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1.
Assist Inferm Ric ; 27(2): 69-76, 2008.
Artigo em Italiano | MEDLINE | ID: mdl-18630490

RESUMO

AIM: The triage forms filled in 2006 by nursing personnel dedicated to the triage in an Emergency Department were analysed. METHODS: The 37.323 triage forms were scrutinized to identify any discrepancies in severity codes assigned by the nurse and by the medical doctor, after the clinical and instrumental assessment. RESULTS: Four-hundred-forty discrepancies were identified (13% of those initially classified as discrepancies): 221 (50.2%) severity codes were overestimated and 219 underestimated. The percentage of discrepancies increased during night hours and at the morning shift change. Nurses who performed the triage less often, made an higher number of over or underestimates. Overall, the number of discrepancies was 0.5 per shift. CONCLUSIONS: The overall performance can be considered very good. A model for analysis of discrepancies can be proposed. A number of proposals have been advanced to further improve the nurses performance.


Assuntos
Serviço Hospitalar de Emergência , Controle de Formulários e Registros , Triagem/normas
2.
SAGE Open Med ; 4: 2050312116660115, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27504183

RESUMO

OBJECTIVE: Assessment of the knowledge and application as well as perceived utility by doctors of clinical governance tools in order to explore their impact on clinical units' performance measured through mortality rates and efficiency indicators. METHODS: This research is a cross-sectional study with a deterministic record-linkage procedure. The sample includes n = 1250 doctors (n = 249 chiefs of clinical units; n = 1001 physicians) working in six public hospitals located in the Emilia-Romagna Region in Italy. Survey instruments include a checklist and a research-made questionnaire which were used for data collection about doctors' knowledge and application as well as perceived utility of clinical governance tools. The analysis was based on clinical units' performance indicators which include patients' mortality, extra-region active mobility rate, average hospital stay, bed occupancy, rotation and turnover rates, and the comparative performance index as efficiency indicators. RESULTS: The clinical governance tools are known and applied differently in all the considered clinical units. Significant differences emerged between roles and organizational levels at which the medical leadership is carried out. The levels of knowledge and application of clinical governance practices are correlated with the clinical units' efficiency indicators (bed occupancy rate, bed turnover interval, and extra-region mobility). These multiple linear regression analyses highlighted that the clinical governance knowledge and application is correlated with clinical units' mortality rates (odds ratio, -8.677; 95% confidence interval, -16.654, -0.700). CONCLUSION: The knowledge and application, as well as perceived utility by medical professionals of clinical governance tools, are associated with the mortality rates of their units and with some efficiency indicators. However, the medical frontline staff seems to not consider homogeneously useful the clinical governance tools application on its own clinical practice.

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