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Objective:To explore the teaching effect of standardized training physicians in department of hematology through the tutor responsibility system combined with case-based learning (CBL teaching method), and to provide new ideas for the formulation of the teaching plan of standardized training physicians in the future.Methods:A total of 52 residents trained in the Department of Hematology, The First Affiliated Hospital of Army Medical University from January to December 2017 were selected in the study. And they were randomly divided into observation group and control group, with 26 cases in each group. The control group received the CBL teaching method, and the observation group received the tutor responsibility system combined with the CBL teaching method, both of which were taught for 3 years. Our hospital's self-made assessment form was used to assess the operating skills, theoretical knowledge and teaching quality of the two groups' residents before and after 3 years of teaching. SPSS 24.0 was used for t test and chi-square test. Results:After 3 years of teaching, the scores of bone marrow aspiration, bone marrow biopsy, lumbar puncture, and intrathecal injection, the basic theories of specialists, standardized diagnosis and treatment of common diseases, analysis of difficult cases, and rescue scores of critically ill patients, the scores of medical knowledge, clinical thinking, professional ethics, doctor-patient communication, theoretical connection with practice of both groups were all increased than before teaching ( P<0.05), and the above scores of the observation group were higher than those of the control group, with statistical differences ( P<0.05). Conclusion:The tutor responsibility system combined with CBL teaching method is conducive to improving the training effect and teaching quality of hematology.
RESUMO
Objective:To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with health education in the treatment of refractory depression and its effects on cognitive function and sleep quality.Methods:Ninety patients with refractory depression who received treatment in Hangzhou Seventh People's Hospital from January 2018 to January 2021 were included in this study. They were randomly assigned to receive either rTMS (control group, n = 45) or rTMS combined with health education (observation group, n = 45). All patients received 4 weeks of treatment. Clinical efficacy, the scores of the Clinical Global Impressions (CGI) Scale and the Hamilton Rating Scale for Depression (HAMD), cognitive function, sleep quality, and quality of life pre- and post-intervention were compared between the two groups. Results:Total response rate was significantly higher in the observation group than in the control group [91.11% (41/45) vs. 71.11% (32/45), χ2 = 5.87, P < 0.05]. CGI scores post-intervention were significantly higher in the observation group than in the control group [(45.23 ± 7.89) points vs. (27.64 ± 4.53) points, t = 12.97, P < 0.05]. HAMD scores were significantly lower in the observation group than in the control group [(16.32 ± 2.76) points vs. (21.86 ± 3.98) points, t = 7.67, P < 0.05]. The number of categories achieved and the number of correct responses post-intervention in the observation group were (3.83 ± 0.61) and (85.45 ± 7.87), respectively, which were significantly higher than those in the control group [(2.98 ± 0.37), (73.25 ± 6.12), t = 7.99, 8.20, both P < 0.05]. The number of perseverative errors post-intervention in the observation group was significantly lower than that in the control group [(32.02 ± 1.89) vs. (35.12 ± 2.09), t = 7.38, P < 0.05]. The Pittsburgh Sleep Quality Index post-intervention was significantly lower in the observation group than in the control group [(9.84 ± 1.56) points vs. (12.32 ± 1.62) points, t = 7.39, P < 0.05). The scores of social function, material well-being, physical function, and psychological function post-intervention in the observation group were (59.98 ± 5.31) points, (34.23 ± 4.12) points, (56.87 ± 5.32) points, and (47.28 ± 5.65) points, which were significantly higher than those in the control group [(45.23 ± 6.57) points, (27.98 ± 2.65) points, (43.24 ± 4.53) points, (36.21 ± 4.12) points, t = 11.71, 8.55, 13.08, 10.62, all P < 0.05]. Conclusion:rTMS combined with health education is highly effective on refractory depression. The combined therapy can improve cognitive function and sleep quality and is of great innovation and science.
RESUMO
Health institutions, particularly hospitals, are characterized as complex structures that need managers with a global view of the institution and its relations with the external environment. The hospital pharmacy is a strategic unit, which cooperates with the institutional management and integrates the multiprofessional team in the process related to the acquisition, provision and control of essential inputs for the inpatient care process. The objective in this study is to demonstrate the applicability, in the context of hospital-based health, of a performance measuring system at the pharmacy. Method: A descriptive and longitudinal study was undertaken on the evolution of the key indicator Absence Rate of Standardized Drugs in inpatient care between March 2004 and December 2013. This indicator was employed to monitor the impact of changes the Pharmacy Division has been implementing, as the first step of the pharmaceutical care cycle in the model of the process-based managed approach at a public university hospital. Qualitative data collection methods were used, including observation and documentary analysis, as well as quantitative data collection. Results: After the application of the model, one point of change in the key performance indicator was detected in the tenth month, when the process-based management model was implemented at the pharmacy. Conclusions: The process-based management approach was effective for the hospital pharmacy. The premise adopted is that the administrative changes (interferences), focused on the improvement of the processes and the selection and monitoring of indicators, influence the processes, reducing the variability and improving the quality (AU)
As instituições de saúde, especialmente hospitais, são caracterizadas como estruturas complexas que precisam de administradores com uma visão global da instituição e de suas relações com o ambiente externo. A farmácia hospitalar é uma unidade estratégica, que colabora com a administração institucional e integra a equipe multiprofissional no processo que tange a aquisição, provisão e controle de insumos essenciais para o processo do atendimento do paciente internado. Este estudo tem como objetivo demonstrar a aplicabilidade, no contexto da saúde hospitalar, de um sistema de medição de desempenho da farmácia. Método: Trata-se de um estudo descritivo, longitudinal, sobre a evolução do indicador chave Taxa de Falta de Medicamentos Padronizados na assistência do paciente internado, no período de março de 2004 a dezembro de 2013. Esse indicador foi empregado para monitoramento do impacto de mudanças que a Divisão de Farmácia vem implementando, como primeira etapa do ciclo de assistência farmacêutica dentro do modelo da abordagem de gestão por processos, em um hospital público universitário. Foram usados métodos de coleta de dados qualitativos, incluindo a observação e análise documental, bem como coleta de dados quantitativos. Resultados: Após a aplicação do modelo, um ponto de mudança no indicador chave de desempenho, foi detectado no 10º mês, quando o modelo de gestão baseado em processo foi implementado na farmácia. Conclusões: A abordagem de gestão baseada em processos foi eficaz para a farmácia hospitalar. A premissa adotada é que as mudanças administrativas (interferências), com foco na melhoria dos processos e seleção e acompanhamento de indicadores, têm influencia sobre os processos, reduzindo a variabilidade e melhoria da qualidade (AU)