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1.
Int. j. clin. health psychol. (Internet) ; 21(1): 198-198, ene.-abr. 2021. tab, graf
Artigo em Inglês | IBECS | ID: ibc-194909

RESUMO

BACKGROUND/OBJECTIVE: The objective of the study was to elucidate the underlying mechanism through which basic personality dimensions predict indicators of psychological functioning during the COVID-19 pandemic, including subjective well-being and perceived stress. As a personality characteristic highly contextualized in stressful circumstances, resilience was expected to have a mediating role in this relationship. METHOD: A sample of 2,722 Slovene adults, aged from 18 to 82 years filled in the Big Five Inventory, the Connor-Davidson Resilience Scale, the Perceived Stress Scale, and the Mental Health Continuum. A path analysis with the Bootstrap estimation procedure was performed to evaluate the mediating effect of resilience in the relationship between personality and psychological functioning. RESULTS: Resilience fully or partially mediated the relationships between all the Big Five but extraversion with subjective well-being and stress experienced at the beginning of the COVID-19 outburst. Neuroticism was the strongest predictor of less adaptive psychological functioning both directly and through diminished resilience. CONCLUSIONS: Resilience may be a major protective factor required for an adaptive response of an individual in stressful situations such as pandemic and the associated lockdown


ANTECEDENTES/OBJETIVO: El objetivo fue dilucidar el mecanismo subyacente a través del cual las dimensiones básicas de la personalidad predicen indicadores del funcionamiento psicológico durante la pandemia de COVID-19, incluido el bienestar subjetivo y el estrés percibido. Como característica de la personalidad altamente contextualizada en circunstancias estresantes, se esperaba que la resiliencia tuviera un papel mediador en esta relación. MÉTODO: Una muestra de 2.722 adultos eslovenos (18-82 años), completó el Big Five Inventory, la Connor-Davidson Resilience Scale, la Perceived Stress Scale y el Mental Health Continuum. Se realizó un análisis de ruta con el procedimiento de estimación Bootstrap para evaluar el efecto mediador de la resiliencia en la relación entre la personalidad y el funcionamiento psicológico. RESULTADOS: La resiliencia medió total o parcialmente las relaciones entre los Cinco Grandes, y la extraversión con bienestar subjetivo y el estrés experimentado, al comienzo del estallido de COVID-19. El neuroticismo fue el predictor más fuerte de un funcionamiento psicológico menos adaptativo, tanto directamente como a través de la disminución de la capacidad de resiliencia. CONCLUSIONES: La resiliencia puede ser un factor de protección importante y requerido para una respuesta adaptativa de un individuo en situaciones estresantes como la pandemia y el confinamiento asociado


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Resiliência Psicológica , Personalidade/fisiologia , Infecções por Coronavirus/psicologia , Pneumonia Viral/psicologia , Pandemias , Inventário de Personalidade/normas , Psicometria/métodos , Neuroticismo/fisiologia
2.
Agri ; 33(Suppl 1): 1-51, 2021 Jan.
Artigo em Turco | MEDLINE | ID: mdl-33523457

RESUMO

Satisfactory pain relief is a fundamental right of every patient suffering from pain. Despite the developments on pharmachologic treatment modalities and interventions for pain control, inadequacy of postoperative pain management is still a major problem. After surgical intervention, 66% of patients experience moderate to severe pain during discharge, 9% after two weeks. Untreated postoperative pain may lead to prolonged hospital stay, increased intensive care needs, development of chronic pain, and reduced the patients quality of life. In the following guideline all aspects of postoperative pain briefly evaluated. The clinical practice of postoperative analgesia, recommendations, the diagnosis, assessment and pharmachologic treatment of acute postoperative pain with the current available agents in Turkey are discussed in this article. Our aim is to promote awareness of effective, and safe postoperative pain management strategies to meet the needs of the patients; minor patient groups, such as paediatric population, pregnant patients, elderly, patient with high body mass index and covid 19 diesease. Despite all the recommendations, any guidelines special cases where standard modalities fail to treat postoperative pain management as in patients with chronic pain who previously used opioids, drug addicts, the patient should be consulted with an pain specialist.


