Objective:This study aimed to describe the implementation of the surgical safety check policy and the surgical safety checklist for invasive procedures outside the operating room(OR)and evaluate its effectiveness.Meth...Objective:This study aimed to describe the implementation of the surgical safety check policy and the surgical safety checklist for invasive procedures outside the operating room(OR)and evaluate its effectiveness.Methods:In 2017,to improve the safety of patients who underwent invasive procedures outside of the OR,the hospital quality and safety committee established the surgery safety check committee responsible for developing a new working plan,revise the surgery safety check policy,surgery safety check Keywords:Invasive procedures outside the operating room Safety management Surgical safety checklist Patient safety form,and provide training to the related staff,evaluated their competency,and implemented the updated surgical safety check policy and checklist.The study compared the data of pre-implementation(Apr to Sep 2017)and two post-implementation phases(Apr to Sep 2018,Apr to Sep 2019).It also evaluated the number of completed surgery safety checklist,correct signature,and correct timing of signature.Results:The results showed an increase in the completion rate of the safety checklist after the program implementation from 41.7%(521/1,249)to 90.4%(3,572/3,950),the correct rates of signature from 41.9%(218/521)to 99.0%(4,423/4,465),and the correct timing rates of signature from 34.4%(179/521)to 98.5%(4,401/4,465),with statistical significance(P<0.01).Conclusion:Implementing the updated surgery safety check significantly is a necessary and effective measure to ensure patient safety for those who underwent invasive procedures outside the OR.Implementing surgical safety checks roused up the clinical staff's compliance in performing safety checks,and enhanced team collaboration and communication.展开更多
In traditional framework,mandatory access control(MAC) system and malicious software are run in kernel mode. Malicious software can stop MAC systems to be started and make it do invalid. This problem cannot be solved ...In traditional framework,mandatory access control(MAC) system and malicious software are run in kernel mode. Malicious software can stop MAC systems to be started and make it do invalid. This problem cannot be solved under the traditional framework if the operating system(OS) is comprised since malwares are running in ring 0 level. In this paper,we propose a novel way to use hypervisors to protect kernel integrity and the access control system in commodity operating systems. We separate the access control system into three parts: policy management(PM),security server(SS) and policy enforcement(PE). Policy management and the security server reside in the security domain to protect them against malware and the isolation feather of the hypervisor can protect them from attacks. We add an access vector cache(AVC) between SS and PE in the guest OS,in order to speed up communication between the guest OS and the security domain. The policy enforcement module is retained in the guest OS for performance. The security of AVC and PE can be ensured by using a memory protection mechanism. The goal of protecting the OS kernel is to ensure the security of the execution path. We implementthe system by a modified Xen hypervisor. The result shows that we can secure the security of the access control system in the guest OS with no overhead compared with modules in the latter. Our system offers a centralized security policy for virtual domains in virtual machine environments.Keywords: hypervisor; virtualization; memo-展开更多
文摘Objective:This study aimed to describe the implementation of the surgical safety check policy and the surgical safety checklist for invasive procedures outside the operating room(OR)and evaluate its effectiveness.Methods:In 2017,to improve the safety of patients who underwent invasive procedures outside of the OR,the hospital quality and safety committee established the surgery safety check committee responsible for developing a new working plan,revise the surgery safety check policy,surgery safety check Keywords:Invasive procedures outside the operating room Safety management Surgical safety checklist Patient safety form,and provide training to the related staff,evaluated their competency,and implemented the updated surgical safety check policy and checklist.The study compared the data of pre-implementation(Apr to Sep 2017)and two post-implementation phases(Apr to Sep 2018,Apr to Sep 2019).It also evaluated the number of completed surgery safety checklist,correct signature,and correct timing of signature.Results:The results showed an increase in the completion rate of the safety checklist after the program implementation from 41.7%(521/1,249)to 90.4%(3,572/3,950),the correct rates of signature from 41.9%(218/521)to 99.0%(4,423/4,465),and the correct timing rates of signature from 34.4%(179/521)to 98.5%(4,401/4,465),with statistical significance(P<0.01).Conclusion:Implementing the updated surgery safety check significantly is a necessary and effective measure to ensure patient safety for those who underwent invasive procedures outside the OR.Implementing surgical safety checks roused up the clinical staff's compliance in performing safety checks,and enhanced team collaboration and communication.
基金supported by the National 973 Basic Research Program of China under grant No.2014CB340600the National Natural Science Foundation of China under grant No.61370230 and No.61662022+1 种基金Program for New Century Excellent Talents in University Under grant NCET-13-0241Natural Science Foundation of Huhei Province under Grant No.2016CFB371
文摘In traditional framework,mandatory access control(MAC) system and malicious software are run in kernel mode. Malicious software can stop MAC systems to be started and make it do invalid. This problem cannot be solved under the traditional framework if the operating system(OS) is comprised since malwares are running in ring 0 level. In this paper,we propose a novel way to use hypervisors to protect kernel integrity and the access control system in commodity operating systems. We separate the access control system into three parts: policy management(PM),security server(SS) and policy enforcement(PE). Policy management and the security server reside in the security domain to protect them against malware and the isolation feather of the hypervisor can protect them from attacks. We add an access vector cache(AVC) between SS and PE in the guest OS,in order to speed up communication between the guest OS and the security domain. The policy enforcement module is retained in the guest OS for performance. The security of AVC and PE can be ensured by using a memory protection mechanism. The goal of protecting the OS kernel is to ensure the security of the execution path. We implementthe system by a modified Xen hypervisor. The result shows that we can secure the security of the access control system in the guest OS with no overhead compared with modules in the latter. Our system offers a centralized security policy for virtual domains in virtual machine environments.Keywords: hypervisor; virtualization; memo-
