一体化门诊信息系统的设计与应用

系统介绍了医院在转变传统服务观念的基础上。利用信息技术引入优化业务流程理论,建设以病人为中心的一体化门诊信息系统。对门诊的业务流程进行充分优化。以求得医院门诊在服务效率、服务质量和服务成本等方面的进一步改善。门诊信息化是门诊流程再造的重要基础,流程再造不能离开信息技术的支持,探讨了提高门诊信息化水平和优化门诊流程的具体方法。     

医学生全程临床能力培养的探索和实践

临床医学是一门实践性很强的专业,由于传统教学模式的局限,医学生临床能力培养尚存在不足。文章借鉴国外临床实践教学的经验并总结自身实践情况,提出从整合课程模式、应用先进的教学方法、加强医学生人文素质培养等方面着手提高医学生临床综合能力。     

关于当前神经外科临床教学中几个问题的思考

现行高等医学教育中,神经外科学的教学工作仍然存在着课程内容单薄、教学时数少、教学效果差等诸多问题。文章就当前神经外科临床教学中存在的几个问题谈一点看法和对策。     

2004-2006年高平市娱乐场所暗娼性病艾滋病监测

[目的]了解高平市娱乐场所暗娼梅毒、艾滋病病毒（HIV）感染现状及相关高危行为情况,为制定艾滋病综合防控措施提供依据。[方法]2004-2006年对本市63家娱乐场所的904名暗娼采用一对一面对面问卷调查,并采集静脉血进行HIV抗体、梅毒血清学检测。[结果]2004～2006年共监测暗娼904人,检出梅毒抗体阳性者2例,阳性率为0．22％;未检出HIV抗体阳性者。其中,2004年检测296人,检出梅毒抗体阳性者2例;2005年检测305人,2006年检测303人。暗娼平均年龄24．48岁,文化程度以初中为主,占74．89％。暗娼中无注射吸毒者,最近一次接客时安全套使用率与最近1个月内接客时安全套使用率,3年间的差异均有统计学意义（P〈0．01）。[结论]高平市HIV感染率保持低流行水平,但仍需加强健康教育、100％安全套推广和行为干预。     

胰岛细胞瘤12例诊治分析

目的探讨胰岛细胞瘤的临床特征、治疗方法。方法对我院2005年到2009年收治的12例胰岛细胞瘤的临床表现、检查方法和治疗结果进行回顾分析。结果本组经手术切除病理证实胰岛素瘤11例,恶性非功能性胰岛细胞瘤1例。肿瘤位置:胰头1例,胰颈3例,胰体4例,胰体尾交界处4例,胰尾2例。12例均施行手术治疗,行胰体尾切除术5例,肿瘤局部切除术7例。功能性胰岛细胞瘤术后血糖上升为5.5~11mmol/L,非功能性胰岛细胞瘤患者术后腹痛症状消失。12例均治愈出院,无手术死亡。结论胰岛细胞瘤主要是胰岛素瘤和无功能胰岛细胞瘤,可行单纯肿瘤切除或胰腺部分切除。     

基本病种和基本诊疗项目界定研究：珠海市经验

目的:对珠海市医疗机构门诊就诊的基本病种及基本诊疗项目进行界定。方法:采用分层抽样和德尔菲法(Delphi Method)对基本病种及基本诊疗项目进行分析。结果:1)门诊病种有146种,分布较广,三个区门诊主要为上呼吸道感染,占26%～40%;2)诊疗项目1864项,总使用频数563633;对使用频数前200位的项目进行分类、汇总合并、排序。结论:基本病种为83种,基本诊疗项目为53项。     

临床护理程序信息系统研究与设计

分析了当前护理信息化的现状、存在的问题及开发护理程序信息系统的必要性,介绍了护理程序的基本概念及内容.详细论述了护理程序信息系统研究、设计思路和实现方法.护理程序信息系统的应用辅助护理人员实现了入院评估、护理诊断、制定护理计划与措施,护理效果评价的全过程,对于进一步提高护理工作效率,促进护理工作决策、科研和质量控制具有重要意义.     

性病门诊患者隐私保护需求调查分析与对策

目的了解性病门诊患者隐私保护需求状况,以采取相应的护理措施。方法发放问卷调查表,对300例性病门诊患者的隐私需求进行调查。结果绝大部分患者认为在就诊、病史采集、体检和护理操作、检查单保管等过程中隐私可能被泄露,从而出现不同程度的心理反应。结论医护人员应增强法律意识,采取多种措施,做好患者的隐私保护,从而使患者做出正确的就医选择,有效地控制社会上的性病传播。     

Evaluation of haptotherapy for patients with cancer treated with chemotherapy at a day clinic

OBJECTIVE: The purpose of this study was to evaluate a haptotherapeutic treatment and its effects on the perceived well-being of patients with cancer treated with chemotherapy in day care. METHODS: The study had a pre-test-post-test semi-experimental design, with 31 patients in the intervention group and 26 in the control group. Patients in the control group were matched with patients in the experimental condition with respect to age, gender, type of cancer, type of chemotherapy, prognosis and the period between pre- and post-test. Standardized questionnaires were used measuring perceived well-being and satisfaction with care (haptotherapy). Indicators of well-being measured were quality of life, mood, meaning in life, general functioning, physical and psychological symptoms, sleep quality and body awareness. The intervention consisted of five haptotherapy sessions of 45 minutes each. Patients in the control condition received standard medical care. RESULTS: Patients were highly satisfied with the haptotherapy treatment, and especially valued the personal attention and the relaxation they experienced. The haptotherapy treatment improved both the perceived general quality of life and the perceived cognitive and social functioning of patients. No improvement was found for mood, meaning in life, general functioning, physical symptoms, sleep quality and body awareness. CONCLUSION: It may be concluded that haptotherapy positively contributes to several indicators of perceived well-being of patients with cancer during the period they receive chemotherapy. More rigorous experimental studies are necessary in this field, especially concerning randomization, number of participants and homogeneity of the sample. PRACTICE IMPLICATIONS: Haptotherapy as a type of complementary medicine is a potentially valuable and effective intervention to raise the well-being of patients with cancer undergoing invasive treatments like chemotherapy.     

Pharmacy students provide care comparable to pharmacists in an outpatient anticoagulation setting

Objective

To evaluate whether student participation in ambulatory clinics influenced the percentage of therapeutic international normalized ratio (INR) results among patients on chronic warfarin therapy.

Methods

Medical records in outpatient anticoagulation clinics managed by pharmacists under physician protocol were reviewed retrospectively in 2 university-affiliated clinics in Amarillo and Lubbock, TX. Pharmacy student activities included patient interviews, vital sign measurements, fingersticks, counseling, and documentation. Patient visits were conducted by a precepted pharmacy student or a pharmacist without a student, and the INR was measured at the subsequent patient visit.

Results

Records of 1,958 anticoagulation patient visits were reviewed; 865 patients were treated by pharmacists, and 1093 were treated by precepted students. The follow-up INR was therapeutic for 48.5% of third-year (P3) students'' patients, 45.6% of fourth-year (P4) students'' patients, 51.2% of residents'' patients, and 44.7% of pharmacists''s patients (p = 0.23). Eight variables were associated with the follow-up INR (baseline INR, warfarin noncompliance, held warfarin doses, a warfarin dosage adjustment, diet change, alcohol use, tobacco use, and any medication changes).

Conclusion

Student participation in the patient-care process did not compromise patient care and no significant difference in patient outcomes was found between patients in an anticoagulation clinic cared for by precepted students and those cared for by pharmacists.