Trends in instrument preference for operative vaginal delivery in a tertiary referral center: 2008-2021.

OBJECTIVE: To examine temporal trends in operative vaginal deliveries as well as the ratio between vacuum and forceps deliveries over 15 years in a large tertiary hospital. METHODS: This retrospective study assessed prospectively collected data from 2008 to 2021. Women with greater than 37 weeks of gestation who underwent an operative vaginal delivery were included. The rate and ratio of instrumental deliveries and perineal trauma were recorded. RESULTS: From 2008 to 2021 there was a total of 109 230 term deliveries, of which 20 151 were an operative vaginal delivery. The rate of operative vaginal delivery as a proportion of all term deliveries decreased from 21.9% (1547 of 7069) in 2008 to 17.1% in 2021 (1428 of 8338, P < 0.001). The ratio between vacuum and forceps-assisted deliveries decreased significantly over the study period, from 7.06 in 2008 to 2.39 in 2021 (P < 0.001). Perineal trauma remained unchanged during the study period. CONCLUSION: Operative vaginal delivery rates declined over the 15-year study period. While vacuum-assisted vaginal deliveries remain the favored instrument, forceps-assisted deliveries are becoming more prevalent. The cause for this change in practice is unclear but is likely multifactorial.

Standard Versus Advanced Protective Measures in a COVID-Free Surgical Pathway.

Introduction The importance of coronavirus disease (COVID)-free surgical pathways during the coronavirus disease 2019 (COVID-19) pandemic has been demonstrated. However, the extent of protective measures to be applied against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), particularly before vaccines became available, remained unclear. Methods This retrospective study included all SARS-CoV-2-negative patients admitted to the COVID-free pathway of a regional abdominal surgery hub center in Northern Italy over 12 months, before the vaccination campaign. During the first seven months, basic protective measures against SARS-CoV-2 were adopted (surgical masks, swabs for symptomatic patients, and intra- or interhospital transfers), since patients were treated as effectively negative (standard management). During the last five months, advanced measures were implemented (enhanced personal protections and systematic control swabs), as patients were considered potentially positive (advanced management). The aim of this article was to compare SARS-CoV-2 incidence and surgical outcomes in these periods. Results A total of 283 and 194 patients were admitted under standard and advanced management, respectively; pre-admission data differed only in the rate of previous SARS-CoV-2 infection (2.5% versus 6.7%, p= 0.034). The SARS-CoV-2 incidence was 3.9% and 3.1% for standard and advanced periods, respectively (p = 0.835). Two internal outbreaks developed during the standard phase. The advanced protocol significantly increased the rate of patients re-tested for SARS-CoV-2 (83% versus 41.7%, p < 0.001) and allowed early detection of all infections, which remained sporadic. Surgical outcomes were similar. Conclusions Advanced management was instrumental in detecting positive patients early and preventing outbreaks, without affecting surgical results; accordingly, it stands as a reproducible model for future pandemic scenarios.

[Design and Implementation of Multifunctional Interactive Electronic Bedside Card System for Inpatients Based on Internet of Things Technology].

This research is based on data from clinical information systems such as HIS, EMR, LIS, etc, based on the functions of the traditional paper bedside card, relying on wired network technology, using the Internet of Things technology to design and develop a multi-functional intelligent interactive electronic bedside card system for inpatients. The functional framework of the system is introduced and discussed in detail, and the design is carried out from several aspects of system architecture, network architecture, software architecture, database and software system. The results show that the system has stable performance and can ensure the real-time and accuracy of medical information. The implementation of the system can fully meet the needs of clinical first-line ward management, reduce the workload of nursing staff, improve work efficiency, and reduce the possibility of medical accidents. At the same time, it can facilitate patients to see their own health information, improve patient experience. It has important guiding significance for the development of ward management and hospital information construction.

[Design and Implementation of Multifunctional Interactive Electronic Bedside Card System for Inpatients Based on Internet of Things Technology].

This research is based on data from clinical information systems such as HIS, EMR, LIS, etc, based on the functions of the traditional paper bedside card, relying on wired network technology, using the Internet of Things technology to design and develop a multi-functional intelligent interactive electronic bedside card system for inpatients. The functional framework of the system is introduced and discussed in detail, and the design is carried out from several aspects of system architecture, network architecture, software architecture, database and software system. The results show that the system has stable performance and can ensure the real-time and accuracy of medical information. The implementation of the system can fully meet the needs of clinical first-line ward management, reduce the workload of nursing staff, improve work efficiency, and reduce the possibility of medical accidents. At the same time, it can facilitate patients to see their own health information, improve patient experience. It has important guiding significance for the development of ward management and hospital information construction.

Application effect of the principle of seamless management in nursing risk control of the department of gastrointestinal surgery.

