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1.
Rev. Esc. Enferm. USP ; 53: e03508, Jan.-Dez. 2019. tab, graf
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1020384

RESUMEN

RESUMO Objetivo Avaliar a estrutura e a adesão às medidas de precauções-padrão e específicas dos profissionais de saúde em Unidade de Terapia Intensiva de hospital de ensino, no Distrito Federal. Método Estudo descritivo, transversal e prospectivo. Utilizou-se de questionário estruturado mediante observações que registraram as práticas dos profissionais com Equipamentos de Proteção Individual e indicações de precauções. Foi aplicado o teste Qui-quadrado, e calculado o p-valor . Resultados Participaram do estudo 52 profissionais, e foram observados 445 procedimentos assistenciais em 36 sessões de auditoria. A média da taxa de adesão ao uso de equipamentos foi de 72,72%, sendo 94,91% às luvas, 91,43% ao avental, 80% à máscara e 24,56% aos óculos de proteção. Quando não havia indicação e não foi utilizado o Equipamento de Proteção Individual, a média da taxa foi de 68,01%, sendo 30,77% em relação às luvas, 87,58% ao avental, 57,58% à máscara, e 96,13% aos óculos. As precauções de contato foram indicadas desnecessariamente em 35% dos pacientes. Conclusão Verificou-se boa adesão ao uso de luvas, avental e máscara, baixa adesão ao uso de óculos de proteção e uso desnecessário de máscaras e precauções de contato admissionais.


RESUMEN Objetivo Evaluar la estructura y la adhesión a las medidas de precauciones estándar y específicas de los profesionales sanitarios en Unidad de Cuidados Intensivos de hospital de enseñanza, en el Distrito Federal. Método Estudio descriptivo, transversal y prospectivo. Se utilizó un cuestionario estructurado mediante observaciones que registraron las prácticas de los profesionales con Equipos de Protección Individual e indicaciones de precauciones. Se aplicó la prueba de Chi cuadrado y se calculó el p-valor. Resultados Participaron en el estudio 52 profesionales y se observaron 445 procedimientos asistenciales en 36 sesiones de auditoría. El promedio de la tasa de adhesión al uso de equipos fue del 72,72%, siendo el 94,91% a los guantes, el 91,43% al delantal, el 80% a la mascarilla y el 24,56% a los anteojos de protección. Cuando no había indicación y no fue utilizado el Equipo de Protección Individual, el promedio de la tasa fue del 68,01%, siendo el 30,77% con relación a los guantes, el 87,58% al delantal, el 57,58% a la mascarilla y el 96,13% a los anteojos. Las precauciones de contacto fueron indicadas innecesariamente al 35% de los pacientes. Conclusión Se verificó buena adhesión al uso de guantes, delantal y mascarilla, baja adhesión al uso de anteojos de protección y uso innecesario de mascarillas y precauciones de contacto de ingreso.


ABSTRACT Objective To evaluate the structure and adherence to the standardized and specific precautionary measures of health professionals in the Intensive Care Unit of a teaching hospital in the Federal District of Brazil. Method A descriptive, cross-sectional and prospective study. A structured questionnaire was used via observations which recorded the practices of professionals with Individual Protection Equipment and indications of precautions. The chi-square test was applied, and the p-value was calculated. Results A total of 52 professionals participated in the study, and 445 care procedures were observed in 36 audit sessions. The average adhesion rate for equipment use was 72.72%, with 94.91% for gloves, 91.43% for aprons, 80% for masks and 24.56% for safety glasses. When there was no indication and no personal protective equipment was used, the average rate was 68.01%, with 30.77% for gloves, 87.58% for aprons, 57.58% for masks, and 96.13% for safety glasses. Contact precautions were unnecessarily indicated for 35% of patients. Conclusion Good adherence to using gloves, aprons and masks were observed, but there was poor adherence to using safety glasses and unnecessary use of masks and admission contact precautions.


Asunto(s)
Humanos , Práctica Profesional , Precauciones Universales , Control de Infecciones , Personal de Salud , Unidades de Cuidados Intensivos , Estudios Transversales , Estudios Prospectivos , Seguridad del Paciente , Hospitales de Enseñanza
2.
Enferm. clín. (Ed. impr.) ; 29(6): 357-364, nov.-dic. 2019. tab
Artículo en Español | IBECS | ID: ibc-184656

RESUMEN

La instauración de las especialidades de Enfermería iniciada en 1953 ha contribuido de forma decisiva en la calidad de la atención sanitaria proporcionada en el Sistema Nacional de Salud. En la actualidad, un elevado número de enfermeras poseen un título oficial de especialista obtenido a través de las distintas modalidades de acceso que establece el Real Decreto sobre especialidades de Enfermería. Por otra parte, los programas formativos tienen que seguir desarrollándose para culminar el catálogo establecido en la mencionada normativa. Cabe destacar que muchos especialistas tienen dificultad para llevar a cabo un ejercicio profesional acorde a su formación y capacitación, debido a la escasa descripción de puestos de trabajo e identificación de competencias en los procesos de selección y acceso a los puestos de trabajo, necesarias para un buen desempeño profesional. Por ello, resulta imprescindible elaborar un catálogo de puestos de trabajo específico de cada una de las especialidades, para dar respuesta a las expectativas de las enfermeras y fortalecer el avance en la calidad de la atención de cuidados


