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Department of pediatric hematology-oncology in Crete

PEDIATRIC HEMATOLOGY AND ONCOLOGY 1996年第5期13卷 397-399页

作者： Kalmanti, M Department of Pediatric Hematology/Oncology University Hospital of Heraklion University of Crete Medical School Heraklion Crete Greece

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关键词：病人医疗小组/组织和管理人员医院/统计学和数值数据研究/组织和管理研究人员/统计学和数值数据

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Seroprevalence of hepatitis C infection among health care personnel in Beirut, Lebanon

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AMERICAN JOURNAL OF INFECTION CONTROL 2001年第1期29卷 20-23页

作者： Irani-Hakime, N Aoun, JP Khoury, S Samaha, HR Tamim, H Almawi, WY Amer Univ Beirut St Georges Hosp Dept Lab Med Beirut Lebanon Amer Univ Beirut St Georges Hosp Dept Med Beirut Lebanon Amer Univ Beirut Fac Hlth Sci Dept Epidemiol & Biostat Beirut Lebanon

Background: Health care workers are at risk of contracting hepatitis C virus (HCV) infection more than the general population, and chronic HCV infection may be asymptomatic. Therefore, the purpose of this study was to determine the seroprevalence of HCV among health care workers at St Georges-Orthodox Hospital, the first study done for a major teaching hospital in Lebanon. Methods: Health care personnel at St Georges-Orthodox Hospital, Beirut, were offered anonymous testing for anti-HCV antibody. Seroprevalence rates of health care personnel were compared with the rates of blood donors screened during the same year. Results: Of the 502 persons screened, 13 (2.60%) initially tested either positive or doubtful-positive by the SM-HCV rapid test;2 (0.4%) mere confirmed positive by 2 commercial enzyme-linked immunosorbent assay kits and reverse transcriptase-polymerase chain reaction. This prevalence rate was comparable with the rate obtained for blood donors (n = 600) during the same period. Conclusion: The seroprevalence of HCV infection among health care workers st St Georges-Orthodox Hospital was similar to the rate observed in local blood donors, which suggests that the occupational risk of HCV infection was low.

关键词：酶联免疫吸附测定肝炎丙型/血液肝炎丙型/流行病学肝炎抗体丙型/血液黎巴嫩/流行病学职业病/血液职业病/流行病学职业暴露人员医院/统计学和数值数据逆转录聚合酶链反应血清流行病学研究成年人女(雌)性人类男(雄)性中年人

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Antibiotic prescribing for dental conditions: general medical practitioners and dentists compared

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BRITISH DENTAL JOURNAL 2000年第7期188卷 398-400页

作者： Anderson, R Calder, L Thomas, DW Univ Wales Coll Med Dept Oral Surg Med & Pathol Cardiff CF4 4XY S Glam Wales

Objective To compare the level of prescribing and types of antibiotics prescribed for dental problems by general medical practitioners and dentists. Design Secondary analysis of standard consultation data and prescription records from four different settings. Setting 30 participating general practices in the General Practice Morbidity Database for Wales in 1996. Subjects 1,185 attendances for tooth-related problems, at 30 participating practices in the General Practice Morbidity Database for Wales in 1996. Standard consultation records from a GDP emergency dental rota, and two weekend emergency dental clinics: one in a health centre, the other in a dental hospital. Results More than two thirds (68%) of attendances at general medical practices for tooth-related problems resulted in a prescription for antibiotics. In contrast less than a third (28%) of patients seen by a GDP rota, about half (52%) of patients at a weekend emergency clinic in a health centre, and just more than a third (38%) of patients attending the dental hospital clinic received antibiotics. General medical practitioners were also more likely to prescribe broad-spectrum antibiotics than dentists. Conclusion For acute dental problems general medical practitioners are more likely to prescribe antibiotics than dentists. There also appear to be inter-professional differences in the tendency to prescribe broad spectrum antibiotics. Initiatives to rationalise prescribing for dental conditions may need to target doctors as well as dentists.

关键词：抗菌药/治疗应用社区牙科学/统计学和数值数据数据库(主题) 牙科医院/统计学和数值数据药物处方/统计学和数值数据药物利用/统计学和数值数据急诊室医院/统计学和数值数据家庭医学/统计学和数值数据开业医生牙科/统计学和数值数据回顾性研究牙疾病/药物疗法威尔士人类

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Investigating pathology utilisation by junior medical staff in a teaching hospital: a qualitative study

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AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE 2000年第2期30卷 261-263页

作者： Enno, A Mondy, P Kerridge, I Pearson, S Hunter Area Pathol Serv Div Haematol Hunter NSW 2310 Australia Univ Newcastle Fac Med & Hlth Sci Newcastle NSW 2308 Australia

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Understanding and comparing differences in reported medication administration error rates

