Effect of Healthcare Failure Mode and Effect Analysis on Reducing Error Risk of Neonatal Parenteral Nutrition Solution Dispensing

[Objectives]To investigate the effect of healthcare failure mode and effect analysis(HFMEA)on reducing error risk of neonatal parenteral nutrition solution dispensing.[Methods]A research team was established to identify the failure mode(FM)in each link of the formulation process of neonatal parenteral nutrition solution by HFMEA,quantify the severity(S),occurrence(O)and detection(D)of FM,and evaluate FM by risk priority number(RPN).For FM with the values of RPN>16,failure cause analysis was conducted,and corresponding improvement measures were formulated.The weight coefficient and random consistency ratio(CR)of deployment process were calculated in Matlab R2018a by compiling the Analytic Hierarchy Process(AHP)program.Six months after the implementation of improvement measures,the implementation effect was evaluated by comparing the changes of the values of RPN which was evaluated comprehensively and the rate of dispensing errors before and after the implementation of HFMEA.[Results]In the preparation process of neonatal parenteral nutrition solution,a total of 13 FMs with medium and above risk were found,the weight coefficient of medical order review,dosing and mixing was 0.2703,the weight coefficient of drug dispensing check and review was 0.1432,the weight coefficient of print label was 0.1015,the weight coefficient of distribution was 0.0716,and CR=0.0491<0.1.After six months of intervention,the total RPN value decreased by 64.81%from 127.8 to 45.0.The deployment error rates were significantly lower after the implementation,and the difference was statistically significant(P<0.05).[Conclusions]HFMEA can effectively reduce the error risk in preparation of neonatal parenteral nutrition solution,improve the quality of dispensing and promote the safety of neonatal medication.

Implementation of a risk management plan in a hospital operating room

A risk management program based on ASeNZS4360 risk management standards was developed and implemented in the operating room of Peking University Third Hospital.To accomplish this task,we developed a risk quantification matrix and a risk register form to identify potential risks in the operating room,and then implemented operating room policies designed to reduce or eliminate those risks.We also established a consultation mechanism and risk monitoring system designed to minimize risks to operation room nurses.Finally,we continuously seek to improve our operating room risk management capabilities,so we can continue to improve the quality of service provided and guarantee the safety of surgical patients.

Application effect of safety hazard self-examination mode in nursing risk management in hepatobiliary surgery

Objective:To explore the application effect of safety hazard self-examination mode in nursing risk management in hepatobiliary surgery.Methods:Sixty patients underwent hepatobiliary surgery in two tertiary hospitals in Shandong Province from May 2021 to October 2021.According to the different implementation time,they were divided into 30 cases in the observation group and 30 cases in the control group.The control group adopts routine risk assessment,and the observation group adopts the self-examination mode of potential safety hazards on the basis of routine risk assessment to compare the incidence of nursing risk between the two groups.Results:The observation group had a significantly lower incidence of safety hazards in terms of missing surgical instruments,lack of aseptic operation,and postoperative pressure injuries than the control group(P<0.05).Conclusion:The appropriate hazard self-examination mode in the hepatobiliary operation room is of positive significance to improve the safety awareness of operating staff and the comprehensive ability of operating room nurses.

Corporate Governance, Enterprise Risk Management, and Inter-temporal Risk Transfer

This work is an initial attempt to describe the interconnections among corporate governance,enterprise risk management,and the phenomena of inter-firm risk transfer that occurs in combination with firms’income smoothing.Corporate governance is conceived as a set of rules according to which a firm is managed and governed by its top managers.Extant literature on corporate governance has pointed out the benefits of the adoption,at a firm level,of a comprehensive enterprise risk management process.We note that,although such an adoption favors the smoothing of a firm’s income,in smoothing the income a firm,it also gives rise to an inter-temporal transfer of risk from the firm itself to its stakeholders,specifically to suppliers and employees.Such transfer of risk depends on the strength of a firm contractual power and on the structural relationships established by a firm with its stakeholders.We therefore argue that larger-sized organizations affiliated with a business group are likely to smooth income to a greater extent than smaller-sized organizations unaffiliated with a business group.The paper also offers some discussions of the findings and points out some important issues to be addressed in future studies.

