Scientific clinical competence assessment and evaluation system is the foundation and guarantee of the quality of the training of graduate students of clinical medicine degree. Here is the clinical medicine thesis I have organized for your reference.
Clinical Medicine Essay Sample 1: Reflections on Quality Control Problems of Clinical Medical Testing
Abstract: Purpose: To explore the problems and countermeasures in the process of quality control of clinical medical testing. Methods: 200 cases of medical test patients admitted to our hospital from May 2013 to May 2015 were randomly grouped to compare the effects of routine test management*** control group, n=100*** and targeted management*** observation group, n=100*** based on the problems existing in the test process. Results: the observation group selected specimen test patient accuracy rate of 98%, significantly higher than the control group of 85%, the difference is statistically significant ***P<0.05***. The clinical test satisfaction of patients in the observation group was 98%, significantly higher than 86% in the control group, and the difference was statistically significant ***P<0.05***. CONCLUSION: For the problems in laboratory quality management, the development of targeted countermeasures, including specimen collection, testing instruments and devices and reagents, testing personnel and other aspects of management, can improve the quality of testing.
Keywords: medical testing; quality control; problems; countermeasures
Modern medicine, clinical testing is an important content, for disease diagnosis and treatment, monitoring, prognosis assessment to provide an accurate reference basis, with the excellent development of medical science and technology achievements, the medical testing technology is also constantly developing, and the accuracy of the test results is to ensure the effective diagnosis of disease and control of the key, directly related to the quality of medical care. The accuracy of test results is the key to guarantee the effective diagnosis and control of diseases, directly related to the quality of medical care, so pay attention to the quality control of medical testing is of great significance to improve the therapeutic effect and improve the doctor-patient relationship [1]. This survey selected clinical test patients, random group, on strengthening quality control management and routine management of the effectiveness of the comparison, now summarized results are as follows.
1 Data and Methods
1.1 General Information
Selected 200 cases of clinical test patients admitted to our hospital from May 2013 to May 2015, 104 men and 96 women, respectively, chemical tests, microbiological tests, immunological tests, hematology tests and so on. Randomly divided into the observation group and the control group of 100 cases each, there is no significant difference in general conditions between the two groups ***P>0.05***, comparable.
1.2 Methods
The control group in the test process application of conventional management program, the observation group to pay attention to the existence of problems, the development of targeted solutions and implementation of countermeasures, the specific operational steps are as follows:
1.2.1 Quality control problems:***1*** specimen collection problems: the subject's diet, exercise, the use of medication can have an impact on the test results, the patient's geographic location, age and age, the patient's health, the patient's health, the patient's health, the patient's health and the patient's health. At the same time, the patient's geographic location, age, gender, ethnicity can also affect the test results. When collecting the specimen, patients should be instructed to discontinue the medication they are using, and the specimen should be collected under quiet or normal activities. However, hemolysis of the specimen may occur if the procedure is not performed properly, such as injecting blood directly into the test tube after completing venous blood collection without removing the needle. Blood collection from an arm vessel that is being transfused will dilute the blood specimen. ***2*** test and inspection device problems: improper maintenance of the instrument, instrument aging, can make the sensitivity of the test is affected, in the accuracy of the problem; due to the limited level of inspection personnel, or do not grasp the function of the instrument, the standard operation, precautions, triggered by the test process problems; such as reagent replacement, the relevant instrument citation has not changed, the standardization of the storage of samples of the awareness is not strong, inducing operational errors The test results may be inaccurate if the reagents are changed. Applied reagents, not set according to the specification requirements, there are error events. ***3*** man-made problems: medical technology has developed rapidly in recent years, the test instrument is becoming more advanced, there is a higher and higher degree of automation, but still need to come to the completion of the operation. Therefore, the test test, the test personnel operating errors is one of the main reasons for the results of the error. Personnel operating errors mainly include: sample exposure time is too long, operating habits are not standardized, sample detection peak area integral there are customary differences and insufficient attention to the results of the test, etc., can lead to adverse events. ***4*** inter-laboratory quality assessment and indoor quality control: indoor quality control that is, indoor quality control, pay attention to the development of indoor quality control is to monitor the instrumentation and equipment, test methods, operating environment, process, reagents and other important initiatives for stability testing, but also to ensure that access to the correct test results of the wind vane. Inter-laboratory quality assessment for the inter-room quality assessment, strengthen the inter-room quality assessment, can be the accuracy of test results and credibility assessment, to ensure that the results are consistent with other units or comparable. ***5*** test after analyzing the problem: medical testing, the results of the review and audit for the last line of defense to ensure quality, inspectors are usually overly reliant on advanced instrumentation and devices, prone to error reports, such as fully automated blood analyzers detected abnormal results, not according to the manual rules of the review, the issuance of erroneous reports and so on.
