Application of Hazard Vulnerability Analysis Based on Kaiser Model in Neonatal Breast Milk Management

Objective:To analyze the existing risks in breast milk management at the neonatal department and provide corresponding countermeasures.Methods:22 risk events were identified in 7 risk links in the process of bottle-feeding of breast milk.Hazard Vulnerability Analysis based on the Kaiser model was applied to investigate and evaluate the risk events.Results:High-risk events include breast milk quality inspection,hand hygiene during collection,disinfection of collectors,cold chain management,hand hygiene during the reception,breast milk closed-loop management,and post-collection disposal.Root cause analysis of high-risk events was conducted and breast milk management strategies outside the hospital and within the neonatal department were proposed.Conclusion:Hazard Vulnerability Analysis based on the Kaiser model can identify and assess neonatal breast milk management risks effectively,which helps improve the management of neonatal breast milk.It is conducive to the safe development and promotion of bottle feeding of breast milk for neonates,ensuring the quality of medical services and the safety of children.

Spatial Analysis of Risks and Vulnerabilities to Major Hazards in Madagascar Using the Multi-Criteria Method Based on the Analytical Hierarchy Process (AHP)

Natural disasters are not negligible factors that have significant impacts on a country’s development. Madagascar cannot escape cyclones, floods and drought due to its geographical situation. The objective in this work is to assess the risks and vulnerability to these hazards in order to strengthen the resilience of the Malagasy population. Our approach is based on multi-criteria spatial analysis using the Analytical Hierarchy Process (AHP). The results form decision spatial information that can be used at the strategic level of natural risk and disaster management. This work focuses on the degree of vulnerability and it was found in this study that the Androy and Atsimo-Atsinanana regions are the most vulnerable to major hazards in Madagascar not only because of their exposure to risk but also because of their very low socio-economic status.

Measuring Social Vulnerability to Natural Hazards in Beijing-Tianjin-Hebei Region,China

Social vulnerability in this study represents the differences between the capacity to cope with natural hazards and disaster losses suffered within and between places.The assessment of social vulnerability has been recognized as a critical step in understanding natural hazard risks and enhancing effective response capabilities.This article presents an initial study of the social vulnerability of the Beijing-Tianjin-Hebei(B-T-H) Region in China.The goal is to replicate and test the applicability of the United States Social Vulnerability Index(So VI) method in a Chinese cultural context.Thirty-nine variables adapted from the So VI were collected in relation to two aspects:socioeconomic vulnerability and built environment vulnerability.Using factor analysis,seven factors were extracted from the variable set:the structure of social development,the level of economic and government financial strength,social justice and poverty,family structure,the intensity of space development,the status of residential housing and transportation,and building structure.Factor scores were summed to get the final So VI scores and the most and least vulnerable units were identified and mapped.The highest social vulnerability is concentrated in the northwest of the study area.The least socially vulnerable areas are mainly distributed in the Beijing,Tianjin and Shijiazhuang core urban peripheral and central city areas of the prefecture-level cities.The results show that this method is a useful tool for revealing places that have a high level of vulnerability,in other words,areas which are more likely to face significant challenges in coping with a large-scale event.These findings could provide a scientific basis for policy making and the implementation of disaster prevention and mitigation in China.

Evaluation and Analysis of Hospital Disaster Preparedness in Jeddah

Introduction: Disaster damage to health systems is a human and health tragedy, results in huge economic losses, deals devastating blows to development goals, and shakes social confidence. Hospital disaster preparedness presents complex clinical operation. It is difficult philosophical challenge. It is difficult to determine how much time, money, and effort should be spent in preparing for an event that may not occur. Health facilities whether hospitals or rural health clinics, should be a source of strength during emergencies and disasters. They should be ready to save lives and to continue providing essential emergencies and disasters. Jeddah has relatively a level of disaster risk which is attributable to its geographical location, climate variability, topography, etc. This study investigates the hospital disaster preparedness (HDP) in Jeddah. Methods: Questionnaire was designed according to five Likert scales. It was divided into eight fields of 33 indicators: structure, architectural and furnishings, lifeline facilities’ safety, hospital location, utilities maintenance, surge capacity, emergency and disaster plan, and control of communication and coordination. Sample of six hospitals participated in the study and rated to the extent of disaster preparedness for each hospital disaster preparedness indicators. Two hazard tools were used to find out the hazards for each hospital. An assessment tool was designed to monitor progress and effectiveness of the hospitals’ improvement. Weakness was found in HDP level in the surveyed hospitals. Disaster mitigation needs more action including: risk assessment, structural and non-structural prevention, and preparedness for contingency planning and warning and evacuation. Conclusion: The finding shows that hospitals included in this study have tools and indicators in hospital preparedness but with lack of training and management during disaster. So the research shed light on hospital disaster preparedness. Considering the importance of preparedness in disaster, it is necessary for hospitals to understand that most of hospital disaster preparedness is built in the hospital system.

