Effect analysis of applying high-quality service model to surgical nursing.

BACKGROUND: Surgical care of the hand plays a crucial role in the medical field, as problems with the hand can profoundly affect a patient's quality of life and function. In order to meet the needs of patients, improve patient satisfaction and improve treatment outcomes, high-quality service models have been introduced in the field of nursing. AIM: To explore the effect analysis of applying high-quality service model to surgical nursing. METHODS: We conducted a retrospective study of patients who underwent hand surgery at our hospital between 2019 and 2022, using a quality service model that included improved patient education, pain management, care team collaboration, and effective communication. Another group of patients received traditional care as a control group. We compared postoperative recovery, satisfaction, complication rate, and length of hospital stay between the two groups. Inferential statistics were used to compare the difference between the two groups by independent sample t test, Chi-square test and other methods to evaluate the effect of intervention measures. RESULTS: Postoperative recovery time decreased from 17.8 ± 2.3 d to 14.5 ± 2.1 d, pain score decreased from 4.7 ± 1.9 to 3.2 ± 1.4, and hand function score increased from 78.4 ± 7.1 to 88.5 ± 6.2. In terms of patient satisfaction, the quality service model group scored 87.3 ± 5.6 points, which was significantly higher than that of the traditional care group (74.6 ± 6.3 points). At the same time, patients' understanding of medical information also improved from 6.9 ± 1.4 to 8.6 ± 1.2. In terms of postoperative complications, the application of the quality service model reduced the incidence of postoperative complications from 26% to 10%, the incidence of infection from 12% to 5%, and the incidence of bleeding from 10% to 3%. The reduction in these data indicates that the quality service model plays a positive role in reducing the risk of complications. In addition, the average hospital stay of patients in the quality service model group was shortened from 6.8 ± 1.5 d to 5.2 ± 1.3 d, and the hospitalization cost was also reduced from 2800 ± 600 yuan to 2500 ± 500 yuan. CONCLUSION: Applying a quality service model to hand surgery care can significantly improve patient clinical outcomes, including faster recovery, less pain, greater satisfaction, and reduced complication rates.

Proactive review for people with diabetes in hospital: a cluster randomised feasibility trial with process evaluation, protocol V3.1.

BACKGROUND: Diabetes inpatient specialist services vary across the country, with limited evidence to guide service delivery. Currently, referrals to diabetes inpatient specialists are usually 'reactive' after diabetes-related events have taken place, which are associated with an increased risk of morbidity/mortality and increased length of hospital stay. We propose that a proactive diabetes review model of care, delivered by diabetes inpatient specialist nurses, may contribute to the prevention of such diabetes-related events and result in a reduction in the risk of harm. METHOD: We will conduct a cluster randomised feasibility study with process evaluation. The proactive diabetes review model (PDRM) is a complex intervention that focuses on the prevention of potentially modifiable diabetes-related harms. All eligible patients will receive a comprehensive, structured diabetes review that aims to identify and prevent potentially modifiable diabetes-related harms through utilising a standardised review structure. Reviews are undertaken by a diabetes inpatient specialist nurse within one working day of admission. This differs from usual care where patients are often only seen after diabetes-related harms have taken place. The trial duration will be approximately 32 weeks, with intervention delivery throughout. There will be an initial 8-week run-in phase, followed by a 24-week data collection phase. Eight wards will be equally randomised to either PDRM or usual care. Adult patients with a known diagnosis of diabetes admitted to an included ward will be eligible. Data collection will be limited to that typically collected as part of usual care. Data collected will include descriptive data at both the ward and patient level and glucose measures, such as frequency and results of capillary glucose testing, ketonaemia and hypoglycaemic events. The analysis aims to determine the fidelity and acceptability of the intervention and the feasibility of a future definitive trial. Whilst this study is primarily about trial feasibility, the findings of the process evaluation may lead to changes to both trial processes and modifications to the intervention. A qualitative process evaluation will be conducted in parallel to the trial. A minimum of 22 patients, nurses, doctors, and managers will be recruited with methods including direct non-participant observation and semi-structured interviews. The feasibility of a future definitive trial will be assessed by evaluating recruitment and randomisation processes, staffing resources and quality of available data. DISCUSSION: The aim of this cluster randomised feasibility trial with a process evaluation is to explore the feasibility of a definitive trial and identify appropriate outcome measures. If a trial is feasible and the effectiveness of PDRM can be evaluated, this could inform the future development of inpatient diabetes services nationally. TRIAL REGISTRATION: UK Clinical Research Network, 51,167. ISRCTN, ISRCTN70402110. Registered on 21 February 2022.

