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1.
Bone Joint J ; 103-B(2): 347-352, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33517742

RESUMEN

AIMS: Surgical costs are a major component of healthcare expenditures in the USA. Intraoperative communication is a key factor contributing to patient outcomes. However, the effectiveness of communication is only partially determined by the surgeon, and understanding how non-surgeon personnel affect intraoperative communication is critical for the development of safe and cost-effective staffing guidelines. Operative efficiency is also dependent on high-functioning teams and can offer a proxy for effective communication in highly standardized procedures like primary total hip and knee arthroplasty. We aimed to evaluate how the composition and dynamics of surgical teams impact operative efficiency during arthroplasty. METHODS: We performed a retrospective review of staff characteristics and operating times for 112 surgeries (70 primary total hip arthroplasties (THAs) and 42 primary total knee arthroplasties (TKAs)) conducted by a single surgeon over a one-year period. Each surgery was evaluated in terms of operative duration, presence of surgeon-preferred staff, and turnover of trainees, nurses, and other non-surgical personnel, controlling cases for body mass index, presence of osteoarthritis, and American Society of Anesthesiologists (ASA) score. RESULTS: Turnover among specific types of operating room staff, including the anaesthesiologist (p = 0.011), circulating nurse (p = 0.027), and scrub nurse (p = 0.006), was significantly associated with increased operative duration. Furthermore, the presence of medical students and nursing students were associated with improved intraoperative efficiency in TKA (p = 0.048) and THA (p = 0.015), respectively. The presence of surgical fellows (p > 0.05), vendor representatives (p > 0.05), and physician assistants (p > 0.05) had no effect on intraoperative efficiency. Finally, the presence of the surgeon's 'preferred' staff did not significantly shorten operative duration, except in the case of residents (p = 0.043). CONCLUSION: Our findings suggest that active management of surgical team turnover and composition may provide a means of improving intraoperative efficiency during THA and TKA. Cite this article: Bone Joint J 2021;103-B(2):347-352.


Asunto(s)
Artroplastia de Reemplazo de Cadera , Artroplastia de Reemplazo de Rodilla , Eficiencia Organizacional , Grupo de Atención al Paciente/organización & administración , Humanos , Relaciones Interprofesionales , Tempo Operativo , Reorganización del Personal , Estudios Retrospectivos
2.
BMJ Open Qual ; 10(1)2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33579746

RESUMEN

Effective communication between members of the multidisciplinary team is imperative for patient safety. Within the Medicine for the Elderly wards at Royal Victoria Hospital (RVH) in Dundee, we identified an inefficient process of information-sharing between the orthopaedics outpatient department (OPD) at the main teaching hospital and our hospital's rehabilitation teams, and sought to improve this by introducing several changes to the work system. Our aim was for all patients who attended the OPD clinic to have a plan communicated to the RVH team within 24 hours.Before our intervention, clinic letters containing important instructions for ongoing rehabilitation were dictated by the OPD team, transcribed and uploaded to an electronic system before the RVH team could access them. We analysed clinic attendances over a 4-week period and found that it took 15 days on average for letters to be shared with the RVH teams. We worked with both teams to develop a clinical communication tool and new processes, aiming to expedite the sharing of key information. Patients attended the OPD with this form, the clinician completed it at the time of their appointment and the form returned with the patient to RVH on the same day.We completed multiple Plan-Do-Study-Act cycles; before our project was curtailed by the COVID-19 pandemic. During our study period, seven patients attended the OPD with a form, with all seven returning to RVH with a completed treatment plan documented by the OPD clinician. This allowed rehabilitation teams to have access to clinic instructions generated by orthopaedic surgeons almost immediately after a patient attended the clinic, essentially eliminating the delay in information-sharing.The introduction of a simple communication tool and processes to ensure reliable transfer of information can expedite information-sharing between secondary care teams and can potentially reduce delays in rehabilitation.


