A qualitative study on the current situation of hospital-institution-community comprehensive prevention of stroke / 中国实用护理杂志

Objective:To deeply explore the real work of primary, secondary and tertiary prevention of stroke in general hospitals, rehabilitation and pension institutions and community health service centers (stations), and to provide reference for improving the level of comprehensive prevention of stroke in the medical system.Methods:From July to November 2022, face-to-face semi-structured interviews with 18 medical staff in general hospitals, 10 medical staff in rehabilitation and pension institutions, and 8 medical staff in community health service centers (stations) were conducted by phenomenological research methods. Colaizzi 7-step analysis method was used to analyze the interview data, and Nvivo12 software was used to code the interview data.Results:Four themes were extracted: hospitals, institutions and communities all played an important role in the comprehensive prevention of stroke and actively cooperated with each other; the public was still lack of comprehensive prevention awareness and correct cognition of stroke; lack of professional medical resources hindered the development of comprehensive stroke prevention; incomplete collaborative mechanism of comprehensive prevention of stroke in hospitals, institutions and communities.Conclusions:In the current comprehensive prevention of stroke, there are still problems such as weak public awareness of prevention, insufficient professional medical resources, and imperfect coordination mechanism. In view of the advantages of medical institutions at all levels, it is necessary to clarify the responsibilities of the system at all levels and explore efficient and sustainable coordination mechanism, so as to improve the comprehensive prevention level of stroke in the medical system.

Investigation on medical practice of overseas acupuncturists based on the top 5 general hospitals in the United States of America and the inspiration / 国际中医中药杂志

This study selected the top five general hospitals in the United States of America, collected the practice information of acupuncturists through the official website, and analyzed the professional department, expertise, professional title, education background, residency, fellowship, board certification, etc. of these acupuncturists to understand the practice situation of acupuncturists in the hospitals. The results of the study showed the practice of acupuncturists in the United States of America is improving. With further localization, locally trained acupuncturists have gradually become the main body of acupuncturists; acupuncture treatment is still mainly for analgesia, but the scope of treatment continues to expand, and departments that accept acupuncturists are gradually increasing. However, the group of licensed acupuncturists is still a minority in the group of acupuncturists in the United States of America. Native American physicians still use acupuncture as an alternative option and neglect to obtain a license. The entry barrier for acupuncturists still needs to be raised.

Perspectives on the use of telegenetics services in the Philippines

@#The Philippines is a densely populated nation faced with multiple challenges in the healthcare field given its geographic, cultural, and socioeconomic barriers. Due to the geographic limitations of medical services in the country, many patients must travel a great distance to referral centers. This was further exacerbated by the Coronavirus disease 2019 (COVID-19) pandemic, which spread across the world and upended lives. This pandemic triggered a public health crisis that impacted healthcare systems, healthcare workers, and communities worldwide. It compounded current difficulties with the provision and accessibility of medical services, necessitating the employment of alternative methods of providing health coverage. As a result, advanced technological methods for patient diagnosis, monitoring, treatment, and counseling were rapidly implemented.1 Interest in these technological advances began prior to the COVID-19 pandemic, though primarily in developed countries. However, during this global outbreak, telehealth practices – which refer to online health care services provided by all health care professions – have seen a rapid increase in popularity.2,3 Telehealth was brought to the forefront in all countries in order to surmount lockdown constraints, allow continuous provision of health care for patients, and limit exposure to health systems and health providers.4 Traditional medical education and training were likewise disrupted during this time, resulting in the incorporation of telehealth into medical education. To reduce the risks associated with more personnel in the hospital, medical students were withdrawn from clinical environments during the COVID-19 outbreak. This created an environment of uncertainty and limited clinical exposure, with concerns surrounding progression through the medical course and training program.5 Continuing medical education, which has traditionally been based on clinical knowledge and skills, now requires online technical communication skills. Innovative services were rapidly developed with health professionals embracing this new technological competence, enabling general consultation for patients, remote patient monitoring, and self-directed patient care, thereby decreasing the burden on health facilities. Digital learning platforms also provided an effective way to address the learning gaps caused by the pandemic. The restriction of “in-person” delivery of healthcare services due to the global outbreak has prompted physicians, including clinical geneticists and genetic counselors, to investigate alternative methods of providing health care to patients. A telehealth innovation for online delivery of clinical genetic and genetic counseling services is the Philippine General Hospital’s Telegenetics Service. Despite being launched in 2013 to serve genetics patients across the country, this service has since been upgraded and capitalized resulting in patient appreciation for its COVID-19 exposure prevention, increased access, and time and cost efficiency. However, the telegenetics service has its limitations.6,7 Despite the expanding scope of telehealth/telegenetics and its immediate application, issues such as data/patient privacy, organizational readiness, digital maturity, regulatory impediments, access and acceptance of the technology, geographical and digital disparities, and its integration with traditional medical services have emerged.8 Lack of a detailed physical examination is also lost in a virtual visit, with focused questions leading to fragmented, impersonal interactions. Even when restrictions were lifted, telehealth usage nonetheless remained significantly higher than it had been prior to the pandemic. This may indicate a shift in public opinion in favor of this innovative medical practice.9 With the expansion of genetic services in the country, there is now a greater need for telegenetics due to the increased demand for clinical genetic and genetic counseling expertise. Therefore, evidence on the safety and efficacy of this technology in comparison to the traditional healthcare delivery approach is required. If the technology has the potential to improve health care, we must guarantee its availability in all resource-limited areas. Future efforts should thus focus on establishing solutions to address the aforementioned issues and concerns within our healthcare and education systems, thereby ultimately enhancing the standard of medical care.

