Objectives:This study was conducted to investigate the current status of handoffs,perception of patient safety culture,and degrees of handoff evaluation in small and medium-sized hospitals and identified factors that ...Objectives:This study was conducted to investigate the current status of handoffs,perception of patient safety culture,and degrees of handoff evaluation in small and medium-sized hospitals and identified factors that make a difference in handoff evaluation.Methods:This is a descriptive study.425 nurses who work at small and medium-sized hospitals in South Korea were included in our study.They completed a set of self-reporting questionnaires that evaluated demographic data,handoff-related characteristics,perception of patient safety culture,and handoff evaluation.Results:Results showed that the overall score of awareness of a patient safety culture was 3.65±0.45,the level was moderate.The score of handoff evaluation was 5.24±0.85.Most nurses experienced errors in handoff and most nurses had no guidelines and checklist in the ward.Handoff evaluation differed significantly according to the level of education,work patterns,duration of hospital employment,handoff method,degree of satisfaction with the current handoff method,errors occurring at the time of handoff,handoff guidelines,and appropriateness of handoff education time(P<0.05).Conclusion:For handoff improvement,guidelines and standards should be established.It is necessary to develop a structured handoff education system.And formal handoff education should be implemented to spread knowledge uniformly.展开更多
The most suitable intervention for energy rehabilitation of historical buildings has to reach both the goal of the optimization of the energy saving and the preservation of the original characteristics of the building...The most suitable intervention for energy rehabilitation of historical buildings has to reach both the goal of the optimization of the energy saving and the preservation of the original characteristics of the building.The present work is related to refurbishment and energy rehabilitation of an historical building dating back to 15th century.The building complex under study is an ancient residential courtyard building located in Northern Italy near Verona.The strategies have been focused on the building envelope and energy supply systems respecting both the regulatory constraints imposed by preservation of historical buildings and,where possible,the current national legislation about the building energy efficiency.This result was achieved only through the identification of best solutions based on mutual compatibility and optimization of the performance of the building envelope and the HVAC systems.In the design phase,the thermal performance of the building for both winter and summer periods have been evaluated by dynamic computer simulations.It has been shown that adequate interventions focused on the building envelope and HVAC systems reduces the energy consumption in a significant way.Further,it has been shown through economical analysis that extra-costs for energy retrofit measures paid back quickly during the life span of the building.Historical buildings are characterized by unique and specific characters that could be preserved,also upgrading them to modern requirements.This study demonstrates how it is possible to intervene effectively(and correctly by the historical and architectural point of view)on the energy performance of ancient buildings.By applying innovative techniques and technologies,in fact,it is possible to achieve high energy efficiency levels,without affecting the original architectural appearance and value.The methodology presented can be an interesting case study for all those building interventions where energy,cultural and historical issues intersect.展开更多
In the 1990s,the American Nurses Association established a certification program called the Magnet Recognition Program through the American Nurses Credentialing Centre(ANCC)to complement the quality care provided to p...In the 1990s,the American Nurses Association established a certification program called the Magnet Recognition Program through the American Nurses Credentialing Centre(ANCC)to complement the quality care provided to patients by hospitals.After the program was recognised,hospitals were identified as magnet hospitals[1].Some studies show that magnet hospitals provide a healthier working environment for nurses,accompanied by higher nurse satisfaction and better patient prognosis than non-magnet hospitals[2e5].The nursing work environment is the sum of various elements that directly or indirectly affect the patient care system[6].Improving the nursing work environment is a focal point and challenge for nursing administrators.Therefore,administrators in magnet hospitals usually apply a variety of assessment tools for effective evaluation of the nursing work environment to maintain and improve the health of the environment.展开更多
绩效评价工具的选择对医院精准测量核心价值观、战略目标、重点工作的落实情况具有重要作用。简要介绍了医院质量改进的绩效评价工具(The Performance Assessment Tool for Quality Improvement in Hospitals,PATH)建立背景、过程及其优...绩效评价工具的选择对医院精准测量核心价值观、战略目标、重点工作的落实情况具有重要作用。简要介绍了医院质量改进的绩效评价工具(The Performance Assessment Tool for Quality Improvement in Hospitals,PATH)建立背景、过程及其优势,提出我国医院绩效评价改革可以借鉴PATH模型,建立科学、统一的指标评价体系,同时加快医疗领域信息化建设,发挥第三方评价机构在医院绩效评价中的作用。展开更多
目的构建适用于三级公立医院的绩效评价体系,为医院开展绩效考核与管理工作提供决策参考。方法应用文献法、个人访谈法和头脑风暴法构建评价模型和初始指标库,运用德尔菲法和层次分析法确定指标及其权重。结果运用医院质量改进的绩效评...目的构建适用于三级公立医院的绩效评价体系,为医院开展绩效考核与管理工作提供决策参考。方法应用文献法、个人访谈法和头脑风暴法构建评价模型和初始指标库,运用德尔菲法和层次分析法确定指标及其权重。结果运用医院质量改进的绩效评价工具(The Performance Assessment Tool for Quality Improvement in Hospitals,PATH)理念构建了以病人为中心、以员工为导向、医疗效果与效率、运营管理、社会责任、卓越提升6个核心维度的三级公立医院绩效评价指标体系。结论指标体系的可信程度、权威性较高,具有较好的适用性。展开更多
基金supported by the National Research Foundation of Korea(NRF-2019R1I1A3A01059093)。
文摘Objectives:This study was conducted to investigate the current status of handoffs,perception of patient safety culture,and degrees of handoff evaluation in small and medium-sized hospitals and identified factors that make a difference in handoff evaluation.Methods:This is a descriptive study.425 nurses who work at small and medium-sized hospitals in South Korea were included in our study.They completed a set of self-reporting questionnaires that evaluated demographic data,handoff-related characteristics,perception of patient safety culture,and handoff evaluation.Results:Results showed that the overall score of awareness of a patient safety culture was 3.65±0.45,the level was moderate.The score of handoff evaluation was 5.24±0.85.Most nurses experienced errors in handoff and most nurses had no guidelines and checklist in the ward.Handoff evaluation differed significantly according to the level of education,work patterns,duration of hospital employment,handoff method,degree of satisfaction with the current handoff method,errors occurring at the time of handoff,handoff guidelines,and appropriateness of handoff education time(P<0.05).Conclusion:For handoff improvement,guidelines and standards should be established.It is necessary to develop a structured handoff education system.And formal handoff education should be implemented to spread knowledge uniformly.