The establishment of nursing specialties that started in 1953 has contributed decisively to the quality of the medical care provided by the National Health System. Nowadays, a large number of nurses have an official specialist qualification achieved through different means of access established by Royal Decree on nursing specialties. Furthermore, the training programmes must continue to develop in order to complete the catalogue established under the aforementioned regulation. It should be pointed out that many specialists face difficulties in carrying out professional practice according to their education and training, due to the lack of job descriptions and identification of competences during recruitment processes and access to job positions, needed for appropriate professional performance. Therefore, it is essential to create a catalogue for specific job positions for each of the specialties to meet the expectations of professional nursing and enhance progress in quality patient care


Asunto(s)
Humanos , Especialidades de Enfermería/tendencias , Práctica Profesional/organización & administración , Práctica Profesional/tendencias , Competencia Profesional , Especialidades de Enfermería/legislación & jurisprudencia
3.
Medicine (Baltimore) ; 98(48): e18114, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31770236

RESUMEN

There is a paucity of succinct measures of physician satisfaction. As part of a Performance Improvement Project, we developed and piloted a simple questionnaire to determine rheumatologists satisfaction.Thirty 5 rheumatologists in the academic or private setting were sent opened-ended questions to determine the factors that made them satisfied or dissatisfied with respect to their rheumatology practice. From the responses we formed 14 questions 1 to 10 scale centering on satisfaction and dissatisfaction that was piloted in 30 rheumatologists and subsequently validated in 173 rheumatologists within the US and Latin America.Our combined sample included 173 rheumatologists (55 English and 118 Spanish-speaking respondents). The mean satisfaction for the combined sample was 6.92 (standard deviation=1.1, range 4.08-9.62). The strongest contributors to physician satisfaction were "Seeing interesting and challenging cases" (8.6 ±â€Š1.5) and "The ability to make a difference in patient's life" as well as "Establishing long term relationship with patients" (8.39 ±â€Š1.5). The strongest contributors to physician dissatisfaction were "Getting inappropriate referrals not in the scope of practice" (4.3 ±â€Š2.13) and "Time spent on documentation" (4.5 ±â€Š2.59). The scale had good reliability, relatively normal distribution, and little or no redundancy among items.A simple and practical questionnaire to measure physician satisfaction, in particular rheumatologists satisfaction, was developed, piloted and successfully validated on a predominately academic sample of rheumatologists within the US and Latin America. This scale will serve as a means to identifying potential barriers to the implementation of performance improvement projects in the practice of Rheumatology.


Asunto(s)
Satisfacción en el Trabajo , Práctica Profesional , Reumatólogos/psicología , Reumatología/normas , Encuestas y Cuestionarios/normas , Adulto , Femenino , Humanos , América Latina , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Estados Unidos
4.
J Leg Med ; 39(3): 229-233, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31626576

RESUMEN

Lapses in professionalism are a common cause of disciplinary action against physicians by U.S. medical boards. However, the exact definition of "professionalism" is unclear, making it likely that a physician will not train or practice under the same framing of professionalism and so may fail to develop certain skills. The goal of this study was to identify and compare the professionalism framings of medical boards. The medical board web pages for all 50 states, the District of Columbia, and four territories were examined in June 2017 for use of the word "professionalism" or "professional" in their application, rules, or laws, which was then coded as a best fit to one of six core framings of professionalism. Of the 55 states and territories, integrity was the most common professionalism framing (40.0%), followed by excellence (23.6%), behavior (12.7%), mixed (9.1%), unclear (9.1%), and absent (5.5%). Although integrity was the most common framing, diversity exists among medical boards, which could lead to board misunderstandings of incidents labeled as professionalism violations and ineffective remediation of offenses. In order to best communicate the nature of the offense and thus best facilitate remediation, the incident should be called by its true name rather than the all-encompassing term "professionalism."


Asunto(s)
Rol del Médico , Médicos/normas , Práctica Profesional/normas , Profesionalismo/normas , Consejo Directivo/legislación & jurisprudencia , Consejo Directivo/normas , Humanos , Mala Conducta Profesional , Profesionalismo/tendencias , Consejos de Especialidades/legislación & jurisprudencia , Consejos de Especialidades/normas , Estados Unidos
5.
Nursing (Säo Paulo) ; 22(257): 3220-3225, out.2019.
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1026095

RESUMEN

Objetivo: identificar a percepção dos enfermeiros de unidades de internação clínica sobre a importância da Sistematização da Assistência de Enfermagem para o planejamento da assistência. Método: Estudo descritivo, qualitativo, realizado após aprovação do comitê de ética em pesquisa, em um hospital universitário de Porto Alegre. Resultados: foram entrevistados 18 enfermeiros. A análise temática dos dados revelou as seguintes áreas: Sistematização da Assistência de Enfermagem: Conhecimento e Aplicação na prática profissional: dificuldades encontradas. Conclusão: apesar das comprovações científicas de sua eficiência, a implementação da SAE necessita superar as limitações impostas pela falta de compreensão do papel do enfermeiro em sua prática assistencial. O aprimoramento científico torna-se imperativo no desenvolvimento de atitudes e habilidades direcionadas a um cuidado ético e responsável.(AU)


Objective: identify the perception of the nurses of clinical hospitalization units about the importance of Nursing Care Systematization for care planning. Method: Descriptive, qualitative study, carried out after approval of the research ethics committee, at a university hospital in Porto Alegre. Results: 18 nurses were interviewed. The thematic analysis of the data revealed the following areas: Systematization of Nursing Assistance: Knowledge and Application in professional practice: difficulties encountered. Conclusion: despite the scientific evidence of its efficiency, the SAE implementation needs to overcome the limitations imposed by the lack of understanding of the role of nurses in their care practice. The scientific improvement becomes imperative in the development of attitudes and abilities directed towards an ethical and responsible care.(AU)


