Objective To explore the moves that creating magnetic work environment in hospital, in order to improve the nurses job satisfaction and reduce the turnover rate then stable the nursing team. Methods Through a series of measures such as the establishment of scientific rational allocation of human resources, implementing fair performance evaluation and allocation mechanism, carrying out the nurse grading management system to create magnetic nursing work environment, the nurse job satisfaction and turnover rate were compared before and after the measures. Results In January 2014 a total of 520 questionnaireswere issued, 519 valid questionnaires, and the effective recovery rate was 99.81%(519/520);And 559 were valid of 577 issued questionnaires, which was 96.88% (559/577). The overall score of nurses′job satisfaction increased from (3.20±0.46) points in 2013 to (3.41±0.52) points in 2014 (t=9.40, P= 0.000); The nurse turnover rate fell to 1.97%(13/661) from 5.13% (30/585) (χ2= 10.27, P= 0.003). Conclusions That is very important for remain stable and high quality nursing team to carry out scientific and fine management according to the demand of nurses, so as to create a safe, harmonious, positive, cooperative magnetic nursing work environment which have development direction and space.

OBJECTIVE: To compare the hemodynamics and post-anesthetic recovery of total intravenous anesthesia (TIVA) with remifentanil or fentanyl combined with propofol administered by target controlled infusion (TCI) in neurosurgery. METHODS: A total of 80 patients undergoing selective neurosurgery were randomly divided into a remifentanil group (Group R, n=40) and a fentanyl group (Group F, n=40). In Group R,remifentanil and propofol was administered by TCI and the blood concentration were 3 approximately 5 microg/L and 3 approximately 5 mg/L each. In Group F, fentanyl was continuously infused at 2 approximately 3 microg/(kg.h) and propofol was administered by TCI with the same blood concentration as that in Group R.Vecuronium was injected at intervals to maintain muscle relaxant.Mean arterial pressure and heart rate during the anesthesia and post-anesthetic recovery were recorded. RESULTS: Mean arterial pressure of all the patients was decreased significantly from induction of anesthesia to termination of operation compared with that before the induction( P<0.01). The heart rate of Group R was increased obviously from recovery of respiration to extubation and heart rate of Group F was decreased obviously from fixed headframe to termination of operation compared with that before the induction (P<0.01). But there was no significant difference between the 2 groups (P>0.05). The eyes opened and extubed time of Group R were decurtated obviously and the scores of pain were increased significantly (P<0.01). CONCLUSION TIVA with remifentanil or fentanyl combined with propofol administered by TCI in neurosurgical operation can provided steadible hemodynamics. Resuscitation of remifentanil with propofol administered by target controlled infusion were more quickly but the scores of pain were more higher than that of fentanyl.
Adolescent ; Adult ; Aged ; Anesthesia Recovery Period ; Anesthesia, Intravenous ; methods ; Anesthetics, Intravenous ; administration & dosage ; Craniotomy ; Female ; Fentanyl ; Humans ; Infusion Pumps ; Male ; Middle Aged ; Neurosurgical Procedures ; Piperidines ; Propofol ; Remifentanil ; Vecuronium Bromide ; administration & dosage ; Young Adult

Objective To explore the effects of transcutaneous electrical acupoint stimulation(TEAS)combined with multi-model analgesia on infrared thermal imaging characteristics and pain after total knee arthroplasty(TKA).Methods A total of 74 patients with TKA were divided into the treatment group and the control group according to random number table method,with 37 cases in each group.The control group was treated with multi-model analgesia,and the treatment group was treated with TEAS on the basis of multi-model analgesia for 30 min,once in the morning and afternoon before the patient's rehabilitation exercise 1-7 days after surgery.The infrared thermal imaging data,visual analogue scale(VAS)score,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score and pain threshold of the two groups were recorded and analyzed before and at different time points after operation.Results There were 2 cases dropped out in each group.Compared with before surgery,both groups had an increase in knee joint temperature on the surgical side 14 days after surgery(P<0.05),and the temperature in the treatment group was lower than that in the control group(P<0.05).The self knee temperature difference in the treatment group was lower than that in the control group 14 days after surgery(P<0.05).Compared with before surgery,the VAS score of the treatment group decreased 3 and 7 days after surgery(P<0.05),while the VAS score of the control group decreased 7 days after surgery(P<0.05);compared with the control group at 3 and 7 days after surgey,the VAS score of the treatment group was lower than that of the control group.Compared with before surgery,the WOMAC scores of both groups increased 7 days after surgery(P<0.05);after 7 days of surgery,the WOMAC score of the treatment group was lower than that of the control group(P<0.05).Compared with before surgery,the pain threshold values of both groups increased 7 days after surgery(P<0.05);compared with the control group at 3 and 7 days after surgery,the pain threshold values of the treatment group was higher than that of the control group(P<0.05).Conclusion TEAS combined with multi-model analgesia can reduce the temperature of the knee joint,relieve the pain of the operated limb,and promote the early functional recovery of the knee joint after TKA.Infrared thermal imaging technology has a certain application value in indirectly assessing the degree of postoperative pain and detecting early infection of the affected limb.

Objective To investigate the effects of transcutaneous electrical acupoint stimulation(TEAS)combined with multimodal analgesia on short-term and long-term joint function after total knee arthroplasty(TKA).Methods Totally 110 patients with TKA were divided into the treatment group and the control group according to random number table method,with 55 cases in each group.The control group was treated with multimodal analgesia,and the treatment group was treated with TEAS on the basis of multimodal analgesia.The VAS score,pain threshold value,WOMAC score and SF-12 score of the two groups before and at different time points after operation were recorded and analyzed.Results The VAS score of the treatment group was lower than that of the control group on the 3rd and 7th day after operation(P<0.05).On the 7th day after operation,the knee pain threshold in the treatment group was higher than that in the control group(P<0.05).The WOMAC score of the treatment group was lower than that of the control group at the 1st,2nd,4th and 12th week after operation(P<0.05).At the 4th and 12th week after operation,the SF-12 score of the treatment group was higher than that of the control group(P<0.05).Conclusion TEAS combined with multimodal analgesia can relieve the pain after TKA,and promote the recovery of joint function in the short term and long term,and the improvement effect in the short term is more obvious than that in the long term.