ObjectiveTo investigate the prevalence rate of nosocomial infection in West China Hospital of Sichuan University and to analyze the implementation effect of nosocomial infection control measures, so as to provide reference for infection control.MethodsAn investigation of the prevalence rate of nosocomial infections was performed on patients who were admitted in West China Hospital of Sichuan University from 0:00-24:00 on a day of every late June from 2012 to 2018 by using bedside investigation in combination with inpatient medical record query, and the data was verified, summarized, and statistically analyzed by the professionals of Nosocomial Infection Management Department.ResultsFrom 2012 to 2018, the prevalence rates of nosocomial infections were 5.19%, 4.20%, 3.94%, 4.26%, 4.29%, 4.25%, and 2.97% in West China Hospital of Sichuan University, which tended to decline (χ2=32.826, P<0.001). There was no significant difference in annual total infection rate in the Department of Internal Medicine, however, the infection rate in the Department of Hematology tended to decline (χ2=6.127, P<0.05); in the Department of Surgical Medicine, the total infection rate tended to decline(χ2=18.721, P<0.001); in particular, the infection rate in the Department of Thoracic Surgery tended to decline(χ2=3.906, P<0.05); the annual difference in infection rate in the Intensive Care Unit (ICU) was not statistically significant. The key site of nosocomial infection was dominated by the lower respiratory tract, and the annual difference was not statistically significant. In particular, postoperative pneumonia has increased since 2014 (χ2=9.56, P=0.002). The nosocomial pathogens which had the highest constituent ratio over the years were Acinetobacter baumannii (in 2012, 2013, 2014, 2017, and 2018), Klebsiella pneumonia (in 2015), and Escherichia coli (in 2016). The annual difference in rate of antimicrobial use was not statistically significant(χ2=3.75, P=0.053), while the rate of antimicrobial use in the ICU tended to decline (χ2=30.42, P=0.000).ConclusionsThe prevalence rate of nosocomial infection in West China Hospital of Sichuan University tends to decline. However, sufficient attention still requires to be paid to lower respiratory tract infection, particularly for patients with postoperative pneumonia.
Objective To evaluate the quality of undergraduate medical education so as to provide useful and effective feedback information for medical schools and to extend GMER (Global Minimum Essential Requirements in Medical Education) standard. Methods Through questionnaires, 205 resident doctors self-evaluated their abilities or qualities based on GMER standard. The unconditioned logistic regression model was used for data analysis. Results Graduates from undergraduate medical programs mastered the abilities or qualities required in 4 GMER domains i.e. “professional values, attitudes, behaviors and ethics”, “clinical skills”, “communication skills”, and “scientific foundation of medicine”. But the abilities or qualities required in “information management”, “population health and health systems” as well as “critical thinking and research” domains have not been obtained. The main factors that affected the evaluation results were corresponding training to the essentials, learner’s attitude, teaching models and teaching hours. Conclusion Educational sectors should adjust curriculum design so as to help medical students master the abilities required in the 3 domains stated above. Medical schools should conduct some educational research to formulate the most beneficial teaching methods, and import advanced ones to raise the quality of medical education in China.
Objective To learn about the evaluation of the practical value of resident doctors towards the Global Minimum Essential Requirements in Medical Education (GMER), so as to provide effective information for the usage of GMER in China. Methods Two hundred and five resident doctors of West China Hospital of Sichuan University were investigated by the use of questionnaires. Results The evaluation of the practical value towards the 7 domains of GMER was high, but the “population health and health systems” domain gains the lowest scores. Conclusion The society might ask doctors to use the abilities required by GMER, especially the requirements in the "population health and health systems" domain. It is suggested that the doctors’ performance evaluation system be adjusted by adding the weight to the lower score domains, and the medical students be trained to be equipped with both macro and micro thinking abilities in medical school, so as to cultivate doctors with the "core competence" of GMER.
Objective To learn about the attitudes and understanding of resident doctors with concerning Global Minimum Essential Requirements in Medical Education (GMER).Methods Two hundred and five resident doctors of West China Hospital of Sichuan University were investigated by using questionnaires. Results The majority of the resident doctors regarded 4 domains of GMER important, but they were lack of the recognition of the importance of “population health and health systems”, “communication skills”, and “management of information” domains. Conclusions Medical curriculum should be revised to strengthen the recognition of the importance of all the 7 domains in medical education, including the postgraduate medical education, so as to cultivate doctors’ suitability for their responsibility in healthcare.
