ObjectiveVideo electroencephalography (VEEG) monitoring for health education of elderly patients based on a process-based communication model, and explore the impact of this model on the success rate, negative emotions, nursing satisfaction, and active cooperation rate of such patients.MethodsFrom September 2017 to September 2019, 118 patients with suspected epilepsy, encephalitis and other diseases who required VEEG monitoring in Suining Central Hospital were selected for this study (patients aged 61 to 73 years; 54 males and 64 females). Patients were divided into 2 groups using a random number table method, 59 patients in each group.A group received routine nursing, and B group received health education based on the process communication model. The monitoring success rate, negative emotion, active cooperation rate, and nursing satisfaction were compared between the two groups.ResultsThe total effective rate in the B group was 86.44%, which was significantly higher than 76.27% in the A group (P<0.05). After nursing intervention, the scores of anxiety and depression in the two groups were significantly decreased, but the decline was greater in the B group (P<0.05). The active cooperation rate and nursing satisfaction of the B group were significantly higher than those of the A group (P<0.05).ConclusionCompared with conventional nursing, health education based on process communication mode can significantly improve the success rate of VEEG monitoring in elderly patients, alleviate the negative emotions of patients, improve the active cooperation rate and nursing satisfaction.
Regarding the working hours generated by clinical trial project services under the guidance of good clinical practice (GCP), taking the standard process of a cancer project screening period as an example, and relying on a standardized management model, this paper uses standard time measurement methods to calculate the standard time of the 12 regular tasks in the GCP project. On this basis, it analyzes the GCP project process in detail to find out the reasons for wasted performance hours, and proposes a series of improvement methods and suggestions, such as formulating and implementing a target assessment mechanism, developing standard format cards, using double-line operations research to carry out parallel operations, using quadrant method to divide tasks, using site management organization and resources of hospital departments to reduce coordination loss, and introducing big data management systems, so as to make the work process of clinical research coordinators more refined and professional.
To explore the method of inducing axial vascularization in a processed bovine cancellous bone scaffold by using an arteriovenous loop, and to evaluate its effect of vascularization. Methods Custom-made processed bovine cancellous bone discs were processed into cyl inder with circular grooves. Thirty male SD rats weighing 300-350 g (3-4 months old) were randomly divided into 2 groups (n=15 per group): experimental group in which the femoral veins in the groin of rats were separated and transplanted to the contralateral femoral artery and vein stump, the processed bovine cancellousbone scaffold was inserted into the arteriovenous loop, which was placed into the annular groove. Control group, in which the blood vessels in the groin of rats were cut, no anastomosis was conducted, and the processed bovine cancellous bone scaffold was planted. At 2, 4 and 8 weeks after operation, gross observation, ink infusion histology observation and microvessel bulk density detection were conducted. Results At each postoperative time point, the samples in the experimental group were fresh red, the circulation of blood vessels were smooth bidirectionally, while the samples in the control group were dark red soft, and flexible. Ink infusion histology observation showed the processed bovine cancellous bone scaffold in the experimental group had obvious vascularization, the blood vessels tended to be mature and integrated into network, and neovascular sprouts originated from arteriovenous loop were evident, especially at 8 weeks after operation; while there was no vascularization in the control group. At 2, 4 and 8 weeks after operation, the bulk density of the microvessels in the experimental group was (3.59 ± 1.84), (16.61 ± 10.23) and (39.04 ± 13.46) μm3/μm3, respectively, and it was (2.43 ± 0.97), (6.79 ± 2.92) and (25.31 ± 10.98) μm3/μm3, respectively, in the control group. Significant differences was noted between two groups at 4 and 8 weeks after operation (P lt; 0.05), and no significant difference was evident at 2 weeks after operation (P gt; 0.05). Conclusion Inducing vascularization in a rocessed bovine cancellous bone using an arteriovenous loop is a new strategy of prevascularization and may provide valuable clues for the preparation of functional artificial bone
Objective To explore the application effect of process optimization in perioperative venous access management. Methods A total of 205 general surgery patients in the Operating Room of Cheng Du Shang Jin Nan Fu Hospital, West China Hospital of Sichuan University from April to May 2018 were selected as the control group, and 205 general surgery patients from June to August 2018 were selected as the observation group. The traditional management process was used in the control group, and the process optimization management was performed in the observation group. The establishment of venous access and related complications between the two groups of patients, as well as the satisfaction of patients and staff before and after the process optimization were compared. Results There was no significant difference in gender, age, education level, operation type, anesthesia method, operation duration, or intraoperative intravenous infusion channels between the two groups of patients (P>0.05). There was no statistically significant difference in gender, age, educational background, job title, job nature, or working years of the staff participating in the satisfaction survey before and after the process optimization (P>0.05). The rate of repetitive venous puncture (15.61% vs. 58.05%) and the idelness ratio of the intraoperative indwelling needle approach (10.73% vs. 52.20%) in the observation group were lower than those of the control group, and the differences were statistically significant (P<0.05). There was no statistically significant difference in the incidence of tube blockage, detubation, or phlebitis/exudation between the two groups (P>0.05). After process optimization, patient satisfaction (22.91±3.43 vs. 17.44±4.90) and staff satisfaction (28.17±2.56 vs. 20.65±3.71) were higher than before optimization, and the differences were statistically significant (P<0.05). Conclusions The process optimization of venous access management for perioperative patients can effectively reduce the rate of venous repeated venipuncture and the idelness ratio of the intraoperative indwelling needle approach, reduce invasive operations on patients, reduce the ineffective work of nurses, avoid the waste of medical resources such as manpower and materials, and improve the satisfaction of patients and staff. It is worthy of promotion and application.
