Thoughts and suggestions on high quality cost accounting at multi-campus public hospitals / 中华医院管理杂志

In the era of the new healthcare reform, high-quality cost accounting can effectively enhance the business performance of public hospitals. Compared with single-campus hospitals, the cost accounting of multi-campus hospitals is faced with greater complexity and challenges. The authors analyzed cost accounting problems found in the latter, namely the lack of top-level design in the construction of a fine multi-campus cost accounting system, difficulty of reasonable collection and allocation of various costs, lack of strong information support, outdated research methods used in item cost accounting among others, as well as their causes. On such basis, the authors put forward countermeasures for high-quality cost accounting in multi-campus hospitals, for the purpose of fully leveraging the leadership of cost control in the high-quality development of public hospitals.

Analysis of common problems in hospital medical service charge management / 中华医院管理杂志

As suggested by regulatory feedbacks from relevant national regulatory agencies on the use of medical insurance funds, noticeable problems were found in the compliance and rationality of medical service charges among Chinese hospitals. Based on the practice of hospital management, the authors summarized common problems of various medical service charge management as reported by the management authorities at all levels. These problems referred to name-replaceable charges and affiliated charges, splitting charges, repeated charges, and multiple(false) charges. On this basis, the paper analyzed such hospital management risks incurred as regulatory penalties, fee disputes and medical disputes, as well as their internal and external causes. In the end, the paper put forward countermeasures and suggestions for reference by hospitals in their management of medical service charges.

Patients in public hospitals received insufficient food to meet daily protein and energy requirements: Cape Town Metropole, South Africa

Objectives: This study aimed to determine the energy and protein content of meals served and consumed by hospitalised patients compared with their needs, to assess patients' food satisfaction and investigate associations with energy and protein intake. Design: This was an exploratory quantitative cross-sectional study. Setting: Three public hospitals within the Cape Town metropole were recruited; a central hospital (945 beds), large district hospital (372 beds) and a medium district hospital (172 beds). Subjects: Adult inpatients 18+ years admitted to medical or surgical wards, on a non-therapeutic/normal hospital diet were recruited by purposive sampling method between 2018 and 2019.Outcomes measures: Each participant's weight and height were measured to calculate body mass index (BMI) and to determine energy/protein requirements. The Acute Care Hospital Foodservice Patient Satisfaction Questionnaire was administered. Meals were weighed before and after consumption to calculate energy and protein intake per patient/day. Results: A total of 128 patients (males = 71) participated. Total protein served did not meet patient requirements in any of the hospitals. Consumed energy and protein were significantly below requirements in all hospitals (p < 0.002). Perceived food quality (r = 0.38, p = 0.039) and staff/service issues (r = 0.39; p = 0.035) were significantly positively correlated with protein intake, while appetite correlated positively (r = 0.42, p = 0.006; r = 0.41, p = 0.008) and length of stay (LOS) correlated negatively (r = −0.46, p = 0.002; r = −0.42, p = 0.008) with energy and protein intake, respectively. Conclusion: Energy and protein served was significantly lower than participants' requirements in all three hospitals and none achieved the official ration scale amounts. Nearly 40% reported having a normal appetite and did not receive additional food from family or friends, which may lead to hospital-acquired malnutrition and increased hospital length of stay (LOS). Improved hospital food quality, quantity, mealtimes and staff training should be a focus to improve patient energy and protein intake

Cost accounting for diagnosis items based on virtual standardized clinical chemistry laboratory / 中华医院管理杂志

Objective:Cost accounting for its diagnosis items based on virtual standardized clinical chemistry laboratory.Methods:Relevant data of clinical chemistry laboratories from January to June 2019 were extracted from the laboratory information systems of 10 hospitals in Shanghai, and three health economic experts and the directors of their laboratory departments were interviewed in this regard.On such basis, a virtual standardized clinical chemistry laboratory was constructed. The project cost of the virtual laboratory was calculated from the aspects of supplies exhaust, labor and others. The routine clinical chemistry diagnosis items were clustered according to the principle of laboratory methods, and the cost differences of items in the same cluster were compared using paired t test. Results:The cost of rate method and dry chemical method in testing alanine aminotransferase was 5.12 and 11.63 respectively, and that of immune turbidimetry and immune scattering turbidimetry method in testing immunoglobulin G was 20.00 and 22.26 respectively. Cluster analysis was conducted on 214 routine clinical biochemical diagnostic items, of which 202 items were classified into 42 clusters. The average of clinical chemistry items accounted for 91.7%(4 493/4 900)of the total per day. Based on enzymology, the calculation costs of alanine aminotransferase(rate method), aspartate aminotransferase(rate method), cholesterol(enzyme method)and uric acid(enzyme method)was 5.12, 5.10, 5.24 and 5.14 respectively, presenting no statistical difference( P>0.05). Conclusions:Research on the cost accounting method of clinical chemistry laboratory diagnosis items constructed includes labor cost, reflects the technical labor value of medical staff. Cost accounting based on project clustering can provide references for medical service pricing and financial management of hospitals.