OBJECTIVE: To determine the application effect of nursing risk control based on the principle of seamless management in the department of gastrointestinal surgery. METHODS: A total of 62 patients with gastrointestinal diseases admitted to the Department of Gastrointestinal Surgery in our hospital for nursing risk management based on the principle of seamless management were enrolled into a research group, and another 58 patients admitted before the implementation of such management were enrolled into a control group. The two groups were compared in the incidence of complications, Chinese Perceived Stress Scale (CPSS) score, self-rating anxiety scale (SAS) score, nursing satisfaction, and awareness rate of health knowledge, and the nursing quality scores and medical complaints and disputes were compared before and after the implementation of nursing risk control based on the principle of seamless management by 19 nurses in the department. RESULTS: The pulmonary infection rate, incision infection rate, incidence of gastrointestinal reaction, and incidence of anastomotic leakage in the research group were all significantly lower than those in the control group (all P<0.05), and CPSS and SAS scores of the research group were also both significantly lower than those of the control group (both P<0.001). In addition, the research group showed significantly higher nursing satisfaction and awareness rate of health knowledge than the control group (both P<0.01), and there were notably less medical complaints and disputes after implementation of the principle of seamless management (P<0.01). Moreover, after implementation of the principle, nursing staff acquired significantly higher scores of professional skills (health education, professional knowledge, and practical operation; all P<0.001), and also contributed to significantly higher scores of nursing work (basic nursing, disinfection and isolation, ward management, intensive care, document writing, and nursing safety; all P<0.001). CONCLUSION: Nursing risk control based on the principle of seamless management can improve the comprehensive quality of nursing staff in the department of gastrointestinal surgery and the overall quality of nursing, thus lowering the incidence of nursing risk, relieving patients' negative moods, and improving the nurse-patient relationship and satisfaction of both nurses and patients.

Design and Implementation of Multifunctional Interactive Electronic Bedside Card System for Inpatients Based on Internet of Things Technology / 中国医疗器械杂志

This research is based on data from clinical information systems such as HIS, EMR, LIS, etc, based on the functions of the traditional paper bedside card, relying on wired network technology, using the Internet of Things technology to design and develop a multi-functional intelligent interactive electronic bedside card system for inpatients. The functional framework of the system is introduced and discussed in detail, and the design is carried out from several aspects of system architecture, network architecture, software architecture, database and software system. The results show that the system has stable performance and can ensure the real-time and accuracy of medical information. The implementation of the system can fully meet the needs of clinical first-line ward management, reduce the workload of nursing staff, improve work efficiency, and reduce the possibility of medical accidents. At the same time, it can facilitate patients to see their own health information, improve patient experience. It has important guiding significance for the development of ward management and hospital information construction.

Design and Implementation of Multifunctional Interactive Electronic Bedside Card System for Inpatients Based on Internet of Things Technology / 中国医疗器械杂志

This research is based on data from clinical information systems such as HIS, EMR, LIS, etc, based on the functions of the traditional paper bedside card, relying on wired network technology, using the Internet of Things technology to design and develop a multi-functional intelligent interactive electronic bedside card system for inpatients. The functional framework of the system is introduced and discussed in detail, and the design is carried out from several aspects of system architecture, network architecture, software architecture, database and software system. The results show that the system has stable performance and can ensure the real-time and accuracy of medical information. The implementation of the system can fully meet the needs of clinical first-line ward management, reduce the workload of nursing staff, improve work efficiency, and reduce the possibility of medical accidents. At the same time, it can facilitate patients to see their own health information, improve patient experience. It has important guiding significance for the development of ward management and hospital information construction.

Management strategies in a thoracic surgery ward during COVID-19 pandemic: Experience from West China Hospital.

The coronavirus disease 2019 was first reported in Wuhan in December 2019 and then spread rapidly throughout the world. On March 11, 2020, the World Health Organization declared coronavirus disease 2019 a pandemic. In response to the pandemic, the management division of West China Hospital oversaw the implementation of hospital-wide emergency measures. In accordance with these measures, the hospital's thoracic surgery ward implemented a new management system by reformulating staff training plans, patient admission procedures, and other systems for managing the ward and protecting perioperative patients. Overall, the ward was successful in restoring normal working order, protecting all staff from occupational exposures, and ensuring the safety of inpatients and their families.

Experiences of prevention and control of hospital infection in the emergency wards:the designated hospital treating new novel coronavirus disease in Shanghai as an example / 上海预防医学

Since the outbreak of novel coronavirus pneumonia, the World Health Organization and the National Health Commission have issued multiple guidance documents.Medical facilities across the nation have actively implemented the countermeasures in response to the epidemic.However, in the real scenario of prevention and control, hospital infection remains a great concern.It is crucial to formulate measures and procedures based on standard prevention and transmission route prevention to avoid cross infection between medical workers and patients.Based on the practice, we summarize the institutional management, layout process, prevention and control of hospital infection in the emergency wards for further discussion and improvement.

