Practice of precise management of antibiotics in a children′s hospital in combination with key performance indicators / 中华医院管理杂志

Bacterial infection is the main cause of infectious diseases in children. Antibacterials play an important role in anti infection treatment of children. At present, the treatment of antimicrobial drugs in children is facing a severe situation of bacterial resistance. In January 2020, a children′s specialized hospital carried out the practice of precise management of antibiotics in combination with key performance indicators. Through the multi sectoral linkage of management and technology, eight key performance indicators and assessment methods were set up from three levels of antibiotic use, bacterial resistance and hospital infection, to standardize the clinical application of antibiotics and continue to promote the rational use of antibiotics. This practice had improved the performance indicators of antibacterial management. Among them, the use intensity of antibacterial drugs for inpatients decreased from 40.07 DDD in 2019 to 29.00 DDD in 2021, the use rate of antibacterial drugs for inpatients decreased from 81.32% to 64.40%, the percentage of antibacterial drug expenses in total drug expenses decreased from 35.41% to 26.82%, the use proportion of non restricted antibacterial drugs in antibacterial drugs increased from 71.30% to 82.21%, and the drug resistance rate of Salmonella to β-Lactam/enzyme inhibitors decreased from 4.84% to 0.03%, and the incidence of hospital infection decreased from 1.16% to 0.96%. The precise management of antibiotics in combination with key performance indicators improved the level of rational use of antibiotics, effectively curbed bacterial resistance, achieved phased results, so as to provide a reference for the scientific management of antibiotics in children′s hospitals.

Practice of promoting high-quality development in a children′s hospital using public hospital performance appraisal as a key point / 中华医院管理杂志

The performance appraisal of tertiary public hospitals is key to their high-quality development. Since 2019, Children′s Hospital of Zhejiang University School of Medicine has taken the following measures to leverage performance appraisal. Namely promoting medical technology innovation to enhance the diagnosis and treatment capabilities of difficult and critical diseases; Reasonably setting a target system, improving the performance appraisal mechanism of the hospital; Improving operational efficiency, enhancing the sense of gain by children patients; Building a high-quality talent pool, promoting sustainable development, and effectively promoting high-quality development of hospitals. These measures can provide reference for promoting the high-quality development of hospitals.

Analysis of satisfaction and influencing factors of scientific research incentive mechanisms for young medical staff in a children′s hospital in Beijing / 中华医学科研管理杂志

Objective:This study aims to explore the satisfaction and influencing factors of scientific research incentive mechanisms for young medical staff in a children′s hospital in Beijing, and to provide references for the management department to develop relevant incentive strategies.Methods:A satisfaction questionnaire survey of scientific research incentive mechanisms was carried out during April and May, 2022. Collected data were analyzed by rank sum test and ordered logistic regression.Results:The level of overall satisfaction of 339 young medical staffs was 81.42%. The satisfaction rate of incentive factors was 80.50% and hygiene factors was 77.51%.According to the findings, there were significant differences in educational backgrounds, professional titles and job types, hygiene factors, and incentive factors ( P<0.05). The contributing factors of the job satisfaction were professional title, hygiene factors and incentive factors. Conclusions:The overall satisfaction with the incentive work of the young research staff surveyed was relatively at high-level. It is necessary to improve tailed hygiene factors to meet the characteristics young medical staff, such as setting up full-time scientific research working hours, exploring the establishment of diversified of scientific research sharing mechanisms to increase the utilization of the scientific research platform. It is important to enhance incentive factors to establish a long-term incentive mechanism for young personnel, such as setting up interdisciplinary research projects, exploring the establishment of a recommendation mechanism for outstanding young talents, in order to provide them with more opportunities for further intensive training.

