ObjectiveTo understand the obstacles in the practice of pulmonary rehabilitation between doctors and patients.MethodsMedical staff and patients with chronic obstructive pulmonary disease (COPD) in public hospitals in this region were randomly sampled, and a questionnaire survey was conducted on possible obstacles to the practice of pulmonary rehabilitation.ResultsTotal of 265 medical staff and 120 COPD patients were recruited in this survey. The obstacles of pulmonary rehabilitation practice of medical staff in clinical work are poor cooperation of patients and their families (84.2%), medical staff’s insufficient awareness of pulmonary rehabilitation (82.3%), and lack of practice and guidelines (78.9%), lack of objective conditions such as site, equipment and equipment (75.1%), lack of multidisciplinary teams (74.3%), pulmonary rehabilitation has fallen by the wayside (73.6%) etc. The main obstacles for COPD patients in pulmonary rehabilitation are lack of access to relevant knowledge (52.4%), insufficient knowledge (36.5%), inconvenient transportation, economic problems and other objective conditions (33.3%). After multiple correspondence analysis, there are differences in the degree of correlation between obstacle factors and groups with different characteristics.ConclusionsThere are many factors hindering the development of pulmonary rehabilitation and there are certain differences among different populations, but the lack of understanding of pulmonary rehabilitation between doctors and patients is the primary problem. It is necessary to improve the cognition of both doctors and patients on pulmonary rehabilitation, and then to solve the obstacles in the implementation of pulmonary rehabilitation.
ObjectiveTo study the effect of new bundle interventions on medical staff’s cognition of occupational exposure protection and exposure rate, and provide evidence for reducing medical staff’s occupational exposure.MethodsThe 1 435 medical practitioners in 37 clinical/technical departments of Nanchong Central Hospital were selected as the research objects. Bundle intervention strategies about occupational exposure for whole population and high risk population were implemented, and the medical staff’s cognition of occupational exposure, occurrence of occupational exposure, and post-exposure reporting in 2017 (before intervention) and 2018 (after intervention) were investigated and compared to evaluate the intervention effects.ResultsThe numbers of valid survey forms collected before intervention and after intervention were 1 160 and 1 421, respectively. The total awareness rate increased from 91.10% before intervention to 96.10% after intervention (P<0.001). The exposure rate and average rank of exposure frequency after intervention were lower than those before intervention (10.98% vs. 17.50%, 1 250.74 vs. 1 340.32), the reporting rate of initial exposure after intervention (69.23%) was higher than that before intervention (57.64%), and the differences were all statistically significant (P<0.05).ConclusionThrough gradually implementing the new bundle interventions, medical staff can improve the cognition of occupational exposure, reduce the occurrence of occupational exposure, improve the enthusiasm of reporting, and create a safe atmosphere.
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。
ObjectiveTo improve the hand hygiene compliance in medical staff via quality control circle (QCC) activities. MethodsFrom January to May 2014, QCC activities were actualized throgh selecting the theme, ensuring the plans, confirming the target, investigating the actuality, validating the true reasons, finding out the countermeasure, ensuring the effect. ResultsHand hygiene compliance, accuracy rate handwashing, and awareness rate before the QCC activities was 53.02%, 65.51% , and 45.56%, respectively; while after the activities was 79.91%, 87.39%, 95.44%, respectively; the differences were significant (P<0.001). ConclusionQCC activities may improve hand hygiene compliance in the medical staff; at the same time, it can fully mobilize the enthusiasm of the medical staff , cultivate the spirit of teamwork , and promote quality improvement .
Objective To investigate the situation and related factors of influenza vaccination among healthcare workers in Sichuan, and provide a basis for the formulation of the strategy of influenza vaccination. Methods From August 1st to August 6th, 2022, healthcare workers from 21 prefectures and cities in Sichuan province were selected by the hospital infection quality control centers to conduct an online questionnaire survey for status and related factors of influenza vaccination. Single factor analysis of vaccination rate was carried out by χ2 test, and the related factors of influenza vaccination were analyzed by binary multiple logistic regression model. Results A total of 3264 copies of questionnaires were distributed, and 3244 valid copies were recovered, with an effective recovery rate of 99.4%. The vaccination rate of influenza vaccine in the surveyed healthcare workers was 56.9% (1846/3244). The gender, age, professional title, position, department, hospital type, hospital nature, hospital level, influenza awareness, and influenza vaccination willingness were the factors resulting in statistically significant differences in influenza vaccination rate among healthcare workers (P<0.05). Binary multiple logistic regression indicated that age≥35 years old [odds ratio (OR)=0.799, 95% confidence interval (CI) (0.681, 0.937), P=0.006], the educational background being bachelor degree or above [OR=1.221, 95%CI (1.036, 1.439), P=0.017], position [nurses vs. doctors: OR=1.339, 95%CI (1.112, 1.612), P=0.002; technicians vs. doctors: OR=1.849, 95%CI (1.278, 2.676), P=0.001], the hospital type being specialized hospital [OR=1.804, 95%CI (1.446, 2.251), P<0.001], hospital level [secondary vs. primary hospitals: OR=0.344, 95%CI (0.271, 0.437), P<0.001; tertiary vs. primary hospitals: OR=0.526, 95%CI (0.413, 0.671), P<0.001], influenza awareness [fair vs. poor: OR=1.262, 95%CI (1.057, 1.508), P=0.010; good vs. poor: OR=1.489, 95%CI (1.142, 1.940), P=0.003], vaccination willingness [OR=4.725, 95%CI (4.009, 5.569), P<0.001] were related factors of influenza vaccination in healthcare workers. The influenza awareness was good in 416 healthcare workers (12.8%), fair in 1989 (61.3%), and poor in 839 (25.9%). The correct rate of influenza vaccination frequency was the highest (82.7%), while the correct rate of influenza contraindication was the lowest (3.2%). Among the healthcare workers, 2206 (68.0%) were willing to be vaccinated, of whom 1548 (70.2%) believed that they could protect people with weak immune function around them after vaccination; 1038 were unwilling to be vaccinated with influenza vaccine in the near future, of whom 335 (32.3%) believed that they had strong immunity and did not need to be vaccinated. Conclusions The influenza vaccination rate of medical staff is related to a variety of factors. Strengthening the publicity and education, and encouraging hospitals to provide free influenza vaccination, especially the correct understanding of contraindications, may be helpful to improve the vaccination rate.
