临床工程部门在数字化手术室建设中应关注的问题

针对目前医院数字化手术室的建设,首先分析了手术室数字化的特征与意义;然后结合建设中遇到的实际问题提出了相应解决方案并总结经验。在医院的数字化建设中,功能完备、经济高效、安全可靠的数字化手术室是建设重点之一。     

高清网络视频系统在数字化手术室的研究与实现

目的：探讨如何利用高清网络视频技术实现数字化手术室的建设和数字化手术室对临床诊疗、临床教学等具体应用的支撑。方法：通过对医院数字化手术室系统的需求分析，运用高清网络视频技术，结合医院已有的其他需交互的HIS、手麻、远程会诊等信息系统，设计和搭建符合现代医院手术室需求的数字化手术室系统。结果：数字化手术室建成后，医院开展手术示教、远程教学、远程会诊等医疗活动，取得良好的效益。结论：数字化手术室系统可以增强医院的环节管理，丰富临床医疗资源和学术依据，具有推广意义。     

洁净手术室现代化发展趋势

洁净手术室作为现代化医院的标志，其设计建造已成为大型医院基础建设的重点内容；本文从洁净化、人性化、数字化三个角度对手术室的发展趋势进行了探讨，强调人性化、数字化是将来现代化洁净手术室的重要标志。     

数字化手术室建设现状分析

数字化手术室建设是数字化医院建设的重要组成部分,介绍了目前国内数字化手术室建设现状,详细分析了建设功能完备数字化手术室需要关注的问题及数字化手、术室产品在临床应用中的功能缺陷。     

浅谈数字化手术室的应用

介绍了数字化手术室的概念和具体功能,分析了数字化手术室在安全的手术环境、医院系统集成、教学及学术交流等方面的应用,并从提升医疗安全和质量、提高工作效率、监控医疗过程、提高医院信息化管理水平等方面详细阐述了数字化手术室应用效果,指出了数字化手术室是医院数字化建设的重要组成部分,为医院带来直接的经济效益和社会效益,提高了医院的核心竞争力,是医院数字化的必然趋势。     

论数字化手术室建设

数字化手术室是手术室现代化建设的发展方向.手术室越来越智能化,各信息系统与医疗设备都存有大量与患者相关的数据,多且分散,需要通过技术手段将所有信息集中展现与记录.文章阐述了数字化手术室相关的技术及数字化对象,分析了数字化手术室建设的实际需求,对数字化手术室展现的功能和价值进行了探讨,并结合医院机器人手术室、MR手术室、DSA手术室的数字化建设实际做了案例阐述.     

数字化手术室的建设与应用

数字化手术室作为数字化医院建设的重要组成部分,对规范麻醉科、手术室、重症监护病房的工作流程,实现麻醉、重症监护的数字化管理具有重要意义。本文主要对数字化手术室的建设内容和功能特点进行介绍。     

电子病历在数字化手术室中的应用

本文介绍电子病历与数字化手术室,分析了两者的关系,列举电子病历在手术室中的一些应用,并从电子病历和数字化手术室的角度对数字化医院的建设提出初步见解。     

医院数字化手术室建设的发展趋势

从4方面阐述数字化手术室建设的发展:①目前市场上销售的各国生产的数字化手术室产品的功能、应用优势、分类及技术特点；②总结数字化手术室项目建设的相关注意事项,包括基本流程、进场时间安排、安装周期、对手术室层高和面积等建筑结构的要求、系统先进性的体现以及医院各科室的配合；③目前国内医院已经投入使用的数字化手术室普遍存在系统与其他品牌的医疗设备不能兼容、没有采用数据存储的标准协议、远程医学通讯的患者影像资料的质量不高、缺少影像支持及手术导航等核心技术支撑等问题；④国内不同的医院进行数字化手术室建设的现实可能性和基本思路.     

数字化手术室改造前需做哪些准备?

目前,国内一些医院在进行数字化手术室改造时走了一些弯路,致使数字化手术室的优势并没有充分发挥出来。那么,医院在进行数字化手术室改造前要做好哪些准备呢?* 要有前瞻性的准确定位很多医院都多多少少地进行了一些手术室数字化改造,但因为缺乏准确定位而显得随意,不能很好地适应未来发展。医院进行数字化手术室改造的前提     

智能监控系统在手术室现代化管理中的应用

目的拓展手术室管理新模式,将电子化智能设备充分运用于手术室日常工作中,提高手术室工作效率和管理效能,实现从传统的管理模式向现代化科学化的转变。方法通过运用先进的指纹信息采集系统和数字化视频监控系统共同搭建手术室监管的综合平台,对于手术室工作实现动态调控及管理。结果该系统促进加强手术室与各手术科室之间的有效合作,改进手术流程,规范医护人员的医疗行为。结论提高手术室护士长的管理质量和效率,全方位、多层次、多角度地实现手术室管理的现代化、科学化、高效化。     

A team approach to OR environmental issues

At Munroe Regional Medical Center in Ocala, FL, an effective partnership between Materials Management and the Operating Room was begun by building consensus around a shared concern--minimizing the Operating Room's impact on the environment. To accurately evaluate cost-in-use issues, Materials Management and the OR needed a better understanding of each other's processes, procedures and decision-making criteria. Materials Management observed surgical procedures to understand product requirements, and OR personnel were given financial information on such matters as group purchasing and disposal costs. After considering all the data, the MM/OR team decided to continue using single-use polypropylene gowns rather than switch to reusable gowns. Success in this endeavor led the team to institute a disposable wrap recycling program. Lasting benefits of the collaboration include higher cost consciousness among clinicians, open communications, greater supplier accountability for cradle-to-grave cost estimates and team building.     

