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This study aimed to explore key quality control factors that affected the prognosis of intensive care unit (ICU) patients in Chinese mainland over six years (2015-2020). The data for this study were from 31 provincial and municipal hospitals (3425 hospital ICUs) and included 2 110 685 ICU patients, for a total of 27 607 376 ICU hospitalization days. We found that 15 initially established quality control indicators were good predictors of patient prognosis, including percentage of ICU patients out of all inpatients (%), percentage of ICU bed occupancy of total inpatient bed occupancy (%), percentage of all ICU inpatients with an APACHE II score ⩾15 (%), three-hour (surviving sepsis campaign) SSC bundle compliance (%), six-hour SSC bundle compliance (%), rate of microbe detection before antibiotics (%), percentage of drug deep venous thrombosis (DVT) prophylaxis (%), percentage of unplanned endotracheal extubations (%), percentage of patients reintubated within 48 hours (%), unplanned transfers to the ICU (%), 48-h ICU readmission rate (%), ventilator associated pneumonia (VAP) (per 1000 ventilator days), catheter related blood stream infection (CRBSI) (per 1000 catheter days), catheter-associated urinary tract infections (CAUTI) (per 1000 catheter days), in-hospital mortality (%). When exploratory factor analysis was applied, the 15 indicators were divided into 6 core elements that varied in weight regarding quality evaluation: nosocomial infection management (21.35%), compliance with the Surviving Sepsis Campaign guidelines (17.97%), ICU resources (17.46%), airway management (15.53%), prevention of deep-vein thrombosis (14.07%), and severity of patient condition (13.61%). Based on the different weights of the core elements associated with the 15 indicators, we developed an integrated quality scoring system defined as F score=21.35%xnosocomial infection management + 17.97%xcompliance with SSC guidelines + 17.46%×ICU resources + 15.53%×airway management + 14.07%×DVT prevention + 13.61%×severity of patient condition. This evidence-based quality scoring system will help in assessing the key elements of quality management and establish a foundation for further optimization of the quality control indicator system.
Subject(s)
Humans , China/epidemiology , Cross Infection/epidemiology , Intensive Care Units/statistics & numerical data , Quality Control , Quality Indicators, Health Care/statistics & numerical data , Sepsis/therapy , East Asian People/statistics & numerical dataABSTRACT
This study aimed to explore key quality control factors that affected the prognosis of intensive care unit (ICU) patients in Chinese mainland over six years (2015-2020). The data for this study were from 31 provincial and municipal hospitals (3425 hospital ICUs) and included 2 110 685 ICU patients, for a total of 27 607 376 ICU hospitalization days. We found that 15 initially established quality control indicators were good predictors of patient prognosis, including percentage of ICU patients out of all inpatients (%), percentage of ICU bed occupancy of total inpatient bed occupancy (%), percentage of all ICU inpatients with an APACHE II score ⩾15 (%), three-hour (surviving sepsis campaign) SSC bundle compliance (%), six-hour SSC bundle compliance (%), rate of microbe detection before antibiotics (%), percentage of drug deep venous thrombosis (DVT) prophylaxis (%), percentage of unplanned endotracheal extubations (%), percentage of patients reintubated within 48 hours (%), unplanned transfers to the ICU (%), 48-h ICU readmission rate (%), ventilator associated pneumonia (VAP) (per 1000 ventilator days), catheter related blood stream infection (CRBSI) (per 1000 catheter days), catheter-associated urinary tract infections (CAUTI) (per 1000 catheter days), in-hospital mortality (%). When exploratory factor analysis was applied, the 15 indicators were divided into 6 core elements that varied in weight regarding quality evaluation: nosocomial infection management (21.35%), compliance with the Surviving Sepsis Campaign guidelines (17.97%), ICU resources (17.46%), airway management (15.53%), prevention of deep-vein thrombosis (14.07%), and severity of patient condition (13.61%). Based on the different weights of the core elements associated with the 15 indicators, we developed an integrated quality scoring system defined as F score=21.35%xnosocomial infection management + 17.97%xcompliance with SSC guidelines + 17.46%×ICU resources + 15.53%×airway management + 14.07%×DVT prevention + 13.61%×severity of patient condition. This evidence-based quality scoring system will help in assessing the key elements of quality management and establish a foundation for further optimization of the quality control indicator system.
