Knowledge and preventive practices related to Monkey pox among medical doctors in Sokoto metropolis of Sokoto State, Nigeria

Background: For effective control of Monkey pox (Mpox), clinicians need to have adequate knowledge of the disease and adopt appropriate practices to contain it. This study sought to assess the knowledge and practices of medical doctors regarding Monkey pox. Methodology: A descriptive cross-sectional design was utilized for the study and using a two stage sampling method, 210 medical doctors working in Sokoto metropolis were recruited into the study. Aset of structured, pretested and self-administered questionnaire was used to obtain relevant information from the study participants. Data obtained was analyzed using SPSS computer software version 23 with level of statistical significance set at p<0.05 Results: All the respondents were aware of Mpox with more than half (52.3%) having the internet as their commonest source of information. The majority, ((72%) of the clinicians had good knowledge and only years of working experience was significantly associated with knowledge of the disease. Preventive practices were well exhibited by all the respondents with the majority (73%) having appropriate preventive practices. Conclusion and recommendation: This study has demonstrated good knowledge towards Mpox by clinicians in Sokoto metropolis, with a greater majority exhibiting appropriate preventive practices. Sustained awareness and retraining of health care workers in general is necessary to maintain the tempo of high index of suspicion for outbreaks of Mpox and other potential epidemics and also regular use of personal protective equipment

Attitudes and perceptions of Filipino clinicians and pathologists towards the autopsy as a medical tool

Background@#Globally, autopsy rates have been continually declining over the course of several years. Previous studies have shown that the perception of pathologists and clinicians may serve as significant factors which may affect the performance of autopsy and contribute to its decreased rate. This study was conducted to determine the attitudes and perceptions of Filipino clinicians and pathologists toward the autopsy as a medical tool.@*Methodology@#This is a cross-sectional descriptive survey of two groups of physicians. Forty-four (n = 44) pathologists nationwide and thirty-three (n = 33) clinicians from Central Visayas participated in the study. A total of seventy-seven (n = 77) physicians completed a survey using a standardized online questionnaire.@*Results@#Of the 77 respondents, 94% of clinicians and 75% of pathologists believed that autopsies could provide relevant findings that could change future clinical practice. Despite this, only 6% of clinicians and 20% of pathologists indicated that the number of autopsy cases in their institutions was sufficient. With regards to their practice, pathologists most strongly agreed (mean = 4.30) that material for medico-legal autopsies should be readily available for teaching and research. However, they most strongly disagreed (mean = 2.00) that residents receive adequate training in performing medico-legal autopsies. The two groups of physicians surveyed determined that there is a deficiency in the number of autopsy cases. This is further influenced by clinicians’ concerns about litigation, religious/superstitious beliefs, and the delay in releasing autopsy results. Furthermore, pathologists specified that performing autopsies was excessively time-consuming with an unjustifiable cost. Sixty-two percent of the pathologists signified more strongly than the clinicians that modern diagnostic techniques have diminished the need to perform hospital autopsies. Nonetheless, 86% of Filipino physicians acknowledged that the autopsy is an important medical tool that should be performed for patients with unknown diagnoses and unexpected death. The number of observed and/or performed autopsy cases was a major factor that affected the pathologists’ attitudes and perceptions toward autopsy.@*Conclusion@#In general, there is recognition of the autopsy’s usefulness as a medical tool among the pathologists and clinicians surveyed. However, the lack of cases referred for autopsy remains a challenge undermining the benefits that are derived from its performance.

Analysis of the current performance of pharmacy outpatient services at grassroots medical institutions at home and abroad / 中华医院管理杂志

Pharmacy services in grassroots medical institutions provide professional pharmacy services for patients. This service not only expanded the scope of primary care delivery, but also meets the residents′need for appropriate medication. At present, the majority of grassroots medical institutions in China provide outpatient pharmacy services by means of pharmacy service alliance, and foreign grassroots medical institutions mainly provide pharmaceutical outpatient services with drug treatment management as the core for patients by granting pharmacists partial prescription rights.In recent years, pharmaceutical outpatient services in grassroots medical institutions had achieved good results in improving patient clinical outcomes, enhancing medication rationality, and enhancing patient compliance. However, there were many unresolved issues, including low public awareness, shortage of pharmaceutical talents, and imperfect guarantee systems. The author suggestted that efforts should be made to increase the publicity of pharmaceutical outpatient services, improve the training mechanism for pharmacists, strengthen cooperation between pharmacists and clinical physicians, include pharmacists in the contracted service team of family doctors, and improve various guarantee systems, in order to provide reference for promoting the sustainable development of pharmaceutical outpatient services in grassroots medical institutions in China.