Trends of hospitalized cases of children′s hospitals in China before and after COVID-19 / 中华医院管理杂志

Objective:To analyze the impact of COVID-19 on the number of hospitalization and the disease spectrum of children′s hospitals in China, so as to provide scientific basis for improving the epidemic response policy of children′s hospitals and restoring hospital operations.Methods:Discharged patients from 27 children′s hospitals from January 1, 2019, to December 31, 2020, were selected from the FUTang Updating medical Records(FUTURE) Database. The ratio of discharge number in 2020 to that in 2019 was calculated. Age groups, disease types, and discharge months were further divided to calculate the ratio of discharge numbers under different conditions.Results:The total number of discharged patients in 2020 was 76.76% of the total number in 2019. In terms of discharge time, the ratio rose slowly from the lowest values in February and March, and reached about 90% of the same period of 2019 at the end of 2020. In terms of age, the biggest change in the discharge number was among children aged 1-3 years, which was 71.87% in 2019. In terms of disease classifications, respiratory diseases changed the most in the number of discharged patients in 2020, accounting for 56.03% of that in 2019. The top five hospitalized diseases of children did not change, while the other ranks changed slightly.Conclusions:COVID-19 has a huge and lasting impact on the number of hospitalizations in children′s hospitals, and the hospitals should develop multiple approaches such as online medical care to cope with the long-term negative impact of the pandemic.

Application of STRONGkids method on assessing the risk of malnutrition among hospitalised children in Universitas Sebelas Maret Hospital

@#Introduction: Hospital malnutrition (HM) in children augments morbidity and mortality, thus early detection is a preventive measure that may improve a patient’s condition. This study identified the risk factors of HM among children hospitalised in Universitas Sebelas Maret (UNS) Hospital using the STRONGkids method. Methods: This observational analytical cross-sectional study was performed in children hospitalised at the paediatric ward of UNS Hospital between February and August 2021. The samples were taken by consecutive sampling technique. Subjects meeting the inclusion criteria were assessed for their underlying disease, nutritional status based on World Health Organization Anthro software, and STRONGkids score. Chi-square test and logistic regression analysis were used, with a p-value of <0.05 considered as statistical significance. Results: A total of 173 children were included in the study, 56% were males, mean age was 62.5 months, 45% had an underlying chronic disease, and 17.9% experienced moderate malnutrition. Based on the STRONGkids score, 39.3% children were at high risk of malnutrition and 60.7% were at moderate risk of malnutrition. Logistic regression analysis showed that high risk of HM was significantly associated with age (OR 2.58, 95% CI 1.38-4.84, p=0.003), chronic disease (OR 7.23, 95% CI 3.3-15.86, p=0.018), and moderate malnutrition (OR 13.5, 95% CI 3.96-45.98, p<0.001). Conclusion: Children hospitalised in UNS Hospital were at risk of malnutrition. Toddlerhood, chronic disease, and moderate malnutrition significantly increased the risk of HM. Thus, these children need optimal nutritional support to improve their clinical condition. STRONGkids is a convenient and easy method to identify malnutrition risk during hospitalisation.

Neumonía por Staphylococcus aureus resistente a meticilina adquirido de la comunidad en un hospital pediátrico. Nuestra experiencia de 10 años / Community-acquired methicillin-resistant Staphylococcusaureus pneumonia in a children's hospital. Our ten-year experience

Introducción. Las infecciones por Staphylococcus aureus resistente a meticilina adquirido de la comunidad (SARM-AC) se han incrementado en los últimos años. Neumonías necrotizantes y empiemas por SARM-AC son cada vez más frecuentes en niños.Objetivos. Determinar la prevalencia de neumonías por SARM-AC y sus características clínico-epidemiológicas, en comparación con las neumonías por Streptococcus pneumoniae (SP) en la misma población.Material y métodos. Estudio descriptivo, observacional, transversal, de pacientes internados con neumonía por SARM-AC en el Hospital de Niños Víctor J. Vilela (período: 1/2008-12/2017).Resultados. De 54 neumonías por Staphylococcus aureus, 46 (el 85 %) fueron SARM-AC. El índice de neumonías por SARM-AC varió de 4,9/10 000 (2008) a 10/10 000 egresos (2017). Presentaron sepsis/shock séptico el 41 %; empiema, el 96 %; neumotórax, el 35 %; requirieron drenaje pleural el 90 % y toilette quirúrgica el 55 %. Ingresaron a Terapia Intensiva el 65 %; la mitad necesitó asistencia respiratoria mecánica. Hubo dos muertes. Resistencia de las cepas: el 17 % a gentamicina, el 13 % a eritromicina, el 11 % a clindamicina. En las neumonías por SARM-AC vs. las neumonías por SP, se observó mayor riesgo de sepsis (IC 95 %; RR 7,38; 3,32-16,38) e ingreso a Terapia Intensiva (RR 4,29; 2,70-6,83). No hubo muertes por SP.Conclusiones. La prevalencia de neumonías por SARM-AC se duplicó durante la última década. Comparadas con las neumonías por SP, las neumonías por SARM-AC se acompañaron, más frecuentemente, de cuadros de sepsis y shockséptico, ingreso a Terapia Intensiva y asistencia respiratoria.