Objetivo: identificar la percepción de las enfermeras de las unidades de hospitalización clínica sobre la importancia de la sistematización de la atención de enfermería para la planificación de la atención. Método: Estudio descriptivo, cualitativo, realizado después de la aprobación del comité de ética de la investigación, en un hospital universitario de Porto Alegre. Resultados: se entrevistó a 18 enfermeras. El análisis temático de los datos reveló las siguientes áreas: Sistematización de la asistencia de enfermería: conocimiento y aplicación en la práctica profesional: dificultades encontradas. Conclusión: a pesar de la evidencia científica de su eficiencia, la implementación de SAE debe superar las limitaciones impuestas por la falta de comprensión del papel de las enfermeras en su práctica de atención. La mejora científica se vuelve imperativa en el desarrollo de actitudes y habilidades dirigidas hacia un cuidado ético y responsable.(AU)


Asunto(s)
Humanos , Planificación de Atención al Paciente , Práctica Profesional , Atención de Enfermería/métodos , Proceso de Enfermería , Unidades de Internación
6.
Rev. bras. ativ. fís. saúde ; 24: 1-5, out. 2019.
Artículo en Portugués | LILACS | ID: biblio-1026754

RESUMEN

O objetivo deste ensaio foi apresentar uma proposta de síntese para a atuação do profissional de Educação Física (PEF) no contexto da Atenção Básica à Saúde (ABS) do Brasil. São apresentadas 15 itens, elaborados a partir de experiências vivenciadas no campo de atuação pelos autores, bem como na literatura. Posteriormente, a clareza e pertinência dos itens foram avaliadas por 33 PEF de nove diferentes municípios brasileiros que atuavam ou tinham atuado anteriormente na ABS. Apesar de os itens apresentados não terem o objetivo de competir ou substituir as diretrizes do Ministério da Saúde ou das secretarias estaduais ou municipais, espera-se que possam ser úteis para os PEF que atuam na ABS, bem como para a formação dos PEF que pretendem atuar neste contexto


The objective of this essay was to present a proposal of the synthesis of the work of the Physical Education Professional (PEF) in Primary Health Care (PHC) in a brazilian context. We present the 15 items, elaborated from experiences lived in the field of actuation by the authors, as well as in the literature. Subsequently, the clarity and pertinence of the items were evaluated by 33 PEFs from nine different Brazilian municipalities that were currently working or who had previously worked in PHC. The items presented are not intended to compete or replace the guidelines of the Ministry of Health or the state or municipal secretariats. In fact, we hope that they may be useful for the PEF working in PHC, as well as for the professional qualification of the PEF who intend to work in this context


Asunto(s)
Atención Primaria de Salud , Práctica Profesional , Sistema Único de Salud , Estrategia de Salud Familiar , Recursos Humanos
7.
Ideggyogy Sz ; 72(7-8): 227-235, 2019 Jul 30.
Artículo en Inglés | MEDLINE | ID: mdl-31517454

RESUMEN

Background and purpose: 3D technologies (3D virtual and physical model, 3D printing, computer aided engineering, finite element analysis based simulations) play an important role in personalized spine surgery. Objective - In collaboration with AOSpine a global, online survey-based study was performed in order to determine the acceptance rate and the factors which stand against the wider spread of 3D technologies. Methods: A survey containing 21 questions was developed and divided into five pages, every page corresponding to one chapter. Our analysis is based on the responses of 282 spine surgeons from 57 countries. To interpret our results in a global context, we used the Human Development Index of the respondent's countries in comparisons. Results: Significant difference between the AOSpine regions (p ≤ 0.05) was found, with the highest acceptance in Asia-Pacific region. There was no significant difference in acceptance score according to the field of spine surgery, or the surgical experience in years (p=0.77, and p=0.19). In the case of public practice, we found significantly higher acceptance compared to private and mixed (public and private) surgical practice (p ≤ 0.05). The acceptance of the technology varied based on the respondent's resident country's Human Development Index and was significantly different between "Medium" vs "Very high" (p = 0.0005) and "High" vs "Very high" (p=0.019) category. Significant positive correlation was found between the acceptance score and the HDI score (Spearman test, ρ = 0.37, p = 0.007). The main limitation factor was identified as the lack of information. Conclusion: There is high interest among spine surgeons towards the incorporation of 3D technologies into the clinical practice. Education, the healthcare system, and the economic environment plays a major role in acceptance. Our results provide the basis of a strategy to promote the application of 3D technologies.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Impresión Tridimensional , Columna Vertebral/cirugía , Cirujanos/psicología , Humanos , Práctica Profesional/estadística & datos numéricos , Fracturas de la Columna Vertebral/cirugía , Traumatismos Vertebrales/cirugía , Encuestas y Cuestionarios
8.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(7): 585-589, sept. 2019. tab, graf
Artículo en Español | IBECS | ID: ibc-185529

