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Objective:To explore the "Internet + nursing service" model based on the nurse-patient safety needs, and provide reference for development of "Internet + nursing service".Methods:The First Affiliated Hospital of Sun Yatsen University established a "Internet+ nursing service" management team in December 2019, developed an information platform, formulated and implemented a specific plan of the "Internet+ nursing service" model, including service objects, service projects and service modes. After the smooth operation of this model, the statistics of the nursing service projects and service times that had been carried out from September 2020 to March 2021, as well as the satisfaction of 21 patients who received nursing services would be counted.Results:From September 2020 to March 2021, 21 patients were provided with 55 on-site nursing services, and 151 operations in 16 projects were completed. No nursing-related adverse events occurred. The patients gave all five-star evaluations to the door-to-door service, the satisfaction score was 5 points, and the overall evaluation was 99.88 points.Conclusions:The pilot work of "Internet + nursing service" based on the nurse-patient safety needs has met the care needs of discharged patients and the safety needs of door-to-door services, guarantee the safety of nurses' door-to-door service effectively. And it provides reference for the development and improvement of "Internet + nursing service" related safety work in tertiary A-level hospitals.
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Abstract@#Type 2 diabetes mellitus (T2DM) has become a worldwide epidemic, which poses a great threat to the global healthcare system. Based on review of publications pertaining to T2DM health management in urban communities, this article focuses on the health management models of T2DM in foreign urban communities, including insurance companies and medical institutions, self-management plans, community management, community and home hybrid services, artificial intelligence + big data management, social media and online community management, precision health management, and proposes suggestions for T2DM health management in Chinese urban communities based on currently available national management models, including increasing the standardization of the management level, improving the supporting facilities of professional talents, mobilizing social forces to support, improving the scientific and technological level of management tools, strengthening the advantages of traditional Chinese medicine and exploring novel personalized models, so as to provide insights into promoting the sustainable development of T2DM health management in Chinese urban communities.
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Objective:To analyze the terminal survey data of hospice care services in a district of Beijing in 2020, and discuss its current situation and existing problems of hospice care services in this district for countermeasures, hence providing reference for the development of hospice care services.Methods:Data were collected from the " Terminal Survey Forms of the Second Batch of Hospice Care Pilot Areas in China in 2020" , which were reported by 4 tertiary hospitals and 5 community health service centers in a district of Beijing. The reporting timeframe ranged from January to December 2020. Text analysis method was used to analyze the hospice care mode, relevant security policies, hospice care team, case diagnosis categories, average hospitalization days and patient cost burden. All the data were subject to descriptive analysis.Results:In 2020, only 4 tertiary hospitals carried out outpatient, consultation and inpatient services of hospice care among the 9 medical institutions in a certain district of Beijing, and none of them carried out home hospice care services. The number of doctors and nurses engaged in hospice care in the four hospitals was 35 and 40 respectively; There were 267 inpatient cases of hospice care, including 121 cases of malignant tumors, accounting for 45.32%; The average hospitalization days of hospice patients (40.0 days) was more than that of the hospital (7.8 days); The average daily hospitalization cost of hospice patients (3 428.7 yuan) was lower than that of the hospital (3 605.6 yuan); Hospice care services had not been included in the scope of medical insurance payment, and the relevant security policies were not perfect.Conclusions:The work of hospice care service in a district of Beijing remains at an initial stage, and the professional team building and supporting policies for hospice care fail to catch up with the demand in this district. The authors suggest to speed up the development of hospice care in primary medical institutions, build a network of " hospital -community-family" levels, enhance training of professionals and technical personnel of hospice care, as well as establish and improve the medical security system, so as to promote the rapid development of hospice care services in this district.
