Framework for creating an incident command center during crises.

The Hospital Incident Command System (HICS) is an incident management system specific to hospitals based on the principles of Incident Command System (ICS), and it includes prevention, protection, mitigation, response, and recovery. It plays a crucial role in effective and timely response during the periods of disasters, mass casualties, and public health emergencies. In recent times, hospitals have used a customized HICS structure to coordinate effective responses to public health problems such as the Ebola outbreak in the US and SARS epidemic in Taiwan. The current COVID-19 pandemic has placed unprecedented challenges on the healthcare system, necessitating the creation of HICS that can help in the proper allocation of resources and ineffective utilization of healthcare personnel. The key elements in managing a response to this pandemic include screening and early diagnosis, quarantining affected individuals, monitoring disease progression, delivering appropriate treatment, and ensuring an adequate supply of personal protective equipment (PPE) to healthcare staff.

Integrating e-collections following the merger of two specialist hospital libraries: a case study.

BACKGROUND: Birmingham Women's and Children's NHS Foundation Trust was formed in February 2017 following an acquisition. The Library and Knowledge Services (LKS) merged while operating across two hospital sites. A priority for the merged Library and Knowledge Service was to integrate e-collections. A literature review identified six papers reporting health libraries that had merged and integrated e-collections. OBJECTIVES: A priority for the merged Library and Knowledge Service was to integrate e-collections. METHODS: To ensure equitable and cost-effective access to an extended collection, an audit of pre-existing e-collections was conducted. Electronic licence agreements enabling cross-site access were negotiated. A new OpenAthens ID was created. RESULTS: The integration of e-collections enabled Trust staff access to a greater number of e-journals and additional e-content, and an overall cost-saving was achieved. DISCUSSION: This case study supports existing literature stating that integrating collections increases the number of e-journals. It further identifies cost-difference in acquiring cross-site access to e-journals compared to databases providing full-text e-journals and additional e-content. CONCLUSION: Integrating e-collections enables equity of access and value. A national co-ordinated approach to procurement of e-collections will further support equity and best value throughout NHS LKS.

A Review of Baclofen Overdoses in Australia: Calls to a Poisons Information Centre and a Case Series.

AIM: to describe trends in baclofen reports to Australia's largest Poisons Information Centre (PIC) and present a case series detailing severity of overdoses. SHORT SUMMARY: PBS data demonstrates baclofen use is increasing in Australia, while calls to NSWPIC illustrate an increase in number of exposures associated with toxicity. Baclofen toxicity may require prolonged intensive care admission. To minimize harms associated, especially with off-label baclofen prescribing for AUD, prescribers should pay careful attention to psychiatric comorbidities, and closely monitor treatment and dispensing. METHODS: this is a retrospective observational study of baclofen overdoses reported to New South Wales PIC (NSWPIC) from January 1 2004 to 31 December 2016. In addition, referrals to a metropolitan toxicology service relating to baclofen toxicity from 2014 to 2017 were analysed. The number of Pharmaceutical Benefit Scheme (PBS) claims for baclofen were also reviewed. RESULTS: during the 13-year study period, 403 cases of baclofen toxicity were reported to NSWPIC. There was a 230% increase in annual exposures over this period, 71% of patients were symptomatic, with 77% requiring hospitalization. Coingestants were reported in 53%, with 57% being psychoactive medications (including alcohol). An increase in number of baclofen dispensing episodes was also noted. From the five cases of deliberate self-harm reported to the metropolitan toxicology service, three obtained baclofen for management of alcohol use disorder (AUD) and required prolonged treatment in the intensive care unit (ICU). CONCLUSIONS: NSWPIC data shows an increase in number of calls regarding intentional baclofen exposures in parallel with increase the number of baclofen PBS claims. These closely parallel the increase in dispensing of baclofen since 2008. Case studies presented reinforce the severity of baclofen toxicity. Together, they demonstrate the potential risk of harm of baclofen prescribing, and the greater need for caution. Baclofen should be considered carefully in patients high risk of overdose or be used only in specialist services with close monitoring.

Survey of faculty workload and operational characteristics for academic drug information centers.