RESUMEN

Introducción: Ixekizumab es un fármaco efectivo y seguro en el tratamiento de pacientes con psoriasis dentro de ensayos clínicos. Nuestro objetivo es valorar la eficacia y seguridad de ixekizumab en la práctica clínica habitual. Material: Estudio retrospectivo incluyendo todos los pacientes que han recibido ixekizumab en 2 servicios de dermatología de la ciudad de Valencia. Resultados: Se incluyeron un total de 75 pacientes, siendo el 53,3% varones y el 46,7% mujeres con una edad media de 48,61 años. El 77,3% (58 pacientes) presentaba una psoriasis en placas, mientras que el 22,7% (17 pacientes) presentaba psoriasis de predominio en un área especial. La comorbilidad más frecuente fue obesidad en el 48% de ellos y el 40% eran naive a biológicos. El PASI inicial medio fue de 9,99, mientras que el PASI medio a la semana 16 era de 1,5. Las respuestas de PASI75 y PASI90 fueron independientes de las comorbilidades analizadas, del sexo, de la edad y del PASI basal. Los pacientes naive a biológicos respondieron mejor que los pacientes que habían recibido tratamiento biológico previo, tanto en la semana 16 como en la semana 52 de forma estadísticamente significativa. Esta observación también se mantuveroni en los pacientes con psoriasis en un área especial. El 25,7% de los pacientes refería algún efecto adverso, siendo lo más frecuente reacción en el sitio de inyección. No se observaron reacciones adversas graves. Conclusiones: El estudio plasma nuestra experiencia en la práctica clínica real de ixekizumab, siendo un fármaco efectivo y seguro para el tratamiento de la psoriasis


Background: Ixekizumab has proven efficacy and safety for the treatment of psoriasis in clinical trials. The aim of this study was to evaluate its effectiveness and safety in routine clinical practice. Methods: Retrospective study of all patients treated with ixekizumab in 2 dermatology departments in the city of Valencia, Spain. Results: Seventy-five patients (53.3% men and 46.7% women) with a mean age of 48.61 years were studied; 77.3% (n = 58) had plaque psoriasis and 22.7% (n = 17) had psoriasis predominantly affecting a specific area. The most common comorbidity was obesity (present in 48% of patients) and 40% of the overall group had not been previously treated with a biologic drug. Mean psoriasis area and severity index (PASI) fell from 9.99 at baseline to 1.5 at week 16. PASI-75 and PASI-90 (improvements of at least 75% and 90% in PASI) were independent of sex, age, baseline PASI, and the comorbidities analyzed. Responses at week 16 and 52 were significantly better in biologic-naïve patients for the overall group and the subgroup of patients with localized psoriasis. Adverse effects were reported for 25.7% of patients and the most common effect was injection-site reaction. There were no serious adverse effects. Conclusions: Our findings show that ixekizumab is both effective and safe in the treatment of psoriasis in routine clinical practice


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anticuerpos Monoclonales Humanizados/uso terapéutico , Fármacos Dermatológicos/uso terapéutico , Psoriasis/tratamiento farmacológico , Práctica Profesional , Evaluación de Resultado (Atención de Salud) , Seguridad del Paciente , Estudios Retrospectivos , Análisis Estadístico
9.
RECIIS (Online) ; 13(3): 569-577, jul.-set. 2019. tab
Artículo en Portugués | LILACS | ID: biblio-1016996

RESUMEN

O uso de aplicativos vem crescendo na área da saúde, tornando-se rotina diária na prática dos profissionais e estudantes. Portanto, conhecer benefícios e riscos de seu uso faz-se necessário. O objetivo do estudo aqui apresentado é verificar opiniões e atitudes relatadas por estudantes de medicina a respeito do uso de aplicativos no cotidiano ambulatorial de um hospital-escola. Trata-se de um estudo transversal desenvolvido, em 2017, em Recife, Pernambuco, Brasil, no qual se utilizaram questionários autoaplicáveis presencialmente em uma população de 73 estudantes concluintes do curso de medicina. Os resultados revelaram que a maioria (95,9%) dos estudantes referiram possuir smartphone e 98,6% afirmaram utilizar dispositivos móveis com intuito acadêmico. A finalidade mais comum do uso de aplicativos foi a de consulta de fármacos existentes (93,2%) e quase a totalidade dos estudantes (98,6%) confia nos aplicativos utilizados. Porém, foi questionado se o uso na rotina interfere na relação profissional-paciente. Concluímos que o uso de aplicativos é uma realidade crescente, mas que ainda há discordâncias sobre seus benefícios e malefícios.


The use of applications has been growing in the field of health, becoming a daily routine in the practice of professionals and students. Therefore, knowing the benefits and risks of its use is necessary. The study presented here aims to verify the opinions and attitudes reported by medical students about the use of applications in the outpatient routine in a teaching hospital. It is a cross-sectional study and it was developed in 2017 in Recife, in the state of Pernambuco, Brazil, using a self-administered questionnaire asked by 73 students of the last year of medicine undergraduate degree. The results reveal that the majority (95.9%) of the students reported having a smartphone and 98.6% specified that they use mobile devices for academic purposes. The most common purpose of using applications was to consult existing drugs (93.2%) and almost all students (98.6%) believe that the applications used are reliables. However, there are doubts if routine use interferes with the professional-patient relationship. We concluded that the use of applications is growing, but there are still disagreements about its benefits and harms.


El uso de aplicaciones viene creciendo en el área de la salud y se ha convertido en rutina diaria en la práctica de los profesionales y estudiantes. Por lo tanto, conocer los beneficios y riesgos de su uso se hace necesario. El objetivo del estudio presentado aquí es verificar opiniones y actitudes relatadas por estudiantes de medicina acerca del uso de aplicaciones en el cotidiano del ambulatorio de un hospital escuela. Un estudio transversal ha sido desarrollado en 2017 en Recife, en el estado de Pernambuco, Brasil, utilizando un cuestionario autoaplicable presencialmente en 73 estudiantes del último año de la graduación del grado en medicina. Los resultados mostran que la mayoría (95,9%) de los estudiantes mencionó poseer teléfono inteligente y 98,6% afirmaron utilizar dispositivos movibles con intención académica. La finalidad más común del uso de aplicaciones fue la de consulta de fármacos existentes (93,2%) y casi la totalidad de los estudiantes (98,6%) confía en las aplicaciones utilizadas. Sin embargo, ha sido cuestionado si el uso en la rutina interfiere en la relación profesional-paciente. Nosotros concluimos que el uso de aplicaciones es creciente, pero todavía hay desacuerdos sobre sus beneficios y maleficios.


