运用PDCA循环改进居家养老护理文件书写质量

目的运用PDCA循环的质量管理方法,改进居家养老护理文件书写质量。方法对现存的护理质量不合格项目进行原因分析、制定改进计划、组织实施、效果评价。结果改进后的居家养老护理文件书写合格率达到98%。结论通过应用PDCA循环质量管理工具进行护理质量管理,使该中心居家养老护理文件书写水平得到大幅度提高,同时促进了该中心护理管理质量的提升。     

PDCA循环在消化道肿瘤伴糖尿病患者营养全程管理中的效果观察

目的 探讨PDCA 循环在消化道肿瘤伴糖尿病患者营养全程管理中的效果观察。方法 运用PDCA循环对80例不同程度营养不良的消化道肿瘤伴糖尿病患者实施营养全程管理,比较干预前后患者的体重、BMI指数、糖化血红蛋白、血红蛋白、总蛋白、白蛋白及球蛋白水平。结果 患者血红蛋白、总蛋白、白蛋白及球蛋白水平均有提高,比较差异均有统计学意义(P＜0.05)。结论 PDCA循环管理在消化道肿瘤伴糖尿病患者营养全程管理中有较大的优势, 值得推广。     

Emergency Medicine/Critical Care Medicine (EM/CCM) Trainees’ Performance on Standardized Critical Care Medicine Examinations: A Ten-Year Review

BackgroundEmergency Medicine/Critical Care Medicine (EM/CCM) trainees may obtain board certification through Internal Medicine (American Board of Internal Medicine [ABIM]), Surgery (American Board of Surgery [ABS]), and Anesthesiology (American Board of Anesthesiology [ABA]). However, EM/CCM trainees experience challenges, including: 1) additional training requirements and 2) an unwillingness to accept EM graduates by many programs.ObjectivesWe sought to: 1) compare EM/CCM knowledge acquisition to medicine (Internal Medicine [IM]/CCM), surgery (surgical critical care [SCC]), and anesthesiology (anesthesiology critical care medicine [ACCM]) Fellows at the local and national level using the Multidisciplinary Critical Care Knowledge Assessment Program (MCCKAP) in-service examination as an objective measure; and 2) compare American Board of Medical Specialties (ABMS) pass rates for EM/CCM.MethodsSingle-center retrospective analysis comparing scores obtained by EM/CCM on the MCCKAP examination with SCC and ACCM over a 10-year period. Scores are presented as means with standard deviations. We performed similar analysis on ABMS examination pass rates.ResultsThere were 117 MCCKAP scores (37 EM/CCM; 80 SCC and ACCM) evaluated. EM/CCM mean score 562.4 (SD 67.4); SCC and ACCM mean score 505.3, (SD 87.5) at the institutional level (p < 0.001). Similarly, EM/CCM scored higher than the national mean (562.4, SD 67.4 vs. 500 SD 100, p < 0.001). Nationally, ABIM-CCM board certification rate was 91.2% for 137 EM/CCM, compared with 93.2% for IM/CCM (p = 0.22); 28 EM/CCM have obtained ABA-CCM board certification with rates similar to ACCM (90.4 vs. 89.3%; p = 0.85).ConclusionsEM/CCM Fellows demonstrate successful knowledge acquisition both locally and at a national level. EM/CCM achieve ABMS pass rates similar to other CCM trainees. The current arbitrary additional training requirements placed on EM/CCM should be removed.     

引入PDCA循环规范医疗废物管理

目的采用PDCA循环法,规范医院医疗废物管理。方法通过计划、实施、检查、处理4个阶段具体实施。结果医疗废物要达到规范化管理,建立有效的组织管理体系,制定切实可行的规章制度是重要保证;加强培训与宣传教育,提高全员管理意识是重要环节;完善医疗废物处置过程中的配套设施是重要基础;制定管理质量标准认真督促检查考核是重要手段。结论PDCA循环法是加强完善医疗废物管理的一种科学的管理方式。     

The Future of Clinical Psychology: Board Certification

The present article presents the future of clinical psychology board certification. With the increasing specialization in the field of professional psychology and the generic nature of state licensure, clinical psychology as a specialty will develop into a specialty area in a similar fashion as have specialties in medicine. A brief history of board certification in professional psychology by the American Board of Professional Psychology is reviewed and the process of becoming board certified in either clinical psychology or clinical child and adolescent psychology is discussed.     

微型计算机在肾图中的应用

用单板计算机配合肾图仪,可自动采集肾图数据、计算并打印指标及曲线.75例病人的配对比较结果表明:计算机结果与原肾图仪无显著性差异.由此证明我们编制的应用程是合理可行的.     

Hydrophobically Modified Poly(acrylic acid) Using 3‐Pentadecylcyclohexylamine: Synthesis and Rheology

Summary: Hydrophobically modified poly(acrylic acid) was synthesized using 3‐pentadecylcyclohexylamine (3‐PDCA), which was in turn synthesized from 3‐pentadecylphenol, one of the components of cashew‐nut shell liquid (CNSL), a renewable resource material. ¹H NMR spectra confirmed the incorporation of 3‐PDCA onto PAA and a series of HMPs with three different molar concentrations, viz ? 3, 5 and 7 mol‐% of 3‐PDCA, were synthesized. An increase in viscosity with increasing hydrophobic content was observed by rheological measurements. The critical association concentrations were determined using an Ubbelohde viscometer and a controlled stress rheometer. The stability of HMPs towards temperature and shear was studied. Rheological measurements showed that there was a steady increase in viscosity with increase in hydrophobe content due to the formation of reversible networks. These polymers exhibited gel‐like behavior at low concentrations (≥2 wt.‐%) with an apparent yield stress (ca. 10 Pa) and showed shear thinning properties (non‐Newtonian). However, below a critical concentration, c [η], they showed Newtonian behavior.

η_sp of unmodified and modified PAA‐Na at various polymer concentrations.     

推行PDCA循环的做法与体会

医院推行PDCA循环并非一成不变,每年的推进都是一个新的循环。介绍了推行PDCA循环的做法与体会,包括成立推进组织,加强组织领导;培育核心团队,坚持长期主义;重视关键节点,加强过程管理;秉承PDCA循环理念,不断持续改进等。针对推进中的问题和难点,认为必须化解推进中的阻力,必须秉承PDCA循环的理念持续改进,必须坚持长期主义等。     

我国科技学术期刊编委会运行机制优化指标体系构建

【目的】 提出期刊出版界、科技界和期刊评价方普遍认同的编委会运行机制优化指标体系,为期刊编委会创建、换届或优化提供参考。【方法】 采用德尔菲法和层次分析法,构建我国科技学术期刊编委会运行机制优化指标体系,并确定权重。【结果】 构建由 “编委会组织优化指标体系(宏观)”和 “编委办刊贡献考核指标体系(微观)”组成的“我国科技学术期刊编委会运行机制优化指标体系”。【结论】 本研究集期刊出版界、科技界和期刊评价方的智慧,构建了“我国科技学术期刊编委会运行机制优化指标体系”,将宏观层面优化和微观层面考核相结合,为我国科技学术期刊编委会创建、换届或优化提供指南或参考,以期真正实现我国科技学术期刊的“专家办刊”,进而推动我国科技学术期刊的高质量发展。