病案管理中数字化技术的系统应用

目的　面对医院传统病案管理模式的困境和当今社会利用病案资料的不断深入 ,探讨医院病案管理数字化实现技术和方案。方法　通过在我院实施“全病案数字化扫描存储检索系统” ,使用高速滚筒式连续扫描仪 ,进行病案资料的数字化采集 ;使用光盘存储技术进行病案资料的实时在线存储归档 ;同时配合大型数据库技术和大容量硬盘资料缓存技术 ,实现病案资料的网络检索、查询和打印输出。结果　“全病案数字化扫描存储检索系统”具有节约空间、提高工作效率、便于资源共享等优势。结论　全病案数字化是医院传统病案管理模式的一次技术革新 ,是纸质病案向电子病案过渡的必经阶段 ,可以解决病案数量上的增长和存储空间不足这一非常迫切的矛盾。     

协作使101医院信息管理进入全数字化多媒体信息阶段

南京军区第101医院与中科院深圳安科公司、3COM公司协作率先在国内使用院的ATM网络运行“全数字化多媒体医院信息系统”获得成功，标志着该医院信息管理从单的字媒体讲入了字、图像、声音的全数字化多媒体信息阶段。     

野战数字化口腔医疗车的研制及应用特点

目的：我院研制的野战数字化口腔医疗车（2个椅位），能达到在野战条件下机动实施口腔医疗保障的目的。方法：利用现代化的牙科医疗、感染控制、数字管理、影像诊断、污水处理、温度调节、发电动力、GPS定位技术研制野战口腔医疗车，增强野战口腔医疗车的急救、医疗和保健功能。结果：野战数字化口腔医疗车具有车辆性能可靠、功能系列化程度高、医疗设施比较齐全、内部布局操作性好等特点。结论：野战数字化口腔医疗车完全可满足部队指战员口腔疾病防治与急救的需要。     

富士CR系统在全脊柱摄影中的应用

目的：研究数字化全脊柱摄影技术，以获得一次摄取完整的全脊柱影像。方法：自行设计并制作全脊柱摄片架和富士CR系统超长摄片盒相配套。结果：共拍摄2000例合格的数字化全脊柱X线影像。结论：数字化全脊柱X线影像为临床诊治脊柱病变提供了可靠的影像资料。     

全数字化摄影对500例女性乳腺影像检查结果分析

目的探讨全数字化摄影在女性乳腺检查中的应用，并对检查结果进行分析，以提高乳腺疾病的诊断率。方法使用飞利浦全数字化乳腺摄影机对500例门诊及体检的妇女进行检查，摄片采用常规头尾位和内外斜位等，并对所测部位及症状形态做总结分析。结果500例检查妇女中有43例患乳腺癌，检出率为1．68％，其中左乳24例，右乳19例；上象限27例（62．8％），下象限11例（25．6％），乳晕中央区5例（11．6％）；肿块29例（67．4％）；结构紊乱7例（16．3％）；恶性钙化16例（37．2％）；局限致密影9例（20．9％）。结论全数字化乳腺摄影在乳腺的结构及密度方面敏感性高，对发现和诊断乳腺癌有重要的临床价值。     

未来医学影像科数字化模式浅谈

目的:探讨未来医学影像科数字化模式的重要意义、所面临的挑战和发展机会,为实现医学影像数字化提供思路。方法:分析未来医学影像科实现数字化放射学、网络化放射学和无片化放射学的发展方向以及实现医学影像科全数字化的具体方法和途径。结果:要实现全数字化医学影像科,不仅在于学科的硬件和软件,而且在于观念的更新、技术人才的培养和资金的准备。结论:医学影像全面实现数字化已经成为必由之路,加强对医学影像设备使用和维护人员的培养,提高其自身素质迎接数字化时代带来的挑战尤为重要。     

数字化转型推动医院信息管理发展的机理与路径研究

近年来，数字化覆盖了全行业，加速了医疗服务的数字化转型。为了推动医院信息管理部门更好地适应数字化转型的新环境，文章阐释了医院数字化转型的机理，分析了信息管理在医院数字化转型中的支撑价值和难点，构建了数字化转型背景下医院信息管理发展的框架，并提出了对应的实施路径。     

计算机通讯多媒体技术与120急救报警系统

１２０急救报警系统作为公共通讯网的特服模块，其作用是汇接本地用户终端的１２０急救报警电话并作出相应处理。采用了全数字化的传输和交换设备，利用多媒体计算机进行监控和辅助检索。使得成本降低，效率提高。     

LDRD-01BC型DRX线机几种特殊故障检修

我院从北京航天中兴公司购置1台DRX线机是低管电流、高管电压、全数字化控制的先进设备。它采用计算机控制系统直接数字化成像并监控其各种状态，各种数据通过I／O接口反馈到CPU板，探测器扫描到的图像数据送到计算处理后在监视器上显示，并传输到医生诊断工作室。使用6a来出现过几种特殊故障，现介绍如下。     

