摘要:目的:探討臨床教學的全程制度化管理及其效果。方法:通過健全組織,完善制度,加強教學、臨床及實習生管理、建立激勵機制等措施,進行全程制度化的規范管理。結果:教學質量顯著提高,不良事件鮮見,無惡性事件發生。近來醫院已有6篇教學論文公開發表,4個先進集體和8名先進個人受到醫院表彰,5名優秀帶教教師和8名實習生受到各學院獎勵。結論:臨床教學全程制度化管理是提高教學質量的切實有效途徑。Abstract: Objective: To investigate system management during the entire clinical teaching process and its effect. Methods: To robust organization, perfect rules, strengthen management of clinical teaching and intern student, and establish encouragement mechanism,and other measures, so as to conduct standard system management during the entire process. Results: Quality of teaching improved notably, bad event was scarce, no malignant event occurred. There were six teaching articles issued publicly, four advanced collectives and eight advanced individuals had been praised by hospital, and five excellent teachers,eight intern students had been rewarded by each college. Conclusion: System management during the entire clinical teaching process is an effective way to improve teaching quality.
As an important tool for nucleic acid detection of variant strains of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2), the mobile air capsule construction laboratory is a key medical resource in the prevention and control of COVID-19. Medical staff, security guards, cleaners, maintenance workers and volunteers in the mobile air capsule construction laboratory have high contact frequency with the samples, so they have a high risk of infection with COVID-19. In order to reduce this risk, this article discusses the infection management measures in the aspects of wearing and taking off personal protective equipment, environmental health management, post use goods management, medical waste management, staff training management and disposal process after occupational exposure, and analyzed the common problems in operation, based on the operation process of Nanchong mobile air capsule construction laboratory. The purpose is to provide a reference for the construction and management of other mobile air capsule construction laboratory.
Objective To summarize and analyze the experience of Canadian hospital report, including report contents, indicators system and result application, so as to provide basis for improving Chinese hospital information report and enhancing healthcare regulation. Methods Official networks and databases in Canada were searched, and relative policies, documents, research reports and information reports were included. Results Canadian Hospital Report Project carried out by Canadian Institute for Health Information was effective for gathering and comparing hospitals’ information, and regulating healthcare service. Ontario Hospital Report Project, as a local policy based on national hospital report project, was a good example of local government to improve healthcare service regulation. Conclusion Canadian Hospital Report and Ontario Hospital Report enlighten us that, carrying out the comparison of hospitals in the same type, ensuring the comparability of data, setting comprehensive and scientific report contents and indicators, and emphasizing the self-evaluation function and self-improvement function of the hospital performance evaluation.
With the continuous development of new drugs and immunotherapy, the survival period of patient with multiple myeloma (MM) is continuously prolonged, and the disease is becoming chronic. Due to the involvement of multiple systems and numerous complications, the daily nursing for MM faces significant challenges. The doctor-nurse-patient integration model and the whole life cycle health management model for daily nursing of MM are expected to reduce the social burden related to diseases, improve patients’ quality of life, and reduce medical costs. This article provides a review on three aspects of MM doctor-nurse-patient integration, whole life cycle health management, and daily health management involving multiple systems.
Continuous renal replacement therapy (CRRT) is an important therapy for patients with severe acute kidney injury. With the development of blood purification, the application of CRRT has been beyond the scope of kidney disease and developed into a comprehensive and integrated organ support platform, providing a hybrid treatment of different blood purification techniques. With the advancement of informatization, it is possible to improve the quality of CRRT treatment to formulate individualized and precise treatment based on the specific information of patients. This article will discuss the precise prescription and development prospective of CRRT from three dimensions: anticoagulation, dosage and volume management.
