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The top-level design and training system of standardized training for residents has been basically completed in China, and now is gradually transiting to connotation construction and quality improvement, with the emphasis on post competency and quality as the core. There are discrepancies in clinical ability among general practice residents of different categories, so the step-up training mode should be adapted for set up and implement of phased training objectives to achieve the overall goal of training qualified general practitioners. The step-up training based on the framework of entrustable professional activities(EPAs)can quantitatively and qualitatively evaluate the competency of general practice residents and continuously track it, so that to ensure the competency of residents. This study has developed assessment item pools of EPAs-based step-up training for general practice residents through literature review and focus group discussion, and proposed implementation plans, and explored the application of EPAs in the step-up training of general practice residents.
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Objective To compare the interventional operation room air disinfection effect of circulatingair disinfection method by an ultraviolet air disinfector with that of air-purifying screen disinfection method in order to provide scientific basis for formulating optimal measures to control hospital infection.Methods By using plate natural sedimentation method,air sampling was conducted at different period of time after the start of air disinfection in operation room.The air sterilization results of the two disinfection methods for the operation room where several consecutive interventional procedures had been performed were compared.Results Both disinfection methods had better preoperative air disinfection effect (P＞0.05).When ultraviolet disinfection method was used,the differences in colony detection results among the air samples that were collected at different time periods were statistically significant (P＞0.01).With the increasing of time after the start of air disinfection,the number of bacterial colonies was increased.If air-purifying screen disinfection method was employed,the air in the operation could be continuously and dynamically purified,the number of bacterial colonies determined in the whole course of operation met the national hygienic standard for air disinfection.Conclusion Continuous air purification by using air-purifying screen disinfection method can shorten the interval between consecutive surgeries,meanwhile,the operation room can be kept in a condition for any emergency surgery at anytime,besides,nosocomialtion can be effectively prevented.
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Objective To investigate the health care workers'(HCWs) knowledge and attitude towards perioperative warming as well as patients' warming status, provide reference for warming in perioperative period and reduce surgical site infection(SSI).Methods Convenience sampling was used to select 198 HCWs in surgical department and operating room as well as 160 patients undergoing operation.HCWs were investigated by referring foreign literatures and designing questionnaires, on-site observation method was used to collect information about warming measures implemented for surgical patients.Results The median (quartile range) of scores of HCWs' knowledge and attitude towards patients' perioperative warming were 9 (2.25) and 25 (1.25) respectively.There was no statistical significance in scores of knowledge and attitude among HCWs with different age, education degree and occupation(all P>0.05).The awareness rates of hypothermia, active warming, and passive warming modes were 21.21%, 43.94%, and 30.81% respectively.80.30%, 89.90%, and 86.36% of HCWs thought that it was essential to keep warming before, during and after surgery.68.13% of surgical patients were warmed by covering cotton quilt and shoulder pad during operation.Conclusion HCWs hold positive attitude towards perioperative warming, but they lack sufficient knowledge about perioperative warming, it is necessary to improve facilities of perioperative warming.
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Objective To understand characteristics and research status of literatures related to surgical site infec-tion(SSI)in China.Methods Literatures about SSI published between January 2000 and March 2016 were retrieved from China National Knowledge Infrastructure(CNKI),VIP database,Vanfang Database,and China Biology Medi-cine(CBM)database. Bibliometric method was adopted to analyze external and internal characteristics of literatures. Results A total of 1036 articles in Chinese were included,40(3.86% ),189(18.24% ),and 807(77.90% )were published in 2000-2005,2006-2010,and the first quarter of 2011-2016 respectively. Articles were mainly pub-lishedinChineseJournalofNosocomiology(n= 226,21.81% ),ChineseJournalofInfectionControl(n= 53, 5.12% ),andChineseJournalofDisinfection(n= 27,2.61% ). The research fields included risk factors(n= 277, 26.74% ),infection rates (n= 261,25.19% ),antimicrobial application (n= 208,20.08% ),and pathogens (n=153,14.77% );the infection rates were higher in general surgery and neurosurgery,the main pathogens were Esch-erichiacoli,Staphylococcusaureus,and Pseudomonasaeruginosa,risk factors mainly included the types of incision, duration of surgery,diabetes,age,and body mass index.Conclusion In recent years,articles about SSI research in-creases significantly,research in etiology and epidemiology has gained substantial achievement,but in the interven-tion and economics is still weak,suggesting that SSI research in economics,risk management,and behavioral aspects should be strengthened.
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Objective To study the effect of evidence-based nursing on improving the nursing requirement of patients with ureter external drainage and inner stent drainage after urological operation. Methods 62 patients in department of urinary surgery from June 2009 to October 2011 were selected as research object,and they were randomly divided into the control group and the observation group with 31 cases in each group,the two groups adopted routine nursing mode and evidence-based nursing mode respectively.Then the nursing requirement and nursing effect before and three and five days after nursing were compared between two groups. Results All the patients existed needs of related knowledge guidance,unhealthy emotion adjustment and social support,and the needs of patients between ureter external drainage and inner stent drainage showed no significant differences,improvement level of each items of the observation group after nursing were all better than those of the control group. Conclusions The patients with ureter external drainage or inner stent drainage have needs of related knowledge guidance,unhealthy emotion adjustment and social support,and the evidence-based nursing mode can effectively improve the patients'demand situations of these items.
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Methylotrophy is a kind of widespread microbe which can use carbon compound as their only carbon and energy sources.It has been reported that methylotrophy can directly use one carbon com-pound to transform into their own metabolic one carbon unit,then these one metabolic one carbon units can be used as energy and carbon skeleton by organisms,which is a main part in one carbon metabolism.Because this is a novel metabolic system,it can be used in the study of biological metabolism and evo-lution.Based on the previous study about Methylobacterium sp.MB200 in our lab,here we summarized the research improvements about methylotrophy from their taxonomy,metabolism,genomics and ap-plications.