The deep integration of modern technology and medical development promotes the change of medical and health management environment. As an important part of hospital medical and health decision-making process, the evaluation and access of medical equipment and consumables need scientific evidence-based evaluation system. This paper introduces a new-equipment evaluation model created by the multi-disciplinary evaluation team of West China Hospital of Sichuan University under the guidance of evidence-based ideas and methods. This model is suitable for the Chinese national conditions and easy to operate.
Continuous renal replacement therapy (CRRT) originated from intermittent hemodialysis. Over the past 40 years, its application scope has gradually expanded from the initial treatment of kidney diseases alone to the support of multi-organ functions. As a safe, adequate, and flexible therapeutic modality, CRRT has become one of the main means of treating critically ill patients. Continuous innovation in technology, biomaterials and other technologies provides important driving force for the sustainable development of CRRT. This paper reviews the technological innovation and development of CRRT devices. With continuous technological updates and iteration, CRRT can better adapt to clinical needs. Biofeedback, portability, and intelligence are several directions of the development of CRRT, which can provide more accurate and personalized treatment for critically ill patients in different scenarios.
Objective To survey the present situation of medical equipment configuration of township hospitals in Shuangliu County, to provide baseline data for the next step of discussing the well-off township hospital medical equipment configuration standards. Methods According to the national guidance on device configuration in township hospitals, the questionnaire was made to survey 24 county township medical units (i.e. 3 central township hospitals, 3 community health centers, and 18 general township hospitals). The descriptive and stratified analysis was performed for the survey results. Results The condition of medical equipment configuration in the 3 central hospitals was better than that in the 3 community health centers which was better than that in the 18 general hospitals. The emergency equipment configuration such as defibrillator units, breathing airbags, and tracheotomy package was poor. Annual inspection rate of medical metering equipment was lower than expectation. In 2010, a total of 127 medical measuring equipments from 98.5% of the township hospitals applied annual inspection, among which, only the total annual rate of black and white B ultrasonic and X-ray machine reached above 60%; the rate of blood cells analyzer, ECG monitoring instrument, and biochemical analyzer were between 50% to 60%; and the rate of urine analyzer was the lowest at 4.5%. Conclusion It is the right time to strengthen the first aid equipment configuration in township hospitals and to enhance the annual inspection rate of the medical measuring equipment, so that the safety use and accuracy detecting can be guaranteed.
ObjectiveTo explore a strategy for selecting and evaluating the warranty contract of medical equipment.MethodsBased on the operating costs of the two linear accelerators between 2016 and 2019, we obtained the criticality of medical equipment by using the five indicators, including necessity of maintenance, function, risk, importance, and age of medical equipment, selected the warranty strategy by comparing the cost of key components, and adjusted and optimized the warranty strategy based on the economic benefit assessment during the implementation process of warranty contract.ResultsThe criticalities of the two linear accelerators were both 18 points, and it was recommended to purchase warranty service. By comparing the cost of key components, the annual average maintenance cost of the key components of the two accelerators was lower than the annual warranty cost, so we chose the semi-guaranteed contract. Finally, according to the economic benefit accounting and evaluation in the implementation process of the warranty contracts of the two linear accelerators, the linear accelerator 1 remained unchanged, and the linear accelerator 2 was turned from the semi-guaranteed contract into the full insurance contract when we renewed the warranty contract.ConclusionsThe warranty contract selection and evaluation strategy proposed in this paper has certain guiding significance for the choice of strategy of warranty contract. By choosing the appropriate warranty service scope and warranty strategy, and continuous adjusting and optimizing according to the actual performance of the contract, we can effectively guarantee the operational efficiency of medical equipment, and reduce operating costs simultaneously.
