Objective To survey the present situation of medical equipment configuration of township hospitals in Shuangliu County, to provide baseline data for the next step of discussing the well-off township hospital medical equipment configuration standards. Methods According to the national guidance on device configuration in township hospitals, the questionnaire was made to survey 24 county township medical units (i.e. 3 central township hospitals, 3 community health centers, and 18 general township hospitals). The descriptive and stratified analysis was performed for the survey results. Results The condition of medical equipment configuration in the 3 central hospitals was better than that in the 3 community health centers which was better than that in the 18 general hospitals. The emergency equipment configuration such as defibrillator units, breathing airbags, and tracheotomy package was poor. Annual inspection rate of medical metering equipment was lower than expectation. In 2010, a total of 127 medical measuring equipments from 98.5% of the township hospitals applied annual inspection, among which, only the total annual rate of black and white B ultrasonic and X-ray machine reached above 60%; the rate of blood cells analyzer, ECG monitoring instrument, and biochemical analyzer were between 50% to 60%; and the rate of urine analyzer was the lowest at 4.5%. Conclusion It is the right time to strengthen the first aid equipment configuration in township hospitals and to enhance the annual inspection rate of the medical measuring equipment, so that the safety use and accuracy detecting can be guaranteed.
ObjectiveTo explore the effect of precise management on life-saving equipment management in Surgical Intensive Care Unit (SICU). MethodsWe actualized precise management in the life-saving equipment management process in March 2014, including precise management control system, precise personnel training, and precise process management. ResultsAfter precise management, the knowledgement of life-saving equipment of the nurses increased from 90.2% (May, 2014) to 98.5%. The number of equipments repaired before (March-May, 2014) and after the management (June-August, 2014) was 65 and 47, respectively; the number of nonstandard management times in nurses after the equipments were used was 98 and 10, respectively. ConclusionPrecise management can drastically improve management efficiency, serviceability rate and service efficiency of life-saving equipment, obviously enhancing the degree of familiarity and using skills of clinical nurses, and ensuring quick and smooth emergency work. It plays an active role in securing severe patients' life.
Foam sclerotherapy is one of the major therapies for varicose veins in lower limbs. It is important to know the influence factor of foam stability which is beneficial to curative effect. The present experiment explored influence of 9 kinds of driving speed on foam stability when using the method of Tessari. Syringes of 5 mL were chosen to do this experiment which was carried out at the liquid gas ratio of 1:4 and the environment temperature of 20℃. A home-made automatic sclerosing foam preparation equipment was used to prepare the foam. A camera recorded the entire process of foam decay. And foam stability indexes which includes drainage time, half-life, foam half-life volume and the drainage rate curve, were analyzed. The results showed that when driving speed ranged from 100 mm/s to 275 mm/s, foam drainage time and the half-life showed a trend of rising. When the driving velocity was greater than 275 mm/s, the foam drainage time and half-life time reduced a little. The largest drainage time and the half-life differences were 340.0% and 118.8% compared to their minimum value. Meanwhile the pressure increased with the increase of driving speed, so that the solubility of carbon dioxide increased and the foam half-life volume decreased with the increase of the driving speed. It can be concluded that when using the method of Tessari to prepare sclerosing foam, driving speed has a significant effect on its stability. With driving speed increasing, foam decay mechanism changes from gas diffusion to liquid drainage as the main function, so the foam stability increased at first and then decreased later. The foam is relatively more stable at the speed of 275 mm/s, which could be considered as the best driving speed.
ObjectiveTo strengthen the management of medical equipment and improve the use value of medical equipment by PDCA cycle. MethodsBetween March and June 2014, we introduced PDCA cycle into the management and use of newly-bought equipment.The use of newly-bought arteriosclerosis detector, TCD and ultrasound bone densitometer between March and June 2014 was regarded as the control group (before the implementation of PDCA cycle), and the use of these three kinds of equipment between March and June of 2015(after the implementation of PDCA cycle) was seen as the observation group.By analyzing the status quo through collected information, we drew a fishbone diagram to find out the factors that could influence the use efficiency of medical equipment.Then, corresponding measures were taken for continuous improvement, including adopting revised regulations, training technicians, quantifying work indexes, informatization, changing service mode, and examining and assessing the effect of implementation.Finally, feedback was summarized for the next PDCA cycle. ResultsAfter the implementation of PDCA cycle, the daily check numbers of hospital medical equipment including arteriosclerosis detector, TCD, and ultrasound bone densitometer all improved significantly (P < 0.05).The daily check numbers of those three kinds of equipment after the implementation of PDCA cycle were respectively 48.52±19.72, 32.14±10.14 and 55.59±25.12, while the numbers before were respectively 32.46±20.69, 15.46±10.05 and 29.83±20.20.Moreover, working days, maximum working hours daily, and total working time were also increased after the implementation of PDCA cycle. ConclusionThe application of PDCA cycle can effectively improve the use value of medical equipment, and improve the social benefit and economic benefit.