Objective To understand the demands of residents in postgraduate medical education for faculty doctors and provide useful information to teaching hospitals. Methods Two hundred residents were interviewed through questionnaires. Results Demands for faulty doctors were consistent in the following 5 fields: faculty’s synthetic diathesis, adaptability to social and medical changes, information management and research, cooperation and teamwork, and innovation and continuous self-improvement (Pgt;0.05). However, with regard to the faculty doctors’ professionalism, teaching models and atmosphere, the demands of residents in the different stages of postgraduate medical education differed significantly (Plt;0.05). Conclusion Teaching hospitals continuously improve faculty doctors’ abilities and pay much attention to residents’ role transformation.
ObjectiveUnder the background of standardized training for general practitioners (including professional master’s degree in general practice), this study aimed to explore a feasible scheme for establishing an evaluation and assessment system for entrustable professional activities (EPAs) for general residency training based on the current application status and objective demands of EPAs by clinical teaching physicians. MethodsA questionnaire survey was conducted among 158 clinical teaching physicians to analyze the current evaluation system for standardized training of general practitioners, as well as their understanding and suggestions on EPAs. ResultsCompared with the emphasis on medical knowledge and skills, the humanistic care, represented by medical ethics education, is found to be insufficient in the standardized training of general practitioners. Regarding actual demands, the order of importance of EPAs by teaching physicians is as follows: standardization (93.04%), objectification (93.04%), multidimensionality (92.41%), lightness (90.51%), and diversity (86.04%). ConclusionIt is suggested that an EPA system for professional confidence based on the actual demands of standardized training for general practitioners in China should be designed to address the shortcomings in humanistic education. This system will improve the teaching competence of faculty and guarantee the output of general medical education.
During the medical rescue after the Wenchuan earthquake, in order to prevent hospital environmental pollution and cross infection, the nosocomial infection control committee of West China Hospital of Sichuan University immediately initiated the emergency response plan, improved the triage system, and organized multi-disciplinary infection control groups to improve the triage of the wounded and the infection control of the emergency department. At the same time, we regulated the individual behavior of healthcare professionals and took appropriate measures for personnel protection so as to ensure the safety of both the wounded and healthcare professionals.
Objective To survey the current situation of the sharp injury in medical workers, and to provide scientific evidence for the prevention and protection of sharp injury. Methods Through applying the questionnaire of sharp injuries designed by Zhongshan Hospital, Shanghai Fudan University, 10% of the workers in all departments of West China Hospital of Sichuan University were selected as respondents according to their job categories. The main contents of the survey included the general information of respondents, reporting after sharp injuries, training participation, and the exposure sources, operations, premises and equipments related to sharp injuries over the past one year.Results Of 840 questionnaires distributed, 100% were valid. The ratio of male was 23% while the female was 72%. There were 50.20% of all respondents who once got injured, and 75% of the respondents having the history of sharp injury worked less than 10 years. The nurses, house keepers and physicians were in the top three positions of suffering from sharp injury; and the operating room was ranked as the highest risk department for sharp injuries. The known haematogenous exposure sources were 69 cases of hepatitis B, 19 syphilis, 6 hepatitis C, and 3 HIV. There were 62% of the respondents who had ever attended related training, and only 11.61% of the injured respondents reported their sharp injuries. Conclusion The incidence rate of the sharp injury is high, but the report rate is low. The operating room is the high risk department, and nurses, house keepers, and physicians are the high risk population for sharp injuries. The prevention and protection and training for sharp injury in target departments and population should be strengthened.
Shortly after Wenchuan earthquake, the department of nosocomial infection control initiated the emergency response plan immediately. Based on the conditions of the wounded delivered to the hospital, especial infection control plans were designed to prevent hospital acquired infections of multi-drug resistant bacteria and infectious disease spread in hospital. The infection control persons inspected the health care workers carried out the plans every day. Through enforced the rules of standard precautions, contact precautions and disinfection methods thoroughly, an effective and efficient medical rescue service has been offered to the wounded.
Objective To find effective ways for controlling the hospital infection to the skeptical gas gangrene patients. Method From May 14th to June 24th, the hospital set up triage spots originally and dealt with the wounded based on their specific conditions in different stages and optimized the flow of admission of the wounded. Owing to correctly treating the wound and screening the skeptical gas gangrene patients, preventing nosocomial infections was shifted forward. Sprending the gas gangrene wound after having flushed it with 3% H2O2. If the wound have been stitched, the stitches should bee taken out, and open the wound and take the debridement for it completely, then treat it with b antibacterial after debridement by sterilization and isolation about operation of gas gangrene. Result Up to June 24th, none of 67 cases of doubtful gas gangrene from the disaster area died and no hospital cross infections happened in courtyard. At present, amomg the 67 cases, 32 were highly suspected of gas gangrene infection, 26 cases were discharged, while 6 cases were undergoing treatment in the hospital. Conclusion Correct management and appropriate treatment are effective ways for controlling hospital cross infection to the skeptical gas gangrene patients.