Barriers and Drivers for Mainstreaming Nature-Based Solutions for Flood Risks: The Case of South Korea

Nature-based solutions(NBS)are seen as a promising adaptation measure that sustainably deals with diverse societal challenges,while simultaneously delivering multiple benefits.Nature-based solutions have been highlighted as a resilient and sustainable means of mitigating floods and other hazards globally.This study examined diverging conceptualizations of NBS,as well as the attitudinal(for example,emotions and beliefs)and contextual(for example,legal and political aspects)barriers and drivers of NBS for flood risks in South Korea.Semistructured interviews were conducted with 11 experts and focused on the topic of flood risk measures and NBS case studies.The analysis found 11 barriers and five drivers in the attitudinal domain,and 13 barriers and two drivers in the contextual domain.Most experts see direct monetary benefits as an important attitudinal factor for the public.Meanwhile,the cost-effectiveness of NBS and their capacity to cope with flood risks were deemed influential factors that could lead decision makers to opt for NBS.Among the contextual factors,insufficient systems to integrate NBS in practice and the ideologicalization of NBS policy were found to be peculiar barriers,which hinder consistent realization of initiatives and a long-term national plan for NBS.Understanding the barriers and drivers related to the mainstreaming of NBS is critical if we are to make the most of such solutions for society and nature.It is also essential that we have a shared definition,expectation,and vision of NBS.

Health Emergency and Disaster Risk Management (Health-EDRM) in Remote Ethnic Minority Areas of Rural China:The Case of a Flood-Prone Village in Sichuan

Remote,rural ethnic-minority communities face greater disaster-related public health risks due to their lack of resources and limited access to health care.The Ethnic Minority Health Project(EMHP) was initiated in 2009 to work with remote,disaster-prone ethnic-minority villages that live in extreme poverty.One of the project's aims is to develop and evaluate bottom-up health risk reduction efforts in emergency and disaster risk management(HealthEDRM).This article shares project updates and describes field intervention results from the Yi ethnic community of Hongyan village in China's Sichuan Province,an area that experiences recurrent floods.It was found that 64% of the village respondents had never considered any form of disaster preparation,even with the recurrent flood risks.Health intervention participants showed sustained knowledge retention and were nine times more likely to know the correct composition of oral rehydration solution(ORS) after the intervention.Participants also retained the improved knowledge on ORS and disaster preparedness kit ownership12 months after the intervention.

Risk Management Strategy for Agricultural Operation Subjects in Simple Scale Expansion Mode

Agricultural operation subject is a main body of the market economy. At present,the simple scale expansion mode is a major mode of agricultural operation in China. According to some hypothesis,scale expansion will inevitably bring high income,but such hypothesis has serious defects. The operation mechanism of the simple scale expansion mode includes farmer operation mechanism,professional farmer operation mechanism,and " company + farmers" operation mechanism. In the production and operation,they will be faced with different natural risks,technical risks,market risks and policy risks. Besides,their risk control ability is also varied. Therefore,it is required to take different agricultural risk management strategies. The " company + farmers" production and operation subjects have the highest ability of risk management. Other subjects should learn their experience.

Risk Management and Operation Strategies of Chinese Overseas Risk Exploration Projects

Currently,the investment of oil and gas industry is still facing an unfavorable environment,in which,instable factors,such as financial crisis,terrorist,religious conflicts and rigorous environmental regulations,keep mucking up the business all around the world.Meanwhile,China’s rapid energy consumption growth boosted by a booming economy has put the country to rely heavily on exported oil.It is therefore extremely urgent to expand and diversify petroleum supply channel in consideration of the country’s energy security.As the world’s economy has been slowly recovering from the slump and

