensive drugs and instruments, but the most important thing is the responsibility, love and confidence of medical staff.
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