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Objective:To provide a basis for later training, by investigating the status quo and influencing factors of the health education competency of nursing staff in secondary and above traditional Chinese medicine hospitals in Anhui Province.Methods:This study was a cross-sectional study. Convenience sampling method was adopted, and 3 482 nursing staff in 13 secondary and 24 tertiary traditional Chinese medicine hospitals in Anhui Province from July to September, 2020 were investigated by a general survey form and a Self-evaluation Scale for Health Education Competency of Nursing Staff in Traditional Chinese Medicine Hospitals, Self-Efficacy Scale and Organizational Support Scale through electronic questionnaires. A total of 3 482 questionnaires were issued, 3 147 questionnaires were effectively returned, and the effective response rate was 90.38%.Results:The total score of health education competency of 3 147 nursing staff in hospitals of traditional Chinese medicine in Anhui Province was (345.80 ± 50.08) points, and the standard score was (77.70 ± 11.25) points. The lower item scores were "knowledge of Yin and Yang and Five Elements""knowledge of Qi, Blood and Body Fluid""effectively convey information to patients through digital media"; the scores of self-efficacy, organizational support, instrumental support and emotional support were (29.28 ± 5.96), (47.56 ± 11.15), (10.25 ± 1.47), (37.31 ± 9.68) points, respectively. Multiple linear regression showed that initial academic qualifications, school health education learning experience, hospital health education training experience, health education work plan, self-efficacy, and organizational support were the main influencing factors of health education competence of nurses in traditional Chinese medicine hospitals (adjusted R2=0.194, F=85.10, P<0.01). Conclusions:The health education competency of nurses in secondary and above Anhui Provincial hospital of traditional Chinese medicine is still at a medium level and needs to be improved. At the same time, managers should also focus on improving their sense of self-efficacy and organizational support to better serve patients.
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Objective:To investigate the mental health status and related influencing factors of medical staff in a tertiary Traditional Chinese Medicine(TCM)hospital during COVID-19 normalized prevention and control period.Methods:In March 2021, the medical staff of a TCM hospital in Beijing were investigated by general information questionnaire, self-rating anxiety scale(SAS), self-rating depression scale(SDS) and 12-item general health questionnaire(GHQ-12). Descriptive analysis, single factor analysis, and logistic regression analysis were preformed by using SPSS 22.0 software.Results:A total of 872 medical staff accepted this survey and 869 valid questionnaires were collected. The total scores of SAS and SDS of medical staff in the hospital were significantly lower than those of medical staff in similar domestic study before the outbreak of COVID-19( P<0.001). The detection rates of anxiety symptoms, depression symptoms and mental health problems were 22.2%(193 cases), 27.8%(242 cases)and 12.5%(109 cases), respectively. There were significant differences in total scores of SAS, SDS and GHQ-12 in education levels, occupation, basic diseases, mental illness and family financial difficulties( P<0.05), and the total scores of SAS and SDS were significantly different in terms of working years( P<0.01). Binary logistic stepwise regression analysis showed that those with mental illness and family financial difficulties were at significantly higher risk of anxiety, depression, and mental health problems( P<0.001), those with low educational level had a significantly higher risk of anxiety and depression( P<0.05), and those with basic diseases had a significantly higher risk of depression( P=0.009). Conclusions:During COVID-19 normalized prevention and control period, some medical staff in the hospital had anxiety, depression and mental health problems with various degrees. More attention should be paid to those with bachelor′s degree or below, nurses and other healthcare staff, senior staff, people with basic diseases, mental illness, and family financial difficulties.