A prospective, questionnaire-based study to evaluate the knowledge, attitude, and practice of rational use of antibiotics among clinical practitioners in a tertiary care hospital

Background: Irrational antibacterial usage leads to emergence of antibiotic resistance. Hence, to ensure rational prescription regular clinical audits are essential in tertiary care hospitals. Aim and Objective: To assess the knowledge, attitude, and perception of clinician抯 on rational use of antibiotics in a tertiary care hospital. Materials and Methods: The prospective, questionnaire-based study was conducted on clinicians in a tertiary care hospital, after getting approval of the Institutional Ethics Committee to obtain information on rational antibiotic usage and was analyzed using descriptive statistics. Results: The study included 100 clinicians. 95% were aware about Rational antibiotic usage, the ingredients, adverse effects, interactions, contraindications, and cost of the drugs they prescribe and they were also analyzing the culture and sensitivity report before prescription of antibiotics, but only 48% of them were prescribing antibiotics from National List of Essential Medicines, 35% were influenced by patient demands. Around 80% agreed with the usefulness of the feedback given by fellow colleagues on antibiotic decisions. Though 98% of them were aware of the hazards of antibiotic resistance only 68% knew about antibiogram and having antibiotic policy at the workplace. In practice, 95% were showing special interest in proper antibiotic usage, 82% knew the new antibiotics available and 91% were providing proper counseling to patients. 95% suggested the need for training on rational use of medicines and antibiotic policy post MBBS. Conclusion: The clinicians recognized the importance of rational antibiotic use in preventing its resistance thus reducing health care burden on the patients.

Cardiovascular Comorbidity and its Impact on Patients with COVID-19 in a Tertiary Care Hospital, Bangladesh

Background: People with cardiovascular issues have been shown to be at an elevated risk of acquiring the 2019 new corona virus infection, according to studies (COVID-19). This study’s objective was to determine if cardiovascular disease has any effect on the severity of COVID-19.Material & Methods:Between January 2020 and December 2020, 210 comorbid patients aged over 40 years old diagnosed with COVID-19 admitted in BIRDEM hospital in Bangladesh were recruited purposively for a cross sectional study as per inclusion criteria. A baseline study was created for each patient based on their medical history, physical examination, biochemical tests, and the amount of care they needed (intensive care vs. ward-based care). SPSS 26 was used to analyze the data.Results:Among the 210 comorbid individuals, 74 had cardiovascular comorbidities and the remaining 136 had other comorbidities. Among the respondents, 48% were serious cases and required ICU support within 30 days. Cases with up to 2 comorbidities did not require ICU support. The severity of COVID-19 was predicted by factors such as age above 80 years (OR 35.5, 95 percent CIs 18.7,98.5), male gender (OR 3.14, CI 1.16, 3.50), and a high troponin level in the patient’s blood (OR 1.34, CI 0.84,3.54). It was shown that cardiovascular comorbidities (CI=1.8,3.0) were 2.9 times more likely to be linked to severity. The risk factors also included a history of diabetes, hypertension, and chronic obstructive pulmonary disease. Conclusions:Cardiovascular patients, who were previously grouped together as high risk due to the nature of their ailment, need more tailored counseling and treatment from public health authorities and clinicians.

Percepción de los pacientes hospitalizados respecto del cuidado de enfermería

Resumen: Introducción: La atención humanizada requiere la interacción entre los conocimientos científicos y los valores, generando la necesidad de particularizar los cuidados, siendo esta una actividad esencial en enfermería. Objetivo: Analizar la percepción que tienen los usuarios hospitalizados respecto del cuidado humanizado que reciben por parte de las profesionales de enfermería. Metodología: Se desarrolló una investigación de tipo cuantitativa, descriptiva, correlacional y de corte transversal, que incluyó a los usuarios hospitalizados en los Servicios Clínicos de Medicina, Cirugía, Pensionado y representantes legales de pacientes menores de 18 años en Pediatría, de un hospital público ubicado en el sur de Chile, con una muestra de 377 participantes. Posterior a aplicación de consentimiento informado, se aplicó una caracterización sociodemográfica y el instrumento Percepción de Comportamientos de Cuidado Humanizado de Enfermería - versión 3, con adaptación transcultural para la población chilena, el cual fue complementado con otros datos pertinentes a los objetivos de la investigación. Resultados: Se encontró que las personas participantes en su mayoría reconocieron al profesional de enfermería por el uniforme, y pese a existir algunas diferencias en cada servicio, refirieron satisfacción con el cuidado recibido (84,6 %). Aspectos como la edad, el tiempo de hospitalización y el reconocimiento del personal de enfermería, evidenciaron relación estadística con la satisfacción. Conclusiones: Se requiere implementar estrategias para fortalecer la percepción del cuidado humanizado de enfermería, siendo estos aspectos una contribución para la construcción de un clima y cultura organizacional que evidencien esta perspectiva de cuidado.

