Evolution of Viral Load in Patients Infected with HIV-1 at Point G University Hospital

Introduction: HIV, the human immunodeficiency virus, is the etiological agent of acquired immunodeficiency syndrome (AIDS). The aim of this study was to assess the evolution of the viral load in patients under treatment. Methodology: This was a study carried out from July 2017 to June 2022 at the Point G University Hospital laboratory. The determination of the viral load of patients was carried out by PCR on the ABOTT M2000sp/rt platform. Results: A total of 129 patients infected with HIV-1, aged 19 to 72 years with a mean age of 40.05 years ± 10.71;all on antiretroviral chemotherapy. The female gender predominated among our patients. The most common treatment regimen was 2INTI + 1INNTI with 72.9% followed by 2INTI + 1INI with 13.2%. As for the combinations of molecules, the combination TDF + 3TC + EFV and TDF + 3TC + DTG predominated, respectively 65.1% and 13.2%. 89.9% of our patients had undetectable viremia after 12 months of treatment (p < 0.005) with an average viral load which had evolved from 681315.65 copies/ml ± 1616908.484 to M0 at 5742.36 copies /ml ± 35756.883 at M12 (p Conclusion: Generally speaking, antiretroviral treatment had contributed to controlling viral loads, however the therapeutic combination TDF + 3TC + DTG had made it possible to obtain more patients with undetectable viremia instead.

Psychological Issues among Women Undergoing Fertility Treatment in a Specialist Fertility Hospital, South East Nigeria

Introduction: In Nigeria, a major reason for marriage is procreation and married couples look forward to having children within a year or two of marriage. The inability to achieve conception and subsequently have a child among couples may lead to psychological complications. Objective: This study assessed the psychological impact of infertility and its management on women receiving treatment at a Fertility Specialist Hospital in a poor resource setting. Methods: This was a cross-sectional study of 376 consenting married women who sought and received fertility treatment at a private Fertility Specialist Hospital, located at Abakaliki, South-East Nigeria between May 1, 2017 and May 31, 2022. Socio-demographic and Structured questionnaires were administered to the participants over a 5-year period. Results: The mean age of the women at presentation was 36.9 (±7.2 SD) years. The majority of the women (227) presented with secondary infertility accounting for 60.4%, while the rest had primary infertility (χ2 = 16.18, P = 0.001). Male-only factor infertility accounted for 22.9% of all the infertility cases, female-only factor 21.3% while both (male and female factors co-existing) accounted for 52.7% of all the cases. The commonest cause of infertility in the study was poor sperm parameters (176) accounting for 46.8% of cases, tubal factor 19.1% and anovulatory factor 22.3% (χ2 = 214.21, P = 0.001). Three hundred and thirty four (88.8%) felt depressed, 266 (70.7%) felt guilty about the past, and 222 (59.0%) had suicidal tendencies because of the infertility ordeal. Two hundred and fifty one (66.8%) felt inferior, 237 (63.0%) cried often and 174 (46.3%) were socially withdrawn. However, 10.4% of the women felt satisfied and well. These negative psychological feelings were statistically significant. Concerning the effect on marriage, the closeness of couples was reduced significantly in 57.7%, 62.8% had reduced coital intimacy, 79.3% had frequent quarrel and misunderstanding, 27.9% had threats of divorce while 4.5% had actually divorced and 11.% separated. However, there was no negative effect of infertility in 8.8% of couples. Conclusion: Psychological issues associated with infertility and its management in women include feelings of depression, guilt feelings, suicidal ideation, weeping episodes, social withdrawal, feelings of inferiority, reduced libido, and poverty of intimacy with frequent quarrels and misunderstanding. Women appear to bear more of the psychological issues associated with infertility. Early marriage on the part of the women, preservation of their reproductive youthful ages, and a better understanding of the concept of infertility by the couple will not only reduce the prevalence of infertility but will also reduce the dangerous psychological issues associated with infertility.