1.2.2 Countermeasures Analysis: ***1*** pre-test quality control: ① Ensure the quality of the specimen: before the collection of samples, pay attention to the application of the concept of humanistic care, and patients and their families to actively communicate with and explain the condition, emotions, physiological changes in the understanding of the purpose, significance of the required examination of the special case, the sampling and self-sample precautions, the impact of the examination of factors to inform to improve the cooperation with the compliant, and the collection of samples is completed in a calm, quiet state. Completion of the collection in a calm, quiet state, to ensure the authenticity of the sample, qualified, to avoid the resulting error events. ② sample qualified: strict implementation of the three check seven collection, confirmation and verification of patient information, specimen collection, time, site, ***, sampling method, the number of strict requirements. Such as the collection of blood samples, usually within 16h fasting, before 9:00 am, the patient to remain calm, quiet and normal state. When collecting urine specimen, patients need to eat and drink regularly, avoid sexual life, sports, drinking alcohol, and when collecting after female menstruation, they need to pay attention to clean the urethral opening, external genitalia and the surrounding panels, so as to avoid being polluted by menstrual blood and *** secretion. Once the samples are collected, they have a real effect and need to be sent for testing in a timely manner, if they do not have the conditions to be sent for testing in a timely manner, they need to be stored correctly in order to prevent deterioration or denaturation, which will have an impact on the test results [2]. ***2*** quality control in the test: ① instrument maintenance: the normal implementation of the instrument in the test process is of great significance, the inspection staff need to do a good job of maintenance and maintenance, regular performance evaluation and calibration, to ensure that the performance of the stability and normal implementation, once the problem occurs, the need to notify the supplier in a timely manner, replacement or repair. At the same time, the training of medical and technical personnel in the Department of Laboratory, to prevent human error. ② need to ensure that the test reagents qualified, the reagent storage environment, strict management of the time limit, before the launch of the shelf-life and production date of the need to pay attention to prevent reagent failure or deterioration induced by the results of the error. Establishment of storage and use of reagents system to ensure the effectiveness and safety, improve the accuracy of test results. ③ Improve the comprehensive quality of testing personnel: modern instruments are refined operation, testing personnel need to have theoretical knowledge and operational skills. Therefore, it is necessary to strengthen the technical operation of training and business learning, skillful mastery of the instrument operating procedures, detection principles, interfering factors, test results of the graphics, information, the meaning of the alarm and how to maintain, maintenance and error removal, to master the effectiveness of the evaluation and calibration standards, to prevent operational errors. At the same time, to have a strong sense of responsibility and love, combined with their own technical level, in response to the patient's questions, reasonable to make explanations, take the initiative to communicate with other departments to understand the patient's condition, and with the combination of clinical symptoms, the results of the results of the accuracy of the assessment, in order to make their own test ability to improve. ***4*** actively carry out indoor quality control, inter-room quality assessment management: before testing the specimen, calibrate the instrument, line indoor quality control, the instrumentation device of the various test quotes and performance testing, normal state, before the specimen can be detected. If out of control, need to record, and analyze the reasons, and actively correct, and then test. Pay attention to the precision of quality control products. Emphasis on inter-room quality assessment to ensure that the test results and other units have consistency and comparability.
1.3 Statistical analysis
The information involved in the text was analyzed using SPSS13.0 statistical software, the count data line χ2 test, P<0.05 difference is statistically significant.
2 results
The accuracy rate of the specimen test patients selected by the observation group was 98%, significantly higher than the 85% of the control group, the difference was statistically significant ***P<0.05***. The clinical test satisfaction of patients in the observation group was 98%, significantly higher than 86% in the control group, and the difference was statistically significant ***P<0.05***.
3 Discussion
Medical testing plays a significant role in modern medicine, is a comprehensive discipline, and its quality management directly affects the overall level of medical care [3]. The problems that cause errors in test results are more, need to conduct a comprehensive analysis, and actively prevent and control the problem in order to reduce the failure rate of specimen testing. In this survey, the observation group for the pre-test specimen collection, testing process deficiencies and personnel, instrumentation, reagents and other factors that cause problems to explore, and develop targeted prevention and control countermeasures, such as focusing on the collection of specimens before the communication with the patient to strengthen the instrumentation, device maintenance and testing, pay attention to the comprehensive qualities of the test personnel to be cultivated, and actively carry out the indoor quality control and inter-room quality assessment to reduce the failure rate of the test and improve patient satisfaction. It is of great significance to reduce the test failure rate and improve patient satisfaction [4]. The results confirm that the observation group is significantly better than the control group. In summary, for the laboratory quality management problems, the development of targeted countermeasures, including specimen collection, testing instruments and devices and reagents, testing personnel and other aspects of management, can improve the quality of testing.
