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Objective:To investigate the effect of failure mode and effect analysis (FMEA) based catheter information platform in preventing catheter-related bloodstream infection (CRBSI) in intensive care unit to improve the current status of CRBSI.Methods:In this study, a retrospective cohort study was conducted using the purposive sampling method, and 140 patients with indwelling central venous catheters admitted to the ICU of Peking University Shenzhen Hospital from August to December 2021 were set as the control group; the 140 patients with indwelling central venous catheters admitted to the ICU from January to May 2022 were set as the observation group. The control group used electronic forms to record and manage at the bedside after CRBSI cluster nursing measures were given, and the observation group used the catheter information platform based on FMEA to conduct information management on catheter evaluation and maintenance process after CRBSI cluster nursing measures were given. Compared the implementation rate (6 items), implementation time, qualification rate, and incidence of CRBSI in ICU patients between two groups of ICU nurses.Results:The implementation rate of CRBSI cluster nursing measures among ICU nurses in the observation group: strict hand hygiene by nurses was 87%(122/140), maximum aseptic barrier during puncture was 97%(136/140), aseptic operation during catheter maintenance was 91%(128/140), 75% alcohol disinfection of connectors was 84%(118/140), 24-hour change of infusion lines was 95%(133/140), and timely change of patches/dressings was 89%(125/140), they were greater than those in the control group 70%(98/140), 87%(122/140), 71%(100/140), 61%(86/140), 71%(99/140), 69%(96/140), the differences were statistically significant ( χ2 values were 9.67 to 29.07, all P<0.05); the execution time and qualification rate among ICU nurses in the observation group were (9.11 ± 2.83) minutes and 91.4% (128/140), the control group were (10.00 ± 2.84) minutes and 60.7% (85/140), with statistically significant differences ( t value was -2.64, χ2 values was 36.28, all P<0.05). Conclusions:The FMEA-based catheterization information platform can help enhance the efficiency of the implementation of CRBSI clustering nursing measures by ICU nurses, improve the quality of care, and thus reduce the occurrence of CRBSI, and the feasibility of clinical promotion is high.
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The surveillance of occupational disease has entered a new stage ofdevelopment, with the implementation of the national health informatization project. To improve the efficiency and quality of occupational disease monitoring information reporting in this paper, the system architecture and related management regulations, as long as the major changes and achievement of "surveillance system of occupational disease and health hazards information" under the framework of National Health Insurance Informatization Project were elaborated. The deficiencies existing in the system were analyzed, and expectation for the construction of the occupational disease surveillance system was addressed.
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Humans , Occupational Diseases , Occupational HealthABSTRACT
OBJECTIVE To establish the path-based management mode of 5-hydroxytryptamine-3 receptor antagonist （5- HT3RA） in chemotherapy patients， and to improve the rationality of medication in chemotherapy patients. METHODS 5-HT3RA standardized drug use control rules were formulated， with the help of medical intelligence and decision support （MINDS） system， path-based management was carried out for chemotherapy patients using 5-HT3RA in the form of whole-process information capture and prescription pre-review， and whole-process intervention was implemented on medication indications， usage and dosage， course of treatment， etc. The intervention effect was analyzed by comparing the changes in the use of 5-HT3RA without indication， unreasonable usage and dosage， repeated medication， unreasonable course of treatment， and per capita drug cost before and after the implementation of path-based management. RESULTS A total of 9 181 patients were included. After the implementation of path- based management， the proportion of unindicated drugs decreased by 0.48%， and the rate of unreasonable single dosage， unreasonable frequency， repeated medication， unreasonable treatment course （5-HT3RA still used 3 days after chemotherapy） decreased by 10.48%， 0.65%， 1.33% and 0.34%； per capita cost of 5-HT3RA decreased by 13.72 yuan； there were statistical significance （P＜0.05）. CONCLUSIONS 5-HT3RA path-based management mode effectively improves the rationality of medication and provides a new idea for rational clinical drug use.
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To change the traditional hospital medical supplies rough management mode, the hospitals build an information material management platform which combines suppliers and hospitals, information systems and smart devices, clinical needs and professional operations innovatively. Finally, a lean management system called SPD is formed under the guidance of supply chain integration and supported by supply chain management theory and information technology. It has realized the whole process of consumables circulation information traceability, intelligent service in the hospital, and refined management of consumption settlement. The application of SPD in hospitals effectively improves the informatization level and overall operation efficiency of medical consumables management which is an important part of hospital information construction.
