Construction of competency evaluation system for infection control personnel in traditional Chinese medicine hospitals

Background:This study uses a literature review and the Delphi expert consultation method to construct a competency evaluation model for infection control personnel in traditional Chinese medicine(TCM)hospitals.The aim is to strengthen infection control management in TCM hospitals,assess the competency of infection control personnel in their positions,and assist them in identifying the competencies that need improvement.Methods:Based on the literature research method and the Delphi expert consultation method,a competency model for the position was constructed through two rounds of expert consultations,analyzing the relationships between various factors and establishing a hierarchical structure model.Pairwise comparisons were made among the elements at the same level to construct a judgment matrix.Through the analytic hierarchy process,the weight coefficients of the indicators at each level in the competency model were obtained.Results:This study conducted a comprehensive assessment of various capabilities and practices related to hospital infection control.The survey results indicate that participants excelled in multiple areas,with a high overall satisfaction rate.95.28%of participants were able to develop hospital infection monitoring plans based on national infection control policies,demonstrating a good understanding and execution of these policies.94.09%of participants were familiar with high-risk populations and key departments in the hospital.91.73%of participants were able to establish monitoring scopes based on the trends of multidrug-resistant bacteria and conduct information monitoring,reflecting strong response capabilities.92.91%of participants were able to collaborate with relevant departments to conduct bacterial resistance monitoring,showing a good team spirit.94.49%of participants were able to perform targeted monitoring,including surgical site infections,indicating that they have effective monitoring strategies.91.34%of participants were able to collect and organize monitoring data and establish a systematic database,demonstrating good data management skills.90.16%of participants were able to interpret laws and regulations related to hospital infection management,indicating a high level of legal knowledge.89.37%of participants generally possessed good communication skills.92.52%of participants were able to guide medical staff on occupational safety and protective knowledge,showing an emphasis on occupational health.Participants demonstrated a strong desire to learn and innovate,with 87.01%actively participating in continuing education and research activities,reflecting a pursuit of professional development.Conclusion:Based on the results of the two rounds of expert consultations,a competency evaluation model for infection control personnel in TCM hospitals was formed.Through the analytic hierarchy process,the weight coefficients of various indicators at different levels in the model were obtained,and the research results have good scientific validity and reliability.

A Comparative Analysis of the Control Effect of Medical Expenses between General Hospitals and Traditional Chinese Medicine Hospitals from 2012 to 2021

Objective To analyze the changing trend of average medical expenses and structure in general hospitals and traditional Chinese medicine(TCM)hospitals and the effects and differences achieved by the two kinds of hospitals through controlling unreasonable growth of medical expenses,so as to provide reference for controlling the rapid rise of medical cost in public hospitals and optimizing the cost structure.Methods Based on the changes of related indicators of medical expense control from 2012 to 2021,the overall characteristics,changes of cost structure and trends of medical expenses in general hospitals and TCM hospitals were investigated.Results and Conclusion From 2012 to 2021,the increase of medical expenses in general hospitals and traditional Chinese medicine hospitals had slowed down,the proportion of drug revenue to medical income began to decline,and the medical service income increased.However,the proportion of inspection,test and sanitary materials income has increased instead of decreasing,but the management cost has decreased.The two kinds of hospitals have achieved certain cost control results,the structure of medical cost has changed greatly,and the technical service and labor value of medical personnel have been reflected to a certain extent.However,it is still necessary to explore a more scientific and reasonable cost control mechanism to promote the further optimization of medical cost structure.