Sustainability of Bridges:Risk Mitigation for Natural Hazards

Bridges serve as essential parts of transportation infrastructure,facilitating the movement of people and goods across rivers,valleys,and other obstacles.However,they are also susceptible to a wide range of natural hazards,including floods,earthquakes,and landslides,which can damage or even collapse these structures,leading to severe economic and human losses.A risk index has been developed to address this issue,which quantifies the likelihood and severity of natural hazards occurring in a specific location.The application of risk indices for natural hazards in bridge management involves a data collection process and mathematical modelling.The data collection process gathers information on bridges’location,condition,and vulnerability,while mathematical modelling uses the data to assess the risk of natural hazards.Overall,risk indices provide a quantitative measure of the vulnerability of bridges to natural hazards and help to prioritize maintenance and repair activities.Mitigation measures are then evaluated and implemented based on the risk assessment results.By using this tool,the UBMS research group has developed an algorithm for risk assessment which will be essential in the decision-making process,specifically focused on enhancing Fund Optimization,Deterioration Modelling,and Risk Analysis.These developments effectively fulfill the primary objectives associated with addressing and mitigating hazards.This development also helps bridge managers understand the potential threats posed by natural hazards and allocate resources more efficiently to ensure the safety and longevity of critical transportation infrastructure.

An Analysis of Social Vulnerability to Natural Hazards in Nepal Using a Modified Social Vulnerability Index

Social vulnerability influences the ability to prepare for, respond to, and recover from disasters. The identification of vulnerable populations and factors that contribute to their vulnerability are crucial for effective disaster risk reduction. Nepal exhibits multihazard risk and has experienced socioeconomic and political upheaval in recent decades, further increasing susceptibility to hazards.However, we still know little regarding social vulnerability in Nepal. Here, we investigate social vulnerability in Nepal by adapting Social Vulnerability Index(SoVI) methods to the Nepali context. Variables such as caste, and populations who cannot speak/understand Nepali were added to reflect the essence of the Nepali context. Using principal component analysis, 39 variables were reduced to seven factors that explained 63.02% of variance in the data.Factor scores were summarized to calculate final SoVI scores. The highest levels of social vulnerability are concentrated in the central and western Mountain, western Hill, and central and eastern Tarai regions of Nepal, while the least vulnerable areas are in the central and eastern Hill regions. These findings, supplemented with smaller-scale analyses, have the potential to assist village officers, policymakers,and emergency managers in the development of more effective and geographically targeted disaster management programs.

粤港澳大湾区复合灾害承灾体脆弱性评估

由多种自然灾害耦合而成的复合灾害对个别区域的人类健康与城市社会发展有着显著的影响,对其主要承灾体的脆弱性评估便成为防灾减灾工作开展的重要前提.基于对自然灾害形势和脆弱性影响因素的深度学习,以粤港澳大湾区境内地级市以下52个区/县、香港地区、澳门地区为研究对象,从物理脆弱性、人口、经济建设、应对能力4个方面选取地均GDP、耕地面积百分比等13项指标建立评价指标体系,并使用主成分分析法分别评估4个方面的脆弱性,再通过综合评价法得出粤港澳大湾区复合灾害承灾体综合脆弱性评价结果.结果表明:高脆弱性集中在天河区、海珠区等靠近珠江口的位置,其共同特点是物理脆弱性与经济脆弱性较高,城市用地多、道路网发达占主导位置.因此,需要尽快通过气候适应战略来缓解城市化高地区局部变暖导致的复合灾害爆发,研究成果为我国华南沿海地区复杂灾害系统的防治提供重要理论支撑.