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Objective:To accurately and effectively identify the most critical needs of extracorporeal membrane oxygenation (ECMO) treatment for patients with severe cardiopulmonary diseases, and to better carry out continuous improvement of medical service quality an patients' satisfaction.Methods:Patients who underwent ECMO and transferred from 56 medical institutions in the Henan Provincial People's Hospital Critical Care Medicine Specialist Alliance [the patients who were transported before applying quality function deployment (QFD) from June 2017 to May 2018 were enrolled as the control group, and patients who were transported after applying QFD from June 2018 to May 2019 were the observation group], medical staff in the alliance hospitals, ECMO transfer teams and transfer driver teams were enrolled as the subjects of the survey. QFD was applied to convert the collected requirements into quality improvement elements for targeted improvement measures.Results:A total of 125 questionnaires were distributed in this survey, and 116 valid questionnaires were collected, including 91 from patients (including 27 from the control group and 64 from the observation group), 10 from the medical staff of the alliance hospitals, 10 from the ECMO transport teams and 5 from the transport driver teams. The questionnaire recovery rate was 92.8%. The improvement elements of ECMO treatment for patients with critical cardiopulmonary diseases were ranked according to the importance, and the top five were as follows: the accuracy of the first diagnosis, the specialization of ECMO team, the guarantee of vehicle safety, the seamless responses, and the smooth coordinated rescue protocol.Conclusion:The top five improvement elements should be prioritized in ECMO treatment of patients with critical cardiopulmonary disease in all hospitals of the Alliance to ensure more accurate and timely treatment.
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Objective:To explore the effect of Internet + technical liaison service mode on the postoperative continuing nursing of elderly patients with osteoporotic hip fractures.Methods:A total of 92 elderly patients with osteoporotic hip fractures who were admitted into in Orthopaedics Department of the First Affiliated Hospital of Soochow University from July 2018 to December 2019 were selected, and randomly divided into intervention group and control group by random number table method, with 46 cases in each group. The control group was given routine follow-up outside hospital, while the intervention group was given the continuing nursing led by the orthopedic specialist nurses based on the Internet + Technology home orthopedic care platform. All patients were followed up to 6 months after operation, and the differences of Harris Hip Score (Harris), Numeric Rating Scales (NRS), Barthel Index, Short Form 36-item Health Survey (SF-36) between the two groups were compared.Results:The Harris scores were 49.74 ± 4.28, 76.59 ± 4.33 and 90.78 ± 2.61 in the intervention group, and 46.17 ± 3.85, 74.26 ± 4.24 and 88.65 ± 2.17 in the control group in 1, 3 and 6 months after operation, respectively. The differences were statistically significant ( t=-4.20, -2.60, -4.26, all P<0.05). The NRS scores in the intervention group were 1.33 ± 0.47, 0.83 ± 0.38 and 0.76±0.43 in 1, 3 and 6 months after operation respectively, while the NRS scores in the control group were 1.61 ± 0.54, 0.96 ± 0.42 and 0.84 ± 0.38, respectively. The difference in pain scores between the two groups was statistically significant only at 1 month after operation ( t=2.68, P<0.05). The Barthel Index in the intervention group were 61.74 ± 8.90, 93.80 ± 5.29 and 98.26 ± 2.83 in 1, 3 and 6 months after operation respectively, while those of the control group were 60.33 ± 5.81, 91.09 ± 7.52 and 97.83 ± 3.10, respectively. The difference in Barthel Index between the two groups was statistically significant only in 3 months after operation ( t=-2.00, P<0.05). The scores of SF-36 in the intervention group were 93.73 ± 3.89, 100.26 ± 3.77 and 107.50 ± 3.56 at 1, 3 and 6 months after operation respectively, while those of the control group were 92.67±3.42, 97.71±2.67 and 103.68±2.83, respectively. The difference in SF-36 scores between the two groups was statistically significant only at 3 and 6 months after operation ( t=-3.74, -5.71, P<0.05). Conclusions:The continuing nursing based on multi-disciplinary team cooperation in hospital + Internet + Technology home orthopaedic nursing platform led by orthopaedic specialist nurses can improve joint function, relieve pain and improve quality of life of elderly patients with osteoporotic hip fractures after operation.
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Objective:To explore the key points and implementation of establishing a whole-process clinical research management system.Methods:Based on the problems in practice, combined with project management experiences, this article analyzed the construction of the whole-process clinical research management system.Results:The establishment of the management system provides a comprehensive and sustainable safeguard for clinical research, as well as the improvement of efficiency and quality of clinical research.Conclusions:The establishment of an effective whole-process management system for clinical research project is a useful exploration of the research service model in China.
