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1.
Article in Chinese | WPRIM | ID: wpr-908295

ABSTRACT

Objective:To investigate the effect of 1M3S nursing management mode combined with transcatheter arterial chemoembolization (TACE) on intestinal microecological distribution in patients with primary liver cancer.Methods:A total of 115 patients with primary liver cancer in Hai′an people′s Hospital from January 2017 to January 2020 were enrolled. Patients were divided into two groups according to the admission time. Patients ( n=56) receiving routine nursing care from January 2017 to December 2018 were set as control group, patients ( n=59) receiving 1M3S nursing management from January 2019 to January 2020 were set as observation group. Another 34 healthy individuals were set as healthy group from January 2017 to January 2020 in Hai′an People′s Hospital. The general data were collected in all three groups, and the serum levels of endotoxin (ET), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected. Fecal samples were collected, and 16S rDNA sequencing method was used to analyze the fecal flora structure and species relative abundance among groups, and alpha diversity was analyzed. Results:At the level of phylum, the dominant phylum of the three groups were Bacteroidetes, Proteobacteria and Firmicutes. After TACE, the ET, ALT and AST levels were (9.67±2.12) ng/L, (53.24±8.47) U/L, (55.48±8.15) U/L in the control group, (4.36±2.15) ng/L, (45.31±8.36) U/L, (47.25±8.21) U/L in the observation group ( t value was 13.328, 5.052, 5.392, P<0.05). Compared with the control group, there was an increase in the relative abundance percentage of Firmicutes( t value was 16.426, P<0.01) and Lachnospiraceae in the observation group ( t value was 4.527, P<0.01), and a decrease in the relative abundance percentage of Proteobacteria ( t value was 8.462, P<0.001) after intervention. Conclusions:TACE can affect the intestinal bacteria in patients with primary liver cancer, resulting in a decrease in the relative abundance of Proteobacteria, Lachnospiraceae, and an increase in the relative abundance of Firmicutes, while application of 1M3S nursing management mode can effectively reduce the level of endotoxin, improve liver function, and reduce the imbalance of intestinal flora caused by TACE.

2.
Article in Chinese | WPRIM | ID: wpr-906641

ABSTRACT

Objective To retrospectively analyze the results of neonatal diseases screening in Yichang from 2017 to 2019, understand the incidence and recall of the diseases, and explore the management mode of neonatal disease screening suitable for this region. Methods The subjects were newborns who were delivered in Yichang midwifery institutions from 2017 to 2019 and were screened for neonatal diseases. Heel blood of the newborns was collected for the screening of neonatal diseases, including congenital hypothyroidism (CH), phenylketonuria (PKU), G6PD deficiency, congenital adrenal hyperplasia (CAH) and thalassemia. Those newborns with positive initial screening were recalled for reexamination and confirmation. The recall rates of different diseases were compared by Chi-square test. Results There were 85 891 live births in Yichang area from 2017 to 2019, and 84 063 cases were screened for neonatal diseases, with a screening rate of 97.87%. A total of 6 043 cases were positive in the initial screening, of which 5,047 cases were recalled, with a recall rate of 83.52%. The recall rates of the traditional two diseases (CH and PKU) and the new three diseases (CAH, G6PD deficiency and thalassemia) were significantly different ( χ2= 197.93, P<0.01). A total of 501 cases were diagnosed. The incidence rate of CH was 1/1,911, the incidence rate of PKU was 1/12 009, the incidence rate of CAH was 1/28 021, the incidence rate of G6PD deficiency was 1/1 121, and the incidence rate of thalassemia was 1/226. Conclusions The neonatal disease screening rate increased year by year in Yichang, but the recall rate of suspicious positive initial screenings decreased. It is necessary to explore a more suitable management mode for the five neonatal disease screenings in this region, improve the recall rate of children with positive screening, reduce the incidence of disabled children, and improve the quality of the birth population.

