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Beijing Union Medical College Hospital applied the standardized management theory, focused on establishing a scientific and standardized system management mechanism, and carried out the exploration of modern hospital management standardization system construction through systematic practice. With the application of the principles of simplification, unification, coordination, optimization and competition of standardization into the construction of modern hospital management system, the basic method for the construction of standardization system was proposed based on standard system management theory. It included the standardization of system architecture, system construction process and system management mechanism. Its purpose was to effectively address the problems of the lack of systematicness, practicality and sustainability in the construction of hospital system. Importantly, the value and vitality of a system depended on its sustainable development. According to the standard system management principle of system effect, structural optimization, orderly development and circular control, the optimization of hospital system could be promoted, which is worth further practice and exploration.
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Peking Union Medical College Hospital, as one of the most stressful medical institutions in China, is facing the problem of emergency department overcrowding. In order to effectively alleviate the emergency overcrowding, improve the medical quality and patients′ medical experience, the hospital firmly grasped the two incremental links of " throughput" and " output" factors, established a multidisciplinary and multi-department cooperation team, constructed a close medical alliance cooperation mode, and innovated and explored a harmonious emergency overcrowding relief mode with the goal of unblocking the " exit" of patients. The practice showed that the comprehensive measures could effectively alleviate the problem of emergency overcrowding, and improve the medical environment and medical quality.
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Objective:To investigate the status of shift nurses′ circadian rhythm, sleep quality and job burnout in 3A-level hospitals, and analyze the influence of circadian rhythm and sleep quality on job burnout, so as to provide theoretical basis for reducing the level of job burnout of shift nurses.Methods:A total of 491 shift nurses were investigated with General Information Questionnaire, Circadian Type Questionnaire(CTI-11), Pittsburgh Sleep Quality Index (PSQI) and Maslach Burnout Inventory General Survey(MBI-GS).Results:The Flexibility or Rigidity score of shift nurses was 10.64±4.14, the Languid or Vigorous score was 17.67±4.80, the PSQI score was 7.47±3.66, the MBI-GS score was 51.14±15.11. The results of multiple regression analysis showed that flexibility or rigidity, languid or vigorous, sleep quality were the influencing factors of emotional exhaustion( t value was 7.415, - 5.281, 7.153, P<0.01); flexibility or rigidity, languid or vigorous, sleep quality were the influencing factors of depersonalization ( t value was 4.828, - 4.079, 4.959, P<0.01); flexibility or rigidity was the influencing factors of professional efficacy( t value was - 3.887, P<0.01). Conclusions:The job burnout of shift nurses in Tianjin 3A-level hospitals were serious. The circadian rhythm and sleep quality are the important factors that affect the job burnout of shift nurses. According to the type of circadian rhythm and sleep quality of nurses, nursing managers can take personalized measures to reduce their level of job burnout.
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Objective To translate Rheumatoid Arthritis Self-efficacy Scale (RASE) into Chinese and to evaluate its reliability and validity. Methods A total of 188 hospitalized patients with rheumatoid arthritis (RA) were selected as research subjects through convenience sampling method. According to the translation mode of the scale, Chinesization and cultural adjustment were conducted to the English version of RASEto test reliability and validity. Results Item analysis showed that the Chinese version of RASE could discriminate the high-score group from the low-score group (P<0.01). Pearson correlation analysis showed that the correlation coefficient between the score of each item and the total score of the Chinese version of RASE was positively correlated (P<0.01).Exploratory factor analysis extracted a total of 8 common factors, which explained 68.55％of the total variance. The Cronbachαof the Chinese version of RASE was 0.901, and Cronbachαof each dimension ranged from 0.660 to 0.867;the retest reliability was 0.955 after 1 week, and ranged from 0.819 to 0.984 for each dimension;the split-half reliability coefficient was 0.848. Conclusion The Chinese version of RASE has good reliability and validity, which can be applied to the research of self-efficacy of patients with RA in China.
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Objective To explore the effect of anxiety, depression, perceived social support on maternal-fetal attachment (MFA) in women during late pregnancy. Method A sample of 207 cases of women during late pregnancy was assessed with Maternal Antenatal Attachment Scale, Perceived Social Support Scale and Hospital Anxiety and Depression Scale. Results Anxiety and depression scores were negatively correlated with MFA scores (r=-0.401,-0.416, P<0.01); perceived social support scores were negatively correlated with anxiety and depression (r=-0.233,-0.362, P<0.01), but positively correlated with MFA scores (r=0.200, P<0.01). The interactive effects of anxiety×perceived social support and depression×perceived social support on MFA were significant(β=0.196、0.204, P<0.01). Conclusion Perceived social support played a moderating role between negative emotion and MFA.
