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Objective: To explore the potential risks in hospital medication management system and propose the preventive meas-ures. Methods: The medication error (ME) cases reported from Jan 1st2012 to Dec 31st2016 in our hospital were retrospectively ana-lyzed in terms of ME category, classification, occurrence link, cause, influencing factors, detecting person and the proportion of high-alert medication MEs. Results: A total of 425 ME reports were collected, and among them, 311 cases were related to western medi-cines (73. 18% ), and 114 cases were related to traditional Chinese medicines (26. 82% ). The proportion of ME in category A, B and C was 4. 24% , 89. 65% and 5. 41% , respectively; the proportion of ME in category D, E and F was 0. 24% . ME in category G, H and I was not reported. In terms of the ME classification, the proportion of drug variety error was the highest (23. 29% ) followed by the repeated medication error (9. 41% ) and the dosage error (8. 94% ). As for the ME occurrence link, the proportion of prescription error was the highest (73. 18% ) followed by the dispensing error (16. 94% ). The top factor to trigger ME was lack of knowledge (26. 82% ) followed by the similar drug name (21. 41% ). The main person who detected ME was pharmacists (93. 88% ). Among of the 425 ME reports, 81 cases were related to high-alert medication, and the top two were insulin errors (48. 15% ) and oral hypoglyce-mic agents errors (23. 46% ). Conclusion: It can partly prevent ME by improving selection and management of new drugs, improving drug information system, enhancing drug quality management and strengthening safe medication knowledge education.
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RESUMO A conservação dos recursos hídricos demanda ações de controle do uso e da ocupação do solo, influenciando instrumentos de gestão territorial nas escalas regional e local. O objetivo deste artigo foi analisar os instrumentos de planejamento territorial aplicados no Brasil, tendo como estudo de caso o litoral norte do Estado de São Paulo. A metodologia é baseada na análise da articulação dos dispositivos legais, notadamente a Política Nacional dos Recursos Hídricos, o Estatuto da Cidade, o Plano de Bacia Hidrográfica, o Zoneamento Ecológico-Econômico e o Plano Diretor Municipal. Como resultados, são apontadas dificuldades relacionadas ao uso de instrumentos normativos de integração, com a ausência de ferramentas de suporte à decisão das distintas competências.
ABSTRACT The conservation of water resources deals with spatial plans, influencing territorial management tools at regional and local scale. This paper aimed to analyze the planning tools applied in Brazil, focusing on the Northern Coast of São Paulo. The methodology was based on the analysis on the articulation of laws: Política Nacional de Recursos Hídricos, Estatuto da Cidade, Plano de Bacia Hidrográfica, Zoneamento Ecológico-Econômico and Plano Diretor Municipal. As results, there are troubles in the laws interaction's, with lack of decision support tools.
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ABSTRACT Identifying and ranking nutrient loss risk areas are important steps towards integrated catchment management. This study aimed to apply the P index model at the Posses catchment, south of the state of Minas Gerais, Brazil. We applied the P index for the current land use at the Posses catchment and for two hypothetical scenarios: scenario 1, in which P fertilizer was applied to all land uses, except for native forests; and scenario 2, which considered the use of P fertilizer as in scenario 1, and that the Environmental Protection Areas referring to the riparian forests and springs were totally restored. Considering current land use, almost the whole catchment area (91.4%) displayed a low P loss risk. The highest P index was associated to croplands and eucalyptus plantations. Regarding scenario 1, areas under pasture fell into the low (15.1%), medium (45.5%), high (27.1%) and very high (12.3%) P index categories. Environmental Protection Areas on scenario 2 decreased the P loss risk from the scenario 1 in 37.6%. Hence, the model outputs indicate that the reforestation of buffer zones can decrease P loss risk in the case increasing use of P fertilizer. The P index model is a potential support tool to promote judicious use of fertilizers and conservation practices at the Posses catchment.
RESUMO Identificar e classificar áreas quanto ao risco de perda de nutrientes são passos importantes para o manejo integrado de bacia hidrográfica. O objetivo deste estudo foi aplicar o modelo Índice P na bacia hidrográfica das Posses, Extrema-MG. O Índice P foi empregado sobre as condições atuais de uso da terra na bacia hidrográfica das Posses e na simulação de dois cenários: cenário 1, o fertilizante P foi aplicado para todos os usos, exceto para florestas nativas e, cenário 2, além do fertilizante P ser aplicado da mesma forma que no cenário 1, considerou-se que as Áreas de Proteção Ambiental referentes as matas ciliares e nascentes fossem totalmente restituídas. Considerando o uso atual, quase toda a bacia hidrográfica (91,4%) apresentou baixo risco de perda de P. O maior Índice de P foi associado a lavouras e plantações de eucalipto. No cenário 1, as pastagem apresentaram Índice P baixo (15,1%), médio (45,5%), alto (27,1%) e muito alto (12,3%). No cenário 2, as Áreas de Proteção Ambiental promoveram uma redução de 37,6% no risco de perda de P do cenário 1. Dessa forma, os resultados do modelo indicam que o reflorestamento de matas ciliares pode reduzir o risco de perdas de P no caso do aumento do uso de fertilizantes. O Índice P é uma potencial ferramenta para promoção do uso criterioso de fertilizantes e de práticas conservacionistas na bacia hidrográfica das Posses.