医院信息系统应急管理体系的建设

随着信息技术的飞速发展,医院业务的连续性越来越依赖信息系统的稳定运行。为了提高医院应对信息系统突发故障事件的处置能力,中山大学附属第六医院借助工具开展灾害脆弱性分析,精准识别出医院信息系统可能面临的高危风险事件,按照风险事件发生后果的严重程度进行排序。结合医院的实际情况建立应急管理组织架构,制订可操作、可执行的应急预案并实施应急演练,不断改进和完善应急预案,建立了一套有效的信息系统故障应急管理体系。本文分享了医院在信息系统故障应急管理体系建设的经验和成果,可为其他医疗机构的应急管理工作提供参考和借鉴。

基于Kaiser模型的灾害脆弱性分析在儿科应急管理中的应用

目的通过Kaiser模型对基层儿科的灾害脆弱性现状进行分析,评估儿科灾害事件风险,以提高应急管理能力。方法基于Kaiser模型,从自然灾害、技术灾害、人员伤害和危险品伤害4类、48种灾害来源调查儿科面临的各类潜在危害,通过对危害风险的分析和风险值排序,明确儿科应急管理的重点,有针对性地强化应急管理的措施,从而健全儿科应急管理体系。结果自然灾害事件中,相对风险值排前5位的依次为地震(34.44%)、暴雨(25.69%)、火灾(23.94%)、极端高温(22.13%)及干旱(15.95%)。技术灾害事件中,相对风险值排前5位的依次为针刺伤(27.62%)、穿刺失败(25.52%)、停水/停电(24.99%)、信息系统故障(24.13%)及电梯意外事件(23.22%)。人员伤害事件中,相对风险值排前5位的依次为“新冠”肺炎院内传播(16.26%)、药物不良反应(15.57%)、跌倒/坠床(12.10%)、暴力伤医事件(11.07%)及误服药物(10.59%)。危险品类事件中,相对风险值排前5位的依次为玻璃体温计断裂(11.77%)、危险气体泄漏(7.89%)、放射性物体泄漏(7.52%)、化学品泄漏(5.40%)及氧气泄漏(5.34%)。全部事件按照风险值由高至低排序,前5位依次为地震(34.44%)、针刺伤(27.62%)、暴雨(25.69%)、穿刺失败(25.52%)及停水/停电(24.99%)。结论Kaiser模型是一种科学有效的应急风险分析工具,为全面保障医疗安全提供了一定参考,对科室应急事件管理有较高的适用性,值得在医院内推广应用。根据灾害脆弱性分析(HVA)结果和报告,应针对暴露的防控薄弱点,修订和完善科室突发事件的应急预案,加强科室应急培训和演练,提高应急反应和医疗保障能力。

基于PCA与改进AHP-CRITIC法的地质灾害风险评价研究——以神木市为例

神木市是西部地区重要的能源城市,对能源的过度开发利用引发了大量地质灾害,严重阻碍着居民生产生活和城市发展建设,因此开展地质灾害风险评价研究是该地区可持续发展的必由之路。为解决多因子综合作用对评价精度的影响,根据神木市地质环境及社会经济情况选取合适的评价因子分别建立危险性和易损性评价体系,利用主成分分析(PCA)法判断、提取主成分来避免因子间相关性的干扰,计算各因子综合分值得到危险性区划图;首次将改进层次分析(AHP)-CRITIC主客观组合赋权法应用于承灾体易损性评价当中,通过该方法计算因子综合权重得到各乡镇易损指数。叠加危险区划图和易损指数图完成神木市地质灾害风险性分区,将风险区划为高、较高、中、较低和低五个等级,分别占全市面积的5.31%、7.72%、14.17%、17.08%和55.72%,表明研究区风险等级中等偏低。可为同类型地区地质灾害风险评价工作提供参考依据。

