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2019 Vol. 26, No. 6
Published: 2019-12-25
 
 
401 The SAS macro program that calculate 10-year cardiovascular risk using Framingham, UKPDS and ASCVD risk scores
Cheng Hui, Lin Binbin, Sun Hongpeng.
DOI: 10.3969/j.issn.1006-5253.2019.06.001
Objective It is hoped that the risk of 10-year cardiovascular diseases can be calculated quickly by compiling SAS macro program, so as to identify high-risk groups of cardiovascular diseases.Methods The cardiovascular risk was calculated by runningthe macro program on Framingham, UKPDS and ASCVD risk scores using the data of the China Health and Retirement Longitudinal Study.Results Running the SAS macro program to analyze the partial data of the China Health and Retirement Longitudinal Studyin2011,and the Framingham, UKPDS and ASCVD risk predictions of the sample population were 9.5%(95%CI:8.4%～10.6%),7.1%(95%CI:6.3%～7.8%) and 16.4% (95%CI:15.1%～17.7%).Conclusion The SAS macro program we compiled can effectively calculate the prediction of cardiovascular disease risk by Framingham, UKPDS and ASCVD risk scores in large sample population.
2019 Vol. 26 (6): 401-403 [Abstract] ( 144 ) HTML (1 KB)  PDF (1282 KB)  ( 436 )
404 Influencing factors of surgical site infection after total hip arthroplasty using decision tree and logistic regression model
Zhou Peimin, Su Zhongliang, Xu Qing, Zheng Shu
DOI: 10.3969/j.issn.1006-5253.2019.06.002

Objective To investigate risk factors for surgical site infection after total hip arthroplasty based on exhaustive CHAID decision tree and logistic regression model, so as to provide the basis for the development of control strategy of surgical site infection (SSI). Methods A retrospective analysis was performed on the patients undergoing total hip arthroplasty from January 2012 to December 2018 in Wenzhou People's Hospital. Twenty four patients with surgical site infection after total hip arthroplasty were selected as the case group, and 576 patients who did not have surgical site infection after total hip arthroplasty in the same period were selected as the control group. Logistic regression and decision tree model were used to determine influencing factors for surgical site infection. Results Four  risk  factors  were  found  by  logistic  regression  model  and  decision  tree  model, including the operation time no less than 180 min, the amount of intraoperative bleeding more than 200 mL, using at least 2 kinds of antibiotics, and serum albumin less than 35 `g/L. The results of CHAID decision tree analysis showed that the operation time was the main factor affecting the SSI. Conclusion In order to provide evidence and reference for prevention and control measure of surgical site infection, it is essential to combine these two different methods to describe influencing factors of surgical site infection from different aspects.
2019 Vol. 26 (6): 404-407 [Abstract] ( 56 ) HTML (1 KB)  PDF (1044 KB)  ( 299 )
408 Status quo and influencing factors of the benefit finding in coronary heart disease patients
Xia Chunju, Huang Lingling, Chen Liu.
DOI: 10.3969/j.issn.1006-5253.2019.06.003

Objective To investigate the status quo and influencing factors of the benefit finding in coronary heart disease patients. Methods Totally 189 coronary heart disease patients were investigated with general data questionnaires and benefit finding scale. Descriptive statistics, correlation analysis and multiple linear regressions were used to explore the influencing factors of benefit finding in coronary heart disease patients.Results The benefit finding score of coronary heart disease patients was (59.25±7.50). Multivariate analysis showed that age, family income, and comorbidities were influencing factors of self-benefit finding in coronary heart disease patients. Conclusion The relevant influencing factors of self-benefit finding in coronary heart disease patients can help the nursing staff to take corresponding measures to improve the level of self-benefit finding, and can make patients have sufficient confidence to cope with the disease, find hope in adversity, and ultimately improve the quality of life.