Collaborative model of care between orthopaedics and allied healthcare professionals (CONNACT) in knee osteoarthritis: Effectiveness-implementation hybrid randomized controlled trial of a community-based, multidisciplinary, stratified intervention.

OBJECTIVE: To compare the clinical and cost effectiveness of the Collaborative Model of Care between Orthopaedics and Allied Healthcare Professionals (CONNACT), a community-based, stratified, multidisciplinary intervention consisting of exercise, education, psychological and nutrition delivered through a chronic care model to usual hospital care in adults with knee osteoarthritis (OA). METHODS: Pragmatic, parallel-arm, single-blinded superiority RCT trial. Community-dwelling, ambulant adults with knee OA (Kellgren-Lawrence grade > 1; Knee Injury and OA Outcome Score (KOOS4) ≤75) were enrolled. Primary outcome was KOOS4 at 12-months; secondary outcomes included: quality of life, physical performance measures, symptom satisfaction, psychological outcomes, dietary habits, and global perceived effect. Intention-to-treat analysis using generalized linear model (GLM) and regression modeling were conducted. Economic evaluation through a societal approach was embedded. RESULTS: 110 participants (55 control, 55 intervention) were randomized. No between-group difference found for the primary outcome (MD [95%CI]: -1.86 [-9.11. 5.38]), although both groups demonstrated within-group improvement over 12-months. Among the secondary outcomes, the CONNACT group demonstrated superior dietary change (12 months) and physical performance measures (3 months), and global perceived effect (6 months). While there was no between-group difference in total cost, significant productivity gains (reduced indirect cost) were seen in the CONNACT group. CONCLUSION: CONNACT was not superior to usual care at 1 year. Further efforts are needed to understand the underlying contextual and implementation factors in order to further improve and refine such community-based, stratified care models moving forward. TRIAL REGISTRATION: Clinicaltrials.gov Identifier: NCT03809975. Registered January 18, 2019. https://clinicaltrials.gov/ct2/show/NCT03809975.

A pre-post study design: evaluating the effectiveness of a new community-based integrated service model on patient outcomes.

This study aimed to evaluate a new service model, Specialists Together In the Community (STIC), in terms of patient outcomes. This model integrates Flexible Assertive Community Treatment (FACT)-principles with expertise of specialized teams that offer diagnosis-related outpatient treatment. In a pre-post design, symptoms and quality of life of 930 former FACT-patients were measured repeatedly pre- and post-STIC. Regarding patients in former specialized teams, pre- and post-treatment social functioning and symptoms were measured for the pre- (n = 944) and post-STIC (n = 544) groups. Against expectation, symptoms of former FACT-patients remained stable post-STIC compared to a slight decrease pre-STIC. According to expectation, pre- and post-STIC groups had an equal symptom reduction. Unexpectedly, the post-STIC group did not improve more on social functioning than the pre-STIC group. Explorative analysis showed less treatment contacts in the post-STIC group. The highly similar patient outcomes post-STIC could be improved by monitoring process outcomes and prolonging study duration.

Service design for children and young people with common mental health problems: literature review, service mapping and collective case study.