文摘The most suitable intervention for energy rehabilitation of historical buildings has to reach both the goal of the optimization of the energy saving and the preservation of the original characteristics of the building.The present work is related to refurbishment and energy rehabilitation of an historical building dating back to 15th century.The building complex under study is an ancient residential courtyard building located in Northern Italy near Verona.The strategies have been focused on the building envelope and energy supply systems respecting both the regulatory constraints imposed by preservation of historical buildings and,where possible,the current national legislation about the building energy efficiency.This result was achieved only through the identification of best solutions based on mutual compatibility and optimization of the performance of the building envelope and the HVAC systems.In the design phase,the thermal performance of the building for both winter and summer periods have been evaluated by dynamic computer simulations.It has been shown that adequate interventions focused on the building envelope and HVAC systems reduces the energy consumption in a significant way.Further,it has been shown through economical analysis that extra-costs for energy retrofit measures paid back quickly during the life span of the building.Historical buildings are characterized by unique and specific characters that could be preserved,also upgrading them to modern requirements.This study demonstrates how it is possible to intervene effectively(and correctly by the historical and architectural point of view)on the energy performance of ancient buildings.By applying innovative techniques and technologies,in fact,it is possible to achieve high energy efficiency levels,without affecting the original architectural appearance and value.The methodology presented can be an interesting case study for all those building interventions where energy,cultural and historical issues intersect.
文摘In the 1990s,the American Nurses Association established a certification program called the Magnet Recognition Program through the American Nurses Credentialing Centre(ANCC)to complement the quality care provided to patients by hospitals.After the program was recognised,hospitals were identified as magnet hospitals[1].Some studies show that magnet hospitals provide a healthier working environment for nurses,accompanied by higher nurse satisfaction and better patient prognosis than non-magnet hospitals[2e5].The nursing work environment is the sum of various elements that directly or indirectly affect the patient care system[6].Improving the nursing work environment is a focal point and challenge for nursing administrators.Therefore,administrators in magnet hospitals usually apply a variety of assessment tools for effective evaluation of the nursing work environment to maintain and improve the health of the environment.
文摘绩效评价工具的选择对医院精准测量核心价值观、战略目标、重点工作的落实情况具有重要作用。简要介绍了医院质量改进的绩效评价工具(The Performance Assessment Tool for Quality Improvement in Hospitals,PATH)建立背景、过程及其优势,提出我国医院绩效评价改革可以借鉴PATH模型,建立科学、统一的指标评价体系,同时加快医疗领域信息化建设,发挥第三方评价机构在医院绩效评价中的作用。
文摘目的构建适用于三级公立医院的绩效评价体系,为医院开展绩效考核与管理工作提供决策参考。方法应用文献法、个人访谈法和头脑风暴法构建评价模型和初始指标库,运用德尔菲法和层次分析法确定指标及其权重。结果运用医院质量改进的绩效评价工具(The Performance Assessment Tool for Quality Improvement in Hospitals,PATH)理念构建了以病人为中心、以员工为导向、医疗效果与效率、运营管理、社会责任、卓越提升6个核心维度的三级公立医院绩效评价指标体系。结论指标体系的可信程度、权威性较高,具有较好的适用性。
文摘目的孤立性肺结节(solitary pulmonary nodule,SPN)的定性诊断十分困难,PET/CT是目前评价良、恶性病变最具优势的影像学手段之一。文中用Meta分析方法综合评价18F-脱氧葡萄糖(18Fluorodexglucose,FDG)PET/CT显像诊断恶性孤立性肺结节的价值。方法以孤立性肺结节、FDG、PET/CT等为检索词,检索1994年1月至2009年7月的Medline数据库、西文生物医学期刊文献服务系统、外文生物医学期刊全文数据库、中国学术期刊网全文数据库等相关中英文文献。对符合标准的研究进行质量评估,用MetaDisc1.4软件进行异质性检验,综合敏感性、特异性和诊断优势比,绘制汇总受试者工作特征(summary receiver operating characteristic,SROC)曲线和计算曲线下面积(the area under the curve,AUC),并进行敏感性分析。结果共检索相关文献29篇,其中11篇符合标准纳入分析,A级1篇,B级10篇,各研究之间存在异质性,按照随机效应模型合并敏感性、特异性、诊断优势比(diagnostic odds ratio,DOR)及其95%可信区间分别为91%(87%~93%)、83%(78%~87%)和51.04(23.33~111.66),AUC为0.9383,Q值为0.875 3,纳入文献稳定性较好。结论 18F-FDG PET/CT显像能灵敏、准确地诊断恶性孤立性肺结节,具有较高的临床应用价值。
