When East meets Wests: community-based rehabilitation in Chinese communities

Purpose.?Community-based rehabilitation (CBR) has been practiced in mainland China for over three decades. This study reviews the development of CBR and describes its practice in Chinese communities in order to discuss current controversies within CBR practice internationally and in the Chinese context.

Method.?Review of literature. Development of CBR, its principles and controversies internationally and in the Eastern world is reviewed. CBR practice in Chinese communities is examined.

Results.?Shifting ideology and practices mean many different activities are labelled CBR. Variation across contexts has led to many controversies, specifically: the lack of evidence to support practice; ownership of programs; conceptual differences surrounding autonomy and participation and cultural issues. Contemporary Chinese cultural values and Chinese CBR are shaped by traditional peasant culture, traditional Chinese philosophy and socialist ideology.

Conclusion.?The review indicates that Western CBR concepts and philosophy cannot be directly applied to the Chinese context. An appropriate model or framework is needed to fit the unique Chinese cultural context and to guide practice in Chinese communities.     

病案管理人员素质教育的探讨

了解病案工作人员素质提高的影响因素,分析原因并提出可行的素质教育模式,以提高病案工作人员的整体素质,以适应病案管理科学发展的需要。     

Nursing case management in the 21st century: intervening where margin meets mission

Case management, the basic process of matching key resources to individual's needs, often carried out across time and place, has been a relatively low-profile function (under various levels) within society, business, and health care for many years. Nurses have been involved in case management since its beginnings in social service and public health. However, nurses only became prominent as case managers during the last half of the 20th century because of the need to establish medical necessity for health care payments and, eventually, the need to provide discharge planning. The 21st century begins with an evolving core for case management functions in health care, the specific models dictated by the margins and missions of the employing organization. Case management, in fact, is the nursing process applied at a system level. However, if case management is to remain an adaptable yet powerful strategy for patients and organizations across the continuum of health care, it will have to move beyond access and medical necessity functions to those functions that demand advanced nursing experience and skills.     

Nursing case management: strategic management of cost and quality outcomes

Nursing Case Management has four essential components: achievement of clinical outcomes within a prescribed timeframe; the care giver as case manager; episode-based RN-MD group practices that transcend units; and active participation by patients/families in goal setting and evaluation. In the first year of implementation, nursing case management has shown positive resolutions for some of the complex issues facing health care administrators, managers, and clinicians. This article describes the model, its practical and philosophical origins, application, and early results.     

Platelet pool inventory management: theory meets practice

BACKGROUND: The shelf life of platelet concentrates (PCs) is a matter of days. Simultaneously, the demand is highly variable, shortages are not allowed, and producing too many results in outdating. Concurrently, younger PCs, implying an extended time till outdating (TTO), are preferred. Common PC inventory management relies on experience‐based order‐up‐to rules. This study aimed at minimizing outdating and shortages, while extending the TTO through a theoretical approach. It focuses on PCs processed from whole blood donations. STUDY DESIGN AND METHODS: A combined approach of stochastic dynamic programming and simulation techniques (SDP/S), from the mathematical discipline operations research, has been implemented. This approach included the design of the dedicated software tool thrombocyte inventory management optimizer (TIMO). Based on the 2007 data, an optimal order‐up‐to rule was calculated. Outdating percentages and TTOs have been collected from August 2005 to July 2010. The resulting order‐up‐to rule has been applied and adjusted from summer 2007 onward. RESULTS: Over the study period, the results of the practical implementation showed significant improvements. The median weekly outdating percentage dropped to less than 1% and a gain in TTO of 0.48 day was reached. The results and the additional computer simulations brought confidence to the personnel to apply and adopt the “theoretical” approach and TIMO. CONCLUSION: Applying theory may help a blood bank to improve its PC inventory management and may help to identify to what extent practical limits can approach theoretical limits. The application of the theory has led to both a significant improvement and a more structured and less panic‐driven PC inventory management.     

Developing standards and quality measurements for case management practice

Case management is a service offered in most health care and social service settings, but a universal definition and standards for practice, applicable to the various case management models, do not exist. Without nationally accepted standards and quality measures for community-based long-term-care case management, many agencies are scrambling to create them in order to justify their services to payers. This article describes the method followed by one county agency serving low-income elders and people with disabilities to create process standards and quality measures for case management practice. The project involved experienced case management staff who created measurement tools encompassing measures of 12 case management activities. Their goal was to justify the importance of the service being offered, to set minimum practice standards, and to raise the awareness and level of quality of case management practice.     

临床实验室标准化电子文档管理系统的研发与应用

目的 开发满足ISO15189质量管理体系要求的临床实验室电子文档管理系统.方法 基于ISO15189相关要求,借助互联网,采用浏览器/服务器(Browser/Server,B/S)模式,利用Java和MySQL数据库等信息技术构建电子化文件管理系统(以下简称系统);通过向实验室184名员工发放调查问卷评价该系统的应用...     

环节质量控制在电子护理病历质量管理中的应用

目的探讨环节质量管理在电子护理病历质量管理中的应用效果。方法于2008年6-8月和2009年6-8月分别在神经内科重症监护室,按随机数字法分别抽取患者出院电子护理病历各110份（各1210项）,分别为常规质量管理与环节质量管理期间的资料。常规质量管理法为由护士长每天抽出一定时间对危重及出院患者病历进行查阅,实施病历质量管理;质量环节管理为由护士长和1-2名责任主管护师每天对每份病历进行检查。比较两种管理方法电子病历规范书写存在缺陷的发生情况。结果环节质量管理后电子护理病历缺陷率为3.80%（46项）,常规质量管理为21.74%（263项）,两种管理方法电子护理病历缺陷率比较,P〈0.001,差异具有统计学意义。结论实施电子病历环节质量管理可减少护理病历记录缺陷和提高护理病历书写质量。     

Blending case management and quality outcomes management into the family nurse practitioner role

As health care reform moves into a new millennium, the importance of comprehensive case management and quality outcomes management still has not brought about the cost-effective quality of care that was hoped. The purpose of this article is to explore further the potential impact that the family nurse practitioner as a primary care provider might have on case management and the management of quality outcomes of care.     

Medication use risk management: hospital meets home care

Risk management is an objective strategy that seeks to eliminate or decrease the chances of financial loss and legal action. Risk management focuses on an actual mistake, an accident, or a potential similar occurrence. Risks occur in nursing in a variety of practice settings. Nursing has identified several key areas in which systematic change has improved and decreased the risk factor encountered in practice. This article targets medication usage and administration and the methods introduced in quality improvement processes to decrease risks and potentially reduce financial and legal risk.     

电子护理病历质量监控方法与体会

目的探讨数字化医院模式下电子护理病历质量的监控方法。方法建立责任主管-护士长-护理部质量控制组的三级质量控制链,对护理病历从书写、环节、终末、反馈质量4个环节进行动态监控和管理,形成多渠道、全方位,层层把关、环环检查的"链式"检查体系。结果电子护理病历达到了规范统一,为护理教学、科研提供了依据。结论 "链式"质量监控法可以保障电子护理病历的质量。