Introduction. Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections have increased in recent years. CA-MRSA necrotizing pneumonia and empyema are now more common in children.Objectives. To determine the prevalence of CA-MRSA pneumonia and its clinical and epidemiological characteristics compared to Streptococcus pneumoniae (SP) pneumonia in the same population.Material and methods. Descriptive, observational, cross-sectional study of patients hospitalized due to CA-MRSA pneumonia at Hospital de Niños Víctor J. Vilela (period: January 2008-December 2017).Results. Out of 54 Staphylococcus aureus pneumonia cases, 46 (85 %) corresponded to CA-MRSA. The rate of CA-MRSA pneumonia ranged from 4.9/10 000 (2008) to 10/10 000 hospital discharges (2017). Sepsis/septic shock was observed in 41 %; empyema, in 96 %; pneumothorax, in 35 %; 90 % of cases required pleural drainage and 55 %, surgical debridement. Also, 65 % of patients were admitted to the intensive care unit (ICU); half of them required assisted mechanical ventilation. Two patients died. Strain resistance: 17 %, gentamicin; 13 %, erythromycin; and 11 %, clindamycin. Compared to SP pneumonia, CA-MRSA pneumonia showed a higher risk for sepsis (95 % confidence interval; relative risk: 7.38; 3.32-16.38) and admission to the ICU (RR: 4.29; 2.70-6.83). No patient died due to SP pneumonia.Conclusions. The prevalence of CA-MRSA pneumonia doubled in the past decade. Compared to SP pneumonia, CA-MRSA pneumonia was more commonly accompanied by sepsis and septic shock, admission to the ICU, and ventilatory support requirement

Caracterización clinicoepidemiológica y supervivencia de pacientes menores de 19 años con leucemia / Clinical epidemiological characterization and survival in patients under 19 years with leukemia

Introducción: La leucemia es el cáncer más frecuente en la infancia y representan 41 % de todas las neoplasias malignas en niños menores de 15 años. Objetivo: Describir las características clinicoepidemiológicas y supervivencia de niños y adolescentes con leucemia. Método: Se realizó un estudio descriptivo, longitudinal y retrospectivo de 82 pacientes menores de 19 años de edad, con diagnóstico de leucemia, atendidos en el Servicio Regional de Hematología del Hospital Infantil Sur Docente Dr. Antonio María Béguez César de Santiago de Cuba, desde enero de 2014 hasta diciembre de 2018. Resultados: En la casuística predominaron el grupo de 1-4 años de edad (42,7 %), el sexo masculino (59,7 %), los mestizos (48,8 %), la leucemia linfoide aguda como variante morfológica (73,2 %), así como el síndrome anémico y febril (97,7 y 86,6 %, respectivamente). En 89,0 % de los pacientes se logró la remisión completa al finalizar la primera fase del tratamiento y 17,1 % presentó algún tipo de recaída en su evolución, donde la médula ósea resultó ser el sitio más afectado. Se logró una supervivencia global de 67,1 %. Conclusiones: Los resultados del estudio no difieren del contexto clínico y epidemiológico mundial y resultan alentadores, teniendo en cuenta la no disponibilidad en la provincia de medios de diagnóstico, con tecnología de avanzada, para una mejor estratificación de los pacientes.

