Effect of Triangle hierarchical management among community patients with hypertension / 预防医学

Objective@#To evaluate the effect of Triangle hierarchical management among community patients with hypertension, so as to provide insights into the improvements of standardized hypertension management.@*Methods@#Patients with newly diagnosed hypertension from 2 community health service centers in Qiantang District of Hangzhou City by the end of 2020 were randomly assigned to the conventional group and the Triangle group. Patients in the conventional group were given health management services according to the requirements of basic public health service standard for one year, while patients in the Triangle group were given Triangle hierarchical management. The blood pressure, self-management behaviors, treatment compliance, smoking, alcohol consumption and exercise were collected using the self-management behavior scale, treatment compliance scale and self-designed questionnaires, and were compared before and after intervention with analysis of covariance and generalized estimation equations.@*Results@#Totally 200 patients with hypertension were recruited, including 100 patients in the conventional group and 100 patients in the Triangle group. There were no significant differences between the two groups before implementation of interventions in terms of gender, age, educational level or occupation (P>0.05). The reduction in blood pressure, increase in the score of treatment, diet, exercise and living habitat management and the total score of self-management behaviors, increase in the score of adherence to medication regimens, daily living management behaviors, smoking and alcohol consumption preference and the total score of treatment compliance, and increase in the number of patients with normal standard of quitting smoking, quitting alcohol consumption, exercise and blood pressure were significantly higher in the Triangle group than in the conventional group after intervention (P<0.05). @*Conclusions @#Triangle hierarchical management may increase the treatment compliance, improve the self-management behavior and facilitate hypertension control among hypertensive patients, which may be popularized for health management among community patients with hypertension.

Research on the Strategies for Personal Information Protection in the Period of Normalization of Epidemic Prevention and Control / 中国医学伦理学

By analyzing the theoretical basis of safeguarding citizens’ personal information right during the normalization period of epidemic prevention and control, this paper concluded that there are some problems in personal information, such as solidified collection and utilization mode, low degree of management systematization, imperfect processing technology and narrow application scope, low degree of data value development and high risk coefficient. Further combined with China’s current epidemic prevention mode and social governance characteristics, this paper put forward the idea of innovating data hierarchical management and implementing the sharing mode in the industry to reduce the number of information circulation, trace the source, strengthen data desensitization technology and broaden its application scope, make rational use of personal information and appropriately develop its commercial use to increase its utilization efficiency.

Constructing an evaluation system for hierarchical management of clinical nurse in top three hospitals based on three-dimensional structure theory of medical quality / 中国实用护理杂志

Objective:To provide a reference for the hierarchical management of clinical nurses in top three hospitals, the hierarchical management evaluation system was conducted and evaluated in the present study.Methods:On the context of three-dimensional structure theory of medical quality, the Delphi method was applied to conduct two rounds of correspondence consultation among 23 nursing experts, and then related indexes were established based on the evaluation results and recommendations.Results:An evaluation system for hierarchical management of clinical nurse in top three hospitals was finally constructed, which included 3 first-grade and 19 second-grade indexes. The effective recovery rate of the two rounds of expert questionnaires and authority Cr of two rounds of expert consultation were 100% and 0.915, respectively. The Kendall coefficients of concordance for significance and operability of the first-grade and second-grade indexes were 0.353/0.515 and 0.344/0.469, respectively ( P<0.01). Conclusions:The hierarchical management of clinical nurses in top three hospitals constructed based on three-dimensional structure theory has reliability and feasibility.

Effect of nurses' hierarchical management on nurses' professional life quality, nursing quality and nursing risk in emergency department / 中国实用护理杂志

Objective:To explore the impact of nurses' hierarchical management on nurses' professional life quality, nursing quality and nursing risk in emergency department.Methods:A total of 40 nurses who were on duty in the Emergency Department of Tangshan Gongren Hospital from February 2018 to May 2020 were selected for the study. Our hospital performed routine management of emergency department nurses from February 2018 to February 2019. After a 3-month wash-out period, nurses were managed hierarchically from May 2019 to May 2020. According to the practical experience and educational background of nurses, they were divided into 5 levels, namely N0 level assistant nurse ( n=12), N1 level registered nurse ( n=9), N2 level responsible nurse ( n=10), N3 level specialist nurse ( n=5), N4 expert level ( n=4). Before and after the hierarchical management of nurses in the emergency department, the Quality of Nursing Work Life (QNWL) scale was used to evaluate the nurse′s quality of life, and the nursing quality was assessed by the Nursing Service Quality Questionnaire. Analyze the incidence of errors in the nursing process to assess the nursing risk. Results:The scores of work environment, work family balance, social environment, workload score and QNWL total score before the implementation of hierarchical management were 46.33 ± 8.52, 30.01 ± 6.07, 21.45 ± 4.60, 94.52 ± 8.06, 192.31 ± 12.46, respectively. After implementation, the scores were 51.29 ± 4.75,34.62 ± 4.68, 25.89 ± 3.58, 109.43 ± 6.15 and 221.23 ± 10.03, respectively. The scores after implementation were higher than those before ( t value was 3.216-11.435, P<0.05). The scores of human resource allocation, ward management, operating procedures, basic nursing, nurse training, nursing efficiency, nursing record writing, and first-aid goods management were 84.29 ± 9.75, 80.39 ± 12.46, 83.02 ± 5.63, 80.93 ± 9.84, 87.14 ± 6.12, 85.91 ± 8.46, 88.20 ± 6.76 and 83.51 ± 7.18, respectively. After the implementation, the scores were 92.38 ± 4.66, 94.67 ± 3.89, 91.25 ± 6.37, 94.78 ± 3.56, 95.01 ± 3.78, 93.81 ± 4.11, 95.13 ± 3.07, 93.57 ± 4.62, respectively. The scores after implementation were higher than those before ( t value was 4.735-8.371, P<0.05). After the implementation of nurses' hierarchical management, the nursing error rate was 4.44% (8/180), which was significantly lower than 10.00% (18/180) before implementation ( χ2 value was 4.146, P<0.05). Conclusions:The application of hierarchical management of nurses in emergency department can improve nurses' professional life quality, improve nursing quality, and reduce the incidence of nursing errors. It is worthy of popularization and application in emergency department.