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Hospital Administration , Hospitals , AllograftsABSTRACT
OBJECTIVE@#In order to solve the problem of inadequate CT screening ability in emergency medical rescue in remote mountainous areas, high-altitude areas, other public health events and sudden natural disasters, a vehicle-mounted mobile CT suitable for emergency medical rescue is studied.@*METHODS@#A vehicle chassis system suitable for long-distance transportation and a cabin system suitable for epidemic prevention and control was designed. A domestic 32-slice CT with small volume, light weight and high stability was selected to design a vehicle-mounted mobile CT suitable for emergency medical rescue.@*RESULTS@#The high-performance vehicle-mounted mobile CT can provide rapid support, and provide large-scale screening, emergency medical rescue, a supplement to daily CT scanning in peacetime and wartime.@*CONCLUSIONS@#The vehicle CT has high stability, fast scanning speed and high social and economic value.
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Currently, the number of clinical research projects continues to grow. Both sponsors and researchers hope to accelerate medical ethical review efficiency, and the regulatory agencies strengthen the control over the ethical review quality. The ethics committee (EC) offices of medical institutions are relatively insufficient in terms of human resource allocation and archiving space. Combined with the development goals of the EC and the requirements of the homogeneity construction of ethical review, it was urgent to optimize the ethics review process and accelerate the efficiency of ethics review through informatization construction. Through informatization construction, the process management of ethical review could be strengthened, the work steps could be simplified, the ethical review level could be improved, and the supervision ability and efficacy of EC on clinical research could be strengthened, which may provide continuous quality improvement strategies and specific optimization measures for the operation and management of the EC, so as to effectively protect the safety, the rights and interests of subjects.
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Objective:In this study, the application value of a specific information platform in heart failure was explored.Methods:We constructed five modules of information platform based on clinical needs, including user interface, patient management interface, follow-up platform, data processing interface and system management. By making good use of the platform, a database of heart failure was established and quality-controlled to realize the management of chronic heart failure, and prepare database for possible clinical research.Results:More than 3 000 patients with heart failure had been registered in the heart failure special disease platform. Long-term out-of-hospital management of cerfain patients with heart failure was conducted through intelligent information means. High-quality heart failure data were obtained and translated into clinical results.Conclusions:Long-term out-of-hospital management of patients with chronic heart failure can be realized through the special disease information platform, and high-quality evidence-based medical data can be obtained. Besides, the platform provides theoretical basis and data support for evaluation system of prognosis of heart failure, provides theoretical basis and data support for improving medication and surgical treatment plans and comprehensive management system of patients with heart failure.
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Objective:In order to reduce the transactional burden of scientific researchers and ensure the researchers concentrate on their scientific research, the hospital implemented the whole-process management and optimization of the scientific research approval process based on the DingTalk platform to improve the efficiency of scientific research.Methods:We sorted out the list of routine work in the implementation of scientific research projects and analyzed the key points affecting the efficiency of scientific research management, specifically the processes of reimbursement of scientific research funds, budget adjustment, paper submission approval, and research drug application, then we developed corresponding modules on the DingTalk platform.Results:In 2021, the hospital approved 3 214 scientific research funding reimbursements, including 1 917 approvals below 5 000 yuan, with a median approval time of 19 (5~28) hours, 1 297 approvals above 5 000 yuan, with a median approval time of 26 (10~50) hours. In addition, 17 budget adjustments, 456 paper submissions, and 31 research drug applications were approved on the DingTalk platform, resulting in a smooth overall approval process, saving the time costs of medical staff and improving work efficiency.Conclusions:The scientific research approval management based on this platform realizes the concept of refined management, which can meet the needs of the normalization of epidemic prevention and control and effectively promote the high-quality development of hospital scientific research management.
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The standardized residency training is an important stage in the training of physicians. Shanghai East Hospital has explored the system of the whole-process tutor management in the residency training. To explore the specific methods of carrying out the whole-process tutor training for residents in the whole hospital, gradually the whole-process tutor system is built with qualification certification, mutual selection of teachers and students, tutor empowerment, plan implementation and assessment and evaluation. Meanwhile, a supporting informatization platform is being developed to provide necessary tool support for the implementation and promotion of the whole-process tutor of residency training. And information tools are used to carry out implementation management, process optimization and quality monitoring, so as to form a closed management loop.
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The military vocational education is facing the reform under the background of "Internet +" education. O2O teaching is a model that combines the online teaching resource platform with the offline traditional education, and it is consistent with the development trend of contemporary military vocational education. In this study, we analyze the comparative advantages of O2O teaching model in military vocational education, including the multi-dimensional teaching content, the interactive teaching method, and the autonomy of teaching design. In this model, students become the subject of learning, and the process of storing knowledge will be transformed into the application and creation of knowledge. This paper also elucidates the feasibility of O2O teaching in the military vocational education, and further discusses its design in application from the point of view of managers, teachers and learners.
