基于Ward等值的三绕组变压器并列运行方式实用辨识方法

变压器运行方式直接影响到电网的实时监视和控制。为准确反映电网运行信息,提出一种三绕组变压器并列运行方式的实用辨识方法。基于三绕组变压器并列运行的拓扑结构及其等值电路,结合简单环形网络的潮流分布公式与Ward等值方法,推导出两台和3台变压器高/中两侧并列运行时的有功功率分配关系。在合理近似的条件下提出变压器并列运行的有功功率分配比例判据,实现变压器并列运行方式的高效辨识。基于典型算例潮流的模拟数据和实际变电站的实测数据,仿真验证所提方法的有效性。

Window Views of Wards in Foreign Hospitals

Through the collection and systematic analysis of documents related to window views of hospitals,it is found that natural window views had a significant impact on patients’health benefits.The research focused on three aspects:“shortening length of stay”,“pain reduction”and“improvement of recovery rate”,mainly covering three types of patients:“heart patients”,“postoperative patients”and“patients of rehabilitation centers”.Based on the above analysis,summary and sorting,new directions and perspectives of hospital environment design and research under the concept of comprehensive health of people’s physiological,psychological and social adaptation will be obtained to provide references for the research and practice of health architecture,rehabilitation architecture,biophile design and other fields.

Tree: Reducing the use of restrictive practices on psychiatric wards through virtual reality immersive technology training

BACKGROUND Restrictive practices(RPs)are defined by measures linked to physical and chemical restraints to reduce the movement or control behaviours during any emergency.Seclusion is an equal part of RPs intended to isolate and reduce the sensory stimulation to safeguard the patient and those within the vicinity.Using interventions by way of virtual reality(VR)could assist with reducing the need for RPs as it could help reduce anxiety or agitation by way of placing users into realistic and immersive environments.This could also aid staff to and change current RPs.AIM To assess the feasibility and effectiveness of using a VR platform to provide reduction in RP training.METHODS A randomised controlled feasibility study,accompanied by evaluations at 1 month and 6 months,was conducted within inpatient psychiatric wards at Southern Health National Health Service Foundation Trust,United Kingdom.Virti VR scenarios were used on VR headsets to provide training on reducing RPs in 3 inpatient psychiatric wards.Outcome measures included general self-efficacy scale,generalised anxiety disorder assessment 7(GAD-7),Burnout Assessment Tool 12,the Everyday Discrimination Scale,and the Compassionate Engagement and Action Scale.RESULTS Findings revealed statistically significant differences between the VR and treatment as usual groups,in the Everyday Discrimination Scale items Q8 and Q9:P=0.023 and P=0.040 respectively,indicating higher levels of perceived discrimination in the VR group.There were no significant differences between groups in terms of general self-efficacy,generalised anxiety disorder assessment 9,and Burnout Assessment Tool 12 scores.A significant difference was observed within the VR group for compassionate engagement from others(P=0.005)over time.Most respondents recorded System Usability Scale scores above 70,with an average score of 71.79.There was a significant reduction in rates of RPs in the VR group vs treatment as usual group with a fluctuating variability observed in the VR group likely due to external factors not captured in the study.CONCLUSION Ongoing advancement of VR technology enables the possibility of creating scenarios and simulations tailored to healthcare environments that empower staff by providing more comprehensive and effective training for handling situations.

Research on the Application Effect of Humanized Nursing Management in Pediatric Rehabilitation Wards

Objective:To explore the application effect of humanized nursing management in pediatric rehabilitation wards.Methods:82 pediatric patients admitted to our hospital between January 2023 and January 2024 were randomly divided into a control group and an observation group.Among them,the control group was given routine care,while the observation group received humanized nursing management,and the clinical nursing effects and situations of the two groups of children were compared and analyzed.Results:After nursing,the observation group showed significantly better performance in intelligent Developmental Quotient(DQ)values(P<0.05).The clinical nursing satisfaction of the observation group was significantly better than that of the control group(χ^(2)=11.710,P<0.05).Conclusion:Humanized nursing management for patients in pediatric rehabilitation wards not only improves their recovery but also significantly enhances parental satisfaction,which is worth learning from and promoting in clinical settings.