Assuntos
Analgésicos Opioides/uso terapêutico , Analgésicos/uso terapêutico , Manejo da Dor/normas , Dor Pós-Operatória/prevenção & controle , Humanos , Guias de Prática Clínica como Assunto
3.
Ann R Coll Surg Engl ; 103(2): 120-129, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33559556

RESUMO

INTRODUCTION: Recent consensus guidelines suggest that the laparoscopic approach may be a useful, safe and feasible approach in emergency general surgery. Despite this, the UK National Emergency Laparotomy Audit (NELA) suggests the rate of laparoscopy is low (9% fully laparoscopic) and slow to increase over time. A European survey found uptake to be variable. This UK survey was therefore undertaken to establish current UK practice and to determine factors affecting implementation. MATERIALS AND METHODS: A questionnaire survey of currently practising UK consultant general surgeons was carried out by the North West Surgical Research Collaborative, using a secure web-based database maintained by the North West Surgical Trials Centre. RESULTS: A total of 151 completed questionnaires were returned from 22 UK centres; 18% of respondents were unaware that laparoscopic cases should be reported to NELA. Appendicectomy (97%) and cholecystectomy (87%) were routinely performed laparoscopically. Laparoscopy was infrequently used in perforation, ischaemia or obstructed hernias. There appears to be equipoise regarding laparoscopic compared with open surgery in small-bowel obstruction among all subspecialty emergency general surgeons, in perforated peptic ulcer among upper gastrointestinal surgeons and in Hinchey III diverticulitis among colorectal surgeons. CONCLUSION: Uptake of laparoscopy in UK emergency general surgery is influenced by surgeon preference, subspecialty, patient and operative factors. Further research into outcomes may help to identify areas of greatest potential benefit. The rate of laparoscopy reported by NELA may be an underestimate due to the 18% of surgeons unaware that laparoscopic cases should be reported, which may affect the validity of analyses performed from this dataset.


Assuntos
Tratamento de Emergência/estatística & dados numéricos , Laparoscopia/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Consenso , Consultores/estatística & dados numéricos , Tratamento de Emergência/normas , Humanos , Laparoscopia/normas , Guias de Prática Clínica como Assunto , Padrões de Prática Médica/normas , Cirurgiões/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Reino Unido
6.
J Am Assoc Nurse Pract ; 33(2): 97-99, 2021 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-33560749

RESUMO

ABSTRACT: The year 2020 was one of tremendous challenge and change for our communities and our profession. As the next decade unfolds, the doctor of nursing practice (DNP) will be required for entry to practice as a nurse practitioner (NP), and we will all continue to recover individually and as a nation from the experiences of the year 2020. Doctor of nursing practice-prepared NPs need to be equipped to take the lead in post-COVID recovery and the challenges the US health care system faces through an increased emphasis on curricula and clinical experiences focused on health disparities, community health, and health promotion.


Assuntos
/enfermagem , Currículo , Educação de Pós-Graduação em Enfermagem/organização & administração , Profissionais de Enfermagem/educação , Profissionais de Enfermagem/normas , Cuidados de Enfermagem/normas , Guias de Prática Clínica como Assunto , Adulto , Competência Clínica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
7.
Z Psychosom Med Psychother ; 67(1): 78-87, 2021.
Artigo em Alemão | MEDLINE | ID: mdl-33565378

RESUMO

Promoting research competence in psychosocial medicine - A new curriculum for medical students Objectives: The objective of this study is the introduction and evaluation of a new graduate-students curriculum to enhance research competence in psychosocial medicine. Method: N = 57 students have participated in the curriculum to date. All participants completed questionnaires regarding teaching quality and pre-post changes in subjective research competence. Results: All items on teaching quality were scored significantly higher (p < 0.05) compared to data of three other comparable psychosocial seminars. In addition, a substantial increase in subjective research competence was found (p < 0.05). Conclusions: The presented curriculum provides an opportunity to strengthen research competence and evidence-based critical thinking of prospective physicians at an early stage. As a consequence of these encouraging results, the curriculum has been implemented permanently at the medical faculty in Heidelberg.


