多媒体联合情景教学在急诊医师培训中的应用

目的探讨多媒体联合情景教学在急诊医师培训的应用效果。方法将本院2018年1月-2018年12月的34名急诊医师纳入观察组,应用多媒体联合情景教学法对其进行院内培训,另将本院2017年1月-2017年12月的34名急诊医师纳入对照组,应用传统教学法对其进行培训,对比两组医师的考试成绩、岗位胜任能力以及应急能力。结果观察组理论知识与技术操作的考试成绩均高于对照组,观察组自学、交流、表达、理解、解决问题的能力以及综合能力的评分均高于对照组,观察组急救意识、急救效率、病情评估、团队合作、职业防护的评分均高于对照组(P<0.05)。结论多媒体联合情景教学在急诊医师培训的应用效果显著,可明显提高医师的考试成绩、岗位胜任能力以及应急能力。     

新冠肺炎危重症患者收治医院护理人力资源应急管理策略

面对新型冠状病毒肺炎疫情,积极与各医疗队进行沟通协调,护理部积极统筹部署,采取系列应急管理策略:梯队调配、建立规章制度、严格岗前培训、提供心理支持和后勤保障等,从而科学合理地进行人力资源管理,对新型冠状病毒肺炎防治工作顺利进行起到积极作用。     

Laboratory Biosafety: Laboratory response checklist for infectious disease outbreaks—preparedness and response considerations for emerging threats

The purpose of the Laboratory Response Checklist for Infectious Disease Outbreaks (the Checklist) is to provide public health laboratories and laboratory networks operating at multiple jurisdictional levels with a useful, adaptable tool to help rapidly identify important outbreak response considerations, particularly when investigating a previously unknown infectious disease threat. The Checklist was developed by the National Microbiology Laboratory of Canada in collaboration with provincial/territorial, national and international laboratory experts, including the Canadian Public Health Laboratory Network, and the Global Health Security Action Group Laboratory Network. While the Checklist was initially designed to reflect lessons learned through National Microbiology Laboratory participation in extended national and international outbreak responses (e.g. Zika virus epidemic [2015–2016], Ebola virus epidemic, West Africa [2014–2016]), the importance of optimizing laboratory response coordination has only been underscored by the ongoing challenges presented by the coronavirus disease 2019 (COVID-19) pandemic response requirements. The Checklist identifies five highly interdependent laboratory response themes, each of which encompasses multiple considerations that may be critical to a coordinated, strategic outbreak response. As such, the comprehensive review of Checklist considerations by responding laboratory organizations may provide a valuable opportunity to quickly detect key response considerations and interdependencies, and mitigate risks with the potential to impact public health action.     

Factors associated with relapses among patients treated for acute urticaria

The benefit of corticosteroids in acute urticaria is controversial. Our objective was to determine the factors associated with relapses in patients presenting with acute urticaria. A retrospective observational study, including all patients with acute urticaria who visited the angioedema reference center of Academic Public Hospitals – Saint‐Antoine in Paris between January 2015 and June 2017, was conducted. The study inclusion criterion was a diagnosis of acute urticaria in an adult patient. The urticaria was spontaneous or inducible urticaria. The primary outcome was relapse at day 7 and the secondary outcome was relapse at week 6. A total of 184 patients with a first episode of acute urticaria were included. Most of the patients were female (66%) with a mean age of 42 ± 16 years. Corticosteroid administration for treatment of acute urticaria was used in 102 (55%) patients. Overall, 85 (46%) patients had relapses after less than 7 days whereas 168 (91%) patients had relapses after more than 6 weeks. In univariate analysis, the rate of corticosteroid administration was significantly higher in cases of relapse after less than 7 days. No difference in relapse rates after more than 6 weeks appeared. In the multivariate analysis, the independent factor associated with relapses after less than 7 days was the administration of corticosteroids as treatment of acute urticaria (odds ratio, 1.93; 95% confidence interval, 1.06–3.57; P = 0.03). The prevalence of corticosteroid administration for patients with acute urticaria was high. Corticosteroid administration was an independent risk factor associated with relapses after less than 7 days.     

Standards for the Use of Telemedicine for Evaluation and Management of Resident Change of Condition in the Nursing Home

Objectives

This document offers guidance to clinicians and facilities on the use of telemedicine to deliver medically necessary evaluation and management of change of condition for nursing home residents.

Surgical emergencies in pregnancy in the era of modern diagnostics and treatment

Pregnancy can be complicated with different surgical emergencies which may potentially endanger the mother as well as foetus. In the modern era of advanced diagnostics and treatments, neither of them in response to a surgical emergency in a pregnant woman should be delayed. Appropriate early intervention is essential to decrease the morbidity and mortality. Following article encompasses common surgical emergencies that can arise in a pregnant woman and tries to suggest the approach that may be taken to reduce the burden of morbidity and mortality.     

分层-团队-导师法用于急诊科护士科研培训研究

目的提高急诊科护士护理科研培训效果。方法对急诊科45名临床护士开展为期1年的分层-团队-导师式科研培训,包括分层理论培训、定期读书报告交流、团队项目设计及实施、老师全程指导;与常规培训方法比较培训效果及护士满意度。结果与常规培训方法比较,护士科研能力自评得分及对培训的满意度显著提高(均P0.01),发表论文数、科研课题及新技术、学术大会交流人次相应增加。结论分层-团队-导师培训法有利于提高科研培训效果,从而护高护士培训满意度。     

Cost-benefit analysis of a national influenza vaccination program in preventing hospitalisation costs in Australian adults aged 50–64 years old

IntroductionInfluenza causes a significant burden among Australian adults aged 50–64, however, vaccine coverage rates remain suboptimal. The National Immunisation Program (NIP) currently funds influenza vaccinations in this age group only for those at high risk of influenza complications.AimsThe main aim of this study was to determine whether a strategy of expanding the government-funded vaccination program to all adults 50–64 in preventing influenza-related hospitalisations will be cost beneficial to the government.MethodsA cost-benefit analysis from a governmental perspective was performed using parameters informed by publicly available databases and published literature. Costs included cost of vaccinations and general practitioner consultation while benefits included the savings from averted respiratory and acute myocardial infarction (AMI) hospitalisations.ResultsIn the base-case scenario, the proposed policy would prevent 314 influenza/pneumonia, 388 other respiratory and 1482 AMI hospitalisations in a year. The government would save $8.03 million with an incremental benefit-cost ratio of 1.40. Most savings were due to averted AMI hospitalisations. In alternative scenarios cost savings ranged from saving of $31.4 million to additional cost to the government of $15.4 million, with sensitive variation in vaccine administration practices (through general practitioner or pharmacists) and vaccine effectiveness estimates.DiscussionExtension of the NIP to include adults 50–64 years of age is likely to be cost beneficial to the government, although this finding is sensitive to vaccine administration cost, which varies if provided through general practitioners or pharmacists; and to variation in vaccine effectiveness. An increased role of pharmacists in immunisation programs would likely result in cost savings in an expanded adult immunisation program.