Association of self-reported alcohol use and hospitalization for an alcohol-related cause in Scotland: a record-linkage study of 23 183 individuals

Aims To investigate the extent to which self‐reported alcohol consumption level in the Scottish population is associated with first‐time hospital admission for an alcohol‐related cause. Design Observational record‐linkage study. Setting Scotland, 1995–2005. Participants A total of 23 183 respondents aged 16 and over who participated in the 1995, 1998 and 2003 Scottish Health Surveys, followed‐up via record‐linkage from interview date until 30 September 2005. Measurements Rate of first‐time hospital admission with at least one alcohol‐related diagnosis. Cox proportional hazards regression analysis was applied to estimate the relative risk of first‐time hospitalization with an alcohol‐related condition associated with usual alcohol consumption level (1–7, 8–14, 15–21, 22–35, 36–49, 50+ units/week and ex‐drinker, compared with <1 unit per week). Findings Of the SHS participants, 527 were hospitalized for an alcohol‐related cause during 135 313 person‐years of follow‐up [39 first admissions per 10 000 person‐years, 95% confidence interval (CI) 36–42]. Alcohol‐related hospitalization rates were considerably higher for males (61/10 000 person‐years, 95% CI 54–67) than for females (22/10 000 person‐years, 95% CI 18–26). Compared with the lowest alcohol consumption category (<1 unit per week), the relative risk of first‐time alcohol‐related admission increased with reported consumption: age‐adjusted hazard ratios ranged from 3 (1–5) for 1–7 units/week to 19 (10–37) for 50+ units/week (males); and from 2 (1–3) for 1–7 units/week to 28 (14–56) for 50+ units/week (females). After adjusting for age and usual alcohol consumption, the relative risk of first‐time alcohol‐related admission remained significantly higher for males reporting binge drinking and for both males and females residing in the most deprived localities. Conclusions Moderate and higher levels of usual alcohol consumption and binge drinking are serious risk factors for alcohol‐related hospitalization in the Scottish population. These findings contribute to our understanding of the relationship between alcohol intake and alcohol‐related morbidity.     

Professional Commitment, Patient Safety, and Patient-Perceived Care Quality

Purpose: To examine how professional commitment influences patient safety and patient-perceived care quality.
Design: Investigators for this study used a cross-sectional design with questionnaires. A total of 348 pairs of nurses and inpatients were contacted at two medical centers in Taiwan during the period from August 2007 to January 2008, yielding 284 pairs of completed questionnaires.
Methods: Frequencies of six adverse patient events were used to measure patient safety; and the Service Quality Scale was used to measure patient-perceived care quality. Four items of the Professional Commitment Questionnaire were used to measure professional commitment. Regressions were used for the analyses.
Findings: Professional commitment positively influenced overall patient safety (ß=.19, p =.00) and overall patient-perceived care quality (ß=.13, p =.03). Furthermore, professional commitment positively influenced all patient safety indicators (ß≥.12, p ≤.04), except frequency of nosocomial infections, the coefficient of which reached borderline significance (ß=.11, p =.07). Professional commitment also positively influenced care quality in terms of responsiveness (ß=.16, p =.01) and empathy (ß=.14, p =.03).
Conclusions: Professional commitment may enhance patient safety and patient-perceived care quality.
Clinical Relevance: This study indicates that nurse professional commitment can enhance patient safety and patient-perceived care quality.     