INTRODUCTION: A survey of drug information specialists from academic drug information centers in the United States was conducted to identify faculty workload, operational characteristics of the center, and contribution of those faculty and centers to pharmacy education. METHODS: A 32-item survey was administered to drug information specialists and pharmacy college/school deans. Faculty workload items included age, credentials, training, and responsibilities. Center operational items identified clients, number of requests, staffing structure, and funding source. Pharmacy education items included number and type of students training at the center as well as drug information's role in the curriculum. Participants were also asked to identify recent and anticipated changes as well as predict future challenges for academic drug information centers. RESULTS: The survey achieved a response rate of 81% from eligible institutions. The typical drug information specialist is between 31 and 50 years old, in a clinical track faculty position, and has an average of 13 years of drug information experience. Academic drug information centers are generally funded by the institution, open five days a week, and serve a variety of clients including the lay public. The average drug information specialist teaches one didactic course and is a preceptor for 17 advanced practice experience students, and 15 introductory practice experience students. CONCLUSIONS: Drug information specialists and centers play an important role in pharmacy education. Results of this survey could assist in the creation of benchmarks for academic drug information faculty and centers in terms of workload, resource allocation, and promotion.

Monitoring new psychoactive substances (NPS) in The Netherlands: data from the drug market and the Poisons Information Centre.

BACKGROUND: In recent years, the number of new psychoactive substances (NPS) appearing on the illicit drug market strongly increased. However, little is known about their toxic effects and risks. Therefore, we determined the most frequently occurring NPS in The Netherlands and combined this with data regarding drug-related intoxications. METHODS: Data from the Drugs Information and Monitoring System (DIMS) and the Dutch Poisons Information Centre (DPIC) were combined and jointly analyzed. RESULTS: The number of drug samples submitted to DIMS for analysis containing NPS increased from 22 in 2007 to 431 samples in 2013. The most frequently submitted NPS in 2013 included 4-bromo-2,5-dimethoxyphenethylamine (2C-B), 4-fluoroamphetamine (4-FA), methoxetamine (MXE) and 6-(2-aminopropyl)benzofuran (6-APB). From 2012 onwards, the number of NPS bought as drug of choice exceeded those appearing as adulterants in established drugs. The DPIC was consulted about 35 NPS exposures in 2013, most frequently involving 4-FA, mephedrone, MXE, 2C-B and 6-APB. Following NPS exposure, neurological and psychological symptoms were most frequently reported, like agitation and hallucinations. In addition, cardiovascular symptoms like hypertension and tachycardia often occurred. CONCLUSIONS: NPS are currently being purchased as drug of choice in The Netherlands and their availability and use is increasing. Although pharmacological and toxicological data are scarce, NPS can induce pronounced clinical effects. Therefore, the monitoring of trends in NPS prevalence needs to be continued, combined with reported clinical effects, and preferably supported by analytical confirmation of exposures in such patients.

Which factors predict the time spent answering queries to a drug information centre?

OBJECTIVE: To develop a model based upon factors able to predict the time spent answering drug-related queries to Norwegian drug information centres (DICs). SETTING AND METHOD: Drug-related queries received at 5 DICs in Norway from March to May 2007 were randomly assigned to 20 employees until each of them had answered a minimum of five queries. The employees reported the number of drugs involved, the type of literature search performed, and whether the queries were considered judgmental or not, using a specifically developed scoring system. MAIN OUTCOME MEASURES: The scores of these three factors were added together to define a workload score for each query. Workload and its individual factors were subsequently related to the measured time spent answering the queries by simple or multiple linear regression analyses. RESULTS: Ninety-six query/answer pairs were analyzed. Workload significantly predicted the time spent answering the queries (adjusted R (2) = 0.22, P < 0.001). Literature search was the individual factor best predicting the time spent answering the queries (adjusted R(2) = 0.17, P < 0.001), and this variable also contributed the most in the multiple regression analyses. CONCLUSION: The most important workload factor predicting the time spent handling the queries in this study was the type of literature search that had to be performed. The categorisation of queries as judgmental or not, also affected the time spent answering the queries. The number of drugs involved did not significantly influence the time spent answering drug information queries.

The host hospital 24-hour underreferral rate: an automated measure of call-center safety.

OBJECTIVES: The goals were to (1) define and illustrate an automated method of monitoring the safety of telephone triage, (2) demonstrate that this method approximates reasonably a more-global safety measure, and (3) describe the month-to-month variability of this automated measure for the call center studied. METHODS: From October 2005 through March 2006, hospitalizations at a tertiary care pediatric hospital after calls to its call center were matched with their respective call-center dispositions. The host hospital 24-hour underreferral rate was defined as the percentage of total admissions to the study institution within 24 hours after a call to the call center for treatment of the same illness or injury that had been assigned a nonurgent disposition by the call center. A convenience sample of call-center calls was surveyed for admissions to other facilities. This sample was then combined with admissions to the pediatric hospital to estimate a true 24-hour underreferral rate. Underreferrals were subjected to clinical and statistical analyses. RESULTS: The host hospital 24-hour underreferral rate was 5.2%. The estimated true 24-hour underreferral rate was 5.95% +/- 2.75%. Diagnoses frequently associated with underreferral were gastroenteritis, croup, asthma, and bronchiolitis. Underreferred patients admitted to the study institution were hospitalized for an average of 1.6 +/- 1.1 days, compared with 2.8 +/- 3.1 days for patients referred by the call center to a higher level of care. The monthly SD of the host hospital 24-hour underreferral rate was 1.56%. CONCLUSIONS: For the call center studied, the host hospital 24-hour underreferral rate could be determined easily and objectively and approximated reasonably the true 24-hour underreferral rate. The month-to-month variability of the host hospital 24-hour underreferral rate was sufficiently small to allow for meaningful internal trending analyses.