应用灾害脆弱性分析提升住院病区护理应急管理能力

目的:应用灾害脆弱性分析对温州医科大学附属第一医院住院病区护理管理风险进行评估,制定高风险环节应急预案,提高护理应急管理能力。方法:查阅文献并结合近3年院内护理不良事件回顾,护理安全质量委员会采用头脑风暴法进行风险指标的筛选和确定,运用Kaiser模型评估工具,计算危害风险值并排序。结果:护理管理风险指标体系包括:A管理指服务管理风险7项、B重点环节风险5项、C患者事故风险7项、D支持保障系统风险1项、E护理人员相关风险1项。危害风险值排序前5的指标及风险值依次为:C1患者发生肺栓塞(58.33%)、C3患者跌倒/坠床(56.02%)、C4患者心脏骤停事件(53.82%)、C6患者发生误吸/窒息(52.86%)、A1医院感染暴发(51.68%)。结论:灾害脆弱性分析是医院应急管理的重要手段,管理者要动态评估住院病区护理管理风险,对高风险事件采取有效的防范措施,开展应急预案演练,不断完善风险预警机制,提升护理应急管理能力,保证患者安全。

基于文献综述视角的医院灾害脆弱性分析

灾害脆弱性分析已成为医院质量持续改进和应急管理的重要管理工具,在我国医院内部得到普遍应用。文章系统梳理了现有医院灾害脆弱性分析的相关研究成果,发现尚存在灾害识别范围不全面、评估方法和视角单一、指标体系评价局限性等问题。下一步研究应拓宽和细化医院灾害脆弱性分析维度、建立医院灾害脆弱性分析的典型评价指标、引入除Kaiser模型以外的模型进行事后评价和对比分析,以期为医院识别、防控和应对风险提供理论支撑和方法借鉴,切实保障医院的安全性。

Debris flow and landslide hazard mapping and risk analysis in China

This paper assesses the hazardousness, vulnerability and risk of debris flow and landslide in China and compiles maps with a scale of 1：6000000, based on Geographical Information System （GIS） technology, hazard regionalization map, socioeconomic data from 2000. Integrated hazardousness of debris flow and landslide is equivalent to the sum of debris flow hazardousness and landslide hazardousness. Vulnerability is assessed by employing a simplified assessment model. Risk is calculated by the following formula： Risk = Hazardousness × Vulnerability. The analysis results of assessment of hazardousness, vulnerability and risk show that there are extremely high risk regions of 104 km2, high risk regions of 283008 km2, moderate risk regions of 3161815 km2, low risk regions of 3299604km2, and extremely low risk regions of 2681709 km2. Exploitation activities should be prohibited in extremely high risk and high risk regions and restricted in moderate risk regions. The present study on risk analysis of debris flow and landslide not only sheds new light on the future work in this direction but also provides a scientific basis for disaster prevention and mitigation policy making.

软式内镜洗消过程质量控制的研究进展

软式内镜的洗消质量直接影响临床诊疗的安全性,建立完善的质控体系是保障其安全应用的关键,本文通过检索NCBI、PQDD、CINAHL、中国知网、万方医学网等数据库,对PDCA循环模式、失效模式与效应分析(FMEA)、信息质量追溯系统、灾害脆弱性分析(HVA)、故障循证管理等不同质控体系的运用作一综述,以期为软式内镜洗消过程的质量控制体系构建提供参考。

Kaiser模型在医院院科两级灾害脆弱性分析中的应用

目的 灾害脆弱性分析是医院应急管理中的重要内容,Kaiser模型作为医疗机构灾害脆弱性分析的重要工具,在使用过程中却缺少相应的标准和规范,本研究旨在通过Kaiser模型在医院和科室灾害脆弱性分析中的使用,探索如何更加规范地使用Kaiser模型。方法 2021年3月分别由选取的相关人员对某医院和医院某临床科室地潜在的风险事件进行筛选,结合Kaiser模型设计相应调查表进行调查,并录入Excel 2007进行统计分析,潜在风险事件根据Kaiser模型评分表的最后评分进行排序,以明确医院和科室当年潜在风险事件的应对重点。结果 灾害脆弱性分析较客观地反映了医院和科室对突发事件的承受能力及目前需要优先应对的突发风险事件,对医院的应急管理具有重要作用。结论 Kaiser模型是医院应急管理的重要工具,如何更好地使用这个工具,使其能真正地反映客观实际,需要在使用过程中更多地探索标准化规范化使用过程。