The effect of the COVID-19 pandemic on procedures performed by fellows of the Vitreo-Retina Training Program at the Philippine General Hospital

BACKGROUND@#The COVID-19 pandemic has affected ophthalmology training. The Vitreo-Retina Training Program extended the training periods of its trainees in anticipation of a drop in surgical cases during the pandemic to make up for the expected drop.@*OBJECTIVE@#This study aimed to determine the effect of the COVID-19 pandemic on the Vitreo-Retinal Fellowship Program at the Philippine General Hospital (PGH), specifically the number of procedures performed by the Vitreo-Retina Fellows before and during the pandemic and their compliance with the Vitreo-Retina Society of the Philippines (VRSP) standards.@*METHODOLOGY@#This is a document review of vitreo-retinal procedures done at the Department of Ophthalmology and Visual Sciences of the PGH from January 1, 2017, to December 31, 2021.@*RESULT@#During the COVID-19 pandemic in 2020, there was a drop in the number of procedures performed by both the first year and second year vitreo-retina fellows. Despite the drop in numbers, the first year vitreo- retina fellows were still in compliance with the VRSP-recommended number of procedures. The second year vitreo-retina fellows, on the other hand, were not able to comply with the recommended numbers by the VRSP. The extension year allowed the second year fellows to do more procedures and comply with the recommended numbers of pars plana vitrectomy only.@*CONCLUSION@#There was a drop in the vitreo-retinal procedures during the COVID-19 pandemic. The second- year fellows were the most affected with the decrease in the number of surgical cases.

A clínica psicanalítica das urgências subjetivas no hospital universitário: construção de um caso clínico / Psychoanalysis of subjective urgencies at a university hospital: construing a clinical case / La clínica psicoanalítica de urgencias subjetivas en el hospital universitario: construcción de un caso clínico

O hospital constitui-se como um contexto em que a urgência subjetiva pode vir a se apresentar de forma frequente, instaurando, para cada sujeito, uma vivência de angústia. O objetivo desta pesquisa foi investigar as possibilidades para uma clínica das urgências subjetivas no contexto de um hospital universitário em Salvador, considerando as vivências em uma residência multiprofissional. Trata-se de uma pesquisa qualitativa de caráter exploratório, em que se realizou revisão teórica sobre o tema e se construiu um caso clínico, sob orientação psicanalítica. A escolha do caso baseou-se na escuta clínica ao longo dos atendimentos e da atuação em equipe multiprofissional, considerando os impasses ao longo do tratamento. Foram utilizados registros documentais produzidos pela psicóloga residente ao longo dos atendimentos, que ocorreram durante três meses. Os resultados apontam para as contribuições da escuta psicanalítica no tratamento das urgências e na atuação em equipe multiprofissional no contexto hospitalar. A subjetivação da urgência permitiu, no caso em questão, um tratamento pela palavra do que havia incidido diretamente no corpo como fenômeno. Conclui-se pela relevância em discutir o tema da urgência e suscitar novas pesquisas, reintroduzindo no contexto hospitalar a questão sobre a subjetividade.(AU)

