RESUMO
PURPOSE: Although "satisfaction" is not easy to define, excellence in health care is impossible without professional/patient satisfaction, so this paper aims to report on a pilot study designed in order to evaluate the degree of nursing staff satisfaction with the implementation of measures to improve quality of care. DESIGN/METHODOLOGY/APPROACH: The project consisted of several phases: writing protocols of care; training of nursing staff in their management; and a cross-sectional study to evaluate nursing staff satisfaction with them. The design of the survey consisted of a 16-item Likert scale, which had to be auto filled. A factorial analysis to simplify and validate the tools was used, using statistical analyses with SPSS software 8.0. PRACTICAL IMPLICATIONS: The results are applicable to young small oncological units with high degree of variability in patient care. The study showed that nursing staff satisfaction with new improvement measures taken improves safety and finally quality of care. FINDINGS: The study obtained four dimensions (D) explaining 100 percent of variance. Each dimension with several items: D1: "Nursing job quality" explaining 48.4 percent of variance; D2: "Satisfaction with the knowledge"; D3: "Nursing job feelings/perceptions"; D4: "Nursing communication with doctors/patients". It provided a direct point of view of each nurse, knowledge about problems encountered daily and demonstration of how a simple/convenient method is useful to engage the staff in decision-making-process and implementation of new strategies or to promote the integration of basic aspects of health management in daily clinical practice. ORIGINALITY/VALUE: This is the first study evaluating nursing staff satisfaction with new improvement measures taken in a small medical unit, aiming at quality of care benefits. Very promising results were obtained although the sample size was small.
Assuntos
Satisfação no Emprego , Recursos Humanos de Enfermagem Hospitalar/normas , Enfermagem Oncológica/normas , Garantia da Qualidade dos Cuidados de Saúde/métodos , Protocolos Antineoplásicos/normas , Estudos Transversais , Pesquisas sobre Atenção à Saúde , Humanos , Recursos Humanos de Enfermagem Hospitalar/educação , Recursos Humanos de Enfermagem Hospitalar/psicologia , Enfermagem Oncológica/educação , Enfermagem Oncológica/tendências , Projetos Piloto , Pesquisa Qualitativa , Garantia da Qualidade dos Cuidados de Saúde/normas , Padrão de CuidadoRESUMO
BACKGROUND AND OBJECTIVES: In the pandemic caused by SARS-CoV-2, identifying which risk factors are associated with the most serious forms of the disease is important. Blood group A has been presented in various studies as a poor prognostic factor. The objective of this study was to evaluate whether patients with blood group A were associated with more important comorbidities, measured by the Charlson Index, which may explain their worse clinical evolution. PATIENTS AND METHODS: A prospective and consecutive study examined 100 patients diagnosed with COVID-19 and admitted in March 2020. A multivariate linear regression model was used to evaluate the association of blood group A with the Charlson Index. RESULTS: Patients in group A had a higher Charlson Index (P=.037), rate of lymphopenia (P=.039) and thrombopenia (P=.014), and hospital mortality (P=.044). Blood group A was an independent factor associated with the Charlson Index (B 0.582, 95% CI 0.02-1.14, P=0.041). CONCLUSIONS: Group A was independently associated with greater comorbidity, associated with an increase of 0.582 points in the Charlson Index compared to other blood groups. It was also associated with lower hospital mortality.
Assuntos
Antígenos de Grupos Sanguíneos , COVID-19 , COVID-19/complicações , COVID-19/epidemiologia , Comorbidade , Mortalidade Hospitalar , Hospitais , Humanos , Estudos Prospectivos , SARS-CoV-2RESUMO
Background and objectives: In the pandemic caused by SARS-CoV-2, identifying which risk factors are associated with the most serious forms of the disease is important. Blood group A has been presented in various studies as a poor prognostic factor. The objective of this study was to evaluate whether patients with blood group A were associated with more important comorbidities, measured by the Charlson Index, which may explain their worse clinical evolution. Patients and methods: A prospective and consecutive study examined 100 patients diagnosed with COVID-19 and admitted in March 2020. A multivariate linear regression model was used to evaluate the association of blood group A with the Charlson Index. Results: Patients in group A had a higher Charlson Index (Pâ¯=â¯.037), rate of lymphopenia (Pâ¯=â¯.039) and thrombopenia (Pâ¯=â¯.014), and hospital mortality (Pâ¯=â¯.044). Blood group A was an independent factor associated with the Charlson Index (B 0.582, 95% CI 0.02-1.14, Pâ¯=â¯.041). Conclusions: Group A was independently associated with greater comorbidity, associated with an increase of 0.582 points in the Charlson Index compared to other blood groups. It was also associated with lower hospital mortality.
