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Objective:To discuss the development and management of full-time research assistants in China′s large hospitals.Methods:Through the methods of policy sorting, literature research, summarization, and classification, this study focused on the policy background, development opportunities, and the needs of the times for the position establishment of research assistants in China′s large hospitals, comprehensively classified the practical exploration and existing problems of employing and managing full-time research assistants in typical large hospitals in the country, and discussed the relevant management strategies learned from international experience.Results:In addition to hospitals directly affiliated with colleges and universities, dozens of large local hospitals in more than ten provinces have carried out beneficial practices of establishing the employment, management, and assessment systems for research assistants positions and achieved some progress. However, there are still common problems such as limited cognition of ″temporary positions″, insufficient coverage of the positions, low salary and welfare, and lack of training and development mechanisms as well as promotion and career development paths.Conclusions:The development and management of research assistants in large hospitals have gradually shifted their purpose from alleviating the employment issue of the graduates to reserving talented people in medical teaching, researching and managing, forming a high-quality, professional, and full-time medical scientific team, and continuously innovating. This article puts forward some suggestions about establishing the management system of research assistants, strengthening the standardized training for talented people, and constructing a diversified incentive mechanism combining performance appraisal and target management for research assistants.
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Objective:To study the impact of the Varian real-time position management (RPM) respiratory gating system on radiotherapy planning dosimetry.Methods:The radiotherapy plans of 40 cases with thoracic or abdominal tumors were retrospectively selected in this study. The motion phantom for quality control was adopted to generate respiratory gating signals, and the 30%-60% stable phase at the end of expiratory was selected as the respiratory gating window. The dose verification for the abovementioned radiotherapy plans was performed using the Portal Dosimetry (PD) system under RPM respiratory gating mode with the Edge accelerator. Afterwards, dose analysis was performed with different γ passing rate criteria and the distribution characteristics of γ values were analyzed. Finally, the verification results between the non-gating mode and the gating mode were compared.Results:Under the respiratory gating mode, the passing rates of all intensity-modulated radiation therapy/volumetric-modulated arc therapy (IMRT/VMAT) plans with or without flattening filters were over 95.5% by γ criteria of (3%, 3 mm) or (3%, 2 mm) and were over 90% by stricter γ criteria of (2%, 2 mm). All plans met the clinical requirements recommended by the American Association of Physicists in Medicine (AAPM). The passing rates of dose verification under non-gating mode were slightly better than those under respiratory gating mode, and the differences between the two modes were statistically significant (3%/3 mm, Z =-1.45; 3%/2 mm, Z =-2.86; 2%/2 mm, Z =-3.70; 1%/1 mm, Z =-4.52; P<0.05). There was no significant difference in the minimum and maximum values of γ and the share of γ > 1.5 of plan verification result under the two modes. However, the average value and standard deviation of the γ were generally smaller under the non-gating mode. Conclusions:The impact of the introduction of RPM respiratory gating technology on dose is clinically acceptable, and the execution of these plans in this gating mode is safe and reliable.
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Objective:To explore the effect of Z type lateral decubitus position in patients with stroke-related pneumonia.Methods:Totally 52 patients with stroke-related pneumonia admitted to the neurology care unit in Qilu Hospital of Shandong University (Qingdao) were randomly divided into the control group and the observation group with 26 cases in each group from February to December 2021.The control group adopted routine position management, and the observation group adopted the Z type lateral decubitus position to observe. The differences in sputum volume, clinical pulmonary infection score (CPIS), blood oxygen saturation change, and hospital stay between the two groups were compared.Results:The SpO 2 was 0.966 ± 0.210 in the observation group and 0.948 ± 0.223 in the control group on the 7th day after the implementation of the measures. There was a significant difference between the two groups ( t=3.07, P<0.01). The sputum aspiration volume of the observation group was (30.65 ± 10.01), (39.27 ± 11.30), (36.92 ± 12.94) ml on the 1st, 3rd, 7th day after the implementation of the measures, which were significantly higher than those of the control group (24.81 ± 9.55), (28.92 ± 9.40), (27.65 ± 7.85) ml. The differences were statistically significant ( t=2.16, 3.59, 3.12, P<0.05). On the 7th day after implementation, the CPIS score of the observation group was 4.54 ± 1.63, which was better than that of the control group 5.46±1.61 ( t=-2.06, P<0.05). The average length of stay in the observation group was (13.35 ± 2.74) d, which was significantly shorter than (15.46 ± 4.42) d in the control group ( t=-2.07, P<0.05). Conclusions:The use of Z type lateral decubitus position has a positive significance for the rehabilitation and recovery of patients with stroke-related pneumonia. This position can promote sputum drainage and improve patients pulmonary function, accelerate the dissipation of patient inflammation, and reduce the length of hospital stay.
