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.

A List of Insects on Stored Traditional Chinese Medicinal (TCM) Materials in Anhui Province of China

[ Objective ] The paper was to ascertain the insects on the stored traditional Chinese medicinal （TCM） materials in Anhui Province of China, so as to control pests on stored TCM materials effectually. [ Method] The insects on stored TCM materials in 17 regions of Anhui Province were investigated from 2009 to 2012 and 873 kinds of insect samples on TCM materials were collected. [ Result] Investigation showed that a total of 94 species of insects on stored TCM materials belonging to 38 families, 9 orders in Anhui Province had been identified, among which 81 species of pests belonged to 31 families, 5 orders, and 13 species of natu- ral enemies belonged to 7 families, 4 orders ; additionally, 24 species of insects were newly recorded in Anhui Province. The distribution and hosts of 94 species of insects were also described. [ Conclusion] The results could provide scientific basis for controlling pests of the stored traditional Chinese medicinal materials in An- hui Province.

Analysis of the Current Filing Status of Traditional Chinese Medicine Preparations Using Traditional Technology in Medical Institutions of Shaanxi Province

Objective:To summarize and analyze the application of traditional technology in preparing traditional Chinese medicine(TCM)preparations in medical institutions in Shaanxi Province after implementing the“Implementation Rules for the Record Management of Traditional Chinese Medicine Preparations in Medical Institutions in Shaanxi Province(Trial)”(“Implementation Rules”),and to provide a reference for the filing of TCM preparations.Methods:The TCM preparations recorded by medical institutions in Shaanxi Province since March 2019 were statistically summarized.The filing status was comprehensively and systematically analyzed based on the number of institutions and preparations,the ratio of commissioned to self-production,dosage form distribution,and the level of medical institutions.Results:Since implementing the Implementation Rules,a total of 479 TCM preparations have been filed in the province.Among these,262 were commissioned for production,and 217 were self-produced,covering 17 dosage forms such as granules,pills,capsules,mixtures,and powders.A total of 86 medical institutions have filed preparations,most of which are located in Xi’an,Xianyang,and Weinan,with these three cities accounting for the largest number of filings.Conclusion:The policy on the TCM preparation filing system has been widely recognized and deeply implemented in Shaanxi Province.Third-level medical institutions are the primary contributors to preparation filings.Regional differences exist in the development of preparation filing,indicating significant potential for further growth in the province’s filing efforts.

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

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fsQCA组态视角下我国中医类医院医疗资源配置效率提升路径分析

目的 探究多重因素协同作用下我国中医类医院医疗资源配置效率提升的优化路径,为中医类医院医疗资源均衡发展提供有力支撑。方法 以数据包络分析法得到的我国31个省(区、市)中医类医院资源配置综合效率值为结果变量,借助模糊集定性比较分析方法,以人均地区生产总值、财政拨款收入占总收入比重、中医执业(助理)医师占执业(助理)医师比重、出院者平均住院日、每千人口总诊疗量、每千人口床位数作为条件变量,探究医疗资源高效配置组态路径。结果 通过对中医类医院医疗资源高效率配置的条件组态进行分析,可归纳为3条等效驱动路径,分别为综合服务能力型、中医优势型及住院驱动型。结论 我国中医类医院医疗资源配置效率整体水平有待提升,未来应努力提高医院综合服务能力和运行效率,充分发挥中医药优势,建设高质量中医人才队伍,合理缩短平均住院日,提高医院床位利用效率。

基于熵权TOPSIS法的全国公立中医类医院中医药特色服务现状分析

目的 了解公立中医类医院中医药特色服务情况,为医院发挥中医药特色优势提供参考。方法 以2022年《国家中医药综合统计制度》调查数据为主要评估内容,通过5个门诊服务中医药特色指标与4个住院服务中医药特色指标,采用熵权TOPSIS法对全国中医类医院中医药特色服务情况进行分析。结果 (1)门诊服务中,“门诊患者使用中医非药物疗法比例”的权重最大(20.40%);住院服务中,“以中医为主治疗的出院患者比例”的权重最大(20.13%)。(2)中医类医院中医药特色服务指数最高为0.854,最低为0.035;西南、中南和华东地区的中医药特色服务能力相对较强;省级、市级、县级及以下中医医院的服务指数(C_(i))分别为0.497、0.487、0.423,三级、二级中医医院的C_(i)分别为0.495、0.416。(3)三级中医专科医院、三级民族医医院、三级中医综合医院的中医药特色C_(i)较高,分别为0.549、0.508、0.496。结论 全国中医类医院在中医药特色服务方面整体表现尚可,但存在地区、医院级别和医院类型之间的差异。