Hospitals are contexts in which subjective urgency can frequently materialize, triggering an experience of anguish for each subject. Hence, this research investigates the possibilities of establishing a subjective urgency clinic at a university hospital in Salvador, considering the experiences in a multidisciplinary residence. A qualitative, exploratory research was conducted by means of a theoretical review on the topic and construction of a clinical case, under psychoanalytical advisement. The case was chosen based on clinical listening during the sessions and performance in a multidisciplinary team, considering the obstacles for long-term treatment. Data were collected from documentary records produced by the resident psychologist during three months. Results point to the contributions of psychoanalytic listening to treating subjective urgencies and to the performance of a multidisciplinary team in the hospital context. In the case in question, subjectivation of urgency allowed a treatment through the word of affecting phenomenon. In conclusion, discussing urgency and conducting further research, are fundamental to reintroduce subjectivity in the hospital context.(AU)

El hospital es un contexto en el que frecuentemente se puede percibir una urgencia subjetiva, estableciendo una experiencia de angustia para cada sujeto. El objetivo de esta investigación fue investigar las posibilidades de una clínica de urgencia subjetiva en el contexto de un hospital universitario en Salvador (Brasil), considerando las experiencias en una Residencia Multiprofesional. Se trata de una investigación cualitativa, de carácter exploratorio, en la que se realizó una revisión teórica sobre el tema y construcción de un caso clínico, con orientación psicoanalítica. La elección del caso se basó en la escucha clínica a lo largo de las sesiones y actuación en un equipo multidisciplinar, considerando los impasses para el tratamiento a largo plazo. Se utilizaron registros documentales elaborados por el psicólogo residente, durante las atenciones, que se realizaron durante tres meses. Los resultados apuntan a las contribuciones de la escucha psicoanalítica en el tratamiento de urgencias y en la actuación de un equipo multidisciplinario en el contexto hospitalario. La subjetivación de la urgencia permitió, en el caso en cuestión, un tratamiento a través de la palabra de lo que había afectado directamente al cuerpo como fenómeno. Se concluye que es relevante discutir el tema de la urgencia y plantear nuevas investigaciones, reintroduciendo el tema de la subjetividad en el contexto hospitalario.(AU)

Experience in radiation protection management in the tertiary general hospital / 中国辐射卫生

@#With widespread popularization, the radiological diagnosis and treatment technology has played an increasingly important role in clinical practice. The tertiary general hospital is generally featured as multiple types of radioisotope and radiation equipment, wide involvement of departments and persons, and many ways of use and potential harms of the radiological diagnosis and treatment technology. Radiation protection has become a content that cannot be ignored in hospital management. This article analyzes the radiation protection management structure of the tertiary general hospital - Guangdong Provincial People’s Hospital. The hospital radiation protection management is gradually improved by clarifying the main leading department, refining duties and responsibilities, strengthening multi-departmental communication and cooperation, and sorting out key connection links. A closed loop of refined management is formed through digging and correcting problems and continuously improving the management level and work efficiency. Valid qualifications are ensured to be obtained in time by radiation workers, radioactive drugs, equipment, and the venues to guarantee the radiation safety of radiation workers and patients and to further promote the construction of the Safe Hospital.

Analysis of accreditation results and development strategies of tertiary hospitals in Jiangsu province from 2018 to 2020 / 中华医院管理杂志

As an important measure starting for hospital management, hospital accreditation can effectively guide hospitals to improve their comprehensive service capabilities and management level. The accreditation results of 38 tertiary general hospitals in Jiangsu province from 2018 to 2020 showed that there were weaknesses existing in the development of hospitals, including the radiosity and influence of tertiary hospitals, patient service mode, construction of medical technology capabilities and disciplines, medical quality and safety, nursing quality management and specialized nursing, and information construction. The author suggested that hospitals should return to functional positioning, improve the service quality, strengthen construction of hospital disciplines and technical projects, consolidate the foundation of quality and safety management, improve the level of information technology construction, for references for promoting the high-quality sustainable development of tertiary general hospitals.

