BACKGROUND:Medication errors are a common source of adverse healthcare incidents particularly in the emergency department(ED) that has a number of factors that make it prone to medication errors.This project aims to r...BACKGROUND:Medication errors are a common source of adverse healthcare incidents particularly in the emergency department(ED) that has a number of factors that make it prone to medication errors.This project aims to reduce medication errors and improve the health and economic outcomes of clinical care in Hong Kong ED.METHODS:In 2009,a task group was formed to identify problems that potentially endanger medication safety and developed strategies to eliminate these problems.RESULTS:Responsible officers were assigned to look after seven error-prone areas.Strategies were proposed,discussed,endorsed and promulgated to eliminate the problems identified.A reduction of medication incidents(Ml) from 16 to 6 was achieved before and after the improvement work.CONCLUSION:This project successfully established a concrete organizational structure to safeguard error-prone areas of medication safety in a sustainable manner.展开更多
Objective: to study the effect of continuous quality improvement measures on nosocomial infection control in operating room. Methods: in a comparative study, patients and medical staff who underwent surgery in our hos...Objective: to study the effect of continuous quality improvement measures on nosocomial infection control in operating room. Methods: in a comparative study, patients and medical staff who underwent surgery in our hospital between 2018 and 2020 were included in this experimental study, including 100 patients and medical staff who underwent continuous quality improvement measures between 2019 and 2020. The qualification and compliance of hand hygiene of medical staff before and after implementation were analyzed, the incidence of medical disputes and nursing adverse events were compared between the two groups, and the nursing feelings of patients in the operating room were specifically scored. Results: after implementation, the qualified rate of hand hygiene was significantly improved, and the score of patients' nursing feelings in the operating room was significantly improved, and the incidence of medical disputes and adverse events was reduced. Conclusion: carrying out continuous quality improvement measures in the operating room of the hospital can improve the prevention and treatment effect of infection. It is a good measure for patients and medical staff, and reduces the incidence of medical accidents. It is of great significance for the development of the hospital.展开更多
Objective: to analyze the effect of continuous quality improvement intervention for patients with surgical catheter receiving general surgical catheter care. Methods: a total of 990 patients with surgical catheterizat...Objective: to analyze the effect of continuous quality improvement intervention for patients with surgical catheter receiving general surgical catheter care. Methods: a total of 990 patients with surgical catheterization admitted to our hospital from March 2021 to March 2022 were selected and randomly divided into two groups, the patients who received conventional general surgical pipeline nursing program (n 495), that is, the control group, and the patients who received continuous quality improvement intervention (n 495), that is, the observation group. The intervention effects of the two groups were compared. Results: the incidence of adverse events, SAS and SDS scores of observation group were lower than those of control group;the nursing satisfaction of observation group was higher than that of control group;the number of qualified cases in theory and skills of nursing staff in observation group was higher than that of control group, and the qualified scores in theory and skills were higher than that of control group;the difference was statistically significant (P < 0.05). Conclusion: patients with clinical surgical catheterization are faced with great treatment risks in the process of treatment, including unplanned extubation, which will not only have a great impact on patients normal treatment work, but also interfere with patients normal emotional state, with high risk. Combining continuous quality improvement measures to nurse the pipeline can standardize the catheter technology and operation steps, reduce the probability of risk events to the lowest possible level and thus improve the level of nursing quality, which is worthy of clinical application.展开更多
