Objective:To evaluate the practical application effect of nursing risk management in preventing falls among inpatients,and to provide a reference for optimizing clinical safety management strategies for inpatients.Met...Objective:To evaluate the practical application effect of nursing risk management in preventing falls among inpatients,and to provide a reference for optimizing clinical safety management strategies for inpatients.Methods:A total of 428 inpatients in our hospital from January 2021 to December 2023 were selected as the research objects.They were divided into a control group(218 cases)and a study group(210 cases)according to the nursing management method.The control group received routine fall prevention nursing,while the study group implemented systematic nursing risk management.The fall rate and post-fall injury rate during hospitalization were compared between the two groups.Results:The fall rate of the study group was significantly lower than that of the control group,and the difference was statistically significant(p<0.05).Conclusion:Nursing risk management can effectively reduce the fall rate and post-fall injury rate of inpatients through systematic risk identification,targeted intervention and continuous quality improvement.It also improves patients’awareness of fall prevention and nursing satisfaction,and promotes the improvement of nurses’risk management ability,which has important clinical promotion value.展开更多
Studies have shown that the implementation of targeted nursing countermeasures can significantly reduce the incidence of hypoglycemia in inpatients with diabetes mellitus,improve patients’quality of life,and promote ...Studies have shown that the implementation of targeted nursing countermeasures can significantly reduce the incidence of hypoglycemia in inpatients with diabetes mellitus,improve patients’quality of life,and promote the stable control of their condition.This paper conducts an in-depth analysis on the influencing factors of hypoglycemia in inpatients with diabetes mellitus and the corresponding nursing countermeasures.It expounds the main factors affecting hypoglycemia in inpatients with diabetes mellitus,and then puts forward effective nursing countermeasures.The purpose is to provide valuable references for promoting the innovative development of clinical nursing work.展开更多
Objective:To analyze the application effect of the Behavior Change Wheel(BCW)theory in fall prevention management for elderly inpatients.Methods:One hundred elderly inpatients admitted to Kunshan Fourth People’s Hosp...Objective:To analyze the application effect of the Behavior Change Wheel(BCW)theory in fall prevention management for elderly inpatients.Methods:One hundred elderly inpatients admitted to Kunshan Fourth People’s Hospital from January 2019 to April 2024 were selected and divided into an experimental group(fall prevention management intervention based on BCW theory)and a control group(routine fall prevention management intervention)using random sampling,with 50 patients in each group.The differences in knowledge,attitude,and behavior levels of fall prevention,prevention efficacy,and the incidence of falls and fall-related injuries during hospitalization,6 months after discharge,and 1 year after discharge were compared between the two groups.Results:Compared with before the intervention,the scores of the fall prevention knowledge,attitude,and behavior scale(knowledge dimension,attitude dimension,behavior dimension,and total score)for elderly inpatients in both groups increased,and the improvement in the experimental group was greater than that in the control group(P<0.05).After the intervention,the revised fall efficacy scale score was higher in the experimental group compared to the control group(P<0.05).The incidence of falls during hospitalization,6 months after discharge,and 1 year after discharge,as well as the rate of fall-related injuries 6 months and 1 year after discharge,were lower in the experimental group than in the control group(P<0.05).There was no statistically significant difference in the rate of fall-related injuries during hospitalization between the two groups(P>0.05).Conclusion:The fall prevention management intervention based on BCW theory has good application value in elderly inpatients.It effectively improves patients’knowledge,attitudes,and behavior levels regarding fall prevention,significantly enhances their self-prevention efficacy,and demonstrates good results in reducing the incidence of falls during hospitalization and after discharge.展开更多
BACKGROUND For children and adolescents,deliberate self-harm(DSH)is becoming a mental health problem of concern.Despite several studies on the prevalence and factors of DSH in the world,there is little information on ...BACKGROUND For children and adolescents,deliberate self-harm(DSH)is becoming a mental health problem of concern.Despite several studies on the prevalence and factors of DSH in the world,there is little information on DSH among children and adolescents in China.This study explores the prevalence,types,associated risk factors and tendency of DSH in pediatric psychiatric inpatients in China.AIM To understand the situation of DSH among hospitalized children and adolescents and its related factors.METHODS In this study,we retrospectively studied 1414 hospitalized children and adolescents with mental illness at Xiamen Mental Health Center from 2014 to 2019,extracted the demographic and clinical data of all patients,and analyzed clinical risk factors of DSH.RESULTS A total of 239(16.90%)patients engaged in at least one type of DSH in our study.Cutting(n=115,48.12%)was the most common type of DSH.Females(n=171,71.55%)were more likely to engage in DSH than males(n=68,28.45%).DSH was positively associated with depressive disorders[OR=3.845(2.196-6.732);P<0.01],female[OR=2.536(1.815-3.542);P<0.01],parental marital status[OR=5.387(2.254-12.875);P<0.01]and negative family history of psychiatric illness[OR=7.767(2.952-20.433);P<0.01],but not with occupation,substance use and history of physical abuse.CONCLUSION Our findings suggest that for patients with depression,females,an abnormal marriage of parents,and no history of mental illness,attention should be paid to the occurrence of DSH.展开更多
This study demonstrated that numbers of hospital inpatient discharges have declined in the metropolitan area of Syracuse, New York. The largest impact has been in adult medicine and adult surgery, the hospital service...This study demonstrated that numbers of hospital inpatient discharges have declined in the metropolitan area of Syracuse, New York. The largest impact has been in adult medicine and adult surgery, the hospital services with the highest utilization rates. Reductions in inpatient care have also affected services with lower utilization, such as pediatrics, obstetrics, and mental health. The study indicated that, between January - June 2019 and 2024, adult medicine discharges declined by 11.9 percent and adult surgery discharges declined by 24.6 percent. A large proportion of the reductions involved orthopedic surgery. They indicated that more than 50 percent of the joint replacements in the Syracuse hospitals have been moved to outpatient services. These patients included those with low severity of illness. The study suggested that reductions in hospital discharges could contribute to the efficiency of care. Fewer inpatient admissions could reduce the need for staffing and other resources. Information from the Syracuse hospitals has suggested that these reductions may continue.展开更多
Our institution, Sultan Qaboos University Hospital, has set a protocol for vaccinating elderly > 65 years and eligible adult groups of patients against seasonal influenza and Streptococcus pneumoniae when admitted ...Our institution, Sultan Qaboos University Hospital, has set a protocol for vaccinating elderly > 65 years and eligible adult groups of patients against seasonal influenza and Streptococcus pneumoniae when admitted as inpatients or seen at outpatient clinics. Here, I assess the compliance of various medical teams with this policy. Background: Methods: electronic records of admitted patients in adult general medical words were reviewed for vaccination from 28 January 2024 until 28 February 2024. Results: Among 203 patients at presentation, 45 patients were new with unknown immunization status. At presentation, only seven and eleven of 158 patients (4.4% and 7%) had been vaccinated in the previous admission for influenza and Pneumococcus respectively. Upon discharge only four and six patients (2.12% and 3.24%) were given seasonal influenza and pneumococcal vaccines respectively. Discharge summaries and referral letters mentioned vaccination status of patients in two cases only. Conclusion: Rates of vaccination against influenza and S pneumoniae are very low in the elderly and adult patients with chronic medical conditions. A surveillance system needs to be set in place to monitor this.展开更多
