Implementation of a risk management plan in a hospital operating room

A risk management program based on ASeNZS4360 risk management standards was developed and implemented in the operating room of Peking University Third Hospital.To accomplish this task,we developed a risk quantification matrix and a risk register form to identify potential risks in the operating room,and then implemented operating room policies designed to reduce or eliminate those risks.We also established a consultation mechanism and risk monitoring system designed to minimize risks to operation room nurses.Finally,we continuously seek to improve our operating room risk management capabilities,so we can continue to improve the quality of service provided and guarantee the safety of surgical patients.

Risk Management Strategy for Agricultural Operation Subjects in Simple Scale Expansion Mode

Agricultural operation subject is a main body of the market economy. At present,the simple scale expansion mode is a major mode of agricultural operation in China. According to some hypothesis,scale expansion will inevitably bring high income,but such hypothesis has serious defects. The operation mechanism of the simple scale expansion mode includes farmer operation mechanism,professional farmer operation mechanism,and " company + farmers" operation mechanism. In the production and operation,they will be faced with different natural risks,technical risks,market risks and policy risks. Besides,their risk control ability is also varied. Therefore,it is required to take different agricultural risk management strategies. The " company + farmers" production and operation subjects have the highest ability of risk management. Other subjects should learn their experience.

Risk Management and Operation Strategies of Chinese Overseas Risk Exploration Projects

Currently,the investment of oil and gas industry is still facing an unfavorable environment,in which,instable factors,such as financial crisis,terrorist,religious conflicts and rigorous environmental regulations,keep mucking up the business all around the world.Meanwhile,China’s rapid energy consumption growth boosted by a booming economy has put the country to rely heavily on exported oil.It is therefore extremely urgent to expand and diversify petroleum supply channel in consideration of the country’s energy security.As the world’s economy has been slowly recovering from the slump and

Application effect of safety hazard self-examination mode in nursing risk management in hepatobiliary surgery

Objective:To explore the application effect of safety hazard self-examination mode in nursing risk management in hepatobiliary surgery.Methods:Sixty patients underwent hepatobiliary surgery in two tertiary hospitals in Shandong Province from May 2021 to October 2021.According to the different implementation time,they were divided into 30 cases in the observation group and 30 cases in the control group.The control group adopts routine risk assessment,and the observation group adopts the self-examination mode of potential safety hazards on the basis of routine risk assessment to compare the incidence of nursing risk between the two groups.Results:The observation group had a significantly lower incidence of safety hazards in terms of missing surgical instruments,lack of aseptic operation,and postoperative pressure injuries than the control group(P<0.05).Conclusion:The appropriate hazard self-examination mode in the hepatobiliary operation room is of positive significance to improve the safety awareness of operating staff and the comprehensive ability of operating room nurses.

Corporate Governance, Enterprise Risk Management, and Inter-temporal Risk Transfer

This work is an initial attempt to describe the interconnections among corporate governance,enterprise risk management,and the phenomena of inter-firm risk transfer that occurs in combination with firms’income smoothing.Corporate governance is conceived as a set of rules according to which a firm is managed and governed by its top managers.Extant literature on corporate governance has pointed out the benefits of the adoption,at a firm level,of a comprehensive enterprise risk management process.We note that,although such an adoption favors the smoothing of a firm’s income,in smoothing the income a firm,it also gives rise to an inter-temporal transfer of risk from the firm itself to its stakeholders,specifically to suppliers and employees.Such transfer of risk depends on the strength of a firm contractual power and on the structural relationships established by a firm with its stakeholders.We therefore argue that larger-sized organizations affiliated with a business group are likely to smooth income to a greater extent than smaller-sized organizations unaffiliated with a business group.The paper also offers some discussions of the findings and points out some important issues to be addressed in future studies.

Identification of Key Links in Electric Power Operation Based-Spatiotemporal Mixing Convolution Neural Network

As the scale of the power system continues to expand,the environment for power operations becomes more and more complex.Existing risk management and control methods for power operations can only set the same risk detection standard and conduct the risk detection for any scenario indiscriminately.Therefore,more reliable and accurate security control methods are urgently needed.In order to improve the accuracy and reliability of the operation risk management and control method,this paper proposes a method for identifying the key links in the whole process of electric power operation based on the spatiotemporal hybrid convolutional neural network.To provide early warning and control of targeted risks,first,the video stream is framed adaptively according to the pixel changes in the video stream.Then,the optimized MobileNet is used to extract the feature map of the video stream,which contains both time-series and static spatial scene information.The feature maps are combined and non-linearly mapped to realize the identification of dynamic operating scenes.Finally,training samples and test samples are produced by using the whole process image of a power company in Xinjiang as a case study,and the proposed algorithm is compared with the unimproved MobileNet.The experimental results demonstrated that the method proposed in this paper can accurately identify the type and start and end time of each operation link in the whole process of electric power operation,and has good real-time performance.The average accuracy of the algorithm can reach 87.8%,and the frame rate is 61 frames/s,which is of great significance for improving the reliability and accuracy of security control methods.

