OBJECTIVE: To set up some objective and accurate criteria to evaluate wound healing. METHODS: Documents about wound healing were reviewed and summarized in detail. RESULTS: Wound healing rate, wound healing time, histopathology analysis, quantity assay of macrophage, determination of hydroxyproline, proliferation of cell, assay of DNA contents and circle of cells, level of transforming growth factor-alpha, levels of interleukin-1, interleukin-6 and tumor necrosis factor, assay of keratinocyte collagenase-1, level of fibroblast growth factor receptor-1, level of monocyte chemoattractant protein-1 and level of keratinocyte plasminogen activator inhabitor type 2 were selected as the evaluation criteria of wound healing. CONCLUSION: Wound healing rate, wound healing time and histopathology analysis are direct and efficient criteria of wound healing.
ObjectiveTo observe the effect of silver dressings on treating diabetic foot ulcer infection. MethodsA total of 105 patients with diabetic foot ulcers treated from May 2012 to April 2014 were randomly divided into two groups:group A and B. Patients in group A were treated with imported silver ion alginate dressing, while group B was treated with domestic nanometer silver dressing. All patients were given basic treatment, and the effect of silver dressing was evaluated by observing bacterial clearance rate and wound healing score. ResultsThere were significant improvement in bacterial clearance rate and wound healing score in both two groups after treatment. The bacterial clearance rate was similar between the two groups (P>0.05). However, the descending trend of wound healing score in group A was significantly more obvious than group B (P<0.01). ConclusionBoth two silver dressings are effective in the treatment of diabetic foot ulcer infection, but the effectiveness of silver ion alginate dressing is superior. Bacterial clearance rate and wound healing score are objective and applicable index to evaluate the treatment effects of silver dressing.
ObjectiveTo set up the evaluation form for classroom teaching quality in nursing humanities concern education, in order to conduct the evaluation on nursing teachers in their teaching of humanistic concern in their nursing class teaching. MethodsWe applied the Delphi approach to consult 16 nursing experts to screen the evaluation indicators combining with the method of dispersion degree. Analytic hierarchy process was carried out to determine the indicator weight to establish the evaluation form. Then we used the form to investigate a small sample of 37 nursing teachers. According to the test results, we checked the reliability and validity of the evaluation form. ResultsThe evaluation form was finally determined. It consisted of five level-1 indicators as well as 23 level-2 indicators. The results of Cranach's α showed that the internal consistency reliability and sensitivity of the evaluation form were very high. The results of Spearman correlation analysis showed that the construction of the evaluation form was quite reasonable. The results of factor analysis showed that the discriminant validity of the evaluation form was quite good. ConclusionThe evaluation form is true, credible and reasonably built. It may be used for self-assessment by the teachers, mutual evaluation as well as evaluation of teachers by leaders or experts for the assessment of humanistic teaching in nursing classes.
In order to evaluate the ability of human standing balance scientifically, we in this study proposed a new evaluation method based on the chaos nonlinear analysis theory. In this method, a sinusoidal acceleration stimulus in forward/backward direction was forced under the subjects' feet, which was supplied by a motion platform. In addition, three acceleration sensors, which were fixed to the shoulder, hip and knee of each subject, were applied to capture the balance adjustment dynamic data. Through reconstructing the system phase space, we calculated the largest Lyapunov exponent (LLE) of the dynamic data of subjects' different segments, then used the sum of the squares of the difference between each LLE (SSDLLE) as the balance capabilities evaluation index. Finally, 20 subjects' indexes were calculated, and compared with evaluation results of existing methods. The results showed that the SSDLLE were more in line with the subjects' performance during the experiment, and it could measure the body's balance ability to some extent. Moreover, the results also illustrated that balance level was determined by the coordinate ability of various joints, and there might be more balance control strategy in the process of maintaining balance.
