Acoustic environment is an important part of the overall environment of a hospital. Acoustic environmental pollution will have varying degrees of impact on human physiology and psychology. Acoustic environmental pollution in outpatient clinics has become a major concern for visitors and medical staff. Exploring the causes of outpatient acoustic environment pollution and adopting active countermeasures are effective methods to control outpatient acoustic environment pollution. This article will review the current situation of acoustic environmental pollution in outpatient clinics and the impact of acoustic environmental pollution on medical staff and visitors, and analyze the common causes of outpatient acoustic environmental pollution based on actual conditions, and propose corresponding solutions for the corresponding causes. It aims to provide a reference for clinically effective control of acoustic environmental pollution in outpatient clinics.
ObjectiveTo explore the potential safety problems of acute alcohol intoxication. MethodsBetweenDecember 2009 and December 2012, 508 patients with acute alcohol intoxication were admitted to the Department ofEmergency of our hospital. We analyzed the potential safety problems of acute alcohol intoxication and made relative countermeasures. ResultsThe 508 cases of acute alcohol intoxication were treated with comprehensive measures, such as physical examination, health condition evaluation, airway patency maintaining, vein channel establishing, accelerating in vivo alcohol exclusion, maintaining consciousness, taking safety protective measures, and strengthening the communication between doctors and patients. There was no accident injury or death occurred. ConclusionWe should pay more attention to the potential safety problems of patients with acute alcohol intoxication, and take measures to ensure their safety.
Measurement properties studies of patient-reported outcome measures (PROMs) aims to validate the measurement properties of PROMs. In the process of designing and statistical analysis of these measurement properties studies, bias will occur if there are any defects, which will affect the quality of PROMs. Therefore, the COSMIN (consensus-based standards for the selection of health measurement instruments) team has developed the COSMIN risk of bias (COSMIN-RoB) checklist to evaluate risk of bias of studies on measurement properties of PROMs. The checklist can be used to develop systematic reviews of PROMs measurement properties, and for PROMs developers, it can also be used to guide the research design in the measurement tool development process for reducing bias. At present, similar assessment tools are lacking in China. Therefore, this article aims to introduce the primary contents of COSMIN-RoB checklist and to interpret how to evaluate risk of bias of the internal structure studies of PROMs with examples.
ObjectiveTo explore the infection condition of Acinetobacter baumannii at the Neurosurgery Intensive Care Unit (NICU), and analyze the possible risk factors. MethodsWe retrospectively analyzed the clinical data of Acinetobacter baumannii infection patients with craniocerebral injury treated at the NICU between January 2011 and June 2013. We collected such information as infection patients' population distribution, infection site, invasive operations and patients' nurse-in-charge level and so on, and analyzed the possible risk factors for the infection. ResultsThirty-one patients were infected with Acinetobacter baumannii, and they were mainly distributed between 60 and 80 years old. The main infection site was lower respiratory tract, followed in order by urinary tract, gastrointestinal tract, skin and soft tissue. The risk factors might be related to age, invasive operation, nurse working ability, etc. ConclusionThe patients at the NICU are vulnerable to infection of Acinetobacter baumannii. Reducing invasive diagnosis and nursing procedures, providing optimal care, and carrying out specialized nurse standardization training may be the important means to effectively reduce the infection.
This article introduces the measures that the scientific research base of West China Hospital has taken in its emergent response to the unexpected huge Wenchuan earthquake disaster, including safe evacuation, safety examination and removal of hidden dangers, damage reporting and a series of subsequent measures.
ObjectiveTo explore the corresponding intervention measures to reduce maternal mortality rate by analyzing the causes and problems of maternal deaths. MethodsA retrospective analysis was conducted to analyze all cases of maternal mortality from January 2005 to June 2013 in West China Second University Hospital. ResultsAmong the 14 cases of maternal deaths, the main diseases of the patients were pregnancy complicated with heart disease, hypertensive disorders, obstetric hemorrhage, amniotic fluid embolism and ectopic pregnancy. Four cases got prescriptive prenatal care during pregnancy, accounting for 28.6% (4/14), while 10 cases did not, accounting for 71.4% (10/14). Six patients died in prenatal period which accounted for 42.9% (6/14), while 8 died in postnatal period which accounted for 57.1% (6/14) and 5 died within 24 hours which accounted for 62.5% (5/8). Seven underwent cesarean section and 6 fetuses survived. Two went through trial of labor and no fetus survived. There was no ordered postmortem. ConclusionIntensifying education of prenatal care during pregnancy, improving quality of obstetrical service and diathesis of healthcare professionals, strengthening the supervision of high-risk pregnancy and timely choosing the time and manner of delivery are the main measures to decrease the maternal mortality.