Introduction: Leukemia is the most frequent cancer in childhood and represents 41 % of all the malignancies in children under 15 years. Objective: To describe the clinical epidemiological characteristics and survival in children and adolescents with leukemia. Method: A descriptive, longitudinal and retrospective study of 82 patients under 19 years, with diagnosis of leukemia was carried out. They were assisted in the Regional Service of Hematology at Dr. Antonio María Béguez César Teaching Southern Children Hospital in Santiago de Cuba, from January, 2014 to December, 2018. Results: In the case material there was a prevalence of the 1-4 age group (42.7 %), male sex (59.7 %), mixed race children (48.8 %), acute lymphoid leukemia as morphological variant (73.2 %), as well as the anemic and fever syndrome (97.7 and 86.6 %, respectively). Complete remission was achieved in 89.0 % of the patients after concluding the first phase of the treatment and 17.1 % presented some type of relapse during their clinical course, where the most affected site was the bone marrow. A global survival of 67.1 % was achieved. Conclusions: The results of the study are encouraging and do not differ from the world clinical and epidemiological context, taking into account the non availability of diagnosis means in the province, with advanced technology, for a better stratification of patients.

Sentidos asociados al juego y al juguete en el ámbito hospitalario / Senses associated with plays and toys in the hospital environment / Sentidos associados ao jogo e ao brinquedo no âmbito hospitalar

Resumen Introducción: en el siguiente artículo se describen los sentidos que asocian al juego y al juguete algunos profesionales de diversas áreas de la salud en el ámbito hospitalario. Objetivo: analizar los sentidos que asocian al juego y al juguete algunos profesionales de diversas áreas de la salud. Materiales y métodos: desde un diseño cualitativo y bajo el método de estudio de caso, se utiliza como técnica de construcción de datos la entrevista semiestructurada para exponer los resultados de la categoría sentidos a partir de dos núcleos de significación teórica: sentido subjetivo autobiográfico y sentido clínico. Resultados: en los hallazgos se pone de manifiesto la manera como el sentido subjetivo autobiográfico de estos profesionales permeó la práctica profesional y se describen algunos sentidos clínicos con relación a la manera como el juego y el juguete permite a estos profesionales formular hipótesis sobre aspectos subjetivos, afectivos, relacionales y comunicativos en los que se apoya un ejercicio diagnóstico, terapéutico o educativo. Conclusiones: estos sentidos se abordan desde dos pilares: la propia infancia de estos profesionales como punto de partida para construir los lazos con el paciente, ya que se evidencia una fuerte conexión entre la propia subjetividad para dinamizar, de manera particular, la relación terapéutica con los niños del hospital y, el segundo, la práctica profesional como experiencia a partir de la cual se configura un sentido para el juego y el juguete.

Abstract Introduction: this article describes the senses associated with plays and toys, by professionals from different areas of health in the hospital environment. Objective: analyze the senses associated with plays and toys, by professionals from different areas of health in the hospital environment. Materials and methods: from a qualitative design and under the case study method, the semi-structured interview is used as a data construction technique to expose the results of the senses category from two nuclei of theoretical significance: autobiographical subjective sense and clinical sense. Results: the findings reveal the way in which the subjective autobiographical sense of these professionals permeated the professional practice and some clinical senses are described in relation to the way in which play and toy allow these professionals to formulate hypotheses about subjective, affective, relational and communicative aspects in which a diagnostic, therapeutic or educational exercise is supported. Conclusions: these senses are oriented from two pillars: the infancy of these professionals as a starting point to build ties with the patient, since there is a strong connection between the subjectivity itself to dynamize, in particular, the therapeutic relationship with children in the hospital and, the second, the professional practice as an experience from which a sense for the play and the toy is configured.

Resumo Introdução: no seguinte artigo descreve-se os sentidos que associam ao jogo e ao brinquedo alguns profissionais de diversas áreas da saúde no âmbito hospitalar. Objetivo: analisar os sentidos que associam ao jogo e ao brinquedo alguns profissionais de diversas áreas da saúde no âmbito hospitalar. Materiais e métodos: desde um desenho qualitativo e através do método de estudo de caso, se utiliza como técnica de construção de dados a entrevista semiestruturada para apresentar os resultados da categoria sentidos a partir de dois núcleos de significação teórica: sentido subjetivo autobiográfico e sentido clínico. Resultados: nos resultados fica claro a forma como o sentido subjetivo autobiográfico destes profissionais permeou a prática profissional e descrevem-se alguns sentidos clínicos em relação à maneira como o jogo e o brinquedo permite a estes profissionais formular hipóteses sobre aspectos subjetivos afetivos, relacionais e comunicativos nos que se apoia um exercício diagnóstico, terapêutico ou educativo. Conclusões: estes sentidos se abordam desde dois pilares: a própria infância destes profissionais como ponto de partida para construir os laços com o paciente, já que evidencia-se uma forte conexão entre a própria subjetividade para dinamizar, de maneira particular, a relação terapêutica com as crianças do hospital e, o segundo, a prática profissional como experiência a partir da qual configura-se um sentido para o jogo e o brinquedo.

