加强妇产科住院医师医学人文观培养

<正>住院医师规范化培训是医学生毕业后医学教育的重要组成部分,现在更成为国家层面调控的重大项目之一,但必须承认的是,无论是在培训内容、培训方式还是考核内容等方面,对住院医师医学人文观念的培养仍有很大欠缺~([1-2])。而妇产科又由于其本身的特殊性,对医师的人文素养要求更高。     

医用直线加速器的安全防护

医用直线加速器的安全防护一方面要确保加速器本身的安全运行，另一方面对相关操作人员及广大患者进行合理的防护。本文主要从机房的防护设计、辐射防护和非辐射防护三个方面阐述直线加速器安装、使用和维护过程中需要注意的一系列问题和应对方法。     

Evaluating the Health Information Technology Regional Extension Center in South Carolina

ObjectiveTo determine the impact of the South Carolina Regional Extension Center, Center for Information Technology Implementation Assistance (CITIA-SC), on physician practices engaged in the process of electronic medical record (EMR) adoption.Data sourcesData from a cross-sectional survey distributed in March 2011 to 1310 primary care practice groups throughout South Carolina was used to determine the degree of EMR adoption throughout the state (n=452 respondents; 34.5% response rate). Participation in CITIA-SC was determined by obtaining a list of practices from CITIA-SC.Study designA posttest-only design with nonequivalent groups was used to estimate the degree of EMR implementation, plans for and perceived barriers to implementation based on CITIA-SC participation.ResultsCITIA-SC practice sites faced similar barriers to EMR implementation as non-CITIA-SC participants, including initial or recurring cost of an EMR, low staff expertise with EMRs or computers, and productivity disruption. Additionally, CITIA-SC practice sites had fewer IT personnel on staff (p=0.0358) and were considering EMR implementation without a plan (p=0.0125). Despite these barriers, more practices participating in the CITIA-SC program were preparing to invest in an EMR system within one year when compared to nonparticipants (75.9% versus 28.3%, p<0.0001).ConclusionOur results indicated that the practice sites that participate in the REC had fewer IT resources and more perceived barriers to implementation. These results suggest that REC participant practice sites intend to implement an EMR, but recognize the need for technical assistance in the preparation and implementation of an EMR system.     

Ultrasound quality assurance and equipment governance

A case is presented to show the importance of good governance of ultrasound medical imaging equipment. Issues relating to the large numbers and diverse range of users and equipment are identified. Based on experience gained over 25 years, supporting upwards of 1000 systems, discussions consider why and how the testing of ultrasound systems should be approached by both the medical physics expert and end user. The management of the process is presented in the context of professional guidance and monitoring organisations’ standards are considered to give a suggested best practice.     

从中美电子病历标准的比较看中国电子病历标准的发展和完善

在借鉴美国电子病历标准基础上,对中美电子病历标准化的发展历史、现状和内容等进行分析比较,找出我国电子病历标准化存在的问题和解决方案,使我国的电子病历标准建设更加健康和规范。     

Evaluation of clinical and financial outcomes of a new no‐sting barrier film and barrier cream in a large UK primary care organisation

The study involves 95 subjects within a UK Primary Care Organisation and was undertaken in two arms. The objective was to determine the clinical outcomes and clinical acceptability of a newly available range of no‐sting barrier film and no‐sting barrier cream products offering significant financial benefits. The importance of undertaking this study is underpinned by evidence in the literature relating to the use of no‐sting barrier preparations within clinical practice. The first part of the study (arm 1) involved extensive evaluation of either the film or cream barrier in 36 patients and was compared to existing standardised barrier protection care within the organisation. The results indicated that the new product range met all the criteria for formulary inclusion and following this the barrier range was further evaluated in arm 2, 33 patients with barrier cream and 26 patients with barrier film. The entire study was conducted over a 3‐month period with patient treatment lasting a minimum of 2 days to a maximum 4‐week period adhering to the agreed evaluation protocol as approved by clinical governance. In arm 1 (n = 36), the clinical expectation of the product was met in 32 cases relating to ease of use, conformability, no‐sting, quick drying, ease of absorption, compatibility with devices, frequency of application, prevention and management including visual skin improvement resulting in a recommendation for formulary listing in 31 of 36 cases. In arm 2 (n = 59), barrier film and barrier cream performance was consistently rated same as, better than or much better than the existing barrier used. A formulary listing recommendation was made in 51 of 59 cases.