Application of tracer methodology combined case-based study model in the pre-job training of medical record writing for residents / 中华医学教育探索杂志

Objective:To observe the value of tracer methodology combined case-based study (CBS) model in the standardized residency training of medical record writing.Methods:A total of 91 residents who were newly recruited from The Sixth Affiliated Hospital of Sun Yat-sen University in July 2019 were selected as the subjects and randomly divided into test group ( n=47) and control group ( n=44). The tracer methodology combined CBS model was used for test group while the traditional model was used for control group to compare the knowledge of medical record writing, performance of medical record writing and feedback to teaching in two groups. SPSS 21.0 was used for t test and chi-square test. Results:The correct response rate in knowledge of medical record writing, the normative scores and integrity scores after training were significantly higher than those before training ( P<0.05). The normative and integrity scores were significantly increased after training, and those in the test group were significantly higher than those in the control group [(90.3±3.5) and (91.3±3.2) vs. (88.6±3.5) and (89.8±3.0), P<0.05, respectively]. The test group was significantly superior to the control group in the autonomous learning ability [97.8% (44/45) vs. 82.9% (34/41)], communication ability [95.6% (43/45) vs. 78.0% (32/41)] and acceptance of teaching form [97.8% (44/45) vs. 82.9% (34/41)] ( P<0.05). Conclusion:The tracer methodology combined CBS model is a good way in the pre-job training of medical record writing for residents, which can mobilize the subjective initiative of the trainees and teachers, complete the teaching tasks and obtain better teaching value.

Application of tracking methodology in senile patients′ physical restraint management / 中国实用护理杂志

Objective To explore the effect of Tracer Methodology on the physical restraint management of the elderly patients. Methods The idea of Tracer Methodology was based on a case study of physical restraint, and then complementary tracking and system tracking. The key problem, which was founded in using Tracer Methodology on the physical restraint management of the elderly patients, could be continuously improved from the regulations, procedures, training, implementation, inspection, feedback, rectification, the implementation and the effectiveness. The normative rate of physical restraint was compared before and after the implementation of this method. Results After using the Tracer Methodology, the rate of physical constraint in the elderly patients was 82% (41/50), which was significantly increased (χ2=5.877,P=0.015) compared with before implementation of this method, which was 60% (30/50). Conclusions Tracer Methodology could improve the normative rate of physical restraint in elderly patients. Meanwhile, it was beneficial for nurses to participate in quality management, and strengthen the team cooperation.

The clinical application and results of tracer methodology in the maintenance of peripherally inserted central catheters for chemoradiotherapy / 中华临床营养杂志

Objective To investigate the quality of nursing care after the application of tracer methodology in patients undergoing chemoradiotherapy with peripherally inserted central catheters (PICC),evaluate the nurses' adherence to the procedural protocol of PICC,and calculate the number of infectious complications related with the placement.Methods We compared the nurses' adherence to the procedural protocol and the number of infectious complications before (April 2014 to June 2015) and after (July 2015 to October 2016) the tracer methodology was applied at the Chemoradiotherapy Center of Ningbo First Hospital in July 2015.Results After the tracer methodology was introduced to the care of patients with PICC,the nurses had better adherence to the procedural protocol,as shown in the rise of quality control score from (94.00± 3.35) to (97.87± 1.42).The incidence of infectious complications dropped significantly (all P＜0.001).Conclusion The clinical application of tracer methodology can improve the quality of nursing for patients with PICC,reduce the incidence of PICC-related infectious complications,and promote patient safety.

Analysis of the Application Effects of High-alert Medications Management Review and Evaluation System Based on Tracer Methodology / 中国药房

OBJECTIVE:To explore the application and feasibility of tracer methodology in the continuous improvement of high-alert medications management in the hospital,and to improve the quality of high-alert medications management and ensure the safety of clinical medication. METHODS:According to the theory and requirements of tracer methodology,a series of interven-tions were applied to the management of high-alert medications in our hospital. The comparisons on the mastery of high-alert medi-cations knowledge,review and evaluation results and the incidence of adverse events were conducted before and after applying trac-er methodology,so as to evaluate the improvement effect of tracer methodology on high-alert medications management. RESULTS:After implementing intervention measures such as the reduction of high-alert medications list and medical staff training about high-alert medications,compared to before management,medical staffs had improved the knowledge level of high-alert medica-tions (the average awareness rate increased from 69.6% to 88.5%);the review and evaluation results had been improved signifi-cantly (the proportion of the terms with qualified level evaluation results or above increased from 66.67% to 88.89%);the inci-dence of adverse events was reduced(from 0.321% to 0.139%). CONCLUSIONS:The tracer methodology has a significant effect on the management of high-alert medications in our hospital. It is feasible and can be widely used in the management of high-alert medications in the hospitals.