3.
Article in Chinese | WPRIM | ID: wpr-906315

ABSTRACT

With the publication of Registration and Classification of Traditional Chinese Medicine (TCM) and Application Data Requirements, the related management and technical documents of TCM with the same name and prescription need to be further studied and formulated. In this paper, the management mode and technical evaluation of TCM with the same name and prescription are discussed to provide reference for the formulation of management and technical documents of TCM with the same name and prescription. The issues to be discussed include which management mode to adopt, how to select the control drugs with the same name and prescription, whether the indication risk level should be divided, whether the indication should be limited to medium and low risk, and how to carry out the technical evaluation of similarity/consistency. From the perspective of technical document research and formulation, this paper mainly focuses on the technical level. However, there are still other theoretical possibilities in the management mode and technical evaluation of TCM with the same name and prescription. Therefore, this paper, as a preliminary summary of the management and technical evaluation of TCM with the same name and prescription, needs more scholars and industry experts to pay attention to and participate in this work.

4.
Article in Chinese | WPRIM | ID: wpr-912788

ABSTRACT

As an advanced medical management mode, attending physician responsibility system is an important means for public hospitals to promote refined management. The authors analyzed the characteristics and problems of the three-level rounds system, sorted out the concept and feasibility of attending physician responsibility system, summarized the exploration and practice of the attending physician in China, and put forward some suggestions on the implementation path of attending physician in China by strengthening medical quality management, making fully reasonable use of hospital resources, carrying out " two permits" and improving the supporting management system of the attending physician.

5.
Article in Chinese | WPRIM | ID: wpr-912610

ABSTRACT

Objective:To establish a supportive and effective management mode of scientific research project application, promote the capacity building of scientific research in the hospital.Methods:Retrospective analysis was conducted on the national and provincial scientific research projects of Xinhua Hospital Affiliated to Shanghai Jiaotong University Medical School from 2010 to 2019, and the practical effect of " point to point" management mode of scientific research project application was evaluated.Results:The funding rate of Xinhua Hospital, especially national scientific research projects and provincial talents projects, was greatly improved by adoption of the multi-dimensional " point to point" management mode of scientific research project application. The number of national scientific research projects increased from 34 (26.02 million) in 2010 to 72 (51.0851 million) in 2019.The number of provincial talents projects increased from 5 (1.05 million) in 2010 to 26 (6.5 million) in 2019.Conclusions:The " point to point" management mode of scientific research project application plays an important role in promoting the overall funding rate. Enhancement of comprehensive capacity of hospital scientific research can be achieved by further improvement of this management mode, early initiation and arrangement of funding application depending on the " close partner" entity, emphasizing scientific research talents cultivation.

6.
Article in Chinese | WPRIM | ID: wpr-882009

ABSTRACT

Objective To introduce and conduct effectiveness evaluation of peer-group level care and management mode in people living with HIV and AIDS(PLHAs)in Jing'an District, Shanghai. Methods We recruited PLHAs who were managed by Jing'an District and participated in the peer-group care activities from 2015 to 2016, and collected their data of general conditions, behavior, antiretroviral therapy, life quality, social support, mental status and medical modes, and then conducted effectiveness evaluation of the mode by multivariate logistic regression model and linear regression model. Results A total of 300 PLHAs were included with 150 cases in each group. PLHAs in target group had higher proportion of antiretroviral therapy[82.7%(124/150)and 64.7%(97/150)]. In addition, they got higher scores in mental health(48.5±9.2 and 43.9±10.6)and social support(28.7±8.2 and 24.8±6.6), and lower scores in depressive severity index(0.5±0.1)and avoidance of medical modes(16.1±3.0 and 17.0±2.5). Multivariate analysis showed that PLHAs in target group had less sex partners(zero partner, OR = 2.1, 95%CI:1.1-3.9;one partner, OR = 3.6, 95%CI:1.9-6.8)and increased condom use(no sex, OR = 5.3, 95%CI:2.4-11.7;complete use, OR = 10.6, 95%CI:4.7-24.1;random miss, OR = 5.1, 95%CI:1.8-14.8)in the last 12 months. Conclusion The effect of peer-group level care and management mode is significantly good in promoting behavior change, enhancing health concern and increasing antiretroviral therapy.

