Knowledge of breastfeeding practices in doctors and nurses: A questionnaire-based survey

Background

As the primary physicians and nurses in hospitals are the first contact with the mothers, we carried out a questionnaire-based survey to assess the knowledge of the MBBS nonspecialist doctors and general duty nurses regarding breastfeeding of normal newborns.

不同级别综合性医院医患关系现状调查与分析

对蚌埠市5家不同级别综合性医院的医务人员进行问卷调查及个人访谈,根据调查数据结果,对不同级别综合性医院医患关系的现状、问题等进行分析探讨,提出合理性意见和建议,以期重建和谐医患关系,提高患者对医院的满意度。     

Design and Development of EMR Supporting Medical Process Management

Current EMR system benefits physicians by facilitating order entry and reducing errors. It can improve the safety and effectiveness of medical services, but cannot manage the whole medical process and the quality of medical services. In addition to physicians, EMR should be designed for all medical professionals because medical services cannot be accomplished by physicians alone, but also requires the involvement of other medical professionals. Therefore, we applied PDCA, the famous quality management cycle to design a comprehensive and coherent EMR system which can be used throughout the entire treatment process. EMR with the PDCA Cycle can record every order state and every treatment procedure in order to monitor the whole medical process. This extends the safety from planning the treatment to fulfilling it. By analyzing the records, doctors and hospital managers can perfect the medical process and improve healthcare quality. The EMR we designed with the PDCA Cycle provides a record entry interface for physicians and a worksheet interface for nurses and other professionals. Every treatment procedure and every change of orders or tasks will be fed back to medical professionals. So information generated from the beginning to the end of treatment will link with each other to avoid any information islands. Furthermore, the EMR can display the additional information intuitively and real-timely without increasing the burden of medical professionals’ work.     

Effectiveness of Teaching of Neonatal Resuscitation Programme at a Workshop for a Mixed Population of Medical Personnel

We evaluated the effectiveness of teaching at a neonatal resuscitation programme (NRP) workshop held for 35 medical personnel (including postgraduate trainee doctors, general duty medical officers, nursing officers and probationer nurses) using a one-group pretest-posttest design. None of the participants had any formal exposure to the NRP guidelines. A pre-workshop test of 20 multiple-choice questions was administered to all the participants. At the end of the workshop, the same 20 questions were administered and the two scores compared using t-test for paired data on SPSS statistical software. The mean pre-workshop score was 9.03 (SD 2.66) which improved to a mean of 15.53 (SD 1.93) post-workshop. This improvement was highly significant with p < 0.0001 (two-tailed) and the 95% confidence interval being -7.41 to -5.59. Subgroup analysis revealed that nursing officers and probationer nurses showed highly significant improvement in the post-workshop scores while trainee doctors doing Medicine, Pediatrics and the general duty medical officers showed statistically significant improvement in the post-workshop scores. This study shows that a medical workshop is an effective means of imparting knowledge to a mixed group of medical personnel.Key Words: Evaluation, Neonatal resuscitation, Teaching, Workshop     

Poor uptake of hepatitis B immunization amongst hospital-based health care staff.

The uptake of hepatitis B vaccine was assessed amongst 100 medical and 100 nursing staff in a teaching hospital with a policy of recommending to those at risk that they should seek immunization from their general practitioners. Sixteen per cent of nurses and 31% of doctors had completed a course of immunization with confirmation of seroconversion. An additional 9% and 18% respectively had been immunized without post-immunization serology. Ninety three per cent of nurses and 61% of doctors who had not been immunized would like to receive the vaccine. The commonest reasons for non-immunization amongst nurses were fear of vaccine and lack of advice, and amongst doctors, apathy and difficulty in obtaining the vaccine. Eighty seven per cent of medical staff and 57% of nurses had a history of needle stick injury. The low rates of vaccine uptake in this study combined with the high incidence of needle stick injury calls for a reappraisal of present hepatitis B vaccination programmes in hospitals. In particular the abrogation of responsibility for immunization to general practitioners is probably a major disincentive to potential vaccines.     