Insertion of nursing professionals in the management of materials in a teaching hospital of Paraná / Inserción de profesionales de enfermería en gestión de materiales en hospital universitario en Paraná / Inserção dos profissionais de enfermagem no gerenciamento de materiais em hospital universitário do Paraná

ABSTRACT Objectives: To analyze the perception of nursing professionals about their insertion in the material management process in hospital units. Methods: Exploratory study with a qualitative approach carried out in a university hospital in Paraná. Data collection was carried out between October and December 2019, through semi-structured interviews recorded in audio. The data were transcribed and submitted to thematic content analysis. Results: 35 nursing professionals participated in the study. From the speeches, four categories emerged: Participation in the process of planning and provision of materials; Sizing of resources in the institution; Participation in the quality control of materials; and Difficulties confronted in the material management process. Conclusion: The results indicate that nursing professionals have a low participation in the material management process and infer that they actively participate only in the quality control process through evaluations and notifications.

RESUMEN Objetivos: Analizar la percepción de los profesionales de enfermería acerca de su inserción en el proceso de gestión de materiales en unidades hospitalarias. Métodos: Estudio exploratorio con enfoque cualitativo realizado en un hospital universitario en Paraná. Se realizó a la recogida de los datos entre octubre y diciembre de 2019, a través de entrevistas semiestructuradas y grabadas en audio. Se transcribió a los datos y se los sometió a un análisis de contenido temático. Resultados: Participaron en el estudio 35 profesionales de enfermería. Surgieron cuatro categorías de los discursos: Participación en la planificación y provisión de materiales; Dimensionamiento de recursos materiales; Participación en el control de calidad de materiales; y, Dificultades enfrentadas en el proceso de gestión de materiales. Conclusión: Los resultados indican que los profesionales de enfermería tienen una baja participación en el proceso de gestión de materiales, e infieren que solo participan activamente en el proceso de control de calidad a través de evaluaciones y notificaciones.

RESUMO Objetivos: Analisar a percepção dos profissionais de enfermagem sobre a sua inserção no processo de gerenciamento de materiais em unidades hospitalares. Métodos: Estudo exploratório de abordagem qualitativa realizado em um hospital universitário no Paraná. A coleta de dados foi realizada entre outubro e dezembro de 2019, por meio de entrevista semiestruturada e gravada em áudio. Os dados foram transcritos e submetidos à análise de conteúdo temática. Resultados: Participaram do estudo 35 profissionais de enfermagem. Dos discursos, emergiram quatro categorias: Participação no processo de planejamento e provimento dos materiais; Dimensionamento de recursos materiais; Participação no controle de qualidade dos materiais; e, Dificuldades enfrentadas no processo de gerenciamento de materiais. Conclusão: Os resultados indicam que os profissionais de enfermagem possuem uma baixa participação no processo de gerenciamento de materiais, e inferem que participam ativamente somente do processo de controle de qualidade por meio das avaliações e notificações.

