RESUMO
AIM OF THE STUDY: The aim of this study was to gain insight into the reporting of errors as perceived by nurses employed in inpatient health-care facilities. METHOD: A representative written survey of nurses working in German nursing homes and hospitals was conducted. RESULTS: The 1100 respondents reported an average of 1.9 errors in the last half year, with nurses working in nursing homes reporting more errors than hospital-employed ones. They estimated that 20.5% of all errors are reported. One third of the participants did not know what events should be reported; more than 20% feared repercussions and mentioned a lack of feedback on error reports. RESULTS are not statistically associated to the presence or absence of an error reporting system, but there are hints for organisational advantages and workload-related disadvantages of systematic forms of reporting. Reporting behaviour was also related to the perception of factors concerning the organisation of the actual reporting of errors. CONCLUSION: Defining reportable error events, organisational barriers to report errors and deficits in the dealing with errors and error reports have to be tackled to augment error reporting rates and profit from reporting systems.
Assuntos
Atitude do Pessoal de Saúde , Hospitais/estatística & dados numéricos , Notificação de Abuso , Erros Médicos/estatística & dados numéricos , Enfermeiras e Enfermeiros/estatística & dados numéricos , Casas de Saúde/estatística & dados numéricos , Gestão de Riscos/estatística & dados numéricos , Alemanha/epidemiologia , Pesquisas sobre Atenção à SaúdeRESUMO
Internationally, research on the consequences of errors caused by nurses is quite comprehensive. In contrast, the body of knowledge on the effects that errors have on the nurses themselves is rather small. It is well known that errors can have profoundly negative outcomes on nurses. In some cases, however, errors can have useful ramifications. This paper shows the research results of a representative cross-sectional survey that covers 1,100 nurses working in German hospitals and nursing homes and illustrates the effects of errors on them. Most participants in the sample mentioned feelings of regret/remorse and irritation/annoyance/stress as an effect when they made a mistake. More than half of the nurses state that they also learnt from their errors. Hospital nurses frequently suffer from psychological effects while nursing home nurses experience more often professional or legal consequences. With increasing age and professional experience the nurses indicate a lower error impact. The answers given by nurse assistants differ from those of nurses with a three-year training course. The results suggest an amount of stress that may reduce efficiency and increase susceptibility to mistakes and which, therefore, needs to be remedied.
Assuntos
Instituição de Longa Permanência para Idosos , Erros Médicos/enfermagem , Casas de Saúde , Recursos Humanos de Enfermagem Hospitalar/psicologia , Recursos Humanos de Enfermagem/psicologia , Adaptação Psicológica , Adulto , Atitude do Pessoal de Saúde , Competência Clínica , Estudos Transversais , Coleta de Dados , Ética em Enfermagem , Feminino , Alemanha , Culpa , Instituição de Longa Permanência para Idosos/ética , Humanos , Masculino , Erros Médicos/ética , Pessoa de Meia-Idade , Relações Enfermeiro-Paciente/ética , Assistentes de Enfermagem/ética , Assistentes de Enfermagem/psicologia , Casas de Saúde/ética , Recursos Humanos de Enfermagem/ética , Recursos Humanos de Enfermagem Hospitalar/ética , Vergonha , Inquéritos e Questionários , Adulto JovemAssuntos
Demência/etnologia , Demência/terapia , Emigrantes e Imigrantes/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Demência/psicologia , Feminino , Alemanha/etnologia , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação das Necessidades , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Inquéritos e Questionários , Turquia/etnologiaRESUMO
Elderly migrants are a rapidly growing group in Germany. Well-grounded health and nursing care reports which deal with the situation of migrants are therefore necessary to secure an appropriate local and national planning of care for elderly migrants. Also quality control and development need substantiated data in order to ensure proper nursing care services for this segment of the population. This contribution explores whether and to what extent data sources provide information about access, quality and use of care services by migrants. The result: the major data sources for regional and national care planning and quality control render no specific information about migrants. This is problematic since several studies indicate severe deficits in nursing care services for this group.
