Objective To explore the effect of evidence-based nursing on medication compliance with multiple chronic disease patients in the community.Methods 60 patients with chronic diseases included in the center from January 2023 to June 2023 were selected,divided into control group and observation group before and after the application of evidence-based care,with 30 cases in each group.The control group adopted the usual care program,and the observation group adopted the evidence-based care program to compare the implementation rate of the review index before and after the evidence application,the medication compliance of the two groups,the drug holding rate and the drug knowledge level of community nurses for chronic diseases.Results After the application of evidence,the implementation rate of the review index was higher,and the medication compli-ance and drug holding rate of patients in the observation group were higher than that of the control group.After the application of evidence,the drug knowledge level of community nurses for chronic diseases was significantly improved,and the difference was statistically significant(P＜0.05).Conclusion The evidence-based nursing practice can standardize the management of medi-cation compliance of patients with chronic diseases in the community,improve the medication compliance of patients with chroni diseases,and improve the knowledge level of chronic diseases in the community nurses.
It is of great significance to conduct investigations and research on party building work in public hospitals to promote high-quality development of hospitals.During the Theme Education period,through visits and research,it was found that due to weak political awareness,outdated infrastructure,and lack of assessment mechanisms,problems such as emphasizing sys-tems over implementation,emphasizing theory over practice,emphasizing business over party building,emphasizing forms over innovation,and emphasizing slogans over implementation were caused.The next step is to strengthen the ideological foundation,innovate the party building brand,encourage secretaries to compete,consolidate basic construction,and improve the supervision and assessment system to comprehensively enhance the hospital's service capacity,providing practical experience for the party building of public hospitals to lead the high-quality development of hospitals.
Objective Through project performance management,to mobilize the enthusiasm of hospital information de-partment engineers and ensure the quality of hospital information project construction.Methods Change the traditional perform-ance allocation scheme,with the project as the main KPI value,and evaluate the comprehensive score through three dimensions:project stage coefficient,difficulty coefficient,and plan completion degree,to obtain the activity coefficient for performance allo-cation.Results Following the principle of"more work,more pay"and"better work,more pay",employees who have the cour-age to undertake information technology projects have received higher performance-based salaries.Conclusion By changing the performance allocation plan,the success rate of information technology projects has been improved,and the overall technical level and professional literacy of the information department have been improved.
Traditional Chinese medicine hospitals are the main battlefield for the inheritance,innovation,and develop-ment of traditional Chinese medicine.Human resource is the primary resource for the development of traditional Chinese medi-cine.The inheritance,innovation,and development of traditional Chinese medicine hospitals cannotwithout the cultivation and creation of high-quality teams.A traditional Chinese medicine hospital in Guangzhou has developed the"Three Projects and One Plan"human resource cultivation plan based on the idea of multi-level training that improve the overall quality of the workforce and focus on potential person.It has constructed a traditional Chinese medicine human resource cultivation system that covers the entire cycle of person.The hospital has carried out in new mechanism of traditional Chinese medicine human resource cultivation,and various measures have been implemented and achieved some success.And then,it will consider the next step of human re-source cultivation.
Public hospitals play a key role in emergency management of public health emergencies.The emergency man-agement capability of public hospitals directly affects the performance of medical services,public health service functions,and their sustainable development.Based on the division of crisis event lifecycle and emergency management stages,this paper analy-zes the inadequate preparation and early warning mechanisms for public health emergency management in public hospitals,as well as the lack of emergency response network and mechanism supply,and summarizes the ability difficulties of delayed evaluation and recovery,and poor circulation in various links.This article draws inspiration from the concept of comprehensive quality man-agement and builds a theoretical framework based on the PDCA cycle and the applicability of public health emergency manage-ment in public hospitals,based on the idea of"scenario-taskand capability-response methods".Based on this,strategies are proposed to enhance the public health emergency prevention and preparedness capabilities,emergency response and disposal ca-pabilities,and emergency regulation and recovery capabilities of public hospitals.
Academic exchange is an important part of cultivating young talents,which plays an important role in promo-ting knowledge dissemination,broadening academic horizons,cultivating scientific research thinking,improving innovation abili-ty,strengthening peer review,and conducting interdisciplinary cooperation.Based on the connotation and significance of academ-ic exchange,this paper analyzes the main problems faced by public hospitals in the process of academic exchange,and puts for-ward some promotion strategies,such as strengthening institutional guarantees,increasing funding support,increasing publicity efforts,and standardizing process management,creates a good academic exchange atmosphere,constructs a diverse academic ex-change platform,and provides reference for improving the quality of young talent cultivation in public hospitals.
