Exploration on standardized management of ethical review of organ donation after citizen’s death / 器官移植

Objective To explore the standardized management mode of the Ethics Committee for organ donation after citizen’s death in hospitals. Methods The situations of ethical review before and after the standardized adjustment of the Ethics Committee of human organ donation in the First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed. Baseline data of donors before and after standardized adjustment of the Ethics Committee of human organ donation were compared. The influence of standardized adjustment of the Ethics Committee on the attendance rate of committee members and duration of ethical review were analyzed. Results No significant differences were observed in donors' ethical review data, such as gender, age and death determination, before and after standardized adjustment of Ethics Committee structure (all P>0.05). Significant difference was noted regarding the cause of death in ethical review (P<0.05). Univariate analysis showed that there were significant differences in the impact of Ethics Committee standardization adjustment and cause of death on the attendance rate of committee members (both P<0.05). Multivariate analysis revealed that gender, cause of death and standardized adjustment of the Ethics Committee were the influencing factors of the attendance rate of committee members, and the attendance rate of committee members after standardized adjustment was higher than that before adjustment (P<0.05). Univariate analysis showed that there were statistically significant differences in the effects of Ethics Committee standardized adjustment, attendance rate of committee members and cause of death on the duration of ethical review (all P<0.05). Multivariate analysis indicated that standardized adjustment of the ethics committee was the influencing factor of the duration of ethical review, and the duration of ethics review after standardized adjustment was shorter than that before adjustment (P<0.05). Conclusions Appropriate arrangement of the total number of ethics committee members and standardizing the review process may improve the efficiency of ethical review. Scientific evaluation mechanism for ethical committee members should be established by dynamically adjusting the ethical committee members, clarifying the responsibilities and tasks of members and secretaries, aiming to further improve standardized management level of ethical review for organ donation after citizen’s death.

Construction and application effect of high quality scientific research management information platform based on combination of education and management in hospitals / 中华医学科研管理杂志

Objective:To explore a more efficient and standardized scientific research management mode, in order to enhance the best practice of conducting research, improve the agency and satisfaction of scientific research investigators, to improve the efficiency of scientific research management.Methods:According to the problems and deficiencies identified during the process of scientific research management, combined with the latest scientific research management policies and guidelines, the research and development concept of hospital scientific research management platform was formed, and tailored scientific research management information platform was developed by making good use of information technology.Results:After the application of the tailored scientific research management information platform, the efficiency of reimbursement and information access of scientific research personnel was significantly improved, with a significant difference.Conclusions:The construction of scientific research information platform based on the combination of education and management helps to achieve the goal of efficient, standardized and refined scientific research management.

The implementation of multi-disciplinary treatment and whole course management in hepatocellular carcinoma / 中华肝胆外科杂志

In China, hepatocellular carcinoma (HCC) accounts for about 50% of cases in the world, which is still challenging. The implementation of multi-disciplinary treatment (MDT) and whole course management of HCC are conducive to improve the prognosis of patients, so as to achieve the goal of increasing by 15% of overall survival of HCC patients as proposed by the "Healthy China 2030" . The standardized management of HCC includes several key points, such as exact diagnosis of the HCC, selection of proper treatment methods, individual postoperative adjuvant therapy and regular follow-up. MDT is the key measure to implement the standardized and whole course management of HCC. Herein, the author tends to summary the experience on standardized management of HCC.

Enlightenment of Continuing Education Curriculum and Implementation Management System for Licensed Pharmacists in the United States to China / 中国药房

OBJECTIVE：To provide reference f or optimizing the curriculum management system of continuing education for licensed pharmacists in China. METHODS ： The content and implementation system of continuing education curriculum management for licensed pharmacists in the United States was introduced ，and policy suggestions were put forward for the curriculum construction and management system optimization of continuing education for licensed pharmacists in China. RESULTS & CONCLUSIONS ：The curriculum management of continuing education for licensed pharmacists in the United States has clear curriculum objectives ，missions and plans ，and evaluates the basic situation of the trainees before continuing education starts ，so as to carry out modular management of the curriculum （including continuing education courses based on knowledge ，application and practice）. In terms of the implementation system of continuing education in the United States ，ACPE has put forward a lifelong learning model （pharmacist continuing career development model ）that emphasizes autonomy and personalization ，and has detailed regulations on teaching methods ，learning cycle and fees. At the same time ，ACPE requires that the feedback of participants on the curriculum must be collected. Combined with the practice in China ，it is suggested that the relevant departments should formulate the Curriculum Standard of Continuing Education for Licensed Pharmacists ， implement standardized management of the curriculum，improve the assessment mechanism of continuing education curriculum ，flexibly grant credits based on the actual education effect ，constantly update the concept and mode of continuing education ，and localize the international theory ，so as to continuously improve the continuing education management system of licensed pharmacists in China.

