Objective To explore the current situation and influencing factors of self-management behavior in patients with primary glaucoma, so as to provide a theoretical basis for formulating intervention strategies to improve patients’ self-management ability. Methods Using convenient sampling method, 400 patients with primary glaucoma visiting the Outpatient Department of Ophthalmology, West China Hospital of Sichuan University between September 2019 and March 2020 were selected. Their current situation of self-management behavior was investigated by self-management behavior questionnaire, and the influencing factors of self-management behavior were analyzed. Results A total of 381 valid questionnaires were recovered. The total score of self-management behavior of patients with primary glaucoma was 51.11±6.22, and the mean scores of life debugging dimension, functional health care dimension, and medical management dimension were 2.66±0.67, 3.02±0.81, and 3.13±0.60, respectively. The results of multiple linear regression analysis showed that age [40-59 vs. <40 years old: unstandardized partial regression coefficient (b)=–2.830, 95% confidence interval (CI) (–4.813, –0.847), P=0.005; ≥60 vs. <40 years old: b=–2.660, 95%CI (–4.820, –0.498), P=0.016], occupation [in-service vs. farmers: b=2.639, 95%CI (0.303, 4.976), P=0.027; unemployed or retired vs. farmers: b=2.913, 95%CI (0.995, 4.831), P=0.003], smoking [smoking vs. non-smoking: b=–3.135, 95%CI (–5.196, –1.075), P=0.003], disease type [primary open-angle glaucoma vs. primary angle-closure glaucoma: b=–2.119, 95%CI (–3.317, –0.921), P=0.001], number of follow-up visits [≤2 vs. >2: b=–1.071, 95%CI (–2.118, –0.024), P=0.045], whether fixed doctor follow-up [unfixed vs. fixed: b=–2.619, 95%CI (–3.632, –1.605), P<0.001] were correlated with the total score of self-management behavior of patients with primary glaucoma. Conclusions The self-management behavior of patients with primary glaucoma is in the middle level. The main factors affecting the self-management behavior level of primary glaucoma patients include age, occupation, smoking, disease type, follow-up times, and fixed doctor’s follow-up. Ophthalmologists should pay attention to the current situation and influencing factors of self-management behavior and take feasible intervention measures to improve the self-management behavior of patients with primary glaucoma.
Nevus flammeus is a skin disease caused by congenital skin capillary malformation. In recent years, photodynamic therapy (PDT) has been proved to be effective and safe for this disease, but significant pain in the treatment process is the biggest obstacle to the implementation of this therapy. This article reviews the current pain management strategies in PDT. The current pain management methods include topical anesthesia, cold air analgesia, nerve block and others. Topical anesthesia has weak analgesic effect and short duration in PDT. Cold air analgesia is simple and feasible, but there is potential risk of affecting the treatment effect. The analgesic effect of nerve block is accurate, but the application scenario is limited. For nevus flammeus patients who need PDT, individualized analgesia should be selected according to the patient’s age and treatment scenario.
Giant thoracic tumor is currently one of the diagnostic and therapeutic challenges of thoracic surgery, with no established guideline or standard for diagnosis and treatment. The quality control of individualized surgical strategy and perioperative management with multi-disciplinary participation is the key to ensure the safety and improve the prognosis of patients. Based on the clinical experience of our institution and others, we hereby discussed and summarized the basic principles, surgical strategies and perioperative management of giant thoracic tumor, aiming to provide a reference of quality control.