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@#AIM: To summarize the implementation effect of comprehensive prevention and treatment service model for diabetic ophthalmopathy in Pudong New Area, and provide practical reference for the establishment and improvement of the community-based comprehensive prevention and treatment service model of diabetic ophthalmopathy.<p>METHODS: From 2018-08 to 2019-08, diabetes patients with chronic disease management were selected for screening in the 45 community of Pudong New Area, stratified sampling by age and sex. The eye health data of long-distance screening were analyzed, and master the degree of satisfaction and participation willingness through the questionnaire survey.<p>RESULTS: The screening included 39 055 patients with DM, all of whom established eye health files for the first time. 15.870%(6 198/39 055)was made a definite diagnosis preliminarily of diabetic retinopathy, the prevalence of mild, moderate, severe NPDR and PDR were 3.974%, 9.904%, 1.746% and 0.246% respectively. The rate of needing referral was 44.325%(17 311/39 055); the rate of actual follow-up was 5.846%(1 012/17 311); the satisfaction of DR screening and willingness to participate were over 85%.<p>CONCLUSION: The service mode of comprehensive prevention and treatment for diabetic ophthalmopathy based on remote screening system was feasible for early detection, early diagnosis and early intervention of diabetic ophthalmopathy, but it needs further optimization and improvement in practice application.
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Objective:Explore a service model on hospice care in China. Method:Investigate on hospice care needs and demands in the city of Beijing, Shanghai and Baotou From June to September 2016. Result:More than 80 percent of the respondents willing to receive hospice care service, and people tend to have different hospice service model in different demographic groups, and the number of people choosing"general hospital" was the highest, nearly one- third. Conclusion:The society has a high demand for hospice care service, and to explore a service model which is government-led and the whole society involved and family as the core and community united and connected by hospice care institution and guided by the general hospital can promote the development of hospice care in China.
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When facing the worldwide abuse of opioid substance,one of the effective responses is opioid substitution therapy (OST).However,different OST service patterns may affect the therapeutic outcome.Using the System Engineering Initiative for Patient Safety (SEIPS) model,we can analyze the factors that affecting the outcomes of patients from the perspective work system.In this paper,SEIPS model is used to describe the existing OST service model.According to the operation mechanism of the methadone maintenance treatment in China and the existing OST service model,some suggestions are put forward to carry out effective OST service in the country.
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When facing the worldwide abuse of opioid substance,one of the effective responses is opioid substitution therapy (OST).However,different OST service patterns may affect the therapeutic outcome.Using the System Engineering Initiative for Patient Safety (SEIPS) model,we can analyze the factors that affecting the outcomes of patients from the perspective work system.In this paper,SEIPS model is used to describe the existing OST service model.According to the operation mechanism of the methadone maintenance treatment in China and the existing OST service model,some suggestions are put forward to carry out effective OST service in the country.
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Objective To establish an extended nursing service model for intravenous treatment in outpatient,so that patients with venous catheters nearby can receive catheter maintenance,which can reduce the medical cost and the incidence of complications during the maintenance of the catheters.Methods A three-level network of catheter maintenance was established in the area to evaluate the rate of return maintenance and the incidence of complications [catheter-related infection,medical adhesive-related skin injuries (MARSI) and catheter blockage] during catheterization.Results The rate of patient return maintenance as statistically signif-icant between the first half of 2015 and the second half of 2016 (60.0％ vs.29.7％,P=0.000).Compared with the first half of 2015,the incidence of catheter-related infections decreased in the second half of 2016 from 8.6％ to 3.3％,the incidence of MARSI decreased from 29.7％ to 10.1％,and the incidence of catheter blockage decreased from 8.5％ to 0.6％.(All P =0.000).Conclusion The comprehensive extended service mode for outpatient with venous catheters can reduce the incidence of complications during catheter maintenance,which can reduce the workload of outpatient intravenous treatment and also provide patients the convenience of catheter maintenance,and is worthy of clinical promotion.
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With the silver wave struck,China has becone the only country entered the elderly population country with lower income.How to solve the pension dilemma faced by the large elderly population was an unprecedented severe problem that China must face in 21st Century.Through the field research,it led and eucowraged private funds enter the pension service market basde on the construction of mdeical suppotr integration legalsand regnlations.How to provide the diversirfication of the main body and expand the path,how to establish medical support integration pension service information network platform,how to implement the nursing statls' training mechanism for medical suppor integration and how to scientificallg integrate the service resonrces for medical support integration were analyzed.The existing problems of medical support integration service mode in Shenyang was analyzed to provide development suggestions and strategies so as to provide strategic thought for implementing medical support integration in Shenyang.
