随着人口老龄化、生活方式的改变，眼科疾病患病人数的增加、国家眼病诊疗相关政策的持续推动、居民健康意识的逐渐提升，眼科门急诊患者数量持续增长，亟需构建科学的眼科急诊预检分诊标准，合理配置医疗资源，确保患者得到及时、恰当的治疗。国外已有医院依据患者症状或体征的严重程度对患者进行等级划分，建立起相对成熟的眼科急诊预检分诊模式，我国目前尚没有统一的、权威的眼科急诊预检分诊标准，国内外现行的眼科急诊预检分诊模式的分诊精准度及临床适用性有待进一步探索。该文通过综述国内外眼科急诊分诊标准及应用评价、眼科远程急诊预检分诊方式研究进展，以期为构建符合我国国情的、科学有效的眼科急诊预检分诊标准、提高眼科急诊分诊质量提供参考。
With the aging of population, the changing of lifestyle and the increasing number of ophthalmic emergency patients,Chinese national policies related to ophthalmic diagnosis and treatment are continually promoted, and residents' health awareness are gradually improved, the volume of ophthalmic outpatients and emergency patients continues to increase. It is urgent needed to establish scientific ophthalmic emergency pre-examination and triage criteria, to reasonably allocate medical resources, and to ensure that patients receive timely and appropriate treatment. The relatively mature ophthalmic emergency pre-examination and triage models with the severity of patients' symptoms or physical signs,have been established in foreign hospitals. Currently, there is no unified and authoritative ophthalmic emergency triage criteria in China. The accuracy and clinical applicability of the existing ophthalmic emergency triage models at home and abroad need to be further explored. This article reviewed the ophthalmic emergency triage criteria and application evaluation at home and abroad, and remote emergency triage in ophthalmology, in order to provide a reference for establishing a scientific and effective ophthalmic emergency triage criteria comformed Chinese national conditions, and improving the quality of ophthalmic emergency triage.
目的：构建眼科日间病房护理质量指标，为眼科日间病房的护理质量管理提供理论依据。方法：以Donabedian三维质量结构模式为理论框架，通过查阅文献、小组讨论，初步拟定眼科专科护理质量评价指标。通过专家函询，对指标进行筛选和修订，确定了眼科日间病房护理质量指标。结果：经过2轮函询，专家意见趋向一致，2轮问卷回收率均为100%，协调系数分别为0.129、0.342(P＜0.01)。构建的眼科专科护理质量指标包括3项一级指标，分别为结构指标(二级指标2项)、过程指标(二级指标8项)和结果指标(二级指标3项)。结论：该指标具有较高的科学性、可靠性、可行性以及专科特色，可为眼科日间病房护理质量的评价提供良好的方法。
Objective: To set up nursing quality indicators for ophthalmic intra-day ward, providing theoretical basis for nursing quality management in ophthalmic intra-day ward. Methods: Based on the "Donabedian three dimensional quality structure model" as the theoretical framework, the preliminary ophthalmic specialized nursing quality assessment indicators were designed by literature review and group discussion. The ophthalmic nursing quality indicators for intraday ward were finalized by expers consultated, indicators screened and revised. Results: After two rounds of inquration by letters, the opinions from the experts were consistent. Questionnaire response rates were both 100% in two rounds, with coordination coefficients of 0.129 and 0.342 respectively (P< 0.01). The nursing quality indicators for ophthalmic intra-day ward were established, including 3 primary indicators, which are structual indicators (2 secondary indicators), process indicators (8 secondary indicators) and outcome indicatiors(3 secondary indicators). Conclusion: The indicators are scientific, reliable, feasible with specialized characteristics, which can provide a good reference for evaluating the nursing quality in ophthalmic intra-day wards.
目的：检索并总结开角型青光眼患者眼部用药规范化护理管理的最佳证据，为临床实践提供参考。方法：通过护理循证方法提出实践问题，按照循证证据检索数据库的“6S”分类模型，检索有关开角型青光眼患者眼部用药管理的所有证据资源类型，包括临床指南、最佳实践信息册、证据总结、系统评价和专家共识等。由2名循证护理研究员对纳入文献的质量进行独立评价并进行证据的归纳总结。结果：最终纳入12篇文献，包括4篇指南、3篇证据总结和5篇系统评价；汇总了19条有关开角型青光眼眼部用药管理的最佳证据，包括滴眼技术指导、依从性管理和信息提供3个方面。结论：总结开角型青光眼眼部用药管理的最佳证据，可为临床医务人员管理患者提供参考和借鉴，以达到患者规范用药、控制眼压和延缓疾病进展的目的。
Objective: To retrieve and summarize the best evidence on standardized ocular medication management among open-angle glaucoma patients. Methods: With evidence-based nursing method, practical problemswere identified. According to the “6S” pyramid model of evidence resource, studies on standardized ocular medication management among open-angle glaucoma patients were retrieved, including clinical guidelines, best practice information booklet, systematic reviews, and expert consensus. Two evidence-based nursing researchers independently evaluated the quality of the included literature and summarized the evidence. Results: A total of 12 articles were ultimately enrolled, including 4 clinical guidelines, 3 evidence summaries and 5 systematic reviews. Finally, 3 aspects including 19 pieces of best evidence were summarized, which were Eye drop technical instruction, medication adherence management and related information provision. Conclusion: The best evidence for the medication management of open-angle glaucoma patients were summarized, which provide reference for clinical medical staffs to manage patients, so as to achieve the purpose of standardizing medication,controlling intraocular pressure and preventing disease progression.