Asunto(s)
/rehabilitación , Servicios de Salud para Ancianos/normas , Grupo de Atención al Paciente/normas , Mejoramiento de la Calidad , Atención Secundaria de Salud/normas , Anciano , Anciano de 80 o más Años , Comunicación , Femenino , Humanos , Relaciones Interprofesionales , Masculino , Atención Secundaria de Salud/métodos
3.
Rev Gaucha Enferm ; 42(spe): e20200158, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33566886

RESUMEN

OBJECTIVE: To report a virtual Cultural Circle experience implemented with nurses to allow them to dialogue and promote health amidst the pandemic of the Coronavirus Disease 2019 (COVID-19). METHOD: Experience report of a virtual Cultural Circle based on Paulo Freire's framework. The stages were correlated to the oil lamp, the symbol of the nursing profession: the lamp body was considered the Thematic Investigation, the lamp support corresponded to Encoding and Decoding, and the light corresponded to Critical Unveiling. Fourteen nurses working in different health settings located in different Brazilian regions participated. RESULTS: Two themes emerged: adjusting my inner light and taking care of my family and work. FINAL CONSIDERATIONS: The nurses exchanged experiences and strengthened themselves to overcome the challenges imposed by the fight against the COVID-19, acquiring autonomy to take care of themselves and provide care to others.


Asunto(s)
/enfermería , Promoción de la Salud/métodos , Relaciones Interprofesionales , Personal de Enfermería en Hospital/psicología , Redes Sociales en Línea , Adulto , Brasil , Femenino , Humanos , Persona de Mediana Edad
4.
J Vet Med Educ ; 48(1): 8-13, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33594955

RESUMEN

The veterinary workplace consists of different professionals working together in inter-professional teams. Previous work has explored the benefits of effective veterinary teamwork for multiple stakeholders. In this teaching tip article, we outline the underlying educational theories and tips for developing inter-professional teaching to foster students' appreciation of the different roles and responsibilities of veterinarians and veterinary nurses/vet techs. Inter-professional education (IPE) requires students to learn with, about, and from each other and implies recognition of social learning as an underpinning approach. It involves developing learning opportunities to address students' potential misunderstandings of each other's motivations, to allow them to explore issues present in the other profession's practice, and to clarify sometimes overlapping roles and responsibilities. Students are given opportunities to explore the complexity of inter-professional teamwork in a safe environment using real-life topics as context for their collaboration. Two veterinary examples of IPE at the Royal Veterinary College (RVC) are provided to explore different teaching methods and topics that have proved successful in our context: dentistry and directed learning scenarios. We describe how RVC has developed an IPE team consisting of faculty members who champion IPE, which has, in turn, inspired students to create a student-led IPE club, hosting extracurricular educational events. This is an example of an effective student-teacher partnership. A number of challenges exist in embedding IPE, but the benefits it offers in integrating clinical and professional elements of the curricula make it worthy of consideration.


Asunto(s)
Técnicos de Animales , Educación Profesional , Educación en Veterinaria , Veterinarios , Animales , Curriculum , Humanos , Relaciones Interprofesionales
6.
BMC Fam Pract ; 22(1): 31, 2021 02 03.
Artículo en Inglés | MEDLINE | ID: mdl-33535973

RESUMEN

BACKGROUND: Interprofessional primary care (IPC) teams provide comprehensive and coordinated care and are ideally equipped to support those populations most at risk of adverse health outcomes during the COVID-19 pandemic, including older adults, and patients with chronic physical and mental health conditions. There has been little focus on the experiences of healthcare teams and no studies have examined IPC practice during the early phase of the COVID-19 pandemic. The objective of the study was to describe the state of interprofessional health provider practice within IPC teams during the COVID-19 pandemic. METHODS: Observational cross-sectional design. A web-based survey was deployed to IPC providers working in team-based primary care clinics in the province of Ontario, Canada. The survey included 26 close-ended and six open-ended questions. Close-ended questions were analyzed using descriptive statistics. Content analysis was used to analyze the open-ended questions. RESULTS: 445 surveys were included in the final analysis. Service delivery shifted from in-person care (77% pre-COVID-19) to telephone (76.5% during the COVID-19 pandemic). Less than half of the respondents (40%) reported receiving any training for virtual delivery. Wait times to access team members were reported to have decreased. There has also been a shift in what IPC providers report as the most commonly seen conditions, with increases in visits related to mental health concerns, acute infections (including COVID-19), social isolation, and resource navigation. Respondents also reported a reduction in healthcare provision for multiple chronic conditions including diabetes, cardiovascular disease, and chronic pain. CONCLUSIONS: IPC teams are rapidly shifting their practice to supporting their patients during the pandemic. A surge in mental health issues has been seen and is expected to continue to increase in response to COVID-19. Understanding early experiences can help plan for future pandemic waves.