基于风险管理的全院“一张床”管理模式的构建与应用

目的:探讨基于风险管理的全院“一张床”管理模式的构建及运行成效。方法:2023年8月我院上线了基于病人信息管理系统、床位调配系统优化后的全院“一张床”管理系统,建立全院“一张床”管理模式,包括相关政策制定、人员培训和技术支持等,并出台了保证病人安全的举措。比较实施前(2022年8月—12月)与实施后(2023年8月—12月)全院收住院病人数量、手术病人数量、平均住院日及满意度评价指标变化。结果:全院2023年8月—12月接收住院病人数量较2022年同比上升27.91%,接收手术病人数量较2022年同比上升38.71%,平均住院日较2022年同比下降11.93%,平均床位使用率较2022年同比上升9.01%,满意度评分较2022年同比上升1.40%。结论:基于风险管理的全院“一张床”管理模式,提升了医院住院病人、手术病人的收治能力,缩短了平均住院时间,提高了病人满意度。

骨科患者术中下肢深静脉血栓风险增高的血流变化及影响因素

目的探讨骨科患者术中下肢深静脉血栓(DVT)风险增高的血流变化特点并分析其影响因素,为手术室护理干预提供临床指导。方法选取151例骨科择期手术患者为研究对象,术中使用多普勒超声诊断仪观察下肢血流改变特征,并收集患者基本资料、手术相关资料、术前实验室检查指标等,患者手术结束24 h内采血行D-二聚体凝血功能检测。结果D-二聚体检测结果显示,DVT高风险患者70例(46.36%),低风险81例(53.64%)。手术结束后DVT高风险患者下肢平均血流速度、血管内径显著低于或小于低风险患者(均P<0.05)。logistic回归分析显示,手术时间>120 min、凝血酶原时间(PT)>13.1 s、术中发生低体温和术中失血量>100 mL是骨科患者术中DVT风险增高的独立危险因素(均P<0.05)。结论骨科手术患者术中DVT发生风险较高,存在明显血流动力学改变。手术室护理人员需针对性地开展手术效率管理、术中低体温监测和预防、维持术中血容量稳定,有效降低骨科手术患者术中DVT发生风险。

失效模式与效应分析提升手术室软式内镜清洗消毒质量的效果

目的探讨失效模式与效应分析(FMEA)在提升手术室软式内镜清洗流程风险管理中的应用效果。方法选择上海交通大学医学院附属瑞金医院2021年1月1日至12月1日自动内镜清洗消毒机(AER)清洗消毒后的内镜共827镜次设为FMEA实施前组,2022年1月1日至12月1日AER清洗消毒后的内镜共844镜次设为FMEA实施后组。运用FMEA对手术室软式内镜清洗操作程序中的各个环节进行分析,通过计算风险优先指数(RPN)查找每个环节中的高危因素,针对RPN>125的关键环节制订改进方案并予以实施。比较FMEA实施前后的失效模式RPN值、内镜消毒合格率、内镜故障维修率、手术患者等待时间、手术室护士AER操作熟练度以及医生满意度。结果FMEA实施后,经过筛选并整改的5个项目的RPN值均下降至<125分;总体的RPN值由1247.24分下降至475.05分,RPN值下降率为61.91%;FMEA实施前后内镜消毒合格率及内镜故障维修率差异均无统计学意义(P>0.05);FMEA实施后手术患者等待时间短于实施前[(10.35±1.57)min vs(12.38±1.91)min],手术室护士AER操作得分及医生满意度高于实施前[(92.50±3.92)分vs(80.49±5.64)分,(93.87±2.16)分vs(83.07±3.10)分],差异均有统计学意义(P<0.05)。结论通过应用FMEA针对性优化相关操作流程,使手术室护士对软式内镜的清洗操作更加熟练,有助于提高清洗效率与质量、减少手术患者的等待时间、提升医生满意度。

新形势下地质勘查单位安全管理研究分析

安全管理对于新时期的矿产地质勘查单位越来越重要,简要分析当前地质勘查单位在安全管理中存在的短板,然后结合矿产地质勘查单位特点,从提升人员安全意识、落实安全生产责任制、健全安全生产管理制度、抓好安全教育培训、提升野外保障能力等方面详细阐述安全管理措施,最后对地质勘查单位关键环节领域进行重点研究分析,有助于地质勘查行业相关单位提升安全管理水平。