Study on the Changes of Medical Income Structure in Governmentrun Hospitals of Traditional Chinese Medicine from 2012 to 2021

Objective To study the changing characteristics and trend of medical income structure in the government-run hospitals of traditional Chinese medicine(TCM),evaluate the effects of relevant reform measures,and to put forward corresponding suggestions for further optimizing their income structure.Methods The data related to the average medical income of government-run hospitals of TCM from 2012 to 2021 were sorted out.Then,descriptive analysis method was used to analyze the changes of related indicators.Besides,structural change method was applied to investigate the changes of outpatient income and inpatient income.Results and Conclusion From 2012 to 2021,the growth of medical income in government-run hospitals of TCM tended to be stable,and the proportion of medical service income increased from 22.62%(2012)to 29.38%(2021),but the average annual growth rate was only 0.68%.The main items that caused the change of outpatient income structure were medicine revenue,laboratory tests,diagnosis and treatment,and the cumulative contribution rate was 89.15%.The main items that caused the change of inpatient income structure were medicine revenue,sanitary materials,and auxiliary examinations income,with a cumulative contribution rate of 80.04%.However,the contribution rate of registration,diagnosis,treatment,surgery and nursing income reflecting the value of medical personnel’s technical labor was relatively small.The medical income structure of government-run hospitals of TCM underwent great changes and gradually became reasonable,but the medical service income increased slowly,and not all indicators achieved the expectations.To promote the sustainable development of public hospitals of TCM and enable them to provide high-quality and efficient TCM medical and health services,it is necessary to further improve the relevant policy mechanism.

Nursing emergency management practice of COVID-19 in a traditional Chinese medicine hospital

Nursing work is an integral part of hospital work.Under the challenge of the COVID-19 epidemic,it is particularly important to establish a timely and efficient nursing management system.The nursing department of our hospital used the theory and method of feedforward control to formulate the emergency plan for epidemic prevention and control and to conduct drills.The plan includes the establishment of the emergency management system for epidemic nursing and key prevention and control positions,rational allocation of human resources,and strengthening personnel training,so as to ensure the efficient operation of nursing epidemic prevention and control work and provide a reference for nursing management mode during the epidemic.

Narrative Medicine Under the Guidance of Traditional Chinese Medicine Theory

This paper is an exploration into the practice of narrative medicine in the clinical setting guided by the theory and approaches of traditional Chinese medicine(TCM).By adopting the theory of TCM,the author attempted to provide the patients with systematic treatment from the perspective of society-psychology-biology under the guidance of both the unity of Heaven and Man,and the unity of Xing(Body)and Shen(Mind/Spirit)through his clinical practice.Guided by yin-yang and Wu Xing(Five Elements)theory and focusing on the social relations of the patients for any possible relationships between patients’social,psychological and biological state,the author took the patients’emotion management as a point of departure and helped the patients recover both physically and psychologically by promoting positive transformation in patients’social,psychological,and biological state.A clinical case was provided at the end of this paper to demonstrate how the above theory was put into practice.Narrative medicine under the guidance of TCM theory can supplement modern medical humanity practices as well as extend the scope of modern medical treatment from the perspective of the unity of Heaven and Man,by enriching the content of narrative medicine,and promoting the medical model from biological medical model toward social-psychological-biological model.

Effect of a traditional Chinese medicine theory-based mobile app on improving symptoms in patients with type 2 diabetes mellitus:A randomized controlled trial

Objective:The aim of this study was to evaluate the effect of the Traditional Chinese Medicine(TCM)theory-based mobile app on improving symptoms in patients with type 2 diabetes mellitus(T2DM)in China.Materials and Methods:A randomized controlled trial was conducted.Ninety-seven patients with T2DM were enrolled and they were randomized into the control group and the experimental group.The control group was given usual diabetes education and follow-up with telephone call,while the experimental group was followed up by using the TCM theory-based mobile app.After 6-month intervention,the diabetic symptom scores,the blood glucose levels,and self-management ability of the two groups were compared.Results:Compared with intervention before,the levels of fasting blood glucose(FBG),2-h postprandial blood glucose(2hPG),and glycated hemoglobin(HbA1c)decreased in the control group(9.28±3.05 vs.8.26±2.73 mmol/L,12.65±4.18 vs.10.65±3.79 mmol/L,and 8.78%±1.76%vs.7.96%±1.47%,respectively,all P<0.05)and also decreased in the experimental group(8.36±2.64 vs.7.35±2.45 mmol/L,11.50±4.29 vs.9.85±2.71 mmol/L,and 8.64%±2.04%vs.7.29%±1.56%,respectively,all P<0.05)after 6-month intervention,while the summary of diabetes self-care activities(SDSCAs)scale scores after 6-month intervention increased significantly in the control group(35.20±14.68 vs.44.78±10.21,P<0.05)and the experimental group(32.16±13.21 vs.50.37±10.06,P<0.05).After 6-month intervention,the diabetic symptom scores(18.16±2.74 vs.22.18±4.77)and HbA1c(7.29±1.56%vs.7.96%±1.47%)were lower,and SDSCA scale scores(50.37±10.06 vs.44.78±10.21)were higher in the experimental group than the control group(all P<0.05).Conclusion:The mobile app based on TCM theory can effectively improve diabetes-related symptoms in patients with T2DM and help control their blood glucose as well as enhance their self-management ability.

