ObjectiveTo investigate the prevalence of thyroid nodules and its influencing factors among medical staff of a hospital in Hengshui. MethodsA total of 2 190 medical workers in a hospital in Hengshui who underwent physical examinations in the Medical Examination Center of Harrison International Peace Hospital from January 2012 to July 2013 were included as the study subjects. Through physical examination, thyroid ultrasonography and questionnaire, we collected data and investigated the prevalence of thyroid nodules and its influencing factors. ResultsThe prevalence rate of thyroid nodules was 39.45% (864/2 190) in these medical staff. The prevalence rates of thyroid nodules in males and females were 32.34% (238/736) and 42.92% (624/1 454), respectively, with statistically significant difference between them (χ2=22.913, P<0.001). With increasing age, the prevalence of thyroid nodules increased gradually, and the prevalence of the same sex increased gradually too (P<0.001). The prevalence rate of women was significantly higher than that of men for each age group (P<0.05). Among the 864 subjects, there were 550 (63.66%) with multiple nodules and 314 (36.34%) with solitary nodules; there were 454 (52.55%) with nodules in both lobes of thyroid, 238 (27.54%) with nodules in the right lobe of thyroid, and 172 (19.91%) with nodules in the left lobe of thyroid; there were 504 (58.33%) with solid modules, 172 (19.91%) with cystic nodules, 114 (13.19%) with solid and cystic nodules, and 74 (8.56%) with calcification. Logistic regression analysis showed that gender, age, educational degree, drinking history, taste habit, stress, agitation were correlated with the development of thyroid nodules. ConclusionThe prevalence of thyroid nodules is high among medical staff of this hospital. Thyroid nodules can be prevented through healthy lifestyle, limiting alcohol intake, emotional control, and relieving stress. Early diagnosis and early treatment should be done to prevent the development and spread of thyroid nodules.
目的 探讨凉山州第一人民医院医务人员锐器伤职业暴露的危险因素及应对措施。 方法 对医务人员在2011年8月1日-31日期间里的锐器伤发生情况进行问卷式和面对面提问式相结合的方式进行调查,共调查医务人员1 112名,包括医生288名,护士589名,医技人员180名,其他55名;采用《医务人员锐器伤调查问卷》进行筛查,筛查后与发生锐器伤的人员面对面交谈,并填写《医务人员锐器伤危险因素调查表》。用医务人员职业暴露监测系统(EPINeT)进行统计分析。 结果 发生锐器伤45例,发生率为4.05%,护士发生锐器伤的比例较高,达到了5.3%,医生为4.5%,医技人员较低为0.56%,其他人员发生锐器伤的可能性较小,经四格表的χ2检验,医生与护士锐器伤的发生率差异无统计学意义(χ2=0.010,P>0.05)。锐器伤发生的主要时机以抽血(占16%)、拔出动静脉针(占14%)、双手回套针帽(占14%)、手术缝针(占12%)以及将针头放入锐器盒(占10%)为主;发生的场所以普通病房(占60%)和手术室(占22%)为主;锐器伤发生的器械以一次性注射器(占32%)、静脉留置针(占18%)、真空采血针(占16%)和手术缝针(占14%)为主。 结论 医生和护士是锐器伤发生的高危人群,应采取一系列措施降低其发生职业暴露的风险,包括增加医护人员数量、加强职业培训、禁止双手回套针帽、采用安全留置针和使用皮肤粘合剂以及采用腹腔镜、阴道镜进行手术等措施,尽量降低医护人员的职业暴露风险。
Objective To explore the impact of community healthcare workers’ (CHWs) knowledge, attitude and practice (KAP) on the influenza vaccination among elderly people. Methods By means of simple random sampling, 1 residential quarter of each communities, 2 communities of each districts, 5 districts of Chengdu city were randomly selected, and the elderly equal to or more than 60-year-old were on-site investigated. Meanwhile, the questionnaire survey was conducted among healthcare workers in the selected communities. Results There were 4 KAP factors played a positive role in influenza vaccination among elderly people: CHWs’ affirmation of the effectiveness of influenza vaccine, explicitly knowing the focus groups for influenza vaccination, recommendation of vaccination in flu season when the elderly visits, and participation in flu-related education activities. When the accuracy rate of each factor got improved by 1%, the influenza vaccination rate would improve by 2.747%, 1.299%, 0.864%, 0.602%, respectively. Conclusion The knowledge, attitude and practice of HCWs have impacts on the influenza vaccination rates of elderly people. They are significant to improve the influenza vaccination rates of the elderly.