ObjectiveNew Rural Cooperative Medical Systems (NCMS) has been constructed as a financial protection for rural population commencing 2003. With the development of NCMS, there were quite a few management models existing across the nation. In order to assess the management alternatives, we try to explore how to set up a set of indicators to analysis management effect of different management models. MethodsBy literature review, we sorted all qualitative indicators into 8 types. Delphi and Multi-Attribute utility theories were applied to construct the appraisal indicators, including shaping first and second level indicators and assigning the weights for each type of indicators. ResultsWe managed to identify the indicator system which was comprised of 4 types of first level indicators, aiming at claim, manament process, transparency and supervision on accredited hospitals. Besides, there were 9 sub-indicators. ConclusionThe evaluation indicators are constructed for future assessment on management effect of rural health insurance.
Objective To analyze the progress of evaluation indexes for enhanced recovery after surgery (ERAS) model at home and abroad, and to propose suggestions for constructing systematic evaluation model of ERAS. Methods Atfirst checked the Chinese and English databases, including Medline, Embase, Sciencedirect, ACP Journal Club, BioMed Central, the Cochrane Central Register of Controlled Trials (CENTRAL), Science Citation Index Expanded, Cochrane Library, NHS Economic Evaluation Database, CNKI, VIP, and Wanfang databases (retrieval time was from January 1997 to December 2017), and then filtered the literatures, excluded duplicate documents, a total of 1 020 English literatures and 786 Chinese literatures were enrolled eventually to make an review. Results The literatures showed that, at present, there was no comprehensive and systematic evaluation index system about ERAS at home and abroad. The existing evaluation indexes mainly included the following deficiencies: localization and fragmentation of evaluation indicators, lack of evaluation indicators of ERAS organizational framework and process management, as well as lack of standardized operational definition of evaluation indicators. Conclusions The evaluation indexes of ERAS at home and abroad do not constitute a systematic evaluation index system according to scientific principles, which will restrict the standardization of accelerated surgical rehabilitation in our country. To establish a multidimensional and comprehensive quality evaluation index system based on multi-evaluation of hospital, patient, social, and medical management institutions, which covers ERAS organizational structure, process management, and clinical outcomes, is a necessary condition for the development of ERAS model.
Under the background of promoting day surgery nationwide and ensure the medical quality, fine management is crucial and in trend. As one of the earliest central health organizations that started day surgery service in China, West China Hospital of Sichuan University has conducted approximate 140 000 day surgery cases in the past nearly 10 years. Based on the experience of practice, West China Hospital of Sichuan University has summarized 26 clinical indicators from 5 aspects to evaluate and monitor the economic efficacy and medical quality and safety of day surgery, including the input and output, the efficiency, the patient experience, the medical quality and safety, and the difficulty evaluation of surgery. The aim is to explore and establish an appraisal and monitoring system for day surgery, promote the stable development of day surgery, improve the work efficiency, and take the government plan of implementation day surgery to improve medical services into action.
ObjectiveTo summarize the evaluation indexes of health resource utilization efficiency in enhanced recovery after surgery (ERAS) , so as to provide reference for the construction of evaluation index system.MethodLiteratures on the allocation, utilization, and efficiency of ERAS health resources at home and abroad in recent years were reviewed and analyzed.ResultsAt present, no systematic evaluation index system of ERAS health resources utilization efficiency had been formed at home and abroad. In the research, the formulation direction of input index mainly included ERAS human resources allocation and material resources allocation, while the formulation direction of output index mainly included ERAS medical resources utilization.ConclusionsThe evaluation system of ERAS health resources utilization efficiency is not perfect and the research scope of its index system is too small, which restricts the standardization promotion of ERAS. It is an urgent problem to construct a scientific evaluation index system for ERAS health resources utilization efficiency.
Since 2015, when the day surgery mode was officially reckoned and supported by the National Health Commission, the day surgery model has entered the new period of rapid development. But at the same time, challenges in the vacancy of the evaluation indexes of the medical quality and safety of day surgery still pose obstacles to its growth. At present, there is no nationally unified evaluating index or appraising system for the day surgery-related medical quality and safety. In this paper, based on structure-process-outcome theory, the day surgery practice and involved researching literature were retrieved, reviewed, and analyzed. Also, the practice model at West China Hospital of Sichuan University (a pioneer day surgery hospital in China) was comprehensively compared with the National Clinical Improvement System. From the aspect of day surgery medical quality and safety evaluation indicators, it is hoped to provide an evidence-based method and evaluation of day surgery, and a theoretical basis for establishing policies and data reference.