Practice of the construction and management of TCM nursing outpatient service--takes a breast specialty in a third-grade hospital in Beijing as an example

Through the phased construction,the breast specialty traditional Chinese medicine(TCM)nursing clinic of our hospital has achieved good results.From 2017 to 2019,the number of patients increased by 7.6%,and the clinical cure rate increased by 9.4%.Take the breast specialty TCM nursing clinic of our hospital as an example,introduce the registration method of TCM nursing clinic,the TCM nurse home call qualification,service mode,and the clinical diagnosis and treatment effect of specialty TCM nursing.It is pointed out that the construction of TCM nursing clinic needs to be guided by clinical efficacy,and to provide patients with professional TCM care through clear positioning,disease refinement,medical division of labor,and highlighting the technical characteristics of TCM nursing.By reviewing the construction and development of breast specialty TCM nursing clinic in our hospital,we introduced the experience in detail,in order to provide ideas and guidance for the construction of other clinical specialty TCM nursing clinic.

Promise of the gut microbiota in prevention and traditional Chinese medicine treatment of diabetic peripheral neuropathy

The pathogenesis of diabetic peripheral neuropathy(DPN)has not been fully elucidated,and treatment options are limited.Currently,the main strategies for treating DPN are strict glycemic control and symptomatic pain relief.In this editorial,we comment on an article by Li et al,which suggested that modulating the gut microbiota using traditional Chinese medicine(TCM)may be a promising strategy for alleviating DPN symptoms.The regulation of the gut microbiota has received widespread attention in the study of various diseases.TCM can parti-cipate in the regulation of gut microbiota through multiple mechanisms,and this regulatory effect can alleviate the clinical symptoms of DPN.We briefly analyzed the promise of the gut microbiota in the early diagnosis,treatment,and clinical efficacy of TCM for DPN.The gut microbiota has potential value at multiple no-des in the occurrence and progression of DPN.

Chemoprophylaxis, diagnosis, treatments, and discharge management of COVID-19: An evidence-based clinical practice guideline(updated version)

The novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is the cause of a rapidly spreading illness,coronavirus disease 2019(COVID-19),affecting more than seventeen million people around the world.Diagnosis and treatment guidelines for clinicians caring for patients are needed.In the early stage,we have issued"A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus(2019-nCoV)infected pneumonia(standard version)";now there are many direct evidences emerged and may change some of previous recommendations and it is ripe for develop an evidence-based guideline.We formed a working group of clinical experts and methodologists.The steering group members proposed 29 questions that are relevant to the management of COVID-19 covering the following areas:chemoprophylaxis,diagnosis,treatments,and discharge management.We searched the literature for direct evidence on the management of COVID-19,and assessed its certainty generated recommendations using the Grading of Recommendations,Assessment,Development and Evaluation(GRADE)approach.Recommendations were either strong or weak,or in the form of ungraded consensus-based statement.Finally,we issued 34 statements.Among them,6 were strong recommendations for,14 were weak recommendations for,3 were weak recommendations against and 11 were ungraded consensus-based statement.They covered topics of chemoprophylaxis(including agents and Traditional Chinese Medicine(TCM)agents),diagnosis(including clinical manifestations,reverse transcription-polymerase chain reaction(RT-PCR),respiratory tract specimens,IgM and IgG antibody tests,chest computed tomography,chest X-ray,and CT features of asymptomatic infections),treatments(including lopinavirritonavir,umifenovir,favipiravir,interferon,remdesivir,combination of antiviral drugs,hydroxychloroquine/chloroquine,interleukin-6 inhibitors,interleukin-1 inhibitors,glucocorticoid,qingfei paidu decoction,lianhua qingwen granules/capsules,convalescent plasma,lung transplantation,invasive or noninvasive ventilation,and extracorporeal membrane oxygenation(ECMO)),and discharge management(including discharge criteria and management plan in patients whose RT-PCR retesting shows SARS-CoV-2 positive after discharge).We also created two figures of these recommendations for the implementation purpose.We hope these recommendations can help support healthcare workers caring for COVID-19 patients.