2019 Vol. 26 (6): 408-410 [Abstract] ( 52 ) HTML (1 KB)  PDF (873 KB)  ( 182 )
411 Analysis of overweight and obesity epidemic among Han residents in rural area of Handan city
Liu Weigang, Wang Lin, Liu Shaojun
DOI: 10.3969/j.issn.1006-5253.2019.06.004
Objective To investigate overweight and obesity epidemic among Han residents over the age of 18 in rural area of Handan city, and thus to provide a reference for the prevention and treatment of overweight and obesity in the area.Methods Totally 18 402 permanent residents over the age of 18 in rural area of Handan city were extracted by random cluster sampling and cross-sectional study methods. The mean value comparison and trend analysis of body mass index, BMI and WC of the study group with different age and income were conducted. Results According to the BMI classification standard of Chinese adult overweight and obesity prevention and control guidelines, the prevalence of overweight in this area was 34.70%, including 32.03% males and 36.64% females. The prevalence of obesity was 15.24%, including 10.49% of males and 18.68% of females. The average BMI of men of different age and income was lower than that of women (P<0.05). There were statistically significant differences in the distribution of overweight and obesity in men and women at different ages and incomes (P<0.05), among which the prevalence of obesity in men decreased with the increase of age (P<0.05), and increased with the increase of income (P<0.05). Conclusion The prevalence of overweight and obesity in females increased with age (P<0.05).Conclusion The prevalence of overweight and obesity in rural area of Hebei Province is relatively high, which needs to cause enough attention and strengthen preventive measures.
2019 Vol. 26 (6): 411-414 [Abstract] ( 51 ) HTML (1 KB)  PDF (856 KB)  ( 190 )
415 Application of comprehensive nursing form based on Omaha System for children with epilepsy
Zhu Liyan, Lin Xiangxiang
DOI: 10.3969/j.issn.1006-5253.2019.06.005
Objective To explore the application of comprehensive nursing form based on Omaha System for children's epilepsy and provide reference for the nursing of children with epilepsy. Methods Forty cases of children with epilepsy treated in our hospital from June to Dec. 2017 were selected as the control group and 40 cases of children with epilepsy treated in our hospital from Jan. to June 2018 were selected as the observation group. The control group received routine nursing and the observation group received routine nursing as well as comprehensive nursing using the form based on Omaha System. The hospitalization of patients in both groups, the effects of intervention and the occurrence of nursing issues in different stages in the observation group were compared. Results The duration of hospitalization, expenditure and readmission rate of the observation group were all significantly lower than those of the control group (P<0.05). Three months after discharge, the incidence of nursing issues in all domains of the observation group were significantly lower than those of during hospitalization except financial situation (P<0.05). Before discharge, one month after discharge and three months after discharge, the nursing issues of the observation group in all domains were significantly improved than those of during hospitalization except cognition and mental health issues (P<0.05).Conclusion The comprehensive nursing form based on Omaha System can significantly improve the healthy behavior and quality of life for children with epilepsy, so it is an effective mode of comprehensive nursing intervention.
2019 Vol. 26 (6): 415-418 [Abstract] ( 59 ) HTML (1 KB)  PDF (846 KB)  ( 160 )
419 Effectiveness evaluation on convalescent schizophrenia patients carrying out comprehensive intervention therapy method
Wang Hong'er
DOI: 10.3969/j.issn.1006-5253.2019.06.006
Objective To explore the clinical effect of convalescent schizophrenia patients carrying out comprehensive intervention therapy method.Methods Eighty convalescent schizophrenia patients were randomly divided into the control group and the intervention group, with 40 cases in each group. The control group was given usual treatment and nursing care, and the intervention group received comprehensive intervention therapy besides usual treatment and nursing care. The scores of stigma, anxiety, depression and self-efficacy were compared between the two groups after intervention.Results After 3 months of intervention, the descending scores of social factor and capacity factor in the intervention group were both larger than those in the control group (P<0.05). The descending scores of anxiety and depression in the intervention group were both larger than those in the control group (P<0.01), but the rising score of self-efficacy in the intervention group was higher than that in the control group (P<0.01).Conclusion Comprehensive intervention therapy on convalescent schizophrenia patients could obviously cut down stigma of the patients, reduce anxiety and depression, raise self-efficacy, and improve prognosis.