Objective To investigate the status of vitamin B 12 deficiency in elderly inpatients in the department of neurology. Methods A total number of 827 patients in the department of neurology of Shanghai Punan hospital, fr...Objective To investigate the status of vitamin B 12 deficiency in elderly inpatients in the department of neurology. Methods A total number of 827 patients in the department of neurology of Shanghai Punan hospital, from March 2007 to July 2008, were employed in the present study. They were 60 years or older, and the average age was 77.1±7.5 years old. All the patients were diagnosed with no severe hepatic or renal dysfunction, without any usage of vitamin B 12 during the previous 3 months before the detection. The levels of serum vitamin B 12, folate and homocysteine （Hcy） were evaluated. The patients with vitamin B 12 deficiency were screened. The resulting symptoms, positive signs of neurological examination, and the neuroelectricphysiological results were compared between patients with or without vitamin B 12 deficiency. Results Vitamin B 12 deficiency was found in 163 patients （19.71% of the total patients）, and was more prevalent in female than in male patients, also with increased incidences with aging. Patients with low levels of serum vitamin B 12 exhibited higher rate of gastrointestinal diseases, while only 9.82% of the vitamin B 12 deficient patients had megaloblastic anemia. Symptoms of vitamin B 12 deficiency included unsteadily walking in the darkness and hypopallesthesia, and some chronic diseases such as cerebral ischemia, hypertension, Parkinson＇s disease （Parkinsonism）, diabetes mellitus and coronary heart disease. Most of the vitamin B 12 deficient patients had neuroelectricphysiological abnormalities. Conclusion Vitamin B 12 deficiency is remarkably common in elderly patients in neurology department, with various and atypical clinical manifestations, and the neurological symptoms are more common than megaloblastic anemia symptoms.展开更多
AIM: To evaluate and validate the national trends and predictors of in-patient mortality of transjugular intrahepatic portosystemic shunt (TIPS) in 15 years.METHODS: Using the National Inpatient Sample which is a part...AIM: To evaluate and validate the national trends and predictors of in-patient mortality of transjugular intrahepatic portosystemic shunt (TIPS) in 15 years.METHODS: Using the National Inpatient Sample which is a part of Health Cost and Utilization Project, we identified a discharge-weighted national estimate of 83884 TIPS procedures performed in the United States from 1998 to 2012 using international classification of diseases-9 procedural code 39.1. The demographic, hospital and co-morbility data were analyzed using a multivariant analysis. Using multi-nominal logistic regression analysis, we determined predictive factors related to increases in-hospital mortality. Comorbidity measures are in accordance to the Comorbidity Software designed by the Agency for Healthcare Research and Quality.RESULTS: Overall, 12.3% of patients died during hospitalization with downward trend in-hospital mortality with the mean length of stay of 10.8 ± 13.1 d. Notable, African American patients (OR = 1.809 vs Caucasian patients, P < 0.001), transferred patients (OR = 1.347 vs non-transferred, P < 0.001), emergency admissions (OR = 3.032 vs elective cases, P < 0.001), patients in the Northeast region (OR = 1.449 vs West, P < 0.001) had significantly higher odds of in-hospital mortality. Number of diagnoses and number of procedures showed positive correlations with in-hospital death (OR = 1.249 per one increase in number of procedures). Patients diagnosed with acute respiratory failure (OR = 8.246), acute kidney failure (OR = 4.359), hepatic encephalopathy (OR = 2.217) and esophageal variceal bleeding (OR = 2.187) were at considerably higher odds of in-hospital death compared with ascites (OR = 0.136, P < 0.001). Comorbidity measures with the highest odds of in-hospital death were fluid and electrolyte disorders (OR = 2.823), coagulopathy (OR = 2.016), and lymphoma (OR = 1.842).CONCLUSION: The overall mortality of the TIPS procedure is steadily decreasing, though the length of stay has remained relatively constant. Specific patient ethnicity, location, transfer status, primary diagnosis and comorbidities correlate with increased odds of TIPS in-hospital death.展开更多
Objective To assess nutritional status and define gender-and age-specific handgrip strength（HGS） cut-point values for malnutrition or nutritional risk in elderly inpatients. Methods A cross-sectional study of 1,343 ...Objective To assess nutritional status and define gender-and age-specific handgrip strength（HGS） cut-point values for malnutrition or nutritional risk in elderly inpatients. Methods A cross-sectional study of 1,343 elderly inpatients was conducted in the Chinese PLA General Hospital. Nutrition Risk Screening（NRS 2002） and Subjective Global Assessment（SGA） were administered. Anthropometric measurements and blood biochemical indicators were obtained using standard techniques. The gender-and age-specific receiver operating characteristic（ROC） curves were constructed to evaluate the HGS for nutritional status by SGA and NRS 2002. Sensitivity, specificity, and areas under the curves（AUCs） were calculated. Results According to NRS 2002 and SGA, 63.81% of elderly inpatients were at nutritional risk and 28.22% were malnourished. Patients with higher HGS had an independently decreased risk of malnutrition and nutritional risk. The AUCs varied between 0.670 and 0.761. According to NRS 2002, the optimal HGS cut-points were 27.5 kg（65-74 years） and 21.0 kg（75-90 years） for men and 17.0 kg（65-74 years） and 14.6 kg（75-90 years） for women. According to SGA, the optimal HGS cut-points were 24.9 kg（65-74 years） and 20.8 kg（75-90 years） for men and 15.2 kg（65-74 years） and 13.5 kg（75-90 years） for women. Conclusion Elderly inpatients had increased incidence of malnutrition or nutritional risk. HGS cut-points can be used for assessing nutritional status in elderly inpatients at hospital admission in China.展开更多
Purpose:To avoid the nursing risk of inpatients,reduce the occurrence of nursing errors and improve the safety of inpatients.Methods:We established a nursing risk early warning and control system,which includes a safe...Purpose:To avoid the nursing risk of inpatients,reduce the occurrence of nursing errors and improve the safety of inpatients.Methods:We established a nursing risk early warning and control system,which includes a safety supervisory network,risk screening and early warning tools,and a risk control process.Results:The qualified rates of risk control measures to prevent pressure ulcers,unplanned extubation and fall/fall from bed all increased.The incidence of reported nursing errors decreased.The number of mistakes in medication-giving decreased.Conclusion:The establishment of an inpatient early warning and control system could effectively avoid nursing risk,improve risk prevention abilities,improve patient safety,and improve nursing quality.展开更多
Aims:To explore the impact of inpatient suicides on nurses working in front-line,the patterns of regulation and their needs for support.Methods:Data were collected through purposive sampling by conducting semi-structu...Aims:To explore the impact of inpatient suicides on nurses working in front-line,the patterns of regulation and their needs for support.Methods:Data were collected through purposive sampling by conducting semi-structured and individual in-depth interviews in a tertiary referral hospital in China.Colaizzi's sevenstep phenomenological method was simultaneously used by two interviewers.Results:Reactions to inpatient suicides revealed three central themes:(1)inpatients were highly likely to commit suicide,(2)inpatient suicide was difficult to prevent,and(3)nurses lacked the necessary suicide prevention skills.Psychological responses mainly included shock and panic,self-accusation or guilt,sense of fear,and frustration.The impacts on practice were stress,excessive vigilance,and burnout.Avoidance and sharing of feelings played key roles in the regulation patterns of nurses.Conclusions:Nurses who experienced inpatient suicide became stressed.Effective interventions must be implemented to improve the coping mechanisms of nurses against the negative consequences of inpatient suicide.The findings of this study will allow administrators to gain insight into the impacts of inpatient suicides on nurses in general hospitals.Such information can be used to develop effective strategies and provide individual support and ongoing education.Consequently,nurses will acquire suicide prevention skills and help patients achieve swift recovery.展开更多
