关于课题制管理

今年 1月 ,国务院办公厅转发了科技部、财政部、国家计委、国家经贸委《关于国家科研计划实施课题制管理的规定》 ,对国家各类科研计划的项目管理、经费管理、资产与成果管理、监督检查等各个环节作出了规范。与过去的科研管理制度相比 ,发生了很大的变化。一、课题制的概念根据国务院办公厅转发的《关于国家科研计划实施课题制管理的规定》里提出的课题制的概念 ,课题制是指按照公平竞争、择优支持的原则 ,确立科学研究课题 ,并以课题为中心、以课题组为基本活动单位进行课题组织、管理和研究活动的一种科研管理制度。这里跟过去相比 ,突出…     

整体护理在临床护理中的应用

随着现代医学模式的转变，护理的中心也由过去以疾病为中心的功能制护理，转变为以病人为中心的心身整体护理，改变了多年来护士执行医嘱加常规的被动局面。本文就这个问题浅谈个人的看法。     

现代护理发展趋势研究

现代护理模式是以病人为中心的护理行为，实现了工作模式的根本转变。传统护理工作模式是以完成任务为中心，其弊端是护士只关心工作，而关心病人不够。整体护理模式则要求以病人为中心，为病人提供主动、全面、系统的护理服务，形成关心病人、一切为病人的行为模式。     

"以病人为中心"为病人提供优质的医疗服务

“20世纪70年代中期，K．Balint博士等人提出了‘以病人为中心’的医疗服务模式（Patient centered medicine）。与‘以疾病为中心’的传统医疗服务模式相比，‘以病人为中心’的医疗服务模式具有明显的时代与人文特点”。“从20世纪到现在，医疗服务的发展经历了‘以疾病为中心’的传统医疗服务模式到‘以病人为中心’的新医疗服务模式的转变；     

以患者为中心的护理理念与实践

长期以来护理工作是在“以疾病为中心”的思想指导下开展的，习惯于以医护人员为中心，很少能从患者利益和心理去考虑护理工作措施。当前，正处在从以疾病为中心的护理模式向以患者为中心的整体护理模式的转变中。在这种理念转变的驱使下，作为医护人员要抛弃传统的护理意识，     

构建“以健康为中心”的医疗卫生人才培养模式

随着医学模式的演变，我国的医疗卫生人才培养模式必须从“以治疗疾病为中心”转变为“以健康为中心”。文章阐述了“以健康为中心”的医疗卫生人才培养模式产生的背景，提出以“治未病与健康管理”博士项目为抓手，推进医学教育模式改革，加快医疗卫生人才培养机制的变革，以适应新时期我国医疗卫生事业发展的需要。     

基础护理学教学中的护士素质教育

现代护理模式由以疾病为中心的功能制护理模式转变为以病人为中心的整体护理模式。护理模式的转变，对护理工作提出了新的要求，护士必须具备丰富的知识和良好的素质，才能为病人提供高质量的服务。因此，加强在校护生的素质教育，以尽快地适应护理模式的转变显得尤为重要。护士的素质主要包括思想品德素质和专业技能素质两个方面。近年来，我们通过加强基础护理教学中护生素质的教育，取得了显著的效果，现将教学体会和教学方法简介如下。     

课题制下高校科研管理工作的体会

本文分析了课题制的概念，阐述了课题制管理的实施为我国科技工作带来新的生机与活力，提出了高校应不断加强与完善课题制下的科研管理。高校应调整管理职能，加强科研项目的沟通与经费管理，完善组织管理，强调团队的作用，继续坚持监督检查制度，加强课题验收与资产、成果管理。     

护理工作模式和护士行为改变对骨科病人的心理影响

随着医学模式的转变,护理模式和工作内容发生了重要变化,使护理模式由以疾病为中心,逐步转变以病人为中心,进而转变到以人的健康为中心,由此进一步提出整体护理的观念,从重视对疾病的护理质量转向病人全方位的护理质量。     

团队管理理论在科研管理"课题制"中的运用

中山大学肿瘤防治中心肿瘤研究所是我国较早建立的肿瘤专科学术性医疗研究机构，具有学科专业较齐、学术水平较高的优势。自成立以来，在组织结构上一直沿袭科室体制。当今时代，科技的高速发展给医疗科研事业带来深刻的影响，传统的经营观念、管理体制和运行机制已经不能完全适应日趋激烈的竞争环境。在此形势下，一种新的科研管理制度———“课题制”的出台成为完善医疗科研管理的一项重要举措。“十五”期间，科研项目全面实行课题制管理，该中心肿瘤研究所也于２００２年７月开始正式实施“课题制”。本文则从团队管理的角度出发，将“…     