Objective: to analyze the nursing quality of continuous quality improvement in outpatient blood sampling department. Methods: 60 patients who received blood sampling from the outpatient department of our hospital were...Objective: to analyze the nursing quality of continuous quality improvement in outpatient blood sampling department. Methods: 60 patients who received blood sampling from the outpatient department of our hospital were randomly selected as the research object. According to the random grouping method, they were divided into experimental group and control group, with 30 cases in each group. The control group implemented routine blood drawing nursing, the experimental group implemented continuous quality improvement nursing, and finally compared the nursing quality. Results: the results showed that the score of nursing quality in the experimental group was better than that in the control group (P < 0.05). Conclusion: the implementation of continuous quality improvement nursing measures for outpatients with blood sampling can improve the quality of nursing and provide high-quality nursing for patients.展开更多
Objective: to explore and analyze the application effect of continuous quality improvement in standard nursing of intravenous indwelling needle. Methods: 60 cases of intravenous indwelling needle patients admitted to ...Objective: to explore and analyze the application effect of continuous quality improvement in standard nursing of intravenous indwelling needle. Methods: 60 cases of intravenous indwelling needle patients admitted to our hospital from October 2018 to October 2020 were selected as observation objects, and the patients were divided into two groups according to the analysis needs. Patients in group B were given the conventional nursing mode, while patients in group A were given the continuous quality improvement based on the nursing of patients in group B. The satisfaction degree of nursing work and the incidence of adverse reactions in the two groups were compared. Results: the satisfaction of patients in group a was significantly better than that in group b (96.67% > 86.67%) (P < 0.05). The incidence of adverse reactions in group a was lower than that in group B (6.67% < 20.00%) (P < 0.05). Conclusion: the application effect of continuous quality improvement in standard nursing of intravenous indwelling needle is significant, and it has high use value and promotion value.展开更多
Objective: to study the application effect of continuous quality improvement in nursing safety of rheumatology and immunology department. Methods: 40 patients treated from January 2019 to January 2020 (before continuo...Objective: to study the application effect of continuous quality improvement in nursing safety of rheumatology and immunology department. Methods: 40 patients treated from January 2019 to January 2020 (before continuous quality improvement) were selected as the control group, and 40 patients treated from January 2020 to January 2021 (after continuous quality improvement) were selected as the observation group. The incidence of adverse events, pain score, life ability and comfort score were observed. Results: the incidence rate of adverse events in the observation group was lower than that in the control group. The incidence rate of adverse events in the observation group was 5.0% and that in the control group was 12.5%. The pain score was lower than that in the control group. The life ability score was higher than that in the control group. The comfort level was better than that in the control group, with statistical significance (P < 0.05). Conclusion: continuous quality improvement plays a positive role in promoting the nursing safety of patients in rheumatology and immunology department. It can reduce the incidence of adverse reactions, relieve pain, enhance satisfaction and comfort, and improve living ability. It is worthy of popularization and application.展开更多
Objective: to analyze the application value of continuous nursing quality improvement to improve the quality of emergency pre-examination and triage nursing. Methods: a total of 76 patients were admitted to the emerge...Objective: to analyze the application value of continuous nursing quality improvement to improve the quality of emergency pre-examination and triage nursing. Methods: a total of 76 patients were admitted to the emergency department of our hospital. The study was conducted from January 2019 to December 2019. According to the principle of random number method, all patients were divided into observation and routine groups, with an equal number of study subjects of 38 cases. Among them, the observation group adopted the quality of continuous care to optimize the triage care, while the routine group adopted the routine emergency triage care model. Statistics and comparison of the two groups of patients were conducted, including the score of nursing quality, nursing service satisfaction, emergency reception, triage evaluation, emergency aid time, the general indicators of pre-examination and triage accuracy of emergency treatment, and the success rate of rescue. Results: compared with the conventional group, observation group of nursing service attitude, psychological intervention level, health education ability, business level, emergency preview triage accuracy, rescue success rate, and emergency environment and nursing staff instrument, sense of responsibility, patrol clinic nursing satisfaction score are higher, and emergency reception, triage evaluation, first aid time is lower, P <0.05. Conclusion: the continuous improvement method of emergency nursing quality can significantly improve the quality of emergency pre-examination and triage nursing, reduce the treatment time of emergency patients, ensure the quality of emergency nursing and the satisfaction of nursing, and have high clinical promotion value.展开更多