Effect of Mobile Health for Standardized Management on Women with Gestational Diabetes Mellitus / 中国医学科学院学报

Objective To explore the performance of mobile health platform for standardized management of pregnant women with gestational diabetes mellitus(GDM). Methods A randomized controlled trial was conducted,in which 295 women with GDM were randomized into two groups(traditional management group and mobile health management group)by a computer-generated sequence.The traditional management group accepted standardized GDM management,and the mobile health management group was supplemented by mobile health management based on the standardized management.The glycemic control rate and the incidences of low birth weight,macrosomia,preterm birth,premature rupture of membranes,postpartum hemorrhage after cesarean section,neonatal asphyxia,malformation,and admission to the neonatal intensive care unit were compared between the two groups. Results The glycemic control rate in mobile health management group was significantly higher than that in the traditional management group [(67.22±22.76)%

Effect of standardized management of hypertension patients in community / 中国基层医药

Objective To investigate the effect of standardized management of hypertension patients in community.Methods Permanent residents aged 50-60 in the community were selected as the survey subjects from January 2016 to January 2017.After the standardized training of professional doctors in the First People's Hospital of Huainan,a unified investigation was carried out.A total of 160 qualified hypertensive patients were selected ,including 91 males and 69 females.According to the random number table method ,the patients were divided into the control group and the intervention group.The control group was given routine community nursing ,and the intervention group was given standardized community team management ,and the intervention period was 1 year.The changes of blood pressure and awareness rate before and after intervention were compared and analyzed .Results Through standardized management of the team , the awareness rate, medication rate and control rate (85.0%,77.5%,47.5%) of the control group were higher than those before management (57.5%,53.8%,28.8%).The ＂three rates＂of hyperten-sion patients in intervention group (100.0%,92.5%,68.8%) were higher than those before management (58.8%, 56.2%,31.3%).Moreover,the awareness rate,medication rate and control rate of the intervention group were signifi-cantly higher than those of the control group (χ2 ＝12.973,7.059,7.421,all P＜0.05).Meanwhile,the DBP and SBP of the intervention group were significantly lower than those of the control group [ DBP:(98.7 ±16.4) mmHg vs. (78.5 ±11.7)mmHg,t＝5.42,P＜0.05;SBP:(161.2 ±10.6)mmHg vs.(130.6 ±12.1)mmHg,t＝-5.31,P＜0.05].Conclusion The effect of standardized management of hypertension patients in community is better than traditional community nursing,which can effectively reduce blood pressure and improve the awareness rate ,and is suitable for clinical application.

Discussion on Standardization Management Mode of Medical Equipment Based on Whole Process Quality Control / 中国医疗器械杂志

This paper introduced the current situation of medical equipment. Based on the current problems such as technology assessment difficulty, weak consciousness on maintenance management, less quality control during clinic use and backward information level, the standardized management based on the whole process quality control was proposed. Combined the whole process quality control system with the construction of quality management information, the management level of the medical equipment was enhanced. The application of standardized management based on the whole process quality control can make the medical equipment work better in the clinic and set a good foundation for the development of hospital.

Effect of standardized management of hypertension patients in community / 中国基层医药

Objective@#To investigate the effect of standardized management of hypertension patients in community.@*Methods@#Permanent residents aged 50-60 in the community were selected as the survey subjects from January 2016 to January 2017.After the standardized training of professional doctors in the First People's Hospital of Huainan, a unified investigation was carried out.A total of 160 qualified hypertensive patients were selected, including 91 males and 69 females.According to the random number table method, the patients were divided into the control group and the intervention group.The control group was given routine community nursing, and the intervention group was given standardized community team management, and the intervention period was 1 year.The changes of blood pressure and awareness rate before and after intervention were compared and analyzed.@*Results@#Through standardized management of the team, the awareness rate, medication rate and control rate (85.0%, 77.5%, 47.5%) of the control group were higher than those before management (57.5%, 53.8%, 28.8%). The " three rates" of hypertension patients in intervention group (100.0%, 92.5%, 68.8%) were higher than those before management (58.8%, 56.2%, 31.3%). Moreover, the awareness rate, medication rate and control rate of the intervention group were significantly higher than those of the control group(χ2=12.973, 7.059, 7.421, all P<0.05). Meanwhile, the DBP and SBP of the intervention group were significantly lower than those of the control group[DBP: (98.7±16.4)mmHg vs.(78.5±11.7)mmHg, t=5.42, P<0.05; SBP: (161.2±10.6)mmHg vs.(130.6±12.1)mmHg, t=-5.31, P<0.05].@*Conclusion@#The effect of standardized management of hypertension patients in community is better than traditional community nursing, which can effectively reduce blood pressure and improve the awareness rate, and is suitable for clinical application.

