For nursing students, learning internal medicine nursing is crucial for students' future study and work. Here is the Internal Medicine Nursing Case Specialty Essay that I have compiled for you for your reference.
Internal Medicine Nursing Case Papers Sample Essay Part 1: "Experimental Analysis of Insecurity Factors in Cardiovascular Internal Medicine Nursing"
Abstract
Purpose: To explore the insecurity factors in cardiovascular internal medicine nursing care and the corresponding countermeasures. Methods To retrospectively analyze the clinical data of 182 cases of cardiovascular disease patients, generalize and summarize the existence of unsafe factors in the nursing process. The results of 182 cases of cardiovascular disease patients in the nursing care and clinical data there are 53 cases (29.1%) of irregular operation or unsafe operation behavior, including 31 cases (58.5%) of health care personnel factors, 14 cases (26.4%) of patient factors, and 8 cases (15.1%) of hospital factors. Conclusion In order to effectively improve the level of cardiovascular care, hospitals should strengthen the education and training of nursing staff, strive to improve the professional ability and nursing level of nursing staff, enhance their legal awareness and safety awareness, and also strengthen the exchange and communication between doctors and patients.
Keywords cardiovascular medicine; nursing; unsafe factors
Cardiovascular diseases with acute onset, complex etiology and rapid changes in the condition of the characteristics of the disease, greatly increasing the risk of clinical nursing work. Once improper care, not only will seriously affect the physical and mental health of patients, threatening their life safety, but also very easy to cause a series of medical disputes [1]. This study selected 182 cases of cardiovascular disease patients admitted to our hospital from February 2014 to February 2015 as the research object, its clinical nursing data retrospectively analyzed, is reported as follows.
1 Data and Methods
1.1 General Data
182 cases of cardiovascular disease patients admitted to our hospital from February 2014 to February 2015 were selected as the study subjects, of which 97 cases were male and 85 cases were female, with the age of the youngest 35 years old, the oldest 83 years old, and the average age (52.7?10.1) years old, including rheumatic heart disease 32 cases, hypertension with coronary heart disease 64 cases, and hypertension with coronary heart disease 64 cases. There were 32 cases of rheumatic heart disease, 64 cases of hypertension with coronary heart disease, 72 cases of myocardial infarction, 6 cases of congenital heart disease, and 8 cases of other cardiovascular diseases.
1.2 Methods
The clinical data and nursing care of 182 patients were retrospectively analyzed to summarize the insecurity factors in cardiovascular nursing.
2Results
There were 53 cases (29.1%) of non-compliance or unsafe operation behaviors in the nursing care and clinical data of 182 patients with cardiovascular and cerebrovascular diseases, including 31 cases (58.5%) of healthcare workers' factors, 14 cases (26.4%) of patients' factors, and 8 cases (15.1%) of hospital's factors.
3 Discussion
3.1 Analysis of unsafe factors
3.1.1 Healthcare personnel factors In cardiovascular internal medicine nursing, the nursing work is a huge responsibility, complicated tasks, and is very easy to produce medical risks. Nursing staff in the existence of unsafe factors mainly include: ① nursing paper writing is not standardized: for some acute myocardial infarction patients, nursing staff must be every 30 minutes on their vital signs and electrocardiogram observation and recording, when the patient's condition is slightly improved, the nursing staff will be negligent and slack, so as to delay the frequency of the patient's diagnostic test and recording, resulting in nursing paper records are not complete [2]; due to the fast-paced pace of nursing, the nursing staff will be very busy, so they can't do anything. Due to the influence of fast-paced work, some nursing staff have also developed the habit of fast-paced registration of paperwork, and their handwriting is scribbling; due to the weak sense of responsibility of some nursing staff, or the lack of supervision in the department, some nursing staff will write randomly when they find that the patient is not in the position in the process of daily nursing inspections; in the case of resuscitation of the patient, the nursing staff forgets to register the nursing paperwork, and there is a lack of integrity of the nursing paperwork. The phenomenon of registering after the fact or the distance between the registration time and the rescue time is too long. ② drug use and dosage error: due to the cardiovascular medicine more varieties of drugs, drugs out of the manufacturer and the name is more complex, and nursing staff workload, work is busy, there may be a wrong drug and other cases; nursing staff to grasp the speed or the patient's own speed up the drip rate will increase the burden on the patient's heart, which will lead to danger; some nursing staff may be based on personal experience to carry out the dosage, which will lead to danger. Some nursing staff may be based on personal experience to make the dosage, which will lead to the dosage error.