Application and Research of Big Data Technology in Intelligent Ward

With the rapid development of information science and technology and the progress of the health service industry,the integration of medical services and new technologies such as big data technology has become more in-depth,and the construction of smart hospitals and smart wards has received more and more attention and application.This article conducts in-depth research and analysis on the application and exploration of big data technology in smart wards and explores the role of big data technology in improving the quality,efficiency,and cost of medical services in smart wards,as well as the application prospects and challenges of big data technology in patient monitoring,disease prevention,and diagnosis and treatment processes in smart wards.The focus is on analyzing and studying the use of big data technology to assist in the construction of smart neonatal surgery wards.This article aims to provide useful references and lessons for the construction and development of smart wards.

Evaluation of Human-Oriented Transport in City Hall Transportation Projects Approach to Sustainable Case Study of the Kerman City Hall

In Iran, the implementation of public transport and non-motorized transport infrastructure warrants the need to allocate adequate funding from the state and city hall. In this regard, in city hall development plans (the format approved by the Ministry of Interior), urban transportation plan has been one of the ten chapters. The purpose of this paper is to survey the content and documents related to the allocation of funds to the traffic sector in the former development program of Kerman city hall and by the way, assess the role of human-oriented transportation among the plans and programs of Kerman city hall. Therefore, the amount of funds allocated to the transport sector in Kerman city hall development plans and programs has been investigated for a period of six years (2009-2014). Comparative analysis method is used for surveying the position and the importance of sustainable transport among planners and urban management. Kerman is the historical city and the most important city in the South East of Iran. Due to uncontrolled population growth in recent decades, a large number of cars added to its pathways, so it is required to have a plan of sustainable transportation programs to be evaluated traffic. Results of the analysis indicate that the budget allocated to the development of the vehicle-oriented transportation is much more than human-oriented transportation and in fact, human-oriented systems of transport such as walking and cycling are considered less than the others. Also in the old fabric of Kerman city that has formed on the basis of the human-oriented transportation, the lowest level of funding is intended to regulate transportation. With this description, it is clear that achieving sustainable development and human-oriented in urban transport sector, it fundamentally needs paradigm shift in urban transport development and revision in the attitudes of managers and planners, and in the meantime it is necessary to correct the programming cycle of urban development along with review of the allocating funds mechanism and to define projects in various sectors. Urban and transport planners can conduct municipalities projects with costing not too much and hereto provide non-motorized styles in the field of urban transport networks. If only allocated apart of the overall funding for roads, highways and city streets to the development of public transport and non-motorized transportation options, the impact would be very high.

Strategy for Human-oriented Living Street Based on the Needs of the Elderly:Taking Dieshan Road as an Example

With the continuous progress of urbanization,motor traffic has occupied the streets of contemporary China,and people's demand for street space has been ignored.The disappearance of street life and the rapid development of cars have caused various problems including congestion,exhaust,noise,accidents,environmental degradation and so on.People-oriented living streets are gradually away from people's life,the street walking environment is getting worse and worse,and the street space does not pay enough attention to the needs of pedestrians,especially the elderly.At present,China has entered an aging society,and paying attention to the needs of the elderly is an inevitable problem in urban construction and development.This study starts with the analysis of the walking needs of the elderly and the street characteristics suitable for the needs of the elderly,and takes the street space of Dieshan Road in Nanchang City as the research area.And the relevant strategies are put forward to improve the living street space environment,so that the elderly can go back to the street space.

