浅谈血压计检定中维修情况的处理

通过对我院在用血压计进行的全面调查和检测,发现,血压计在使用过程中操作不规范、人为损坏率较高,因此需要加强血压计在使用过程中管理,严格制定检定周期,定期安排专职人员进行培训。     

水银血压计维修要点

目前 ,医院内普遍使用的水银血压计 ,是多种血压计中首选之一。它主要特点是 :量值准确 ,结构简单 ,操作方便 ,示值重复性好 ,价格也较便宜。由于使用频繁 ,临床上常出现漏气、破损、水银溢出等问题 ,影响了血压计的准确性 ,进而影响到了医护人员对病情的正确诊断。因此 ,除定期对水银血压计进行检定外 ,还须快速、准确地对血压计进行及时的维修 ,确保临床诊断的需要。近十年来 ,作者一直担任医院大规模的水银血压计维修工作 ,通过在实践中探索 ,初步总结出水银血压计维修存在以下几个方面的要点。1 压力系统漏气 :在测量血压时 ,水银柱打上…     

汞柱式血压计与电子血压计测量结果异常研究

目的：分析汞柱式血压计与电子血压计测量结果差异。方法：利用血压计标准器对汞柱式血压计进行检定,把检定合格的汞柱式血压计同电子血压计一起,在相同条件下对不同患者进行测量,计算出汞柱式血压计与电子血压计血压测量的差值。结果：10名被测量患者中有7名患者血压值在最大允许误差范围内,赋予差值的电子血压计可信度为70%。结论：在使用电子血压计时,一定要按说明要求,规范操作,减少人为因素引起的差异。     

电子血压计与汞柱式血压计测量儿童青少年血压的一致性分析

目的研究电子血压计、汞柱式血压计用于儿童青少年血压测量时的一致性。方法样本来自湖南省攸县6个居委会的6~17岁儿童青少年201人,使用迈克大夫BPA100 Plus电子血压计和汞柱式血压计比对3次,汞柱式血压计测量值为金标准。两种血压计同时各测量3次取平均值。利用配对t检验、Bland-Altman图示分析法、组内相关系数来验证两种血压计测量结果的一致性。结果配对t检验显示两种血压计测得收缩压(t=24.71,P0.0001)、舒张压(t=23.81,P0.0001)有统计学差异,电子血压计结果均高于汞柱式。Bland-Altman图示表明两种血压计不能替换。组内相关系数结果显示,两种方法一致性较差。结论在儿童青少年大规模营养与健康的现场调查中,若使用电子血压计,建议进行电子血压计和汞柱式血压计的比较研究,从而得到科学结论。     

现场调查中汞柱式血压计和电子血压计的对比研究

目的研究在现场调查中,电子血压计与汞柱式血压计得到的人群平均血压水平、高血压患病率之间的差异,并得到两种血压计结果的数值转换关系。方法样本来自湖南省攸县6个居委会的18岁及以上成年人共544名,使用欧姆龙HEM-907电子血压计和汞柱式血压计进行比对,汞柱式血压计测量值为金标准。两种血压计同时各测量3次取平均值。利用配对t检验、Bland-Altman图示分析法来验证两种血压计测量结果的差异或一致性;卡方检验验证两种设备判断高血压患病率是否存在差异;用一般线性回归得到不同设备血压值之间的换算方程。结果配对t检验显示两种血压计所得收缩压、舒张压值有统计学差异(P<0.0001);χ2检验显示,两种血压计在判定成人高血压患病率上具有统计学差异,电子血压计高于汞柱式血压计(χ2=422.6,P<0.0001)。Bland-Altman图示表明两种血压计不能替换;得到两种设备血压值之间的回归方程:电子血压计收缩压=11.65+0.96×汞柱式血压计收缩压(R2=0.9391,P<0.0001),电子血压计舒张压=2.27+0.95×汞柱式血压计舒张压(R2=0.8133,P<0.0001)。结论在大规模营养与健康的现场调查中,电子血压计和汞柱式血压计存在一定差异,在使用电子血压计前建议进行应用上的比较研究。     

使用血压计标准器检测台式血压计示值误差的不确定度

依据标准GB3053-93<血压计和血压表>,使用血压计标准器对台式血压计(简称血压计)的示值误差进行测定,系统分析测定过程中的不确定度来源,并对测定结果的不确定度进行评定.     