Preventive online and offline health management intervention in polycystic ovary syndrome

BACKGROUND Polycystic ovary syndrome(PCOS) is characterized by hyperandrogenism, hyperinsulinemia, ovarian polycystic changes, and irregular ovulation, often occurring in women of childbearing age for whom it can be a cause of infertility. Hypothalamus-pituitary-ovarian axis dysregulation is important in the pathogenesis of PCOS and the associated chronic excess of sex hormones can lead to cardiovascular and cerebrovascular diseases, diabetes, and malignancies such as endometrial cancer, and breast cancer. At present, most scholars agree that lifestyle interventions in conjunction with drug treatment can help PCOS patients achieve their goals of successful pregnancy and childbirth.AIM To investigate the clinical effect of an online and offline(O2O) preventive health management model on PCOS with kidney deficiency and phlegm dampness.METHODS A total of 82 patients with PCOS of the kidney deficiency and phlegm dampness type who were admitted to Beijing Luhe Hospital Affiliated to Capital Medical University from April 2019 to June 2020 were randomly divided into two groups. The treatment group was treated with oral Diane-35 for 3 mo and received preventive O2O medical health management for 6 mo(including eating and living, exercise, drug management). The control group was treated with oral Diane-35 for 3 mo and completed outpatient health education. The traditional Chinese medicine(TCM) syndrome score, acne score, hair score, sex hormone level and clinical effects were compared between the two groups before and after the intervention. RESULTS After treatment, the TCM syndrome score, acne score, and serum luteinizing hormone/follicle stimulating hormone level were significantly lower in the treatment group than in the control group(P < 0.05). After 3 mo of treatment, the TCM syndrome curative effect index in the treatment group was 97.30% compared to 54.05% in the control group(P < 0.05), whereas the total treatment effect in the treatment group was 91.89%, compared to 54.05% in the control group(P < 0.05).CONCLUSION An integrated therapeutic approach incorporating medication, TCM methods and social media is more effective than standard treatment for PCOS.

Letter to the editor: Comment on the Regulatios of the Simplified Registration and Approval Management for Compound Recipe of Classical Prescription of Traditional Chinese Medicine

To the Editor:On Oct 9,2017,China Food and Drug Administration announced1~ the Regulations of the Simplified Registration and Approval Management for Compound Recipe of Classical Prescription of Traditional Chinese Medicine(Exposure Draft)which has been stirring up intense debate in the West.The article China to Roll Back Regulations for Traditional Medicine Despite Safety Concerns lately

Brief Introduction to Xiyuan Hospital of China Academy of Traditional Chinese Medicine

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Acute Myocardial Infarction in Chinese Medicine Hospitals in China from 2006 to 2013: An Analysis of 2311 Patients from Hospital Data

