浅析培养基质量控制与标准检验方法及评审准则要求

目的归纳微生物实验室在实施国家标准检验方法或规范过程中如何对培养基进行质量控制。方法结合《实验室资质认定评审准则》、《检测和校准实验室能力的通用要求》等评审准则的要求,对微生物实验室在培养基质量控制过程中发生的常见问题,进行了总结分析,提出了解决问题的方法。结果在计量认证或实验室认可评审工作中,发现有不少实验室对培养基的质量控制不规范。结论要做好微生物检测质量控制工作,检测人员除了要掌握好微生物学的有关基础知识外,还要正确理解并掌握相关的国家标准检验方法和质量控制的原则,以及与实验室认证、认可评审准则有关的规定。     

湖北省疾病预防控制机构计量认证相关问题分析

计量认证工作在湖北省开展以来,为规范检涮机构的行为和提高卫生检测工作的质量发挥了应有的作用。近5年来,全省各级疾病预防控制机构的计量认证评审条款已从原来的《产品质量检验机构计量认证技术考核规范）50条,更新到《产品质量检验机构计量认证／审查认可（验收）评审准则》（以下称评审准则）的13个要素,遵照新的准则的要求,通过计量认证复查换证和首次评审的机构均建立了新的质量管理体系。     

卫生检测机构46次现场评审工作回顾分析

6年来，国家计量认证卫生评审组依据《产品质量检测机构计量认证／审查认可（验收）评审准则》和CNAS—CL01：2005《检测和校准检测机构能力认可准则》的要求，对36个卫生检测机构进行了46次现场评审工作，其在规范我国卫生检测机构的行为，提高检验水平，保证数据可靠，促进其质量管理水平提高等方面确实发挥了积极作用。但随着《行政许可法》实施和国外独资从事技术测试、分析、检验的机构进入中国市场，我们深感卫生计量认证和检测机构认可评审工作急需总结一些经验和规则，才能促进卫生检测机构提高自身质量管理水平和国际竞争力，更有效地为社会提供优质服务。为此，国家认证卫生评审组对2000年9月～2005年12月期间46次现场评审工作进行了分析研究，从而基本摸清了我国卫生检测机构现阶段存在的问题。     

疾控机构实验室建立质量管理体系的做法和体会

建立符合《产品质量检测机构计量认证／审查认可（验收）评审准则》（以下简称“评审准则”）或其他相应准则的质量体系，是保证检测检验质量的关键。疾控机构为增强检测检验业务市场的竞争能力，保证检测数据公正性、准确性，以证明其出具公证数据的资格，按“评审准则”建立质量体系十分必要。我站于2002年11月份按“评审准则”的13个要素建立了适合本站检测检验特点的质量体系文件，经6个月的运行于2003年7月通过省级计量认证考核评审。     

浅谈疾病预防控制中心管理评审工作

管理评审是按照《产品质量检验机构计量认证/审查认可评审准则》(以下简称《评审准则》)实施计量认证后,对检测机构最高管理者提出的一项重要管理要求.疾病预防控制机构属检测机构的一种,也需要进行管理评审,它是各级疾病预防控制中心主任实施质量管理和质量控制的重要手段.……     

计量认证扩项评审过程的应对及体会

计量认证扩项工作的重点是放在和扩项相关的质量体系要素和技术层面等软、硬件的准备上，对实验室来讲，认为范围较计量认证首次、复查评审狭窄，所以往往造成重视程度不够，评审现场更容易出现一些应对上的问题。依据《实验室资质认定评审准则》，本中心于2007年7月通过了公共场所集中空调及生活饮用水、医疗机构污水、车间空气等相关项目共17个参数的扩项评审，     

平阴县计量认证复核工作的做法与体会

计量认证与审查认可在我国开展10几年来，为规范质量检验机构的行为，加强管理，全面提高检测技术水平与工作质量发挥了应有的作用。国家质量技术监督局规定了《产品质量检验机构计量认证／审查认可（验收）评审准则》，该准则共16章13要素，56条165款，该准则解决了重复考核和与国际接轨问题，为国内检验机构走出国门创造了必要条件。2004年，平阴县卫生防疫站通过了该标准的复核验收。现谈谈我站计量认证复核工作的作法与体会。     

日常检测工作中质量控制校核方法的应用体会

为保证检测结果的准确性和可靠性，本中心自2001年开始国家实验室认可工作以来，按照《实验室认可准则》及《计量认证／审查认可(验收)评审准则》的有关要求，在开展的各项检测检验工作中，除积极参加国家实验室认可委员会组织的能力验证和上级业务部门组织的检测质量控制外，在日常工作中，通过使用规定的校核方法，     