基于风险管理的全院“一张床”管理模式的构建与应用

目的:探讨基于风险管理的全院“一张床”管理模式的构建及运行成效。方法:2023年8月我院上线了基于病人信息管理系统、床位调配系统优化后的全院“一张床”管理系统,建立全院“一张床”管理模式,包括相关政策制定、人员培训和技术支持等,并出台了保证病人安全的举措。比较实施前(2022年8月—12月)与实施后(2023年8月—12月)全院收住院病人数量、手术病人数量、平均住院日及满意度评价指标变化。结果:全院2023年8月—12月接收住院病人数量较2022年同比上升27.91%,接收手术病人数量较2022年同比上升38.71%,平均住院日较2022年同比下降11.93%,平均床位使用率较2022年同比上升9.01%,满意度评分较2022年同比上升1.40%。结论:基于风险管理的全院“一张床”管理模式,提升了医院住院病人、手术病人的收治能力,缩短了平均住院时间,提高了病人满意度。

骨科患者术中下肢深静脉血栓风险增高的血流变化及影响因素

目的探讨骨科患者术中下肢深静脉血栓(DVT)风险增高的血流变化特点并分析其影响因素,为手术室护理干预提供临床指导。方法选取151例骨科择期手术患者为研究对象,术中使用多普勒超声诊断仪观察下肢血流改变特征,并收集患者基本资料、手术相关资料、术前实验室检查指标等,患者手术结束24 h内采血行D-二聚体凝血功能检测。结果D-二聚体检测结果显示,DVT高风险患者70例(46.36%),低风险81例(53.64%)。手术结束后DVT高风险患者下肢平均血流速度、血管内径显著低于或小于低风险患者(均P<0.05)。logistic回归分析显示,手术时间>120 min、凝血酶原时间(PT)>13.1 s、术中发生低体温和术中失血量>100 mL是骨科患者术中DVT风险增高的独立危险因素(均P<0.05)。结论骨科手术患者术中DVT发生风险较高,存在明显血流动力学改变。手术室护理人员需针对性地开展手术效率管理、术中低体温监测和预防、维持术中血容量稳定,有效降低骨科手术患者术中DVT发生风险。

失效模式与效应分析提升手术室软式内镜清洗消毒质量的效果

目的探讨失效模式与效应分析(FMEA)在提升手术室软式内镜清洗流程风险管理中的应用效果。方法选择上海交通大学医学院附属瑞金医院2021年1月1日至12月1日自动内镜清洗消毒机(AER)清洗消毒后的内镜共827镜次设为FMEA实施前组,2022年1月1日至12月1日AER清洗消毒后的内镜共844镜次设为FMEA实施后组。运用FMEA对手术室软式内镜清洗操作程序中的各个环节进行分析,通过计算风险优先指数(RPN)查找每个环节中的高危因素,针对RPN>125的关键环节制订改进方案并予以实施。比较FMEA实施前后的失效模式RPN值、内镜消毒合格率、内镜故障维修率、手术患者等待时间、手术室护士AER操作熟练度以及医生满意度。结果FMEA实施后,经过筛选并整改的5个项目的RPN值均下降至<125分;总体的RPN值由1247.24分下降至475.05分,RPN值下降率为61.91%;FMEA实施前后内镜消毒合格率及内镜故障维修率差异均无统计学意义(P>0.05);FMEA实施后手术患者等待时间短于实施前[(10.35±1.57)min vs(12.38±1.91)min],手术室护士AER操作得分及医生满意度高于实施前[(92.50±3.92)分vs(80.49±5.64)分,(93.87±2.16)分vs(83.07±3.10)分],差异均有统计学意义(P<0.05)。结论通过应用FMEA针对性优化相关操作流程,使手术室护士对软式内镜的清洗操作更加熟练,有助于提高清洗效率与质量、减少手术患者的等待时间、提升医生满意度。

