计划免疫金卡统计软件的应用进展和几点建议

计划免疫金卡统计软件使用至今已有两年多了，从1996年下半年深圳市开始在各医院逐点推广，至现在全市6个区82个基层门诊已全部使用。1997年5月广州市9个区163个计划免疫点也实施使用，8个区卫生防疫站和市卫生防疫站也配备了计算机。1998年5月无锡市经过整体策划，全市6个区同时实施了金卡统计软件管理。两年多来，金卡统计软件的实用性和安全性经历了时间的考验，逐渐被推广使用，同时自身也在不断的改进和完善。l软件的改进金卡统计软件已由V3．0基础版升级到V4．0版。我在1997年《中国计划免疫》第5期《计划免疫金卡系统的可行性和可改…     

丰县计划免疫疫苗使用情况及未种、漏种原因分析

疫苗使用情况和儿童未种、漏种的多少是反映一个地区计划免疫工作质量好坏的重要指标。为评价基层计划免疫报表数据的真实性及实际接种情况，对丰县14个镇中50％的乡镇2002年度“四苗”使用情况和儿童未种、漏种的原因进行了专题调查，结果报告如下。     

河南省濮阳市基层计划免疫安全注射情况调查

为了解濮阳市基层计划免疫 (计免 )接种工作中安全注射现状及预防接种人员的安全注射知识掌握情况 ,于 2 0 0 1年 11月对全市 180个基层计免接种点进行了调查。1.材料与方法 :将全市所辖 6个县 (区 )按标准组群抽样方法抽取 3 0个计免接种站 ,共计 180个接种点。调查内容为接种点的注射与灭菌方式、安全注射情况、接种人员安全注射知识掌握情况。安全注射判断标准 :对玻璃注射器做到一人一针一管及压力蒸汽灭菌 ;对一次性注射器做到一次性使用 ,并在使用后正确处理 (消毒毁型、烧毁或深埋 )。2 .结果与分析 :单用一次性注射器的接种点 162个…     

儿童免疫磁卡系统软件在计划免疫管理中的应用

将研制的儿童计划免疫磁卡系统软件，在预防接种点推广使用，取得了良好效果。该系统软件不仅解决了基层防保组织对接种儿童的规范化、科学化管理，而且建立了儿童监护人与计算机的直接联系。还能以疫苗种类、时间变量为基础，按要求快速打印出规范报表。该系统也是金卡工程在卫生防疫领域中的首次应用，为儿童计划免疫的管理提供了一个新方法。     

1999年广东省计划免疫冷链现况分析

广东省地处亚热带，一年有８个月气温超过２０℃，全省陆地面积１７．８万平方公里，以公路交通为主，自１９８６年全省实施计划免疫冷链运转以来，经过１３年的发展配置，已形成了从省、市、县、乡镇到接种点环环相扣的冷链常规运转系统，保障了全省高质量的接种效果，现将１９９９年广东省有关冷链装配现况总结分析如下：１资料来源全省２１个地级市上报的冷链基本情况调查表，计划免疫接种报表，广东省卫生防疫站疫苗监测报告以及基层调查材料等。依迮文远《计划免疫学》作为冷链设备配备达标判断标准。２结果全省２１个地级市、１２２个…     

三水市计划免疫后九年麻疹监测

我市1969年开始使用麻疹疫苗，1986年7月全面推行计划免疫一冷链运转系统，纵观计划免疫后九年麻疹流行情况，虽然接种率稳定在90％以上，但发病率仍出现反复。为探讨我市麻疹发病原因和趋势，现将九年来麻疹监测情况分析如下：材料与方法1资料来源全市历年传染病年报表、年终计划免疫检查周岁以内儿童四苗接种情况统计表。2免疫监测2．1疫苗庙台调查接种时随机抽检市、镇、管理区接种点所用疫苗测定滴度。2．2免疫成功率及人群抗体水平调查防机抽检接种前和接种后一个月的初免儿童进行免疫成功率调查。按东、南、西、北、中五个不同方位确…     

广州市黄埔区流动儿童计划免疫影响因素调查与管理对策

目的调查广州市黄浦区流动儿童计划免疫的接种情况,探讨影响流动儿童计划免疫的因素,提出相应的管理对策。方法在黄埔区随机抽取4条街为调查现场,采用现场询问及查对疫苗接种记录情况的方法,获得流动儿童计划免疫情况,开展家长计划免疫接种相关知识问卷调查,了解家长对儿童计划免疫工作的认识和影响。开展计免工作人员和基层管理单位人员相关工作问卷调查,了解其对流动儿童免疫接种工作的服务情况。结果父母为打工者的儿童计划免疫接种率比父母为司机、职员或其他职业的儿童计划免疫接种率低(p均<0.05);农村来源的儿童免疫接种率较城镇来源的儿童免疫接种率低(p<0.05);父母对计免知识知晓情况好的,儿童的免疫接种率高(p<0.05);基层免疫接种点的服务状况对儿童免疫接种率也有影响;多数村、居委会能协助社区卫生服务中心开展流动儿童的计划免疫工作。结论流动儿童的免疫接种率受众多因素的影响,今后应加强对流动儿童计划免疫的管理;制定流动人口儿童等特殊人群计免管理办法;对流动儿童的父母开展各种形式的健康教育;加强多部门的合作;提高流动儿童的计划免疫接种率,减少相应传染病发病率。     