全面实施评审准则的实验室内部质量管理体系

《产品质量检验机构计量认证 /审查认可评审准则》已于2 0 0 0年 10月 2 4日发布 ,2 0 0 1年 12月 1日实施 ,包括 13个评审要素 ,5 6条 ,12 6款。强调全过程的质量控制 ,是新评审准则的重要特征。柳洲铁路局疾病预防控制中心于 2 0 0 2年 12月 3 0日顺利通过了区技术监督局的评审 ,成为广西卫生系统首家以评审准则进行计量认证的单位。我们根据评审准则及《全国疾病预防控制机构工作规范》 ,建立了一个由质量手册、2 7个程序文件、质量记录及近 2 0 0个作业指导书组成的质量体系、建立了全过程的内部质量控制措施 ,及时发现随机因素和系统因…     

巩固计量认证/审查认可成果,实现实验室国家认可

随着入世，对检验机构的考核标准与国际上对实验室考核的标准日趋一致，“二合一”评审准则代替原计量认证考核条款(50条)和审查认可(验收)条款(39条)，已于2000年10月24日发布，于2001年12月正式实施，本中心从2003年12月开始就着手按照《产品质量检验机构计量认证／审查认可(验收)评审准则》，开展了计量认证／审查认可的筹备工作，并于2004年9月通过省卫生防疫专业评审组的现场评审，通过一个月的整改，取得合格证书。     

Criteria for clinical audit of the quality of hospital-based obstetric care in developing countries

Improving the quality of obstetric care is an urgent priority in developing countries, where maternal mortality remains high. The feasibility of criterion-based clinical audit of the assessment and management of five major obstetric complications is being studied in Ghana and Jamaica. In order to establish case definitions and clinical audit criteria, a systematic review of the literature was followed by three expert panel meetings. A modified nominal group technique was used to develop consensus among experts on a final set of case definitions and criteria. Five main obstetric complications were selected and definitions were agreed. The literature review led to the identification of 67 criteria, and the panel meetings resulted in the modification and approval of 37 of these for the next stage of audit. Criterion-based audit, which has been devised and tested primarily in industrialized countries, can be adapted and applied where resources are poorer. The selection of audit criteria for such settings requires local expert opinion to be considered in addition to research evidence, so as to ensure that the criteria are realistic in relation to conditions in the field. Practical methods for achieving this are described in the present paper.     

上海市医院等级评审标准中的“人”事第一原则

上海市借鉴国际先进医院评审经验,起草、修订、完善《上海市三级综合医院评审标准》,从病人和医院员工角度出发,贯穿了“人”事第一原则,切实体现了“以人为本”的公立医院办院宗旨。     

医院财务管理中的首签负责制

河南省肿瘤医院简化审批流程,强化审批责任,在医疗卫生系统推行财务管理"首签负责制",在有效简化财务支出审批流程的同时,也确保规章制度管理的刚性。实施后,业务部门和财务部门的首签人对支出事项的管理力度明显加大,工作效率明显提高,审批的质量明显提升。     

Understanding institutional review boards: practical guidance to the IRB review process.

The purpose of this paper is to provide practical guidance to assist investigators in the preparation of materials and obtaining approval for research projects that require oversight by an institutional review board (IRB). The central requirements for IRB approval and core considerations of IRBs are described. Specific suggestions for investigators regarding how to prepare their IRB applications to anticipate and address potential IRB concerns and questions are proposed. When researchers are familiar with these criteria and how they may be interpreted by an IRB, they can avoid deferrals or lengthy requests for protocol modifications or clarifications. General tips regarding the preparation of IRB submission materials that may allow for a smoother IRB review process are also discussed. A brief list of additional resources for investigators is appended.     

A systematic review of psychometric evidence and expert opinion regarding the assessment of faecal incontinence in older community-dwelling adults