Assuntos
Bases de Dados Factuais , Atenção à Saúde/estatística & dados numéricos , Serviços de Saúde para Idosos/estatística & dados numéricos , Casas de Saúde/estatística & dados numéricos , Garantia da Qualidade dos Cuidados de Saúde/estatística & dados numéricos , Projetos de Pesquisa/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Feminino , Alemanha , Humanos , Masculino , Garantia da Qualidade dos Cuidados de Saúde/métodosRESUMO
The manifestations of Crohn's disease in the stomach can be demonstrated by a doublecontrast technique. Recognition of detailed mucosal changes, together with certain other typical findings, makes a diagnosis possible, as has been demonstrated by one case.
Assuntos
Doença de Crohn/diagnóstico por imagem , Gastrite/diagnóstico por imagem , Adulto , Doença de Crohn/complicações , Gastrite/etiologia , Humanos , Masculino , Métodos , RadiografiaRESUMO
The starting point of this analysis is the concept of "The stranger", as discussed in "transcultural nursing" in the USA and currently researched by cultural anthropologist. The aim is to designate common areas of interest between nursing sciences and cultural anthropology and between ethnological and nursing practice. It is pointed out that more space is needed in nursing theory and practice, for the discussion of the concept of "stranger" and that this should not be confined to the "exotic ethnic" stranger.
Assuntos
Teoria de Enfermagem , Enfermagem Transcultural , Antropologia Cultural , Etnologia , Humanos , Pesquisa em EnfermagemRESUMO
This article concerns the discourse on intercultural nursing which can stimulate the further development of nursing theories and practices. In introduction, the article outlines the core of the discourse and some formal aspects. Subsequently, the overlapping discourses concerning the situation of migrant people in the social sciences and in society are discussed and the conclusion is prompted that the discourse needs to become part of general nursing theories to avoid a "culturalization" of ist subject.
Assuntos
Diversidade Cultural , Modelos de Enfermagem , Pesquisa em Enfermagem/organização & administração , Teoria de Enfermagem , Enfermagem Transcultural/organização & administração , Aculturação , Emigração e Imigração , Humanos , Avaliação das Necessidades/organização & administração , Refugiados , Ciências Sociais , MigrantesRESUMO
UNLABELLED: Ovarian cancer (OC) is a disease with poor prognosis, and molecular markers are needed to improve understanding of disease progression and resultant treatment. Only limited data concerning the expression of maspin, a serine protease inhibitor, in ovarian cancer (OC) are available. This study investigates the prognostic value of maspin expression (ME) in various OC cell lines and clinical tissue specimens from OC patients. PATIENTS AND METHODS: Tumour purified mouse anti-human maspin monoclonal antibody was applied to tissue specimens from 87 OC patients. ME was recorded by an immunoreactive score, which was correlated with grading, stage, histopathological subtypes and overall survival. Additionally ME was evaluated in established ovarian cancer cell lines (HEY, SKOV3, OVCAR3/8) and paclitaxel- and docetaxel-resistant HEY cells by QRT-PCR. RESULTS: There was significant correlation between cytoplasmatic ME and overall survival (p<0.05). OC patients with high levels of ME had a median survival of 28 vs. 57 months for those with low levels. Significant differential ME was detected between benign, borderline ovarian lesions and OC, as well as among different tumour gradings. Normal ovarian epithelial cells expressed less maspin than ovarian cancer cells as measured by QRT-PCR. Docetaxel- and paclitaxel-resistant ovarian cell lines showed an even higher level of ME, suggesting an unfavourable role of ME in OC cell lines. CONCLUSION: Maspin is expressed differentially in OC, and low expression levels of maspin are correlated with a longer survival.
Assuntos
Adenocarcinoma/metabolismo , Neoplasias Ovarianas/metabolismo , Serina Proteases/metabolismo , Inibidores de Serina Proteinase/biossíntese , Serpinas/biossíntese , Adenocarcinoma/enzimologia , Adenocarcinoma/patologia , Linhagem Celular Tumoral , Núcleo Celular/metabolismo , Citoplasma/metabolismo , Feminino , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Ovarianas/enzimologia , Neoplasias Ovarianas/patologia , Inibidores de Serina Proteinase/metabolismo , Serpinas/metabolismoAssuntos
Dor/enfermagem , Enfermagem Transcultural , Comparação Transcultural , Humanos , Dor/etnologiaRESUMO
Despite the many potential sources of stress and strain that accompany a migration situation, there are very few data in official statistics with regard to the health and social situation of migrants in Germany. The fact that this information is not available for public health reporting could lead to problems of improper, lacking or excessive health care. A working group within the Arbeitskreis Migration und Offentliche Gesundheit has been addressing this problem since 2003. In this article, a systematic overview of the most important data sources for public health reporting and of the indicators for migration background and social status that each one contains will be given. After that we will present examples of good practice in migration-sensitive data collection at the local and national level. Finally suggestions for improving the data situation with regard to the health of migrants based on the recommendation for recording the migration status in epidemiological studies will be made.