References
[1] Hao Lili. Quality control of clinical medical testing before analysis [J]. Primary Medical Forum, 2014, 18***20***: 2672-2673.
[2]Mao Yinghua. Quality management and control of medical tests before analysis [J]. Experimental and Laboratory Medicine, 2012, 30***1***: 50-51.
[3]Dong Daguang. Introduction to medical testing pre-analytical quality control [J]. Chinese Family Medicine, 2012, 10***7***: 1143-1144.
[4]Xue Jianli. Talk about how to control the error in medical testing in the process of test operation [J]. *** and Rehabilitation Medicine: Lower Decade, 2011, 2***11***: 221.
Second: the quality of grassroots employment of clinical medical graduates to enhance the strategy
Abstract: College employment is a topic that requires the whole society *** with the same concern, and grass-roots employment is an important employment pathway for medical students, and the quality of its employment The quality of employment is related to personal career development and the long-term development of medical and health care. Therefore, improving the quality of grassroots employment of medical students has become the focus of employment work in medical schools. In recent years, the grass-roots employment situation of medical school graduates is not optimistic, and employment at the grass-roots level is the mainstream choice of medical specialist graduates, and puts forward the ways to realize the improvement of the grass-roots employment quality of graduates of higher vocational colleges and universities majoring in clinical medicine from three aspects.
Keywords: grass-roots employment; employment quality; clinical medicine specialty; graduates
1 Current grass-roots employment status of medical students
According to the statistics of Huayu Education Network, the mainland of China's public medical***pharmaceutical*** science colleges and universities amounted to more than 40, and these schools annually cultivate medical***pharmaceutical*** science and health talents of the community of nearly 100,000 people. Although medical colleges and universities have a certain scale in China, and their graduates have made a greater contribution to the health of our people, but in the massification of higher education today, the trend of the marketization of higher education is becoming increasingly obvious, the seizure of the education market, the competition for educational talent is becoming increasingly fierce, so that medical colleges and universities are facing a huge challenge [1]. Medical higher specialized colleges and universities talent training orientation is oriented to the grassroots, rural training of medical and health care personnel, but with the rapid development of China's higher medical education, the number of medical graduates has also increased year by year. Specialized graduates, due to the influence of academic level and professional nature, compared with undergraduates and graduate students in colleges and universities, the employment situation of specialized graduates is more severe [2]. In recent years, with the development of China's medical and health care, "*** Central Committee and State Council on deepening the reform of the medical and health system" *** China Development [2009] No. 6 **** implementation as well as the new rural cooperative medical system to further carry out, grassroots hospitals, medical and health care conditions have been improved, most of them appear to be overloaded with the implementation of the state of the increase in the demand for health care personnel, guide and encourage college students to Oriented to grassroots employment, although it has attracted the attention of *** at all levels, introduced a series of policies and measures to promote the grassroots employment of university graduates, and made certain achievements, to a certain extent, to alleviate the employment pressure on college students, but compared with the policy objectives, it is far away, and the effect is less than ideal [3]. Wang Yunpeng in the "medical school graduates to grass-roots employment of long-term mechanism to build" proposed that, at present, 80.0% of China's medical and health resources are concentrated in the city and large hospitals, each year about 90.0% of graduates of medical schools are employed in large and medium-sized cities and coastal economically developed provinces and cities, the grass-roots health care presents a lack of resources, poor conditions, fewer devices, lower level and other characteristics. Pan Riming et al.[4] found that only 4.0% of students were willing to be employed at the grassroots level in their survey on "grassroots employment intention", and Zhou Jing found that only 4.0% of students were willing to be employed at the grassroots level in their survey on "college students' participation in grassroots employment". Zhou Jing found that only 7.6% of the students chose "active participation" in the survey on "the enthusiasm of college students to participate in grassroots employment". In recent years, China has been increasing its support for the grassroots employment of college students year by year in terms of policy support, financial support and employment positions, and has also taken corresponding preferential and encouraging measures in the areas of graduate school, recruitment of civil servants and employment in public institutions, etc. However, the information from various surveys shows that medical students lack a correct understanding of the grassroots employment, and lack of rational choices. This shows that medical students choose the direction of employment and health care market demand there is a deviation, there is a more serious employment tendency mismatch phenomenon.
