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Clinical data is one of the key sources of real-world data, while the reliability of such data is often hindered by unscientific and irregular data management. Based on various problems found in the application of clinical data to scientific research, this study formulated a standard operation procedure(SOP) for real-world data management, and organized the data in terms of content and logic consistency, completeness and standardization. The clinical data of syphilis at a tertiary hospital were used as an example for verification. The clinical data of syphilis patients in the dermatology department from January 1, 2008 to January 1, 2018 were derived from the basic information database, diagnosis database, laboratory information database, and treatment information database of its hospital information system, and a total of 71 705 pieces of relevant information were extracted. SOP analysis showed that 6 816 articles were completely repeated. There were content or logical inconsistencies in name, medical identification number, resident ID number, age and gender, being 152, 360, 88, 107 and 457 respectively. There were many missing entries for marital status, ethnicity, gender, birthday, and ID number, being 1 711, 1 077, 457, 496 and 355 respectively. The standardization situation was generally good, and the number of irregularities in filling out occupational items was 1 884. The standardized and collated data could effectively count the proportion of patients in different stages of syphilis and the cost of diagnosis and treatment, indicating that the real-world data management and analysis SOP proposed in this study could be used to build a clinical-research oriented dual-functional database based on medical practice data.
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Objective:To investigate the application value of standard operation procedure (SOP) of thoracentesis in clinical skills training for undergraduates.Methods:In this study, 63 undergraduates were randomized into two groups, with 29 students in experimental group receiving SOP training, and 34 students in control group trained by traditional teaching methods. The performance of the two groups at different stages of thoracentesis were compared after the training. SPSS 19.0 was used to analyze the assessment data.Results:The experimental group was significantly superior to the control group in the stages of "puncture operation" and "post-puncture operation" [(33.76±2.46) points vs. (31.91±3.60) points, P=0.02; (7.93±1.53) points vs. (6.79±1.84) points, P=0.01], as well as the total scores [(82.59±4.14) points vs. (79.26±4.94) points, P=0.01]. Conclusion:It's suggested that application of SOP may improve the effectiveness of thoracentesis training, and organized teaching methods are essential for clinical skills training.
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Objective: To summarize the current progress of clinical therapy for concha-type microtia. Methods: The domestic and overseas literature about the treatment of concha-type microtia was reviewed and the contents of operative timing, operation selection, and complications were analyzed. Results: The unified therapeutic schedule of the concha-type microtia has not yet been determined due to its complicated various therapeutic methods and unknown etiology. The operation methods commonly used in clinic are partial ear reconstruction with autologous costal cartilage framework and free composite tissue transplantation. The timing of the partial ear reconstruction depends on the development of costal cartilage and children's psychological healthy. The timing of free composite tissue transplantation depends on the severity. It is recommended to perform the operation at about 10 years old for mild patients. For moderate patients, ear cartilage stretching should be performed at 1-2 years old and free composite tissue transplantation would be performed at about 10 years old. The complications of partial ear reconstruction with autologous costal cartilage framework for concha-type microtia mainly include framework exposure, deformation, infection, cartilage absorption, and skin necrosis. The complications of free composite tissue transplantation have not been reported. Conclusion: Etiology and elaborated classifications with individualized treatment are the future research directions.
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Liver transplantation has become the most effective treatment of end-stage liver disease. Nursing care for enhanced recovery is safe and effective in the management after liver transplantation, which is conducive to the early recovery of body function of the recipients. In this article, relevant literature review was conducted to summarize the standard operation procedure (SOP) of nursing care for enhanced recovery after liver transplantation from the postoperative vital signs and fluid temperature management, gastrointestinal function and nutrition management, early grading activities, sedation, analgesia and sleep management, infection prevention and control, etc.
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Under the vigorous support of the Chinese Burn Association, MEEK skin-grafting technique has accumulated abundant experiences during widespread clinical application in burn surgery in a long term, since its import into China over a decade ago. Recently, it has been widely and successfully used in many big rescues of burn casualties. In order to obtain more better gasp on MEEK skin-grafting technique and play its advantage, MEEK Micro-skin Transplantation Technology Collaboration Group of Chinese Burn Association organized domestic experts to complie clinical operation procedure of grafting technique of MEEK micro-skin, including indication, preoperative preparation, operating procedure, postoperative care, and points for attention, for getting more standard application of this technology and better therapeutic outcome.