Fundamento y objetivos: En la pandemia provocada por SARS-CoV-2, es importante identificar qué factores de riesgo se asocian a las formas más graves de la enfermedad. El grupo sanguíneo A se ha presentado en diversos estudios como factor de mal pronóstico. El objetivo de este estudio radica en evaluar si los pacientes de grupo sanguíneo O asocian comorbilidades más importantes, medido por el Índice de Charlson, que puedan justificar también su peor evolución clínica. Pacientes y método: Estudio prospectivo y consecutivo con 100 pacientes diagnosticados de COVID-19 ingresados en marzo de 2020. Se empleó un modelo de regresión lineal multivariante para evaluar la asociación del grupo sanguíneo A con el Índice de Charlson. Resultados: Los pacientes del grupo A presentaron mayor Índice de Charlson (Pâ¯=â¯.037), linfopenia (Pâ¯=â¯.039), trombopenia (Pâ¯=â¯.014) y mortalidad hospitalaria (Pâ¯=â¯.044).El grupo sanguíneo A demostró ser un factor independiente asociado a dicho índice [B 0.582, IC 95% (0.021.14), Pâ¯=â¯.041]. Conclusiones: El grupo A se asocia de forma independiente a mayor comorbilidad, asociando un incremento de 0.582 puntos en el índice de Charlson con respecto al resto de grupos sanguíneos. Además, asocia una tendencia de menor mortalidad hospitalaria.
RESUMO
Severe status of coronavirus disease 2019 (COVID-19) is extremely associated to cytokine release. Moreover, it has been suggested that blood group is also associated with the prevalence and severity of this disease. However, the relationship between the cytokine profile and blood group remains unclear in COVID-19 patients. In this sense, we prospectively recruited 108 COVID-19 patients between March and April 2020 and divided according to ABO blood group. For the analysis of 45 cytokines, plasma samples were collected in the time of admission to hospital ward or intensive care unit and at the sixth day after hospital admission. The results show that there was a risk of more than two times lower of mechanical ventilation or death in patients with blood group O (log rank: p = 0.042). At first time, all statistically significant cytokine levels, except from hepatocyte growth factor, were higher in O blood group patients meanwhile the second time showed a significant drop, between 20% and 40%. In contrast, A/B/AB group presented a maintenance of cytokine levels during time. Hepatocyte growth factor showed a significant association with intubation or mortality risk in non-O blood group patients (OR: 4.229, 95% CI (2.064-8.665), p < 0.001) and also was the only one bad prognosis biomarker in O blood group patients (OR: 8.852, 95% CI (1.540-50.878), p = 0.015). Therefore, higher cytokine levels in O blood group are associated with a better outcome than A/B/AB group in COVID-19 patients.
Assuntos
COVID-19/imunologia , Citocinas/sangue , SARS-CoV-2/fisiologia , Sistema ABO de Grupos Sanguíneos , Idoso , Biomarcadores , COVID-19/diagnóstico , COVID-19/mortalidade , Progressão da Doença , Feminino , Fator de Crescimento de Hepatócito/sangue , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Respiração Artificial , Índice de Gravidade de Doença , Análise de SobrevidaRESUMO
Fundamento y objetivosEn la pandemia provocada por SARS-CoV-2 es importante identificar qué factores de riesgo se asocian a las formas más graves de la enfermedad. El grupo sanguíneo A se ha presentado en diversos estudios como factor de mal pronóstico. El objetivo de este estudio radica en evaluar si los pacientes de grupo sanguíneo A asocian comorbilidades más importantes, medido por el Índice de Charlson, que puedan justificar también su peor evolución clínica.Pacientes y métodoEstudio prospectivo y consecutivo con 100 pacientes diagnosticados de COVID-19 ingresados en marzo de 2020. Se empleó un modelo de regresión lineal multivariante para evaluar la asociación del grupo sanguíneo A con el Índice de Charlson.ResultadosLos pacientes del grupo A presentaron mayor índice de Charlson (p=0,037), linfopenia (p=0,039), trombocitopenia (p=0,014) y mortalidad hospitalaria (p=0,044).El grupo sanguíneo A demostró ser un factor independiente asociado a dicho índice (B 0,582; IC 95% [0,02-1,14], p=0,041).ConclusionesEl grupo A se asocia de forma independiente a mayor comorbilidad, asociando un incremento de 0,582 puntos en el índice de Charlson con respecto al resto de grupos sanguíneos. Además, asocia una tendencia de menor mortalidad hospitalaria. (AU)
Background and objectivesIn the pandemic caused by SARS-CoV-2, identifying which risk factors are associated with the most serious forms of the disease is important. Blood group A has been presented in various studies as a poor prognostic factor. The objective of this study was to evaluate whether patients with blood group A were associated with more important comorbidities, measured by the Charlson Index, which may explain their worse clinical evolution.Patients and methodsA prospective and consecutive study examined 100 patients diagnosed with COVID-19 and admitted in March 2020. A multivariate linear regression model was used to evaluate the association of blood group A with the Charlson Index.ResultsPatients in group A had a higher Charlson Index (P=.037), rate of lymphopenia (P=.039) and thrombopenia (P=.014), and hospital mortality (P=.044). Blood group A was an independent factor associated with the Charlson Index (B 0.582, 95% CI 0.02-1.14, P=0.041).ConclusionsGroup A was independently associated with greater comorbidity, associated with an increase of 0.582 points in the Charlson Index compared to other blood groups. It was also associated with lower hospital mortality. (AU)