ATUAÇÃO DO ENFERMEIRO NO PROCESSO DE LIMPEZA EM UM CENTRO DE MATERIAL E ESTERILIZAÇÃO / Nurse's role in cleaning process at a material and sterilization center / Función de la enfermera en el proceso de limpieza en un centro de materiales y esterilización

Objetivo: Contextualizar a atuação do enfermeiro no processo de limpeza de materiais hospitalares em um Centro de Material e Esterilização. Método: Relato de experiência que emergiu das atividades desenvolvidas na disciplina "Prática Supervisionada em CME", do Curso de Pós-Graduação Lato Sensu "Enfermagem em Centro Cirúrgico, Recuperação Pós-Anestésica e Centro de Material e Esterilização" de uma universidade privada no Rio Grande do Sul. Resultados: A atuação do enfermeiro no processo de limpeza ocorre frente às necessidades do setor, tais como qualificar a equipe; estimular o uso dos equipamentos de proteção individual; participar da aquisição de equipamentos e insumos; qualificar o método de limpeza; conhecer a complexidade do instrumental cirúrgico; participar do controle de qualidade da água, do enxágue, da secagem, da lubrificação e da inspeção dos materiais; e escolher os indicadores para comprovar a qualidade dos processos, conforme as legislações vigentes. Conclusão: Este estudo proporcionou ampliar conhecimentos sobre as responsabilidades inerentes à atuação do enfermeiro no Centro de Material e Esterilização, o que reflete em segurança para o paciente.

Objective: To examine the role of nurses in the process of cleaning hospital materials in the Material and Sterilization Center. Method: Experience report that emerged from the activities developed in the discipline "Supervised Practice in Material and Sterilization Center", Lato Sensu Postgraduate Course "Nursing in Surgical Center, Post-Anesthesia Recovery and Material and Sterilization Center" of a private university in Rio Grande do Sul. Results: The nurse's role in the cleaning process occurs in response to the needs of the sector, such as training the team, promoting the use of personal protective equipment, participating in the acquisition of equipment and supplies, certifying cleaning methods, understanding the complexity of surgical instruments, participating in water quality control and rinsing, drying, lubrication and inspection of materials, and chosing the indicators to verify the quality of the processes, according to current law. Conclusion: This study provided an insight into the responsibilities inherent to the nurse's work in the Material and Sterilization Center, which reflects the safety of the patient

Objetivo: Examinar el papel de las enfermeras en el proceso de limpieza de los materiales del hospital en el Centro de Materiales y Esterilización. Método: Informe de la experiencia que surgió de las actividades desarrolladas en la disciplina "Práctica Supervisada en el Centro de Materiales y Esterilización", Lato Sensu Curso de Postgrado "Centro de Enfermería en Cirugía, Recuperación Post-Anestesia y Centro de Materiales y Esterilización" de una universidad privada en Rio Grande do Sul. Resultados: El papel de la enfermera en el proceso de limpieza ocurre en respuesta a las necesidades del sector, como capacitar al equipo, promover el uso de equipos de protección personal, participar en la adquisición de equipos y suministros, certificar métodos de limpieza, comprender la complejidad de Instrumentos quirúrgicos, participando en el control de calidad del agua y enjuague, secado, lubricación e inspección de materiales, y seleccionando los indicadores para verificar la calidad de los procesos, de acuerdo con la legislación vigente. Conclusión: este estudio proporcionó una perspectiva de las responsabilidades inherentes al trabajo de enfermeros en el Centro de Material y Esterilización, que refleja la seguridad del paciente

Research and application of intelligent error correction system for medical service pricing at public hospitals / 中华医院管理杂志

Deepening healthcare reform highlights the importance of medical services pricing adjustment, and the imperativeness to strengthen the informationized management of such pricing.With this concept in mind, the authors analyzed the problems and causes of the current management on medical service pricing informatization at public hospitals, and discussed the construction strategy of an intelligent error correction system in this regard. That is, to develop a technical process from the four aspects of software flow, interface flow, project rules, and reporting system. This system is designed with such functions as inpatient cost inquiry, inpatient information, price adjustment analysis, price feedback record statistics and inquiries over the hospitalization expense ceiling, as well as inpatient cost omission inquiry.This paper also discussed the construction of a platform to transform the knowledge of pricing policy into the knowledge base of medical service pricing, in order to improve the level of medical pricing management, promote the efficiency of hospital operation and management, and reduce the burden of patients.

