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Self-destructive acts occurring during medical general hospitalization

GENERAL HOSPITAL PSYCHIATRY 2000年第2期22卷 115-121页

作者： Hung, CI Liu, CY Liao, MN Chang, YH Yang, YY Yeh, EK Chang Gung Mem Hosp Dept Psychiat Tao Yuan 333 Taiwan Chang Gung Mem Hosp Dept Nursing Tao Yuan 333 Taiwan Natl Taiwan Univ Hosp Dept Psychiat Taipei 100 Taiwan Taipei Med Coll Taipei Taiwan

Although several articles about suicide in general hospitals have been published, the rates of self-destructive individuals among various diseases and departments have not been reported previously. Moreover, self-destructive acts in Chinese general hospital inpatients have been neglected. We retrospectively investigated self-destructive incidents among medical general inpatients. A total of 75 self-destructive incidents, including 15 fatalities, were identified during the 10-year study period. The self-destructive rate was 8.7 per 100,000, and the fatality rate was 1.8 per 100,000 admissions. The highest self-destructive rate occurred in patients admitted to the rehabilitation weird (33.4 per 100,000) followed by the neurology ward (29.9 per 100,000). The highest fatality rate occurred among patients in the neurology ward (6.7 per 100,000). The majority of self-destructive patients suffered from a chronic or terminal illness with the most frequent types of illnesses being malignant neoplasm (31.1%), neurological disease (20.3%), and chronic obstructive pulmonary disease (COPD, 10.8%). COPD patients had the highest rate of self-destructive behavior (64.0 per 100,000) and the highest fatality rate (16.0 per 100,000) due to these incidents. The most common self-destructive incident was knife-cutting More than one-half (53.4%) of the self-destructive incidents occurred within the first 2 weeks of admission, and nearly one-half (46.7%) occurred during the night shift. Moreover, the majority of severe or fatal incidents also occurred during the night shift. The results suggest that close supervision of high-risk patients should be mandatory within the first 2 weeks following admission, especially during the night shift. (C) 2000 Elsevier Science Inc.

关键词：疾病/心理学医院科室/统计学和数值数据医院综合/统计学和数值数据住院病人/心理学住院病人/统计学和数值数据住院时间危险性评估自杀/预防和控制自杀未遂/心理学自杀未遂/统计学和数值数据台湾/流行病学时间因素成年人老年人女(雌)性人类男(雄)性中年人

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Vancomycin use in pediatric neurosurgery patients

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AMERICAN JOURNAL OF INFECTION CONTROL 1999年第6期27卷 482-487页

作者： Shah, SS Sinkowitz-Cochran, RL Keyserling, HL Jarvis, WR Ctr Dis Control & Prevent Hosp Infect Program Natl Ctr Infect Dis Atlanta GA 30333 USA

Objective: The objective of this article is to describe a pediatric neurosurgery patient population receiving vancomycin and examine the indications for and appropriateness of vancomycin use. Methods: A cross-sectional study was performed on the pediatric neurosurgery patients at Egleston Children's Hospital who received vancomycin from January 1 through December 31, 1996. Vancomycin use was compared with the Centers for Disease Control and Prevention Hospital Infection Control Practices Advisory Committee recommendations for vancomycin use. Results: Thirty patients received 115 doses of vancomycin. The median patient age was 8.0 years, and 17 (56.7%) were male. Vancomycin was used for prophylaxis in 28 (93.3%) patients and empiric therapy in 3 (10.0%) patients;one patient received vancomycin for surgical prophylaxis followed by empiric therapy for suspected meningitis. Vancomycin prophylaxis was initiated after the incision in 6 (21.4%) patients and was continued as prophylaxis for more than one dose in 26 (92.9%) patients. Conclusions: Vancomycin was used primarily as surgical prophylaxis in pediatric neurosurgery patients, and use was not consistent with the Hospital Infection Control Practices Advisory Committee recommendations. These data suggest that for certain subpopulations, such as pediatric neurosurgery patients, there is a need for more specialized recommendations. Furthermore, prudent vancomycin use is warranted to successfully decrease the risk of further emergence of vancomycin resistance. Because vancomycin use may be prevalent in this population, assessment of vancomycin use in pediatric neurosurgery patients followed by establishment of vancomycin clinical guidelines may help improve the appropriateness of vancomycin use in this population.