The standardized training of resident doctors has entered a new stage of quality construction.The multi-station assessment in clinical context takes clinical problems as the core and residents as the main body,and uses the way of integrating practice and clinical thinking training to help residents build the comprehensive ability to solve clinical practical problems.This paper reviews and summarizes the practice of multi-station assessment mode in a tertiary hospital in Tianjin in recent three years from the aspects of assessment scheme,examination station setting,examination content,requirements and characteristics of ex-amination questions.Problem-oriented,find out the problems existing in the operation process and put forward solutions,so as to provide a reference for further improving the assessment and training system,promoting the training management of residential training bases and improving the training quality.
Objective To address the issues of decentralized blood transfusion services and the persistence of paper-based approval processes,as well as to meet the requirements of electronic medical record grading and interoperability assess-ments.Methods Combining the requirements of the assessments,we have restructured and designed the blood transfusion serv-ice processes,and developed a comprehensive closed-loop management system for clinical blood transfusion based on an integrat-ed platform.Results Six major closed-loop processes were established for blood transfusion services and blood management.This transformation led to more standardized transfusion documentation,centralized blood transfusion services,and enabled data sharing across the entire hospital.Conclusion The rationality,standardization,and safety of clinical blood transfusions have improved,leading to a reduction in the incidence of adverse transfusion reactions.
Objective By analyzing the current situation of employee entry and exit(resignation and retirement)in a large Grade-A public hospital in the past five years,the specific influencing factors under the background of personnel changes will be discussed and corresponding countermeasures also be proposed,so as to provide reference for human resource management and talent management in public hospitals.Methods From September 2019 to September 2023,the enrolled and discharged employees of a large Grade-A public hospital were selected as the research objects.Through statistical description and analysis,the changes of their educational background,professional title and job category were studied.Results Among the discharged personnel,nurses were the main component,followed by doctors.The number of people with bachelor's degree and below,jun-ior professional title and no professional title accounted for more than 50%of the annual departures;Among those who resigned voluntarily,the number of those who had worked for less than 2 years increased year by year and exceeded 30%.Conclusion Hospitals need to pay attention to the situation of new employees,improve the incentive mechanism and talent training system,and enhance the sense of belonging and identity of employees as soon as possible;at the same time,attach importance to the de-velopment of employees after retirement,and improve the retirement and reemployment system to achieve the inheritance of"pass-ing on help and helping".
Objective To evaluate the effects of simulation training based on the concept of experiential education on im-proving first aid skills of medical staff in nursing homes.Methods The assessment data of 120 medical staff participating in first aid simulation training in our nursing home from January 2020 to June 2023 were retrospectively analyzed.Using a self-controlled design,the changes in skills operation,reaction time,team cooperation,etc.were statistically analyzed.Results All indicators were significantly improved after training.The skill operation score increased by 12.4 points(P＜0.05),the average reaction time decreased by 5.2 seconds(P＜0.05),and the team cooperation score increased by 13.8 points(P＜0.05)compared with before training.Conclusion Simulation training based on the experiential education model can effectively improve the first aid skills and cooperation ability of medical staff,which is an important means to continuously improve the emergency response capac-ity in nursing homes.
Objective To explore the application effect of quality control circle in the quality management improvement of the occupational disease diagnostic and code.Methods To established across departmental team of medical record QCC,we Select 132 cases of the occupational disease departmentin specialized Hospital from May 1,2022 to June31,2022,Analyze the reasons of inaccurate that main diagnosisselection and code mapping.After formulating a series of improvement measures,we Se-lect 71 cases of occupational disease department from November 1,2022 to December 31,2022.To compared effect that before and after the implementation of QCC.Results After6 months of improvement,The utilization rate of main diagnosis mapping Z-code was decreased from 36.3%to 12.7%,goal achievement rate of 106.3%,improvement rate of 65.0%.Enrollment rate of major diagnostic was increased from 53.0%to 86.3%,goal achievement rate of 116.4%,Improvement rate of 62.8%.Conclu-sion We have changed the quality control management mode of diagnosis and coding by the QCC,implement targeted feedback,supervision,and training,establish a reward and punishment mechanism that matches indicators to improved accuracy of enroll-ment.Upgrading the quality management level of medical records and medical safety at the same time.Should continue to pro-mote theimplementation.
High-quality hospital development calls for high-quality hospital culture.Hospital culture is the core of hospi-tal management,which deeply affects the development direction and operation mode of the hospital,throughout the whole process of high-quality development of the hospital,but also an indispensable component of social culture.This paper discusses and con-siders the definition and value of hospital culture,the dilemma of the ideological level and management level of hospital culture construction,and countermeasures,which provides a reference for hospital management and promotes the high-quality develop-ment of hospitals.