El Instituto Joanna Briggs: recursos para la práctica enfermera basada en la evidencia de los cuidados / The Joanna Brigss Institute: resources on evidence-based nursing practice

El Instituto Joanna Briggs (JBI) es una unidad internacional de investigación y dedesarrollo del Hospital Real de Adelaida, afiliado a la Universidad de Adelaida,y que surge de la necesidad de incorporar la evidencia científica a la prácticaasistencial. Una de las tareas principales que está desarrollando el CentroColaborador Español de la JBI en una primera etapa es la traducción de laspublicaciones Best Practice Information Sheet al español, con la finalidad defacilitar que las recomendaciones de los mejores cuidados de Enfermería puedanser útiles tanto a los profesionales como a la población en general. El objetivode este artículo es difundir el conocimiento disponible en el JBI para facilitarla incorporación de la evidencia disponible en la práctica asistencial

The Joanna Briggs Institute is an international Research and Development Unitof Royal Adelaide Hospital, and an Affiliated Institute of the University ofAdelaide. The Institute arose from the recognition of a need for a collaborativeapproach to the evaluation of scientific evidence into health care practice.One of the most important tasks being developed by the SpanishCollaborating Centre of the JBI in a first stage is the translation of the BestPractice Information Sheet into Spanish, with the aim of facilitating the communicationof the best nursing care recommendations to both the nursingprofessional and the general population. The objective of this paper is to disseminatethe knowledge available at the JBI in order to facilitate the incorporationof the available evidence into health care practice

Remedios frente a la 'infoxicación'. Papel de las fuentes de información secundarias / Remedies against 'infoxication'. Role of the sources of secondary information

No disponible

Current status of pharmacist-operated drug information centers in the United States.

PURPOSE: Pharmacist-operated drug information centers (DICs) in the United States and Puerto Rico were surveyed, and the results were compared with those of similar surveys conducted over the past 30 years. METHODS: In January 2003, surveys were mailed to 151 institutions that were thought to have an organized DIC, defined as a center that regularly accepts a broad scope of requests from health care professionals, regardless of the location or affiliation of those professionals. The survey covered such topics as affiliations, staffing, services, resources, quality assurance, involvement in education, and funding. RESULTS: One hundred nineteen DICs responded (79%), of which 81 met the criteria. Hospitals and medical centers and colleges and schools of pharmacy continued to be the most commonly reported affiliations. The number of DICs declined in the past decade, and the number of DIC pharmacists and other personnel was the lowest reported in the past 30 years. Drug information pharmacists appeared to be better trained than in the past, and a larger percentage had advanced degrees. Services provided by DICs remained consistent with previous findings, except for greater participation in the training and education of pharmacy students and residents. The resource most commonly reported by DICs as useful was Micromedex Healthcare Series, followed by MEDLINE and AHFS Drug Information. The percentage of DICs with formal quality assurance programs did not change significantly in the past decade. Funding sources and fee-for-service activities remained the same. CONCLUSION: The number of DICs has declined steadily since 1986, and the number of drug information pharmacists is at its lowest in 30 years. DIC services continue to be comprehensive. Only half of the DICs surveyed had a formal quality assurance program.

Bioethics in Germany: debates and infrastructure.

In Germany the public awareness on ethical problems of the application of medicine and life sciences on human beings is very high. It can be observed that German Society is rather sensitive concerning bioethical issues. Politics supports this attitude. Many articles in professional journals as well as in newspapers cover bioethical issues. Conferences and workshops on a professional and an educational level deal with topics on ethics of life sciences and ethics in general. Moreover, in the case of bioethics many different disciplines contribute with relevant considerations to the process of opinion and judgment formation. This paper summarizes the main ethical and legal debates on bioethical issues in Germany, specifies the focus of leading German centres of bioethics and biolaw, and explains the tasks, services and networking of the German Reference Centre for Ethics in the Life Sciences (DRZE) which was founded by the Federal Government.