BACKGROUND： Effective pain management among hospitalized patients is an important aspect of providing quality care and achieving optimal clinical outcomes and patient satisfaction. Common pharmacologic approaches for...BACKGROUND： Effective pain management among hospitalized patients is an important aspect of providing quality care and achieving optimal clinical outcomes and patient satisfaction. Common pharmacologic approaches for pain, though effective, have serious side effects and are not appropriate for all inpatients. Findings from randomized controlled trials（RCTs） support the efficacy of acupuncture for many symptoms relevant to inpatients including postoperative pain, cancer-related pain, nausea and vomiting, and withdrawal from narcotic use. However, the extent to which findings from RCTs translate to real-world implementation of acupuncture in typical hospital settings is unknown. METHODS/DESIGN： In partnership with the launch of a clinical program offering acupuncture services to inpatients at the University of California San Francisco’s Mount Zion Hospital, we are conducting a pilot study using a hybrid effectiveness-implementation design to：（1） assess the effectiveness of acupuncture to manage pain and other symptoms and improve patient satisfaction; and（2） evaluate the barriers and facilitators to implementing an on-going acupuncture service for inpatients. During a twomonth pre-randomization phase, we evaluated and adapted clinical scheduling and treatment protocols with acupuncturists and hospital providers and pretested study procedures including enrollment, consent, and data collection. During a six-month randomization phase, we used a two-tiered consent process in which inpatients were first consented into a study of symptom management, randomized to be offered acupuncture, and consented for acupuncture if they accepted. We are also conducting in-depth interviews and focus groups to assess evidence, context, and facilitators of key provider and hospital administration stakeholders.DISCUSSION： Effectiveness research in ＂real-world＂ practice settings is needed to inform clinical decision-making and guide implementation of evidence-based acupuncture practices. To successfully provide clinical acupuncture services and maintain a rigorous research design, practice-based trials of acupuncture require careful planning and attention to setting-specific, contextual factors.TRIAL REGISTRATION： This trial has been registered in Clinical Trials.gov. The identifier is NCT01988194, registered on November 5, 2013.展开更多
Background Facing the social panic and substantial shortage of medical resources during the coronavirus disease 2019(COVID-19)outbreak,providing psychological first-aid to inpatients is essential for their rehabilitat...Background Facing the social panic and substantial shortage of medical resources during the coronavirus disease 2019(COVID-19)outbreak,providing psychological first-aid to inpatients is essential for their rehabilitation and the orderly operating of medical systems.However,the closed-ward environment and extreme shortage of onsite mental health workers have limited the use of traditional face-to-face diagnosis and psychological interventions.Aim To develop a mental health intervention model for inpatients that can be applied during a widespread epidemic,such as COVID-19.Methods In a medical team stationed in Leishenshan Hospital,Wuhan,China,we integrated onsite and online psychological support resources to implement a graded psychological intervention system.The onsite psychiatrist established trust with the patients and classified them into categories according to their symptom severity.While face-to-face evaluation and intervention are critical for effective online support,the online team effectively extended the scope of the'first-aid'to all patients.Conclusion This integrated onsite and online approach was effective and eficient in providing psychological interventions for inpatients during the crisis.Our model provides a realistic scheme for healthcare systems in or after the COVID-19 epidemic and also could be adopted in areas of the world with insufficient mental healthcare resources.展开更多
Aggressive behavior in patients with psychiatric disorders is attracting increasing research interest.One reason for this is that psychiatric patients are generally considered more likely to be aggressive,which raises...Aggressive behavior in patients with psychiatric disorders is attracting increasing research interest.One reason for this is that psychiatric patients are generally considered more likely to be aggressive,which raises a related question of whether diagnoses of psychiatric disorders predict the prevalence of aggressive behavior.Predicting aggression in psychiatric wards is crucial,because aggressive behavior not only endangers the safety of both patients and staff,but it also extends the hospitalization times.Predictions of aggressive behavior also need careful attention to ensure effective treatment planning.This literature review explores the relationship between aggressive behavior and psychiatric disorders and syndromes(dementia,psychoactive substance use,acute psychotic disorder,schizophrenia,bipolar affective disorder,major depressive disorder,obsessivecompulsive disorder,personality disorders and intellectual disability).The prevalence of aggressive behavior and its underlying risk factors,such as sex,age,comorbid psychiatric disorders,socioeconomic status,and history of aggressive behavior are discussed as these are the components that mostly contribute to the increased risk of aggressive behavior.Measurement tools commonly used to predict and detect aggressive behavior and to differentiate between different forms of aggressive behavior in both research and clinical practice are also reviewed.Successful aggression prevention programs can be developed based on the current findings of the correlates of aggressive behavior in psychiatric patients.展开更多
Objective： An understanding of the levels and trends of medical cost is made for breast cancer patients with different medical insurance coverages in China（mainland）, in an attempt to offer a clue to further contro...Objective： An understanding of the levels and trends of medical cost is made for breast cancer patients with different medical insurance coverages in China（mainland）, in an attempt to offer a clue to further control the costs.Methods： The inpatient payments of 9,716,180 breast cancer patients spent in medical institutions of different types and grades during 2011–2015 were collected from the inpatient medical record home page（IMRHP） dataset.The data were then processed with SAS（Version 9.3; SAS Institute, Cary, NC, USA）. Indicators like means,increase（decrease） percentages were used to descriptively analyze the average hospitalization expense of each time（AHEET） and its trends of breast cancer patients with different medical insurance coverages treated in medical institutions of different types and grades.Results：In 2011–2015,the AHEET borne by breast cancer patients in China had been constantly increasing.Specifically,the self-pay inpatients had the largest increase,inpatients covered by Urban Employee Basic Medical Insurance（UEBMI）and Urban Resident Basic Medical Insurance（URBMI）were the next,and those covered by New Rural Cooperative Medical System（NRCMS）had the least increase.Breast cancer inpatient treated in public hospitals had quite greater increase and higher expenditure level than those in private hospitals.The AHEET borne by the inpatients in Grade 3 hospitals had greater increase and higher cost than those in Grade 2 hospitals.Conclusions：The inpatient payments of breast cancer patients will be wisely controlled by reducing the number of self-pay inpatients,taking advantage of restriction mechanism of the medical insurances,and promoting healthy competition between private hospitals and public hospitals.The economic burden imposed on the society by breast cancer can be relieved through further control of inpatient payments of UEBMI-and URBMI-covered breast cancer patients and of Grade 3 hospitals.展开更多