2019 Vol. 26 (6): 419-421 [Abstract] ( 54 ) HTML (1 KB)  PDF (838 KB)  ( 145 )
422 Risk factors of recurrent cerebral infarction using logistic regression analysis
Wang Zhi, Xu Hanwen, Yang Jianbang
DOI: 10.3969/j.issn.1006-5253.2019.06.007
Objective To explore the risk factors of recurrent cerebral infarction and in order to provide a certain reference value for clinical prevention and treatment. Methods Totally 138 patients with recurrent cerebral infarction in the Department of Neurology were selected as research objects. Sixtyfive cases with recurrent cerebral infarction belonged to the recurrence group, and 73 cases with primary cerebral infarction belonged to the primary group. The chisquare test and logistic analysis were used to analyze the relations between general clinical data and physiological factors and recurrent cerebral infarction, in order to identify risk factors of recurrent cerebral infarction. Results There were statistically significant differences between the recurrent group and the primary group in the history of diabetes, atrial fibrillation, transient ischemic attack and hyperhomocysteinemia (P<0.05). However, There were no statistically significant differences between the two groups in cerebrovascular disease, TOAST type, history of hypertension, history of hyperlipidemia, history of coronary heart disease, history of alcohol abuse and history of smoking (P>0.05). Having hyperhomocysteine (OR: 3.894, 95% CI: 1.514～10.018), history of atrial fibrillation (OR: 3.112, 95% CI: 1.248～7.757), history of transient ischemic attack (OR: 2.824, 95% CI: 1.361～5.857), and history of diabetes (OR: 2.571, 95% CI: 1.293～ 5.112) were risk factors for recurrent cerebral infarction (P<0.05). Conclusion The risk factors of recurrent cerebral infarction indicate that paying attention to these risk factors can effectively reduce the occurrence of recurrent cerebral infarction.
2019 Vol. 26 (6): 422-424 [Abstract] ( 53 ) HTML (1 KB)  PDF (836 KB)  ( 124 )
425 Analysis of influencing factors of hospitalization expenses for patients with spinal deformity in a top three hospital
Cheng Ning, Pang Yu, Li Xuan, Huang Lufei, Yuan Jing, Gao Yan, Hu Sizhen, Tang Ling.
DOI: 10.3969/j.issn.1006-5253.2019.06.008
Objective To analyze the hospitalization expenses of patients with spinal deformity and to explore the influencing factors.Methods Through the compilation and summary of the homepage information of patients with spinal deformity, the composition changes and time trend changes of hospitalization expenses were analyzed. The factors affecting hospitalization expenses were discussed by single factor analysis methods.Results The median total hospitalization cost increased year by year. The hospitalization cost of surgical patients was higher than that of non-surgical patients. The median hospitalization cost of patients aged 18～45 years old was the highest, being 106 754 yuan. The medical payment method was self-paying patient hospitalization expenses. The median was the highest, at 11 846 yuan. The median hospitalization cost was the highest in the hospitalized patients, which was 127 349 yuan. The median hospitalization cost for hospitalization days was more than 30 days, which was 121 644 yuan. The difference was statistically significant(P<0.05).Conclusion hospitalization costs by controlling consumables costs, standardizing surgical indications, and shortening preoperative hospital stays.
2019 Vol. 26 (6): 425-428 [Abstract] ( 67 ) HTML (1 KB)  PDF (843 KB)  ( 142 )
429 Analysis on the change of expenditure of lung cancer inpatients in a tertiary hospital from 2004 to 2017
Zhang Limin, Wu Jingtao, Yu Chuanhua, Hu Ying
DOI: 10.3969/j.issn.1006-5253.2019.06.009
Objective To analyze the condition and cost of patients with lung cancer in a tertiary hospital, in order to provide the basis and strategy for the control of the cost of patients with lung cancer.Methods The expense data of lung cancer inpatients from 2004 to 2017 in a tertiary hospital were used to analyze the patients′ basic situation and expense, and to evaluate the change of inpatients′ expense. Results According to 36 621 records included from 2004 to 2017, it was found that the average hospitalization expenditure of lung cancer patients decreased, but the average hospitalization frequency increased, and the average daily hospitalization expenditure increased, with the median rising from 1153.81 yuan in 2004 to 1 971.40 yuan in 2017, with the total cost increasing. The largest proportion was western medicine, accounting for 49.00% of the total cost and the proportion of constituents has been decreasing year by year. The proportion of self-paid patients accounted for 21.81% and the proportion of self-paid cost accounted for 18.08% of the total cost. The proportion of self-paid patients decreased from 52.60% to 5.10% over time. Multivariate logistic regression found that the main influencing factors of high single cost were over 60 years old, cure, later year, long hospital stay and low frequency.Conclusion The reform of medical expenditure since 2004 has greatly reduced the proportion of self-expenditure in medical cost of lung cancer. It is suggested that the prevention of lung cancer should be strengthened, the quality of treatment should be improved and the best possible quality of life should be guaranteed.