The application of tracer methodology in the management of medical high-value consumables / 中国医学装备

Objective:To discuss the application of tracer methodology in the management of medical high-value consumables, find out the problems and existing risks, and propose possible solutions. Methods: The system tracing based on high-value consumables and the case tracing based on patient were used to track and check the medical high-value consumables in hospital. The inspectors summarized and discussed the issues as well as the possible risks after inspection, to develop the appropriate improvements.Results: There were many problems that were found in the management of medical high-value consumables in this tracing program, of which the main aspects were the species introduction, the implementation of procurement and relative departments, and the organization and leadership among departments.Conclusion:The management of medical high-value consumables is an important part of hospital management, and the tracer methodology provides an effective guarantee for the medical equipment management in hospital.

Application of Tracer Methodology in Reducing Dispensing Errors in PIVAS / 中国药房

OBJECTIVE:To reduce dispensing errors in Pharmacy intravenous admixture service(PIVAS),improve compound-ing quality of transfusion and guarantee the safety and rationality of clinic transfusion. METHODS:The case tracking method was applied to analyze each link of the work in PIVAS to find the reasons of configuration errors and control risk;and then the system tracking method was applied to analyze the hidden safety risk and the crack of quality from the inside of the system and work flow. Countermeasures and supporting continuous improvement were established to evaluate the effect of management before and after 6 months. RESULTS:Tracer methodology(TM)was adopted to find out the weakness in the key link and work flow of the cause of the configuration errors,the relative work pattern and work environment was improved,the relative system was formulated and completed,strength of rewards and punishment was increased. Through the implementation of the countermeasures,the number of dispensing errors was reduced from 81 to 38,and the error rate was reduced from 0.035% to 0.011%(P<0.01). CONCLU-SIONS:TM can be adopted in the key link and work flow of the cause of the configuration errors,aim at formulate and strictly carry out relative countermeasures to reduce errors in PIVAS,and promote the safety of drug use.

Application of tracer methodology in management of high-risk medicine / 现代临床护理

ObjectiveTo explore the effect of tracer methodology on management of high-risk medicine.Methods The management of high-risk medicine was investigated with tracer methodology to find out the problems in the medicine management, construct effective management system and establish tracer programme and pyramid management mode for high-risk medicine management.The rate of adverse events in high-risk medicine management before the use of tracer methodology was compared with that after the use.Result The incidence of adverse events was significantly lower than that before the use of tracer methodology (χ2=5.379,P<0.05).Conclusion The tracer methodology in the management of high-risk medicine can be effective in the reduction of incidence of adverse events in high-risk medicine management and promotion of safety management.

Application of tracer methodology in the training of intern medical record writing / 中华医学教育探索杂志

Objective To discuss the effectiveness of tracer methodology in the training of intern medical record writing. Methods Fifty interns who received medical record writing training in July 2012 were set as control group and were trained by traditional methods. Meanwhile, 58 interns who received medical record writing training in July 2013 were set as investigation group and were trained by tracer methodology. Pre-training questionnaire survey was conducted for interns in investigation group and targeted training was provided. After the training, interns in two groups were surveyed by questionnaire of basic norms of medical record writing. Excel software was used to do data entry and SPSS 21.0 statistical software was used to statistical analysis. P<0.05 signifies statistical differences. Results Final record writing exam after the training demonstrated that there were significant differ-ences in basic requirement of record writing, basic principle of record writing, history taking, record time limit, contents of record writing and correct rate of patients' answer to the document between in-vestigation group and control group with statistical differences(P<0.05). Conclusion Tracer method-ology has obvious effects in intern medical record writing training and is worth popularization and ap-plication in clinical teaching.

Application of tracer methodology for hospital assessment and continuous quality improvement / 中华医院管理杂志

The paper described the basic theory and methods of tracer methodology. By means of case study, case tracing and system tracing, the authors applied this methodology in review or appraisal work in such aspects as priority focus process, priority focus content, clinical service team, appraisal process, and tracing pathways. All these aim at promoting continuous improvement of the quality of care.