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关于海南省突发公共事件卫生管理的综述 总被引:1,自引:0,他引:1
通过对海南省目前突发公共事件卫生管理的状况的全面综述 ,分析了本省在突发事件卫生管理方面存在的优势和弱点 ,提出了加强和改善本省突发事件卫生救援管理的相应对策 ,并系统阐述了应急管理所需的人力和资源。认为 :用现代科学的系统管理方法实施突发公共卫生事件的综合管理 ,建立高效的应急管理机制势在必行。 相似文献
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To protect public health and national safety, AMIA recommends that the federal government dedicate technologic resources and medical informatics expertise to create a national health information infrastructure (NHII). An NHII provides the underlying information utility that connects local health providers and health officials through high-speed networks to national data systems necessary to detect and track global threats to public health. AMIA strongly recommends the accelerated development and wide-scale deployment of electronic public health surveillance systems, computer-based patient records, and disaster-response information technologies. Such efforts hold the greatest potential to protect our citizens from disaster and to deliver the best health care if disaster strikes.To protect public health and national safety, AMIA recommends that the federal government dedicate technologic resources and medical informatics expertise to create a national health information infrastructure (NHII). An NHII provides the underlying information utility that connects local health providers and health officials through high-speed networks to national data systems (e.g., Centers for Disease Control and Prevention) necessary to detect and track global threats to public health.In the short term, this means adapting existing information systems to facilitate public health surveillance and emergency response. To establish a permanent infrastructure, AMIA strongly recommends the accelerated development and wide-scale deployment of electronic public health surveillance systems, computer-based patient records, and disaster-response information technologies. Such efforts hold the greatest potential to protect our citizens from disaster, and to deliver the best health care if disaster strikes.While meeting the acute needs of today, this initiative will begin laying the groundwork for a NHII that will continue to serve the health needs of the nation—a lasting endowment for future generations. Establishing an NHII requires thoughtful strategic planning and strong inter-agency leadership. Work on key components of the NHII must begin immediately. These key components include:
- Strategic planning and coordination. There must be a central coordinating entity that can quickly inventory existing public- and personal-health initiatives and develop a strategy to fashion a national system to protect Americans against health threats of various types, including biological, chemical, nuclear, and physical. The short-term strategy must be part of a framework for a permanent infrastructure that serves public health, patient care, and research.
- Connectivity and communications. Local, regional, and national coordination cannot exist without efficient, instantaneous communication. Public health services must be linked using secure connections to the Internet as an immediate top priority. AMIA recommends federal government funding to guarantee high-speed, dedicated access to the Internet for all public and private health care facilities and related organizations. Minimum-level workstations should be required, and adequate tools and training should be provided.
- Standards. Effective communication among local, community, state, and federal facilities require the use of standards. Health care messaging standards should be used for data interchange. A common vocabulary standard and required data elements for public health surveillance databases are required to enable effective sharing of data. Without a common vocabulary, data from local systems cannot be analyzed to detect emerging health threats. Government coordination and support for consensus standardization and low-cost distribution of common vocabularies for health event detection, prevention, and intervention are a fundamental aspect of an NHII.
- Resource databases. An up-to-date, central, Internet-based health resources directory containing information about available resources—knowledge, physical, and human—is vital to providing the timely information needed to manage any public health crisis. The national health resource directory would include information about physical resources, such as health care organizations, safety facilities, and environmental agencies; human resources, including physicians, nurses, and public health and support personnel; organizational resources, such as emergency medical services, county and city law enforcement agencies, and other emergency-response groups; and knowledge resources ranging from clinical guidelines to extensive clinical decision support algorithms related to threat vectors. Local health authorities must be trained in use of the directory to effectively derive maximal benefit when responding to national health threats.
