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OBJECTIVE：To explore refined management mode of outpatient pharmacy ，and to improve the efficiency and quality of outpatient pharmacy service. METHODS ：From the hospital information and big data center of our hospital ，the outpatient pharmacy prescription data under the traditional management mode were collected ；fish bone analysis was used to find out the factors that may affect the waiting time of patients ，the work efficiency and quality of pharmacy ；4M1E method was adopted to improve the related problems and implement refined management. The prescription data of 10 working days before improvement，stage 1 and stage 2 of refined management were selected. The work efficiency of pharmacists ，average waiting time of patients ，dispensing errors and inventory errors before and after the improvement were compared and analyzed to evaluate the effects of refined management. RESULTS ：By fishbone diagram ，the factors influencing the waiting time of patients ，the work efficiency and quality of outpatient pharmacy service in our hospital included personnel factors ，machine factors ，material factors ， method factors ，environmental factors ，such as the number of personel and time alloction was unreasonable ，the machine was aging，etc. After the implementation of refined management ，the outpatient pharmacy of our hospital had taken a variety of measures，such as adjusting the staff working time and refining the performance rew ard scheme ，maintaining the automatic dispensing machine and updating the prescription scanning equipment，setting up temporary drug containers and opti- mizing the location number ，strengthening drug management and relevant personnel training ， openning the window ofcharacteristic single variety dispensing. The statistical results com showed that in the first stage of fine management ，the number of dispensing prescriptions and the number of p rescription items in the outpatient pharmacy of our hospital increased slightly in 10 working days. Due to the decrease of the number of on-the-job staff and the change of the number and time of open windows ，the cumulative working hours of on-the-job staff decreased from 1 680 hours to 1 440 hours；the number of dispensing prescriptions and prescription items per hour per capita increased from 52.0 pieces，58.7 to 65.1 pieces，69.6（P＜0.05）；the number of dispensing errors decreased from 30 to 5；there was no significant change in waiting time of patients and inventory errors. In the second stage of fine management ，when the amount of dispensing prescriptions in outpatient pharmacy of our hospital was similar ，the number of dispensing prescriptions and the number of prescription items per hour per capita increased from 52.0 pieces，58.7 to 59.9 pieces，67.3，respectively（P＜0.05）；the average waiting time of patients decreased from 9.30 min to 7.32 min（P＜0.05）. After further refining the error data collection method and adjusting the performance incentive scheme ，the number of dispensing errors in outpatient pharmacy increased to 75，and the number of inventory errors decreased from 5 to 0. CONCLUSIONS ：By 4M1E method，outpatient pharmacy of our hospital carry out refined management ，to achieve the improvement of work efficiency and quality，shorten the waiting time of patients
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Recently, a standing desk is being installed as a behavior change strategy to reduce sitting time in the workplace. However, the standing posture has been suggested to decrease forehead oxygenated hemoglobin (oxy-Hb), which might impair task performances. Therefore, we examined whether prolonged standing impairs speed and accuracy of computer subtraction task associated with a decrease in forehead oxy-Hb. Nine healthy young males completed 4 × 15-min computer tasks under two conditions, i.e., sitting and standing. In the computer tasks, all subjects were required to subtract a two-digit number from a four digit number written on the paper and to input the answer to the answer colomn on the computer. Task performances were evaluated as the number of achievements and accuracy rate every 15 minutes. Moreover, oxy-Hb and deoxygenated-hemoglobin (deoxy-Hb) in the site of left forehead area and lower limb were monitored throughout the experimental period by near-infrared spectroscopy. Forehead oxy-Hb was significantly associated with the number of achievements during computer tasks (p < 0.001). In addition, forehead oxy-Hb and task performances did not differ between sitting and standing. The number of achievements of subtraction task under standing condition was significantly decreased as time proceeds. Our results demonstrate that prolonged standing might impair computer subtraction task performances irrespective of the change in forehead oxy-Hb.
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The " Trinity" management model of refined management, PDCA cycle and quality control circle was introduced into operating room ( OR ) management at our hospital since 2017. This practice aims to improve the OR process with refined management, elevate management practice with PDCA cycle, and improve detailed efficiency with quality control circle. 2017 witnessed a significant increase of the hospital in the number of surgical procedures, the punctuality rate of anesthesia, and the punctuality rate of the first surgery, as well as OR turnaround times than 2016. This model plays an important role in improving the efficiency of the OR, thus raising business revenue of the hospital.