Application and Practice of Drug Quantitative Scoring Table in the Temporary Drug Purchase of Our Hospital / 中国药房

OBJECTIVE： To standardize the management of temporary drug purchase， and to provide reference for drug selection in Hospital Pharmaceutical Administration and Drug Treatment Committee （Pharmaceutical Association）. METHODS： Clinical pharmacists set up drug quantitative scoring table according to the 10 attributes of drugs as effectiveness， safety， economy， etc. 15 temporary purchased drugs submitted by departments in Oct. 2018 were graded according to the rules of the scoring table， and the evaluation results were fed back to Pharmaceutical Association. A retrospective evaluation of 20 temporary purchased drugs which were discussed at the Pharmaceutical Association from Jul. to Sept. 2018 was made according to previous approval model without using drug quantitative scoring table. The effect of pre-intervention was evaluated after using drug quantitative scoring table. RESULTS： Among 15 temporary purchased drugs， 2 of them scored below 60， and the unqualified rate was 13.3％. It suggested that 2 drugs could not be discussed at the meeting. Among 20 temporary purchased drugs that have been discussed at the meeting， 9 of them scored below 60， with the unqualified rate of 45.0％， suggesting that 9 drugs may have wasted the workload of the Pharmaceutical Association. CONCLUSIONS： Drug quantitative scoring table can play a pre-intervention role in the scoring of temporary purchased drugs to a certain extent. At the same time， the table can also be used as a relevant reference for hospital drug evaluation. It is helpful to optimize hospital drug use list and improve the level of rational drug use in clinic.

Establishment and practice of a point-of-care testing management system in hospitals / 中华医院管理杂志

With the market-oriented application of new technologies and the development of various subjects in hospitals, more and more point-of-care test(POCT) devices appear in medical institutions, as an important method for rapid clinical acquisition of test results. As introduced by the authors, the hospital since 2017, established based on the hospital′s total quality management system, the POCT management committee, and built the hospital′s POCT quality management system. Thanks to its efforts, the hospital has fully standardized the POCT management from equipment procurement, test, maintenance, personnel training and examination, thus further ensuring medical quality.

Overview on standardization of medical quality and safety management at home and abroad / 中华医院管理杂志

Based on a systematic literature review on medical quality and safety management at home and abroad, the authors presented such international standards as ISO, JCI, KTQ, NICE and ACHS, as well as China′s national and industrial standards for hospital grading appraisal and medical management, and introduced China′s standardization development. These efforts aim at referencing on domestic and international experiences for standard development by hospital quality and safety management entities.

Effect and influencing factors of standard management on patients with hypertension / 预防医学

Objective To learn the implementation and effects of standardized management of hypertension in Xiangshan. Methods A total of 1500 patients who were over 35 years and admitted to community hypertension management were enrolled in the research. The patients were given standardized management of hypertension, and acceptance questionnaire survey and physical examination. Multivariate logistic regression model was used to analyze the influencing factors of blood pressure control. Results Totally 597 patients were managed according to the standardized management requirements, and the standardized management rate was 39.80％ . All patients were received blood pressure ≥1 times /year, 84.00％ , 84.47％ , 78.27％ and 77.67％ of the patients were received dietary guidance, physical activity guidance, guidance and control tobacco smoking cessation / drinking / alcohol limit guidance respectively. The standardized blood pressure control rate was 42.20％ , which was higher than that of the non standardized management patients (31.01％), and the difference was statistically significant (P<0.05) . Logistic regression showed that high education background (ORjunior middle scho l=0.86, 95％ CI: 0.78-0.95;ORhighscho landabove= 0.76, 95％ CI: 0.68-0.85), excessive waist circumference (OR=0.93, 95％ CI: 0.89-0.97), obesity (OR=0.66, 95％ CI: 0.47-0.93) , receiving dietary guidance, (OR=0.73, 95％ CI: 0.56-0.95 ) , receiving physical activity guidance (OR=0.89, 95％CI: 0.81-0.98), acceptance of standardized management (OR=0.74, 95％CI: 0.62-0.88) were promote factors of blood pressure control. Elder (OR=1.29, 95％CI: 1.08-1.54), male (OR=1.12, 95％ CI: 1.02-1.23), living in rural areas (OR=1.09, 95％ CI: 1.03-1.15) and high income (OR=2.01, 95％ CI: 1.31-3.08) were barriers of blood pressure control. Conclusion Providing standardized management services for patients with hypertension can effectively control the blood pressure level.

