临床论坛中医护理适宜技术的应用与实践

张掖市人民医院中医科护理工作注重整体护理及辩证施护,依托中医护理特色和优势,积极探索开展拔罐、刮痧、灸法、中药离子导入、隔物灸等中医护理技术操作,实现了社会效益和经济效益双赢。进一步总结经验,从开展护理技能竞赛,严格落实护理制度,加强护理技术教育培训方面加强中医护理适宜技术的应用与实践。     

陕西省消除疟疾全球基金项目实施效果评价

目的 目的 评价陕西省消除疟疾全球基金项目的实施效果, 为科学实施消除疟疾行动计划及考核评估工作提供参考依据。方法 方法 收集整理2010-2012年陕西省27个全球基金疟疾项目县疟疾防治工作资料并进行统计学分析, 评价陕西省消除疟疾全球基金项目的实施效果。结果 结果 2010-2012年陕西省全球基金项目实施地区共报告疟疾病例64例, 年均发病率为0.15/10万, 发病率呈逐年下降趋势; 病例感染地来源以境外输入性为主, 占总病例数的79.69%;“三热” 病人血检工作完成率为94.14%, 血检工作开展范围扩大到88个县 （含61个三类县）; 疟防知识和技能培训覆盖率达到100%, 中小学生和居民疟防知识知晓率分别为91.68%和89.44%; 病例诊断后24 h内网络报告、 个案调查和疫点处置、 实验室检测和确诊等病例管理能力显著提高。结论 结论 全球基金疟疾项目的实施加速了陕西省消除疟疾工作的进程, 项目实施地区的疟疾防治工作能力得到显著提升。     

An implementation study of neonatal hearing screening in the Netherlands

The objective of this study was to investigate whether universal neonatal hearing screening could be integrated in the youth health care program. The screening was performed by nurses of the well baby clinics. A three stage transient evoked otoacoustic emission screening was performed in three different screening settings in order to study the most effective set up regarding participation, refer rates, and costs. In one setting parents visited the well baby clinic, and in two settings babies were screened at home (either in combination with the screening for metabolic diseases or during an intake visit). Screening was performed on 3114 healthy newborns. The setting where universal neonatal hearing screening is integrated with the screening for metabolic diseases, proved to be most efficient and effective. The participation rate of 88.9% was highest in this setting and the overall refer rate (1.4%) was the lowest. The implementation of universal neonatal hearing screening by the well baby clinic nurses was judged to be possible. The results of this study formed the basis for nationwide implementation.     

河南省基层医疗卫生机构实施国家基本药物制度情况的调查分析

目的:为进一步完善国家基本药物制度提供参考。方法:自行设计调查问卷,在6所国家基本药物制度试点乡镇卫生院进行问卷调查,共发放问卷100份,了解实施该制度存在的问题及改进建议。结果:共收回有效问卷83份。统计结果表明,基层医务人员对国家基本药物制度相关知识及政策了解不够,基本药物目录内药品不能满足基层临床需求、基本药物不能保障供应等问题影响了基本药物在基层医疗卫生机构的使用。结论:要顺利实施国家基本药物制度,需要加强基本药物相关知识和政策的宣传,根据各地情况适当增补一些临床必需的品种,完善标准规范的临床路径或指南,保障基本药物的供应。     

Fracture liaison programs

In view of the high imminent risk of having subsequent fractures after a fracture, early evaluation and treatment decisions to prevent subsequent fractures are advocated. After a hip fracture, the fracture liaison service (FLS) and orthogeriatric care are considered the most appropriate organisational approaches for secondary fracture prevention following a recent fracture.Their introduction and implementation have been shown to increase evaluation and treatment of patients at high risk for subsequent fracture. Of real-world cohort studies, most, but not all studies, indicate a lower incidence of fracture and longer survival after treatment with nitrogen-containing bisphosphonates.     

Using an action research process in pharmacy practice research—A cooperative project between university and internship pharmacies

BackgroundAction research (AR) is a common research-based methodology useful for development and organizational changes in health care when participant involvement is key. However, AR is not widely used for research in the development of pharmaceutical care services in pharmacy practice.ObjectivesTo disseminate the experience from using AR methodology to develop cognitive services in pharmacies by describing how the AR process was conducted in a specific study, and to describe the outcome for participants.MethodsThe study was conducted over a 3-year period and run by a steering group of researchers, pharmacy students, and preceptors. The study design was based on AR methodology. The following data production methods were used to describe and evaluate the AR model: documentary analysis, qualitative interviews, and questionnaires.ResultsExperiences from using AR methodology and the outcome for participants are described. A set of principles was followed while the study, called the Pharmacy-University study, was being conducted. These principles are considered useful for designing future AR studies. Outcome for participating pharmacies was registered for staff-oriented and patient-oriented activities. Outcome for students was practice as project leaders and enhancement of clinical pharmacy-based skills. Outcome for researchers and the steering group conducting the study was in-depth knowledge of the status of pharmacies in giving advice to patient groups, and effective learning methods for students.ConclusionDeveloping and implementing cognitive pharmaceutical services (CPS) involves wide-reaching changes that require the willingness of pharmacy and staff as well as external partners. The use of AR methodology creates a platform that supports raising the awareness and the possible inclusion of these partners. During this study, a set of tools was developed for use in implementing CPS as part of AR.     

Implementing a Pharmacy System: Facilitators and Barriers

To describe facilitators and barriers to the implementation of an inpatient pharmacy system at two pediatric hospitals. Interviews, pre- and post-implementation, were conducted with pharmacy and clinical managers. Key findings from the pre-implementation survey were included in the post-implementation survey to further assess facilitators and barriers to the adoption of a pharmacy system. The majority of pharmacy participants and all clinical leaders believed that project goals were being met. Pharmacist’s described staff readiness-to-change as the most significant facilitator to adoption and concerns with the usability of information in the pediatric drug file as the most significant barrier. Clinical managers described system training and education as the most significant facilitator to adoption and adjustment to new work processes as the most significant barrier. We described major facilitators and barriers to the adoption of an inpatient pharmacy system at two pediatric hospitals. Strategies identified by our informants to overcome barriers may promote successful pharmacy implementations at other pediatric facilities.     

Neonatal intensive care nurses’ perceptions of implementing parent discharge preparation tools

BackgroundStandardized tools for discharge education can facilitate transitions from the neonatal intensive care unit to home. Perceptions of nurses regarding parental discharge preparation and relevant tools can inform implementation.PurposeTo describe nurses’ perceptions of discharge preparedness and implementation of a standardized tool to facilitate nurse-parent engagement in discharge education.MethodsWe conducted semi-structured interviews with seven nurses meeting eligibility criteria. Interviews were conducted using an interview guide developed for this study and were audio-recorded, transcribed verbatim, and thematically analyzed.ResultsThree major themes emerged: 1) Discharge Education is an Ongoing and Evolving Process; 2) Nurse-Parent Partnerships; and 3) Importance of Context to Implementation of Standardized Tools. Sub-themes emerged from the data to support each major theme.ConclusionStandardized tools can improve parent discharge preparedness and implementation of these tools is facilitated by well-described processes, partnerships between nurses and parents, and tailoring to the unit context.