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IntroductionPatients admitted from emergency units represent a large portion of the population in internal medicine departments. The aim of this study is to identify characteristics of patients and organization of these departments.MethodsBetween June 29th and July 26th 2015, voluntary internal medicine departments from the SiFMI group prospectively filled anonymized internet forms to collect data of each patients admitted in their ward from emergency units, during seven consecutive days.ResultsThree hundred and sixty-five patients from emergency departments were admitted in 18 internal medicine inpatients departments, totalling 1100 beds and 33,530 annual stays, 56% of them for emergency units inpatients. Mean age was 68 years, 54% were women, mean Charlson score was 2.6 and 44% of the patients took at least three drugs. Main causes of hospitalization were infectious (29%) and neurological (17%) diseases. Mean length of stay was 9.2 days. The medical team was composed by a median value of 4,5 [2,75–6,25] senior full-time equivalents, 86% were internists. Each department except one received residents, two third of them were from general medicine.ConclusionThis study highlights a high organizational variability among internal medicine departments and patients, and sets internal medicine as a specialty with a great capacity to achieve an integrative/comprehensive management of patients and to offer a comprehensive basis for physicians in training.  相似文献   
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A reflection is made, from an interpretative perspective, on the historical evolution of health care in the West. It starts from the moment that this became a way to intervene the sick and an instrument for healing diseases, focusing on original documents and written sources which account for results of historical research, which range from XV century until today. To do this, it tries to understand the health care as an ideographic body of knowledge consisting of five pieces of a puzzle composed by: the state policy of hospitals accumulation implemented in Spain, the accumulation of medical practices in what is currently Germany, the hospital wards in England, the nosological rationality in France, and the US sanitizing machine; all these movements as producers of closely linked health care developments, that are nothing more than collective actions regulated by social norms around health.  相似文献   
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目的及时监测临床分离的主要标本类型和主要科室来源大肠埃希菌的耐药性,为医院抗菌药物及医院感染控制提供依据。 方法用WHONET5.6对本院2017年1月1日~12月31日间临床主要标本类型来源的大肠埃希菌(尿液、血液、痰液)和主要科室来源的大肠埃希菌(肾内科病房、ICU病房、儿内科病房)分别进行耐药性分析。 结果痰液、血液和尿液标本分离的大肠埃希菌对碳青霉烯类抗菌药物亚胺培南的耐药率分别为1.63%、0.46%和0.30%。对喹诺酮类抗菌药物左氧氟沙星的耐药率分别为45.65%、41.94%和56.70%。ICU病房、肾内科病房和儿内科病房分离的大肠埃希菌对碳青霉烯类抗菌药物亚胺培南的耐药率分别为2.15%、0.00%、0.00%,对喹诺酮类抗菌药物左氧氟沙星的耐药率分别为52.69%、50.00%和21.84%。 结论我院主要标本类型和主要科室来源分离的大肠埃希菌对临床常用多数抗菌药物的耐药率相差较大,临床医师及时掌握不同来源主要病原菌的耐药性,可减少治疗失败。  相似文献   
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目的探讨专科-老年科联合教学查房模式在老年病教学中的应用效果与价值。方法以急性心肌梗死教学查房为例,入选2013年1月-12月在培的住院医师(42人)和研究生(24人)为研究对象,随机分组:试验组33人,由心内科与老年科医师共同主持;对照组33人,由心内科专业医师主持。查房后由教育处人员、学员、患者分别对教学查房质量进行评分,并对学员心肌梗死知识进行再次测评。结果试验组在生活方式问诊、结合老年病特点分析病情、健康管理、注重预防为主理念等方面优于对照组(t值分别为2.008,1.099,2.129,2.309,P值均<0.05);试验组对医患沟通能力、慢性病预防保健知识方面的评价较高(P值均<0.05)。教学查房后两组学员的测试成绩均有明显提高,而试验组在诊断治疗、预防及慢病管理方面的学习效果更加明显(t值分别为8.517,6.400,P值均<0.05)。结论联合查房模式能明显提高老年科医师的教学查房效果,有助于老年科医师临床能力的培养。  相似文献   
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Inpatient glycaemic control remains an important issue due to the increasing number of patients with diabetes admitted to hospital. Morbidity and mortality in hospital are associated with poor glucose control, and cost of hospitalization is higher compared to non‐diabetes patients. Guidelines for inpatient glycaemic control in the non‐critical care setting have been published. Current recommendations include basal‐bolus insulin therapy, regular glucose monitoring, as well as enhancing healthcare provider's role and knowledge. In spite of growing focus, implementation in practice is limited, mainly due to increasing workload burden on staff and fear of hypoglycaemia. Advances in healthcare technology may contribute to an improvement of inpatient diabetes care. Integration of glucose measurements with healthcare records and computerized glycaemic control protocols are currently being used in some institutions. Recent interests in continuous glucose monitoring have led to studies assessing its utilization in inpatients. Automation of glucose monitoring and insulin delivery may provide a safe and efficacious tool for hospital staff to manage inpatient hyperglycaemia, whilst reducing staff workload. This review summarizes the evidence on current approaches to managing inpatient glycaemic control; its utility and limitations. We conclude by discussing the evidence from feasibility studies to date, on the potential use of closed loop in the non‐critical care setting and its implication for future studies.  相似文献   
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目的 :探讨医院物流信息系统在病区耗材管理中的应用效果。方法 :在某院消化科病房使用医院物流信息系统,引进"定数管理"概念,发行指定一次性材料、部门、数量的定数条码,通过回收扫描该定数条码来确认相关一次性材料在病区的消耗,并由库房对低于警戒数量的耗材主动发货补给。采用自身前后对照,比较2014年3月—2014年6月(实验前)及2014年6—9月(实验后)病区一次性耗材库存量及每周耗材管理所需护理工时有无统计学差异。结果 :实验后病区耗材库存量由(1.30±0.17)m3降至(0.28±0.10)m3(P0.05),每周耗材管理所需护理工时由(138.81±19.68)min降至(40.17±8.10)min(P0.01)。结论:医院物流信息系统可节约病区空间、降低存货成本,并大大降低护理人力资源成本,今后将扩大覆盖科室及耗材品种。  相似文献   
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