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眼科门诊患者的护理管理 总被引:1,自引:0,他引:1
眼睛是心灵的窗口,眼睛健康对于每个人都非常重要。对眼科门诊患者的护理管理是专科护理的重要内容。眼科门诊的特点是:患者诊疗数量大,时间比较集中,检查和治疗项目多,许多问题需要在短时间内解决。因此,护理人员必需具备眼科常见的基本知识,熟练掌握专科护理技能。 相似文献
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为深化公立医院改革,北京同仁医院积极开展门诊知名专家团队服务模式试点工作,建立医院内部层级诊疗服务新模式。通过门诊就诊流程调整、服务模式变革,破解“挂号难”“号贩子”等相关问题,实现了医院内部门诊资源的优化利用,是医院内部分级诊疗的有益实践与探索,真正体现了医疗机构“以患者为中心”的服务理念,也为未来广泛推广分级诊疗模式奠定了坚实的基础。 相似文献
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通过历史流量数据及流量监测系统,对医院门诊流量情况进行分析,为门诊人力资源合理分配提供依据。 方法 应用时间序列数据季节指数分析法对医院历史门诊流量数据按月份、周和每日不同时间段流量进行分析,并对流量监测系统的历史数据进行统计分析。 结果 门诊流量3、5、7、11、12月份较大,1、2月份较少;一周中周一至周三流量较大,周四、周五流量较少;一天中早上8:00~10:00流量较大,呈明显就诊高峰,下午14:00~16:00为就诊低峰。 结论 医院门诊流量在一年的不同月份、每周的不同天次、每日的不同时间段都有不同的变化规律。 相似文献
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目的 探讨专家门诊亚专科化及专病门诊优化对学科发展及患者就诊的影响。方法 2011年及2014年分别对老年医学科及普通外科专家门诊实行亚专科化并在2013年至2014年对专病门诊进行优化,比较调整前后门诊相关指标的变化。结果 亚专科化后,两个专科的专家门诊量分别增长了63.0%和5.6%,均高于医院同期平均水平(经χ2检验,P=0.000)。普通外科4级手术率达34.9%,高于2013年同期(经χ2检验,P=0.000),挂号错误率也明显下降(经χ2检验, P=0.000)。2014年底专病门诊增至38个,其中联合专病门诊7个,门诊量增长了36.5%,高于同期专病门诊数量及医院门诊量的增长率(经χ2检验,P=0.000)。结论 专家门诊的亚专科化及充分发挥专病门诊的作用是促进学科建设、提升医院影响力、方便患者就诊的有效措施之一。 相似文献
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Background Tuberculosis (TB) remains a leading infectious cause of morbidity and mortality throughout the world. Medication non-compliance has been recognised as one of the drawbacks in the successful management of this disease. Hence, different approaches for ensuring medication compliance have been adopted; these include the Directly Observed Therapy Short course (DOTS). TB is associated with psychiatric morbidity, particularly depressive disorder, and this has been recognised as a cause of poor compliance and a cause of increased morbidity and mortality from the disease. Despite this recognition, little attention is paid to the identification of depression among TB patients, particularly in the DOTS clinics that most of these patients attend. This study was designed to determine the prevalence of depression in patients with TB attending the DOTS outpatient clinic in a university teaching hospital in Nigeria, and to find out the factors that may be associated with this.Method All consenting TB patients attending the clinic completed a socio-demographic questionnaire and nine-item Patient Health Questionnaire (PHQ-9) designed to screen for depression, especially in outpatient and primary care settings.Results Sixty-five patients participated in the study of whom 41 (63.1%) were males. The mean age of the respondents was 35.1 ± 14.4 (range 15-70 years). Eighteen (27.7%) of the patients had depression, comprising 14 (21.5%) with mild depression and four (6.2%) with moderate depression. Socio-demographic factors (age groups, P=0.024; and financial status, P=0.02) and a clinical factor (persistent cough, P=0.04) were significantly associated with depression.Conclusion Measures to reduce depression among patients with TB should include effective symptom control, particularly of coughing, and measures to improve the financial status of this group of patients. Financial empowerment of patients may reduce depression in them, improve the compliance rate to anti-TB medication, and could furthermore bring an improvement to their quality of life. 相似文献
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M. I. F. J. Oerlemans D. J. A. Lok J. H. Cornel A. Mosterd 《Netherlands heart journal》2009,17(2):52-55