Background:Inpatient suicide is an important part of patient safety management in general hospitals.Incidence of inpatient suicide can be decreased by health personnel mastering inpatient suicide prevention strategy.T...Background:Inpatient suicide is an important part of patient safety management in general hospitals.Incidence of inpatient suicide can be decreased by health personnel mastering inpatient suicide prevention strategy.To enhance health personnel’s inpatient suicide prevention strategy,education intervention is a common method.Educational interventions in the researches varied in contents,duration and outcome measurements.However,there has been not synthesis of education interventions targeting health personnel on inpatient suicide prevention.Objective:Prevention of inpatient suicide is a critical priority in patient safety management in general hospitals.Incidence of inpatient suicide can be decreased by effective strategies mastered by health personnel through education interventions.Educational interventions in researches varied in contents,duration and outcome measurements.We aimed to review education interventions targeting health personnel on inpatient suicide prevention.Methods:A scoping review was used to analyze existing researches on education interventions targeting health personnel focusing on inpatient suicide prevention in general hospitals.Cochrane Library,PubMed,Embase,CINAHL,China National Knowledge Infrastructure,WanFang,and Chinese Scientific Journal Database were searched in Oct 2019.According to the inclusion and exclusion criteria,the searched studies were screened by two reviewers.And then,two researchers conducted the data extraction independently by using a table format,including the first author,year of publication,study design,participants,education intervention,etc.Results:Twelve studies were included in this scoping review.The contents of education interventions on inpatient suicide prevention included three aspects:suicide knowledge,suicide assessment,and skills for coping with suicide.The duration of education interventions ranged from 1.5-h to 32.0-h.The effects of education interventions were mainly focused on participants’knowledge,attitudes and skills of suicide prevention.Conclusion:The evidence showed that education interventions on inpatient suicide prevention had positive impact on health personnel’s knowledge,attitude and skills about inpatient suicide prevention in general hospitals.However,the best health personnel-targeted education intervention on inpatient suicide prevention in general hospitals was yet to be determined.In the future,it is necessary to combine evidence in this review and the actual condition in clinical practice.展开更多
Objective Hepatitis B virus(HBV)infection,which has been recognized as an international public health challenge,has caused significant morbidity for the entire world.This research focused on patients with HBV in China...Objective Hepatitis B virus(HBV)infection,which has been recognized as an international public health challenge,has caused significant morbidity for the entire world.This research focused on patients with HBV in China to examine health utilization and expenses.Methods Patients hospitalized with HBV from 2017 to 2019 in tertiary hospitals in Hubei,a province located in central China,were selected as the study population.Healthcare information was collected from the provincial inpatient electronic system database.Univariate and regression analyses were performed to describe the basic situation of healthcare services and determine the influencing indicators of inpatient service expenditure.Results A total of 367381 cases of HBV infection were identified in the study area.Most of these cases were patients who were married(90.2%)and males(63%).With the great efforts by the universal coverage of the basic medical insurance(BMI)in China,the increasing rate of inpatient hospitalization for HBV was 3.5 times higher than that of the total inpatient health service cases in the study area.The average age of this group was 52.84±14.10 years and 11.1%of patients paid for their own medical expenditures without insurance.The average length of stay(LOS)was 11.10 days,and the average cost per patient was 15712.05 RMB.Both values were higher than the average level in study area.Gender,marital status,career,payment type,and kind of hospitals significantly influenced healthcare utilization.Males and the elderly might incur higher healthcare costs than their counterparts.Conclusion The BMI operated by government has played a role in the utilization release of health services for HBV carriers.However,researchers must pay more attention to the continuing increase in the medical expenses of this group.展开更多
<strong>Objective</strong>: This paper aims to explore clinical status and related influence factors of pressure injury (PI) in the elderly inpatients with kidney disease, so as to provide reference for th...<strong>Objective</strong>: This paper aims to explore clinical status and related influence factors of pressure injury (PI) in the elderly inpatients with kidney disease, so as to provide reference for the prevention and treatment of PI in the elderly inpatients with kidney disease. <strong>Methods</strong>: Retrospective collection method is adopted to collect 158 clinical cases of the elderly inpatients with kidney disease aged ≥ 60 in the Nephrology Department, the First Affiliated Hospital of Jinan University from January 2017 to December 2019, and then least absolute shrinkage and selection Operator (LASSO) regression analysis is used to analyze 17 possible influence factors;finally Logistic regression model is established to analyze and screen influence factors of risk. <strong>Results</strong>: 1) Among 158 elderly inpatients with medium and high risk of PI, the incidence of PI is 20.25%;the most common stage of injury is stage I (42.5%);sacrococcygeal (60%) is the high-risk site of pressure injury. 2) LASSO regression analysis shows that history of present respiratory infection/respiratory failure (<em>β </em>= 1.2714. <em>P</em> < 0.05) and hospitalization time (<em>β</em> = 0.4177. <em>P </em>< 0.05) are independent factors influencing PI risk in the elderly inpatients with kidney disease. <strong>Concl</strong><strong>usio</strong><strong>n</strong>: The elderly patients with kidney disease and PI risk are the high incidence population of hospital acquired PI;for the elderly inpatients with kidney disease and having respiratory infection history or respiratory failure, prolonged hospitalization will significantly increase the risk of PI. Therefore, targeted preventive and control measures should be taken to reduce the incidence of PI.展开更多
Objective： The aim of this study was to identify the risk factors for inpatient suicide in a general hospital. Methods： Thirty suicide victims were drawn from the adverse event reports of suicidal acts during hospit...Objective： The aim of this study was to identify the risk factors for inpatient suicide in a general hospital. Methods： Thirty suicide victims were drawn from the adverse event reports of suicidal acts during hospitalization in a general hospital from 2008 to 2014. Data were gathered from a focus group interview of 6 medical staff who had experienced inpatient suicide. Interpretative phenomenological analysis was used to analyze the data. Results： Five main themes regarding high-risk factors for inpatient suicide emerged from this study： mental disorders, diseases, the source of money to meet medical expenses, social support, and the hospital environment. Patients with mental disorders were at a high risk of suicide. Having a serious disease, paying high medical expenses alone, the loss of social support and unsafe hospital environments were also associated with an increased risk of suicide. Conclusions： This study puts forward different perspectives on the reasons that inpatients commit suicide and corresponding preventive measures based on these 5 main themes that could be implemented to avoid or reduce suicidal acts among inpatients during hospitalization.展开更多
文摘Objective:To evaluate the practical application effect of nursing risk management in preventing falls among inpatients,and to provide a reference for optimizing clinical safety management strategies for inpatients.Methods:A total of 428 inpatients in our hospital from January 2021 to December 2023 were selected as the research objects.They were divided into a control group(218 cases)and a study group(210 cases)according to the nursing management method.The control group received routine fall prevention nursing,while the study group implemented systematic nursing risk management.The fall rate and post-fall injury rate during hospitalization were compared between the two groups.Results:The fall rate of the study group was significantly lower than that of the control group,and the difference was statistically significant(p<0.05).Conclusion:Nursing risk management can effectively reduce the fall rate and post-fall injury rate of inpatients through systematic risk identification,targeted intervention and continuous quality improvement.It also improves patients’awareness of fall prevention and nursing satisfaction,and promotes the improvement of nurses’risk management ability,which has important clinical promotion value.