Background: The mental health of children/young people is a growing concern internationally. Numerous reports and reviews have consistently described United Kingdom children's mental health services as fragmented, variable, inaccessible and lacking an evidence base. Little is known about the effectiveness of, and implementation complexities associated with, service models for children/young people experiencing 'common' mental health problems like anxiety, depression, attention deficit hyperactivity disorder and self-harm. Aim: To develop a model for high-quality service design for children/young people experiencing common mental health problems by identifying available services, barriers and enablers to access, and the effectiveness, cost effectiveness and acceptability of such services. Design: Evidence syntheses with primary research, using a sequential, mixed-methods design. Inter-related scoping and integrative reviews were conducted alongside a map of relevant services across England and Wales, followed by a collective case study of English and Welsh services. Setting: Global (systematic reviews); England and Wales (service map; case study). Data sources: Literature reviews: relevant bibliographic databases and grey literature. Service map: online survey and offline desk research. Case study: 108 participants (41 children/young people, 26 parents, 41 staff) across nine case study sites. Methods: A single literature search informed both reviews. The service map was obtained from an online survey and internet searches. Case study sites were sampled from the service map; because of coronavirus disease 2019, case study data were collected remotely. 'Young co-researchers' assisted with case study data collection. The integrative review and case study data were synthesised using the 'weaving' approach of 'integration through narrative'. Results: A service model typology was derived from the scoping review. The integrative review found effectiveness evidence for collaborative care, outreach approaches, brief intervention services and the 'availability, responsiveness and continuity' framework. There was cost-effectiveness evidence only for collaborative care. No service model appeared to be more acceptable than others. The service map identified 154 English and Welsh services. Three themes emerged from the case study data: 'pathways to support'; 'service engagement'; and 'learning and understanding'. The integrative review and case study data were synthesised into a coproduced model of high-quality service provision for children/young people experiencing common mental health problems. Limitations: Defining 'service model' was a challenge. Some service initiatives were too new to have filtered through into the literature or service map. Coronavirus disease 2019 brought about a surge in remote/digital services which were under-represented in the literature. A dearth of relevant studies meant few cost-effectiveness conclusions could be drawn. Conclusions: There was no strong evidence to suggest any existing service model was better than another. Instead, we developed a coproduced, evidence-based model that incorporates the fundamental components necessary for high-quality children's mental health services and which has utility for policy, practice and research. Future work: Future work should focus on: the potential of our model to assist in designing, delivering and auditing children's mental health services; reasons for non-engagement in services; the cost effectiveness of different approaches in children's mental health; the advantages/disadvantages of digital/remote platforms in delivering services; understanding how and what the statutory sector might learn from the non-statutory sector regarding choice, personalisation and flexibility. Study registration: This study is registered as PROSPERO CRD42018106219. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 17/09/08) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 13. See the NIHR Funding and Awards website for further award information.

In this research study, we explored services for children and young people with 'common' mental health problems like depression, anxiety and self-harm. We aimed to find out what services exist, how children/young people and families find out about and access these services, what the services actually do, whether they are helpful and whether they offer value for money. We looked at the international literature (reports and research papers) to identify different approaches to providing support, and to find out whether certain approaches worked better than others and whether children/young people and families preferred some approaches over others. The literature provided very little information about the value for money of services. We also carried out a survey and used the internet to identify 154 relevant services in England and Wales. To explore services in more detail, and hear directly from those using them, we planned to visit 9 of the 154 services to interview children/young people, parents and staff. Unfortunately, coronavirus disease 2019 stopped us directly visiting the nine services and so we conducted phone and video interviews instead. We still managed to speak to, and hear the experiences of, more than 100 people (including children/young people and parents). We combined information from the literature with information from the interviews to create an evidence-based 'model' of what services should look like. This model considers some basic things like how quickly children/young people could access a service, what information was available, the importance of confidentiality and whether staff make the service fit with the child/young person's needs and interests. It also considers whether the service helps children/young people learn skills to manage their mental health and whether staff at a service work well together. We hope our model will help existing and new services improve what they offer to children/young people and families.

Shifting Responsibilities: Developing a Pan-European Service Model for an eHealth Technology Supporting Self-Management of People with Chronic Obstructive Pulmonary Disease and Comorbidities.