Asunto(s)
/epidemiología , Relaciones Interprofesionales , Atención Primaria de Salud/métodos , Estudios Transversales , Humanos , Trastornos Mentales/diagnóstico , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Ontario/epidemiología , Grupo de Atención al Paciente/organización & administración , Grupo de Atención al Paciente/estadística & datos numéricos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Atención Primaria de Salud/estadística & datos numéricos , Encuestas y Cuestionarios
7.
J Drugs Dermatol ; 20(2): 215-223, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33538568

RESUMEN

BACKGROUND: COVID-19 has had significant negative economic ramifications on dermatologic care delivery, including curtailing live on-site physician-pharmaceutical-representative interactions (PPRI). OBJECTIVE: To determine the impact of COVID-19 and pandemic regulations on current and future PPRI. METHODS: Cross-sectional survey-based study that analyzed data from 400 surveyed dermatologists using a pre-validated questionnaire sent via email. Data regarding PPRI were collected over 1 week in July 2020 to compare demographics and practice standards from April 2019, April 2020, July 2020, and predictions for 2021. RESULTS: Virtual-only PPRI increased from 7.8% in April 2019 to 26.5% during April 2020 (mean difference, 18.8%; 95% confidence interval, 13.6%–23.9%). Virtual-only PPRI remained elevated at 24.5% while hybrid PPRI increased, eventually surpassing the April 2019 mark (27.0%). These trends persisted among all studied practice types and levels of experience. Practices predicted no significant percent differences in participation in PPRI (87.3% vs 90.3%; P=0.0834), but a significant shift in method of delivery where the odds ratio of incorporating a virtual component into PPRI in 2021 increased by a factor of 3. LIMITATIONS: Relatively small sample size, especially among subgroups. Responses may have been retrospective estimates. There may also be selection bias given slightly increased representation of more experienced dermatologists. CONCLUSION: PPRI materially decreased during the initial COVID-19 peak but will likely return to baseline volume moving forward with a significant component being hybrid PPRI. Further studies may better elucidate the economic and clinical impact associated with these changes and their effect on dermatologists’ ability to provide patients with samples and educational materials. J Drugs Dermatol. 2021;20(2):215-223. doi:10.36849/JDD.2021.5651.


Asunto(s)
Dermatólogos , Relaciones Interprofesionales , Pandemias , Farmacéuticos , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Consultorios Médicos , Encuestas y Cuestionarios , Telemedicina
9.
Khirurgiia (Mosk) ; (1): 93-97, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33395519

RESUMEN

It is very difficult to find certain surgical field in which surgeon's decision is absolutely evidence-based. The objective of evidence-based medicine (and surgery) is offering the best treatment for each patient that should encourage conducting the randomized trials (RT) as the highest level of evidence. The results of RTs often contradict the existing clinical experience, and experience per se does not always confirm the significance of the results obtained. One cannot make any conclusions based on RT data. Treatment strategy for a particular patient remains unclear. The authors have analyzed the results of large-scale RTs devoted to laparoscopic cholecystectomy, rectal surgery, lung cancer surgery, postoperative care, treatment of pulmonary emphysema. It was shown that RT data as the highest level of evidence are not always true for surgery. In most clinical situations, the decision is not based on RT results. The desire of surgeons to master a new technique is often more significant than patient care, while clinical experience and the laws of the market are more important than science. There is no doubt that knowledge of RT results are essential in training period, but this means quite a bit for a particular patient. The best decision can be made during discussion and conversation with colleagues, where an experience of each specialist will have the same value as the best evidence.