2019 Vol. 26 (6): 429-431 [Abstract] ( 61 ) HTML (1 KB)  PDF (1320 KB)  ( 165 )
432 Analysis of 429 cases of adverse reactions in Yiwu Traditional Chinese Medicine Hospital from 2015 to 2018
Wang Yun
DOI: 10.3969/j.issn.1006-5253.2019.06.010
Objective To investigate the adverse reactions of 429 cases in Yiwu Traditional Chinese Medicine Hospital from 2015 to 2018, and provide evidence for clinical rational drug use. Methods Totally 429 patients with adverse drug reaction(ADR) in Yiwu Traditional Chinese Medicine Hospital from January to February 2018 were selected as subjects. The patient case data were reviewed to analyze the drug type and department distribution of ADR patients. Patients diagnosed with ADR were carried out effective measures for treatment intervention, the results of ADR were recorded, and effective measures for intervention were formulated according to the causes of ADR. Results Among the 429 patients with ADR, the top two were in 2018 and 2017, with 29.14% and 26.81% respectively; 429 patients with ADR had relatively more drug types, and ranking the top three were antibacterial drugs, cardiovascular system drugs, parenteral nutrition drugs, accounting for 33.33%, 26.11% and 14.92% respectively; 429 cases of ADR patients in Yiwu Traditional Chinese Medicine Hospital were relatively wide, and the top three departments were the Emergency Department, the Internal Medicine Department, and the Orthopedics Department, accounting for 27.04%, 24.94% and 17.25% respectively; 429 cases of ADR patients in Yiwu Traditional Chinese Medicine Hospital were treated with corresponding symptoms after diagnosis. The symptoms of the patients were significantly improved, and the cure and improvement rate was 100.00%. Conclusion The incidence of ADR in Yiwu Traditional Chinese Medicine Hospital from 2015 to 2018 is high, and it is mainly based on antibiotics, mainly in the Emergency Department, the Internal Medicine Department and the Orthopedics Department. It is necessary to strengthen clinical drug intervention and guidance to improve the safety of medication.
2019 Vol. 26 (6): 432-434 [Abstract] ( 70 ) HTML (1 KB)  PDF (836 KB)  ( 236 )
435 Analysis and countermeasures of patients with overlong inpatient days in a hospital
Lu Qin, Liu Chunxiang, Zhou Juan, Wang Xiang
DOI: 10.3969/j.issn.1006-5253.2019.06.011
Objective To analyze the distribution characteristics of 161 inpatients discharged after more than 50 days of hospitalization from a hospital, and to provide an effective basis for the hospital management to shorten the average length of stay.Methods The hospital stay exceeding 99% quantile (P99=50 days) of the hospital stay of discharged patients in 2018 was defined as the extremely long hospital stay. Excel was used to analyze the data.Results In 2018, 11465 patients were discharged from the hospital, with an average hospitalization time of 9.31 days and the main age group was from 40 to 49 years old. The sex ratio of men and women patients with overlong hospitalization was 2.10 :1 and the average cost was 83 249.20 yuan, The department distribution mainly concentrated in Joint Surgery, Flap Surgery, and Internal Medicine, and the top three diseases were injury, poisoning and certain other consequences of external causes, diseases of the circulatory system, and diseases of the musculoskeletal system and connective tissues.Conclusion We should strengthen the management of departments, implement the clinical pathway management, improve the outpatient service model, and strengthen the doctor-patient communication.
