人性化护理服务

目的：分析人性化护理服务的应用体会。方法针对我院100名住院患者进行问卷调查,调查内容包括护士礼仪、护理专业技能、健康教育和护理环境等方面,根据调查结果分析患者对人性化护理模式的满意率。结果大部分患者仍然希望护理人员有过硬的专业技能,并希望护理人员保持亲切、有耐心的服务态度,因此这两个方面是实施人性化护理服务的重点内容;满意度调查方面,患者对病房环境的改善总满意度为97%,护患沟通及护理技术总满意度为95%,疾病健康宣教总满意度为94%,出院指导总满意度为92%;护理人员采取人性化护理措施后,患者对护理服务的整体满意度较高。结论人性化护理服务可有效提高患者满意度,值得全面推广。     

手术家属等候区人性化管理的现状分析

目的：对手术室家属等候区人性化管理的现状进行分析。方法随机从我院2012年手术家属等候区中抽取52例作为研究对象,对其管理进行评价,针对其中的问题于2013年加强人性化管理,并再次随机抽取52例患者家属进行评价,对比2次的评价结果。结果2013年手术患者家属的满意度为%,显著高与2012年的%,且差异具有统计学意义(<0.05)。结论对手术家属等候区采取人性化管理措施有助于提高患者家属的满意度,改善医患关系。     

人性化护理在人工肩关节置换术患者中的应用

目的 对于人性化护理在某医院人工肩关节置换术患者的应用进行探索.方法 选择1009年3月～2010年7月在某医院收治的人工肩关节置换术的患者100例,年龄22～64岁,平均41.8岁.,对其进行人性化护理.结果 100例患者经过上诉人性化护理之后,显效(症状较治疗前明显减轻)83例(83%),有效(症状有所减轻)14例(14%),无效(治疗前后临床症状无改善)3例(3%),总有效率97%.结论 该医院人工肩关节置换术患者的人性化护理效果良好.     

对我院内科患者行健康教育护理干预效果研究

目的：研究加强健康教育护理干预的实施对临床患者满意度和病情恢复情况的影响。方法选取2013年8月~2014年2月在我院内科接受诊治的患者149例，按其接受的护理方案将其分成常规组和加强组，其中常规组患者79例，加强组70例。对两组患者出院时对医院整体的满意度和其恢复情况进行比较研究。结果参与本次调查的患者治疗后加强组患者满意率为72.9%；常规组患者满意率为34.2%，加强组患者的满意度高于常规组，两组患者的满意度比较得小于0.05，即两组患者对医院服务的满意度差异有意义。结论本次研究实验数据显示对内科患者加强健康教育护理能提高患者对医院的满意度。     

人性化护理在骨外科中的应用

目的：通过人性化护理的开展,使科室对"以人为本","以患者为中心"的核心理念和中心任务得以展现和进行。方法选取在我院骨科住院的患者200例,分为观察组和对照组各100例,对照组采用常规的护理程序进行护理,观察组采用人性化护理程序进行护理,后将两组患者发生护患纠纷率和满意度进行统计及比较。结果观察组发生护患纠纷率和满意度均优于对照组均<0.05,有明显性差异。结论骨科病区实施人性化护理,有利于提高护理服务质量,提高患者的治疗依从性及满意度。     

HIS与医保系统间资源共享的探索与体会

医院信息系统(HIS)与医保系统的资源共享。对医院至关重要，但两系统间的连接尚存在诸多难题，接口方式虽多但各有利弊。本文结合我院HIS与医保系统的软件接口、硬件接口、对数据库的特殊处理以及接口的维护技巧等方面的成功经验，阐述了如何在保证各自系统数据的完整性、安全性、系统维护的独立性等前提下，实现两系统间的连接与资源共享。     

人性化管理理念在内科护理管理中的应用效果

目的：探讨并分析人性化管理理念在内科护理中起到的应用效果。方法选取我院内科2012年1~12月未采用人性化管理的患者800例为对照组,和2013年1~12月800例采用人性化管理的患者为观察组进行分析比较。结果经过两组在护士工作表现和患者对护理的满意度等方面进行对比分析,观察组数据为(35.26±4.12)、(97.5%),均明显高于对照组,两组比较差异有统计学意义(P<0.05)。结论在内科护理工作任务量大,患者繁多的情况下,引进人性化管理理念对于医院、护士、患者及家属,都是良好有效的发展。     

住院患者对医院服务态度与服务质量的期望研究

研究住院患者及其家属对医院服务的期望，有利于促进医院服务理念的更新和管理模式的转变．提高医院的服务水平和服务质量。根据目前的研究与临床实践，阐述了患者对医院环境、服务态度和医患关系、服务质量、医疗信息、医疗费用等五个方面的期望。     

