Objective To analyze the causes for day surgery cancellations before admission or on the same day of operation, and put forward targeted measures to improve the medical resource utilization and patient satisfaction. Methods The basic information and clinical data of patients who had been scheduled for surgery in the Day Surgery Center of West China Hospital, Sichuan University between January 2018 and September 2021 were collected. The reasons for the surgery cancellations before admission or on the same day of operation were analyzed. Results From January 2018 to September 2021, a total of 45176 patients were successfully scheduled for day surgery, and 44300 patients completed surgery as planned. A total of 876 operations (1.94%) were cancelled after being scheduled, including 546 (1.21%) before admission and 330 (0.73%) on the surgery day. Ranked from high to low according to the cancellation rates, the top five departments were Department of Dermatology, Department of Vascular Surgery, Department of Hepatobiliary Surgery, Department of Otorhinolaryngology, Head and Neck Surgery, and Department of Gastroenterology, with a cancellation rate of 3.38% (8/237), 2.90% (25/863), 2.85% (101/3548), 2.48% (171/6893), and 1.91% (260/13578), respectively. In the reasons for cancellations, patient factors accounted for 57.31% (502/876) and medical management factors accounted for 42.69% (374/876). Conclusions The cancellations of day surgery mainly occur before admission, and are mainly caused by patient factors. It is necessary to strengthen the preoperative education for day surgery patients, and enhance the communication and cooperation between surgery physicians, nurses and technicians, in order to reduce the operation cancellation rate and make reasonable and efficient use of medical resources.
针刺平行随机对照试验通常没有准确报告试验组和对照组的干预方法.为促进标准化,国际上有经验的针刺医师和研究者组成的小组制定了一些原则,即针刺临床对照试验中干预措施报告的标准(缩写为STRICTA).在征求意见过程中,一些期刊编辑协助对此标准进行了修改,使之与随机对照试验报告的标准(CON-SORT)格式一致,作为该指南对针剌研究报告的延伸.参与此事的杂志编辑已确定要发表该标准,建议其作者群按照此标准准备论文,并将邀请更多杂志采用该标准.目的是使针剌对照试验的干预措施充分报告,从而有利于对这些研究的严格评价、分析及这些措施的推广.
Objective To explore the influencing factors and improving measures of hand hygiene among healthcare workers. Methods From June to August 2016, several healthcare workers from clinical departments and nosocomial infection control department in Chengdu were selected by purposive sampling method. Data was collected by individual in-depth interviews, and was three-rank coded by Nvivo 8 software based on Grounded Theory. Results After three-rank coding, 6 important influencing factors were generalized which were re-categorized into 3 levels: personal cognition, behavior capacity and social support. At the last, the whole framework of the theory was constructed through core coding. Conclusion In clinical practice, we should take reasonable measures to strengthen the training of hand hygiene, improve the hand hygiene facilities, strengthen supervision and management, and effectively improve the implementation rate of hand hygiene.
This article introduces the measures that the scientific research base of West China Hospital has taken in its emergent response to the unexpected huge Wenchuan earthquake disaster, including safe evacuation, safety examination and removal of hidden dangers, damage reporting and a series of subsequent measures.
目的:探讨白内障超声乳化术中发生后囊破裂的原因及处理措施。方法:总结我科2006～2008年近3年间施行的白内障超声乳化术患者508眼,人为将超乳手术过程分为超声乳化、吸出皮质、植入人工晶体三个阶段,对发生术中后囊破裂的26眼患者进行原因分析。结果:发现后囊破裂可发生在手术每个阶段,发生原因多与术者操作技巧有关,少数与患者自身因素有关。结论:严格的筛选患者,提高手术技巧,医生高度的责任心,良好的超乳设备是预防及处理手术并发症的关键。
This paper is to discuss the research of heterogeneity in Meta-analysis, including the definition of the heterogeneity in Meta-analysis and classification it into clinical heterogeneity, methodological heterogeneity and statistical heterogeneity, the strategies for diminishing clinical heterogeneity and methodological heterogeneity, the five testing methods in statistical heterogeneity (Q statistic, I2 statistic, H statistic, Galbraith plot and L’Abbe plot) and the examples and applying conditions of the five testing methods, classification of meta-analysis into exploratory meta-analysis and analytic meta-analysis according if the meta-analysis has heterogeneity, and the strategies and the flowchart when existing the heterogeneity in meta-analysis.