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1.
Am J Phys Med Rehabil ; 100(5): 432-434, 2021 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33819923

RESUMEN

ABSTRACT: Spinal cord injuries lead to impairment of the central regulation of respiratory muscle activity. This impairs the cough response, which can increase the risk of complications if infected with coronavirus disease 2019. This case describes a 32-yr-old man with an acute traumatic motor incomplete spinal cord injury, C4 American Spinal cord Injury Association Impairment Scale D D, in an inpatient rehabilitation facility who presented with only a fever. Initial infectious workup was negative, and he continued to have elevated temperatures with no other symptoms. He was then tested for coronavirus disease 2019 and found to be positive. This is the first documented case that identifies this potentially lethal disease in an acute motor incomplete spinal cord injury in an inpatient rehabilitation setting. We further discuss how physiatrists need to be aware of milder presentation of coronavirus disease 2019 in patients with spinal cord injuries. Inability to recognize this disease can lead to delayed diagnosis and asymptomatic spread in an inpatient rehabilitation setting.


Asunto(s)
/complicaciones , Control de Infecciones/organización & administración , Traumatismos de la Médula Espinal/rehabilitación , Adulto , Vértebras Cervicales , Hospitalización , Humanos , Masculino , Traumatismos de la Médula Espinal/complicaciones
2.
Rural Remote Health ; 21(2): 6256, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33822637

RESUMEN

CONTEXT: The COVID-19 outbreak at the North West Regional Hospital (NWRH) site in Tasmania, Australia in April 2020 was both rapid and tragic. Within 10 days of identification of the first healthcare worker infection, both hospitals had closed, and all patients were discharged or decanted to other facilities within the state. The entire hospital staff (approximately 1300 people) and their households (approximately 3000-4000 people) were furloughed for 14 days to halt the spread of infection. During the furlough period, a decommissioning, terminal clean and recommissioning process was undertaken alongside recovery and reorientation of the workforce to personal protective equipment. Within 4 days of closure, an Australian Defence Force and Australian Medical Assistance Team team opened the prioritised emergency department to provide emergency care for the local community, supported by modified diagnostic services. The decommissioning and cleaning rolled on over the ensuing month, in a predetermined priority order. As staff returned from quarantine, they recommissioned their clinical areas. The final ward, a modified medical isolation wing, reopened on day 29. ISSUE: Disaster management activities may be grouped under four main headings: prevention, preparedness, response and recovery. There are many opportunities for improvement and learning, and this article focuses on the local response and recovery, describing the process undertaken from the perspective of a small management group. Authors CC, HE, TB and MW were on the ground during the decommissioning process, then managed aspects of the cleaning and recommissioning remotely from furlough. Authors TA and TC provided specialist IPC support and developed education remotely. LESSONS LEARNED: Almost 2 months on, no new COVID-19 infections had been reported. The aim of this article is to provide a foundation for site-specific adaptation to include in pandemic escalation plans in other regional and rural settings.


Asunto(s)
/epidemiología , Personal de Salud/organización & administración , Hospitales/estadística & datos numéricos , Control de Infecciones/organización & administración , Pandemias , Cuarentena/métodos , Recursos Humanos/organización & administración , Humanos , Tasmania/epidemiología
3.
G Ital Nefrol ; 38(2)2021 Apr 14.
Artículo en Italiano | MEDLINE | ID: mdl-33852221

RESUMEN

The public emergency caused by Covid-19 has forced health services to reorganize in order to separate positive patients from negative ones. In nephrology, this reorganization involves several levels of assistance concerning hospitalizations, ambulatory care and haemodialysis. Within the Complex Unit of Nephrology in Ragusa, the distribution of nephro-dialytic resources has involved four different hospitals, hence ensuring haemodialysis services for asymptomatic and pauci-symptomatic Covid-19 patients as well as for patients in Covid-Unit, Sub-Intensive Therapy and Intensive Care Unit. In this complex context, we had to create a common protocol involving all the professionals who provide assistance in our Unit, across the different structures. We also report some encouraging data that seem to indicate the effectiveness of the protocols put in place.