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Objective@#To explore the effect of anxiety, depression, perceived social support on maternal-fetal attachment (MFA) in women during late pregnancy.@*Method@#A sample of 207 cases of women during late pregnancy was assessed with Maternal Antenatal Attachment Scale, Perceived Social Support Scale and Hospital Anxiety and Depression Scale.@*Results@#Anxiety and depression scores were negatively correlated with MFA scores (r=-0.401,-0.416, P<0.01); perceived social support scores were negatively correlated with anxiety and depression (r=-0.233,-0.362, P<0.01), but positively correlated with MFA scores (r=0.200, P<0.01). The interactive effects of anxiety×perceived social support and depression × perceived social support on MFA were significant(β=0.196、0.204, P<0.01).@*Conclusion@#Perceived social support played a moderating role between negative emotion and MFA.
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Objective:To understand the effect and existing problems of teaching reform about primary health care demands in local medical universities and colleges.Methods:With sampling survey method,150 students from Xi'an Medical College were investigated using questionnaires.Results:Totally 93.1％ of the freshmen approved of setting up the courses,72.6％ of the students thought that nursing ethics and skills were equally important,43.2％ of the students thought learning this course made themselves have a new understanding of nursing ethics.Totally 84.2％ of the students were satisfied with the teacher's teaching process,while 69％ of the students were not satisfied with the existing teaching materials.Conclusion:The teaching method oriented by practical problems and the teachers' own efforts are prerequisites for students' acceptance of this course.Content setting based on post needs is an important link of nursing ethics teaching effect.Setting up sustainable teaching time is the basis of the teaching effect.High quality teaching materials are necessary conditions to achieve the teaching orderly.
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Objective:To screen the active fractions from purple sweet potatoes containing flavonoids with insulin resistance impro -ving ability.Methods:L6 cell model with insulin resistance was established .The extracting solutions with different polarity of purple sweet potato flavonoids were used to affect the model .The residual glucose concentration in insulin resistant L 6 cells was observed and compared before and after the intervention .Results:The residual glucose concentration of total flavonoids extracting solution , butanol extracting solution at middle and high dose , and chloroform extracting solution at all doses of purple sweet potato were lower than that of IR group (P<0.05).Conclusion:The total flavonoids extract, chloroform extracting solution and butanol extracting solution of purple sweet potato can improve insulin resistance in L 6 cells.
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Objective To evaluate the effects of dietary intervention with low glycemic index (LGI) and low glycemic load (LGL) on dietary knowledge and dietary modification of patients with type 2 diabetes mellitus (T2DM).Methods This study was a cluster randomized controlled study.From June to September 2010,105 T2DM patients were randomly sampled from 3 residential areas (n =35 in each) in Jin Pen Ling community,Changsha,Hunan province and divided into three groups with a random number table:whole-day dietary intervention group (group A,n =35),breakfast dietary intervention group (group B,n =35),and control group (group C,n =35).Interventions included 3-month health education and dietary intervention.Dietary knowledge,dietary oils,glycemic index (GI),and glycemic load (GL) of the three groups were compared before and after intervention.Results Before intervention,all the three groups showed a low level of knowledge about GI (57.7 ％),and high levels of average GI value of each meal (69.71 ± 8.55),GL value per day (132.45 ± 16.25),and daily cooking oil intake [(39.95 ± 20.64)g].The average knowledge level about GI increased after intervention in both group A (96.3％ vs.57.1％,P ＜0.05) and group B (94.5％ vs.60.5％,P＜0.05),but not in group C (54.8％ vs.55.3％,P＞0.05).The reduction of daily cooking oilintake in group A was larger than those in group B and group C [(7.81 ± 3.91) g vs.(-5.12 ± 1.37) g,(7.81 ± 3.91) g vs.(-3.45 ± 5.95) g,both P ＜ 0.05];so was the average GI value of each meal [group A,(5.95±2.27);groupB (-0.85±1.87);groupC,(-2.87±1.93);allP＜0.05].The changes of GL values in group A (11.31 ±4.31) was better than in group B (1.23 ±27.82) and group C (-0.43 ± 18.40)(both P ＜0.05).Conclusions The average GI value,GL value,and daily cooking oil intake of T2DM patients were all at a high level before intervention,while the level of knowledge about GI was at a low level.Health education providing GI knowledge may effectively improve the knowledge about GI in T2DM patients,while LGI and LGL dietary intervention may promote diet modification.Whole-day dietary intervention may be more effective than breakfast intervention.
