Progress in applying patient experience in nursing quality improvement

Background： Improving and sustaining the quality of nursing care is an intractable and persistent challenge. The patient experience of nursing care can give a different perspective on nursing quality and help clinical nursing staff to direct quality improvement. Attempts to identify what is patient experience,the relationship with nursing care, and the application of patient experience in nursing quality improvement practice, in order to provide advices for constructing the quality standards and quality improvement strategies of nursing care.Methods： We conducted a literature review of original research publications. The database platforms Pubmed, Web of Science, China National Knowledge Infrastructure（CNKI） and Wanfang were searched from inception until end of August 2015. After screening retrieved articles, 40 sources（articles and organizational websites） were selected for analysis for the connotation, development and application of patient experience in nursing quality researches.Results： Our study identified several concepts about patient experience, roughly sorted out the development path of patient experience in worldwide and the application of patient experience in nursing quality improvement. It points out four precautions when applying patient experience in nursing quality improvement, which are differentiating patient satisfaction and patient experience, choosing appropriate data collection method and appropriate feedback time, and the last but the most important, applying theories to actual clinical practice.Conclusions： Professional indexes are important to maintain the care quality, but it cannot fully reflect quality of nursing care, which needs patient experience as the supplement. Nursing staffs need to make more efforts to enhance patient＇s nursing care experience, and apply the research results to clinical practice, and finally make patient-centered care come true. For future study, the evaluation system and management strategies about patient experience need to be developed to guide nursing quality improvement.

Steel Slag as an Iron Fertilizer for Corn Growth and Soil Improvement in a Pot Experiment

The feasibility of steel slag used as an iron fertilizer was studied in a pot experiment with corn. Slag alone or acidified slag was added to two Fe-deficient calcareous soils at different rates. Results showed that moderate rates (10 and 20 g kg-1) of slag or acidified slag substantially increased corn dry matter yield and Fe uptake. Application of steel slag increased the residual concentration of ammonium bicarbonate-diethylenetriamine pentaacetic acid (AB-DTPA) extractable Fe in the soils. The increase of extractable Fe was usually proportional to the application rate, and enhanced by the acidification of slag. Steel slag appeared to be a promising and inexpensive source of Fe to alleviate crop Fe chlorosis in Fe-deficient calcareous soils.

Mechanism of drilling rate improvement using high-pressure liquid nitrogen jet

To address the high rock strength and low drilling rate issues in deep oil/gas and geothermal exploitation, we performed mechanical property tests on three kinds of rock samples(granite, shale and sandstone) subjected to liquid nitrogen(LN2) cooling and conducted rock-breaking experiments using LN2 jet. Rock-breaking characteristics and mechanisms of LN2 jet, heat transfer features between LN2 and rock and thermal stress evolution in rock were analyzed. A novel high-pressure LN2 jet assisted drilling method was proposed accordingly. The study results show that LN2 thermal shock can significantly reduce uniaxial compression strength and elastic modulus of rock. Rock damage and corresponding mechanical deterioration become more pronounced with increasing rock temperature. The LN2 jet has merits of high rock-breaking efficiency and low threshold rock-breaking pressure. Rock failure under LN2 jet impact is characterized by large volume breakage and the rock-breaking performance becomes more significant with increase of rock temperature. Under the impact of LN2 jet, the damage of granite is the most remarkable among the three rock samples. Thus, this method works better for high temperature granite formations. It has a good application prospect in speeding up drilling rate in deep hot dry rock geothermal reservoirs.

Field experiments to improve the efficacy of gargoor (fish trap) fishery in Kuwait's waters

