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Objective:To explore the application and practice of "flipped classroom" in the teaching of general surgery interns.Methods:A total of 20 internship groups (3 to 5 people in each group) were randomly selected from the general surgery practice group in the Department of General Surgery of the Second Clinical Medical College of North Sichuan Medical College. They were randomly divided into the flipped group (45 people) and the traditional group (40 people), with 10 subgroups in each group. The flipped group adopted the flipped classroom teaching mode (students' self-study by handing out materials before class, students and teachers' discussion in class, and students and teachers' evaluation after class), while the control group adopted the current conventional teaching mode (students' preview before class, teachers' explanation in class, and teachers' question answering after class). At the end of the teaching, a questionnaire was used to evaluate the participation and completion of each student. The teaching effect was evaluated by medical history collection and case analysis. The participation, completion, and teaching effect between the two groups were compared and analyzed. SPSS 23.0 software was used for t-test and Chi-square test. Results:The participation of the flipped group was better than that of the traditional group [(17.45±1.83) vs. (15.57±1.52)], and the difference was statistically significant ( P < 0.05). There was no statistically significant difference between the flipped group and the traditional group. There was no significant difference in medical history collection scores between the two groups. The case analysis of the flipped group was better than that of the traditional group [(87.30±6.06) vs. (81.50±5.88), P < 0.05]. The questionnaire shows that about 90% of the students think that flipped classroom can improve their interest in learning [96% (43/45)], improve their autonomous learning ability [89% (40/45)], and have better learning effect. At the same time, 78% (35/45) of students think that learning time is too long. Conclusion:The flipped classroom teaching model can improve the teaching participation of general surgery students, improve students' interest in learning, improve their self-learning ability, and improve students' thinking ability of medical record analysis.
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Objective To investigate the current status of multidrug-resistant organism (MDRO) infection in the general surgery department of a tertiary first-class hospital, and understand the efficacy of comprehensive intervention measures.Methods Targeted monitoring on MDROs was implemented among patients who were hospitalized in a general surgery department for>48 hours between March 2015 and October 2016, comprehensive intervention measures were taken since January 2016.MDRO infection before and after intervention was compared.Results Between March 2015 and October 2016, a total of 6 406 hospitalized patients were monitored, 155(2.42%) developed MDRO infection.The most common infection sites were abdominal cavity(hydrops, bile) (n=76, 49.03%) and surgical site (n=43, 27.74%).MDRO infection rate dropped from 2.79% (99/3 549) before intervention (March-December, 2015) to 1.96% (56/2 857) after intervention (January-October, 2016) (x2=4.612, P=0.032).There was no difference in MDROs between before and after intervention, the major were both Escherichia coli.Conclusion Comprehensive intervention measures can reduce the incidence of MDRO infection in the general surgery department of this hospital.
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Objective To evaluate the application of nutritional risk screening in children hospitalized in general surgery department,in order to provide the basis for selecting the screening tool.Methods Nutritional risk screening was performed on 123 children hospitalized in the general surgical department by using the Assessment of Malnutrition in Paediatrics (STAMP) and Paediatric Yorkhill Malnutrition Score (PYMS).The malnutrition prevalence based on the World Health Organization (WHO) child growth standards(WHO standards) was evaluated.The data of hospital stay and total hospital expenses were recorded and analyzed.Results By using the STAMP and PYMS,76.4％ (94/123 cases) and 85.4％ (105/123 cases) of the patients had low-moderate nutritional risk,23.6％ (29/123 cases) of the patients and 14.6％ (18/123 cases) had high nutritional risk,respectively.The malnutrition prevalence was 17.9％ (22/123 cases) based on WHO standards.Children with high nutritional risk screened by STAMP,PYMS and malnutrition evaluated by WHO standards had significantly longer hospital stay(days) and higher total hospital expenses(yuan) compared with those in low-moderate nutritional risk or non-malnutrition patients,and the differences were statictically significant (hospital stay:STAMP:M =8.50 ＞ 7.00,Z =-2.608,P =0.008;PYMS:M =8.00 ＞6.25,Z =-2.761,P =0.006;WHO standards:M =8.25 ＞6.75,Z =-2.812,P =0.005.Total hospital expenses:STAMP:M =4 970.46 ＞ 2 939.07,Z =-2.913,P =0.004;PYMS:M =5 486.57 ＞ 3 294.96,Z =-3.024,P =0.002;WHO standards:M =5 515.87 ＞ 3 170.04,Z =-3.098,P =0.002).According to WHO standards,the sensitivity,specificity,Youden index,positive predictive value and negative predictive value of STAMP and PYMS were 68.2％ vs.77.3％,86.1％ vs.99.0％,54.3％ vs.76.3％,51.7％ vs.94.4％,92.6％ vs.95.2％ respectively.Conclusion Both STAMP and PYMS can be used for nutritional risk screening in hospitalized children in general surgery department,while sensitivity and specificity of PYMS are better than those of STAMP.
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Objective To investigate the application effect of flexible management in nursing of general surgery department. Methods 21 nursing staff and 836 patients from January to October, 2007 were selected as research object, and were given flexible management. 21 nursing staff and 797 patients from January to December were selected as the control. The influence of flexible management on nurses and patients and satisfaction degree with nursing work before and after application of flexible management were compared. Results Working and learning enthusiasm greatly improved,educational background and professional titles of nurses increased after application of flexible management. The average hospitalization time was 28 days,the per capita cost was 12 131 yuan,satisfaction degree with nursing was 87.0% before application of flexible management, but the average hospital stay of patients decreased to 20 days, the per capita cost decreased to 8764 yuan and satisfaction degree with nursing increased to 97.0% after application of flexible management. Conclusions Application of flexible management in nursing care of general surgery department showed significant effect,it is suitable for more application in practice.