3.1.2 Patient factors in cardiovascular care, some patients do not strictly implement the medical advice, for example, some patients will be because of their symptoms are less severe, and thus will hold a kind of contempt for the disease of the mentality, in the case of not obtaining the permission of the medical staff, unauthorized departure from the hospital and wards, or leave to go out and did not return to the wards on time and so on [3]. Because cardiovascular disease is special, in the noisy external environment, coupled with the patient's own fatigue and other factors, it is very easy to trigger the onset of the disease. Some patients and their families lack a full understanding of the disease, often hold high expectations of medical treatment, once the condition has not improved, or even deterioration, often all the blame on the medical staff, can not fully trust the medical staff of the treatment and care, and thus induced insecurity factors.
3.1.3 Hospital factors due to the cardiovascular ward beds, medical equipment and more people coming and going, the environment is more noisy, will affect the rest of the patients in the department, easy to trigger the patient's complaints. If the medical staff do not clean the ward thoroughly in time, the slippery and wet ground will easily cause the patients to fall, which will bring adverse effects to the patients' psychology and physiology. Due to the special nature of cardiovascular diseases, its treatment costs are often high, if the nursing staff did not timely and detailed cost details to inform the patients and their families, it is very easy to lead to the occurrence of medical disputes at the time of billing [3].
3.2 Countermeasures
3.2.1 Enhance the nursing level of nursing staff hospitals to strengthen the education and training of cardiovascular medicine nursing staff, to teach more scientific nursing knowledge and skills, to provide more opportunities for learning and training, and at the same time, through the examination of the way to examine the nursing staff to the degree of mastery of nursing knowledge and skills [4]. Nursing staff should also listen to lectures and room visits and other forms, and constantly strengthen the learning and consolidation of nursing knowledge, through the nursing practice to continuously improve their own nursing ability, and then constantly improve the level of nursing. In addition, the hospital should also strengthen the legal knowledge and safety knowledge of the mission, to enhance the nursing staff's legal awareness and safety awareness, so that they can effectively protect their legitimate rights and interests. Nursing staff should strictly standardize nursing records, timely and carefully written nursing documents, so as to fully guarantee the authenticity and integrity of nursing records.
3.2.2 Strengthen nurse-patient communication, improve the construction of the hospital environment nursing staff to strengthen the exchange and communication with patients and their families, to fully respect should care about the patient, careful observation of the patient's condition and needs, and timely resolution of the patient's physiological and psychological difficulties, to help patients set up confidence in overcoming the disease [5]. In addition, nursing staff should also introduce the medication and diagnosis and treatment methods to the patients in detail, and inform the patients of the medical cost in detail, so as to enhance the recognition and trust of the patients and their families, and avoid the occurrence of nurse-patient disputes. Hospitals should strengthen the construction of the hospital environment in all aspects of the conditions allow. Such as adding microwave ovens and TVs and other equipment in the wards, fully guarantee the quietness and cleanliness of the wards, and strive to create a warm and harmonious hospitalization environment for the patients. In summary, due to the cardiovascular diseases have certain special characteristics, there are often more unsafe factors in the nursing process, mainly due to patients, hospitals and nursing staff. In order to effectively improve the quality of cardiovascular care and nursing level, promote faster and better recovery of patients, and effectively reduce the incidence of medical disputes, hospitals should analyze in-depth cardiovascular care in the presence of insecurity factors, and take effective preventive measures.
References
[1] Chen Shaomei. Analysis of the causes of nursing disputes in cardiology and countermeasures. Hebei Medicine,2010,9(7):886-887.
[2]Bai Ju'e. Problems and countermeasures in cardiology nursing. Anhui medicine,2011,11(9):1772-1773.
[3]Erdeng Gezhil. Analysis of unsafe factors in cardiovascular internal medicine nursing. Medical Aesthetics and Cosmetology (Zhongdian),2014(6):324-325.
