Objective To investigate the mastery of the management knowledge of patients with atrial fibrillation after coronary artery bypass grafting by cardiac surgeons in Beijing tertiary hospitals, and the practice status and obstacles of following the guidelines for postoperative atrial fibrillation. Methods A convenient sampling method was used to select cardiac surgeons from four tertiary hospitals in Beijing, and a self-designed questionnaire on the management of postoperative atrial fibrillation patients was used. Results A total of 227 valid questionnaires were collected. Only 47.9% of doctors and 12.8% of nurses passed in knowledge, and 31.3% of doctors and 28.5% of nurses passed in behavior. Among them, risk factor assessment, preventive medication, stroke and bleeding risk assessment were the weakest. "Lack of departmental requirements" was identified as a common barrier to healthcare workers' adherence to guidelines. Job title and participation in training were common influencing factors that affected the knowledge and behavior of healthcare workers, and knowledge level was an important factor affecting healthcare worker behavior. Conclusion In order to improve the effect of CABG surgery and improve the quality of postoperative patient management, hospitals should further strengthen the knowledge and skills training of medical staff on the management guidelines of postoperative atrial fibrillation with CABG, formulate relevant systems to ensure the clinical implementation of guidelines.
ObjectiveTo understand the treatment status and economic burden of convulsive epilepsy patients in Hailin City, Heilongjiang Province, who had received an epilepsy management program that was terminated for 6 years, and to estimate the long-term effect of the epilepsy management program.MethodsFollow up the 234 patients in the program of epilepsy prevention and management in rural areas at the end of December 2011 by standardized questionnaire and interview.ResultsAmong the 234 patients who received antiepileptic drugs (AEDs) and follow-up management at the end of epilepsy prevention and management program in rural areas, 172 patients received Phenobarbitone (PB) and 62 patients received Sodium valproate (VPA). 86 patients completed the survey. Among them, 46 (53.49%) were still taking original drugs, 31 (36.05%) changed to other AEDs, 9(10.47%) gave up the treatment due to the closure of the program. The treatment costs of patients in adherence group were also lower than that of other patients, and the average cost was only 43.61% of that of the replace group. There were statistical significant differences in annual household income, drug costs, offset seizure frequency and current seizure frequency between the two groups.ConclusionThe epilepsy management program had remarkable long-term effects and short-term effects, it had advantages in treatment effect and reducing drug costs. It could be recommended throughout rural China.
This article briefly introduces the management of clinical trials of investigational new drugs, hospital-made preparations, post-marketing drugs and other types of clinical trials. The WHO International Clinical Trial Register Platform (WHO ICTRP), Chinese Clinical Trial Register (ChiCTR) and Chinese Clinical Trial Registration and Publishing Collaboration (ChiCTRPC) are also described. People conducting trials are advised to apply the basic philosophy of evidence-based medicine in their implementation, which is considered to be one of the guarantees of the validity of clinical trials.
ObjectiveTo investigate the medical quality of rehabilitation departments in medical institutions at all levels in Shenzhen and analyze the problems, so as to promote the continuous improvement of rehabilitation care quality in this city.MethodsFrom September to November 2019, a field investigation was carried out in 53 rehabilitation departments in Shenzhen. Five dimensions were scored by experts, including professional capacity, rules and regulations, knowledge and skills, supervision and feedback, and hospital infection control. Descriptive statistical analysis was used to characterize the data, and one-way analysis of variance was used to analyze the difference among different level hospitals.ResultsThe average score of rehabilitation medical care quality in Shenzhen was 83.98±8.28. The average score of tertiary, secondary, and primary hospitals were 85.61±7.02, 84.54±7.83, and 77.55±10.60, respectively, and the difference among different level hospitals was statistically significant (P<0.05). According to the standard score, the highest score was in the dimension of supervision feedback (95.75±6.50), and the lowest score was in the dimension of knowledge and skills (77.27±14.64).ConclusionThe overall quality of rehabilitation care in Shenzhen needs to be improved, and the management and professional training systems need to be established.
摘要:目的：評價圍手術期預防性應用抗菌藥物現狀及合理性。方法：采用回顧性調查的方法，隨機抽查2009年度Ⅰ類切口手術圍手術期病案500份，設計外科圍手術期預防性應用抗生素調查表，對預防用藥的適應證、用藥種類、聯合用藥、給藥時機及持續時間進行統計分析。結果：未使用抗生素5例，預防性使用抗生素495例，其中不合理80例（16.00％）。預防性使用抗生素總品規數為540，其中頭孢菌素類453例（83.89%），青霉素類（包括加酶抑制劑）26例（4.81%），喹諾酮類44例（8.15%）。選用頭孢唑啉鈉178例（32.96%）居第一位，頭孢替唑鈉第二，151例（2796%）。結論：Ⅰ類切口手術患者圍手術期預防性使用抗菌藥物較為合理，但仍存在用藥指征把握不嚴，抗菌藥物的選擇、抗菌藥物使用時間較長等問題，有待進一步規范化管理。Abstract: Objective: To understand the current application of perioperative preventive antibiotics, and their rationality. Methods: Five hundred perioperative records of patients with incision Ⅰ were randomly chosen and surveyed in 2009. A questionnaire for prophylactic use of antimicrobial was designed. The indication of antimicrobial use, the species, combination, timing and drug duration were analyzed. Results: Our of 500, 495 used antimicrobial and 80 were unreasonable; 540 kinds of antimicrobial were used, included cephalosporin 453 cases (83.89%), penicillin class (including plus enzyme inhibitors) in 26 cases (4.81%), quinolone 44 cases (8.15%). Cefazolin sodium (178 patients, 32.96%) ranked first, second was cefazolin sodium (151, 27.96%). Conclusion: Perioperative use of antimicrobial prophylaxis in patients with incision Ⅰ is reasonable, but standardization management should be strengthened in the indication, species, and duration.