Introduction: Active participation of patients in their care via self-management is an important pillar to manage chronic conditions. Self-management education and continuous support are needed to improve patients' confidence to take such active role. One way to do this is through eHealth technologies. However, those technologies can only be successful when actively used in daily practice and when integrated in overall care. Therefore, this study investigated how a self-management eHealth technology could be implemented that emphasises the active role of patients in their care. Methods: The service modelling method was utilized as implementation strategy. The design process consisted of five phases with salient stakeholders and consortium members of a European project to develop the service model. Studies with salient stakeholders were carried out in three different countries (Italy, Estonia, the Netherlands). A combination between face-to-face and online methods facilitated the participatory design process. Results: Due to the pan-European context, different stakeholders in the three countries were identified. Research nurses and case managers were not yet established in practice but once implemented, expected to contribute to optimal implementation. During service modelling, a crucial step was revealed: providing self-management training before technology use to let patient familiarise with the concept of taking an active role. As HCPs felt that they were not necessarily equipped to guide patients in terms of self-management, they also should have access to such self-management training. Conclusion: By demonstrating a way for implementation while emphasising patients' active role, we also showed the complexity of the method in two ways. First, by demonstrating the fine line between the descriptive and prescriptive model. Thus, showcasing the need to recognize that prescriptive models may be hampered by the delay in changing work practices. Second, by highlighting the importance of identifying country-specific differences in the pan-European context, revealing that service modelling is not a one-size-fits-all approach.

Effect of Internet + continuous midwifery service model on psychological mood and pregnancy outcomes for women with high-risk pregnancies.

BACKGROUND: There are many drawbacks to the traditional midwifery service management model, which can no longer meet the needs of the new era. The Internet + continuous midwifery service management model extends maternal management from prenatal to postpartum, in-hospital to out-of-hospital, and offline to online, thereby improving maternal and infant outcomes. Applying the Internet + continuous midwifery service management model to manage women with high-risk pregnancies (HRP) can improve their psycho-emotional opinion and, in turn, minimize the risk of adverse maternal and/or fetal outcomes. AIM: To explore the effectiveness of a midwife-led Internet + continuous midwifery service model for women with HRP. METHODS: We retrospectively analyzed the clinical data of 439 women with HRP who underwent prenatal examination and delivered at Shanghai Sixth People's Hospital (affiliated to the Shanghai Jiao Tong University School of Medicine) from April to December 2022. Among them, 239 pregnant women underwent routine obstetric management, and 200 pregnant women underwent Internet + continuous midwifery service mode management. We used the State-Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale, and analysis of delivery outcomes to compare psychological mood and the incidence of adverse delivery outcomes between the two groups. RESULTS: The data showed that in early pregnancy, the anxiety and depression levels of the two groups were similar; the levels gradually decreased as pregnancy progressed, and the decrease in the continuous group was more significant [31.00 (29.00, 34.00) vs 34.00 (32.00, 37.00), 8.00 (6.00, 9.00) vs 12.00 (10.00, 13.00), P < 0.05]. The maternal self-efficacy level and strategy for weight gain management were better in the continuous group than in the traditional group, and the effective rate of midwifery service intervention in the continuous group was significantly higher than in the control group [267.50 (242.25, 284.75) vs 256.00 (233.00, 278.00), 74.00 (69.00, 78.00) vs 71.00 (63.00, 78.00), P < 0.05]. The incidence of adverse delivery outcomes in pregnant women and newborns and fear of maternal childbirth were lower in the continuous group than in the traditional group, and nursing satisfaction was higher [10.50% vs 18.83%, 8.50% vs 15.90%, 24.00% vs 42.68%, 89.50% vs 76.15%, P < 0.05]. CONCLUSION: The Internet + continuous midwifery service model promotes innovation through integration and is of great significance for improving and promoting maternal and child health in HRP.

Corrigendum: Construction of smart older adults care service model driven by primary health care.

[This corrects the article DOI: 10.3389/fpubh.2023.1157758.].

Bringing mental health to the frontlines: A proactive team-based model for healthcare workers during the COVID-19 pandemic.

