目的:信息系统的改进应用是为确保急诊科预检分诊处将来能使医院对自然灾害事件的伤员救治时以最便捷、最快速的方式录入自然灾害事件伤员的信息资料和快速评估伤情,优先准确的将伤员按病情和就诊区域分类,以便畅通及时救治伤员;在治疗中和日后便于识别、查找、统计灾害事件伤员。方法:LIS(检验系统)+ RIS(影像系统)+ HIS(无纸化办公系统)三合一系统和增加自然灾害伤员的“录入信息资料”眉栏。结果:进一步改进信息网络应用系统后,能满足一般患者信息资料录入和自然灾害事件应急状况下的患者资料录入,实现电子病历和电子处方等信息网络系统,达到院内、科内资源共享。
分析国内急诊护理教育现状与发展情况,介绍自身急诊护理发展情况及教育成效。提出急诊护理教育必须注重急诊理论教育与专科操作技能的结合,综合运用课堂教学、读书报告、业务查房、论文撰写等多样的形式组织学习,并定期考核。通过急诊护理教育的拓新,必将保证急诊临床护理质量,促进专科发展。
目前,国内尚未制定出较为完整的康复医学专业常见骨关节疾病的康复临床路径,为适应现代康复医学发展的需要,四川大学华西医院康复医学科根据卫生部《临床路径管理指导原则》要求,结合康复医学科住院患者的疾病、康复评定、康复治疗、康复护理、康复教育等,于2011年制定了康复医学科常见疾病的康复临床路径,希望通过临床试用,对路径的临床实用性、可行性进行探讨,并逐渐完善。
目前,国内尚未制定出较为完整的康复医学专业常见骨关节疾病的康复临床路径,为适应现代康复医学发展的需要,四川大学华西医院康复医学科根据卫生部《临床路径管理指导原则》要求,结合康复医学科住院患者的疾病、康复评定、康复治疗、康复护理、康复教育等,于2011年制定了康复医学科常见疾病的康复临床路径,希望通过临床试用,对路径的临床实用性、可行性进行探讨,并逐渐完善。
卫生部下发《临床路径管理指导原则(试行)》(卫医管发〔2009〕99号)的通知, 希望建立一套既能贯彻医院质量管理标准, 又能节约资源的医疗标准化模式。为适应现代医学和康复医学发展的需要, 采用康复临床路径对康复治疗进行规范, 是非常重要的。四川大学华西医院康复医学科根据临床路径要求, 于2011年制定了康复医学科膝骨关节病康复临床路径, 希望通过临床试用, 对路径的临床实用性、可行性进行探讨, 并逐渐完善。
At present, upper limb motor rehabilitation relies on specific rehabilitation aids, ignoring the initiative of upper limb motor of patients in the middle and late stages of rehabilitation. This paper proposes a fuzzy evaluation method for active participation based on trajectory error and surface electromyography (sEMG) for patients who gradually have the ability to generate active force. First, the level of motor participation was evaluated using trajectory error signals represented by computer vision. Then, the level of physiological participation was quantified based on muscle activation (MA) characterized by sEMG. Finally, the motor performance and physiological response parameters were used as inputs to the fuzzy inference system (FIS) to construct the fuzzy decision tree (FDT) output active participation level. A controlled experiment of upper limb flexion and extension exercise in 16 healthy subjects demonstrated that the method presented in this paper was effective in quantifying difference in the active participation level of the upper limb in different force-generating states. The calculation results of this method and the active participation assessment method based on sEMG during the task cycle showed that the active participation evaluation values of both methods peaked in the initial cycle: (82.34 ± 9.3) % for this paper’s method and (78.44 ± 7.31) % for the sEMG method. In the subsequent cycles, the values of both showed a dynamic change trend of rising first and then falling. Trend consistency verifies the effectiveness of the active participation assessment strategy in this paper, providing a new idea for quantifying the participation level of patients in middle and late stages of upper limb rehabilitation without special equipment mediation.
Objective To explore the referral patterns for rehabilitation of patients with spinal cord injury (SCI) in community hospitals and establish green channel for SCI rehabilitation between community hospitals and large comprehensive hospitals. Methods Thirty SCI patients who were referred from the Center of Rehabilitation Medicine, West China Hospital to community hospitals between February 2013 and June 2014 were selected for this study. All the patients were assessed with American Spinal Injury Association (ASIA 2011), activities of daily living (ADL), and instrumental activities of daily living (IADL). Based on the assessment results, rehabilitation plan was made and the patients underwent community rehabilitation treatment. Results After rehabilitation treatment in community hospitals, the scores of ASIA, ADL and IADL in all the SCI patients were significantly higher than those at the time of referral (P<0.001). Conclusions SCI patients can accept rehabilitation treatment in community hospitals with good conditions. This practice can provide a new type of seamless referral pattern between large comprehensive hospitals and community hospitals for rehabilitation of SCI patients.