Internal quality audit and quality standards as a method of quality improvement at the Department of Ophthalmology, University Hospital

Quality assessment of clinical health care with the programme of quality standard is a method of health management, through which better efficiency and safety of health outcomes can be achieved. In the period from 2002 to 2004, a pilot program of quality has been carried out on the Department of Ophthalmology, University Hospital Center in Zagreb. Seven internal audit teams of hospital commission and teams of hospital departments were evaluating introducing practice for quality standards every three months. In the period of two years improvement in all standards of quality has been noticed (expressed in percent of progress towards the ideal result of 100%): personnel 20%, patient rights 15%, medical equipment 40%, quality of emergency service 60%, implementation of clinical guidelines and criteria for elective admission 55%, quality of risk prevention 70%, quality of medical records 60%. The two-years-improvement dynamics of about 46%, first year 24%.     

洪堡大学Virchow后期临床教学医院和Robert—Rssle医院的外科和肿瘤外科系的研究概况

简要介绍了位于柏林的洪堡大学Ｖｉｒｃｈｏｗ后期临床教学医院的Ｒｏｂｅｒｔ—Ｒｏｓｓｌｅ医院的外科和肿瘤外科系的概况和与激光有关的研究项目。     

Role of the School Eye Clinic in Modern Ophthalmology

Routine sight tests for children at intervals throughout their school career are clearly important; three-quarters of those referred to the school eye clinics in this area had some ocular defect. It is probably no longer necessary for myopic schoolchildren to be treated by a consultant ophthalmologist after their initial examination.Forty-five per cent. of children referred to the school eye clinics in this area were found to have squint and/or hypermetropic/anisometropic/astigmatic refractive errors. Priority should be given to this group because of the association of amblyopia with these conditions. Their treatment requires closer association with the hospital ophthalmic department, perhaps even complete unity. Transfer of children at present seen in the school eye clinic to a hospital-based “children''s eye clinic” would also fit in with a unified health service administration structure and be better placed to indicate, evaluate, and control future developments towards the prevention of amblyopia.     

Blastocystis hominis in patients at the Ruiz y Paez University Hospital from Bolivar City, Venezuela]

Blastocystis hominis is a polymorphic protozoan of discussed taxonomic position, which is currently associated with human intestinal disease. In order to determine the prevalence of the microorganism in a sample of hospitalized patients, a study was carried out from november 1996 to april 1997 on 100 adult patients of both sexes aged 20 to 79 years at the "Ruíz y Páez" University Hospital of Bolivar city, Venezuela. A coproparasitological study was carried out using direct examination and Faust method. Infection by parasites and/or commensals was demonstrated in 48 patients. The most frequent agent was B. hominis with a prevalence of 42.0%. We did not find a statistically association between sex (P > 0.05) or age (X2 = 3.52; d.f; = 3) and B. hominis infection. B. hominis was most frequently identified as the single parasite (88.1%), and with a number of less than 5 cells per 400X microscopic field (73.8%). The infection was more common in patients with base chronic-immunosuppressive diseases, the major one being cancer. Diarrhea was observed in 27.0% of cases. Due to its high prevalence, especially as a single agent, together with the particular immunological characteristics of the patients studied, a potential pathogenic role of the opportunistic type is suggested for B. hominis.     

Bacterial and fungal bloodstream infections in patients at the University Hospital of Cracow

In presented material evaluation of changes in sepsis and types of bloodstream infections of hospitalized patients in Wards of the University Hospital in Cracow were examined. Results of 9,138 blood cultures studied in years 1989-1999 were analysed. All of the blood samples were recovered from 4,656 infected adults at Clinics of the University Hospital in Cracow. Microbiological blood examinations were held in system of constant monitoring of isolated cultures applying BacT/Alert--colorimetric system (Organon Teknika). Cultured micro--organisms were identified using commercial biochemical tests (bio-Merieux). During period of research changes of profile of isolated microorganisms was observed. Percentage of blood infections of Enterococcus spp. etiology increased from 2.2% in 1989 to 9.8% in 1997-98 (p = 0.014). Dynamic growth of non-fermentative S. maltophilia bacilli to 5.5% (p = 0.036) and Serratia marcescens to 13.8% (p = 0.042) in 1999 was revealed. Designed according to our research review of fungal flora in years 1989-1999 revealed tendency of systematic growth of invasive candidemia frequency, from 1.1% to 10.4%. Diagnostic and therapeutic profile of Departments was in a strict connection with increase of the number and meaning of the politiological bacteremias (p = 0.036) in total number of systemic infections cases.