In recent years, target temperature management (TTM) has been increasingly applied to cardiac arrest patients, and programs and strategies for TTM are in a constant state of update and refinement. This paper analyzes and proposes relevant strategies from the concept of TTM, its clinical application status for cardiac arrest patients in domestic and international medical institutions, its deficiencies in the clinical practice, and factors affecting the development of TTM, with a view to providing a realistic basis for the development of high-quality TTM in medical institutions.
Objective To investigate the staffing status of full-time personnel for healthcare-associated infection (HAI) management department in secondary or above medical institutions in Yunnan Province, analyze the factors affecting the stability of the HAI workforce, and provide a scientific basis for strengthening the department of HAI professionals and improving the standard of the full-time personnel team. Methods In April 2023, a questionnaire survey was conducted to investigate the staffing status of full-time HAI management department personnel across 394 secondary or above medical institutions in Yunnan Province. Results A total of 394 secondary or above medical institutions were included in this survey. Among the institutions participating in the survey, 393 (99.75%) had established a separate hospital-acquired infection management, and 303 (76.90%) met the requirement of having at least one full-time infection control personnel for every 200 beds. Among the 689 full-time HAI management department practitioners surveyed, the majority were female (94.34%), those aged 41-50 were the largest age group (34.69%), the predominant educational background was a bachelor’s degree (72.42%), the primary specialty was nursing (80.84%), and the most common professional title was intermediate level (36.14%). There were statistically significant differences between the full-time HAI practitioners in secondary medical institutions and those in tertiary medical institutions in educational background (Z=–6.220, P<0.001), specialty (χ2=41.612, P<0.001), professional title (Z=–2.432, P=0.015), and years of engagement (χ2=47.298, P<0.001). There was no statistically significant difference in gender or age (P>0.05). The primary reason for full-time practitioners engaging in HAI work was “following leadership arrangements” (79.97%). Tertiary medical institutions had a significantly higher proportion of full-time HAI management personnel who took up their positions due to “graduation recruitment” or “major matching” than secondary medical institutions (P<0.05), while the proportion of those who entered the field due to “leadership arrangement” was significantly lower than that in secondary medical institutions (P<0.05). In the survey on factors contributing to the instability of the full-time personnel team, the top three factors identified were excessive work pressure, difficulties in professional title promotion, and an overwhelming amount of required learning content. Conclusions There is an insufficient allocation of full-time HAI control personnel in secondary or above medical institutions in Yunnan Province, and the professional composition of this workforce requires greater diversification. The primary factors contributing to the instability of the dedicated personnel team are high work pressure and difficulties in professional title promotion. It is recommended to expedite the improvement of career advancement pathways for HAI control personnel to provide support and guarantees for building a robust full-time infection control workforce.
Early onset and high incidence of myopia has caused great concern of the Party and the Government. On August 30th 2018, eight ministries and commissions, such as the Ministry of Education, jointly issued the Comprehensive Prevention and Control Implementation Scheme of Child and Adolescent Myopia, which put forward the actions and specific measures to various aspects, and particularly mentioned that the medical and health institutions should work together with families, schools, etc, to reduce the incidence of myopia. Medical institutions should do a good job in the following items: setting up visual archives for adolescents, so as to prevent and control myopia with pertinence and individualization; standardizing the process of diagnosis and treatment, doing a good job in refractive examination and correction of adolescents, and resolutely combating the commercial "treatment and correction" of myopia; strengthening myopia-related health education, and eliminating erroneous understanding to myopia prevention and control. Optometrists should play an important role in the prevention and control of myopia, speed up the cultivation of optometry talents, and call on the state to establish a professional title system and professional access standards for optometry talents as soon as possible.
Objective To investigate and analyze the difficulties of nosocomial infection management in different-level medical institutions in Shanghai, and to provide scientific basis for improving the level of nosocomial infection management. Methods A questionnaire was designed to include 10 difficulties in nosocomial infection management such as professional title promotion, salary, and personnel allocation. In October 2023, the Shanghai Nosocomial Infection Quality Control Center, in collaboration with the Shanghai Hospital Association, conducted a questionnaire survey among the heads of nosocomial infection management departments in medical institutions in Shanghai. The scores of difficulties were analyzed by stratification according to hospital level, allocation and changes of full-time personnel. Results A total of 548 questionnaires were distributed, and 530 valid questionnaires were retrieved, with a recovery rate of 96.72%. There were 55 public tertiary, 93 public secondary, 169 public primary and 213 social medical institutions. The rates of full-time personnel allocation meeting standards were 76.36% (42/55), 72.04% (67/93), 31.95% (54/169), and 21.60% (46/213), respectively. There was a statistically significant difference in the rates of full-time personnel allocation meeting standards among different levels of medical institutions (χ2=105.149, P<0.001). There was no statistical difference in the total scores of nosocomial infection management difficulties among different-level medical institutions (F=1.657, P=0.176). There were statistically significant differences in the scores of difficulties in professional title promotion, cumbersome daily norms and requirements, insufficient allocation of full-time personnel, and high personnel turnover (P<0.05). Conclusions The main difficulties in nosocomial management of medical institutions at all levels in Shanghai include the difficulty in career promotion, cumbersome daily norms and requirements, insufficient allocation of full-time personnel and lack of experience. In the future, medical institutions should strengthen the allocation of full-time personnel and enhance their capabilities, provide smooth promotion channels, to promote the high-quality development of nosocomial infection management ultimately.