Asunto(s)
/epidemiología , Nefrología/organización & administración , Pandemias , Asignación de Recursos/organización & administración , Atención Ambulatoria/organización & administración , Accesibilidad a los Servicios de Salud/organización & administración , Humanos , Control de Infecciones/métodos , Unidades de Cuidados Intensivos/organización & administración , Italia/epidemiología , Diálisis Renal
4.
Rev Lat Am Enfermagem ; 29: e3407, 2021.
Artículo en Inglés, Portugués, Español | MEDLINE | ID: mdl-33852679

RESUMEN

OBJECTIVE: to analyze, in the clinical practice of large hospitals, how the adoption of measures to prevent and control the spread of bacterial resistance has occurred, and to propose a score for the institutions' adherence. METHOD: a cross-sectional study carried out in 30 large hospitals of Minas Gerais, from February 2018 to April 2019, after approval by the Ethics and Research Committee. Interviews were conducted with hospital managers, with Hospital Infection Control Services coordinators, and with the care coordinators of the Inpatient Units and Intensive Care Center. In addition, observations were made of the adoption of preventive measures by the multidisciplinary team in the care units. RESULTS: in the 30 participating hospitals, 93.3% (N=28) had protocols for prophylactic antibiotics, and 86.7% (N=26) performed their audit, 86.7% (N=26) for therapeutic antibiotics and 83.3% (N=25) their audit; 93.3% (N=56) used gloves and cloaks for patients in contact precautions, and 78.3% (N=47) of the professionals were unaware of or answered incompletely on the five moments for hand hygiene. In the score to identify the adoption of measures to control bacterial resistance, 83.3% (N=25) of the hospitals were classified as partially compliant, 13.3% (N=04) as deficient, and 3.4% (N=01) as non-adoption. CONCLUSION: it was found that the recommended measures to contain bacterial resistance are not consolidated in the clinical practice of the hospitals.


Asunto(s)
Infección Hospitalaria , Higiene de las Manos , Infección Hospitalaria/prevención & control , Estudios Transversales , Adhesión a Directriz , Hospitales , Humanos , Control de Infecciones
5.
Anticancer Res ; 41(4): 1903-1908, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33813395

RESUMEN

BACKGROUND/AIM: We employed a survey to the American Society of Plastic Surgeons (ASPS) to investigate the management of breast reconstruction across the US during the COVID-19 pandemic. PATIENTS AND METHODS: An electronic survey on breast reconstruction practice demographics, COVID-19-related restrictions on breast reconstruction, and pertinent dates of restrictions was employed. RESULTS: A total of 228 responses were obtained. Demographics were balanced for geography with most respondents located in either urban or suburban settings (91.2%). The majority proceeded with mastectomy/reconstruction as originally planned (39.0%), followed by hormonal/chemotherapy only (22.6%). The most common reconstructive option was tissue expander/implant-based reconstruction (47.7%). Most institutions implemented restrictions between March 11-20th (59%). Almost all respondents (91.8%) reported mandatory pre-operative SARS-Cov-2 testing once cases resumed. CONCLUSION: COVID-19 has forced the breast surgical team to adapt to new conditions to the detriment of women with breast cancer requiring reconstruction. Varying restrictions have limited access to breast reconstruction, carrying consequences yet to be determined.


Asunto(s)
/epidemiología , Mamoplastia/estadística & datos numéricos , Mastectomía/estadística & datos numéricos , Pandemias , Pautas de la Práctica en Medicina/estadística & datos numéricos , Implantes de Mama/estadística & datos numéricos , Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/patología , Neoplasias de la Mama/cirugía , Estudios Transversales , Femenino , Humanos , Control de Infecciones/normas , Cuarentena , Cirujanos/estadística & datos numéricos , Encuestas y Cuestionarios , Dispositivos de Expansión Tisular/estadística & datos numéricos , Estados Unidos/epidemiología
6.
Ann Palliat Med ; 10(3): 3452-3458, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33849129

