目标性培训在消毒供应中心培训中的应用

目的 探讨目标性培训方法在消毒供应中心岗位人员器械培训中的应用效果。方法 本研究为随机对照试验。选取2021年4月至7月在揭阳市人民医院消毒供应中心从事手术组工作的 20名 33～45岁女性岗位人员作为培训对象，采用随机数字表法将其分为对照组和观察组，各 10名。 对照组应用传统的培训方法，观察组应用目标性培训方法。培训后比较两组人员操作技能考核成绩、 培训满意度、负责清洗包装腹腔镜基础器械包的清洗质量和包装质量合格率。符合正态分布的计量资料采用均数±标准差（xˉ ± s）表示，组间比较采用独立样本t检验；计数资料采用例数或率（%）表示， 组间比较采用卡方检验；P＜0.05为差异有统计学意义。结果 观察组考核成绩、培训满意度及其负责清洗包装的腹腔镜基础器械包清洗质量、包装质量合格率明显高于对照组［（90.2±6.1）分比（77.0± 7.5）分、（90.0±6.0）分比（72.1±9.8）分、487（97.4%）比453（90.6%）、492（98.4%）比472（94.4%）］，差异有统计学意义（均P＜0.05）。结论 在消毒供应中心岗位人员器械培训时应用目标性培训方法，可有效提高岗位人员考核成绩及培训满意度及其负责清洗包装的腹腔镜基础器械包清洗质量、包装质量合 格率，保障患者安全。     

Assessing care-givers’ satisfaction with child immunisation services in Zambia: Evidence from a national survey

AimThe main aim of this study was to assess care-giver satisfaction with vaccination services in public health facilities in Zambia, and examine its determinants.MethodsThis study used data from a recent population-based household survey, conducted from May to August 2015. Respondent satisfaction with vaccination services received during the last visit was measured on a five point Likert scale ranging from 1 to 5. We used an ordered logistic regression model to analyse the significance of perceived quality of vaccination services, immunisation delivery mode and a range of individual characteristics in predicting care-giver satisfaction.ResultsFindings show that one in five care givers were unsatisfied with the vaccination services that they had received, with rural populations showing a significantly higher level of satisfaction. Poor quality of care, defined by long waiting times, poor quality of communication between health staff and care givers, long distance to vaccination sites, mode of delivery, and personal characteristics were among major factors driving care-giver satisfaction ratings. We also find that receiving a vaccination at outreach mode of delivery was associated with higher odds of greater satisfaction compared to on-facility vaccination services. The odds of satisfaction were lower for respondents living further away from a health facility, which emphasizes the importance of access in seeking vaccination services.ConclusionThese findings suggest that major improvements in quality of vaccination and service organisation will be needed to increase client satisfaction and service utilisation.     

安全护理管理中应用根本原因分析法的研究

目的探讨在安全护理管理中应用根本原因分析法的效果。方法选取我院60例护理缺陷事件,应用根本问题分析法(RCA法)找出问题发生的根本原因,再针对问题拟定、落实相应的改进措施。结果 60例护理缺陷事件中有43例(71.7%)为系统原因,17例(28.3%)为非系统原因。实施RCA后,病区患者的响铃率显著低于实施前(P<0.05);实施后的患者满意度(97.8%)显著高于实施前(82.2%),P<0.05,差异具有统计学意义。结论在安全护理管理工作中,应用RCA法可有效提高临床护理工作的质量,增强护理安全性,提升患者满意度,值得推广应用。     

Contraception des femmes françaises de 15 à 45 ans : enquête nationale sur un échantillon représentatif de 5963 femmes

ObjectivesTo describe French women's use of contraceptive methods and study their satisfaction and expectations about contraception.Patients and methodsA survey carried out by mail questionnaire filled in by a representative sample group of French women aged 15 to 45 years (Panel Postal Metascope TNS Sofres) in June 2007.ResultsOf 10,000 questionnaires sent out, 6044 questionnaires were returned, of which 5963 were usable. Seventy-three percent of women surveyed used some method of contraception, of which 46% was an oral contraceptive, 15% an IUD and 7% used condoms. A minority used new contraceptive methods (implant, patch, vaginal ring). The average age at first sexual relationship was 17.8 years. It was 18.5 among 40–45-year-olds and gradually reduced to 16.7 in the under 25-year-olds. Twenty-three percent of pregnancies remain unwanted and unplanned. For 96% of patients, the choice of contraception was considered to be important. Thirty-six percent thought that contraception could be harmful to health. Only 63% of women believed themselves to be well informed the first time they used contraception. Satisfaction for contraception method was evaluated from 7.3/10 (condom) to 9.7/10 (sterilization).Discussion and conclusionTwenty-seven percent of women do not use any contraception and 23% of pregnancies are unwanted despite a large offering of contraceptives. Our study enables the drawing of ‘patient-profiles’ for the main methods of contraception in order to better determine women's expectations and to pass the findings on to health professionals.     

Anejaculation: Relevance to Sexual Enjoyment in Men and Women

IntroductionEjaculation and orgasm are important components of sexual response in men. Our understanding of both phenomena is limited. Anejaculation can be a source of substantial distress, even when procreation (ostensibly the only purpose of ejaculation itself) is not a priority.AimTo present an opinion on male perceptions of ejaculation disorders (specifically anejaculation) based on a variety of data sources, including peer-reviewed literature.MethodsA non-systematic review of literature on anejaculation and other impairments of ejaculatory and orgasmic response was conducted. Relevant articles were critically analyzed and reportedMain Outcome MeasureAn opinion is presented, based on existing data sources, on how and why ejaculation is deemed important to men and their sexual partners.ResultsThe peer-reviewed literature on disorders of ejaculation is scant; existing reports oftentimes do not adequately distinguish between orgasm and ejaculation in assessment. Men’s perceptions of ejaculation quality appear to be positively associated with satisfaction with sexual response, particularly regarding orgasm. Based on very limited data, female sexual partners of men appear to often (but not always) value the orgasmic experience of their partner; only a minority prioritize actual ejaculation. There is evidence that disorders of ejaculation may be particularly troublesome for men who have sex with men.Clinical ImplicationsThe influence of medical conditions and treatments on ejaculation should be considered in the clinical context. Psychological adaptations and interventions may be of value in some cases.Strengths & LimitationsData on the clinical relevance of anejaculation outside the context of concomitant orgasmic dysfunction are sparse. Men’s experience of orgasm is at least partially associated with ejaculation-specific variables; whether this association is mediated by psychological, physical, or a combination of factors remains unclear.ConclusionsEjaculation, orgasm, and sexual satisfaction are closely intertwined but distinct phenomena.Shindel AW. Anejaculation: Relevance to Sexual Enjoyment in Men and Women. J Sex Med 2019;16:1324–1327.     

Incorporating peer-to-peer facilitation with a mid-level fidelity student led simulation experience for undergraduate nurses

BackgroundThe aim of this study was to evaluate peer-to-peer facilitated student led mid-level fidelity simulation experiences.MethodsSecond and third year nursing students (N = 637) were invited to complete a 16-item 6-point Likert scale questionnaire after the simulation experience.ResultsStudents reported high self-confidence in their nursing skills (M = 4.14, SD = 0.92) and a high level of satisfaction in the learning they received during the peer-to-peer facilitated student led simulation experience (M = 4.42, SD = 0.93).ConclusionUsing peer-to-peer teaching strategies during student led simulation experience is an effective approach for ensuring active engagement of all learners during midlevel fidelity group-based simulations and has the potential for broad applicability.