基于超效率DEA的天津市基本公共卫生配置资源效率研究

评价天津市各辖区基本公共卫生服务的资源配置效率,寻求有效的资源配置措施和方法,为进一步优化卫生资源配置提供参考依据。方法利用数据包络分析,对天津市16辖区的基本公共卫生服务进行效率评价。结果天津市基本公共卫生服务的资源配置效率整体不高,仅有5辖区达到了规模最优,多数区非DEA有效,且投入过剩与产出不足并存。结论为了达到最优的基本公共卫生服务效率,政府及各级基本公共卫生服务机构必须有效地完善、落实相关政策,优化资源投入结构,统筹地区差异,加强资源供给管理,提高资源利用效率。     

医疗护理安全与护士的职业道德

目的:探讨医疗护理安全与护士职业道德水平的关系。方法:分析目前护理不安全因素,寻找相应对策。结果:医疗护理安全大大提高,医疗纠纷发生率明显下降。结论:在医疗护理安全活动中,护理安全担当着一个重要角色。通过对护士进行职业道德教育、素质教育及法制教育等措施,提高了医疗、护理安全,减少了医疗纠纷发生。     

减少急诊医疗纠纷实行全程无缝隙优质服务

目的防范医疗纠纷,提供“全程无缝隙优质服务”,以提高急诊护理急救服务质量。方法对急诊33 700例急症病人采用热情接诊、主动护送(护送病人检查和转入病区)、细心观察、真实记录、送走道别等服务措施。结果共紧急护送急症患者33 700例(100%);在护送过程中发生病情变化者117例(0.35%),经急救处理全部脱险;医疗纠纷发生率为0。结论采用“全程无缝隙优质服务”,可减少急诊科医疗纠纷的发生,提高医疗质量。     

应用秩和比法研究门诊人数增长与门诊医疗质量因子的关系

目的研究医院门诊人数增长与门诊医疗质量因子的关系,找出影响门诊人数增长的主要门诊医疗质量因子。方法利用秩和比法对实例进行分析。结果影响门诊人数增长的门诊质量因子,首先是高中级职称比(χ2=32.43,P<0.05),其次是副高以上职称的坐诊工时比(χ2=31.91,P<0.05),再次是新技术项目或重大改革(χ2=28.54,P>0.05)。结论研究医院门诊人数增长与门诊医疗质量因子的关系时,秩和比法有应用推广的价值。     

Krankheitsprognose,psychosoziale Belastung und Einstellung von Melanompatienten zu unterstützenden psychotherapeutischen Maßnahmen

Zusammenfassung Bei 205 Melanompatienten im Stadium I und II wurden das Ausma? der psychosozialen Belastung und der sozialen Unterstützung sowie die Einstellung der Patienten zu unterstützenden Gespr?chsangeboten erhoben. 59% der Patienten fanden zus?tzliche unterstützende Gespr?che mit dem behandelnden Dermatologen, 20% mit einem Psychotherapeuten sinnvoll. Patienten, die starke Angst vor einem Fortschreiten des Tumors ?u?erten und die sich über die Erkrankung nicht ausreichend aufgekl?rt fühlten, wünschten Gespr?che mit dem behandelnden Arzt. Patienten, die sich psychosozial st?rker belastet fühlten und sozial weniger Unterstützung durch ihr soziales Umfeld angaben, befürworteten Unterstützung durch einen Psychotherapeuten. Auch eine ungünstige Prognose scheint das Interesse an psychotherapeutischer Unterstützung zu verst?rken. Eingegangen am 13. Januar 1995 Angenommen am 23. August 1995     

Action Research: a valuable research technique for service delivery development

The evaluation of healthcare practice and service delivery is fraught with difficulties. Service development and / or delivery occurs within socially dynamic settings which are in a continual state of change. Service development also often involves large elements of improvisation. The action research approach is useful for health service research, as it supports collaboration between researchers and practitioners, and not only allows but makes explicit that the action researcher has both roles within the setting being studied. This paper discusses action research methodology and offers insight into principles that favor its use for service delivery development. This includes consideration of the interactive variables within studies of health care systems and the importance of evaluating relationships between stakeholders to understand how these factors or variables, which cannot be controlled for, are responsible for successful development of the service. Action research facilitates change and helps bridge the heory--practice gap. With the current dynamic changes within both the pharmacy profession and national health services, researchers may find the action research technique of value when considering new roles and innovative ways of engaging in collaborative, multi-disciplinary working to improve delivery of patient care.Accepted july 2004     

我院护士在职教育的体会

本文针对不同层次护理人员制定不同的培训目标和计划,采取岗前培训,岗位培训(专科培训、在职分层培训、护理人才培训),自学等形式,开展护士在职教育,不断扩充更新知识,以适应现代护理工作要求。     

Enhancing laboratory report contents to improve outpatient management of test results

In today''s environment, providers are extremely time-constrained. Assembling relevant contextual data to make decisions on laboratory results can take a significant amount of time from the day. The Regenstrief Institute has created a system which leverages data within Indiana Health Information Exchange''s (IHIE''s) repository, the Indiana Network for Patient Care (INPC), to provide well-organized and contextual information on returning laboratory results to outpatient providers. The system described here uses data extracted from INPC to add historical test results, medication-dispensing events, visit information, and clinical reminders to traditional laboratory result reports. These “Enhanced Laboratory Reports” (ELRs) are seamlessly delivered to outpatient practices connected through IHIE via the DOCS4DOCS clinical messaging service. All practices, including those without electronic medical record systems, can receive ELRs. In this paper, the design and implementation issues in creating this system are discussed, and generally favorable preliminary results of attitudes by providers towards ELRs are reported.