新型冠状病毒肺炎疫情期间武汉方舱医院的供应药品分析

目的分析新型冠状病毒肺炎疫情期间武汉方舱医院供应药品的品种,为方舱医院药物遴选及合理用药提供参考。方法以武汉市东西湖方舱医院为样本医院,系统分析该样本医院的药品目录,对比方舱医院实际供应药品目录与推荐目录的差异,分析药品的剂型和给药途径。结果样本方舱医院共供应114种药品,有35种药品是超出推荐目录范围内的药品;现有药品中,药品剂型以注射液(41种,占35.96%)和片剂(33种,占28.95%)为主,给药方式以口服(54种,占47.37%)和注射(51种,占44.74%)为主,药物剂型和给药途径均较集中。结论方舱医院的药学服务应注重口服给药的药物相互作用和注射给药的配伍禁忌,临床使用时应加强监护。     

医院内外感染葡萄球菌的耐药性分析

目的分析医院内与院外感染葡萄球菌的耐药性,为临床用药提供依据。方法收集2011年1月至2013年12月黄石市中心医院门诊(院外)、住院(院内)患者各种标本中分离的454株葡萄球菌,用VITEK-32专用卡GPI及血浆凝固酶试验进行鉴定,药敏试验按K-B琼脂扩散法进行,根据美国临床和实验室标准化协会2006对头孢西丁的耐药情况进行分类分析,数据分析用WHONET 5.5药敏分析软件。结果在379株金黄色葡萄球菌(SA)中,耐甲氧西林金黄色葡萄球菌(MRSA)检出率为41.2%,医院内、外标本MRSA检出率分别为44.1%和19.6%,差异有统计学意义(P0.05);共检出凝固酶阴性葡萄球菌75株,医院内、外标本耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)检出率分别为61.1%和38.1%,差异有统计学意义(P0.05)。未检出万古霉素、替考拉宁耐药菌株。结论耐甲氧西林葡萄球菌具有多重耐药性;院外SA感染者首选药物为庆大霉素、苯唑西林;若为院内SA和对于MRCNS引起的不论是院内或院外感染,均推荐首选万古霉素或替考拉宁。     

Stop violence against medical workers in China

The incidence of patient-doctor disputes are alarmingly increasing in China, this article reviews the current status and causes of violence against medical workers in China, six strategies to tackle the daily worrying problems have been proposed and hopefully could improve the medical working environment in China.     

山东省立医院在健康中国行动中的探索与实践

《关于实施健康中国行动的意见》推出健康中国行动15项行动计划,公立医院成为实施健康中国行动防病治病的主战场。山东省立医院积极探索"六位一体"的健康医院模式,通过健康管理打造一站式服务医院,健康宣教打造人文爱心医院,医务社工打造温情医院,"互联网+医疗"打造智慧医院,医养结合打造示范医院,控费提效打造便民惠民医院,取得一定成效。剖析了现存问题,提出了下一步开展健康中国行动的思路。     

从某大型公立三甲医院门诊疾病构成分析看“分级诊疗”

分级诊疗是解决百姓看病难、看病贵的核心制度之一,其理念聚焦于"小病在基层、大病到医院、康复回基层"。作者选取一所大型公立三甲医院,对其门诊病人量及构成进行分析,发现大型医院的门诊量增长率显著高于全国平均水平,医生人均接诊量仍在增长;接诊疾病范围广、复杂、重症病人多,但是慢性病、常见病占其接诊病人比例仍较高,且以慢性病为主的专科病人增长率显著高于医院平均值。研究结果提示:分级诊疗的实质落地仍然需要更进一步强有力的约束措施。     

景德镇市三级医院儿科护理人员执业环境调查研究

目的 调查景德镇市全市三级医院儿科护理人员执业环境,为护理人员执业环境改善提供参考。方法 纳入2019 年4 月～2020 年4 月景德镇市全市三级医院儿科护理人员80 例,采用儿科临床护理人员一般情况调查表、儿科临床护士执业环境测评量表调查儿科护理人员执业环境情况,比较儿科护士执业环境各维度评分与磁性医院均分、儿科护士执业环境评分前5 位及后5 位条目。结果 与磁性医院均分相比,景德镇市全市三级医院儿科护理人员在护士参与医院事务、人力和物力配备、医护合作及薪酬待遇和社会地位几个维度评分明显较低,差异有统计学意义（P＜0.05）;护士执业环境评分前5 位条目分别为医院积极实施护士岗位培训和继续教育计划、护士长领导能力及管理能力强、护理团队能够针对患者护理问题进行日常讨论、科室的医护人员协同工作、医院实施护理质量持续改进;评分后5 位条目分别为有机会参与进修、成为医院护理委员会成员、参与医院管理决策、科室有充足护理人员完成护理工作、参与医院内部管理。结论 景德镇市全市三级医院儿科护理人员执业环境整体评分有待提升,应针对执业环境现状,积极促进护理人员参与医院管理决策,为其提供进修机会,改善执业环境。     

结合新型冠状病毒肺炎疫情议“三山医院”的建设要领

新型冠状病毒肺炎疫情引起全球关注,病毒的高度传染性致使疫情迅速蔓延和大规模暴发。在应对突发的迅速蔓延的疫情过程中,快速建设一个安全性能高的应急传染病专科医院,对于患者治疗、医护人员防护和疫情的控制十分重要。笔者结合“三山医院”建设的经验和温州医科大学附属第一医院应急传染病治疗中心改造的实际经验,系统地对医院选址、医院规划和设计、暖通系统、给排水系统、医用气体要求及医疗废物处置进行阐述,并对关键环节进行探讨。     

Infant-holding side biases: Comparison of laterality patterns in childcare professionals and mothers or students

Among the various interactions between an adult and an infant, postural behaviours and their lateral biases expressed by adults for holding an infant represent a growing field of investigation. To better understand the building up of mother/child relationships, the current study reports data concerning infant-holding biases collected in a new population, namely childcare professionals, where experience with and emotional relationships with infants could be classified as intermediate between basic and advanced. Two sub-populations of childcare professionals were studied: women who work in maternity hospitals and women who work in day-care centres. Their infant-holding side preferences were correlated with emotional perceptive biases to ascertain whether hemispheric specialisation influences holding side biases as well as in basic holding relationships. Results showed that childcare professionals behaved like mothers, which means like participants with advanced holding relationships. The discussion emphasises the complexity of infant-holding behaviours and the importance of considering the nature of holding relationships in the study of side-of-hold biases.     

Positive Distraction in Pediatric Healthcare Waiting Spaces: Sharing Play Not Germs through Inclusive,Hands-Free Interactive Media

ABSTRACT

Purpose: To investigate the value of shared opportunities for positive distraction in pediatric healthcare environments.

Methods: Self-selected activities of 271 young people (5–19 years) with diverse neurodevelopmental conditions were observed in an ambulatory pediatric rehabilitation clinic. Shared opportunities included hands-free media (nature video or interactive media) and an aquarium. Anxiety was self-reported on the State Trait Anxiety Scale upon arrival and after 10 minutes in the waiting space.

Results: Young people engaged more with shared opportunities for distraction (n = 170/271) than personal items brought from home (n = 119/271), p = 0.02. Personal electronic devices were used by 67 young people, but did not positively impact anxiety. Interactive media and the aquarium significantly reduced anxiety (p < 0.04) while the nature video appeared to increase anxiety (p = 0.036). Age influenced activity preference and anxiety. Shared, hands-free interactive media engaged individuals of diverse age and mobility.

Conclusion: Shared opportunities for positive distraction in healthcare facilities are valuable, particularly hands-free interactive media.