Analysis of Distribution and Drug Resistance of Bloodstream Infection Pathogens in A Children ’s Hospital from Zhengzhou during 2014-2019 / 中国药房

OBJECTIVE：To analyze the distribution and drug resistance of bloodstream infection pathogens in a Children’s Hospital from Zhengzhou，and to provide reference rational selection of drugs in anti-infective treatment. METHODS：By retrospective analysis，128 318 blood culture specimens were collected from inpatients in the Affiliated Children’s Hospital of Zhengzhou University from Oct. 2014 to Sept. 2019. The positive rate，clinical symptoms and clinical diagnosis of children with bloodstream infection were analyzed statistically. WHONET 5.6 software was used to analyze pathogenic bacteria of positive specimen，the departments and the resistance of pathogens to the main clinical antibiotics. RESULTS：In 128 318 blood culture samples of inpatients，the positive rate was 2.14％ （2 746/128 318）；among 2 746 blood culture positive sample，the main Symptom of childrem with blood stream infection was fever（1 986/2 746）；main clinical diagnosis included sepsis（1 679/2 746）， bronchopneumonia（858/2 746），purulent meningitis（555/2 746）. The main departments included neonatal diagnosis and treatment center （1 090 strains，accounting for 39.69％） [neonatal intensive care unit （279 strains，accounting for 10.16％），neonatal surgery department （223 strains，accounting for 8.12％），neonatal internal medicine department （209 strains，accounting for 7.61％），infant pediatrics department（200 strains，accounting for 7.28％） and premature pediatrics department（179 strains， accounting for 6.52％）]，hematology oncology department （216 strains，accounting for 7.87％），cardio vascular medicine department（206 strains，accounting for 7.50％）. Gram-positive bacteria accounted for 72.80％，Gram-negative bacteria 24.21％， fugus 2.99％. Among Gram-positive bacteria，coagulase negative staphylococcus（1 414 strains）and Staphylococcus aureus（146 strains）were the most common. The resistance rate of the former to penicillin G，oxacillin and erythromycin was more than 80％， and that of the latter to penicillin G and erythromycin was more than 80％. Among Gram-negative bacteria，Klebsiella pneumoniae （183 strains） and Escherichia coli （172 strains） were the most common. The resistance rates of the former to ampicillin， piperacillin，ampicillin/sulbactam and cefazolin were more than 80％，and the latter to ampicillin and tetracycline were more than 80％. Among the fungus，Candida albicans（42 strains）and Candida parapsilosis（22 strains）were the most common，and the resistance rate to common antifungal drugs was less than 10％. CONCLUSIONS：The pathogens of bloodstream infection in the hospital are complex，mainly coagulase negative staphylococcus and K. pneumoniae，and the drug resistance is severe.

Advices on the prevention and control of nosocomial infection of novel coronavirus within children’s hospitals / 中华医院管理杂志

The pneumonia caused by the novel coronavirus (2019-nCoV), which began in December 2019, has become the most serious public health problem, threatening people's health and life. This threat is posing a severe challenge on the diagnosis and treatment of 2019-nCoV infection, the prevention and control of hospital cross infection of medical staff. It is suggested that in addition to strengthening the organization and leadership of the abovementioned work, establishing and improving the prevention and control mechanism deserve greater attention. Furthermore, special attention should be given to the safety of the medical staff, strengthening their infection monitoring and outbreak management. Medical staff in different work areas and positions should be placed under careful protection, cleaning and disinfection measures. The protection during specimen collection, transportation and medical waste management should also be prioritized. This paper also put forward management suggestions for the outpatient department, isolation ward and other key departments. These measures are proposed to provide a guidance for the prevention and control of 2019-nCoV nosocomial infection in the pediatric outpatient and ward.