- Public health surveillance systems. Effective public health practice and decision making depend on timely information, much of which is not readily available. Information about patients with clinical conditions of public health importance, symptoms compatible with prodromes of serious infection or exposure, health behaviors, and environmental risk factors must be collected, transmitted, aggregated, analyzed, and utilized for prompt decision making. Whether the health threat is biological, chemical, or nuclear, early detection and rapid response are essential. Existing public health systems in place and under development should be adapted to meet the current needs. Implementation of public health system initiatives such as the National Electronic Disease Surveillance System and Health Alert Network must be accelerated to meet the acute threat posed by bioterrorism.
- National identifiers. National identifiers for providers, insurers, businesses, and individuals are required by the Health Insurance Portability and Accountability Act (HIPAA) of 1996. The privacy provision of HIPAA that protects confidential health information has been finalized. In the face of the acute crisis, the work on identifiers should be accelerated so that effective epidemiologic data can be gathered and analyzed and appropriate health care services delivered where needed.
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目的 为本教研室的医学生提供结构化的教育指导和资源,开发和设计灾难医学课程。方法 采用医学教育课程开发六步法作为组织流程,急诊及灾难医学专家的专业知识、文献检索灾害医师培训计划、科学证据,作为内容开发的基础。结果 最后课程由14个模块组成,每个模块教学事件2 小时。介绍灾难医学概念,包括灾难的响应、医疗救助、法律条款、指挥、协调、沟通和大规模灾难的管理。综述全球灾难援助的医院预案和经验。讨论灾难发生条件下挽救生命的急诊治疗与有限的个人治疗。介绍爆炸、战争、辐射/核事件、化学和生物事件尤其是传染病和恐怖袭击初始处理的特殊性。灾难疏散的演习,大规模灾难分诊分流与当地救灾机构合作的模拟。当地消防部门合作演练个人去污与净化。人体模型复苏练习,个人防护设备应用练习。职业道德、应激疾病、社会心理干预措施和质量改进的培训。结论 该课程设计提供了合理的时间框架、多学科、多实践的灾难医学教育模式,可以作为医学生灾难医学教育的基本模板。因其具有全面灵活的组织结构,其进一步深化,也有利于急救或灾难专业医疗学生的灾难医学教育课程 相似文献
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在公共卫生体系建设中,卫生应急能力建设与发展是一个高度关注的问题.现阶段,我国尚有局部地区的县乡级医疗卫生机构由于受"过去‘卫生防疫'工作模式"以及"卫生应急能力建设投入不足和其机构内部资源配置失衡"等因素影响,导致卫生应急能力建设滞后、卫生人才匮乏、卫生应急管理体制和保障制度不健全.因此,必须通过"创新机制、转变职能、增加专项投入、建立专门的卫生应急机构和服务设施"等一系列的保障措施,着力加强县乡级卫生机构卫生应急能力建设,增强卫生应急人员综合素质与技术理论水平,从根本上改变或提升县乡二级医疗卫生机构的卫生应急能力. 相似文献
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This study evaluates how emergency physicians and nurses perceive their job climates in their hospital-based emergency departments
(ED). In total, 208 emergency physicians and 234 emergency nurses were surveyed, applying a validated survey instrument covering
the job facets of medical and nursing autonomy, professional accomplishments and outcomes, leadership, communication, management,
hospital policies and regulations, and external health policy environments germane to emergency medicine. The findings reveal
that the average satisfaction score for professional growth and accomplishments was ranked highest by emergency physicians,
and job communication within EDs was ranked highest by emergency nurses. Several emergency medical professional characteristics,
including age, education, medical authority, employment duration, full-time or part-time statuses, perceived workloads, and
hospital accreditation levels, were all related to job satisfaction in this surveyed population. New insights generated from