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OBJECTIVE:To conduct whole process information management in PIVAS of our hospital,and to promote the work quality and efficiency of pharmacy intravenous admixture service(PIVAS). METHODS:The whole process information management in PIVAS of Tianjin medical university cancer hospital(it is called our hospital for short)was introduced in respects of prescription review,medical order disposal,the deployment of the outboard and so on. Related data were selected from PIVAS of our hospital during Jun. 2015-Feb. 2017. The effects of whole process information management in PIVAS of our hospital in May 2016 were evaluated by retrospective analysis,pre and post control research method. RESULTS:Through the application of whole process information management system,the improvement of relevant management,the functions of primary checking of medical order,drug quantity statistics,record traceability,workload account,responsible person and operation time recording were realized in the links of prescription checking,medical order processing,outboard allocation,inboard allocation,cabin checking,automatic sorting. Compared with before application,6 indexes of work efficiency were improved by 33.3%-86.1% after application(P<0.05);4 indexes of the work quality were improved by 28.6%-66.7%(P<0.05);quality index of finished product infusion was improved by 12.5%(P<0.05). CONCLUSIONS:The application of whole process information management in PIVAS can improve work quality and efficiency,and facilitate the convenience of management assessment.
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Objective To explore the effect of small package plastic ampoule products in preventing bacterial contamination of injectable drugs.Methods A retrospective study was carried out.In August 2015,78 first-line nurses in our hospital were recruited to the observation group using convenience sampling method,and the other 78 first-line nurses in the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine were selected as the control group at the same period.The control group utilized glass ampoule products in intravenous infusion of drugs,while the observation group utilized plastic ampoule products.Recorded the incidence of bacterial contamination of injectable drugs and sharp instrument injury.Results The incidence rate of bacterial contamination of injectable drugs in the observation group (1.3 ％) was obviously lower than that in the control group (10.2 ％),there was statistically significant difference (P＜0.05).The times expended in opening and identifying ampoule products in the observation group were (20.42±3.22)s and (28.40-4-4.20)s,which were significantly shorter than times expended in the control group[(40.20±4.10)s and (34.20±t5.21)s],there were statistically significant differences (P＜0.05).No sharp instrument injury was observed in the observation group,and the incidence rate of sharp instrument injury in the control group was 5.1 ％,the incidence rate of the observation group was significantly lower than that of the control group (P＜0.05).Conclusion Clinical application of plastic ampoule products can shorten the nurses operating time,effectively prevent the bacterial contamination of injectable drugs,and reduce the occurrence of sharp instrument injury during operation.
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Objective:To explore the application value of therapeutic intervention scoring system-28(TISS-28) in the management for intensive care unit (ICU) nursing.Methods: 120 elderly patients who received cure in ICU were divided into observation group (60 cases) and control group (60 cases) according to treatment time. Patients of observation group received the nursing method of TISS-28, and patients of control group received traditional nursing method. The average work time of nursing, the satisfactory degree of patients for nursing work and the satisfactory degree of paramedics for the manpower management of nursing of the two groups were compared.Results: The average work time of nursing of observation group was significantly less than that of control group (t=16.886, P<0.05). The satisfactory degrees for nursing work included life care, health education, communication with family member and humanistic care of observation group were significantly higher than that of control group, respectively (x2=5.175,x2=4.183,x2=4.227,x2=5.175;P<0.05). The general satisfactory degree for nursing work of observation group was significantly higher than that of control group (x2=4.227,P<0.05). The satisfactory degrees of doctor and paramedic for the nursing manpower management of observation group were significantly higher than that of control group (x2=4.571,P<0.05).Conclusion: It is benefit for scientific management of nursing that TISS-28 is adopted to manage the nursing of ICU, and it can enhance work efficiency of nursing and quality of nursing, and improve the satisfactory degrees of patients for nursing work and paramedics for the personnel management.
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Objective To explore the effect of small package plastic ampoule products in preventing bacterial contamination of injectable drugs.Methods A retrospective study was carried out.In August 2015,78 first-line nurses in our hospital were recruited to the observation group using convenience sampling method,and the other 78 first-line nurses in the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine were selected as the control group at the same period.The control group utilized glass ampoule products in intravenous infusion of drugs,while the observation group utilized plastic ampoule products.Recorded the incidence of bacterial contamination of injectable drugs and sharp instrument injury.Results The incidence rate of bacterial contamination of injectable drugs in the observation group (1.3 ％) was obviously lower than that in the control group (10.2 ％),there was statistically significant difference (P＜0.05).The times expended in opening and identifying ampoule products in the observation group were (20.42±3.22)s and (28.40-4-4.20)s,which were significantly shorter than times expended in the control group[(40.20±4.10)s and (34.20±t5.21)s],there were statistically significant differences (P＜0.05).No sharp instrument injury was observed in the observation group,and the incidence rate of sharp instrument injury in the control group was 5.1 ％,the incidence rate of the observation group was significantly lower than that of the control group (P＜0.05).Conclusion Clinical application of plastic ampoule products can shorten the nurses operating time,effectively prevent the bacterial contamination of injectable drugs,and reduce the occurrence of sharp instrument injury during operation.