文摘Studies have shown that the implementation of targeted nursing countermeasures can significantly reduce the incidence of hypoglycemia in inpatients with diabetes mellitus,improve patients’quality of life,and promote the stable control of their condition.This paper conducts an in-depth analysis on the influencing factors of hypoglycemia in inpatients with diabetes mellitus and the corresponding nursing countermeasures.It expounds the main factors affecting hypoglycemia in inpatients with diabetes mellitus,and then puts forward effective nursing countermeasures.The purpose is to provide valuable references for promoting the innovative development of clinical nursing work.
基金Application of Behavior Change Wheel(BCW)Theory in Fall Prevention Management for Elderly Hospitalized Patients(Key Research and Development Program of Kunshan City,Jiangsu Province(KS2372))。
文摘Objective:To analyze the application effect of the Behavior Change Wheel(BCW)theory in fall prevention management for elderly inpatients.Methods:One hundred elderly inpatients admitted to Kunshan Fourth People’s Hospital from January 2019 to April 2024 were selected and divided into an experimental group(fall prevention management intervention based on BCW theory)and a control group(routine fall prevention management intervention)using random sampling,with 50 patients in each group.The differences in knowledge,attitude,and behavior levels of fall prevention,prevention efficacy,and the incidence of falls and fall-related injuries during hospitalization,6 months after discharge,and 1 year after discharge were compared between the two groups.Results:Compared with before the intervention,the scores of the fall prevention knowledge,attitude,and behavior scale(knowledge dimension,attitude dimension,behavior dimension,and total score)for elderly inpatients in both groups increased,and the improvement in the experimental group was greater than that in the control group(P<0.05).After the intervention,the revised fall efficacy scale score was higher in the experimental group compared to the control group(P<0.05).The incidence of falls during hospitalization,6 months after discharge,and 1 year after discharge,as well as the rate of fall-related injuries 6 months and 1 year after discharge,were lower in the experimental group than in the control group(P<0.05).There was no statistically significant difference in the rate of fall-related injuries during hospitalization between the two groups(P>0.05).Conclusion:The fall prevention management intervention based on BCW theory has good application value in elderly inpatients.It effectively improves patients’knowledge,attitudes,and behavior levels regarding fall prevention,significantly enhances their self-prevention efficacy,and demonstrates good results in reducing the incidence of falls during hospitalization and after discharge.
基金Supported by Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties,No.SZGSP013Shenzhen Key Medical Discipline Construction Fund,No.SZXK042+2 种基金Sanming Project of Medicine in Shenzhen,No.SZSM202311025Natural Science Fund of Fujian Province,No.2023J011622Natural Science Fund of Xiamen City,No.3502Z20224ZD1259.
文摘BACKGROUND For children and adolescents,deliberate self-harm(DSH)is becoming a mental health problem of concern.Despite several studies on the prevalence and factors of DSH in the world,there is little information on DSH among children and adolescents in China.This study explores the prevalence,types,associated risk factors and tendency of DSH in pediatric psychiatric inpatients in China.AIM To understand the situation of DSH among hospitalized children and adolescents and its related factors.METHODS In this study,we retrospectively studied 1414 hospitalized children and adolescents with mental illness at Xiamen Mental Health Center from 2014 to 2019,extracted the demographic and clinical data of all patients,and analyzed clinical risk factors of DSH.RESULTS A total of 239(16.90%)patients engaged in at least one type of DSH in our study.Cutting(n=115,48.12%)was the most common type of DSH.Females(n=171,71.55%)were more likely to engage in DSH than males(n=68,28.45%).DSH was positively associated with depressive disorders[OR=3.845(2.196-6.732);P<0.01],female[OR=2.536(1.815-3.542);P<0.01],parental marital status[OR=5.387(2.254-12.875);P<0.01]and negative family history of psychiatric illness[OR=7.767(2.952-20.433);P<0.01],but not with occupation,substance use and history of physical abuse.CONCLUSION Our findings suggest that for patients with depression,females,an abnormal marriage of parents,and no history of mental illness,attention should be paid to the occurrence of DSH.
文摘This study demonstrated that numbers of hospital inpatient discharges have declined in the metropolitan area of Syracuse, New York. The largest impact has been in adult medicine and adult surgery, the hospital services with the highest utilization rates. Reductions in inpatient care have also affected services with lower utilization, such as pediatrics, obstetrics, and mental health. The study indicated that, between January - June 2019 and 2024, adult medicine discharges declined by 11.9 percent and adult surgery discharges declined by 24.6 percent. A large proportion of the reductions involved orthopedic surgery. They indicated that more than 50 percent of the joint replacements in the Syracuse hospitals have been moved to outpatient services. These patients included those with low severity of illness. The study suggested that reductions in hospital discharges could contribute to the efficiency of care. Fewer inpatient admissions could reduce the need for staffing and other resources. Information from the Syracuse hospitals has suggested that these reductions may continue.
