Résumé
OBJECTIVE:To standardize the ward rescue and essential drugs quality management in wards,and reduce the med-ication risk of patients. METHODS:Failure mode and effect analysis(FMEA)was used to analyze the inspection items and failure modes of quality management of ward rescue and essential drugs. According to scoring the possibility,severity and detectability de-gree of the failure modes and calculating the risk priority number(RPN),failure modes that should be given priority improvement were quantified and determined,improvement measures were developed and conducted,and management effects were evaluated af-ter 6 months. RESULTS:12 failure modes were determined,including the residue treatment of narcotic and the first-class psycho-tropic drugs was not recorded,drug storage temperature was not up to standard and drug expired,etc. Improving related systems, enhancing the inspection management,cold chain management,daily management and other measures were implemented and con-ducted. After 6 months,the top 3 items with the highest RPNs were dropped from 320,240,216 score to 16,16,27 scores,re-spectively,all in a relatively low risk area. Numbers of failure mode event were dropped from 1869 to 218,dropping by 88.3%. CONCLUSIONS:According to qualifying the failure modes in ward rescue and essential drugs quality management by using FMEA in our hospital,the management items with the highest risk has determined and improved,the medication risk of patients has significantly reduced.
Résumé
OBJECTIVE:To standardize the ward rescue and essential drugs quality management in wards,and reduce the med-ication risk of patients. METHODS:Failure mode and effect analysis(FMEA)was used to analyze the inspection items and failure modes of quality management of ward rescue and essential drugs. According to scoring the possibility,severity and detectability de-gree of the failure modes and calculating the risk priority number(RPN),failure modes that should be given priority improvement were quantified and determined,improvement measures were developed and conducted,and management effects were evaluated af-ter 6 months. RESULTS:12 failure modes were determined,including the residue treatment of narcotic and the first-class psycho-tropic drugs was not recorded,drug storage temperature was not up to standard and drug expired,etc. Improving related systems, enhancing the inspection management,cold chain management,daily management and other measures were implemented and con-ducted. After 6 months,the top 3 items with the highest RPNs were dropped from 320,240,216 score to 16,16,27 scores,re-spectively,all in a relatively low risk area. Numbers of failure mode event were dropped from 1869 to 218,dropping by 88.3%. CONCLUSIONS:According to qualifying the failure modes in ward rescue and essential drugs quality management by using FMEA in our hospital,the management items with the highest risk has determined and improved,the medication risk of patients has significantly reduced.
Résumé
Objective To summarize the experience in nursing children with pediatric advanced intraocular retinoblastoma treated with 23-gauge microinvasive vitrectomy. Methods Eleven infants (12 eyes) suffered from advanced intraocular (D or E) retinoblastoma and treated with 23-gauge microinvasive vitrectomy. Preoperative psychological nursing, postoperative complication nursing and follow-up nursing were performed. Results The retinal tumors was completely removed in all 12 eyes. After the follow-up of a half year, the conditions in 8 eyes were stable, and the tumors in 4 eyes recurred. Visual acuity in 4 eyes improved and that in 1 eye remained unchanged. Conclusions Microinvasive vitreous operation can effectively remove advanced intraocular retinoblastoma. Active efficient perioperative nursing plays an important role for the prevention of complications and promoting the recovery of affected eyes.
Résumé
<p><b>OBJECTIVE</b>To assess efficacy of membrane peeling combined with intravitreal injection of bevacizumab in the treatment of macular epiretinal membrane.</p><p><b>METHODS</b>From January, 2012 to June, 2013, 33 patients (33 eyes) with the diagnosis of macular epiretinal membrane underwent vitreous surgery and membrane peeling. The patients were randomly divided into intravitreal bevacizumab group (IVB group) and non-intravitreal bevacizumab group (non-IVB group). All the patients underwent standard three-port vitrectomy and peeling of epiretinal membrane, with intravitreal injection of 1.5 mg bevacizumab at the end of operation in IVB group. The best corrected visual acuity and optical coherence tomography (OCT) were examined before and after the treatment. The patients were followed up for 3-14 months (mean 6.5 months).</p><p><b>RESULTS</b>Macular epiretinal membranes were successfully peeled during operation in all the patients without postoperative intraocular infection or bleeding. Fifteen eyes received vitrectomy combined with intravitreal injection of bevacizumab, and 18 underwent only vitreous operation and membrane peeling. At the end of the follow up, the visual acuity improved in 11 eyes (73.3%) in IVB group, as compared to 13 eyes (72.2%) in the non-IVB group (P=0.627). Central macular thickness decreased by 143∓62 µm in IVB group and by 96∓28 µm in non-IVB group, showing a significant difference between the two groups (t=5.564, P<0.01).</p><p><b>CONCLUSION</b>Vitrectomy and membrane peeling combined with intravitreal injection of bevacizumab can promote the recovery of macular morphology but not visual function, and its clinical use still needs to be tested in a long-term and large-sample randomized controlled study.</p>