Objective:To assess the trends in characteristics,treatments,and outcomes of acute myocardial infarction(AMI)patients in tertiary Chinese medicine(CM)hospitals in China between 2006 and 2013.Methods:This retrospective study was based on two nationwide epidemiological surveys of AMI in tertiary CM hospitals during 2 years(2006 and 2013).Patients admitted to the hospital for AMI were enrolled.Hospital records were used as the data source.Case data were derived regarding baseline characteristics,treatments,and outcomes of patients to assess changes from 2006 to 2013.Logistic regression was used to analyze the relationship between prognosis,general influencing factors of disease,and various treatment measures.Results:Totally 26 tertiary CM hospitals in 2006 and 29 tertiary CM hospitals in 2013(18 were repetitive)were surveyed.A total of 2,311 patients with AMI were enrolled(1,094 cases in 2006 and 1,217 cases in 2013).From 2006 to 2013,the mean age did not significantly change,but the proportion of patients younger than 65 years increased.The prevalence of risk factors such as hypertension,diabetes,and hyperlipidemia also increased.Significant increases were observed in primary percutaneous coronary intervention[20.48%(2006)vs.24.90%(2013)]and revascularization[36.11%(2006)vs.52.42%(2013)].In-hospital mortality decreased from 11.15%in 2006 to 10.60%in 2013.A mortality logistic regression analysis identified reperfusion therapy[odds ratio(OR),0.222;95%confidence interval(CI),0.106–0.464],Chinese patent medicines(OR,0.394;95%CI,0.213–0.727),and CM decoctions(OR,0.196;95%CI,0.109–0.353)as protective factors.Conclusion:Reperfusion and revascularization capabilities of tertiary CM hospitals have improved significantly,but in-hospital mortality has not significantly decreased.Efforts are needed to improve medical awareness of AMI and expand the use of CM to reduce in-hospital mortality in China.

Expert knowledge maps for knowledge management: a case study inTraditional Chinese Medicine research

OBJECTIVE:To design a model to capture information on the state and trends of knowledge creation,at both an individual and an organizational level,in order to enhance knowledge management.METHODS:We designed a graph-theoretic knowledge model,the expert knowledge map(EKM),based on literature-based annotation.A case study in the domain of Traditional Chinese Medicine research was used to illustrate the usefulness of the model.RESULTS:The EKM successfully captured various aspects of knowledge and enhanced knowledge management within the case-study organization through the provision of knowledge graphs,expert graphs,and expert-knowledge biography.CONCLUSION:Our model could help to reveal thehot topics,trends,and products of the research done by an organization.It can potentially be used to facilitate knowledge learning,sharing and decision-making among researchers,academicians,students,and administrators of organizations.

Symptom Assessment and Management in Patients with Lung Cancer Undergoing Conventional or Traditional Chinese Medicine Care

Patients with lung cancer may experience various symptoms as the disease progresses,which may reduce the benefits of cancer treatment,reduce treatment compliance,delay cancer treatment,reduce the quality of life(QoL),and impact survival.This review discusses comprehensive symptom assessment and management,which are crucial for high-quality lung cancer treatment.Traditional Chinese medicine(TCM)is important in relieving cancer-related symptoms in patients with lung cancer.Including patient-reported outcomes(PROs)in clinical trials and practice can provide a better assessment of symptom burden and the effectiveness of symptom management.Patient-centered care with TCM in lung cancer patients may include six steps:Symptom screening,etiology investigation,comprehensive assessment,integrative management,reassessment,and regular symptom follow-up monitoring.PRO measures can be used to evaluate symptom intensity,the degree to which symptoms interfere with activities of daily living,and the QoL.Clearly defined and reliable PRO measures can enhance patient satisfaction and improve symptom control.Quantitative PRO measures developed from the TCM perspective should be considered one of the important outcome measurements in TCM care.A multidisciplinary collaborative symptom management model,including TCM and conventional therapy,will be the future goal for treating patients with lung cancer.