Asunto(s)
Humanos , Estudiantes de Medicina , Educación Médica , Aplicaciones Móviles , Estudio Observacional , Teléfono Inteligente , Rendimiento Académico , Relaciones Médico-Paciente , Práctica Profesional , Personal de Salud , Sistemas de Apoyo a Decisiones Clínicas , Computadores de Bolsillo , Medios de Comunicación Sociales
10.
J Athl Train ; 54(7): 822-830, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31386576

RESUMEN

CONTEXT: Medical documentation is a required component of patient care in all health care professions. OBJECTIVE: To evaluate athletic trainers' perceived behaviors toward, barriers to, and confidence in their medical documentation. DESIGN: Cross-sectional study. SETTING: Web-based survey. PATIENTS OR OTHER PARTICIPANTS: We purchased a list of randomly selected e-mails from the National Athletic Trainers' Association. Of the 9578 participants, 1150 accessed our questionnaire (12.0% access rate), 1053 completed at least 1 portion, and 904 completed the questionnaire in its entirety (85.8% completion rate). Of the participants, 60.1% (n = 569/947) were female, 66.6% (n = 632/949) held a master's degree, 39.3% (n = 414/1053) worked in a collegiate or university setting, and 36.1% (n = 381/1053) worked in a secondary school setting. MAIN OUTCOME MEASURE(S): We used a 31-item questionnaire with demographics (12 items), medical documentation behaviors (16 items), barriers (2 items), and perceptions (1 multipart item) sections. The questionnaire explored athletic trainers' behaviors as well as confidence in, comfort with, and concerns about their documentation practices (Cronbach α = 0.887). We used descriptive statistics to identify characteristics of central tendency (mean, standard deviation, mode, frequency). RESULTS: Participants always (45.7%, n = 478/1046) or very frequently (39.0%, n = 408/1046) used a double documentation system consisting of electronic and paper records (50.4%, n = 523/1038). They most often documented to provide legal protection (86.8%, n = 914/1053), because it is a legal obligation (79.1%, n = 833/1053), or to track patient progress (83.9%, n = 883/1053). The most frequently cited barriers to medical documentation were time (76.5%, n = 806/1053), managing too many patients (51.9%, n = 547/1053), technological concerns (17.2%, n = 181/1053), and software limitations (17.2%, n = 181/1053). Respondents believed they were competent, comfortable, and confident in their documentation practices. CONCLUSIONS: We were able to evaluate the generalizability of previous research while adding to the understanding of the behaviors toward, barriers to, and perceptions about medical documentation. We confirmed that time and patient load affected the ability to perform high-quality medical documentation.


Asunto(s)
Documentación , Atención al Paciente , Práctica Profesional , Deportes , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Competencia Profesional , Instituciones Académicas , Encuestas y Cuestionarios , Universidades
11.
Br J Nurs ; 28(15): 993-1000, 2019 Aug 08.
Artículo en Inglés | MEDLINE | ID: mdl-31393771

RESUMEN

This article discusses the development of a professional practice model (PPM) within NHS Grampian. A shared governance approach was used to develop the model, supported by the findings from a Florence Nightingale Travel Scholarship, which included visiting hospitals in Australia to explore the principles adopted by Magnet-designated organisations. The process of developing the PPM is described: this involved senior nurses and staff across various nursing, midwifery and allied health professional teams and collaborating with graphic design colleagues and communication design students. The article then describes how the model was disseminated and used across the health board in presentations, and at conferences and workshops.


Asunto(s)
Modelos Organizacionales , Práctica Profesional/organización & administración , Medicina Estatal/organización & administración , Comunicación , Humanos , Estudiantes/psicología , Reino Unido
12.
BMC Health Serv Res ; 19(1): 591, 2019 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-31438959

RESUMEN

BACKGROUND: The key to the effective management of healthcare wastes is segregation of the waste at the point of generation; no matter what final strategy for treatment and disposal of wastes is selected, it is critical that waste streams are separated. In Ethiopia, healthcare waste segregation practice among healthcare workers is overlooked and scarcely addressed in the scientific literature. This hospital-based cross-sectional study was, therefore, conducted to assess healthcare waste segregation practice and its correlate among healthcare workers in Bale zone, southeast Ethiopia. METHODS: All five hospitals found in Bale zone were included and the study participants were selected using a systematic sampling technique from each hospital. Data were collected through interview using structured questionnaires. Descriptive statistics were computed. Bivariate and multivariable logistic regression analyses were employed to identify factors that correlate with healthcare waste segregation practice. RESULTS: A total of four hundred and nine healthcare workers participated in the study, for a response rate of 97.4%. Of these, 220(53.8%) (95% CI: 49.1-58.9) of healthcare workers were found to have reported good healthcare waste segregation practice. Being male gender (AOR = 1.70, 95%CI: 1.04-2.78), less than 30 years of age (AOR = 2.02, 95%CI: 1.06-3.84), less than 2 years work experience (AOR = 2.95, 95%CI: 1.39-6.26), having good self-reported standard precaution practice (AOR = 8.47,95%CI:4.98-14.42), and working in a department with an on-site healthcare waste segregation container (AOR = 2.10, 95%CI:1.24-3.55) were factors that correlated with self-reported healthcare waste segregation practice. CONCLUSION: Overall, only half of the healthcare workers had good healthcare waste segregation practice, which is low and unsatisfactory. Less service year, having good standard precaution practice, and the presence of onsite waste segregation container were the most important variables that correlate with self-reported healthcare waste segregation practice. Therefore, to improve healthcare waste segregation practice health authorities should focus on sufficient allocation of onsite waste receptacles. In addition, periodic training on standard precaution will improve compliance with segregation practice.


