Re-evaluation for quality standard of Compound Lumbrical Capsule based on enzyme activity / 中草药

Objective: The quality standard of Compound Lumbrical Capsule (CLC) was re-evaluated using blood and anti-coagulation intensity as indexes. Methods: Fibrin plate method was used to determine the strength of promoting blood circulation and anti-coagulation for CLC by selecting urokinase and thrombin as reference substances. Results: The results of urokinase concentration and transparent circle area showed a good linear relationship in 200-1 000 U/mL, r = 0.999; The results of thrombin concentration and precipitation circle area showed a good linear relationship in 8-40 U/mL, r = 0.997. The blood anti-coagulant activity of compound earthworm capsule of temporary regulations were not less than 12 840 U/g and 113 822 U/g. Conclusion: The method is rapid, simple, and accurate for determining the activity of promoting blood circulation and anticoagulation for compound lumbrical capsule, thus it can be used for the quality control of CLC.

Calidad de la ejecución del Programa de Bajo Peso al Nacer en un área de salud urbana / Quality of the implementation of the Program of Low Birth Weight in an urban health area

Se realizó una investigación sobre servicios y sistemas de salud, con vistas a evaluar la calidad de la ejecución del Programa de Bajo Peso al Nacer en el Policlínico Universitario "Julián Grimau García", desde enero del 2011 hasta igual mes del 2013. Se empleó la metodología para la evaluación de la calidad en atención primaria de salud. Se elaboraron criterios, indicadores y estándares, en tanto la dimensión de la calidad evaluada fue el proceso (competencia y desempeño profesional). Se contó con la participación del total de especialistas y residentes en medicina general integral que laboraban en la unidad durante ese periodo. La evaluación de la mayoría de los indicadores del proceso fue inadecuada.

An investigation on health services and systems was carried out, with the objective of evaluating the quality of the implementation of the Low Birth Weight Program in "Julián Grimau García" University Polyclinic from January, 2011 to the same month of 2013. The methodology for the evaluation of the quality in primary health care was used. Approaches, indicators and standards were elaborated, as long as the dimension of the quality evaluated was the process (competence and professional training). All the specialists and residents in comprehensive general medicine working in the institution during that period participated. The evaluation of most of the indicators of the process was inadequate.

Evaluación de la satisfacción en salud: un reto en la atención estomatológica / Evaluation of satisfaction in health: a challenge in the stomatological care

Se realizó un estudio descriptivo y transversal durante 2013 para evaluar el grado de satisfacción de 5 proveedores de salud bucal (2 especialistas en estomatología general integral y 3 licenciados en atención estomatológica) con la atención que brindan y de 195 usuarios (148 escolares y 47 preescolares) con el servicio recibido, pertenecientes al Policlínico Universitario "Josué País García" de Santiago de Cuba, mediante criterios, indicadores y estándares. En los primeros, solo uno de los 13 criterios resultó adecuado; en los segundos, el total de la muestra manifestó estar satisfecho con la atención recibida.

A descriptive and cross sectional study was carried out during 2013 to evaluate the satisfaction degree of 5 oral health suppliers (2 specialists in comprehensive general stomatology and 3 graduates in stomatological care) with the care they provide and from 195 users (148 scholars and 47 preschool) with the received service, belonging to "Josué País García" University Polyclinic in Santiago de Cuba, by means of criteria, indicators and standards. In the first ones, just one of the 13 criteria was appropriate; in the second ones, the total of the sample manifested to be satisfied with the received care.

Actividades de la brigada de control de focos del Aedes aegypti: evaluación de su calidad en un área de salud / Activities of the brigade for controlling Aedes Aegypti breeding sites: evaluation of the quality in a health area i: en

Se efectuó una investigación sobre sistemas y servicios de salud, con vistas a evaluar la calidad de las actividades de la brigada de control de focos del Aedes aegypti en el Policlínico "Dr. Carlos Juan Finlay" de Santiago de Cuba, durante el mes de Junio del 2013, para lo cual se diseñó un sistema de indicadores de estructura, procesos, resultados e impacto, con una evaluación final integradora que favoreció la valoración de los objetivos de trabajo de esta brigada en la vigilancia y lucha antivectorial. Todos los indicadores fueron evaluados de bien y se propuso este instrumento para ser aplicado por los diferentes niveles de actuación en la lucha antivectorial.

A study on health systems and services was carried out in order to assess the quality of activities of the brigade for controlling Aedes aegypti breeding sites in "Dr. Carlos Juan Finlay" Polyclinic of Santiago de Cuba, on June 2013, for which an indicator system of structure, processes, results and impact was designed with an integrative final evaluation that favored the assessment of work objectives of this brigade in the surveillance and vector control. All indicators were well and this system was proposed to be applied at different levels of action in the vector control.