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Objective:To investigate the effects of purple sweet potato flavonoids (PSPF)in the extracts with different polarity on the insulin resistant HepG2 (IR-HepG2) cells.Methods: PSPF in the extracts with different polarity was used to intervene the IR-HepG2 model, and the remaining glucose concentration in the IR-HepG2 group and PSPF intervention groups was compared .Results:The remaining glucose concentration in PSPF intervention group , PSPF with chloroform as the extracting solvent at high , medium and low dose of PSPF , and PSPF with butanol as the extracting solvent at high and medium dose of PSPF was obviously lower than that in the IR-HepG2 group(P<0.05).Conclusion:PSPF, the chloroform extract of PSPF and the butanol extract of PSPF can enhance the consumption of glucose in IR-HepG2 cells.
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Objective Reengineering of existing facility capacity of the hospital operating department to tap the potential of the capacity, and development of scientific and quantitative basis for hospital decision-making. Methods Existing data of the hospital's operating department was called into play for a fit test of probability distribution, followed by an analysis of such capacity in the queuing theory, ending with a redesign based on the present service demand.Results The operating department in question was found with a low utilization, and with surplus capacity. When the utilization lies between 70% and 80% (7 operating rooms), the queuing system indexes are optimal.Conclusion It is rational and feasible to analyze and optimize operating department facility capacity in the queuing theory. This is conductive to increasing operating room utilization and enhancing hospital competitiveness.
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Objective To observe the histopathologic injury of small intestine and intestinal permeability in chronic renal failure (CRF) rats. Methods Twenty male Sprague-Dawley rats were randomly assigned to CRF group (n=10) and control group (n=10). 5/6 nephrectomy was used to establish CRF rats, while sham operation for control. Blood biochemistry was regularly monitored until CRF model was successfully established. The model rats were fed with lactulose (L) and mannitol (M) through intragastric administration. Urine was collected after 6 hours, and the concentration of lactulose and mannitol in urine was measured using high pressure liquid chromatograph with refractive index detector (HPLC-RID), and the ratio of urinary excretion of L/M was calculated to evaluate intestinal permeability. Small intestinal mucosa were stained by hematoxylin-eosin (HE) and observed with light microscope (villus height, thickness of muscle layer and villus count), histological damage score was used to evaluate intestinal injury. Results The L/M ratio of CRF group was higher than that of control group (1.75±0.11 vs 1.20±0.06, P<0.01). The small intestinal mucosal villus height and thickness of muscle layer in CRF group were higher (P<0.01), and the number of villi was lower compared to control group (P<0.01). The score of histopathologic intestine damage of CRF group was higher than that of control group (1.00±0.71 vs 0, P<0.01). Conclusion The intestinal permeability of CRF rats is increased with varying degrees of intestinal damage.
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Objective To investigate the value of ratio of luteinizing hormone (LH) to folliclestimulating hormone (FSH) in diagnosis of polycystic ovarian syndrome (PCOS) among women with ploycystic ovary (PCO) and to compare the difference of the diagnostic criteria between the Rotterdam Consensus and the Committee for Reproductive and Endocrine in Japan Society of Obstetrics and Gynecology.Methods By means of transvaginal Doppler ultrasound, 195 women with PCO were diagnosed in Nanfang Hospital of Reproductive Medicine Center and compare difference of multiple clinical indexes according to Rotterdam consensus and Japan consensus respectively. In the mean time, the ratio of LH/FSH, the level of LH, testosterone (T) and recevier operating characteristic (ROC) curve were explored to on the value of diagnosis of PCOS. Results By Rotterdam consensus, 144 women were diagnosed with PCOS and 51 women were non-PCOS, while 111 were identified as PCOS and 84 were non-PCOS according to Japan consensus. LH/FSH in PCOS and non-PCOS were 1.59 ±0. 84 and 0. 85 ±0. 47 respectively when based on Rotterdam consensus, and this ratio were 1.87 ± 0. 76 in PCOS and 0. 78 ± 0. 39 in non-PCOS based on Japan consensus. When using LH/FSH to diagnosis PCOS by Rotterdam consensus and Japan consensus,areas under ROC curve are 0. 786 and 0. 942, respectively. Conclusions The ratio of LH/FSH ≥ 1 provide the significant value in the diagnosis of PCOS. The criteria of the Committee for Reproductive and Endocrine in Japan Society of Obstetrics and Gynecology is more suitable for Chinese patients.