Asunto(s)
Medicina Basada en la Evidencia/normas , Medicina de Precisión/normas , Práctica Profesional/normas , Calidad de la Atención de Salud/normas , Ensayos Clínicos Controlados Aleatorios como Asunto , Procedimientos Quirúrgicos Operativos , Colecistectomía Laparoscópica , Competencia Clínica/normas , Toma de Decisiones , Procedimientos Quirúrgicos del Sistema Digestivo , Medicina Basada en la Evidencia/métodos , Humanos , Relaciones Interprofesionales , Cuidados Posoperatorios/normas , Enfisema Pulmonar/terapia , Ensayos Clínicos Controlados Aleatorios como Asunto/normas , Procedimientos Quirúrgicos Operativos/métodos , Procedimientos Quirúrgicos Operativos/normas
10.
Nurs Manag (Harrow) ; 28(1): 32-41, 2021 Feb 04.
Artículo en Inglés | MEDLINE | ID: mdl-33496150

RESUMEN

Stress, suboptimal mental health and an inadequate work-life balance are underlying and serious issues in the nursing profession, affecting staff recruitment and retention and potentially having a detrimental effect on patient care. While compassion towards patients is central to the nursing role, often 'compassion towards the compassionate' is lacking. The need for compassion is even more important now, and in the months ahead, due to the additional stressors experienced by nurses during the COVID-19 pandemic, whether they are on the front line, furloughed or shielding. This article includes reflections from nursing staff and uses their stories to encourage reflection on ethical and moral dilemmas experienced during the pandemic. The Compassion in the Workplace model is suggested as a tool that can be used by nurse managers to examine their compassion levels and to support the development of a compassionate workplace. In addition, this article offers some practical ideas on what compassionate leadership might look like in day-to-day practice.


Asunto(s)
/enfermería , Empatía , Relaciones Interprofesionales , Enfermeras Administradoras/psicología , Enfermería/organización & administración , Humanos , Liderazgo , Personal de Enfermería/psicología
11.
Am J Nurs ; 121(2): 40-45, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33470614

RESUMEN

ABSTRACT: The authors describe the personal protective equipment (PPE) clinicians require when involved in the care of patients with potential or confirmed exposure to highly infectious pathogens, such as the Ebola virus, multidrug-resistant organisms, or severe acute respiratory syndrome coronavirus 2, the cause of COVID-19. They discuss the communication challenges that arise with the various PPE required when caring for patients in high-containment clinical environments and how they and their colleagues in the National Institutes of Health's Special Clinical Studies Unit developed, field-tested, refined, and ultimately implemented policies and procedures that enabled clinicians to communicate effectively with other staff, patients, and external partners, such as governmental agencies, other specialized units, and nonprofit organizations.


Asunto(s)
Personal de Salud/organización & administración , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Relaciones Interprofesionales , Exposición Profesional/prevención & control , Equipo de Protección Personal/estadística & datos numéricos , /prevención & control , Brotes de Enfermedades/prevención & control , Humanos
13.
N Engl J Med ; 384(6): e18, 2021 02 11.
Artículo en Inglés | MEDLINE | ID: mdl-33503341
14.
Acad Med ; 96(1): 134-141, 2021 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-33394664

RESUMEN

PURPOSE: The combination of power and conflict is frequently reported to have a detrimental impact on communication and on patient care, and it is avoided and perceived negatively by health care professionals. In view of recent recommendations to explicitly address power and conflict in health professions education, adopting more constructive approaches toward power and conflict may be helpful. This study examined the role of power in conflicts between health care professionals in different cultural contexts to make recommendations for promoting more constructive approaches. METHOD: The authors used social bases of power (positional, expert, informational, reward, coercive, referent) identified in the literature to examine the role of power in conflicts between health care professionals in different cultural settings. They drew upon semistructured interviews conducted from 2013 to 2016 with 249 health care professionals working at health centers in the United States, Switzerland, and Hungary, in which participants shared stories of conflict they had experienced with coworkers. The authors used a directed approach to content analysis to analyze the data. RESULTS: The social bases of power tended to be comparable across sites and included positional, expert, and coercive power. The rigid hierarchies that divide health care professionals, their professions, and their specialties contributed to negative experiences in conflicts. In addition, the presence of an audience, such as supervisors, coworkers, patients, and patients' families, prevented health care professionals from addressing conflicts when they occurred, resulting in conflict escalation. CONCLUSIONS: These findings suggest that fostering more positive approaches toward power and conflict could be achieved by using social bases of power such as referent power and by addressing conflicts in a more private, backstage, manner.