Resumo: Introdução: Uma atenção humanizada requer a interação entre saberes científicos e valores, gerando a necessidade de particularização ou cuidado, sendo essa uma atividade essencial na enfermagem. Objetivo: Analisar a percepção que os usuários hospitalizados têm sobre o atendimento humanizado que recebem dos profissionais de enfermagem. Método: Es uma investigação quantitativa, descritiva, correlacional e transversal, que incluiu os usuários hospitalizados nos Serviços de Medicina, Cirurgia, Pensionista e representantes legais de pacientes menores de 18 anos em Pediatria, de um hospital público localizado no sul do Chile, com uma amostra de 377 participantes, Após a aplicação do consentimento informado, foi aplicada uma caracterização sociodemográfica e foi aplicado o instrumento Percepção de Comportamentos de Assistência Humanizada de Enfermagem - versão 3, com adaptação transcultural para a população chilena, ou que foi complementado com outros dados pertinentes aos objetivos da pesquisa. Resultados: Verificou-se que os participantes, em sua maioria, reconheciam ou profissionais de enfermagem pelo uniforme e, apesar da existência de algumas diferenças em cada Serviço, relatam sentir-se satisfeitos com o atendimento recebido (84,6 %). Aspectos como a idade, tempo de internação e reconhecimento da equipe de enfermagem apresentam relação estatística com a satisfação. Conclusões: É necessário implementar estratégias que fortaleçam a percepção do cuidado humanizado de enfermagem, sendo esses aspectos uma contribuição para a construção de um clima e cultura organizacional que demonstrem essa perspectiva de cuidado.

Abstract: Introduction: Humanized care requires the interaction between scientific knowledge and values, generating the need to particularize care, which is an essential activity in nursing. Objective: To analyze the perception of hospitalized users regarding the humanized care they receive from nursing professionals. Methodology: A quantitative, descriptive, correlational, and cross-sectional research was carried out, which included hospitalized users in the Clinical Services of Medicine, Surgery, Private, and legal representatives of patients under 18 years of age in Pediatrics, of a public hospital located in the south of Chile, with a sample of 377 participants. After the application of informed consent, it was applied a sociodemographic characterization as well as the instrument Perception of Humanized Nursing Care Behaviors - Version 3, with transcultural adaptation for the Chilean population, which was complemented with other data pertinent to the objectives of the research. Results: It was found that most of the participants recognized the nursing professional by the uniform, and despite some differences in each service, they reported satisfaction with the care received (84.6%). Aspects such as age, length of hospitalization and recognition of the nursing staff showed a statistical relation with satisfaction. Conclusions: It is necessary to implement strategies to strengthen the perception of humanized nursing care, being these aspects a contribution to the construction of an organizational climate and culture that evidences this perspective of care.

Study on the current status and feasibility of payment reform for TCM dominant diseases from the perspective of clinicians / 中国药房

