Objective To assess the effectiveness of the course of “Being a Friend with Patients”. Methods There were three parts in this course: (1) To experience what the empathy was, by counseling activities; (2) To accompany patients in hospital; (3) To share the experience after accompanying. There were 118 participants who were freshmen at the end of 2005. Results and Conclusions According to feedback from the students, they understand empathy and how the patients feel after the counseling. The course is accepted by all students. It may help students to be more attentive to and concerned about their patients, and to provied help for them.
Objective To evaluate the effectiveness of intravenous patient-controlled analgesia versus epidural patient-controlled analgesia for postoperative analgesia, sedation, and the incidence of side effects. Methods We searched the specialized trials registered in the Cochrane anesthesia group, The Cochrane Library (CCTR), MEDLINE (1966 to Sept. 2008), EMbase (1966 to Sept. 2008), PubMed (1966 to Sept. 2008), and handsearched some Chinese anesthesia Journals and Clinical anesthesia journals. Randomized controlled trials (RCTs) and quasi-RCTs of intravenous versus epidural analgesia for post-operation were included. The quality of the trials was critically assessed. RevMan 4.2.8 software was used for meta-analyses. Results Thirteen RCTs involving 580 patients of intravenous versus epidural analgesia for post-operation were included. The results of meta-analyses showed that there were no significant differences in postoperative analgesia and sedation at the hour-points of 2nd, 4th, 8th, 12th, and 24th hours after operation. There were no significant differences in plasma fentanyl concentration in the two groups on the same analgesia effects. There were also no significant differences in side effects. Conclusion Both intravenous patient-controlled analgesia and epidural patient-controlled analgesia have the same clinical effects. Compared with epidural patient-controlled analgesia, intravenous patient-controlled analgesia has fewer side effects and is more convenient. At the same time, it can reduce more costs of hospitalization. But because of the low quality and small sample size of the included studies, more well-designed, large scale, randomized controlled trials are needed.
ObjectiveTo explore the application of discharge planning model in Respiratory Department.
MethodWe developed discharge planning model in the Respiratory Department and performed standardized management on inpatients by assessing, planning, implementing and following up the whole process. A total of 716 discharged patients before the implementation of the planning model (January to March 2014) were designated as the control group, and 739 discharged patients after the model implementation (April to June 2014) were regarded as the observation group. Then, we compared such indexes as the rate of discharge planning, average length of hospital stay, retention rate of discharged patients, the number of new hospital admissions and medical orders during the time of weak nurse strength, and inpatient satisfaction before and after the model implementation.
ResultsAfter implementation of discharge planning model, all observed indicators were significantly better in the observation group (P<0.05).
ConclusionsImplementation of discharge planning model can effectively promote physician-nurse cooperation, plan health guidance for discharged patients, make them be ready to return to society and family, improve patients' satisfaction, and achieve the aim of patient-oriented high quality care. Meanwhile, it also can shorten the average length of hospital stay, reduce orders during the time of weak strength. It can not only ensure the ward medical indexes, but is helpful to manage nursing schedule.
To ensure the scientific and recognized evaluation of patient-centered clinical research outcomes, the drug development tool qualification certification website of the Center for Drug Evaluation and Research and the Center for Biologics Evaluation and Research have disclosed the information of clinical outcome assessment (COA) submitted for certification, and encouraged the use of certified COA. This paper searched all COA and approval decisions on the website, analyzed the submitted information and certification status of COA, and interpreted the certification technology and process of COA, so as to provide references and suggestions for the development of patient-centered clinical research outcome evaluation.
Integrating medical instruments with medical information systems becomes more and more important in healthcare industry. To make medical instruments without standard communication interface possess the capability of interoperating and sharing information with medical information systems, we developed a medical instrument integration gateway based on Integrating the Healthcare Enterprise Patient Care Device (IHE PCD) integration profiles in this research. The core component is an integration engine which is implemented according to integration profiles and Health Level Seven (HL7) messages defined in IHE PCD. Working with instrument specific Javascripts, the engine transforms medical instrument data into HL7 ORU message. This research enables medical instruments to interoperate and exchange medical data with information systems in a standardized way, and is valuable for medical instrument integration, especially for traditional instruments.
Objective To provide information for the establishment of a medical risk monitoring and precaution system in China, by reviewing and analyzing the current status of medical risk management system and preventative measures in New Zealand, Methods We searched EI (1969-2006), SCI and SSCI (1975-2006), EMBASE (1966-2006), SCOPUS (included 100% MEDLINE) (1960-2006), VIP (1989-2006), CNKI (1979-2006) and relevant official and governmental websites. This search was conducted in January 2006 and articles about medical risk management and prevention were collected. Results We included 10 articles involving medical adverse events, patient safety and medical litigation. New Zealand took many measures in order to prevent medical error and improve medical quality, including strengthening medical practice standards, doctor-patient communication, safety awareness and promoting informationization of hospitals. New Zealand also revised “The Health Practitioners Competence Assurance Act” and improved medical litigation to form an appropriate law environment. Conclusions New Zealand has taken many measures and established a medical risk management system to prevent medical risk. Some issues of particular relevance to China include building corresponding medical litigation and relevant laws and regulations.