文摘Our institution, Sultan Qaboos University Hospital, has set a protocol for vaccinating elderly > 65 years and eligible adult groups of patients against seasonal influenza and Streptococcus pneumoniae when admitted as inpatients or seen at outpatient clinics. Here, I assess the compliance of various medical teams with this policy. Background: Methods: electronic records of admitted patients in adult general medical words were reviewed for vaccination from 28 January 2024 until 28 February 2024. Results: Among 203 patients at presentation, 45 patients were new with unknown immunization status. At presentation, only seven and eleven of 158 patients (4.4% and 7%) had been vaccinated in the previous admission for influenza and Pneumococcus respectively. Upon discharge only four and six patients (2.12% and 3.24%) were given seasonal influenza and pneumococcal vaccines respectively. Discharge summaries and referral letters mentioned vaccination status of patients in two cases only. Conclusion: Rates of vaccination against influenza and S pneumoniae are very low in the elderly and adult patients with chronic medical conditions. A surveillance system needs to be set in place to monitor this.
基金supported by the grant from Shanghai Pudong New District Science and Technology Committee (No. PKJ2008-Y09)Shanghai Pudong New District Social Development Bureau (No. PDRd2006-09)
文摘Objective To investigate the status of vitamin B 12 deficiency in elderly inpatients in the department of neurology. Methods A total number of 827 patients in the department of neurology of Shanghai Punan hospital, from March 2007 to July 2008, were employed in the present study. They were 60 years or older, and the average age was 77.1±7.5 years old. All the patients were diagnosed with no severe hepatic or renal dysfunction, without any usage of vitamin B 12 during the previous 3 months before the detection. The levels of serum vitamin B 12, folate and homocysteine （Hcy） were evaluated. The patients with vitamin B 12 deficiency were screened. The resulting symptoms, positive signs of neurological examination, and the neuroelectricphysiological results were compared between patients with or without vitamin B 12 deficiency. Results Vitamin B 12 deficiency was found in 163 patients （19.71% of the total patients）, and was more prevalent in female than in male patients, also with increased incidences with aging. Patients with low levels of serum vitamin B 12 exhibited higher rate of gastrointestinal diseases, while only 9.82% of the vitamin B 12 deficient patients had megaloblastic anemia. Symptoms of vitamin B 12 deficiency included unsteadily walking in the darkness and hypopallesthesia, and some chronic diseases such as cerebral ischemia, hypertension, Parkinson＇s disease （Parkinsonism）, diabetes mellitus and coronary heart disease. Most of the vitamin B 12 deficient patients had neuroelectricphysiological abnormalities. Conclusion Vitamin B 12 deficiency is remarkably common in elderly patients in neurology department, with various and atypical clinical manifestations, and the neurological symptoms are more common than megaloblastic anemia symptoms.
文摘AIM: To evaluate and validate the national trends and predictors of in-patient mortality of transjugular intrahepatic portosystemic shunt (TIPS) in 15 years.METHODS: Using the National Inpatient Sample which is a part of Health Cost and Utilization Project, we identified a discharge-weighted national estimate of 83884 TIPS procedures performed in the United States from 1998 to 2012 using international classification of diseases-9 procedural code 39.1. The demographic, hospital and co-morbility data were analyzed using a multivariant analysis. Using multi-nominal logistic regression analysis, we determined predictive factors related to increases in-hospital mortality. Comorbidity measures are in accordance to the Comorbidity Software designed by the Agency for Healthcare Research and Quality.RESULTS: Overall, 12.3% of patients died during hospitalization with downward trend in-hospital mortality with the mean length of stay of 10.8 ± 13.1 d. Notable, African American patients (OR = 1.809 vs Caucasian patients, P < 0.001), transferred patients (OR = 1.347 vs non-transferred, P < 0.001), emergency admissions (OR = 3.032 vs elective cases, P < 0.001), patients in the Northeast region (OR = 1.449 vs West, P < 0.001) had significantly higher odds of in-hospital mortality. Number of diagnoses and number of procedures showed positive correlations with in-hospital death (OR = 1.249 per one increase in number of procedures). Patients diagnosed with acute respiratory failure (OR = 8.246), acute kidney failure (OR = 4.359), hepatic encephalopathy (OR = 2.217) and esophageal variceal bleeding (OR = 2.187) were at considerably higher odds of in-hospital death compared with ascites (OR = 0.136, P < 0.001). Comorbidity measures with the highest odds of in-hospital death were fluid and electrolyte disorders (OR = 2.823), coagulopathy (OR = 2.016), and lymphoma (OR = 1.842).CONCLUSION: The overall mortality of the TIPS procedure is steadily decreasing, though the length of stay has remained relatively constant. Specific patient ethnicity, location, transfer status, primary diagnosis and comorbidities correlate with increased odds of TIPS in-hospital death.
文摘Objective To assess nutritional status and define gender-and age-specific handgrip strength（HGS） cut-point values for malnutrition or nutritional risk in elderly inpatients. Methods A cross-sectional study of 1,343 elderly inpatients was conducted in the Chinese PLA General Hospital. Nutrition Risk Screening（NRS 2002） and Subjective Global Assessment（SGA） were administered. Anthropometric measurements and blood biochemical indicators were obtained using standard techniques. The gender-and age-specific receiver operating characteristic（ROC） curves were constructed to evaluate the HGS for nutritional status by SGA and NRS 2002. Sensitivity, specificity, and areas under the curves（AUCs） were calculated. Results According to NRS 2002 and SGA, 63.81% of elderly inpatients were at nutritional risk and 28.22% were malnourished. Patients with higher HGS had an independently decreased risk of malnutrition and nutritional risk. The AUCs varied between 0.670 and 0.761. According to NRS 2002, the optimal HGS cut-points were 27.5 kg（65-74 years） and 21.0 kg（75-90 years） for men and 17.0 kg（65-74 years） and 14.6 kg（75-90 years） for women. According to SGA, the optimal HGS cut-points were 24.9 kg（65-74 years） and 20.8 kg（75-90 years） for men and 15.2 kg（65-74 years） and 13.5 kg（75-90 years） for women. Conclusion Elderly inpatients had increased incidence of malnutrition or nutritional risk. HGS cut-points can be used for assessing nutritional status in elderly inpatients at hospital admission in China.
基金This study was supported by the Shanghai Health System Advanced and Appropriate Technology Promotion Project(No.2013SY030).
文摘Purpose:To avoid the nursing risk of inpatients,reduce the occurrence of nursing errors and improve the safety of inpatients.Methods:We established a nursing risk early warning and control system,which includes a safety supervisory network,risk screening and early warning tools,and a risk control process.Results:The qualified rates of risk control measures to prevent pressure ulcers,unplanned extubation and fall/fall from bed all increased.The incidence of reported nursing errors decreased.The number of mistakes in medication-giving decreased.Conclusion:The establishment of an inpatient early warning and control system could effectively avoid nursing risk,improve risk prevention abilities,improve patient safety,and improve nursing quality.
