Assessing clinical handover between paramedics and the trauma team

Introduction

The aim of effective clinical handover is seamless transfer of information between care providers. Handover between paramedics and the trauma team provides challenges in ensuring that information loss does not occur. Handover is often time-pressured and paramedics’ clinical notes are often delayed in reaching the trauma team. Documentation by trauma team members must be accurate. This study evaluated information loss and discordance as patients were transferred from the scene of an incident to the Trauma Centre.

Methods

Twenty-five trauma patients presenting by ambulance to a tertiary Emergency and Trauma Centre were randomly selected. Audiotaped (pre-hospital) and videotaped (in-hospital) handover was compared with written documentation.

Results

In the pre-hospital setting 171/228 (75%) of data items handed over by paramedics to the trauma team were documented and in the in-hospital handover 335/498 (67%) of information was documented. Information least likely to be documented by trauma team members (1) in the pre-hospital setting related to treatment provided and (2) in the in-hospital setting related to signs and symptoms. While 79% of information was subsequently documented by paramedics, 9% (n = 59) of information was not documented either by trauma team members or paramedics and constitutes information loss. Information handed over was not congruent with documentation on seven occasions. Discrepancies included a patient's allergy status and sites of injury (n = 2). Demographic details were most likely to be documented but not handed over by paramedics.

Conclusion

By documenting where deficits in handover occur we can identify points of vulnerability and strategies to capture this information.     

Use of the Internet by burns patients, their families and friends

INTRODUCTION: The Internet has also become an increasingly important source of health-related information. However, with this exponential increase comes the problem that although the volume of information is huge, the quality, accuracy and completeness of the information are questionable, not only in the field of medicine. Previous studies of single medical conditions have suggested that web-based health information has limitations. The aim of this study was to evaluate Internet usage among burned patients and the people accompanying them to the outpatient clinic. METHODS: A customised questionnaire was created and distributed to all patients and accompanying persons in the adult and paediatric burns clinics. This investigated computer usage, Internet access, usefulness of Internet search and topics searched. RESULTS: Two hundred and ten people completed the questionnaire, a response rate of 83%. Sixty three percent of responders were patients, parents 21.9%, spouses 3.3%, siblings, children and friends the remaining 10.8%. Seventy seven percent of attendees had been injured within the last year, 11% between 1 and 5 years previously, and 12% more than 5 years previously. Seventy four percent had computer and Internet access. Twelve percent had performed a search. Topics searched included skin grafts, scarring and scar management treatments such as pressure garments, silicone gel and massage. DISCUSSION: This study has shown that computer and Internet access is high, however a very small number actually used the Internet to access further medical information. Patients with longer standing injuries were more likely to access the Internet. Parents of burned children were more frequent Internet users. As more burn units develop their own web sites with information for patients and healthcare providers, it is important to inform patients, family members and friends that such a resource exists. By offering such a service patients are provided with accurate, reliable and easily accessible information which is appropriate to their needs.     

认知行为干预及信息支持对先兆流产产妇心理状况及分娩结局的影响

目的：探析认知行为干预及信息支持对先兆流产产妇心理状况及分娩结局的影响。方法整群选取2015年1月―2016年1月在该院治疗的124例先兆流产产妇随机分为研究组和对照组,每组62例,对照组患者予以常规护理,而研究组患者在此基础上加强认知行为干预及信息支持,对比干预前后两组患者的焦虑、抑郁评分以及分娩结局。结果干预后,研究组产妇焦虑评分为(47.9±4.3﹚分,抑郁评分为(44.7±3.8﹚分;对照组产妇焦虑评分为(52.9±4.1﹚分,抑郁评分(54.2±4.1﹚分。研究组产妇焦虑、抑郁评分均明显低于对照组,且研究组的保胎成功率(93.55%﹚也显著高于对照组(80.56%﹚,差异均有统计学意义(P<0.05﹚。结论认知行为干预及信息支持能有效缓解先兆流产产妇紧张、焦虑等不良情绪,提高保胎成功率。     

