Trends in medical microbiology--gene probes in medical microbiology

At first the principle of nucleic acid hybridisation, some important technics used heretofore, and methods to label nucleic acids are described. The advantages and disadvantages regarding to the application to microbiological diagnostics are discussed. The advantage, before all, is the high specificity of the test which allows to detect the presence and the properties of genes which are not expressed. The methods known up to now can only be applied if the probe is labelled radioactively, since under these conditions the sensitivity is high enough to identify bacteria contained in clinical isolates without prior cultivation. The comparable complex methods are restricted, presently, to special mostly epidemiological problems. To improve these technics regarding increased sensitivity, to the use of non-radioactively labelled probes, to higher speed, and to the automation of the test internationally much work is carried out with great intensity. The solution of these problems will create conditions for a wide application of DNA probes in the general microbiological laboratory.     

论医疗卫生机构的医疗废物管理

医疗废物是一类危险性大、社会影响广泛、来源及危害性明确的特殊危险废物,是指医疗卫生机构在医疗、预防、保健以及其他相关活动中产生的具有直接和间接感染性、毒性以及其他危害性的废物,《中华人民共和国固体废物污染环境防治法》将医疗废物归类为危险废物。为了加强对医疗废物的安全管理,防止其对人体的危害及环境的污染,国务院制定的《医疗废物管理条例》和卫生部制定的《医疗卫生机构医疗废物管理办法》中明确要求对医疗废物必须进行无害化处理。     

医疗救援卫生耗材的保障策略

目的:加强医疗救援卫生耗材的应急保障。方法:分析日常医疗耗材的供应基础和要求,明确应急医疗耗材供应的管理要素。结果:应急医疗耗材的供应保障需要更多的经验积累和科学统筹的管理。结论:应该充分重视应急医疗救援的耗材供应,克服管理混乱的弊端,才能保障应急救援工作更快捷、更顺利、更精细。     

某院109例医疗纠纷中医方缺陷分析

医疗纠纷是指患者或其亲属认为医疗单位或者医护人员提供的诊疗护理服务有过错并造成患者人身、财产、精神的损害,而与医疗单位或卫生行政主管部门或医疗事故鉴定机构之间产生的争执[1]。近年来,医疗纠纷日渐增多,医患冲突不断升级,已成为困扰医院发展的严峻问题。作为医疗中主     

建立军队医疗机构医学计量管理体系的实践与思考

介绍了建立军队医疗机构医学计量管理体系的必要性,提出基于GB/T 19022-2003《测量管理体系测量过程和测量设备的要求》建立军队医疗机构医学计量管理体系的原则和思路.分析了该医学计量管理体系在某院实际计量管理实践中的实用性和可操作性,从标准化、精细化、信息化3个方面进行了进一步的探索和改进,逐步建立了一套适合军队医疗机构的医学计量管理体系.该计量管理体系的建立,对实现军队医学计量管理的规范化、程序化和系统化具有重要意义.     

Role of state medical boards in continuing medical education

The evaluation of physician competency prior to issuing an initial medical license has been a fundamental responsibility of medical boards. Growing public expectation holds that medical boards will ensure competency throughout a physician's career. The Federation of State Medical Boards (FSMB) strongly supports the right of state medical boards to require physicians to demonstrate continuing qualification for medical licensure. The FSMB views continuing medical education (CME) as an important component of any maintenance-of-competence initiative. Most medical boards require CME as part of their license renewal process. Learner-focused CME with measurable outcomes enables the medical profession's emphasis on core competencies, training, and assessment, and the general public's expectation for maintenance of physician competence. To effectively move their licensee populations toward the most effective CME tools and structure, medical boards must recognize physicians' educational needs and preferences. Medical boards can be proactive by fostering educational consortia involving medical boards, medical societies, and academic medical centers and featuring educational sessions that represent the best in current CME practices.     

The underrepresented in graduate medical education and medical research

There is a perception that the career options open to medical school graduates who are members of minority groups are restricted. This perception relates especially to those postgraduate medical training programs that have not traditionally encouraged or had significant minority participation. Data were therefore sought to determine whether this perception was well founded. Recent reports show the strikingly low numbers of minorities on medical school faculties and in administrative positions in spite of efforts to fill such positions. Information on the specialties of practicing minority physicians is limited, but accurate figures are available on the participation of minorities in various specialty postgraduate training programs. For instance, during recent years, 50 to 60 percent of all black residents have been trained in internal medicine, pediatrics, general surgery, and obstetrics and gynecology. Further studies are needed to document or disprove the conception that minority physicians have less access than other physicians to certain careers in the delivery of health care and education. In the interim, efforts should be continued to encourage minority physicians not only to seek preparation for community primary care practice, but also for professional participation in academic careers of other specialties (and subspecialties), in biomedical and clinical research, and in health care administration. The ability to enter these diverse careers is most often determined by the opportunities available at the time of completion of medical school education. Therefore, those involved in graduate medical education should address the challenge of providing opportunities for the proportionate representation of minorities in all aspects of medical care and medical education.     

Education review: applied medical informatics--informatics in medical education

The importance of informatics training within a health sciences program is well recognized and is being implemented on an increasing scale. At Chicago Medical School (CMS), the Informatics program incorporates information technology at every stage of medical education. First-year students are offered an elective in computer topics that concentrate on basic computer literacy. Second-year students learn information management such as entry and information retrieval skills. For example, during the Introduction to Clinical Medicine course, the student is exposed to the Intelligent Medical Record-Entry (IMR-E), allowing the student to enter and organize information gathered from patient encounters. In the third year, students in the Internal Medicine rotation at Norwalk Hospital use Macintosh power books to enter and manage their patients. Patient data gathered by the student are stored in a local server in Norwalk Hospital. In the final year, we teach students the role of informatics in clinical decision making. The present senior class at CMS has been exposed to the power of medical informatics tools for several years. The use of these informatics tools at the point of care is stressed.     