RESUMEN

The novel coronavirus disease 2019 (COVID-19) epidemic broke out in 2019, it is highly contagious, and the infection rate among medical staff is high. The management of infection prevention and control during emergency surgery of COVID-19 patients has been outlined and the perioperative infection management checklist for emergency surgery of COVID-19 patients has been summarized and validated. There have been 13 emergency surgeries performed on COVID-19 patients at our hospital during this time. Two cases were cured and discharged, and the others were discharged after improvement and transferred to further rehabilitation, 30-day mortality of the emergency surgical is 0%. Once the emergency surgery protocol in the hospital is successfully established, emergency surgery can be performed as soon as the surgical planning decision is made, and the operating room can be prepared for use at any time. The incidence of surgical site infection (SSI) was largely higher than that of ordinary patients in the same time; however, the successful implementation of emergency surgery for COVID-19 had positive significance in reducing the incidence of death, risk of bleeding, and hypoxia. The current cumulative cure rate of COVID-19 in our hospital is 98%, patient mortality rate is 0%, and the incidence of COVID-19 infection in medical staff is 0%. The emergency surgical infection management checklist is feasible and effective in guiding the preoperative and intraoperative surgical procedures.


Asunto(s)
Lista de Verificación , Servicio de Urgencia en Hospital , Control de Infecciones/normas , Procedimientos Quirúrgicos Operativos/normas , China , Humanos
8.
Artículo en Inglés | MEDLINE | ID: mdl-33800648

RESUMEN

The COVID-19 pandemic poses a significant threat to people's lives. Compliance with preventive behaviors, recommended by public health authorities, is essential for infection control. In the remission stage, one year after the initial COVID-19 outbreak in China, we advanced a moderated parallel mediation model of the link between risk perception and compliance with preventive behaviors as well as a serial mediation model of the link between optimism and compliance with preventive behaviors, explaining the roles of various psychosocial factors in these associations. In January 2021, 200 participants under 50 years of age, located in 80 Chinese cities, participated in an online survey assessing risk perception, compliance with preventive behaviors, fear, anxiety, political trust, government dependency, and dispositional optimism. The results showed that the effect of risk perception on compliance with preventive behaviors was mediated by political trust and fear, and was moderated by government dependency. Anxiety and fear serially mediated the effect of optimism on compliance with preventive behaviors. Our study provided implications for future research to reduce negative emotions, strengthen confidence in the government, and sustain moderate government dependency accompanied by individual self-efficacy.


Asunto(s)
Pandemias , China/epidemiología , Humanos , Control de Infecciones
9.
Artículo en Inglés | MEDLINE | ID: mdl-33806138

RESUMEN

Background: Standard precautions prevent the spread of infections in healthcare settings. Incompliance with infection control guidelines of healthcare workers (HCWs) may increase their risk of exposure to infectious disease, especially under pandemics. The purpose of this study was to assess the level of compliance with the infection prevention and control practices among HCWs in different healthcare settings and its relationship with their views on workplace infection control measures during the COVID-19 pandemic. Methods: Nurses in Hong Kong were invited to respond to a cross-sectional online survey, in which their views on workplace infection and prevention policy, compliance with standard precautions and self-reported health during pandemics were collected. Results: The respondents were dissatisfied with workplace infection and prevention policy in terms of comprehensiveness (62%), clarity (64%), timeliness (63%), and transparency (60%). For the protective behavior, the respondents did not fully comply with the standard precautions when they were involved in medical care. Their compliance was relatively low when having proper patient handling (54%) and performing invasive procedures (46%). A multivariate analysis model proved that the level of compliance of the standard precautions was positively associated with the satisfaction on infection control and prevention policy among high risk group (0.020; 95% CI: 0.005-0.036), while older respondents had higher level of compliance among the inpatient and outpatient groups (coefficient range: 0.065-0.076). The higher level of compliance was also significantly associated with working in designated team and having chronic condition of the respondents among high-risk and inpatient groups. Conclusions: Standard precautions are the most important elements to reduce cross-transmission among HCWs and patients while the satisfaction on infection control and prevention policy would increase the compliance among the high-risk group. An overall suboptimal compliance and poor views on the infection prevention and control guidelines is a warning signal to healthcare system especially during pandemics.


