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Objective:To explore the effect of the application of nursing decision support information system in the continuing nursing of stroke patients in convalescent period, and to provide guidance for the information-based whole process nursing of stroke patients in convalescent period.Methods:A total of 107 stroke patients in convalescent period admitted to 4 Grade Ⅲ Level A hospitals of Beijing city from March to November 2019 were selected. The patients were divided into control group (53 cases) and test group (54 cases) by coin tossing method. The control group followed uniformly formulated discharge health education manual for post-discharge management and follow-up, while the test group received health guidance and follow-up through the nursing decision support information system. Barthel Index and MOS SF-36 were used to evaluate the activities of daily living and quality of life of the two groups of patients before intervention and 3 and 6 months after the intervention, and the results were compared.Results:There was no significant difference in Barthel Index before the intervention between the two groups( P>0.05). After 3 months of intervention, the Barthel Index ≤ 49, 50-70 and ≥ 71 in the test group were 7, 17 and 27 cases respectively, and 16, 21 and 13 cases in the control group respectively, and the difference between the two groups was statistically significant ( Z=-2.95, P<0.01). After 6 months of intervention, the Barthel Index ≤ 49, 50-70 and ≥ 71 in the test group were 7, 12 and 32 cases respectively, and 10, 15 and 25 cases in the control group respectively,and the difference between the two groups was statistically significant ( Z=-2.21, P<0.05). There was no significant difference in MOS SF-36 before the intervention between the two groups( P>0.05). After 3 and 6 months of intervention, the total score of MOS SF-36 in the test group was (50.51 ± 14.57), (57.06 ± 14.85) respectively, and that in the control group was (42.02 ± 15.48), (45.58 ± 14.97) respectively, and the differences between the two groups were statistically significant ( t=2.84, 3.23, both P<0.05). Conclusions:The application of nursing decision support information system can effectively improve the daily life ability of patients, enhance the quality of life of patients.
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Objective:Through the establishment of a tertiary hospital ethics review information system, the information management of ethics review is carried out, thereby improving the quality and efficiency of ethics review.Methods:Four steps that including status quo analysis and problem identifying, corrective action plan making, outcome monitoring, as well as experience analysis were conducted, according to which a full-chain ethical review information system was developed. This system has certain characteristics such as well-featured functions, reasonable structure and user friendly, which fulfilled the expectation of the information management of review work.Results:The updated ethics review information system provides much stronger support for ethics review management and also improves its efficiency.Conclusions:The information system makes the management of ethics review more efficient, standardized and well-organised.
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December 2019 witnessed the outbreak of COVID-19 in Wuhan city and its rapid spread to other parts of China, and overseas as well. Tongji Hospital, as a designated hospital for treatment of critically ill patients, shoulders the diagnosis and treatment tasks of numerous critically ill patients of such a disease. For the purpose of handling their medical records and effectively preventing the nosocomial infection of the disease, the hospital puts in place both the electronic signature system of patients based on a Wechat applet and a paperless medical record total solution based on the data center. These measures overcome the challenges incurred by patients’ signature on paper-based records and medical records archiving during the epidemic. On the other hand, they can not only downsize the paper-based medical records, minimize the risk of infection caused by paper-based medical records via contacts, but also effectively save the hospital of its operating costs and improve its efficiency of clinical work.
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Objective An analysis of informationized multi-platform big data was conducted to learn about the quality change of health management data for hypertension and diabetes patients in Baoshan District of Shanghai since 2017.The result provided important information for further evaluation of the effect of quality control measures, and the prevention and management of chronic diseases. Methods Height, weight, blood glucose level, diagnosis and treatment information were collected from different databases of patients with hypertension and diabetes in Baoshan District from 2017 to 2019, and the consistency of the data from different sources was analyzed. Results Both the percentages of weight and height inconsistency among patients with hypertension and diabetes together were lower in 2019 than in 2017 (10.99% vs 18.72%, χ2=822.38, P < 0.001 and 0.86% vs 2.74%, χ2=347.03, P < 0.001, respectively).In 2019, the percentage of registered hypertensive patients with abnormal traceability from diagnosis was higher than that in 2017 (12.67% vs 11.72%, χ2=4.01, P=0.045).Similar results were also obtained in patients with diabetes.Analysis of glycated hemoglobin value last position in diabetic patients showed that the coefficient of variation of the last position composition ratio of the value in 2019 was significantly lower than that in 2017 (0.19 vs 0.31).The ratio in patients with the last position of glycosylated hemoglobin value of 0 was lower in 2019(4 701 cases, 12.72%) than that in 2017 (9 485 cases, 17.14%), and the difference was statistically significant. Conclusion The study result shows an improvement in quality management of hypertension and diabetes in Baoshan District of Shanghai.Information technology should be more widely used in promoting technical standardization, strengthening technical training, data quality control and effect evaluation.