NEW APPROACHES TO EDUCATING SOCIAL WORK PROFESSIONALS FOR ADMINISTRATIVE ROLES IN A NATIONAL HEALTH SYSTEM

As national health insurance becomes a reality we can anticipate a shift in emphasis from delivery of acute in-hospital care to community-based care. Professional social work functions in the future will likely be increasingly directed toward the administration and management of supportive health care services. This paper describes an interdisciplinary graduate educational program in administration and management of social health care services, developed by the School of Social Work jointly with the Maxwell School of Citizenship and Public Affairs at Syracuse University and the Upstate Medical Center in Syracuse. The curriculum is designed to train future social work professionals in planning, evaluation, and managerial skills necessary to perform middle-management and decision-making functions. The curriculum is provided by an interdisciplinary faculty team, and implemented with a task-oriented problem-solving approach. The program is in its 3rd year and hsa graduated 20 students.     

Managing miscarriage: the management of the emotional sequelae of miscarriage in training practices in the West of Scotland

Miscarriage is a very common event which is rarely a medical emergency, and which, from a biomedical perspective, may justifiably be viewed as a 'normal' complication of early pregnancy. From the mother's point of view however, the loss of a wanted pregnancy may be viewed quite differently. A number of studies have identified significant levels of dissatisfaction with the medical care which women have received at the time of a miscarriage. This paper describes a survey of the management of miscarriage by general practitioner trainees and trainers in the West of Scotland and on the basis of responses to a series of MEQ-type questions, indicates GPs views on the importance of counselling, sympathetic listening and good information in this area. The translation of these attitudes and beliefs into practice is, of course, a different issue, and one which may be affected by the task-oriented approach of the new contract.     

Integrating the Dynamical Systems Theory,the Task-Oriented Approach,and the Practice Framework for Clinical Reasoning

ABSTRACT

This paper describes the purposeful integration of dynamical systems theory, the occupational therapy task-oriented approach, and Framework II to inform clinical reasoning. Dynamical systems theory provides the clinician with information about how systems interact to influence motor behavior. The task-oriented approach helps the practitioner to clinically improve motor behavior. Framework II gives the clinician guidance in terms of scope of practice and an overarching goal of intervention. Ideological similarities between these three resources for clinical reasoning include client-centeredness, an emphasis on occupation, and interaction between person, task, and environment. The process of clinical reasoning is illustrated using an integrated practice model applied to a clinical example of an adult with a hand injury requiring transfer of hand dominance.     

Creating the future. Nurses can shape their profession by getting involved in healthcare reform

To remain relevant in a reformed healthcare system, nurses will have to redefine and remake themselves. Three aspects of the new healthcare age--megahospitals, managed care, and redefined professional roles--will have a significant impact on healthcare professions, including nursing. Across the United States hospitals are merging to form sophisticated networks that provide a continuum of care. Under this delivery model, nurses will play a variety of new roles and work collaboratively with the entire spectrum of health social service professionals. A related development--the growth of managed care--is an increasingly attractive option among large employers. It will also accelerate changes in the way healthcare professionals work. Managed care will force physicians to enter into appropriate group affiliations and hospitals to reconfigure themselves to meet the needs of a dynamic system that no longer requires yesterday's beds or management structures. The future will force healthcare professionals to go through regular, radical changes in their job requirements. But it will also allow nurses and others to emerge from their task-oriented past and take on work that requires them to think, judge, and intervene.     

生物反馈联合上肢任务导向性训练对脑卒中偏瘫患者上肢功能的影响

目的探讨生物反馈联合上肢任务导向性训练对脑卒中偏瘫患者上肢功能的影响。方法选取我院2017年3月至2019年12月收治的脑卒中偏瘫患者87例,随机分为观察组(44例)和对照组(43例)。对照组行上肢任务导向性训练,观察组行生物反馈联合上肢任务导向性训练。采用Fugl-Meyer运动评分(FMA)评价患者上肢运动功能,采用偏瘫上肢功能测试-香港版(FTHUE-HK)评价患者上肢功能,采用脑卒中专用生活质量表(SS-QOL)评价患者生活质量。结果治疗后,两组的FMA评分、FTHUE-HK评级、SS-QOL评分均高于治疗前,且观察组的FMA评分、FTHUE-HK评级、SS-QOL评分均高于对照组(P<0.05)。结论生物反馈联合上肢导向性训练治疗脑卒中偏瘫患者能有效改善其上肢功能及运动能力,提高生活质量。     