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Objective To understand the status of healthcare-associated infection(HAI)management in traditional Chinese medicine hospitals as well as integrated traditional Chinese and Western medicine hospitals in Fujian Pro-vince,analyze the existing problems and weak links,and put forward corresponding improvement measures.Methods A questionnaire was designed through literature and expert consultation,from March to April 2016,42 secondary and above traditional Chinese medicine hospitals as well as integrated traditional Chinese and Western medicine hos-pitals in 8 cities of Fujian Province were conducted on-site investigation,data were analyzed.Results A total of 42 hospitals participated in the investigation,92.86% were traditional Chinese medicine hospitals,7.14% were inte-grated traditional Chinese and Western medicine hospitals;all hospitals set up HAI management committees and HAI management groups of clinical departments,there were 100 HAI management professionals(66 were full-time,34 were part-time),nursing staff accounted for 63.00%,junior college and undergraduate personnel accoun-ted for 84.00%,staff with intermediate and senior professional titles accounted for 79.00%.There were significant differences in academic disciplines and education levels among administrators in secondary and tertiary hospitals(P<0.05). All hospitals carried out HAI case surveillance,only 2.38% achieved HAI informational software monito-ring,83.33% carried out comprehensive and targeted monitoring,42.86%,71.43%,and 80.95% of hospitals car-ried out targeted monitoring on multidrug-resistant organisms,surgical site infection,and intensive care unit respec-tively.Conclusion The environment of majority of Chinese medicine hospitals in Fujian Province improved signifi-cantly,organizations of HAI management is rational,staffing and quality of HAI management personnel is imbal-anced,HAI monitoring is still at preliminary stage,lack information management,HAI management in key depart-ments is not optimistic.
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Objective To evaluate the traditional Chinese medicine(TCM) output efficiency of the coUnty-level TCM hospitals in Jiangsu Province before and after the reimbursement mechanism reform,and to analyze the factors which affect the efficiency of county-level TCM hospitals.Methods Using DEA to analyze the efficiency of county TCM hospitals,and using the Tobit regression to analyze the influence factors.Results The output efficiency of county-level TCM hospitals in Jiangsu Province is low,and the reimbursement mechanism reform in county-level hospitals of TCM efficiency further decreases;payment model,cost model and revenue model of regression analysis indicate that different factors has different influence on output efficiency of county hospitals of TCM.Conclusion The reimbursement strategy of county-level TCM hospitals should be optimized,the balance of revenue and expenditure structure be adjusted,and the intensity of TCM services reimbursement be increased.
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Objective To discuss the risk factors and nursing intervention of multidrug-resistant organism (MDRO) infection in patients of traditional Chinese medicine hospital (TCM). Methods By investigating the patients admitted to Beijing Xuan Wu Hospital of Traditional Chinese medicine from June 2015 to June 2016, 756 patients of them who were confirmed with clinical diagnosis of infection and pathogen detection with positive, which were divided into MDRO group including 97cases and non-MDRO group including 659 cases, then the pathogens of MRDO infection species and distributionwere counted, and analyzed risk factors for infection. Results A total of 756 cases were detected positive strains 816 strains, including 611 strains of monitoring target strains, 116 strains of MRDO. The top three were methicillin-resistant staphylococcus aurous 30.17%(35/116), Pseudomonas aeruginosa 18.97% (22/116) and Klebsiella pneumonia 18.10% (21/116). Single factor analysis results showed that the patients' age, hospitalization days, the history of other hospital admission, invasive procedure, basic chronic disease (diabetes, cerebrovascular disease, lung disease) and combined use of antibiotics were MDRO infection risk factors (χ2=9.470-198.609, P < 0.01); multivariate Logistic regression analysis showed that the independent risk factors of MDRO infection were the history of other hospital admission (OR=2.085, 95%CI1.040-4.179), invasive procedure (OR=3.063,95% CI1.526- 6.150), diabetes (OR=2.037,95% CI1.070- 3.877), cerebrovascular disease (OR=4.349,95%CI 2.035-9.293)and combined use of antibiotics (OR=18.723,95% CI9.202-38.094). Conclusions Patients of TCM have many characteristics, such as with more basic diseases, longer length of stay, elder and so on. So we should be alert to the risk of MDRO infection and take nursing interventions to prevent and strengthen the isolation prevention.
