ObjectiveTo explore the plan-do-check-action (PDCA) circulation method in reducing errors in general inspection items of health examination and to improve the quality of examination. MethodsUsing PDCA circulation method, the reasons of errors in general items of health examination for 39 individuals examinied between August and December 2010 were analyzed. Rectification was carried out according to the reasons, and the differences in the incidence rate of errors in general items of health examination before (from August to December, 2010) and after the rectification was (from Auguest to December, 2011) was compared. ResultsAfter the rectification, the incidence of errors in general items of health examination (0.08%) was significantly lower than that before the rectification (0.45%) (P<0.05). ConclusionPDCA circulation method can effectively reduce the incidence of errors in general items of health examination thus may ensure the medical quality.
目的 对烧伤层流病房多重耐药菌感染的相关因素进行分析，通过护理干预来预防和减少烧伤病房多重耐药菌感染的发生。 方法 回顾性分析2011年1月－12月收治的629例烧伤患者，其中发生多重耐药菌感染74例，感染率为11.8%。 结果 感染部位：创面分泌物培养感染占70.2%，痰液标本培养感染占9.4%，血液标本培养感染占16.2%，其他占4.2%。感染病原菌：以金黄色葡萄球菌为主，占77.0%；鲍曼不动杆菌占4.2%，铜绿假单胞菌占10.8%，肺炎克雷伯菌占6.7%，真菌感染占1.3%。 结论 对发生医院内多重耐药菌感染的原因进行分析并及时采取相应的护理干预措施，及可行的医院感染管理控制措施，对烧伤患者预后有重要的意义，可有效降低院内感染率的发生。
ObjectiveTo evaluate the effect of bundle strategies on the prevention and control of multidrug-resistant organisms (MDROs) in intensive care unit (ICU), in order to effectively prevent and control the severe situation of multiple drug-resistant bacteria in ICU.MethodsWe selected patients who admitted into the ICU from January 2016 to December 2017 as study subjects, and monitored 6 types of MDROs. Basic information was surveyed and collected from January to December 2016 (before intervention), while bundle strategies on MDROs were implemented from January to December 2017 (after intervention), including issusing isolation orders, hanging isolation marks, wearing isolation clothes, using medical articles exclusively, cleaning and disinfecting environment, implementing hand hygiene, etc. Then we compared the MDRO detection rate, nosocomial infection rate, MDRO nosocomial infection rate, and compliance rates of interventions between the two periods.ResultsThe MDRO detection rate before intervention was 77.10%, and that after intervention was 49.12%, the difference between the two periods was statistically significant (χ2=69.834, P<0.001). The nosocomial infection rate of ICU decreased from 23.51% before intervention to 15.23% after intervention, the MDRO nosocomial infection rate decreased from 13.70% before intervention to 5.84% after intervention, and the differences between the two periods were statistically significant (χ2=8.594, P=0.003; χ2=13.722, P<0.001). The compliance rates of doctor’s isolation orders, hanging isolation marks, wearing isolation clothes, using medical articles exclusively, cleaning and disinfecting environment, and hand hygiene, as well as the correct rate of hand hygiene after intervention (92.12%, 93.55%, 81.77%, 84.24%, 82.90%, 77.39%, and 96.37%) were significantly higher than those before intervention (31.94%, 52.00%, 23.43%, 48.18%, 67.16%, 59.46%, and 88.64%), and the differences were all statistically significant (P<0.001).ConclusionThe implementation of the above bundle strategies on the prevention and control of MDROs can decrease the MDRO detection rate and MDRO nosocomial infection rate.
This paper is to discuss the research of heterogeneity in Meta-analysis, including the definition of the heterogeneity in Meta-analysis and classification it into clinical heterogeneity, methodological heterogeneity and statistical heterogeneity, the strategies for diminishing clinical heterogeneity and methodological heterogeneity, the five testing methods in statistical heterogeneity (Q statistic, I2 statistic, H statistic, Galbraith plot and L’Abbe plot) and the examples and applying conditions of the five testing methods, classification of meta-analysis into exploratory meta-analysis and analytic meta-analysis according if the meta-analysis has heterogeneity, and the strategies and the flowchart when existing the heterogeneity in meta-analysis.
ObjectiveTo investigate the reason, prevention, and treatment measures of gastrointestinal unplanned reoperation. MethodsClinical data of 21 patients who carried out gastrointestinal unplanned reoperation for various reasons from Jun. 2012 to Jun. 2013 in our hospital were retrospectively analyzed. ResultsTwenty-one of 2 492 patients with gastrointestinal tract surgery carried out gastrointestinal unplanned reoperation, and the incidence of reoperation was 0.8%. The causes of reoperation were intra-abdominal hemorrhage in 10 cases, gastrointestinal fistula in 7 cases, inflammatory intestinal obstruction with peritonitis in 1 case, and incision dehiscence in 3 cases. After undergoing suture hemostasis, colostomy, anastomotic fistula repair, debridement, and suture,20 cases were cured or improved, and 1 case died. The median of hospitalization expense was 76 000 yuan(46 000-116 000 yuan), and the median of hospital stay was 25-day(16-49 days). ConclusionsGastrointestinal unplanned reoperation can cause more serious economic and emotional burden to patients, standardizing surgical procedure and enhancing perioperative monitoring can reduce the incidence of unplanned reoperation. In addition, grasp legitimately the indications of reoperation, implement timely, and effective reoperation can avoid further deterioration of the disease.