基于ELM神经网络的高速公路隧道运营风险评估模型

为克服传统高速公路隧道运营安全风险评估方法计算过程繁琐、运算效率低及泛化能力差等问题,采用极限学习机(Extreme Learning Machine,ELM)神经网络模型对高速公路隧道运营风险进行评估。首先,基于系统工程理论,分析了高速公路隧道运营风险影响因素,构建了运营风险评估指标体系。然后,以全国126个隧道典型运营事故数据为样本集,基于ELM神经网络算法,对比不同激活函数模型的分类准确率和测试时间指标,选定Sigmoid作为激活函数,训练得到高速公路隧道运营风险评估模型。最后,以该模型为核心算法开发了隧道运营风险评估系统,并依托广东省某高速公路隧道路段开展了工程应用。结果表明,所构建的风险评估模型简化了人工计算过程,可提升高速公路隧道运营风险评估的及时性和有效性。

现代化水库运行管理矩阵体系分析与构建关键问题研究

为支撑行业重点任务建设,提高现代化水库运行管理矩阵的建设水平,通过文献查阅、实地考察和交流咨询等方法,绘制了以工程安全、设施设备、影响区、运行调度和管理监督5个关键环节为一体的现代化水库运行管理矩阵构建体系“一张图”。给出了现代化水库运行管理矩阵的整体架构、层次演进和各要素之间的相互关系,系统梳理了现代化水库运行管理矩阵提出的背景、内涵和要求,对“四全”、“四制(治)”、“四预”、“四管”和雨水情监测预报、工程安全风险感控、生产安全风险感控“三道防线”的对象进行了系统整合和扩展,分析了各概念之间的相互关系和关键技术问题。研究结果表明,构建现代化水库运行管理矩阵是科技和管理水平发展的必然要求。

“双碳”视角下煤炭上市公司全面风险管理水平对经营效率影响

全面风险管理作为提升公司经营效率和风险防范能力的重要手段,为促进煤炭上市公司低碳转型,助力“双碳”目标提供新引擎。文中基于“双碳”视角,采用三阶段DEA-Malmquist模型测算我国煤炭上市公司2008—2022年的经营效率;采用门槛模型和固定效应模型,对煤炭上市公司全面风险管理与经营效率的关系进行研究。研究结果表明:我国煤炭上市公司总体经营效率偏低,经营根据投影值分析,R&D人员、R&D经费投入冗余是造成煤炭上市公司效率无效的主要原因;风险管理流程对全要素生产率、技术效率、规模效率呈现倒“U”型双门槛特征,其通过规模效率的变动进一步影响公司技术效率变动,最终对全要素生产率产生影响;风险管理文化对效率作用效果影响不明显。建议合理调整公司R&D投入,制定基于ESG发展理念的全面风险管理路径,实现公司经营效率系统的平衡。

商业银行信用风险数字化管理体系建设

随着银行业的不断发展和国家监管要求的加强,商业银行信用风险管理已经成为一个重要问题。本文从数字化管理体系方面出发,探讨商业银行信用风险数字化管理的必要性,并提出信用风险数字化管理体系的构建框架和管理准则。通过梳理国内外相关研究和实践经验,总结出商业银行信用风险数字化管理体系的关键指标和操作流程。分析了信用风险数字化管理体系效果和现有问题,并提出相应的改进建议。

基于关联性风险分析的过程管理策略对医疗设备运行效益的影响研究

目的:基于医疗设备关联性风险分析,制定过程性管理策略,提高医疗设备临床运行效益。方法:制定医疗设备管理对策,从主体、质量、环境、制度和诊疗角度进行风险矩阵评估,建立关联性风险综合评估模型。选取2021年4月至2022年3月上海市第八人民医院临床在用的400台医疗设备,采用数表法将其分为对照组和观察组,每组200台,对照组采用个体化风险分析法进行过程性管理,观察组采用关联性风险分析法进行过程性管理。对比分析两组医疗设备的风险等级和运行效益。结果:观察组医学影像诊断及辅助设备、手术治疗设备、生命支持与急救设备、体外循环及血液处理设备和健康监测及康复设备的高危险占比分别为17.39%(4/23)、14.58%(7/48)、12.24%(6/49)、5.55%(1/18)和5.06%(5/62),均低于对照组,其差异有统计学意义(x^(2)=4.132、4.009、6.275、4.833、4.859,P<0.05);观察组医疗设备的成本效益、社会效益、诊疗效益和发展效益评分分别为(91.37±6.15)分、(92.78±3.80)分、(95.25±2.09)分和(90.51±3.82)分,均高于对照组,其差异有统计学意义(t=2.392、3.877、4.841、2.504,P<0.05)。结论:关联性风险分析方法可降低医疗设备安全风险发生概率和危害程度,提高医疗设备临床运行效益,过程管理策略符合医疗设备全生命周期管理的实际需要。

基于NLP的油气非常规作业风险识别及管控措施推送

本文介绍了一种基于自然语言处理(NLP)技术的油气非常规作业风险识别及管控措施推送方法。该方法通过构建非常规作业JSA知识库和风险智能识别模型,并集成于非常规作业许可管理系统中,实现了对油气非常规作业风险的高效自动识别和针对风险的管控措施精准推送,最终提高油气非常规作业风险管控水平。