浅谈医疗纠纷的防范

浅谈医疗纠纷的防范宋鹏雁湖北省襄樊市铁十一局医院医务处关键词医疗事故，医疗纠纷随着社会经济的发展和人民文化生活水平的提高，人们对医疗保健需求的质量要求亦愈来愈高。但广大医务工作者在对患者的诊断、治疗和护理等医疗服务过程中难免出现令患者或家属不满意的地...     

卫生监督信息系统数据元标准化应用尝试

本文主要介绍中山市卫生监督信息系统在开发过程中使用"卫生监督基本数据集标准"效果.并根据现场实际情况对"基本数据集"进行扩充的情况,以及扩充设计与分类方案.     

我市卫生监督监测检验报告系统设计思路

为了充分发挥检验报告的法律作用。满足卫生监督工作宏观管理的需要，建设一套具有本行业特色的系统，以适应事业的总体发展需要，本文对采用VFP可视化计算机编程工具制作的规范计量认证检验报告的发放和管理系统阐明了设计思路，讨论了技术要点，确立了主要程序模块。     

浅谈乐清市卫生监督职能调整后现状与应对措施

卫生监督体系是公共卫生体系的重要组成部分,是执行国家卫生法律法规、维护公共卫生秩序和医疗服务秩序、保护人民群众健康、促进经济社会协调发展的重要保证。本文针对餐饮服务监管职能调整后乐清市卫生监督的工作现状、存在的问题进行探讨,并提出应对措施,提高卫生监督工作效能。     

医疗纠纷对医师心理状态的影响

目的:了解医疗纠纷对临床医师心理状态的影响.方法:采用自编调查表、SCL-90量表和Beck抑郁量表(BDI)对涉及医疗纠纷的82名医师(实验组)进行问卷调查,并与对照组进行比较.结果:实验组在医疗纠纷出现后1～2周SCL-90和BDI量表得分最高,随着时间的延长量表分降低(P<0.05～0.01),6～8周后趋于平稳;实验组量表得分在初期多高于对照组,在随访后期与对照组无显著性差异.结论:医疗纠纷对医师的心理状态有不同程度的影响,随着时间的延长这种影响可逐渐减轻.     

卫生部关于做好卫生监督协管服务工作的指导意见

为深入贯彻《国务院办公厅关于印发医药卫生体制五项重点改革2011年度主要工作安排的通知》（国办发（2011）8号）的精神,进一步落实卫生部、财政部《关于做好2011年基本公共卫生服务项目工作的通知》（卫妇社发（2011）37号）的要求,努力实现基本公共卫生服务均等化的目标,有效维护广大人民群众的健康权益,现就开展卫生监督协管服务工作提出以下意见：①充分认识开展甲生监督协管服务的重要意义;②进一步明确卫生监督协管服务的主要任务和目标;     

试论卫生执法监督信息系统建设

卫生执法监督信息系统是<全国卫生信息化2003～2010发展规划纲要>中明确提出的八大信息化建设任务和六大信息系统建设目标之一.作者结合本单位的实际情况,从卫生执法监督信息系统建设的现状和问题着手,论述了卫生执法监督信息系统建设的目标、对策.以及建设方针和原则,期许为各级政府和卫生行政部门决策提供参考.     

2005-2006年《中国卫生监督杂志》论文引文分析

通过对《中国卫生监督杂志》2005-2006年引文分析,揭示卫生监督领域论文的一般规律,了解和分析著者利用科技文献的实际情况,为卫生监督信息情报工作人员提供参考。     

卫生执法监督信息管理平台的构建研究

卫生执法监督系统是我国公共卫生信息系统基础构架的重要组成部分,卫生执法监督信息化建设可以提高卫生综合执法监督的能力,是提高卫生执法监督机构运行效率的重要途径。本文通过我国卫生执法监督信息化建设的现状与问题的分析,探讨了卫生执法监督信息管理平台构建的指导思想、原则、方法、功能构建和效益分析等问题。     

青岛某区生活饮用水卫生现状与对策

本文介绍了通过水质监测能力建设、开展世界卫生组织合作项目、水质基线调查等卫生管理方式,推进生活饮用水安全工程,辖区饮用水卫生监督覆盖率400%以上,水质消毒率上升到100%。     

多模态医学图像配准技术的分类与研究进展

多模态医学图像配准技术是目前医学图像处理中的研究热点 ,对于临床诊断和治疗有重要意义。本文首先分析了图像配准的过程 ,并在此基础上对配准方法进行了反映其本质的分类 ,然后综述了目前的一些主要的多模态医学图像的配准方法 ,最后提出了医学图像配准研究中的几个主要问题。     

The level of medical services and secondary school-aged athletes

Context:

Medical organizations have recommended that administrators, parents, and community leaders explore every opportunity to make interscholastic athletic programs safe for participation, including employing athletic trainers at practices and competitive events.

