军队医院等级评审医院感染管理质量改进的研究

目的 探讨医院感染管理质量持续改进的原理和方法及其在军队医院等级评审过程中的绩效,以提高医院感染管理质量.方法 将全面质量管理中PDCA循环的理论和方法运用到军队医院等级评审“围评价期”医院感染预防与控制管理全过程中,对医院感染迎检和管理操作实施程序化、规范化和标准化,并且及时监督反馈,落实医院感染改进的计划方案,达到医院感染控制的持续质量改进.结果 通过PDCA循环的持续监测和反馈,不断发现和解决医院感染控制问题,医院感染管理质量获得持续改进,等级评审医院感染管理结果优良.结论 军队医院等级评审过程中,应用PDCA循环管理能够促进医院感染预防和控制工作效能的持续改进,不断强化各级管理者的质量意识,有效改善医院感染薄弱环节,实现医院感染管理水平的全面提升,达到医院感染管理评审结果优良的目标.     

追踪方法学与PDCA循环管理在医院感染管理质量控制中的应用

目的通过应用案例介绍追踪方法学和PDCA循环管理在医院感染管理质量控制中的作用。方法介绍追踪方法学与PDCA循环管理的基本理论和方法,结合医院评审,通过多药耐药菌预防控制追踪案例,阐述追踪方法学和PDCA循环管理在医院感染管理质量控制中的应用。结果运用追踪方法学和PDCA循环管理工具可以达到科学管理医院感染控制质量的目的。结论追踪方法学和PDCA循环管理在医院感染管理质量控制中的应用实践经验,可以为医疗机构更好的运用科学管理工具提供参考。     

论PDCA在医院评审中的运用

建设以PDCA为基础的医院全面质量管理体系,对于促进医院发展的不断完善、提高服务质量、保障医疗质量与安全具有重要意义,同时,它还有利于医院建立持续改进的长效管理机制,是等级医院评审的质量管理工具。各医院应该结合自身的实际情况,因地制宜,合理运用PDCA循环,努力提高医院各方面的管理和质量,使得评审工作顺利达标。     

运用PDCA循环评价等级评审医院感染管理工作

目的对二级综合医院等级评审医院感染管理44个条款通过运用PDCA循环管理模式,推动完成条款的标准要求,实现医院感染管理质量和安全的持续改进。方法以二甲医院评审为契机,分解44个条款对应的271条评审要点,运用计划、实施、检查、处理（PDCA）循环原则,每季度对医院感染管理工作推进情况进行完成率评价。结果通过实施一年的PDCA管理,使“A”条款由初评0个上升至终评29个;“D”条款由初评25个减少至终评1个;“C”条款由初评7个减少至终评3个,两项核心条款均达到了A级。结论PDCA循环的运用使医院感染管理形成了质量管理的良性循环体系。但也发现,在评审中投入了大量人、财、物,评审之后之后如何巩固成果,使员工在评审后保持持续改进工作的积极性,这仍是管理者应认真思考的问题。     

以医院评审为契机构建基于PDCA循环的医院质量管理体系

新一轮医院评审为医院质量管理实现质的飞跃创造了契机.构建基于PDCA循环的医院质量管理体系,应该遵循两个“符合”,使质量管理标准规范化;把握三项准则,使质量管理工作常态化;结合三级考评,使质量/评审一体化;形成良性循环,使持续改进制度化.构建了基于PDCA循环的医院质量管理体系,实现了医院全面质量管理水平的持续提高.     

PDCA循环在等级医院评审中的应用

在总结我国第一周期医院评审评价和医院管理年活动等工作的基础上,卫生部医管司组织制定了一系列医院评审评价相关文件,并借鉴美国JCI、日本、台湾、香港等国家(地区)的医院评审评价经验,出台了《三级综合医院评审标准(2011年版)》[1],条款设置遵循PDCA循环原理。PDCA循环最早由     

在JCI标准下改善医院后勤管理的做法

主要阐述在JCI的评审与持续改进过程中,医院后勤保障部门运用具体的PDCA循环工具改善后勤管理质量,提高后勤服务水平,为医院医疗工作的开展提供保障.     

运用PDCA循环,实现全方位护理管理

美国著名质量管理专家戴明在五十年代创造了全面质量管理的科学方法——PDCA循环。PDCA循环又称管理环,即按照计划(Plan)实施(Do),检查(Check),处理(Acfion)四个阶段顺序进行管理,并不断循环。近年来,我院护理部针对等级医院第一周期评审后存在的主要问题,以现代管理理论为依据,运用PDCA,对全院护理业务技术水平,全体护士的综合素质、护理工作的内在质量进行全方位管理,以达到不断上升的目的。     

以等级医院评审为契机努力开创医院管理新局面

新疆医科大学附属肿瘤医院借助等级医院评审工作,以患者需求为导向,建立健全医疗、护理、管理等各项规章制度,梳理工作流程,重构完整的质量管理体系,并运用管理学工具,围绕质量、安全、服务、管理、绩效等方面,执行PDCA和循环,全面提升医院管理水平.     

PDCA循环在医院社会化保洁质量管理中的效果研究

目的：探究PDCA循环管理在医院社会化保洁质量管理中的应用效果。方法：2019年6月—2020年1月在医院社会化保洁工作中实施PDCA循环全面质量管理活动的全过程。 结果：PDCA 循环管理实施后，保洁员消毒隔离知识掌握程度、保洁工作质量、患者对保洁工作的满意度评分均提高，病房物体表面、保洁员手表面微生物监测合格率均提高。PDCA循环管理前后相同指标对比，P < 0.05有统计学意义。结论：在医院社会化保洁工作中实施PDCA循环管理，可有效提高保洁员知识、技能、保洁质量、患者满意度，显著降低院感率，具有积极推广意义。     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.