Asunto(s)
Actitud del Personal de Salud , Personal de Salud/psicología , Incivilidad/prevención & control , Relaciones Interprofesionales , Negociación/métodos , Negociación/psicología , Poder Psicológico , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos
15.
Rev Infirm ; 70(267): 44-46, 2021 Jan.
Artículo en Francés | MEDLINE | ID: mdl-33455683

RESUMEN

In women's psychiatric clinics, in a short to medium-term free hospitalisation service, the psychologist-nurse collaboration proves to be an important elaborative support to accompany patients in an introspective work. The creation of an intra-service "writing" mediation group has highlighted the therapeutic interest of the complementary functions and the process of appropriation of care by the patients themselves.


Asunto(s)
Relaciones Interprofesionales , Trastornos Mentales , Enfermeras y Enfermeros , Psicología , Instituciones de Atención Ambulatoria , Femenino , Humanos , Trastornos Mentales/terapia , Enfermeras y Enfermeros/psicología
16.
Support Care Cancer ; 29(1): 85-96, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32803729

RESUMEN

PURPOSE: To care for the growing population of cancer survivors, health services worldwide must reconsider how to deliver care to people living with and beyond a cancer diagnosis. Shared care, defined as cancer care that is shared between specialist and primary care providers, is one model that has been investigated; however, practical guidance to support implementation is lacking. This systematic review aimed to explore facilitators and barriers to implementing shared cancer care and to develop practice and policy recommendations to support implementation. METHODS: A systematic literature search was conducted in June 2019 across MEDLINE, Embase, Emcare, and PsycINFO databases. Quantitative and qualitative data relevant to the review question were extracted and synthesized following a mixed methods approach. RESULTS: Thirteen papers were included in the review, 10 qualitative and three quantitative. Included articles were from Australia (n = 8), the USA (n = 3), and one each from the UK and the Netherlands. Sixteen themes were developed under four categories of patient, healthcare professional, process, and policy factors. Key themes included the perceived need for primary care provider training, having clearly defined roles for each healthcare provider, providing general practitioners with diagnostic and treatment summaries, as well as protocols or guidelines for follow-up care, ensuring rapid and accurate communication between providers, utilizing electronic medical records and survivorship care plans as communication tools, and developing consistent policy to reduce fragmentation across services. CONCLUSION: Recommendations for practice and policy were generated based on review findings that may support broader implementation of shared cancer care.


Asunto(s)
Cuidados Posteriores/métodos , Supervivientes de Cáncer/estadística & datos numéricos , Personal de Salud/estadística & datos numéricos , Relaciones Interprofesionales , Atención Primaria de Salud/métodos , Australia , Femenino , Humanos , Neoplasias/terapia , Países Bajos , Supervivencia
17.
Nurs Res ; 70(1): 58-66, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32649391

RESUMEN

BACKGROUND: Preventable clinician communication errors are the most frequent root cause of surgical adverse events. Effective communication among surgical team members is an important overall indicator of clinical nursing excellence and is crucial to promote patient safety and reduce healthcare risk. OBJECTIVE: The purpose of this publication is to describe our research protocol, which will comprehensively investigate surgical team communication and surgical team structure. There are two overall study objectives: (a) to characterize the network factors that influence perioperative clinician communication and (b) to identify how team structure shapes communication effectiveness. Specifically, we will study the association among clinician relationships, surgical team familiarity, surgical team size, and communication effectiveness. METHODS: We will use an exploratory, prospective, cross-sectional, network-centric approach using social network analysis to determine how interdependent clinician relationships influence surgical communication patterns. Targeting an 80% response rate, we will use total population sampling to recruit all clinicians (nurses, surgeons, anesthetists, surgical technologists, students, residents) who directly provide surgical care in the operating room at a large military medical center. We will administer an electronic survey to surgical teams at the end of the surgical day to elicit clinician communication assessments and relational preferences. From the survey questions, we will develop six relational networks (interaction, close working relationship, socialization, advice seeking, advice giving, speaking up/voice) and three models that represent communication effectiveness for each participant and team. We will use various statistical methods to characterize the network factors that shape operating room clinician communication and identify how team structure shapes communication effectiveness. RESULTS: This study will start enrolling participants in 2020. DISCUSSION: We are among the first to comprehensively investigate operating room communication using social network analysis. The results of this study will provide valuable insight into nurse collaboration and communication in interprofessional teams, enable a thoughtful analysis of surgical staffing and perioperative team building, and inform future-targeted interventions to improve operating room communication weaknesses.


