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1.
医院经营管理策略探析   总被引:2,自引:0,他引:2  
在市场经济体制下,医院经营环境发生了巨大变化,面对各种不确定因素,学习经营理论,借鉴企业先进的管理方法,做好医院经营管理工作,使医院的资产保值增值,是值得医院管理者研究的新课题。  相似文献
2.
乳腺外科围术期抗菌药物应用管理策略   总被引:1,自引:0,他引:1  
目的 探讨乳腺外科围术期抗菌药物合理应用方案和管理策略实施的可行性,以及对医疗质量指标和卫生经济学指标的综合影响.方法 以普外科乳腺手术病例为研究对象,分为干预组和对照组,每组各47例,共94例,采用1:1病例对照研究;干预组采用围手术期抗菌药物合理应用管理策略,对照组按照外科医师传统用药方法;比较两组住院天数、住院总费用、抗菌药物费用、用药合理性比例、医院感染率.结果 干预组患者住院时间为(7.28±2.16)d,较对照组的(9.19±2.04)d明显缩短(P=0.0000);干预组住院总费用、抗菌药物费用分别为(4222.59±1056.57)元、(685.82±299.94)元,较对照组的(5457.84±1768.18)元、(1049.50±453.05)元,显著减少,差异有统计学意义(P<0.05);干预组用药合理性为87.24%,而对照组为23.40%,二者差异有统计学意义(P<0.01);两组患者均未发生医院感染.结论 围手术期抗菌药物合理应用管理策略实施后,乳腺手术围手术期抗菌药物的预防性使用更加合理,住院天数和药品费用明显减少;进而促进安全、有效、经济、合理地使用抗菌药物,为医院降低单病种费用提供了一种有效且可行的模式.  相似文献
3.
湖州市三级医院护理人力资源配置现状及对策研究   总被引:1,自引:0,他引:1  
目的:了解湖州市市级医院护理人力资源配置现状,探讨管理对策。方法:对湖州市5家市级医院护理部进行问卷调查,内容包括护理人力基本配置、队伍结构、编外护士情况三部分。结果:5家医院实际开放床位与护士数之比为1∶0.55,普通病房实际开放床位与护士数之比为1∶0.35,ICU实际开放床位与护士数之比为1∶1.14,手术台与护士数之比为1∶2.26;大专学历占50.4%,本科学历占19.8%,在读研究生0.4%;高级职称护士占5.8%,高职称护士转岗到非护理岗位率达19.8%;30岁以下护士占52.9%;编外聘用护士占34.5%。结论:湖州市5家市级医院护理人力资源总量相对不足,队伍结构欠合理,人力配置中资源紧张与浪费现象并存;高学历高学位人才紧缺,解决编外聘用护士队伍稳定问题迫在眉睫。建议强化医疗机构责任,确保从数量、质量上合理配置护士;进一步规范编外聘用护士的准入管理,以确保护理队伍稳定。  相似文献
4.
This paper describes the development, testing, and validation of summary scales measuring nursing processes commonly used in caring for elderly nursing home residents with cognitive, mood, and behavior problems, or other markers of mental disorder. Data were obtained from a cross-sectional study of 1017 residents from a proportionate random sample in Delaware nursing facilities, to determine the prevalence of mental disorders and to describe distinguishing characteristics and treatments. An exploratory factor analysis was performed on 11 frequently encountered nursing management strategies as applied to 808 subjects with some indicator of mental disorder. Two factors emerged, which were subsequently conceptualized as separate scales (composed of six and five elements, respectively) that measure the basic approaches termed Encouragement and Control. Alpha reliability levels determined internal consistency for each scale. Cognitive, behavioral, and mood correlates were identified for each scale using multiple regression. Replication and validation were achieved when similar findings were obtained using a random sample of 290 residents at Hebrew Rehabilitation Center for Aged, a 725-bed long-term care facility in Boston. LISREL analyses confirmed the presence of at least two dimensions in behavior management strategies. The identification of these approaches is significant in providing non-pharmacologic and non-restraint alternatives to managing elderly residents with symptom distress.  相似文献
5.
Many beach and holiday resorts experience major problems with alcohol-related public disorder. Following an escalation in alcohol-related incidents in the New Zealand beach community of Piha, a community-driven response to address issues of community well-being and safety was initiated by concerned residents. A case study evaluation reported on the development of a community coalition involving community and statutory stakeholders and the successful implementation of local community action strategies. These included a beach alcohol ban, extensive local publicity and a community policing presence over successive summers. An examination of the case study suggests that inter-sectoral collaboration, and multiple level strategies through policy, promotion and enforcement activities are key factors in enabling communities to successfully reduce alcohol-related harm.  相似文献
6.