OBJECTIVE: A novel team-based service was developed at the beginning of the pandemic in which sixty liaisons were assigned to provide proactive, tailored psychological support for healthcare workers (HCWs) across three of NewYork-Presbyterian's Weill Cornell affiliated hospitals. METHOD: The program took the proactive approach of bringing mental health awareness to every department and major division that interfaced with COVID-19 patients. Virtual and in-person team-based "town hall" meetings were offered to provide psychoeducation, facilitate discussion, foster adaptive coping and social cohesion, and identify employees who would benefit from further individualized support. RESULTS: The program's success was reflected in the number of town halls (1000+) and attendees (6000+) and in qualitative feedback from departments who requested ongoing services. CONCLUSIONS: This article presents the development, implementation, challenges, and opportunities in designing a team-based support model for HCWs. This model may be useful for organizations that seek to develop similar programs.

Green synthesis of novel biochar from Abelmoschus esculentus seeds for direct blue 86 dye removal: Characterization, RSM optimization, isotherms, kinetics, and fixed bed column studies.

The presence of Direct blue 86 dye (DB86) in water can lead to various health hazards to the humans and animals. The study explored efficacy of biochar derived from Abelmoschus Esculentus seeds (AESB) to remove DB86 from an aqueous solution. BET analysis of AESB delineated H4 classification with the predominance of micropores and mesopores spread throughout the surface. FTIR study demonstrated the presence of the alkyl (C-H), Alkene (C]C), Carbonyl (C]O) and O-H bond of the sulphonic group which helped in adsorption of DB86 molecules through various mechanisms i.e., pore filling, π-π interactions, and hydrogen bonding interactions. Response surface methodology (RSM) was used for designing the adsorption experiment and analysing the optimum operating parameters. Batch experiments demonstrated excellent adsorption capacity (277.04 mg/g) of AESB and was efficient in 98.06% removal of DB86 at optimal conditions i.e., dye conc. = 300 mg/L, dose = 2.5 g/L, pH = 2, time of 120 min. Adsorption followed nonlinear Sips model (R2 = 0.999) with an error (X2 = 0.13, RMSE = 0.83, MAPE 0.56 and MSRE = 0.0006). The kinetic analysis revealed intra-particle diffusion being the rate-determining step and followed nonlinear pseudo-first-order kinetics (R2 = 0.997). Thermodynamic study revealed that the adsorption of DB-86 proceeded spontaneously and exhibited endothermic characteristics, with the enthalpy change primarily governed by the physisorption mechanism. Thomas model revealed inverse relation of breakthrough and exhaustion time with flow while it was proportional to bed height. The sorption capacity (N0) (2.2493 mg/l min) and rate constant (Ka) (0.028 L/min. mg) of BDST model can accurately be used for predicting the performance of AESB in full scale column.

The Use of Extended Reality in Rehabilitation for Patients with Acquired Brain Injury: A Scoping Review.

BACKGROUND: Extended reality (XR) seems promising for rehabilitation for people with acquired brain injury in terms of reducing professional supervision, faster recovery, shorter hospital stays, and reduced expenses. Since there is no overview this scoping review describes how XR can be utilized in rehabilitation, particularly for people with acquired brain injury (ABI). METHODS: The Arksey and O'Malley framework and PRISMA-ScR reporting guideline were followed. Studies between 2010 and May 2022 screened from healthcare as well as technical databases were imported in RAYYAN. Three researchers selected relevant articles in three rounds based on title, abstract and full text. RESULTS: 75 articles were included in this scoping review. Most studies used VR as technology with therapy objectives in three main categories: cognitive, physical and diagnostic. The outcomes of the studies show potential and promising results of the use of XR, and enthusiasm with as well patients as professionals. A selection of four domains of the NASSS framework: condition, technology, value proposition and adopters were reported. Important lessons learned by the included studies are development of XR software, improvement of the hardware, improving feeling of safety and giving support to the patient, and support healthcare professionals for acceptance of XR. DISCUSSION: the use of XR for people with ABI has potential and is promising but not common practice yet. Future research should focus on implementation factors with a diverse and inclusive patient group using service modelling.

Evaluation of a new Perinatal Mental Health Service in a University Maternity Hospital.

