Results of offering oral rapid HIV screening within a dental school clinic

To broaden the availability of human immunodeficiency virus (HIV) testing, we offered rapid HIV screening tests to 811 patients attending a dental school for routine dental hygiene care. Study design is a prospective cross‐sectional study. The 319 (39.3%) agreeing to test, self‐identified as: Hispanic (34.4%), White (25.8%), African American (13.1%), Asian (8.3%), Native American/Pacific Islander (0.9%), more than one race/ethnicity (1.1%) or declining to state (16.5%). Over 35% (n = 113) were first time HIV test takers, with another 2.2% (n = 7) unaware of their testing history. Approximately 60% of the decliners choose “just don't want test today” as the reason. Following a strictly structured algorithm, four possible undiagnosed infections were initially identified, with one completing the algorithm to case confirmation. In conclusion, the confirmed incidence rate finding of HIV seropositivity of 0.31% found through initial screening at the dental clinic, compared with the 0.018% incidence rate of HIV with confirmed diagnosis in Los Angeles County, indicates that a rapid HIV screening test offered in a dental school clinic can potentially play an important role in discovering undiagnosed HIV individuals.     

COVID - 19流行期间基于信息系统上报的27 455名发热就诊病例资料分析

目的 分析COVID - 19流行期间，济南市发热门诊重点对象健康管理系统报告的发热就诊病例的流行病学特征，为疾病预防与控制提供参考。方法 对济南市发热门诊重点对象健康管理系统报告的27 455发热门诊就诊病例的流行病学、临床表现、来院/离院方式、流向等资料进行描述分析。结果 自2月5日系统创建启用至3月5日，共报告27 455发热就诊人次，男女性别比1.25∶1。年龄中位数29岁，其中1岁儿童最多，以5岁以内、20～39岁人群居多。来院、离院方式均以非公共交通工具为主，其中自驾占来院方式60.46%，离院49.33%。就诊者以发热为主诉占74.09%。重复就诊病例2 422人，占发热就诊总病例数的8.82%。男性重复就诊比例高于女性，重复就诊者年龄中位数高于非重复就诊者。是否重复就诊患者的最终流向分布也不同（P＜0.05）。发热就诊病例中发现常见法定报告传染病76例，COVID - 19病例11例。结论 COVID - 19流行期间建立的发热门诊重点对象健康管理系统报告的发热就诊病例以儿童、中青年居多，来院/离院方式以非公共交通工具为主。该系统对包含COVID - 19在内的以发热、咳嗽为主诉的呼吸道传染病预警具有一定价值。     

Antenatal anaesthetic assessment of obstetric patients

Early identification and anaesthetic assessment of high-risk patients in pregnancy is important and best delivered through a formal assessment clinic. It provides the opportunity to provide information, agree management plans, and carry out necessary investigations and referrals to other specialists prior to labour and delivery. Clear referral criteria and lines of communication are necessary for an effective service.     

Optimization of Patient Scheduling in a Hematology Outpatient Setting

BackgroundA sequelae of increased cancer incidence is the need for specialized outpatient care. The purpose of this project was to improve scheduling of multifaceted treatments and care within an outpatient clinic.MethodsA decision support tool was developed within research electronic data capture (REDCap) to improve patient scheduling.ResultsPatients reported satisfaction with access and appointment coordination. Nurse practitioner clinic utilization and new-patient volumes increased. Qualitative themes included ease in facilitating transfer of care.ConclusionsA decision support tool within REDCap was successfully implemented within an outpatient cancer clinic and may be considered for other specialty services.     

我国全科诊所发展影响因素的鱼骨图分析

通过文献检索,运用鱼骨图法对当前影响我国全科诊所发展的因素归纳为4个方面:政策因素、组织因素、供方因素和需方因素。对照国外全科诊所发展经验,结合我国全科诊所发展的实际情况,对4个方面的影响因素进行分析和总结,为促进全科诊所发展提供参考。     