台式血压计上盖防脱位装置

本文介绍了一种台式血压计上盖防脱位装置的设计方案和制作方法,该装置的使用,从根本上解决了台式汞柱血压计上盖与底座容易脱位的常见故障。     

在用血压计质量状况分析

调查研究了新疆军区驻乌鲁木齐市部队在用血压计、血压表的使用状况。依据《JJG270—2008血压计和血压表检定规程》对该部队的605台血压计、血压表进行检定,结果表明示值误差超差、气密性不符合要求以及袖带破损是造成血压计、血压表不合格的主要因素,为血压计、血压表的正确使用和质量控制提供了借鉴。     

急救现场三种测压方法的对比性研究及合理应用

目的探讨台式水银血压计、电子血压计、多功能监护仪血压测量值是否存在差异,从而为急救护士合理使用血压计提供指导。方法随机抽取219例急救患者在救护车上交替采用台式水银血压计和电子血压计,台式水银血压计和多功能监护仪同一病人同体位同部位测血压二次,采用t检验方法进行比较。结果台式水银血压计与电子血压计测得的血压差异有统计学意义（P〈0．05）;台式水银血压计和多功能监护仪测得的血压差异有统计学意义0P〈0．05）。结论血压计的选择对测得血压值有影响,在急救抢救中要引起注意。     

量血压选好血压计

高血压是一种慢性病,日常自我监测血压的变化就成了高血压患者每天的"必修课"。随着科技的发展,血压计出现了日新月异的变化,从传统的水银血压计到现在的电子血压计、臂式电子血压计,甚至腕式、指夹式电子血压计……到底使用哪种血压计好呢?     

汞柱式血压计计量检测分析及汞泄漏问题讨论

目的：分析汞柱式血压计在计量检定过程中发现的故障和维修方法,强化汞泄漏防范意识和处理的方法,引导临床规范化操作。方法：统计分析本次检定的68台在用汞柱式血压计的检定记录和维修记录。结果：首次检测合格率仅为66%,维修后检测合格率为99%,总计补充汞185 g。结论：强化汞柱式血压计的维护和使用,确保测量的准确性;了解汞的特性及汞污染对人体的危害,掌握血压计汞泄漏的防范措施和处理方法。     

可控简易气囊加压包扎带战地急救应用探讨

目的：探讨可控简易气囊加压包扎带在未来高技术条件下局部战争中大量战地伤员现场急救的可行性和优越性.方法：利用一次性输液袋替代部分敷料包扎在三角巾底部,接上血压计打气球和压力表以及肝素帽,打气加压并且控制在3～5kPa的压力.结果：该包扎带结构简单合理、操作简便,压力调节灵活方便、价格低廉、通用性强、效果明显,同时可以应用于骨折临时固定.     

Evaluation of the DINAMAP blood pressure monitor in an ambulatory primary care setting

Automatic blood pressure recorders have gained acceptance in many clinical settings. New devices have usually been validated with invasive monitoring as the "gold standard." There is a lack of sound empirical evidence, however, supporting the routine use of these monitors in ambulatory settings. This study evaluated the DINAMAP 8100, an oscillometric automated blood pressure monitor, using the Hawksley Random-Zero Sphygmomanometer as the standard. A sample of 80 normotensive and hypertensive ambulatory patients from the Department of Family Medicine at the Medical University of South Carolina were studied. A clinical trial was conducted in which readings from the DINAMAP 8100 were compared with those from the Hawksley Random-Zero Sphygmomanometer, in a 2 (instrument) X 2 (arm) X 2 (investigators) X 4 (pairs of simultaneous measurements) factorial design. The DINAMAP 8100 overestimated systolic readings (mean difference = 7.6 +/- 9.1 mmHg, P less than .0001, paired t test). More than one third of systolic measurements and one quarter of diastolic measurements were greater than 10 mmHg discrepant from the standard. The results of this study suggest that routine use of the DINAMAP 8100 would lead to serious misclassification errors in screening for hypertension and in the follow-up of known hypertensive patients. The DINAMAP 8100, therefore, is not an appropriate instrument for routine use in primary care settings.     

基于新颖血压参数标定法的无袖套血压获取系统

基于Moens—Koneweg模型和流体静力学原理,提出了一种简易人体血压参数标定方法,通过改变手腕血压测量点与心脏的垂直距离,用流体静力压来影响血液在血管中的流动．改变血压与脉搏波传导时间,从而得到多组不同的心血管参数值,由此建立起血压与脉搏波传导时间的关系式。文中详细介绍了各部分电路及软件设计。通过对不同年龄、性别的人分别进行长期和短期的监测．并与医用OMRON EW3152电子血压计进行对比．结果表明用此方法测量有较高的精确度和测试一致性。     

汞柱式血压计使用风险控制研究

目的：对无锡市某三甲医院440台汞柱式血压计进行计量检测,以预估汞柱式血压计在使用过程中的风险,并提出解决方法来控制风险,使之降到最低。方法：依据JJG270---2008《血压计和血压表检定规程》对汞柱式血压计进行计量检定,并对结果进行深入分析。结果：该院汞柱式血压计总体合格率较高。结论：汞柱式血压计是测量血压的常规仪器之一,需要格外关注使用中可能会发生的风险,采取预防性维修措施,可提高汞柱式血压计使用的安全性、有效性和可靠性。     