Measuring the medical home infrastructure in large medical groups

The patient-centered medical home is taking center stage in discussions of primary care innovation as a new delivery model that provides comprehensive, coordinated care across the lifespan. Although the medical home is widely discussed by policymakers, payers, and other stakeholders, the extent to which physician practices have the infrastructure in place to function as medical homes is not known. Using data from the 2006-07 National Study of Physician Organizations, we examine the extent of adoption of medical home infrastructure components among large primary care and multispecialty medical groups and their association with medical group size and ownership.     

湖北省医疗机构医疗废物管理现状调查

目的调查湖北省医疗机构医疗废物的管理现状,并提出改进对策。方法依据相关规范自行设计调查问卷,采用随机分层抽样方法于2015年4月实地调查湖北省75所医院医疗废物管理情况,获得有效问卷73份。结果73所医院的医疗废物管理软硬件建设基本符合规范要求,组织与制度管理、科室分类处置情况各项合格率均在90%以上;83.56%（61/73）的医院开展了医疗废物最佳环境实践相关宣传;减少使用一次性医疗器械、用品品种达40余种;76.71%（56/73）的医院输液软袋都交由签约公司回收利用;医院病理科的化学性废液交危险废物处置中心处理的仅占21.54%（14/65）;骨科钢板处置方法不一, 56.16%（41/73）的医院将其作为医疗废物,仅35.62%（26/73）的医院告知患者处置方式,与患者签署知情同意书。结论湖北省医疗机构医疗废物管理已逐步得到重视,但对于特殊类别的医疗废物处置,如输液袋（瓶）、骨科钢板、病理科化学性废液处置均存在不同程度的问题,仍需加大培训,进一步规范医疗废物分类处置。     

农村医疗卫生机构医疗废物产污系数的研究

目的：调查浙江省桐庐县县级和乡镇医疗卫生机构的医疗废物情况。方法：对桐庐县所有乡镇以上医疗卫生机构开展调查，共对5家县级医院和13家乡镇医疗卫生机构2001—2006年的医疗废物产污系数进行研究。结果：桐庐县县级医院产污系数从2001年的0．04Kg／床／日增加到2006年的0．61Kg／床／日；乡镇街道医疗机构产污量从2004年0．33Kg／10人增加到2006年的0．66Kg／10人。结论：研究所获得的医疗废物产污系数为我国的医疗废物管理提供了重要的技术参数。     

125家医疗机构医疗废物管理调查情况

目的了解某省医疗机构医疗废物管理情况,规范医疗机构医疗废物的管理。方法采取分层抽样方法,统一向全省140家医疗机构发放医疗废物调查表,回收调查表,录入调查结果并进行统计分析。结果共回收125份合格调查表,合格率为89.29%;125家医疗机构总床位为62 246张,医疗废物总量为10 859 897.55千克,医疗废物产生量为0.48千克/床·日;医疗废物主要以感染性废物(87.00%)和损伤性废物(11.34%)为主;共111家医疗机构的感染性废物和损伤性废物交医疗废物处置中心集中处置;124家医疗机构未向患者收取医疗废物处置费用;122家医疗机构有医疗废物处置支出费用,支出总额为31 456 289元,每床每日支出金额为1.38元;医疗废物支出方式以按床位数(61.48%)支出为主;118家医疗机构共产生玻璃输液瓶1 537 910.40千克,产生量为0.07千克/床·日;123家医疗机构共产生塑料输液瓶1 046 399.35千克,产生量为0.05千克/床·日;玻璃输液瓶和塑料输液瓶处置方式主要按医疗废物处置、按生活垃圾处置以及由有资质单位收取专门处置;共有100家和105家医疗机构分别不了解玻璃输液瓶和塑料输液瓶的最后去向与用途。结论目前某省医疗废物管理基本规范,但仍存在问题,需要加强多部门沟通合作、加强医疗废物统一监督和管理。     

构建基层医疗卫生机构医学装备质量控制体系

国家为了健全基层医疗卫生服务体系,划拨专款加大基层医疗卫生机构医学装备配备投入,如何使得基层医学装备为保障人民健康充分发挥作用,各级必须重视基层医疗卫生机构医学装备规范化管理,充分认清加强质量控制体系建设重要性。通过分析当前基层医疗卫生机构医学装备管理现状,阐明基层医疗卫生机构医学装备质量控制影响因素和基本控制方法,提出科学构建基层医学装备质量控制体系初步思路。     

Continuing medical education and continuing medical education accreditation in Spain

Nearly all Spanish physicians are employed by public or private institutions, and employers are enabling the continuing medical education (CME) of physicians. In view of coexisting CME accreditation systems in Spain, we conclude that a common approach is needed. We recommend establishing formal relationships with American and European systems to ensure consistent accreditation and mutual recognition of CME credits and improvement in accreditation.     

化学性医疗废物在医疗卫生机构中处置现况调查

作者对上海市长宁区医疗卫生机构化学性医疗废物的产生来源、分类收集、内部运送、暂时贮存、回收处置等进行现况调查,掌握化学性医疗废物在医疗卫生机构中的处置现状,提出化学性医疗废物应纳入集中回收处置,积极推行从源头减少化学品使用等建议,以规范化学性医疗废物在医疗卫生机构中的安全处置,保护环境,保障人体健康。