7.
Article in Chinese | WPRIM | ID: wpr-823148

ABSTRACT

Objective To investigate the effect of comprehensive management mode intervention in elderly patients with moderate/severe chronic obstructive pulmonary disease at stable stage. Methods A total of 150 elderly patients with stable-stage COPD were randomly divided into two groups, 75 in each group. The control group received routine medication, while the observation group was given comprehensive management mode intervention, including health education,rational medication, pulmonary rehabilitation training and psychological guidance. Both groups were treated for 12 months. Differences in lung function parameters, modified Medical Research Council (mMRC) dyspnea scale, COPD assessment test (CAT), 6-minute walk test (6MWT), and frequency of acute exacerbation of COPD (AECOPD) were compared between the two groups. Results: After treatment, FEV1/FVC and FEV1%pred of observation group(57.65±11.62%、61.83±13.50%)were higher than control group(52.38±13.24%、53.42±13.93%)(P0.05). Within 12 months of treatment, the frequency of AECOPD in the observation group was less than that in the control group (P<0.05). Conclusions: In the treatment of elderly patients with moderate/severe chronic obstructive pulmonary disease, comprehensive management mode intervention can help delay the deterioration of lung function, correct the difficulty of breathing, improve the quality of life, and reduce the number of AECOPD.

8.
Article in Chinese | WPRIM | ID: wpr-746307

ABSTRACT

Objective To summarize the practical experiences of Clinical Research Unit (CRU) platform established by Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine,provide reference for domestic institutions that have prepared or to prepare to establish CRU platform.Methods Oriented by demand,this platform has set up six modules including project management module,methodology support module,data management module,quality risk management module,project transformation module and training and international exchange module.Besides,it also establishes and improves the corresponding module system,quality assurance,technical support and information data platform system.Results With this platform,the enthusiasm of departments to carry out clinical research has been continuously enhanced,the talent pool of clinical research has been expanded;the awareness of clinical research cooperation has been improved and the international cooperation fields have been further extended;the number of clinical research projects and funding have increased rapidly.Conclusions CRU Platform in Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine provides all-dimensional technical support and whole-process informatization management to improve clinical research quality and efficiency.While learning from the advanced international concepts,we still need to explore and improve the platform construction and management mode in line with general research-oriented hospitals in China,further to enhance the academic research internationally.

9.
China Medical Equipment ; (12): 123-126, 2018.
Article in Chinese | WPRIM | ID: wpr-706499

ABSTRACT

Objective: To explore the application of digital nursing management mode in the management of endoscope instruments of urological surgery. Methods: The digital nursing management mode was adopted to carry out management training for personnel of operation room, and improve management process for instrument of urological surgery, and fortify measurements of cleaning and maintaining for instruments. And the endoscope instrument error rate of pre-operation, missing parts number and doctors' satisfaction between pre and post implementation of digital nursing management mode were compared and analyzed. Results: The digital nursing management mode reduced the error rate of endoscopic instrument for department of urology surgery (x2=5.351, P<0.05), and reduced the number of missing parts (x2=4.033, P=0.05), and enhanced doctors' satisfaction(x2=67.944, P<0.01). Conclusion: Digital nursing management mode can strengthen the standardized management for endoscopic instrument of urology surgery, and reduce the error rate of endoscope instrument pre operation and number of missing parts, and effectively enhance the doctors' satisfaction. Therefore, it is worthy to be popularized and applied.