Objective:

To determine the overall level of medical services provided for secondary school-aged athletes at high school athletic events in a rural southern state, to evaluate the employment of athletic trainers in the provision of medical services in secondary schools, and to compare athletic training medical services provided at athletic events among schools of various sizes.

Design:

Cross-sectional study.

Setting:

Questionnaires were sent to administrators at 199 secondary schools.

Patients or Other Participants:

A total of 144 administrators, including interscholastic athletic directors and school principals, from 199 secondary schools participated (72% response rate).

Main Outcome Measure(s):

Participants completed the Self-Appraisal Checklist for Health Supervision in Scholastic Athletic Programs from the American Academy of Pediatrics, which has been demonstrated to be valid and reliable. The Kruskal-Wallis and Mann-Whitney tests were used to measure differences in groups.

Results:

We found differences in cumulative scores when measuring between institutional classifications (P≤.05). Cumulative scores for the Event Coverage section of the instrument ranged from 80.5 to 109.6 out of a total possible score of 126. We also found differences in several factors identified in the Event Coverage section (P≤.05).

Conclusions:

The number of coaching staff certified in cardiopulmonary resuscitation or first aid was minimal. Most schools did not have a plan for providing minimal emergency equipment, ice, or water for visiting teams. We found that 88% (n = 7) of the 8 essential Event Coverage components that the American Academy of Pediatrics deems important were not addressed by schools represented in our study.     

医院图书馆与医务人员卫生法学教育

为了改变卫生人员和医学生的知识结构,自觉执行卫生法,培养适应新时代有道德、有文化、守纪律、高素质的卫生人员,必须要加强学习卫生法学教育。文章阐述了卫生法的概念,及其教育的意义,卫生法学在医疗实践中的作用;同时提出了图书馆如何配合医院开展卫生法学教育的措施,扩大藏书内容,开办法律讲座学习班,做好法律知识宣传工作,坚持以医教研为中心,深化服务质量。     

Impact of a hand hygiene educational programme on hospital-acquired infections in medical wards

Improvement in hand hygiene (HH) compliance has been associated with a decrease in the incidence of hospital-acquired infection (HAI) and hospital-acquired methicillin-resistant Staphylococcus aureus (HA-MRSA) infection/colonization. We aimed to evaluate the impact of a multimodal intervention in medical wards on HH compliance, alcohol-based hand rub (AHR) consumption and incidence of HAI and HA-MRSA. A before-after intervention study and an assessment 1 year later were conducted in three internal medicine wards. HH compliance during routine patient care was monitored using the WHO HH observation method. AHR consumption was registered. HAI incidence was actively sought during the PRE and POST periods. HAI risk factors were prospectively recorded and incidence density was calculated. A total of 825 patients were prospectively followed in the PRE period and 868 patients in the POST period. We observed 1531 opportunities for HH in PRE and POST periods and 450 1 year later. HH compliance improved from 54.3% to 75.8% (p 0.005) and remained 75.8% at follow-up. AHR consumption increased from 10.5 to 27.2 L/1000 hospital-days and 31.5 L/1000 hospital-days at follow-up. Incidence density of HAI was 6.93 and 6.96/1000 hospital-days in the PRE and POST intervention periods, respectively. HA-MRSA incidence density was 0.92 in the PRE period vs. 0.25/1000 hospital-days in the POST period (p 0.2) and 0.15/1000 hospital-days (p 0.1) 1 year later. A sustained increase in AHR consumption was followed by an improvement in HH compliance after a multimodal campaign. A trend for lower incidence density of new hospital-acquired MRSA was detected in the POST intervention and follow-up periods.     