OBJECTIVE To understan d the c urrent situation and feasibility of payment reform for TCM dominant diseases from the perspective of clinicians ，so as to provide reference for optimizing and improving the reform scheme. METHODS A questionnaire was designed by ourselves ，and a simple random sampling method was used to select clinicians from the pilot hospitals of payment reform for TCM dominant diseases in Guizhou province to conduct a face-to-face questionnaire survey. SPSS 20.0 software was used for statistical analysis. The single-factor analysis and ordered Logistic regression analysis of multi-factor were used to analyze the influential factors of reform feasibility. RESULTS A total of 420 questionnaires were distributed in this survey，and 413 valid questionnaires were recovered ，with an effective rate of 98.3％. Totally 86.0％ of the clinicians thought that it was feasible for the reform to be carried out in their hospitals ，and 81.8％ thought that the selected TCM dominant diseases in the pilot hospitals were reasonable. After the reform was carried out ，61.0％ and 58.8％ of clinicians indicated that the daily number of patients treated in their departments and their willingness to communicate with patients increased ，respectively；60.3％ indicated that the difficulties and obstacles encountered in the reform were the complexity and diversity of TCM diseases ，for the treatment of patients with integrated traditional Chinese and Western medicine ，which was difficult to use a unified disease and surgery code to correctly code ；76.3％ indicated that the greatest advantage of the reform implementation was the improvement of medical quality ，while 54.2％ indicated that the greatest disadvantage was the excessive restriction of doctors ’autonomy. The results of multi-factor ordered Logistic regression analysis showed that changes in treatment services （changes in readmission rate of patient），the reasonableness of the selection of TCM dominant diseases ，and whether to reduce medical costs ，improve doctor-patient relationship ， and promote hierarchical treatment were the influential factors of reform feasibility after the implementation of reform （P＜0.05）. CONCLUSIONS It is feasible to carry out payment reform for TCM dominant diseases in Guizhou province ，but it is still in the exploratery stage ，and there are many factors affecting the feasibility of the reform. It is suggested that in the future ，when promoting in the whole pr ovince and even the whole c ountry，we should pay attention to selecting more and more reasonable dominant diseases for payment reform ， further standardize the diagnosis and treatment behavior of clinicians ， control the unreasonablegrowth of medical expenses ， strengthen communication between clinicians and patients， improve the accurate diagnosis rate of traditional Chinese medicine diseases ，implement hierarchical calculation of dominant diseases ，and promote hierarchical diagnosis and treatment of medical institutions.

Current situation and influencing factors of clinical research data sharing of gastroenterology collaboration network / 中华医学科研管理杂志

Objective:The paper aims to investigate the current situation and influencing factors of clinical research data sharing of gastroenterology collaboration network of Beijing municipal hospitals so as to provide reference basis for establishing data sharing mode of collaboration center.Methods:A total of 13 gastroenterology department of Beijing municipal hospital collaboration network units enrolled the research. Each department selected 10-15 clinicians for a questionnaire survey. A total of 157 valid questionnaires were collected.Results:The awareness rate of public data platform(realized at least one) is 81.5%. The rate of browsing public data platform is 65.6%. The rate of downloading and uploading rare data are 13.4% and 1.3%, respectively. As the level of professional titles increases, the proportion of clinicians realizing and downloading raw data has increased significantly( P<0.05). In this survey, 31.3% clinicians used the sharing data from other hospitals within the research group and 53.5% clinicians indicated that there is the data sharing platform based on hospital information system within their hospital/department. The rate of willing to share clinical data is 73.3%. However, a majority of clinicians are inclined to accept the sharing within the research group/hospital, and they prefer to share their data when their papers or research results are published. Data storage is mainly numerical and text structured data. Sharing risk, sharing platform, sharing system and data itself are the top four factors affecting data sharing. Conclusions:Relevant departments should strive to establish sharing mechanism, build sharing platforms, refine the sharing access qualification and improve the sharing awareness of medical personnel so as to lay a necessary foundation for further open sharing of big data on digestive diseases.

Extent of EBP process implementation of PT Clinicians in PLM-affiliated institutions

Background@#Evidence Based Practice (EBP) is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of an individual patient. It integrates clinical expertise, best evidences and patient's values through the implementation of 5 EBP processes: Ask, Acquire, Appraise, Apply and Assess which improve both patient care and clinical practice every time the cycle completes its turn. Despite of its effectiveness, implementation of EBP is a challenge. Variations and inconsistencies in the implementation of the EBP processes were found due to different factors and barriers. Philippines shares the same challenges and barriers in the implementation of EBP process but no local study has been found on the extent of implementation of EBP processes among Physical Therapist. @*Objectives@#This study determines the extent of the EBP processes implemented by PT clinicians in PLMaffiliated institutions. @*Methodology@#This is a descriptive cross-sectional survey that made use of a developed and validated questionnaire which collected the data on demographic profile: age, gender and year graduated, highest educational attainment and the extent of EBP process implementation of Physical Therapist in PLM – affiliation centers.@*Results@#Ninety-three PTs responded in the study. 89.2% (n=83) has BSPT as their highest educational attainment. 2.2% (n=2) has Masters while 3.2% (n=3) has Doctorate in Physical Therapy. EBP is implemented by respondents. Asking clinical questions was implemented at a high extent (composite mean = 2.88) while searching for evidence (2.17), critical appraisal (2.25), use or integration of research (2.46), evaluation of outcomes (2.1) were implemented at a low extent. @*Conclusion@#Although, EBP processes has been implemented in the local university's affiliation, majority of the processes were implemented at a low extent except for asking clinical questions, which was implemented at a high extent. Greater efforts on addressing common barriers have been recommended to be able to fully implement EBP practice.

