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《Enfermería clínica》2019,29(6):352-356
More the 30 years have passed since the first Royal Decree that regulated nursing specialties was published in 1987. It is the Royal Decree published in 2005 that really allowed the training development of part of the specialties recognized in it (family and community nursing, paediatric nursing, geriatric nursing and occupational health nursing) since the obstetric-gynaecological specialist nurses (midwives) and mental health specialists had long since already started their training processes through the resident internal nurse model, today, training in the specialty of family and community nursing has been implemented in all the autonomous communities, but has not had the same development in terms of the incorporation of specialists in the health institutions of the respective health services of the autonomous communitiesThis circumstance is generating a great lack of motivation among community nurses, both specialists and those who hope to obtain the qualification through a specialty exam.Many of the objectives achieved to date have been made possible thanks to the work of the scientific societies of community nursing (Association of Community Nursing [AEC] and Federation of Associations of Community Nursing and Primary Care [FAECAP]), which have allowed progress to be made and the process not to be halted, although there are still many achievements to be made on which the aforementioned scientific societies continue to work.In a society in which nursing care is increasingly necessary and demanded, it must have greater consideration and position in health policies, since it has demonstrated its effectiveness and can be the model that allows the health system to be sustainable. Therefore, nurses who specialize in family and community nursing must cease constituting an opportunity and become a reality.  相似文献   
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Objective

To describe the progress of the attractiveness of rheumatology at successive MIR calls, from 1983 to 2014.

Methods

Candidates in the Spanish training system for medical doctors choose their specialties sequentially, ordered by their ranking in the qualifying exam (MIR). The highest, median and lowest rank of candidates choosing rheumatology training positions in every MIR call from 1983 to 2014 was requested from the Department of Management of Specialized Medical Training (General Department of Professional Regulation; Spanish Ministry of Health). To compare, the same data was requested for other specialties. In order to define and analyze the attractiveness of each specialty we introduce an ‘index of attractiveness’, based on the normalized difference of the actual median rank reported for each year and the average median obtained in 1000 simulations in which candidates choose specialties at random.

Results

Regarding the median of the election of rheumatology, the range went from 244th in 1983 to 3394th in 2008, showing a progressive increase over the years in absolute figures. A mathematical simulation allowed quantifying the difference between the observed median and what would have happened if specialties had been chosen by pure chance. Results show a tendency to recover the attractiveness of rheumatology in recent years.

Conclusions

After a sharp decline in the attractiveness of rheumatology during the last years of the 20th century, there seems to be a recovery.  相似文献   
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目的 通过对脑外伤表格加焦点式护理记录单的设计与临床应用,指导神经外科医护人员专业化、个体化观察病情,进一步优化细化护理内容,更好地保证脑外伤患者的医疗护理安全.方法 根据疾病种类和症状学特点设计脑外伤表格加焦点式护理记录单,与原运行的病情观察护理记录单对照,选择护理记录时间、护理记录缺陷发生率、护士专业知识考试结果、医生满意度作为效果评定指标.结果 临床应用130例患者,经效果评价,临床应用效果优于原运行护理记录单.结论 表格加焦点式护理记录单更能科学便捷地记录脑外伤病情及治疗护理过程,突出个体化、专业化的护理理念,值得推广.  相似文献   
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本文采用自填式问卷调查和典型调查相结合的方式对17个公立医院改革国家级联系试点城市的全部二、三级公立医院(其中北京市和上海市为市级公立医院)正副院长、正副书记进行了问卷调查。研究得出医院院长职业化和专业化建设的现状和问题是:院长多为医学专业背景;多数人不愿放弃临床专业;“医而优则仕”的选拔方式;管理者职能与所有者权力混淆;对院长的绩效考核和激励刚起步;院长职业化培训有提高的空间;院长职业化人才市场尚未形成。通过对现状和问题的分析,得出院长职业化建设推进策略为:促进院长的管理专业化建设;改革干部人事制度,建立院长的公开选拔机制;完善院长的绩效考核体系和激励约束机制;制定院长职业化的相关法律法规。  相似文献   
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军队干部医疗保障是部队医院的重要任务之一。新形势下部队医院尤其是军区总医院级别医院的干部医疗保障工作,呈现出疾病诊疗不专业、患者住院时间长、医疗服务效率低等问题,文中对此进行全面分析,就干部病区专科化收治模式的创立及干部专科病区的设置进行阐述。认为通过新模式的应用和管理创新,使病区诊断准确率有所提升,治疗程序得到合理规范,医疗服务意识逐渐增强,可持续发展能力不断促进,既提高了部队干部的满意度,又提升医师工作积极性,干部病区呈现出全面发展的态势。  相似文献   
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综合性医院专病化门诊管理探讨   总被引:1,自引:0,他引:1  
专病化引领了医院未来学科建设与人才培养的新方向。专病门诊作为专病化在门诊诊疗模式中的体现,无疑将成为医院门诊创新的趋势和热点,对提高医院诊疗水平与患者满意度意义重大。文中对综合性医院专病化门诊的概念和发展现状进行介绍,分析了目前我国医院开展专病门诊过程中的现存问题,在阐述专病门诊2种主要运行模式后,从注重初诊筛查、再造专病诊疗流程、严格准入管理、建立协调机制、优化利益分配5个方面对综合性医院专病化门诊的管理策略进行探讨。  相似文献   
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