Objective To provide theoretical basis for the reasonable selection of personal protective equipment by analyzing the willingness of protection and the contamination of severe acute respiratory syndrome coronavirus 2 of medical staff in the designated hospital for treatment of coronavirus disease 2019. Methods The medical staff of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine who entered the contaminated area from May 1 to 31, 2022 were collected as the study subjects. A simple random sampling method was adopted to investigate the willingness of protection of different medical staff leaving the cabin. Contamination of severe acute respiratory syndrome coronavirus2 was detected by fluorescence polymerase chain reaction. Results A total of 70 medical staff were included. There were 61 nurses and 38 in intensive care unit. The survey showed that 47 medical staff chose disposable isolation clothes, 44 medical staff chose protective face screen and 69 medical staff chose double-layer shoe cover/boot cover. A total of 640 specimens were collected. Six positive samples for severe acute respiratory syndrome coronavirus2 nucleic acid test were detected, with a positive rate of 0.94%. All the positive samples were sampled from the sole of a protective clothing. Six positive samples were willing to choose double-layer shoe cover/boot cover. Conclusions The medical staff in designated hospital for treatment of coronavirus disease 2019 tend to take high protection during daily medical activities. However, personal protective equipment is less likely to be contaminated by severe acute respiratory syndrome coronavirus2, and it should be selected rationally to avoid excessive protection.
ObjectiveTo present the application of mini-health technology assessment (Mini-HTA) method in configuration management of anti-magnetic anesthesia machine.MethodsFrom February to March 2019, the specialist operation assistant used Mini-HTA method to analyze and evaluate the anti-magnetic anesthesia machine applied by the department from basic situation and four dimensions, including technical dimension, patient dimension, hospital dimension, and economic dimension.ResultsA hospital health technology assessment report was prepared based on the evaluation of the specialist operation assistant, the suggestion of which was adopted by the hospital. As a result, an anti-magnetic anesthesia machine was arranged in the MRI room.ConclusionMini-HTA method can provide decision support for hospital equipment configuration and is conducive to the scientific and rational allocation of resources in hospitals.
ObjectiveTo explore the effect of precise management on life-saving equipment management in Surgical Intensive Care Unit (SICU). MethodsWe actualized precise management in the life-saving equipment management process in March 2014, including precise management control system, precise personnel training, and precise process management. ResultsAfter precise management, the knowledgement of life-saving equipment of the nurses increased from 90.2% (May, 2014) to 98.5%. The number of equipments repaired before (March-May, 2014) and after the management (June-August, 2014) was 65 and 47, respectively; the number of nonstandard management times in nurses after the equipments were used was 98 and 10, respectively. ConclusionPrecise management can drastically improve management efficiency, serviceability rate and service efficiency of life-saving equipment, obviously enhancing the degree of familiarity and using skills of clinical nurses, and ensuring quick and smooth emergency work. It plays an active role in securing severe patients' life.
Foam sclerotherapy is one of the major therapies for varicose veins in lower limbs. It is important to know the influence factor of foam stability which is beneficial to curative effect. The present experiment explored influence of 9 kinds of driving speed on foam stability when using the method of Tessari. Syringes of 5 mL were chosen to do this experiment which was carried out at the liquid gas ratio of 1:4 and the environment temperature of 20℃. A home-made automatic sclerosing foam preparation equipment was used to prepare the foam. A camera recorded the entire process of foam decay. And foam stability indexes which includes drainage time, half-life, foam half-life volume and the drainage rate curve, were analyzed. The results showed that when driving speed ranged from 100 mm/s to 275 mm/s, foam drainage time and the half-life showed a trend of rising. When the driving velocity was greater than 275 mm/s, the foam drainage time and half-life time reduced a little. The largest drainage time and the half-life differences were 340.0% and 118.8% compared to their minimum value. Meanwhile the pressure increased with the increase of driving speed, so that the solubility of carbon dioxide increased and the foam half-life volume decreased with the increase of the driving speed. It can be concluded that when using the method of Tessari to prepare sclerosing foam, driving speed has a significant effect on its stability. With driving speed increasing, foam decay mechanism changes from gas diffusion to liquid drainage as the main function, so the foam stability increased at first and then decreased later. The foam is relatively more stable at the speed of 275 mm/s, which could be considered as the best driving speed.
To reduce the infection risk of 2019-novel coronavirus and to protect medical staffs, “Graded personal protection scheme for preventing medical staffs from 2019-novel coronavirus infection in West China hospital” was formulated according to the guidance and notice issued by the National Health Commission combined with the actual situation of West China Hospital. This scheme could provide reference for preventing such disease for medical staffs.