Effectiveness evaluation of standardized community-based hypertension management in Jinhua City / 中华健康管理学杂志

Objective To evaluate the effectiveness of community?based standardized blood pressure control and lifestyle management in hypertensive patients in Jinhua. Methods The study included patients with primary hypertension from community health service centers in Yongkang, Lanxi, and an urban district in Jinhua. Electronic health record data from 2015 to 2017 were collected, and relevant indicators before and after standardized management were assessed. Rates and constituent ratios were used for statistical evaluation. Numeric data were compared using the chi square test, and means were compared using the t?test. Results Of 14 943 hypertensive patients who underwent standardized management, 8 052 were women (53.88%) and 6 891 were men (46.12%). The average age of these patients in early 2015 was 66.63 years. After 3 years of standardized management, the rate of blood pressure control increased from 42.85% to 49.50%. The difference was statistically significant (χ2=133.019, P<0.05). The mean systolic and diastolic blood pressure values (138.67 mmHg and 84.46 mmHg, respectively) (1 mmHg=0.133 kPa) after standardized management were significantly different from those (139.40 mmHg and 85.08 mmHg, respectively) before standardized management (t=7.667, P<0.05; t=6.583, P<0.05, respectively). The average body weight, number of cigarettes smoked daily, and regular exercise time (61.51 kg, 15.28 cigarettes, and 40.56 min, respectively) after standardized management were significantly different from those (61.62 kg, 15.49 cigarettes, and 40.31 min, respectively) before standardized management (t=5.015, P<0.05; t=1.848, P<0.05; t=2.455, P<0.05, respectively). The medication compliance and willingness of being managed had significantly increased. The difference was statistically significant (χ2=72.600, P<0.05; χ2=299.434, P<0.05, respectively). Conclusions Standardized community-based management of hypertension effectively improved the rate of blood pressure control and the overall health of residents.

Clinical management of procedural pain in the neonate:policy statement of prevention and management of procedural pain in the neonate by American Academy of Pediatrics Committee on Fetus and New-born and Section on Anesthesiology and Pain Medicine / 中国小儿急救医学

Neonatal pain is a common phenomenon. For a long time neonatal pain had not been focus on properly and managed appropriately. American Academy of Pediatrics Committee on Fetus and Newborn and Section on Anesthesiology and Pain Medicine published policy statement to emphasize the necessity of neonatal pain assessment,and summarize the neonatal operability pain assessment method,drug and non-drug control measures,also update prevention and management of procedural pain in the neonate in 2016. Until today the guideline for neonatal pain management has not yet been released in China. As the reference for clinicians in domestic,the content of policy statement will be reorganized and introduced.

Ethical Reflection on Standardized Management of Intestinal Microbiota Transplantation / 中国医学伦理学

Intestinal microecology is an important and complex biological system necessary for human health.Its disorder is involved in the development of various diseases of human body.The technology of intestinal microbiota transplantation can effectively regulate the intestinal flora,repair the imbalance of the intestinal microecology,and bring a new breakthrough for the treatment of many diseases of gastrointestinal tract and outside gastrointestinal tract.However,there is still no systematic and complete management standard for intestinal microbiota transplantation technology.This paper discussed related content involved in standardized management of intestinal microbiota transplantation technology and reflected the ethical problems involved in standardized management from the perspective of medical ethics,in order to promote the clinical application of intestinal microbiota transplantation technology.

Toxicological pathology in preclinical drug safety evaluation / 药物评价研究

Toxicological pathology is a morphological elucidatet ion of tissue damage caused by drug toxicity,including damage type,location,severity grade and prognosis.It provides objective and accurate data to support preclinical drug safety evaluation.Therefore,toxicological pathology plays an important role in drug safety evaluation,and the pathologic data or conclusion often determines the termination or continuation in many drug development projects.In this paper,the characteristic of toxicological pathology,standardized management,the development of new techniques including in situ hybridization,laser scanning cytometry and laser capture microdissection,and related problems in pathology are discussed briefly.

