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Objective:To construct a risk prediction and assessment system for incisional infection after spinal surgery.Methods:Based on the failure mode and effect analysis (FMEA), risk factors and assessment indicators of postoperative incisional infection in spinal surgery were sorted out through literature search followed by expert consultation using the Delphi expert consultation method. After three-level assessment indicators were selected according to their importance and expert opinions and assigned by different scores, a risk prediction and evaluation system was constructed for postoperative incisional infection after spinal surgery.Results:The 2 rounds of expert consultation questionnaire resulted in an effective response rate of 100%. The degree of expert consultation authority was 0.85, showing high reliability; the Kendall coordination coefficients of expert consultation ranged from 0.525 to 0.686, showing good coordination ( P<0.05). The three-level assessment indicators consisted of 3 primary, 18 secondary and 54 tertiary ones. After statistical analyses of the important risk indicators selected which consisted of 6 preoperative evaluation ones and 18 postoperative evaluation ones, 6 preoperative and 12 postoperative predictive indicators were obtained. The values of risk priority number (RPN) were calculated for high, medium and low risks for postoperative incisional infection using a semi-quantitative method. Conclusion:A self-designed system has been constructed for risk prediction and assessment of incisional infection after spinal surgery based on expert consultation and FMEA method.
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Objective To explore what kind of strategies should be adopted by the medical disciplines of comprehensive universities in China,taking into account and respect the particularity nature of medical science,inspiring innovative creation to build the First-Class disciplines.Methods Literature review and quantitative research were adopted in this paper.By reviewing published articles to better understand the special laws of medical disciplines and identify current development problems.Furthermore,the data from ESI,QS Ranking,and the Ministry of Education were collected to reveal problems and to propose strategies.Results The future development of Medicine disciplines possesses the characteristics of integration,technology dependence,heterogeneity,etc.In the new era of building world-class disciplines and first-class universities,compared with international first-class disciplines,peaks of medical disciplines in Chinese universities are still relatively scarce.The comprehensive university medical discipline should adhere to the principle of ‘connotative development’.In the process of construction,medical discipline should pay full attention to cross-integration,promote cross-disciplinary,adjust and optimize the former system.Strengthen the construction of new disciplines development to build medical disciplines with distinctive features.Optimize top-level design to foster disciplines peaks.Attach great importance to the construction of talents to build up high-level talent team with sustainable development ability.Emphasize on medical education to improve the quality of personnel training.Promote institutional innovation to activate the vitality of integration.Build an effective evaluation system to promote construction.Conclusions With the premise of fully respecting the special laws and characteristics,the medical discipline constructions of comprehensive universities should be guided by the future development model of medicine and clinical needs,and adhered to the ‘connotative development’.With the development of medical disciplines,the level of clinical diagnosis and treatment will be improved,the original innovation will be enhanced,as well as the social service capabilities of comprehensive universities,furthermore,the frontiers of scientific development and national strategic development needs will be effectively supported.
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OBJECTIVE: The aim of the study was to survey the current burn units in China to understand the burn care system in the country and supply basic data for the National Burn Repository of China (NBRC) and further research. METHOD: A questionnaire was developed and sent to burn unit directors in China via e-mail, which was followed up with reminder text messages to obtain information for the study. RESULTS: Of the 405 hospitals from the 31 provinces in mainland China that responded to the questionnaire, 63.7% of the responses came from Grade 3A hospitals, and the most popular model of organisation was the Burns and Plastic Surgery arrangement (63.0%). An average of 9.43±0.351 doctors work in each burn unit with 70.4% of all units having 4-11 doctors. The ratio of chief surgeon to associate chief surgeon to attending surgeon to resident surgeon and surgeon assistant was 1:1.8:2.2:2.3. An average of 30% of all doctors in each burn unit held postgraduate degrees, and more than 90% of all surgeons held a bachelor's degree or higher. There were 16.48±0.637 nurses per burn unit, 56.5% of burn units had 8-15 nurses, and the ratio of chief nurse to associate chief nurse to supervisor nurse to nurse practitioner to junior nurse was 1:11.8:57.0:82.1:86.1. More than 80% of all nurses had received a college education or above. However, only 30% of nurses held bachelor's degrees or higher, while only 0.66% of nurses had received postgraduate degrees. A total of 39.91±1.50 beds were available in each burn unit and 45% of burn units had 20-39 beds. Up to 70% of the total beds were prepared for patients with burn, and more than 10% of the beds were specifically for patients with severe burn. The ratios of doctors to nurses, beds to doctors, beds to nurses, and beds to doctors and nurses were 0.64±0.01, 4.48±0.12, 2.67±0.09, and 1.66±0.06, respectively. The workload of each doctor and nurse was most heavy in units with 40-59 beds. In addition, we estimated that there were 0.05, 0.5, 0.8, and 1.9 burn units, burn doctors, nurses, and beds, respectively, per 100,000 members of the population in mainland China. Chinese burn units lack special burn treatments, nursing equipment, and operation apparatuses. CONCLUSION: To the best of our knowledge, this is the first survey of the present burn care system in China. These results confirm that the burn care system is not equivalent to the national power of this country and the system lacks a great number of trained burn professionals. Burn doctors and nurses bear a heavy burden of work. This report supplies basic data to spur further research. We propose creating a burn unit registration system and a special database in China.
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Burn Units/organization & administration , Burns/therapy , Health Services Accessibility/organization & administration , China , Educational Status , Equipment and Supplies, Hospital/statistics & numerical data , Health Services Research , Hospital Bed Capacity/statistics & numerical data , Humans , Medical Staff, Hospital/supply & distribution , Nursing Staff, Hospital/supply & distribution , Surveys and Questionnaires , Workforce , Workload/statistics & numerical dataABSTRACT
In this article,the strategy and achievements of the interdisciplinary in recent years in Peking University are summarized.We also discussed the remaining problems in the development of medical science and interdisciplinary as well as how to improve the management system and operational mechanism.
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Research collaboration and interdisciplinary integration is anecessary trend of the development of science and technology,and is especially true in biomedical field.This paper describes the interdisciplinary practice of the projects at Peking University Health Science Center in recent years.Problems and the efficiency of the management is also analysed.
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In this report, we summarized the achievements of Peking University Health Science Center (PUHSC) after implementating "985 Project Ⅱ ," and analyzed the gap between PUHSC and worldclass universities. Suggestions were also made for the improvement in the future.