Epidemiology and Management of Heart Failure in the Medicine Department of Tombouctou Hospital

Introduction: Heart failure is a complex syndrome and very frequently observed and secondary to the outcome of many advanced heart diseases. It is made up of a set of symptoms that reflect the tissue and visceral consequences of heart failure. The objective was to determine the hospital prevalence and to describe the management of heart failure in the medical department of Tombouctou hospital in Mali. Methods: This is a descriptive cross-sectional study with retrospective data collection, carried out over 24 months and involving the analysis of 266 records of patients hospitalized for heart failure. Results: The frequency of heart failure was 17.6% with a female predominance. The average age was 48 years with extremes of 16 and 90 years. Cardiovascular risk factors were dominated by high blood pressure with 38%. Global heart failure was the mode of discovery in 72.2% of cases. The etiologies were dominated by hypertensive dilated cardiomyopathy in 36.8% and peripartum cardiomyopathy in 32% of cases. The majority of our patients benefited from diuretic treatment, i.e. 95.9% frequency;with a favorable evolution in 96.2% of cases. We recorded 10 deaths, i.e. a lethality of 3.7%. We report some difficulties encountered during our security study because Tombouctou is a war zone and the lack of a technical platform for biology such as (BNP or NT-proBNP). Conclusion: Heart failure is a real public health problem. Its prevalence is increasing due to the aging of the population and especially the poor management of arterial hypertension in our context.

Multi-disciplinary treatment for hepatocellular carcinoma in primary hospitals in China during the COVID-19 epidemic

Hepatocellular carcinoma(HCC)is a common malignant tumor in the Chinese population.Due to its high degree of malignancy,rapid progression,and poor prognosis,it mainly requires multi-disciplinary treatment(MDT)in the clinic.In December 2019,COVID-19,a novel coronavirus pneumonia,broke out in Wuhan,China.It has rapidly spread across the country,with various places launching a level I response to major public health emergencies and traffic being restricted.Most patients with HCC were only able to attend primary hospitals,while the MDT model for HCC in provincial hospitals was restricted.Therefore,it was a huge task for clinicians in primary hospitals to ensure MDT was given to patients with HCC during the level I response to major public health emergencies.How to formulate a reasonable MDT mode for patients with HCC according to local conditions was worthy of consideration by hepatobiliary surgeons in primary hospitals.

Utilization of the current national antimalarial treatment guidelines among doctors in army hospitals in Lagos, Nigeria

Introduction: Human malaria infection remains a problem of public health importance in many regions of the world. The infection continues to spread particularly in sub-Saharan Africa. In Nigeria, malaria and its treatment have been affected by factors like wrong diagnosis, wrong attitude of the people, unavailability of drugs, fake and substandard drugs, attitude and practices of medical and paramedical personnel. Nigeria’s national standard for malaria treatment was recently changed to artemisinin combination therapy. Methods: A descriptive study using a structured questionnaire was administered to all doctors (123) practicing in the three Army hospitals in Lagos. The study was done between March, 2009 and April, 2009. The findings were precoded;data entry and analysis was done using EPI INFO version 3.5.1 statistical software. Results: Presumptive/clinical diagnosis was still a common practice for diagnosing malaria among doctors, as well as the use of microscopy. None of the doctors had the facility for diagnosing malaria with rapid diagnostic test in their hospitals. Fifty one percent of the doctors stated that they utilized the current National antimalarial treatment guidelines. Significant proportion of the doctors used Artemisinin-based Combination Therapy (ACTs) as first line treatment of uncomplicated malaria in adults and children. Chloroquine was the commonest drug for first line treatment of uncomplicated malaria in pregnancy. Only 45.5% of the doctors had correct knowledge of Intermittent Preventive Treatment in pregnancy (IPTp), while 33.3% knew the stage of pregnancy in which a pregnant woman should receive IPTp with sulphadoxine-pyrimethamine. Awareness and the content of knowledge of the current National antimalarial treatment guideline were not affected by the category or current position of the doctors. Thirteen percent of the respondents had attended training/update workshop organized by the Federal Ministry of Health (FMOH) Roll Back Malaria programme on the current National antimalarial treatment guideline. Conclusion: The study showed that there is need to improve use of recommended antimalarial medicines for all categories of patients by doctors in Army Hospitals in Lagos. More effort should be made by the Federal Ministry of Health and other stakeholders to organize training and refresher courses on the current National antimalarial treatment guidelines for all categories of health care providers.