Asunto(s)
Cuerpo Médico de Hospitales/normas , Eliminación de Residuos Sanitarios/normas , Práctica Profesional/normas , Adulto , Anciano , Estudios Transversales , Etiopía , Femenino , Hospitales , Humanos , Masculino , Cuerpo Médico de Hospitales/estadística & datos numéricos , Eliminación de Residuos Sanitarios/métodos , Persona de Mediana Edad , Autoinforme , Encuestas y Cuestionarios , Adulto Joven
14.
Rev. bras. ativ. fís. saúde ; 23: 1-5, fev.-ago. 2019. fig
Artículo en Portugués | LILACS | ID: biblio-1026722

RESUMEN

O objetivo deste artigo foi descrever uma experiência curricular fundamentada no referencial da espiral construtivista em uma disciplina do curso de Educação Física da Universidade Federal do Rio Grande do Sul (UFRGS), no contexto do Sistema Único de Saúde (SUS). Em quatro encontros, cada um com quatro horas-aula, em duas turmas, práticas corporais e atividades físicas (PCAFs) em interface com o SUS foram tematizadas através da elaboração e do atendimento de casos-problemas. Inspirados em situações do cotidiano de trabalho, equipes formadas pelos estudantes delimitaram e estudaram objetivos de aprendizagem a partir de necessidades emergentes. Procedimentos como a organização em rede, as tecnologias de apoio matricial, projeto terapêutico singular, uso de prontuário, genograma, ecomapa, entre outros, delimitaram o foco do trabalho de contextualização do uso das PCAF nos casos-problemas. Considerando a avaliação realizada, conclui-se que a proposta potencializou a aprendizagem dos estudantes a respeito dos saberes e práticas relativos ao SUS


The objective of this study was to describe a curricular experience based on the constructivist spiral in a dis-cipline of the Physical Education course of the Federal University of Rio Grande do Sul (UFRGS), in the Unified Health System (SUS) context. In four meetings, each with four hours of classes, in two class groups, the corporal practices and physical activities (PCAF) in interface with SUS were thematized through the elaboration and attendance of problem cases. Inspired by everyday work situations, teams formed by students delimited and studied learning objectives based on emerging needs. Procedures such as network organization, matrix support technologies, unique therapeutic design, use of medical records, genogram, ecomap, among others, delimited the focus of the work of contextualizing the use of PCAF in case-problems. Considering the evaluation which were carried out, it is concluded that the proposal strengthened students' learning about SUS knowledge and practices


Asunto(s)
Práctica Profesional , Sistema Único de Salud , Aprendizaje Basado en Problemas , Curriculum , Recursos Humanos
15.
Rev. ADM ; 76(4): 234-241, jul.-ago 2019.
Artículo en Español | LILACS | ID: biblio-1024069

RESUMEN

Ética, moral y la deontología, se ocupan de un mismo objetivo: la valoración de lo bueno y de lo malo en la conducta humana. Sus enfoques del problema, no son totalmente iguales. La ética utiliza el análisis filosófico, ilumina el problema desde el ángulo axiológico, y a través de la especulación pura trata de establecer un deber ser de valor universal. La moral estudia las acciones humanas desde un punto de vista empírico, histórico, en la realidad de las diferentes culturas y teniendo en cuenta la diversidad de su idiosincrasia, trata de establecer juicios de valor adecuados a tales circunstancias. La deontología, fluctuando entre la ética y la moral y basándose en las conclusiones de ambas, se propone establecer las normas concretas que deben regir la conducta en situaciones determinadas, como puede ser el ejercicio de una profesión. La bioética establece los conceptos morales, éticos y racionales derivados en la interdisciplina de la ciencia y la biomedicina (AU)


Ethics, Moral and deontology, deal with the same objective: The assessment of good and evil in human behavior. Their approaches to the problem are not totally the same. Ethics uses philosophical analysis, illuminates the problem from the axiological angle, and through pure speculation tries to establish a duty of universal value. Morality studies human actions from an empirical, historical point of view, in the reality of different cultures and taking into account the diversity of their idiosyncrasy, tries to establish value judgments appropriate to such circumstances. Deontology, fluctuating between ethics and morals and based on the conclusions of both, it is proposed to establish the specific rules that should govern behavior in certain situations, such as the exercise of a profession. Bioethics establishes the moral, ethical and rational concepts derived in the interdiscipline of science and biomedicine (AU)


Asunto(s)
Sociedades Odontológicas , Códigos de Ética , Ética Odontológica , Práctica Profesional/ética , Bioética , Teoría Ética , México , Moral
16.
Med Care ; 57(9): 680-687, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31295166