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Under the vigorous support of the Chinese Burn Association, MEEK skin-grafting technique has accumulated abundant experiences during widespread clinical application in burn surgery in a long term, since its import into China over a decade ago. Recently, it has been widely and successfully used in many big rescues of burn casualties. In order to obtain more better gasp on MEEK skin-grafting technique and play its advantage, MEEK Micro-skin Transplantation Technology Collaboration Group of Chinese Burn Association organized domestic experts to complie clinical operation procedure of grafting technique of MEEK micro-skin, including indication, preoperative preparation, operating procedure, postoperative care, and points for attention, for getting more standard application of this technology and better therapeutic outcome.
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Humans , Burns , General Surgery , China , Postoperative Care , Skin , Skin Transplantation , MethodsABSTRACT
Objective@#To investigate the present situation about the best evidence communication and application of blood specimen collection.@*Methods@#A total of 312 nurses from Zhongshan Hospital Affiliated to Fudan University were investigated with self-designed questionnaire.@*Results@#The scores of the best evidence knowledge of blood specimen collection was 15.23±2.45, 1.9% (6/312) nurses obtained full score. The scores of the best evidence behavior of blood specimen collection was 38.11±2.93, 1.6% (5/312) nurses got full score.@*Conclusions@#The nursing staff had a poor knowledge in the best evidence of blood specimen collection. There was a gap between the best evidence of blood specimen collection and clinical practice. The state of communication and application of the best evidence of blood specimen collection is not good.
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Objective To develop an integrated standard operation procedure (SOP) for in-hospital emergency care of severe acute pancreatitis (SAP), and to explore the clinical application value. Methods We designed an integrated SOP for in-hospital emergency care of SAP by consulting some experts from emergency intensive care unit (ICU) quality control centers in Shanghai, referencing relevant literature and SAP guidelines at home and abroad, and considering the clinical practice and the experience gained in the integration of “emergency-ICU” contraction at Changzheng Hospital of Navy Medical University (Second Military Medical University). Forty-two SAP patients meeting the SOP criteria, who were admitted to Department of Emergency of Changzheng Hospital of Navy Medical University (Second Military Medical University) between Jul. 2015 and Jan. 2017, were included and set as optimization group. Forty SAP patients, who were admitted to the Department of Emergency between Jan. 2014 and Jun. 2015, were set as routine group. Clinical data of the patients were compared between the two groups, including treatment efficiency, white blood cell count, neutrophil ratio, C-reactive protein level, procalcitonin level, blood amylase level, blood glucose level, blood lactic acid level, serum creatinine level, oxygenation index, modified CT severity index (MCTSI) score, intra-abdominal pressure, urinary neutrophil gelatinase-associated lipocalin (NGAL) level and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score on 72 h and 1 week after admission, complications and survival. Results The proposed SOP mainly referred to the international standard for diagnosis and treatment of SAP in 2012. The updates were mainly in the emergency first visit and comprehensive treatment scheme. In the former, the emergency surgery doctor was changed to emergency green channel (resuscitation room). In the latter, several clinical protocols were added, such as intrarenous injection of a large dose of ulinastatin, rapid infusion of human albumin (intravenous injection of furosemidum when necessary), standardized full-thatch mirabilite external application and coloclysis of sterile solution of rheum officinale. Compared with the routine group, the total rate of treatment efficiency was significantly better, and hospital stay, exhaust recovery time, bloating relief time, ICU duration time, and continuous renal replacement therapy time were significantly shorter in the optimization group (all P0.05). There were significant differences in the white blood cell count, neutrophil ratio, oxygenation index, MCTSI score and intra-abdominal pressure and the levels of C-reactive protein, procalcitonin, blood glucose, lactic acid, serum creatinine, urinary NGAL on 72 h and 1 week after admission between the two groups (all P0.05). The levels of blood amylase were significantly different between the two groups on 72 h after admission (P0.01). The incidences of acute renal failure, acute respiratory distress syndrome, ascites, abdominal compartment syndrome, pancreatic pseudocyst and pancreatic abscess were significantly lower in the optimization group than those in the routine group (all P0.05). Compared with the routine group, the survival time was significantly longer and the survival rate within two months was significantly higher in optimization group (P0.05). Conclusion The proposed in-hospital integrated emergency SOP can standardize the diagnosis and treatment process of SAP, improve the efficiency of treatment, and reduce mortality of patients.