Objective To understand the current situation of patient satisfaction management in public hospitals, and provide reference for improving the level of hospital satisfaction management and enhancing patients’ medical experience. Methods A questionnaire survey was conducted on public hospitals using a combination of purposive sampling and convenience sampling between May 2021 and March 2023. The survey covered the current situation of organizational support, institutional construction, human resource allocation, evaluation technology, evaluation process, work mode, assessment incentives, and effectiveness tracking in satisfaction management of public hospitals. Results A total of 101 hospitals were surveyed. Among them, 85 hospitals (84.2%) had formulated and issued satisfaction management measures, 37 hospitals (36.6%) had not set up independent satisfaction management departments, and only 27 hospitals (26.7%) had set up a dedicated budget for satisfaction management. 37 hospitals (36.6%) did not use online survey methods for satisfaction evaluation, and 14.9%, 21.8%, and 37.6% of hospitals did not include demographic information such as age, gender, and education level in the questionnaire design, respectively. 66 hospitals (65.3%) were used satisfaction evaluation results as the basic basis for evaluating department and employee performance, while only 25 hospitals (24.8%) had set up a satisfaction award for year-end evaluations. There were differences in the specialized budget for satisfaction management and the design of satisfaction survey questionnaires among hospitals of different levels (P<0.05). There were differences in whether different types of hospitals had dedicated personnel responsible for daily management work such as satisfaction evaluation, opinion collection, and assessment (P<0.05). Conclusions There are still shortcomings in the institutional construction, institutional setting, and resource investment of satisfaction management in public hospitals, which restrict its standardized and long-term development. The informationization and professionalism of satisfaction evaluation in public hospitals need to be improved, and construction needs to be strengthened to enhance data quality. The utilization and incentive mechanism of satisfaction evaluation results in public hospitals are insufficient, limiting their potential in improving service quality and employee motivation.
ObjectiveTo provide a scoping review of the healthcare provider patient-sharing network. MethodsPubMed, EMbase, Scopus, ProQuest, Web of Science Core Collection, ScienceDirect, SAGE, Wiley Online Library, Google Scholar, CNKI and WanFang Data databases were electronically searched to collect studies on patient-sharing network of healthcare providers from inception to July 31, 2021. Two reviewers independently screened literature, extracted data and then Arksey and O 'Malley's scoping review method was used to analyze the study. ResultsA total of 110 studies were included. In which, 70.0% were published in 2016 and later, 78.2% were carried out in the United States, 96.4% used secondary data, and 45.5% adopted social network analysis methods such as exponential random graph model. In terms of network characteristics, 43.6% of the studies adopted the theoretical framework of social network theory, and the network node type was mainly 1-mode, accounting for 87.3%. When constructing the physician patient-sharing networks, 64.5% of the studies had a threshold of 1 patient. We also synthesized existing studies on patient-sharing networks of healthcare providers in the light of factors of networks and related outcomes. ConclusionThe studies of healthcare provider patient-sharing network have potentials to improve clinical practice and health policies. Further studies should consider adopting longitudinal design to validate evidence of study, expanding the scope of study subjects except physicians and enriching the evidence of the relationship between network and health-related outcomes.
ObjectiveTo compare postoperative patient-controlled epidural analgesia (PCEA) and intravenous patient-controlled analgesia (PCIA) on maternal low back pain after caesarean section.
MethodsSixty cases of American Society of Anesthesiology gradeⅠ-Ⅱ single-birth full-term elective caesarean delivery primiparae chosen between July to September 2012 were divided into 3 groups randomly, 20 in each group. Group A accepted sufentanil 1 μg/mL and ropivacaine 1 mg/mL PCEA; group B had sufentanil 1.5 μg/mL PCEA; group C was given sufentanil 1.5 μg/mL and ondansetron 0.16 mg/mL PCIA. Background dose was 2 mL/h, patient-controlled analgesia dose was 2 mL, and locking time was 20 min. Visual analogue pain score was used to assess the effect of postoperative analgesia, and we recorded analgesia pump usage, adverse reactions, and at the same time investigated the onset of maternal low back pain.
ResultsNo obvious postoperative pain was found, and the analgesic effect was good in all the three groups, and the differences were not statistically significant (P>0.05). All three groups of women had a certain proportion of low back pain, and the differences were not statistically significant (P>0.05). After operation, group A had 5 cases of leg numbness, group B had 1, and group C had none. Leg numbness occurred significantly more in group A than in group B and C (P<0.05). Group B had one case of nausea and vomiting, while none occurred in group A and C (P>0.05).
ConclusionWith the same effect of postoperative analgesia, compared with PCIA, PCEA does not increase postoperative low back pain incidence after caesarean section.