A survey of grief counseling of clinicians from coronavirus disease 2019 designated hospitals / 第二军医大学学报

Objective To investigate the current status of grief counseling of clinicians from five coronavirus disease 2019 (COVID-19) designated hospitals in Wuhan and to provide reference for hospital management. Methods A total of 223 clinicians from designated hospitals were investigated with a basic information questionnaire and attitudes and skills of grief counseling scales. Results A total of 208 valid questionnaires were collected, with an effective rate of 93.3%. The score of grief counseling skills of clinicians from COVID-19 designated hospitals was 19.35±4.75, which was in the middle and lower level. Responsibilities and roles, and frequency of contacting bereaved family members had significant effects on the grief counseling skills (P0.01). While the score of grief counseling attitudes of clinicians was 33.21±9.23, which was in the middle level. Whether they had received relevant training, the communication ability, and other grief counseling skills had significant impacts on their grief counseling attitudes (P0.01). Conclusion The skills and attitudes of grief counseling of clinicians from COVID-19 designated hospitals in Wuhan still need to be improved. The hospital should set up a grief counseling committee, establish a complete grief guidance system and build a long-term training mechanism.

Survey of clinicians' needs of support for conducting clinical research / 中华医学科研管理杂志

Objective To explore and understand limitations and needs of support for conducting clinical research among clinicians in China.Methods The in-service clinician in our hospital were enrolled in as survey participants,survey questionnaires were designed and filled up by target audience in the questionnaire star platform.Results Main problems identified as restrictions for conducting clinical studies including lack of data platform,have ideas but not protocols,lack of research funding and project management.On the other hand,identified needs for support including research-related technical support,project management facilitation,training,external communication and exchange,as well as quality risk management.Conclusions Hospital should establish Clinical Research Unit to help clinicians to improve research quality by training,providing technical support and administrative service of clinical research.

Validation of a questionnaire of knowledge and attitudes about the subcutaneous venous reservoir in nursing / Validação de um questionário de conhecimentos e atitudes sobre o cateter venoso totalmente implantado em Enfermagem / Validación de un cuestionario de conocimientos y actitudes sobre el reservorio venoso subcutáneo en enfermería

Objective: design and validate a questionnaire to evaluate the knowledge and attitudes of nurses about the subcutaneous venous reservoir. Method: pilot test: 30 specialized care nurses. Main study: 236 nurses of primary and specialized care. Content validity was evaluated by Lawshe index, reliability by test-retest, internal consistency by Cronbach alpha, and construct validity by exploratory factorial analysis. Results: Items with a Lawshe index lower than 0.51 were eliminated. In the test-retest, the intraclass correlation coefficient was higher than 0.75 for all items. The Cronbach alpha of the attitude questionnaire reached 0.865. The Cronbach alpha value for knowledge was 0.750. The exploratory factor analysis identified a set of four dimensions for each part that explain 64% (attitude) to 80% (knowledge) of variability. Conclusion: the analysis of the reliability and validity of the questionnaire supports its use as an instrument to assess the knowledge and attitudes of nurses towards the subcutaneous venous reservoir.

Objetivo: construir e validar um questionário para avaliar os conhecimentos e as atitudes dos profissionais de enfermagem sobre o cateter venoso totalmente implantado. Método: teste piloto: 30 enfermeiros de atendimento especializado. Estudo principal: 236 enfermeiros de atendimento primário e especializado. Avaliou-se a validade de conteúdo por meio do índice de Lawshe, a confiabilidade por meio do teste-reteste, a consistência interna mediante o alfa de Cronbach, e a validade de construto por meio de uma análise fatorial exploratória. Resultados: foram eliminados os itens com um índice de Lawshe inferior a 0,51. No teste-reteste, o coeficiente de correlação intraclasse foi maior que 0,75 para todos os itens. O alfa de Cronbach do questionário de atitude atingiu um valor de 0,865. O valor de alfa de Cronbach para o de conhecimentos foi de 0,750. A análise fatorial exploratória identificou um conjunto de quatro dimensões para cada parte, que explicam a variabilidade de 64% (atitude) a 80% (conhecimentos). Conclusão: a análise da confiabilidade e a validade do questionário endossam seu uso como instrumento para avaliar os conhecimentos e as atitudes dos profissionais de enfermagem em relação ao cateter venoso totalmente implantado.