Children's Internet hospital: Construction and practice / 第二军医大学学报

Internet hospital is an online service, diagnosis and treatment platform that relies on the traditional hospital, and it can connect doctors and patients through Internet, providing patients with the whole process of medical service through the integration of online and offline services. To construct children's Internet hospital, the following measures were adopted: Using Internet technology, we constructed a whole process online and offline child service platform; using the concept of health closed-loop management, we carried out core medical service such as online diagnosis and treatment; and based on telemedicine technology, the collaborative medical interaction service between doctors was achieved. We also created our own platform to ensure information security and children's medical experience with the help of system data interaction and cloud technology. Besides, an Internet hospital management system was established to ensure medical quality and safety. The children's Internet hospital can improve not only the medical service efficiency, but also the children's medical experience.

Relationship between temperature indicators and hospital admission for childhood pneumonia / 预防医学

Objective@#To explore the relationship between different temperature indicators and hospital admission for childhood pneumonia.@*Methods@#The hospital admissions for pneumonia in children aged 0-14 years and meteorological data in Ningbo from 2015 to 2017 were collected. A distributed lag non-linear model combined with a generalized linear model was employed to analyze the exposure-response relationships between different temperature indicators（daily average,minimum and maximum temperature;the first percentile as low temperature and the 99th percentile as high temperature）and hospital admission for childhood pneumonia.@*Results@#A total of 4 542 cases of childhood pneumonia were recruited. There were obvious seasonal fluctuations found in the inpatient volume of childhood pneumonia,which peaked in winter and bottomed in summer. After adjusting for potential confounding variables such as relative humidity,PM2.5,long term trend and seasonal trend,the results suggested that after exposed to whether low or high temperature,the inpatient volume of childhood pneumonia would increase. When the daily average temperature and daily minimum temperature were employed,the effect of high temperature on the increase of inpatient volume for childhood pneumonia was statistically significant and the cumulative relative risk for a lag of 0-7 days were 1.52（95%CI：1.04-2.23）and 1.59（95%CI：1.08-2.34）,respectively. When the daily maximum temperature was employed,the effect of low temperature on the increase of inpatient volume for childhood pneumonia was statistically significant and the cumulative relative risk for a lag of 0-7 days were 1.30（95%CI：1.02-1.66）.@*Conclusion@#Our findings suggested that an increased risk of hospital admission for childhood pneumonia was associated with both low and high temperature.

Food Allergy-related Awareness and Performance of Dietitians at Children's Hospitals in Korea: Comparison of Certificate Possession among Clinical Dietitians / 대한지역사회영양학회지

OBJECTIVES: The purpose of this study was to examine the food allergy-related knowledge, awareness, and performance of dietitians at children's hospitals, depending on whether or not they have a clinical dietitian certificate.METHODS: A questionnaire survey was administered to 41 dieticians at children's hospitals registered as a part of the Korean Hospital Association. The survey consisted of questionnaires examining general characteristics, nutritional counseling-related characteristics, and food allergy-related characteristics (food allergy-related knowledge, awareness, and performance). We examined differences according to the status of clinical dietitian certification.RESULTS: The proportion of subjects who were holders of clinical dietitian certificates was 48.8%. There were differences between holders of clinical dietitian certificates and non-holders as follows. Regarding nutritional awareness and performance, ‘needs to provide nutrition counseling in children's hospitals’, ‘providing nutrition counseling services in working hospitals’, and ‘whether there is a nutrition counseling room’ scored higher among holders of clinical dietitian certificates than non-holders. Holders of clinical dietitian certificates showed higher scores for knowledge of food allergy symptoms and food allergy management than non-holders. For food allergy awareness and performance, ‘self-assessment of food allergy knowledge understanding level’, ‘awareness of open oral food challenge (OFC)’, ‘recognition of the need for education and counseling on food allergy for patients/guardians’, and ‘food allergy related educational experience’ scored higher among holders of clinical dietitians certificates than in non-holders.CONCLUSIONS: Children's hospital dietitians with a clinical dietitian certificate showed high knowledge, awareness, and performance related to food allergies. It is thus necessary to employ a clinical dietitian for food allergy management in children's hospitals. In addition, training and conservative education are necessary for the management of food allergies for children's hospital dietitians.