RESUMEN

BACKGROUND: Properties of social networks and shared patient networks of physicians are associated with important outcomes, including costs, quality, information exchange, and organizational effectiveness. OBJECTIVES: To determine whether practice consolidation affects size, strength, and stability of US practice-based physician shared patient networks. RESEARCH DESIGN: We used a dynamic difference-in-differences (event study) design to determine how 2 types of vertical consolidation (hospital and health system practice acquisition) and 2 types of horizontal consolidation (medical group membership and practice-practice mergers) affect individual shared patient network characteristics, controlling for physician fixed effects and geographic market (metropolitan statistical area). SUBJECTS: Practice-based US physicians whose practices consolidated 2009-2014 are identified via health system, hospital, and medical group affiliation information and appearance/disappearance of listed practice affiliations in the SK&A Physician Database. MEASURES: Outcomes measured were network size (number of individual physicians with whom a physician shares patients within 30 d), strength (average number of shared patients within those relationships), and stability (percent of shared patient relationships that persist in the current and prior year), all generated from Medicare Shared Patient Patterns (30-d) data. RESULTS: Shared patient network stability increases significantly after acquisition of practices by horizontal practice-practice mergers [ßt=1=0.041 (P<0.001), ßt=2=0.047 (P<0.001), ßt=3=0.041 (P<0.001), ßt=4=0.031 (P<0.05), where t is the number of years after the consolidation event]. These effects were robust to sensitivity analyses. Shared patient network size and strength are not observably associated with practice consolidation events. CONCLUSIONS: Practice consolidation can increase the stability of physician networks, which may have positive implications for organizational effectiveness.


Asunto(s)
Redes Comunitarias/estadística & datos numéricos , Atención al Paciente/estadística & datos numéricos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Atención Primaria de Salud/estadística & datos numéricos , Práctica Profesional/organización & administración , Redes Comunitarias/organización & administración , Humanos , Médicos/organización & administración , Pautas de la Práctica en Medicina/organización & administración , Atención Primaria de Salud/organización & administración , Estados Unidos
17.
BMC Med ; 17(1): 137, 2019 07 17.
Artículo en Inglés | MEDLINE | ID: mdl-31311535

RESUMEN

The digital revolution is disrupting the ways in which health research is conducted, and subsequently, changing healthcare. Direct-to-consumer wellness products and mobile apps, pervasive sensor technologies and access to social network data offer exciting opportunities for researchers to passively observe and/or track patients 'in the wild' and 24/7. The volume of granular personal health data gathered using these technologies is unprecedented, and is increasingly leveraged to inform personalized health promotion and disease treatment interventions. The use of artificial intelligence in the health sector is also increasing. Although rich with potential, the digital health ecosystem presents new ethical challenges for those making decisions about the selection, testing, implementation and evaluation of technologies for use in healthcare. As the 'Wild West' of digital health research unfolds, it is important to recognize who is involved, and identify how each party can and should take responsibility to advance the ethical practices of this work. While not a comprehensive review, we describe the landscape, identify gaps to be addressed, and offer recommendations as to how stakeholders can and should take responsibility to advance socially responsible digital health research.


Asunto(s)
Inteligencia Artificial/ética , Prestación de Atención de Salud/ética , Investigación sobre Servicios de Salud/ética , Práctica Profesional/ética , Prestación de Atención de Salud/métodos , Prestación de Atención de Salud/tendencias , Promoción de la Salud/ética , Promoción de la Salud/métodos , Promoción de la Salud/tendencias , Humanos , Invenciones/ética , Invenciones/tendencias , Aplicaciones Móviles/ética , Medicina de Precisión/ética , Medicina de Precisión/métodos , Medicina de Precisión/tendencias
18.
Medicina (B Aires) ; 79(3): 174-184, 2019.
Artículo en Español | MEDLINE | ID: mdl-31284251

RESUMEN

Argentina is a country characterized by a heterogeneous distribution of its population, its economic resources and, consequently, access to health services, which could affect the diagnosis and treatment of patients with myelodysplastic syndromes. Based on the increasing complexity to arrive at the diagnosis, estimate the risk and indicate an adequate treatment, we have conducted a survey of twenty-three questions to evaluate patterns of clinical practice. The questionnaire was distributed among 850 hematologists registered at the XXII Argentine Congress of Hematology, and 195 (22.9%) were answered; 40.0% report that < 75% of their patients access the karyotype, bone marrow histology and flow cytometry. This access decreases significantly due to low health coverage (OR 6.3), in the adult population (OR 3.8), when the cytogenetic study is derived (OR 3.2) and outside the metropolitan area of Buenos Aires (OR 2.4). The respondents avoid oncological terminologies (77.0%) when introducing the diagnosis and use the international prediction system or its review (74.2%) to stage risk. However, they prioritize age when selecting treatment and pediatricians preferentially recommend the transplantation of hematopoietic precursors. Most of the haematologists have prescribed the recommended treatments, whose suspensions were related to lack of response (62.7%), with reduced participation in clinical trials (8.9%). Therefore, they report heterogeneity in the access to complementary diagnostic tools with differences at the time of indicating a treatment, depending on the age of their patients without apparent limitations in their prescription.


Asunto(s)
Síndromes Mielodisplásicos/diagnóstico , Síndromes Mielodisplásicos/terapia , Práctica Profesional , Argentina , Protocolos Clínicos , Encuestas Epidemiológicas , Humanos , Encuestas y Cuestionarios
19.
Rev. enferm. UFSM ; 9: [19], jul. 15, 2019.
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1024241

RESUMEN

Objetivo: conhecer a percepção de enfermeiras obstetras sobre o modelo e prática assistencial em uma maternidade filantrópica. Método: estudo qualitativo com 13 enfermeiras obstetras que trabalham em uma maternidade mineira, coleta de dados de setembro de 2015 a fevereiro de 2016 por meio de entrevista semiestruturada, utilizando-se Análise de Conteúdo. Resultados: emergiram como categorias: Atuação pautada na humanização e nas boas práticas; Autonomia para atuar; Profissional de referência para tomada de decisões; Atuação em equipe e Modelo de atuação. Discussão: verificou-se que as enfermeiras atuam com autonomia em equipe, não nomeiam um modelo de assistência e apontam a demanda de serviço e o modelo tecnocrático como dificultadores. Considerações finais: apoio e suporte dos gestores são importantes para a atuação das profissionais, contribuindo para um trabalho autônomo. Apesar dos avanços, ainda há desafios a serem superados tanto no âmbito da equipe e comunicação, quanto do suporte dos gestores.


