我国输血领域信息化管理和网络化建设的现状与展望

目的了解我国输血领域的信息化管理和网络化建设情况。方法以发放调查表的方式,对全国除西藏自治区外的31个血液中心和324个市地级中心血站的信息化管理和网络建设情况进行调查,对相关信息进行汇总和统计分析。结果有50.14%的采供血机构对献血点进行了联网,有4.23%进行了部分联网,目前已联网的献血点数量超过1 222个,且华东地区的联网率显著高于全国水平,而西南地区则显著低于全国水平;有42.25%的采供血机构与全部用血单位实现了联网,有1.69%与用血单位实现了部分联网,目前已联网的用血单位数量超过2 302个,中南地区采供血机构与用血单位间的联网率显著高于全国水平。有19.35%(6个)省、市、区实现了辖区内全部采供血机构的联网,有16.13%(5个)实现了辖区内部分采供血机构的联网,有64.52%(20个)尚未进行辖区内联网。结论虽然当前状况并不乐观,但是血液信息的网络管理是采供血机构进入数字化、网络化、标准化和规范化时代的必由之路。     

汶川地震对极重灾区妇幼信息系统的影响及其重建启示

目的通过明确地震对于极重灾区妇幼信息系统的破坏程度,为重建和恢复妇幼信息系统指出工作重点。方法利用全国妇幼卫生监测办公室组织的对汶川地震10个灾区收集的定量及定性调查资料,根据妇幼卫生信息系统（Mater-nal and Child＇s Health Information System,MCHIS）运行特点,从三个层面去评估地震对MCHIS的影响,分别是地震对MCHIS结构性破坏、信息流的破坏,以及对数据本身质量的影响。结果地震对灾区MCHIS系统造成了结构性破坏,对MCHIS信息收集机制、数据的及时性和准确性均有很大影响。结论妇幼信息系统的重建应该更多的关注在基础设施建设,增加经费投入与工作人员的配置,灾区居民的有效管理,加强交流、质控与督导工作的开展等方面。     

建立基于网络综合集成应用系统的市级公共卫生信息系统的设想

21世纪是一个全面发展的信息化时代,信息技术成为世界各国国力竞争的制高点.计算机己由单机运行进入了网络化时代,市级公共卫生信息系统管理者和信息管理人员必须将丰富的信息资源服务于社区医院的发展建设中去.     

美国护理信息系统的临床应用

近年来，随着医院信息化建设的发展，我国医院在NIS方面的发展有了长足的进步，但是与美国相比，无论是在系统的开发研究还是在临床的应用上均有一定差距，本文就美国在护理信息系统（Nursing Information System，NIS）的应用与发展作详细介绍，以供同行借鉴。     

我院信息系统的实施

在信息产生飞速发展的今天，我国各大中型医院越来越多实行了网络化管理，为了适应新的发展，我院于2001年6月废弃了旧的网络管理，隆重推出了“军卫一号”工程高级版，制定了一整套实施办法和详细的工作方案，先后按制定方案、组织实施、稳步前进、逐步拓展的步骤进行，医院狠抓落实，取得了明显的成效，现将具体做法和体会报告如下。     

医院信息化感染管理系统的开发与应用

目的建立新型智能医院信息化感染管理系统,评价该系统应用价值。方法通过更新医院管理系统软件内容,扩容医院环境微生物监测、医生感染专率调查和医院感染监测预警系统内容,经过省内100多家医院推广使用进行评价。结果运用该软件系统,开展医院感染综合性监测、目标性监测、特殊耐药菌株监测及医院感染的预警系统监测,均得到提高工作效率、明显扩充了信息量、很容易提取和获得最新信息,能及时提供医院感染动态信息,节省经费,进一步提高医院感染管理水平。结论通过完善和更新该医院感染管理系统软件内容,使医院感染管理工作实现了网络智能信息化。     

军队疗养院数字化建设的问题与对策

全军疗养院作为医疗卫生机构的重要组成部分,承担着疗养人员身心健康和提高部队战斗力的重要任务.而疗养院信息化建设是促进其全面发展、提高服务保障质量的重要手段.2005年,大连疗养院根据军队卫生信息化建设关于"构建数字化疗养院"的总体要求,研发了"军队疗养院信息系统",在全军疗养院推广应用,并获军队科技进步二等奖.     