A comparative analysis of clinical operation system and continuing education of pediatricians between Chinese and American children's hospitals / 中华医学教育探索杂志

For provincial children's hospitals and children's hospitals affiliated to medical colleges and universities with a high level of the diagnosis and treatment,they are the center of referral and need to retain pediatricians and build a high-level team of pediatricians.With the authors' own experience in Cincinnati Children's Hospital Medical Center in the US,this article briefly introduces the current clinical operation mode in American children's hospitals,especially the consultation system mainly composed of attending physicians and the mode of continuing medical education based on both clinical and scientific research.Such experience provides a reference for pediatricians in China.

Analysis of 2720 causes of complaints from government hotline in a children′s hospital in Nanjing / 中华医院管理杂志

Objective To analyze the complaints made at government hotlines against a children′s hospital in 2016 and 2017, and to provide reference for the continuous construction of harmonious doctor-patient relationship. Methods This study retrospectively analyzed 2720 cases of " 12345 " hotline complaints received by a children′s hospital in the years from 2016 to 2017. The causes for complaints were counted and the changes in the content of the appeals were compared. Data analysis was performed using statistical methods such as descriptive analysis and chi-square test. Results Lack of medical resources became the primary cause of complaints, accounting for 30. 4％ ; complaints caused by poor communication between doctors and patients were high in the emergency department and inpatient department, accounting for 21. 7％ and 20. 0％ respectively. Compared with 2016, medical treatment complaints in 2017 caused by insufficient resources and medical behavior increased by 18. 9％ and 5. 3％ , respectively, and complaints caused by doctor-patient communication problems decreased by 7. 5％ . Conclusions In order to reduce medical complaints, it is proposed to increase policy support, improve medical resources, strengthen communication between doctors and patients, pay attention to humanistic care, improve hospital quality management, improve patient experience, pay attention to changes in complaints and improve medical services.

The study and analysis of the effectiveness of "health education mobile classroom" in the outpatient department of children's hospital / 中国实用护理杂志

Objective To evaluate the effect of "health education mobile classroom " in the outpatient department of children's hospital, and to analyze the needs of the outpatient and family members on health education. Methods Through the retrospective analysis of the information of the outpatient and emergency patients in the children's specialist hospital to determine the content, the venue and the time period of the "health education mobile classroom". Selection and training the health educator to implement the health education. At the same time, push the training content through the mobile APP to the patient's family, to expand the education audience. To compare and analyze the patient satisfaction of the hospital and the satisfaction with the dimensions of the project. In the evaluation of the effect of health education and the influencing factors, the relationship between income, occupation and children is positively related, and age is negatively related to it. Results After the implement of this project, the satisfaction of the patient had increased for 3.65%(P=0.001). Overall assessment of the audience was very satisfied with (3.94 ± 0.25) points. In each dimension analysis, the satisfaction of the "training method"was the highest, at (3.94 ± 0.26) points. Satisfied with the attitude of the trainers and comprehensive ability were more than 3.80 points. Conclusions The "health education mobile classroom" can improve patient satisfaction in the outpatient department and emergency of children's specialist hospital. Audience has a certain degree of acceptance and satisfaction with this health education mode.

Competency characteristics study of clinical nurse specialist in comprehensive childrenˊs hospital / 中国实用护理杂志

Objective To analyze job information of clinical nurse specialist (CNS) in comprehensive children′s hospital,andclarify CNS′s qualification requirements. Methods Using working log and questionnaires to conduct a survey on 39 nurses and doctors in children′s hospital. Results Qualified CNS position asks for academic requirements for the undergraduate or above;pediatric work experiences for more than 5 years, pediatric specialist work experiences for more than 3 years, and also 3-6 months ICU work experience; competency of clinical practice skills, interpersonal skills, analysis and evaluation of decision-making. Direct clinical nursing is the core of CNS daily work content. Conclusions Job descriptions should be established to meet the pediatric CNS job characteristics,to ensure the CNS personnel selects.