Analysis on patent development at 13 general hospitals in Beijing / 中华医院管理杂志

Objective:To analyze the patent development status of 13 general hospitals in Beijing, for reference in promoting the management and translation of intellectual property rights of public hospitals.Methods:13 tertiary general hospitals in Beijing as one of the top 100 hospitals in China in terms of science and technology evaluaton metrics in 2020 were selected as the research subjects. The patent application and authorization information of 13 hospitals was retrieved from the IncoPat technology innovation intelligence platform, during the period from January 1, 2012 to December 31, 2021. The patent application and authorization status, international patent classification distribution, inventor information, patent validity, and registration of patent transfer were analyzed.Results:The numbers of patent applications and authorizations from 13 hospitals increased from 123 and 13 in 2012 to 2 053 and 2 368 in 2021, respectively. From 2012 to 2021, 13 hospital applied for 10 050 patents and authorized 6 896 patents, including 906 authorized invention patents, 5 863 utility model patents, and 127 appearance design patents. Valid patents amounted to 5 925, accounting for 85.92%, and valid authorized invention patents amounted to 796, accounting for 13.43%. 110 of these patents were transferred or licensed, accounting for 1.60% of the authorized patents.Conclusions:Aapplied and authorizated patents were rising year by year, but the ratios of invention patents and patient translation remained at a low level. The author suggestted that hospitals should highlight the value orientation of patents, strengthen-industry-academia-research cooperation, establish a professional management team and standardized management system for intellectual property, cultivate high-value patents, conduct pre patent application evaluation and screening, and improve patent conversion and technological innovation capabilities.

Application of union physio-psycho-social assessment questionnaire in screening anxiety and depression in outpatients from general hospital / 中华行为医学与脑科学杂志

Objective:To explore the application of union physio-psycho-social assessment questionnaire (UPPSAQ-70) in screening anxiety and depression in outpatients from general hospital.Methods:A total of 510 outpatients from Peking Union Medical College Hospital from June 2020 to November 2021 were recruited.They were assessed with UPPSAQ-70, self-rating anxiety scale (SAS) and self-rating depression scale (SDS). The internal consistency of the UPPSAQ-70 was tested by Cronbach′s α coefficient.The convergent validity of the UPPSAQ-70 was evaluated by examining correlations with the SAS and SDS.Clinical diagnosis, being considering as the " gold standard" , was used to test criterion validity.Result:The UPPSAQ-70 showed good item characteristics and reliability (Cronbach α=0.947). The UPPSAQ-70 total score showed significant correlations with SAS( r=0.843, P<0.01) and SDS ( r=0.852, P<0.01). The area under the curve (AUC) of the UPPSAQ-70 was 0.875 ( P<0.01), the cut-off value was 65 points with the sensitivity 83.2% and the specificity 75.5%.The AUC of the SAS and SDS was 0.848 and 0.808 respectively(both P<0.001). For the SAS(standard score of 50 as the cut-off value), the sensitivity was 47.3%, and specificity was 92.5%.For the SDS(standard score of 53 as the cut-off value), the sensitivity was 62.9%, and specificity was 86.8%. Conclusion:UPPSAQ-70 has high sensitivity and is more suitable for screening of anxiety and depression in general hospital outpatients.

Investigation of medical humanistic practice ability of nurses and factors affecting their practices: a questionnaire-based analysis of 1196 cases in a general hospital in Hunan Province / 南方医科大学学报

OBJECTIVE@#To investigate humanistic practice ability of nurses in a general hospital in Hunan Province and analyze the factors affecting their practices to provide evidence for interventions to improve humanistic practice ability of the nurses.@*METHODS@#A total of 1196 nurses were surveyed using a self-designed questionnaire and a nurse humanistic practice ability assessment scale questionnaire for assessment of their abilities for humanistic care practice, psychological adjustment, interpersonal communication, self-management, ethics and legal practice. Univariate and multivariate analyses were performed for analysis of the factors affecting the practice abilities of the nurses.@*RESULTS@#The total score of humanistic practice ability of the 1196 nurses was 105.69±16.45 (the full score of the scale was 130), and the scores of humanistic care practice ability, psychological adjustment ability, interpersonal communication ability, self-management ability, ethics and legal practice ability were 40.95±6.46, 16.41±2.66, 16.41±2.66, 11.32±2.05 and 12.43±2.00, respectively. Univariate analysis and multiple linear regression analysis showed that gender (P=0.033), age (P < 0.001), department (P=0.015), working years (P < 0.001), professional title (P < 0.001), first academic degree (P < 0.001), highest academic degree (P < 0.001), family location (P=0.010), marital status (P=0.023), number of patients to care for (P=0.022), number of children (P=0.001), previous humanities related training (P < 0.001), training times (P < 0.001), and care received from family members (P < 0.001) and colleagues (P < 0.001) were all the factors affecting humanistic practice ability of the nurses. Among these factors, age, working in department of obstetrics and gynecology and emergency department, professional title, humanities training, and care from family and colleagues explained 20.7% of the variance.@*CONCLUSION@#The humanistic practice ability of nurses in this general hospital is above the average level, but their self-management ability needs to be improved. Intervention measures should be implemented to improve the nurses' humanistic practice ability including more attentions to the key groups and departments, strengthening the training of humanistic practice ability, and improving the promotion assessment system.