术后患者自控镇痛:北京协和医院30年临床管理经验

术后疼痛严重影响患者的康复进程,从而导致住院时间延长,照护成本增加。合理应用患者自控镇痛装置可有效缓解围术期急性疼痛。北京协和医院于1994年引入患者自控镇痛技术,并于2004年成立了急性疼痛服务工作组,以麻醉医生为指导、手术室疼痛专科护士为基础,联合实施基于患者自控镇痛的全流程、规范化管理,并不断改进和创新工作方法,为术后疼痛管理的发展奠定了坚实基础。本文从临床工作重点、护理管理经验、疼痛治疗理念的推广与传播、新形势下急性疼痛服务模式的发展等方面对该项工作进行系统回顾与总结,以期为全面加强患者诊疗过程中的疼痛管理、提升患者围术期镇痛服务满意度提供有价值的参考。

基于5G技术的医院智慧病房建设探讨

介绍了5G、物联网、云计算等技术在智慧病房建设中的创新应用,以进一步改善患者的就医体验为目标,构建了智慧病房整体解决方案,通过全面感知、安全传递、共享协作和智能处理,为患者提供更高效、更安全、更舒适的医疗服务。

基于大数据的多学科协作教学模式在全科病房护生实习带教中的应用

目的:研究基于大数据多学科协作教学模式在全科病房护生实习带教中的应用。方法:选择2018年4月至2020年4月我院全科病房实习护生98名,依据随机数表法分组。对照组接受常规教学,试验组接受基于大数据的多学科协作教学模式。比较两组综合护理能力考核成绩及满意度。结果:试验组理论考核、操作技能、病例分析、文献检索、语言表达及团队协作等综合护理能力考核成绩均高于对照组(P<0.05);试验组带教满意度高于对照组(P<0.05)。结论:基于大数据的多学科协作教学可提高理论考核、操作技能及团队协作等综合能力,增加护理满意度。

某三级医院鲍曼不动杆菌临床分布及耐药性变迁

目的:分析川北医学院附属医院分离的鲍曼不动杆菌(AB)的临床分布及耐药情况,了解其变化趋势。方法:分析川北医学院附属医院分离的764株AB的临床分布及药敏试验结果,并与课题组前期研究结果进行对比分析。结果:本次检出的AB在各标本中及在临床科室的占比与川北医学院附属医院2004~2008年和2011~2014年报告数据存在统计学差异(P<0.05),三个时期均以痰标本检出率最高(73.1%~84.2%),ICU和神经外科占比位列前两位;近年急诊科的AB分离率高达17.3%。三个时期12种抗菌药的合计耐药率分别为69.2%、79.6%和58.1%(P<0.05)。2020~2021年,AB对所试13/16种抗菌药的耐药率均>50%。2020~2021年神经外科和ICU分离菌株对所试12种抗菌药的合计耐药率分别为66.5%和75.4%,较2011~2014年的耐药率(分别为79.7%和84.1%)降低(P<0.05)。结论:川北医学院附属医院AB主要见于呼吸道感染,以ICU、神经外科和急诊科较为常见。AB(尤其在ICU和神经外科病房)多重耐药现象较为严重。规范抗菌药物使用和加强细菌耐药性实时监测具有重要意义。

综合性医院病区分类管理评价指标体系构建

目的:构建综合性医院临床病区分类管理指标体系,为科学评价岗位价值奠定基础、对护理岗位管理提供理论依据。方法:对综合医院病区分类管理主要构成要素进行分析,根据专科属性结合各临床病区的工作量、护理难度等因素选择客观、可测量的指标,采用德尔菲专家咨询法构建临床病区分类管理指标体系。结果:2轮函询分别向15名专家发出函询表,回收率均为100%。2轮专家函询有12名专家提出修改意见,专家权威程度为0.89。最终形成包括护理工作量、护理工作难度、护理职业风险和工作压力负荷4个一级指标、11个二级指标、33个三级指标的评价体系。结论:构建的综合医院病区分类管理指标可为临床病区分类及临床护理管理实践提供理论基础。

