Health personnel-targeted education interventions on inpatient suicide prevention in general hospitals:A scoping review

Background:Inpatient suicide is an important part of patient safety management in general hospitals.Incidence of inpatient suicide can be decreased by health personnel mastering inpatient suicide prevention strategy.To enhance health personnel’s inpatient suicide prevention strategy,education intervention is a common method.Educational interventions in the researches varied in contents,duration and outcome measurements.However,there has been not synthesis of education interventions targeting health personnel on inpatient suicide prevention.Objective:Prevention of inpatient suicide is a critical priority in patient safety management in general hospitals.Incidence of inpatient suicide can be decreased by effective strategies mastered by health personnel through education interventions.Educational interventions in researches varied in contents,duration and outcome measurements.We aimed to review education interventions targeting health personnel on inpatient suicide prevention.Methods:A scoping review was used to analyze existing researches on education interventions targeting health personnel focusing on inpatient suicide prevention in general hospitals.Cochrane Library,PubMed,Embase,CINAHL,China National Knowledge Infrastructure,WanFang,and Chinese Scientific Journal Database were searched in Oct 2019.According to the inclusion and exclusion criteria,the searched studies were screened by two reviewers.And then,two researchers conducted the data extraction independently by using a table format,including the first author,year of publication,study design,participants,education intervention,etc.Results:Twelve studies were included in this scoping review.The contents of education interventions on inpatient suicide prevention included three aspects:suicide knowledge,suicide assessment,and skills for coping with suicide.The duration of education interventions ranged from 1.5-h to 32.0-h.The effects of education interventions were mainly focused on participants’knowledge,attitudes and skills of suicide prevention.Conclusion:The evidence showed that education interventions on inpatient suicide prevention had positive impact on health personnel’s knowledge,attitude and skills about inpatient suicide prevention in general hospitals.However,the best health personnel-targeted education intervention on inpatient suicide prevention in general hospitals was yet to be determined.In the future,it is necessary to combine evidence in this review and the actual condition in clinical practice.

SSIs in Italy: Prevention and Surveillance during the Last Five Years

Surgical site infections (SSIs) are recognized as a common surgical complication, occurring in about 2% - 5% of all surgical procedures. For this reason, it is the second most common nosocomial infection, representing the 19.6% of all infections observed in hospitalized patients and 38% of those observed among surgical patients. Among SSIs prevention strategies, surveillance has been proved to be very incisive. The most recent surveillance study carried out at a national level in Italy is SNICh protocol (National Surveillance System of Surgical Site Infections), which analyses data received from 127 Italian hospitals, from the 2009 to 2011 and the entire 2013. The only application of a surveillance strategy, observing the recommended prophylaxis protocols, brought to a reduction of SSIs: their incidence has been shown to be comparable to European or American one. Furthermore, recent studies have brought strong evidence that the development of new devices, such as dressings impregnated with silver nanoparticles or triclosan-coated sutures, is strongly connected with the reduction of incidence of SSIs. In conclusion, if common preventive techniques were applied to all surgical procedures performed in the country, about 14,000 SSIs per year could be avoided with a possible savings after three years between 50 million and EUR 175 million euro.

Analysis of the Role of General Practitioners Services in Rural Areas during the COVID-19 Epidemic

Since the outbreak of the COVID-19,various regions of China have been rapidly deployed under the leadership of the Central Committee of the Party to actively prevent and control the COVID-19.The rural areas of my country have weak links to the prevention and management of public health emergencies.Problems include lack of medical and health resources and farmers’low awareness of epidemic prevention.Situations that correspond to the prevention and management of the COVID-19 are more serious.As the patient’s first contact and“gatekeeper”in the fight against the epidemic,the general practitioner is responsible for the“first visit-subsequent ongoing intervention”.This article is about the prevention and control of the COVID-19 epidemics and epidemic prevention in terms of dissemination of knowledge,informed crowd control,joint prevention and control,and standardized management of people.This is a summary of the efforts of general practitioners.Quarantine at home,interactive referrals to medical consortiums,special care for contracted families.The function during the management period aims to analyze the role played by general practitioners during the epidemic and to provide new ideas for the prevention and management of the epidemic.Provide more targeted general practitioner-style services in rural areas to promote the implementation and improvement of health and poverty alleviation.The health level of the rural population provides a theoretical standard.