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The healthcare-associated infections (HAI) cases monitoring system, automatic access to the medical record homepage and HAI early warning application of untreated early warning information interception and other means of information are introduced into the hospital. These means ensure the accuracy and integrity of the medical record homepage diagnostic and statistical data base information, and HAI consistency as well. Closed loop management of HAI cases provides accurate information for the hospital business intelligence platform, serving hospital administration and clinical management with accurate data. Hence precise decision-making basis can be provided for the improvement of medical quality of the hospital.
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The rapidly aging society gives rise to sizable demands for chronic disease nursing care. With IT development as backup, the hospital has developed a platform for regional collaborative nursing informationization within a medical alliance and a health management platform for home care of the elderlies. This practice can build an extended nursing care model, featuring the three main service lines of " hospital-family, hospital-medical alliance and hospital-community hospital-family". The model provides diversified, personalized, disease specific, informationization and multi-disciplinary coverage for nursing care, providing the primary level with high quality nursing resources.Medical alliances and corresponding communities share information, for a full-range, full region and full timeframe coverage of nursing health supervision and scientific guidance, thus effectively minimizing the rate of revisit to upper-level hospitals by patients and implementing the hierarchical medical system.
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Rational drug use and patient medication safety have always been key to pharmaceutical management.The authors introduced the practice of informationization management of rational drug use in the medical alliance of Luohu Hospital Group.The main measures refer to building an informationization platform for drug purchasing and supply management, dispensing management, medication intervention and medication guidance.This practice can realize closed-loop drug management, achieving full-range supervision and traceability for drugs and higher patient drug use safety.
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Objective To establish a set of operational status assessment indicators to meet the needs of informationized hospital management.Methods Assessment indicators were selected and weights were set respectively through literature review,field interview,and questionnaire survey.Six target dimensions were key performance indicators medical business,operational performance,cost control,medical insurance,balance and risk management,and development capability.Thus a set of operational status evaluation indicators was established in IT means,and based on the informationization level of a tertiary A general hospital in Zhejiang province.Results In the principle of public welfare,objectivity,effectiveness and prospectiveness,we analyzed and sorted out relevant data in the current hospital informationization,identifying six quantitative indicators,15 level-1 indicators,and 86 level-2 indicators.Conclusions It is feasible to build a set of assessment indicators for hospital operation and management in view of both technology and methodology.
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Informationization as conducted by the Hospital Authority (HA) of Hong Kong features the following aspects.Collective deployment of IT professionals from its medical institutions is designed for development of a unified,coordinated and clinical centered information system among its medical institutions.In addition,HA has built a control center for centralized information system operation & maintenance,which enjoys sufficient funding support for health informationization.In the course of information sharing,HA pays close attention to patients' privacy protection.Shanghai Hospital Development Center can take HA's experience on municipal hospitals health informationization,for the purposes of building a unified,coordinated and clinical centered information system and furthering Shanghai municipal hospital's health informationization.
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As a key part of the emergency medical system, pre-hospital emergency service proves critical for critical care, higher pre-hospital care success rate, improvement of patient outcome, and promotion of health recovery. This paper analyzed the status quo of pre-hospital emergency services information, discussed the application of information technology in pre-hospital industries including command and dispatch system, ambulance real-time positioning and tracking system, pre-hospital emergency video surveillance system, medical record system, electronic patient health file system, electronic payment system, and data mining and analysis system.Furthermore, it also discussed the prospect of sizably upgrading pre-hospital emergency service and building intelligent pre-hospital emergency coordination system.
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As a key part of the emergency medical system,pre-hospital emergency service proves critical for critical care,higher pre-hospital care success rate,improvement of patient outcome,and promotion of health recovery.This paper analyzed the status quo of pre-hospital emergency services information,discussed the application of information technology in pre-hospital industries including command and dispatch system,ambulance real-time positioning and tracking system,pre-hospital emergency video surveillance system,medical record system,electronic patient health file system,electronic payment system,and data mining and analysis system.Furthermore,it also discussed the prospect of sizably upgrading prehospital emergency service and building intelligent pre-hospital emergency coordination system.