ABSTRACT
Objectives: To develop and validate patients’ knowledge, attitudes, and practice instrument for uncomplicated malaria(PKAPIUM).Material and Methods: A draft PKAPIUM scale was developed after the review of relevant literature and malariatreatment guidelines, and six experts validated its content. Monte Carlo simulation principle was followed in arrivingat 300 patients populations whose data were used to reduce the items based on “Kaiser’s eigenevalue-greater-than-onerule.” This was followed by the test of validity and reliability to assess the psychometric properties of the instrument.Results: The items content validity indices (I-CVI) and the scale CVI (S-CVI) using universal agreement (UA) withinexperts (S-CVI/UA) and average CVI (S-CVI/Ave) approaches were good (0.8–1.00), with absence of items’ floor orceiling effects. Twenty-one items were retained in the new scale arranged under four factors with average varianceextracted (AVE) and square root AVE values of 0.58–0.70 and 0.76–0.84, respectively, suggesting convergent anddiscriminant validities. The goodness-of-fit results [Chi-square (CMIN/DF) = 3.07, p = 0.00], standardized root meansquare residual = 0.070, root mean square error approximation = 0.08 confirmed the hypothesized factor structuresof the scale whose internal consistency of Cronbach’s alpha and composite reliability values were 0.74 and 0.82,respectively, and stability of ICC = 0.92 [95% confidence interval : 0.87–0.95, F = 43 (p = 0.51)].Conclusion: The validity and reliability of the PKAPIUM were in acceptable ranges.
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Tem sido dada uma importância muito maior à participação dos trabalhadores e retenção desde que a Índia está enfrentando a maior taxa de atrito globalmente Economic Times, 2015¹. Assim, considerando os fatores de Pessoa - job apto a interpretar o impacto no compromisso de trabalho é muito bem essencial, especialmente no Compromisso scenario.Work atual é um elemento vital de qualquer constituição que tem um impacto notável na produtividade e funcionamento . Mas, quando os funcionários vão sentir o compromisso de trabalho é o futuro pergunta. Existe uma forte relação entre ajuste pessoa - trabalho e compromisso de trabalho . ajuste pessoa - trabalho é a compatibilidade entre competência e habilidades da pessoa e as exigências do trabalho Zheng et al.². Se existe uma incompatibilidade entre o ajuste pessoa - trabalho, então as consequências podem resultar em compromisso de trabalho pobre, baixa satisfação no trabalho e extremamente menor envolvimento no trabalho. OBJETIVO: Este estudo analisou os principais fatores que contribuem para a pessoa- a compatibilidade de trabalho entre TI trabalhadores e também analisou a relação e o impacto da compatibilidade de trabalho Person- no compromisso de trabalho. MÉTODO: Exploratory Factor de Analysis (EFA) foi usado para filtrar os fatores-chave inicialmente, seguido por uma técnica de regressão linear para determinar o impacto da pessoa- fatores de compatibilidade emprego no compromisso de trabalho em uma amostra de 300 empregados. EFA utilizada análise de componentes principais para a extração e Promax para rotação . Finalmente a análise de regressão foi realizada para prever o compromisso de trabalho por meio de variáveis estatisticamente significativas de compatibilidade pessoa - trabalho. RESULTADOS: Os resultados revelaram os principais fatores que determinam o nível de compromisso de trabalho são condições de RH, remuneração e benefícios e relacionamento entre os colegas de trabalho. CONCLUSÃO: Os principais fatores que são responsáveis pela criação de compromisso de trabalho entre empregados são Relacionamento, Políticas e estratégias de RH, remuneração e benefícios, o trabalho autonomia e crescimento do empregado. Os regride mais contribuem que representa a criação de compromisso de trabalho são as políticas de RH, remuneração e benefícios, o crescimento do empregado e trabalhar autonomia. O impacto da compatibilidade pessoa-trabalho no compromisso de trabalho foi estudada através de análise de regressão e isso implica que para cada aumento de uma unidade na política de RH, a 0,52 (coeficientes unstandardised) aumento no compromisso de trabalho está previsto e foi acabou como uma variável de maior impacto para prever compromisso de trabalho. Os coeficientes para Relacionamento (B = 0,330, sig = 0,000), Políticas de Recursos Humanos (B = 0,519, sig = 0,000), remuneração e benefícios (B = 0,386, sig = 0,000) e Crescimento Empregado (B = 0,290, sig = 0,001) foram significativamente diferente de 0, desde o seu valor de p era 0,000 que é menor do que 0,05. Os coeficientes para o Trabalho Autonomia (B = 0,154, SOG = 0,081) não foi estatisticamente diferente de zero, porque o seu valor-p é 0,081, que é maior do que 0,05. A implicação desta pesquisa vai ajudar os gestores a criar um ambiente de trabalho bem compatível concentrando-se em importantes construções de compatibilidade trabalho pessoa- que têm um possível efeito positivo no compromisso de trabalho e reduzindo, assim, a intenção de rotatividade dos empregados. Ainda mais aumentou compromisso de trabalho resultará em resultados do trabalho positivos, tais como a satisfação no trabalho e comprometimento organizacional