Asunto(s)
Comunicación , Relaciones Interprofesionales , Personal Militar/psicología , Grupo de Atención al Paciente/normas , Guías de Práctica Clínica como Asunto , Cirujanos/psicología , Cirujanos/normas , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Estados Unidos
18.
Nurs Sci Q ; 34(1): 33-38, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33349174

RESUMEN

This is a dialogue between two PhD nurses who have served as chief nursing officers; one is now in academia wondering about current scholarly endeavors in practice. Topics addressed include working relationships at the executive level, the chief nursing officer that is PhD prepared, theory in practice, scrambling to honor nursing's pact with society during the COVID-19 pandemic, and some recommendations for academia.


Asunto(s)
Liderazgo , Enfermeras Administradoras/psicología , Educación en Enfermería , Educación de Postgrado en Enfermería , Humanos , Relaciones Interprofesionales , Rol de la Enfermera , Teoría de Enfermería
19.
Rev. enferm. UERJ ; 28: e50078, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1118065

RESUMEN

Objetivo: compreender as causas dos conflitos entre as equipes de saúde na transferência do cuidado pré-hospitalar sob a perspectiva dos profissionais. Método: estudo qualitativo, descritivo e exploratório, realizado no Serviço de Atendimento Móvel de Urgência (SAMU) de Porto Alegre/RS. Foram entrevistados 28 profissionais do SAMU e observados 135 horas de atendimentos. Empregou-se a análise de conteúdo temática. Resultados: As causas atribuídas aos conflitos foram: (1) a superlotação dos hospitais e a pouca receptividade da equipe: os profissionais do SAMU se sentem culpabilizados pela superlotação dos serviços e punidos por meio da retenção de macas; e (2) a regulação e as (in)definições de fluxos na rede: há lacunas nas pactuações sobre o destino dos pacientes, recaindo aos profissionais o desafio de dar sequencia ao atendimento. Conclusão: o excesso de demandas e a baixa articulação dos serviços na rede causam conflitos entre as equipes de saúde na transferência do cuidado pré-hospitalar.


Objective: to understand, from the health personnel's perspective, the causes of conflicts between health care teams during transfer from pre-hospital care. Method: this exploratory, qualitative, descriptive study was conducted at the ambulance service (Serviço de Atendimento Móvel de Urgência, SAMU) of Porto Alegre, Rio Grande do Sul, Brazil. Twenty-eight SAMU personnel were interviewed and 135 hours of care service observed. Thematic content analysis was used. Results: the causes attributed to conflicts were: (1) hospital overcrowding and poor staff receptivity: SAMU personnel felt blamed for service overcrowding and punished by gurneys being withheld, and (2) the bed regulation center and (in)definition in patient flows: there were gaps in patient routing agreements, it then falling to SAMU personnel to meet the challenge of completing the service. Conclusion: excessive demands and poor coordination between services in the health care network cause conflicts between teams in transfer from pre-hospital care.


