The design of an estimation norm to assess nurses required for educational and non-educational hospitals using workload indicators of staffing need in Iran.

BACKGROUND: One of the effective strategies in the fair distribution of human resources is the use of estimation norm of human workforce. A norm is a coefficient or an indicator for estimating the required human resources in an organization. Due to the changes in the available working hours of nurses in recent years and to use of a standard method, the Iranian Ministry of Health decided to update nursing estimation norm in hospitals in 2014-2015. This study aimed to design a nurse-required estimation norm for educational and non-educational hospitals based on the workload indicator in Iran. METHODS: This was a descriptive cross-sectional study, carried out from December 2015 to November 2016 in 49 wards in 12 educational and 17 non-educational hospitals in Mashhad, Iran. The wards and hospitals who had the best performance in nursing care quality indicators were selected. Focus group, work study, consensus, interview, and reviewing documents, staff and patient records, and the calculations of modified Workload Indicators of Staffing Needs (WISN) were used to collect the data. RESULTS: Patient care, cardiopulmonary resuscitation, and transfer out of the hospital were identified as the main activities of holding focus groups. Interviews and reviewing documents led to the identification of 10 factors associated with nurses' available working time. In both educational and non-educational hospitals, the annual working time of all nurses except nurses working in the burn and psychiatric, burn ICU, and pediatric psychiatry wards, which was 1302 h per year, was 1411 h per year. The calculations of the modified WISN method showed that the lowest norm in educational hospitals was for psychiatric, eye surgery, and dermatology wards (0.53) and in non-educational hospitals was for ENT ward (0.57). The highest norm in educational and non-educational hospitals was for burn ICU (3.95) and general ICU (3.07) wards, respectively. CONCLUSION: The nursing estimation norm in different wards of the hospital varies, considering that the time available to nurses and their workload in different wards and hospitals are different, and each ward has its special norm therefore, a single norm for all wards and hospitals cannot be used for a fair distribution of nurses.

National study on the adequacy of antidotes stocking in Lebanese hospitals providing emergency care.

BACKGROUND: Antidotes stocking is a critical component of hospital care for poisoned patients in emergency. Antidote stocking represents a major health challenge worldwide and in Lebanon. Systematic data monitoring of antidote stocking in Lebanese hospitals is lacking. The objective of this study is to assess the adequacy of antidotes stocking in Lebanese hospitals according to type and quantity and explore the characteristics associated with their differential availability. METHODS: Data collection to assess antidote availability and its correlate was undertaken through a self-administered questionnaire. The questionnaires were distributed by the unit of surveillance at the Ministry of Public Health to eligible hospitals providing emergency care services. The list of essential antidotes was adapted from the World Health Organization (WHO) list and the British Columbia Drug and Poison Information Centre. RESULTS: Among the 85 Lebanese hospitals surveyed none had in stock all the 35 essential antidotes required. The frequency of stocking by type of antidote varied from a minimum of 1.2 % of the hospitals having a (cyanide kit) to 100 % availability of (atropine and calcium gluconate). Teaching hospitals and those with a large bed-capacity reported a higher number of available antidotes for both immediate and non-immediate use than non-teaching hospitals while controlling for the hospital geographical region and public vs private sector. CONCLUSION: The Lebanese hospitals have a suboptimal stock of essential antidotes supply. It is recommended that the Lebanese Ministry of Public Health monitors closely on the hospital premises the adequacy and availability of essential antidotes stock.

Descripción de casos de coinfección dengue y malaria, Hospital Escuela Universitario, Tegucigalpa, Honduras, 2010-2014 / Description of cases of dengue and malaria coinfection, Hospital Escuela Universitario, Tegucigalpa, Honduras, 2010 ­ 2014