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The visual angle of active participation reference model was not scientific and its contents were not sys-tematic in the past EBM information service. A new EBM information service model was thus established by compa-ring the finding process of evidence and the transforming process ofinformation-knowledge-intelligence with the need of evidence-based decision making in clinicians as a logic starting point in order to provide the theory of what to do andhow to scientifically do for clinical librarians and clinicians, to effectively direct clinical librarians to perform EBM information service, and to help clinicians to scientifically make their decision.
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An integrated "medical institutions-communities-patients-volunteers" health management service model of chronic diseases was established by investigating early screen, risk prediction, early warning and compre-hensive treatment according to the actual conditions in Heilongjiang Province in order to reduce the occurrence and development of chronic diseases, promote the recovery and improve the quality of life of chronic disease patients.
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Based on introducing the current status of clinical key specialty and remote consultation,the paper discusses the remote consultation modes based on clinical key specialty mainly from 3 aspects:feasibility,medical network organization structure as well as hospitalier-centered service mode.
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After the exploration of how to integrate the army and people, how to reform the medical treatment sys-tems, how to improve the critical and emergent treatment ability, how to improve the abroad medical support level, how to update the diagnosis and treatment by stages, how to solve the problems of insufficient medical resources and unbalanced resources allocation, following measures were proposed to solve the disgusting situation of "no doctors for critical disease, no surgeons for operation and insufficient support for medical security" for the soldiers and citi-zens performing their mission in the border areas and islands of our country and in foreign countries by applying the key remote medical technologies to the remote diagnosis of diseases, rote monitoring of chronic diseases, and rescue on the emergent disaster field.
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After the exploration of how to integrate the army and people, how to reform the medical treatment sys-tems, how to improve the critical and emergent treatment ability, how to improve the abroad medical support level, how to update the diagnosis and treatment by stages, how to solve the problems of insufficient medical resources and unbalanced resources allocation, following measures were proposed to solve the disgusting situation of "no doctors for critical disease, no surgeons for operation and insufficient support for medical security" for the soldiers and citi-zens performing their mission in the border areas and islands of our country and in foreign countries by applying the key remote medical technologies to the remote diagnosis of diseases, rote monitoring of chronic diseases, and rescue on the emergent disaster field.
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The knowledge economy development depends on knowledge and innovation.Prime Minister,Keqiang Li,proposed that the development of Internet + action plan in the government's report of the Twelfth National People's Congress third meeting of,which made the whole China's Businesses animate.In such rapid development situation in terms of big data,cloud computing,Internet +,and other modern technology,integrate Internet resources,transfer big data into required da ta after analysis,change the magazine service mode,then promote clinical science and technology magazine to make it more humane-oriented as well as satisfy the need of each reader.This study proposed certain ideas on the development of the Internet + and medical technology magazines.
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Objective:To provide informational and personalized health service platform for the current number of chronic diseases and health groups. Methods:a variety of portable devices physiological data were collected to transmit to the remote health monitoring platform, making the service with strong mobility for home care, postoperative care and patient care whenever and wherever needed to provide the best care service model, so that medical and health care is no longer subject to the constraints of time, hospitals and other fixed places. Results: Through a variety of wireless transmission technology and the intelligent terminal and regional health data center, it can be further mining, analysis and storage for the data information, and provide diagnostic advice. It can effectively alleviate the tension of medical resources. Conclusion:The establishment of remote health monitoring platform can alert doctors and relatives when data is abnormal to win time for rescue. It can effectively manage the disease treatment, prevention and rehabilitation.
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In order to deepen the reform of public hospitals,Beijing Tongren Hospital has carried out the pilot effort of famous experts team service model in out-patient,established a new mode of interior hierarchical medical services in the hospital.Through the adjustment of outpatient service process and the change of service model,issues of difficult medical treatment and ticket scalpers were solved.The reform has achieved the optimal utilization of outpatient resources inside the hospital,has been the beneficial exploration and practice of hospital internal hierarchical diagnosis and treatment,truly reflected the hospital service concept of taking the patient as the center,and has laid a solid foundation for the future widely hierarchical diagnosis and treatment mode.