中医医院新入职本科护士培训考核评价指标的构建

目的 构建中医医院新入职本科护士培训考核评价指标。方法 通过文献研究、小组讨论,建立中医医院新入职本科护士培训考核评价指标初稿,选取来自7个省份的中华护理学会中医中西医结合护理分会的15名专家进行2轮专家咨询,确定考核评价内容及其权重。结果 2轮专家函询问卷的有效回收率均为100%,专家权威系数分别是0.962、0.980,肯德尔协调系数分别是0.220、0.268(均P<0.05),最终形成的中医医院新入职本科护士培训考核评价指标包括5项一级指标、24项二级指标和77项三级指标。结论 构建的中医医院新入职本科护士培训考核评价指标具有较高的可靠性和科学性,可为中医医院管理者及培训者选拔人才提供参考。

湖北省中医医院信息化建设现状分析与思考

目的/意义了解湖北省中医医院信息化建设现状和问题,提出进一步推进中医医院信息化建设的建议。方法/过程基于2022年湖北省中医医院信息化建设现状调查数据,采用描述统计、χ^(2)检验、Fisher检验等方法,阐述湖北省公立中医医院信息化管理部门设置与人员结构、基础设施与资金投入、业务应用系统、信息标准及新一代信息技术应用等方面的现状,剖析存在的主要问题。结果/结论湖北省中医医院信息化建设取得初步成效,但仍应优化信息管理部门职能、充实信息化人才队伍、加强经费投入、强化标准应用、深化中医药特色优势、推进新技术应用等。

基于双重差分法的DRG付费对中医医院的影响研究

目的:评估按疾病诊断相关分组(DRG)付费对中医医院住院患者例均总费用、费用结构、住院时长、出院人数及中医特色的影响。方法:以某中医类国家区域医疗中心为研究对象,使用双重差分回归模型(DID)分析付费改革政策实施前后医保患者(干预组)与非医保患者(对照组)的各项指标差异,通过平行趋势检验和安慰剂检验证实模型可靠性和稳定性。结果:例均住院总费用、病例数、住院天数、医疗服务收入占比、饮片收入占比等十一项指标的DID交互项系数显著(P<0.05),费用指标回归系数均小于0。饮片使用率、中医非药物疗法收入占比等四项指标DID交互项系数不显著(P>0.05)。结论:DRG付费政策显著降低付费病组例均总费用,其中耗材、医技费用下降显著,费用结构优化,中药饮片费用占比略微下降。应持续关注DRG付费对中医医院影响,进一步扩大样本范围,跟踪分析政策影响,全面评价DRG付费政策对我国中医医疗机构的影响。

基于波士顿矩阵分析法的区域医院科技创新效率研究

目的通过客观评价了解区域医院科技创新效率,推动医院医学学科建设,为医院争创国家区域医疗中心的建设目标提供助力。方法基于医院科技量值指标体系,选取深圳市67家三级医院作为研究对象,分析医院科技创新发展情况,利用波士顿矩阵分析法反映医院科技创新效率。结果深圳市医院间科技创新效率有较大差距:6家医院以相对低的科技投入产生了较高的科技产出,科技创新效率最好;13家医院以较高的科技投入产生了较高的科技产出,具有较好的科技创新效率,科技产出仍可再提升;1家医院科技投入高而科技产出较低,具有较低的科技创新效率,在科技产出方面仍有较大提升空间;47家医院科技投入较低且科技产出也较低,在科技投入及科技产出两个维度仍需发力。结论应依据城市经济高质量发展水平,加强医院科技创新投入水平,引导产出高质量医学科技成果,提升医院科技创新效率。

子宫内膜异位症患者的中医慢病护理门诊管理

目的评价中医慢病护理门诊对子宫内膜异位症患者的管理效果。方法采用历史对照法,将2020年1-12月行腹腔镜手术的子宫内膜异位症门诊就诊的痛经患者88例作为对照组,按常规行术后门诊复诊及随访;2021年1-12月行腹腔镜手术的门诊就诊的88例痛经患者为观察组,在对照组基础上实施子宫内膜异位症中医慢病护理;干预3个月。干预后3、6、12个月评估干预效果。结果两组各85例患者完成研究及随访。两组痛经评分、自我管理能力评分及生存质量评分比较,组间效应、时间效应及交互效应差异有统计学意义(均P<0.05)。结论对子宫内膜异位症患者实施中医慢病护理门诊管理,可更有效地改善痛经症状,提高疾病自我管理能力和生存质量。