Assuntos
Coleta de Dados/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos , Indicadores Básicos de Saúde , Vigilância da População/métodos , Adolescente , Adulto , Criança , Segurança Computacional/legislação & jurisprudência , Alemanha , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , HumanosRESUMO
The Northern Germany Nursing Research Network (Pflegeforschungsverbund Nord) has dedicated itself to developing management instruments intended to optimize the nursing process. It is coordinated by the administrative office of the Institute of Public Health and Nursing Research (Institut für Public Health und Pflegeforschung IPP, director: Prof. Dr. Stefan Görres), Department of "Interdisziplinäre Alterns- und Pflegeforschung", University of Bremen. Four partial projects are currently being worked on in two groups: Group A--"Deficient areas of nursing action": The projects belonging to this group are "Individual care-patterns of elderly people and their determinants" (University of Bremen) and "Mobility Restrictions in Nursing Homes-Multicentre Observational Study (MORIN)" (University of Hamburg). The purpose of these studies is to examine the relevance of quantitatively significant risk combinations from a nursing science perspective. Group B--"The generation and testing of nursing action management instruments": The projects in this area are "Nursing rounds as instruments of quality assurance in home-based care" (University of Applied Sciences, Bremen) and "Predicting the risk of falls, efficiency of standard scales in opposition to nursing assessment-Cluster-Randomised Controlled Trial (PROFESSION)" (University of Hamburg). These studies concentrate in a unique manner on the generation and testing of management/control instruments suitable for application to nursing action.
Assuntos
Pesquisa em Enfermagem Clínica/organização & administração , Enfermagem Geriátrica/organização & administração , Cuidados de Enfermagem/organização & administração , Garantia da Qualidade dos Cuidados de Saúde/organização & administração , Sociedades de Enfermagem , Atividades Cotidianas/classificação , Idoso , Avaliação da Deficiência , Alemanha , Humanos , Avaliação em EnfermagemRESUMO
25 cases of primary cutaneous amyloidosis are studied. 16 patients had macular amyloidosis (MPA) and 9 lichen amyloidosus (LPA). gamma-Globulins were increased in 50% of the patients. IgG and IgA were increased in the serum of 5 and 3 patients with MPA and 4 and 2 patients with LPA, respectively. Volume of amyloid deposits was similar in both forms. By direct immunofluorescence we demonstrated IgG in the amyloid deposits of 21 of the 25 cases and C3 in 13; IgM was present in 9 cases of MPA and in 3 cases of LPA. MPA was more frequent than LPA; histologically, it was impossible to distinguish MPA from LPA; correlation between serum levels of gamma-globulins and their presence in amyloid deposits was weak; MPA and LPA seem to be distinct clinical manifestations of the same disease and itching does not cause transformation of MPA in LPA.
Assuntos
Amiloidose/imunologia , Dermatopatias/imunologia , Amiloidose/patologia , Complemento C3/metabolismo , Feminino , Fibrina/metabolismo , Fibrinogênio/metabolismo , Imunofluorescência , Humanos , Imunoglobulina A/metabolismo , Imunoglobulina E/metabolismo , Imunoglobulina G/metabolismo , Imunoglobulina M/metabolismo , Masculino , Pessoa de Meia-Idade , Dermatopatias/patologiaRESUMO
A comparative study of two groups of patients with paracoccidioidomycosis was carried out with the objective of comparing the evolutionary serologic, clinical and radiologic results after 6, 12, 15 and 18 months of treatment with ketoconazole (22 patients) or amphotericin B plus sulfonamides (32 patients). The serologic data analyzed as a whole showed a tendency to sharper drops in antibody titers in the patients treated with ketoconazole. Clinically patients treated with ketoconazole fared better but the differences were not statistically significant. No statistical difference was detected between groups in terms of the results of radiologic evolution.