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BACKGROUND: The size and cost of outpatient capacity directly affect the operational efficiency of a whole hospital. Many scholars have faced the study of outpatient capacity planning from an operations management perspective. OBJECTIVE: The outpatient service is refined, and the quantity allocation problem of each type of outpatient service is modeled as an integer linear programming problem. Thus, doctors' work efficiency can be improved, patients' waiting time can be effectively reduced, and patients can be provided with more satisfactory medical services. METHODS: Outpatient service is divided into examination and diagnosis service according to lean thinking. CPLEX is used to solve the integer linear programming problem of outpatient service allocation, and the maximum working time is minimized by constraint solution. RESULTS: A variety of values are taken for the relevant parameters of the outpatient service, using CPLEX to obtain the minimum and maximum working time corresponding to each situation. Compared with no refinement stratification, the work efficiency of senior doctors has increased by an average of 25%. In comparison, the patient flow of associate senior doctors has increased by an average of 50%. CONCLUSION: In this paper, the method of outpatient capacity planning improves the work efficiency of senior doctors and provides outpatient services for more patients in need; At the same time, it indirectly reduces the waiting time of patients receiving outpatient services from senior doctors. And the patient flow of the associate senior doctors is improved, which helps to improve doctors' technical level and solve the problem of shortage of medical resources.
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Pacientes Ambulatoriais , Médicos , Humanos , Assistência Ambulatorial , Hospitais , Programação Linear , Número de Leitos em HospitalRESUMO
Objective:To explore the effect of continuous nursing on the psychology and quality of life of patients with mild traumatic brain injury.Methods:A review of 120 patients with mild traumatic brain injury who were hospitalized in the Second Affiliated Hospital of Wenzhou Medical University from January 2016 to December 2019 were selected. According to the order of admission, sample numbers were drawn from the random number list and entered into groups. There were 60 cases in the control group and the intervention group. The control group received routine general nursing, and the intervention group received continuous nursing. The Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), and Quality of Life Scale (SF-36) were used to evaluate the psychology and quality of life of patients on the day of discharge and one week, one month, and three months after discharge.Results:There was no significant difference in the scores of HAMA, HAMD and SF-36 between the two groups on the day of discharge ( P>0.05). The HAMA scores at 1 week, 1 month and 3 months after the intervention of the intervention group were (18.2±8.6), (13.7±5.8) and (5.6±2.3), which were significantly lower than those of the control group (24.2±11.2), (20.4±8.2), (8.9±3.6), the differences were statistically significant ( t values were 2.32, 3.67, 4.13, P<0.05). The HAMD scores at 1 week, 1 month and 3 months after the intervention of the intervention group were (24.3±7.1), (10.9±4.2), (6.8±2.9), which were significantly lower than those of the control group (28.6±8.5), (15.3±8.3), (14.8±4.6), the differences were statistically significant ( t values were 2.11, 2.57, 7.99, P<0.05). The SF-36 scores at 1 week, 1 month and 3 months after the intervention of the intervention group were (77.2±8.9), (85.2±9.7), (87.8±12.9), which were significantly higher than those of the control group (72.3±8.2), (79.4±10.9), (81.0±11.5), the differences were statistically significant ( t values were -2.23, -2.14, -2.13, P<0.05). Conclusions:Continuing care can be extended to the patient's family, so that the health problems faced by the patient after discharge from the hospital can be effectively solved, relieve psychological pressure and improve the quality of life, and it is worthy of clinical application.
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How to raise the quality of life of discharged patients with moderate or severe craniocerebral trauma, how to improve their social adaptive ability and reduce occurrence of complications constitute key researches in neurosurgery care. Using two-dimension code plus WeChat friends for continuing care of such patients, the hospital has significantly improved the functional state, activity of daily living, complications and family care ability, contributing to better outcomes of such patients care.