Calidad del desempeño profesional en el Departamento de Estomatología del Policlínico Universitario "Ramón López Peña" / Quality of the professional performance in the Stomatology Department from “Ramón López Peña” University Polyclinic

Se realizó un estudio descriptivo y transversal, con vistas a evaluar la calidad de la Estomatología General Integral en el departamento de esta especialidad del Policlínico Universitario "Ramón López Peña" de Santiago de Cuba, desde noviembre del 2008 hasta marzo del 2009, mediante la metodología propuesta en el documento para este fin. El universo estuvo constituido por 20 estomatólogos generales y especialistas en Estomatología General Integral. Se evaluó la calidad de la historia clínica mediante criterios, indicadores y estándares utilizados para valorar el desempeño profesional, el cual fue inadecuado.

A descriptive and cross-sectional study, aimed at evaluating the quality of the Comprehensive General Stomatology in the department of this specialty from "Ramón López Peña" University Polyclinic in Santiago de Cuba was carried out from November, 2008 to March, 2009, by means of the methodology proposed in the document for this aim. The universe was constituted by 20 general stomatologists and specialists in Comprehensive General Stomatology. The quality of the medical record was evaluated by means of criteria, indicators and standards used to evaluate the professional performance, which was inadequate.

Calidad de la ejecución del Programa de Vigilancia y Control de Otros Culícidos / Quality of the implementation of the Surveillance and Control Program of Other Culicids

Se realizó una investigación sobre sistemas y servicios de salud para evaluar la calidad de la ejecución del Programa de Vigilancia y Control de otros Culícidos en las áreas de salud "XX Aniversario" y "Armando García Aspurú" del municipio de Santiago de Cuba, en el período 2009-2010. El universo estuvo constituido por 28 criaderos naturales, 10 puntos de captura específica, 11 prestadores y 60 usuarios. Las dimensiones estudiadas fueron la calidad científico-técnica (competencia profesional) y la satisfacción de prestadores y usuarios. La evaluación de la estructura reveló que fue inadecuada por déficit de personal especializado (50,0 %), por la ausencia del programa y por la escasa disponibilidad de pilas y cucharones carter; la del proceso, por baja competencia profesional e incumplimientos de tratamientos biológicos y físicos; la de los resultados, por insatisfacción con las actividades de capacitación (81,1 %) y por déficit de recursos materiales (63,6 %). El porcentaje de positividad de los criaderos resultó ser elevado, las densidades larvarias e índices de picada estuvieron fuera de parámetros permisibles y predominaron las malas condiciones de saneamiento. Se emitieron recomendaciones relacionadas con los problemas identificados.

A research on health systems and services was conducted to evaluate the quality of implementation of the Surveillance and Control Program of other culicids in "XX Aniversario" and "Armando García Aspurú" health areas of Santiago de Cuba municipality in the period 2009-2010. The sample consisted of 28 natural breeding sites, 10 specific capture points, 11 providers and 60 users. The aspects studied were scientific and technical quality (professional competence) and satisfaction of providers and users. Evaluation of the structure revealed that it was inadequate due to specialized personnel deficit (50.0 %), absence of the program and limited availability of batteries and carter buckets; evaluation of the process revealed low professional competence and failure to comply with biological and physical treatments; and that of the results showed dissatisfaction with the training activities (81.1 %) and lack of material resources (63.6 %). The percentage of positive breeding sites was found to be high, larval densities and bite rates were out of permissible parameters, and poor sanitation prevailed. Recommendations related to identified problems were given.

Calidad de la ejecución del Programa de Atención a Centros con Becarios Extranjeros / Quality of the implementation of the Program of Care for Centers with Foreign Scholars

Se realizó una investigación sobre sistemas y servicios de salud para evaluar la calidad de la ejecución del Programa de Atención a Centros con Becarios Extranjeros en el municipio de Santiago de Cuba, durante el 2010. El universo estuvo constituido por los 6 centros que albergan a becarios extranjeros, 25 prestadores y 26 usuarios. Las dimensiones estudiadas fueron la calidad científico-técnica (competencia profesional) y la satisfacción de prestadores y usuarios. La evaluación del proceso reveló que fue inadecuado por la baja competencia profesional de los prestadores (66,6 %), por la alta frecuencia de inspecciones sanitarias sin resultados y por la baja exigencia sanitaria (33,4 %); la de los resultados, por incumplimiento de indicadores del programa. Hubo insatisfacción de usuarios y prestadores. Se emitieron recomendaciones relacionadas con los problemas identificados.