Characterization of Defaulters from Tuberculosis Treatment in a Tertiary Hospital in South Eastern Nigeria

Background: Tuberculosis is second only to HIV/AIDS as the greatest killer worldwide, due to a single infectious agent. Directly Observed Treatment Short-Course (DOTS) is presently the WHO recommended programme to fight tuberculosis worldwide. There is a need to understand the characteristics of patients who default from treatment for tuberculosis. This will help modify the strategies to reduce such default to the barest minimum and achieve higher levels of adherence. Objective: The aim of this study was to describe the characteristics of patients that defaulted from treatment for TB at Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi DOTS clinic for the period 1st January 2011 to 31st December 2012. Materials and Methods: This was a retrospective study conducted at the DOTS clinic at Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria. The records of patients who received treatment from the clinic from 1st January 2011 to 31st December 2012 (2 years) were reviewed. The data collected include patients’ demographic characteristics, treatment category, patient type, baseline sputum smear result, and retroviral status. From the data, default rate was calculated and its relationship with other variables noted. Associations between patients’ characteristics were determined using chi square test of independence. The significance level was set at p = 0.05. Results: A total of 765 patients enrolled for TB treatment in the DOTS clinic of the study area within the study period of 1st January 2011 and December 31st 2012. The mean age at commencement of the treatment was 33.14 years (±18.09). The outcome of treatment showed that 260 (34%) had treatment completed, 230 (30.1%) cured, 120 (15.7%) defaulted, 103 (13.5%) died, 40 (5.2%) were transferred-out, and 12 (1.6%) failed in the treatment, giving a treatment success rate of 64.1%. Among the 120 (15.7%) patients that defaulted from treatment, majority 80 (66.7%) were males, and most 30 (25.0%) were in the 30 - 39 years age group. Conclusion: Defaulting starts with treatment interruption hence prompt management of interruption of treatment and default will largely help in preventing drug-resistant TB.

Molnupiravir for Oral Treatment of Covid-19 in Nonhospitalized Patients

Background:New treatments are needed to reduce the risk of progression of coronavirus disease 2019(Covid-19).Molnupiravir is an oral,small-molecule antiviral prodrug that is active against severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Methods:We conducted a phase 3,double-blind,randomized,placebo-controlled trial to evaluate the efficacy and safety of treatment with molnupiravir started within 5 days after the onset of signs or symptoms in nonhospitalized,unvaccinated adults with mild-to-moderate,laboratory-confirmed Covid-19 and at least one risk factor for severe Covid-19 illness.Participants in the trial were randomly assigned to receive 800 mg of molnupiravir or placebo twice daily for 5 days.The primary efficacy end point was the incidence hospitalization or death at day 29;the incidence of adverse events was the primary safety end point.A planned interim analysis was performed when 50%of 1550 participants(target enrollment)had been followed through day 29.

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.

Audit study of the new hospitalization for assessment scheme for forensic mental health in Japan

AIM: To clarify the components of hospitalization for assessment(HfA) and the management changes from the beginning of the scheme to the present.METHODS: This study is composed of two surveys. In 2013 survey, we created two paper questionnaires(facility and case questionnaires) for psychiatrists working in psychiatric hospitals accepting HfA patients. Questionnaires were sent to 205 hospitals that were identified as accepting the Hf A cases, and responses were requested via mail. The facility questionnaire was designed to clarify the following specifications and characteristics of each facility: the facility organizer(public sector or private hospital), and the number of beds, psychiatrists, psychiatric nurses, occupational therapists, psychiatric social workers, psychotherapists, public health nurses, and patients treated through Hf A during the survey period. The case questionnaire was then used to collect data of the patients under Hf A based on the Medical Treatment and Supervision(MTS) Act who were discharged between July 1, 2012 and June 30, 2013. Gathered information included: legal information of each case, demographic data, past history of the offenders, issued offense and the relationship to the victim, information regarding past psychiatric testimonies, psychiatric diagnoses, contents of the treatment during Hf A, information regarding seclusion and restraint during the Hf A, the verdict of the District Court panel, and so forth. Next, we compared those results with relevant data obtained in 2007. The 2007 survey comprised data of Hf A patients from July 15, 2005(the date the MTS Act was enforced) to January 15, 2007.RESULTS: We obtained 171 cases, approximately a half of whole contemporary cases of HfA, from 134 facilities, of which 46 were national, prefectural, or semi-official hospitals, and 88 were private hospitals, in 2013 survey. The majority of subjects were male, schizophrenic, and experienced previous psychiatric treatment. The most frequent type of the offense was injury, followed by arson. Most of the subjects were medicated, and a few cases took psychotropic injection during the Hf A. The frequency of injection was decreased in 2013(χ2 = 7.54, df = 1, P = 0.006) than in 2007. Psychiatric testimony was more likely to be conducted in 2013(χ2 = 8.56, df = 1, P = 0.004). The examiner psychiatrist was more likely to belong to the Hf A facility to which the patient was hospitalized(χ2 = 5.32, df = 1, P = 0.02). Hospitalization orders were more frequently selected in 2013(χ2 = 19.76, df = 3, P < 0.001), although the characteristics of the subjects had not changed.CONCLUSION: Although the management of HfA has improved in recent years, structural problems remain.