Caracterización clinicoepidemiológica de los tumores de cabeza y cuello en niños y adolescentes desde 2000 hasta 2016 / Clinical epidemiological characterization of head and neck tumors in children and adolescents from 2000 to 2016

Se realizó un estudio descriptivo, transversal y retrospectivo de 23 pacientes con tumores de cabeza y cuello, atendidos en el Servicio de Oncología Pediátrica del Hospital Infantil Sur Docente Dr Antonio María Béguez César de Santiago de Cuba durante el período 2000-2016. En la casuística predominaron el grupo etario de 10-14 años (39,1 por ciento), el sexo masculino, la localización nasofaríngea (39,1 por ciento), el linfoma no Hodking y el carcinoma papilar como variedades histológicas, el estadio clínico III y el mayor número de pacientes diagnosticados en 2013 y 2014

A descriptive, cross-sectional and retrospective study of 23 patients with head and neck tumors, assisted in the Oncology Pediatric Service of Dr Antonio María Béguez César Southern Teaching Children Hospital was carried out in Santiago de Cuba during 2000-2016. In the case material there was a prevalence of the 10-14 age group (39.1 percent), male sex, nasopharingeal localization (39.1 percen), non Hodking lymphoma and papillary carcinoma as histological varieties, phase III clinical stage and the highest number of patients diagnosed in 2013 and 2014

Comparative analysis of influenza etiology surveillance in general hospital and children′s hospital / 国际检验医学杂志

Objective By comparing and analyzing the etiological monitoring results of influenza in Xicheng District general hos-pital and children′s Hospital ,to explore the epidemic regularity of influenza in children ,so as to provide the basis for developing in-fluenza prevention and control measures .Methods A total of 40 swabs of influenza samples were collected every week from two sentinel hospitals ,and the virus RNA was extracted and detected by RT-PCR method .Results There was a statistically significant difference in positive rate of influenza pathogen surveillance between general hospitals and children′s hospitals (21 .8% vs .14 .9% ) (P<0 .001) .In the general hospital ,the positive rate was highest in people aged ≥60 years old(31 .3% ) .In the children′s hospital , the positive rate was highest in people aged >4—14 years old(26 .7% ) .Both hospitals had an epidemic peak of influenza from No-vember to December of next year ,it was typical influenza epidemic of the North area .But the children′s hospital had a epidemic trough in January and February .In both hospitals ,the circulating strains were H3 ,H1N1 ,type B ,the predominant type was H3 and type B .Conclusion Taking the general hospital as a reference ,the quality of influenza surveillance in the children′s hospital was relatively stable and reliable .Lack of the people aged >24— <60 years old and aged ≥60 years old in children′s hospital ,is the key reason of the statistically significant difference of the positive rate ,between the general hospital and the children′s hospital .Chil-dren′s influenza vaccination rate is higher than the other age group ,and the protective effect of vaccine is better .

Comparative analysis of influenza etiology surveillance in general hospital and children′s hospital / 国际检验医学杂志

Objective By comparing and analyzing the etiological monitoring results of influenza in Xicheng District general hos-pital and children′s Hospital ,to explore the epidemic regularity of influenza in children ,so as to provide the basis for developing in-fluenza prevention and control measures .Methods A total of 40 swabs of influenza samples were collected every week from two sentinel hospitals ,and the virus RNA was extracted and detected by RT-PCR method .Results There was a statistically significant difference in positive rate of influenza pathogen surveillance between general hospitals and children′s hospitals (21 .8% vs .14 .9% ) (P<0 .001) .In the general hospital ,the positive rate was highest in people aged ≥60 years old(31 .3% ) .In the children′s hospital , the positive rate was highest in people aged >4—14 years old(26 .7% ) .Both hospitals had an epidemic peak of influenza from No-vember to December of next year ,it was typical influenza epidemic of the North area .But the children′s hospital had a epidemic trough in January and February .In both hospitals ,the circulating strains were H3 ,H1N1 ,type B ,the predominant type was H3 and type B .Conclusion Taking the general hospital as a reference ,the quality of influenza surveillance in the children′s hospital was relatively stable and reliable .Lack of the people aged >24— <60 years old and aged ≥60 years old in children′s hospital ,is the key reason of the statistically significant difference of the positive rate ,between the general hospital and the children′s hospital .Chil-dren′s influenza vaccination rate is higher than the other age group ,and the protective effect of vaccine is better .