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Objective To explore the method of real-time identification and early warning of drug-resistant bacteria through information technology, timely obtain information about drug-resistant bacteria in clinic.Methods Interface of Hospital Information System (HIS), Laboratory Information Management System (LIS) and healthcare-associated infection (HAI) surveillance system were reconstructed in 2015, HL7 was used as interface framework to design standard, LIS was as baseline data source and HIS as patient information database, multi-information exchange was implemented on the commonly used interface, identification and early warning of detected drug-resistant bacteria was conducted, identification of drug-resistant bacteria before and after informationization was compared.Results Through the information construction, the information interface showed that the rules of drug-resistant bacteria determination can be changed at will, data results were more accurate and timely.The judgment time of manual review was reduced from 30 minutes to 2 minutes every day, information of drug-resistant bacteria can be obtained timely and conveniently on any internal network computer by clinical staff.After timely identification and intervention of drug-resistant bacteria, 284, 289 and 309 strains of drug-resistant bacteria were detected in key departments of HAI control in 2015-2017, drug-resistant bacteria per 1 000 bed-day were 9.23‰ (284/30 773), 8.91‰ (289/32 429), and 8.34‰ (309/37 031) respectively, with a slight decrease.Conclusion Through information technology, drug-resistant bacteria can be found timely, and new drug-resistant bacteria can be identified and intervened in time, so as to effectively reduce the infection rate of drug-resistant bacteria.
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To establish a systemized malaria biobank with well-rounded epidemiologic data and a computer-aid management system, thus to provide qualified sources for malaria elimination and human malaria research.The malaria biobank was based on the platform of Jiangsu Institute of Parasitic Diseases. The blood smear samples, dried blood samples, whole blood samples and parasite strains isolated from patients (from both local and imported cases) were collected since 2011 according to a standardized operational procedure. The biobank management software was applied to input of the epidemiological data and samples, and the quality of samples was monitored regularly.A standard malaria biobank was established. The Information Management System was applied to input, storage and output of samples. Totally 99.42% (2 223/2 236) of the blood smear samples, 92.58% (2 070/2 236) of the dried blood samples, 94.50% (2 113/2 236) of whole blood, and 2.06% (46/2 236) of the isolated stains in 2 236 reported cases were included in the malaria biobank in Jiangsu Province from 2011 to 2017. Based on the malaria biobank, 99.42% (2 223/2 236) of the blood smears and 82.74% (1 850/2 236) of DNA (from dried blood and whole blood samples) from malaria patients in Jiangsu Province were re-checked. Moreover, the samples in the malaria biobank were used in the studies of the mechanism of parasite drug resistance, malaria molecular epidemiology, and diagnosis technology development and evaluation.The establishment of malaria biobank provides a guarantee for malaria elimination in Jiangsu Province and also provides a qualified resource for malaria research.
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Objective To explore the impact of diagnosis related groups (DRGs) payment and drug zero plus on the management of intensive care medicine department. Methods The clinical data of patients in one year from 2016 to 2017 admitted into the Department of ICU in Liuzhou Worker's Hospital concerning their numbers of discharged patients, transferred patients, bed utilization rate, number of bed turnover, average length of stay of discharged patients, cure and improvement rates, admission and discharge diagnostic coincidence rate, 3-day definite diagnosis rate, clinicopathological diagnosis coincidence rate, rescue success rate, total income, drug proportion, consumable proportion, DRGs payment and settlement data, etc were retrospectively analyzed to explore the dual challenges, DRGs payment and drug zero plus, facing the department and how to respond and deal with them. Results In 2016 and 2017, the total incomes of the department of critical care medicine in our hospital were 42.107 0 million yuan and 41.371 3 million yuan respectively, and the medical insurance incomes were 15.03 million yuan and 16.69 million yuan respectively;in 2016 and 2017, 2 693 patients and 2 922 patients were admitted and treated respectively; 595 patients and 577 patients were discharged respectively, with 2 071 patients and 2 334 patients transferred respectively; the balances of the department were 15.48 million yuan and 29.11 million yuan, respectively. From July to December 2017, the medical insurance DRGs payment data suggested that the proportion of loss of the department be 7.02%. Accelerating the Grade 6 electronic medical records and informationization construction, adopting the severe disease information solution program and fine quality control management in the department of critical care medicine can reduce the cost of manpower. Conclusion Our future development direction in the Department of Intensive Care Medicine includes the following aspects: Open source and reduce expenditure, strictly control the proportions of drugs and consumables, improve the balance of the department, and actively respond and deal with the medical insurance DRGs payment.