Analysis on labor dispatch management at institutions of healthcare and public health / 中华医院管理杂志

Objective To understand the basics and existing problems of labor dispatchers at institutions of healthcare and public health, and to provide reference for its improvement. Methods In October 2017, 3548 dispatchers from 29 such institutions in Beijing were investigated to find out the basic salary and welfare, career development and labor disputes of their dispatchers. Descriptive statistics was used to analyze the data. Results Among those dispatched of 29 institutions surveyed, 51. 2％ were employed upon staffing quota, 31. 1％ were dispatched and 17. 7％ were employed in other forms. Labor dispatchers had higher educational level as a whole, mainly college and undergraduate education, accounting for 79. 6％;their social security was well assured, and there were few cases of labor disputes. Conclusions It is necessary to further improve the management of labor dispatch personnel, highlight post management, improve salary and welfare mechanism, smooth career development channels, and strengthen the awareness of risk prevention and control.

Improvement of public hospital's pricing management based on big data analysis / 中华医院管理杂志

Hospital A is cited as an example to analyze existing problems of pricing management in public hospitals in an attempt to use big data thinking, especially in pricing management improvement using whole sample and correlation analysis. The study covers specifics like logic relations based on pricing items and related indicators, establishment of big data analysis framework and production of analysis statements;and system automatic pre-warning using big data analysis results for higher management efficiency.

Formação do enfermeiro para atuar na central de esteriliação / Training of nurses to work in the central sterile supply department nurse / Formación del enfermero para actuar en la central de esterilización

Objetivo: Compreender a formação do enfermeiro para atuar na Central de Material Esterilizado (CME). Método: Estudo descritivo qualitativo, constituído por uma amostra de 20 enfermeiros matriculados nos programas de mestrado profissional e acadêmico da Faculdade de Medicina de Marília (Famema), no período de 2011 a 2014. A coleta de dados foi realizada por meio de entrevista em 2014. Resultados: Foram identificadas duas categorias temáticas: a formação do enfermeiro pautada no modelo tecnicista e a perspectiva da formação generalista. Constatou-se que o mundo do trabalho e a formação estão entrelaçados, sendo que a graduação contribui para o desenvolvimento de profissionais competentes e éticos, considerando as suas realidades nos processos de formação. Conclusão: Independente da proposta curricular das instituições de ensino, os enfermeiros tiveram dificuldades para o aprofundamento quanto ao tema proposto, mas colaboraram com sugestões de transformações das práticas de ensino e aprendizagem para atuação dos enfermeiros na CME e que essa formação possa ser repensada mais adequadamente.

Objective: To understand the training of nurses who will work in the Central Sterile Supply Department (CSSD). Method: Descriptive and qualitative study including a sample of 20 nurses enrolled in the professional and academic Master's Degree Programs of Faculdade de Medicina de Marília (Famema), in the period 2011 to 2014. The data were collected by interviews in 2014. Results: We found two thematic categories: nurse training based on the technicist model and the perspective of generalist training. The world of work and training are intertwined and the undergraduation course, therefore, contributes to the development of competent and ethical professionals, since it considers their realities in training processes. Conclusion: Regardless of teaching institutions' curriculum, nurses faced difficulties in studying the proposed theme further; however, they have collaborated with suggestions regarding changes in the teaching and learning practices for nurses that work in the CSSD; and they have also suggested it could be reconsidered in a better way.

Objetivo: Comprender la formación del enfermero para actuar en la Central de Material Esterilizado (CME). Método: Estudio descriptivo cualitativo, constituido por una muestra de 20 enfermeros matriculados en los programas de maestrando profesional y académico de la Facultad de Medicina de Marília (Famema), en el período de 2011 a 2014. La colecta de datos fue realizada por medio de entrevista en 2014. Resultados: Fueron identificadas dos categorías temáticas: la formación del enfermero pautada en el modelo tecnicista y la perspectiva de la formación generalista. Se constató que el mundo del trabajo y la formación están entrelazados, siendo que la graduación contribuye para el desarrollo de profesionales competentes y éticos, considerando sus realidades en los procesos de formación. Conclusión: Independiente de la propuesta curricular de las instituciones de enseñanza, los enfermeros tuvieron dificultades para la profundización cuanto al tema propuesto, pero colaboraron con sugerencias de transformaciones de las prácticas de enseñanza y aprendizaje para actuación de los enfermeros en la CME y que esa formación pueda ser repensada más adecuadamente.