Objective To explore the effect of “net bottom” management in the control of device-associated infections (DAIs) in elderly patients by setting infection monitoring doctors and nurses in the emergency intensive care unit (EICU). Methods Elderly patients who aged≥60 years old admitted to the EICU of the First People’s Hospital of Lianyungang between April 2018 and March 2021 were selected as the research subjects. A “net bottom” management mode was established and implemented for the purpose of infection prevention and control, taking medical and other departments as the coordination and management subjects, and infection monitoring doctors and nurses as the core. The effectiveness of the management intervention was evaluated by comparing the incidences of DAIs in elderly patients, the compliance rates of medical staff in hand hygiene, and the consumption of hand sanitizer per bed day in EICU among the primary stage (from April 2018 to March 2019), intermediate stage (from April 2019 to March 2020), and later stage (from April 2020 to March 2021). Results During the primary stage, intermediate stage, and later stage, there were 540, 497, and 507 elderly inpatients in EICU monitored, respectively, and the incidences of nosocomial infections were 7.22% (39/540), 5.84% (29/497), and 4.14% (21/507), respectively, showing a decreasing trend (χ2trend=4.557, P=0.033). The incidences of ventilator-associated pneumonia, central line-associated bloodstream infections, and catheter-associated urinary tract infections decreased from 4.82‰, 2.53‰, and 0.95‰, respectively in the primary stage, to 0.51‰, 1.01‰, and 0.53‰, respectively in the later stage, among which the difference in the incidence of ventilator-associated pneumonia was statistically significant (P<0.05). The hand hygiene compliance rate of EICU medical staff increased from 70.39% to 86.67% (P<0.05), and the consumption of hand sanitizer per bed day increased from 33.70 mL to 67.27 mL. The quarterly hand hygiene compliance rate was positively correlated with the quarterly consumption of hand sanitizer per bed day (rs=0.846, P=0.001), and negatively correlated with the quarterly incidence of nosocomial infections (rs=–0.769, P=0.003). Conclusion The “net bottom” management by setting up infection monitoring doctors and nurses in the EICU and multi-department collaboration can reduce the incidence of DAIs in elderly patients in EICU, which plays a positive role in promoting the hospital infection management and improving the quality of hospital infection management.
With the rapid development of day surgery mode in China, day surgery management has shifted from extensive to refined, but there are still many problems in the information system of day surgery in Chinese hospitals. The Second Affiliated Hospital Zhejiang University School of Medicine has developed a day surgery information management system since 2018, established a pre-hospital and in-hospital day surgery ecological management, and integrated daily management concepts and management rules into the system through the whole-process information management. It realized the whole process, full data, closed-loop and path-based information management of day surgery. This paper introduces the day surgery information management system of the Second Affiliated Hospital Zhejiang University School of Medicine, and aims to share the experience of building the day surgery information management function module.
摘要:目的: 探讨临床护理安全规范化管理的有效方法和效果。 方法 :成立病房护理安全管理小组;完善护理安全管理制度,培养质量管理意识;改善重点环节工作流程,强化质量监控;构建护理安全文化氛围。 结果 : 患者满意度明显提高,用药错误、管道脱落、压疮、投诉等发生率明显降低(〖WTBX〗P lt;0005)。 结论 : 规范化的护理安全管理提高了护理质量,保障了患者的安全,有效降低了护理风险的发生。Abstract: Objective: To discuss a effective way and effect of standardardized management of clinical nursing safety.Methods :Setted up nursing safety management team; Improved the nursing safety management system and trained awareness of quality management; Improved workflow of key links,and strengthened the quality control; Built a nursing safety culture. Results : Patients satisfaction improved obviously, and the medication errors、 pipe off、pressure sores、the incidence of complaints such as decreased obviously(P lt;0005).Conclusion : Standardized management of nursing safety improved the nursing quality, protected patients safety, and effectively reduced the risk of the occurrence of nursing.
Ocular trauma is the most common cause of monocular vision loss in children. Among the patients with eye trauma in China, 15%-20% are children. The complexity of diagnosis and treatment and the uncertainty of prognosis are high because the ocular tissue of children is not fully developed and the history collection and examination are difficult. In order to further standardize the treatment of children's eye trauma and improve the treatment level, China Ocular Trauma Society has formulated Expert consensus of the treatment of pediatric ocular trauma in China by combining domestic and foreign literature and the actual medical situation in China. This consensus provides detailed recommendations on the classification, cause of injury, history collection, examination methods, diagnosis and treatment principles of pediatric eye trauma. This consensus applies to Chinese ophthalmologists and medical personnel engaged in the treatment of children's eye trauma, aiming to provide scientific guidance for the diagnosis and treatment of children's eye trauma, assist clinical decision-making, and further improve the treatment level of children's eye trauma in China.
