Second-class Hospitals Research Articles

Investigation on feasibility analysis of the training for specialist nurse in operating room under direction of the third-degree subject

Objective To identify the needs of different degree hospitals for specialist nurse in operating room, and to explore the specialist nurse training programs which can meet their actual requirements. Methods We used the self-designed questionnaire to carry out a survey in students which were graduated from the training courses for specialist nurses in operating room in Jiangsu province. Four points of the contents were as below: the general information, the refinement situation of the third-degree subject and subspecialty of one′s own hospital, how their jobs were going after the traing, and the feasibility and plan of the training for specialist nurses in operating room under the direction of third-degree subject. Results 100% of participants thought that it was necessary to hold a training for specialist nurses in operating room, 80.00% of them thought that the current mode belonged to the general nursing, 72.22% of whom from the second-class hospital thought that both the theoretical knowledge and skill learned from the clinical practice could meet their working requirements, and they would continue to take the current training mode. 74.19% of whom from the tertiary hospital thought that although it could meet the requirements, it was not strong enough and was short in details for their own direction, they thought specialist nurses should be trained according to the third-degree subject. Conclusions The training mode is combined with centralization and decentralization, and it includes unified entrance, synchronous training, hierarchical culture. It is established based on the actual needs getting from the hospitals in different grades, so it is better to adapt for different needs of different hospitals. Key words: Specialist nurse; Operating room; Direction of the third-degree subject; Training

Investigation on post setting of mobile nurses in grade II ＆amp; III hospitals

Objective To investigate the awareness , the nursing position demand and capacity requirements of mobile nurses , so as to provide the basis for setting and development of the mobile nurses . Methods Investigated 1 415 nursing staff from 120 hospitals in four provinces about mobile nurse awareness , willingness and ability requirements .Results The awareness of mobile nurses to nurses was 84.45%, only 20.83%of the hospital departments had mobile nurses .Position demand scores of tertiary hospitals , wards with bed utilization rate 90%or higher, and surgery departments respectively were （4.40 ±0.98）, （4.46 ±0.87）, and（4.35 ±1.04）,more higher than that of second-class hospital, wards with bed utilization rate less than 90%, and medicine departments, and significant difference was statistically significant （t/F=20.17,207.49, 10.92,respectively;P〈0.05）.Conclusions The management and operation of mobile nurses in China is in the initial stage, mobile nurses are urgent needed in the surgical ward of tertiary hospitals .Mobile nurses should possess general nurses ability and emergency care skills . Key words: Nurses; Mobile; Cognition; Position requirement

Comparison of the peritoneal dialysis treatment outcome and quality of life on end-stage renal disease patients with high and low clinical compliance

Objective To analyze the correlation between clinical compliance and peritoneal dialysis treatment outcome and quality of life on end-stage renal disease patients with high and low clinical compliance. Methods Total of 137 continuous ambulatory peritoneal dialysis (CAPD) patients of end-stage renal disease were collected in second-class hospital in Weifang by convenience sampling, and divided into high and low clinical compliance group(68 patients in each)according to ESA score. SF-36, dropout rate, fatality rate, infection rate and rehospitalization rate were used to estimated, and Cox multi-factor regression model was used to analyze correlation between therapy outcome and risk factors. Results 61 CAPD patients(44.52%) were dropout, with 23 cases (37.70%) by death. The dropout rate without death(11.8%, 44.12%), fatality rate(7.4%, 26.5%) and infection rate(8.8%, 38.2%)had significant difference between high and low clinical compliance group (P<0.05). The SF-36 scores of 8 dimension also had significant difference between the two groups. Cox multi-factor regression model showed that clinical compliance was an important risk factor of therapy outcome and death(HR=1.68, P<0.05). Conclusion Clinical compliance is an important risk factor of therapy outcome, and should be listed as efficacy monitoring index of peritoneal dialysis and the target of improving the curative effect of the intervention. Key words: End-stage renal disease; Peritoneal dialysis; Clinical compliance; Quality of life; Therapy outcome

Impact of high quality nursing service on patient satisfaction in a second-class comprehensive hospital

Objective To provide some references for improving the quality of nursing service investigating the impact of high quality nursing service on patient satisfaction in a second-class comprehensive hospital.Methods From May 2010,to August,2012,968 inpatients were investigated with patient satisfaction questionnaire and stratified random sampling method.Results The overall patient satisfaction 2010 to 2012 was over 90％.The scores of overall patient satisfaction and the patient satisfaction to technical service level and management level had stastical differences between different years (P ＜ 0.05) and increased year by year.The patient satisfactions to registaiton introduction,service attitude,and nurses' operation skill were 87.82％,86.86％,and 87.82％,respectively,which were top 3 in 2010.The patient stisfactions to introduction of primary nurse,ward management,and observation of illness state(active patrol) were 52.88％,59.94％,and 64.74％,respectively,in 2010.All indexes of the patient satisfaction survey in 2012 were over 85％,with statistical differences comparing with those in 2010 (P ＜ 0.05).Conclusions Being patient-centered,carrying out “the demonstration project of high quality nursing service”,implementing the basic nursing,improving medical environment,and strengthening the nurse-patient communication and nurses' high quality service concept are effective ways for improving patient satisfaction. Key words: High quality nursing service; Second-class comprehensive hospital; Patient satisfaction