医务人员手带菌状况调查与对策

目的 调查不同情况下医务人员手部带菌状况，并研究相应对策。方法 随机抽查本院168名工作中的临床医护人员，调查洗手前后手部带菌状况，并对菌株进行分离鉴定和耐药性分析。结果 洗手前手细菌总数平均41．064cfu／cm^2，洗手后手合格率84．8％。医生手细菌总数洗手前后均较护士多。“无菌操作”组手卫生状况较好。手部检出细菌主要是葡萄球菌、枯草芽孢杆菌和非发酵革兰氏阴性杆菌，医务人员手耐药菌携带率高。结论 医务人员手卫生状况不容乐观，应加强医务人员手卫生培训与监督，提高医务人员手卫生合格率。     

北京市医用高分子材料在医疗器械产业发展中的现状调研

目的深入调研北京市医疗器械用高分子材料的开发及产业化情况,探寻本领域发展所面临的机遇与挑战。方法 2014~2016年,北京理工大学材料学院师生结合专业学习,与中关村医疗器械产业联盟合作,对北京市与医用材料产业化相关的企业、科研院所、专家学者及行业协会,通过问卷调查、参观、生产实习、座谈等形式进行调研,并对调研结果进行深入的分析。结果梳理了北京市医疗器械用高分子材料的开发及产业化过程中,在新型高分子材料的研发及应用、技术开发及创新、人才培养等方面所存在的问题及解决的措施,为加速实现医用高分子材料的产业化提出了有针对性的意见和建议。结论本研究对促进北京市医疗器械用高分子材料的开发及产业化具有一定的指导意义。     

医院图书馆发展之我见

本文从主客观两个方面论述了如何使医院图书馆摆脱制约,加速发展,在日新月异的信息时代立于不败之地。     

Embodiment and the supervisory task: The supervision of Dance Movement Psychotherapists in training

Supervision is an intimate act of creation and this article endeavours to understand the mercurial nature of this task, drawing on theoretical perspectives grounded in a Jungian framework. With a focus on training, supervisor and supervisee negotiate a labyrinth as they co-create a process within a triangular relationship, in which one key player, the client, is absent. The role of embodied knowing shapes a process involving the body as an active agent of change, whilst the wider matrix of the institution offers a multi-layered universe of parallel processes. The article offers composite vignettes to illustrate how unarticulated embodied wisdom transforms into a conceptualised understanding of clinical material through the transcendent function. The article illuminates the value of the body as radar for unconscious communication within the supervisory relationship.     

The evolving classification of soft tissue tumours: an update based on the new WHO classification

Tumour classifications have become an integral part of modern oncology and, for pathologists, they provide guidelines which facilitate diagnostic and prognostic reproducibility. In many organ systems and most especially over the past decade or so, the World Health Organization (WHO) classifications have become pre-eminent, partly enabled by the timely publication of new "blue books" which now incorporate detailed text and copious illustrations. The new WHO classification of soft tissue tumours was introduced in late 2002 and, because it represents a broad consensus view, it has gained widespread acceptance. This review summarizes the changes, both major and minor, which were introduced and briefly describes the significant number of tumour types which have been first recognized or properly characterized during the past decade. Arguably the four most significant conceptual advances have been: (i) the formal recognition that morphologically benign lesions (such as cutaneous fibrous histiocytoma) may very rarely metastasize; (ii) the general acceptance that most pleomorphic sarcomas can be meaningfully subclassified and that so-called malignant fibrous histiocytoma is not a definable entity, but instead represents a wastebasket of undifferentiated pleomorphic sarcomas, accounting for no more than 5% of adult soft tissue sarcomas; (iii) the acknowledgement that most lesions formerly known as haemangiopericytoma show no evidence of pericytic differentiation and, instead, are fibroblastic in nature and form a morphological continuum with solitary fibrous tumour; and (iv) the increasing appreciation that not only do we not know from which cell type(s) most soft tissue tumours originate (histogenesis) but, for many, we do not recognize their line of differentiation or lineage--hence an increasing number of tumours are placed in the "uncertain differentiation" category.     

医疗设备信息化管理进展分析

医院目前普遍存在医疗设备数量大、金额高的现状,信息化成为提高管理质量和管理效率的最佳方式。文章阐述了当前医院在用的信息化管理系统的来源和特点,总结了互联网技术、物联网技术和移动通信技术(手机端)在信息化管理中的发展和应用现状。文章最后指出,现代科学技术在医疗设备管理领域的应用是实现医疗设备全生命周期管理的助推器。