1.Retrospective Analysis on 1 900 Cases of Medical Malpractices.
Li YANG ; Ji Feng CAI ; Dong GAO ; Zhen Hua DENG ; Ya Dong GUO ; Yun Feng CHANG
Journal of Forensic Medicine 2019;35(4):428-432
Objective To study the change trend, distribution characteristics and causes of medical malpractices in 18 years, through retrospective analysis of 1 900 cases of medical malpractices, in order to provide guidance for the precaution and the treatment of medical malpractices. Methods A thousand and nine hundred medical malpractice cases that were accepted by Hunan Xiangya Judical Identification Center from 2000 to 2017 were collected. Statistical analysis on the caseloads, the clients, the department distributions, the levels of the hospital and the causes of medical malpractices, etc were conducted. Results The number of cases commissioned by third-party accreditation agencies for medical fault identification was on the rise; The clients of medical malpractices changed significantly in 18 years. Most of the medical malpractice cases occurred in secondary and tertiary hospitals, significantly more in surgery, obstetrics and gynecology. The occurrence of medical malpractices was related to the doctor's insufficient prediction of the severity of the disease and the possible complications, and failure to fully inform the relevant duty of care, etc. Conclusion China's medical malpractice solutions and medical fault identification procedures are gradually improving. Strengthening the medical malpractice precaution awareness of medical workers in surgery, obstetrics and gynecology will be conducive to resolution of medical malpractices.
China
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Female
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Humans
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Malpractice/trends*
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Obstetrics and Gynecology Department, Hospital
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Pregnancy
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Retrospective Studies
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Surgery Department, Hospital
4.Nutritional risk screening and its clinical significance in 706 children hospitalized in the surgical department.
Lu-Ting PENG ; Rong LI ; Wei-Hua ZHAO ; Yin-Hua CHEN ; Xiao-Mei LI ; Meng-Ying CHEN ; Jia CAO ; Xiao-Nan LI
Chinese Journal of Contemporary Pediatrics 2013;15(10):880-885
OBJECTIVETo investigate nutritional risk and its relationship with clinical outcome in children hospitalized in the surgical department, and to provide a scientific basis for clinical nutrition management.
METHODSNutritional risk screening was performed on 706 children hospitalized in the surgical department using the Screening Tool for Risk on Nutritional Status and Growth. The data on nutritional support during hospitalization, incidence of infectious complications, length of hospital stay, post operative length of hospital stay and total hospital expenses were recorded.
RESULTSOf the 706 cases, 11.5% had high nutritional risk, 46.0% had moderate nutritional risk, and 42.5% had low nutritional risk. Congenital hypertrophic pyloric stenosis, intestinal obstruction and congenital heart disease were the three most common types of high nutritional risk. The incidence of high nutritional risk was significantly higher in infants than in other age groups (P<0.01). Fifty-two (64.2%) of the eighty-one children with high nutritional risk received parenteral nutrition. Children with high nutritional risk were significantly more likely to have weight loss than children with low nutritional risk (P<0.05). Children with high nutritional risk had significantly increased incidence of infectious complications, length of hospital stay, post operative length of hospital stay and total hospital expenses compared with those with moderate or low nutritional risk (P<0.01).
CONCLUSIONSModerate or high nutritional risk is seen in children hospitalized in the surgical department. Nutritional risk score is correlated with clinical outcome. Nutritional support for these children is not yet properly provided. Nutritional risk screening and standard nutritional support should be widely applied among hospitalized children.
Adolescent ; Child ; Child, Preschool ; Female ; Hospitalization ; Humans ; Infant ; Male ; Nutritional Status ; Nutritional Support ; Risk ; Surgery Department, Hospital
5.Early recognition of deteriorating patient program in department of cardiac surgery.
Chunxiang QIN ; Ping MAO ; Peng XIAO ; Sainan ZENG ; Jianfei XIE ; Siqing DING
Journal of Central South University(Medical Sciences) 2014;39(3):307-312
OBJECTIVE:
To explore the application and the effect of early recognition of deteriorating patient program in department of cardiac surgery.
METHODS:
We used the early recognition of deteriorating patient program in the cardiac surgery groups, including cardiac surgeons, nurses in ward, ICU and operation rooms of the cardiac surgery department, and compared the satisfaction of nurses and doctors, handover time, handover score of critical patients, and rate of unplanned ICU admission before and after the intervention.
RESULTS:
After using the early recognition of deteriorating patient program, the satisfaction of doctors and nurses was increased, the handover time was lowered 0.56 min/time (t=2.22, P<0.05), the handover score of critical patients enhanced by 19.59 points (t=30.57, P<0.001), the rate of unplanned ICU readmission after the operation reduced by 4.8% (χ2=4.14, P<0.05).