10.
China Pharmacy ; (12): 1453-1457, 2018.
Article in Chinese | WPRIM | ID: wpr-704820

ABSTRACT

OBJECTIVE:To provide reference for pharmacists to participate in the management of chronic disease. METHODS:A total of 259 patients with chronic airway disease [included asthma and chronic obstructive pulmonary disease (COPD)] met the inclusion criteria were selected from our hospital and 5 community health care centers of medical consortium. These patients received medication safety assessment management,which was led by clinical pharmacists of our hospital with the participation of community pharmacists,including medication safety comprehensive evaluation and risk classification management, follow-up and medication guidance, integrated prescriptions checking, establishment of shared database. 1 years after the implementation,the effectiveness were evaluated by score the relatived indicators in related groups. RESULTS:After a year of the management mode practice,compared with before intervention,the patients'safety medication cognitive ability score in high-risk and low-risk group increased from(4.49±1.26)and(7.31±1.01)to(5.40±1.56)and(7.44±0.91);medication adherence score increased from(4.96±1.21)and(7.08±1.24)to(6.66±1.08)and(7.38±0.98);ACT score from asthma patients increased from (16.15±2.58)and(21.15±1.03)to(16.80±2.57)and(21.64±1.55);CAT score from COPD patients decreased from(25.51± 4.07) and (14.90 ± 3.95) to (24.20 ± 3.96) and (13.80 ± 4.08);the rate of irrational prescription effective identification and intervention by pharmacists increased from 3.6% and 1.4% to 9.4% and 7.6%,respectively. All the differences above were statistically significant (P<0.05). CONCLUSIONS:The participation of pharmacists in long-term medication safety assessment management for chronic airway disease patients can improve patients'safety medication cognitive ability,medication adherence, disease control and the pharmacists'ability of irrational drug use identification and intervention.

11.
Article in Chinese | WPRIM | ID: wpr-789451

ABSTRACT

[Objective]To ascertain the status and related factors of antiretroviral therapy adherence and analyze the influence of management mode on adherence in HIV infected patients in Jing' an District, Shanghai. [Methods]We recruited 150 HIV infected patients who participated in the "peer group care"activities (target group) and those from another 150 patients who did not (control group) but received antiviral treatment during the period from 2015 to 2016 (221 cases in total) into the study. We collected data on general conditions, behavioral way, antiretroviral therapy adherence, life quality, social support, mental status and medical coping modes, and analyzed the related factors of antiretroviral therapy adherence by linear regression model. [Results]The 221 HIV infected patients were included, with 124 in target group and 97 in control group. The proportion of good antiretroviral therapy adherence was 86.0%, with 91.9% in target group and 78.4% in control group. Multiple analysis showed that the related factors of antiretroviral therapy adherence were management mode (β = 1.871, P < 0.001) , disposable income per month (β = 0.600, P = 0.001) , social support utilization (β = 0.174, P = 0.044) and yield attitude of medical coping modes (β =-0.153, P = 0.003). [Conclusion]Antiretroviral therapy adherence of HIV infected patients in Jing'an District should be further improved. "Peer group level care and management mode"could effectively promote the increase of antiretroviral therapy adherence; however, it should be improved and perfected in the aspects of its coverage and content.

12.
Article in Chinese | WPRIM | ID: wpr-618911

ABSTRACT

Objective To explore the secondary inventory appropriate to improve the stomatological hospital in cost control for medical consumables,standardizing patient charging,dynamic materials management,zero inventory and enhancing hospital economic benefit.Methods An enterprise resource planning (ERP) secondary inventory information system was developed to solve the problems in medical materials management of the stomatological hospital,and then went through practical trials in three departments to determine its efficacy and deficiencies.Results The information system facilitated cost control,standardized patient charging,and the trials in three departments showed the rate for material consumption was decreased greatly.The deficiencies still existed in the traceability,mobile App,manual input and etc.Conclusion The ERP secondary inventory information system reduces the running cost of the department,increases the hospital abilities in cost control and management,and thus is worthy promoting practically.

13.
Article in Chinese | WPRIM | ID: wpr-617180

ABSTRACT

Objectivde To explore the efficacy of i-GMS applied to the diabetes patient outside the hospital.Methods Totally 80 type 2 diabetes mellitus patients were divided into an experiment group (Group A) and a control group (Group B).Group A executed blood glucose monitoring by Glucose Management App and intelligent blood glucose meter (personal version),and Group B completed monitoring by some portable blood glucose meter.Telephone follow-up was performed once a week,and the two groups were compared on glycated albumin (GA) value 3 weeks after discharging,values of HbA1c,FPG and PG2h 3 months after,the times of blood glucose monitoring and hypoglycaemia as well as the patient satisfaction over the glucose management.Results Group A had the values of GA,HbA1c,FPG and PG2h significantly lower than those of Group B (P< 0.05).The times of glucose monitoring and patient satisfaction in Group A were statistically higher than those of Group B,while the incidence rate of hypoglycaemia of the former was lower than that of the latter (P<0.05).Conclusion I-GMS proves efficient when used for glucose self monitoring and management of the type 2 diabetes mellitus patient.