医院数字化管理进程中的技能培训与教学原则

本文以我院的数字化建设与实施进程对各级各类人员的培训为例，探讨医护人员的计算机技能培训特点和教学原则。     

ICU护士人工气道气囊管理知识与操作行为调查

目的调查重症监护室（ICU）护士对人工气道气囊管理知识掌握与实际操作情况,为制定气囊管理规范提供参考依据。方法采用自设问卷,对72例ICU护士的气囊管理知识和行为进行问卷调查。结果72例ICU护士气囊管理知识得分为2．44±1．11,呼吸监护室（RICU）护士得分最高（3．15±0．77）,外科监护室（SICU）护士得分最低（1．78±0．97）;多元逐步回归分析显示,知识得分与护士在ICU的工作年限呈正相关,而年龄、学历、职称等未能进入回归方程;72例ICU护士在气囊管理行为方面均存在操作不规范现象,以气囊压力监测、气囊管理时体位等方面不规范操作比例较高;不同科室在气囊充气方法、压力监测方法、清除囊上分泌物方法以及气囊充气前口咽吸引方面的差异有统计学意义（P〈0．05）。结论ICU护士对气囊管理知识掌握及规范操作方面均有待提高。各科室之间应加强沟通,取长补短。     

手术患者截石位摆放时机的护理研究

目的研究肛肠外科、泌尿科及妇科患者于全麻前后不同时机进行截石位摆放所产生的护理效果。方法将200例接受全身麻醉下截石位手术患者,随机分成观察组（100例,全身麻醉前摆放体位）和对照组（100例,全身麻醉后摆放体位）。观察两组患者术后舒适度、操作所消耗护士人力及时间、手术医生及患者的满意度。结果观察组需要1名护士为患者进行体位摆放,耗时2-3 min,省力,患者舒适度高;对照组需要2名护士同时为患者摆放体位,耗时7-8 min,较费力,术后舒适度不良。两组患者舒适度及满意度比较差异有统计学意义（P〈0.05）,手术医生对两组患者满意度相同。结论与传统的全身麻醉后摆放截石位相比,在全身麻醉前摆放截石位可提高患者的舒适度,有效预防并发症的发生;提高护士工作效率;提高手术医生及患者的满意度。     

232名医护人员16PF人格特征调查分析

目的 调查分析医护人员的人格特征,为医护人员的选拔与培养以及心理健康监护提供科学依据.方法 采用16PF人格问卷对232名医护人员进行调查,所得数据采用SPSS 16.0软件进行描述统计、t检验、相关分析.结果 ①医生和护士在聪慧性、稳定性、恃强性、有恒性、敢为性、敏感性、世故性和实验性等因素得分差异具有统计学意义（P＜0.01）;②医生与护士在适应焦虑型、怯懦与果敢型、心理健康因素、专业成就个性因素和创造能力个性因素上具有显著性差异（P＜0.01）;③工龄与聪慧性、有恒性、世故性等3个人格因素均呈显著的正相关（r=0.279 ～0.333,P＜0.001）.结论 医生和护士的人格特征各有不同,在医护人员的选拔与培养上应考虑人格特征因素.     

乡村医护人员对全科医学教育需求的调查分析

目的 了解乡村医护人员对全科医学的需求,探讨开展全科医学教育的必要性.方法 采用抽样调查的方法,抽取部分乡镇及其所属村卫生室的医护人员以及部分家庭成员,采取调查问卷、座谈、走访等方式进行调查,了解医护人员的基本信息以及对全科医学教育的需求状况;了解群众参加新农合情况、就医地点、对基层医疗机构的满意度等.结果 临沂市乡村医护人员中,获得本科学历的医生只占9.86％,护士只有3.13％;具有高级职称的医生只占4.23％;年龄在30岁以下者只占13.04％ ;88.35％的医护人员没有参加过全科医学培训.被调查的村民中,99.02％的家庭参加了新农合,73.53％的就医地点选在乡村卫生室,有45.10％的家庭对乡村医疗服务不满意.结论 乡村医护人员接受全科医学教育是当务之急.     