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AMERICAN JOURNAL OF MEDICAL QUALITY 1999年第2期14卷 73-80页

作者： Wakefield, DS Wakefield, BJ Borders, T Uden-Holman, T Blegen, M Vaughn, T Univ Iowa Coll Med Div Hlth Management & Policy Iowa City IA 52242 USA Univ Iowa Vet Affairs Med Ctr Iowa City IA 52242 USA Univ Iowa Coll Nursing Iowa City IA 52242 USA Univ Iowa Inst Qual Healthcare Iowa City IA 52242 USA

The prevention of medication administration errors (MAEs) represents a central focus of hospitals' quality improvement and risk management initiatives. Because the identification and reporting of MAEs is a nonautomated and voluntary process, it is essential to understand the extent to which errors may not be reported. This study reports the results of 2 multihospital surveys in which over 1300 staff nurses in each survey estimated the extent to which various types of nonintravenous (non-IV) and intravenous (IV)-related MAEs are actually being reported on their nursing units. Overall, respondents estimated that about 60% of MAEs are actually being reported. Considerable differences in estimated rates of MAE reporting were found between staff and supervisors working on the same patient care units. A simulation based on actual and perceived rates of MAE reporting is presented to estimate the range of errors not being reported. Implications regarding the reliability, validity, and completeness of MAEs actually being reported are discussed.

关键词：药物副反应报告系统/利用计算机模拟卫生保健调查衣阿华给药错误/预防和控制给药错误/统计学和数值数据护理人员医院/统计学和数值数据可重复性结果危险处理/统计学和数值数据真相揭露人类

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PSYCHIATRIC-TREATMENT IN A DELIMITED POPULATION - WITH PARTICULAR REFERENCE TO OUTPATIENTS

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ACTA PSYCHIATRICA SCANDINAVICA 1976年第1期53卷 35-50页

作者： KASTRUP, M NAKANE, Y DUPONT, A BILLE, M INST PSYCHIAT DEMOG 8240 RISSKOV DENMARK RANDERS GEN HOSP PSYCHIAT DEPT 8900 RANDERS DENMARK

The present investigation analyzes the psychiatric service available to and utilized by a population in a geographically delimited area, namely the Randers area [Denmark] with a population of 108,928. During the period 1970-74, the average yearly rate of patients admitted to the 3 psychiatric institutions covering this area was per 1000: 7.9 males and 9.1 females. During 1970-71, 1.2 males and 1.8 females per 1000 were treated as outpatients in a psychiatric clinic affiliated to a psychiatric hospital, and a psychiatric outpatient clinic in a general hospital discharged 4.1 males and 7.7 females per 1000. Despite outpatient treatment the number of admissions increases slightly rather than decreases, and consequently, outpatient treatment cannot replace psychiatric admission.

关键词：丹麦住院医院精神病/统计学和数值数据精神障碍/流行病学精神障碍/治疗门诊部医院/统计学和数值数据精神病科医院/统计学和数值数据社会工作精神病青少年成年人老年人女(雌)性人类男(雄)性中年人

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Medical student effect on emergency department length of stay

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ANNALS OF EMERGENCY MEDICINE 2001年第3期37卷 275-278页

作者： Gerbeaux, P Ledoray, V Liauthaud, H Torro, D Takun, K Thirree, R Nelh, P Jean, P Hop Concept Serv Accueil & Traitement Urgences F-13385 Marseille France Hop Concept Dept Med Informat F-13385 Marseille France

Study objective: Taking advantage of a medical student strike. the authors evaluated the effect of medical students on emergency department length of slay (LOS). Methods: ED LOS and patient characteristics were compared for the 4-day strike period and the same days the week before. Proportions were compared by using the Mann-Whitney U test and the chi (2) test (P<.05). Results: Eight hundred thirty-one patients were studied. There was no significant difference between the study and control periods for the general patient characteristics or laboratory or radiologic investigations. Median LOS decreased by 24% (31 minutes, 95% confidence interval [CI] 24 to 38) during the strike (110 minutes [95% CI 65 to 178] to 79 minutes [95% CI 40 to 135], P<10(-4)). Conclusion: Medical students lengthen ED FOS. This should be explained to patients and should be considered as one justification for increasing medical staff in the teaching ED.