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Objective To analyze the regional management policies for the configuration and utilization of medical facilities before the issuing of Regulations for the Supervision and Administration of Medical Devices in May 2017, so as to provide reference for relevant policy-making in the future. Methods Regional policies in 15 provincial-level administrative regions such as Zhejiang, Shanghai and Hunan were collected and analyses were conducted on regulations of the configuration management, application and discard of large-scale medical facilities. Results While regional policies played a crucial role in the configuration and administration of medical facilities, problems still existed, and proposals were made on future policy-making accordingly. Conclusion Policies for the configuration and administration of medical facilities require to be improved.
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Objective To investigate and analyze the management of high-value medical consumables in the district hospitals of Nanjing so as to facilitate their standardized management.Methods The present situation of high-value medical consumables management in the district hospitals of Nanjing was studied with mass screening,questionnaire and field survey,and discussion meeting and case history sampling were also involved into the study.Results The high-value medical consumables management had problems in organization,clinical application,informatization,supervision and etc.Conclusion The standardized high-value medical consumables management has to be executed from the aspects of rules and regulations,clinical application,informatization,supervision and etc to ensure their safe use in the hospitals.
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Aims: To provide a soil quality assessment frame work and threshold limits for assessing soil quality in Ultisol of subtropical China region. Study Design: Selected minimum data set for soil quality assessment and threshold limits for the study were total carbon, nitrogen, soil pH and phosphorus, biomass carbon, nitrogen and phosphorus, maize grain and fresh potato tuber yields. Soil data (2000-2010), maize grain and fresh potato yield data (2000-2009) from a long term experiment under the Institute of subtropical Agriculture, China were analyzed using the SAS statistical package and means were graphically compared to determine threshold limits for selected data set and fitted into a soil quality model. Place and Duration of Study: The key Laboratory for Agro-ecological Processes in Subtropical Regions, Chinese Academy of Sciences; Institute of Subtropical Agriculture, Changsha, Hunan China long-term experimental site in Taoyuan county, conducted from the year 2000 to 2010. Methodology: Soils samples at the experimental fields were obtained from depths 0-20 cm using an auger at each replicate in triplicates and homogenized to obtain a composite sub sample, air-dried, sieved through 2.0 mm to obtain samples for analysis in the Laboratory. Parameters analyzed for were organic carbon concentration, measured by the combustion method using an automated C/N analyzer (Vario MAX CN, Elemental Co., Germany) while total nitrogen was by the Kjeldahl method of ISSCAS (1978). Microbial carbon, nitrogen and phosphorus levels were determined using the chloroform-fumigationextraction method (Jenkinson and Powlson, 1976; Vance et al., 1987; Brookes et al., 1982) and adopting the conversion factors 0.45 (Wu et al., 1990), 0.45 (Brookes et al., 1985), and 0.29 (Wu et al., 2000) respectively for the C, N and P. Extractable N and Olson P were taken from values obtained from the non fumigated soil samples. Data obtained were statistically analyzed using the SAS package for ANOVA and significant means were separated using the Duncan’s New Multiple Range Test (DNMRT). Treatment means were also matched graphically to delineate critical threshold limits between classes for each parameter. Soil quality was assessed by using the Parr et al. (1992) equation; SQ =ƒ(SP,P,E,H, ER,BD,FQ, MI); where SQ= soil quality, SP= soil properties, P = potential productivity, E=environmental factor, H= health (human/animal), ER= erodibility, BD= biodiversity, FQ= food quality and MI= management input. A score scale of 1 to 5 was used in the assessment of parameters in the model; where 1 is best and 5 is the worst condition. However, E, H, ER, FQ and MI were each scored 1.0 because the long-term experiment has an environmental component, health factor, biodiversity, food quality and management input components that are being optimally managed. Therefore SQ= f(SP, P) was used to assess quality of the Ultisol at the uplands and slope land locations. Results: At the uplands, the practice of maize-rape/marsh residue+NK (8.54gkg-1 C, 1.0 gkg-1 N and 5.67 mgkg-1 P) treatments could be rotated with Maize-rape/nil fertilizer (7.51 gkg-1 C, 0.87 gkg-1 and 0.39 mgkg-1 P) to encourage improved soil quality by allowing for more years with soil carbon sequestration, nitrogen and phosphorus credit than years of depletion and discourage soil degradation. At the slope lands, treatments that combined application of organic and inorganic fertilizer materials [Sweet potato-rape/NP+straw (7.18 gkg-1 C, 0.88 gkg-1 N and 0.38 mgkg-1 P) and Peanut-broadbean/NP+straw (6.81 gkg-1 C, 0.86 gkg-1 N and 0.38 mgkg-1 P)] improved soil quality significantly over time by sequestering significantly higher total carbon, nitrogen and phosphorus better than sole inorganic fertilizer [Sweet potato-rape/NPK (6.52 gkg-1 C, 0.81 gkg-1 N and 0.38 mgkg-1 P)]. Conclusion: Ultisol at the upland positions had better quality (SQ1) than those at the slope (SQ2) positions. Threshold limits for nutrients, pH and yield of maize and Fresh Potato tubers in the subtropical China region Ultisol was developed.
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Medical equipment maintenance management as an important part of hospital management has always been a difficulty, particularly in small and medium-sized hospital. Because of their weak technical force and the growing diversity, complexity, high-tech modern medical equipment, methods for scientific and effective management are more important. The experiences of how to manage equipment maintenance are introduced.