Investigation on the cognition of blood glucose monitoring knowledge in junior nurses from grade 3 and second-class hospital in Tengzhou City of Shandong Province

Objective To study the cognition of junior nurses on blood glucose monitoring knowledge,so as to provide training strategies.Methods Totals of 185 junior nurses from a grade 3 and second-class hospital in Tengzhou City of Shandong Province were investigated with the questionnaire about the knowledge of blood glucose monitoring,blood glucose levels and the ways how the junior nurses get the knowledge.Resrlts One hundred and eighty-five questionnaires were distributed and 185 were retrieved with a effective response rate of 100％.Among 185 junior nurses,the score of blood glucose monitoring related knowledge was between 5 ～ 16 point,average score was (10.23 ± 1.02) point.Bachelor nurses got the highest points,junior college nurses for second.Nurses who monitored the blood glucose more than 5 times one day got higher points.For low blood glucose level,blood glucose normal scope after meal within 2 h and normal scope of glycosylated hemoglobin were lower than 40％.Check items before blood glucose monitoring and sterile technique'both mastered above 90％.The ways junior nurses acquired blood glucose monitoring related knowledge were mainly from school time learning or education during internship,some were from department ward round and small from classroom learning.The fewest junior nurses get the knowledge by reading journal and information from internet.Conclusions Junior nurses acquired good knowledge on blood glucose monitoring operation,but bad on theory of monitoring indexes,low of learning initiative.Ideological education,making rules,and professional knowledge training should be suggested to improve the theory standard of junior nurses. Key words: Junior nurse; Blood glucose monitoring; Cognition investigation; Training strategy

PHP22 - Medication Use Survey Of Inpatients With Basic Medical Insurance From 2009 To 2010

To understand hospitalization costs, expenses covered by insurance and disease distribution among urban inpatients with basic health insurance (BHI) in China between 2009 and 2010, providing data evidence for the government further improving BHI policies and drug regulation system. A nationwide, cross-sectional sampling of urban inpatients with BHI was conducted in mainland China. A retrospective analysis was adopted and all results were extrapolated to the whole country according to the population, economics and other factors in the inpatients’ cities. The statistics analysis software was SQL Server 2003. There were 31,460,000 cases after extrapolated (sample=236,366) in 2010, with an increase of 13.92% than that of the previous year. Second-class hospitals received more hospitalization cases (45.47% of the total ) in 2010 than the previous year (41.28% of the total). Average hospitalization cost per visit in 2010 was 8056 RMB, an increase of 5.05% from the previous year. Remarkably, medication expenses accounted for about 49%, which was approximately equal to the previous year. The expenses covered by BHI accounted for 67.73% for each vist, which was higher than that of the previous year. Cerebrovascular disease had the most hospitalization cases (9.95% of the total), followed by cancer, ischemic heart disease, Hypertension and chronic lower respiratory diseases. The total hospitalization cost of cancer (36.403 billion RMB) was the highest, followed by cerebrovascular disease (25.242 billion RMB) and ischemic heart disease (20.472 billion RMB). The average hospitalization costs per visit and total hospitalization costs all increased. And rational drug use should be still paid more attention since the drug costs percentage was steadily high. Helping inpatients select proper hospitals to see doctors and strengthening the administration of diseases cost highly will be helpful for reducing the medical costs.

The prevalence of percutaneous coronary intervention in Beijing residents with coronary heart disease, 2007–2009

ObjectivesTo describe the prevalence of percutaneous coronary intervention (PCI) in Beijing residents with coronary heart disease (CHD) from 2007 to 2009.MethodThe study is based on a subset of records extracted...

Utilization of antibacterials in 26 second-class and third-class hospitals in Shanghai during 2007-2009

Objective:To investigate the utilization of antibacterials in second-calss and third-class hospitals in Shanghai,so as to provide a base for rational use of antibacterials.Methods:The numbers of prescriptions,consumption sum,average cost of each prescription,use frequency,compound annual growth rate(CAGR) of antibacterials in 12 second-class hospitals and 14 third-class hospitals in Shanghai during 2007-2009 were statistically analyzed.Results:The constituent rate of consumption sum of antibacterials was significantly higher in the second-class hospitals than that in the third-class hospitals(22.11% vs 15.05%,P0.01).The consumption sum,number of prescriptions and average cost of each prescription in second-class and third-class hospitals were increasing on an annual basis;and the constituent rate of consumption sum of antibacterials of special management class was highest.The second and third generation cephalosporins and quinolones ranked top 3 in consumption sum.The consumption sum of cephamycins had the fastest increase.β-lactams were the dominant in the top 10 drugs of consumption sum,but the CAGR of each drug was different.Most of the antibacterials which ranked top 10 in DDDs were the same in second-class and third-class hospitals,and the rank of DDDs was inconsistent with that of consumption sum.Conclusion:There was some difference in the utilization of antibacterials between the second-class and the third-class hospitals.The management of antibacterials should be strengthened,and attention should be paid to the clinical rational use of antibacterials.