Objective To explore the effects of the centralized management of bed use in a large-scale integrated hospital. Methods We selected the staff with good quality for centre work after setting up the bed use centralized management centre in the West China Hospital. Then, we formulated unified an admission principle and incorporated it into the systematic management and control, made a short instructional video for rolling show in the centre so as to let the patient know basic conditions of this hospital before admission; and regulated the admission process for patients’ convenience. Results After more than one year, the centre simplified the in-patient admission procedures, regulated the process, saved nursing manpower (24 persons), and increased patients’ satisfaction (from 89.30% to 93.25%). Meanwhile, the bed use rate was increased and the average length of stay was shortened the to some extent, which improved the order in wards. Conclusion Unified bed use management centre established in large-scale integrated hospitals, can save nursing manpower, simplify the admission process of patients, and meet the need for the development of hospitals, which is worthy of promoting application.
目的：为了在门诊“一切以病人为中心”的服务理念中体现人性化护理服务，为病人提供优质护理。方法：通过自行设计的问卷调查门诊病人的需求。针对这些需求及门诊护理工作的特点，提出作为门诊护士长及护士的管理要求。结果：病人需求最高的是高操的医疗技术和早就诊，早明确诊断，尽早治疗的迫切心理，各占95.18%、94.68%；其次是希望能有一简便、快捷、明了的就诊流程占88.59%，再其次为希望得到医护人员关注，对医护人员态度的要求比例也较高各占调查的85.17%和83.36%。结论：通过了解病人的需求，从护理的角度有针对性的实行有序管理，改善就诊流程，简化就诊手续，最终赢得病人的认可，使病人满意度提高至95%以上。
Objective To investigate safety of influenza A H1N1 vaccine vaccinations. Methods A total of 3 300 medical workers were vaccinated by batch of 200909012 influenza A H1N1 vaccine produced by Shanghai Biological Products Corporation Limited according to the principle of voluntary and concentration. The adverse reactions were observed within half an hour, three days and a week after vaccinations, respectively. Results The inoculators with local or systemic reaction reached 1.18% (39/3 300). There were 0.15% (5/3 300) of the inoculators with adverse reaction within half an hour; 0.70% (23/3 300) within 1 to 3 days after vaccination; and 0.33% (11/3 300) within 3 days to 1 week after vaccination. No severe adverse events were found. Conclusion Influenza A H1N1 vaccine vaccinations is an economic and effective way of influenza A H1N1 prevention with mild reactions.
摘要:在汶川地震救援中,华西医院门诊部作为医院的窗口、形象,地震发生当天迅速组织人员,沉着、冷静地疏散门诊附近万名患者及家属,无一例踩伤、摔伤;随着各种渠道转来医院的患者增多,为利于有效的管理与护理人力安排,在保证门诊正常工作开展的前提下,服从医院大局安排,抽调护理人员承担起每日到机场接送患者的任务及急诊注射室的工作,为地震伤员的及时转送与救治、处理作出了应有的贡献。
Objective To optimize the environment of outpatient clinics in large hospitals, facilitate the patients’ visits and improve the comprehensive management level. Methods From September to November 2015, 2 hospitals in each part of a provincial city (middle, east, west, north and south), a total of 10 hospitals were chosed by convenient sampling method. The forms, types and distribution of outpatient navigation service system were investigated and analyzed by using a self-designed questionnaire. Results There were a total of 14 forms of counseling-guide services in the 10 hospitals. Just 1 hospital provided all the 14 forms of counseling-guide services, and 2 hospitals provided 13 forms of counseling-guide services, which were relatively complete. While the other 7 large hospitals provided only 4 to 6 forms of counseling-guide services, which were relatively simple. Conclusion Qualified outpatient navigation service system can help patients to receive more effective treatment, optimize the environment, highlighting the modern hospital humanistic service and the concept of intelligent service and scientific management.
Diabetic foot is one of the most common complications of diabetes. The incidence of diabetic foot is high and its treatment is difficult. The cost of treating this disease is huge, which brings a huge burden to patients, families, and society. According to the development process of diabetic foot, this article reviews the rehabilitation nursing of diabetic foot from the perspective of rehabilitation nursing problems, intervention measures, and intervention modes. The rehabilitation nursing problems are summarized as body functions, body structures, activities, and participation; the intervention measures involve rehabilitation education, skin nursing, exercise therapy, mental nursing, hyperbaric oxygen therapy, platelet-rich plasma therapy, and rehabilitation aids; the intervention modes include preventive rehabilitation nursing, in-hospital rehabilitation nursing, community and family rehabilitation nursing, and palliative nursing.
