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新加坡急诊预检分诊模式介绍 总被引:1,自引:0,他引:1
从急诊预检内涵、预检分诊模式、分诊工作内容等多方面介绍新加坡医院的急诊预检分诊系统。新加坡各家医院急诊预检分诊工作遵照国际通行的级别分诊标准,结合国情进行细微的调整,体系统一、规范,合理科学地分配医疗资源和医疗空间,有利于急诊工作的开展,可提高急诊救治效果。新加坡急诊预检分诊模式值得我国急救护理工作借鉴。 相似文献
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目的探讨急诊预检分诊系统用于改善医疗服务质量的效果。方法随机选择2014年1~2月及2016年1~2月急诊预检分诊各1 000例患者为对照组和观察组,对照组采用传统的预检分诊方法,观察组采用基于法国预检分诊指南研发的急诊预检分诊系统进行预检分诊。结果与对照组比较,观察组分诊准确率由91.6%上升为98.7%,平均分诊时间由(145.34±68.15)s缩短为(99.58±28.73)s,患者对病情分级、等待分诊时间、等待看诊时间满意率提高(均P0.01)。结论急诊预检分诊系统的应用实现了临床信息共享,提高了急诊分诊准确率,缩短了分诊时间,有利于改善急诊医疗服务质量。 相似文献
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介绍美国波士顿儿童医院的预检流程,包括预检评估内容、急诊严重指数预检分级法以及预检记录.提出应借鉴波士顿儿童医院分诊预检模式的优势,研发适用于我国的儿科急诊分诊预检模式,从而提高急诊分诊预检工作质量. 相似文献
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目的探讨三甲医院急诊预检分诊岗位的改进方法,为急诊预检分诊岗位管理提供参考。方法分析预检分诊岗位的临床现状以及存在的管理问题,从设立合理岗位及班次,完善预检分诊岗位说明书,对预检分诊岗位护士进行培训、考核等方面进行预检分诊岗位管理的实践。比较预检分诊岗位改进与管理实施前后急诊患者的就诊满意度、护士二次评估及提前评估的执行情况。结果进行预检分诊岗位管理的实践后,二次评估率、提前评估率、患者满意度显著提高,与实施前比较,差异有统计学意义(P0.05,P0.01)。结论基于工作量分布特点改进急诊科预检分诊护士岗位管理,可有效保证预检分诊岗位职责落实,保障急诊患者安全及时就诊。 相似文献
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《护理学杂志》2015,(15)
目的对三级综合医院儿科急诊预检实施规范化管理,提高预检分诊效率。方法对儿科门诊的3 396例患儿实施规范化的预检分诊管理,即成立预检分诊小组,制订预检分诊流程图,建立预检分诊工具;由预检分诊护士对患儿应用快速评估工具、4级预检分诊标准进行评估、分诊,准确、快速分诊患儿至相应就诊区,候诊期间分诊护士定时巡视候诊区域,发现问题及时处理。结果分诊为1级、2级、3级、4级的患儿分别为7例(0.21%)、232例(6.83%)、761例(22.41%)、2 396例(70.55%);急诊患儿均在就诊2min内分诊至相应的诊室。患儿入院率、入PICU/NICU率及医疗资源使用情况与分诊级别显著相关(均P0.01)。结论对三级综合医院儿科急诊预检实施规范化管理,能够准确识别出患儿病情的轻重缓急,而且能够在有限的时间内规范分诊,提高预检分诊效率。 相似文献
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《浙江创伤外科》2019,(4)
目的研究改良早期预警评分(Modified Early Waming Score,MEWS)在胸痛患者急诊预检分诊中的临床价值。方法 2016年9月到2017年9月,采取MEWS系统预检分诊937例急性胸痛患者(治疗组),并比较采取MEWS系统前(2015年8月至2016年8月)857例胸痛患者(对照组)急诊预检分诊状况。结果采取MEWS系统进行预检分诊后,治疗组患者候诊时问为(12.3±2.1)分钟,低于对照组的(18.6±2.5)分钟,差异有统计学意义(P0.05);治疗组分诊准确率为87.9%(824/937),高于对照组的78.1%(669/857),差异有统计学意义(P0.01)。结论应用MEWS系统对胸痛患者进行急诊分诊,可缩短就诊等待时间,提高急诊分诊准确率,有利于患者及时诊断、治疗。 相似文献
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目的探讨改良澳大利亚预检系统(Australian Triage Scale,ATS)在急诊创伤患者分诊中的应用价值。方法组织专业人员对澳大利亚预检系统进行翻译,并结合我国临床工作实际情况进行修订和改进。将178例批量创伤患者按照时间顺序分为对照组(87例)和观察组(91例)。对照组应用AIS-ISS评分检伤分诊,观察组应用ATS系统评估分诊。比较两组在检伤分诊时间、分诊准确率、抢救成功率和患者/家属对分诊工作满意度。结果观察组评估分诊时间短于对照组(P0.01);而分诊准确率、抢救成功率、患者/家属对分诊工作满意度显著高于对照组(均P0.05)。结论改良澳大利亚预检系统能快速评估伤情,指导急诊抢救治疗工作,减少分诊盲目性、增强准确性,为急诊创伤患者及时救治、合理分流提供科学依据。 相似文献
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A National Survey Assessing the Current Workforce of Transplant Pharmacists Across Accredited U.S. Solid Organ Transplant Programs
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D. J. Taber N. A. Pilch J. Trofe‐Clark T. E. Kaiser 《American journal of transplantation》2015,15(10):2683-2690
Integration of pharmacists into multidisciplinary transplant patient care has advanced in recent years, with limited data available to evaluate the current status of the profession. This was a national survey developed as an AST Pharmacy COP initiative. Responses were solicited from pharmacists practicing at U.S. transplant programs based on UNOS listing; 176 participants from 113 centers (41%) responded, with 79% practicing ≤10 years. There is a median of 1.4 pharmacist full‐time equivalents (FTEs) (range 0.1–7.1) for every 100 transplants. The predominant activities performed by pharmacists during the transplant phase include medication review (95%), lab review (92%), allergy review (88%), medication therapy management (92%), bedside rounds (87%), medication education (79%), documentation (71%), and coordinating discharge medications (58%). Similar activities were reported during the other phases, but participation was less common. The involvement of dedicated transplant pharmacists within multidisciplinary care has become standard at a large number of centers, although expansion is still needed to ensure core pharmaceutical care components are provided to all transplant recipients across all centers. These results inform on the typical responsibilities of pharmacists practicing within the field of transplantation and illustrate that the level of pharmacist involvement significantly varies across transplant centers and the phases of transplantation. 相似文献