基于ELM神经网络的高速公路隧道运营风险评估模型

为克服传统高速公路隧道运营安全风险评估方法计算过程繁琐、运算效率低及泛化能力差等问题,采用极限学习机(Extreme Learning Machine,ELM)神经网络模型对高速公路隧道运营风险进行评估。首先,基于系统工程理论,分析了高速公路隧道运营风险影响因素,构建了运营风险评估指标体系。然后,以全国126个隧道典型运营事故数据为样本集,基于ELM神经网络算法,对比不同激活函数模型的分类准确率和测试时间指标,选定Sigmoid作为激活函数,训练得到高速公路隧道运营风险评估模型。最后,以该模型为核心算法开发了隧道运营风险评估系统,并依托广东省某高速公路隧道路段开展了工程应用。结果表明,所构建的风险评估模型简化了人工计算过程,可提升高速公路隧道运营风险评估的及时性和有效性。

新形势下地质勘查单位安全管理研究分析

安全管理对于新时期的矿产地质勘查单位越来越重要,简要分析当前地质勘查单位在安全管理中存在的短板,然后结合矿产地质勘查单位特点,从提升人员安全意识、落实安全生产责任制、健全安全生产管理制度、抓好安全教育培训、提升野外保障能力等方面详细阐述安全管理措施,最后对地质勘查单位关键环节领域进行重点研究分析,有助于地质勘查行业相关单位提升安全管理水平。

现代化水库运行管理矩阵体系分析与构建关键问题研究

为支撑行业重点任务建设,提高现代化水库运行管理矩阵的建设水平,通过文献查阅、实地考察和交流咨询等方法,绘制了以工程安全、设施设备、影响区、运行调度和管理监督5个关键环节为一体的现代化水库运行管理矩阵构建体系“一张图”。给出了现代化水库运行管理矩阵的整体架构、层次演进和各要素之间的相互关系,系统梳理了现代化水库运行管理矩阵提出的背景、内涵和要求,对“四全”、“四制(治)”、“四预”、“四管”和雨水情监测预报、工程安全风险感控、生产安全风险感控“三道防线”的对象进行了系统整合和扩展,分析了各概念之间的相互关系和关键技术问题。研究结果表明,构建现代化水库运行管理矩阵是科技和管理水平发展的必然要求。

Micro,Small,and Medium Enterprises’Cross-Border Business Strategies

This paper explores the operational strategies of cross-border micro, small, and medium enterprises (MSMEs). Against the backdrop of globalization and digitalization, cross-border trade has become one of the important pathways for many MSMEs to achieve growth and competitive advantage. Firstly, the paper outlines the concept and characteristics of cross-border MSMEs, as well as the analysis of their operational environment in the context of globalization, including political, economic, social, technological, environmental, and legal factors. Secondly, the paper proposes operational strategies for cross-border MSMEs, including international market selection and positioning, cross-border marketing strategies, supply chain management, cross-border financial management, and cross-border risk management. Finally, the paper summarizes the importance of effectively implementing these strategies for cross-border MSMEs to seize international market opportunities, reduce operational risks, and enhance competitiveness and profitability.

“双碳”视角下煤炭上市公司全面风险管理水平对经营效率影响

全面风险管理作为提升公司经营效率和风险防范能力的重要手段,为促进煤炭上市公司低碳转型,助力“双碳”目标提供新引擎。文中基于“双碳”视角,采用三阶段DEA-Malmquist模型测算我国煤炭上市公司2008—2022年的经营效率;采用门槛模型和固定效应模型,对煤炭上市公司全面风险管理与经营效率的关系进行研究。研究结果表明:我国煤炭上市公司总体经营效率偏低,经营根据投影值分析,R&D人员、R&D经费投入冗余是造成煤炭上市公司效率无效的主要原因;风险管理流程对全要素生产率、技术效率、规模效率呈现倒“U”型双门槛特征,其通过规模效率的变动进一步影响公司技术效率变动,最终对全要素生产率产生影响;风险管理文化对效率作用效果影响不明显。建议合理调整公司R&D投入,制定基于ESG发展理念的全面风险管理路径,实现公司经营效率系统的平衡。