El proceso de institucionalización de la enfermera gestora de casos en España. Análisis comparativo entre los sistemas autonómicos de salud

Care of chronicity is a pressing issue for health systems because of its high prevalence and the organisational challenges that it generates. Different countries solve the complexity of the care of chronicity through case management by the nursing profession, obtaining good results.This paper analyses the status of institutionalisation of the case management nurse in Spain through the design of a reference standard to compare between the autonomous communities in their approach to chronicity. Thus, we sought to monitor the degree of progress of the institutional structure of the policies for the care of chronicity in our country through this healthcare professional. Our results showed that no autonomous community has reached the maximum standard of implementation and that the situation is very heterogeneous, confirming a weak and erratic degree of institutionalisation of the case management nurse in Spain despite the formal recognition of their role in patient care.     

层级管理模式在医院信息技术人员管理中的应用

以解放军第187中心医院信息科网络信息中心的技术人员为研究对象,实施层级管理模式,从人员层级设置、分工模式、分层培训、评价指标等方面具体介绍层级化管理模式的实施方法。结果表明实施层级管理后,服务满意率及考试优秀率均明显高于层级管理前。     

Ductal carcinoma in situ – update on risk assessment and management

Ductal carcinoma in situ (DCIS) accounts for ~20–25% of breast cancers. While DCIS is not life‐threatening, it may progress to invasive carcinoma over time, and treatment intended to prevent invasive progression may itself cause significant morbidity. Accurate risk assessment is therefore necessary to avoid over‐ or undertreatment of an individual patient. In this review we will outline the evidence for current management of DCIS, discuss approaches to DCIS risk assessment and challenges facing identification of novel DCIS biomarkers.     

区域性消毒供应中心的网格化集中式管理

目的探讨网格化集中式管理模式在区域性消毒供应中心的运用效果。方法采用互联网结合WiFi无线网络技术,移动PDA技术,二维条形码技术,建立闸北区区域性消毒供应中心网络系统,闸北区内28个基层医疗机构均是管理系统里的一个网格,采用网格化集中管理模式进行管理,并与常规集中式管理进行效果比较。结果网格化集中式管理模式下消毒供应工作流程中回收、去污、消毒、包装、灭菌、储存和运送质量检查合格率,医疗机构满意率显著高于常规集中式管理,各岗位每人每小时消毒灭菌包个数显著多于常规集中式管理(均P0.01)。结论网格化集中式管理模式应用于区域化消毒供应中心可提高基层医院消毒物品质量,提高工作效率,达到资源共享和质量追溯。     

门诊输液室护理管理缺陷分析及对策

门诊输液室常存在护理管理缺陷,本研究分别从患者的识别、健康教育、医务人员、患者等因素对这些缺陷进行分析,提出了制作座号牌,制定健康教育宣传单,实行量化管理、弹性排班、对输液室护士进行急救理论及技能的培训等针对性的防范措施。通过这些措施提高了门诊输液室的护理质量,减少了医疗纠纷的发生。     

Pain Management in Current Combat Operations

Pain management in the U.S. Military, particularly in combat, shares many of the same principles found in civilian heath care organizations andinstitutions. Pain is one of the most common reasons for which soldiers seek medical attention in the combat environment, which mirrors the civilian experience. However, the combat environment exacerbates the typical challenges found in treating acute pain andhas the additional obstacles of a lack of supplies andequipment, delayed or prolonged evacuation times anddistances, devastating injuries, provider inexperience, anddangerous tactical situations. These factors contribute to the difficulty in controlling a soldier's pain in combat. Furthermore, civilian health care providers have also learned the importance of practicing pain management principles in austere andtactical environments because of recent natural andman-made domestic disasters. Pain management research, education, andtreatment strategies have been created to try to achieve adequate battlefield analgesia, andthese lessons learned may aid civilian health care providers if the circumstances arise. This article presents a brief history andcurrent overview of pain management for combat casualties on today's battlefield. Recent natural disasters andincreased threats for terrorist acts have proven the need for civilian health care providers to be properly trained in pain management principles in an austere or tactical environment     

护理安全标识在临床应用中存在的问题分析及对策

目的分析护理安全标识在临床应用中存在的问题及对策。方法对2008年6月实施护理安全标识以来发生的与护理安全标识相关的问题进行分析，针对问题实施质量改进。结果护理不良事件发生率逐年下降。结论通过实施有效管理，护理安全标识在临床应用形成了持续改进的循环管理系统，可以有效降低护理不良事件的发生率。     

二维码技术在我院PIVAS管理信息系统中的应用

目的:提高我院静脉药物配置中心(PIVAS)信息管理水平,并为PIVAS中的条形码设计与发展提供参考。方法:在我院原有的医院资源管理平台上,以二维码技术代替原来的一维码用于PIVAS的信息管理系统,并介绍其功能作用及应用效果。结果与结论:二维码技术可用于PIVAS信息管理系统中的输液标签生成、输液记费、输液出仓核对、输液数量统计等功能中,不但信息存储量大,而且运行稳定、操作简易,在提高PIVAS工作效率、减少人为因素导致的差错的同时,也为PIVAS今后的电子信息扩充提供了有力保障,值得推广。