Objective To review the adverse event of hysterectomy caused by postoperative infection after cesarean section, formulate prevention and control strategies in combination with risk assessment tools, promote the standardization of perioperative management, reduce the medical burden on pregnant women, and improve patient satisfaction. Methods The two adverse events of hysterectomy caused by postoperative infection after cesarean section that occurred in the obstetrics ward between October and November 2024 were selected as the research objects. A root cause analysis and risk assessment team composed of personnel from multiple departments was established. Through interviews, observations, and data review, the potential failure modes and causes were sorted out. The risk priority number (RPN) was calculated to determine the high-risk factors. Improvement strategies were formulated and implemented. After two-month implementation, the RPN scores and the compliance of various measures before and after the implementation were compared. Results Before the improvement, the total RPN of the healthcare failure mode and effects analysis was 367.8. When rechecked in January 2025, the total RPN after the improvement dropped to 105.7, and no serious adverse events occurred again. The compliance and passing rates of various operations significantly increased: the intervention rate for maternal malnutrition rose from 17.5% to 48.6%, the passing rate of appropriate timing for prophylactic use of antimicrobial agents before surgery increased from 50.5% to 81.0%, the compliance rate of scrubbing the vagina with disinfectant before surgery increased from 15.0% to 60.0%, the implementation rate of standardized skin disinfection during surgery rose from 66.7% to 95.2%, the passing rate of aseptic techniques and hand hygiene operations during surgery increased from 75.0% to 95.2%, and the timely submission rate of specimens from infected patients increased from 29.4% to 47.6%, and all these differences were statistically significant (P<0.05). Conclusion The combination of healthcare failure mode and effect analysis and root cause analysis can effectively improve adverse events during the perioperative period, optimize the perioperative management of cesarean section, and reduce the risk of infection.
The pharmacy management of medical institutions is the basic condition for the pharmacy management of medical alliances. There are many common factors in the pharmacy management of each medical institution, and these common factors are the basic conditions for the pharmacy management of medical alliances. The pharmacy management of a medical alliance is composed of both shared aspects and aspects that meet the individual needs of different medical institutions. There are many problems in the primary medical institutions of the medical alliances, such as obsolete concepts of pharmacy management and weak pharmaceutical service capabilities. Pharmaceutical information collection is an important part in the pharmacy management of medical institutions, which can connect all aspects and better reflect the advantages of the special organization of the medical alliances. This paper explores pharmacy management in medical consortia for the specific organisational form of medical alliances, examines the basic situation of pharmacy management in different medical institutions in medical consortia, analyzes the basic conditions and basic characteristics of pharmacy management in medical consortia, so as to find a breakthrough in pharmacy management in medical consortia.
Objectives To explore the application effect of orthopedic psychological sleep management mode based on enhanced recovery after surgery (ERAS) in orthopedic patients. Methods A non-synchronous clinical controlled study was conducted. The intervention group enrolled 118 orthopedic patients who admitted to our hospital between April and June 2017, and the control group enrolled 111 orthopedic patients who admitted to our hospital between January and March 2017. The control group used routine nursing measures during hospitalization, while the intervention group implemented an ERAS-based orthopedic psychological sleep management mode based on routine nursing measures, which included carrying out a new mode of multidisciplinary collaborative management, implementing the normative path of orthopedic psychological sleep management, and implementing the comprehensive psychological sleep management. The mood, sleep quality and satisfaction of the two groups within 24 hours after admission and before discharge were compared. Results Before the intervention, there was no statistically significant difference in general data, mood or sleep quality between the two groups (P>0.05). After the intervention, the median score (the lower and upper quartiles) of the Huaxi Emotional Index of the intervention group was 1 (0, 5), while the score of the control group was 2 (0, 6); the median score (the lower and upper quartiles) of the Pittsburgh Sleep Quality Index was 4 (3, 7) in the intervention group and 6 (4, 9) in the control group; the satisfaction score in the intervention group was better than that in the control group (96.47±2.72vs. 95.52±2.79); the differences between the two groups were statistically significant (P<0.05). Conclusions The ERAS-based orthopedic psychological sleep management mode is beneficial to improve the patients’ emotional disorder, sleep quality and satisfaction. It facilitates the patients’ accelerated recovery.