Objective To evaluate the current status of human resources in healthcare-associated infection prevention and control (infection control) in Jiangxi Province, and explore the impact of emergency public health events on the human resources of infection control professionals in various levels and types of medical institutions. Methods From October 1st to 31st, 2023, questionnaire and on-site interviews were conducted to investigate the human resources situation of infection control professionals in various levels and types of medical institutions in Jiangxi Province. Three stages were selected for the investigation: before the outbreak of COVID-19 (before the event, December 2019), during the event (June 2022), and after the transition of COVID-19 (after the event, June 2023), focusing on the characteristics of human resources between before the event and after the event by the comparative analysis. Results Finally, 289 medical institutions were included. There was a statistically significant difference in the number of infection control professionals in medical institutions among 2019, 2022, and 2023 (χ2=189.677, P<0.001). The number of infection control professionals in 2019 was lower than that in 2022 (P<0.001) and 2023 (P<0.001), but there was no statistically significant difference between 2022 and 2023 (P=0.242). The number of infection control professionals per thousand beds in 2019, 2022, and 2023 was 4.40, 6.16, and 5.76, respectively. There was no statistically significant difference between 2019 and 2023 in terms of professional titles, gender, educational level, or professional background (P>0.05). Conclusion Emergency public health events have promoted the increase in the number of infection control professionals, but there is no statistical significance in the professional titles, educational level, or professional background of infection control professionals.
ObjectiveTo understand the development of clinical nutrition departments in western China, analyze the main problems and factors restricting its development, and provide a basis for promoting the construction and development of clinical nutrition departments in western China and formulating clinical nutrition management standards.MethodsQuestionnaires were used to investigate the development of clinical nutrition services in some hospitals in 11 provinces/municipalities/autonomous regions in western China (except Tibet) in March 2019. ResultsA total of 230 hospitals participated in the survey. Most clinical nutrition departments set up outpatient clinics (76.1%), with an average annual number of outpatients of 884; most of them carried out nutrition inspection visit/follow-up work (86.5%), and the average number of inspection visit/follow-ups was 3 876. Most hospitals had incomplete hardware and software facilities in the clinical nutrition departments. The charging items for diagnosis and treatment were complicated, and the charging standards were uneven. There were still 47.0% of the clinical nutrition departments of hospitals that did not offer diagnosis and treatment charging items. The surveyed hospitals believed that the talent team was the number one factor restricting the development of the clinical nutrition department, and regular skills training was the number one project that urgently needed the help of the Clinical Nutrition Discipline Alliance of West China Hospital of Sichuan University.ConclusionIn the future, the western region should increase the investment in hardware and software facilities, strive for policy support for maintaining department operations and formulate unified standards to regulate the development of disciplines.
ObjectivesTo investigate the present status of clinical nurses' attitude towards patient safety and its influencing factors.MethodsA total of 2 290 clinical nurses in 10 large general hospitals in Anhui Province were investigated by general data and patient safety attitude questionnaire (SAQ).ResultsThe total score of the nurse's patient safety attitude was 112.57±11.83, in which the 6 dimension scores arranged from high to low were management recognition, working conditions, job satisfaction, team cooperation, safety climate, and pressure perception. Nurses who were female, marriage, college degrees, head nurse, and receivded patient safety education had higher total scores.ConclusionsScores of nurses of tertiary 3A hospitals in Anhui Province are overall above average. The influencing factors of nurses’ safety attitude are gender, marital status, education level, length of service, whether being head nurse, and whether being received safety education.
ObjectiveTo analyze the accessibility of primary care in Sichuan Province from both the perspective of doctors, patients, and field workers, and then make some policy recommendations.MethodsBased on the Quality and Costs of Primary Care in Europe primary care questionnaire, we surveyed 48 primary care facilities from six cities / states in Sichuan by multi-stage stratified random sampling method, taking in account of the regional development level from November 2017 to December 2018. Then integrated accessibility score for primary care was calculated based on the question items for both doctors and patients.ResultsThis study effectively surveyed 319 primary care doctors and 641 patients. In general, the integrated accessibility score for primary care for these areas was 0.25. The accessibility of primary care was worst in less-developed regions (0.23), while it was much better in medium-developed area (0.30) and developed area (0.28).ConclusionsWe can do lots of things to improve accessibility of primary care. Evidence based policies are needed to promote this goal that everyone will have access to basic medical and health services.
ObjectiveTo investigate the job satisfaction, emotional state and related factors of medical staff participating in online consultation of West China Internet Hospital during the COVID-19 epidemic.MethodsThrough literature review and expert consultation (Delphi method), the questionnaire was developed, and the online consulting medical staff of West China Hospital of Sichuan University were invited to conduct the questionnaire survey from 26 January to 19 June 2020, and finally the statistical analysis was summarized.ResultsA total of 132 valid questionnaires were retrieved. Of the 132 subjects, 127 people (96.2%) expressed satisfaction or special satisfaction with the online consulting office format; 103 respondents (78.0%) said that online consulting did not affect or completely did not affect the work and life; 81 people (61.4%) consulted online more than 5 days a week, and 108 people (81.8%) worked within 2 hours a day; the vast majority (97.7%) of the research subjects were satisfied with the content of the training materials and the related support work of the coordination group. Only 29 (22.0%) of the study participants believed that the epidemic caused negative emotions, mainly due to the severity of the epidemic.ConclusionThe online consulting medical staff are satisfied with the office form, training materials and coordination work group of the COVID-19 epidemic, and think that it does not affect their work and life. 22.0% of medical staff have negative emotions, and the severity of the epidemic is the main reason.