Application of two-dimensional code in management of nursing instruments / 中华护理杂志

Objective To explore the effects of two-dimensional code on nursing instruments management.Methods Information regarding nursing instruments were edited and corresponding two-dimensional codes were generated which would be pasted on both the instruments and the registration book,and nurses were notified about the twodimensional codes.The effects of the application of two-dimensional code were assessed among 145 nurses using questionnaires,and 40 nurses were evaluated for theoretical and operational skills of the instrument.Results After applying two-dimensional code in management of nursing instruments,nurses' scores for utilizing,maintenance,addressing malfunction,storage and counting were higher than previous management method for instruments(P＜0.05),and the performance of theoretical and operational skills of 40 nurses were increased significantly(P＜0.05).Conclusion Two-dimensional code provides valuable benefits for information storage,instrument tracking,etc.,shows great convenience and efficiency to nursing instruments management,and helps to improve nurses' application skills of instruments.

Controlling Legal Risk for Effective Hospital Management

PURPOSE: To analyze the types of medical malpractice, medical errors, and medical disputes in a university hospital for the proposal of countermeasures that maximize the efficiency of hospital management, medical departments, and healthcare providers. MATERIALS AND METHODS: This study retrospectively reviewed and analyzed 55 closed civil lawsuits among 64 medical lawsuit cases carried out in Pusan National University Hospital from January 2000 to April 2013 using medical records, petitions, briefs, and data from the Medical Dispute Mediation Committee. RESULTS: Of 55 civil lawsuits, men were the main plaintiffs in 31 cases (56.4%). The average period from medical malpractice to malpractice proceeding was 16.5 months (range, 1 month to 6.4 years), and the average period from malpractice proceeding to the disposition of a lawsuit was 21.7 months (range, 1 month to 4 years and 11 months). CONCLUSIONS: Hospitals can effectively manage their legal risks by implementing a systematic medical system, eliminating risk factors in administrative service, educating all hospital employees on preventative strategies, and improving customer service. Furthermore, efforts should be made to establish standard coping strategies to manage medical disputes and malpractice lawsuits, operate alternative dispute resolution methods including the Medical Dispute Mediation Committee, create a compliance support center, deploy a specialized workforce including improved legal services for employees, and specialize the management-level tasks of the hospital.

The nurse in the management of materials in teaching hospitals / El enfermero en la gestión de materiales en hospitales de enseñanza / O enfermeiro no gerenciamento de materiais em hospitais de ensino

OBJECTIVETo present the nurse's integration within materials management of six teaching hospitals of Paraná - Brazil, and to describe the activities performed by nurses within this process.METHODA study of a qualitative approach and descriptive nature, conducted in teaching hospitals in Paraná, between June and August of 2013. The data collection was conducted through semi-structured interviews with eight nurses who worked in materials management; data were analyzed using content analysis.RESULTSThese showed that nurses perform ten categories of activities, distributed into four of the five steps of the materials management process.CONCLUSIONThe nurse, in performing of these activities, in addition to favoring the development of participative management, contributes to the organization, planning, and the standardization of the hospital supply process, giving greater credibility to the work with professionals who use the materials, and to the suppliers.

OBJETIVOPresentar el marco de inserción del enfermero en la gestión de materiales de seis hospitales de enseñanza de Paraná - Brasil y describir las actividades por él desarrolladas en ese proceso.MÉTODOEstudio de abordaje cualitativo y naturaleza descriptiva desarrollado en hospitales de enseñanza de Paraná, en el período de junio y agosto de 2013. La recogida se llevó a cabo mediante entrevista semiestructurada a ocho enfermeros actuantes en la gestión de materiales y los datos fueron analizados por la técnica de análisis de contenido.RESULTADOSMostraron que el enfermero desempeña diez categorías de actividades, distribuidas en cuatro de las cinco etapas del proceso de gestión de materiales.CONCLUSIÓNEl enfermero en el desempeño de esas actividades, además de favorecer la construcción de gestión participativa, contribuye con la organización, planificación y sistematización del proceso de suministro de los hospitales, brindando mayor credibilidad al trabajo junto con los profesionales que utilizan los materiales y los proveedores.