实行妇幼保健保偿的管理机制 开拓妇幼卫生工作新局面

为了提高妇幼卫生工作的服务质量，确保全区妇女儿童的身心健康，腾飞我区的经济，增强人民体质，我站从1998年开始组织实施了《孕产妇保健保偿》和《儿童保健保偿》。通过开展此项工作，使我区孕产妇的系统管理率由53．8％提高到93．3％；儿童的系统管理率由63．2％提高到98．5％；住院分娩率由58．5％提高到98．9％；高危孕产妇的筛查率由38．3％提高到     

急诊护理信息系统应用现状与展望

从急诊护理信息化现状、急诊护理信息化的必要性及急诊护理信息系统的预期功能等方面对急诊护理信息系统应用现状进行综述。     

手术室信息系统的功能与应用

我院是一所以肝胆外科为主的专科医院，在未使用计算机信息系统之前，手术室的业务主要靠人工进行处理，每天都要填写大量的手术安排表格、手术耗材登记表格，总是存在人手不够的现象。为了将手术室护士从繁重的任务中解脱出来，手术室采用了适合自身特点的信息化管理系统。目前我院手术室有10间独立的手术间，每个手术间都配备1台电脑，可连入医院信息系统，医务人员可以在各自的手术房间将患者在术中所用的一切药品、物品等手术相关信息输入电脑模块，术后统一到手术室控制室打印，夹入病历，现报道如下。     

How public health nurses understand mothers of abused and neglected children: The perception of 'Shindosa' in mothers

Aim: The purpose of this paper is to describe the practical knowledge that public health nurses use in identifying and providing assistance to the mothers of child abuse victims. Methods and Results: A grounded theory qualitative research method was used to collect and analyse semistructured interviews of 22 public health nurses from health centers in Osaka, Japan. The data was systematically analysed by using a constant comparison process. The participants had an average age of 46.2 years with an average of 21.6 years of experience in their profession. The research examined the perspective of the public health nurses regarding the mothers of child abuse victims. The key factor ‘shindosa’, which is a sense of fatigue, defeat, or lack of energy, emerged from the data. In addition, public health nurses used a two‐step process of perception. First, public health nurses began providing assistance to mothers by noticing the presence of shindosa in thems. Nurses became concerned by the state of the mothers and the way they interacted with their children. They perceived that the mother might be experiencing shindosa. Second, through continuous involvement with the mothers, public health nurses came to ascertain the essence of shindosa in mothers. Thus, their initial vague impression of the presence of shindosa became the catalyst to providing assistance to the mothers, and as a result, they gradually understood the fundamental nature of shindosa. Conclusion: By focusing on mothers as well as children, public health nurses successfully achieved their goal to provide the appropriate and specific care to each mother with shindosa as a solution in the prevention of child abuse.     

Mental health of mothers caring for ventilator-assisted children at home

The complex management of ventilator-assisted children cared for in the home can place emotional and mental strain on parents, in particular, mothers. The purpose of this study was to explore the relationships among functional status of the child, impact of ventilator-assistance on the family, coping, social support, and depression in mothers caring for ventilator-assisted children at home. Thirty-eight mothers participated in the study. Almost half of the mothers experienced depressive mood symptoms. Impact on family was positively related to depression and social support was inversely related to depression. In addition, social support was a significant predictor of depression. The findings show that the high demands related to the care of ventilator-assisted children can be a significant risk factor for poor mental health outcomes of those mothers providing care at home. Interventions by mental health and pediatric nurses should focus on enhancing mothers' coping skills and assisting mothers in accessing a positive social network to help mediate the stress related to caring for their child.     