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An analysis of the development and present status of overseas hospital cost management pinpoints the setbacks found in China's hospital cost management, and brings forth the proposal to learn from advanced ideas and methods in overseas hospital industrial engineering and cost management. The goals are to build a nationwide total cost control system, explore new fields in cost management and introduce strategic cost management, in an effort to realize scientific cost management in China.
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Objective Depending on the analysis of patients who were diagnosed as Community-Acquired Pneumonia in our hospital during 2004-2005, we compared with 《Directory for Diagnose of Community-Acquired Pneumonia》(Draft) in order to provide the guidance for the rational antimicrobial use in clinic. Methods Using the Retrospective Analyze method,we analyzed the cases which included: Name, Sex, Age, time during in hospital, Fees, Medicine and Note. Results Compared from 2005 with 2004, the top 3 ranks of the DDDs in 2004 were cefoperazone sodium/sulbactam sodium;L-ofloxacin ; etimicin and in 2005 were L-ofloxacin; cefoperazone sodium/sulbactam; etimicin. The rate of medicine fees were decreased,but the unites to use medicine,the average time in hospital and the average medicine fees were not deferent remarkable. Conclusions After 《Directory for Diagnose of Community-Acquired Pneumonia》(Draft) was carried out,the condition of application was more rational in 2005 than in 2004, but there were still many problems should be improved.
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Objective Through an investigation and analysis of the using situation of anti-infectious medicine for the patients of ICU in hospital,to provide guidance for the rational antimicrobial use in clinic and strengthen the level of clinical doctors′reasonable use of the medicine. Methods The anti-infectious medicine used for the patient of ICU in hospital is analysed in respect to defined daily dose (DDD),drug utilization index(DUI). Results An overwhelming majority of anti-infectious medicine′s utilization is reasonable,but 52.4% of the anti-infectious medicine is over the demand of DUI≤1.The result of the DDDs:the Chemical Synthesis′s capacity(32.14%),the aminoglycosides(13.62%),the ?-Lactams and their?-Lactamase inhibitors(13.20%),the antifungal agents(12.66%),the cephalosporins(9.52%).The fuloroquinolones,the third and the forth cephalosporins and the carbapenems are used broadly.The medicine's unit-rate gets 92%,and six unit is the most of all.It can be seen from the category and distribution of the use of anti-infectious medicine that the cephalosprins is the first.The antimicrobial resistance is developed rapidly.The antimicrobial resistance of levofloxacin is 54.45%,then gentamicin is 51.78% and ampicillin,ciprofloxacin,cefazolin,ceftriaxone,SMZco are more than 40%. Conclusions In choosing the dose with the normal regulation(not the dose of indication),doctors consider less for the factors such as the age,medicine interacion,dose of indication,etc.Using the broad-spectrum usually led to many universal phenomenon such as antimicrobial resistance,bacteria migrated and antimycotic infection,etc.That makes double infection(32%) which can't be neglected.The theory of medicinal economics is less used in the clinic practices.
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OBJECTIVE:To establish a RP-HPLC method for determination of the contents of resibufogenin and cinobufagin in Meihuadianshe pills METHODS:The condition of HPLC was Kromasil C18 column,acetonitrile-0 5%KH2PO4(50∶50) as a mobile phase and detecting wavelength 296nm RESULTS:This method showed good linearity The average recoveries of resibufogenin and cinobufagin were 97 40% with a RSD of 2 2% and 97 78% with a RSD of 2 6% respectively CONCLUSION:The method is simple,reliable and satisfactory in resolution It can be used in quality control of Meihuadianshe pills
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Objective To develop an information system for hospital material flow management.Methods The system,taking financial accounting and hard assets controlling as the primary purpose and making the flow rebuild as the masterstroke,mainly consisted of seven functions as follows: management of medical material and non-hygiene material,management of antisepsis providing department,management of hard assets,management of drug,management of storehouse materials economical using and support in peacetime and war time,management of biohazard waste and management of the budget of finical IC card department.Results The system formed the information chain of the whole hospital material flow process and effectively controlled the hospital medical costs and operational costs.Furthermore,the system firstly developed the storehouse material economical using and support management system both in peacetime and war time in our country.Conclusion The information system for hospital material flow management can resolve the problem of financial and material management divorce and promote the hospital holistic management level.