COVID-19 pandemic,as experienced in the surgical service of a district hospital in Spain

The coronavirus disease 2019,which is caused by severe acute respiratory syndrome coronavirus 2,was first identified in December 2019 in Wuhan,China,and has since spread rapidly,evolving into a full-blown pandemic.We would like to report our experience after 1 year of this pandemic in the surgical service of a district hospital in Spain.There have been many changes(including new protocols)that our service and the hospital have undergone,to adapt to the new situation.We believe that this experience can be useful for other professionals who have lived and are living a similar situation.

Clinical presentation and endoscopic management of Dieulafoy's lesions in an urban community hospital

AIM:To identify rates of occurrence,common clinical and endoscopic features,and to review the outcome of endoscopic management of Dieulafoy's lesions in the upper gastrointestinal (GI) tract in an urban community hospital setting. METHODS:Endoscopic data from esophagogastroduo denoscopies (EGDs),done at Wyckoff Heights Medical Center,Brooklyn,NY between 2000 and 2006 were reviewed to identify patients with Dieulafoy's lesions. Demographic data,medical history,examination findings,lab data,endoscopic findings and details of therapy for patients treated for Dieulafoy's lesions were reviewed retrospectively. RESULTS:Dieulafoy's lesions were documented to be the cause of bleeding in approximately 1% of patients presenting with upper gastrointestinal bleeding,while they were detected in only 2 patients when the indications for EGDs were different from active GI bleeding. When we analyzed EGDs performed in patients above age 65 years presenting with gastrointestinal bleeding,prevalence of Dieulafoy's lesions approached 10 percent. The most common location of the lesion was the body of stomach (7),followed by the cardia (4) and the esophagus (2). One patient had this lesion in the fundus and one patient in the duodenal apex. All patients were initially treated endoscopically with epinephrine injection,in eight cases heater probe was applied following epinephrine and endoscopic clips were applied in two cases. All but one of the patients did well in near and intermediate term follow-up (average follow-up period of 18 mo). One patient died of multi-organ failure during the same hospital stay. Average length hospital stay was 7 d.CONCLUSION:Community hospital gastroenterologists and endoscopists should be aware that Dieulafoy's lesions are an uncommon cause of upper GI bleeding among elderly patients. Early accurate diagnosis through emergent endoscopy and endoscopic therapy,especially in patients with multiple co-morbid conditions,can be very effective and life saving.