The physical health of rural mothers and their low birth weight children

The purpose of this research was to examine the physical health of rural mothers and their low birth weight children (< 2,500 gm). The health of rural mothers is of concern because rural families have poorer health than urban ones, and as the primary caregiver for the low birth weight child, mother's health affects the child's care and potentially the child's health. In this cross-sectional, exploratory study, in-home interviews were conducted with 48 mothers between 2 weeks and 18 months after their children were discharged from their birth hospitalization. Mothers' physical health and their perceptions of their children's health were assessed. The mothers were more concerned about their children's health than their own (p = .0005). The concerns included uncertainty about the children's future health, growth, and development. Suggestions for community health care providers are addressed.     

Factors influencing health promoting activities of mothers caring for ventilator-assisted children

The extensive care a ventilator-assisted child (VAC) requires when cared for in the home can impact the mother's ability to participate in health promotion activities. The purpose of this study was to examine health promotion activities and the relationships among functional status of the child, impact of the illness on the family, coping, social support, and health promotion activities of mothers who care for ventilator-assisted children at home. Thirty-eight primary female caregivers, mostly mothers, participated in the study and completed the Personal Lifestyle Questionnaire (PLQ), measures of child's functional status, impact of the illness on the family, coping, social support, and demographic data. Findings revealed that the mothers scored low on the nutrition, exercise, relaxation, and general health promotion subscales of the PLQ. Functional status of the child and coping were positively correlated with participation in health promotion activities, whereas impact of the child's illness on the family was inversely related to health promotion of the mothers. Regression analysis revealed that functional status of the child and coping were significant predictors of mothers' participation in health promotion activities. The high demands associated with caring for a VAC with poor functioning can be a significant risk factor for not participating in health promotion activities. Nurses need to help mothers with coping and finding resources to help mediate the stress related to caring for their child, thereby helping the mothers to maintain their own health.     

Structured training in the management of emergencies in mothers,babies and children in a poorly resourced health system: Logbooks to document skill use

ObjectiveTo evaluate the use of a structured training programme in emergency care in Pakistan through the completion of logbooks documenting actual resuscitation attempts.DesignCross-sectional survey.SettingAll tiers of health care settings across all regions of Pakistan.Participants120 health workers, trained in the skills for managing maternal, neonatal and childhood emergencies as part of a system development programme called “Essential Surgical Skills–Emergency Maternal and Child Healthcare (ESS–EMCH).MethodsFollowing a series of 6 five-day training courses developed as part of the ESS–EMCH programme between January and December 2006, participants were provided with logbooks to document the actual use of their newly acquired skills during the resuscitation of mothers, infants and children.Results1123 resuscitation attempts were documented and received from 63 of the 120 participants (response rate 53%; number of forms 4–22 per participant). Seventy-six percent (858/1123) of documented cases were received from doctors and 24% (265) from nurses. The patients receiving resuscitation were neonates 31% (n = 349), infants and children 38% (n = 426), pregnant mothers 21% (n = 233) and other adults 10% (n = 111). The commonest emergencies treated in neonates were resuscitation at birth, sepsis, shock and difficulty in breathing. Haemorrhage was the commonest obstetric emergency (52%, n = 52/101), followed by eclampsia and shoulder dystocia. Skills used to secure the airway; breathing (use of oxygen and bag valve mask ventilation) and circulation were used in 58%, 82% and 73% of resuscitated patients. Oxygen was used in 87% of neonates and in 62% of pregnant mothers. The overall survival rate in the cases reported was 89%.ConclusionsResuscitation logbooks can be used to assess which skills are used in emergency care. This analysis provides some evidence that the skills taught during the ESS–EMCH programme are used by the trained health workers. Individually held and completed logbooks should continue to act as a feedback and audit mechanism to measure outcomes, in conjunction with other methods of evaluating the impact of the training component of this programme.