关键词：抗菌药/治疗应用抗生素预防横断面研究药物利用/统计学和数值数据医院科室/统计学和数值数据神经外科手术/方法手术后并发症/药物疗法登记可重复性结果抽样研究美国万古霉素/治疗应用万古霉素抗药性青少年儿童儿童学龄前女(雌)性人类男(雄)性

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The valuation of pastoral care by hospital administrators: A survey of selected for-profit and non-profit institutions

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Journal of Health Care Chaplaincy 1990年第1期3卷 5-22页

作者： Manns, Maureen Young Pastoral care and education at brigham’s and women’s hospital Boston MA United States

This paper reports on a study of 600 hospital administrators, half of which were in non-profit institutions and half of which were in hospitals owned or managed by the Hospital Corporation of America. The project was designed to identify what differences, if any, existed between surveyed administrators in both bypes of institutions in their valuation of pastoral care. No significant differneces were found between the two groups of administrators in the valuation of pastoral care. All administrators were found to be concerned about the quality of patient care and to value aspects of care such as pastoral care which are personal and difficult to quantify. © 1990 Taylor & Francis Group, LLC.

关键词：方差分析医务工作者的态度宗教事务科医院/统计学和数值数据评价研究医院管理人员/统计学和数值数据医院科室/统计学和数值数据医院医院私营/组织和管理医院慈善/组织和管理牧师心理治疗/统计学和数值数据问卷调查美国人类

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11 years of million-dollar medical malpractice claims in Ohio.

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Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management 1994年第3期14卷 17-25页

作者： Sites, R.L. Ohio Hospital Association Columbus United States

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How do canadian hospitals do it?: A comparison of utilization and costs in the United States and Canada

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Hospital Topics 1995年第1期73卷 10-22页

作者： Weil, Thomas P. Bedford Health Associates Inc. Asheville NC United States

In 1990 Canadian hospitals provided more services at less cost than did acute care facilities in the United States. Canadians spent $2, 720 less per discharge for 48 percent longer stays. If U.S. acute care facilities had achieved an average discharge cost comparable to that in Canada, the annual savings among hospitals in the United States would have totalled $84.3 billion. In a comparative study of volumes and costs in medium-size and teaching hospitals, it was found that U.S. hospitals had greater costs for delivering services than Canadian acute care facilities did in almost every department. © 1995 Taylor & Francis Group, LLC.

关键词：加拿大财务管理医院/统计学和数值数据卫生保健改革/经济学卫生经费支出/统计学和数值数据医院费用/标准医院费用/统计学和数值数据医院科室/经济学医院科室/统计学和数值数据医院教学/经济学保险住院国家卫生规划/经济学地区卫生计划/经济学社会正义美国

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Study of the relationships of physical and mental health to patient satisfaction.

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Journal for healthcare quality : official publication of the National Association for Healthcare Quality 1999年第6期21卷 39-46页

作者： Welton, R. Parker, R. University of Maryland Medical Center Baltimore United States

This study examined the relationships of patients' self-report of their physical and mental health to their satisfaction with care received during recent hospitalization. These associations were examined within and across 11 service groups in a mid-Atlantic academic medical center. The sample size of 944 patients was distributed among the service groups, with 68-105 patients in each service. The instruments were a portion of the institution's patient satisfaction survey and the SF-12 (a 12-item generic measure of health status), both administered through telephone interviews. Across all hospital services, the relationships between satisfaction and health were too weak to interpret, with only 0.36% and 0.81% of the variance explained between overall satisfaction with care delivery and physical and mental health, respectively. At the service level, however, a number of significant but weak associations were found between satisfaction and health status in the otolaryngology, orthopedic, cardiothoracic, and transplant populations. Mental health and patients' likelihood to return to the hospital were negatively correlated in the neurology/neurosurgery populations, indicating that at higher levels of mental function, patients reported lower likelihood of their returning to the hospital.

关键词：医学科学研究中心/标准医学科学研究中心/统计学和数值数据卫生保健调查健康状况医院科室/标准医院科室/统计学和数值数据中大西洋地区病人满意度/统计学和数值数据自我评价(心理学) 女(雌)性人类男(雄)性中年人

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