关于重庆市口腔专科护士的专业知识现状及培训需求调查

目的了解重庆市口腔专科护士的培训现状,并对重庆市口腔专科护士培训提出可行性建议。方法针对医生与护士自制相应调查问卷,在重庆市内各级口腔医疗机构进行问卷调查,将所得数据进行统计分析。结果 96.23%的护士表示需要接受培训,43.40%的护士认为目前培训效果欠佳,43.56%的护士期待系统专科培训。超过95%的医生和护士认为四手操作诊疗模式值得推广,并希望采取四手操作模式运用于临床实践,但目前仅有14.54%的医生和25.77%的护士正在采用四手操作诊疗模式。结论开展口腔专科护士专业知识培训是现实需要,且培训应多种方法并举,同时加强四手操作技术的培训。     

Doctors' and nurses' attitudes towards and experiences of voluntary euthanasia: survey of members of the Japanese Association of Palliative Medicine

OBJECTIVE: To demonstrate Japanese doctors' and nurses' attitudes towards and practices of voluntary euthanasia (VE) and to compare their attitudes and practices in this regard. DESIGN: Postal survey, conducted between October and December 1999, using a self-administered questionnaire. PARTCIPANTS: All doctor members and nurse members of the Japanese Association of Palliative Medicine. MAIN OUTCOME MEASURE: Doctors' and nurses' attitude towards and practices of VE. RESULTS: We received 366 completed questionnaires from 642 doctors surveyed (response rate, 58%) and 145 from 217 nurses surveyed (68%). A total of 54% (95% confidence interval (CI): 49-59) of the responding doctors and 53% (CI: 45-61) of the responding nurses had been asked by patients to hasten death, of whom 5% (CI: 2-8) of the former and none of the latter had taken active steps to bring about death. Although 88% (CI: 83-92) of the doctors and 85% (CI: 77-93) of the nurses answered that a patient's request to hasten death can sometimes be rational, only 33% (CI: 28-38) and 23% (CI: 16-30) respectively regarded VE as ethically right and 22% (CI: 18-36) and 15% (CI: 8-20) respectively would practise VE if it were legal. Logistic regression model analysis showed that the respondents' profession was not a statistically independent factor predicting his or her response to any question regarding attitudes towards VE. CONCLUSIONS: A minority of responding doctors and nurses thought VE was ethically or legally acceptable. There seems no significant difference in attitudes towards VE between the doctors and nurses. However, only doctors had practised VE.     

髋关节镜手术配合与护理

目的探讨髋关节镜手术中医护配合与护理。方法对我院2002年11月-2009年6月525例髋关节镜手术的护理配合进行分析,统计手术时问、并发症、术后平均住院日,调查医生及病人满意率。结果本组手术时间20—129（69．1±9．8）min,患者满意率100％,医生满意度为（97.3±2．5）分;未发生与手术配合相关的并发症。结论术前认真评估患者情况,术中密切配合是确保手术质量的关键。     

医生与护士职业紧张对比研究

目的　为了探讨医护人员职业紧张方面的差异。方法　应用职业紧张测试指标ＯＳＩ对１０８ 名护士、７５ 名男医生和７０ 名女医生进行了测试，对样本进行年龄和婚姻状况配对，资料使用ｔ检验和逐步回归进行分析。结果　医生比护士经历了更多的紧张，女医生躯体不适得分非常显著的高于男医生，医护人员工作满意感、心理卫生和躯体不适回归方程的主要预测因素不尽相同。结论　提示医护人员对各种紧张因素的反应存在着差异，而且中和缓解因素在紧张因素－ 紧张反应这一因果关系链中修饰作用人群间也不相同     

Telling the truth.

Are doctors and nurses bound by just the same constraints as everyone else in regard to honesty? What, anyway, does honesty require? Telling no lies? Avoiding intentional deception by whatever means? From a utilitarian standpoint lying would seem to be on the same footing as other forms of intentional deception: yielding the same consequences. But utilitarianism fails to explain the wrongness of lying. Doctors and nurses, like everyone else, have a prima facie duty not to lie--but again like everyone else, they are not duty-bound to avoid intentional deception, lying apart; except where it would involve a breach of trust.     