Asunto(s)
Pandemias , Estudios Transversales , Adhesión a Directriz , Personal de Salud , Hong Kong/epidemiología , Humanos , Control de Infecciones , Pandemias/prevención & control , Políticas , Estándares de Referencia
10.
Kyobu Geka ; 74(3): 228-231, 2021 Mar.
Artículo en Japonés | MEDLINE | ID: mdl-33831880

RESUMEN

An 81-year-old male was referred to our institute. His chief complaint was high fever. Computed tomography (CT) angiography demonstrated newly saccular aortic aneurysms at both thoracic and abdominal aorta. We used intravenous antibiotics( ceftriaxone 4 g/day) for seven days. Positron emission tomography (PET)/CT showed active inflammation sign at both chest and abdominal aneurysms. Open surgery for double aortic aneurysms seemed too invasive because of his past medical history. At eighth day after admission, we performed thoracic endovascular aortic repair( TEVAR) and endovascular aortic repair (EVAR) for preventing rupture of aortic aneurysms. After surgery, we continued intravenous antibiotics (ceftriaxone 4 g/day) for 15 days. We changed intravenous antibiotics to oral antibiotics( levofloxacin 500 mg/day). The postoperative course was uneventful. He was discharged at 19th day after surgery. Since surgery, no symptoms of reinfection have been observed at outpatient clinic. PET/CT was useful to evaluate the control of local infection in this case.


Asunto(s)
Aneurisma de la Aorta Torácica , Aneurisma de la Aorta , Implantación de Prótesis Vascular , Procedimientos Endovasculares , Anciano de 80 o más Años , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Aneurisma de la Aorta Torácica/cirugía , Prótesis Vascular , Humanos , Control de Infecciones , Masculino , Tomografía Computarizada por Tomografía de Emisión de Positrones , Estudios Retrospectivos , Resultado del Tratamiento
11.
Rev Cardiovasc Med ; 22(1): 83-95, 2021 03 30.
Artículo en Inglés | MEDLINE | ID: mdl-33792250

RESUMEN

The coronavirus disease-19 (COVID-19) pandemic has forced hospitals to prioritize COVID-19 patients, restrict resources, and cancel all non-urgent elective cardiac procedures. Clinical visits have only been facilitated for emergency purposes. Fewer patients have been admitted to the hospital for both ST-segment elevation myocardial infarctions (STEMI) and non-ST segment elevation myocardial infarctions (NSTEMI) and a profound decrease in heart failure services has been reported. A similar reduction in the patient presentation is seen for ischemic heart disease, decompensated heart failure, and endocarditis. Cardiovascular services, including catheterization, primary percutaneous coronary intervention (PPCI), cardiac investigations such as electrocardiograms (ECGs), exercise tolerance test (ETT), dobutamine stress test, computed tomography (CT) angiography, transesophageal echocardiography (TOE) have been reported to have declined and performed on a priority basis. The long-term implications of this decline have been discussed with major concerns of severe cardiac complications and vulnerabilities in cardiac patients. The pandemic has also had psychological impacts on patients causing them to avoid seeking medical help. This review discusses the effects of the COVID-19 pandemic on the provision of various cardiology services and aims to provide strategies to restore cardiovascular services including structural changes in the hospital to make up for the reduced staff personnel, the use of personal protective equipment in healthcare workers, and provides alternatives for high-risk cardiac imaging, cardiac interventions, and procedures. Implementation of the triage system, risk assessment scores, and telemedicine services in patients and their adaptation to the cardiovascular department have been discussed.


Asunto(s)
/epidemiología , Cardiología/organización & administración , Prestación de Atención de Salud/organización & administración , Control de Infecciones/organización & administración , /prevención & control , Procedimientos Quirúrgicos Cardiovasculares , Humanos , Telemedicina , Triaje
12.
Phys Rev Lett ; 126(11): 118301, 2021 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-33798363

RESUMEN

Although COVID-19 has caused severe suffering globally, the efficacy of nonpharmaceutical interventions has been greater than typical models have predicted. Meanwhile, evidence is mounting that the pandemic is characterized by superspreading. Capturing this phenomenon theoretically requires modeling at the scale of individuals. Using a mathematical model, we show that superspreading drastically enhances mitigations which reduce the overall personal contact number and that social clustering increases this effect.