Objective: to explore the application value of continuous quality improvement in blood collection nursing. Methods: the nursing management of blood collection in blood stations was divided according to the groups befo...Objective: to explore the application value of continuous quality improvement in blood collection nursing. Methods: the nursing management of blood collection in blood stations was divided according to the groups before and after the implementation of continuous quality improvement. From January 2020 to December 2020, it was the routine nursing group, and routine nursing was implemented, and the continuous quality improvement from January 2021 to December 2021.The satisfaction of blood donors, the incidence of adverse reactions and the scrap rate of blood donors between the two groups were compared. Results: there were significant differences in the satisfaction, incidence of adverse reactions, blood scrap rate and routine care group, P <0.05. The satisfaction and the incidence of adverse reactions in blood donors were higher than those in the usual care group (P <0.05).The satisfaction of the continuous quality improvement care group was 94.22 ± 3.61, the incidence of adverse R was 1.00%, while the usual care group was 80.01 ± 2.12, and the incidence of adverse R was 9.00%.The blood scrap rate in the continuous quality improvement care group was lower than that in the usual care group (p <0.05).One was had blood scrap, accounting for 1%, while 15, accounting for 15.0%.Conclusion: continuous quality improvement of blood collection can improve the quality of care, reduce blood scrap, reduce adverse reactions, and improve the satisfaction of blood donors.展开更多
Objective: to study and analyze the value of medical record quality management in the continuous improvement of medical quality. Methods: 30 cases were included in our hospital from May 2021 to June 2022. From May 202...Objective: to study and analyze the value of medical record quality management in the continuous improvement of medical quality. Methods: 30 cases were included in our hospital from May 2021 to June 2022. From May 2021 to May 2021,15 cases and 15 cases from January 2022 to June 2022 were included in the control group;The quality management quality, writing quality and quality control of the two groups were evaluated. Results: study group patients management quality, writing quality, quality control patients management quality score is higher than the control group, patients writing quality assessment of grade A is higher than the control group, patients homepage, admission records, hospital records, discharge records, the incidence of quality control defects are lower than the control group, the difference has statistical significance (P 0.05). Conclusion: the application of medical record quality management has an outstanding value in improving the quality of medical record management, writing quality and quality control quality.展开更多
Objective: to evaluate the effectiveness of the continuous improvement of nursing quality in uterine fibroids care. Methods: the study range from January 2020 to July 2021, choose to our hospital gynecology of uterine...Objective: to evaluate the effectiveness of the continuous improvement of nursing quality in uterine fibroids care. Methods: the study range from January 2020 to July 2021, choose to our hospital gynecology of uterine fibroids patients for the research goal, statistics of 136 cases according to computer random distribution method, control group accept routine care, observation group to take nursing quality continuous improvement scheme, evaluation of the quality of life, psychological status and clinical care quality score. Results: the quality of life scores in the observation group were significantly higher than the control group (P <0.05), the psychological status score was insignificant, and the anxiety and depression scores were significantly lower than the control group, with statistical results P <0.05. Conclusion: the continuous nursing quality of uterine fibroids patients can not only achieve a high level of nursing services, but also further improve the quality of life and treatment mood, which is worth clinical application.展开更多