2019 Vol. 26 (6): 435-437 [Abstract] ( 63 ) HTML (1 KB)  PDF (938 KB)  ( 189 )
438 Analysis on disease composition of inpatients in a maternal and child health care institute
Sun Hongxia, Wang Fang
DOI: 10.3969/j.issn.1006-5253.2019.06.012
Objective To understand the composition and trend of disease spectrum in a hospital for women and children, and to provide scientific basis for the disease prevention.Methods Relevant data of 342,822 inpatients admitted to the hospital from 2014 to 2018 were sorted out, counted and analyzed.Results In the disease composition of hospitalized patients in 5 years, the top 10 diseases were pregnancy delivery and puerperium (32.22%), nervous system (20.73%), respiratory system (8.28%), perinatal disease (7.94%), urogenital (6.84%) ), tumors (5.11%), mental and behavioral disorders (4.82%), health status (3.29%), congenital malformations (3.20%), and infectious and parasitic diseases (2.42%), accounting for 94.86% of hospitalized patients.Nervous system disease was the top among inpatients below 5 years old. Respiratory system disease was the top among inpatients from 5 to 15 years old. Childbirth and puerperal disease was the top among inpatients from 15 to 44 years old.Tumor and genitourinary system disease was the top among inpatients from 45 to 59 years old and 60 years old and above.Conclusion The hospital should increase the discipline construction of key diseases, increase the input of medical resources, and improve the quality and efficiency of services for women and children.
2019 Vol. 26 (6): 438-441 [Abstract] ( 59 ) HTML (1 KB)  PDF (846 KB)  ( 198 )
442 Analysis on the distribution features and prognosis of benign gynecological tumor in a women and children's hospital from 2014 to 2018
Guo Xuting
DOI: 10.3969/j.issn.1006-5253.2019.06.013
Objective To explore distribution features and prognosis of gynecological benign tumor in a women and children's hospital in the last 5 years.Methods Information of discharged patients with gynecological benign tumor in a women and children's hospital from 2014 to 2018 was collected and analyzed retrospectively. Disease constitution in different years and different groups were analyzed and different gynecological benign tumors weresorted by rank accordingly.Results There were 2 776 discharged patients with gynecological benign tumor in the women and children's hospital from 2014 to 2018. Among the gynecological benign tumors, the top 3 were endometrial polyp (1 236 patients，accounting for 44.5%), uterine leiomyoma (593 patients, accounting for 21.4%),and cervical intraepithelial neoplasia (298 patients, accounting for 10.7%). There were significant differences in disease composition sequence among different age groups (P<0.05), while the top 5 diseases were similar in these age groups. With respect to prognosis for different diseases, hospital discharge accounted for above 95%.Conclusion Endometrial polyp, uterine leiomyoma and cervical intraepithelial neoplasia were accounting for the major disease constitution among gynecological benign tumors in the women and children's hospital. Diseases of gynecological benign tumor with high incidence should be received attention. Factors including different age groups should beconsidered in disease diagnosis and treatment and preventive education.
2019 Vol. 26 (6): 442-444 [Abstract] ( 79 ) HTML (1 KB)  PDF (842 KB)  ( 175 )
445 Determination of annual priority improvement indexes of hospital′s quality and safety with delphi method and analytic hierarchy process
Qi Aijie, Liu Lun, Zhang Lin, Zhang Chunjie
DOI: 10.3969/j.issn.1006-5253.2019.06.014
Objective To determine the annual priority improvement indexes of hospitals' quality and safety with delphi method and analytic hierarchy process.Methods Delphi method is used to establish the annual index system for optimization, and AHP is used to establish evaluation index system and check consistency of the judgment matrix.Results Nine hospitals′ annual improvement priority indexes are selectedand consistency check results are good.Conclusion Using Delphi method and AHP to determine the hospitals′ improved indicators is quite scientific and feasible. These two methods are effective tools for hospital management.
2019 Vol. 26 (6): 445-449 [Abstract] ( 54 ) HTML (1 KB)  PDF (1130 KB)  ( 473 )
450 Risk of debt management and its countermeasures of public hospitals in Shandong Province
Wang Huayi, Sun Jingjie, Zhang Li
DOI: 10.3969/j.issn.1006-5253.2019.06.015
Objective To understand the debt situation of public hospitals in Shandong Province. Methods Qualitative and quantitative analysis and comparative analysis were used to study the changes of liabilities in public hospitals. Results At present, in order to improve the competitiveness of public hospitals under the circumstance of limited financial input, hospitals generally build by borrowing money. But at the same time, a large amount of debt has also brought heavy burden to public hospitals, hindering the longterm and healthy development of hospitals.Conclusion We should strictly control the debt scale of public hospitals, strengthen the control and management of financial risk of public hospitals, and implement the financial subsidy policy of public hospitals, effectively resolve the financial crisis of public hospitals and make them develop healthily.