利用合理用药监测系统促进用药安全及对合理用药监测系统的评价

目的调查并评价合理用药监测系统在临床的使用。方法利用系统查询统计程序,分析我院限定时间内问题医嘱构成、频率和涉及药品等。结果共审查出1 564 337条问题医嘱,其中黑、红2色超过15%,80%以上为配伍禁忌和药物相互作用;重症病房黑、红2色问题医嘱发生率居一级科室首位,平均2条·床~(-1)·d~(-1);阿托品和苯巴比妥注射液居黑色配伍禁忌首位,地高辛与含钙注射液、螺内酯与氯化钾分居黑、红2色药物相互作用首位;儿童警告占全部问题医嘱的1.09%(17 055条),金霉素眼膏居首位。结论合理用药监测系统有助于发现问题医嘱,促进用药安全,但是有诸多问题急需改进。     

传染病医院开展临床药学工作的实践与体会

目的:建立健全传染病医院临床药学服务体系。方法:介绍我院临床药学工作模式。结果与结论:我院通过对门诊患者和住院患者分别进行药学服务,包括构建信息化系统、设立门诊咨询室、建立门诊患者药历,以及药师深入临床查漏补缺、收集药物资料为医师和患者举办药物知识讲座、深入开展药品不良反应监测、制定个体化用药方案等,使我院合理用药水平得到了进一步提升。     

实施零库存理念管理模式,优化医院药库工作流程

目的:为医院药库实施零库存理念管理提供参考。方法:以我院药库管理经验为蓝本,探讨实施零库存理念管理的模式。结果与结论:我院药库实施零库存理念管理模式后,药品周转次数达每季度8~9次,大大降低了药品的储存成本,极大地盘活了流动资金,使我院药品资金降至仅占医院流动资金的15%左右。因此,建立适合院情的库存管理模式,应用零库存理念管理医院药库,对降低医院运营成本、提高工作效率具有重大意义。     

基层医院白内障超声乳化手术转型分析

目的:探讨基层医院白内障从现代囊外摘除术(ECCE)到超声乳化术(phacoemulsification)的过渡.方法:对有ECCE手术经验的医生,通过130眼动物实验后,进行100例老年性白内障Phaco带教培训.结果:术后1d视力≥0.3者94%,≥0.5者83%;术后3mo视力≥0.3者96%,≥0.5者90%,人工晶状体植入率100%,无角膜失代偿、核坠落、视网膜脱落等严重并发症,实现了从ECCE到Phaco的安全过渡.结论:基层医生只要以严谨、积极的科学态度进行学习,有扎实的显微手术基础,严格选择病例,配以良好的设备,强调规范化操作,同样能成功地完成转化过程,开展较高质量的白内障超声乳化手术.     

基层医院与白内障防盲手术车的协作体会

目的:探讨基层医院与白内障防盲手术车的协作.方法:对本院2004/2006组织783例白内障患者在防盲手术车行手术进行总结.结果:累计30个工作日内,一台手术车,一个主刀医师顺利完成783例白内障手术,术后1d视力≥0.5者744例(95.0%).除1例并发视网膜脱离,2例并发糖尿病视网膜病变,10例先天性白内障手术效果较差外,99.0%均视力有明显改善.结论:基层医院在术前有效地组织,术后护理及合理用药作好相应工作,能协助防盲手术车有序、高效运行,并取得良好的手术效果.     

实行人本管理加强院前急救队伍建设

探讨针对院前急救的行业特点实行人本管理的新思路.从正反两个方面分析实行人本管理的重要性和必要性.坚持以人为本的管理理念,加强院前急救队伍建设,提高院前急救能力,为保障人民健康服务.     

加强医院文化建设提高医疗服务水平

探讨医院文化建设问题,总结分析县医院文化建设的实践经验,提出以医院文化建设提高医疗服务水平.     

药学服务和信息化背景下的新观点:构建医院药学信息系统

目的:论证医院药学信息系统的新观点。方法:剖析药学服务和信息化背景下,医院信息系统和医院药学发展历程,分析医院药学信息化建设的新需求。结果:传统管理信息系统将面临因业务重组和学科快速转型而淘汰的风险,如果延续部门级或局域的业务管理信息系统概念和模型,将弱化医院药学学科发展目标,无法适应向以病人为中心的药学服务模式转变。结论:有必要提出全局性的医院药学信息系统新观点,以适应学科和社会的快速发展。