分诊安全管理结合风险管理提高急诊科护理质量评分的作用分析

目的探讨分诊安全管理结合风险管理提高急诊科护理质量评分的作用。方法该院于2018年6月起加强对急诊科的分诊安全管理结合风险管理,以于2017年6月—2019年6月在该院急诊科就诊的患者为研究对象,评价管理策略实施前后护理风险发生率、护理质量评分以及患者满意度等评价指标变化情况。结果实施后基础护理、实践操作、消毒隔离、急救药品、护理文件方面的护理质量评分均较实施前显著提高(P<0.05);实施后护理差错、护理缺陷、护理投诉的发生率分别为0.26%、0.58%、0.19%,均较实施前显著降低(P<0.05);实施后护理总满意率为94.92%,较实施前显著提高(P<0.05)。结论分诊安全管理结合风险管理有效提高了急诊科护理质量,提升了患者满意度,减少了护理风险事件的发生。     

Sexual Content-Induced Delay With Double-Entendre Words

Seventy-three men and 72 women made lexical decisions to target words that followed sentences constructed so that the last word was a sexual double-entendre. Prime target relatedness, erotic versus nonerotic target, stimulus onset asynchrony, and participant's gender were varied in a between-subjects design. A second analysis that substituted sentence context for prime target relationship also was conducted. Data were collected on the emotionality and social acceptability of priming sentences and target words. Results revealed that, as with previous research on neutral words, prime target relatedness facilitated lexical decisions. Additionally, there was evidence of slowing in making lexical decisions when erotic material was presented or was part of a contextual bias. This delay was accentuated in women. A model that proposes that sexual words evoke a more complex processing sequence is presented. The model suggests that appraisal and checking or editing mechanisms, which are accentuated in women, help explain the phenomenon. Portions of this work was submitted by the junior author in partial fulfillment of the requirements for Honors in Psychology at Louisiana State University     

Evaluating the impact of a service fee on patient compliance

This paper addresses an evaluation of an administrative decision to change the manner in which services were paid for at a Student Health Center (SHC). The impact of the change in payment was observed through monitoring the number of scheduled appointments at the SHC which the patient failed to attend, reschedule, or cancel. The impact was assessed through a comparison of the weekly no-show rates from the year prior to the change in payment practices through the year following the change. A time-series statistical package was used to analyze the no-show data. Collateral measures on the number of students attending the university, staff opinions, and usage of the SHC by different student groups were collected. Evaluations of the impact of administrative decisions on health-related behavior were discussed, in addition to a discussion of the usefulness of time-series models for this type of evaluation.     

中药复方发明专利创造性审查的影响因素分析

目的 寻找中药复方发明专利创造性审查的关键影响因素并分析原因,为完善相关审查标准提供参考。方法 筛选驳回依据为创造性的中药复方发明专利复审决定,建立数据库,通过分类和单因素逻辑（Logistic）回归等方法分析影响因素。结果 中药复方专利创造性的审查标准受年度变化的影响明显。按要求补充实验数据、区别技术特征数量、复方的发明类型、审查员所引用的对比文件及公知常识情况均能提高专利复审的撤驳率。结论 我国尚未建立合理、统一、清晰的中药复方发明专利创造性审查标准,仍有待从多个方面进一步完善。     

Determinants of information diffusion in online communication on vaccination: The benefits of visual displays