There have been given a much higher importance to employee commitment and retention since India is experiencing the highest attrition rate globally Economic Times, 2015¹. Hence, considering the factors of Person-job fit to interpret the impact towards work commitment is very well essential, especially in the current scenario. Work Commitment is a vital element in any organization which has outstanding impact on productivity and functioning and hence it is very much vital to have a committed workforce which is necessary in this competitive environment and tight labour market. In the same way, there is considerable amount of evidence that if P-J fit is high then it will have a direct impact on organization commitment also. Person-job fit is the compatibility between person's competency and abilities and the requirements of the job Zheng et al.². If there exists a mismatch between person-job fit then the consequences might result in poor work commitment, low job satisfaction and extremely lower involvement in the job. OBJECTIVE: This study analyzed the key factors that contribute to Person- job compatibility among IT workers and also analyzed the relationship and impact of Person- job compatibility towards work commitment. METHODS: Exploratory Factor Analysis (EFA) was used to filter the key factors initially, followed by a linear regression technique to determine the impact of Person- job compatibility factors in work commitment on a sample of 300 employees. EFA used Principal Component analysis for extraction and Promax for rotation. Finally regression analysis was carried out to predict the work commitment through statistically significant person-job compatibility variables. RESULTS: The impact of person-job compatibility on work commitment was studied through regression analysis and it imply that for every unit increase in HR Policy, a 0.52(unstandardised coefficients) increase in work commitment is predicted and it has been turned out as a most impacting variable to predict work commitment. The coefficients for Relationship (B =.330, sig =.000), HR Policies (B =.519, sig =.000), Pay and Benefits (B =.386, sig =.000) and Employee Growth (B =.290, sig =.001) were statistically significant, since its p-value is .000 which is smaller than .05. The coefficients for Work Autonomy (B =.154, sig = .081) was not statistically significant, since its p-value is 0.081 which is greater than.05. CONCLUSION: The major factors responsible for creating work commitment among IT employees are Relationship, HR Policies and strategies, Pay and benefits, Work autonomy and Employee growth. The most contributing regressors which accounts for creating work commitment are HR policies, Pay and benefits, Employee growth and work autonomy
Subject(s)
Humans , Male , Female , Workforce , Professional Autonomy , Work , Working Conditions , Working Conditions , Factor Analysis, Statistical , Job Satisfaction , Linear Models , Health StrategiesABSTRACT
Objective: To develop a Constructive Thinking Scale for Chinese pupils. Methods: Data were collected from a sample of 302 primary school pupils tested with the Constructive Thinking Scale. Results: ①Item analysis showed that the Constructive Thinking Scale had satisfactory item discrimination; ②The Constructive Thinking Scale had a satisfactory reliability with a 0.83 test-retest reliability, and the Cronbach’s ? was 0.88; ③The result of EFA had five factors, and the range of factor loading was between 0.36 and 0.75. The final revised questionnaire included 23 items, which could explain 53.13% of the total variances. The scale had an ideal criterion validity. Conclusion: The Constructive Thinking Scale for pupils has ideal reliability and validity, and can be used in assessing Chinese pupils’ constructive thinking .
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0.40); ②The result of EFA had four factors: physical aggression, anger, hostility and substitution aggression. The range of factor loading was between 0.51 and 0.75; ③The Chinese version of BPAQ had a satisfactory reliability with a 0.92 test-retest reliability and the Cronbach’s ? was 0.84; ④There was significant gender difference in physical aggression, substitution aggression and the total aggression. Conclusion: The Chinese version of BPAQ is a reliable and valid instrument for measuring aggression of adolescents.
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BACKGROUND: Evening primrose oil(EPO) is a rich source of cis-linoleic acid and gammalinolenic acid(GLA) and has been used as a therapeutic agent in various skin diseases such as atopic dermatitis. OBJECTIVE: The purpose of this study was to evaluate the suppressive effect of EPO on murine contact sensitivity. METHODS: BALB/c mice were divided into 3 groups, positive control, experimental and negative control groups: the positive control group represents a group of mice which were sensitized and challenged with DNFB, the experimental group represents EPO-pretreated positive control group and the negative control group represents a group of mice which were challenged only. The changes of ear thickness were measured, and H & E staining and immunohistochemical staining for ICAM-1 expression of ear skin were performed to evaluate the histological changes of each group. RESULTS: The Pretreatment of mice with EPO resulted in suppression of contact sensitivity by more than 82%. On H & E staining, only a mild inflammatory reaction was observed in the dermis. Also ICAM-1 expression of keratinocytes, the intensity of the staining was significantly decreased in the experimental group compared with positive group. CONCLUSIONS: Our study indicates that EPO was able to suppress the induction of contact sensitivity.