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Objective To investigate the current status of healthcare-associated infection(HAI) management professionals in county and above levels of traditional Chinese medicine(TCM) institutions in a province.Methods The uniform questionnaires were adopted to investigate the basic status of HAI professionals in county and above levels of TCM institutions in a province.Results There were 117 county and above levels of TCM institutions in this province,85 TCM institutions participated the investigation,there were a total of 128 professionals,including 82 professionals in 65 secondary hospitals,and 46 in 20 tertiary hospitals.Among the investigated TCM hospitals,83 (97.65 ％) set up HAI management committees,77 (90.59％) set up independent HAI management departments,55 (64.71％) assigned HAI professionals that met The Requirements of HAI Surveillance Guideline,27 (31.76 ％) exclusively engaged in management of HAI,58 (68.24 ％) were also responsible for other management besides HAI management.Among investigated professionals,91.41％ were nursing staff,55.47％ received undergraduate course or above,54.69％ had intermediate professional titles,61.72％ were at the age of 41-50,45.31 ％ engaged in HAI management for 1-3 years,115 professionals had management certificates.Conclusion The infec tion management in provincial traditional Chinese medicine institutions are understaffed,professional structure is unitary,professional quality is low,leaders in different levels of TCM institutions should enhance HAI management awareness,strengthen the construction of professional quality,and cultivate multi-disciplinary talents as soon as possible.
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Objective To investigate the score changes of graduates majoring in clinical medicine after using the method of “role of identification”. Methods Sixty students who were undertaking internship in Endocrinology Department of Shanghai Traditional Chinese Medicine Hospital received three-week clinical teaching and examination. Then they got into one-week “role of identification”, and were appointed as clinical teachers to teach what they have learned during the last 3 weeks to the next batch of interns and make another examination. Scores of the two examinations were compared. Results Scores of the examination after received the method in“role of identification”improved significantly (P<0.01). Conclusion The method of“role of identification”can enhance clinical medicine graduates’ mastery of professional knowledge.
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Objective Survey of Guangxi Traditional Chinese Medicine hospital hand hygiene facilities at all levels was made with improvement measures proposed.Methods Hand Hygiene Norms for Medical Workers questionnaires designed by the Ministry of Health was used in a field survey on hand hygiene facilities of 89 TCM hospitals in Guangxi.Results Facilities of the non-hand-touch taps,hand sanitizer and hand disinfectants were found satisfactory at key departments at all TCM hospitals in the region,yet poor performance with the hand drying facilities.Hospitals with such departments with non-hand-touch taps,hand sanitizer and hand disinfectants accounted for 93.3％,100.0％ and 100.0％.Only 41.6％ of the hospitals were found to use dry hand towels as drying facilities.Significant difference was found at various levels of hospitals' hand hygiene facilities.Conclusion The hand hygiene facilities at such hospitals in Guangxi are receiving growing attention,yet further investment is still required for further improvement and compliance of the medical staff in hand hygiene.
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Objective To find out the general status about the traditional Chinese medicine therapies that were included into medicare among the selected hospitals in the country's public hospital reform project, and to investigate the reasons for those not included and make recommendations.Methods Collecting relevant information through questionnaires, experts interviews and discussions.Results There are still some TCM therapies not included into the range of reimbursement.Most Of them are external treatment of traditional Chinese medicine, acupuncture, massage, special treatments of traditional Chinese medicine and comprehensive therapies of TCM.Conclusions The establishment of negotiations department about medicare in the field of traditional Chinese medicine was needed.Medicare should be in favor of TCM therapies, and traditional Chinese medicine hospitals should strengthen training of personnel and hiring.At the same time, a reasonable increase of the proportion of TCM experts involved in the making health insurance directory was needed.