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Objective To study the application of the family centered escort system in neurosurgical intensive care units (NICU). Methods 416 cases of NICU patients from January 2015 to December 2016 were selected, 197 cases of the patients from January to December 2015 serving as the control group subject to a restrictive visit system. 219 cases of patients from January to December 2016 were used as the study group subject to the family centered escort system. The two groups were compared as to the anxiety state and satisfaction of the family members, the job satisfaction of nurses, the duration and cost of the patients in NICU, the ratio of the patients subject to sedation and restraint bands, and the incidences of adverse events of patients during NICU. Results Scores of anxiety state of the family members showed that the control group (52. 76 ± 5. 21) was significantly higher than that of the study group (34. 61 ± 5. 98). The dimensions of " information acquisition" and " access to patients" as found in the satisfaction survey of the family members showed the study group as higher than the control group, a difference of statistical significance between two groups (both P＜0. 01). The dimensions of " state at work" and " interpersonal relationship at work" showed the study group as higher than the control group, a difference of statistical significance between two groups ( P ＜ 0. 05 ) as found in the job satisfaction survey of nurses. The comparison between the two groups in NICU duration and expenses showed no significant statistical difference (P＞0. 05). The ratio of sedation treatment and restraint band usage of control group was significantly higher than that of the study group, a difference of statistical significance (P＜0. 01). The incidence ratio of lower extremity venous thrombosis showed that the control group (13. 7%, 27/197) was higher than that of the study group (6. 8%, 15/219), a difference of statistical significance (P ＜0. 01). There was no significant difference as to the incidences of other adverse events of the two groups ( P ＞ 0. 05 ). Conclusions Compared with the restricted visiting system, the family centered escort system in NICU is beneficial to both the nurses and patients, justifying the humanity of the latter system.
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Objective To survey the influence of nursing intervention on cognition level for pressure sores and psychological state among accompany family members of patients with cerebral injury. Methods 123 accompany family members of patients with cerebral injury were selected and took part in the investigation about cognition level for pressure sores, besides, SDS and SAS were also adopted to evaluate their psychological state. Later nursing intervention was given to increase their cognition level for pressure sores, then another evaluation was carried out. Results before and after the intervention were compared. Results The accompany family members lacked knowledge of pressure sore, showed serious anxiety and depression for nursing pressure sore before intervention. But their cognition level for pressure sore improved and anxiety and depression lightened after intervention. Conclusions Nursing intervention is effective to alleviate cognition level for pressure sore and psychological state among accompany family members of patients with cerebral injury, which is worthy of clinical application.
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Objective To investigate antibiotic resistance and staphylococcal cassette chromosome mec(SCCmec)genotype of Staphylococcus aureus isolated from patients with nosocomial infections.Methods Antibiotic susceptibility pattern anti the gene mecA were examined in 89 Staphylococcus aureus isolates from patients with nosocomial infection in Tianjin Medical University Cancer Institute and Hospital.The SCCmec genotype in the mecA-positive strains were fuaher investigated with multiplex PCR.Results In 89 Staphylococcus aureus strains,21(23.6%)were phenotypic methicillin-resistant Staphylococcus aureus (MRSA)and 39(43.8%)were rnecA positive,the difierence was of statistical significance(χ2=8.146,P=0.004).MRSA strains showed multiple-antibiotic resistance but sensitive to vancomycin.Tvpe Ⅲ SCCmec carriers were the major epidemiological strains(26/39,66.7%).ConclusionMRSA strains isolated from Tianjin Medieal University Cancer Institute and Hospital are characterized by multi-drug resistance,and type Ⅲ is the dominant SCCmec earried by the MRSA strains.
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Objective To investigate the prevalence of nosocomial infections in Tianjin Children's Hospital and to provide database for monitoring and control of nosocomial infection.Methods The medical records of 6101 children admitted in the first half of 2005 and the laboratory results of isolated bacteria from clinical samples in 2005 were retrospectively investigated.Results The total nosocomial infection rate was 3.47%(212/6101),in which the surgical nosocomial infection rate was 2.66%(32/1204)and 2.95%(180/6101)infections were caused by non-surgical incisions.Respiratory tract was the most frequent infection site(119/212,56.1%).Several opportunistic pathogens were responsible for the major nosocomial infections,they were Escherichia coli,Coagulase negative staphylococcus,Enterococcus,Klebsiella pneumonia,Staphylococcus aureus and Pseudolnonas aeruginosa.Conclusion The pathogenic isolates for the infections show high resistance to most antibiotics.Monitor and control of the incidence of nosocomial infections and resistance to antibiotics should be enforced.