Objetivo: diseñar y validar un cuestionario para evaluar los conocimientos y las actitudes del personal de enfermería sobre el reservorio venoso subcutáneo. Método: prueba piloto con 30 enfermeros/as de atención especializada. Estudio principal con 236 enfermeros/as de atención primaria y especializada. Se evaluó la validez de contenido mediante el índice de Lawshe, la fiabilidad mediante test-retest, la consistencia interna mediante el alfa de Cronbach y la validez de constructo con un análisis factorial exploratorio. Resultados: se eliminaron los ítems con un índice de Lawshe inferior a 0,51. En el test-retest, el coeficiente de correlación intraclase resultó ser mayor que 0,75 para todos los ítems. El alfa de Cronbach del cuestionario de actitud alcanzó un valor de 0,865. El valor de alfa de Cronbach para el de conocimientos fue de 0,750. El análisis factorial exploratorio identificó un conjunto de cuatro dimensiones para cada parte que explican del 64% (actitud) al 80% (conocimientos) de la variabilidad. Conclusión: el análisis de la fiabilidad y la validez del cuestionario avalan su uso como instrumento para valorar los conocimientos y actitudes del personal de enfermería en torno al reservorio venoso subcutáneo.

Atención de Enfermería durante el postoperatorio a paciente sometido a clipaje de aneurisma por ruptura / Postsurgical Nursing Attention on a patient who underwent aneurysm clipping / Assistência de enfermagem no pós-operatório ao paciente submetido a ruptura de aneurisma

Introducción Es reconocido que el personal de enfermería es quien tiene mayor interacción con el paciente, por lo que se ve obligado a contar con conocimientos y experiencia suficiente que permita identificar y atender las necesidades de individuos que sufren de enfermedad cerebrovascular. Esta condición de salud puede ser secundaria a la ruptura de un aneurisma, lo que conduce al paciente a un estado crítico; además, puede traducirse en riesgo para el equilibrio financiero de la familia y el Sistema Sanitario. Métodos: Se desarrollaron las etapas del proceso de cuidado de enfermería centradas en una situación real de la práctica clínica durante el periodo postoperatorio de una paciente sometida a clipaje de aneurisma. Se utilizó el modelo de patrones funcionales de Marjory Gordon para la recolección de los datos; además de la taxonomía NANDA-NIC-NOC. Resultados: Se presentan los planes de cuidado en los que se centró la intervención de enfermería en la paciente valorada. Así como la evaluación del proceso en las dimensiones de estructura, proceso y resultado. Discusión/conclusiones: El EVC secundario a ruptura de aneurisma cerebral es una situación grave y devastadora para la familia y el sistema sanitario. Por tanto, una adecuada atención de enfermería a este problema es de la mayor importancia.

Introduction: It is well acknowledged that nursing staff have the greatest interaction with patients and thus, nurses need to have sufficient knowledge and experience to identify the diverse needs, for example of those patients suffering from cerebrovascular disease. This condition can be a consequence of a ruptured aneurysm, which can in turn lead the patient to a critical status jeopardizing the financial equilibrium of his/her family and the health system. Methods: The nursing process stages were developed during the postsurgical period of a patient who underwent an aneurysm clipping. The Gordon's functional health patterns model was used to collect data, in addition to the NANDA/NIC/NOC taxonomy. Results: Care plans derived from the nursing intervention were presented, as well as the related assessment in terms of the structure, process, and results dimensions. Discussion/Conclusion: The CVE secondary to the rupture of an aneurysm is a serious and devastating situation for the patient, his/her family, and the health system, therefore, an adequate related nursing attention becomes of the most importance.

Introdução: Reconhece-se que os enfermeiros têm maior interação com o paciente, sendo obrigados a ter conhecimento e experiência suficientes para identificar e atender às necessidades dos indivíduos portadores de doença cerebrovascular. Essa condição de saúde pode ser secundária à ruptura de um aneurisma, que leva o paciente a um estado crítico; além disso, pode ser traduzido em risco para o equilíbrio financeiro da família e do Sistema de Saúde. Métodos: Desenvolveram-se as etapas do processo de cuidar em enfermagem, enfocando uma situação real da prática clínica no pós-operatório de um paciente submetido a clipagem de aneurisma. O modelo de padrões funcionais de Marjory Gordon foi utilizado para coleta de dados; além da taxonomia NANDA-NIC-NOC. Resultados: São apresentados planos de cuidados em que a intervenção de enfermagem foi focada no paciente valorizado. Assim como a avaliação do processo nas dimensões de estrutura, processo e resultado. Discussão / conclusões: A EVC secundária a um aneurisma cerebral roto é uma situação grave e devastadora para a família e o sistema de saúde. Portanto, cuidados de enfermagem adequados para este problema são de extrema importância.