2019 Vol. 26 (6): 450-452 [Abstract] ( 63 ) HTML (1 KB)  PDF (830 KB)  ( 171 )
453 Adverse drug reactions and countermeasures for prescriptions in pharmacy intravenous admixture service
Yu Wenying, Wang Xuejun, Li Li
DOI: 10.3969/j.issn.1006-5253.2019.06.016
Objective To discuss the adverse drug reactions and countermeasures for prescriptions in intravenous admixture services (PIVAS). Methods Totally 2 000 copies of PIVAS prescriptions were selected from January to December 2018 and were investigated in incompatibility, types of solvents, dosage, route of administration, drug concentration, solvent quantity, frequency of administration, combined medication, and input errors, and their adverse reactions were counted. Results In this survey, 220 unreasonable prescriptions were used, and the incidence was 11.00%. Among them, the reason for unreasonable application was 42 copies incompatibility (2.10%), types of solvents 35 copies (1.75%), dosage 30 copies(1.50%), route of administration 28 copies (1.40%), drug concentration 24 copies (1.20%), solvent quantity 20 copies(1.00%), frequency of administration 19 copies (0.95%), combined medication 15 copies (0.75%), and input error 7 copies (0.35%). Among them, 20 prescriptions with adverse drug reactions were reported, and the incidence was 9.09%. Univariate analysis showed that adverse drug reactions of PIVAS were related to incompatibility, types of solvents, dosage, frequency of administration, drug concentration, and combined medication (P<0.05). However, it was not related to the solvent quantity, route of administration, and input errors (P>0.05). Logistic regression analysis showed that incompatibility, types of solvents, dosage, frequency of administration, drug concentration, and combined medication were independent risk factors for adverse drug reactions of PIVAS (P<0.05). Conclusion Irrational use of PIVAS can cause adverse drug reactions. It is suggested that the prescription review of PIVAS should be strengthened and unreasonable drug use should be corrected in time to reduce the occurrence of adverse drug reactions.
2019 Vol. 26 (6): 453-455 [Abstract] ( 56 ) HTML (1 KB)  PDF (875 KB)  ( 175 )
456 Comprehensive evaluation of scientific research performance in a hospital by modified close-value method
Lin Jianchao
DOI: 10.3969/j.issn.1006-5253.2019.06.017
ObjectiveTo evaluate the scientific research performance of a comprehensive hospital from 2013 to 2018. Methods According to the statistical reports of the hospital's scientific research data, the modified close value method was used to evaluate the quality of the scientific research. Results  According to the closevalue method analysis, the research performance of the institute in 2017 was the smallest while the quality of scientific research was the best. However, the scientific research performance of 2014 was the worst. Conclusion  The result of comprehensive evaluation of the modified closevalue method is consistent with the actual situation of scientific research in this hospital. It could evaluate the work precisely.
2019 Vol. 26 (6): 456-458 [Abstract] ( 56 ) HTML (1 KB)  PDF (838 KB)  ( 147 )
459 Analysis on advantages and disadvantages of medical insurance payment reform in Zibo City
 
 [J]. journal1, 2019,26(6): 459-460')" href="#"> Fang Zeguo, Zhu Meilin
DOI: 10.3969/j.issn.1006-253.2019.06.018
Medical insurance payment is an important link in the management of basic medical insurance and an important lever to regulate the behavior of medical service and guide the allocation of medical resources. The reform of medical insurance payment is not only a technical reform, but also an important position in the new health care reform. It is a strategic issue related to the success of the new health care reform. In order to improve the efficiency of medical insurance fund and control the rapid growth of medical insurance expenses, Zibo City has been trying out the method of disease score payment under the total amount control since 2017. This method can ensure the strict execution of the health insurance fund budget, reduce the waste of medical resources and excessive medical behavior, and avoid the negative effects of quota allocation. But it does not solve the problem of reducing the necessary medical service in order to reduce the medical cost, which restricts the enthusiasm of the hospital to develop new technology and new business.