Cardiac surgery is associated with high risks, significant trauma, and long recovery periods. With advances in cardiac surgery techniques, the mortality rate and incidence of complications have been steadily decreasing. Patient-reported outcomes (PROs) have gradually become an important area of research in postoperative recovery of cardiac surgery. The use of patient-reported outcome measures (PROMs) in this field helps to reflect patients' physiological, psychological, and social functioning during recovery, and provides scientific evidence for clinical interventions, which may further improve prognosis and enhance patient recovery experience. This paper reviews the dimensions of PROMs in the field of cardiac surgery recovery, the current status of existing PROMs scales, and the progress of their application, while also identifying the limitations of the existing tools. Finally, it explores future research directions for PROMs in cardiac surgery patients.
Objective To analyze outpatient pharmacy internal prescription dispensing errors list and raise suggestions on preventive measures, in order to provide better and safer medical service for patients. Methods We summarized and analyzed the prescription dispensing error types and causes based on 320 cases of internal prescription dispensing errors of the outpatient pharmacy in a hospital of the highest rank between January and June 2014. Then, we put forward suggestions on improvement measures. Six months after the implementation of these measures, we compared the error rate after dispensing between January and June 2014 with those between July and December 2014. Results Among all the 320 prescription dispensing errors, 120 (37.50%) were wrong medication amount, 101 (31.57%) were wrong drugs, 76 (23.75%) were wrong usage and dosage, 17 (5.31%) were wrong packaging specification, and 6 (1.87%) were wrong medication form. The dispensing error rate between July and December 2014 was reduced compared with the rate between January and June 2014. The error rate after dispensing declined from 0.01‰ to 0.006‰. Conclusion Encouraging drug dispensing personnel to issue internal dispensing error recording list for the staff who had errors in dispensing, promoting pharmacists’ professional quality, strengthening the management of outpatient pharmacy, reasonable storage of medicines, enhancing intervention of irrational prescriptions, improving the spatial layout of the pharmacy, and perfecting dispensing error management system, can in a large extent reduce medication errors.
Cardiac surgery is often associated with significant trauma, which can lead to a suboptimal recovery experience for patients. With advancements in cardiovascular surgical techniques, the rates of surgical mortality and complications have significantly decreased, leading to increased attention on patients' subjective recovery experiences after the surgery. Patient-reported outcomes (PROs) refer to the feedback provided directly by patients regarding their health status, functional abilities, and treatment experiences. Accurate assessment and timely intervention of PROs have become a growing area of interest in the academic community, with improvements in certain PROs showing significant correlations with prognostic benefits. However, there remains controversy regarding which dimensions of PROs should be prioritized in the postoperative recovery of cardiac surgery patients and how to select appropriate evaluation scales for these dimensions. We referenced the research progress both domestically and internationally, combined with clinical practices from around the world, and widely solicited expert opinions to reach a consensus on the evaluation dimensions of postoperative PROs for cardiac surgery patients. This includes the overall recovery status of patients (surgical recovery, quality of life) and its nine dimensions (pain, physiology, sleep, thirst, frailty, activity, cognition, mental health, and social support). This consensus comprehensively considers the application of PROs scales, and introduces 1-3 scales with the widest application and most solid evidence for each dimension, aiming to further standardize the evaluation dimensions of PROs after cardiac surgery in China and the selection of scales for each dimension.
ObjectiveTo analyze the reasons for Non-iatrogenic Complaint in general hospital inpatients and its preventive measures. MethodsWe analyzed 338 cases of non-iatrogenic complaint from January 2008 to December 2013 in two tertiary hospitals. ResultsComplaint for poor service attitude of medical personnel and poor communication between doctors/nurses and patients accounted for 86.1% and 62.4% respectively. Complaint for poor hospital management accounted for 46.2%. Non-iatrogenic complaint which appeared in the form of medical dispute complaint due to technical factors accounted for 20.1%. The first five departments being complained were Emergency Department, Pediatrics Department, Obstetrics Department, Osteology Department, Cardiology Department, respectively. Among all complaint, the proportion of complaint from emergency patients exceeded that from nonemergency patients. The proportion of complaint from patients whose duration of hospitalization exceeded two weeks were much more than that from patients whose duration of hospitalization was less than two weeks. The proportion of complaint from patients whoes frequency of hospitalization within one year was more than two times exceeded that from patients whose frequency of hospitalization within one year was less than two times. The proportion of complaint from patients who earned their high school diploma exceeded that from patients who droped out of their high school. The proportion of complaint from town patients exceeded that from rural patients. The proportion of complaint from patients under 45 years old was more than that from patients ≥ 45. ConclusionMore weight and strengthen should be placed on doctor-patient communication in clinical practice. Humane medical service deserve special emphasis and the patientcentered service idea should also be established, so that non-iatrogenic complaint may be reduced.