Objetivo: comprender, desde la perspectiva del personal de salud, las causas de los conflictos entre los equipos de salud durante el traslado desde el cuidado prehospitalario. Método: este estudio exploratorio, cualitativo y descriptivo se realizó en el servicio de ambulancia (Serviço de Atendimento Móvel de Urgência, SAMU) de Porto Alegre, Rio Grande do Sul, Brasil. Se entrevistó a 28 miembros del SAMU y se observaron 135 horas de servicio de atención. Se utilizó análisis de contenido temático. Resultados: las causas atribuidas a los conflictos fueron: (1) hacinamiento hospitalario y poca receptividad del personal: el personal del SAMU se sintió culpable por el hacinamiento del servicio y castigado con camillas retenidas, y (2) centro de regulación de camas y (in) definición en los flujos de pacientes: Hubo lagunas en los acuerdos de enrutamiento de pacientes, y luego le correspondió al personal de SAMU enfrentar el desafío de completar el servicio. Conclusion: las demandas excesivas y la mala coordinación entre los servicios de la red sanitaria provocan conflictos entre los equipos en el traslado desde el cuidado prehospitalario.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Grupo de Atención al Paciente , Servicios Médicos de Urgencia , Atención Prehospitalaria , Pase de Guardia , Brasil , Carga de Trabajo , Investigación Cualitativa , Relaciones Interprofesionales
20.
Rev. enferm. UERJ ; 28: e48849, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1119635

RESUMEN

Objetivo: descrever o atual processo de convocação de pacientes para procedimento cirúrgico, bem como a comunicação entre a equipe multiprofissional e o paciente no período pré-operatório e identificar a linha de cuidados prestados pela equipe multiprofissional no período pré-operatório. Método: pesquisa exploratória, descritiva e qualitativa. Amostra contemplou 28 participantes, membros da equipe multidisciplinar da clínica cirurgia geral de um hospital universitário do Rio de Janeiro. Os dados foram coletados por dois roteiros de entrevista semiestruturada, de fevereiro a abril de 2019, após autorização do Comitê de Ética em Pesquisa. Resultados: a falta de planejamento, protocolos e fluxo intenso de pacientes levou a dúvidas, estresse, cancelamento de cirurgias no decorrer da internação. Conclusão: a ausência de protocolos articulados com ações e treinamentos prejudicou o processo de internação, bem como a comunicação entre a equipe multiprofissional e paciente. Fizeram parte da linha de cuidados: anamnese, sinais vitais, conciliação medicamentosa e orientações gerais.


Objective: to describe the current process of calling patients in for surgical-clinic unit, as well as communication between multidisciplinary team and patient in the preoperative period. Method: in this exploratory, qualitative, descriptive study, the 28 participants were members of the multidisciplinary team of surgical-clinic unit of a university hospital in Rio de Janeiro. Data were collected from February to April 2019 using two semi-structured interview scripts. The study was authorized by the research ethics committee. Results: the lack of planning and protocols and the intense flow of patients led to doubts, stress, and cancellation of surgeries during hospitalization. Conclusion: the absence of protocols coupled with actions and training impaired the hospitalization process, as well as communication between multidisciplinary team and patient. The line of care comprised: anamnesis, vital signs, medication reconciliation and general guidelines.


Objetivo: describir el proceso actual de convocatoria de pacientes para unidad clínica quirúrgica, así como la comunicación entre equipo multidisciplinario y paciente en el período preoperatorio. Método: en este estudio exploratorio, cualitativo, descriptivo, los 28 participantes eran miembros del equipo multidisciplinario de la unidad clínica quirúrgica de un hospital universitario de Río de Janeiro. Los datos se recopilaron de febrero a abril de 2019 mediante dos guiones de entrevistas semiestructurados. El estudio fue autorizado por el comité de ética en investigación. Resultados: la falta de planificación y protocolos y el intenso flujo de pacientes generó dudas, estrés y cancelación de cirugías durante la hospitalización. Conclusión: la ausencia de protocolos sumados a acciones y formación perjudicó el proceso de internación, así como la comunicación entre equipo multidisciplinar y paciente. La línea de atención comprendió: anamnesis, constantes vitales, conciliación de medicamentos y pautas generales.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Adulto Joven , Admisión del Paciente , Cuidados Preoperatorios/métodos , Hospitales Universitarios , Grupo de Atención al Paciente , Relaciones Profesional-Paciente , Brasil , Epidemiología Descriptiva , Investigación Cualitativa , Hospitalización , Relaciones Interprofesionales
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