ObjectiveTo present the application of mini-health technology assessment (Mini-HTA) method in configuration management of anti-magnetic anesthesia machine.MethodsFrom February to March 2019, the specialist operation assistant used Mini-HTA method to analyze and evaluate the anti-magnetic anesthesia machine applied by the department from basic situation and four dimensions, including technical dimension, patient dimension, hospital dimension, and economic dimension.ResultsA hospital health technology assessment report was prepared based on the evaluation of the specialist operation assistant, the suggestion of which was adopted by the hospital. As a result, an anti-magnetic anesthesia machine was arranged in the MRI room.ConclusionMini-HTA method can provide decision support for hospital equipment configuration and is conducive to the scientific and rational allocation of resources in hospitals.
The deep integration of modern technology and medical development promotes the change of medical and health management environment. As an important part of hospital medical and health decision-making process, the evaluation and access of medical equipment and consumables need scientific evidence-based evaluation system. This paper introduces a new-equipment evaluation model created by the multi-disciplinary evaluation team of West China Hospital of Sichuan University under the guidance of evidence-based ideas and methods. This model is suitable for the Chinese national conditions and easy to operate.
ObjectiveTo explore a strategy for selecting and evaluating the warranty contract of medical equipment.MethodsBased on the operating costs of the two linear accelerators between 2016 and 2019, we obtained the criticality of medical equipment by using the five indicators, including necessity of maintenance, function, risk, importance, and age of medical equipment, selected the warranty strategy by comparing the cost of key components, and adjusted and optimized the warranty strategy based on the economic benefit assessment during the implementation process of warranty contract.ResultsThe criticalities of the two linear accelerators were both 18 points, and it was recommended to purchase warranty service. By comparing the cost of key components, the annual average maintenance cost of the key components of the two accelerators was lower than the annual warranty cost, so we chose the semi-guaranteed contract. Finally, according to the economic benefit accounting and evaluation in the implementation process of the warranty contracts of the two linear accelerators, the linear accelerator 1 remained unchanged, and the linear accelerator 2 was turned from the semi-guaranteed contract into the full insurance contract when we renewed the warranty contract.ConclusionsThe warranty contract selection and evaluation strategy proposed in this paper has certain guiding significance for the choice of strategy of warranty contract. By choosing the appropriate warranty service scope and warranty strategy, and continuous adjusting and optimizing according to the actual performance of the contract, we can effectively guarantee the operational efficiency of medical equipment, and reduce operating costs simultaneously.
To reduce the infection risk of 2019-novel coronavirus and to protect medical staffs, “Graded personal protection scheme for preventing medical staffs from 2019-novel coronavirus infection in West China hospital” was formulated according to the guidance and notice issued by the National Health Commission combined with the actual situation of West China Hospital. This scheme could provide reference for preventing such disease for medical staffs.
Objective To understand the current situation of the use and cognition of personal protective equipment (PPE) by healthcare workers in the isolation wards (rooms) during the coronavirus disease 2019 epidemic, and provide data support for the country to further optimize the configuration of PPE and carry out more targeted training and supervision. Methods In March 2020, healthcare workers in isolation wards (rooms) in provinces and cities in the country were investigated by filling in a questionnaire about the use of different levels of PPE. Results A total of 6 859 questionnaires were collected from 29 provinces and cities, containing 5 935 valid questionnaires (86.53%). Among them, there were 448 assisting-Hubei medical team members and 5 487 non-assisting-Hubei healthcare workers. The actual use rate (74.22%) and intended use rate (73.14%) of surgical masks in the cleaning areas were the highest. The actual use rate and intended use rate of working caps in potentially contaminated areas and contaminated areas were higher than 90%. There were various combinations of protective articles, and there were significant differences between actual use and intention (P<0.05). Except for the boot covers (single layer) in the cleaning areas, the working caps, isolation clothing and boot covers (double layer) in the potential pollution areas, and the protective face screens, working caps, three-layer shoe covers and single/double/three-layer boot covers in the pollution areas-splashing operations (P>0.05), the actual utilization rates of protective articles of the assisting-Hubei medical team members were generally higher than those of the non-assisting-Hubei healthcare workers (P<0.05). Conclusions The instructions for the use of PPE in different areas and operations should be further refined, and standardized training should be increased. The phenomenon of non-standard use of protective equipment should be reduced, and a safety barrier should be provided to the healthcare workers.