农村计划免疫苗使用率相关因素的调查分析

计划免疫中的卡介苗、脊髓灰质炎疫苗、百白破三联苗和麻疹疫苗（以下简称四苗）的预算供应，基层一般参照历年常规用量，上级防疫部门则主要根据各地人口资料、发病情况和一定的疫苗损耗系数调整分配。近年来，由于农村计划生育工作的落实，人口出生率显著下降，疫苗使用率也随之下降，消耗系数大增。为探讨影响疫苗使用率的有关因素并提供合理的解决办法，特对有34万人口的宁化县农村（未包括城区居民）进行调查研究。一、材料和方法设计1994年度计划免疫基本情况、疫苗分配与使用情况调查表，由县防疫站计免工作人员深入各乡、村（接种点…     

应用Microsoft Excel处理常规免疫报表

<正>计划免疫日常工作中,每月都有报表需要汇总、统计。按传统的手工统计方法,一个有40个乡镇的县卫生防疫站汇总月报工作需2个工作日,而且容易出错。目前各地卫生防疫站虽然基本上配备了电脑,但计划免疫信息化管理软件成本高、各地发展极不平衡。本人自1999年开始使用Microsoft Excel处理常规免疫报表。经过两年的探索和不断完善,目前汇总义乌市49个接种点的月报表只需半个小时左右即可完成原始数据输入、自动统计、分析、打印输出,而且出错率几乎为0。具体     

上蔡县预防接种安全注射现状调查

目的了解上蔡县基层预防接种安全注射现状,促进预防接种安全注射。方法采用分层多阶段随机抽样方法,对25个城乡基层接种点进行了预防接种安全注射现状调查。结果除1个接种点是一次性注射器与玻璃注射器混合使用外,其余均使用一次性注射器或自毁型注射器;99.2%的接种点实行了"一人一针一管"但仍有5.8%的接种点不能正确处理用后的一次性注射器。个别乡村医生不知道乙型肝炎疫苗的接种部位和贮存条件,存在不安全注射隐患。结论加强对基层计划免疫人员的培训及督导很必要。     

中山市预防接种计算机化管理现状和需求分析

目的 提高预防接种计算机化管理工作水平，并为预防接种管理软件升级提供依据。方法 调查预防接种计算机化管理工作现状，分析为适应免疫规划工作发展而需要加以解决的问题并探讨解决方案。结果 29个镇(区)医院中已有25个实现预防接种计算机化管理。结论 说明在基层开展预防接种计算机化管理是可行的，为适应免疫接种工作发展，要着重处理好网络化管理、多模式运转、多形式发布接种通知、报表统计方案等技术问题。     

Creating the future. Nurses can shape their profession by getting involved in healthcare reform

To remain relevant in a reformed healthcare system, nurses will have to redefine and remake themselves. Three aspects of the new healthcare age--megahospitals, managed care, and redefined professional roles--will have a significant impact on healthcare professions, including nursing. Across the United States hospitals are merging to form sophisticated networks that provide a continuum of care. Under this delivery model, nurses will play a variety of new roles and work collaboratively with the entire spectrum of health social service professionals. A related development--the growth of managed care--is an increasingly attractive option among large employers. It will also accelerate changes in the way healthcare professionals work. Managed care will force physicians to enter into appropriate group affiliations and hospitals to reconfigure themselves to meet the needs of a dynamic system that no longer requires yesterday's beds or management structures. The future will force healthcare professionals to go through regular, radical changes in their job requirements. But it will also allow nurses and others to emerge from their task-oriented past and take on work that requires them to think, judge, and intervene.     