Asunto(s)
/epidemiología , Modelos Estadísticos , Transmisión de Enfermedad Infecciosa/prevención & control , Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Humanos , Control de Infecciones/métodos , Control de Infecciones/estadística & datos numéricos , Pandemias , Red Social
13.
Medicine (Baltimore) ; 100(15): e25290, 2021 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-33847627

RESUMEN

ABSTRACT: Health care employees are the front liners whom are directly involved in the management of COVID-19 at high risk of developing psychological distress and other mental health illness. We aim to assess the burden of depression during this pandemic on health care employees treating COVID-19 in Saudi Arabia. We also will shed the light on the best solutions of how to encounter depression.A cross-sectional, hospital-based survey conducted via a region-stratified, 2-stage cluster sample was conducted for 554 participants in >15 hospitals from April 29, 2020, to June 30, 2020. Depression is measured using the established PHQ9 score system. We grade PHQ9 depression scores as: normal, 0 to 4, mild, 5 to 9, significant (moderate or severe), 10 to 27. χ2/Fisher exact test was used; significant association between level of depression and survey characteristics were made. P value <0.05 was considered statistically significant.A total of 554 participants completed the survey. A total of 18.9% (n = 105) were aged <29 years, 51.2% (n = 284) were between 30 to 39 years and female represent 70% of all participants. Of all participants, 53.7% (n = 298) were nurses, and 38.6% (n = 214) were physicians; 68.5% (n = 380) worked in central area hospitals in Saudi Arabia. No significant (P = .432, 95% confidence interval [CI]) association was observed between sex and depression classifications. However, female had high proportion of significant depression 75.0% (n = 76) was observed as compared to male 24.8% (n = 25). Depression was significant in Saudis 61.4% (n = 62) (P < .001, 95% CI) and medical staff who encountered corona patients 51.5% (n = 52) (P < .002, 95% CI). Hospital preparedness associated with more freedom of depression symptoms 69.1% (n = 199/288) (P < .001, 95% CI).Frontline young health care workers especially physician in Saudi Arabia reported a high rate of depression symptoms. Countermeasures for health care workers represent a key component for the mental and physical well-being as part of public health measures during this pandemic. Attention to hospital preparedness and adequacy of personal protective equipment contributed to milder depression symptoms. Further studies need to be conducted on crisis management and depression.


Asunto(s)
Ansiedad , Depresión , Personal de Salud , Control de Infecciones , Estrés Laboral , Adulto , Ansiedad/diagnóstico , Ansiedad/etiología , Ansiedad/prevención & control , /psicología , Estudios Transversales , Depresión/diagnóstico , Depresión/etiología , Depresión/prevención & control , Femenino , Personal de Salud/clasificación , Personal de Salud/psicología , Médicos Hospitalarios/psicología , Médicos Hospitalarios/estadística & datos numéricos , Humanos , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Control de Infecciones/normas , Masculino , Salud Mental/estadística & datos numéricos , Salud Laboral/normas , Estrés Laboral/prevención & control , Estrés Laboral/psicología , Equipo de Protección Personal/provisión & distribución , Arabia Saudita/epidemiología
14.
Medicine (Baltimore) ; 100(15): e25435, 2021 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-33847644

RESUMEN

BACKGROUND: While this reduced-visit prenatal care model during the COVID-19 pandemic is well-intentioned, there is still a lack of relevant evidence to prove its effectiveness. Therefore, in order to provide new evidence-based medical evidence for clinical treatment, we undertook a systematic review and meta-analysis to assess the efficacy of reduced-visit prenatal care model during the COVID-19 pandemic. METHODS: The online literature will be searched using the following combination of medical subject heading terms: "prenatal care" OR "prenatal nursing" AND "reduced-visit" OR "reduce visit" OR "virtual visit." MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science will be searched without any language restrictions. A standard data extraction form is used independently by 2 reviewers to retrieve the relevant data from the articles. The outcome measures are as following: pregnancy-related stress, satisfaction with care, quality of care. The present study will be performed by Review Manager Software (RevMan Version 5.3, The Cochrane Collaboration, Copenhagen, Denmark). P < .05 is set as the significance level. RESULTS: It is hypothesized that reduced-visit prenatal care model will provide similar outcomes compared with traditional care model. CONCLUSIONS: The results of our review will be reported strictly following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria and the review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/WYMB7.