ObjectiveTo summarize the method of quality management in long term video electroencephalogram (VEEG) monitoring process.MethodsTo summarize the VEEG monitoring process in 4 935 patients, the following methods were adopted: adequate preparation before examination, selection of suitable electrode wearing methods, regular inspection of the quality of the lead wire, inspection and observation of whether the electrodes have fallen off, process inspection, behavioral intervention guidance, timely manage the artifacts, pay more attention to the inducted experimental, timely identification of paroxysmal events, standardize the procedures for the management of seizures, standardize the processing of electrode cleaning and disinfection, continuously improve the quality.ResultsFour hundred and tworoy are paroxysmal events of various types occurred during the monitoring period. All of them were handled in time and the patients were all safe. Among these events, 4 children ended the examination in ahead of the normal procedure due to fever, crying or other reasons. two patients were transferred to intensive care unit due to changes in patients ’conditions such as hypopnea and decreased oxygen saturation of artery blood of finger. The remaining 4 829 patients completed VEEG detection for 8 ~ 24 h. and got good quality images.ConclusionsQuality management is a guarantee of qualified, high quality, low artifact EEG reports.
After 38 years of development, the procedure of selection and evaluation of the World Health Organization Essential Medicine List (WHO EML) is increasingly scientific and formal. However, peer review for the applications of WHO EML is always required in a short period. It is necessary to build up a set of methods and processes for rapid review. The most important items for the rapid review of WHO EML peer reviewers are: 1) to confirm the requirements and identify the purposes; 2) to establish the research questions and translate the questions into the ‘Participants, Interventions, Comparators, Outcomes, Study design' (PICOS) format; 3) to search and screen available evidence, for which high-level evidence is preferred, such as systematic reviews or meta-analyses, health technology assessment (HTA), clinical guidelines; 4) to extract data, where we extract primary information based on the purposes; 5) to synthesize data by qualitative methods, assess the quality of evidence, and compare the results; 6) to provide the answers to the applications, quality of evidences and strength of recommendations. Our study established a set of methods and processes for the rapid review of WHO EML peer review, and our findings were used to guide the reviewers to fulfill the 19th WHO EML peer review. The methods and processes were feasible and met the necessary requirements in terms of time and quality. Continuous improvement and evaluation in practice are warranted.
ObjectiveTo analyze the limitations and challenges for the use of real-world data in the decision making of drug reimbursement through literature review and provide standard process and guideline for the real-world study supporting drug reimbursement. MethodsBy summarizing the relevant policies, regulations, and guiding principles of major drug regulatory agencies worldwide, the study analyzed the applicable conditions, framework, and reimbursement mode for using real-world evidence in the decision making of drug reimbursement. ResultsThe study found that the health technology assessment departments of major developed countries and Asian countries have used real -world evidence to evaluate the drug efficacy and safety. The application scope of real-world data for reimbursement decision included describing the treatment process of the disease, assessing economic burden, verifying economic models, and evaluating the efficacy and safety of drugs. Some developed countries including the United Kingdom and the United States had released guidelines or frameworks of the real-world study for reimbursement decision. The process and framework of using real-world data in reimbursement decision could be divided into three models: coverage with evidence development, outcome-based contract, and re-assessment. ConclusionReal-world data has been widely used in the process of health technology assessment. To adapt to the development of the pharmaceutical industry and to meet the needs of clinical patients, it is urgent to standardize the process of collecting real-world data and formulate the scope and process of using real-world data in the reimbursement process.
Unprocessed red meat and processed meat consumption: dietary guideline recommendations from the NutriRECS consortium is based on five high quality systematic reviews that were developed using the nutritional recommendations guideline development process. The guideline develop recommendations primarily focus on participant important health outcomes (such as the incidence of cancer, cardiovascular disease and mortality) related to the consumption of red and processed meats. Based on the estimated average weekly intake of these meats (3 to 4 servings/week) in North America and Western Europe, the panel suggests that adults continue their current unprocessed red meat and processed meat consumption. The present paper interprets the guideline.
Consultation is an important form for the diagnosis and treatment of severe diseases, and consultation management is an important content of medical management work, which directly affects the medical quality and treatment efficiency of the hospital. With the help of information network platform, our hospital has realized electronic consultation system online through scientific development, training enhancement, and safeguard mechanism improvement. The system can optimize consultation work process effectively, improve the consultation work, save manpower cost and help construction of hospital informatization.
The concept of clinical trial transparency has been promoted for more than 40 years. The act of clinical trial registration, report guidelines development, and data sharing has has been strongly pushed forward and become a common practice. The clinical trial process being the key procedure of trial operation and quality control, determines the accuracy of the results. However, the process report of clinical trials is insufficient. In this article, we summarize the importance of clinical trial process report and provide corresponding suggestions. We propose that medical journals, reporting guidelines developers and clinical trial registration platforms should work together to strengthen the process report of clinical trials and promote full transparency of clinical trials.