重庆市九龙坡区流动性人口艾滋病综合干预模式实践与评价

目的探讨通过地区性干预模式的建立,达到控制艾滋病在流动人口中传播和蔓延的目的。方法建立一套以政府主导、多部门配合的流动人口艾滋病综合干预模式,实施多年的干预活动,结合定量调查和定性访谈,对干预效果和模式进行评价。结果经过5年的实践,地区性流动人口艾滋病综合干预模式得到建立,流动人口艾滋病知识知晓率得到提高,综合干预取得了一定的成效。结论以政府主导、多部门配合的流动人口综合干预模式取得了一些经验,可以推广。     

医院商务智能的移动趋势

信息时代下,为不断改善医疗服务质量,现代大型医院对获取信息的实时性要求越来越高,传统的信息平台已无法满足要求。在这种背景下,移动商务智能应运而生,其作为商务智能和移动设备的结合,使信息可随时随地获取,成为商务智能领域新的增长点和研究热点。随着未来越来越多的云计算应用,移动商务智能将完全改变每个人的工作模式。     

基于J2ME的多参数智能手机监护界面的设计

目的:本文采用J2ME技术设计一种穿戴式多参数智能手机监护界面.方法:系统在Wireless Toolkit模拟环境下进行了仿真实验,并结合穿戴式检测技术和GPRS技术实现多生理参数的远程监护.结果:系统可以实时检测心电、心率、血压、体温以及血氧饱和度,具有数据分析、异常报警等功能.最后将参数传至智能手持设备,并能与医疗服务中心站建立远程通信.结论:实验结果表明系统具有移植性强、简单易用、响应速度快等优点.本系统有望实现3G时代下的重大医疗应用并为远程医疗的进一步研究提供基础.     

Mobile and Fixed Computer Use by Doctors and Nurses on Hospital Wards: Multi-method Study on the Relationships Between Clinician Role,Clinical Task,and Device Choice

Background

Selecting the right mix of stationary and mobile computing devices is a significant challenge for system planners and implementers. There is very limited research evidence upon which to base such decisions.

Objective

We aimed to investigate the relationships between clinician role, clinical task, and selection of a computer hardware device in hospital wards.

Methods

Twenty-seven nurses and eight doctors were observed for a total of 80 hours as they used a range of computing devices to access a computerized provider order entry system on two wards at a major Sydney teaching hospital. Observers used a checklist to record the clinical tasks completed, devices used, and location of the activities. Field notes were also documented during observations. Semi-structured interviews were conducted after observation sessions. Assessment of the physical attributes of three devices—stationary PCs, computers on wheels (COWs) and tablet PCs—was made. Two types of COWs were available on the wards: generic COWs (laptops mounted on trolleys) and ergonomic COWs (an integrated computer and cart device). Heuristic evaluation of the user interfaces was also carried out.

Results

The majority (93.1%) of observed nursing tasks were conducted using generic COWs. Most nursing tasks were performed in patients’ rooms (57%) or in the corridors (36%), with a small percentage at a patient’s bedside (5%). Most nursing tasks related to the preparation and administration of drugs. Doctors on ward rounds conducted 57.3% of observed clinical tasks on generic COWs and 35.9% on tablet PCs. On rounds, 56% of doctors’ tasks were performed in the corridors, 29% in patients’ rooms, and 3% at the bedside. Doctors not on a ward round conducted 93.6% of tasks using stationary PCs, most often within the doctors’ office. Nurses and doctors were observed performing workarounds, such as transcribing medication orders from the computer to paper.

Conclusions

The choice of device was related to clinical role, nature of the clinical task, degree of mobility required, including where task completion occurs, and device design. Nurses’ work, and clinical tasks performed by doctors during ward rounds, require highly mobile computer devices. Nurses and doctors on ward rounds showed a strong preference for generic COWs over all other devices. Tablet PCs were selected by doctors for only a small proportion of clinical tasks. Even when using mobile devices clinicians completed a very low proportion of observed tasks at the bedside. The design of the devices and ward space configurations place limitations on how and where devices are used and on the mobility of clinical work. In such circumstances, clinicians will initiate workarounds to compensate. In selecting hardware devices, consideration should be given to who will be using the devices, the nature of their work, and the physical layout of the ward.     