Research on standardized management of quality control for medical equipment / 医疗卫生装备

Objective To discuss the standardized management strategies of medical equipment quality control in the whole life cycle of medical equipment.Methods The quality control was prepared from the aspects of management,technology and materials firstly,then quality control object was determined through a comprehensive risk rating system with quantitative values at risk,and overall analysis was executed with PDCA method finally.Results The management of medical equipment quality control was further standardized,the risks during medical equipment utilization were reduced,and the comprehensive benefit of the hospital was increased.Conclusion The standardized management of medical equipment quality control is of great importance to enhance medical quality.

Investigution and Analysis of Off-label Drug Use in Fertility Clinic of One Hospital / 中国药师

Objective:To analyze the situation of off-label drug use in fertility clinic of one hospital to provide scientific evidence for clinical rational drug use and further standardize the behavior of off-label drug use in clinical physicians. Methods:The outpatient prescriptions in the reproductive center of the hospital during January and December in 2016 were randomly selected, the off-label drug use prescriptions were statistically analyzed according to the drug package inserts, and the rationality of the off-label drug use were e-valuated by searching the related literatures. Results:A total of 4176 off-label drug use prescriptions were collected, the primary types of off-label drug use were off-label indication, off-label dose and off-label administration. The top 3 drugs with off-label use were aspi-rin enteric-coated tablets (42. 05%), dydrogesterone tablets (27. 37%) and levocarnitine oral solution (16. 02%). The most of off-label use was supported by evidence-based medicines, while unreasonable use still existed. Conclusion: Off-label drug use is very common in the reproductive center of the hospital. The hospital should pay more attention to the phenomenon and establish relevant management system to standardize the behavior of off-label drug use in order to reduce the legal risk and promote clinical rational drug use.

Investigution and Analysis of Off-label Drug Use in Fertility Clinic of One Hospital / 中国药师

Objective:To analyze the situation of off-label drug use in fertility clinic of one hospital to provide scientific evidence for clinical rational drug use and further standardize the behavior of off-label drug use in clinical physicians. Methods:The outpatient prescriptions in the reproductive center of the hospital during January and December in 2016 were randomly selected, the off-label drug use prescriptions were statistically analyzed according to the drug package inserts, and the rationality of the off-label drug use were e-valuated by searching the related literatures. Results:A total of 4176 off-label drug use prescriptions were collected, the primary types of off-label drug use were off-label indication, off-label dose and off-label administration. The top 3 drugs with off-label use were aspi-rin enteric-coated tablets (42. 05%), dydrogesterone tablets (27. 37%) and levocarnitine oral solution (16. 02%). The most of off-label use was supported by evidence-based medicines, while unreasonable use still existed. Conclusion: Off-label drug use is very common in the reproductive center of the hospital. The hospital should pay more attention to the phenomenon and establish relevant management system to standardize the behavior of off-label drug use in order to reduce the legal risk and promote clinical rational drug use.

Applications and effects of standardized management model in pediatric laparoscopic surgery ;nursing / 中国实用护理杂志

Objective To improve pediatric laparoscopic surgical nursing care by establishing and applying standardized management mode, and ensure the operations and the children′s safety. Methods 100 children were respectively selected who received laparoscopic surgery from January to June and from July to December 2015 as control group and test group. Nursing workflow were respectively carried out before and after standardized management mode applied in control group and test group. Then we compared the differences in examination scores, time cost of operative preparation and surgeon satisfaction of specialist nurses between the two groups. Results After the implementation of standardized management, the examination scores of specialist nurses were higher than before. The theoretical and operating scores before implementation were (74.94 ± 2.01) and (81.63 ± 0.92) points, while the scores after implementation were (80.67 ± 3.91) points and (86.22 ± 1.48) points relatively. The differences were statistically significant (t=3.726,7.570, P<0.01);The time cost of operative preparation was significantly shortened from (27.94±1.88) minutes to (23.56±1.61) minutes (t=5.181,P<0.01);In the survey of nurses′satisfaction, the nursing knowledge scores increased from (3.77 ± 0.57) points to (4.17 ± 0.46) points after the implementation, while skill scores lifted from (3.57 ± 0.63) points to (4.00 ± 0.83) points, with all the differences above are statistically significant(t=2.994, 2.282,P < 0.01). The rate of laparoscopic equipment failure was declined, especially the case of equipment failure due to misuse had reduced from 12 to 2 cases (χ2=7.680,P < 0.05). Conclusions Application of standardized management mode can effectively improve the nurses′ professional ability and the rate of normally used equipment in the operation, which improved surgeon′s satisfaction.