Immediate Effect of Working Splints on Grip Strength of Arthritic Patients

The Study described in this paper tests the assumption that, because splinting reduces pain, unconscious relaxation of grip will be reduced, resulting in an immediate increase in grip strength. It also aims to determine which type of splint might be most beneficial. The averages of three trials with a Sphygmomanometer by ninety-two female rheumatoid arthritic (RA) volunteers, aged between mid twenties to late seventies, were analysed by a single classification ANOVA. This ananysis yielded no significant differences between four types of splint wearing and a control group, for both dominant and non-dominant hands. Similarly, no significant differences in grip strength were revealed between various pain levels, as measured by the Ritchie scale, though the results suggest the possibility of a trend that should be investigated further.     

Processes maps in public health organizations: the experience of the Galician Department of Public Health

To design the processes map of the Galician Department of Public Health, we performed document reviews, held meetings and interviewed persons in charge of programs and departments to identify the processes carried out. The processes were classified into strategic, key and support processes. We defined 4 levels of disaggregation and management and staff were kept informed throughout the process. At level 0, we included 4 key processes that defined the organization's mission. At level 1, 5 strategic, 5 support and 10 key processes were defined. The key processes at level 2 identified the health programs' services. A processes map was obtained by consensus and was then approved by management and staff as a first step in implanting a process management system to improve the organization's performance.     

The cost management organization: the next step for materiel management

With Materiel Management's transition over the last decade from simple logistics to analysis and cost management, it has gained recognition as a key part of the management team responsible for supplies, equipment, standards, and associated processes to identify, purchase, store, distribute, issue, and dispose of supplies and equipment. The materiel manager's job consists of putting the right product in the right place at the right time and in the right quantity at the best total delivered cost. In this context, Materiel Management has made powerful impacts to lower costs associated with: Distribution--costs have been lowered by actively adopting advanced supply channel management techniques such as primary suppliers, JIT, stockless programs, case cart/custom kit/procedure based delivery systems, modified stockless programs as well as margin management through cost plus, flat fee, or margins paid per activity. Cost of goods--lowered through aggregated purchasing in the forms of regional and national purchasing alliances and local capitation or other gain/risk share programs. Internal process costs--lowered by out-sourcing and/or integrating supplier processes and personnel into operations via partnership approaches. We have also reduced transactional costs through EDI transaction sets and the emerging use of the inter and intranet/electronic commerce, procurement cards, and evaluated receipt settlement processes. De-layering--We have lowered the operating costs of Materiel Management overhead by re-design/re-engineering, resulting in reduced management and greater front line authority. Quality--We have learned to identify and respond to customer and supplier needs by using quality improvement tools and ongoing measurement and monitoring techniques. Through this we have identified the waste of non-beneficial products and services. We have adopted supplier certification measurers to ensure quality is built into processes and outcomes. With so much already accomplished, it should be easy to rest on these laurels and simply operate. However, we believe that this is just a beginning. A new generation of highly educated leaders are emerging and taking advantage of the contributions of pioneers who laid the ground work. These new leaders will have advanced management, statistics, and behavioral sciences skills. They will be analysts and organizational motivators. Their goal will be to improve financial and clinical performance measured by real time process and performance data. The new leaders will have information at their fingertips thanks to significant leaps forward in data collection, automated continuous replenishment processes, and software designed for better management of clinical and cost outcomes. This article documents significant Materiel management accomplishments and conceptualizes cost management processes. The cost management organization is the logical evolution in our efforts for better outcomes in healthcare Materiel management.     

Michigan oncology practices showed varying adherence rates to practice guidelines, but quality interventions improved care

Despite improvements in care for patients with cancer, and in their survival rates, it is not clear that best practices are uniformly delivered to patients. We measured the quality of outpatient cancer care, using validated quality measures, in a consortium of thirty-six outpatient oncology practices in Michigan. We discovered that throughout the measurement period, for breast and colorectal cancer care, there was a more than 85 percent rate of adherence to quality care processes. For end-of-life care processes, the adherence rate was 73 percent, and for symptom and toxicity management care processes, adherence was 56 percent. In particular, we found variations in care around the fundamental oncologic task of management of cancer pain. To address quality gaps, we developed interventions to improve adherence to treatment guidelines, improve pain management, and incorporate palliative care into oncology practice. We concluded that statewide consortia that assume much of the cost burden of quality improvement activities can bring together oncology providers and payers to measure quality and design interventions to improve care.