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PURPOSE: We describe the current status of quality of care measurement for localized prostate cancer and provide a framework for preserving a leadership role for our specialty in this dynamic and controversial field. MATERIALS AND METHODS: Basic methodological principles of quality of care assessment were reviewed. Several factors that suggest the potential for current variation in the quality of care for patients with localized prostate cancer, particularly those receiving active treatment, were then analyzed. Subsequently contemporary publications and investigations that comprise the current foundation of prostate cancer quality of care research were reviewed. RESULTS: The foundation for much of the emerging research in prostate cancer quality of care assessment is based on the Donabedian structure-process-outcome paradigm. The RAND candidate quality indicators for localized prostate cancer were developed in this framework and they represent the first effort to systematically consider the measurement of quality as it relates to prostate cancer. The feasibility of applying the RAND quality indicators to clinical quality of care assessments has been demonstrated, although further modification and refinement of the indicator set are necessary prior to large-scale, population based implementation of these quality assessment measures. Moreover, future quality of care efforts must make the transition to primarily prospective or concurrent quality assessments, such that measures can be taken to modify the structure and/or process of care at the time of delivery or shortly thereafter. CONCLUSIONS: Prostate cancer quality of care assessment represents a burgeoning domain of urological health services research. To date such initiatives have come from within and outside of our specialty. In the future such efforts are likely to expand and they may have a substantial impact on the clinical and administrative aspects of urological practice. As a result, urologists should maintain a leading role in efforts to further define of quality of care as it relates to prostate cancer and radical prostatectomy. 相似文献
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Diana M. Tisnado PhD Jennifer L. Malin MD PhD May L. Tao MD Patricia Ganz MD Danielle Rose-Ash PhD Ashlee F. Hu MD John Adams PhD Katherine L. Kahn MD 《The breast journal》2009,15(1):17-25
Abstract: The structure of health care has been rapidly evolving in response to financial pressures and demands to improve quality. Little work has documented the structure of care and its impact in the context of breast cancer care. We conducted a survey to characterize Los Angeles physicians caring for breast cancer patients and the structural landscape of the healthcare system in which they practice. Cross-sectional survey of physicians who treated a population-based cohort of breast cancer patients. We surveyed 477 physicians, targeting all Los Angeles County medical oncologists, radiation oncologists, and surgeons reported by patients participating in the Los Angeles Women's Health Study (77% response rate). Specialty-specific questionnaires were developed. Items were based on the structure and quality of care literature, cognitive interviews with cancer care specialists, and existing physician survey instruments. Breast cancer care providers in Los Angeles are diverse, with one-third non-white and 46% speaking a non-English