Exploration on an integrated care mode of rehabilitation by both clinicians and physiatrists at a rehabilitation hospital / 中华医院管理杂志

Tertiary rehabilitation hospitals should not only serve patients with systemic and specialized rehabilitations but also have capabilities in diagnosis/treatment,and even emergency responses.This paper introduced an integrated care mode at a rehabilitation hospital,in practicing in-depth and phased integration of clinical service and rehabilitation.Phase 1 (March 2015-March 2016) witnessed the "two-way" model,with coexisting rehabilitation pathway and clinical pathway.The second phase,from April 2016 to September 2017,witnessed the integrated care mode in which clinicians and physiatrists jointly took care of patients.A comparison between the same period of 2016 with data of 2015,and that of 2017 with data of 2016,found average length of stay was shortened by 0.5 day and 3.6 days respectively,the drug ratio fell by 4.63％ and 8.47％ respectively;the rehabilitation effective percentage was increased from 95.2％ to 98.0％.The percentage of cure or improvement for primary diseases was over 97％.The integrated care mode by both clinicians and physiatrists can shorten the length of stay,lower the drug ratio,raise medical efficiency,and encourage a more reasonable ratio of medical expenses.

Patient Safety Management Activities of Clinical Nurse: A Modified Theory of Planned Behavior / 간호행정학회지

PURPOSE: The purpose of this study was to develop a structural model for patient safety management activities and to identify the influencing factors of organizational and individual dimensions that promote patient safety management activities and to suggest effective intervention plans.METHODS: A structured self-report questionnaire was used to measure organizational factor, attitude, subjective norm, perceived behavior control, and patient safety management activities. The questionnaires were distributed to 300 nurses and 275 were included in the analysis. SPSS 25.0 and AMOS 21.0 were used to analyze the model fitness, indirect effect, and direct effect of the model.RESULTS: The hypothetical model for patient safety management activities was appropriate. Among the 8 pathways, 6 direct pathways were significant. Organizational factor affected individual attitudes, subjective norms, and perceived behavior control. Perceived behavior control, and subjective norm affected behavioral intention. Behavioral intention affected patient safety management activities. Perceived behavior control did not affect patient safety management activities.CONCLUSION: Organizations and individuals must change together to promote patient safety management activities. The organization should establish practical education and training, systems and regulations. Individuals should increase behavioral intention by strengthening perceived behavioral control and subjective norm.

Path on the management of surgical graded and refined management based on information technology / 中华医院管理杂志

The authors attempted to use information technology in hierarchical management on clinician′s surgical authority. By means of a hierarchical surgery catalogue database, clinicians′ surgical authority is subject to by-level IT-based approval, and such authorities as clinician′s surgical medical advice, application for surgery, and approval of special surgeries are regulated. Thanks to multi-dimensional objective data, clinicians′surgical competence is subject to a dynamic evaluation, hierarchical authorization and reauthorization. These measures further standardize the behavior of the surgeons, and rule out unauthorized operations, thus improving fine management of surgeries and ensuring patient safety.

Exploration of clinicians′professional competency evaluation based on DRGs indexes / 中华医院管理杂志

Objective To evaluate the professional competency of the clinicians with DRGs indexes. Methods The homepages of medical records of the hospital from January to June in 2018 were extracted, and the conventional evaluation indexes ( i. e. percentage of drug expenditure, percentage of medical consumables expenditure, and percentage of antimicrobials application ) of each clinician were obtained. " CN-DRGs" burster was used to calculate the DRGs indexes. The weighted RSR was applied to evaluate the professional competency of the resident physicians. Results A comprehensive evaluation of the professional competency of 438 resident clinicians was conducted. 218, 190, and 30 clinicians fell into excellent, medium and poor categories respectively. The results of ANOVA showed that the differences of the 3 categories were significant ( F =664. 863, P <0. 001 ). Conclusions The evaluation of clinicians′professional competency based on DRGs was reasonable, objective and feasible, proving its importance for the establishment of a scientific and standardized clinicians evaluation system.