A research on health systems and services was conducted to evaluate the quality of the implementation of the Program of Care for Centers with Foreign Scholars in Santiago de Cuba municipality during 2010. The universe was constituted by 6 centers with foreign scholars, 25 service providers and 26 users. The issues studied were scientific-technical quality (professional competence) and satisfaction of providers and users. The process of evaluation revealed it was inappropriate due to the low professional competence of providers (66.6 %), the high frequency of health controls without results, and the low demand for health (33.4 %); and evaluation of the results was also inappropriate because of failure to comply with the indicators of the program. There was dissatisfaction of providers and users. Recommendations related to these problems were made.

The use of the tracer methodology to assess the quality of care for patients enrolled in Medical Insurance for a New Generation / El uso de la metodología de trazadores para la evaluación de la calidad de la atención en pacientes afiliados al Seguro Médico para una Nueva Generación

OBJECTIVE: To assess the quality of care provided at medical units that provide services to Medical Insurance for a New Generation (SMNG) enrollees. MATERIALS AND METHODS: The tracer methodology was used in a sample of 82 medical units selected in fifteen states of Mexico and data collected in November 2009. RESULTS: Problems were found to locate the minimal number of the 18 medical charts requested in three of the tracers. The first level of care on the average reports that the quality of the process of care is 6, in a 10 point scale. In the second level improves and the third level of care is better qualified. CONCLUSIONS: The tracer methodology has enabled us to assess the quality of care. There is room for improvement in the medical units of the state health services, to that end should be directed the efforts in the health system in Mexico.

OBJETIVO: Evaluar la calidad de la atención en unidades médicas que prestan servicios a afiliados al Seguro Médico para una Nueva Generación (SMNG). MATERIAL Y MÉTODOS: Se utilizó la metodología de trazadores en una muestra de 82 unidades médicas seleccionadas en quince estados de la República mexicana y los datos fueron recolectados en noviembre de 2009. RESULTADOS: En tres de los trazadores no se encontró el número de expedientes en las 18 unidades médicas. En el primer nivel de atención se reporta que la calidad del proceso de atención es de 6 en una escala de 0 a 10. La calidad mejora en el segundo nivel, y es la más alta en el tercer nivel. CONCLUSIONES: Se evaluó la calidad e identificaron oportunidades de mejora en la calidad de las unidades médicas del SMNG. Hacia ese objetivo deben ser dirigidos los esfuerzos en el sistema de salud en México.

Evaluación de la calidad de las preguntas de selección múltiple utilizadas en los exámenes de Certificación y Recertificación en Cardiología en el año 2009 / Evaluation of the Quality of Multiple-Choice Questions Used in Cardiology Certification and Recertification Exams

La Sociedad Argentina de Cardiología, en los procesos de Certificación y Recertificación de Especialistas, implementa exámenes escritos de selección múltiple. Dos observadores independientes revisaron las 200 preguntas utilizadas en dos exámenes (A y B) realizados durante 2009. Se usó el Índice de Calidad de Galofré; este instrumento toma en cuenta 10 criterios que se deben considerar en la redacción de las preguntas de selección múltiple y establece una escala de 1 a 5 puntos según la cantidad de defectos de construcción que tenga la pregunta. El valor máximo de calidad posible es 5. La media aritmética de los valores de calidad de las preguntas expresa el Índice de Calidad del examen en su totalidad. Se encontró que el 30% de las preguntas tenían muy buena calidad técnica (valores de calidad 4 y 5); cerca del 40% eran preguntas aceptables (valor de calidad 3) que se deberían mejorar y el 30% eran inaceptables (valor de calidad 1 y 2). El examen A tiene un Índice de Calidad de 2,15 y el examen B, de 3,21. En ambos exámenes se encontró que los defectos más frecuentes en la redacción de las preguntas eran la falta de viñeta (caso clínico o problema) y la exploración de conocimientos sólo a nivel de memoria o recordación de datos aislados. Se concluyó que sería conveniente constituir en la Sociedad Argentina de Cardiología un grupo de trabajo permanente para revisar y mejorar las preguntas y armar un banco de ítems.

The Argentine Society of Cardiology uses multiple-choice questions for Cardiology Certification and Recertification exams. Two independent observers revised 200 questions used in two examination tests (A and B) during 2009. We used the Galofré Quality Index, which considers 10 criteria for writing multiple-choice questions and establishes a scale ranging from 1 to 5 points according to the number of construction defects the question has. The maximum value of quality is 5. Mean value of the quality of questions represents the Quality Index of the whole test. We found that 30% of the questions had a very good technical quality (quality value 4 and 5); about 40% were acceptable questions (quality value 3) that should be improved, and 30% were unacceptable (quality value 1 and 2). The Quality Index of test A was 2.15 and of test B was 3.21. The most frequent writing defects in both exams were the lack of bullet points (case report or problem) and exploring knowledge only in terms of memory or recalling isolated information. In conclusion, it would be convenient to constitute a permanent work group in the Argentine Society of Cardiology to revise and improve the questions and create a bank of items.