目的：构建具有较强科学性和实用性的眼科专科护士培训体系，为眼科专科护士的准入、培养、考核提供理论基础。方法：通过查阅文献、焦点小组和专家会议法，拟定眼科专科护士培训体系的课程、带教、评价体系。结果：构建的眼科专科护士培训体系内容包括课程体系、培训过程、临床实践指标、考核评价方法4个部分。其中，课程体系部分包含一级指标5项，二级指标11项，三级指标55项；培训过程包括一级指标4项、二级指标12项；临床实践指标包括一级指标6项、二级指标23项；考核评价方法包括一级指标5项、二级指标10项。结论：眼科专科护士培训体系构建过程科学，内容设置合理，对开展专科护士培训具有较好的指导意义。
Objective: To develop a scientific and practical training system for ophthalmic specialist nurses and provide theoratical basis for the the admission, training and assessment of ophthalmic specialist nurses. Methods: Through extensive review of domestic and foreign literatures, a focus group interview and an expert meeting, the curriculum, teaching and evaluation system of the ophthalmic specialist nurses training system was developed.Results: The training system for ophthalmic specialist nurses consists of four parts: training content, training process, clinical practice, assessment and evaluation. Among them, the training content includes 5 first-level indicators, 11 second-level indicators and 55 third-level indicators. The training process of ophthalmic specialist nurses includes 4 indicators of the first level and 12 indicators of the second level. The clinical practice indexes of ophthalmic specialist nurses include 6 indexes of the first grade and 23 indexes of the second grade. The methods of assessment and evaluation of ophthalmic specialist nurses include 5 indicators of the first level and 10 indicators of the second level. Conclusion: The scientific process and reasonable content of the training system for ophthalmic specialist nurses have a good guiding significance for the training of ophthalmic specialist nurses.
为较好地满足眼科诊疗的使用要求，提升医护人员的工作效率以及患者的治疗效果，笔者设计了一种眼科多功能尺。该眼科多功能尺主要采用PVC材料，其结构主要包括圆盘、主尺、第一副尺、第二副尺以及第三副尺；功能主要包括测量长度、视力检查、照明、患者体位角度测量等。该眼科多功能尺设计巧妙，功能较齐全，能够较好地满足眼科医疗和诊断过程的使用要求。
To meet the demands of ophthalmic medical diagnosis, and to improve the efficiency of medical staff and patients’ treatment, the authors designed an ophthalmological multifunctional ruler. Its main material is PVC, and mainly includes a circular disk and 4 rules (the main ruler, the first ruler, the second ruler and the third ruler). Its functions mainly contain the measurement of length, visual test, illumination, the angle measurement for patients position and so on. The ruler is ingenious in design and has complete functions, which can meet the requirements of ophthalmic medical treatment and diagnosis.
目的：探讨品管圈在缩短眼底外科门诊患者就诊时长中的应用效果。方法：成立品管圈小组，确立缩短眼底外科门诊患者就诊时长活动主题，选择2020年9月份眼底外专科门诊就诊的484例患者为活动前研究对象。2020年12月份眼底外科门诊就诊的976例患者为活动后研究对象，分析干预前眼底外患者就诊时长，患者就医体验差的原因，针对原因拟定对策并组织实施。结果：开展品管圈活动后，眼底外科门诊患者的平均就诊时长显著缩短(P<0.05)。借助信息系统优化就诊流程，提高了患者满意度，圈员的团队凝聚力、积极性、沟通协调能力显著提高。结论：品管圈活动能缩短眼底外科患者就诊时长，提高患者就医体验，提升护理团队综合能力，且改善效果可持续保持。
Objective: To explore the application effect of quality control circle in shortening the length of outpatient visit in fundus surgery. Methods: A quality control circle group was established to set up the activity theme of shortening the duration of treatment for outpatient patients of fundus surgery, and 484 patients who visited outpatient clinics outside fundus in September 2020 were selected as the pre-activity research objects. In December 2020, 976 patients who visited fundus surgery outpatient department were the subjects of the post-activity study. We analyzed the duration of treatment and the reasons for poor medical experience of patients before the intervention, formulated countermeasures for the reasons and organized and implemented them. Results: After the quality control circle activity was carried out, the mean duration of outpatient visits in fundus surgery was significantly shortened (P<0.05). With the help of the information system, the medical treatment process was optimized to improve the satisfaction of patients, and the team cohesion, enthusiasm, communication and coordination ability of the circle members were significantly improved. Conclusion: Quality control circle activities can shorten the duration of treatment for fundus surgery patients, improve patients' medical experience, enhance the comprehensive ability of the nursing team, and the improvement effect can be maintained sustainably.
