Objective To investigate the effects of pain specialist nurse training (PSNT) on nurse’s pain management knowledge and attitude. Methods By distributing the “questionnaire of pain management knowledge and attitude”, 95 certified nurses, who were from 24 hospitals of different levels in Sichuan, Chongqing, Yunnan and Xinjiang, were investigated to survey their knowledge and attitude changes before and after PSNT. The data were analyzed by t-test. Results A total of 190 questionnaires were distributed to 95 nurses, and 190 returned, with a effective response rate of 100%. The result showed that, the total score after training (34.00±5.30) was significantly higher than that before training (17.58±4.00), with a significant difference (P=0.000). Conclusion The pain specialist nurse training can improve nurses’ knowledge and their attitudes on pain management.
Objective To explore the effects of the centralized management of bed use in a large-scale integrated hospital. Methods We selected the staff with good quality for centre work after setting up the bed use centralized management centre in the West China Hospital. Then, we formulated unified an admission principle and incorporated it into the systematic management and control, made a short instructional video for rolling show in the centre so as to let the patient know basic conditions of this hospital before admission; and regulated the admission process for patients’ convenience. Results After more than one year, the centre simplified the in-patient admission procedures, regulated the process, saved nursing manpower (24 persons), and increased patients’ satisfaction (from 89.30% to 93.25%). Meanwhile, the bed use rate was increased and the average length of stay was shortened the to some extent, which improved the order in wards. Conclusion Unified bed use management centre established in large-scale integrated hospitals, can save nursing manpower, simplify the admission process of patients, and meet the need for the development of hospitals, which is worthy of promoting application.
Objective To investigate the current situations of human resource management in the public hospital pharmacies, and to provide the evidence and suggestions for improving the performance of the public hospital pharmacies. Methods According to the principles and study methods of human resource management, we designed the questionnaire to investigate the human resource management among 307 managers and pharmacists working in 74 public hospital pharmacies. We used percentage and proportion for statistical description. Results 56% participants considered that the public pharmacists had professional qualities. Nearly 73% considered that there were good interpersonal relationship; 45% wanted to do present job. Nearly 75% thought that the mechanism of performance appraisal should be consummated. About 63% considered that the learning and training was not fitting and proper. 63%thought they could not develop their ability and talent. Conclusion The human resource management system in public pharmacies should be improved.
Objective To provide evidence for establishing a medical risk precaution and monitoring system in China by evidence-based evaluation of the medical risk monitoring and precaution system in Canada, including the current situation and corresponding prevention measures. Method According to the unified search strategy made by our research group, we searched relevant databases and official or government websites. We included articles about medical risk management, medical error and patient safety in Canada. The included articles were classified and the quality was ranked. Results A total of 15 articles were included, among which 10 were official documents (about 2/3) and 5 described research methods (about 1/3), mainly involving medical risk management or evaluation, medical error and patient safety. In 2002, Canada established its National Steering Committee on Patient Safety (NSCPS) and proposed the suggestions to integrate health care resources accross the country, build a patient safety system, and established the Canada Patient Safety Institution (CPSI) to improve patient safety. Canada revised the patient safety management system, collected and issued related information, strengthened doctor-patient communication, developed continuous education for medical staff, practiced the best medical behavior and model and improved lawsuit procedures. These activities have achieved great progress in practice. Conclusions What have been done in Canada will provide a guide for us to establish scientific patient safety system and promote public awareness of patient safety.
The artificial ventilation system is a multi-factor system with some high uncertain risks which should be under controlled by medical risk management of hospitals. The key suggestions for reducing the accidence caused by ventilator are recommented： 1 ） to clarify the risk factor of ventilators, 2 ） to set up management group of ventilators with a clinical engineer who is good at management and quality control of medical equipment on ventilators, 3 ） to develop ventilator clinical practice for safety use, 4 ） to explore the effective risk monitoring and early warning system and mechanism on ventilator application.
Objective To evaluate the effects of a preoperative pain education program on patients’ knowledge of postoperative pain management, measures taken for such pain management and the actual postoperative pain. Methods A total of 84 patients undergoing abdominal surgery were non-randomly divided into two groups, 42 in each group. Patients in group A received routine preoperative care and 30 minutes of education about pain management, while patients in group B received routine preoperative care only. All patients completed the Postoperative Pain Management Questionnaire on the second postoperative day. Results Patients in group A achieved higher scores for their knowledge about postoperative pain management than those in group B (Plt;0.05). More patients in group A took non-medical pain relief methods after surgery (Plt;0.05); and patients in group A were able to use the PCA pump more correctly than those in group B (Plt;0.05). No significant differences were observed between the two groups in the frequency of asking for analgesics or their pain score when they requested analgesics (Pgt;0.05). The average score for postoperative pain was lower for group A compared to group B (Plt;0.05). Conclusions A program of preoperative pain education can improve patients’ knowledge of postoperative pain management and encourage them to participate actively in such pain management, so as to further relieve the postoperative pain.
摘要:目的:探讨临床教学的全程制度化管理及其效果。方法:通过健全组织,完善制度,加强教学、临床及实习生管理、建立激励机制等措施,进行全程制度化的规范管理。结果:教学质量显著提高,不良事件鲜见,无恶性事件发生。近来医院已有6篇教学论文公开发表,4个先进集体和8名先进个人受到医院表彰,5名优秀带教教师和8名实习生受到各学院奖励。结论:临床教学全程制度化管理是提高教学质量的切实有效途径。Abstract: Objective: To investigate system management during the entire clinical teaching process and its effect. Methods: To robust organization, perfect rules, strengthen management of clinical teaching and intern student, and establish encouragement mechanism,and other measures, so as to conduct standard system management during the entire process. Results: Quality of teaching improved notably, bad event was scarce, no malignant event occurred. There were six teaching articles issued publicly, four advanced collectives and eight advanced individuals had been praised by hospital, and five excellent teachers,eight intern students had been rewarded by each college. Conclusion: System management during the entire clinical teaching process is an effective way to improve teaching quality.
Vague preoperative localization and ectopic parathyroid often lead to the failure of operation in primary hyperparathyroidism. From Jun 1989 to March 1998, 11 cases of primary hyperparathyroidism had been treated surgically in the general surgery department of our hospital. Of them, 10 cases were operated successfully with the pathological diagnosis of adenoma and one parathyroid removed was reported normal. Preoperative localization, the knowledge of ectopic parathyroids, careful exploration during operation and the postoperative medical treatment are important for the perioperative management. Postoperative followup has emphasized to benefit the treatment in primary hyperparathyroidism.
Perioperative management of 58 hypertensive patients suffering from surgical disease is reported. We emphasize that before operation the blood pressure should be adequately controlled, and heart function promoted. It is safer that the diastolic pressure is controlled under 14 kPa before operation. During operation we strictly observe the change of the blood pressure and manage it in time. Analgesic and antihypertensive agents are used after operation.
This article reports the management of thirty elderly patients of septic shock during anesthesia. Twenty-four of them received continious epidural anesthesia, five of them were under intravenous general anesthesia with endotracheal intubation, and onr patients recerived intravenous ketamine anesthesia. The effects of these patients on enesthesia wer satisfactory. Twenty-four patients recouverd after roperation. Six patients died. The authors atresses the high risk of anesthetic management in these patients. Experiences are introduced in per-anesthetic preparation and medication selection and maintenance of anesthesia, monitoring and treatment during anesthesia and postoperative care of septic shock of the elderly.