Smartphone as an intervention to intention-behavior of patient care

PurposeSmartphone intervention can be critical for healthcare professionals who often experience human life at risk. This study attempts to assist healthcare professionals to better understand the intervention role of smartphones in intention-behavior of patient care.Research design/methodologyExploratory in nature, this study uses various literatures and articles published in journals and magazines as well as primary data collected using a qualitative approach. Purposive sampling made it possible to conduct in-depth interviews with healthcare professionals, namely, doctors, nurses, and ward boys from hospitals and clinics of the Punjab region of India. The study uses a data saturation method to realize the adequacy of the sample size, and a grounded theory approach to analyze the interviews.FindingsThis study found a gap between intentions and behavior in patient care among healthcare professionals. A smartphone intervenes in the intention-behavior relationship of patient care in three modes, namely propinquity, applications, and communication. The smartphone propinquity pertains to the physical proximity of the healthcare professionals to the smartphone; the applications refer to those installed in the smartphone; and communication indicates calling and e-communications made using the smartphone.Practical implicationsThis study will assist hospital management, governments, and other organizations in drafting a suitable policy for the use of smartphones by healthcare professionals. The manufacturers and software developers of smartphones can deliver devices and software that meet the needs of healthcare professionals for patient care. This study will help healthcare professionals to better understand the usage and effects of smartphones with respect to patients, and to decrease the gap between intention and behavior to improve patient care.OriginalityThis study is unique in that there have been no comprehensive studies of smartphone intervention with respect to its influences on intention-behavior in patient care.     

北京市某区33所村卫生室服务现状调查

目的 了解转型后的乡镇卫生院目前的服务内容及服务效果,探讨其未来的功能定位.方法 从北京市某区分层抽取A、B、C 3个乡(镇),选择其乡镇卫生院进行实地调研,了解乡镇卫生院的服务内容、服务方式及服务效果等.结果 3所卫生院目前提供的服务内容中,A院的公共卫生、基本医疗服务各占50%;B院的公共卫生占70%,基本医疗占30%;C院的公共卫生占60%,基本医疗占40%.乡镇卫生院在公共卫生服务方面开展得相对较好的有全民建档、传染病管理、突发公共卫生事件的应急管理、免疫接种等.结论 乡镇卫生院作为农村三级卫生服务网的枢纽,应重新对其进行功能定位,以满足广大居民的健康服务需求.     

Factors associated with the utilization of electronic medical records in the Eastern Region of Ghana

ObjectivesThis study examined the factors associated with the use of Electronic Medical Records (EMR) in public hospitals in the Eastern Region of Ghana.MethodsThree hundred and ninety-six (396) healthcare professionals were surveyed from the various public hospitals in the Eastern Region of Ghana. The participants included physicians, physician assistants, nurses, laboratory technicians, radiologists, pharmacists, record managers, and ICT staff. Frequency and Chi-Square analyses were performed on the data.ResultsThe results showed that approximately 59% (n=212) of health professionals indicated low use of EMR services in their hospitals. Lack of computer competence (p<0.001), poor communication between users (p=0.050), cost of EMR resources and facilities (p<0.001), lack of technical personnel to install and operate EMR technology resources (p<0.001), and lack of EMR software packages (p<0.001) had significant negative relationships with EMR utilization.ConclusionUtilization of EMR services is low among the healthcare professionals in the Eastern Region. Therefore, the Ghana Health Service needs to provide training to their employees and supply the needed resources to encourage and support the hospitals and healthcare workers to increase the utilization of the EMR services that improve healthcare delivery in the Region. To enhance EMR utilization, it will be essential that government supports health facilities who have challenges using EMR. To better understand the issues, a mixed method approach is recommended to be used to study healthcare workers from both private and public healthcare facilities in the Eastern Region of Ghana.     

Optimizing teacher basic need satisfaction in distributed healthcare contexts

Optimizing teacher motivation in distributed learning environments is paramount to ensure high-quality education, as medical education is increasingly becoming the responsibility of a larger variety of healthcare contexts. This study aims to explore teaching-related basic need satisfaction, e.g. teachers’ feelings of autonomy, competence and relatedness in teaching, in different healthcare contexts and to provide insight into its relation to contextual factors. We distributed a digital survey among healthcare professionals in university hospitals (UH), district teaching hospitals (DTH), and primary care (PC). We used the Teaching-related Basic Need Satisfaction scale, based on the Self-Determination theory, to measure teachers’ basic needs satisfaction in teaching. We studied relations between basic need satisfaction and perceived presence of contextual factors associated with teacher motivation drawn from the literature. Input from 1407 healthcare professionals was analyzed. PC healthcare professionals felt most autonomous, UH healthcare professionals felt most competent, and DTH healthcare professionals felt most related. Regardless of work context, teachers involved in educational design and who perceived more appreciation and developmental opportunities for teaching reported higher feelings of autonomy, competence, and relatedness in teaching, as did teachers who indicated that teaching was important at their job application. Perceived facilitators for teaching were associated with feeling more autonomous and related. These results can be utilized in a variety of healthcare contexts for improving teaching-related basic need satisfaction. Recommendations for practice include involving different healthcare professionals in educational development and coordination, forming communities of teachers across healthcare contexts, and addressing healthcare professionals’ intentions to be involved in education during job interviews.