It is essential that public hospitals,as the main body of China's health care service system,must uphold the overall leadership of the Communist Party of China(CPC)to achieve high-quality development in the new era,which requires the deep integration of Party building and hospital operation.Since the CPC's 18th National Congress,public hospitals have actively strengthenedprimary-level Party building by consolidating the foundation,which has largely contributed to advancing the Healthy China Initiative and optimizing the allocation of medical resources.However,there remain some problems in the integration of Party building and hospital operation,such as insufficient understanding of the integration and simple methods to achieve it,lead-ing to inadequate integration in some hospitals.By analyzing of the causes of above problems,based on Sun Yat-sen Memorial Hospital,Sun Yat-sen University's practices in Party building,the author actively explores the effective path of deep integration of party building and business work in public hospitals from the aspects of promoting party building and theoretical learning,sys-tem design,team building and business characteristics.In order to provide useful references for public hospitals to achieve high-quality development in the new era.
On the background of high-quality development of public hospitals,the prevention and control of infectious diseases and various public health emergencies have become normal,which puts higher requirements on the emergency handling and management capacity of public hospitals.Large Grade three A hospitals should establish and improve the emergency com-mand system,improve the emergency plan system,strengthen training and drills,and improve the ability to deal with various public health emergencies and disasters,so as to protect people's health.This paper expounds the specific practice process,a-chievements and thinking of the special work of improving hospital emergency ability,summarizes and puts forward the methods of improving hospital emergency ability,in order to provide reference for emergency management of other hospitals.
目的 利用STEP函数构建钙通路基因的风险评分模型用于分析结肠癌患者的预后和免疫状况,为进一步研究这些基因在结肠癌的诊断和治疗机制中的作用提供了临床基础.方法 从癌症基因组图谱项目(the cancer ge-nome atlas,TCGA)数据库中获取结肠癌患者的基因表达数据和临床信息,并鉴定差异表达的钙信号通路基因.STEP函数构建基于钙信号通路基因的结肠癌风险预后模型,并在基因表达综合数据库(gene expression omnibus,GEO)中的结肠癌患者队列中进行模型效能验证.Kaplan-Meier曲线和受试者操作特征(receiver operating characteristic,ROC)曲线用于分析评估模型的预测准确性.多因素回归分析独立危险因素,构建结肠癌患者生存列线图模型.TIMER和CIBERSOFT算法用于探究风险评分与免疫细胞浸润情况之间的相关性.结果 共有 50 个钙信号通路基因在结肠癌组织和癌旁组织中的表达具有显著差异.其中,STEP函数筛选并构建了9 个钙通路基因相关的风险评分预后模型.在TCGA和GEO结肠癌患者队列中,高危险组的总生存率显著低于低危险组.ROC分析结果显示TCGA训练队列的 3 年预测曲线下面积(area under curve,AUC)值大于0.7,而GEO验证队列的 1 年、3 年和5 年预测AUC值均大于0.8,表明该模型具有较高的预测精度.此外,基于钙信号通路基因和临床特征构建的临床列线图的C-指数为 0.723,显示出潜在的临床预测价值.免疫细胞相关性分析显示,钙信号通路基因与多种免疫细胞呈密切相关性.结论 构建基于钙通路基因的结肠癌风险预后模型,该模型具有预测患者预后和免疫状态的潜力.
Objective To comprehend the trends and fundamental characteristics of medical damage disputes in Guan-gxi,and to offer insightful advice on how to improve patient-physician communication and lower the likelihood of medical dis-putes.Methods The China Judgements Online was searched for a total of 549 civil judgments on medical damage disputes in Guangxi from 2017 to 2021,and the sample sizes were subsequently analyzed by descriptive statistics in four dimensions:distri-bution of precedents,identification,division of liability,and amount of compensation.Results In terms of distribution charac-teristics,the types of medical institutions where disputes occurred were mainly general hospitals above the second level,with ob-stetrics and gynaecology,emergency medicine and orthopaedics being the departments with a high incidence of disputes;in terms of identification,medical fault judicial appraisal was mostly used for identification,and the court's acceptance of the identifica-tion results reached 93.3%,with the average length of the case hearing being about 11.8 months;in terms of the division of re-sponsibility,medical institutions took secondary responsibility From the analysis of liability,medical institutions were mostly re-sponsible for secondary liability,accounting for 37.5%;from the analysis of the amount of compensation,the average amount of compensation has been increasing year by year.Conclusion Medical institutions need to lessen the frequency of litigation cases and lessen litigation compensation since the connection between doctors and patients remains strained.To reduce medical disputes and litigation,they should improve medical risk identification,improve medical safety management,direct people's mediation,investigate medical risk sharing mechanisms,enhance the independence and professionalism of judicial appraisal,standardize the notification of autopsies,and employ expert support personnel.