OBJETIVOApresentar o contexto de inserção do enfermeiro no gerenciamento de materiais de seis hospitais de ensino do Paraná - Brasil e descrever as atividades por ele desenvolvidas neste processo.MÉTODOEstudo de abordagem qualitativa e natureza descritiva desenvolvido em hospitais de ensino do Paraná, no período de junho e agosto de 2013. A coleta foi realizada por meio de entrevista semiestruturada a oito enfermeiros atuantes no gerenciamento de materiais e os dados foram analisados pela técnica de análise de conteúdo.RESULTADOSMostraram que o enfermeiro desempenha dez categorias de atividades, distribuídas em quatro das cinco etapas do processo do gerenciamento de materiais.CONCLUSÃOO enfermeiro no desempenho destas atividades, além de favorecer a construção de gerenciamento participativo, contribui para a organização, o planejamento, e a sistematização do processo de abastecimento dos hospitais, conferindo maior credibilidade ao trabalho junto aos profissionais que fazem uso dos materiais e fornecedores.

Utilização do custeio baseado em atividades em centro de material e esterilização como ferramenta gerencial / Using activities-based costing in a sterile processing department as a management tool

O Centro de Materiais e Esterilização (CME) baseia-se nos custos que incidem nos processos desenvolvidos para seu gerenciamento e o custeio baseado em atividades (ABC) pode ser uma ferramenta adequada para auxiliar o gestor nas decisões e prática gerencial. O objetivo do estudo foi avaliar a aplicação do custeio ABC para uma prática gerencial baseada em evidências e seu apoio ao processo de tomada de decisão. Estudo de caso, realizado em CME de hospital de ensino, usando análise documental para aplicação do custeio ABC. O custo individual da esterilização dos artigos foi de R$ 6,05 (US$ 3,23) e desinfecção foi de R$ 3,03 (US$ 1,61). O custeio ABC é aplicável e destaca evidências que balizam a tomada de decisão na prática gerencial, garantindo a análise do processo produtivo e intervenções decisivas e impactantes na gestão de custos

The Center of Materials and Sterilization (CMS) is based on the cost related to the processes developed for its management and the activities-based costing (ABC) can be an adequate tool to help the manager in management decisions and practice. The aim of the study was to evaluate the application of ABC for an evidence-based management practice and its support for process of decision making. This is a case study, performed in a CMS of a teaching hospital, using documental analysis to apply the ABC. The individual cost to sterilize goods was R$ 6,05 (US$ 3,23) and to disinfect was R$ 3,03 (US$ 1,61). The ABC is applicable and highlights evidence supporting decision making in management practice, guaranteeing the analysis of the productivity process and the decisive and impacting interventions in the management of costs.

Gerenciamento de recursos materiais com enfoque na queixa técnica / Management of material resources with a focus on technical complaints / Gerenciamiento de recursos materiales con enfoque en la queja técnica

Estudo descritivo cujo objetivo foi caracterizar o processo de notificação da queixa técnica de material de consumo em hospital de ensino público e integrante da Rede Hospital Sentinela da Agência Nacional de Vigilância Sanitária. Os dados obtidos dos Impressos de Notificações resultaram em 260 notificações analisadas, relativas ao período 2007 a 2009. Os resultados apontaram predominância de não conformidades no grupo de material médico-hospitalar (80,4%) e as queixas principais se referiram à estrutura dos produtos utilizados (79%). Do montante das notificações, 7,7% foram encaminhados ao Sistema Nacional de Notificações em Vigilância Sanitária. Os enfermeiros foram os profissionais que majoritariamente (81,2%) realizaram as notificações. Os achados desta investigação revelaram a relevância da implantação e uso de sistemas de registros sistemáticos de avaliações de materiais, enquanto subsídio para uma gestão eficiente no que concerne à maximização de recursos econômicos.

Descriptive study aimed to characterize the process of notification of the technical complaint of consumables in a public teaching hospital, a member of Sentinela Hospital Network of the National Health Surveillance Agency. The data obtained was from the printed notices that resulted in 260 notifications analyzed from 2007 to 2009. The results showed a predominance of non-conformities in the group of medical-hospital material (80.4%) and the main complaints referred to the structure of the products used (79%). Of the total amount of notifications, 7.7% were referred to the National System of Notifications in Sanitary Surveillance. The nurses were the professionals who mostly (81.2%) made the notifications. The findings of this research revealed the importance of implementing and using systems for making systematic records of material evaluations as a basis for efficient management regarding the maximization of economic resources.