Qualidade em ambientes de um programa de educação infantil pública / Quality of environments of a public child education program

Este estudo objetivou avaliar a qualidade dos ambientes de um programa público de educação infantil - PEI, utilizando os instrumentos Infant/Toddler Environment Rating Scale - Revised Edition (ITERS-R) e Early Childhood Environment Rating Scale - Revised Edition (ECERS-R). Foram avaliadas 16 turmas com faixa etária entre 4 e 68 meses. A média obtida pelas turmas com a ITERS-R foi de 2,80. As turmas avaliadas por meio da ECERS-R obtiveram média de 2,69. Segundo as escalas utilizadas, esses resultados indicam um padrão de qualidade entre inadequada e minimamente adequada. Quanto aos itens das escalas, verificou-se uma maior variação nos escores das turmas com idade de até 3 anos. Os resultados obtidos evidenciaram a necessidade de intervenções no programa, sobretudo nos itens relacionados à rotina e cuidados pessoais com as crianças de até 3 anos e aqueles relativos às atividades, com as crianças a partir de 3 anos até 68 meses.

This study aimed to evaluate the quality of infant public educational environments, by the indicated means for this kind of evaluation: Infant/Toddler Environment Rating Scale - Revised edition (ITERS-R) and Early Childhood Environment Rating Scale - Revised Edition (ECERS-R). Sixteen school groups were evaluated, with ages from six to sixty-eight months. The average gotten by the groups that were evaluated through ITERS-R was of 2.80. The groups that were evaluated through ECERS-R, got an average of 2.69. According to the scales adopted, these results indicate a quality pattern between insufficient and minimally adequated. As the scales items, it was verified a major variation in the scores from classes of until 3 years old. The obtained result showed the necessity of interventions in the program, especially in the items related to the routine and daily care of children with until 3 years old and those related to the activities, with children from 3 years old to sixty-eight months.

Application of comprehensive evaluation of quality in the nursing management of cardiovascular intensive care unit / 中国实用护理杂志

Objective To discuss the nursing management method in the cardiovascular intensive care unit. Methods The management evaluation standard was set up and the comprehensive evaluation of quality (CEQ) was introduced according to factors influencing nursing quality. Results The nursing quality control data and complications after operation before and after the application of CEQ were statistically different. Conclusions Nursing management should innovate unceasingly and comprehensive quality evaluation is one of the effective nursing management method.

Quality Evaluation of Randomized Controlled Trails Papers on Acupuncture and Moxibustion for Vertebrobasilar Insufficiency / 中国中医药信息杂志

Objective To evaluate the quality of clinical trials about acupuncture and moxibustion treatment of vertebrobasilar insufficiency in China.Methods Literature of clinical trials of acupuncture was collected and analyzed,evaluated by the randomized controlled test criteria and the clinical assessing method in Cochrane handbook of international Cochrane cooperation net.Results Sixteen literatures were brought in.87.5% of the included literature had no clear description of random methods,and no allocation concealment,use of blind methods,sample size calculation,intention-to-treat analysis.Among them,62.5% had explicit diagnosis criteria,12.5% with correct randomizing method,62.5% with explicit evaluation criteria,however,31.22% with no words referring to the comparability among the groups.Conclusions Though acupuncture and moxibustion have been widely applied in prevention and treatment of vertebrobasilar insufficiency,it can not provide evidences of higher reliability for clinical treatment due to less clinical randomized controlled tests and lower quality,which severely hinder testing and verifying of clinical therapeutic effects of acupuncture and moxibustion.It is proposed that multiple central and randomized controlled test should be made,so as to search for feasible acupuncture and moxibustion methods with definite therapeutic effect for vertebrobasilar insufficiency,and provide basis for further systematical evaluation.

Significance of comprehensive evaluation in selecting maintenance & service plan for large-scale medical equipment / 医疗卫生装备

The contrast of technical force between hospital and society is astonishing in the maintenance & service of large-scale medical equipment.When the maintenance & service plan must be chosen to socialized service,all the plans must be seriously compared and evaluated according to the current situation of the equipments in hospital for an economical and suitable selection.A right selection is necessary in promoting maintenance and management of large-scale medical equipment,keeping good operation of equipment,prolonging service life,and creating better economic and social benefits.