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Based on the limitations of certain conditions in the traditional clinical pathology teaching, this paper puts forward the "quaternity" hybrid digital teaching reform practice of clinical medicine, imaging, anatomy and pathology content. This teaching method can optimize the teaching process and improve the teaching efficiency. The specific advantages of this teaching method are as follows: the digital materials of different modules of clinical practice, imaging, anatomy and pathology are integrated to make the teaching content more perfect; it is helpful to improve the cognition of resident doctors on the pathological characteristics and the overall characteristics of the disease, and promote their thinking ability of clinicopathological integration; the combination of hybrid digital teaching and various teaching methods, including clinical pathology discussion, makes teaching more free and is conducive to classroom learning and self-learning. This paper discussed the construction and application of the "quaternity " hybrid digital teaching mode, and provided new ideas and methods for clinical pathology teaching and talent training.
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Objective:To explore the application effect of pre-hospital information publicity and education management model in patients with gastrointestinal tumors.Methods:The inpatients with gastrointestinal tumors who made an appointment in the outpatient department of the Affiliated Hospital of Qingdao University were randomly divided into 225 cases in the control group and 226 cases in the experimental group. The control group was treated according to the routine process, the experimental group implemented pre hospital information education and management, and the patients were individually assessed and health education through the official account of WeChat, Heals mobile education system, telephone communication and WeChat group.Results:After the implementation of pre-hospital information management model, the anxiety and depression scores of patients in the experiment group were (55.89 ± 15.53) and (56.19 ± 17.87), which were significantly better than those in the control group, (60.84 ± 15.42) and (62.28 ± 19.67) ( t = 3.40, 3.43, both P<0.01). The awareness rate of admission related knowledge (74% to 93%) and satisfaction with pre-hospital publicity and education management in the experimental group were also higher than control group ( χ2 values were 5.84-20.28, all P<0.05). The hospitalization rate of patients in the experimental group was 91.15%(206/226), which was significantly higher than that in thecontrol group, 81.78%(184/225), the difference was significant ( χ2 = 8.47, P<0.01). The secondary hospitalization rate in the experimental group was 8.41%(19/226), which was significantly lower than that in the control group, 19.11% (43/225)( χ2 = 10.90, P<0.01). Conclusion:The pre-hospital information publicity and education management model can improve the awareness rate of patients′ admission related knowledge, improve patients′ satisfaction with pre hospital publicity and education management, reduce the secondary hospitalization rate and shorten the average preoperative hospital stay, which is worthy of further promotion and application in clinic.
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China’s chronic disease management suffers from problems such as unclear institutional function， insufficient information technology application， and weak regulation support. On the basis of current chronic disease management condition in China， this paper proposes to apply the concept of “people-centered” integrated health management to community chronic disease management and discusses the content and procedure of establishing an integrated community-based chronic disease management model driven by massive databases. The model innovatively combines technology integration， data integration and service integration， and can accurately and efficiently realize the "people-centered" full-course health management of various chronic diseases. Shanghai has provided integrated community-based chronic disease management service for 1.98 million citizens through applying this model. The model warrants further effectiveness and economic evaluation. This study provides precious experience for the development of chronic disease prevention and treatment in China.
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Objective:By optimizing the fund management mode, a scientific research management platform with high efficiency can be created, which can innovate the vitality of scientific research and improve the level of scientific research management.Methods:Applying the scientific research fund management model based on information platform interconnects each system and forms a new fund management model.Results:The fund management mode based on the information platform standardizes the business process, reduces the risk of internal control and facilitates the scientific researchers and financial personnel to control and manage the quality of scientific research.Conclusions:The fund management mode based on the information platform achieves the management goals of improving work efficiency, standardizing business process, strengthening internal control and innovating scientific research vitality by integrating system resources and business process.
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OBJECTIV E To develop the infor mation-based pharmaceutical care pathway of anticoagulant therapy in patients with atrial fibrillation and improve the efficacy and safety of treatment for them. METHODS The“anticoagulant pharmaceutical care”module was developed on the basis of medical intelligent and decision system. Patients with atrial fibrillation were taken pharmaceutical care in the whole anticoagulant treatment by evaluating the thromboembolism and bleeding risks ，pre-reviewing antithrombotic prescriptions ，monitoring efficacy and drug interactions ，and warning adverse reactions. RESULTS A total of 1 228 patients receiving anticoagulant therapy were enrolled. It was found after analysis of their doctor ’s orders that 9.27％ of the patients adjusted the improper antithrombotic therapies ，3.99％ modulated treatments according to the effects of potential drug interactions or the risk of adverse reactions ，and 70.29％ of the wrong prescriptions were intervened successfully. After the information-based pharmaceutical care ，the anticoagulation treatment rate increased from 88.73％ to 97.40％，the rate of patients ’achievements to warfarin’s international normalized ratio in hospital increased from 38.64％ to 66.67％，and the incidence of serious bleeding events decreased from 2.94％ to 0.37％ （P＜0.05）. CONCLUSIONS The information-based pharmaceutical care path of anticoagulant therapy achieved comprehensive ，efficient and accurate management of patients with atrial fibrillation ，and improved the rationality ，effectiveness and safety of anticoagulant therapy.