ObjectivesTo investigate Chinese health practitioners’ usage and demand for clinical practice guidelines in general so as to improve the development and implementation of guidelines.MethodsWe conducted a cross-sectional questionnaire survey that covered health practitioners from different levels of medical institutions in 17 provinces in China. Attitudes, adherence, usage barriers and demands for clinical practice guidelines were investigated.ResultsA total of 953 health practitioners were involved in the survey in which 931 completed the questionnaires. Respondents generally held positive attitudes toward guidelines and agreed that they improved quality of care and standardized diagnosis and treatment. More than 80% of the respondents reported a fine adherence to guidelines. The most reported barriers to follow the guidelines were " several guidelines are competing” and " lack of facilities and medical resources”. Most respondents agreed that it was necessary to establish a national guideline database, appraise implementation effect of guidelines, develop evaluation tools for guidelines that are applicable for Chinese clinical practice, and provide guidelines training.ConclusionsThis study finds favorable attitudes and fine adherence towards clinical guidelines in general in China. However, internal barriers, such as authority of guidelines, and external barriers, such as supplying system and patients’ preference, can affect guideline dissemination and implementation. It is suggested that establishing a national guidelines database, developing evaluation tools for guidelines that fit for Chinese clinical practice, and provision of guideline training, would facilitate the use of guidelines.
目的 了解临床医务人员锐器伤发生状况及上报时间,从而有针对性地加强职业暴露防护措施。 方法 采用回顾性调查方式,对医院2009年1月-2011年12月报告的76例锐器伤医务人员的备案资料,如人员分类、操作环节、科室、上报时间进行统计分析。 结果 从人员构成看护理人员最多,占46.05%(35例),其次为实习同学/规范化培训医生,占23.68%(18例);手术、整理或清洗器械是造成医务人员锐器伤的主要环节,分别占30.26%、26.32%;妇产科是最易发生锐器伤的科室,其发生率达25.75%,其次为急诊科为25.00%,门诊系统为13.79%;发生锐器伤后的上报时间24 h内、48 h、72 h、72 h以上分别占51.32%、19.74%、10.52%、18.42%。 结论 医院应进一步完善各项规章制度及操作规范,加强医务人员特别是新近的实习医生及规范化培训医生的职业防护培训及教育,规范锐器伤上报管理工作,对不及时上报及易发生锐器伤的主要操作环节等进行针对性培训,以便于加强锐器伤的防护及对职业暴露者采取及时的预防控制措施。
Objective To investigate the free influenza vaccination of health care workers in major departments and explore the possible influencing factors of influenza vaccination of staff. Methods In November 2021, a questionnaire survey was conducted among health care workers who received free influenza vaccination in 19 major departments of West China Hospital of Sichuan University, and the un-vaccinated workers’ information was obtained from the registration system of staff information. Multiple logistic regression model was used to analyze the possible influencing factors of free influenza vaccination. Results The coverage rate of centralized free influenza vaccination of staff in major departments was 32.7% (1101/3369). Multiple logistic regression analysis showed that workers who were female [odds ratio (OR)=1.853, 95% confidence interval (CI) (1.481, 2.318), P<0.001], with an educational background of high school or below [OR=4.304, 95%CI (2.484, 7.455), P<0.001], engaged in nursing work [OR=2.341, 95%CI (1.701, 3.221), P<0.001], and with 11 or more years of working experience [OR=2.410, 95%CI (1.657, 3.505), P<0.001] were more likely to inject influenza vaccine, and workers who had a bachelor’s degree were less likely to inject influenza vaccine. Conclusions The rate of free influenza vaccination among medical staff is low. In order to mobilize the enthusiasm of influenza vaccination among medical staff, it is necessary to analyze the characteristics of the population and take targeted measures to improve the level of vaccination among medical staff.
