ObjectiveTo discuss the application and effect of PDCA cycle in urgent values management in surgical intensive care unit. MethodsWe analyzed the quality of 141 cases of urgent value reports in surgical intensive care unit from May to July 2013 before the application of PDCA management. The quality of urgent values were totally controlled by PDCA circle. There were 135 cases of urgent value reports after the use of PDCA cycle. The data including qualify rate of specimens, record specification rate, and handover of urgent values were compared between the two groups of urgent values. ResultsAfter the application of PDCA cycle management, the awareness rate of urgent value content and disposal processes among medical staffs increased from 75% to 95%, with significant improvement in the quality rate of samples, recording and processing of urgent values and the quality rate of recording. ConclusionThe application of PDCA circle management can constantly correct the problems and ensure the policy implementation in the urgent values system in clinical departments, which can promote continuous quality improvement.
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.
Objective To explore the role and significance of full-time infection control nurses in the prevention and control of nosocomial infection in Intensive Care Unit (ICU). Methods Before Februry 2013, there was no full-time infection control nurses in ICU in West China Hospital of Sichuan University (before implementation); since March 2013, with a comprehensive evaluation of bed numbers and infection control nurses workload, the job of full-time infection control nurses were initiated (after implementation). The management of infection control was achieved through clarifying the responsibility of full-time infection control nurses, the implementation of infection monitoring and other related measures. Results Comparing to the condition before implementation, the hand hygiene compliance among nurses, doctors, workers and cleaners in ICU elevated from 49.8% to 74.9%, the infected rate decreased from 15.3% to 9.3%, the positive rate of multiple resistant bacteria decreased from 18.3% to 13.5%, the incidence of ventilator-associated pneumonia decreased from 13.02‰ to 6.63‰, and central venous catheter-related bloodstream infection rate decreased from 6.559‰ to 2.422‰; the differences were all significant (P<0.05). The incidence of urinary tract infection decreased from 1.21‰ to 1.07‰, and the difference was significant (P>0.05). Conclusions Full-time infection control nurses can introduce continuous and effective training to medical staffs, supervise the execution of hospital infection prevention and control measures, and examine all steps involved and relevant feedbacks. Therefore, the full-time infection control nurses play an important role in the prevention and control of nosocomial infection in ICU.
目的 探討結腸癌患者術后3年生存情況的影響因素。方法 回顧2006年1月至2007年12月期間筆者所在科室收治的確診為結腸癌且隨訪資料完整的169例患者臨床資料，從術前CEA水平、腫瘤病理分型、分化程度和體質指數（BMI）方面分析影響結腸癌預后的因素。結果 術前CEA水平、腫瘤分化程度及BMI對術后3年生存期的差異有統計學意義（P＜0.05），術前CEA水平對術后3年生存率的差異均有統計學意義（P＜0.05）；術前CEA水平、病理分型、分化程度對術后發生轉移的差異有統計學意義（P＜0.05）。結論 術前CEA水平是結腸癌預后的高危因素。