Epidemiology and outcome of Crohn's disease in a teaching hospital in Riyadh

AIM: To know the epidemiology and outcome of Crohn's disease at King Khalid University Hospital, Riyadh, Saudi Arabia and to compare the results from other world institutions.METHODS: A retrospective analysis of patients seen for 20 years (between 1983 and 2002). Individual case records were reviewed with regard to history, clinical, findings from colonoscopy, biopsies, small bowel enema, computerized tomography scan, treatment and outcome.RESULTS: Seventy-seven patients with Crohn's disease were revisited, 13% presented the disease in the first 10 years and 87% over the last 10 years. Thirty-three patients (42.9%) were males and 44 (57.1%) were females. Age ranged from 11-70 years (mean of 25.3+11.3 years). Ninety-two (92%) were Saudi. The mean duration of symptoms was 26+34.7 mo. The mean annual incidence of the disease over the first 10 years was 0.32:100 000 and 1.66:100 000 over the last 10 years with a total mean annual incidence of 0.94:100 000 over the last 20 years. The chief clinical features included abdominal pain, diarrhea, weight loss,anorexia, rectal bleeding and palpable mass. Colonoscopic findings were abnormal in 58 patients (76%) showing mostly ulcerations and inflammation of the colon. Eighty nine percent of patients showed nonspecific inflammation with chronic inflammatory cells and half of these patients revealed the presence of granulomas and granulations on bowel biopsies. Similarly, 69 (89%) of small bowel enema results revealed ulcerations (49%), narrowing of the bowel lumen (42%), mucosal thickening (35%) and cobblestone appearance (35%). CT scan showed abnormality in 68 (88%) of patients with features of thickened loops (66%) and lymphadenopathy (37%). Seventy-eight percent of patients had small and large bowel disease, 16% had small bowel involvement and only 6% had colitis alone. Of the total 55 (71%) patients treated with steroids at some point in their disease history, a satisfactory response to therapy was seen in 28 patients (51%) while 27 (49%) showed recurrences of the condition with mild to moderate symptoms of abdominal pain and diarrhea most of which were due to poor compliance to medication. Seven patients (33%) remained with active Crohn's disease. Nine (12%) patients underwent surgery with resections of some parts of bowel, 2 (2.5%) had steroid side effects, 6 (8%) with perianal Crohn's disease and five (6.5%) with fistulae.CONCLUSION: The epidemiological characteristics of Crohn's disease among Saudi patients are comparable to those reported from other parts of the world. However the incidence of Crohn's disease in our hospital increased over the last 10 years. The anatomic distribution of the disease is different from other world institutions with less isolated colonic affection.

Management of Urological Emergencies at the Nianankoro Fomba Hospital in Segou: A Case Report of 72 Patients

PURPOSE: Our aim was to present the diagnostic and therapeutic aspects of urological emergencies in a regional hospital. MATERIAL AND METHODS: We conducted a prospective study over a period of 6 months (April 2021 to September 2021) collecting all the emergencies received by the on-call urology team at the Nianankoro Fomba Hospital in Segou. This team was led by a DES in urology under the supervision of a urological surgeon. We were interested in age, sex of patients, diagnosis, number of patients hospitalised and type of surgery performed in emergency. RESULTS: We registered 72 patients. The mean age of our patients was 58.8 years with extremes of 6 and 90 years. Acute bladder retention was represented in 61% and total haematuria in 24%. Renal colic was reported in 8%. Acute prostatitis was reported in 4% of cases, and acute pyelonephritis in 1%. Urogenital trauma accounted for 6%. CONCLUSION: Although underestimated, in our context, the management of urological emergencies remains a regular activity of the urology department in view of the number of patients managed. Bladder drainage remains the most frequent procedure.

Analysis on the Construction and Operation Mode of Internet Hospitals

Internet + medical health have become anational key strategy, and the industries of medicalinformation have ushered in new development.Internet hospitals have broken through the limitationsof diagnosis and treatment. Diagnosis, doctor’seducation, family doctors, and post-hospital trackinghave been introduced to the Internet hospital system,the whole process of medical management serviceincluding ‘health management, diagnosis, in-hospital,rehabilitation’ has been gradually established,and coordinating to the medical resources, familydoctors and channels of medicine, to realize the realcirculation of medical resources. The authors screenedsix Internet hospitals and comprehensively analyzedtheir construction and operation modes, with a viewto providing reference for the construction of Internethospitals.

Opinion on double strategy to fight against COVID-19:Vaccination and home treatment with non-steroidal anti-inflammatory drugs

The goals of global vaccination are to control,eliminate,or eradicate infectious diseases in a sustainable way that strengthens public health systems.Although the use of vaccines is essential for the control of epidemics,the vaccines against coronavirus disease 2019(COVID-19)proved to be inadequate to end the pandemic and thus are considered incomplete.These vaccines failed to prevent infection,so their primary purpose has been shifted to prevent severe disease and reduce hospitalizations and deaths.Therefore,we believe that all the strategies available to reduce transmission,hospitalizations and deaths due to COVID-19 will be put in place.It is reported that uncontrolled inflammation and thrombosis are the principal mechanisms for aggravation and death in patients with COVID-19.Unlike corticosteroids that should not be administered at the beginning of the symptoms for their immunosuppressive action,which could worsen the evolution of the disease,the usefulness of non-steroidal anti-inflammatory drugs in the early at-home treatment of the disease is becoming evident.