this study could provide increased guidance to hospital and ED unit managers toward enhancing wellness and limiting dissatisfaction
and disharmony relative to long-term career survival and the well-being of ED specialists. 相似文献
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目的 了解基层卫生应急人员对突发公共卫生事件风险沟通的认知现状,为提高基层卫生应急人员风险沟通的认识和能力提供依据.方法 采用问卷调查的方法,对重庆市19个样本区县承担突发事件应急处置的基层卫生应急人员进行调查,采用描述性分析和x2检验对调查数据进行分析.结果 共计调查了429名基层卫生应急人员.4.7%(20/429)的应急人员对风险沟通概念的熟悉度为“听说过、很熟悉”,且不同年龄、职称、参与风险沟通培训情况、参与风险沟通工作情况应急人员之间的认知存在一定差异(P<0.05);风险沟通知识核心信息全部知晓率仅为0.5%(2/429);24.9%(107/429)的应急人员表示非常愿意承担风险沟通工作;分别有超过60.0%的应急人员认为现阶段影响基层风险沟通开展最主要的因素是风险监测信息收集不完全(78.8%,338/429)、没有形成常规的工作机制(68.8%,295/429)、部门间沟通困难(62.7%,269/429)、缺乏风险沟通的技术方案(指南)或缺乏可操作性(60.8%,261/429).结论 基层卫生应急人员对突发公共卫生事件风险沟通的认知水平相对较低,专业队伍缺乏风险沟通相关知识,风险沟通工作意愿普遍不高,不能满足基层卫生应急工作需要.应采取多种有效方式,加大风险沟通培训力度,造就一支能适应基层卫生应急工作需要的队伍. 相似文献
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While much attention has been paid to the short-term impact that widespread adoption of health information technology (health IT) will have on the healthcare system, there is a corresponding need to look at the long-term effects that extant policies may have on health IT system resilience, innovation, and related ethical, social/legal issues. The American Medical Informatics Association's 2010 Health Policy Conference was convened to further the national discourse on the issues surrounding these longer-term considerations. Conference participants self-selected into three broad categories: resilience in healthcare and health IT; ethical, legal, and social challenges; and innovation, adoption, and sustainability. The discussions about problem areas lead to findings focusing on the lack of encouragement for long-term IT innovation that may result from current health IT policies; the potential impact of uneven adoption of health IT based on the exclusions of the current financial incentives; the weaknesses of contingency and risk mitigation planning that threaten system resilience; and evolving standards developed in response to challenges relating to the security, integrity, and availability of electronic health information. This paper discusses these findings and also offers recommendations that address the interwoven topics of innovation, resilience, and adoption. The goal of this paper is to encourage public and private sector organizations that have a role in shaping health information policy to increase attention to developing a national strategy that assures that health IT innovation and resilience are not impeded by shorter-term efforts to implement current approaches emphasizing adoption and meaningful use of electronic health records. 相似文献
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面对信息技术支撑薄弱、顶层设计缺乏、业务条线整合差的卫生应急系统现状,提出在重庆建设基于区域卫生信息平台,覆盖全市各级医疗机构、疾控中心、卫生监督机构的卫生应急专网的设计思路。 相似文献
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Inglesby TV O'Toole T Henderson DA Bartlett JG Ascher MS Eitzen E Friedlander AM Gerberding J Hauer J Hughes J McDade J Osterholm MT Parker G Perl TM Russell PK Tonat K;Working Group on Civilian Biodefense 《JAMA》2002,287(17):2236-2252