     

医院感染管理相关科研现状调查及发展趋势

目的了解1986年以来我国医院感染管理相关科研现状及发展趋势,为提高我国医院感染管理研究能力提供依据。方法采用多阶段分层抽样的方法抽取全国13个省及军队系统的170所医院进行问卷调查,调查内容包括：医院感染专职人员论文发表情况、医院感染相关著作出版情况、医院感染相关科研课题申报情况及其科研获奖情况。结果170所医院中二级医院63所、三级医院107所。1986—2015年期间医院感染管理专职人员共发表论文2 596篇,其中中文论文2 555篇,英文论文41篇;二级医院共发表论文105篇,三级医院2 491篇。4个时间段中论文发表数量均逐年增多。2011年以后三级医院的英文论文发表数量明显增多。被调查医院1986—2015年共编写了68部医院感染管理方面书籍,其中2011—2015年共出版35部,占总数的51.47%。1986—2015年间共申请各类医院感染相关科研课题217项,其中三级医院213项,占98.16%。申请课题的时间以2011年以后为主,共125项,占57.60%。结论我国医院感染管理相关研究已进入快速发展阶段,医院感染管理部门及医院感染专职人员均逐渐重视科研工作。     

儿童医院医院感染管理30年状况调查

目的了解我国儿童医院30年医院感染管理发展历程及现状。方法采用回顾性调查方法对20所儿童医院进行调查,调查内容包括：医院基本情况、医院感染管理组织和专职人员配备、医院领导对医院感染管理工作的支持情况、医院感染知识培训情况、医院感染监测情况等。结果至2015年20所医院均设置了独立的医院感染管理科,并成立了医院感染管理委员会。2015年1 000张床以上的医院有46.15%（6/13）的医院专职人员配备不足。2015年20所儿童医院共有医院感染管理专职人员88名,学历以本科为主（47名,占53.41%）,职称以中级为主（30名,占34.09%）,专业以护理为主（41名,占46.59%）。至2015年,医院感染发病率、漏报率、抗菌药物使用率、新生儿医院感染发病率均较2006年下降。2015年20所（100.00%）医院均开展了抗菌药物使用监测、多重耐药菌监测、消毒灭菌监测、配备了防护用品。2015年9所医院（45.00%）的全部病区使用非手触式水龙头,19所（95.00%）医院全部病区配备了干手纸巾、速干手消毒剂。1996年无一所医院医院感染专职人员参加国家级培训≥3次,2015年有11所（55.00%）。结论近30年来,我国儿童医院的医院感染管理工作基本达到要求,医院感染监测逐步完善,但医院感染专职人员配备、人员素质能力仍需加强。     

医务人员对三级公立医院绩效考核政策的关注度及其影响因素分析

目的调查医务人员对国家三级公立医院绩效考核政策的关注度及其影响因素。方法多阶段随机抽取我国东部、中部、西部地区2019年度考核等级结果为优秀、良好、一般的各一家三级公立医院（共计9家）,对13 211名医务人员进行问卷调查。使用SPSS 22.0软件对数据进行统计分析。结果医务人员对国考政策的医疗质量、运营效率、持续发展、患者满意度、医务人员满意度5个维度关注度分别为95.88%、94.00%、94.58%、93.26%、98.27%;总关注度为97.78%,影响因素包括地区、专业技术职称以及行政管理职务。 结论医务人员对国考政策总体关注情况良好,低职称者以及无管理职务者是关注度的重点提升人群。建议医院管理者对不同类别医务人员进行个性化管理,从医院绩效管理循环入手,提升医务人员关注度,促进国考政策落实。     

What impact will the ‘conversion’ of two district general hospitals into teaching hospitals have? Views from the field

AIM: To gather opinions from a variety of healthcare professionals in Birmingham and the Black Country as to the potential impact of 'converting' 2 district general hospitals into teaching hospitals. METHODS: Thirty-three semi-structured interviews were conducted with healthcare professionals including Directors of Public Health, Community Health Council Chief Officers, Trust Chief Executives, medical directors, trust managerial and consultant staff, junior doctors and nurses. Interviewees were asked to outline what they felt the major impacts of the 'conversion' to teaching status were likely to be. RESULTS: Five main thematic areas were identified from the interviews. Three of these related to the medical students receiving their clinical training in the new teaching hospitals, the teachers undertaking new or additional teaching duties and the patients being treated in the new teaching settings. Interviewees also identified several organisational effects relating to the new, established and non-teaching hospitals in the locality and discussed potential impacts outside of health care settings. CONCLUSIONS: The majority of views expressed by participants were positive citing potential benefits from developments in teaching provision. Areas of concern generally related to the need for successful implementation of the changes within clinically focused environments rather than to the effects of teaching per se. The impacts consequent to the reconfiguration of district general hospitals to teaching hospitals should be evaluated by appropriately designed longitudinal studies.