Operative photography in gynaecological endosurgery

OBJECTIVES: To define the attitude of patients, doctors and nurses to operative photographs captured at gynaecological endosurgery, and to determine the value of these photographs in patient education. DESIGN AND SETTING: Postal questionnaire survey of specialists, general practitioners, nurses and patients at a tertiary referral hospital in south-west Sydney. PARTICIPANTS: All patients who underwent endoscopic gynaecological surgery between 1 February and 1 May 1998, and for whom good quality operative photographs were available, and medical and nursing staff randomly selected from lists of practitioners within the Southwest Sydney Area Health Service. MAIN OUTCOME MEASURES: Opinions on whether operative photodocumentation assists patients in understanding their condition; the value to patients of these records; whether operative photographs assist referring doctors in subsequent management of patients; the use of operative photographs in medical records or as personal records for patients; whether photographs may lead to anxiety or be used in medicolegal action. RESULTS: All patients believed operative images were valuable in helping them understand their condition. 19 of 20 specialists (95%), 85 of 123 general practitioners (69%) and 23 of 28 nursing staff (82%) also believed that operative images assist patients in understanding their disease. Nearly all patients denied that operative images would create anxiety, and specialists, general practitioners and nurses also felt that the photographs would not cause anxiety. 78% of general practitioners expressed a desire to receive operative images. CONCLUSIONS: Photographic records of operative procedures are regarded as valuable by both referring doctors and their patients. Patients find photographs useful in understanding their disease.     

某综合医院工作人员感染SARS情况的分析

目的：调查某综合医院工作人员感染SARS的基本情况，分析发生感染的可能原因、途径和高危人群，为今后预防和控制SARS及类似传染病可能造成的院内感染提供依据。方法：采用中国国家卫生部推荐的《非典型肺炎病例个案调查表》，由经过培训的调查员，对某院工作人员中所有感染SARS患，进行逐个个案调查。资料采用SPSS11．0进行整理和统计处理。结果：发生在某综合医院的这次SARS疫情，共造成41名工作人员感染，罹患率6．1％。医生、护士和病区内物业人员感染率高于医院其他人员，院内SARS性别罹患率无显性差异(χ^2=3．05，P=0．08)。结论：SARS在综合医院暴发流行，存在明显的医院聚集性，医生、护士和病区内物业人员是感染SARS的高危人群之一，他们之间可能存在共同的危险因素。     

Evaluation of Computerized Physician Order Entry System—A Satisfaction Survey in Taiwan

In the rapidly developing world of information technology, computers have been used in various settings for clinical medicine application. Studies have focused on computerized physician order entry (CPOE) system interface design and functional development to achieve a successful technology adoption process. Therefore, the purpose of this study was to evaluate physician satisfaction with the CPOE system. This survey included user attitude toward interface design, operation functions/usage effectiveness, interface usability, and user satisfaction. We used questionnaires for data collection from June to August 2008, and 225 valid questionnaires were returned with a response rate of 84.5?%. Canonical correlation was applied to explore the relationship of personal attributes and usability with user satisfaction. The results of the data analysis revealed that certain demographic groups showed higher acceptance and satisfaction levels, especially residents, those with less pressure when using computers or those with less experience with the CPOE systems. Additionally, computer use pressure and usability were the best predictors of user satisfaction. Based on the study results, it is suggested that future CPOE development should focus on interface design and content links, as well as providing educational training programs for the new users; since a learning curve period should be considered as an indespensible factor for CPOE adoption.     

癌症临床医患交流满意度问卷的编制与测评

目的 研制和测评癌症临床医患交流满意度问卷(DNPCSQC),包括评价医生和护士的问卷.方法 以严谨的程序编制问卷,随机抽取557例癌症患者进行测定,对请患者、183位亲属和96位医护人员做重要性评分,并对问卷进行筛选和信度、效度进行分析.结果 1.最后问卷共有14个条目,包括医患交流信息、形式与医生、护士的表现满意度三个维度和一项总的医患交流满意度评价条目.2.问卷具较好的内容效度,能较贴切地反映癌症患者对医患交流的满意度情况,结构与设计的理论构思相符,参照于总满意度的效标效度评价医生与护士问卷分别为0.83和0.80.3.三个维度和总分的重测信度:评价医生问卷分别为0.82,0.78,0.88和0.86,评价护士问卷分别为0.83,0.76,0.80和0.83;Cronbach α评价医生问卷分别为0.89,0.76,0.78和0.86,评价护士问卷分别为0.83,0.77,0.80和0.83;分半信度均为0.90.结论 DNPCSQC具较好的效度、信度,在临床上有一定的实用价值.