A (DES) INTEGRALIDADE DAS PRÁTICAS DE ATENÇÃO EM SAÚDE MENTAL NUMA EMERGÊNCIA DE UM HOSPITAL "QUASE GERAL" / THE (DIS) INTEGRALITY OF MENTAL HEALTH CARE PRACTICES IN AN EMERGENCY OF AN "ALMOST GENERAL" HOSPITAL

A política de saúde mental brasileira aponta o hospital geral como parte integrante da rede de serviços substitutivos ao hospital psiquiátrico. É preconizado que os serviços substitutivos levem em consideração o acolhimento, o vínculo e a integralidade na prestação do cuidado. O objetivo deste artigo constitui-se em analisar as práticas assistenciais as pessoas com transtornos mentais em uma emergência de um hospital geral e os seus efeitos para integralidade do cuidado. Materiais e métodos: Pesquisa descritiva de abordagem qualitativa. O cenário foi o serviço de emergência de um hospital geral, localizado na zona oeste do município do Rio de Janeiro. Os dados foram obtidos por meio de entrevista semiestruturada e observação participante. Resultados: O espaço físico da emergência pouco favorecia o desenvolvimento de uma atenção acolhedora, resolutiva e humanizada. As práticas assistenciais eram predominantemente pautadas pelo modo asilar. Noções de acolhimento, vínculo e integralidade faziam parte do discurso mas ainda não se materializam nas práticas assistenciais. Discussão: O estigma atribuído à doença mental constituiu-se empecilho à adoção de práticas acolhedoras. Conclusão: A fim de possibilitar que hospital geral adote práticas integrais e que se constitua como parte da rede de serviços substitutivos em saúde mental é necessário investir em novos arranjos institucionais que coloquem o usuário no centro dos modos de produção de atos de saúde; investir na dimensão cuidadora da qualificação dos profissionais de saúde.

The current Brazilian mental health policy points to the general hospital as an integral part of the network of substitutive services to the psychiatric hospital. It is recommended that substitute services take into account, among other premises, the user embracement, bonding and integrality in the provision of care.The purpose of this article is to analyze the care practices of people with mental disorders in a general hospital emergency and their effects for integral care.Materials and methods: Descriptive research of qualitative approach. The scenario of the study was the emergency service of a general hospital, located in the western part of the municipality of Rio de Janeiro. Data were obtained through a semi-structured interview and participant observation.Results: The physical space of the emergency did not favor the development of a warm, resolutive and humanized attention. The care practices were predominantly based on the asylum mode. Notions the user embracement, bond and integrality were part of the discourse, but they did not materialize in the assistance practices. Discussion: The stigma attributed to mental illness was perceived as hindering the adoption the user embracement practices. Conclusion: In order to make it possible for a general hospital to adopt comprehensive and to be part of the network of substitutive services in mental health, it is necessary to invest in new institution arrangements that place the user at the center of the modes of production of health acts.

Journey from seclusion to inclusion: Development of mental health services in India since independence

Mental health is an integral and essential component of “Health”. It is more than the mere absence of mental disorders or disabilities. It determines the quality of life of the individuals. The progress and prosperity of a nation depend on the overall quality of health of its citizens. However, until early twentieth century the issues of mental health and well-being were inadequately addressed. Often people with psychological ailments were considered to be non-productive people, confined in asylums, received inhumane treatment and were completely secluded from the mainstream society. Since independence initiatives have been taken by individuals and by the central government and the state governments, to develop the mental health services in India. This paper reviewed published articles, book-chapters and books to explore the development of mental health services in India since Independence. It was observed that measures were taken to improve the conditions of the mental hospitals. A trend towards deinstitutionalization was set by the Government of India and that initiated the creation of general hospital psychiatric units and community mental health services. Humanistic approach in treatment, development of psychotropic drugs and psychotherapies facilitated the management and care of the patients with psychiatric diseases, thereby improving their quality of life.