Preliminary application of optimized hierarchical management model for nurses based on advanced professional competence system / 中华医学教育探索杂志

Objective To investigate the clinical application effect of the optimized hierarchical management model based on the advanced system of nursing professional competence.Methods A total of 500 nurses from 5 secondary or tertiary hospitals in Dazu district of Chongqing were selected and randomly divided into intervention group and control group,with 250 nurses in each group.The traditional management model was adopted for the control group,and the optimized hierarchical management model based on the advanced professional competence system was adopted for the intervention group.The two groups were compared in terms of nursing ability,clinical work quality,and incidence rate of adverse events.All the data were analyzed by SPSS 23.0,Chi-square test and t test were used for statistical analysis.Results There were no significant differences in age,sex,marital status,professional title,and working years between the two groups (P＞0.05).The baseline data were consistent and comparable.Compared with the control group,the intervention group had significantly higher scores of nursing ability [(82.30 ± 3.83) vs.(72.78 ± 5.33)] and nursing quality [(97.53 ± 9.71) vs.(90.17 ± 8.18)].The intervention group had a significantly lower incidence rate of adverse events than the control group [(0.9％ vs.3.9％),P＜0.05].Conclusion The optimized hierarchical management model for nursing staff based on the advanced professional competence system can improve the professional competence and clinical nursing quality of nursing staff,reduce the incidence rate of adverse events,and provide a reference for improving the level of nursing management.

Research progress on hierarchical management of diabetes / 中国实用护理杂志

In the past 40 years, the prevalence of diabetes in China has been increasing year by year. The prevention and treatment of diabetes were very arduous. Hierarchical management is not only a major mode of chronic disease management in China, but also a research trend in recent years. The study reviewed the status of hierarchical management of diabetes including tertiary prevention, grading diagnosis and treatment, community grading intervention, diabetic foot ulcer and cardiovascular disease risk grading and management. And summarized the grading management indicators, methods, effects, existing problems and improvement measures. In order to provide a new direction for the development of diabetes management.

Research progress on hierarchical management of diabetes / 中国实用护理杂志

In the past 40 years, the prevalence of diabetes in China has been increasing year by year. The prevention and treatment of diabetes were very arduous. Hierarchical management is not only a major mode of chronic disease management in China, but also a research trend in recent years. The study reviewed the status of hierarchical management of diabetes including tertiary prevention, grading diagnosis and treatment, community grading intervention, diabetic foot ulcer and cardiovascular disease risk grading and management. And summarized the grading management indicators, methods, effects, existing problems and improvement measures. In order to provide a new direction for the development of diabetes management.

Comparison of hierarchical management core competence training of ICU nurses in China and England / 中国实用护理杂志

ICU nursing is a vitalpartof the development of specialized nursing in China, and the standardized training of the corecompetence of ICU nurses is the primary goal of the development of ICU nursing. This paper took the First Affiliated Hospital of Sun Yat-sen University in China and the Royal Free Hospital in London, the United Kingdom as example, and compared the hierarchical management and core competencies training status of ICU nurses in China and England to find out the similarities and differences, and then to put forward valuable suggestions for hierarchical management and the core competence training of ICU nurses in China.

The research progress of nurses hierarchical management / 中国实用护理杂志

In order to improve the utilization efficiency of nursing human resources, stable nursing troop and enhance the quality of care, at present, the post management experiences for nurses of domestic and international are adopted by many hospitals and certain results are achieved. Study about nurses stratified management is reviewed, the approach, basis, effects, features and the advantages and disadvantages of hierarchical management experiences for nurses in different countries and regions is summarized and some thinking and prospect in studying is proposed in this article, as well as the follow-up research, to explore a constructive policy of further promoting the development of the level management for nurses.