Purpose In 2003 the Dutch Health Care Inspectorate introduced performance indicators to monitor and compare quality of care in Dutch hospitals. In 2007, the new performance indicator ‘one-year mortality after a first visit to a cardiology outpatient clinic’ was introduced. We set out to evaluate this new indicator in three Dutch teaching hospitals. Methods Using electronic medical records, information was collected retrospectively of patients aged ≥70 years who visited the cardiology outpatient clinic of Medical Centre Alkmaar, Meander Medical Centre Amersfoort and Deventer Hospital between 1 January 2006 and 31 January 2006. Diagnoses were based on the diagnosis treatment combination (DBC) coding system. Results 547 patients (mean age 78.0 years, 53% men) were included, 35 (6.4%) of whom had died after one year. Cardiovascular disease was the most frequent cause of death (22/35, 62.9%). The oneyear mortality among the three hospitals varied from 5.0 to 7.3% (NS). Conclusion One-year mortality after the first visit to a cardiology outpatient clinic amounted to 6.4% in patients aged ≥70 years and did not differ significantly between the three Dutch teaching hospitals. The administrative load to obtain the necessary information was considerable. One-year mortality should be regarded as an ‘outcome’ parameter rather than a ‘performance’ indicator. (Neth Heart J 2009;17:52-5.) 相似文献
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KATHERINE A. HALMI 《World psychiatry》2009,8(3):150-155
Eating disorders are challenging and difficult to treat, because of the necessity of a multidisciplinary treatment team for effective outcomes and the high mortality rate of anorexia nervosa. An adequate initial assessment and evaluation requires a psychiatric assessment, a medical history and medical examination, a social history and an interview of family members or collateral informants. A comprehensive eating disorder treatment team includes a psychiatrist coordinating the treatment and appropriate medical physician specialists, nutritionists, and psychotherapists. An adequate outpatient eating disorder clinic needs to provide individual psychotherapy with cognitive behavioral techniques specific for anorexia nervosa and bulimia nervosa, family therapy, pharmacological treatment and the resources to obtain appropriate laboratory tests. Eating disorder patients requiring inpatient care are best treated in a specialized eating disorder inpatient unit. A cognitive behavioral framework is most useful for the overall unit milieu. Medical management and nutritional rehabilitation are the primary goals for inpatient treatment. Various group therapies can cover common core eating disorder psychopathology problems and dialectical behavior therapy groups can be useful for managing emotional dysregulation. Residential, partial hospitalization and day treatment programs are useful for transitioning patients from an inpatient program or for patients needing some monitoring. In these programs, at least one structured meal is advisable as well as nutritional counseling, group therapy or individual counseling sessions. Group therapies usually address issues such as social skills training, social anxiety, body image distortion or maturity fears. Unfortunately there is s paucity of evidence based randomized control trials to recommend the salient components for a comprehensive service for eating disorders. Experienced eating disorder clinicians have come to the conclusion that a multidisciplinary team approach provides the most effective treatment. 相似文献
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目的 应用排队论理论和方法分析门诊化验服务效率,提出优化资源配置的方案。方法(1)利用Microsoft Excel软件分别对周一、周三、周五上下午门诊采血窗口患者到达情况及工作人员服务时间分布进行分析;(2)建立排队模型,用Queuing ToolPark4.0软件分析流程效率;(3)按原卫生部“三好一满意”活动对门诊排队量化指标的要求,提出流程再造和资源配置方案。结果 (1)门诊化验采血窗口患者到达情况服从Poisson分布。其λ值(患者平均每分钟到达率)为3.09人次/分钟、1.80人次/分钟、2.91人次/分钟、1.70人次/分钟、2.40人次/分钟、1.73人次/分钟;(2)采血的服务时间服从负指数分布,窗口平均服务率μ为0.91人/分钟;(3)排队模型对流程效率的分析,除周一上午化验采血窗口劳动强度大(ρ=87%).服务效率低(系统空闲率为2%,等待概率为72%)外,其它时间均能满足卫生部对门诊排队量化指标的要求。结论(1)应根据不同时段,调整和配置相应的资源,周一上午采血窗口应增加1个服务台;(2)采用排队论的理论和方法评价门诊流程效率,提出优化门诊流程绩效是可行的,值得推广。 相似文献