[4]Zhou Liuxiang. Analysis of unsafe factors in cardiovascular internal medicine nursing. China Medicine Herald,2010,12(3):54.
[5]Liang Xiuping. Analysis of unsafe factors in cardiovascular internal medicine nursing and preventive measures. Chinese and foreign medical treatment,2012(31):182-183.
Internal medicine nursing case study essay example 2: "Talk about the safety details of emergency internal medicine nursing work"Abstract: Nurses in the infusion process should strengthen the rounds, to prevent the patient from the infusion reaction, and when the patient has an infusion reaction, effective measures should be taken immediately. The infusion rate should be strictly controlled when the infusion is given to the patient.
Keywords: emergency internal medicine nursing; safety details
1 condition observation
In order to make a systematic and comprehensive judgment of the patient's condition, health care personnel should have a comprehensive understanding of the patient's medical history and current situation. In the emergency treatment of internal medicine patients, health care personnel should carefully and conscientiously observe and diagnose their condition, in order to provide a basis for the development of the patient's clinical treatment and nursing program. Nursing staff should have a comprehensive understanding of the cause of the patient's illness, the site of the disease and the symptoms it manifests when observing the patient's condition, and take reasonable nursing measures.
1.1 Judge the development trend of the disease
The internal medicine nursing staff should comprehensively observe the patient's condition, and have a clear idea of the severity of his condition, so as to predict the development trend of the disease he suffers. For example, when the condition of the internal medicine patients appeared more substantial changes (body temperature plummeted, blood pressure suddenly high and low), it can be predicted that its condition is about to deteriorate; when the internal medicine hospitalized patients if energetic, good appetite, it can be predicted that its condition will be very soon recovered.
1.2 Observation of the clinical efficacy of the patient and the reaction to medication
In the process of treatment and care for patients with internal diseases, if their condition gradually improves, it means that the treatment measures are effective; if the patient's condition fails to improve or an adverse reaction occurs, it means that there are errors in the treatment and care measures. The following case for reference: patient, male, 67 years old, suffering from cerebral infarction. A time for the patient in the process of intravenous injection of cerebral protein hydrolysate injection, the nurse in the inspection found that it appeared asthma, lips cyanosis and other symptoms, after the examination, its heart rate is 109 times / min, blood pressure is 90/50mmHg, the whole body appears scattered urticaria. The nurse immediately stopped the medication for the patient, and took oxygen, sedation dexamethasone 10mg, intramuscular chlorpheniramine 10mg, sedation niclosamide 0.375mg, Lobelin 3mg, aminophylline 0.125g, etc. After 1 hour, the patient's symptoms gradually relieved, blood pressure rose to 107/70mmHg, and he was out of danger. It is important to note that some of the discomfort experienced by the patient after medication may only be a normal reaction to the medication, rather than an adverse reaction.
1.3 Timely detection of critical illness or complications
The condition of patients with internal diseases is complex and variable, and many complications can often occur. Nursing staff should closely observe the changes in their condition to avoid sudden deterioration or serious complications. This requires the nursing staff to enhance the sense of responsibility, master the scientific nursing method, once found that the patient critical or serious complications can take reasonable rescue measures in a timely manner, and effectively control their condition.
2 correct implementation of the doctor's orders
The doctor's orders are based on the patient's condition of the diagnosis and treatment plan, is the nurse to take treatment and care of measures to guide the basis. The Regulations on Medical Accident Handling stipulate that medical advice can be used as legal evidence. In clinical practice, nurses often do not pay enough attention to the importance of strict implementation of medical advice, thus laying a lot of safety hazards in nursing work. In order to prevent problems before they occur, avoid nursing accidents, improve the doctor-patient relationship, increase patient satisfaction, and improve the quality of care, we should take the following five measures to ensure the accuracy of the implementation of medical advice.
2.1 Nursing staff should train and cultivate communication skills with patients, and emphasize communication and collaboration with physicians in the process of executing medical advice, so as to ensure the effective execution of medical advice.
2.2 The supervision and management of the accuracy of nursing staff's implementation of medical advice should be strengthened to promote timely and accurate implementation of medical advice by nursing staff. A strict review system for the implementation of medical advice and the implementation of norms should be established to ensure that the medical advice given by the physician can be implemented in a timely, accurate and error-free manner.