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。
ObjectiveTo explore the risk factors for hematogenous occupational exposure by analyzing hematogenous occupational exposure in medical workers, and discuss countermeasures in order to reduce the occurrence of hematogenous occupational exposure in medical workers. MethodsWe summarized and analyzed the hematogenous occupational exposure reported by registered medical personnel in the First People's Hospital of Yibin City from January 2012 to December 2014. ResultsThere were 129 cases of hematogenous occupational exposure, and nurses were at high risk of such exposure (65.12%).The exposure occurrence focused in medical personnel with working time shorter than 5 years.The top three high-risk operational procedures were needle injection, puncture, and medical waste disposal; sharp instrument injuries (109 cases, 84.50%) were the main factor leading to hematogenous occupational exposure in medical workers.Sources of exposure were detected and confirmed in 92 cases (71.32%); after testing, 79 cases (61.24%) of infections were confirmed in the source patients with one or more blood-borne pathogens.Through scientific treatment, no infection after hematogenous occupational exposure was detected in the medical workers. ConclusionMonitoring and analysis of hematogenous occupational exposure can facilitate identification of key departments, target population and risk factors, which is important for taking appropriate interventions.
Objective To investigates the awareness of medical staff on prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) . Methods Between April and July 2014, health workers from towns and cities of Liangshan Prefecture participated in the class of prevention of HIV PMTCT for key areas in Sichuan province. Those participants, together with some other health workers from the same area whose daily work was related to prevention of PMTCT, were selected as the study subjects. PMTCT prevention knowledge survey questionnaire was given out for the investigation, and chi-square test was used for statistical analysis. Results We retrieved altogether 447 (out of 450) valid questionnaires. Of all the respondents, 94.18% were aware of proper time for HIV antibody testing and routes of transmission in the perinatal period, 95.30% knew the strategy of applying as early as possible antiviral drugs during pregnancy, and 86.58% learned to know when to give the first dose to the newborns and avoidance of breast-feeding. However, the awareness of relevant applied knowledge was relatively low. The total awareness rate of medical workers from women and children’s hospitals were significantly better than that of medical workers from general hospitals (P<0.05), and differences of the awareness depended on different specialties, professional titles and working age (P<0.05). Conclusions The majority of medical personnel in the surveyed area have grasped basic knowledge of PMTCT of HIV, but the ability of applying relevant knowledge precisely, promptly and standardly in daily practices needs to be improved. We recommend that, in addition to strengthening routine training on knowledge of PMTCT of HIV, the mastering and practice of key technical intervention strategies should be followed up and evaluated, especially for those from general hospitals. And it is also important to give training and after-training assessment based on different specialties.
ObjectiveTo investigate the knowledge and attitude of medical professionals in various regions of China on obstructive sleep apnea (OSA) and to find out the influence of sleep center setting on the above results.MethodsA self-designed questionnaire based on OSAKA questionnaire was designed. A total of 630 medical staff were investigated in 7 hospitals at different levels in various regions in China. The subjects were divided into two groups according to whether they had sleep center (including sleep monitoring room) or not. Survey data were analyzed.ResultsA total of 630 questionnaires were sent out, and 590 valid questionnaires were received, and the effective response rate was 93.65%. About half of those surveyed had sleep centers in the hospitals where they worked. There was no significant difference in three attitude problems and the choice of continuous positive airway pressure and surgical treatment between the two groups (all P>0.05). Subjects whose hospital had no sleep center were more prone to select weight loss (estimated parameters=0.513, P=0.046), no smoking and wine (estimated parameter=0.472, P=0.040), avoidance of overwork (estimated parameter=0.933, P=0.000), and drug (estimated parameter=0.802, P=0.000). The average correct rate of OSA knowledge was 45.59%±20.68%. Among them, the correct rate of response to treatment measures was the highest, and the correct rate of other knowledge points was poor. The average correct rate of total accuracy, symptoms and target organ damage in subjects whose hospital had sleep center was higher than that in subjects whose hospital had no sleep center, and there were significant differences (P=0.001, P=0.012, P=0.000). There was a positive correlation between the knowledge of OSA and their attitude towards OSA, treatment and further understanding of the knowledge (r=0.247, P=0.000).ConclusionIt is necessary to strengthen propaganda and education of OSA, and the establishment of sleep center is helpful for medical personnel to know more about OSA and to develop sleep medicine.