Background:Strong scientific evidence is needed to support low-income countries in building effective and sustainable immunization programs and proactively engaging in global vaccine development and implementation ini...Background:Strong scientific evidence is needed to support low-income countries in building effective and sustainable immunization programs and proactively engaging in global vaccine development and implementation initiatives.This study aimed to implement and evaluate the effectiveness of system-wide continuous quality improvement(CQI)interventions to improve national immunization programme performance in Ethiopia.Methods:The study used a prospective,quasi-experimental design with an interrupted time-series analysis to collect data from 781 government health sectors(556 healthcare facilities,196 district health offices,and 29 zonal health departments)selected from developing and emerging regions in Ethiopia.Procedures included baseline quality assessment of immunization programme and services using structured checklists;immunization systems strengthening using onsite technical support,training,and supportive supervision interventions in a Plan-Do-Check-Act cycle over 12 months;and collection and analysis of data at baseline and at the 6th and 12th month of interventions using statistical process control and the t-test.Outcome measures were the coverage of the vaccines pentavalent 3,measles,Bacillus Calmette-Guérin vaccine(BCG),Pneumococcal Conjugate Vaccine(PCV),as well as full vaccination status;while process measures were changes in human resources,planning,service delivery,logistics and supply,documentation,coordination and collaboration,and monitoring and evaluation.Analysis and interpretation of data adhered to SQUIRE 2.0 guidelines.Results:Prior to the interventions,vaccination coverage was low and all seven process indicators had an aggregate score of below 50%,with significant differences in performance at healthcare facility level between developing and emerging regions(P=0.0001).Following the interventions,vaccination coverage improved significantly from 63.6%at baseline to 79.3%for pentavalent(P=0.0001),62.5 to 72.8%for measles(P=0.009),62.4 to 73.5%for BCG(P=0.0001),65.3 to 81.0%for PCV(P=0.02),and insignificantly from 56.2 to 74.2%for full vaccination.All seven process indicators scored above 75%in all regions,with no significant differences found in performance between developing and emerging regions.Conclusions:The CQI interventions improved immunization capacity and vaccination coverage in Ethiopia,where the unstable transmission patterns and intensity of infectious diseases necessitate for a state of readiness of the health system at all times.The approach was found to empower zone,district,and facility-level health sectors to exercise accountability and share ownership of immunization outcomes.While universal approaches can improve routine immunization,local innovative interventions that target local problems and dynamics are also necessary to achieve optimal coverage.展开更多
Background The maximal use of the limited resource to improve peritoneal dialysis （PD） penetration and clinical outcomes is a challenge for all PD centers. In this study, we reported the experience and outcomes in s...Background The maximal use of the limited resource to improve peritoneal dialysis （PD） penetration and clinical outcomes is a challenge for all PD centers. In this study, we reported the experience and outcomes in successfully managing a rapidly growing PD center in Southern China. Methods A standard PD program with a team consisted of 6 nephrologists （3 doctors were in charge of catheter insertion and in-patients care, the other 3 doctors focused on PD patients＇ follow-up and education） and 11 nurses in a PD center at Sun Yat-sen University was established for PD patients follow-up in 2005. A prospective and observational study was conducted in all patients undergoing continuous ambulatory PD （CAPD） at our center from January 1,2006 to December 31,2009. Results The yearly number of prevalent CAPD patients was 297, 409, 547 and 695 in 2006, 2007, 2008 and 2009, respectively. The PD catheter insertion was performed by the nephrologists with open surgical procedure and 94% of catheters were patent at one year. In 841 incident CAPD patients, the survival rates at the end of 1,2, 3 and 4 years were 94%, 87%, 83% and 76%, respectively, while cumulative technique survival rates （death-censored） were 98%, 95%, 91% and 90%, respectively. Peritonitis rate was 1/68.5 patient months. Conclusions Better patient and technical survival rates as well as lower peritonitis episode have been achieved in our rapidly growing PD center. A standardized PD program, well-trained team members of PD doctors and nurses, and continuous quality improvement of PD are important elements in managing a successful PD program.展开更多
文摘BACKGROUND:Medication errors are a common source of adverse healthcare incidents particularly in the emergency department(ED) that has a number of factors that make it prone to medication errors.This project aims to reduce medication errors and improve the health and economic outcomes of clinical care in Hong Kong ED.METHODS:In 2009,a task group was formed to identify problems that potentially endanger medication safety and developed strategies to eliminate these problems.RESULTS:Responsible officers were assigned to look after seven error-prone areas.Strategies were proposed,discussed,endorsed and promulgated to eliminate the problems identified.A reduction of medication incidents(Ml) from 16 to 6 was achieved before and after the improvement work.CONCLUSION:This project successfully established a concrete organizational structure to safeguard error-prone areas of medication safety in a sustainable manner.