探讨人性化护理在急诊患者护理工作中的应用效果

目的：探讨人性化护理在急诊患者护理工作中的应用效果。方法选取我院2011年5~2013年5月于门诊接受护理的急诊患者200例,将患者随机分为观察组和对照组各100例,对对照组进行常规护理,对观察组给予人性化服务护理措施的方法,在护理结束后发放问卷进行调查,比较两组患者的护理质量以及满意程度。结果观察组的生活质量各项指标都高于对照组,差异具有统计学意义(<0.05)。观察组在护理的满意情况方面也好于对照组,差异具有统计学意义(<0.05)。结论人性化护理在急诊患者护理工作中的应用效果有更好的效果,并且能够提高患者的满意度,值得推广。     

深圳市某街道医院2005～2009年医院感染调查分析

目的 了解深圳市某街道2005~2009年住院患者医院感染情况.方法 对某街道医院2005~2009年间82168例全部住院患者病历资料进行回顾性调查.结果 2005~2009年,医院感染发病率依次为1.32%、0.65%、0.74%、0.61%、0.65%、0.76%;感染率最高的科室为脑外(1.49%);医院感染发病年龄段第一位的是>60岁年龄段的病人;下呼吸道(23.63%)为最常见的感染部位;5月份(1.05%)医院感染率最高;男女患者之间的医院感染率有显著差异.结论 2005~2009该街道医院感染率呈下降趋势,重点应针对脑外科室、>60岁年龄的病人、下呼吸道部位和每年5月份采取相应预防措施,可进一步降低医院感染的发生.     

Development of simulation optimization methods for solving patient referral problems in the hospital-collaboration environment

This research studied a patient referral problem among multiple cooperative hospitals for sharing imaging services’ referrals. The proposed problem consisted of many types of patients and the uncertainty associated with the number of patients of each type, patients’ arrival time, and patients’ medical operation time, leading to a difficulty in finding solutions due to the uncertain environment. This research used system simulation to construct a model and develop a simulation optimization method, combining the heuristic algorithm (patient referral mechanism) with the particle swarm optimization (PSO) method, to determine a better way to refer patients from one hospital (referring hospital) to another (recipient hospital) to receive certain imaging services. After the simulated model was verified and validated, three patient referral mechanisms to dispatch referring patients to the appropriate recipient hospitals were proposed. Based on the numerical results, the findings showed that Mechanism 2, transferring patients to the hospital with the shortest waiting time, had good performance in both scenarios: allowing patient referrals among all hospitals and limiting the patients’ waiting time. Finally, this study presents the conclusions and some directions for future research.     

Informing patients about medicines—A hospital in-patient survey in England

Objective

To determine the frequency with which hospital in-patients receive information about medicines and whether this varies dependent on patient characteristics or hospitals.

Methods

Cross-sectional survey of medical in-patients in six hospitals in North West England.

Results

1218 questionnaires were completed sufficiently for analysis by medical in-patients. 534 (43.9%) respondents were informed fully about their medicines by a hospital doctor, nurse or pharmacist and 411 (33.9%) partly informed, but 272 (22.49%) had received no information or could not recall any. Fewer than 20% had received written medicines information. The majority of respondents (763; 62.6%) were not asked if they had any concerns or could not recall this. Patient factors including age, educational level and number of medicines taken did not influence whether or not medicines information was provided, but there were differences between hospitals.

Conclusion

There is considerable variation between hospitals in the frequency with which patients are given verbal and written information about medicines and are asked about any medicine-related concerns.

Practice implications

Informing patients about medicines while in hospital needs to be improved. Doctors, nurses and pharmacists all need to accept and co-ordinate responsibility for informing patients about medicines and asking if they have any concerns or questions.     

The impacts of smart cards on hospital information systems--an investigation of the first phase of the national health insurance smart card project in Taiwan