3种现代医院图书馆服务平台功能比较

探讨目前流行的3种网络信息交流工具——博客、微博和微信,比较分析其在医院图书馆发展中的作用及其特征。指出医院图书馆应根据自身需要应用这些交流工具开展相应服务,为用户搭建互动交流平台,促进服务质量的提高。     

医院虚拟化云平台构建研究

介绍医院虚拟化云平台的概念和特点,着重探讨此平台的整体架构及物理架构,整体架构由基础设施层、虚拟化层、平台管理层和平台服务层组成,物理架构分为存储池、SAN网络池、计算内存池、高速网络池和服务应用池,最后阐述构建该平台时应注意的问题。     

北京协和医院“申请-考核”制博士招生工作改革实践

目的分析北京协和医院招生模式从"统一招生考试"变为"申请-考核"制后的博士招生工作情况,并对招生工作进行梳理和总结。方法收集整理2016年按照"统一招生考试"和2017、2018年按照"申请-考核"制两种不同招生方式中的考生信息,进行比较;利用自拟问卷,调查2018级博士对"申请-考核"制工作的看法;使用Excel 2016录入数据,进行描述性统计分析;利用SPSS 20.0对定量资料行卡方检验、t检验。结果自2016年以来,报考北京协和医院的学生总量呈下降趋势,考生年龄也呈年轻化趋势。但考生的性别、生源、硕士期毕业学校之间差异不存在统计学意义。仅2017与2018年报考我院应届生和往届生情况差异有统计学意义(P=0.025)。问卷结果显示,学生对协和医院的"申请-考核"制工作满意度高(82.54%,52/63);90.00%以上的学生赞同目前设立的招生评价各项指标;有85.71%(54/63)的学生建议专业型和学术型博士研究生可采用不同的招生评价指标,以全面反映考生专业素质和培养潜力。结论招生模式从"统一招生考试"转变为"申请-考核"制,对报考协和医院的考生影响不大。在推行"申请-考核"制过程中,北京协和医院教育管理部门在制度建设和规范流程上作了积极探索,并监督整个招生过程;赢得了考生的信赖与认同,该项工作的学生满意度高。     

医院图书馆对新型冠状病毒肺炎的信息资源推介

医院是抗击新型冠状病毒肺炎的第一线,医院图书馆通过梳理世界卫生组织和各国疾控中心、卫生部发布的新型冠状病毒肺炎指南,整合国内外主要数据库和期刊的新冠肺炎专题,及时、有效、精准地开展信息推介服务,在新冠肺炎疫情时期,对医务及科研人员抗击新冠肺炎疫情工作的开展具有非常重要的意义和循证医学的价值。     

高校图书馆重大公共卫生事件应急响应服务策略

对42所“双一流”建设高校图书馆在新冠肺炎疫情期间的应急响应速度和响应内容进行了调研，结合教育部高校图工委网站的各省市高校图书馆新冠肺炎疫情防控调研报告及中国医科大学图书馆的实际工作，总结了高校图书馆应对重大公共卫生事件的应急服务经验，提出了疫情期间图书馆“云”信息服务和情报决策支撑服务策略，为高校图书馆对突发公共卫生事件的快速响应提供参考借鉴。     

中美两国公众健康信息网站对比分析及启示

本文以中国公众健康网(CHealth)和国际上最具影响力的公众健康网站MedlinePlus_?为对象,从健康信息权威性、资源建设、信息组织与利用、网站设计几方面对两网站做比较分析,并提出几点建议,以期为我国公众健康网站建设提供有价值的参考。     

航空医学知识服务的挑战与对策

【】信息技术的发展为图书馆的信息服务赋予了新的形式和内涵,加速了图书馆个性化、知识化服务的进程。本文分析了航空医学知识服务的现状及面临的保密要求、信息获取、团队建设等主要难题,探讨了实践知识化服务应采取的方法与策略,如深入了解航空医学科研核心任务、利用开放获取资源、进行纸本资源的数字化,借助信息技术实现资源的知识组织与揭示等。