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OBJECTIVE To sum marize the pro cedure and informatization construction of centralized volume-based procurement（VBP）in our hospital ，in order to give references for normal development of centralized VBP. METHODS The standardized workflow system was established ，including using flow chart method to establish standardized workflow ，carrying out procedure training and inspection of procedure implementation ， and continuously conducting procedure optimization. The information system was developed for the task links that needed a lot of calculation to improve the automation level of information processing. RESULTS & CONCLUSIONS Eight specific work procedures were established in our hospital ，including the work procedures of submitting the demand data of centralized VBP and the implementation of centralized VBP ，and has taken measures such as procedure training ，establishing supervision and inspection system and using auxiliary means to promote the implementation of the procedure ，so as to optimize the procedure and work form. An informatization platform for the clinical task allocation of the agreed purchase quantity of centralized VBP and a supervision platform for the daily use of VBP were also established in our hospital，then the two tasks with a large amount of calculation could be finished. Standardized workflow system and informatization platform construction has improved the operation and supervision efficiency of centralized VBP in our hospital ，ensured the completion of centralized purchase tasks and saved human resources ，which has a certain promotion value.
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Quality management and control of single disease is a means to continuously improve medical quality and safety by building a set of quality control indicators and evaluation systems based on the whole process of disease diagnosis and treatment. In the actual single disease management process, the reporting of each disease involved data from various systems such as electronic medical records, and the data integration was difficult. While the traditional manual reporting method took a lot of time and the data accuracy could not be guaranteed. In the development process of hospital informatization, a hospital has designed a set of intelligent full-closed loop single disease management platform based on the hospital information system, by integrating the existing human and information data resources of the hospital. This platform integrated functions of single disease intranet reporting, in-depth capture of reporting elements, single-disease quality index management, and single-disease real-time intelligent control, in order to promote more refined and intelligent disease management and thus steadily improve medical quality and safety.
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Objective:To analyze the health development plans of the provinces in China during the " 14th Five-Year Plan" , and explore the key tasks, similarities and differences of health informatization construction in each province.Methods:Using the website of local people′s government and the official website of the provincial Health Commission, 27 copies of health development plans of various provinces during the " 14th Five-Year Plan" period were retrieved and collected from February 16 to June 5, 2022. The relevant statements of health information in the plan were extracted, content analysis was used to reveal the structural characteristics of the policy in the form of word frequency statistics, and discourse analysis was used to study the policy content.Results:The health information policies of 27 provinces during the " 14th Five-Year Plan" period could be summarized as 10 major themes, such as accelerating the construction of hierarchical diagnosis and treatment system, promoting the high-quality development of public hospitals, and deepening the reform of medical security system. The health information policy in the eastern, central and western regions was relatively clear, and there were certain differences in the construction points according to their own characteristics.Conclusions:During the " 14th Five-Year Plan" period, the policies of each province around the field of health information are well defined, and the core structure and content are similar. The distribution of key points in the eastern region is relatively balanced; the construction of health information in the central region is more prioritized and prominent; the construction of health information in the western region is focused on complementing the weak links and weaknesses.
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Objective:Exploring effective methods of information management in the practice of constructing practical and beautiful websites.Methods:Building a website that fits the management concept through research needs, page planning and design, column layout and other links. Standardize the website management by improving the management system, improving the management mechanism, and building a solid foundation for information security protection.Results:The revised website becomes not only an important window and bridge for external publicity and communication of the scientific research institutes, but also a concentrated embodiment of the achievements of information construction and management quality.Conclusions:Unified construction and management of the website can integrate resources, realize the coordination and efficiency of scientific research management, significantly improve the timeliness of information dissemination, promote the diversification of publicity modes, and improve the quality of scientific research services.
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Objective:Combined with the development and application of the hospital's current scientific research fund management information system, this paper explores how to further improve the informatization of scientific research fund management.Methods:Through the analysis of the service condition of four information systems, this paper identifies and illustrates problems existed in the process of informatization of scientific research funds.Results:There are some problems in the information system of scientific research funds, such as the failure to realize the " full life cycle" informatization of scientific research funds management, the uneven quality of information system, and lack of top-level design of management team. Route-cause analysis is conducted.Conclusions:It is suggested that the top-level design of information management at the national level, the reform of internal control system in hospitals, the cultivation of inter-disciplinary talent, and the increase of publicity should be taken to improve the informatization management of scientific research funds and improve the efficiency of funds utilization.