Fish traps were investigated to understand the effects of season, bait type, trap size, and trap soak time on catch rates, catch composition, and trap loss rates from March 2004 to September 2005, to improve the performance and management of Kuwait＇s gargoor （cage style fish trap） fishery, which used to be the nation＇s most important one in terms of value and landings volume. Catch rates were the highest in April/May （5 8 kg/trap haul） and again in December （7 kg/trap haul）. Bait type and trap size also affected catch rates and species composition. Of the seven baits tested, the best catch rates, 〉5 kg/trap haul, occurred with cuttlefish （Sepia pharaonis）, but wolf-herring （Chiroeentrus dorab） and mullet （Liza klunzingeri） also produced good results （4-5 kg/trap haul）. Within the five tested sizes, the two largest-sized traps captured more fish and larger size fish. Analysis of variance （ANOVA） showed significant differences of catch rate among traps with different baits as well as among traps of different sizes. Duncan test further revealed these differences between two specific baits and sizes. Cluster Analysis of species composition showed more differences among different baits than among different trap sizes. Longer soak times did not result in larger catch rates, but increased trap loss. About 10-day soak time resulted in trap loss 7%, while 40-day soak time could result in a loss of around 20%. Consequently, it is recommended that the gargoor be checked every 10 or fewer days. The average overall catch rate during the study period was lower than that of 1980s （4.5 vs. 5.8 kg/trap haul）, indicating a possible decline offish abundance in Kuwait＇s waters. It is recommended that the number of gargoor fishing boats and gargoors from each boat should be limited to allow stock rehabilitation.

An Improved Experiment to Determine the‘Past of a Particle’in the Nested Mach-Zehnder Interferometer

We argue that the modification proposed by Li et al. [Chin. Phys. Lett. 32 （2015）050303] to the experiment of Danan et al. [Phys. Rev. Lett. 111 （2013） 240402] does not test the past of the photon as characterized by local weak traces. Instead of answering the questions： （i） were the photons in A？ （ii） were the photons in B？ and （iii） were the photons in C？ the proposed experiment measures a degenerate operator answering the questions： （i） were the photons in A？ and （ii） were the photons in B and C together？ A negative answer to the last question does not tell us if photons were present in B or C. On the other hand, a simple variation of the proposal by Li et al. does provide conceptually better evidence for the past of the pre- and post-selected photon, but this evidence will be in agreement with the results of Danan et al.

How PDCA cycle implementation improved surgical time-out compliance rate

Objective： To explore the effect of PDCA-cycle in improving time-out compliance rate and improvement in quality and safety management of surgery. Methods： We improved time-out compliance rate by using PDCA-cycle （a quality improvement tools）. Data were collected before and after the implementation of PDCA-cycle. The results were analyzed. Results： After implementation of PDCA-cycle, over all time-out compliance rate was increased from 80% to 99.8% （P=0.000）. The compliance rate of identifying patient, performing site marking before surgery, verification of correct-site and correct procedure were increased from 85.1%, 79.2%, 89.7% and 89.1% to 99.8%, 99.9%, 100% and 100% （P〈0.05） respectively. Conclusion： Our study validated the PDCA-cycle methodology improves time-out compliance rate, and it is one of the most effective quality improvement tools for hospital management.

多学科诊疗门诊现状与质量控制——以广西某三甲医院为例

多学科诊疗(MDT)门诊广泛应用于肿瘤、疑难危重复杂疾病及多病共存的患者诊疗。文章旨在研究在三级医院开展MDT门诊一站式就诊模式和诊后闭环管理,在实现医疗资源整合、优化就医流程、改善患者就医体验、保障医疗质量与安全方面起到重要作用。针对MDT门诊管理中职能部门重视不足、临床医师积极性不高、患者就诊主动性不强、MDT门诊信息化建设不完善、质量改进效果不佳等薄弱环节及质量控制难点,采取核心成员引领、配套激励考核机制、定期通报质量情况、完善信息化建设、延伸服务范围、加大宣传力度等有效管理手段持续改进,在提升病例病种数量、扩大品牌影响力、提高会诊质量方面取得了明显成效。

高电压下多孔材料沿面闪络特性综合实验

针对电气设备复合绝缘在高电压下极易发生沿面闪络故障问题,提出利用多孔结构提升闪络强度的方法,并设计了多孔绝缘材料沿面闪络特性综合实验。利用油/水乳液法制备了多孔聚二甲基硅氧烷材料,通过观测微观形貌分析了材料的孔隙分布特性,实验测试了直流和交流电压下的沿面闪络强度,通过等温表面电位衰减、表面电荷扫描和闪络路径观测探讨了闪络强度提升机理,利用表面流注发展的流体仿真考察了孔隙对沿面放电的影响,揭示了多孔结构的抑制碰撞电离和促进表面电荷消散效应在提升闪络强度中的作用。该实验涉及电气、材料、物理及多物理场模拟,可有效提高学生的实验、仿真及理论分析等方面能力。