Objective: to identify the perception of obstetric nurses about the healthcare model and practice in a philanthropic maternity hospital. Method: qualitative study of 13 obstetric nurses working in a Minas Gerais maternity hospital. Researchers used semi-structured interviews for data collection which took place from September 2015 to February 2016. Data analysis used content analysis. Results: the following categories emerged: Performance based on humanization and good practices; Professional autonomy; Professional mentoring during decision making; Teamwork and Performance Model. Discussion: research revealed that nurses are autonomous and work as a team; they did not single out a healthcare model and identified work demand and technocratic model as obstacles. Final considerations: management support is important for the professionals' performance since it contributes to autonomy at work. Despite the progress made, there are still challenges both in terms of staff and communication, as well as management support


Objetivo: conocer la percepción de las enfermeras obstétricas sobre la práctica y el modelo de atención en una maternidad de beneficencia. Método: estudio cualitativo con 13 enfermeras obstétricas de una maternidad de Minas Gerais; los datos, recogidos de septiembre de 2015 a febrero de 2016 en entrevistas semiestructuradas, se analizaron según el análisis de contenido. Resultados: se identificaron las siguientes categorías: Desempeño basado en la humanización y en las buenas prácticas; Autonomía para trabajar; Coaching para la toma de decisiones; Trabajo en equipo y Modelo de desempeño. Discusión: las enfermeras actúan con autonomía, en equipo, no mencionaron ningún modelo de atención; la demanda de servicios y el modelo tecnocrático representaban obstáculos. Consideraciones finales: el respaldo de la gerencia es fundamental para el desempeño profesional y contribuye a que se trabaje con autonomía. Aún hay retos por superar, tanto a nivel de equipos y comunicación como de respaldo de la gerencia.


Asunto(s)
Humanos , Práctica Profesional , Autonomía Profesional , Partería , Enfermería Obstétrica
20.
Cad. Ibero Am. Direito Sanit. (Impr.) ; 8(2): 64-61, abr.-jun.2019.
Artículo en Español | LILACS | ID: biblio-1016282

RESUMEN

Objetivo: Analizar el delito de ejercicio ilegal de las profesiones de farmacia y medicina en Costa Rica. Metodología: Se realizó una investigación bibliográfica en libros y artículos del área jurídica, se analizó la legislación promulgada en Costa Rica, Argentina y España, además de las sentencias de tribunales penales, emitidas en Costa Rica desde el año 1980. Resultados: se determinó la legislación que ha regulado el delito de ejercicio ilegal de la profesión, así como los principales aspectos considerados en las sentencias para establecer los elementos que configuran el delito. Conclusión: El profesional en farmacia podría incurrir en el delito de ejercicio ilegal de la medicina en caso de que prescriba medicamentos, así como, el profesional en medicina podría cometer el delito de ejercicio ilegal de la farmacia si despacha medicamentos. El ejercicio de las profesiones médicas o farmacéuticas por personas no autorizadas debe ser analizado en sede penal, sin embargo, se asume el criterio que la sanción debería ser pecuniaria y no privativa de libertad. (AU).


Objective: to analyze the crime of illegal exercise of the professions of pharmacy and medicine in Costa Rica. Methodology: a bibliographic research was carried out in books and articles of the legal area; the legislation promulgated in Costa Rica, Argentina and Spain was analyzed, as well as the sentences of criminal courts, issued in Costa Rica since 1980. Results: creation of a legislation that regulated the crime of illegal exercise of the profession, as well as the main aspects considered in the sentences to establish the elements that make up the offense. Conclusion: the professional in pharmacy could incur in crime of illegal exercise of medicine in case he or she prescribes a medication, as well as, the medical professional could commit the crime of illegal exercise of the pharmacy if it dispenses medication. The exercise of the medical or pharmaceutical professions by unauthorized persons must be analyzed at the criminal court, however, it is assumed that the sanction should be pecuniary and not custodial. (AU).


Objetivo: analisar o crime de exercício ilegal das profissões de farmácia e medicina na Costa Rica. Método: uma pesquisa bibliográfica foi realizada em livros e artigos na área jurídica, a legislação promulgada em Costa Rica, Argentina e Espanha, bem como as sentenças de tribunais criminais, emitido em Costa Rica desde 1980. Resultados: determinou-se a legislação que regulamenta o crime de exercício ilegal da profissão, bem como os principais aspectos considerados nas sentenças para estabelecer os elementos que compõem o delito. Conclusão: o farmacêutico profissional pode incorrer no crime de prática ilegal da medicina se prescrever medicamentos, bem como o profissional médico pode cometer o crime de exercício ilegal da farmácia se despachar medicamentos. O exercício de profissões médicas ou farmacêuticas por pessoas não autorizadas deve ser analisado em um tribunal criminal, no entanto, a pena deve ser de pecuniária. (AU).


Asunto(s)
Humanos , Práctica Profesional/ética , Costa Rica , Mala Conducta Profesional , Ética Médica , Ética Farmacéutica , Ética Profesional
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