ObjectiveTo review the clinical research progress of spinal epidural lipomatosis (SEL). Methods The clinical studies on SEL at home and abroad in recent years were extensively reviewed, and the pathogenesis, clinical and imaging manifestations, and treatment status of SEL were summarized and analyzed. ResultsSEL is a disease characterized by compression of the spinal cord and nerve roots due to abnormal accumulation of epidural adipose tissue in the spinal canal. Its prevalence and diagnosis rate are low and the pathogenesis is not fully understood. MRI is the most sensitive and specific diagnostic test for SEL. Surgical decompression and removal of excess adipose tissue are the only options for patients with acute SEL or those who have failed conservative management, and conservative management should be considered for other patients. ConclusionSEL is a rare disease and related research still needs to be improved. In the future, high-quality, multi-center and large-sample studies will be of great significance for evaluating the choice of treatment methods and effectiveness of SEL patients.
Objective To provide scientific evidence for the establishment of medical specialist system in China by analyzing the current situation and problems, putting forward solution thoughts and countermeasures, from the angle of medical education system, residency training program and licensed physician management. Method Principle and method of evidence-based medicine were adopted. Retrospective investigation was conducted to gain information from 1996 to 2002 about enrollment and running form of medical education, current situation of residency and specialist training. Data was then extracted and analyzed for the benefit of corresponding countermeasures. Results By the end of 2001, there were totally 1 640 thousand physicians in China. The enrollment proportion of undergraduate and junior college student steadily increased from 1996 to 2002, while the situation quite the reverse as for medical secondary school. More than 300 thousand have taken part in the licensure exam, among whom less than 15% had university diploma. About 52 000 doctors have already completed the residency training program, and 65 700 are being trained. Standardized system of specialist training and admittance is not available in China. Conclusions It was three main tough problems that mainly account for the poor quality of doctor as a whole in China, which include diversity of educational system, insufficient software and hardware of residency training program, and absence of specialist training system. An allied funded program of "research on medical specialist training and admittance" has been on the way, and research outcomes will be published soon.
摘要:醫院有效事前監測、管控醫療不良事件，是保障患者安全、提高醫療質量的管理措施之一。超大型醫院對醫療不良事件管理的實戰中，建立、實施醫療安全隱患事件關鍵監測指標、醫療安全隱患事件篩查程序指標，積極開展醫療不良事件后臺監管工作，切斷醫療安全隱患事件向醫療風險事件演變、醫療風險事件向醫療糾紛事件演變的環節，保障患者安全。Abstract: Effective supervision in advance to the medical adverse event, is one of measures which hospital adopt to guarantee patient safety and enhance medical quality. The actual combat of supervision to the medical adverse event in super sized hospital, set up and put in practice on the key target of supervising the medical adverse event and the key target of ridding procedure, remain in the background and work actively on supervision on the medical adverse event, shut off the road from the medical safety issue to the medical risk issue and the road from the medical risk issue to the medical dissension in order to guarantee the patient safety.
Pain education based on biomedical models is currently a common approach to patient pain management. However, due to its inability to accurately explain pain, patients may develop incorrect beliefs and understandings about pain, leading to anxiety and fear of movement. Pain neuroscience education is based on a biological psychological social educational model, aiming to redefine the concept of pain. It has a positive effect on pain, catastrophizing, anxiety, and fear of movement, and is a reliable new method for pain rehabilitation therapy and management. This article provides a review of the concept, implementation principles, implementation methods, dosage factors, combination therapy, and clinical application of pain neuroscience education, in order to provide ideas for the rehabilitation therapy of pain.
Chronic kidney disease (CKD) is a public health issue of global concern, and nutritional management of CKD can improve the nutritional status of patients and slow down the progression of the disease. However, nutrition management is a complex scientific issue, and there are few clinical practices of nutrition management in CKD, so there is an urgent need for a theoretical framework of nutrition management to guide the construction of a scientific and standardized program. This review will systematically describe the relationship between nutrition and kidney disease, sort out the current status of nutrition management in CKD in China, introduce the experience of CKD medical and nursing nutrition integration in West China Hospital of Sichuan University, and provide thoughts for further improvement of standardized scientific formulation of nutrition management strategy.