化学“101计划”化学测量学实验课堂提升工作实践

化学测量学实验是教育部化学“101计划”12门核心课程之一,吸收融合了多门化学实验课、具有全新架构的实验课程体系。通过这门课的学习,学生将不但可以了解仪器原理,还能够利用先进的科学仪器进行物质结构、性质和性能的测量,甚至能够设计和搭建仪器。本文主要介绍化学测量学实验课堂提升工作实践,以期更好地促进教师课堂教学实践的交流与借鉴,切实提升国内化学学科的化学测量学实验的教学水平。

乙二胺四乙酸铁钠补铁剂制备实验改进

本项目将乙二胺四乙酸铁钠(NaFeEDTA)补铁剂制备实验项目进行了改进,将理论知识与实际生产紧密衔接,依据药物制备工艺流程,设置集方案设计、药物制备、结构鉴定、纯度分析等模块于一体的全链条实验内容,将实验项目由验证性实验转变为综合性、设计性实验,引导学生结合制药工艺流程中所涉及到的质量控制、安全生产、环境保护等因素设计实验方案。本实验项目可结合多条专利路线,能激发学生探究兴趣,促进学生自主探究,培养学生方案设计和创新思辨能力,提升学生解决实际问题能力和科学素养,增强专业自信。

矿物药的理化鉴别与含量测定实验教学改进设计

对本科无机化学教学实验中“矿物药的鉴别”实验进行了改进,选用6种外观难以区分、类白色的矿物药粉末作为实验对象,创新地设计了矿物药鉴别的盲盒实验,并增加了含量测定内容,优化了部分离子的鉴别方法,能够让学生体会无机化学反应在药物鉴别和分析中的现实意义,并强化了本科生灵活运用理化反应原理解决实际问题的能力。

基于门诊全流程服务管理的提升患者体验实践探索

提升患者门诊全流程就诊体验是改善患者就医感受的重要举措。首都医科大学附属北京同仁医院在持续改善医疗服务的基础上探索建立门诊全流程服务管理体系,通过理念向前服务前置,聚焦患者诊前体验;流程简化智慧引领,优化患者诊中体验;延续诊疗模式创新,提升患者诊后体验。打造现代门诊医疗服务模式,不断满足人民群众日益增长的医疗服务需要。

开放实验教学模式下微生物免疫学实验在口腔专业教学中的应用和效果评估

目的探讨基于开放实验教学模式的微免实验在口腔专业本科生教学中的应用价值及前景。方法以西安交通大学口腔医学院77位本科生为研究对象,对其进行了微免疫实验操作技能课程指导。以核心知识点为依托,实施探索性教学。课后通过问卷调查方法评价教学效果及满意度,并采用随堂测验及回访进行短效和长效的教学评价。结果通过问卷调查、随堂测验及回访统计,学生整体满意度较高,且掌握程度较好,并可以提高学生对科研的自主性、自觉性及创新性。结论将开放实验教学模式与微免实验联合应用于口腔专业本科生教学中,可激发学生学习的热情和主动性,使其能充分认识疾病,为正确诊断、治疗打下夯实的基础,增强其解决问题、分析问题的能力。同时可提高教学质量,可在口腔专业本科生教学中推广。

多目标金属露天矿配矿装载点选取问题及求解算法

目的:为了减少矿产资源浪费,提高贫矿的利用率,针对大型金属露天矿多装载点配矿问题,综合考虑矿石剩余量不足、铲装设备数量有限等因素对配装载点选取的影响,以品位偏差最小、生产成本最小、车辆总排队时间最短为目标建立配矿装载点选取模型。方法:采用二维矩阵整数编码法,并设计一种基于随机片段交叉与特定变异算子相结合的间接二次遗传优化算法对模型进行求解。结果:以国内某大型金属露天矿实际生产数据为例进行仿真实验,结果表明:所得出的装载点选取方案在受铲装设备数量限制、优先开采矿石剩余量相对较少装载点的条件下,仍能满足配矿计划需求。结论:所提模型、算法能普遍适用于大型金属露天矿山开采,使装载点的矿石得到充分利用。意义:提高了企业的经济效益和矿山整体开采效率。

