RESUMO
Optimizing pre-hospitalized services is a powerful measure for hospitals to improve patient experience. In June 2022, a certain maternal and child health hospital had carried out a value chain management for pre-hospitalized patient communication based on patient needs. The Kano model and value chain theory were used to analyze the patient demand attributes, clarify the value-added activities of pre-hospitalized patient communication value chain, and implement value-added activities, including carrying out the GLTC doctor-patient communication model, optimizing the information management system of the admission preparation center, establishing a hospital preparation group management platform, and introducing the " Zhejiang Nursing" platform, to achieve the added value of key value chains in patient communication, improve the quality of pre-hospitalized services, and improve patient experience. After one year of practice, the pre-hospitalized patient management indexes, including the unregistration rate after issuing the hospitalization certificate, the cancellation rate after registration, and the average length of stay had decreased from 9%, 3%, and 4.65 days before practice (June 2021 to May 2022) to 6%, 1%, and 4.13 days after practice (June 2022 to May 2023), respectively. As well as the timely completion rate of pre-hospital inspection and the average satisfaction rate of pre-hospitalized patients had increased from 93% and 94% to 98% and 97%, respectively. The practice had achieved good application effects, so as to provide references for improving the level of pre-hospitalized services and improving the patient experiences in medical institutions in our country.
RESUMO
Based on synergetics, system theory and dissipative structure theory, the connotation and composition of the compound system of rural public health service in country area are described in the paper. The authors proposed that the synergy degree model of the compound system for rural public health service in county areas comprises the order degree model and the synergy degree model of the compound system, which are composed of such subsystems as functionality, service network, demand, and economy. They also probed into the evaluation method for synergy degree and built the measuring index system of synergy degree comprising 59 level-2 evaluation indicators.
RESUMO
Objective The incidence rate of pressure ulcer is high in critical patients and off-loading mattresses and reposi-tioning are known as effective interventions for the prevention of pressure ulcers .However, evidence is lacking for selection of the right type of mattresses and suitable interval of repositioning .This study was to compare the effects of two types of off-loading mattresses with two different repositioning intervals in preventing pressure ulcers in critical patients . Methods According to the design of this ran-domized controlled trial , we made a training plan concerning the participants , methods of intervention and comparison , criteria and methods of observation , and methods of recording , and trained 26 nurses from 7 hospitals .Using non-inferiority design and the method of stratified blocked randomization , we divided 1194 patients with the risk of pressure ulcer into a trial group ( n=596) and a control group ( n=598) , a viscoelastic sponge mattress with every-four-hours repositioning used for the former and an automatic aeration mat-tress with every-two-hours repositioning for the latter , both for 7 successive days .We examined the patients every day , recorded the in-cidence and stages of pressure ulcer , and compared the data obtained between the two groups of patients . Results The total inci-dence rate of pressure ulcer was 1.09%(13/1194), significantly lower in the trial than in the control group (0.34%[2/596] vs 1.84%[11/598], P=0.012). Conclusion A viscoelastic sponge mattress with every-four-hours repositioning is superior to an automatic aeration mattress with every-two-hours repositioning and therefore is preferred to the latter in preventing the incidence of pressure ulcer in critical patients in the ICU .
RESUMO
The blocking effect of selenium-enriched malt (Se-malt) on AFB1-in-duced UDS was reported. When the rats were fed with food containing lppm Se in form of Se-malt for two weeks, the UDS values of leukocytes treated with 6?10-7M AFB1 in vitro was decreased from 54.8 ?14.0 opm/106 WBC to 35.1?10.0 cpm/106 WBC (p