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Objective To explore the effects of target value management for quality control indexes in chest pain center on the efficiency and effectiveness of in-hospital treatment for STEMI patients.Methods The database of Chest Pain Center in General Hospital of Guangzhou Military Command was retrospectively analyzed.STEMI patients who visited our hospital from March 2011 to March 2018 were selected as the research subjects.During the review period,the target values of quality control indexes were adjusted 4 times.Before and after the 4 adjustment,the efficiency indexes of in-hospital treatment STEMI patients were compared,including the first medical contact to the first electrocardiogram (FMC2ECG) time,catheter lab activation time and Door-to-Balloon (D2B) time.Length of hospital stay,in-hospital mortality and hospitalization cost were compared as well.Results A total of 332 STEMI patients were included in the study.As the quality control target values became stricter,the median and the average value of FMC2ECG time,catheter lab activation time and D2B time showed a downward trend.Among these data,the D2B time decreased from 95 (74,134.5) min to 50 (44.5,71) min,and its differences were of the most significance.However,there is no significant difference in the hospitalization cost,length of hospital stay and in-hospital mortality of STEMI patients.Conclusions The target value management of quality control indexes can improve the in-hospital treatment efficiency for STEMI patients,but the improvements of treatment efficiency and effectiveness cannot be immediately revealed.It takes a certain amount of time and needs enough cases to reach a significant difference.
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Objective To explore the nursing cooperation ofpre-hospital emergency trauma and hospital treatment intelligent network operation system seamless docking. Methods 56 cases of traumatic patients had surgical treatment in the hospital from July 1,2016 to November 30,2016 had pre-hospital emergency trauma hospital treatment intelligent network operation system (TPEITS) applied in emergency saving, at the same time of pre-hospital first aid, by CT and ultrasound B checking hospital appointments was finished with TPEITS system to open checking green channel and shorten the checking waiting time of patients. When the booking checking, operating room and emergency personnel appointment was finished through TPEITS system, open the green channel of the surgery, shorten the surgery patients waiting time,and in pre-hospital and hospital emergency care coordination were applied. Effective treatment time (patients disease onset to surgery time), rescue success rate, length of hospital stay and patients′satisfaction of the patients were statistically analyzed.And 32 cases of emergency trauma patients had normal pre-hospital emergency, hospital surgical treatment and nursing from February 1, 2016 to June 30,2016 were taken as control group.TPEITS system and regular pattern effective treatment time, rescue success rate, length of hospital stay and patients′ satisfaction, etc were compared. Results Effective treatment time and hospital stay of TPEITS system were(42.26±5.47)min and(36.45±9.85)d respectively,which were shorter than the(78.53±16.78)min and(48.28±12.55)d of regular pattern.And rescue success rate and patients′satisfaction of TPEITS system were 94.64%(53/56)and 92.86%(52/56) respectively,which were higher than the 75.00%(24/32)and 68.75%(22/32)of regular pattern(x2=5.500, 8.846, P<0.05). Conclusions Pre- hospital emergency trauma combined with hospital treatment intelligent network operation system seamless docking with good nursing can shorten the emergency response time, shorten the operation prepare time, improve the rescue effect and patient satisfaction,therefore,it worth clinical promotion.
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OBJECTIVES: The purpose of this study was to investigate the effectiveness of a day-hospital treatment program designed to help development of children with pervasive developmental disorder (PDD) and mental retardation (MR). METHODS: Retrospective review of the charts of 32 children (28 with PDD, 4 with MR), who participated in a day-hospital treatment program of Seoul Metropolitan Eunpyeong Hospital, from October 2008 to February 2012, was conducted. Development level of each patient was evaluated according to the Psycho-Educational Profile-Revised (PEP-R), Social Maturity Scale (SMS), and Childhood Autism Rating Scale (CARS). Evaluation was done at two points, before participation and after 1 year participation. RESULTS: Children who participated in the day-hospital treatment program showed significant improvement in all categories of PEP-R, SMS, and CARS. CONCLUSION: Day-hospital treatment program is effective for helping development of children with PDD and MR.
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Criança , Humanos , Transtorno Autístico , Deficiência Intelectual , Estudos Retrospectivos , SeulRESUMO
Objective To explore the risk factors related to death in patients with acute myocardial infarction(AMI) in hospital,so as to guide clinical treatment to reduce the occurrence of death.Methods Two hundred and seventy cases with AMI who got in infarction within 24 h were studied in the Cardiology Departmentof Zhongnan Hospital of Wuhan University from Jan.2010 and Jun.2013.The patients were divided into the death group(n =32) and the cured group(n =232) according to the endpoint in hospital.The clinical information was recorded and multiple factors logistic regression analysis was applied to analyze the risk factors of death due to AMI.Results The age,serum creatinine(Cr) in both groups were ((65.21 ± 13.55) years old,(76.41 ±10.19) years old) and ((100.23 ±65.99) μmol/L,(139.22 ±92.03) μmol/L) and there were statistically significant differences (P ＜ 0.05).The differences of other indicators in two groups were no statistically significant.Clinical data comparison between the two groups showed that incidence rate of arrhythmia (14.7％),the disease rate of anterior descending coronary artery (50.4％),the disease rate of circumflex branch coronary artery (48.7％),the level of high sensitivity C reactionprotein (hs-CRP) ((5.92 ± 4.41) mg/L),brain natriuretic peptide (BNP) ((844.89 ± 1108.41) ng/L) and creatine kinase-MB (CK-MB) ((87.99 ± 140.45)U/L) in death group were lower than those in cured group (31.3％,81.3％,68.8％,(10.82 ± 2.29) mg/L,(1210.57 ± 984.44) ng/L,(161.86 ± 214.75) U/L; P ＜ 0.05).Multiple factors logistic regression analysis showed that elder age (OR =1.078,95 ％ CI:1.014-1.118,P =0.015),arrhythmia occurred or not in hospital (OR =1.636,95％ CI:1.151-3.041,P =0.024),the pathological changes of anterior descending coronary artery (OR =1.428,95 ％ CI:1.143-2.437,P =0.018),the level of hs-CRP (OR =1.352,95％ CI:1.137-1.607,P =0.001) were the independent risk factors for myocardial infarction patients' death.Conclusion Elder age,arrhythmia occurred in hospital,the pathological changes of anterior descending coronary artery,the high level of hs-CRP are the independent risk factors for AMI patients death.Relevant measures in the treatment should be taken to reduce their risk of death.