Estudio descriptivo que objetivó caracterizar el proceso de notificación de queja técnica de material de consumo en hospital de enseñanza pública, miembro de la Red Hospitalaria Centinela de la Agencia Nacional de Vigilancia Sanitaria. Los datos obtenidos de los Impresos de Notificaciones totalizaron 260 notificaciones analizadas, relativas al período 2007 a 2009. Los resultados expresaron predominancia de inconformidad en el grupo de material médico-hospitalario (80,4%) y las quejas principales se refirieron a la estructura de los productos utilizados (79%). Del total de notificaciones, el 7,7% fue derivado al Sistema Nacional de Notificaciones en Vigilancia Sanitaria. Los enfermeros fueron quienes realizaron mayoritariamente las notificaciones (81,2%). Los hallazgos de esta investigaci ón revelaron la importancia de implantar y utilizar sistemas de registro informático de evaluaciones de materiales como respaldo de una gestión eficiente en lo referente a la optimización de recursos económicos

Current status of healthcare-associated infection management in 118 basic level private medical institutions / 中国感染控制杂志

Objective To investigate the current situation of healthcare-associated infection (HAI)management in basic level private medical institutions.Methods 118 basic level private medical institutions in a district of Chengdu were investigated through visiting and questionnaire.Results Of 118 medical institutions,only 2 had HAI manage-ment personnel,4 had HAI management system.22.03% had hand washing facilities in therapeutic rooms and con-sulting rooms,37.29% of institutions stored aseptic items in accordance with the requirements,55.93% of institu-tions disposed medical waste at disposal center;99.15% handled reusable items by users.Conclusion HAI manage-ment status is worried,health administrative department should strengthen support and supervision,especially in-tensified the supervision of private dental clinics.

Role of healthcare-associated infection management platform from the view of information fusion / 中国感染控制杂志

Objective To evaluate the important role of information collection,exchange,and analysis in the management of healthcare-associated infection(HAI),and demonstrate the characteristics of HAI management plat-form.Methods Role of HAI management platform was demonstrated according to information fusion theory,the monitoring level ,feature level and decision level information fusion method,as well as examples and data of interna-tional/domestic and historical comparison.Results HAI management committee as a platform,and HAI manage-ment departments as the fusion system of information analysis and process department is the foundation of HAI management.Conclusion HAI monitoring system should be strengthened,multi-disciplinary integration should be developed,and HAI committee decision coordination platform should be intensified.

Investigation on implementation of three standards by central sterile sup-ply departments / 中国感染控制杂志

Objective To realize the status in the implementation of three industry standards of central sterile sup-ply department (CSSD),and provide a scientific basis for carrying out of the standards. Methods According to three standards,investigation forms were designed by specialists,written survey on 365 hospitals in 9 provinces and field investigation on 1 5 hospitals in 3 provinces were performed,the implementation of three standards were investi-gated.Results Of 365 hospitals,the number of provincial and ministerial level,municipal level,and county level hospitals were 90,87 and 188 respectively. More than 94% of hospitals established CSSD management system and regulations,>90% of hospitals met the requirements of CSSD layout;All hospitals were equipped with pressure steam sterilizer,all levels of hospitals basically equipped with the necessary equipments and facilities;CSSD respon-sible officers of 94.52% (345/365)of hospitals participated in training on standards;69.61% (252/362)of hospi-tals were using or developing CSSD information systems;>92% of the CSSD responsible officers considered that three standards played an important role in facilitating centralized management,and improving the quality of clean-ing,disinfection and sterilization.Conclusion Hospitals need to strengthen the management and training on stand-ards of CSSD,management of loaner instruments and development of information system need to be standardized.

Hospital administrators’recognition extent to healthcare-associated infec-tion management staff ’s competency and qualification / 中国感染控制杂志

Objective To realize hospital administrators ’recognition extent to healthcare-associated infection (HAI )management staff ’s competency and qualification.Methods The unified questionnaires were filled in by respondents in 173 hospitals of Inner Mongolia autonomous Region,administrators’recognition on the competency and qualification of HAI management staff were surveyed.Results Of 445 hospital administrators,20.09%, 19.89%,and 18.05% considered that staff members in HAI management departments should have the knowledge background of preventive medicine,clinical medicine,and nursing respectively.58.20%,89.44%,and 43.37% of hospital administrators considered that the directors of HAI management departments should have senior profession-al titles,undergraduate course or above,and with 2 -5 working experience,respectively.34.92% and 30.93%considered that the most important professional ability of directors of HAI management department were profession-al and management ability,respectively.Conclusion Hospital administrators are apt to consider that the competen-cy and qualification of HAI management staff are strong professional ability and certain management ability,and are interdisciplinary talents.