OBJECTIVES: Specialist Perinatal Mental Health Services (SPMHS) are a new development in Ireland. This service evaluation examined the impact of the introduction of a SPMHS multidisciplinary team (MDT) on prescribing practices and treatment pathways in an Irish maternity hospital. METHODS: Clinical charts were reviewed to collect data on all referrals, diagnoses, pharmacological and non-pharmacological interventions delivered in a SPMHS over a 3-week period in 2019. The findings were compared to the same 3-week period in 2020 following the expansion of the SPMHS MDT. RESULTS: In 2019 (n = 32) and 2020 (n = 47), most (75 and 79%, respectively) assessments were antenatal. The proportion of patients prescribed psychotropic medication within the SPMHS was not significantly different from 2019 (31%) to 2020 (23%), though more patients were already prescribed psychotropic medications at the time of referral (22% in 2019 v. 36% in 2020). There was an increase in MDT interventions in 2020 with more input from psychology, clinical nurse specialist (CNS), and social work intervention. Adherence to prescribing standards improved from 2019 to 2020. CONCLUSION: Prescribing patterns remained unchanged between 2019 and 2020. Improvement was observed in adherence to prescribing standards and there was increased provision of MDT interventions in 2020. Broader diagnostic categories were also used in 2020, possibly suggesting that the service is now providing more individualized care.

Construction of smart older adults care service model driven by primary health care.

In recent years, with the arrival of an overall aging population, how to provide for the elderly has become the focus of government departments and society. The traditional elderly care service model has problems such as backward construction of information platforms, low quality of elderly care services, and "digital divide". For this reason, based on grassroots medical and health care, this paper improves the quality of elderly care services by establishing a smart elderly care service model. Through experiments, it can be found that compared with the traditional elderly care service model, the intelligent elderly care service model has an absolute advantage in the identification of nursing data. The recognition accuracy rate of the smart elderly care service model for all kinds of daily care data is above 94%, while the recognition accuracy rate of the traditional elderly care service model is below 90%. Therefore, it is of great significance to study the smart elderly care service model driven by primary medical care and health.

Enterprise-Based Participatory Action Research in the Development of a Basic Occupational Health Service Model in Thailand.

Various basic occupational health services (BOHS) are provided, particularly in-plant BOHS; however, it might be necessary to start expanding BOHS. The current study focuses on BOHS model development using participatory action research (PAR) at a large-sized enterprise in northeastern Thailand. The PAR began with a situation analysis using ILO Convention C161, problem and cause analysis, the development of an action plan, observation and action, evaluation, and replanning. The research tools included interviews, focus group discussions (FGDs), and participant observations. The participants included managers, human resource staff, safety officers, and workers. Both inductive and deductive thematic analyses were undertaken. The results showed that (1) education and learning experience led to the workers detecting work-related diseases early by themselves and the implementation of medical surveillance programs; (2) the workers' occupational health needs led to return-to-work assessments and first aid room system development; (3) the employer's experience led to appropriate fit-for-work examinations and emergency preparedness; and (4) the feedback from BOHS providers led to a hospital-to-in-plant return-to-work conversion. The study concluded that the enterprise could develop fit-for-work and return-to-work assessments as per the ILO Convention C161 under the policy; however, medical surveillance and the first aid room system need to be developed through counseling at the hospital's occupational medicine clinic.

Developing Specialist Perinatal Mental Health Services: the door of opportunity.

The development of Specialist Perinatal Mental Health Services in Ireland in recent years (2018-2021) is described. The paper highlights the role of unexpected opportunity in advancing this much needed service for women, infants and their families. It also emphasises the need for funding combined with an implementation mechanism to ensure that the service emerging is true to the Model of Care designed and is available in a uniform manner to women nationally.

Health management models of type 2 diabetes mellitus in domestic and foreign urban communities / 预防医学

Abstract@#Type 2 diabetes mellitus (T2DM) has become a worldwide epidemic, which poses a great threat to the global healthcare system. Based on review of publications pertaining to T2DM health management in urban communities, this article focuses on the health management models of T2DM in foreign urban communities, including insurance companies and medical institutions, self-management plans, community management, community and home hybrid services, artificial intelligence + big data management, social media and online community management, precision health management, and proposes suggestions for T2DM health management in Chinese urban communities based on currently available national management models, including increasing the standardization of the management level, improving the supporting facilities of professional talents, mobilizing social forces to support, improving the scientific and technological level of management tools, strengthening the advantages of traditional Chinese medicine and exploring novel personalized models, so as to provide insights into promoting the sustainable development of T2DM health management in Chinese urban communities.