2019 Vol. 26 (6): 459-460 [Abstract] ( 64 ) HTML (1 KB)  PDF (856 KB)  ( 143 )
461 Effect evaluation of quality control team management joint information traceability system in pediatric outpatient infusion management
Cheng Xiaowei, Chen Si, Gao Xiaofei
DOI: 10.3969/j.issn.1006-5253.2019.06.019
Objective To study the application value of the quality control group management mode combined with information traceability system in the infusion refinement management of pediatric outpatients. Methods Totally 386 children who underwent infusion therapy in the Pediatric Outpatient Clinic from January 2017 to October 2018 were observed. All the patients were divided into the control group and the study group by reference to the random number table method, with 193 cases in each group. The patients in the control group were given separate fine management, and the patients in the study group were given quality control group management mode and the information traceability system in the refined management. The infusion waiting time, puncture pain degree, one-time puncture success rate, unplanned extubation rate, infusion complication rate, and nursing service quality were compared between the two groups. Results The infusion waiting time and puncture VAS scores of the study group were lower than those of the control group (P<0.05). The success rate of onetime puncture in the study group (89.1%, 172/193) was higher than that in the control group (76.2%, 147/193), and the unplanned extubation rate in the study group was (15.5%, 30/193) lower than that in the control group (36.8%, 71/193) (P<0.05); The total incidence of infusion complications in the study group (6.2%, 12/193) was lower than that in the control group (14.5%, 28/193) (P<0.05). The first-aid management, nursing safety, and ward management scores of the study group were higher than those of the control group (P<0.05).Conclusion The quality control group management mode combined with information tracing system has high application value in pediatric outpatient infusion refinement management, which can shorten infusion waiting time, reduce puncture pain, improve puncture quality and quality of care, and reduce the risk of infusion complications. It is worthy of clinical promotion.
2019 Vol. 26 (6): 461-464 [Abstract] ( 39 ) HTML (1 KB)  PDF (851 KB)  ( 161 )
465 Application of microcourse platform with microvideo as the main carrier in the nursing teaching of cardiothoracic surgery
Jiang Xiaofan
DOI: 10.3969/j.issn.1006-5253.2019.06.020
Objective To explore the application effect of micro-course platform with micro-video as the main carrier in nursing teaching of the Department of Cardiothoracic Surgery.  Methods Totally 80 nursing students who rotated in the Department of Cardiothoracic Surgery in our hospital were selected from Jan. 2016 to Jan. 2018, and they were divided into the observation group (n=40) and the control group (n=40) according to random number table method. The control group was taught with traditional PPT, while the observation group was taught with micro-video as the main carrier. The examination results of the two groups and the evaluation of the teaching effect between the two groups were compared. Results The scores of nursing theory and operation in the observation group were significantly higher than those in the control group (P<0.05). The nursing students in the observation group gave a higher evaluation of the teaching effect. Conclusion The application of micro-video as the main carrier of micro-course platform in cardiothoracic surgery nursing teaching can improve the effect of teaching.
2019 Vol. 26 (6): 465-467 [Abstract] ( 56 ) HTML (1 KB)  PDF (832 KB)  ( 98 )
468 Strengthening statistical audit of research subjects of the hospital, improving the overall level of scientific research
Wang Ruizheng, Wang Xue
DOI: 10.3969/j.issn.1006-5253.2019.06.021
Objective Statistical analysis is the key point to scientific research, so here we evolved an examination and verification process to avoid the common statistical error, thereby to enhance the standard of hospital research. Methods The technical work reports of scientific research subjects at all levels that have been completed in two tertiary hospitals in Jinan from 2015 to 2017 were selected as the research objects. One hundred and twenty research reports were selected after inclusion and exclusion criteria were set, and were reviewed by professional statisticians. The statistical errors found were analyzed with Microsoft Excel and SPSS. Results There were 4 types of statistical errors in scientific research projects at all levels, among which the incidence of statistical errors in national research projects was lower than that in municipal research projects, and the difference was statistically significant. Among all kinds of statistical errors, the errors of incomplete statistical analysis conclusions were the most, followed by the errors of sampling methods and testing methods. Conclusion Lack of statist participates and no statistical examination and verification during the study are the main reasons for the high statistical error incidence in hospital study. Thereby, it is necessary to improve the involvement and audit of the statisticians of the research project and improve the overall level of the research project.