Assuntos
Pesquisa Biomédica/educação , Pesquisa Biomédica/normas , Currículo , Competência Profissional , /normas , Estudantes de Medicina/psicologia , Competência Clínica , Humanos , Estudos Prospectivos
9.
Mo Med ; 118(1): 7-12, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33551470

RESUMO

Medical students, residents, and practicing physicians experience high burnout, depression, and suicide rates, and the COVID-19 pandemic has exacerbated stress for many.1-6 While laudable, current well-being efforts appear insufficient to meet the challenges that so many are facing. This essay explores approaches that individuals and organizations can take to promote mental health and well-being from medical school to practice.


Assuntos
/psicologia , Saúde Mental/normas , Médicos/psicologia , Estudantes de Medicina/psicologia , Adaptação Psicológica/fisiologia , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/terapia , /epidemiologia , Terapia Cognitivo-Comportamental/métodos , Depressão/epidemiologia , Depressão/terapia , Humanos , Sistema Límbico/fisiopatologia , Saúde Mental/estatística & dados numéricos , Atenção Plena/métodos , Faculdades de Medicina/organização & administração , Faculdades de Medicina/normas , Estresse Psicológico/complicações , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Suicídio/prevenção & controle , Suicídio/psicologia , Suicídio/estatística & dados numéricos
10.
Mo Med ; 118(1): 45-49, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33551485

RESUMO

Healthcare providers perform lifesaving work in unusually stressful work environments due to the challenges and related risks of battling the unprecedented COVID-19 pandemic. The potential personal and professional toll is substantial. This article describes how one healthcare facility benefited from existing peer support resources to address workforce well-being, ensuring that resources were available to support workforce resilience throughout the protracted COVID response.


Assuntos
/psicologia , Pessoal de Saúde/psicologia , Mão de Obra em Saúde/estatística & dados numéricos , Saúde do Trabalhador/normas , Local de Trabalho/psicologia , Adaptação Psicológica/fisiologia , Adulto , /epidemiologia , Assistência à Saúde/organização & administração , Recursos em Saúde/provisão & distribução , Humanos , Masculino , Saúde Mental/tendências , Missouri/epidemiologia , Estresse Ocupacional/epidemiologia , Estresse Ocupacional/psicologia , /isolamento & purificação , Grupos de Autoajuda/organização & administração , Universidades/organização & administração , Local de Trabalho/estatística & dados numéricos
11.
Mo Med ; 118(1): 81-84, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33551491

RESUMO

The public health community has used contact tracing to address pandemics since the eighteenth century. With the emergence of COVID-19, these classical skills are the primary defense for communities to limit morbidity and mortality during the pandemic. Here we describe the methods, strengths, and challenges of contact tracing.


Assuntos
/prevenção & controle , Busca de Comunicante/métodos , Pandemias/prevenção & controle , Conscientização , /epidemiologia , Busca de Comunicante/estatística & dados numéricos , Surtos de Doenças/prevenção & controle , Desinfecção das Mãos/métodos , Humanos , Missouri/epidemiologia , Isolamento de Pacientes/métodos , Saúde Pública/métodos , Saúde Pública/normas , Quarentena/métodos , /isolamento & purificação
12.
Medicine (Baltimore) ; 100(6): e24690, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578603