PURPOSE: To investigate the impacts of the first phase of Taiwan's Bureau of National Health Insurance (TBNHI) smart card project on existing hospital information systems. SETTING: TBNHI has launched a nationwide project for replacement of its paper-based health insurance cards by smart cards (or NHI-IC cards) since November 1999. The NHI-IC cards have been used since 1 July 2003, and they have fully replaced the paper-based cards since 1 January 2004. Hospitals must support the cards in order to provide medical services for insured patients. METHODS: We made a comprehensive study of the current phase of the NHI-IC card system, and conducted a questionnaire survey (from 1 October to 30 November, 2003) to investigate the impacts of NHI-IC cards on the existing hospital information systems. A questionnaire was distributed by mail to 479 hospitals, including 23 medical centers, 71 regional hospitals, and 355 district hospitals. The returned questionnaires were also collected by prepaid mail. RESULTS: The questionnaire return rates of the medical centers, regional hospitals and district hospitals were 39.1, 29.6 and 20.9%, respectively. In phase 1 of the project, the average number of card readers purchased per medical center, regional hospital, and district hospital were 202, 45 and 10, respectively. The average person-days for the enhancement of existing information systems of a medical center, regional hospital and district hospital were 175, 74 and 58, respectively. Three months after using the NHI-IC cards most hospitals (60.6%) experienced prolonged service time for their patients due to more interruptions caused mainly by: (1) impairment of the NHI-IC cards (31.2%), (2) failure in authentication of the SAMs (17.0%), (3) malfunction in card readers (15.3%) and (4) problems with interfaces between the card readers and hospital information systems (15.8%). The overall hospital satisfaction on the 5-point Likert scale was 2.86. Although most hospitals were OK with the project, there was about 22% dissatisfied and strongly dissatisfied, that is twice as many hospitals with satisfied (about 10%). CONCLUSIONS: Our recommendations for those who are planning to implement similar projects are: (1) provide public-awareness programs or campaigns across the country for elucidating the smart card policy and educate the public on the proper usage and storage of the cards, (2) improve the quality of the NHI-IC cards, (3) conduct comprehensive tests in software and hardware components associated with NHI-IC cards before operating the systems and (4) perform further investigations in authentication approaches and develop tools that can quickly identify where and what the problems are.     

Patient satisfaction in Kazakhstan: Looking through the prism of patient healthcare experience

ObjectivesThis study aimed to explore the relationship between patient satisfaction and patient experience after exposure to inpatient hospitalization.MethodsA cross-sectional self-completed survey at the bedside in the Inpatient departments of the University Medical Center hospitals (UMC) in Nur-Sultan city, Kazakhstan was submitted. A total of 153 patients completed the survey from September 2017 to June 2018. The survey used the Picker Patient Experience questionnaire validated in Russian and Kazakh languages.ResultsThe majority of patients were satisfied with their hospital stay (90.8 %). Only self-rated health status was associated with overall satisfaction (OR 1.922, 95 % CI 1.09−3.37). Patient experience assessment revealed an association of physical comfort and respect for patient preferences with overall satisfaction (OR 0.101, 95 % CI 0.01−0.91 and OR 0.317, 95 % CI 0.11−0.92).ConclusionsStudy findings support that patient satisfaction is an exaggerated image of healthcare performance. Groups with negative experience have shown lower overall satisfaction in the dimensions ‘physical comfort’ and ‘respect for patient preferences’.Practice implicationsImproving patient centered communication and pain control in clinical practice may lead to the improvement in patient satisfaction.     

Implementation,participation and satisfaction rates of a web-based decision support tool for patients with metastatic colorectal cancer

ObjectiveTo examine implementation and patients’ and providers’ participation and satisfaction of a newly developed decision support tool (DST) for patients with metastatic colorectal cancer (mCRC) in palliative setting.MethodsOur DST consisted of a consultation sheet and web-based tailored information for mCRC treatment options. We conducted an implementation trajectory in 11 Dutch hospitals and evaluated implementation, participation and satisfaction rates.ResultsImplementation rates fluctuated between 3 and 72 handed out (median:23) consultation sheets per hospital with patients’ login rates between 36% and 83% (median:57%). The majority of patients (68%) had (intermediate)-high participation scores. The median time spent using the DST was 38 min (IQR:18–56) and was highest for questions concerning patients’ perspective (5 min). Seventy-six% of patients were (very) satisfied. The provider DST rating was 7.8 (scale 1–10) and participation ranged between 25 and 100%. Remaining implementation thresholds included providers’ treatment preferences, resistance against shared decision-making and (over)confidence in shared decision-making concepts already in use.ConclusionWe implemented a DST with sufficient patient and oncologist satisfaction and high patient participation, but participation differed considerably between hospitals suggesting unequal adoption of our tool.Practice implicationsRequirements for structural implementation are to overcome remaining thresholds and increase awareness for additional decision support.     

新形势下基层医院开展优质护理对提高患者满意度的研究

目的 研究新形势下基层医院开展优质护理对提高患者满意度的效果。方法 选取2017年2月~12月我院住院患者1000例为研究对象,将其随机分为研究组和对照组,各500例。对照组实施常规护理,研究组在对照组基础上实施优质护理服务。出院时对两组患者进行满意度调查,并进行比较。结果 研究组满意度为95.25%,高于对照组的78.82%,差异具有统计学意义（P＜0.05）。结论 实施优质护理服务能够有效提高护理质量,提高患者的满意度。     

Healthcare Spending and Performance of Specialty Hospitals: Nationwide Evidence from Colorectal-Anal Specialty Hospitals in South Korea

Purpose

Aim of this study is to investigate the characteristics and performance of colorectal-anal specialty vs. general hospitals for South Korean inpatients with colorectal-anal diseases, and assesses the short-term designation effect of the government''s specialty hospital.