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The apphcation of radioactive seeds implantation in treatment of malignant solid tumor of the abdomen has been 18 years in China.The teatment is applied by more and more hospitals,however,the operation procedure is not the same in each hospital,which affected the therapeutic effect of radioactive seeds implantation,and means more safety risks.This paper summarizes the operation procedures of radioactive seeds implantation in treatment of malignant solid tumor of the abdomen,and minimizes the loopholes in clinical operation,in order to improve the therapeutic effect and reduce the safety risks.
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Objective:To compare the efficacy and complication in clinical application about the indwelling central venous transfusion port and peripheral venipuncture central vein indwelling catheter.Methods: 80 cases with indwelling central vein transfusion port were arranged to observation group and 80 cases with peripheral venipuncture central vein indwelling catheter were arranged to control group. All of patients were detected for blood routine, blood coagulation time and chest X-ray fluoroscopy routine examination before operation. And to take venipuncture by right subclavicle of patient skin under X-ray fluoroscopy guided, and then indwell catheter. To compare the clinical effect for the two kinds of indwelling catheter method.Results:In observation group, the successful rate was 97.5% (78/80), the average operation time was (51.23±10.21) min; while in control, the successful rate was 78.8% (63/80), the average operation time was (67.42±11.03)min, there were statistical significant difference in successful rate (x2=13.44,P<0.05) and average operation time (t=9.63,P<0.05) between observation and control group. In observation group, the rate of complications occurred was 13.75% (11/80), which was significant lower than 32.5% of control (26/80)(x2=7.91,P<0.05).Conclusion: It is safe and reliable to use the dwelling central venous transfusion port, and the complication of some patients mainly related with nursing skill of paramedic and the proficiency degree of pillbox puncture and using skill in this operation.
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By formulating the standard operating procedures for clinical skills, and standardizing the operation steps, the Affiliated Hospital of Inner Mongolia Medical University further refines and quantifies the scoring criteria, and this is also applied in the teaching practice of medical students' clinical skills. The two operations of clean wound dressing and diagnostic peritoneal puncture are taken as an example for description. The assessment results shows that the level of medical students' clinical skills has improved significantly. Questionnaire survey also shows that teachers' training efficiency and students' learning effi-ciency have been improved , indicating that clinical skills standard operation procedures have achieved good teaching results in clinical skills teaching practice.
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Objective To explore the effects of application of standard operation procedure (SOP) for perioperative nursing in children with developmental dislocation of the hip (DDH).Methods From March to September 2015,a total of 59 children with DDH were provided SOP for perioperative nursing.We retrospectively analyzed 50 cases of children with DDH treated with routine perioperative nursing admitted between June 2014 and December 2014.We compared the completeness of preoperative preparation,the incidence of postoperative complications and the parental satisfaction between two groups.Results Application of SOP for perioperative nursing increased the completeness of preoperative preparation,decreased the incidence of postoperative complications,and the parental satisfaction was greatly improved.Conclusion SOP for perioperative nursing for children with DDH can standardize nurses' working procedure,making nursing practice procedure much more specific,specified and clear,and can better guide clinical practice.
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Objective To explore the effects of application of standard operation procedure (SOP) for perioperative nursing in children with developmental dislocation of the hip (DDH).Methods From March to September 2015,a total of 59 children with DDH were provided SOP for perioperative nursing.We retrospectively analyzed 50 cases of children with DDH treated with routine perioperative nursing admitted between June 2014 and December 2014.We compared the completeness of preoperative preparation,the incidence of postoperative complications and the parental satisfaction between two groups.Results Application of SOP for perioperative nursing increased the completeness of preoperative preparation,decreased the incidence of postoperative complications,and the parental satisfaction was greatly improved.Conclusion SOP for perioperative nursing for children with DDH can standardize nurses' working procedure,making nursing practice procedure much more specific,specified and clear,and can better guide clinical practice.