RESUMO

ABSTRACT: Pediatric procedural sedation (PPS) is often performed outside of the operating room, and by various sub-specialty providers. There is no consistency in how pediatric emergency medicine (PEM) fellows are trained in PPS. The objective of this study was to survey PEM program directors (PDs) and PEM fellows about their current sedation teaching practices via a direct survey. While many fellowship programs train PEM fellows in PPS, we hypothesize that there is no consistent method of developing and measuring this skill.A 12-question survey was sent to PEM PDs directly via email. A separate 17-question survey was sent to current PEM fellows via their program coordinators by email. Each survey had multiple choice, yes-no and select-all program questions. Responses were collected in an online (REDCap) database and summarized as frequencies and percentages.Based on identifiable email, 67 programs were contacted, with a PD response rate of 46 (59%). Sixty-two program coordinators were contacted based on identifiable email with 78 fellow responses. We noted that 11/46 PD respondents offer a formal PPS rotation. Thirty programs report using propofol in the emergency department and 93% of PD respondents (28/30) actively train fellows in the use of propofol. Approximately 62% of PEM fellow respondents (48/78) report sedating without any attending oversight. Twenty-eight percent of PEM fellow respondents report using simulation as a component of their sedation training.PPS is a critical skill. However, there is a lack of consistency in both education and evaluation of competency in this area. An organized PPS rotation would improve PPS case exposure and PPS skills.


Assuntos
Anestesiologia/educação , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Bolsas de Estudo/estatística & dados numéricos , Medicina de Emergência Pediátrica/educação , Anestésicos Intravenosos/administração & dosagem , Anestésicos Intravenosos/uso terapêutico , Competência Clínica/estatística & dados numéricos , Gerenciamento de Dados , Educação de Pós-Graduação em Medicina/métodos , Escolaridade , Serviço Hospitalar de Emergência/estatística & dados numéricos , Humanos , Internato e Residência/normas , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Propofol/administração & dosagem , Propofol/uso terapêutico , Treinamento por Simulação/estatística & dados numéricos , Inquéritos e Questionários
13.
Medicine (Baltimore) ; 100(6): e24703, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578607

RESUMO

RATIONALE: The abnormal expression of B-cell lymphoma-2 (Bcl-2) family members is often associated with the progression of the disease. Bcl-2 inhibitors (eg, venetoclax) were first reported to inhibit the proliferation of malignant lymphocytes and have a significant effect on patients with chronic lymphoblastic leukemia, but research on myeloid tumors is relatively delayed. Venetoclax was approved in 2018 for the treatment of acute myeloid leukemia (AML) patients who were not suitable for high-dose chemotherapy. The approval of venetoclax is an advance in the treatment of hematological tumors. PATIENT CONCERNS: Here we report a 64-year-old male with an increased white blood cell (WBC) count (39.0 × 109/L) and lymphocyte count (30.6 × 109/L) on physical examination in July 2014. The patients were diagnosed with chronic lymphocytic leukemia (CLL) through bone marrow (BM) smears and immunophenotyping without any cytogenetic or molecular abnormalities. Chlorambucil was prescribed, WBC was stable between 15 × 109/L and 25 × 109/L in the past 6 years. He came to the hospital again in May 2020 and complained of fatigue for 2 weeks. WBC (16.7 × 109/L) and lymphocyte (14.76 × 109/L) counts were increased, hemoglobin (HGB) and platelet (PLT) were decreased in peripheral blood, which indicated the progression of the disease. DIAGNOSES: The patient was diagnosed as secondary AML after CLL based on the clinical and laboratory findings. INTERVENTIONS: He achieved a morphological complete remission in both AML and CLL without any adverse reactions after one course of venetoclax monotherapy. OUTCOMES: He received standard daunorubicin and cytarabine combined with venetoclax as consolidation therapy and is now ready for allogeneic-hematopoietic stem cell transplantation. LESSONS: Our case presents a challenge to traditional treatment. New drugs such as venetoclax have shown outstanding effects in this respect. High expression of Bcl-2 can identify the responders of venetoclax. These findings should be validated in future clinical trials. We fully believe that in the near future, the comprehensive use of targeted drugs with different mechanisms will not only improve the quality of life of patients, but also completely change the prognosis of patients with recurrent and refractory hematological malignancies.