A atuação do enfermeiro no gerenciamento de materiais em hospitais de ensino do Paraná / The role of nurses in material management in teaching hospitals in Paraná

Este trabalho tem por objetivo apresentar o contexto de inserção do enfermeiro no gerenciamento de materiais nos hospitais de ensino do Paraná; descrever as atividades por ele desenvolvidas neste processo; identificar as competências requeridas para o gerenciamento de materiais e como elas são desenvolvidas. Foram entrevistados oito enfermeiros atuantes no gerenciamento de materiais de seis Hospitais de Ensino do Paraná. Para análise das falas dos participantes da pesquisa utilizou-se a análise de conteúdo temática proposta por Bardin. Durante a realização da pesquisa os aspectos éticos foram respeitados conforme os preceitos da Resolução 466/12. As categorias temáticas extraídas foram: Contexto de atuação do enfermeiro do GM; Atividades desenvolvidas pelo enfermeiro do GM; Competências requeridas do enfermeiro para atuação no GM e Desenvolvimento de competências para o GM. Entre os resultados verificou-se que a inserção do enfermeiro na atividade ocorre de maneira não programada, mas correlacionada ao conhecimento do profissional sobre os materiais e a experiências prévias no seu uso. Identificou-se a atuação do enfermeiro nas etapas de programação, compra, armazenamento, distribuição e controle; com destaque para as atividades de elaboração de projetos para a captação de recursos, que o possibilita integrar instâncias mais elevadas do planejamento; e a educação permanente da equipe, pelo atendimento a missão dos hospitais de ensino de formar e capacitar recursos humanos em saúde. Para o desempenho destas atividades observou-se o emprego das competências de Planejamento e Organização, Gestão de recursos e Trabalho em equipe. Estas foram desenvolvidas pelos profissionais por meio das experiências prévias na prática profissional e da experiência em atividades afins ao GM, motivadas pelo interesse pessoal e sob reforço da educação permanente e do contato com outros profissionais. Entende-se que o enfermeiro do GM abriu canais de comunicação para a construção de um gerenciamento de materiais mais participativo, o que reitera o papel da equipe técnica assistencial como sujeito das ações e aproxima-os de outras instâncias da administração dos hospitais de ensino. Além de imprimir ao processo organização e planejamento, a sistematização das ações avaliativas de produtos e de controle dos recursos durante o seu uso confere maior credibilidade ao trabalho junto aos profissionais que fazem uso dos materiais e dos fornecedores.

This work aims: to present the context of nurses inclusion regarding supplies management in Paraná state teaching hospitals; to describe the activities they carry out in this process; to identify the skills required for the supplies management and how they are developed. Eigth active management nurses who work in six Teaching Hospitals in Paraná state were interviewed. For analysis of the statements of the interviewed people we used the thematic content analysis proposed by Bardin. During the research the ethical aspects were maintained in accordance with provisions of Resolution 466/12. The themes were: GM Nurses performance context; Activities performed by GM; skills required of nurses to act in the GM alongside with skills development for the GM. Among the results, it was found that the insertion of the nurse in activity is not programmed, but correlated with professional knowledge of the supplies and their experience in previous use. We identified the role of the nurse in the stages of planning, purchasing, storage, distribution and control, highlighting the activities of preparing projects for funding, which allows him/her to integrate the highest levels of planning, as well as the ongoing education of the staff by achieving the mission of teaching hospitals to educate and train human resources for health. For the performance of these activities we observed the use of the skills of planning and organization, resource management and teamwork. These skills were developed by professionals through professional practice and previous experience in related activities at the GM experiments, which were motivated by self-interest and in enhancing continuing education and contact with other professionals. It is understood that GM nurses achieved the needed amounts of communication for building a more participatory supplies management, which reinforce the role of the staff as a subject of actions and approaches from other instances of the administration of teaching hospitals. Apart from giving the process planning and organization, the systematization of evaluation actions of products and control of resources during use gives greater credibility to work with professionals who use the supplies, as well as the providers.