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Objective:To optimize the storage placement of drug in automatic dispensing machine so as to increase the dispensing speed and work efficiency.Methods: The drugs were dispensed on the up and down side of the center of axle wire from high to low according to the dispensed frequency. The application regularity of various drugs was analyzed by using a number of prescription information and the relevant drugs were stored in nearest tank aroundthe drug outlet as the principle of minimum time algorithm. Through optimizing the storage placement of automatic dispensing machine and applying average dispensing time as evaluation index, the change of average dispensing time between before and after 3 months of the optimization of storage placement was analyzed.Results: After the storage placement was optimized, average dispensing time was shortened 2.0s. And the difference of the time between before and after optimization was statistically significant (t=11.92,P<0.05). Conclusion: Through applying minimum time algorithm, the optimized storage placement of automatic dispensing machine shortens the dispensing time of prescription and increases work efficiency.
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Objective To investigate the application and feasibility of the single bed work efficiency in the evaluation of hospital beds efficiency,to establish the hospital beds efficiency evaluation model,in order to provide the basis for scientific and effective utilization and evaluation of beds.Methods Proposing the concept of single bed work efficiency,establishing a new evaluation model of bed efficiency,and analyzing the utilization of hospital beds in 2015.Results Single bed work efficiency is supenor to other indexes in evaluating the Utilization efficiency of hospital beds,and the new bed efficiency evaluation model is more objective and accurate.Conclusion The evaluation model of hospital beds utilization efficiency based on the single bed work efficiency is more comparable and operable,which can be widely used in hos pital delicacy management.
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Objective:To explore the application value of therapeutic intervention scoring system-28(TISS-28) in the management for intensive care unit (ICU) nursing.Methods: 120 elderly patients who received cure in ICU were divided into observation group (60 cases) and control group (60 cases) according to treatment time. Patients of observation group received the nursing method of TISS-28, and patients of control group received traditional nursing method. The average work time of nursing, the satisfactory degree of patients for nursing work and the satisfactory degree of paramedics for the manpower management of nursing of the two groups were compared.Results: The average work time of nursing of observation group was significantly less than that of control group (t=16.886, P<0.05). The satisfactory degrees for nursing work included life care, health education, communication with family member and humanistic care of observation group were significantly higher than that of control group, respectively (x2=5.175,x2=4.183,x2=4.227,x2=5.175;P<0.05). The general satisfactory degree for nursing work of observation group was significantly higher than that of control group (x2=4.227,P<0.05). The satisfactory degrees of doctor and paramedic for the nursing manpower management of observation group were significantly higher than that of control group (x2=4.571,P<0.05).Conclusion: It is benefit for scientific management of nursing that TISS-28 is adopted to manage the nursing of ICU, and it can enhance work efficiency of nursing and quality of nursing, and improve the satisfactory degrees of patients for nursing work and paramedics for the personnel management.
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OBJECTIVE:To improve the working efficiency of the drug delivery system. METHODS:The kinds of drugs in delivery system and manual dispensing window were adjusted through comparing the number of prescriptions and drug box dis-pensed by the system and manual window in our hospital before adjustment (Jun. 2014),combining with analysis of EIQ(En-try-item-quantity)-ABC. The improvement effect was evaluated through analyzing related index after adjustment(Aug. 2014). RE-SULTS:The data before adjustment showed the workload of the delivery system was lower than that of manual delivery in term of the number of drug box (P=0.000),and they were similar in term of the number of prescription (P=0.122). The drug delivery system was significantly better than manual delivery in terms of two indexes after resetting the type of drugs in the system(P=0.000). CONCLUSIONS:Optimized delivery system can effectively improve the working efficiency.