Objectives This review had two objectives: (i) to determine what is required in an assessment of faecal incontinence issues for older community-dwelling adults; and (ii) to determine the psychometric tools most effective for assessment of faecal incontinence in older community-dwelling adults. Inclusion criteria For the review of psychometric tools, studies were included if they were concerned with people living in the community, included a significant proportion of the sample aged 65?years or over, and either examined psychometric properties of assessment tools or assessed sensitivity of assessment tools to non-surgical interventions available in the community setting. For the review of expert opinion, the search was limited to expert opinion provided by an expert in faecal incontinence that related to community-based assessment. Only articles published in English were eligible for inclusion and no limits were placed on publication dates. Search strategy An initial search of Medline and CINAHL databases identified terminology frequently used in the literature with regard to assessment of faecal incontinence. An extensive search was then undertaken using all identified key words and index terms. The third step involved a search of reference lists and bibliographies of all relevant articles. Methodological quality All identified studies that met the inclusion criteria were assessed for methodological validity in the case of studies considered for inclusion in the psychometric review. Validity of expert text was also assessed prior to it being included in the review. Results The final search strategy identified approximately 7000 references. Full-text versions of 144 references were critically appraised for inclusion in the review. Of these, 25 sources were included in the review of expert opinion and 16 in the review of psychometric properties. In the review of expert opinion, 254 conclusions were extracted for synthesis. The 31 thematic categories were organised under five major themes: History-taking, bowel assessment, psychosocial aspects, physical examination and specialist referral. From the sources that survived critical appraisal, 52 conclusions relating to psychometric properties of assessment tools were derived. There was limited, if any, analysis of psychometric properties for the majority of assessment tools. The Wexner and Vaizey symptom severity scales demonstrated acceptable test-retest reliability and convergent validity. The Fecal Incontinence Quality of Life Scale (FIQLS) demonstrated reasonable reliability and good convergent and criterion-related validity. There was, however, some evidence questioning its discriminant validity. Conclusions This systematic review represents an important first stage in developing guidelines for assessment of faecal incontinence in community-dwelling older people. Assessment should be comprehensive in nature. Gaps in expert opinion are evident regarding issues such as assessment of cognitive decline and specialist referral. Continence advisors need to be appropriately trained in using and interpreting results from assessment tools and conducting physical examinations. Although studies in the review of psychometric properties suffer from limitations such as inadequate sample sizes, the Vaizey and Wexner scales would appear to be the tools of choice. The FIQLS is clearly the tool of choice at this stage for measuring faecal incontinence quality of life. Further validation of tests used in faecal incontinence assessments is required.     

澳大利亚职业风险评估模型在蓄电池生产企业中的应用

目的 探索适用于我国职业危害风险评估的模型.方法 将澳大利亚职业风险评估模型的6个基本步骤（确定环境、识别危害、分析危害潜在的风险、评价风险、治理风险、监测与复查风险）逐步应用于某蓄电池生产企业职业风险评估,获得评估结论,并总结分析该模型的优缺点.结果 蓄电池生产企业存在的主要职业病危害因素包括铅烟、铅尘、硫酸、噪声和高温.暴露于硫酸的劳动者存在＂高风险＂职业危害,其他危害因素存在＂重大风险＂.存在＂高风险＂的岗位经优先采取职业卫生控制措施,已取得显著成效;存在＂重大风险＂的岗位企业也应尽快完善各项防护措施.结论 澳大利亚职业风险评估模型有助于发现企业职业危害关键控制点,但应用于某特定企业职业危害风险评估难以避免偏倚.     

基于全程动态管理理念的科研管理信息系统的研制

科研管理是一项系统工程,以信息网络技术为依托、基于动态管理理念的科研管理信息系统的研制是顺势之需.本系统围绕医药卫生项目,将申报、评审、立项、中期考核、结题和鉴定等不同节点关联起来、环环相扣,达到全程动态管理之目的.系统的前期运行证明卓有成效的科研管理是将人为影响因素降到最低,实现每个课题各阶段数据的连贯性、可重复性乃至整个过程的延续性.     

Measuring the performance of health care services: a review of international experiences and their application to urban contexts

BACKGROUND: The objective of performance assessment is to provide governments and populations with appropriate information about the state of their health care system. The objective of this paper is to present the most recent developments in performance assessment and their application in urban contexts. METHODS: Literature review in PubMed (1970-2004). We identified additional papers and grey literature from retrieved references. RESULTS: Performance assessment initiatives were identified in Australia, Canada, the United Kingdom, and New Zealand. The World Health Report 2000 is one of the best known examples of a transnational approach to performance assessment. CONCLUSION: The best developed initiatives to date are those that define precise categories, criteria and indicators with which to analyse and assess health care systems, based on a solid conceptual framework. Performance assessment fits perfectly in urban contexts, as it is a useful tool for designing and monitoring policies, assessing the quality of the services provided, and measuring the health status of city dwellers. Barcelona and Montreal are currently collaborating together on a project to assess the performance assessment of their respective health care services.     

儿童食品销售中营养素度量法的应用现况调查

目的对国际上儿童食品销售中营养素度量法的应用现状进行调查分析,为制定我国儿童食品销售的营养评价技术和方法提供基础。方法通过网络、会议、专家咨询和访谈等方式进行调查,并对收集的信息进行整理分析。结果调查结果显示,符合调查标准的营养素度量模型共有8个,其中由政府、NGO和企业制定的分别为3、2．3个,构建模型的指标营养素或食品类别、标准应用范围、计算单位、模型类型等各要素间存在多样性。结论NP模型作为儿童食品销售的良好评价工具和限制性措施,具有广泛应用的趋势。