基于5G的专科联盟分级诊疗平台的构建与应用

目的:为了进一步推进医联体远程医疗协作业务向基层医疗卫生机构提供远程医疗相关服务,通过信息化手段促进资源的纵向流动,提高优质医疗资源的可及性以及医疗服务整体效率。方法:基于5G虚拟专网技术,在医联体内建立集远程会诊、远程示教、远程培训、数字资源共享等多种功能为一体的远程医疗协助服务平台。结果:在医联体内部,通过移动专网的使用,医护人员能够更加便捷、安全地进行远程会诊和教学工作。结论:充分利用虚拟专网优势,实现了通信主体间高速、高可靠、低时延以及安全的信息传输,保障了远程医疗协作业务应用场景的顺利开展。

暖箱流转溯源管理系统在新生儿无陪护病房中的应用

目的探讨暖箱流转溯源管理系统在新生儿无陪护病房中的应用。方法深圳市儿童医院普外科及深圳市第三人民医院儿科于2023年1月开始应用暖箱流转溯源管理系统进行管理。选取2022年1—12月深圳市儿童医院及深圳市第三人民医院实施暖箱干预并予以常规暖箱管理的100例新生儿为对照组,将2023年1—12月实施暖箱干预并予以暖箱流转溯源管理系统的100例新生儿为观察组。比较2组护理环节不良事件发生率、新生儿院内感染发生率、护理质量(护理技术、基础护理及综合评价)及护理满意度(服务态度、业务水平、病房环境、识别流程及护理结果)。结果观察组护理环节总不良事件发生率(5%)低于对照组(14%)(P<0.05)。观察组新生儿院内感染发生率(3%)低于对照组(10%)(P<0.05)。观察组护理质量、基础护理及综合评价维度评分均高于对照组(P<0.05)。观察组护理满意度总分及病房环境、识别流程、护理结果维度评分高于对照组(P<0.05)。结论将暖箱流转溯源管理系统应用于新生儿无陪护病房效果显著,可降低病房护理环节不良事件发生率及新生儿院内感染发生率,提高护理质量和护理满意度。

“针灸科嵌入式查房”管理模式提升临床医疗效能:以上海某二级医院糖尿病周围神经病变病种为例

目的 构建“针灸科嵌入式查房”模式,研究其对于提升糖尿病周围神经病变(DPN)诊治及预后的应用效果。方法 医院于2021年10月引入并实施“针灸科嵌入式查房”,开始改革针灸诊疗模式。实施前收集2019年10月至2021年10月我院内分泌科收治的DPN患者85例,实施后收集2021年10月至2023年6月我院内分泌科收治的DPN患者96例,共181例患者。对比改实施前后DPN患者医疗服务能力(平均住院日、平均住院费用、中医非药物治疗费用、中医非药物治疗率)、患者就医感受度(7 d满意度、30 d满意度)等相关质量安全指标。结果 与实施前相比,实施后平均住院日缩短,平均住院费用减少,平均中医非药物治疗费用增加,中医非药物治疗率提高(P <0.05)。实施后,内分泌科、针灸科的7 d满意度、30 d满意度均比实施前上升(P <0.05)。结论 实施“针灸科嵌入式查房”模式能够对该病种增强医疗服务能力,提升临床医疗效能,缩短住院时间,减少住院费用,提升患者就医感受。

基于物联网的多院区病区中央监护系统的建设实践

基于目前医院普通病区患者生命体征监测现状,设计开发了基于物联网的多院区病区中央监护系统,在病区床旁通过PDA扫码实现监护仪与患者绑定和解绑。病区中央监护系统与护理综合信息平台通过接口对接,患者生命体征定时发送到护理综合信息平台,实现了普通病区患者生命体征实时监测。通过基于物联网的多院区病区中央监护系统的应用,显著减少了护士工作量,提高了护士工作效率。