2019 Vol. 26 (6): 468-470 [Abstract] ( 48 ) HTML (1 KB)  PDF (833 KB)  ( 145 )
471 Analysis of medical record utilization in a general hospital from 2010 to 2017  
Wen Jianzhen，Chen Danfen，Jiang Lifeng，Yang Shuai
DOI: 10.3969/j.issn.1006-5253.2019.06.022
Objective To retrospectively analyze the utilization of medical records in a general hospital from 2010 to 2017 to master the utilization of medical records. Methods The statistical data of medical records borrowed from Guangdong Medical Institution Statistical Management System and Hospital Information System and the data of various types of registration forms were classified and summarized, and chisquare test analysis was carried out with SPSS 16.0 software.Results From 2010 to 2017, the total number of medical records used was 166 012, and the utilization rate was 53.59%.The utilization rate of hospital medical records was not exactly the same each year with χ2=61.78, P<0.001. The utilization composition of medical records in and out of the hospital was not exactly the same for each year, with χ2=67.25，P<0.001. The use type composition of hospital medical records was not exactly the same for each year, with χ2=1 288.43，P<0.001. Conclusion We should improve the professional and service level of medical record managers, and provide medical record information for medical record users with simple and scientific methods as far as possible, without violating the authority of medical record use, so as to promote the development and utilization of hospital medical record information resources and improve the utilization rate of medical records.
2019 Vol. 26 (6): 471-473 [Abstract] ( 47 ) HTML (1 KB)  PDF (838 KB)  ( 107 )
474 Morphological coding analysis of papillary thyroid carcinoma
Li Xinmei, Xiao Xiaolan
DOI: 10.3969/j.issn.1006-5253.2019.06.023
Objective There are more variant subtypes of thyroid papillary carcinoma, which cause difficult coding of thyroid papillary carcinoma and are prone to miscoding. According to the histological classification criteria of thyroid tumors and the ICD-O-3 principle, the coding characteristics of thyroid papillary carcinoma are analyzed to improve the coding accuracy rate. Methods  The hospital medical record information inquiry system was used to retrieve 417 cases of thyroid papillary cancer diagnosed from January 2016 to December 2018 in a hospital. The ICD-O-3 classification rule was used to analyze the morphological coding situation of thyroid papillary carcinoma in a hospital for nearly 3 years. The existing problems were summarized and analyzed. Results There were 159 coding errors and the error rate was 38.13%. Among them, 2 cases of NOS were misclassified in M8000/3 malignant tumor, accounting for 0.48%; 149 cases were misclassified in M8050/3 papillary carcinoma, accounting for 35.73%; the disease classifier was not familiar with the pathological variant subtype of papillary thyroid carcinoma. Pathological diagnosis had given specific subtypes, but was misclassified in M8260/3 papillary adenocarcinoma in 8 cases, accounting for 1.92%; missing morphological morphology was 1 case, accounting for 0.24%.Conclusion Disease classifiers are unfamiliar with the pathological features and variant subtypes of thyroid papillary carcinoma, lack the homepage quality control link, and the coding library is relatively lagging behind clinical development. These reasons are likely to cause coding errors, so disease classification personnel must carefully read the medical records and pathology reports, actively communicate with clinicians and patho logists, update relevant knowledge structures, and continuously improve the accuracy of thyroid papillary cancer coding.
2019 Vol. 26 (6): 474-476 [Abstract] ( 55 ) HTML (1 KB)  PDF (830 KB)  ( 411 )
477 Simplified formula of interval estimation for normal population mean and its application in health statistics
Zhang Ya′nan, Rao Kelang
DOI: 10.3969/j.issn.1006-5253.2019.06.024
Objective To simulate the confidence interval estimation formula of the normal population mean with negative power function, in order to avoid the t boundary value table when calculating interval estimation. Methods According to the t boundary value (tα/2,v/√n) presenting the fast convergence of the change rule with the increase of sample size, the fitting analysis was carried out for classical interval estimation formula using the negative power function model, based on the least square method. Results The mathematical model derived from the linear combination of -1/2 and -2 power functions of n can fit the t boundary value with high precision. Through changing the constant coefficient of function model, the unilateral and bilateral confidence interval estimation empirical formula can be obtained with different confid ence level. Conclusion Three-parameters empirical formulas proposed have enough fitting precision, and the form is simpler, in which the only three parameters contained can be obtained easily from sample data, namely sample size, mean and standard deviation respectively. In this way, the process of searching in t boundary value table is omitted, which improves the application convenience of interval estimation theory.
2019 Vol. 26 (6): 477-480 [Abstract] ( 47 ) HTML (1 KB)  PDF (1163 KB)  ( 181 )
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