ObjectiveTo investigate the status of knowledge, attitude, and practice of patient identification in nurses, and provide a basis for clinical managers to carry out targeted training.MethodsA total of 3 696 nurses of tertiary, secondary, and primary hospitals in Guizhou Province were recruited and investigated for the status of knowledge, attitude, and practice of patient identification with a questionnaire by using convenient sampling in May 2019.ResultsThe scores of identification knowledge, attitude, and practice of the 3 696 nurses were 47.87±6.10, 27.39±3.15, and 57.19±4.86, respectively. Logistic regression analysis showed that the higher the educational level was, the higher the score of nurses’ knowledge of patient identification was [odds ratio (OR)=1.592, 95% confidence interval (CI) (1.084, 2.338), P=0.018]; the higher the personal monthly income was, the more positive the nurses’ attitude towards patient identification was [OR=1.570, 95%CI (1.005, 2.453), P=0.048].ConclusionsThe general situation of patient identification in nurses is good, but there are still differences among nurses with different characteristics. It is suggested that managers should pay special attention to the training of nurses with low educational level and low income, make them master the knowledge of patient identification, at the same time, improve their enthusiasm and standardize their behavior, so as to ensure the safety of patients.
The Essential of ACC/AHA Guidelines for the Management of Patients with ST-Elevation Myocardial Infarction was introduced, including epidemology, initial management in the emergency department and hospital management.
ObjectiveTo carry out the construction of star ward in the day care ward, and to provide efficient, comfortable and safe service for the patients by grasping the basic work, understanding the regulations, focusing on enhancing quality of service, and deepening the connotation of high-quality nursing care construction. MethodsDuring the construction of star ward, we adopted such measures as full mobilization, strengthening nursing post management, strengthening nursing staff training, standardizing nursing services, implementation of holistic nursing of bedside work responsibility system, selection of star nurses and extension of services. ResultsAfter the construction of star ward, nursing disputes complaints in the day ward decreased, nursing satisfaction and nursing staff skills improved significantly (P<0.05). ConclusionConstruction of star ward can improve nurses' comprehensive quality, enhance the level of nursing service, improve nursing quality, and increase patients' satisfaction.
The Evidence-based guidelines for diagnosis and treatment of age-related macular degeneration in China (2023) is the first evidence-based clinical practice guidelines for the diagnosis and treatment of age-related macular degeneration (AMD) in China that strictly follows the WHO guideline formulation and international guideline standards. Based on the latest evidence-based medical evidence and the rapid development of ocular fundus imaging technology, the new version of the guidelines has been updated in the diagnosis, treatment and follow-up of AMD. Based on the origin and presence of neovascularization in retinal tissue, the macular neovascularizations are divided into type 1, type 2 and type 3 macular neovascularization (MNV). Optical coherence tomography (OCT) plus OCT angiography is recommended as the useful diagnostic method in neovascular AMD patients. Antioxidant vitamins, zinc, lutein, zeaxanthin, or a mix of antioxidant vitamins and minerals are recommended to prevent the progression of early to intermediate AMD. Intravitreal administration of anti-vascular endothelial growth factor (VEGF) agents is the first-line treatment for neovascular AMD, and once a month for the first 3 months plus treatment and prolonged administration regimen shows benefit to a certain extent. For poor response and non-response neovascular AMD patients, the clinician should decide the next treatment plan based on comprehensive consideration. Close observation is recommended for non-exudative MNV, and anti-VEGF therapy should be used promptly once non-exudative MNV transfer to exudative MNV. It is hoped that this guideline will improve the diagnosis, treatment, prevention and follow-up of AMD in China.
ObjectiveTo explore the implementation of standardized training of general practitioners system in China. MethodsA total of 25 bases of training general practitioners and its collaborative community service centers, which were located in the east and western region of China, met the inclusion criteria; qualitative interviews and questionnaires were done between November 2012 and November 2013, including 456 teachers, 281 students, and 166 teaching management staff. Survey content involved implementation of standardized training system, teaching method and so on. ResultsSatisfaction rate of training general practitioners training system with teachers, students, and administrators was 76.2%, 71.3%, and 86.3%, respectively (χ2=92.372, P<0.001). The average satisfaction rate of training model, teaching programme, teaching materials, teaching arrangements, the examination system, the quality of training, and supporting policies was 95.7%, 92.1%, 73.8%, 65.7%, 72.5%, 86.8%, and 48.9%, respectively (χ2=813.196, P<0.001). Satisfaction rate of teaching method with teachers, students, and administrators was 81.1%, 74.4%, and 67.7%, respectively (χ2=40.159, P<0.001). ConclusionSatisfaction rates of training general practitioners training system and teaching method with teachers, students, and administrators are low. The main impact factors are:the syllabus and textbooks are not practical, qualified teachers are short, teaching arrangements is unreasonable, teaching content is specialization, government support is inadequate and so on.
