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Objective To explore the application effect of continuous quality improvement (CQI) in promoting regional cooperation and development of district-level Central Sterile Supply Department (CSSD). Methods The CQI program had been carried out based on the cooperative development of district-level Central Sterile Supply Department science 2020. The quality of cleaning and disinfection of medical apparatus package collected from district-level CSSD was evaluated before and after implementation of CQI. The knowledge level and satisfaction of nursing staff from district-level CSSD were assessed. Results The rates of qualified preprocessing, cleaning, packaging and storage in CSSD after implementation of CQI were higher than those before implementation of CQI(P＜0. 01). The rate of CSSD-related knowledge mastery and total satisfaction rate after the implementation of CQI were higher than those before implementation of CQI (P＜0. 01). Conclusion The application of CQI in the management of district-level Central Sterile Supply Department can ensure the quality of equipment cleaning and sterilization, improve the work efficiency and the overall level of infection prevention and control of medical institutions in the region. (目的 探讨持续质量改进(CQI)在促进区级消毒供应中心区域合作发展的应用效果。方法 2020年度基于医院的区域化消毒供应中心实施CQI管理。分别于CQI实施前和实施后抽取各合作基层医疗机构送至医院消毒供应中心再处理物品240件, 比较2019年1月—12月(实施前)及2020年1月—12月(实施后)消毒供应中心器械管理质量, 评价区域化消毒供应涉及医护人员消毒供应理论水平和满意度情况。结果 CQI实施后消毒供应中心器械预处理合格率、清洗合格率、包装合格率、存储合格率均高于实施前, 差异有统计学意义(P＜0. 01)。CQI实施后医护人员对消毒供应理论知识及流程掌握度及满意度均较CQI实施前提升, 差异有统计学意义(P＜0. 01)。结论 在区级消毒供应中心管理中应用CQI, 可以确保器械清洗、灭菌质量, 提高工作效率, 整体提升区域内医疗机构感染防控水平, 确保患者安全。)

Objective To investigate the incidence and influencing factors of adverse reactions of injection site after subcutaneous anticoagulant injection under the guidance of evidence-based nursingMethods Using the convenient sampling method, 608 patients with anticoagulant subcutaneous injection were investigated with self-designed general data questionnaire. Results Totally 98 patients had hemorrhagic related adverse reactions, the total incidence was 16. 12%. Age, sex, body mass index, abdominal skin fold thickness, and concomitant other anticoagulants were the main influencing factors. The levels of D-dimer and fibrinogen were specific indexes. Conclusion Standardizing subcutaneous injection method of anticoagulants can reduce the risk of bleeding and other adverse reaction. Patients should be comprehensively evaluated before injection and master the correct injection method. Elderly, female, obesity, and the use of other anticoagulant drugs and D-dimer, fibrinogen decreased in patients are high-risk groups. (目的 调查基于循证护理指导下抗凝剂皮下注射不良反应发生率, 并进行影响因素分析。方法 采取便利抽样法, 对608例患者抗凝剂皮下注射后皮下瘀点瘀斑、硬结等进行记录, 计算发生率, 对年龄等影响因素进行多元回归分析。结果 通过规范注射, 有98例患者发生不良反应, 总发生率为16. 12%。年龄、性别、体质量指数、腹部皮肤褶皱厚度、同时使用其他相关药物是其主要影响因素。D-二聚体、纤维蛋白原水平是特异性指标。结论 规范抗凝剂皮下注射方法, 可降低出血相关不良反应。注射前应全面评估患者, 掌握正确的注射方法。高龄、女性、肥胖、同时使用其他相关药物和D-二聚体、纤维蛋白原降低的患者是高危人群。)

Objective To investigate the health literacy and related influencing factors among patients undergoing thrombolytic therapy for acute ischemic stroke, and provide reference for establishment of effective health education strategy for stroke prevention. Methods A cross-sectional descriptive study was performed, and Short-form Health Literacy Questionnaire( HLS-SF12) was adopted to survey health literacy among 148 patients undergoing thrombolytic therapy for acute ischemic stroke. Results The average score of HLS-SF12 was (19. 64±8. 26), and score of patients with stroke recurrence and family history was (19. 56±7. 62) and (22. 04±8. 80)respectively. The highest score of dimension was (9. 08±2. 33) in medical care, followed by (8. 79±2. 68) in health promotion and (7. 80±2. 24) in disease prevention. The univariate analysis showed that there was a significant difference in HLS-SF12 score of patients with different gender, age, education level, occupation, marital status, residence status, monthly income, medical insurance payment method(P＜0. 05). Conclusion Findings of study indicated a relatively low level of health literacy among patients undergoing thrombolytic therapy for acute ischemic stroke. Influencing factors of health literacy include gender, age, education level, occupation, marital status, residence status, monthly income, medical insurance payment method. (目的 调查急性缺血性卒中溶栓患者健康素养现状并分析其影响因素, 为建立有效的卒中健康教育策略提供依据。方法 本研究为横断面描述性研究, 研究对象为某三级甲等综合性医院148例急性缺血性卒中溶栓患者。采用HLS-SF12健康素养调查问卷对患者进行问卷调查。结果 研究对象健康素养平均得分(19. 64±8. 26)分, 其中卒中复发及有家族史患者健康素养平均得分分别为(19. 56±7. 62)分和(22. 04±8. 80)分。健康素养各维度得分依次为医疗保健(9. 08±2. 33)分、健康促进(8. 79±2. 68)分、疾病预防(7. 80±2. 24)分。单因素分析结果显示不同性别、年龄、文化程度、职业、婚姻状况、居住状况、月收入水平、医疗付费方式的研究对象在健康素养得分上差异有统计学意义(P＜0. 05)。结论 急性缺血性卒中溶栓患者健康素养水平低下, 其中卒中复发及有家族史患者健康素养仍然不足。不同性别、年龄、文化程度、职业、婚姻状况、居住状况、月收入水平、医疗付费方式是急性缺血性卒中溶栓患者健康素养的主要影响因素。)

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With the continuous development of hypersonic aircraft towards high Mach and wide speed domains, the propulsion system faces low dynamic pressure working conditions, leading to a huge challenge to the flow mixing in the combustion chamber. The influence mechanism of hydrocarbon fuel preheating on supersonic shear mixing characteristics in the scramjet combustor was studied, and the influence of temperature and hydrocarbon fuel pyrolysis on mixing characteristics was analyzed. It is found that the preheating of non-cracking hydrocarbon fuel will enhance the viscous dissipation of the jet and reduce the mixing efficiency. When the fuel temperature increases from 750 K to 900 K, the mixing efficiency of the combustion chamber will decrease by nearly 5%, and the total pressure loss will increase by about 20%. However, the thermal cracking reaction of hydrocarbon fuel has a dual effect on the shear mixing. The expansion performance of the cracked hydrocarbon fuel is improved, and the mixing efficiency near the nozzle is increased by about 18%； However, due to the decrease in turbulent kinetic energy of the fluid in the shear layer, the mixing efficiency decreases by about 6% at a position far from the nozzle. [ABSTRACT FROM AUTHOR]

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Copyright of Journal of Kunming Medical University / Kunming Yike Daxue Xuebao is the property of Kunming Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)