ABSTRACT
Objective:To explore the effect of fishbone diagram combined with PDCA(plan, do, check, action) closed-loop management in the teaching of orthopedic interns in operating room.Methods:The 60 interns received by the Department of Orthopedics in our hospital from January 2019 to August 2020 were randomly divided into the conventional group and the observation group in average. The conventional group used traditional methods, and the observation group introduced fishbone diagram combined with PDCA closed-loop management. The theoretical and practical assessment scores and the evaluation of satisfaction with the teaching were compared between the two groups before and after the teaching in the operating room. SPSS 22.0 was used for t-test and Chi-square test. Results:The scores of each theoretical assessment, the total scores of theoretical assessments, and the scores of practical assessments, in the observation group were higher than those of the conventional group ( P<0.05). The satisfaction rates of interest, effectiveness, rationality, and popularization with teaching in the observation group were 100.00%, 100.00%, 96.67%, and 100.00% respectively, which were higher than those (80.00%, 83.33%, 80.00%, and 83.33% respectively) in the conventional group. Conclusion:The application of fishbone diagram combined with PDCA closed-loop management in orthopedic operating room teaching can improve the performance of interns in the assessment, and can also achieve better teaching satisfaction.
ABSTRACT
Objective To analyze retrospectively the quality control data to enhance the infant incubator risk management. Methods The factors influencing the qualified rate of the infant incubator were analyzed by fishbone analysis method,and then the data statistics method was used to analyze the quality control data from 2013 to 2015 to find out the causes of the factors that affected the qualified rate. Some practical improvement measures were put forward. Results The improvement measures enhanced the qualified rate of the infant incubator quality control greatly. Conclusion The retrospective quality control data analysis contributes to bettering the infant incubator quality control and its clinical safety.
ABSTRACT
Objective To analyze the regularity and characteristics of 2621 cases of adverse drug reaction (ADR) occur-ring in our hospital during 2013-2016 ,and to explore the factors and causes of ADRs ,so as to provide evidence for the contin-uous improvement of rational use of drugs .Methods 2621 cases of ADR reports were retrospectively analyzed by monitoring software to extract ADR report source ,patient age and sex ,related pharmaceutical dosage forms ,routes of administration , clinical characterization ,organ involvement and other information .The Pareto method was used to identify the main drugs that caused ADR and ADR factorial analysis was performed with Fishbone diagram .Results ADR mainly reported by physicians (2573 cases ,98 .17％ ) and pharmacists reported at least (3 cases ,0 .11％ );population aged >70 years accounted for the lar-gest proportion (570 cases ,21 .74％ );ADR mainly caused by intravenous infusion (1680 cases ,64 .10％ ) .The clinical mani-festations were gastrointestinal system lesions (717 cases ,24 .17％ ) .Pareto analysis showed that the main drug factors in-volved anti-infective drugs ,anti-neoplastic drugs ,Chinese medicine injections and parenteral nutrition drugs .Fishbone analysis showed that elderly patients ,intravenous administration ,incomplete monitoring and related drugs were the determining factors associated with ARDs .Conclusion The close attention should be paid to monitoring and guidance of special populations ,espe-cially the elderly ;reducing intravenous forms ,monitoring the main factors of medicines ,carrying out the individualized medica-tion monitoring ,strengthening clinical pharmacy ,in order to promote clinical rational use drug and reduce the occurrence of drug-induced diseases .
ABSTRACT
OBJECTIVE:To improve high-alert medication management in our hospital. METHODS:According to assessment criteria of JCI,referring to the problems of high-alert medication management in our hospital,PDCA(plan,do,check,action)cy-cle method,reverse fishbone diagram and other methods were adopted to formulate and implement relevant countermeasures. Com-pliance rate of 29 departments was evaluated within 12 months after the implementation of countermeasures. RESULTS:Relevant emergency measures were formulated for 2 negative factors by reverse fishbone diagram;whole-course and orderly quality control of high-alert medication was conducted through establishing high-alert medication management institutions,formulating high-alert medication management system and quality measurement criteria,strengthening staff training and education,improving hospital in-formation system,etc. The compliance rate of departments increased from 53% in Jan. to 100% in Jun.(P<0.05),and kept sta-ble until Dec. CONCLUSIONS:PDCA cycle improves the systemization and standardization of high-alert medication management and multiple department cooperation,and contributes to the safety of drug use.
ABSTRACT
Objective To investigate the influence of fishbone diagram in the incidence of blood residual after sealing tube indwelling needle in cardiovascular disease patients.Methods Two hundred and ninety-three patients(1,035 times)with sealing tube intravenous indwelling needle were assigned into control group and another 272 ones(1,276 times)with the needle into experiment group according to admission sequence. In the former group the method of conventionally sealing the tube for intravenous indwelling needle was applied and in the latter,fishbone diagram was applied to analyze the key factors for blood residuals and regulate pertinent measures for effective sealing of tube.The two groups were compared in terms of incidence of blood residuals.Result The incidence of blood residuals in the experiment group was significantly lower than that in the control group(P<0.05).Conclusion The fishbone diagram is effective in reducing the incidence of blood residuals after sealing the tube for intravenous indwelling needle by way of taking effective interventional measures after screening out the key influential factors for blood residuals.
ABSTRACT
This paper analyzes the explore the factors influencing the TCM clinical pathway using the fishbone dragram. We found that the main impacting factors of TCM clinical pathway were government policy factors, hospital management factors and personal factors. It was suggested to promote Chinese medicine clinical pathway pilot job, not only need to cooperate with the administrative departments of health and medical institutions, also need to strengthen the change of the idea of both doctors and patients.
ABSTRACT
The main impacting factors on implementing clinical pathway were analyzed by applying fishbone diagram.The factors include policy factors,organizational factors and personal factors.It was suggested to improve the trial work of implementing clinical pathway management by reforming the medical care payment system,putting the clinical pathway management into the evaluation system,building up medical information system,putting more efforts on promotion and enhancing cooperation among related departments.