2.3 With the continuous development of computer information technology, computerized medical advice management software plays an increasingly important role in the medical advice processing system. Therefore, the information construction of nursing work should be strengthened, so that nursing staff have a certain level of computer, should standardize the entry, transcription, preservation, printing, checking system of medical advice, to ensure that medical advice processing, printing, checking, execution and other aspects of the institutionalization, proceduralization, standardization, so as to truly achieve the accuracy of the medical advice to carry out each of the treatment and nursing advice.
2.4 Nurses should take verbal medical advice seriously, fully recognize the importance of verbal medical advice, and conscientiously and correctly implement verbal medical advice given by doctors.
2.5 Nursing staff should have professional knowledge of the pathological changes of the disease and other aspects of the disease, to avoid blindly implementing medical advice. For example, leukemia patients in the emergence of high fever, the physician issued medical advice for? Physical cooling? , at this time the nurse should not choose alcohol bath, so as not to cause or aggravate subcutaneous hemorrhage due to the stimulation of the patient's skin by alcohol. (This article is from the "seeking medical advice" magazine. Seek medical advice" magazine introduction for more details...)
3 Intravenous infusion
Nurses in the infusion process should strengthen the rounds, to prevent patients from infusion reaction, when patients appear infusion reaction should immediately take effective measures. The speed of infusion should be strictly controlled during infusion for patients. When infusing routine drugs for adults, the routine infusion rate can be maintained at about 40-60 drops/minute. The infusion rate can be increased to 60 to 100 drops/minute when administering fluids to patients who urgently need to replenish blood volume. Strict control of the dosage and rate of infusion is necessary when administering intravenous fluids to patients with medical disorders. During infusion, the following precautions should be given to the patient: do not adjust the drip rate arbitrarily, and pay attention to the protection of the infusion site.
References
1, the construction and implementation of clinical nursing pathway in internal medicine He Hong; Nursing Research 2009-02-11
2, respiratory internal medicine nursing care for critically ill patients emergency nursing interventions Ye Renqiu; China Contemporary Medicine 2011-07-08
Internal Medicine Nursing Case Study Essay Sample Part III: "Talking about the Internal Medicine Chinese Medicine Nursing"Abstract Chinese medicine nursing is an applied discipline that takes Chinese medicine theory as a guide, takes nursing procedure as a basic framework, applies the holistic concept of Chinese medicine, carries out evidence-based nursing care for diseases, and applies traditional nursing techniques and methods to provide care and services to patients and populations to protect human health. Since China's integration into the World Trade Organization (WTO), China's medical and health undertakings have made rapid development, from the past to the development of traditional medicine to modern medicine, internal medicine is also moving towards modernization. As a branch of internal medicine, internal medicine nursing plays an important role in the treatment of internal medicine patients in the hospital.
Keywords Internal medicine Chinese medicine nursing; means; nursing logo
Chinese medicine's holistic concept theory, the principle of evidence-based care is the basic theory that nursing staff must master; traditional therapies are the technical means that nursing staff in Chinese hospitals must master. Chinese medicine nursing is to follow the theoretical system of Chinese medicine, reflecting the characteristics of Chinese medicine evidence-based care nursing theory and nursing technology. With the development of medical model and people's deep understanding of disease, Chinese medicine nursing has become an important part of medical activities.
First, Chinese medicine nursing in medicine treatment effect
Chinese medicine nursing technology operation is the core of Chinese medicine nursing, Chinese medicine traditional nursing technology operation in clinical nursing work is widely used. For example, the use of acupuncture, acupoints, acupoint injections, umbilical therapy, massage, Chinese medicine hot compresses and other technical operations to lift urinary retention; the use of auricular pressure bean method, massage, plum blossom needle, Chinese medicine iontophoresis and qigong and other methods to adjust the internal and external environments of the human body and the treatment of insomnia; through the needle, baking, auricular pressure bean, cupping, and the external application of traditional Chinese medicine and so on, to deal with the pain, constipation, decubitus ulcers, hardening of the muscle injections, and so on. Chinese medicine nursing staff has Chinese medicine nursing technology operation of the indications, the use of the scope of continuous expansion, continuous excavation, organization, improvement, innovation. Such as the use of homemade beneficial stomach powder acupoint external treatment of gastric pain; with moxa fumigation baby-friendly wards, etc. has achieved better results, but also on the antigenicity of the hepatitis B virus also has a certain destructive effect.