辅助生殖技术后妊娠晚期自然流产的相关因素分析

目的:探讨辅助生殖技术(ART)助孕妊娠后晚期发生自然流产的相关因素。方法:回顾性分析2000年1月～2008年12月ART术后妊娠晚期自然流产的患者111例及同期ART后足月分娩的183例妇女,分析与晚期自然流产有关的因素。结果:ART后晚期流产的相关因素有宫颈操作次数(OR=1.356)、胎膜早破(OR=13.881)、减胎术(OR=5.363)、双胎妊娠(OR=1.136)。结论:行ART治疗的不孕患者如有多次宫腔操作史,后天性的宫颈管机械损伤不容忽视;当伴多胎妊娠时应严密监测宫颈长度,必要时行宫颈环扎术。     

Decision support system for the operating room rescheduling problem

Due to surgery duration variability and arrivals of emergency surgeries, the planned Operating Room (OR) schedule is disrupted throughout the day which may lead to a change in the start time of the elective surgeries. These changes may result in undesirable situations for patients, wards or other involved departments, and therefore, the OR schedule has to be adjusted. In this paper, we develop a decision support system (DSS) which assists the OR manager in this decision by providing the three best adjusted OR schedules. The system considers the preferences of all involved stakeholders and only evaluates the OR schedules that satisfy the imposed resource constraints. The decision rules used for this system are based on a thorough analysis of the OR rescheduling problem. We model this problem as an Integer Linear Program (ILP) which objective is to minimize the deviation from the preferences of the considered stakeholders. By applying this ILP to instances from practice, we determined that the given preferences mainly lead to (i) shifting a surgery and (ii) scheduling a break between two surgeries. By using these changes in the DSS, the performed simulation study shows that less surgeries are canceled and patients and wards are more satisfied, but also that the perceived workload of several departments increases to compensate this. The system can also be used to judge the acceptability of a proposed initial OR schedule.     

Operating room cost awareness committee. A model for collaboration

Kaiser Santa Rosa (KSRO), a small facility in the Kaiser Permanente health maintenance organization, was found to have an unfavorably high non-payroll cost per surgical hour as compared with other Kaiser facilities. An Operating Room Cost Awareness Committee was formed to address the problem and has now become a standing committee at KSRO. The committee is composed of surgeons, nurses, materiel management personnel and administrative representatives. Through a spirit of cooperation and the authority to approve and deny all OR supply requests, the committee has been able to bring its OR costs in line with other Kaiser facilities.     

智能数字温度控制器在设备改造维修中的应用

本文介绍了智能数字温度控制器和利用智能数字温度控制器对几种不同类型的设备进行技术改造的应用实例。     

Cognitive performance is associated with macronutrient intake in healthy young and middle-aged adults

Abstract

Primary objective: The objective was to examine whether dietary intakes of macronutrients are associated with neuropsychological performance.

Research design and method: Study participants were 3960 adults aged 20–59 years, who completed three neuropsychological tests and a 24-hour dietary recall as a part of the Third National Health and Nutrition Examination Survey, 1988–1994. Poor performance was defined as the test score below gender-specific 15th percentile.

Main outcomes and results: While holding the energy percentages from different macronutrients, additional 100 kcal intake of energy was associated with a reduced odds of poor performance on serial digital learning test (OR = 0.98, 95%CI = 0.96, 0.99) and symbol digital substitution test (OR = 0.97, 95%CI = 0.96, 0.99). Compared with equivalent energy from carbohydrates, each 5% of energy from poly-unsaturated fatty acids (PUFA) or total fat was associated with a reduced OR of poor performance on simple reaction time test (PUFA: OR = 0.77, 95%CI = 0.63–0.95 and total fat: OR = 0.93, 95%CI = 0.87, 0.99). Poor global cognition was associated with an additional intake of 100mg cholesterol (OR = 1.14, 95%CI = 1.05, 1.23). These associations were more salient in men.

Conclusion: Habitual intake of macronutrients is weakly but significantly associated with cognitive functioning. These relationships are more evident in men.     

PSA testing and digital rectal examination in New Zealand

OBJECTIVE: To investigate the use of digital rectal examination and prostate specific antigen (PSA) testing in a population-based sample of men in New Zealand. METHODS: A random selection of men aged 40-74 years, weighted by age, was chosen from the general electoral roll of New Zealand. Only men with a telephone who had been married at some time were eligible. Telephone interviews were conducted using a standard questionnaire. Crude and age-adjusted proportions were calculated. Logistic regression was used to explore associations between sociodemographic factors and digital rectal examination or PSA testing. RESULTS: Interviews were completed for 85% of the 1,486 eligible men and analyses were confined to the 1,225 European men. Many more men reported having a digital rectal examination (41%; 95% CI 33.8-48.2) than a PSA test (9%; 95% CI 4.2-14.2). Men in the lowest social class were significantly less likely to have had a digital rectal examination (OR 0.30; 95% CI 0.18-0.50) or PSA test (OR 0.25; 95% CI 0.11-0.60) compared with those in the highest social class. Men with vocational training or no post-school qualifications were approximately half as likely to report a digital rectal examination or a PSA test compared with men with degrees or diplomas. CONCLUSIONS: Although current New Zealand recommendations are that population screening for prostate cancer should not be introduced, many men are still having digital rectal examinations and PSA tests in the absence of symptoms. The frequency of PSA testing is considerably lower than in Australia and appears to be largely influenced by a man's social class.