文摘Objective: to study the effect of continuous quality improvement measures on nosocomial infection control in operating room. Methods: in a comparative study, patients and medical staff who underwent surgery in our hospital between 2018 and 2020 were included in this experimental study, including 100 patients and medical staff who underwent continuous quality improvement measures between 2019 and 2020. The qualification and compliance of hand hygiene of medical staff before and after implementation were analyzed, the incidence of medical disputes and nursing adverse events were compared between the two groups, and the nursing feelings of patients in the operating room were specifically scored. Results: after implementation, the qualified rate of hand hygiene was significantly improved, and the score of patients' nursing feelings in the operating room was significantly improved, and the incidence of medical disputes and adverse events was reduced. Conclusion: carrying out continuous quality improvement measures in the operating room of the hospital can improve the prevention and treatment effect of infection. It is a good measure for patients and medical staff, and reduces the incidence of medical accidents. It is of great significance for the development of the hospital.
文摘Objective: to analyze the effect of continuous quality improvement intervention for patients with surgical catheter receiving general surgical catheter care. Methods: a total of 990 patients with surgical catheterization admitted to our hospital from March 2021 to March 2022 were selected and randomly divided into two groups, the patients who received conventional general surgical pipeline nursing program (n 495), that is, the control group, and the patients who received continuous quality improvement intervention (n 495), that is, the observation group. The intervention effects of the two groups were compared. Results: the incidence of adverse events, SAS and SDS scores of observation group were lower than those of control group;the nursing satisfaction of observation group was higher than that of control group;the number of qualified cases in theory and skills of nursing staff in observation group was higher than that of control group, and the qualified scores in theory and skills were higher than that of control group;the difference was statistically significant (P < 0.05). Conclusion: patients with clinical surgical catheterization are faced with great treatment risks in the process of treatment, including unplanned extubation, which will not only have a great impact on patients normal treatment work, but also interfere with patients normal emotional state, with high risk. Combining continuous quality improvement measures to nurse the pipeline can standardize the catheter technology and operation steps, reduce the probability of risk events to the lowest possible level and thus improve the level of nursing quality, which is worthy of clinical application.
文摘Objective: to analyze the nursing quality of continuous quality improvement in outpatient blood sampling department. Methods: 60 patients who received blood sampling from the outpatient department of our hospital were randomly selected as the research object. According to the random grouping method, they were divided into experimental group and control group, with 30 cases in each group. The control group implemented routine blood drawing nursing, the experimental group implemented continuous quality improvement nursing, and finally compared the nursing quality. Results: the results showed that the score of nursing quality in the experimental group was better than that in the control group (P < 0.05). Conclusion: the implementation of continuous quality improvement nursing measures for outpatients with blood sampling can improve the quality of nursing and provide high-quality nursing for patients.
文摘Objective: to explore and analyze the application effect of continuous quality improvement in standard nursing of intravenous indwelling needle. Methods: 60 cases of intravenous indwelling needle patients admitted to our hospital from October 2018 to October 2020 were selected as observation objects, and the patients were divided into two groups according to the analysis needs. Patients in group B were given the conventional nursing mode, while patients in group A were given the continuous quality improvement based on the nursing of patients in group B. The satisfaction degree of nursing work and the incidence of adverse reactions in the two groups were compared. Results: the satisfaction of patients in group a was significantly better than that in group b (96.67% > 86.67%) (P < 0.05). The incidence of adverse reactions in group a was lower than that in group B (6.67% < 20.00%) (P < 0.05). Conclusion: the application effect of continuous quality improvement in standard nursing of intravenous indwelling needle is significant, and it has high use value and promotion value.
文摘Objective: to study the application effect of continuous quality improvement in nursing safety of rheumatology and immunology department. Methods: 40 patients treated from January 2019 to January 2020 (before continuous quality improvement) were selected as the control group, and 40 patients treated from January 2020 to January 2021 (after continuous quality improvement) were selected as the observation group. The incidence of adverse events, pain score, life ability and comfort score were observed. Results: the incidence rate of adverse events in the observation group was lower than that in the control group. The incidence rate of adverse events in the observation group was 5.0% and that in the control group was 12.5%. The pain score was lower than that in the control group. The life ability score was higher than that in the control group. The comfort level was better than that in the control group, with statistical significance (P < 0.05). Conclusion: continuous quality improvement plays a positive role in promoting the nursing safety of patients in rheumatology and immunology department. It can reduce the incidence of adverse reactions, relieve pain, enhance satisfaction and comfort, and improve living ability. It is worthy of popularization and application.