Chinese medicine nursing is realized through the operation of Chinese medicine nursing technology in clinical practice, but also a way to test the theory of Chinese medicine nursing. With the development of clinical medicine, some of the existing Chinese medicine nursing technical operation still need to be further improved, such as strengthening the research of painless acupuncture, smokeless moxibustion method and the improvement of enema, ion implantation machine, gua sha apparatus; also need to standardize some Chinese medicine nursing technical operation research, that is, the quantitative research of the relevant operation index. Therefore, we must inherit the traditional Chinese medicine nursing technical operation at the same time absorb the modern nursing operation of advanced, scientific, practical content to enrich themselves, and constantly enrich and improve the Chinese medicine nursing technical operation.
Second, the specific means of scientific internal medicine care in various situations
1, the care of special needs internal medicine: the so-called special needs internal medicine care refers to the development of social and economic development, to some of the special needs of the patient patient in the special needs wards when the care. It is a way of internal medicine care, but also the needs of special needs patients. Most of these special needs patients come from various institutions in the society and hold certain positions, patients with certain financial ability and foreigners from countries in the neighboring areas. For the care of special needs patients. In following the principle of ? Patient-centered? the premise of the service concept, the author believes that special needs patients should be diversified care. Specifically, the following measures can be taken: (1) first of all, due to the regional differences, patients should be made to adapt to the new environment and enter the role of patients as soon as possible, so as to facilitate the treatment and nursing management; (2) communication in diversified care: this mainly includes two aspects, i.e., linguistic communication and cultural communication. Therefore, for internal medicine nursing nurses need to master the language of the region where the nursing object is located (sometimes even dialect) as well as their cultural practices; (3) special needs ward nurses should be able to develop a good habit of flexibility, especially to strengthen the theoretical and technical learning, and master the basic skills of special needs nursing, such as venipuncture, painless injections, catheterization, enemas, and other operations should be light and sharp.
2, cardiology patient safety risks and care: cardiology patients are those suffering from heart disease, coronary heart disease, hypertension and other diseases. The main clinical manifestations of falls, sudden death and bleeding and other symptoms. To be on the collection and organization of the three types of clinical case data, the author summarizes the following specific nursing means and methods: (1) the above three types of patients for the degree of illness assessment: specific from the patient's age, medical history, emotional state, with or without vertigo, check whether there is no obvious triggers to carry out the assessment, this is the cardiology nursing staff need to have the first of all the technical class of the ability to; (2) for the different types of Patients with different types of nursing responses: for patients who have fallen: observe the three? For patients who have fallen: observe the three half-minute rule, i.e., sit up for half a minute. principle, that is, sitting up for half a minute, lying down for half a minute, and sitting on the edge of the bed with the lower limbs hanging down for half a minute. In this process, it is necessary to strengthen the prevention of falls when walking and bathing, but also to guide the patient to correctly use the medication, insert all kinds of signs in front of the patient's bed, such as? Fall prevention? and other markings. Strengthen the psychological appeasement, for the patient's family should avoid and prevent cerebral hemorrhage and hypertension.
Chinese medicine emphasizes evidence-based treatment, evidence-based care is also based on the basic theories of Chinese medicine to identify the basic rules of care,? It is a method of taking corresponding nursing measures according to the principle of diagnosis and treatment based on the theory of traditional Chinese medicine and combining the specific symptoms of the disease. The specific embodiment is? Different care for the same disease The specific embodiment of this is? The first time I saw this, I was able to see it in a different way, and I was able to see it in a different way.