Asunto(s)
Atención Ambulatoria , Práctica Clínica Basada en la Evidencia , Atención Prenatal/organización & administración , Atención Ambulatoria/métodos , Atención Ambulatoria/estadística & datos numéricos , /prevención & control , Práctica Clínica Basada en la Evidencia/métodos , Práctica Clínica Basada en la Evidencia/normas , Práctica Clínica Basada en la Evidencia/tendencias , Femenino , Humanos , Control de Infecciones/métodos , Metaanálisis como Asunto , Embarazo , Proyectos de Investigación , Revisiones Sistemáticas como Asunto
16.
Int J Med Sci ; 18(10): 2146-2154, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33859521

RESUMEN

Objectives: To report a COVID-19 outbreak among workers and inpatients at a medical ward for especially vulnerable patients. Methods: Descriptive study of a nosocomial COVID-19 outbreak registered in March-April 2020 at medical ward of onco-hematological patients in an Spanish hospital. Confirmed cases were hospitalized patients, healthcare and non-healthcare workers who tested positive by PCR on a nasopharyngeal swab. Results: Twenty-two COVID-19 cases (12 workers and 10 inpatients) were laboratory-confirmed. Initial cases were a healthcare provider and a visitor who tested positive. The median patients age was 73 years (range 62-88). The main reason of admission was haematological in 8 patients and oncologic in 2. All patients followed an immunosuppressive treatment, 5/10 with high-flow oxygen nebulizations. Five patients presented a moderate/serious evolution, and 5 patients died. The mean workers age was 42.1±10.9. One healthworker required Intensive Care Unit admission, and all of them recovered completely. Conclusions: In the hospital setting, close patients surveillance for SARS-CoV-2 is essential, especially in immunosuppressed patients. Replacing nebulizations or high-flow oxygen therapies, when other equivalent options were available, to reduce dispersion, and controlling ventilation ducts, together with hygiene measures and an active follow-up on inpatients, visitors and workers appear to be important in preventing nosocomial outbreaks.


Asunto(s)
/epidemiología , Infección Hospitalaria/epidemiología , Control de Infecciones/métodos , Adulto , Anciano , Anciano de 80 o más Años , Brotes de Enfermedades , Femenino , Personal de Salud , Enfermedades Hematológicas/terapia , Unidades Hospitalarias , Humanos , Huésped Inmunocomprometido , Pacientes Internos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Nebulizadores y Vaporizadores , España
17.
BMC Pregnancy Childbirth ; 21(1): 310, 2021 Apr 19.
Artículo en Inglés | MEDLINE | ID: mdl-33874913

RESUMEN

BACKGROUND: Induction of labour (IOL) is one of the most commonly performed interventions in maternity care, with outpatient cervical ripening increasingly offered as an option for women undergoing IOL. The COVID-19 pandemic has changed the context of practice and the option of returning home for cervical ripening may now assume greater significance. This work aimed to examine whether and how the COVID-19 pandemic has changed practice around IOL in the UK. METHOD: We used an online questionnaire to survey senior obstetricians and midwives at all 156 UK NHS Trusts and Boards that currently offer maternity services. Responses were analysed to produce descriptive statistics, with free text responses analysed using a conventional content analysis approach. FINDINGS: Responses were received from 92 of 156 UK Trusts and Boards, a 59% response rate. Many Trusts and Boards reported no change to their IOL practice, however 23% reported change in methods used for cervical ripening; 28% a change in criteria for home cervical ripening; 28% stated that more women were returning home during cervical ripening; and 24% noted changes to women's response to recommendations for IOL. Much of the change was reported as happening in response to attempts to minimise hospital attendance and restrictions on birth partners accompanying women. CONCLUSIONS: The pandemic has changed practice around induction of labour, although this varied significantly between NHS Trusts and Boards. There is a lack of formal evidence to support decision-making around outpatient cervical ripening: the basis on which changes were implemented and what evidence was used to inform decisions is not clear.


Asunto(s)
Actitud del Personal de Salud , Maduración Cervical , Vías Clínicas , Trabajo de Parto Inducido , Adulto , Atención Ambulatoria/métodos , /prevención & control , Toma de Decisiones Clínicas , Vías Clínicas/organización & administración , Vías Clínicas/tendencias , Femenino , Humanos , Control de Infecciones/métodos , Trabajo de Parto Inducido/métodos , Trabajo de Parto Inducido/tendencias , Servicios de Salud Materna/tendencias , Innovación Organizacional , Formulación de Políticas , Embarazo , Encuestas y Cuestionarios , Reino Unido
18.
Dermatol Online J ; 27(3)2021 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-33865273