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Objective To analyze the relationship between measures and economic benefit under the total medical insurance prepaid system in Xuzhou TCM hospital.Methods The trend of financial data of Xuzhou TCM hospital from 2010 to 2013, its incomes, assets, and liabilities were analyzed to evaluate its profitability, operating capacity and solvency.Results Income:The annual average income was 439.81 million yuan, with an annual average growth rate of 12%;the annual average net profit was 24.36 million yuan, with an annual average growth rate of 0.004% (excluding the profit adjustment factors in 2010). Assets:The annual average total assets was 355.82 million yuan, in which 73.21 million yuan was the added value in 2010 compared with 2009 and the growth rate was 17.22%;247.71 million yuan has been reduced in 2011 compared with 2009;45.11 million yuan has increased in 2012 compared with 2011, while in 2013, 35.58 million yuan has increased compared with 2012. The state owned assets has increased significantly. Liabilities:The annual total liabilities were 114.86, 84.03, 112.35, and 120.52 million yuan respectively from 2010 to 2013;the average debt level was 105.61 million yuan. The rate of assets and liabilities were 23.04%, 33.52%, 37.98%, and 36.37% respectively from 2010 to 2013;the annual average debt rate was 29.68%. Profitability:The average net operating margin, net interest rate of total assets and net assets yield rate were 5.54%, 6.85% and 9.73% respectively, which showed the gradually increased profitability. Hospital operating capacity:The average total assets turnover rate was 124% from 2010 to 2013. The solvency of the hospital:asset liability ratio of the hospital was 29.68% from 2010 to 2013 on average, which was in the low level of debt.Conclusion Under the total prepaid system, the measures of the hospital are proper. Economic operation of the hospital is favorable, giving the consideration of combining both economic benefit and social benefit.
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ObjectiveTo analyze the complaints of outpatient of Guang’anmen Hospital, China Academy of Chinese Medical Sciencse, discuss the countermeasures to alleviate the contradiction and promote the normalization of the relationship between doctors and patients.Methods Based on analysis of outpatient complaints from Jan. 2008 to Dec. 2012 in our hospital, statistics and classification data were obtained from the aspects of service attitude, medical errors, process and communication.ResultsOutpatient amount of our hospital form Jan. 2008 to Dec. 2012 was 10.55 million. There were 1426 outpatient complaints (service attitudes 24.2%, medical errors 11.5%, process 40.3%, and communication 24%), etc. Complaints rate was 0.135‰ and satisfaction degree of dealing with complaints was 99.3%.Conclusion Through active service, the complaints of outpatients has been reduced, and diagnostic and treatment quality and satisfactory degree have been increased of our hospital.
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Objective To understand the basic situation and existing problems of cost accounting information construction in the traditional Chinese medicine hospital. Methods We made a cross-sectional study of all traditional Chinese medicine hospitals cost accounting informatization, and then analyzed the results. Results In the survey of 1588 traditional Chinese medicine hospitals, there exists the problem with 78.65%for limited software;57.43%for not sharing between the systems;43.20%for outdated software. The occupancy rate was 81.86%for HIS system, 87.09%for the accounting software, 39.11%for cost accounting software, 5.42%for none. The proportion of hospitals was over 95% whose income data statistics to department;80% for spending data;73.05%for fixed assets depreciation cost;51.39%for amortization of intangible assets and 52.77%for medical risk fund. The proportion of hospitals was 81.49%whose data inside services statistics to medical auxiliary departments and higher than the logistics department, which was 63.85%.Conclusion The occupancy rate of cost accounting system software was limited in traditional Chinese medicine hospitals. The problems were limited cost accounting system software and unavailable information shared between the systems.
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Traditional Chinese medicine ( TCM ) is an important part of traditional Chinese culture . As the car-rier of TCM culture , TCM hospital should continuously strengthen its culture construction . This is conducive to develop TCM advantages , to consolidate the development direction of TCM , to embody basic features of TCM hospital , to improve the core competitive power , to meet needs of the masses of TCM services . Therefore , fur-ther promoting the cultural construction of TCM hospital is worth thinking and practicing deeply . This article discussed the connotation and function of hospital culture , elaborated measures and effects by demonstrating the process of hospital cultural construction , and put forward ideas for the reform and innovation of hospital cultur-al construction .