Application progress of nurse allocation based on diagnosis related groups in specialized hospitals and general hospitals / 中国实用护理杂志

This article summarized the overview of diagnosis related groups (DRGs), the necessity of comprehensively popularizing and applying DRGs in specialized hospitals and general hospitals, the different methods and effects of nursing human resource allocation based on DRGs in specialized hospitals and general hospitals at home and abroad, and analyzed the different challenges and opportunities faced by DRGs in the implementation of human resource allocation in two types of hospitals. According to the types and characteristics of hospitals, this paper put forward some corresponding suggestions and prospects for the future, such as intelligent human resource prediction system and the construction of information sharing platform, so as to provide reference for the comprehensive promotion of DRGs in different types of hospitals in China.

Sobre cuidados em saúde em um hospital geral / Sobre cuidados de salud en un hospital general / About health care in a general hospital

Este artigo analisa práticas de cuidado em saúde vivenciadas em um hospital geral do Sistema Único de Saúde (SUS), com a intenção de problematizar e refletir sobre o cuidado e as práticas em saúde que se fazem presentes entre pessoas, no cotidiano do serviço, nas relações e nos fluxos que são estabelecidos. Utilizamos a Etnografia para descrever uma cena que reflete as relações entre os saberes, os cuidados e descuidados que se fazem em um hospital. Propomos pensar o cuidado como múltiplo e observamos o hospital por meio de sua constituição como uma "máquina de curar". Refletimos o encontro entre profissional e usuário, entre o cuidador e quem recebe o cuidado, para propor que em todo e qualquer encontro de saúde certo cuidado é realizado. (AU)

Este artículo analiza prácticas de cuidado de salud vividas en un hospital general del Sistema Único de Salud, con la intención de problematizar y reflexionar sobre el cuidado y las prácticas de salud presentes entre las personas, en el cotidiano del servicio, en las relaciones y en los flujos establecidos. Utilizamos la etnografía para describir una escena que refleja las relaciones entre los saberes, los cuidados y descuidados realizados en un hospital. Proponemos pensar el cuidado como múltiple y observamos el hospital a partir de su constitución como "máquina de curar". Reflejamos el encuentro entre profesional y usuario, entre el cuidador y quien recibe el cuidado, para proponer que en todos los encuentros de salud hay cierto cuidado que se realiza. (AU)

This article analyzes health care practices experienced in a general hospital of the Brazilian National Health System, with the intention of problematizing and reflecting on the care and health practices that are present among people, in the daily service, in the relationships and flows that are established. We use ethnography to describe a scene that reflects the relationship between knowledge, care and un-care practices that are performed in a hospital. We propose to think of care as multiple and we observe the hospital from its constitution as a "healing machine". We reflect the encounter between professional and user, between the caregiver and the one who receives the care, to propose that in any and all health meetings, certain care is performed. (AU)

Promotion effects of trans-regional review system on rational drug use in second-grade general hospital / 中国药房

OBJECTIVE To explore the role of the establishment of the trans-regional review system on rational drug use in second-grade general hospital ，and to promote the rational drug use. METHODS With the administrative support of Jiuquan Health Commission，5 second-grade general hospitals in Jiuquan Medical Association jointly established Jiuquan Rational Drug Use Review Training Center . A trans-regional review system was established to carry out cross-review of prescriptions and medical orders among 5 second-grade general hospitals. Totally 1 500 prescriptions and 900 medical records were collected from 5 second-grade general hospitals before （April to June ，2020）and after （July to September ，2020）the implementation of the project. The changes of rational drug use indicators ，the results of prescriptions and medical order review were investigated before and after the implementation of the project. RESULTS After the implementation of the project ，except for one hospital ，the proportion of drugs in other hospitals decreased to varying degrees with the highest decline rate of 22.56％ . Compared with before the implementation of the project ，reasonable rate of outpatient and emergency prescription review increased by 5.72％ averagely and the reasonable rate of medical order review increased by 10.10％（P＜0.05）. The average utilization rate of antibiotics in outpatients decreased by 14.45％，the average utilization rate of antibiotics in inpatients decreased by 7.98％，and the average use intensity of antibiotics decreased by 25.19％. CONCLUSIONS Through the establishment of trans-regional review system ，medical institutions can be forced to pay more attention to prescription review ，effectively improve the prescription review of pharmacists in medical institutions，and promote the rational use of drugs in medical institutions in the region. However ，there are still some problems ， such as incomplete system coverage ，insufficient work experience ，lagging of informatization ，uneven pharmacist level ，and insufficient assessment and supervision of administrative functional departments.