With the increasing demand for medical and health services in China, Internet hospitals have emerged, which can provide the public with diversified health services from multiple levels and dimensions. Based on the Internet hospital policies issued, this article sorts out and summarizes the information of Internet hospitals publicly reported in China, compares and analyzes the classification characteristics and similarities and differences of the two major service models of Internet hospitals, which are the second-named entity medical institutions, and Internet hospitals independently established by medical institutions, puts forward suggestions on how to improve the service model of Internet hospitals, and reveals the challenges faced by Internet hospitals. It aims to provide a reference for the promotion and development of Internet hospitals in China in the future.
Objective To investigate the awareness of diabetes complications in outpatients with diabetes. Methods A total of 300 cases of diabetic were collected from Department of Endocrinology between September 1st and October 10th, 2016. The awareness of diabetes complications in patients with diabetes was investigated by a self-made questionnaire, and the influencing factors on the awareness rate of diabetes complications were analyzed. Results The awareness rates of acute and chronic complications were all low. The awareness rate of hypoglycemia was the highest (59.0%) and the chronic pyelonephritis was the lowest (22.0%). In addition, the difference in awareness rate between different sexes was not significant (P>0.05). Educational extent had significant influence on the awareness rate of chronic pyelonephritis, retinopathy, glaucoma, myopia or hyperopia, iridocliory lesions, polyneuropathy, oculomotor and abducens nerve paralysis, vegetative nerve lesion, skin, muscle, and joints lesions, and infection complications (P<0.05). Occupation had significant influence on the awareness rate of ketoacidosis, diabetic hyperosmolar coma, hypoglycemia, diabetic cardiopathy, iridocliory lesions, polyneuropathy, oculomotor and abducens nerve paralysis, vegetative nerve lesion, skin, muscle, and joints lesions, and infection complications (P<0.05). Conclusions The awareness of diabetes complications in outpatients with diabetes is low. It is needed to strengthen the health education of diabetes complications and improve the awareness rate of complications.
ObjectiveTo explore whether education and management of medical care integration can improve asthma control. MethodsA prospective, 12-month, cohort study was undertaken in a real-world setting based on Australasian severe asthma network (ASAN). A total of 516 patients with stable asthma were consecutively recruited, who received education and management of medical care integration, and step-wise anti-asthma regimens determined by physicians’ standard practice. Furthermore, inhaled corticosteroid (ICS) adherence, lung function, asthma symptom control and exacerbation were assessed at 1, 3, 6, and 12 months. ResultsAt the end of 12 months, ICS adherence (47.7% vs. 81.5%, P<0.05), lung function, and asthma symptoms were assessed by asthma control text (ACT) [20 (16, 23) vs. 23 (21, 24), P<0.05], which were significantly improved in comparison to the status at baseline, and 86.0% of patients achieved total/well-controlled level of asthma. The exacerbation (14.2% vs. 36.2%, P<0.01) and hospitalizations (8.5% vs. 15.3%, P<0.01) because of asthma for the following year significantly decreased compared with those in the past year. The multivariate regression analysis indicated that poor ICS adherence (RR=1.52, 95%CI 1.02 to 2.25, P=0.039), depression symptoms (RR=1.19, 95%CI 1.05 to 1.34, P=0.007), and exacerbation during the past year (RR=2.81, 95%CI 1.49 to 5.27, P=0.001) were associated with an increased risk of future exacerbation. ConclusionIn a real-world setting, most of asthmatics achieve total/well-controlled asthma by education and management of medical care integration including shared decision-making between physicians and patients and step-wise anti-asthma regimens. ICS adherence and depression symptoms independently predict asthma exacerbations, and strengthening education and management of medical care integration, esp. psychological nursing, would improve asthma control levels.
Multi-disciplinary team (MDT) is a leading diagnosis and treatment model widely respected in modern international medical field, which plays an important role in clarifying disease diagnosis, determining treatment direction, and reducing patient time and labor cost. In recent years, China has issued relevant policies to encourage hospitals to vigorously develop MDT. West China Hospital of Sichuan University established a MDT clinic in 2013. Through continuous innovation and bold breakthrough in terms of experience accumulation, clinical resource integration, disciplinary collaboration and other aspects, the hospital breaks the barriers of MDT, timely helps complex severe diseases patients to solve the diagnosis and treatment needs, provides patients with the best personalized treatment plan, and continuously improves the medical experience of patients. Therefore, this article introduces and summarizes the implementation process and experience of MDT outpatient clinic in West China Hospital of Sichuan University.