CONCLUSION
Early recognition of deteriorating patient program can improve the safety of cardiac patients, enhance the self-confidence of nurses and work efficiency.
Cardiology Service, Hospital
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organization & administration
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Critical Illness
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Humans
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Intensive Care Units
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Outcome and Process Assessment, Health Care
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Patient Handoff
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Surgery Department, Hospital
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organization & administration
6.Preliminary experience on construting research-based gastrointestinal surgery department of Nanfang Hospital.
Guoxin LI ; Jiang YU ; Yanfeng HU ; Hao CHEN
Chinese Journal of Gastrointestinal Surgery 2019;22(1):22-26
Construction of research-based surgery department includes standardizing surgical practices, collecting and analyzing clinical data, discovering problems in clinical practices, designing and conducting reliable and high-level clinical research, improving and innovating surgical technologies according to research conclusions, working out technical specifications and promoting them through clinical education, and creating new clinical research needs arised by innovative and cutting-edge technologies and theories. By integrating technology, research, standardization, promotion and evaluation, and making close connections between different parts of clinical practices, scientific research and clinical teaching, it helps achieve coordinated development of surgical practices and translational research, and will finally promote the cultivation of medical talents and the progress of medical technologies. Since 2010, the General Surgery Department of Nanfang Hospital has established the basic idea of subject construction of "research-oriented surgery with data as the core, minimally invasive surgery with laparoscopic as the characteristic, and specialized surgery with high-efficiency service as the guidance", and has taken a series of measures to build it into a well-known research-based gastrointestinal surgery in China. The achievements of this speciaty have emerged from nothing, research platforms from few to many, the talent echelon from following to leading, and the influence from regional to international. The discipline construction has achieved a leap from quantitative to qualitative changes.
Biomedical Research
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standards
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China
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Digestive System Surgical Procedures
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standards
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Gastrointestinal Diseases
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surgery
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Hospitals
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standards
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Humans
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Minimally Invasive Surgical Procedures
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standards
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Program Development
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Surgery Department, Hospital
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standards
7.Study on depressive disorder and related factors in surgical inpatients.
Hong-min GE ; Lan-fen LIU ; Jian-bo HAN
Chinese Journal of Surgery 2008;46(5):362-365
OBJECTIVETo investigate the prevalence and possible influencing factors of depressive disorder in surgical inpatients.
METHODSTwo hundred and sixty-six surgical inpatients meeting the inclusion criteria were first screened with the self rating depression scale (SDS), and then the subjects screened positive and 20% of those screened negative were evaluated with Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) as a gold standard for diagnosis of depressive disorder. Possible influencing factors were also analyzed by experienced psychiatrists.
RESULTSThe standard score of SDS in the surgical inpatients were significantly higher than those in the Chinese norm, and the incidence of depressive disorder in the surgical inpatients was 37.2%. Unvaried analysis showed that depressive disorder were associated with gender, education, economic condition, variety of diseases, hospitalization duration, and treatment methods. Logistic regression analysis revealed that gender, economic condition, treatment methods and previous history were the main influencing factors.
CONCLUSIONSThe incidence of depressive disorder in the surgical inpatients is high, and it is mainly influenced by gender, economic condition, treatment methods and previous history.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Depressive Disorder ; epidemiology ; Female ; Humans ; Inpatients ; statistics & numerical data ; Male ; Middle Aged ; Prevalence ; Surgery Department, Hospital ; statistics & numerical data
9.The effect of funding cuts on the utilization of an oral pathology diagnostic service.
Deepika CHUGH ; R John MCCOMB ; David MOCK
International Journal of Oral Science 2009;1(3):151-155
AIMTo examine what impact the loss of funding had on the utilization of the oral pathology service.
METHODOLOGYBiopsy records were retrieved and examined in the two year period before and after the elimination of the subsidies in 2003.
RESULTSAfter the loss of funding, there was a 31% decrease in the number of specimens submitted from practitioners in private practice, with the greatest drop noted in submissions from endodontists.
CONCLUSIONDespite the immediate decrease in the number of biopsies submitted after the introduction of fee-for-service, the number of specimens being submitted appears to be on the rise again, as practitioners appear to recognize the value of a specialized oral pathology diagnostic service.
Biopsy ; economics ; utilization ; Diagnosis, Oral ; economics ; Diagnostic Services ; economics ; utilization ; Endodontics ; Fee-for-Service Plans ; economics ; utilization ; Financial Support ; General Practice, Dental ; Humans ; Pathology Department, Hospital ; economics ; Pathology, Oral ; economics ; Periodontics ; Private Practice ; utilization ; Retrospective Studies ; Schools, Dental ; economics ; Specimen Handling ; economics ; utilization ; Surgery, Oral