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侯艳

丁香诊所 医院护理部

医院护理部视频

丁香诊所全科培训课程 86:解析医院危机降级CEDN 模式

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课程介绍

在丁香诊所「全科医生强化培训班」中,马里兰大学医学院附属医院医生委员会主席 Steve Bentman 与大家一起讨论《常见结膜炎的诊治与用药》。

病毒性结膜炎最常见的病原体是腺病毒,其次还有单纯疱疹病毒和水痘-带状疱疹病毒。一般累及双眼,后两种病毒可表现为单眼累及。

腺病毒性结膜炎极具传染性,为接触传播。表现为结膜充血,球结膜水肿和眼睑水肿,可有轻度刺痛,可伴流感症状。视力检查一般无视力损伤,下睑结膜可见滤泡。是自限性疾病,治疗包括冷敷,勤洗手,萘甲唑林滴眼药收缩血管,人工泪液,不需要抗生素,严禁使用激素。病程为 2~3 周。

单纯疱疹性结膜炎,表现为畏光,视力模糊,流泪,结膜充血,剧痛,滤泡性结膜炎,眼睑可有水疱,荧光素染色可发现角膜树突。可有皮损或眼睑周围可见水疱(Hutchinson 征)。治疗可用如 1% 曲氟尿苷滴眼液 2 小时 1 次,痊愈后改为 4 小时 1 次维持 7 天,5% 阿糖腺苷眼膏 1 天 5 次,口服抗病毒药可选用阿昔洛韦 600~800 mg,一天 5 次,7~10 天,有合并细菌感染的风险,应建议立即转诊至眼科。

水痘-带状疱疹病毒引起的结膜炎,常伴水痘或水疱征,疼痛,感觉异常,荧光素染色可见角膜树突,严重时角膜上可见水疱和溃疡,可导致失明。当患者鼻尖有病变时,需怀疑本病的可能。治疗主要是抗病毒,如阿昔洛韦 600~800 mg,一天 5 次,7~10 天,并立即转诊至眼科。

眼科疾患需重视视力检查,激素使用必须由眼科专科医师决定,全科医生应牢记不能予以眼科疾患激素。

丁香诊所「全科医生强化培训班」中,北京和睦家医院护理部侯艳护士长与大家一起讨论《医院危机降级》。

在当前的医疗环境下,所有医护人员都有必要掌握医院危机降级的技巧。工作场所暴力给医护带来身心伤害,造成医院财产损失,面对这些,我们要学会化解愤怒、焦虑与冲突。造成冲突的因素包括易激惹的个性、对服务不满、抢劫和人际冲突等。

患者表现出疼痛、压力、害怕或悲伤、抑郁时很可能已经生气了,这时要注意倾听,必要时换其他人处理。当病人或家属表现出敌意时,他们在试图「沟通」,面对这种情形,我们要学会保护自己,尽可能不要在脖子上挂东西,并将锐器拿开。

医院危机降级的 CEDN 模式包括保持冷静(C)、消除不满(D)、共情/同理心(E)和协商/谈判(N)四个步骤。保持冷静主要是学会管理自己的情绪;同理心主要体现在把病人的感受和对当前环境的感受结合起来,注意倾听和理解,学会表达同情,道歉、沟通、解释和感谢是很有用的手段;消除不满首先是真诚的道歉,关注病人的体验而不是自己的感受或事实,道歉要保持镇静并注意态度真诚、强调事实;谈判的目标是让病人感受到我们是在帮他们,然后给他们一个选择来把接下来的事情做的更好。

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侯艳 丁香诊所 医院护理部

Hou Yan, 北京和睦家医院护理部副主任、护士长。

25 years nursing experience in internal medicine, emergency and intensive care; 11 years nursing management experience as head nurse of Emergency Room and Intensive Care Unit and Assistant Chief Nursing Officer.

Management Experience:
2004-present, Associate Chief Nursing Office (ACNO),Beijing United Family Hospital, Beijing, China.
Supervised inpatient department including intensive care units, pediatric, medical-surgical, 08-GYN inpatient department, and operating room
Managed daily operations and dealt with unusual issues
Quality champion of nursing
Chair of nursing policy and procedure committee, and develop nursing policies and forms,
Provided quarterly audit to the entire nursing team in the hospital
Involved in nurse recruitment and selection processes and provided training to new nurses
Have excellent organizational, interpersonal, problem-solving, and decision-making skills
Successfully lead supervised nursing team through four times of Joint Commission International (JCI) Accreditation (2005, 2008, 2011 & 2014)
Received UFH Clinician of the year from the UFH health Care Group

2001-2004, Head Nurse - Emergency Room and Intensive Care Unit, Beijing United Family Hospital, Beijing, China
Delegated staff nurse duties and functioned as role model to co-workers Preceptor new staff members and nursing students
Functions as clinical manager of the Emergency Room & Intensive Care Unit and has both clinical and management responsibilities
Supervise clinical personnel
Coordinate and manage clinic-based training programs
Possess good computer and information technology skills
Prepare annual budget for both ER and ICU and analyze fiscal and patient care data

2001- 2010, Registered nurse -- Emergency Room & Intensive Care Unit Beijing United Family Hospital, Beijing, China
Beijing United Family Hospital and Clinics is the first joint venture International hospital, and the first joint commission international accredited (JCIA) hospital in China. The hospital is multidisciplinary institution with 50 beds capacity in the early years, and currently is 120 inpatient beds. English is the official language in this hospital.

June1995-May 1997,Registered Nurse trainee Internal Medicine Ward, TTSH

March 1998-August 2001, Registered Nurse, Neurology &Neurosurgery Ward, Surgical Intensive Care Unit(SICU) ,Tan Tock Seng Hospital (TTSH), Singapore
Tan Tock Seng Hospital, Singapore is a general hospital with 1000 beds, it is the first trauma centre in Singapore. Internal medicine ward has 36 beds. Neurology &Neurosurgery Ward has 36 beds, SICU has 8 beds.

June, 1990-May, 1995, Registered nurse, Internal Medicine Ward, (June, 1990-May, 1995) TB and Cancer Hospital, Teng Zhou City, Shandong Province, China

June, 1990-May, 1995, Registered nurse, Internal Medicine Ward,TB and Cancer Hospital, Teng Zhou City, Shandong Province, China
TB and Cancer Hospital Teng Zhou city has 400 beds; it is the largest hospital in the city that is focused on care of TB, Lung cancer and other pulmonary disease.

Education:
May 2011-March 2013, Master of Science of Nursing --Leadership & Management (On-line) Walden University, United States

Feb 1999- March 2001, Bachelor of Science of Nursing (post -registration) Monash University, Australia

September 1987 - July 1990, Diploma of Nursing, 2nd Nursing School, Zao zhuang City, Shandong Province, China

Certification & Training:
Basic Life Support (BLS)
Advanced Cardiovascular Life Support (ACLS)
Pediatric Life Support (PALS)
Nurse Manager Course
Ward Sister Course (on leadership & management)
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