关键词：效率急诊室医院/统计学和数值数据法国医院大学住院时间/统计学和数值数据学生医科/统计学和数值数据时间和运动研究成年人女(雌)性人类男(雄)性

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Analysis of pediatric hospitalizations after emergency department release as a quality improvement tool

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ANNALS OF EMERGENCY MEDICINE 2002年第2期39卷 159-163页

作者： DePiero, AD Ochsenschlager, DW Chamberlain, JM Childrens Natl Med Ctr Div Emergency Med Dept Pediat Emergency Med Washington DC 20010 USA George Washington Univ Sch Med & Hlth Sci Dept Pediat Washington DC 20052 USA George Washington Univ Sch Med & Hlth Sci Dept Emergency Med Washington DC 20052 USA

Study objective: We characterize repeat pediatric emergency department visits and determine the cause for such visits as an indicator of potential need for quality improvement. We hypothesized that most repeat ED visits resulting in hospitalization do not represent medical errors. Methods: The study was performed at a large, tertiary care, academic children's hospital. Patients who returned to the ED within 72 hours of a previous visit were identified by computerized registration data. The charts of these patients were then reviewed by a member of the ED medical staff to identify factors from the initial visit that contributed to the return visit. A multidisciplinary committee then reviewed each case until consensus was achieved regarding the cause for the repeat visit. In this study, we analyzed the quality improvement decisions from a 12-month period. Results: Over a 12-month period, during which there were a total of 51,195 visits, 285 (0.56%) patients were hospitalized after a repeat visit. The repeat visit was determined to be unrelated to the first visit in 12 (4.2%) patients. In 12 (4.2%) cases, the cause for repeat visit and hospitalization could not be determined. This resulted in a total of 261 patients for analysis. In 234 (90.0%) patients, the return visit was determined to be a result of the progression of illness (no medical error). Ten (3.8%) patients had a missed diagnosis, whereas 2 (0.8%) patients had errors in their treatment (likely medical error). An incomplete workup was cited in 7 (2.7%) patients (potential medical error). Parenting factors (refusing admission, not filling prescriptions, not giving prescribed medications) were noted in 5 (1.9%) cases. Three (1.1%) patients did not follow up with appropriate subspecialists. Conclusion: The overall rate of repeat visits resulting in hospitalization is small. In the majority of these cases (90.0%), the ED evaluation was appropriate and the admission was for progression of the patient's illness. G

关键词：误诊哥伦比亚特区急诊室医院/统计学和数值数据住院/统计学和数值数据医院儿科/统计学和数值数据质量保证卫生保健儿童人类

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Opportunistic urine ligase chain reaction screening for sexually transmitted diseases in adolescents seeking care in an urban emergency department

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ANNALS OF EMERGENCY MEDICINE 2000年第1期36卷 28-32页

作者： Embling, ML Monroe, KW Oh, MK Hook, EW Univ Alabama Dept Pediat Div Emergency Med Midtown Ctr Birmingham AL 35233 USA Univ Alabama Div Ambulatory Med Birmingham AL 35233 USA Univ Alabama Dept Med Birmingham AL 35233 USA Univ Alabama Div Infect Dis Birmingham AL 35233 USA

Study objective: Neisseria gonorrhoeae and Chlamydia trachomatis are the most common bacterial sexually transmitted diseases (STDs) in sexually active youth and many infections are asymptomatic or unrecognized. This study used ligase chain reaction assays for determination of prevalence of gonococcal and chlamydial infections in adolescents seeking care at an urban emergency department. Methods: An unlinked prevalence study was performed with ligase chain reaction tests on Voided urine specimens from a convenience sample of adolescents 14 years or older who sought care at the Children's Hospital of Alabama ED. Demographic data and data an care provided in the ED were determined from retrospective chart review of those patients whose urine specimens were tested. Results: Of 282 urine specimens screened, 13.5% (38) yielded positive findings on ligase chain reaction testing for either or both pathogens (20 [7%] positive for N gonorrhoeae, 23 [8%] positive for C trachomatis). In the context of acute care, gonorrhea or chlamydial infection was diagnosed in 5 (1.8%). STD prevalence did not vary significantly by age. Only 39% (15/38) of patients with infections detected by ligase chain reaction testing received potentially effective antibiotics as a result of their urgent care evaluation. Conclusion: Many adolescents use the ED for nonurgent care and unsuspected STDs are often missed. Urine ligase chain reaction testing is a sensitive, noninvasive means of detecting STDs by which unsuspected adolescent STD cases can be detected in an ED setting.

关键词：亚拉巴马/流行病学衣原体感染/诊断衣原体感染/流行病学沙眼衣原体/遗传学横断面研究急诊室医院/统计学和数值数据基因扩增/遗传学遗传学技术淋病/诊断淋病/流行病学发病率普查/统计学和数值数据淋病奈瑟球菌/遗传学试点项目性传播疾病细菌性/诊断性传播疾病细菌性/流行病学青少年女(雌)性人类男(雄)性

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Prescribing privileges among pharmacists in Veterans Affairs medical centers

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AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY 2001年第12期58卷 1143-1145页

作者： Clause, S Fudin, J Mergner, A Lutz, JL Kavanaugh, MM Fessler, K Chirumamilla, S Samuel S Stratton Dept Vet Affairs Med Ctr Albany NY 12208 USA Albany Coll Pharm Albany NY USA Albany VAMC Albany NY USA

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