基金The authors would like to express our gratitude to all participants who have given generosity of their time as well as shared with the research team their feelings and experience.In addition,they thank Yanhong Han for her help in the preparation of this manuscriptFunding:The research for this paper was supported by Natural Science Fund of Hubei Province(No.2014CKB1014).
文摘Aims:To explore the impact of inpatient suicides on nurses working in front-line,the patterns of regulation and their needs for support.Methods:Data were collected through purposive sampling by conducting semi-structured and individual in-depth interviews in a tertiary referral hospital in China.Colaizzi's sevenstep phenomenological method was simultaneously used by two interviewers.Results:Reactions to inpatient suicides revealed three central themes:(1)inpatients were highly likely to commit suicide,(2)inpatient suicide was difficult to prevent,and(3)nurses lacked the necessary suicide prevention skills.Psychological responses mainly included shock and panic,self-accusation or guilt,sense of fear,and frustration.The impacts on practice were stress,excessive vigilance,and burnout.Avoidance and sharing of feelings played key roles in the regulation patterns of nurses.Conclusions:Nurses who experienced inpatient suicide became stressed.Effective interventions must be implemented to improve the coping mechanisms of nurses against the negative consequences of inpatient suicide.The findings of this study will allow administrators to gain insight into the impacts of inpatient suicides on nurses in general hospitals.Such information can be used to develop effective strategies and provide individual support and ongoing education.Consequently,nurses will acquire suicide prevention skills and help patients achieve swift recovery.
基金Fund for Innovative Research in Integrative Medicinethe National Institutes of Health (NIH),National Center for Complementary and Integrative Health(Chao:K01AT006545+2 种基金Chang:T32AT003997Hecht:K24AT007827)the National Center for Advancing Translational Sciences (KL2TR00143)
文摘BACKGROUND： Effective pain management among hospitalized patients is an important aspect of providing quality care and achieving optimal clinical outcomes and patient satisfaction. Common pharmacologic approaches for pain, though effective, have serious side effects and are not appropriate for all inpatients. Findings from randomized controlled trials（RCTs） support the efficacy of acupuncture for many symptoms relevant to inpatients including postoperative pain, cancer-related pain, nausea and vomiting, and withdrawal from narcotic use. However, the extent to which findings from RCTs translate to real-world implementation of acupuncture in typical hospital settings is unknown. METHODS/DESIGN： In partnership with the launch of a clinical program offering acupuncture services to inpatients at the University of California San Francisco’s Mount Zion Hospital, we are conducting a pilot study using a hybrid effectiveness-implementation design to：（1） assess the effectiveness of acupuncture to manage pain and other symptoms and improve patient satisfaction; and（2） evaluate the barriers and facilitators to implementing an on-going acupuncture service for inpatients. During a twomonth pre-randomization phase, we evaluated and adapted clinical scheduling and treatment protocols with acupuncturists and hospital providers and pretested study procedures including enrollment, consent, and data collection. During a six-month randomization phase, we used a two-tiered consent process in which inpatients were first consented into a study of symptom management, randomized to be offered acupuncture, and consented for acupuncture if they accepted. We are also conducting in-depth interviews and focus groups to assess evidence, context, and facilitators of key provider and hospital administration stakeholders.DISCUSSION： Effectiveness research in ＂real-world＂ practice settings is needed to inform clinical decision-making and guide implementation of evidence-based acupuncture practices. To successfully provide clinical acupuncture services and maintain a rigorous research design, practice-based trials of acupuncture require careful planning and attention to setting-specific, contextual factors.TRIAL REGISTRATION： This trial has been registered in Clinical Trials.gov. The identifier is NCT01988194, registered on November 5, 2013.
文摘Background Facing the social panic and substantial shortage of medical resources during the coronavirus disease 2019(COVID-19)outbreak,providing psychological first-aid to inpatients is essential for their rehabilitation and the orderly operating of medical systems.However,the closed-ward environment and extreme shortage of onsite mental health workers have limited the use of traditional face-to-face diagnosis and psychological interventions.Aim To develop a mental health intervention model for inpatients that can be applied during a widespread epidemic,such as COVID-19.Methods In a medical team stationed in Leishenshan Hospital,Wuhan,China,we integrated onsite and online psychological support resources to implement a graded psychological intervention system.The onsite psychiatrist established trust with the patients and classified them into categories according to their symptom severity.While face-to-face evaluation and intervention are critical for effective online support,the online team effectively extended the scope of the'first-aid'to all patients.Conclusion This integrated onsite and online approach was effective and eficient in providing psychological interventions for inpatients during the crisis.Our model provides a realistic scheme for healthcare systems in or after the COVID-19 epidemic and also could be adopted in areas of the world with insufficient mental healthcare resources.
文摘Aggressive behavior in patients with psychiatric disorders is attracting increasing research interest.One reason for this is that psychiatric patients are generally considered more likely to be aggressive,which raises a related question of whether diagnoses of psychiatric disorders predict the prevalence of aggressive behavior.Predicting aggression in psychiatric wards is crucial,because aggressive behavior not only endangers the safety of both patients and staff,but it also extends the hospitalization times.Predictions of aggressive behavior also need careful attention to ensure effective treatment planning.This literature review explores the relationship between aggressive behavior and psychiatric disorders and syndromes(dementia,psychoactive substance use,acute psychotic disorder,schizophrenia,bipolar affective disorder,major depressive disorder,obsessivecompulsive disorder,personality disorders and intellectual disability).The prevalence of aggressive behavior and its underlying risk factors,such as sex,age,comorbid psychiatric disorders,socioeconomic status,and history of aggressive behavior are discussed as these are the components that mostly contribute to the increased risk of aggressive behavior.Measurement tools commonly used to predict and detect aggressive behavior and to differentiate between different forms of aggressive behavior in both research and clinical practice are also reviewed.Successful aggression prevention programs can be developed based on the current findings of the correlates of aggressive behavior in psychiatric patients.
基金supported by National Natural Science Foundation of China (No. 71403189)
文摘Objective： An understanding of the levels and trends of medical cost is made for breast cancer patients with different medical insurance coverages in China（mainland）, in an attempt to offer a clue to further control the costs.Methods： The inpatient payments of 9,716,180 breast cancer patients spent in medical institutions of different types and grades during 2011–2015 were collected from the inpatient medical record home page（IMRHP） dataset.The data were then processed with SAS（Version 9.3; SAS Institute, Cary, NC, USA）. Indicators like means,increase（decrease） percentages were used to descriptively analyze the average hospitalization expense of each time（AHEET） and its trends of breast cancer patients with different medical insurance coverages treated in medical institutions of different types and grades.Results：In 2011–2015,the AHEET borne by breast cancer patients in China had been constantly increasing.Specifically,the self-pay inpatients had the largest increase,inpatients covered by Urban Employee Basic Medical Insurance（UEBMI）and Urban Resident Basic Medical Insurance（URBMI）were the next,and those covered by New Rural Cooperative Medical System（NRCMS）had the least increase.Breast cancer inpatient treated in public hospitals had quite greater increase and higher expenditure level than those in private hospitals.The AHEET borne by the inpatients in Grade 3 hospitals had greater increase and higher cost than those in Grade 2 hospitals.Conclusions：The inpatient payments of breast cancer patients will be wisely controlled by reducing the number of self-pay inpatients,taking advantage of restriction mechanism of the medical insurances,and promoting healthy competition between private hospitals and public hospitals.The economic burden imposed on the society by breast cancer can be relieved through further control of inpatient payments of UEBMI-and URBMI-covered breast cancer patients and of Grade 3 hospitals.