Clinical Research of Pre-Hospital Emergency Care, Nursing, Infection Prevention and Control for Senile Osteoporotic Vertebral Compression Fracture during Epidemic Period

Background: Novel coronavirus pneumonia (NCP) and osteoporotic vertebral compression fractures (OVCF) are the high incidences of diseases in the elderly. During the epidemic period, if not treated in time, the complications are high and the mortality is high. If we do not pay attention to infection prevention and control in pre-hospital emergency care, it will lead to the first time infection of medical staff and in-hospital cross infection in emergency outpatient receiving area. The correct consideration of both and the establishment of perfect pre-hospital emergency treatment and infection prevention and control synchronous strategy is an important premise to ensure the stable, orderly and safe medical treatment. Objective: To explore the effect of synchronous implementation of pre-hospital emergency care, nursing and infection pre-vention and control for senile OVCF during the epidemic. In order to improve the efficiency of pre-hospital emergency care and prevent the spread of infection. Method: A total of 92 elderly patients with OVCF who received pre-hospital treatment in 18 hospitals in Zhangjiakou City during the epidemic prevention and control period from January 2020 to November 2022 and met the inclusion criteria were selected as research objects, including 24 males and 68 females, aged 65 - 82 (74.2 ± 2.2) years. All patients were associated with concomitant injuries and underlying diseases. All patients in this group underwent predictive pre-hospital rescue and infection prevention and control procedures. Results: All the 92 elderly patients with OVCF received timely pre-hospital treatment during the epidemic period, and no aggravation occurred of the 92 patients, 35 were in the high risk area, 10 were in the medium risk area, and 47 were in the low risk area. Exclude OVCF for NCP Patients were treated according to the conventional diagnosis and treatment principles. Suspected and confirmed cases are transferred to designated surgical hospitals for treatment. All patients were followed up 3 months, 6 months and 12 months after treatment. There was no death rate, high satisfaction of pre-hospital first aid, high diagnostic accuracy, and good curative effect. None of the rescue personnel had any infection rate, and no hospital infection transmission and nosocomial cross infection occurred. Conclusion: It is the first step to safely treat patients and prevent cross infection to establish a perfect synchronous strategy of pre-hospital first aid and infection prevention and control.

职能部门多学科联合诊疗提升医疗质量的实践路径——以浙江大学医学院附属儿童医院为例

医疗质量安全是公立医院高质量发展的基础和前提,多学科联合诊疗(multi-disciplinary treatment,MDT)理念对于医院职能部门协同开展医疗质量管理实践具有重要价值。浙江大学医学院附属儿童医院创新探索符合儿童医院自身特色的质量管理模式,构建职能部门医疗质量MDT实践路径,形成临床科室主动发起会诊,各职能部门多方协同双向互动,精准发现并解决问题,持续追踪并反馈改进的闭环管理流程。该模式实施后,全院医疗质量安全水平全面提升,主要表现为科室一级质控能力增强,绩效考核核心指标优化,患者满意度显著提升,对促进医院高质量发展具有深远意义。

急性缺血性卒中绿色通道构建与运行的教学方法探讨

急性缺血性卒中(acute ischemic stroke,AIS)是一种严重危害我国国民健康的疾病,占全部脑卒中患者约70%。由于“时间就是大脑”的理念,AIS的救治效果与开始救治的时间高度相关,同时也与医院救治水平、影像学评估方法、救治策略等几种因素相关。这需要一个完整的快速救治流程,包括院前救治和院内救治,作为支撑。在我国,这种流程被称为AIS的绿色通道。如何为医护人员提供关于AIS绿色通道构建和运行的培训,对于提高社会和医疗机构的AIS救治水平具有重要意义。文章对于AIS绿色通道构建和运行中六个重要节点的教学方法进行具体介绍,有利于医护人员了解如何整合社会、医院、脑卒中救治团队的力量救治AIS患者,最终提高AIS的救治水平,降低AIS的病死率和病残率。

针灸治疗质量安全管理标准的应用实践

中国医院协会颁布的《中国医院质量安全管理》团体标准“第2-27部分:患者服务中医药治疗”规范了针灸治疗质量与安全管理,科室人员基于此搭建针灸治疗质量安全管理标准框架,确立人员管理、治疗管理、不良事件处理3个环节、10个节点、14个要素的框架体系。标准实施后,针灸不良事件减少,门诊投诉率降低,院感防控落实度提高。