Assuntos
Leucemia Linfocítica Crônica de Células B/complicações , Leucemia Linfocítica Crônica de Células B/tratamento farmacológico , Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Mieloide Aguda/etiologia , Antibióticos Antineoplásicos/administração & dosagem , Antibióticos Antineoplásicos/uso terapêutico , Antimetabólitos Antineoplásicos/administração & dosagem , Antimetabólitos Antineoplásicos/uso terapêutico , Antineoplásicos/administração & dosagem , Antineoplásicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Compostos Bicíclicos Heterocíclicos com Pontes/administração & dosagem , Compostos Bicíclicos Heterocíclicos com Pontes/uso terapêutico , Citarabina/administração & dosagem , Citarabina/uso terapêutico , Daunorrubicina/administração & dosagem , Daunorrubicina/uso terapêutico , Progressão da Doença , Transplante de Células-Tronco Hematopoéticas/normas , Humanos , Imunofenotipagem/métodos , Leucemia Linfocítica Crônica de Células B/patologia , Leucemia Mieloide Aguda/patologia , Contagem de Leucócitos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Indução de Remissão , Sulfonamidas/administração & dosagem , Sulfonamidas/uso terapêutico , Resultado do Tratamento
14.
Am J Trop Med Hyg ; 104(2): 433-435, 2021 01 13.
Artigo em Inglês | MEDLINE | ID: mdl-33534734

RESUMO

As COVID-19 vaccines are distributed across the United States, it is essential to address the pandemic's disproportionate impact on refugee, immigrant, and migrant (RIM) communities. Although the National Academies Press Framework for Equitable Allocation of COVID-19 Vaccine provides recommendations for an equitable vaccine campaign, implementation remains. Practical considerations for vaccine rollout include identifying and overcoming barriers to vaccination among RIM communities. To identify barriers, information regarding vaccine beliefs and practices must be incorporated into the pandemic response. To overcome barriers, effective communication, convenience of care, and community engagement are essential. Taking these actions now can improve health among RIM communities.


Assuntos
/administração & dosagem , Emigrantes e Imigrantes , Refugiados , Migrantes , /epidemiologia , Humanos , Estados Unidos , Vacinação/normas
15.
BMJ Open Qual ; 10(1)2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33589506

RESUMO

The surge in clinical demand, shortage in personal protective equipment and high-exposure risk for healthcare workers during the COVID-19 pandemic has challenged hospital common practices and forced a reassessment of care delivery models. Code blue teams are highly specialised units that partake in life-saving situations that can jeopardise the safety of team members. There is a paucity of guidance in regards to proper infection control measures to protect the responders.This study describes a methodical approach to assessing vulnerabilities to transmission of SARS-CoV-2 within existing code blue practices, modalities to limit the number of code blue team responders and modifications to the protocol at a large community teaching hospital. The effort undertaken faced challenges due to the nature of the pandemic and the increased demand on healthcare workers. Quality improvement methods facilitated our protocol design and implementation. To this date, there has been no identified COVID-19 disease in any protected code blue (PCB) team members. We recommend that similar practices be considered and adopted widely and practised periodically.


Assuntos
/prevenção & controle , Pessoal de Saúde/educação , Equipe de Respostas Rápidas de Hospitais/normas , Controle de Infecções/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Adulto , Feminino , Grupos Focais , Pessoal de Saúde/normas , Hospitais de Ensino , Humanos , Controle de Infecções/métodos , Masculino , Pessoa de Meia-Idade , Equipamento de Proteção Individual , Melhoria de Qualidade
16.
Isr Med Assoc J ; 23(2): 76-81, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33595210