文摘Background:Inpatient suicide is an important part of patient safety management in general hospitals.Incidence of inpatient suicide can be decreased by health personnel mastering inpatient suicide prevention strategy.To enhance health personnel’s inpatient suicide prevention strategy,education intervention is a common method.Educational interventions in the researches varied in contents,duration and outcome measurements.However,there has been not synthesis of education interventions targeting health personnel on inpatient suicide prevention.Objective:Prevention of inpatient suicide is a critical priority in patient safety management in general hospitals.Incidence of inpatient suicide can be decreased by effective strategies mastered by health personnel through education interventions.Educational interventions in researches varied in contents,duration and outcome measurements.We aimed to review education interventions targeting health personnel on inpatient suicide prevention.Methods:A scoping review was used to analyze existing researches on education interventions targeting health personnel focusing on inpatient suicide prevention in general hospitals.Cochrane Library,PubMed,Embase,CINAHL,China National Knowledge Infrastructure,WanFang,and Chinese Scientific Journal Database were searched in Oct 2019.According to the inclusion and exclusion criteria,the searched studies were screened by two reviewers.And then,two researchers conducted the data extraction independently by using a table format,including the first author,year of publication,study design,participants,education intervention,etc.Results:Twelve studies were included in this scoping review.The contents of education interventions on inpatient suicide prevention included three aspects:suicide knowledge,suicide assessment,and skills for coping with suicide.The duration of education interventions ranged from 1.5-h to 32.0-h.The effects of education interventions were mainly focused on participants’knowledge,attitudes and skills of suicide prevention.Conclusion:The evidence showed that education interventions on inpatient suicide prevention had positive impact on health personnel’s knowledge,attitude and skills about inpatient suicide prevention in general hospitals.However,the best health personnel-targeted education intervention on inpatient suicide prevention in general hospitals was yet to be determined.In the future,it is necessary to combine evidence in this review and the actual condition in clinical practice.
基金the Fundamental Research Funds for the Central Universities(No.2020kfyXJJS057)China Association for Science and Technology Foundation(No.20200608CG111320).
文摘Objective Hepatitis B virus(HBV)infection,which has been recognized as an international public health challenge,has caused significant morbidity for the entire world.This research focused on patients with HBV in China to examine health utilization and expenses.Methods Patients hospitalized with HBV from 2017 to 2019 in tertiary hospitals in Hubei,a province located in central China,were selected as the study population.Healthcare information was collected from the provincial inpatient electronic system database.Univariate and regression analyses were performed to describe the basic situation of healthcare services and determine the influencing indicators of inpatient service expenditure.Results A total of 367381 cases of HBV infection were identified in the study area.Most of these cases were patients who were married(90.2%)and males(63%).With the great efforts by the universal coverage of the basic medical insurance(BMI)in China,the increasing rate of inpatient hospitalization for HBV was 3.5 times higher than that of the total inpatient health service cases in the study area.The average age of this group was 52.84±14.10 years and 11.1%of patients paid for their own medical expenditures without insurance.The average length of stay(LOS)was 11.10 days,and the average cost per patient was 15712.05 RMB.Both values were higher than the average level in study area.Gender,marital status,career,payment type,and kind of hospitals significantly influenced healthcare utilization.Males and the elderly might incur higher healthcare costs than their counterparts.Conclusion The BMI operated by government has played a role in the utilization release of health services for HBV carriers.However,researchers must pay more attention to the continuing increase in the medical expenses of this group.
文摘<strong>Objective</strong>: This paper aims to explore clinical status and related influence factors of pressure injury (PI) in the elderly inpatients with kidney disease, so as to provide reference for the prevention and treatment of PI in the elderly inpatients with kidney disease. <strong>Methods</strong>: Retrospective collection method is adopted to collect 158 clinical cases of the elderly inpatients with kidney disease aged ≥ 60 in the Nephrology Department, the First Affiliated Hospital of Jinan University from January 2017 to December 2019, and then least absolute shrinkage and selection Operator (LASSO) regression analysis is used to analyze 17 possible influence factors;finally Logistic regression model is established to analyze and screen influence factors of risk. <strong>Results</strong>: 1) Among 158 elderly inpatients with medium and high risk of PI, the incidence of PI is 20.25%;the most common stage of injury is stage I (42.5%);sacrococcygeal (60%) is the high-risk site of pressure injury. 2) LASSO regression analysis shows that history of present respiratory infection/respiratory failure (<em>β </em>= 1.2714. <em>P</em> < 0.05) and hospitalization time (<em>β</em> = 0.4177. <em>P </em>< 0.05) are independent factors influencing PI risk in the elderly inpatients with kidney disease. <strong>Concl</strong><strong>usio</strong><strong>n</strong>: The elderly patients with kidney disease and PI risk are the high incidence population of hospital acquired PI;for the elderly inpatients with kidney disease and having respiratory infection history or respiratory failure, prolonged hospitalization will significantly increase the risk of PI. Therefore, targeted preventive and control measures should be taken to reduce the incidence of PI.
基金supported by Huazhong University of Science and Technology independent innovation fund in 2013-chinical skills(No.01-18-530069)
文摘Objective： The aim of this study was to identify the risk factors for inpatient suicide in a general hospital. Methods： Thirty suicide victims were drawn from the adverse event reports of suicidal acts during hospitalization in a general hospital from 2008 to 2014. Data were gathered from a focus group interview of 6 medical staff who had experienced inpatient suicide. Interpretative phenomenological analysis was used to analyze the data. Results： Five main themes regarding high-risk factors for inpatient suicide emerged from this study： mental disorders, diseases, the source of money to meet medical expenses, social support, and the hospital environment. Patients with mental disorders were at a high risk of suicide. Having a serious disease, paying high medical expenses alone, the loss of social support and unsafe hospital environments were also associated with an increased risk of suicide. Conclusions： This study puts forward different perspectives on the reasons that inpatients commit suicide and corresponding preventive measures based on these 5 main themes that could be implemented to avoid or reduce suicidal acts among inpatients during hospitalization.
