RESUMO
BACKGROUND: Some residency programs responded to duty hour restrictions by implementing night rotations. Night supervision models can vary, resulting in potential patient safety issues and educational voids for residents. OBJECTIVE: We evaluated the impact of multiple evidence-based interventions on resident satisfaction with supervision, perception of the education value of night rotations, and residents' use of online educational materials. METHODS: The night team was augmented with an intern to assist with admissions and a senior resident (the "nighthawk") to supervise inpatient care and deliver a night medicine curriculum. We instituted a "must-call" list, with specific clinical events requiring mandatory attending notification, and reduced conflict in the role of the night float team. We studied patient contact, online curriculum use, residents' perceptions of nighthawk involvement, exposure to educational materials, and satisfaction with supervision. RESULTS: During the first half of academic year 2016-2017, 51% (64 of 126) of trainees were on the night medicine rotation. The nighthawk reviewed 1007 intern plans (15 per night; range, 6-36) and supervised 215 hands-on evaluations, including codes and rapid responses (3 per night; range, 0-12). The number of users of the online education materials increased by 85% (13 to 24), and instances of use increased 35% (85 to 115). The majority of residents (79%, 27 of 34) favored the new system. CONCLUSIONS: A nighthawk rotation, a must-call list, and reducing conflict in night team members' roles improved resident satisfaction with supervision and the night medicine rotation, resulting in increased communication.
Assuntos
Atitude do Pessoal de Saúde , Educação de Pós-Graduação em Medicina/organização & administração , Internato e Residência , Satisfação no Emprego , Assistência Noturna/organização & administração , Segurança do Paciente , Admissão e Escalonamento de Pessoal/organização & administração , Tolerância ao Trabalho Programado , Instrução por Computador , Currículo , Humanos , Equipe de Assistência ao Paciente/organização & administraçãoRESUMO
La enfermedad hemorroidal es un padecimiento frecuente (más del 50 por ciento) en la consulta general y la del especialista. Su prevalencia es mayor en las mujeres (2:1), tendencia que se acentuó sobre todo en los últimos años. Las causas que la desencadenan son aún desconocidas. Para tratarla se requiere un método seguro, eficaz, económico y con un índice bajo en complicaciones; debe elegirse el más apropiado para cada paciente, tomar en cuenta la estancia hospitalaria, la comodidad del tratamiento, el beneficio a bajo costo y la eficacia del método utilizado. En el Hospital Central Militar se practica el método de ligadura de banda de hule, opción terapéutica eficaz que permite efectuarse de manera ambulatoria, circunstancia que la hace más económica y accesible