RESUMO

BACKGROUND: The coronavirus disease-2019 (COVID-19) pandemic presented a major medical management challenge to ophthalmology departments throughout Israel. OBJECTIVES: To examine the managerial challenges, actions taken, and insights of directors of ophthalmology departments in Israel during the COVID-19 pandemic. METHODS: We conducted a cross sectional survey of directors of ophthalmology departments during the COVID-19 pandemic while the Israeli population was quarantined. RESULTS: All 21 directors answered the survey. The majority of the COVID-19 admissions were located in the center of Israel (53%) and Jerusalem (30%). E-communication took a central role in coping with the pandemic with 80% of the directors satisfied with this form of communication; 75% reported a reduction in clinical and surgery volume of at least 25%, and 40% reported reallocations of manpower. Most of the medical staff used gloves, a face shield, disposable robe, and a mask with no uniformity across departments. Cross satisfaction was noted regarding a hospital's ability to equip the departments. Lack of preparation for post-pandemic era was reported by all directors, but one (95%). Directors sought guidelines and uniformity regarding outpatient referral to the hospital (p = 0.035). CONCLUSIONS: Guidelines via safe digital platforms aid in management decisions and uniformity across departments. Advanced preparation is needed to prevent adverse clinical outcomes and to maintain treatment continuum. Our results can be used to guide and help improve the preparedness of ophthalmology departments during COVID-19 and for future pandemics.


Assuntos
Departamentos Hospitalares/organização & administração , Oftalmologia/organização & administração , Equipamento de Proteção Individual/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Adulto , Comunicação , Estudos Transversais , Equipamentos Descartáveis/estatística & dados numéricos , Luvas Protetoras/estatística & dados numéricos , Departamentos Hospitalares/normas , Humanos , Israel , Máscaras/estatística & dados numéricos , Pessoa de Meia-Idade , Equipamento de Proteção Individual/provisão & distribução , Quarentena , Encaminhamento e Consulta , Inquéritos e Questionários
17.
BMJ Case Rep ; 14(2)2021 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-33597165

RESUMO

Placement of a double-lumen tube to achieve one lung ventilation is an aerosol-generating procedure. Performing it on a patient with COVID-19 will put healthcare workers at high risk of contracting the disease. We herein report a case of its use in a patient with traumatic diaphragmatic rupture, who was also suspected to have COVID-19. This article aims to highlight the issues, it presented and ways to address them as well as the perioperative impact of personal protective equipment.


Assuntos
/prevenção & controle , Pessoal de Saúde/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Ventilação Monopulmonar/normas , Equipamento de Proteção Individual/normas , Acidentes de Trânsito , Adulto , /transmissão , Diafragma/lesões , Diafragma/cirurgia , Humanos , Masculino , Ventilação Monopulmonar/instrumentação , Guias de Prática Clínica como Assunto , /etiologia , Ruptura/etiologia , Ruptura/terapia
18.
J Infect Dev Ctries ; 15(1): 51-57, 2021 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-33571145

RESUMO

BACKGROUND: COVID-19 is a global pandemic. The virus spreads through respiratory droplets and close contact. Therefore, the availability of personal protective equipment (PPE) for healthcare professionals is essential. 3D printing technology could represent a valid option to ameliorate PPE shortages. METHODOLOGY: Custom-made face mask were designed on the basis of facial scan and then 3D-printed. The whole protocol is executed with freeware software and only required a 3D printer. Six healthcare workers wore the device weekly thus expressing a judgment regarding quality of work, respiratory and skin comfort. RESULTS: The estimated total cost of a single mask is approximately 5 USD. The virtual design of a complete mask lasted 68 minutes on average. Most healthcare workers rated comfort as very good. CONCLUSIONS: Based on the encouraging results obtained, we can confidently confirm that custom-made masks are novel and useful devices that may be used in the fight against COVID-19.


Assuntos
/prevenção & controle , Desenho de Equipamento/métodos , Máscaras/normas , Impressão Tridimensional , Desenho de Equipamento/instrumentação , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Máscaras/economia , Impressão Tridimensional/economia
19.
BMJ Open Qual ; 10(1)2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33579746

RESUMO

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.


Assuntos
/reabilitação , Serviços de Saúde para Idosos/normas , Equipe de Assistência ao Paciente/normas , Melhoria de Qualidade , Atenção Secundária à Saúde/normas , Idoso , Idoso de 80 Anos ou mais , Comunicação , Feminino , Humanos , Relações Interprofissionais , Masculino , Atenção Secundária à Saúde/métodos
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