麻醉科专科护士岗位胜任力评价指标体系的构建

目的 构建适合我国的麻醉科专科护士岗位胜任力评价指标体系,为麻醉科专科护士培养及评价提供参考.方法 通过文献回顾法、小组讨论法、德尔菲专家函询法以及层次分析法,确定麻醉科专科护士岗位胜任力各级评价指标及权重.结果 麻醉科专科护士岗位胜任力评价指标体系包含专业知识、专业技术、专业能力、管理能力和个人特质5项一级指标和38项二级指标.两轮函询专家积极系数分别为89.47％和94.12％,专家权威系数分别为0.865和0.889,肯德尔协调系数分别为0.182、0.237(均P＜0.01).结论 构建的麻醉科专科护士岗位胜任力评价指标体系,可作为麻醉科专科护士岗位胜任力水平的测评工具,为麻醉科专科护士培训、考核及任用提供参考.     

Sandwich联合案例教学法在神经内科临床实习中的应用

目的 探讨Sandwich联合以案例为基础的教学法在神经内科临床实习中的应用效果,为进一步优化教学方法提供参考.方法 以98名神经内科实习护理本科生为对象,按照实习病区分为对照组与观察组各49名.对照组采用传统教学法进行教学,观察组在对照组基础上采用Sandwich联合以案例为基础的教学法.出科前比较两组理论考试成绩及对教学方法的评价.结果 观察组理论考试成绩及教学满意评分显著高于对照组(P＜0.05,P＜0.01).结论 Sandwich联合以案例为基础的教学法可有促进学生对理论知识的掌握,提高教学效果.     

The associations of medical marijuana policies with opioid‐related health care utilization

ObjectiveTo examine the associations between medical marijuana policies and opioid‐related hospitalizations and emergency department visits.Data SourcesWe utilized quarterly rates of hospital discharge data from the Healthcare Cost and Utilization Project''s (HCUP) Fast Stats Database from 2005 to 2016 along with state‐level sociodemographic data from US Census Bureau and Bureau of Labor Statistics and opioid‐related state health policy data from publicly available sources for the analysis.Study DesignAnalyses were carried out using a difference‐in‐differences regression approach. We estimate heterogeneous effects of medical marijuana policies such as initial policy, presence of active dispensary, and home cultivation on opioid‐related hospitalizations and emergency department visits related to opioids.Data Collection/Extraction MethodsPublicly available secondary data were collected, linked, and analyzed. Observations with missing values for explanatory variables were excluded from the analysis.Principal FindingsRegression results indicate that type of medical marijuana policy has varying effects on opioid‐related hospitalizations and emergency department visits. States that allow home cultivation of medical marijuana experienced significant positive associations with opioid‐related hospitalizations and emergency department visits, while no effect was observed with medical marijuana dispensaries. Moreover, recreational marijuana policies were positively associated with opioid‐related hospitalizations.ConclusionsThe findings indicate that the effects of medical marijuana policies on opioid‐related hospitalizations and emergency department visits vary depending on the type of medical marijuana policy. Our findings indicate that the implementation of home cultivation of marijuana is positively associated with hospitalizations and emergency department visits related to opioids, suggesting that easier access to marijuana among opioid users may result in adverse health conditions that need treatment.     

手部肌腱吻合术后康复

目的作者自2000年初至2004年7月进行手部肌腱吻合120例,随访120例,手部肌腱吻合术后进行程序化的康复训练,方法肌腱吻合法均采用3-0或4-0聚丙烯单针缝线、改良的Bunnell、Kessler和肌腱编制缝合法,患者肌腱均为I期手术吻合,术后伤口I/乙愈合105例、II/乙15例,手部肌腱吻合术后均采用程序化的康复训练, 结果对手部肌腱吻合术后的患者进行程序化的康复训练,取得良好的效果. 结论本康复训练程序目前已逐渐形成我院的治疗常规,并逐步推广和普及.     

专科医院住院部各科医疗质量综合评价的初步探讨

目的：探讨专科医院住院各科工作情况综合评价方法,向临床科室提供医疗质量信息,促进医疗质量的提高。方法：以医院工作报表为数据来源,用秩和比法从诊疗质量,工作强度和经济效益三方面量化科室医疗质量考核指标。结果：综合数能更全面、有效、合理地评价住部各科医疗质量优劣等级,提出科室改进的指标。结论：此评价方法简便,实用,有利于深化院内改革,强化行政部门管理。     

Photodynamic therapy in the bladder: Can the light dose be easily quantified?

The shape of the bladder and the optical characteristics of the tissue within the wall can be shown to play an important role in the amount of light actually received at the wall. The use of estimated doses even assuming spherical geometry, cannot therefore be relied upon. This paper describes some experimental work carried out on a glass model that was used to simulate the bladder. A specially constructed dual detector was used which consisted of an isotropic probe and semiconductor detector. This enabled measurements of irradiance and space irradiance (light energy fluence rate) to be made simultaneously. By changing the optical characteristics of the wall a four-fold increase in space irradiance was measured. Contamination of the water contained within the model by blood was also investigated and has shown that with concentrations as low as 0.5% the delivered light dose reaching the wall can be reduced by up to 50% at a wavelength of 510 nm. Some in vivo measurements are also presented together with some comments on the difficulties that have been encountered when transferring measurements from the model to the patient.     

295例外科感染患者抗菌药物应用调查分析

目的：探讨医院外科感染病例抗菌药物应用情况.方法：对抗菌药物使用的种类、用药频度、联用、致病菌分离菌株的耐药情况等进行统计分析.结果：阿米卡星、氧氟沙星、甲硝唑、庆大霉素、青霉素、头孢噻肟、环丙沙星、头孢唑林、诺氟沙星、替硝唑的使用频度位居前10位；不合理用药类型主要有选药不当、给药时间不当等.结论：合理应用抗菌药物有利于整体医疗水平的提高,减少耐药菌株的产生.     

药物不良事件的防范研究

目的：探讨心内科病房药物不良事件(ADE)的防范特征。方法：由药师深入心内科病房，集中监测药物不良事件。主要监测内容是药物不良事件的存在与否，可否防范及严重程度。结果：5个月研究期间共鉴定ADE64次，其中28％可以防范。在重度ADE中，50．0％可防范；在中度ADE中，33．3％可防范；在轻度ADE中，可防范的比例最少，为13．6％。结论：药物不良事件中有相当一部分可以防范，而且越是严重的ADE就越有可能被防范。应该采取有效的措施来防范药物不良事件。