Integrating Post-Abortion family planning services into existing abortion services in hospital settings in China (INPAC) Project Management Characteristics / 中华医学科研管理杂志

Integrating Post-Abortion family planning services into existing abortion services in hospital settings in China (INPAC) Project under European Union Framework 7 is an international cooperative study underwent by 7 Sino-European research institutions and non-profit organizations.By learning experiences and integrating the methods of tree-like hierarchical management, whole process management and fine management, the Chinese Medical Association explored a characteristic management method of international cooperative study suitable for non-profit organization, which effectively facilitated project management and financial management and stimulated the disciplinary development and talents building.

Application of hierarchical management for psychiatric nursing in psychiatric ward / 中国实用护理杂志

Objective To know the effects of using hierarchical management for psychiatric nursing in psychiatric ward,and then to offer some rationales and theoretical support for hospital management.Methods The fine hierarchical management was implemented from Janurary 2012 in Xi'an Mental Health Center and the metal hygiene clinics of Xi'an Jiaotong University.Before and after the hierarchical management carried out,the nursing care quality was assessed among the family members of hospitalized patients by using satisfaction survey questionnaires,flight rate of patients was evaluated,and at the same time,nursing care quality and the nurse comprehensive ability was inspected.And then,the EPIDATE 3.0 and SPSS16.0 software was used to analyze and compare the satisfaction scores.The nurse comprehensive ability,and nursing care quality scores before and after implementation.Results The nurse comprehensive ability were improved.The satisfaction scores of family members of hospitalized patients was higher than that before implementation after the fine management implementation,which had statistical difference,P＜ 0.05.The satisfaction rate of patients' family member was 96.77％(2 543/2 628) after the fine management implementation,which was significant higher than that of before implementation,91.19％(2 382/2 612),x2=107.66,P＜0.05.Flight rate of patients was reduced after the hierarchical management,which was significantly lower than that of in before,P＜0.05.Nursing care quality scores were higher than those of in before,which has a statistical difference respectively,P＜0.05.Conclusions The hierarchical management could improve the satisfaction of family numbers,reduce the flight rate of patients,enhance nursing care quality and improve the nurse comprehensive ability.It would reduce the incidence of medical malpractice.The fine hierarchical management is worth to be applied and generalized in nursing care of psychiatric nursing in psychiatric ward.

The application of medical coordination and hierarchical responsibility system in interventional ward nursing / 介入放射学杂志

Objective To discuss the clinical application of medical coordination and hierarchical responsibility system in interventional nursing care which is carried out based on the “Henan Province Model”. Methods From November 2003 to April 2014 at authors’ hospital, medical coordination and hierarchical responsibility system was executed through setting up a ranking system of nursing position , optimizing shift process , dividing physician-nurse medical liability groups , strengthening medical training , implementing medical coordination service mode, etc. The clinical results were compared with those of conventional nursing care that were recorded during the period from May to Oct. of 2013. Results After implementation of medical coordination and hierarchical responsibility system, the quality of medical care, the patent’s satisfaction, the cooperation satisfaction of physicians and nurses were significantly improved. Compared with those before implementation of medical coordination and hierarchical responsibility system , the differences in the above indexes were statistically significant(P<0.01 or P<0.05). Conclusion Based on multidisciplinary joint diagnosis and treatment, and combined with coordination physician-nurse service mode, the enthusiasm of nursing staff can be motivated and the tacit understanding between physicians and nurses as well as the quality of nursing service can be improved. All of the above will promote the development of nursing discipline.

Research on the application effect of hierarchical management in medical care / 中国医学装备

Objective:To study the application effect of hierarchical management in medical care. Methods:A retrospective analysis about sixty-eight patients were taken hierarchical management methods in nursing work from February 2009 to February 2010. Results:The quality of nursing and patients nursing satisfaction were obviously higher than before the management layer in 68 patients,, the result is significant difference(t=3.02,t=3.69;P<0.05). Conclusion: The hierarchical management method not only can effectively improve the quality of nursing, but also greatly improve the patient care satisfaction and the clinical application and popularization.

Application of nursing hierarchical management model in modern hospital / 中国实用护理杂志

[Objective] To investigate the application effects of nursing hierarchical management model in modern hospital.[Methods] By using the “quality nursing demonstration project”activities launched by the hospital as an opportunity,the nursing shift reform in the emergency department was carried out from March 2011,the hierarchical management of group nursing model was implemented.The management effect was observed.[Results] After nursing hierarchical management,nursing knowledge,nursing attitude scores of 14 nurses were higher than before.Assessment indicators of quality of nursing were improved,the sense of competition,service and responsibility of nurses were enhanced.[Conclusions] Nursing hierarchical management model in the modern hospital includes workforce management,responsibilities management and assessmcnt management.It can improve nursing knowledge and attitudes,enhance the sense of competition,service and sense of responsibility of nurses,which should be widely apphed.