Previous research shows that too often acute psychiatric inpatient care is neither safe nor therapeutic for patients. Earlier studies focused on promoting safety through good ward design, staff being able to anticipate and prevent violence, and use of medication. The current evidence base overwhelmingly reflects a staff perspective on risk management, and there is little evidence on how service users cope in this environment or about the strategies they employ to manage the risks they face or pose to others. This paper presents findings on this from two studies: (a) ethnographic research on three UK acute psychiatric wards, undertaken between 2000 and 2002, and (b) a content analysis of qualitative data from a 1999/2000 survey of psychiatric wards in England. Findings show that while some users perceive their ward to be comparatively safe--given the crisis they were in before being admitted--it is nonetheless a volatile environment in which risks are concentrated. Many risks, such as physical assault, are attributable to other patients. However, they are better understood as an outcome of the interplay between a range of interactional and contextual factors: for example, low staffing levels/minimal or poor surveillance may increase the risk of assault. Users were found to employ 10 strategies to manage risk on the ward, including actively avoiding risky situations/individuals, seeking staff protection, and getting discharged. Integral to these strategies are the risk assessments that patients make of one another. These findings shed light on how people cope while living in one of the most anxiety-inducing institutions of a 'risk management society'. Service users routinely take an active role in making a safe environment for themselves, in part because they cannot rely on staff to do this for them. Future clinical practice guidelines should consider how to harness what users are already doing to manage risk.  相似文献
7.
目的 探讨系统管理对妊娠期糖尿病患者母婴结局的影响.方法 选取妊娠期糖尿病患者 96 例为观察组,对其行系统管理至分娩;同期随机抽取 96例妊娠期糖尿病的患者作为对照组,接受常规护理.比较两组孕妇羊水指数、孕期增加体重、身体质量指数(BMI)、餐后 2h 血糖、母婴结局(早产、剖宫产、产后出血、泌尿系统感染、窒息、 缺氧性脑病、 巨大儿、低血糖及高胆红素血症).结果 观察组患者孕期增加体重、BMI、餐后2h血糖、羊水指数等各项临床指标均低于对照组,母婴结局优于对照组,差异均有统计学意义(P<0.05).结论 系统管理可以明显改善妊娠期糖尿病患者的母婴结局.  相似文献
8.
目的 对四川广元地区2012至2013年妊娠期糖尿病(GDM)发病情况进行分析,为提高GDM筛查和管理水平建立预防策略.方法 收集四川省广元市2012年1月至2013年12月采用75g葡萄糖糖耐量筛查的10 973例孕妇的临床资料,分析GDM的发病率、危险因素及对妊娠结局的影响.结果 10 973例孕产妇共发现GDM患者201例,GDM发病率为1.83%.年龄、喜食甜食、家庭月收入、家族糖尿病史情况不同,患者GDM发病率差异有统计学意义(x2值分别为8.678、39.778、22.321、59.773,均P<0.05).进行多因素分析发现,年龄大于30岁,家庭月收入低于3 000元,有家族糖尿病史,喜食甜食等4项是GDM发生的高危因素(均P<0.05).GDM患者剖宫产比例、妊娠期其他并发症及合并症发病率、新生儿并发症发生率、转新生儿科比例均高于非GDM产妇(x2值分别为14.899、124.250、21.782和8.667,均P<0.05).结论 GDM发病率与患者家庭条件、家族糖尿病史、饮食习惯、年龄等有着密切的关系,应在妊娠早期进行建档管理,以预防GDM的发生和改善母婴结局.  相似文献
9.
为解决医疗费用过快上涨、医保对供方行为约束不足、基金运行风险加剧等问题,人力资源和社会保障部等要求在统筹地区开展以总额控制为主的医保支付方式改革.总额控制对城市大型公立医院的经营管理产生了较大的影响.按照总额控制政策,提出3个层面的转型策略.在发展战略方面,转变增长方式,发挥医联体作用,增强辐射能力;在业务管理方面,确保医疗质量和安全,落实临床路径,优化服务流程;在行政管理方面,强化成本控制,加强信息化建设,转变管理职能.  相似文献
10.
目的 分析2011年深圳市第26届大学生运动会(大运会)病媒生物控制所面临的风险与挑战,及时制定行之有效的控制措施和保障策略。方法 对深圳市病媒生物种群、密度消长情况以及危害程度进行分析研究;同时,依据2009-2011年大运会场馆及周边环境病媒生物密度消长情况、病原与抗药性监测结果,提出大运会召开期间虫媒传染病发生的危害性以及病媒生物可能造成的骚扰影响,制定大运会病媒生物控制保障策略。结果 大运会在深圳市召开期间存在病媒生物性传染病发生和病媒生物造成骚扰的危险;健全的管理体制与完善的突发病媒生物性传染病事件应急预案和技术实施方案、科学的密度监测与风险评估、合理用药、应急演练、全员培训、专家咨询委员会的组建等措施成为大运会病媒生物控制的主要策略;通过这些策略的实施,保障大运会举办期间不发生病媒生物危害的影响。结论 第26届大运会举办期间未发生病媒生物危害及骚扰的控制目标,为今后大型活动的公共卫生保障尤其是病媒生物控制打下了坚实基础。  相似文献
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