应急机动卫勤分队136名队员心理应对机制的分析

目的了解应急机动卫勤分队队员心理应对机制的特点及应对方式与个性因素和心理健康水平的关系。方法采用临床症状自评量表（SCL-90）、卡特尔十六种个性因素问卷（16PZ）和简易应对方式问卷（SCSQ）对136名分队队员进行测试。结果应急机动卫勤分队队员积极应对和消极应对得分与全国常模比较均有非常显著差异,积极应对高于常模,而消极应对低于常模。积极应对与情绪稳定、有恒、敢为、忧虑、自律、紧张、适应焦虑、心理健康、专业成就和成长能力等因素相关,均达到显著水平（P〈0.05）以上。消极应对与情绪稳定、敢为、怀疑、忧虑、紧张、适应焦虑、内向外向、心理健康、专业成就、SCL-90总分和总均分等因素相关,达显著水平（P〈0.05）以上。结论应急机动卫勤分队队员应对方式成熟、积极,应对方式与某些个性因素及心理健康水平相关。     

机动卫勤分队组织与药材装备模块化

将模块化原理运用到机动卫勤分队的组织、药材装备建设上,是提高机动卫勤分队保障能力,遂行平、战时卫勤保障任务的需戛;按照伤病员救治的基本环节,建立单一功能的组织模块,实行人员模块化编成;在组织模块化的基础上,对品类繁多的药品、装备和器材按照功能进行模块划分,达到规范管理和高效利用的目的。     

无线移动技术在现代医院管理中的创新应用实践

将无线移动通信技术引入医院管理,目前已经成为国内外医院数字化建设的热点。我院较早在国内引入这一技术,并作了一系列探索与尝试,主要包括无线移动查房、无线移动护理、无线移动心电信息系统和无线移动资产管理等,在技术、功能、应用等方面进行了诸多创新,给传统的临床医疗、护理、医院管理等多个方面带来了较大的变革,对于提高医院的运营效率和服务质量,控制医疗缺陷,提高经济和社会效益有着十分突出的推广价值。     

便携式超声诊断仪在抗震救灾中的应用价值

目的：探讨便携式超声诊断仪在抗震救灾中的应用价值。方法：根据地震灾区的环境和伤情特点,使用索诺声180型便携式超声诊断仪协助临床医生诊断疾病．并对其优缺点进行评估。结果：便携式超声诊断仪除了在胸腹脏器损伤、结石,浅表小器官损伤,软组织损伤,四肢、血管损伤,妇产科疾病等诊断过程中发挥重大作用外,还在骨折、关节损伤、颅脑损伤、异物等常规条件基本不使用超声诊断的情况下非常规应用,并发挥了意想不到的作用。结论：便携式超声诊断仪优点突出,应用范围广,适用于抗震救灾等特殊环境下伤员的检诊工作。     

PDA在医院固定资产管理中的应用

介绍个人数字助理(PDA)在解放军第105医院固定资产管理信息系统的主要用途,包括对固定资产信息随时随地查看、提高固定资产盘点工作效率、协助医疗设备维护人员排除故障等。PDA的使用可以更加方便、准确、快捷地对固定资产进行查询、盘点,极大地方便了工作。同时还简述了使用第105医院自行开发的数据同步软件如何将PDA中的数据与HIS系统中的数据同步。这种数据的同步软件特别适用还没有上无线网络的医院。     

大型综合性医院实施电子病历的难点和对策

大型综合性医院组织架构层级复杂,管理制度严谨完善,业务流程纷繁多变,因此在实施电子病历的过程中要涉及多个部门,改变多个传统的业务流程,并力求满足管理人员及临床医务人员的工作需求,是医院信息化建设过程中较为困难的步骤。以中山大学附属中山医院为例,探讨了电子病历实施过程中的难点和解决对策。