Third, there are problems and factors affecting
1, identification of evidence-based care in form: identification of evidence-based care is the most characteristic of Chinese medicine nursing care model, but in the clinical implementation of the often difficult to identify the evidence, a single nursing measure and in form. The main reasons for this phenomenon are: the basic knowledge of Chinese medicine is not solid, can not correctly identify the evidence and affect the effect of nursing care, is a common problem; do not fully understand the connotation of Chinese medicine nursing, just Chinese medicine diagnosis, nursing plus Chinese medicine technical operation; health promotion is more routine, from nursing history writing found that the same disease health promotion of the same; the majority of nurses are able to patient Identification under the Chinese medicine nursing intervention, but the patient's specific implementation or not, how effective, the lack of corresponding evaluation mechanism.
2, Chinese medicine nursing operation clinical application rate is relatively not high: Although the scarf nursing technology operation is simple, equipment requirements are not high, easy to take, reliable results, but the use of Chinese hospitals is not high, the reasons are: (1) the limitations of the operation of Chinese medicine nursing technology. Chinese medicine nursing technology operation time is long, the effect is difficult to see immediate results. Therefore, it is only applied relatively more in traditional Chinese medicine or internal medicine in Chinese hospitals. (2) The nature of nursing work constrains the application of Chinese medicine nursing techniques. Nurses to carry out Chinese medicine nursing operation must be carried out in the case of medical advice, however, clinical doctors rarely open Chinese medicine nursing technical operation of medical advice.
3, nursing record defects: clinical nurses tend to focus on the operation, ignoring the record, the operation is not done in a timely manner to record the time, method, effect, Chinese medicine operation record should also record the selection of acupuncture points, skin conditions. At present, the setup of the quality control and assessment system about Chinese medicine overall nursing, standardization within the industry and the content of Chinese medicine nursing medical records, the specific requirements of the format and other issues have not really been resolved, coupled with the busy work of the nurses led to the record of the formality.
The characteristics and advantages of traditional Chinese medicine nursing have been generally recognized by nursing colleagues at home and abroad. The scientific and systematic organization, development and application of the nursing theories and experiences of the traditional medicine of the motherland, and putting them into practice for testing, is the source of the forward development of the nursing career of Chinese medicine. The development of evidence-based nursing provides favorable conditions for the continuous self-improvement of the theoretical system and skills, and through clinical practice verification, it constantly finds the contradictions between old theories, old experiences, old technologies and modern nursing science, replaces the original practices with new ones, and absorbs the latest scientific and technological achievements of the present time, thus accelerating the process of TCM nursing towards scientization, specialization and modernization.
More and more nursing theories and nursing technical operations look forward to research evidence. To find out new ways to solve them, they must be explained and supported by trustworthy scientific research results. Therefore, nursing scientific research should start from the perspective of nursing applied disciplines, take the solution of practical problems in real work as the main breakthrough, carry out extensive basic experimental research and clinical experimental research under the premise of inheriting the characteristics of traditional Chinese medicine, focusing on the scientific basis of nursing theories and the feasibility, safety, and comfort of the technical operations, selecting the most suitable topics for clinical research and utilizing the Internet resources*** Enjoy! Literature database of open research pathway design, integration of evidence-based nursing concepts, accelerate the motherland of traditional nursing academic thinking and technical expertise in the excavation and transformation of research results, so that the work of Chinese medicine nursing to adapt to the development of medical technology at the same time to better meet the needs of the people's health.
References?
[1] Liu Ping, Pan Guangming. Application of nursing program in teaching internal medicine nursing. Chinese Ethnic and Folk Medicine, 2010, 19(7)?
[2]Liu, W.H.. Research on the development of Chinese medicine nursing. Zhongwei Modern Drug Application, 2008, 2(6): 96-97?
[3]Zhu Shuihua. Exploration of teaching internal medicine nursing using nursing program, 2001(2)?
[4]Zhang Guangqing. Current status of Chinese medicine nursing and research outlook. Chinese Nursing Journal.
[5]Feng Xianqiong, Cheng Yijuan, Li Jiping, et al. Evidence-based nursing: a new trend in nursing development[J]. Journal of Practical Nursing, 2001, 17(6):1-3?
[6]Zhang Baozhong. Fundamentals of Traditional Chinese Medicine Nursing [M] Harbin: Heilongjiang Science and Technology Press, 2002.23?
[7]Liu Rongrong. On the specific means and importance of scientific internal medicine nursing HEALTH WORLD2010, 04(8)
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