14.
Article in Chinese | WPRIM | ID: wpr-617167

ABSTRACT

Objective To introduce three-dimensional management mode to manage the devices in the operating room so as to reduce the risks.Methods A three-dimensional quality control group was established to strengthen the devices management.From three dimensions of thinking,communication and action some measures were proposed including training for standardized operation and incident treatment,improving guidance,sticking warning signs,advocating active report of adverse events,preventive maintenance and etc.Efficacy inspection and continuous improvement were carried out.Results The examination scores,inspection results and active reports of adverse events were significantly different before and after the introduction of three-dimensional management mode.Conclusion Three-dimensional management mode,in which the three dimensions connect to and cycle through each other,makes nursing staffs progressively develop the habit of safe operation in an environment of safety culture.Three-dimensional management mode is a scientific and applicable management method to reduce risks in using the devices in the operating room.

15.
Article in Chinese | WPRIM | ID: wpr-616135

ABSTRACT

[abstract] Objective To study the health education on diabetes nurse diabetes management mode at the core of application in the patients with follow-up effect. Methods Our hospital endocrinology in October 2015,participate in blood sugar management company research project(namely,doctors,nurses and patients ofthree Eonline and offline (O2O) integration management system).The project is the specialist education nurses,doctors and patients of organic whole,to form a closed-loop management.Use of the project with mobile tablet (PAD),SMS platform on the first base into a group of patients with type 2 diabetes insulin for 5 minutes on education and baseline data collection,and in the next 15 weeks of diabetes health education nurses via text message and phone tracking in the form of blood sugar and insulin dose data,at the same time for more than three months of education,guidance and management,to help patients with initial foundation of insulin self management knowledge and skills,promote the blood glucose control is at target. Results In 12 weeks of the completion of this project and follow-up,425 patients of FPG success rate is 82.6%. Conclusion Nurse diabetes health education as the core of diabetes management model is feasible in patients with type 2 diabetes, the effect is good,that greatly arouse the subjective initiative of patients;Improve the patients′self-management ability,improving according to the medical behavior;Improved treatment adherence to standard prompt patients FPG.

16.
Article in Chinese | WPRIM | ID: wpr-611083

ABSTRACT

Objective To investigate the hospital laboratory management mode.Methods We used literature review and comparative analysis to understand the different laboratory management mode,explore suitable operation mechanisms for hospital research and the development of hospital la boratory.Through a variety of measures to improve the efficiency and level of management,we tried to ensure the high efficiency and high quality operation of clinical laboratory,hospital science research,personnel training,discipline construction to provide quality services.Results There were two kinds of hospital laboratory management modes,which were centralized and decentralized management mode.Both management modes had advantages and disadvantages.We thought the centralized-decentralized binding mode was an ideal combination.Based of this mode,we implemented a number of initiatives and achieved significant results.Conclusions From the scale of hospital and its long-term development,centralized decentralized binding mode is a kind of ideal mode.