Materials and Methods

Nationwide all colorectal-anal disease inpatient claims (n=292158) for 2010-2012 were used to investigate length of stay and inpatient charges for surgical and medical procedures in specialty vs. general hospitals. The patients'' claim data were matched to hospital data, and multi-level linear mixed models to account for clustering of patients within hospitals were performed.

Results

Inpatient charges at colorectal-anal specialty hospitals were 27% greater per case and 92% greater per day than those at small general hospitals, but the average length of stay was 49% shorter. Colorectal-anal specialty hospitals had shorter length of stay and a higher inpatient charges per day for both surgical and medical procedures, but per case charges were not significantly different. A "specialty" designation effect also found that the colorectal-anal specialty hospitals may have consciously attempted to reduce their length of stay and inpatient charges. Both hospital and patient level factors had significant roles in determining length of stay and inpatient charges.

Conclusion

Colorectal-anal specialty hospitals have shorter length of stay and higher inpatient charges per day than small general hospitals. A "specialty" designation by government influence performance and healthcare spending of hospitals as well. In order to maintain prosperous specialty hospital system, investigation into additional factors that affect performance, such as quality of care and patient satisfaction should be carried out.     

Improving patient education by an in-service communication training for health care providers at a cancer ward: Communication climate,patient satisfaction and the need of lasting implementation

Objective

To show the effects of an in-service communication training for health care providers at a cancer ward, to improve the quality and quantity of the patient education, and patient satisfaction with the care received.

Methods

A 3-year in-service communication training was held at a cancer ward. Pre- and post-data were collected about the quality and quantity of the communication of nurses, physicians and other health care providers (HCPs) towards patients and colleagues (n = 22) as well as the satisfaction of the patients with the quality of care (n = 90).

Results

The communication training raised significantly the quality and quantity of the communication towards patients and with colleagues. Also patient satisfaction with the quality of care increased. However, the long-term implementation of the benefits was proved disappointing.

Conclusion

In-service communication training is an important means for the long-term improvement of the quality of patient education at nursing departments in hospitals. Lasting implementation of the benefits however requires attention to organizational obstacles, budgetary conditions, leadership factors at the ward, and the application of an organizationally oriented theoretical framework.

Practice implications

Improvement of patient education at nursing wards does not only require educational means, organizational facilities and professional training, but can be improved too by in-service communication training, which increases the quality of the patient-centered care. An organizational oriented change-strategy is needed to ensure the implementation produces lasting effects.     

What education do stroke patients receive in Australian hospitals?

Objective

This study evaluated the educational practices of staff working in acute stroke wards in Australian hospitals, including the coordination and methods of patient education provision, post-discharge education and support services available, and the education and support services that health professionals would like to provide.

Methods

Health professionals who worked in acute stroke wards in Australian hospitals were surveyed about the stroke education practices of staff in their ward. Thirty-four hospitals returned a completed questionnaire via email or fax.

Results

Verbal communication and written materials were the most frequently used methods of information provision. Twenty-three (67.6%) wards developed their own written education materials, five (14.7%) offered group education programs, and 19 (55.9%) offered education or support after discharge. Fourteen (41.2%) wards had a particular staff member responsible for coordinating the provision of education to patients and one (2.9%) ward had a written policy on stroke education. The majority (70.6%) of participants would like to be able to provide more education/support services.

Conclusion

The educational practices of the Australian hospitals surveyed were variable, with improvements needed in the coordination and documentation of patient education and the available follow-up services.

Practice implications

Health professionals need to be aware of the importance of education in the care of patients following stroke. Patients’ informational needs, while in hospital and after discharge, may be better met if staff in acute stroke wards had improved communication and coordination practices and ensured that stroke education was appropriately documented and supported by policy.     

住院患者陪护就寝方式及其满意度的调查

目的 本项目拟对住院患者陪护就寝方式及其满意度进行现况调查,分析影响因素,为医院软文化建设和国家收费政策的拟定提供合理的依据。方法 任意选取唐山市三甲医院、二甲医院的开放式病区中800名住院患者陪护/家属,发放患者陪护/家属就寝管理模式与满意度调查表并现场收回,对不同医院之间对陪护就寝的管理规范程度、患者的满意程度进行分析比较。结果 不同医院之间对陪护就寝的管理规范程度、患者的满意程度对比,差异具有统计学意义（P＜0.05）;和三甲医院比较,二甲医院的规范程度和满意度更高;管理规范程度和满意度之间呈正相关（r=0.497,P＜0.05）。结论 不同医院之间对陪护就寝管理规范程度有差异,规范程度和陪护的满意度之间呈正相关。