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Objective To discuss the application and effect evaluation of the standard operation procedure ( SOP ) teaching method during applying surgical practice teaching in local medical college . Method 123 undergraduate students from Grade 2011 clinical medical major in Medical College of Shaoguan University were selected as objects of study. The students were divided into test (odd) group and control (even) group by draw. The two groups were taught by the same teachers, while the SOP method was applied to the test group (n=62) and the traditional surgical clinical teaching method was applied to the control group (n=61). Meanwhile, we used a combined method of the formative assessment and final assess-ment to compare and analyze the teaching feedback. After their graduate internship, we compared their autonomous study capability, clinical evaluation thought, normativity of the operation and capability in their intern positions as well as the degree of satisfaction of the test of two groups by doing a survey among them. All these were analyzed by SPSS 18.0 software, and t test was used to compare two groups' measurement in-formation and count data with chi-square. Results The comprehensive evaluation scores of the test group were significantly higher than the control group, in which the margin was of statistical value [(79.394 ± 8.049) vs. (71.703±10.462), t=39.632, P=0.000]. The percentage of excellence of the test group was signif-icantly higher than the control group, in which the margin was of statistical value (59.68% vs. 39.35%, χ2=5.082, P=0.024). The percentage of failure of the test group was lower than the group taught by the tradi-tional method, in which the margin was of statistical value (3.22%vs. 16.39%, χ2=4.652, P=0.031). Its for-mative assessment result on the evaluation of the experimental teaching process and summative assessment scores were higher than the control group, and the difference was statistically significant [formative scores points: (46.018 ±5.749) vs. (42.771 ±6.459), t=19.445, P=0.000; summative scores: (33.659 ±3.437) vs. (29.063±4.366), t=36.249, P=0.000]. As far as their clinical graduate internship adaptation capabilities were concerned, students from the test group had more satisfaction on the teaching feedback over 4 perspectives than the other group, in which the margin was of statistical value. Experimental groups' satisfaction showed that: 93.55% of students thought the standard operation procedure (SOP) teaching method was beneficial to improving their clinical practice skills, 91.94%thought that it improved their surgical clinical work ability to adapt, 85.48% thought it helped to cultivate their surgical clinical thinking and innovation ability. Conclusions The SOP teaching method in surgical practice teaching helps to enhance students' clinical operation and adaptation capability and promote the teaching quality.
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Objective To explore the safety and feasibility of operation procedure improvement and process optimization for pancreatoduodenectomy.Methods The effect of the duation time of opertion and postoperative complications of operation procedure improvement and process optimization for pancreatoduodenectomy in 98 patients in the Tumour Hospital Affiliated to Zhengzhou University from August 2008 to May 2015 were retrospective analyzed.Results The duation time of opertion was 145-205 min,average time was 175 min.There were 5 cases (5.1％) of bile leakage,6 case (6.12％) of pancreatic fistula and 4 cases (4.08％) of hemorrhage,and laparotomy revealed that one of them with pancreas-intestinal anastomotic hemorrhage,the haemorrhage stop after sufficient drainage,but due to infection,organ failure,this case was dead half a year after the operation.The remaining patients recovered uneventfully through open drainage,partial flush,somatostatin application,and other conservative treatment.Conclusion The improved pancreatoduodenectomy can shorten operation time and reduce operation complication,is a safe and feasible method,and worthy of clinical popularization.
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Objective To standardize the operation processes of neonatal instrument,ensure the standards effectiveness and safety of equipment use.Methods A retrospective study had been taken on after the developments and implementations of all neonatal instruments standard operation procedure (SOP).The equipment maintenance data were collected and analyzed one year before and after the implementation of SOP.Results After the effective implementation of the SOP,the incidence of instrument repair due to misoperation,improper maintenance reduad by 59％(19/32),9/14,4/7,the instrument management efficiency was enhanced,and the safety of nurses and patients was guaranteed,and the patients satisfaction was improved,and also the quality of care was enhanced.Conclusions SOP procedure plays a very important role in improving neonatal care management and overall efficiency.It makes a continuous improvement of nursing care which is worth widely being implemented.
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Objective We sought to establish the standard operation procedures in department of cardiology.Methods According to the method of constructing standard operation procedures,the standard operation procedures for the department of cardiology was constructed through induction and consulting literature materials.Results 16 standard operation procedures for the department of cardiology were developed,including 8 SOP of common diseases to rescue,2 SOP of common operation in perioperative period,4 SOP for common instruments,2 SOP for common drugs usage.Conclusions Construction of standard operation procedures in department of cardiology can provide the basis for clinical nursing work,it can also supply methodological reference to build the standard operation procedures in other departments.
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OBJECTIVE:To promote the safety and effectiveness of clinical medication.METHODS:In drug dispension process,operation procedure was carried out strictly and different dispensing methods were adopted according to the characteristics of drugs.RESULTS & CONCLUSIONS:Dispensing guidelines for common injection,insoluble drug and chemotherapy drugs were summarized and improved to promote quality of intravenous drugs dispension.