language. Group practice is most common, (37% single specialty, 16% group-model HMO, 8% multi-specialty group). Minimal teaching involvement predominates. Mean new breast cancer patient volumes are relatively high (8 per month overall; six for surgeons), representing 46% of new cancer patients. Physicians reported high career satisfaction levels (83–92%). Physicians were least satisfied with the amount of time spent with patients (82%). Data from this study represent important building blocks for further analyses to determine the impact of structural characteristics on the quality of care that breast cancer patient's experience. 相似文献
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David F. Friedlander Quoc-Dien Trinh Anna Krasnova Stuart R. Lipsitz Maxine Sun Paul L. Nguyen Adam S. Kibel Toni K. Choueiri Joel S. Weissman Mani Menon Firas Abdollah 《European urology》2018,73(3):445-451
Background
The gap in prostate cancer (PCa) survival between Blacks and Whites has widened over the past decade. Investigators hypothesize that this disparity may be partially attributable to differences in rates of definitive therapy between races.Objective
To examine facility level variation in the use of definitive therapy among Black and White men for localized PCa.Design, setting, and participants
Using data from the National Cancer Data Base, we identified 223 873 White and 59 262 Black men ≥40 yr of age receiving care within the USA with biopsy confirmed localized intermediate/high-risk PCa diagnosed between January 2004 and December 2013.Outcome measurements and statistical analysis
Multilevel logistic regression was fitted to predict the odds of receiving definitive therapy for PCa. Sensitivity and subgroup analyses were performed to adjust for inherent patient and facility-level differences when appropriate.Results and limitations
Eighty-three percent (n = 185 647) of White men received definitive therapy compared with 74% (n = 43 662) of Black men between 2004 and 2013. Overall rates of definitive therapy during that time increased for both White (81% vs 83%, p < 0.001) and Black (73% vs 75%, p = 0.001) men. However, 39% of treating facilities demonstrated significantly higher rates of definitive therapy in White men, compared with just 1% favoring Black men. Our study is limited by potential selection bias and effect modification.Conclusions
After adjusting for sociodemographic and clinical factors, we found that most facilities favored definitive therapy in Whites. Health care providers should be aware of these inherit biases when counseling patients on treatment options for localized PCa. Our study is limited by the retrospective nature of the cohort.Patient summary
We found significant differences in rates of radiation and surgical treatment for prostate cancer among White and Black men, with most facilities favoring Whites. Nonclinical factors such as treatment facility type and location influenced rates of therapy. 相似文献17.
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Quality of life after intensive care 总被引:2,自引:0,他引:2
An important aspect of effectiveness of intensive care services is change in the quality of life of survivors after critical illness. A questionnaire was complied using established methods for assessment of quality of life and sent to all known survivors of a regional intensive care unit. Each patient's quality of life was then quantified using disability categories. The results show that patients with a good premorbid quality of life suffered a significant decline after critical illness. Similar important decreases in quality of life were found in younger patients and trauma victims. Quality of life may be a valuable consideration in determining the appropriateness of intensive care management. 相似文献
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