Satisfacción laboral de enfermería. Diferencias de ámbitos en atención primaria en salud y cuidado intensivo / Nursing job satisfaction. Differences of areas in primary health care and intensive care

La satisfacción laboral en la enfermería establece la calidad de los servicios prestados. Al determinar esta en ámbitos hospitalarios como unidades de cuidado intensivo y en la Atención Primaria en Salud en ámbito comunitario, a través del autoreporte de 280 enfermeros con la aplicación del cuestionario Font roja de 24 ítems, se encuentra que el 39,6% de la población está entre los 20 y 30 años, donde el ámbito comunitario posee medias más elevadas y estadísticamente significativas (p=0,00) en la relación interpersonal con sus jefes y compañeros, percepciones que favorecen a la autonomía del profesional de enfermería. El ámbito hospitalario goza de mayor satisfacción por el trabajo, de igual forma se satisface mejor con la competencia profesional. La monotonía laboral que manifiesta la escasa variedad del trabajo es autodeclarada con una media mayor en el ámbito comunitario, y afirmada con un OR de 2,36 (p=0,00) considerándose un factor de riesgo para este. Para concluir, la satisfacción laboral comparada en dos ámbitos laborales ratifica una realidad ante la insatisfacción de las relaciones interpersonales con los compañeros y jefes del ámbito hospitalario y la monotonía como factor de riesgo en ambientes comunitarios.

Nursing job satisfaction establishes the quality of the services provided. When determining this in hospital settings as intensive care units and Primary Health Care in the community, through the self-report of 280 nurses with the application of Font Roja questionnaire of 24 items, it is found that 39.6% of the population is between 20 and 30 years old, where the community environment has higher and statistically significant averages (p=0.00) in the interpersonal relationship with their heads and colleagues, perceptions that favor the autonomy of the nursing professional. The hospital environment enjoys greater satisfaction with work, in the same way, it is better satisfied with professional competence. The labor monotony that manifests the scarce variety of work is self-reported with a higher average in the community environment, and affirmed with an OR of 2.36 (p = 0.00), considering it a risk factor for this. To conclude, comparative job satisfaction in two work environments ratifies a reality of the dissatisfaction of interpersonal relationships with colleagues and heads of the hospital environment and monotony as a risk factor in community environments.

The Frequency of Job Performance of the Korean Professional Medical Support Staff at Medical Institutions over 500 Beds / 중환자간호학회지

PURPOSE: This study was intended to investigate the frequency of job performance of the Korean professional medical support staffs (PMSS).METHOD: The data of 1,666 PMSS from 36 hospitals and over 500 beds were analyzed. The participants were divided into 5 groups: advanced practice nurses (APN), clinical nurse experts, physician assistants (PA), coordinators, and others.RESULTS: Among the 5 main domains of job performance, advanced clinical practice has the highest frequency (111.36 d/y), followed by consultation/collaboration (75.66 d/y), education/counseling (53.54 d/y), leadership (23.90 d/y), and research (19.14 d/y). There was a significant difference in the frequency of job performance between the 5 groups of participants. The invasive activities were more frequent in the PA group. In the education and counseling domain, APNs had a higher level of job frequency than others (p < .001). In the research and leadership domains, APNs and coordinators had more prominent performance frequency than other groups (p < .01). However, there are some ambiguities in the job performance of the 5 groups depending on institutional characteristics.CONCLUSION: To establish the scope of work of PMSS, organizational and individual efforts are needed to promote and expand the leadership and research domains. To resolve the ambiguities of PMSS' roles, it is necessary to reorganize their titles.

The Current Status of Professional Medical Support Staffs in General Hospitals less than 500 Beds / 임상간호연구

PURPOSE: This study aimed to investigate the current statistics of professional medical support staffs(PMSSs) working in general hospitals with less than 500 beds. METHODS: This study was conducted on 35 general hospitals with less than 500 beds from September 11th to October 27th, 2017. RESULTS: Four hundred fifty one PMSSs were currently providing medical support. The number of clinical nurse experts was the highest among the roles, followed by Physician Assistants(PA) and Advanced Practice Nurses. The mean job satisfaction score was 3.07 out of 5. In the case of PA group, most of the delegated prescriptions were performed, however the delegated roles were not much documented in written format. The paucity of documentation requires a development of a committee for PMSSs, including a development of selection criteria and a scope of practice in each institution. CONCLUSION: The results of this study suggested the composition of a committee for PMSSs in the medical institutions and renaming the specified titles of PMSSs.