四川省三级公立综合医院中西医协同建设现状调查

目的调查四川省三级公立综合医院中西医协同建设现状,为进一步开展中西医协同工作提供参考。方法2024年1月-3月,对四川省28所三级公立综合医院的中西医协同基本情况、中医药服务能力建设与中医技术开展情况、中西医协同管理情况等进行问卷调查。采用SPSS 22.2软件对调查结果进行统计分析。结果53.57%的医院年门急诊中医诊疗人次集中在>1万人次~<4万人次,50.00%的医院年出院患者中医诊疗人次<1000人次,中医类别执业医师占全院医师中位比例为5.7%。中医门诊诊室面积最小的仅有10.00 m 2,中医诊疗设备种类最少的仅有2种,约50%的医院中医优势病种数少于5种,中西医结合优势病种联合门诊数仅有1个,中医医疗技术最少的仅有5项,近60%的医院无中药制剂。仅18所(64.28%)医院成立工作领导小组推进中西医协同工作,针对中西医结合医疗实践和效果制订差别化绩效考核指标。20所(71.43%)医院建立了中西医联合查房模式和中西医结合分级诊疗服务体系,17所(60.71%)医院开展西学中人才培养教育,仅13所(46.43%)医院的非中医临床科室开展中医药类科研项目。结论四川省三级公立综合医院中西医协同建设工作仍需不断加强。未来需加强中西医协同服务能力建设,完善管理机制,创新中西医结合医疗模式,加大中西医结合人才培养力度,提升中医药临床科研能力。

中医医疗机构应急救援管理提升的实践与建议

中医药作为我国医疗卫生事业的特色及关键部分,在重大疫病预防及救治中发挥了积极作用,但其在应急救援管理当中如何发挥优势作用还需进一步挖掘与发展。为提升我国中医医疗机构特色应急救援水平,中医药应全程参与应急救援管理,将中医急救技术与疫病防治的优势及现有的应急救援体系相结合,优势互补、协调发展,共建具有中国特色的中西医结合应急救援管理体系。

山西省2 412名中医医院护士中医护理规范化培训现况及影响因素分析

目的:了解山西省中医医院护士中医护理规范化培训的现况及影响因素,为进一步完善我省中医医院护理规范化培训模式提供参考依据。方法:通过采用自行设计的山西省中医医院护士中医护理规范化培训现状调查问卷,于2023年1月—8月对山西省21所中医医院2 412名护士进行问卷调查。结果:2 412名护士中有79.73%接受过系统的中医理论技能培训,近3年内接受中医理论和技能培训≥100个学时的占60.82%,各医院理论与操作的学时分配、培训形式及内容等不统一。多元线性回归分析结果显示,第一学历毕业院校、中医护理领域工作年限和是否接受过系统的中医理论技能培训是护士中医护理知识与技能的影响因素(P<0.05)。结论:现阶段山西省各中医医院开展中医护理规范培训处于初步探索阶段,在课程体系设置、培训方式以及培训内容等方面仍需进一步完善。

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.

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。

2018年至2022年某中医院第二类精神药品使用情况分析

目的促进中医院第二类精神药品的合理使用。方法利用医院信息系统收集安徽省芜湖市中医医院2018年至2022年第二类精神药品的销售数据,分析用药频度(DDDs)、限定日费用(DDC)、排序比(B/A);按第二类精神药品门急诊处方150张/年和病历医嘱50份/年,根据药品说明书、相关指南及专家共识进行处方点评。结果2020年,第二类精神药品销售金额最大,占全院药品销售总金额的1.86%;地佐辛注射液、盐酸曲马多缓释片、咪达唑仑注射液销售金额排名前3;阿普唑仑片、艾司唑仑片、地佐辛注射液的DDDs排名前3;阿普唑仑片的DDC最低;地佐辛注射液的B/A在0.33~1.00之间。共收集1000张处方/医嘱,其中合理处方709张,合理医嘱228条,合理率为93.70%;不合理类型包括用药不规范、不适宜。结论该院2018年至2022年第二类精神药品的使用存在不合理现象,应继续加强对其的管理和监控,确保临床用药安全、合理。

“六一”绩效管理模式赋能中医医院高质量发展实践探索

目的探索构建公立中医医院内部绩效考核管理体系,实现以绩效“国考”推动公立医院高质量发展的目标。方法在分析绩效考核过程中存在的问题与面临的困境的基础上,以三级公立中医医院绩效考核指标为导向,创新“六一”绩效管理策略和手段,即坚持“一盘棋”整体规划、“一条链”融会贯通、“一张网”全面覆盖、“一条龙”全程服务、“一本账”精细管理、“一个螺旋”持续改进,建立医院内部绩效考核管理体系。结果医院内涵建设取得一定成效,中医特色优势持续彰显,质量安全内涵日趋深化,运营管理效率稳步提升,学科建设成果实现突破,人才培养成效显著,医患双方满意度提升明显。结论构建科学、规范、标准的医院内部绩效考核管理体系,确保国家三级公立中医医院绩效考核工作落实到位,促进公立医院高质量发展。