17.
China Pharmacy ; (12): 3545-3548, 2017.
Article in Chinese | WPRIM | ID: wpr-611008

ABSTRACT

OBJECTIVE:To standardize the clinical use of adjuvant therapy drugs. METHODS:To establish the clinical use management mode of adjuvant therapy drugs in our hospital and summarize the usage amount and irrational drug use of adjuvant therapy drugs before and after implementing the management,and the management effect was assessed. RESULTS:The manage-ment mode of adjuvant treatment drugs in our hospital included ensuring the directory for adjuvant therapy drugs,establishing the management system and ensuring its basic principles,then conducting drug use review with the ranking of drug dosages and mak-ing full use of evidence-based medical evidence,as well as developing principle of classification disposal for the irrational drug use (off-indications,overdose,ultra treatment) of adjuvant therapy drugs. After more than one year of management practice,the use of adjuvant therapy drugs in our hospital is increasingly standardized. The sales amount of adjuvant therapy drugs to all drugs was reduced from 20.90% before management(Aug. 2014-Jul. 2015)to 15.99%(reduced by 5%)after management(Aug. 2015-Jul. 2016). Compared with Aug. 2015,the sales amount of 48 varieties in the 93 adjuvant therapy drugs was dropped more than 15%in Aug. 2016,and irrational drug use decreased obviously. CONCLUSIONS:The established management mode of adjuvant thera-py drugs in our hospital has effectively improved clinical rational drug use and reduced medical costs.

18.
Article in Chinese | WPRIM | ID: wpr-515003

ABSTRACT

Objective To study the application effect of PDCA management mode in the teaching process of practice nurses in spine surgery to reduce the occurrence of nursing errors. Methods A total of 35 practice nurses in spine surgery from March 2014 to March 2015 received the routine teaching mode were set as control group, and 35 practice nurses from April 2015 to April 2016 implemented PDCA management mode were set as intervention group. The occurrence rate of nursing adverse events in two years was observed, and the interns for clinical teaching evaluation model of quality and satisfaction and the intern examination results were summarized. Results The incidence of nursing adverse events was 22.86% (8/35) in control group, and 2.86% (1/35) in intervention group, the difference was statistically significant (χ2= 17.85, P = 0.00). The intern teacher for clinical teaching content arrangement, teaching attitude, detail guidance and skills training indicators evaluation score were (15.46±1.03), (14.18±1.06), (14.61±1.11), (13.30±1.07) points in control group, and (18.26±1.00), (18.48±0.51), (19.43±0.21), (19.16± 0.28) points in intervention group, the differences were statistically significant (t = 11.54- 31.34, P <0.01). The interns given theory and skills examination results were (80.15±1.61), (85.16±1.02) points in control group, and (93.10±2.01), (91.06±2.03) points in intervention group, the difference was statistically significant (t = 29.75, 15.36, all P = 0.00). The clinical teaching satisfaction was 57.14% (20/35) in control group, and 80.00% (28/35) in intervention group, the difference was statistically significant (χ2=12.12, P=0.00). Conclusions PDCA management model applied to clinical practice in department of orthopedics teaching process, can effectively improve the intern theory knowledge and skills to master the ability, most of the interns examination results are more optimistic, and for this kind of management pattern for the process of teaching evaluation of higher satisfaction, the teachers care under the guidance of intern nursing mistake, nursing adverse events is low, this method is worthy of promotion.

19.
Article in Chinese | WPRIM | ID: wpr-511468

ABSTRACT

This article analyzed the present situation of development of TCM prevention and health care services in Nanning area of Guangxi Province, put forward a new mode of constructing regional TCM Prevention and health care service system: strengthen, clear and standardization, expounded the key points of implementation of construction of three-level health service system of TCM prevention and health care in Nanning area, practical significance of the construction of regional medical prevention and health care service system, and the advantages of three-level health service system of TCM prevention and health care. Finally, it summarized the experience in preliminary construction of three-level health service system of TCM prevention and health care services in Nanning area.

20.
China Medical Equipment ; (12): 107-110, 2017.
Article in Chinese | WPRIM | ID: wpr-508327

ABSTRACT

Objective:To investigate and explore the science management mode for high- value medical consumables in order to solve the problem of management deficiency in purchase and using of high-value medical consumables.Methods: To strengthen the management for high value consumables on 5 aspects: systematized institution, normalized processes, standardized operation, scientific evaluation and informationalized management.Results:The normalized, standardized and programmed management mode for high-value medical consumables has been established and improved throughout the whole process monitoring and management of total life cycle for the consumables. This research normalized the management for these consumables and formed a new science management mode.Conclusion: The exploration and implementation of new management method and path for medical high-value consumables can effectively improve the level of hospital material management, reduce management loopholes, decrease the cost of high-value consumables and increase work efficiency.

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