计算机通讯及多媒体技术与120急救报警系统

120急救报警系统作为公共通讯网的特服模块，其作用是汇接本地用户终端的120急救报警电话并作出相应处理。采用了全数字化的传输和交换设备，利用多媒体计算机进行监控和辅助检索。使得成本降低，效率提高。     

潜水员水下心率实时监测系统的设计

目的：研制一种用于监测水下作业潜水员实时心率参数的便携式装置。方法：硬件系统设计为2个部分,包括心率检测单元和心率接收单元。心率检测单元位于潜水服之内,心率接收单元位于潜水服之外,2个单元之间采用无线通讯方式,心率接收单元与船上计算机之间采用有线的485传输方式,可进行长距离传输。结果：样机完成后经过反复测试,基本达到设计要求,成功实现陆上心率实时传输和水下模拟心率信号实时传输功能。无线传输模块水下可靠传输的最大距离可达10 m,且无线信号的传输距离和深度、压力无关。结论：硬件装置改进耐压和防水性能后,完全可以实现潜水员水下心电、心率信号的实时监测,并可扩展到其他生理信号的实时监测。     

数字化便携式口腔综合医疗系统的研制与应用

目的：为满足野战救治、基层部队和巡回医疗中口腔医疗保健的需要,对数字化便携式多功能口腔医疗系统进行研制。方法：在调查、了解口腔颌面部创伤救治和基层部队、远航舰船与巡回医疗对便携口腔医疗装备多方面需求的基础上,将数字化口腔X线影像、口腔内窥镜和远程图像传输等技术应用到便携式多功能口腔医疗系统的开发中,与有关医疗器械公司合作,从系统组成、技术参数及多功能整合等方面对数字化便携口腔医疗系统进行研制。结果：数字化便携式口腔综合医疗系统研制成功,系统便于携带,操作简单,具备野战急救、基本口腔医疗及远程会诊等多方面的功能。结论：数字化便携式口腔综合医疗系统整合了多种先进口腔诊疗技术,功能较为全面,能满足野战救治和基层部队、远航舰船与巡回医疗中的口腔医疗和保健需求,能有效提高军队口腔卫勤保障水平,拓宽保障范围。     

A Care-by-Parent Unit: Its Planning, Implementation and Patient Satisfaction

Influenced by a shortage of nurses, the high cost of hospitalization and a belief that parents can give adequate care to certain hospitalized children a care-by-parent unit (CBPU) was developcd Patient care is provided by parents No nurses are on the unit, a unit coordinator is the only hospital personnel A care-by-parent committee composed of representatives from several disciplines gives direction to the unit Unit success has been measured by several criteria Cost-per-patient day has been lowered, physicians have expressed satisfaction, and a survey of children and their parents indicates that both are highly supportive of the unit.     

A Care-by-Parent Unit: Its Planning,Implementation and Patient Satisfaction

Influenced by a shortage of nurses, the high cost of hospitalization and a belief that parents can give adequate care to certain hospitalized children a care-by-parent unit (CBPU) was developcd Patient care is provided by parents No nurses are on the unit, a unit coordinator is the only hospital personnel A care-by-parent committee composed of representatives from several disciplines gives direction to the unit Unit success has been measured by several criteria Cost-per-patient day has been lowered, physicians have expressed satisfaction, and a survey of children and their parents indicates that both are highly supportive of the unit.     

Early experience with transmission of data from moving ambulances to improve the care of patients with myocardial infarction

We conducted a feasibility study of a mobile unit capable of recording a 12-lead electrocardiogram (ECG) and transmitting it to a receiving hospital workstation. Two ambulances were equipped with the mobile unit and the ECGs recorded were compared with standard ECGs recorded on the hospital ward after admission. In six months, 62 patients participated in the study. The ambulance crew transmitted messages to the coronary care unit for 56 patients. Thirty-five patients were directed to the coronary care unit, four were directed to the emergency department as no beds were available and then transferred to the coronary care unit later, and the remaining 23 were directed to the emergency department. Comparative hospital and mobile ECGs were available for 31 patients. Although the mobile unit recorded smaller R- and S-wave deflections than on the standard hospital ECGs, the medical and nursing staff were able to differentiate between normal and abnormal tracings. The mobile unit may be useful to triage patients with chest pain before they reach hospital.     

野战综合手术队卫生员护理技能培训实践

根据未来战争的需求,我军机动卫勤力量呈多样化建设格局,野战综合手术队是我军机动性、专业性较强的卫勤力量之一,通常由联勤部队医院的外科手术医师和卫生员组成,执行加强保障任务.针对野战综合手术队卫生员担任护士岗位的实际,实行在任务医院在营训练护理技能的训练方法.强化培训内容,合理安排训练时间,使联勤部队卫生员快速适应综合手术队护士角色,为遂行使命任务提供保障.     