Construction and implementation of the "Internet+nursing service" model based on the nurse-patient safety needs / 中国实用护理杂志

Objective:To explore the "Internet + nursing service" model based on the nurse-patient safety needs, and provide reference for development of "Internet + nursing service".Methods:The First Affiliated Hospital of Sun Yatsen University established a "Internet+ nursing service" management team in December 2019, developed an information platform, formulated and implemented a specific plan of the "Internet+ nursing service" model, including service objects, service projects and service modes. After the smooth operation of this model, the statistics of the nursing service projects and service times that had been carried out from September 2020 to March 2021, as well as the satisfaction of 21 patients who received nursing services would be counted.Results:From September 2020 to March 2021, 21 patients were provided with 55 on-site nursing services, and 151 operations in 16 projects were completed. No nursing-related adverse events occurred. The patients gave all five-star evaluations to the door-to-door service, the satisfaction score was 5 points, and the overall evaluation was 99.88 points.Conclusions:The pilot work of "Internet + nursing service" based on the nurse-patient safety needs has met the care needs of discharged patients and the safety needs of door-to-door services, guarantee the safety of nurses' door-to-door service effectively. And it provides reference for the development and improvement of "Internet + nursing service" related safety work in tertiary A-level hospitals.

Sleep clinic service model with closed-loop management for insomnia.

Insomnia is a common medical condition associated with other psychological and physiological disorders, and may require long-term treatment and outpatient management. As such, it is critical that effective treatment and management is provided in clinical practice. This study introduces an innovative outpatient service model for patients with insomnia, which includes providing medical care before, during and after diagnosis in public hospital clinics, completing prescribed treatments at home and return visits. It is a digital health-based, patient-centred, collaborative care model with closed-loop management. The proposed management strategy may help achieve a balance between the efficiency and the quality of outpatient medical care for insomnia.

Would Chinese Men Who Have Sex With Men Take Up Human Papillomavirus (HPV) Screening as an Alternative Prevention Strategy to HPV Vaccination?

Background: Men who have sex with men (MSM) are at high risk for human papillomavirus (HPV) infection. A community-based organization (CBO)-private clinic service model promoting HPV vaccination among MSM was implemented in Hong Kong. The aim of this study was to evaluate the effectiveness of this service model in increasing HPV screening among MSM. Methods: This was a secondary analysis of the CBO-private clinic service model in increasing HPV screening among MSM. Participants were Hong Kong Chinese-speaking MSM aged 18-45 years who had never received HPV vaccination. All participants completed a telephone survey at baseline before receiving online intervention promoting HPV vaccination and completed another telephone survey 12 months afterward. Results: A total of 350 participants completed a baseline telephone survey and received interventions promoting HPV vaccination. Among 274 participants being followed up at Month 12, 33 (12.0%) received any type of HPV screening during the study period. Such uptake rate was similar to the prevalence of HPV screening in the past year measured at baseline (12.0 vs. 9.9%, p = 0.43). More MSM preferred HPV vaccination or HPV vaccination plus HPV screening, and very few preferred HPV screening alone. After adjusting for significant baseline characteristics, higher perceived susceptibility to HPV (adjusted odds ratio (AOR): 1.16, 95% confidence interval (CI): 1.00-1.34) and receiving HPV vaccination during the study period (AOR: 7.03, 95% CI: 3.07-16.13) were significantly associated with higher HPV screening uptake. Conclusions: The CBO-private clinic service model promoting HPV vaccination had limited impact in increasing HPV screening among MSM in Hong Kong. MSM in Hong Kong may not use HPV screening as an alternative prevention strategy to HPV vaccination. Future programs preventing HPV-related diseases among MSM in Hong Kong should focus on HPV vaccination promotion.