Antecedentes: Honduras es país endémico de dengue y malaria. La coinfección se informa poco, con posible sub-registro. Se ha descrito una presentación clínica más severa que en las infecciones individuales. Objetivo: Identificar frecuencia y ca-racterizar los casos de coinfección dengue y malaria,Hospital Escuela Universitario (HEU), 2010-2014. Métodos: Estudio descriptivo transversal.Identificación de casos mediantecomparación del registro de malaria, Servicio de Parasitología HEU, con base de datos dengue, Departamento Vigilancia de la Salud HEU y Laboratorio Nacional Virología, Secretaría de Salud. Se revisaron expedientes clínicos. Caso: sujeto con diagnósticos de dengue y malaria, confirmados por laboratorio; caso sospechoso: sujeto con malaria con-firmada y certificado como dengue por Comisión de Certificación sin confirmación por laboratorio. Resultados: Se registraron 6,164 casos de dengue, 216 de malaria y 27 sospechosos de coinfección. Tres casos confirmados como coinfección (7.5% de casos malaria y 2.5% de dengue, año 2012): mujeres): mujeres, edad promedio 21 años (rango 14-34), procedencia Francisco Morazán, Olancho y Comayagua; todos Plasmodium vivax, un caso malaria complicada; todos dengue no grave y manejados como grupo B. No fueron confirmados 24 casos sospechosos, 47.8% (11/27) no estaba en base de datos de Laboratorio de Virología, 17.3% (4/23) sin resultado de laboratorio, 21.7% (5/27) tenía resultado IgM Negativo (4 con muestra inadecuada). Discusión: Se confirmó coinfección dengue y malaria en tres pacientes en 2012. Se documentó fallas en registro de la información dificultando un análisis adecuado. La vigilancia de la coinfección puede ser más eficiente a partir de casos confirmados de malaria...(AU)

Building medical education and research capacity in areas of conflict and instability: experiences of the OxPal Medlink in the occupied Palestinian territories.

Medical education and research capacity are often neglected in areas of conflict and instability. Physical and geographical barriers to accessing clinical learning environments, lack of dedicated teaching hospitals and frequent economic sanctions may all stunt the growth of a robust teaching culture in such regions. Here, we focus on the unique geopolitical situation of the occupied Palestinian territories and present our experiences with the OxPal MedLink, a web-based distance-learning collaboration which aims to address the educational needs of Palestinian medical students.

Fetal intervention: providing reasonable access to quality care.

Interest in fetal intervention has become widespread in recent years. Laser therapy for the treatment of severe twin-twin transfusion alone has been the subject of more than 100 peer-reviewed articles in the past 3 years. Significant issues have arisen that affect the availability of these new therapies in the United States. Formal training fellowships have yet to be established. Questions as to the ultimate number of treatment centers that are required to provide reasonable access should be addressed. The establishment of research networks to evaluate new fetal therapies through randomized clinical trials would appear paramount to the advancement of the field.

Endoscopía digestiva: tendencias actuales y futuras, realidad en nuestro hospital / Digestive endoscopy: recent and future trends, reality of our hospital

El desarrollo técnico permitió la realización de una gran variedad de nuevos procedimientos endoscópicos. En este trabajo, se describen brevemente los nuevos métodos implementados en el Laboratorio de Endoscopía Digestiva de Servicio de Gastroenterología de nuestro hospital, desde la adquisición de los primeros videoendoscopios en 1994 hasta junio de 1999. En este período se observó un aumento de 30 por ciento en el número anual de los procedimientos endoscópicos con una proporción creciente de procedimientos terapéuticos, aparecieron 20 nuevas técnicas y se formó una nueva generación de endoscopistas. El progreso permitió que nuestro centro se colocó entre los más grandes y más completos del país. Sin embargo, mientras tanto se desarrollaron los métodos de la endoscopía virtual que probablemente reemplazarán la mayor parte de los procedimientos diagnósticos endoscópicos. Endoscopistas, cirujanos y radiólogos deben prepararse en conjunto para enfrentar el gran desafío: el cambio cualitativo y cuantitativo en el trabajo cotidiano, en consecuencia de la endoscopía virtual. En el próximo futuro

Policies to influence the spatial distribution of physicians: a conceptual review of selected programs and empirical evidence.

To increase the usefulness of existing physician location literature for policy evaluation, literature is grouped into intraurban and urban-rural studies. A conceptual overview of physician location literature is presented. Consensus results, if any, are discussed. A list of hypotheses suggested by the literature is then utilized in a discussion of economic social, prior exposure, and professional development incentives embodied in selected public and private sector programs. Programs are evaluated by type of incentive mechanism and geographic target area to determine if present program structures are based on a solid empirical foundation. This assessment indicates that, in general, use of prevalent location incentive mechanisms is not justified by a consensus of empirical evidence.