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目的 探索我国公立医院临床医师临床路径应用和实施效果评价的影响因素。方法 对我国东、中、西3省(直辖市)1 638名临床医师进行问卷调查;对54所公立医院进行机构问卷调查。结果 甘肃省医院和二级医院临床医师临床路径执行率较高, 但临床路径实施病种数较少医院的临床医师临床路径执行率较低。临床路径相关培训可提高临床医师临床路径应用和实施效果的正向评价。结论 医院所处地区和级别对临床医师临床路径执行率影响大,医院临床路径实施推广和培训能推动临床医师临床路径应用和正向效果评价。 相似文献
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目的 临床路径实施中的持续改进。方法 采用专家咨询法和文献查阅设定临床路径过程质量的评价指标及权重系数;对每项指标与医院3年平均值或医保规定标准值比较的差值设定4个等级分数,再将各指标的评分求和即得出被评价病种的最终量化的评价结果。以此标准计算每季度入径病种总得分及各指标得分。结果 根据病种总得分与路径文本应得总分按百分比进行符合度比较,符合度低的病种优先干预;病种中影响总得分程度最大的评价指标(即得分最低的)作为下一季度优先干预的环节。结论 建立临床路径过程质量的评价体系,有利于临床路径过程质量的分层管理,是促进临床路径实施过程持续改进的一种管理模式。 相似文献
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目的探讨临床护理路径在妇产科临床护理教学中的建立及应用效果。方法选取2014~2015年实习护生164名为研究对象,其中以2014年的实习护生为对照组,2015年的实习护生为观察组。对照组采用传统教学模式,观察组采用临床护理路径进行教学,比较两组护生的综合考核成绩、教师和护生对临床护理路径的效果评价。结果观察组实习护生的综合考核成绩显著高于对照组,差异有统计学意义(P0.05);而且观察组教师与实习护生对临床护理教学路径的评价较高,与对照组比较差异有统计学意义(P0.05)。结论在妇产科临床教学中应用临床护理教学路径能提高教学效率,弥补传统教学中不足,并能激发教师的教学积极性,提升学生学习效率和学习主动性。 相似文献
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徐淑娟侯朋远田立启尤琳杨松凯 《现代生物医学进展》2011,11(12):2279-2281
目的:调查分析实施过程中各种可能的影响因素。方法:就临床路径实施情况对患者及医务人员进行问卷调查,并分析其影响因素。结果:试点临床路径后患者住院时间及住院费用有显著下降,受试者对临床路径认知程度、自身文化水平、不同疾病差异等导致问卷结果差异和变异情况的发生。结论:临床路径的实施有着多方面的积极作用,进一步推广应用需改进临床路径的宣传教育、制定和落实情况,并加强有关影响因素的深入研究。 相似文献
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《生物技术世界》2015,(6)
目的:通过中医路径对急性眩晕病的治疗,观察评价其对眩晕病的临床疗效。方法:以临床90例急性眩晕症门诊患者作为研究对象,采用随机对照研究,分为中医临床治疗组46例及常规治疗组44例。治疗完成后,通过对中医路径和常规治疗路径的诊疗效果进行对比,比较其临床症状改善情况。结果:中医路径组症状改善率为90%,常规治疗组改善率率为80%,治疗效果差异明显;中医路径组血压降低有效率为88%,非路径组降压总有效率为73%,经统计学分析,两组降压有效率差异明显。结论:急性眩晕病中医临床路径在临床治疗中能够有效改善患者临床症状,有效控制患者血压,患者对诊疗过程满意度颇高,对中医路径接受度较高,可进一步推广于临床应用。 相似文献
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基于电子病历的急性ST段抬高型心肌梗死临床路径与决策辅助系统 总被引:2,自引:0,他引:2
目的:研究在结构化电子病历上实现计算机化的急性ST段抬高型心肌梗死临床路径,进一步评价该方法的试用结果,为辅助临床医生治疗决策、规范治疗行为,并借此提高医疗质量,合理控制医疗费用提供有效的手段。方法:选取最新的、具有权威性的关于急性ST段抬高型心肌梗死诊治指南作为制定治疗决策方案及编写临床路径的依据;通过程序设计将临床路径编写入医学知识库系统,并将医学知识库系统与结构化电子病历进行无缝连接;将20例无严重并发症的急性ST段抬高型心肌梗死病人均分为两组,其中观察组推行计算机化临床路径,在患者住院天数、住院费用、患者及家属满意度以及医生对该系统的评价方面与对照组进行比较。结果:观察组患者平均住院天数及平均住院费用明显低于对照组(p<0.000);患者及家属满意度普遍提高(p<0.05);该系统得到所有被调查医生的认可。结论:运用计算机化临床路径管理无严重并发症的急性ST段抬高型心肌梗死患者能在维持甚至提高医疗质量的前提下,减少患者平均住院天数、平均住院费用,提高患者及家属对医疗行为的满意度,增强医生对治疗指南的顺从性。 相似文献
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In experiments on Black Sea skates (Raja clavata), the potential of the receptor epithelium of the ampullae of Lorenzini and spike activity of single nerve fibers connected to them were investigated during electrical and temperature stimulation. Usually the potential within the canal was between 0 and –2 mV, and the input resistance of the ampulla 250–400 k. Heating of the region of the receptor epithelium was accompanied by a negative wave of potential, an increase in input resistance, and inhibition of spike activity. With worsening of the animal's condition the transepithelial potential became positive (up to +10 mV) but the input resistance of the ampulla during stimulation with a positive current was nonlinear in some cases: a regenerative spike of positive polarity appeared in the channel. During heating, the spike response was sometimes reversed in sign. It is suggested that fluctuations of the transepithelial potential and spike responses to temperature stimulation reflect changes in the potential difference on the basal membrane of the receptor cells, which is described by a relationship of the Nernst's or Goldman's equation type.I. P. Pavlov Institute of Physiology, Academy of Sciences of the USSR, Leningrad. I. M. Sechenov, Institute of Evolutionary Physiology and Biochemistry, Academy of Sciences of the USSR, Leningrad. Pacific Institute of Oceanology, Far Eastern Scientific Center, Academy of Sciences of the USSR, Vladivostok. Translated from Neirofiziologiya, Vol. 12, No. 1, pp. 67–74, January–February, 1980. 相似文献
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N. P. Vesselkin Yu. V. Natochin 《Journal of Evolutionary Biochemistry and Physiology》2010,46(6):592-603
Evolution of living organisms is closely connected with evolution of structure of the system of regulations and its mechanisms.
The functional ground of regulations is chemical signalization. As early as in unicellular organisms there is a set of signal
mechanisms providing their life activity and orientation in space and time. Subsequent evolution of ways of chemical signalization
followed the way of development of delivery pathways of chemical signal and development of mechanisms of its regulation. The
mechanism of chemical regulation of the signal interaction is discussed by the example of the specialized system of transduction
of signal from neuron to neuron, of effect of hormone on the epithelial cell and modulation of this effect. These mechanisms
are considered as the most important ways of the fine and precise adaptation of chemical signalization underlying functioning
of physiological systems and organs of the living organism 相似文献
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