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Currently,the quick development of information technology is enriching the traditional teaching.As a new form of teaching resource,a micro-lecture focused on a specific topic is a good combination of information technology and traditional teaching.It not only increases the vividness and visualization of teaching,but also boosts the learning interest of students in the course.What's more,it helps to show an integral time-consuming experiment in 5-10 minutes'micro-vedio,which broadens the contents of the course and offers convenience of self-teaching for students.In this article,we took the example of micro-lecture"Western blot"in the course of immunologic technology to post-graduates in Shanghai University of Traditional Chinese Medicine to clarify the advantages and the procedures of a typical micro-lecture,and to discuss about it.The experience achieved from the construction of this micro-lecture may offer a new idea of modern information education reform.
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The authors introduced the development and application of an outpatient triage safety management system for hospitals. The system consists of the triage queue module, fast track module for prioritized special outpatients and subsequent outpatients, vital signs data recording module, assessment module for high fall risk outpatients, and high risk outpatient transfer module. These functions enable outpatient triage nurses to focus on pre-examination, safety factor identification, and high risk outpatient transfer, thus shortening outpatient queue time and high risk outpatient transfer to emergency, and lower adverse events. With this system, nursing safety management becomes more scientific, standardized and systematic, enabling optimized nursing staff efficiency and fine management of nursing care.
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OBJECTIVE:To provide reference for informationized construction of outpatient narcotic drug management in the hospital. METHODS:The narcotic drugs management system,which consisted of the hospital information system and the intelli-gent management machine of narcotic drugs were introduced in working procedure and informationized management,and its effects were evaluated. RESULTS:After informationized construction,the recycling of empty ampoules and used patches was included in compulsory management procedure;informationized management would be achieved completely from safety management,prescrib-ing and dispensing property management,prescription management,batch number management,outcoming and incoming manage-ment,five specialmanagement,etc. Compared with traditional dispensing mode,the dispensing time of each prescription was shortened under informationized dispensing mode,decreasing from(174±32.3)s to(128±30.7)s(P<0.05). Pharmacists could communicate with physicians online by the system;drug application,incoming,use,inventory reconciliation,special book for reg-istration and special book of account were all completed by electronic recording and electronic registering;the system could auto-matically complete the report form of prescription information for evaluation. CONCLUSIONS:It is feasible of the informationized mode of outpatient narcotic drug management in our hospital.
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The authors introduced the development and application of an outpatient triage safety management system for hospitals. The system consists of the triage queue module, fast track module for prioritized special outpatients and subsequent outpatients, vital signs data recording module, assessment module for high fall risk outpatients, and high risk outpatient transfer module. These functions enable outpatient triage nurses to focus on pre-examination, safety factor identification, and high risk outpatient transfer, thus shortening outpatient queue time and high risk outpatient transfer to emergency, and lower adverse events. With this system, nursing safety management becomes more scientific, standardized and systematic, enabling optimized nursing staff efficiency and fine management of nursing care.
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In real world clinical studies,standardized data acquisition method is a key step in the formation of reliable clinical evidence.This article described how to carry out clinical data collection and how to preprocess data in order to ensure the quality of data.The results showed that from the data sources,data collection contents,collection key points,data description and evaluation,this paper put forward the method of collecting the real world data of traditional Chinese medicine (TCM).It was concluded that the standardized methods of clinical data acquisition had laid a solid foundation for real world research.
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Chronic obstructive pulmonary disease (COPD) is the leading death cause of pulmonary diseases, ranking the fourth of global death causes. Self-management program is able to gradually improve the Airways of COPD patients with ventilation, reduce the degree of lung failure, elevate the health status as well as promoting self-efficacy, which is the key process to effectively control COPD relapse. In recent years, more and more domestic and foreign academic employ the widely-used network technology and carry out a large number of information study on COPD self-management intervention. This article reviewed literatures about the intervention methods on self-management of patients suffered from COPD, aimed at providing a better basis for exploring more effective self-management.