文摘Objective: to analyze the application value of continuous nursing quality improvement to improve the quality of emergency pre-examination and triage nursing. Methods: a total of 76 patients were admitted to the emergency department of our hospital. The study was conducted from January 2019 to December 2019. According to the principle of random number method, all patients were divided into observation and routine groups, with an equal number of study subjects of 38 cases. Among them, the observation group adopted the quality of continuous care to optimize the triage care, while the routine group adopted the routine emergency triage care model. Statistics and comparison of the two groups of patients were conducted, including the score of nursing quality, nursing service satisfaction, emergency reception, triage evaluation, emergency aid time, the general indicators of pre-examination and triage accuracy of emergency treatment, and the success rate of rescue. Results: compared with the conventional group, observation group of nursing service attitude, psychological intervention level, health education ability, business level, emergency preview triage accuracy, rescue success rate, and emergency environment and nursing staff instrument, sense of responsibility, patrol clinic nursing satisfaction score are higher, and emergency reception, triage evaluation, first aid time is lower, P <0.05. Conclusion: the continuous improvement method of emergency nursing quality can significantly improve the quality of emergency pre-examination and triage nursing, reduce the treatment time of emergency patients, ensure the quality of emergency nursing and the satisfaction of nursing, and have high clinical promotion value.
文摘Objective: to explore the application value of continuous quality improvement in blood collection nursing. Methods: the nursing management of blood collection in blood stations was divided according to the groups before and after the implementation of continuous quality improvement. From January 2020 to December 2020, it was the routine nursing group, and routine nursing was implemented, and the continuous quality improvement from January 2021 to December 2021.The satisfaction of blood donors, the incidence of adverse reactions and the scrap rate of blood donors between the two groups were compared. Results: there were significant differences in the satisfaction, incidence of adverse reactions, blood scrap rate and routine care group, P <0.05. The satisfaction and the incidence of adverse reactions in blood donors were higher than those in the usual care group (P <0.05).The satisfaction of the continuous quality improvement care group was 94.22 ± 3.61, the incidence of adverse R was 1.00%, while the usual care group was 80.01 ± 2.12, and the incidence of adverse R was 9.00%.The blood scrap rate in the continuous quality improvement care group was lower than that in the usual care group (p <0.05).One was had blood scrap, accounting for 1%, while 15, accounting for 15.0%.Conclusion: continuous quality improvement of blood collection can improve the quality of care, reduce blood scrap, reduce adverse reactions, and improve the satisfaction of blood donors.
文摘Objective: to study and analyze the value of medical record quality management in the continuous improvement of medical quality. Methods: 30 cases were included in our hospital from May 2021 to June 2022. From May 2021 to May 2021,15 cases and 15 cases from January 2022 to June 2022 were included in the control group;The quality management quality, writing quality and quality control of the two groups were evaluated. Results: study group patients management quality, writing quality, quality control patients management quality score is higher than the control group, patients writing quality assessment of grade A is higher than the control group, patients homepage, admission records, hospital records, discharge records, the incidence of quality control defects are lower than the control group, the difference has statistical significance (P 0.05). Conclusion: the application of medical record quality management has an outstanding value in improving the quality of medical record management, writing quality and quality control quality.
文摘Objective: to evaluate the effectiveness of the continuous improvement of nursing quality in uterine fibroids care. Methods: the study range from January 2020 to July 2021, choose to our hospital gynecology of uterine fibroids patients for the research goal, statistics of 136 cases according to computer random distribution method, control group accept routine care, observation group to take nursing quality continuous improvement scheme, evaluation of the quality of life, psychological status and clinical care quality score. Results: the quality of life scores in the observation group were significantly higher than the control group (P <0.05), the psychological status score was insignificant, and the anxiety and depression scores were significantly lower than the control group, with statistical results P <0.05. Conclusion: the continuous nursing quality of uterine fibroids patients can not only achieve a high level of nursing services, but also further improve the quality of life and treatment mood, which is worth clinical application.