With the aggravation of population aging, the medical and care needs of the elderly have increased significantly. Nowadays the integrated elderly care and medical services have been greatly promoted and various services modes have been developed in different regions. In order to promote the healthy development of integrated elderly care and medical services in China, we summarized the practical experience of integrated elderly care and medical services implemented in various parts of China, including six typical service modes such as elderly care in medical services, medical care in elderly care, cooperation between medical services and elderly care, community radiation, family doctor embedded and “Internet+”. Moreover, we compared their providers, service methods, construction specifications, service standards, regulatory agencies and payment methods. Finally, we analyzed the problems and their causes, and proposed corresponding improvements for outstanding problems in the practice of integrated elderly care and medical services in China.
ObjectiveTo carry out the work of overseeing transparent administration of clinical department affairs, have clear knowledge on the progress of making clinical department affairs public, and find out problems the staff focus most. MethodQuestionnaire survey was used, combined with the participation of various meetings, interviews with staff, access to documents and other ways between November and December 2013. ResultsIt showed that the rate of transparent administration of clinical department affairs was (78.39±18.55)%. Among all the affairs, policy ones had the highest scores (over 85%), while the rates of research and academic tenure, financial transactions and remuneration allocation, personnel arrangements and training were the lowest (below 75%), and faculty focused on these affairs. ConclusionsFive methods can improve the rate of transparent administration of clinical department affairs effectively:enough attention from clinical departments, concerning what employees focus on, utilizing methods rationally, strong supervision and making full use of monitoring.
Objective To explore the teaching effects of problem-based learning (PBL) in diagnostic practice teaching. Methods A total of 32 students enrolled into PBL group adopted the PBL teaching method based on certain cases in some sections while the other 210 students into the control group adopted the traditional teaching method. Their scores in the theory, the practice skill examination and the evaluation of the analytical ability of the medical records were compared. A questionnaire survey was measured in PBL group after class. Results There was no significant difference in scores of theory and practice skill examination in the two groups. The questionnaire survey revealed that the PBL method could improve the learning interest, independent study, b communication, analytical skills, and team spirit. However, there were defects in systematization of imparting knowledge. Conclusion The PBL method has an obvious advantage in diagnostic practice teaching.
【摘要】目的介绍华西医院支援西部地区卫生工程项目的实践和成效。方法过去5年间，华西医院响应国家号召，通过各种帮扶形式，开展了一系列对口支援活动。结果华西医院利用自身的资源优势，通过各种帮扶形式，提高基层医院的医疗救治水平和综合服务能力，为建立城市支援农村卫生工作的长效机制进行了积极的实践和探索，取得显著成效。结论基层卫生事业与人民健康需求和现代医学进步存在着相当的差距，医疗体制改革对部属部管医院的对口支援提出了更高的要求，对口支援的许多细节还需要我们去进一步完善。【Abstract】Objective To introduce the practice and progress of the supportive rural hygiene program of West China Hospital. Methods In the past five years, West China Hospital had made a lot of supportive rural hygiene practice. Results West China Hospital made good use of its own advantages in resources to develop the treatment level and the comprehensive service capability of primary hospital. West China Hospital did a lot of practice to establish the effective system of assistance of city medical care to rural areas, and had already achieved remarkable effects. Conclusionre is a lot of disparity between the basic public health or the requirement of people and the modern medicine progress. Many details for support should be further consummated.
Rapid development of recently emerging precision medicine techniques represented by gene therapy has brought hope for the treatment of rare blinding eye diseases such as inherited retinal diseases (IRDs) for which there was no effective treatment previously. Although the globally growth of clinical trials for IRDs has increased rapidly over the past decade, due to the highly genetic and clinical phenotypic heterogeneity, as well as limited data on epidemiology and natural history of the disease, along with severe loss of vision function of majority patients for which the established measurements may not be appropriate, such studies lack standard outcome measurements and endpoints to asses clinical meaningful effectiveness, posing great challenges in terms of study design and evaluation of treatment efficacy, as well as clinical practice application. At present, there is no systematic nor standardized guidance on safety measures, clinical outcomes and endpoints of visual function for clinical trial design in IRDs. Therefore, in order to standardize the validated evaluation of IRDs clinical efficacy outcome measurements and endpoints, the Fundus Disease Group of Chinese Medical Association Ophthalmology Branch and Fundus Disease Committee of Chinese Medical Doctor Association Ophthalmology Branch organized domestic experts to put forward consensus and recommendations on standardizing outcome measurements and endpoints for clinical study design in IRDs, aiming to advance the study design of IRDs natural history research and clinical trials and to effectively evaluate disease progression and intervention efficacy. Along with the development of medical science and clinical trials, relevant content will be improved and updated accordingly.