任务导向性训练对脑瘫儿童手功能的疗效研究

目的研究任务导向性训练对痉挛型脑瘫儿童手功能及日常活动参与的疗效变化。方法选取2018年1月至2019年12月在陕西省康复医院做康复训练的4~14岁痉挛型脑瘫儿童60例,采用随机对照方法分为研究组及对照组。研究组采用任务导向性训练结合常规康复治疗,对照组采用常规康复训练,两组治疗时间均为3个月。治疗前及治疗3个月后对两组儿童分别应用Peabody运动发育量表-精细运动(PDMS-FM)、儿童能力评估量表(PEDI)进行功能及能力评定并比较。结果治疗3个月后,研究组与对照组PDMS-FM评分、PEDI评分均优于治疗前(研究组:t值分别为4.514、22.557;对照组:t值分别为3.451、16.013,均P<0.05),且研究组优于对照组(t值分别为2.016、4.011,均P<0.05)。治疗后,研究组学龄期儿童PDMS-FM、PEDI评分均高于学龄前期儿童(t值分别为3.968、4.625,均P<0.05),手功能分级(MACS)为Ⅰ~Ⅱ级的儿童PDMS-FM、PEDI评分均高于MACSⅢ~Ⅳ级儿童(t值分别为2.917、3.579,均P<0.05)。结论痉挛型脑瘫儿童通过任务导向性训练有利于改善双手抓握及实物操作能力;任务导向性训练结合常规康复训练有利于改善痉挛型脑瘫儿童的日常生活活动。年龄及功能障碍严重程度等因素可能影响任务导向性训练的康复疗效。     

Limits to employee empowerment in the UK NHS. Locality managers in a community health trust

The concern of this paper lies with empowerment of middle managers in a community health trust. It considers the impact of traditional structures and cultures upon the level of decision which middle managers are empowered to make. The conclusion reached is one which suggests that the level of discretion available to middle managers was one of making task-oriented decisions rather than decisions about strategic change. However, even this was compromised by financial constraints and by "best practices" imposed by the personnel function.     

New care model transforms facility

*Nursing role is redefined; RNs now act more as case managers, with LPNs handling task-oriented activities. *Central nurses' station removed; alcoves created for atmosphere conducive to communication and collaboration. *Lean tool used to establish improvement targets and realize a reduction in errors.     

The Enhanced Productivity Program

The Enhanced Productivity Program is based on an organizational audit of a dietary department by a foodservice consultant. The objective of the program was to enhance department productivity by increasing personnel efficiency through work simplification and work organization principles while maintaining quality standards. The Enhanced Productivity Program comprises 13 subsystems that interact to affect overall productivity of the department. The program was structured by a task-oriented program schedule that identified tasks to be carried out in each subsystem. A system diagram detailed time frames and milestones guiding each task to completion. A comprehensive work plan was developed for each task. Time and motion studies carried out before and after implementation of program changes demonstrate a savings of 9.27 labor hours per day. Trayline speed increased from 1.7 trays to 3 trays per minute. Improved personnel efficiency allowed an 11% growth in meal volume in 6 months, thus improving departmental productivity.     

发育性协调障碍儿童动作能力干预研究系统评价

目的 探讨不同干预方法对发育性协调障碍(DCD)儿童动作能力的影响,为DCD儿童干预方案的选择提供理论依据。方法 搜集1995年1月-2015年3月关于针对改善DCD儿童动作能力的中英文干预研究,并对文献进行筛选、资料提取分析、文献质量评价、结果讨论和结论报告。41篇文献最终被纳入系统评价,本文将纳入文献中提及的干预方式分为“以任务为导向”的方法、“以过程为导向”的方法和药物治疗3类,并采用PEDro量表和牛津中心证据水平评价纳入文献的质量,进而对每类方法的治疗效果进行评价。结果 PEDro量表文献质量评价平均得分为6.3,为中等水平;采用牛津中心证据水平对文献质量评价,证据水平均在中等(Ⅱb)及以上。不同类型干预方式对DCD儿童动作能力改善程度为:“以任务为导向”的方法对DCD儿童动作能力的提高最有效,其效果高于“以过程为导向”的方法。药物治疗对DCD和ADHD共病儿童具有一定的疗效。结论 以“任务为导向”的DCD儿童动作能力发展干预方法优于以“过程为导向”的方法,药物治疗对DCD和ADHD共病儿童有较好的干预。