Status quo and development recommendations for infectious disease early warning system in public general hospitals in China / 中华医院管理杂志

Early warning of infectious disease outbreak is key to controlling epidemics. Public general hospitals can effectively play their " outpost" role in the early warning and response of infectious diseases, which is directly related to the success of epidemic prevention and control. The authors summarized the current construction and main functions of infectious disease early warning systems at national level, regional level and public general hospitals, analyzed the problems existing in such construction, and put forward targeted suggestions. As found by the authors, some public general hospitals in China have initially built an early warning system for infectious diseases, achieving early recognition, early warning and reporting of infectious diseases to some extent. However, these systems were challenged by such shortcomings as insufficient intelligence, lack of data information exchange, immature practice and application, and lack of attention to the monitoring and early warning of endemic infectious diseases. It is suggested to improve the policy and system support in the future, to expand the types of infectious diseases for monitoring and early warning, to enlarge the sources of monitoring data and to strength hospital informationization construction.

Analysis of strategies for the construction of scientific research sharing platform in general hospitals / 中华医学科研管理杂志

Objective:To strengthen the standardized management of instrument and equipment sharing and users of public research platforms in general hospitals.Methods:Taking the Research Center of Basic Medicine of the Second Affiliated Hospital of Wenzhou Medical University as an example, this study analyzed the service status and current predicaments of the instruments and equipment since the establishment of the large-scale instrument sharing system and discussed the optimization construction and management strategies of the scientific research platform.Results:Although there are still many problems in the sharing system and equipment management, safe, intelligent, and convenient equipment information management should be achieved to a certain extent by differentiated sharing, differentiated supervision, personalized training, and other strategies, leading to fully sharing of instruments and equipment within a certain range and improvement of scientific nature of management.Conclusions:The problems existing in our Research Center of Basic Medicine are common to other scientific research platforms. It is expected to provide a good reference for the platform management of other universities and affiliated hospitals, which is of great significance to improve the scientific research level and hospital management level of general hospitals in the future.

A qualitative study on the working status of outpatient nurses in general practice departments in general hospitals in Beijing / 中华全科医师杂志

Objective:To survey the working status of outpatient nurses in general practice departments of general hospitals.Methods:From March to April 2021, personal in-depth interviews were conducted with outpatient nurses from general practice residency training bases in Beijing. The thematic framework analysis method was used to analyze the interview data and refine the themes.Results:Fourteen nurses working in general practice outpatient clinics were interviewed in this study. Four themes were extracted from the interview data: (1) inadequate staffing of full-time outpatient nurses in general practice departments of comprehensive hospitals; (2) unclear job functions for outpatient nurses in general practice departments; (3) no standardized patient health education in the department; (4) no relevant training received systematically.Conclusion:General practice departments in general hospitals should setup full-time general practice nurse positions, clarify the job responsibilities, strengthen the relevant training and enhance core competency for nurses working in general practice department.

Perfil sociodemográfico e clínico de usuários de substâncias psicoativas atendidos em hospital filantrópico acreditado / Sociodemographic and clinical profile of users of psychoactive substances in an accredited philanthropic hospital / Perfil sociodemográfico y clínico de usuarios de sustancias psicoactivas en un hospital filantrópico acreditado

OBJETIVO: descrever o perfil de usuários de substâncias psicoativas, seu desfecho e complicações clínicas. MÉTODO: estudo transversal com 67 pacientes em um hospital geral filantrópico acreditado. Análise descritiva exploratória a partir dos dados obtidos com os instrumentos Addicttion Severity Index - 6 e Alcohol Smoking and Substance Involvement Screening Test. RESULTADOS: houve predominância do sexo masculino em 83,5% das causas de admissão, 32,8% estavam relacionadas ao sistema musculoesquelético, e 43,3% dos pacientes desconheciam comorbidades prévias. Prevalência de 73,7% do uso abusivo de álcool, 44,8% tiveram pontuação superior a 27 pontos, indicando necessidade de encaminhamento para especialidade psiquiátrica. CONCLUSÃO: carecem esforços no sentido de aprimorar e amadurecer processos para garantir a qualidade do serviço e segurança do paciente em envolvimento com substâncias psicoativas em hospital geral filantrópico.