Salud mental / Mental health

El boletin ofrece una recopilación de información acerca de las diversas teorias psicológicas feministas, psicoanálisis, evolutiva y Terapias de intervención en crisis, aromaterapia, bioenegética y grupos de ayudad todas estas bibliografía poseen un breve resúmen del contenido del documento

Where are they now? A case study of health-related Web site attrition.

BACKGROUND: When considering health-related Web sites, issues of quality generally focus on Web content. Little concern has been given to attrition of Web sites or the "fleeting" nature of health information on the World Wide Web. Since Web sites may be available for an uncertain period of time, a Web page may not be a sound reference. OBJECTIVE: To address the issue of attrition, a defined set of health-related Web sites was examined at two separate time intervals. METHODS: To determine the degree of attrition, Web sites obtained and recorded from a previous study were revisited approximately three years later. From December 1998 to May 1999, 184 Web sites were collected from which health claims were identified. During May and June 2002, the previously recorded URL for each Web site was entered into the address field of the browser Netscape Navigator. It was documented whether the original Web site could not be found, moved to a different URL location, or the URL and site location was found unchanged from the original search. For a Web site whose URL remained unchanged, it was also noted whether the site had maintained currency, (i.e. updated) since the original posting. To ensure that inaccessibility may not be due to temporary server problems, another attempt was made to access the sites at different periods of time. RESULTS: When each URL address from the original set of 184 Web sites was re-entered into the address field of the browser, 108 (59%) of the sites could not be found, 31 (17%) had moved to a new URL address, and 45 (24%) of the sites could be found from the original URLs obtained in the previous study. Of the Web sites that moved to a new URL address, 7 sites provided a link from the original URL to redirect the viewer to the new location. Of the Web sites still in existence, 17 (38%) provided update information from the original posting. CONCLUSIONS. It can be difficult to locate information that was previously found on the Web, and if a reference to an item is provided, there is no guarantee that viewers will be able to find the site at a later time. Enhancements in Web technologies such as the Internet Archive may improve this situation. Future research that is directed toward making sure Web site viewers know the site will be accessible at a later time will enhance the Web as a valuable medical information resource.

Los centros de documentaciónde drogodependencias. Especificidadesdel centro de documentación de la delegacióndel gobierno para el plan nacional sobredrogas (DGPNSD) / The drug dependence documentation centers. Specificities of the documentation center of the governmental department for the national plan on drugs (GDNPD)

Objetivo: la necesidad de documentación que los profesionales que intervienen en drogodependencias requieren para la idónea realización de su trabajo diario hace necesaria la creación de Centros de documentación especializados, adaptados al carácter multidisciplinar que caracteriza el fenómeno de las adicciones. Material y métodos: se analizan las características que deben tener los centros de documentación en drogodependencias, con especial referencia al Centro de Documentación de la Delegación del Gobierno para el Plan Nacional sobre Drogas. Resultados: el primer Centro de Documentación de drogodependencias en España se crea en 1986: es el de la Delegación del Gobierno para el Plan Nacional sobre Drogas --DGPNSD--. Sus principales características son: pertenece a la Administración del Estado; asume los esfuerzos de renovación de la Administración pública española, centrados en la potenciación de las unidades de atención al público; ha apostado seriamente por las nuevas tecnologías de la información para hacer accesible un cúmulo de información y documentación a una amplia diversidad de usuarios, al margen de la mayor o menor proximidad geográfica de éstos; sus fondos bibliográficos abarcan todo tipo de sustancias adictivas (tanto "legales" como "ilegales"); cuenta con una Sección de Publicaciones que tiene encomendada la difusión de las editadas por la DGPNSD; elabora y distribuye, con carácter trimestral, un Boletín de Documentación para soslayar el retraso que suele producirse en la incorporación de las nuevas referencias a las bases de datos; y recopila una amplia tipología de documentos: monografías, publicaciones periódicas de carácter científico y divulgativo, "literatura gris", folletos, vídeos, CD-ROM, artículos de prensa...Conclusiones: si bien cabe considerar al Centro de Documentación de la DGPNSD como el Centro de referencia sobre drogodependencias a nivel nacional, no hay que olvidar que ha de ir acometiendo de forma permanente nuevos trabajos para adaptarse a las nuevas demandas de información y/o documentación que la sociedad va planteando: recatalogación informatizada de los documentos que componen su fondo histórico, incorporación a proyectos internacionales como la Biblioteca Virtual del Observatorio Europeo de la Droga y las Toxicomanías (AU)