基于灾害脆弱性分析的普外科急诊手术护理风险管理及效果分析

目的探讨灾害脆弱性分析(HVA)在普外科急诊手术护理风险管理中的应用及效果。方法运用灾害脆弱性分析管理工具对普外科急诊手术护理风险进行系统分析,通过RISK风险值计算及矩阵分析,明确需要优先关注及改进的风险事件,制定并实施前瞻性防控与改进措施。结果实施HVA及改进后,普外科急诊手术有5项高风险事件的RISK风险值均明显下降,降幅均达到50%以上;护理安全事件发生例数减少了38.94%,其中投诉事件减少了77.77%、管道相关事件减少了47.05%。结论采用HVA管理工具对普外科急诊手术护理风险进行分析与管控,可提升科室应急管理能力,保障医疗护理安全。

灾害脆弱性分析在疫情防控阶段血液透析室应急管理中的应用

目的 通过灾害脆弱性分析(HVA)制订并完善疫情防控下医院血液透析室的应急预案,旨在提升临床工作人员对疫情的防控管理能力。方法 以Kaiser模型为指导构建血液透析室疫情防控风险评估表,识别疫情防控工作中的主要风险,根据风险值排序和事件发生的可能性和严重性均较高的风险事件构建应急防控预案。选择血液透析室工作人员44例为评价对象,比较实施防控预案前(2022年3月)和实施后(2022年6月)的效果。结果 以HVA为基础的血液透析室疫情防控应急管理预案应用后,病房工作人员相关防护知识掌握及落实情况、手卫生执行率、患者及家属防护行为等数据都得到提高,病区实现了零感染,无聚集性病例发生。结论 灾害脆弱性分析能及时有效地发现疫情防控下血液透析室的应急管理风险事件,明确风险管理重点,以此为基础制订的风险防控方案能够有效降低高风险事件发生率,减少医患双方的心理恐慌,确保在疫情防控下血液透析室工作的顺利开展。

基于Kaiser模型的灾害脆弱性分析在妇科护理风险管理中的应用研究

目的运用基于Kaiser模型的灾害脆弱性分析(HVA)对妇科护理管理相关事件进行风险评估,识别高风险事件,为开展风险管理提供依据。方法构建妇科护理管理风险事件指标体系,运用HVA对3大类51项指标进行风险评估,通过指标可能性与严重性矩阵分析,对排名前5的高风险事件开展应急演练和改进。结果通过HVA对妇科护理高风险事件进行干预前后比较,原高风险5项优先改进指标风险值均有所下降,干预后的原高风险5项护理安全事件发生比例均低于干预前,差异有统计学意义(p<0.05)。结论采用HVA评估妇科护理风险事件,提高妇科护理风险管理效率,保障医疗质量与患者安全。

基于加权信息量模型的多要素地质灾害易发性评价——以福州市晋安区为例

本文对福州市晋安区的地质灾害易发性进行研究,根据研究区地质条件和地质灾害的形成机制和制灾机理,确定高程、坡度、坡向、地质构造、岩土体类型、降雨、地表水系、植被密度8个影响地质灾害易发性的环境因素。构建信息量模型计算8个因素的信息量,采用层次分析法对8个因素的信息量进行赋权,最后使用ArcGIS软件依据权重叠加指标,实现研究区易发性可视化、数据化。依据计算结果,对研究区易发性进行评价,其成果可为制定福州市晋安区的地质灾害防治方案提供依据。

Assessing Social Vulnerability to Flood Hazards in the Dutch Province of Zeeland

The 2007 European Union Floods Directive encouraged member nations to pursue a more integrated view of flood risks and management strategies, taking into account social vulnerabilities of residents. To date, most flood-risk analyses conducted by the Dutch government have focused on physical risk. This study utilizes fine-scale data to construct a social vulnerability index for 147 districts of the Dutch province of Zeeland, located in the Southwestern Delta and the scene of widespread devastation following the 1953 North Sea Flood. Factor analysis of 25 indicators of social vulnerability selected from related research in Europe and the United States results in seven factors explaining roughly 66% of the total variance. These factors of social vulnerability in Zeeland are urban density,low-income households, recent population change, female gender, train access, and self-employed and service-sector employment. The index was constructed using the toploading variable in each of these factors, with weights determined by the variance explained by each factor.Scores range from a low of 0.20 in Schore, municipality of Kapelle, to the highest score of 0.64 in Oudelandse Hoeve of Terneuzen. The most vulnerable districts are located in South Zeeland, with eight of the 10 found in Terneuzen.The majority of less vulnerable districts are located in Zeeland’s central region.