2 to grass-roots employment is the mainstream choice of medical graduates
With the rapid development of higher education, colleges and universities in the quality of talent to improve at the same time the number of talents delivered to the community is also increasing, prompting the community's requirements for graduates * * * * including the level of qualifications, comprehensive ability * * * is also comprehensively improved. In recent years, the expansion of medical schools make big cities and other medical personnel market is basically in a saturated state, increasingly fierce competition for employment so that the employment market for medical students to the relatively less competitive, job demand is relatively more small and medium-sized cities, primary health care units tilt. In fact, the lack of talent at the grassroots level has been a long-standing problem, especially with the accelerated development of rural health care, employment at the grassroots level has become the mainstream choice of medical students, especially graduates of medical specialties, but also the embodiment of the correct values of medical students. This trend is conducive to solving the problem of "difficult to see the doctor" of the grassroots, is conducive to improving the health of the grassroots, is conducive to broadening the employment channels of medical school graduates, and is conducive to promoting the growth of medical school graduates, and in the long run, in line with China's national conditions, with far-reaching strategic significance [5]. It is emphasized that contemporary college students should have high aspirations, be practical, change the concept of career choice, adhere to the actual starting point, the courage to go to the grass-roots front line and hard places, the road of life step by step, good at creating extraordinary performance in ordinary positions. Medical students to grass-roots employment is China's new era of health reform and development needs, is to realize the opportunity of self-employment and success. Medical graduates should recognize the social employment situation and professional development trend, do a good job of personal career planning, and can do persistent efforts, look at the rural areas, grass-roots level of the vast space and development arena, correct employment orientation, to achieve the best combination of people and society, reasonable, scientific employment [6].
3 Countermeasures to improve the quality of grassroots employment of clinical graduates
The quality of employment of college students can not be measured only by the employment rate, it should be judged from the following aspects: the first is the wage and income and welfare treatment, wages and treatment is often a matter of concern to people, which is related to the employee's judgment of the value of their own labor; the second is the work environment and location, which is the people's consideration of the environment as well as the work comfort; the third is the specialty as well as the development prospects; the fourth is the employer's satisfaction with the graduates and so on [7]. High-quality employment is the re-enhancement of employment, which is the need to promote economic development, safeguard and improve people's livelihood, and is also a yardstick to measure the quality of university education. With the development of the economy, industry competition is becoming increasingly fierce, all walks of life need more and more specialized talents, only high-quality employment can meet today's social and economic development of the demand for talents [8]. The improvement of grassroots employment quality of graduates of clinical majors in higher vocational colleges and universities can be realized in the following three aspects. First, the drive of social synergy. *** To continue to increase the support of grassroots medical and health units, improve their economic and social environment, and improve their medical conditions; improve the treatment of medical students grassroots employment, special care in terms of remuneration, the implementation of various insurance *** housing provident fund, pension insurance, medical insurance, etc. *** system and according to the economic conditions of the region appropriately given subsidies; to encourage the large hospitals and grassroots medical units "Twinning", the establishment of cooperation *** building relationship, increase mutual exchanges and counterpart support efforts, to provide learning opportunities for medical graduates, regular job training, improve the level of business; title promotion priority consideration of personnel with grassroots work experience, etc.. Consider the development of grass-roots work-related systems, such as grass-roots service according to graduates to enjoy the corresponding preferential policies, grass-roots service for 3 to 5 years can be 80% reduction in tuition fees, more than 5 years of tuition fee reduction 100%, and according to the needs of the work of the hospital does not limit its development to the next level. Second, the role of the school to help promote. Widely publicize the national and local *** various policies and measures for college students to serve the grassroots, establish an excellent image of grassroots employment of medical students, publicize the advanced models of medical students who have grown up and become successful at the grassroots level, so that the medical students can learn more about the implementation of preferential policies for employment at the grassroots level, grass-roots employment of personal interests and protection, grass-roots employment of the advantages conducive to the development of the individual, and so on, to create the grass-roots employment cultural atmosphere, and to help medical students to Correctly understand the current employment situation, adjust the employment orientation, so that graduates voluntarily, actively and positively strive to go to grass-roots employment; market demand-oriented school development planning, determine the direction of personnel training, targeted courses to adapt to the grass-roots jobs, according to the grass-roots health care units to start a specialty direction *** such as anesthesia, midwifery, rehabilitation *** clinical medicine class, training "marketable" talents; and primary medical units jointly run "grass-roots employment orientation class", by ***, medical units to provide tuition and subsidized living expenses, which not only help poor students to solve the problem of difficult to study, but also for the employment of poor medical students and primary medical units to absorb talent to open up a new way of life. This not only helps poor students to solve the problem of difficult schooling, but also opens up a new channel for the employment of poor medical students and the absorption of talents by grassroots medical units. Organize and carry out social practice activities, arrange clinical medical students to go to the governing unit for apprenticeship, top internship, build a platform for communication between the two sides, so that medical students can feel the grass-roots working environment, strengthen the medical students' understanding of grass-roots work, and shorten the period of adaptation to grass-roots employment; strengthen the grass-roots employment guidance, pay attention to career planning guidance, and help medical students to correctly understand the needs of the labor market, grasp their own conditions, and do not think of themselves as high-level professionals, and reduce the number of students who need to be employed. The establishment of a long-term mechanism for tracking and investigating graduates employed at the grass-roots level, and the provision of assistance to help stabilize their careers according to their needs, such as free pre-service training and training for the ****Assistant ****Practitioner Qualification Examination. Third, family support and personal strength enhancement.