RESUMEN

OBJECTIVE: We update and expand our 2010 article in this journal, Patient safety in dermatology: A review of the literature [4][DH1]. METHODS: PubMed at the National Center for Biotechnology Information (NCBI), United States National Library of Medicine (NLM) was searched September 2019 for English language articles published between 2009 and 2019 concerning patient safety and medical error in dermatology. Potentially relevant articles and communications were critically evaluated by the authors with selected references from 2020 added to include specific topics: medication errors, diagnostic errors including telemedicine, office-based surgery, wrong-site procedures, infections including COVID-19, falls, laser safety, scope of practice, and electronic health records. SUMMARY: Hospitals and clinics are adopting the methods of high-reliability organizations to identify and change ineffective practice patterns. Although systems issues are emphasized in patient safety, people are critically important to effective teamwork and leadership. Advancements in procedural and cosmetic dermatology, organizational and clinical guidelines, and the revolution in information technology and electronic health records have introduced new sources of potential error. CONCLUSION: Despite the growing number of dermatologic patient safety studies, our review supports a continuing need for further studies and reports to reduce the number of preventable errors and provide optimal care.


Asunto(s)
Dermatología/estadística & datos numéricos , Seguridad del Paciente , Accidentes por Caídas/prevención & control , Accidentes por Caídas/estadística & datos numéricos , /transmisión , Infección Hospitalaria/prevención & control , Fármacos Dermatológicos/efectos adversos , Errores Diagnósticos/prevención & control , Errores Diagnósticos/estadística & datos numéricos , Documentación , Registros Electrónicos de Salud , Fuego , Humanos , Control de Infecciones , Rayos Láser/efectos adversos , Errores Médicos/prevención & control , Errores Médicos/estadística & datos numéricos , Errores de Medicación/prevención & control , Errores de Medicación/estadística & datos numéricos , Equipo de Protección Personal , Factores de Riesgo
19.
Curr Sports Med Rep ; 20(5): 259-265, 2021 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-33908913

RESUMEN

ABSTRACT: Cardiopulmonary exercise testing (CPX) is a valuable tool in both clinical practice and research settings. Therefore, it is advantageous for human performance laboratories to continue operating during the coronavirus disease 2019 (COVID-19) pandemic. All institutions should adhere to general COVID-19 guidelines provided by the Centers for Disease Control. Because of the testing environment, CPX laboratories must consider additional precautionary safety measures. This article provides recommendations for modifying the CPX protocol to ensure safety for all stakeholders during the pandemic. These modifications are universal across all populations, types of institutions and testing modalities. Preliminary measures include careful review of federal, local, and institutional mandates. The description outlines how to evaluate a testing environment and alter workflow. Guidelines are provided on what specific personal protective equipment should be acquired; as well as necessary actions before, during, and after the CPX test. These precautions will limit the possibility of both clients and staff from contracting or spreading the disease while maintaining testing volume in the laboratory.


Asunto(s)
/prevención & control , Prueba de Esfuerzo/métodos , Control de Infecciones/métodos , Humanos , Equipo de Protección Personal
20.
Artículo en Inglés | MEDLINE | ID: mdl-33804360

RESUMEN

The purpose of this study was to examine compliance with infection prevention and control practice and factors affecting compliance in nursing students who are about to graduate. A cross-sectional survey design was used. A total of 178 students from two nursing colleges in South Korea responded to self-reported questionnaires. Descriptive statistics, independent t-test, Pearson correlation, and multiple regression analysis were conducted. Mean score for compliance was 4.09 ± 0.43 out of 5. The highest score was on compliance with prevention of cross-infection (4.42 ± 0.54) and the lowest was on use of protective devices (3.86 ± 0.78). Non-occupational exposure scores on compliance subcategories were significantly higher than those for occupational exposure. Students' perception of safe environment for infection control and a positive attitude toward infection control predicted compliance significantly (ß = 0.28, p < 0.001; ß = 0.18, p = 0.014, respectively). The findings clarify that the level of infection control compliance among Korean nursing students is moderate. In order to increase the level of compliance, a climate that emphasizes a safe environment for healthcare-associated infections should be strengthened. In addition, nursing education should endeavor to develop a positive attitude toward infection prevention.


Asunto(s)
Facultades de Enfermería , Estudiantes de Enfermería , Estudios Transversales , Humanos , Control de Infecciones , Estudios Prospectivos , República de Corea , Encuestas y Cuestionarios
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