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OBJECTIVE:To establish a new semi-automatic drug dispensing mode,with proper cost,which falls in between full-automatic drug dispensing mode and manual drug dispensing mode,good work efficiency,standard and simple operation meth-od and meets national laws and regulations. METHODS:A semi-automatic drug dispensing system was designed,in which the in-formation in the drug dispensing sheet could be automatically printed on the drug bag,and automatic bagging,packaging and deliv-ery of drugs were realized. Such drug dispensing system included hardware(mechanical structures such as drug turntable and drug funnel,transmission device,etc.)and software control systems(the program of interface with hospital information system,micro control unit software,computer software,etc.). Through commissioning,formal operation and statistics,based on 18 oral drug dis-pensing sheets with the same contents,calculated the time of drug dispensing and the number of drug dispensing errors by 3 phar-macists respectively in manual drug bag dispensing mode and semi-automatic drug dispensing mode,to evaluate the effect of the semi-automatic drug dispensing system. RESULTS:From commissioning in May 2012 to formal operation in September 2012,the system operated normally and utility model patents were obtained. In the two modes,the total time of drug dispensing was 481 and 397 min (t=6.82,P<0.001),the numbers of drug dispensing errors were 25 and 7 (χ2=9.353 8,P=0.002 2),respectively. There was statistical significance. CONCLUSIONS:The semi-automatic drug dispensing system has higher efficiency and less num-ber of drug dispensing errors compared with manual drug bag dispensing mode and lower cost compared to full-automatic drug dis-pensing system. It deserves promotion.
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Objective To investigate the development of the digital wireless network billing system of oxygen flow in clinical application. Methods By random 220 cases of patients who need to absorb oxygen were divided into the observation group(108 cases)and the control group(112 cases), the observation group used the digital wireless network billing system of oxygen flow, and the control group adopted the traditional buoy type oxygen gauge instrument. The following items were compared between the two groups: dispute rates between nurses and patients for different amount of absorbed oxygen, the average time cost for nurses in measuring the duration of oxygen absorbing, total income per barrel for recycling oxygen. Results For the dispute rates between nurses and patients for different amount of absorbed oxygen were 0.93% in the observation group, and 75.89% in the control group. The average time cost for nurses in measuring the duration of oxygen absorbing was 2.03 minutes for the observation group, and 12.54 minutes for the control group; total income per barrel for recycling oxygen was 42.68 yuan per barrel of the observation group, and 28.23 yuan in the control group. The statistical analysis between the two groups was supported by 95% confidential level. Conclusions Using the digital wireless network billing system of oxygen flow in clinical can reduce the dispute rates between the nurses and patients, improve patients' satisfaction degree, reduce the total time cost for nurses in measuring the duration of oxygen absorbing, raise efficiency, build a clear scientific charge system of oxygen flow, and restore economic loss.
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Objective To study the influence of pharmacy intravenous admixture servers(PIVAS)on human resource prioritized allocation.Methods We compared the time consumption and efficiency of drug dispensing as well as the human resource allocation before and after the establishment of PIVAS.The influence of PIVAS on the human resource allocation of nursing and pharmacy staff and work efficiency were analyzed.Results Nursing human resource were economized and we realized human resource prioritized allocation after the establishment of PIVAS.Conclusions Establishment of PIVAS facilitated the human resource prioritized allocation of nursing and pharmacy staff.It can promote the development of nursing cause and possesses wide application value.
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Objective To explore the effects of mild and moderate acute hypobaric hypoxia on manual performance.Methods Using hypobaric chamber to simulate hypoxia conditions and devising 4 kinds of objective ergonomic testing items(Insert sticks into holes-board,ISIHB;nut-bolt assembly task,NBAT;shape discrimination,SD;and Grip strength,GS including fatigue and tolerance)and one subjective research item(questionnaire subjective sense)to examine manual work efficiency varieties of 9 subjects exposed to a hypobaric chamber with 5 simulated altitudes(3 500,4 000,4 500,5 000 and 5 500 m),for(25?5)min.Results Compared to control group(50 m,the altitude of Beijing):Accomplish time(AT)performance of ISIHB and NBAT significantly decreased(P
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Objective: Little has been reported on the utilization of the preoperative preparing room before anesthesia.This article aimed to investigate how to improve work efficiency in the operation theatre by utilizing the preoperative preparing room.Methods: Two hundred patients undergoing elective surgery were equally randomized into an operation room group and a preoperative preparing room group,for which the preoperative preparations were made in the operation room and the preoperative preparing room,respectively.Records were made of such parameters as the anxiety score,mean arterial pressure(MAP) and heart rate(HR) of the patients,as well as the surgery rotation time.Results: The anxiety score,MAP and HR were significantly lower(P