多院区医院床位效能优化评测实践与探索

目的科学合理设置病房布局和规模,实现床位效能最优化。方法选取医院2022年住院统计报表及DRG相关数据,包括出院人次、实际占用床日数、床位使用率、病床周转次数等。运用指数分布图将全院病区分为四类,建立床位工作效率模型和病床产出效率模型,并引入CMI指标进行调整。结果医院有40%的病区位于“效率型”象限,5.3%位于“压床型”象限,28%位于“周转型”象限,26.7%位于“空置型”象限。经CMI调整后的病床产出效率、病区布局显著改善,实现了资源的优化配置。结论通过床位工作效率和病床产出效率进行床位合理区间估算,结合实际情况进行适时床位调整和人员调配,有效提升了医院运营效率。

某大型公立医院医养结合模式实践探索

随着人口老龄化程度的加深以及医疗需求的增加,家庭病房作为一种医养结合服务模式逐渐受到重视,成为一种对医疗资源紧缺的重要补充手段。广东省第二人民医院建设智慧家庭病房,探索实践医养结合“互联网+养老”新模式。本文以广东省第二人民医院建设智慧家庭病房的医养结合实践为对象,探索分析公立医院医养结合“互联网+养老”模式在应用中存在的问题,并提出相应的对策建议。

广东省三级综合医院优质护理服务评价指标的构建

目的构建广东省三级综合医院优质护理服务评价指标,为促进优质护理服务评价工作和规范优质护理服务提供参考。方法基于文献检索的基础上,应用头脑风暴法并借鉴国内已有的相关制度、标准和政策构建出评价指标条目池和问卷初稿;采用德尔菲法对评价指标进行两轮专家函询。结果两轮专家函询的回收率分别为80.00%和91.67%;权威程度系数均为0.93,医院部分Kendall协调系数W分别为0.128和0.116,病区部分分别为0.193、0.107,差异具有统计学意义(均P<0.001)。第2轮函询医院各指标的重要性均数为(4.43~5.00)分。第2轮函询病区各指标的重要性均数为(4.59~5.00)分。构建的广东省三级综合医院优质护理服务评价指标包括医院和病区两个部分,其中医院部分包括一级指标8项、二级指标22项、三级指标65项,病区部分包括一级指标9项、二级指标23项、三级指标50项。结论本研究编制的广东省三级综合医院优质护理服务评价指标具有较好的科学性和可靠性,有利于完善优质护理服务管理制度,引导优质护理服务健康发展。

以病房示教为主联合TBL教学法在眼科教学中的探索

目的眼科学是临床专业学生的必修内容,其内容专业性强、学时相对有限、教学难度大。在眼科教学过程中改进教学方法并提高教学效率已经成为眼科学教学研究的重要课题。方法选取2021年11月—2022年5月于中山大学附属第五医院眼科见习的79名中山大学临床医学系本科学生为研究对象。随机分为对照组和研究组,对照组39名,研究组40名。对照组授课方式为传统教学法,研究组授课采用以病房示教为主联合以团队为基础的教学法(team-based learning,TBL)。教学结束后进行理论及技能考试对教学效果进行评价,采用问卷调查的方法评估学生对教学模式的满意度。结果研究组病例分析成绩[(89.04±4.03)分]优于对照组[(80.29±4.51)分],差异有统计学意义(P<0.001);研究组理论成绩较对照组稍提高,差异无统计学意义(P>0.05)。教学满意度评价显示,研究组中对眼科疾病的整体认识、理论知识掌握程度及提高临床思维能力、拓宽知识面增强横向联系及纵向认知、提高眼科学专业学习兴趣、提升学习效率、提高沟通能力、提高团队合作精神的满意程度更高,差异有统计学意义(P<0.05)。结论病房示教为主联合TBL教学法的教学模式是眼科学临床教学方法改革的积极探索,可显著提高见习生对临床眼科疾病的识别及诊疗能力,加强眼科见习生对眼科疾病的掌握程度。