ISO9001:2000标准在医院感染质量管理中的应用

摘要：目的探讨ISO9001：2000标准在医院感染管理中的应用。方法用ISO9001：2000的管理理论体系进行医院感染质量的管理，将管理职责、资源管理、过程管理、测量分析与改进作为管理体系的主要过程，进行全面的质量管理。结果服务、管理质量有了很大提高。结论ISO9001：2000质量管理体系用于医院感染管理，能显著提高各项管理指标。     

医院质量管理体系诊断与改进中评价标准应用研究

为实现医院质量管理体系的诊断与改进，本文对ISO9000：2000标准和Baldrige标准的结构、主要内容以及两者的特点等进行了分析比较。在此基础上，提出一个将ISO9001和Baldrige标准集成的模型，并应用于医院质量管理体系的诊断与改进过程。该模型依据Baldrige标准，分析诊断出医院质量管理体系中存在的主要问题及改进策略，进而通过两个标准之间的相关关系，将质量管理体系改进策略分解配置到相关的ISO9001条款；最后，参照ISO9001标准中相应条款的要求，制订出具体的改进计划和改进措施。     

实施ISO9001质量管理体系 实现医院质量管理理念和方式的深化变革

我院自2001年10月开始推行ISO9001：2000质量管理体系认证工作，与2002年6月26日正式通过ISO9001：2000国际质量标准体系(简称QMS)认证，在贯彻标准和持续改进的过程中，对医院现行的管理体制进行了改革的尝试，取得了一定的管理成效。笔者就ISO9001在医院质量管理中的应用谈一些认识和体会。     

ISO9001质量管理体系在民营医院管理中的实践与探索

目的探索ISO9001:2000质量管理体系的管理方法在民营医院管理中的有效性和可行性。方法引进ISO9001:2000质量管理体系,学习ISO9001标准;编写和建立质量管理体系文件,组织实施并有效运行,聘请审核专家审核认证;对运行ISO标准前、后的有关质量目标进行统计分析。结果业务流程更加科学合理;终末质量得到提升;整体素质不断增强;基本实现了全程、全面、适时和事前控制;医院知名度和病人满意率提高;平均住院日明显减少;有关质量目标在ISO标准运行前后的差异有非常显著性统计学意义。结论民营医院施行ISO9001标准可进一步提高民营医院医疗安全和质量,增强市场竞争力。因此,民营医院施行ISO9001标准管理是必要和有效的。     

建立ISO9001医院质量管理体系建设基本现代化医院

ISO9001质量管理体系标准 2000版于 2000年 11月 15日投票通过, 12月 28日发布, 2001年 6月 1日实施. 2000版采用了"过程方法"的模式结构,取代原 ISO9001、 ISO9002、 ISO9003的 20项质量体系要素的模式结构,并将上述三种标准合并为一个 ISO9001标准,进一步提高了标准使用的灵活性和适用性.标准中规定的质量管理体系要求除了产品质量保证以外,还旨在增强顾客满意.该标准能用于内部和外部 (包括认证机构 )评定组织满足顾客、法律法规和组织自身要求的能力. 2000版 ISO9001质量管理体系标准的确定,意味着国际质量管理观念迈向一个崭新的阶段,将给管理带来明显的持续的进步.为我们建立医院质量管理体系,建设基本现代化医院提供了新的思路.     

ISO9001质量管理体系与现行急诊管理体制

我院自2001年10月开始推行ISO 9001：2000质量管理体系认证工作，于2002年6月26目正式通过ISO 9001：2000国际质量标准体系(简称QMS)认证，从而把急诊急救工作的整个过程纳入ISO 9001国际质量体系运作，取得了初步效果，现就ISO 9001与现行急诊管理体制的区别做一粗浅的分析。     

国内首家硅藻泥企业通过ISO9000质量体系认证

日前，北京大津硅藻新材料有限责任公司顺利通过ISO9000质量管理体系的认证，获得ISO9001：2000国际标准质量管理体系认证证书，成为中国硅藻泥行业首家通过ISO9000质量管理体系认证企业。     

应用"JCI"进行药剂科质量管理体系的持续改进

文章简述了南京医科大学附属南京第一医院药剂科在实施ISO9001：2000质量管理体系的经验和体会。在运行体系改进版本之际，参照本行业的有关评审标准，进一步完善ISO9001质量管理体系在医院药剂科管理中的应用，使体系运行的有效性、适宜性得到进一步提高，努力使药剂科的各项管理达到一个较高的水平。     

ISO9001:2000在急诊医疗质量控制中的应用

目的：探索ISO9001：2000在急诊医疗质量控制中的理论与实践模式。方法：前瞻性方法，采用描述性研究与具体实践相结合的方法，并与该体系实施前后2年相关指标进行比较分析。结果：建立了实施ISO9001质量管理体系的急诊科；获得中国长城(天津)质量保证认证公司颁发的质量管理体系认证证书：取得了急诊医疗纠纷降低、质量意识及创新意识提高等的良好效果。结论：导入ISO900l不失为一种有效的急诊质量控制的新尝试和新方法。     

ISO9001∶2000标准在医院感染质量管理中的应用

目的探讨ISO9001∶2000标准在医院感染管理中的应用。方法用ISO9001∶2000的管理理论体系进行医院感染质量的管理,将管理职责、资源管理、过程管理、测量分析与改进作为管理体系的主要过程,进行全面的质量管理。结果服务、管理质量有了很大提高。结论ISO9001∶2000质量管理体系用于医院感染管理,能显著提高各项管理指标。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.