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Objective:To explore the effect of management mode of correspondence of potencyscale on impro-ving the nurses′job satisfaction and patient satisfaction in the department of neurology and analyze the medical eth-ics. Methods:We selected 37 nurses in the department of neurology. From July 2013 to March 2014, they were provided with the traditional management mode, whereas from March 2014 to June 2015 with management mode of correspondence of potencyscale. The questionnaire survey was conducted to measure the job satisfaction of nurses and the satisfaction degree of patients. Results:After the implementation of management mode of correspondence of potencyscale, the research indexes were significantly higher than before. Conclusion:The management mode of correspondence of potencyscale can improve the nursing staff′s work enthusiasm, patient satisfaction, and the quali-ty of care. Meanwhile, it is the specific practice of nursing ethics.
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PURPOSE: To quantify the cardiac dose reduction during breathing adapted radiotherapy using Real-time Position Management (RPM) system in the treatment of left-sided breast cancer. MATERIALS AND METHODS: Twenty-two patients with left-sided breast cancer underwent CT scans during breathing maneuvers including free breathing (FB), deep inspiration breath-hold (DIBH), and end inspiration breath-hold (EIBH). The RPM system was used to monitor respiratory motion, and the in-house self respiration monitoring (SRM) system was used for visual feedback. For each scan, treatment plans were generated and dosimetric parameters from DIBH and EIBH plans were compared to those of FB plans. RESULTS: All patients completed CT scans with different breathing maneuvers. When compared with FB plans, DIBH plans demonstrated significant reductions in irradiated heart volume and the heart V25, with the relative reduction of 71% and 70%, respectively (p < 0.001). EIBH plans also resulted in significantly smaller irradiated heart volume and lower heart V25 than FB plans, with the relative reduction of 39% and 37%, respectively (p = 0.002). Despite of significant expansion of lung volume using inspiration breath-hold, there were no significant differences in left lung V25 among the three plans. CONCLUSION: In comparison with FB, both DIBH and EIBH plans demonstrated a significant reduction of radiation dose to the heart. In the training course, SRM system was useful and effective in terms of positional reproducibility and patient compliance.
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Humans , Breast Neoplasms , Cardiac Volume , Feedback, Sensory , Heart , Lung , Patient Compliance , Radiotherapy , Respiration , Tomography, X-Ray ComputedABSTRACT
Objective To study the responsibilities of nurses at different levels in providing clini cal care for patients in wards.Methods On the basis of conducting hierarchical management on nurses,the tasks of nurses in providing patients in wards with clinical care were summed up by means of data analysis and field observation.According to the tasks,a questionnaire about the responsibilities of nurses at all levels was designed.The 132 nurses from a Grade-3 Class-A general hospital in Chongqing Municipality who were responsible for providing clinical cares for patients in wards completed these questionnaires.Results Nurses in charge of providing clinical care for patients in wards usually undertook 11 tasks which could be divided into four aspects,which were,clinical nursing,nursing management,teaching on nursing and research into nursing.Based on the 11 tasks,44 responsibilities these nurses shouldered were defined,which included 4 responsibilities for N0-level nurses,6 for N1-level nurses,10 for N2-level nurses,11 for N3-level nurses,8 for N4-level nurses and 5 for N5-level nurses.Conclusions By defining in a scientific and systematic way the responsibilities and tasks of nurses at different levels in providing clinical cares for patients in wards,the research offered clinical nurses clear guidance on their work,and provided basis for the hospital's decision on clinical nurses,such as the personnel allocation,performance assessment and training; it could also help promote the position management on the work of nurses in China.