葡萄糖酸锌制备与分析的实验改进

综合性实验对于锻炼学生的基础实验操作能力,提高学生运用多种知识技能综合分析解决问题的能力和数据处理能力有着重要的作用。本文通过对葡萄糖酸锌制备过程的样品添加量、水浴温度、过滤方式和分析过程进行设计改进,并对样品进行了XRD和FT-IR表征分析,通过将无机制备实验、常量分析和仪器分析实验相结合于一体,将其设计为大学无机化学实验的一个综合实验项目。在无机化学实验课程中增加这一综合性实验,学生可以通过先制备产品再对产品分析表征,熟悉无机材料制备表征方法,初步建立化学研究思维。

改良花岗岩残积土的渗透特性研究

针对福建尤溪花岗岩残积土遇水易软化崩解的特性,采用外掺法对其掺入改良剂进行改良,以降低其渗透系数。同时掺入石灰和粉煤灰,灰土质量比(即石灰质量∶粉煤灰质量∶花岗岩残积土质量)分别设置为1∶1∶8,1∶2∶7和1∶3∶6。对福建尤溪花岗岩残积土进行基本土工试验、击实试验和颗粒分析试验,对改良前后的尤溪花岗岩残积土进行变水头渗透试验,试验结果表明:(1)经掺入石灰和粉煤灰改良后的花岗岩残积土,其饱和渗透系数较改良前均有所降低,其抗渗性得到了提高。(2)当灰土质量比为1∶2∶7时,其饱和渗透系数降低幅度最大,改良效果最好。(3)无论重塑土还是改良土,其饱和渗透系数均随孔隙比的增大而增大,随干密度的增大而降低。

电力系统保护与控制实验评定体系构建

以专业认证为发展契机,探讨了实验评定体系对实验教学的重要性。在对几种常见的成绩评定方法探索的基础上,引入了改进模糊层次分析法,将实验评定体系分解成目标层、准则层、指标层进行定性与定量分析,使用MATLAB进行求解,得到了影响评定体系的各因素权重,并用模糊综合评价法得出学生的最终成绩。结果表明基于改进模糊层次分析法的电力系统保护与控制实验评定体系使实验成绩更加科学与全面,促进了教学目标的达成。

甘肃积石山6.2级地震青海震区应急响应经验

2023年12月18日甘肃临夏回族自治州积石山县发生了6.2级地震,由于震中处在甘肃、青海两省交界处,造成青海省2个市(州)4个县(市)受灾。地震发生后短时间内,青海省各级部门迅速采取应急响应,体现了我国在应急管理体系的发展与进步。通过分析该地震的概况、对青海震区造成的破坏与影响以及应急响应工作过程,认为加强地震监测预警准确性、提升建筑物抗震标准、深化防震减灾教育是未来优化应急响应机制的关键。甘肃积石山6.2级地震青海震区的应急响应经验为提升我国地震灾害应对能力提供了宝贵借鉴。

基于响应面法的PP-PAM复合改良微生物固化膨胀土优化研究

【目的】采用微生物诱导碳酸钙沉淀技术(MICP)加固膨胀土,可有效提高膨胀土的强度,降低胀缩性,但存在土体破坏时脆性明显,以及养护初期崩解量高等问题,为了进一步改善微生物固化膨胀土的脆性破坏和养护初期崩解量高的问题,【方法】在微生物固化膨胀土的基础上,研究掺入聚丙烯纤维(PP)和聚丙烯酰胺(PAM)对微生物固化膨胀土破坏模式和水稳性的影响。以纤维长度、纤维掺量和聚丙烯酰胺掺量为影响因素,以无侧限抗压强度和崩解量为响应值,采用Box-Behnken响应面法进行条件优化试验,建立了响应面回归模型,获得聚丙烯纤维长度、聚丙烯纤维和聚丙烯酰胺用量及其交互作用对微生物固化膨胀土强度和崩解性综合指标的影响。【结果】结果表明:聚丙烯纤维的掺入降低了微生物固化膨胀土破坏时的脆性、提高了土体强度、降低了膨胀土的崩解性,但随着纤维长度的增加,崩解量逐渐增加;聚丙烯酰胺的掺入降低了膨胀土的崩解量,但会降低土体强度。【结论】在影响因素试验范围内,以无侧限抗压强度最高和崩解量最低为原则,通过Box-Behnken响应面法获得最佳配比为:聚丙烯纤维长度为9 mm,掺量为0.5%,聚丙烯酰胺掺量为0.12%。在此配比下,复合固化土的无侧限抗压强度为1.24 MPa,相比优化前提高了29.57%,崩解量仅为0.34%,相比优化前降低了99.07%。