OBJECTIVE: To review and update consensus-based recommendations for medical and public health professionals following a Bacillus anthracis attack against a civilian population. PARTICIPANTS: The working group included 23 experts from academic medical centers, research organizations, and governmental, military, public health, and emergency management institutions and agencies. EVIDENCE: MEDLINE databases were searched from January 1966 to January 2002, using the Medical Subject Headings anthrax, Bacillus anthracis, biological weapon, biological terrorism, biological warfare, and biowarfare. Reference review identified work published before 1966. Participants identified unpublished sources. CONSENSUS PROCESS: The first draft synthesized the gathered information. Written comments were incorporated into subsequent drafts. The final statement incorporated all relevant evidence from the search along with consensus recommendations. CONCLUSIONS: Specific recommendations include diagnosis of anthrax infection, indications for vaccination, therapy, postexposure prophylaxis, decontamination of the environment, and suggested research. This revised consensus statement presents new information based on the analysis of the anthrax attacks of 2001, including developments in the investigation of the anthrax attacks of 2001; important symptoms, signs, and laboratory studies; new diagnostic clues that may help future recognition of this disease; current anthrax vaccine information; updated antibiotic therapeutic considerations; and judgments about environmental surveillance and decontamination. 相似文献
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目的了解农村基层防保机构的现状,为农村公共卫生体系建设提供指导。方法采用表格询问调查,通过统一培训调查员和专业人员抽查进行质控。结果从机构设置、人员配备、经费保障和工作开展等层面看,全市防保机构发展不平衡,仅能满足基本工作需要。结论基层防保体制必须进行改革、创新,以适应和谐社会、和谐农村的需要。 相似文献
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回顾1986年-1995年中资料较全的5次灾害所致大五伤员的入院前处理,从灾害急救医学观点讨论灾害发生后入院前与大量伤员处理密切相关的急救通讯、检伤分类、现场急救、伤员运送等重要环节,提出存在的问题,吸取经验教训,以利提高救灾医疗水平. 相似文献
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本文简述医疗资源的内涵及其配置要素,对国内外突发公共卫生事件下医疗资源配置研究的现状和进展进行梳理和评述。评述主要从应急资源配置规则、应急管理流程和评估、医疗资源需求量测算、医疗人力、机构、设备、物资和内外部管理等方面进行,提出现有国内外研究存在的问题和不足,包括:(1)对突发公共卫生事件应急管理法律、规则和制度、应急管理常态化流程等体制机制设计的研究没有充分结合各国实际卫生体制考虑;(2)具体对应急场景与医疗资源配置衔接的相关研究较少;(3)我国研究应急医疗资源配置的方法比较有限,大多以定量研究的方法集中在医疗机构选址和应急物资优化配置上,而在突发公共卫生事件场景下如何进行医疗资源种类的确定等方面鲜有涉及。基于以上梳理,提出进一步的研究方向,包括:(1)结合本国国情,开展突发公共卫生事件下应急法律法规及规则流程的相关研究;(2)结合现有卫生体制改革,进行医疗资源配置策略的相关研究;(3)结合具体测算方法,进行医疗资源种类确定、配置要素的优先排序、医疗人财物资源需求测算的研究。 相似文献
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目的 比较研冤国内外突发手件卫生厘急反应,分析各国哭发手件卫生应急反应体糸建设特点,提出符合我国实际的针对突发事件卫生应急防制策略和应对措施。方法 应用循证医学的思想,采用文献回顾的方法,对Pubmed、国内各大数据库、报纸杂志、官方网站的信息进行广泛收集,对符合研究标准的纳入文献,进行综合评价。结果 美、英、俄、日的法制建设较为健全,组织管理体系也较为健全,应急反应人员也更为专业,应急能力较强;公共卫生方面的投入美国居首,英、日相当,中、俄相对较低,美、英、日信息服务和反馈较迅速,后勤保障良好。结论 应结合我国实际在卫生应急的各个方面有所加强,加强同各国的经验交流,建立健全符合我国实际的应对突发事件的机制,提高我国突发事件卫生应急能力。 相似文献
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目的了解青海省、市、县三级疾病预防控制中心卫生应急工作现状,推动疾控机构卫生应急能力体系建设。方法采用卫生部统一制定的全国卫生应急基本情况调查问卷表对青海省疾病预防控制机构的卫生应急情况进行调查。结果青海省各级疾控机构目前已经初步构建了卫生应急体系,应急预案制定率为100.0%。92.3%的机构组建了卫生应急队伍;平均演练次数为1.4次,平均培训次数2.7次;96.2%的机构有应急物资储备,46.2%的机构有日常卫生应急经费。结论落实卫生应急协调组织机构,解决应急机构编制;制定应急培训规划,系统开展培训;提高演练次数和质量,提升基层卫生应急专业能力;加强突发公共卫生事件的评估与总结;建立应急专项经费保障和应急物资储备长效机制等是提升卫生应急能力的关键措施。 相似文献