浅谈电子信息化系统在Ⅰ期/BE临床试验管理中的作用

目的： 为提高Ⅰ期临床试验整体质量，本文探讨电子信息化系统在临床试验中的功能及建设思路。方法： 分析早期临床试验管理方式的弊端及目前临床试验使用电子信息化系统的现状。结果： 找出目前电子化信息系统需改进之处。结论： 电子信息化系统在确保试验结果的真实可靠，提高临床试验整体质量等方面具有重要意义。     

一种新的加速器EPID机械精度的高精准测量方法及其实现

目的设计并实现了一种电子射野影像装置(Electronic Portal Imaging Device,EPID)机械精度的精确检测方法,可对EPID各机械参数进行测量和定量分析。方法系统硬件采用双目红外相机和定位小球,双目相机以20 Hz频率输出小球的空间坐标,根据小球坐标实时计算EPID平板角度和影像等中心位置以及位置偏差,实现对EPID的精确检测。结果本方法在某医院的EPID上进行多次试验和分析,得到机械等中心与影像等中心误差、EPID平板角度等数据。结论本方法操作简单,具有较高的重复性,可有效帮助技术人员进行机器日常维护工作,对EPID的日常检测和质量控制有指导意义。     

The impact of a closed-loop electronic blood transfusion system on transfusion errors and staff time in a children's hospital

ObjectivesTo assess the impact of a closed-loop electronic blood transfusion system on transfusion errors and staff time.Materials and methodsBefore and after study in all wards of a children's hospital, involving patients and staff of all the wards. The changes were closed-loop electronic blood transfusion, barcode patient identification, electronic blood transfusion administration records and error pop-up warning. The main outcome measures were percentage of blood transfusion errors, time spent on transfusion tasks.ResultsTransfusion errors were identified in 3.87% of 2556 blood transfusion orders pre-intervention and 0.78% of 2577 orders afterwards (P < 0.01). Phlebotomists, nurses, and physicians may make mistakes, including wrong blood type when apply for blood, wrong patient when blood draw or transfusion, wrong dose when apply for blood and the wrong tube label when blood draw or cross-matching, which are significantly reduced after change (1.09% vs 0.31%, 1.13% vs 0%, 0.31% vs 0%, 1.33% vs.0.78%, P < 0.01). Time spent on blood apply was 5.3 ± 1.2 min, hand over blood bag at the transfusion department was 14.9 ± 1.4 min and blood transfusion was 15.8 ± 2.4 min. Time per transfusion round decreased to 2.6 ± 1.0 min, 6.3 ± 1.6 min and 9.3 ± 2.2 min respectively (P < 0.01).ConclusionsA closed-loop electronic blood transfusion, barcode patient identification and error pop-up warning reduced transfusion errors, and increased confirmation of patient and blood types identity before transfusion. Time spent on blood transfusion tasks reduced.     

A practical approach to perioperative management of cardiac implantable electronic devices

With the increased use of cardiac implantable electronic devices (CIEDs), it is increasingly important to recognise the unique challenges involved in the management of patients with CIEDs who are undergoing surgery. Practice advisories and consensus statements have been issued by the American Society of Anesthesiologists and the Heart Rhythm Society, advocating a multidisciplinary approach. This review discusses and presents a practical approach to perioperative CIED management in the Singapore context.