OBJECTIVE: to describe the profile of users of psychoactive substances, their outcomes and clinical complications. METHOD: a cross-sectional study with 67 patients in an accredited philanthropic general hospital. Exploratory descriptive analysis based on data obtained with the addiction severity index - 6 and the Alcohol Smoking Substance and Involvement Screening Test. RESULTS: there was predominance of males in 83.5% of the causes of admission, 32.8% were related to the musculoskeletal system, and 43.3% of the patients were unaware of previous comorbidities. Prevalence of 73.7% of alcohol abuse, 44.8% scored higher than 27 points, indicating the need for referral to the psychiatric specialty. CONCLUSION: efforts are needed to improve and mature processes to ensure the quality of service and patient safety in involvement with psychoactive substances in a philanthropic general hospital.

OBJETIVO: este estudio presenta el perfil de los usuarios de sustancias psicoactivas, el resultado, las complicaciones clínicas y el contexto familiar. MÉTODO: estudio transversal en un hospital general filantrópico acreditado con 67 pacientes. Un análisis exploratorio descriptivo basado en los datos obtenidos con los instrumentos Addicttion Severity Index - 6 y Alcohol Smoking and Substance Involvement Screening Test. RESULTADOS: hubo un predominio del sexo masculino en el 83,5% de las causas de admisión, el 32.8% fueron relacionados con el sistema muscular esquelético, y el 43,3% de los pacientes desconocían las comorbilidades anteriores. Prevalencia del 73,7% del abuso de alcohol, el 44,8% obtuvo más de 27 puntos, lo que indica la necesidad de derivación a la especialidad psiquiátrica. CONCLUSIÓN: el contexto familiar es también un factor que contribuye a la vulnerabilidad del individuo. Por lo tanto, se advierte la necesidad de realizar esfuerzos para mejorar y madurar los procesos para garantizar la calidad del servicio y la seguridad del paciente en el contexto de la atención de salud mental en un hospital general.

Kangaroo mother care implementation at the Philippine General Hospital: A quality assurance initiative

Background@#The Philippine General Hospital (PGH) implemented the Kangaroo Mother Care (KMC) Program in 2014, recognizing its benefits in helping low birth weight (LBW) infants survive. @*Objective@#To determine the acceptability and compliance of the stakeholders to the KMC program after one year from implementation. @*Method@#Data were obtained from the NICU Annual statistics, KMC data forms, logbooks, and questionnaires to the stakeholders-doctors rotating at the NICU, NICU nurses, and mothers enrolled in the KMC program. @*Results@#One year into the KMC program implementation, the KMC enrollment increased from 57% in 2014 to 75% in 2015. All mothers enrolled in the program said that they received their KMC knowledge from the health providers and firmly believed that KMC benefited them and their infants. The mothers also became more confident in taking care of their babies after each KMC encounter. Although only 50% said they would continue KMC at home, 85% proceeded. Furthermore, both doctors and nurses believed that KMC was beneficial to both mothers and infants, decreased hospital cost and nursing workload. KMC provision was 0.5-6 hours/day. Also, less than half of the data forms were accomplished. The KMC program was acceptable to all stakeholders who believed in the benefits of KMC to preterm infants. The mothers were very receptive and continued KMC even after discharge. However, there was sub-optimal engagement provided by the health providers with the mothers. There was also low adherence to recommended duration of KMC per day provided by the mothers. KMC data records were frequently not accomplished. PGH has instituted strategies to improve the KMC implementation by providing dedicated KMC rooms and supplying meals to mothers to increase KMC duration and frequency. A computer-based program for data entry was developed for the health providers, and a dedicated encoder was assigned. @*Conclusion@#KMC acceptability was high among stakeholders. Compliance increased after one year, with enrolment going up to 75%. However, adherence to the recommended KMC duration per day and accomplishment of data forms were still sub-optimal.