26所基层民营口腔诊所医务人员手卫生现况调查

 目的 调查十堰市区基层民营口腔诊所医务人员手卫生现况。方法 2019年9—11月采用便利抽样法对十堰市区民营口腔诊所医务人员手卫生现况进行隐蔽式调查,分析并比较不同岗位类别医务人员的手卫生依从率及正确率。结果 共调查民营口腔诊所26所,设有专用洗手设施的仅17所(占65.38%),配有快速手消毒剂的12所(46.15%)。隐蔽式观察102名医务人员,观察有效手卫生时机2 183次,医务人员实际执行572次,手卫生依从率26.20%,正确率25.52%(146次)。不同岗位类别医务人员的手卫生依从率、正确率比较,差异均有统计学意义(均P＜0.001)。护士的手卫生依从率(30.80%)、正确率(31.85%)较其他岗位人员高。医务人员在接触患者体液后的依从率(76.24%)和正确率(40.26%)较其他手卫生时刻高,接触患者前后的手卫生依从率最低,仅为15.38%、24.72%。医务人员不同手卫生时刻的依从率、正确率比较,差异均有统计学意义(均P＜0.001)。结论 基层民营口腔诊所医务人员手卫生依从率和正确率均较低,急需相关部门加强对基层民营口腔诊所的手卫生管理。     

“钉钉”辅助教学在骨科临床教学中的应用

目的本文介绍智能软件“钉钉”在骨科规培医师中的应用,描述其作为骨科教学辅助工具的可行性。方法选取本院2018年10月—2020年8月期间骨科住院医师规范化培训学员76名,随机分为两组,即对照组和试验组,每组各38名。对照组采用常规线下方式完成传统带教方法,以讲课的形式介绍骨科专业基础知识要点,试验组实施后应用智能软件“钉钉”作为视听工具完成培训,比较两组学员的理论考核成绩及学员评价教学效果的调查问卷。结果试验组学员的理论考核成绩优于对照组,试验组的各项教学效果评分优于对照组,差异有统计学意义(P<0.05)。结论明确了新型智能软件“钉钉”在临床带教中的效果,可以以高速、高质量、高效的方式传播,而且有效地提高规培医师和带教教师的互动,逐步形成多样化的新型临床带教方法,极大的提高骨科教学效率与质量。     

Hello,can you hear me? Orthopaedic clinic telephone consultations in the COVID-19 era- a patient and clinician perspective

BACKGROUNDThe coronavirus disease 2019 (COVID-19) pandemic has resulted in seismic changes in healthcare delivery. As a result of this, hospital footfall required to be reduced due to increased risk of transmission of infection. To ensure patients can safely access healthcare, we introduced orthopaedic clinic telephone consultations in our busy district general hospital.AIMTo investigate patients’ and clinicians’ perspective of telephone consultations during COVID-19, and whether this method of consultation could be a viable option in the post- pandemic future. METHODSThis is a single centre, prospective study conducted in a busy National Health Service district general hospital. In May 2020, 100 non- consecutive adult patients were contacted by independent investigators within 48 h of their orthopaedic clinic telephone consultation to complete a telephone satisfaction questionnaire. The questions assessed satisfaction regarding various aspects of the consultation including overall satisfaction and willingness to use this approach long term. Satisfaction and perspective of 25 clinicians conducting these telephone consultations was also assessed via an online survey tool.RESULTS93% of patients were overall satisfied with telephone consultations and 79% were willing to continue this method of consultation post- pandemic. Patients found telephone consultations to reduce personal cost and inconvenience associated with attending a hospital appointment. 72% of clinicians reported overall satisfaction with this service and 80% agreed that telephone consultations should be used in the future. The majority found it less laborious in time and administration in comparison to face to face consultations. Patients and clinicians expressed their desire for video consultations as a method of further improving their experience with remote consultations.CONCLUSIONOur study has shown that telephone consultations are a safe and rapid method of adaptation to the COVID-19 pandemic, achieving the aim of reducing hospital footfall. This method of consultation has resulted in immense clinician and patient satisfaction. Our findings suggest that this tool has benefits in post pandemic healthcare delivery. It has also highlighted that telephone consultations can act as a steppingstone to the introduction of the more complex platform of video consulting.     

Remote telephone clinics in oral medicine: reflections on the place of virtual clinics in a specialty that relies so heavily on visual assessment. A note of caution

During the COVID-19 pandemic, NHS services had to convert face-to-face consultations to remote consultations to facilitate the ongoing provision of healthcare. Many specialties including Oral and Maxillofacial Surgery and Rheumatology have found such virtual clinics effective and appreciated by both patients and clinicians. In Oral Medicine, whilst responses to virtual clinics have been positive, we have recognised that they are not sufficient. In this reflective piece, we describe our experiences and our approach to their use in the management of Oral Medicine and Behçet’s disease patients, which has developed iteratively during the lockdown period. We also consider the role of virtual clinics in Oral Medicine in the post-COVID-19 era.