ObjectiveTo investigate the job satisfaction, emotional state and related factors of medical staff participating in online consultation of West China Internet Hospital during the COVID-19 epidemic.MethodsThrough literature review and expert consultation (Delphi method), the questionnaire was developed, and the online consulting medical staff of West China Hospital of Sichuan University were invited to conduct the questionnaire survey from 26 January to 19 June 2020, and finally the statistical analysis was summarized.ResultsA total of 132 valid questionnaires were retrieved. Of the 132 subjects, 127 people (96.2%) expressed satisfaction or special satisfaction with the online consulting office format; 103 respondents (78.0%) said that online consulting did not affect or completely did not affect the work and life; 81 people (61.4%) consulted online more than 5 days a week, and 108 people (81.8%) worked within 2 hours a day; the vast majority (97.7%) of the research subjects were satisfied with the content of the training materials and the related support work of the coordination group. Only 29 (22.0%) of the study participants believed that the epidemic caused negative emotions, mainly due to the severity of the epidemic.ConclusionThe online consulting medical staff are satisfied with the office form, training materials and coordination work group of the COVID-19 epidemic, and think that it does not affect their work and life. 22.0% of medical staff have negative emotions, and the severity of the epidemic is the main reason.
ObjectiveTo provide a scoping review of the healthcare provider patient-sharing network. MethodsPubMed, EMbase, Scopus, ProQuest, Web of Science Core Collection, ScienceDirect, SAGE, Wiley Online Library, Google Scholar, CNKI and WanFang Data databases were electronically searched to collect studies on patient-sharing network of healthcare providers from inception to July 31, 2021. Two reviewers independently screened literature, extracted data and then Arksey and O 'Malley's scoping review method was used to analyze the study. ResultsA total of 110 studies were included. In which, 70.0% were published in 2016 and later, 78.2% were carried out in the United States, 96.4% used secondary data, and 45.5% adopted social network analysis methods such as exponential random graph model. In terms of network characteristics, 43.6% of the studies adopted the theoretical framework of social network theory, and the network node type was mainly 1-mode, accounting for 87.3%. When constructing the physician patient-sharing networks, 64.5% of the studies had a threshold of 1 patient. We also synthesized existing studies on patient-sharing networks of healthcare providers in the light of factors of networks and related outcomes. ConclusionThe studies of healthcare provider patient-sharing network have potentials to improve clinical practice and health policies. Further studies should consider adopting longitudinal design to validate evidence of study, expanding the scope of study subjects except physicians and enriching the evidence of the relationship between network and health-related outcomes.
目的:调查分析临床医务人员对医疗废物分类知识的知晓程度及存在问题。方法:随机抽查我院临床医务人员210人,填写医疗废物分类知识调查问卷。结果:我院临床医务人员对医疗废物分类知晓程度较低,其中护士对多数问题的知晓率高于医生和护工,医生和护工之间其知晓率没有统计学差异。结论:医疗废物管理的首要环节是医疗废物的分类收集,提高临床医务人员对相关知识的知晓率至关重要。
Objective To provide theoretical basis for the reasonable selection of personal protective equipment by analyzing the willingness of protection and the contamination of severe acute respiratory syndrome coronavirus 2 of medical staff in the designated hospital for treatment of coronavirus disease 2019. Methods The medical staff of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine who entered the contaminated area from May 1 to 31, 2022 were collected as the study subjects. A simple random sampling method was adopted to investigate the willingness of protection of different medical staff leaving the cabin. Contamination of severe acute respiratory syndrome coronavirus2 was detected by fluorescence polymerase chain reaction. Results A total of 70 medical staff were included. There were 61 nurses and 38 in intensive care unit. The survey showed that 47 medical staff chose disposable isolation clothes, 44 medical staff chose protective face screen and 69 medical staff chose double-layer shoe cover/boot cover. A total of 640 specimens were collected. Six positive samples for severe acute respiratory syndrome coronavirus2 nucleic acid test were detected, with a positive rate of 0.94%. All the positive samples were sampled from the sole of a protective clothing. Six positive samples were willing to choose double-layer shoe cover/boot cover. Conclusions The medical staff in designated hospital for treatment of coronavirus disease 2019 tend to take high protection during daily medical activities. However, personal protective equipment is less likely to be contaminated by severe acute respiratory syndrome coronavirus2, and it should be selected rationally to avoid excessive protection.