Currently, the state of the grass-roots employment of college students have a clear orientation and corresponding preferential policies, graduates of the family and individuals to recognize the current employment situation, grasp and effectively utilize these policies, with the vision of sustainable development of the grass-roots level of employment, not only respect for the objective reality of the community should also take into account their own circumstances, in the current stage of the employment situation is not optimistic to be in the right position, do not miss the opportunity to seize the At the present stage when the employment situation is not optimistic, they should correct their position, seize the opportunity to get employment, actively participate in the grassroots service program, and take the initiative to choose grassroots employment. In particular, clinical medical students have a narrower employment surface, on the one hand, in ordinary times, pay more attention to professional skills and non-professional skills learning and exercise, improve the knowledge structure, improve their overall strength to broaden employment channels; on the other hand, strengthen the self-adjustment of the psychology, in the process of choosing a career, employment, rational positioning, in the employment army to find their own seating point, to grasp the initiative of employment, based on grass-roots level, to maintain career stability and enhance personal capabilities, improve employment opportunities. stabilization and enhancement of personal ability to improve the quality of employment. In terms of career choice and employment, at present, college graduates generally have the phenomenon of pursuing high salary and comfort, which leads to the obvious polarization of the excess and lack of talents in urban hospitals and grassroots medical and health care units, and the competition among graduates is extremely fierce, especially among the students of higher vocational colleges and schools of medicine, if the students still take the concept of "elites" to choose their career and employment, they will be out of touch with the society and the society. If students, especially those in higher vocational college of medicine, still take the concept of "elite" to choose their career and employment, they are out of touch with the needs of the society and the real needs. Therefore, medical graduates should adjust the employment concept and expectations, reasonably reduce the level of employment, personal ideals and the country, the nation, the development of the times are closely integrated in the dedication to realize self-worth. Practice has proved that the grassroots is a fertile ground for medical students to exercise growth and healthy growth, the more difficult the conditions, the more able to cultivate talent, exercise talent, create talent [9].
References:
[1] Chen Mingxiong, Guo Jinxia, Zou Zizheng, et al. Research on the characteristics and positioning of medical higher specialized schools [J]. Health Vocational Education, 2014, 32***3***: 5-6.
[2]Li Bohe, Wang Fengzhi, Gao Suping. Orientation effect of "1+2m" talent cultivation model on grassroots employment of clinical medicine graduates[J]. China Science and Education Innovation Guide, 2012***29***: 118, 120.
[3]Zhou Jing, Liu Lezhou. Current situation analysis and countermeasure research on college students' grassroots employment awareness[J]. Science and Education Guide, 2015***1***:20-21.
[4]Pan Riming, Zeng Xiaofeng. Analysis of Reasons and Countermeasures Research on Employment Difficulties of College Students at the Grassroots Level[J]. Contemporary Education Forum, 2007***10***: 78-80.
[5]Yang Qiong. Research on Medical School Graduates' Service to Grassroots and Its Countermeasures [D]. Changsha: Hunan University, 2014.
[6]Zhang Tianlian. Grass-roots employment is promising--an analysis of the inevitability of grass-roots employment of medical graduates[J]. Journal of Mudanjiang Medical College, 2011, 32***4***: 94-95.
[7]Zheng Xiaofei. A preliminary study of methods to improve the employment quality of college students in higher education[J]. Journal of Shanxi Normal University: Social Science Edition, 2014***41***: 202-203.
[8]Dang Zhiping. Research on grassroots employment quality improvement mode of college graduates in the context of high-quality employment[J]. Modern Education Science, 2014***6***: 155-158.
[9]Cao Wei. Construction of grassroots employment work system for medical students[J]. Northwest Medical Education, 2009, 17***4***: 790-792.