目的：探究角膜移植日间手术患者的延续护理需求现状及其影响因素。方法：采用便利抽样法抽取行角膜移植日间手术的173例患者，采用课题组自行设计的一般资料调查表、角膜移植日间手术患者延续护理需求调查问卷进行调查。采用独立样本t检验、单因素方差分析、多元线性回归进行统计分析。结果：角膜移植日间术后患者延续护理需求得分为88.13±15.55，其中，对疾病相关知识的需求得分最高，为4.39±0.66，对心理护理的需求得分最低，为2.72±1.18；在延续护理实施方式方面，74.6%患者倾向于电话随访，只有5.8%倾向于上门服务；在影响因素方面，婚姻状况、视力、家庭月收入、文化程度是延续护理需求的影响因素。结论：角膜移植日间术后患者的延续护理需求较高，应根据患者延续护理需求及影响因素进行个性化指导，以提高角膜移植手术的成功率和减少并发症的发生。
Objective: To explore transition care needs among patients with keratoplasty in day ward and analyze the influencing factors. Methods: Using convenience sampling method, 173 patients undergoing keratoplasty in day ward were selected, and they were investigated by using a self-designed general information questionnaire and a questionnaire of transitional care needs of patients with keratoplasty in day ward. T-test, one-way analysis of variance (ANOVA), multiple linear regression were used to analyze the data. Results: The total score of transitional care needs among patients with keratoplasty in day ward was 88.13±15.55. The demand for disease related knowledge was the highest (4.39±0.66), the demand for mental nursing was the lowest (2.72±1.18). In terms of the way of implementation, 74.6% patients preferred telephone follow-up and only 5.8% preferred door-to-door service. Single-factor analysis showed that marital status, vision, monthly income, educational level were the factors influencing the demand for transitional care (P<0.05). Conclusion: Patients with keratoplasty in day ward have a high demand for transitional care. In order to improve the success rate of keratoplasty and reduce the incidence of complications, personalized guidance should be given according to patients’ transitional care needs and influencing factors.
克服现有婴幼儿眼科手术病号服存在的穿脱不便、容易着凉、无法避免患儿抓挠术眼等问题，提供一种便于穿脱、保护胸腹部和术眼的婴幼儿眼科手术病号服*。
Abstract Present patient clothing for infants and children with ophthalmic surgery have several limitations, which is inconvenient to wear, hard to keep warm and difficult in preventing patients from scratching eyes underwent surgery. A modified patient clothing for infants and children is designed to overcome these existing problems.
目的：通过中山大学中山眼科中心眼科互联网护理咨询门诊建设与运营经验，对互联网专科护理服务模式及效果进行分析，为眼科互联网+护理服务提供参考。方法：依托医院优质资源，成立眼科互联网护理咨询门诊；根据眼科患者的实际需求，制订互联网护理咨询门诊服务制度、工作流程，对出诊专家进行资质审核、培训与考核。收集、统计眼科互联网护理咨询门诊接诊量、患者满意度、首诊问题分类及护士职业获益感等数据。结果：2021年6月26日至12月31日累计接诊患者1266人次；接诊时间主要在08:00—22:00；咨询次数最多的问题种类是眼健康知识科普；患者对眼科互联网护理咨询门诊的总体满意度为99.52%；眼科互联网护理咨询门诊运营后，眼科护士职业获益感总分及各维度得分均有提高，差异均有统计学意义(均P<0.05)。结论：眼科互联网护理咨询门诊服务可有效满足各类人群的眼健康护理需求，患者满意度高，亦可提高眼科护理人员的职业获益感，值得进一步推广
Objective: Based on the construction and practice of Internet nurse-led clinic in our hospital, the model and effect of Internet specialized nursing service were analyzed to provide reference for Internet-based nursing service in ophthalmology. Methods: Relying on the hospital’s high-quality resources, the Internet nurse-led clinic in ophthalmology was established. According to the actual needs of ophthalmology patients, the Internet nursing consultation outpatient service system and workflow were formulated, experts’ qualification were reviewed, and training and assessment for the experts were conducted. The data on the number of outpatient visits, patients’ satisfaction, advisory questions and nurses’ perceived professional benefits were collected and analyzed. Results: From 26th June to 31st December 2021, the number of clinical reception was 1 266. The visit time is mainly between 08:00 to 22:00, the most frequently asked questions were eye health knowledge, the overall patients’ satisfaction was 99.52%, and the total score and the score of all dimensions of nurses’ perceived professional benefits were improved, with statistical significance (all P<0.05). Conclusion: Ophthalmic internet nurse-led consultation clinic can effectively meet the health care needs of all kinds of people, with high patient satisfaction, and can also improve nurses’ perceived professional benefits, which is worthy of further promotion.