Characteristics of and management strategies for 54 suicidal inpatients in a general hospital

Objective： The aim of this study was to explore the characteristics of and preventive management strategies for suicidal inpatients in a general hospital.Methods： A total of 54 suicide victims were drawn from a patient safety adverse event network reporting system during hospitalization in a general hospital from November 2008 to January 2017.Results： Subjects who committed suicide in the general hospital were women and those who suffered from malignant neoplasms during general hospital treatment. Furthermore, most of the patients who committed suicide used more violent suicide methods. The most common and lethal means was jumping from heights at the windowsill.Conclusions： It is concluded that management straties for suicide prevention can be provided from the aspects of patients, medical staff and the hospital environment. It is not only urgent but also feasible to reduce the suicide rate of inpatients and further improve hospital safety management.

Doctor-reported hospital management of acute coronary syndrome in China: A nationwide survey of 1029 hospitals in 30 provinces

Background: Despite recent improvements in the hospital treatment of ACS, little is known about current cardiological practice in China or use of evidence-based approach in Chinese hospitals. Methods: A questionnaire about doctor-reported hospital management of ACS was posted to the head of the cardiology department of 1397 hospitals across 30 provinces of China. Reported use of various clinical procedures and treatments were analysed and compared between different types of hospital. Results: Of the 1029 (74%) hospitals that responded, 43% were tier III (tertiary) hospitals. For STEMI, primary PCI was used as the main reperfusion therapy by 50.2% of tier III and 9.3% of tier II/I (secondary) hospitals. Most of hospitals also used various proven therapy routinely for STEMI and NSTEMI/UA, including anti-platelet therapy (98% and 93%), anticoagulant (96% and 90%), statin (97% and 94%), oral β-blockers (87% and 86%) and ACE-I (88% and 83%). However, certain therapies with little or no proven value (eg, G.I.K., magnesium and Chinese tradition medicine) remained used routinely by 25% - 40% of tier II/I hospitals. After discharge, statin, antiplatelet, β-blockers and ACE-I were reportedly used routinely by 85% - 95% of the responders for secondary prevention. Conclusions: With a few exceptions, doctor-reported hospital management of ACS in China is largely consistent with that recommended by current guidelines. Large nationwide registries are needed to assess long-term adherence to treatments after hospital discharge.

互联网在医院COVID-19疫情防控中的应用与展望

医院作为新冠肺炎诊治机构,面临严峻的防控考验。本文就医院在传统防控策略基础上,应用互联网、人工智能、云平台等信息化技术,建立院前、院中、院后三个层面的网络服务体系,为医院疫情防控,疫情期间患者诊疗服务提供了信息化选择,有效避免了传统诊疗服务疫情感染的风险。

Windsurfing vs kitesurfing:Injuries at the North Sea over a 2-year period

AIM To analyze all windsurfing and kitesurfing(kiteboarding) injuries presented at our coastal hospital over a 2-year period. METHODS Twenty-five windsurfers(21 male; aged 31 ± 8 years) and 32 kitesurfers(23 male; aged 29 ± 11 years) presented at our hospital during the 2-year study period. Various injury data were recorded,including transport to hospital and treatment. After a median follow-up of 16 mo(range,7-33 mo),18 windsurfers(72%) and 26 kitesurfers(81%) completed questionnaires on the trauma mechanisms,the use of protective gear,time spent on windsurfing or kitesurfing,time to return to sports,additional injuries,and chronic disability. RESULTS Most patients sustained minor injuries but severe injuries also occurred,including vertebral and tibial plateau fractures. The lower extremities were affected the most,followed by the head and cervical spine,the upperextremities,and the trunk. The injury rates were 5.2 per 1000 h of windsurfing and 7.0 per 1000 h of kitesurfing(P = 0.005). The injury severity was the same between groups(P = 1.0). Less than 30% of the study population used protective gear. Kitesurfers had a higher number of injuries,and required transport by ambulance,inpatient hospital stay and operative treatment more often than windsurfers,but these differences were not statistically significant(P > 0.05). The median time to return to windsurfing and kitesurfing was 5 and 4 wk,respectively(P = 0.79). Approximately one-third of the patients in each group experienced chronic symptoms.CONCLUSION Kitesurfing results in a significantly higher injury rate than windsurfing in the same environmental conditions but the severity of the injuries does not differ.