基金The project received financial support from Gavi,the Vaccine Alliance through the FMoH of the Government of Ethiopia.
文摘Background:Strong scientific evidence is needed to support low-income countries in building effective and sustainable immunization programs and proactively engaging in global vaccine development and implementation initiatives.This study aimed to implement and evaluate the effectiveness of system-wide continuous quality improvement(CQI)interventions to improve national immunization programme performance in Ethiopia.Methods:The study used a prospective,quasi-experimental design with an interrupted time-series analysis to collect data from 781 government health sectors(556 healthcare facilities,196 district health offices,and 29 zonal health departments)selected from developing and emerging regions in Ethiopia.Procedures included baseline quality assessment of immunization programme and services using structured checklists;immunization systems strengthening using onsite technical support,training,and supportive supervision interventions in a Plan-Do-Check-Act cycle over 12 months;and collection and analysis of data at baseline and at the 6th and 12th month of interventions using statistical process control and the t-test.Outcome measures were the coverage of the vaccines pentavalent 3,measles,Bacillus Calmette-Guérin vaccine(BCG),Pneumococcal Conjugate Vaccine(PCV),as well as full vaccination status;while process measures were changes in human resources,planning,service delivery,logistics and supply,documentation,coordination and collaboration,and monitoring and evaluation.Analysis and interpretation of data adhered to SQUIRE 2.0 guidelines.Results:Prior to the interventions,vaccination coverage was low and all seven process indicators had an aggregate score of below 50%,with significant differences in performance at healthcare facility level between developing and emerging regions(P=0.0001).Following the interventions,vaccination coverage improved significantly from 63.6%at baseline to 79.3%for pentavalent(P=0.0001),62.5 to 72.8%for measles(P=0.009),62.4 to 73.5%for BCG(P=0.0001),65.3 to 81.0%for PCV(P=0.02),and insignificantly from 56.2 to 74.2%for full vaccination.All seven process indicators scored above 75%in all regions,with no significant differences found in performance between developing and emerging regions.Conclusions:The CQI interventions improved immunization capacity and vaccination coverage in Ethiopia,where the unstable transmission patterns and intensity of infectious diseases necessitate for a state of readiness of the health system at all times.The approach was found to empower zone,district,and facility-level health sectors to exercise accountability and share ownership of immunization outcomes.While universal approaches can improve routine immunization,local innovative interventions that target local problems and dynamics are also necessary to achieve optimal coverage.
文摘Background The maximal use of the limited resource to improve peritoneal dialysis （PD） penetration and clinical outcomes is a challenge for all PD centers. In this study, we reported the experience and outcomes in successfully managing a rapidly growing PD center in Southern China. Methods A standard PD program with a team consisted of 6 nephrologists （3 doctors were in charge of catheter insertion and in-patients care, the other 3 doctors focused on PD patients＇ follow-up and education） and 11 nurses in a PD center at Sun Yat-sen University was established for PD patients follow-up in 2005. A prospective and observational study was conducted in all patients undergoing continuous ambulatory PD （CAPD） at our center from January 1,2006 to December 31,2009. Results The yearly number of prevalent CAPD patients was 297, 409, 547 and 695 in 2006, 2007, 2008 and 2009, respectively. The PD catheter insertion was performed by the nephrologists with open surgical procedure and 94% of catheters were patent at one year. In 841 incident CAPD patients, the survival rates at the end of 1,2, 3 and 4 years were 94%, 87%, 83% and 76%, respectively, while cumulative technique survival rates （death-censored） were 98%, 95%, 91% and 90%, respectively. Peritonitis rate was 1/68.5 patient months. Conclusions Better patient and technical survival rates as well as lower peritonitis episode have been achieved in our rapidly growing PD center. A standardized PD program, well-trained team members of PD doctors and nurses, and continuous quality improvement of PD are important elements in managing a successful PD program.