Objective This study conducted the ARIMA model to analyze the cost structure and trend of inpatients with diabetes in a grade-A tertiary hospital and provide scientific basis for effectively controlling diabetes hospitalization expenses and reduce patient's economic burden.Methods The data of 18 371 inpatients with diabetes from 2012 to 2022 in a grade-A tertiary hospital were collected.We collected inpatient data of diabetes from 2012 to 2021 to fit the average inpatient expenses and drug proportion,and used data 2022 to verify the effect of model prediction.We predicted the average inpatient expenses and drug proportion from 2023 to 2025.Results The difference between the predicted value and the actual value was small,and the mean absolute percentage error was within the acceptable range.ARIAM model could be used to predict the expenses of diabetes.Conclusion The average cost of hospitalization showed a decreasing trend,and"the five colors,one map,one index"manage-ment model has achieved results.The proportion of drugs decreased obviously,but the composition of hospitalization expenses should be further optimized.The research of expenses prediction based on diabetes needs to be depended.
Objective To investigate the feasibility and clinical value of using acicular electrosurgical knife for coniza-tion of cervix in the diagnosis and treatment of cervical intraepithelial neoplasia(CIN).Methods A retrospective analysis was conducted on the surgical data,pathological findings,and pregnancy-related complications of 60 patients who underwent acicular electrosurgical knife conization(AEKC)from January 2016 to December 2019.Results The operation time ranged from 10 to 140 minutes(median,26 minutes),and the amount of bleeding during surgery was minimal to 100 mL(median,10 mL).The cone cutting width is between 1-3 cm,the cone cutting depth is between 0.5-2.5 cm.No hemorrhoeaoccur within 14 days after surgery.The pathological concordance rate before and after surgery was 68.3%,the margins were clear and negative,and the ex-cision rate was 100%.The incidence of cervical incompetency,preterm birth and premature rupture of membranes during preg-nancy after AEKC was 3.3%,18.6%and 23.7%respectively.Conclusion By selecting acicular electrosurgical knife,suffi-cient excision and intraoperative hemostasis were ensured during conization.At the same time,it does not affect the pathological diagnosis of margin.Moreover,it has a low incidence of pregnancy-related complications such as cervical incompetency,preterm birth and premature rupture of membranes.
In the new situation,it puts forward the requirements for the construction of public hospitals'style,such as constructing the organizational system,leading the party building,maintaining the anti-corruption high pressure,improving the working system,strengthening the education of style,and cultivating the all-round supervision system.However,at this stage,there are still problems in the construction of public hospitals,such as imperfect institutions,insufficient play of the leading role of party building,inadequate understanding of medical personnel,low participation,lack of education in the style of work,low standardization,and insufficient use of information technology.By constructing and improving the organizational system and work-ing mechanism,tying the system cage,carrying out special work,strengthening the education of the profession,advanced demon-stration and guidance,strengthening social supervision,strict assessment,and fully operating information means,we can continu-ously improve the awareness of clean practice of medical personnel,improve the level of medical services,and improve the satis-faction of the people with medical treatment.
Objective To understand the utilization and satisfaction of Internet hospitals among residents in Guangdong Province,and to provide suggestions.Methods A questionnaire survey was conducted to analyze the use of Internet hospitals and the satisfaction among 601 residents in Guangdong Province.Results 69.88%of residents have used Internet hospitals,54.41%of residents used the Internet hospitals founded by large medical institutions,77.70%of residents used online registra-tion or payment services provided by Internet hospitals,and 60.23%of residents have used online consultation services,and 54.91%ofresidents have used information services about hospitals,doctors,and disease.In terms of detailed services,there was a low utilization rate of return visit and drug support of chronic diseases together with telemedicine,and no more than 20.00%of residents used the three services.75.20%of residents were very satisfied and relatively satisfied with Internet hospi-tals and their services,while residents were mainly dissatisfied with return visit and drug support of chronic diseases as well as telemedicine.Conclusion The utilization rate of Internet hospitals among residents was high,and their awareness and satisfac-tion were also high.However,there was still a problem of 15.31%ofresidents who didn't have used Internet hospitals.It is necessary to further strengthen the propaganda and improve the areas of dissatisfaction.Emphasis should be placed on return visit and drug support among patients with chronic diseases,and telemedicine to improve residents'satisfaction and utilization.