Prevention and control strategies of coronavirus disease 2019 in oral and maxillofacial surgery wards / 第二军医大学学报

Coronavirus disease 2019 (COVID-19) has been confirmed to transmit by contact and respiratory droplets, and possibly by aerosols. Medical staff of oral and maxillofacial surgery departments need close contact with head and face of patients during the diagnosis and treatment, and aerosols may be generated during the operation. The risk of infection exposure is high, and the ward management is facing severe challenges. During the COVID-19 epidemic, the diagnosis and treatment in oral and maxillofacial surgery wards should be carried out reasonably after comprehensive assessment of patient condition. We put forward relevant prevention and control measures during the epidemic from the aspects of patient treatment, ward infection prevention and control, supply management, emergency plan, and training of medical staff, so as to provide references for prevention and control of the epidemic in oral and maxillofacial surgery wards.

An evaluation index system of ward management: development and practice / 中华医院管理杂志

Objective To construct an evaluation index system of ward management,which can evaluate the efficiency of ward management fairly, and make the ward management more scientific and standardized.Methods Delphi method was used in semi-structured interview of 31 experts and 74 experts were subject to questionnaire consultation, so as to establish the index system.Results The index system of ward management so built consisted of three level-1 indexes of safety and quality, teamwork and patient satisfaction, six level-2 indexes of daily monitoring, service environment, adverse events, doctor-nurse cooperation, evaluation of administrators and patient satisfaction, and 25 level-3 indexes.Practice of this system in the past two years reduced adverse events and elevated quality of care.Conclusions This system as used clinically proves its operability and objectivity.

RFID analytics for hospital ward management.

In this paper, we present an RFID-enabled platform for hospital ward management. Active RFID tags are attached to individuals and assets in the wards. Active RFID readers communicate with the tags continuously and automatically to keep track of the real-time information about the locations of the tagged objects. The data regarding the locations and other transmitted information are stored in the ward management system. This platform enables capabilities of real-time monitoring and tracking of individuals and assets, reporting of ward statistics, and providing intelligence and analytics for hospital ward management. All of these capabilities benefit hospital ward management by enhanced patient safety, increased operational efficiency and throughput, and mitigation of risk of infectious disease widespread. A prototype developed based on our proposed architecture of the platform was tested in a pilot study, which was conducted in two medical wards of the intensive care unit of one of the largest public general hospitals in Hong Kong. This pilot study demonstrates the feasibility of the implementation of this RFID-enabled platform for practical use in hospital wards. Furthermore, the data collected from the pilot study are used to provide data analytics for hospital ward management.

Quality, efficiency and integrity: value squeezes in management of hospital wards.

AIM: The aim of this study was to explore and describe the value squeezes experienced by ward managers in connection with quality management in hospital wards. The study focused on integrity pressure and coping strategies to deal with such pressure. BACKGROUND: Nurses in the role of ward managers have a key function in the field of quality improvement. These managers are also responsible for the efficient running of their wards and thus face tensions between demands for both quality and efficiency. METHOD: Data were collected through interviews conducted with 10 ward managers from six Norwegian hospitals. The data were analysed using both content and template analysis. RESULTS: Ward managers felt squeezed between conflicting values associated with demands for both quality and efficiency. These tensions resulted in pressure on integrity for the managers as well as their nursing colleagues. Three different management strategies were used to cope with such pressure: quality conscious, efficiency adjusting and hybrid. CONCLUSION: A hybrid strategy appeared to be the best, both for the ward managers and the hospital organisations, despite the fragmentation associated with this strategy. IMPLICATIONS FOR NURSING MANAGEMENT: Hybrid management may be beneficial for coping with pressure on integrity, although more empirical research is needed.

Computerization in Ward Nursing Information System Using Order-Communicating System / 대한의료정보학회지

In the complexity and diversity of modem society, there is an urgent need for an information system which can systematically collect, manage and analyze data. Especially in the discipline of Nursing, a nursing information system is necessary to maximize nursing resources and improve nursing care in the present system which is faced with increases in client needs and multiple changes in recent hospital environment. This research was done to provide a basis for the development of nursing information system, which was extracted from an analysis of the demand of nurses and other medicine staffs in the general wards excluding the special unit(ER, OR, CSR, etc.). The ward nursing information system was analysed through analysis of nursing practice related to recordings, such as the work book, work list, kardex, other nursing practice recording on 24 wards, and open questionnaire of 288 nurses. Through this process, only four subsystems of output material for nursing practice were described in this study; (1) order communication system in nursing, (2) ward management system in nursing, (3) census reporting system in nursing, (4) materials management system.