ObjectiveSocial media are an increasingly important source of information on the benefits and risks of vaccinations, but the high prevalence of misinformation provides challenges for informed vaccination decisions. It is therefore important to understand which messages are likely to diffuse online and why, and how relevant aspects—such as scientific facts on vaccination effectiveness—can be made more comprehensible and more likely to be shared. In two studies, we (i) explore which characteristics of messages on flu vaccination facilitate their diffusion in online communication, and (ii) whether visual displays (i.e., icon arrays) facilitate the comprehension and diffusion of scientific effectiveness information.MethodsIn Study 1, 208 participants each rated a random sample of 15 out of 63 messages on comprehensibility, trustworthiness, persuasiveness, familiarity, informativeness, valence, and arousal, and then reported which information they would share with subsequent study participants. In Study 2 (N = 758), we employed the same rating procedure for a selected set of 9 messages and experimentally manipulated how scientific effectiveness information was displayed.ResultsStudy 1 illustrated that scientific effectiveness information was difficult to understand and thus did not diffuse well. Study 2 demonstrated that visual displays improved the understanding of this information, which could, in turn, increase its social impact.ConclusionsThe comprehensibility of scientific information is an important prerequisite for its diffusion. Visual displays can facilitate informed vaccination decisions by rendering important information on vaccination effectiveness more transparent and increasing the willingness to share this information.     

The effect of intensive care on in-hospital survival

Intensive Care Units (ICU) are one of the most powerful and expensive technologies within inpatient care. However, its effect on survival is still an issue under discussion. The objective of this paper is to assess the effect of General ICU on in-hospital survival. We assessed the effect of ICU on survival using Linear and Probit regressions. Since admission to IC is not random and depends on unobserved (to the researcher) heterogeneity, we reassessed the IC effect by Instrumental Variables (IV) and Bivariate Probit techniques, using crowding in the IC unit as an instrument. The results show that a simple Probit of the IC effect on survival is 7–10 percentage-points (pts). The IV estimate of the IC effect on survival is 21–34 pts, and the Bivariate Probit estimate is 17–21 pts. We conclude that although admitted patients are at lower risk of death, as determined by their observable (to the researcher) characteristics, controlling for observable differences, those with a higher unobserved risk of mortality are more likely to be admitted. The implications for an optimal admission policy are discussed.     

Ethical issues in neonatal intensive care and physicians' practices: A European perspective

An international project (EURONIC) was carried out to explore the end-of-life decision-making process in a large, representative sample of neonatal intensive care units (NICUs) in eight western European countries: France, Germany, Great Britain, Italy, Luxembourg, the Netherlands, Spain and Sweden. Structured questionnaires were used to record data on NICU organization and policies, and to survey staff views and practices regarding ethical decision-making. One hundred and twenty-two NICUs were recruited by census or random sampling (response rate 86%); 1235 physicians and 3115 nurses completed the staff questionnaire (response rates 89 and 85%, respectively). This paper focuses on the physicians' answers. In all countries but Italy, most physicians reported having been involved at least once in setting limits to intensive care because of a baby's incurable condition and/or poor neurological prognosis. Adopted strategies varied between countries. Practices such as the continuation of current treatment without intensifying it and the withholding of emergency manoeuvres appeared widespread. In contrast, the frequency of doctors reporting withdrawal of mechanical ventilation was highest in the Netherlands (93%), Sweden (91%) and the Great Britain (88%), intermediate in France and Germany, and lowest in Spain and Italy (34 and 21%, respectively).
Conclusion: Ethically problematic clinical cases are approached differently in the various countries. The findings of this study may provide an opportunity for physicians to review their practices critically, in light of how other colleagues proceed, and foster an open discussion about these difficult issues.     

改良早期预警评分在心脏科门诊预检分诊中的应用

目的评估改良早期预警评分系统（MEWS评分）在心脏科门诊识别危重患者的应用效果。方法将2012年10～12月来我院就诊的心内科门诊19971例患者进行MEWS评分，据此安排就诊先后顺序，并根据病情危重程度实施必要的处置，将MEWS评分与病情转归进行比较和分析。结果MEWSO～4分患者18634例随诊，5～8分患者1063例，与专科病房及CCU／ICU做好无缝隙连接；≥9分患者274例，死亡危险性明显增加，立即进行紧急医疗干预，实施特别护理。结论简便的MEWS将心脏科患者病情分值化，使医护人员对就诊患者分诊依据更充分，具有识别潜在危重病的作用。