The role of the dietitian in the intensive care unit

PURPOSE OF REVIEW: The role of the intensive care unit registered dietitian has evolved over the past few years to become a vital component of the intensivist-led multidisciplinary intensive care unit team. The purpose of this review is to define the level of clinical practice and skill set of the intensive care unit dietitian, which defines them as a clinician, educator and researcher worthy to practice alongside their colleagues on the intensive care unit team. RECENT FINDINGS: An intensive care unit registered dietitian must be a dedicated professional with advanced training in critical care nutrition, the ability to read critically and evaluate new literature, a willingness to think 'outside the box', the fortitude to be an active participant in the intensive care unit team, the aptitude to educate colleagues and students from all disciplines, and the desire to participate in clinical research. Intensive care unit registered dietitians have published research concerning the nutritional assessment of the critically ill patient, the route of nutritional support, nutritional access, fluid and electrolyte issues, speciality enteral products, and optimal blood glucose control. They continue to attain skills and knowledge to extend their scope of practice and improve the quality of care in the intensive care unit. Recent guidelines adapted to the nutritional care of critically ill patients have been published for guidance. SUMMARY: The scope of practice of intensive care dietitians defines them as clinicians, educators and researchers. Their skill set is a unique and vital component of the intensivist-led multidisciplinary intensive care unit team.     

Conformity of commercial oral single solid unit dose packages in hospital pharmacy practice.

BACKGROUND: There are limited published data on the labelling of single unit dose packages in hospitals. SETTING AND PARTICIPANTS: The study was conducted in three large hospitals (two adult and one paediatric) in the metropolitan Montreal area, Quebec, Canada. OBJECTIVE: The objective is to evaluate the labelling of commercial oral single solid unit dose packages available in Canadian urban hospital pharmacy practice. METHOD: The study endpoint was the labelling conformity of each unit dose package for each criterion and overall for each manufacturer. Complete labelling of unit dose packages should include the following information: (1) brand name, (2) international non-proprietary name or generic name, (3) dosage, (4) pharmaceutical form, (5) manufacturer's name, (6) expiry date, (7) batch number and (8) drug identification number. We also evaluated the ease with which a single unit dose package is detached from a multiple unit dose package for quick, easy and safe use by pharmacy staff. Conformity levels were compared between brand-name and generic packages. RESULTS: A total of 124 different unit dose packages were evaluated. The level of conformity of each criterion varied between 19 and 50%. Only 43% of unit dose packages provided an easy-to-detach system for single doses. Among the 14 manufacturers with three or more unit dose packages evaluated, eight (57%) had a conformity level less than 50%. CONCLUSION: This study describes the conformity of commercial oral single solid unit dose packages in hospital pharmacy practice in Quebec. A large proportion of unit dose packages do not conform to a set of nine criteria set out in the guidelines of the American Society of Health-System Pharmacists and the Canadian Society of Hospital Pharmacists.     

Rhetoric and reality in stroke patient care

The aim of this study was to identify aspects of the process of care that might help explain the improved outcomes associated with stroke units. Three different care settings for stroke patients, an elderly care unit and general medical ward in an inner-city teaching hospital and a stroke unit in another teaching hospital in the same city, were compared using non-participant observational methods. Nurses on the stroke unit and general medical ward usually engaged in standardised and functional interaction with patients, while nurses on the elderly care unit were observed to adopt a more personal and attentive approach with patients. Rehabilitation nursing was rarely observed on the stroke unit, never on the general medical ward but always on the elderly care unit. There was evidence of effective communication between nurses and therapists on the elderly care unit but this was not observed on the stroke unit. On the elderly care unit the team appeared divided, with therapists and nurses on one side and medicine on the other, while on the stroke unit the divide was between doctors and therapists on one hand and nurses the other. On the general medical ward there was no team working. The observed lack of rehabilitation nursing, nurses' disengagement from the team and nurses' observed lack of warmth towards patients on the stroke unit were all surprising findings. Further research needs to examine whether such findings would be reproduced in stroke units elsewhere. If so, it might be that the better outcomes achieved on stroke units are despite rather than because of the nursing they receive there.     

When to wash walls in ward rooms?

Surface contamination with Staphylococcus aureus on walls and floors of occupied rooms in an orthopaedic ward, an infectious disease unit, and a burns unit were studied. It was found that walls and floors in the burns unit carried large numbers of bacteria, 10–100 times higher than those in the other units. This may indicate a requirement for routine disinfection of walls and floors in the burns unit but not usually in other wards.