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Rev. Hosp. Ital. B. Aires (2004) ; 40(3): 127-131, sept. 2020. tab
Artigo em Espanhol | LILACS | ID: biblio-1129089


Introducción: Los aspirantes a las residencias en salud pertenecen a una generación que suele preferir instituciones flexibles y poco estructuradas para avanzar en su desarrollo profesional. Objetivo: Nos propusimos explorar cuáles son las motivaciones de los aspirantes en la elección de la institución en donde llevarán a cabo su residencia. Material y métodos: Se realizó un estudio de corte transversal a través de una encuesta anónima a todos los aspirantes a las residencias médicas. Se evaluaron edad, sexo, universidad de procedencia, especialidad elegida, preferencia de tipo de gestión y la descripción de las tres condiciones que consideran más importantes para elegir una institución en orden de importancia. Resultados: Se analizaron 1113 encuestas y el 59% correspondieron a mujeres. Las primeras tres condiciones elegidas fueron: 1.°) calidad académica (65,4%), prestigio institucional (16%) y caudal y complejidad de pacientes (5,9%); 2.°) clima de aprendizaje (21,6%), calidad académica (20%) y prestigio institucional (18,8%) y 3.°) clima de aprendizaje (16,1%), condiciones laborales (16,1%) y calidad académica (14,5%). No se encontró asociación entre las motivaciones para elegir una institución y sexo, universidad de origen, tipo de especialidad o preferencia de gestión. Conclusión: Los aspirantes a las residencias valoran en primer lugar los aspectos vinculados con su formación académica. Por otra parte, es relevante la importancia adjudicada al clima de aprendizaje y las condiciones laborales. (AU)

Introduction: Applicants to health care residences belong to a generation that often prefers flexible and unstructured institutions to develop their professional development. Objective: We set out to explore what the applicants' motivations are in choosing the institution where they will carry out their residence. Material and methods: A cross-sectional study was conducted through an anonymous survey of all applicants to medical residences. Age, sex, university of origin, chosen specialty, management type preference and the description of the three conditions that they consider most important to choose an institution in order of importance were evaluated. Results: 1,113 surveys were analyzed and 59% were women. The first three conditions chosen were: 1st) academic quality (65.4%), institutional prestige (16%) and wealth and complexity of patients (5.9%); 2nd) learning climate (21.6%), academic quality (20%) and institutional prestige (18.8%) and 3rd) learning climate (16.1%), conditions labor (16.1%) and academic quality (14.5%). No association was found between the motivations for choosing an institution and sex, home university, type of specialty or management preference. Conclusion: Applicants to residences value first the aspects related to their academic training. On the other hand, the importance attached to the climate of learning and working conditions. (AU)

Humanos , Masculino , Feminino , Estudantes de Medicina/estatística & dados numéricos , Internato e Residência/tendências , Argentina , Médicos/tendências , Instituições Acadêmicas/estatística & dados numéricos , Ambiente de Trabalho/estatística & dados numéricos , Condições de Trabalho , Estudos Transversais , Inquéritos e Questionários , Capacitação Profissional , Esgotamento Psicológico , Ambiente de Instituições de Saúde/estatística & dados numéricos , Internato e Residência/estatística & dados numéricos , Satisfação no Emprego
Brain Behav Immun ; 88: 50-58, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32512133


Sleep is known to play an important role in immune function. However, the effects of sleep quality during hospitalization for COVID-19 remain unclear. This retrospective, single-center cohort study was conducted to investigate the effects of sleep quality on recovery from lymphopenia and clinical outcomes in hospitalized patients with laboratory-confirmed COVID-19 admitted to the West District of Wuhan Union Hospital between January 25 and March 15, 2020. The Richards-Campbell sleep questionnaire (RCSQ) and Pittsburgh Sleep Quality Index (PSQI) were used to assess sleep quality. The epidemiological, demographic, clinical, laboratory, treatment, and outcome data were collected from electronic medical records and compared between the good-sleep group and poor-sleep group. In all, 135 patients (60 in good-sleep group and 75 in poor-sleep group) were included in this study. There were no significant between-group differences regarding demographic and baseline characteristics, as well as laboratory parameters upon admission and in-hospital treatment. Compared with patients in the good-sleep group, patients in the poor-sleep group had lower absolute lymphocyte count (ALC) (day 14: median, 1.10 vs 1.32, P = 0.0055; day 21: median, 1.18 vs 1.48, P = 0.0034) and its reduced recovery rate (day 14: median, 56.91 vs 69.40, P = 0.0255; day 21: median, 61.40 vs 111.47, P = 0.0003), as well as increased neutrophil-to-lymphocyte ratio (NLR; day 14: median, 3.17 vs 2.44, P = 0.0284; day 21: median, 2.73 vs 2.23, P = 0.0092) and its associated deterioration rate (day 14: median, -39.65 vs -61.09, P = 0.0155; day 21: median, -51.40% vs -75.43, P = 0.0003). Nine [12.0%] patients in the poor-sleep group required ICU care (P = 0.0151); meanwhile, none of the patients in good-sleep group required ICU care. Patients in the poor-sleep group had increased duration of hospital stay (33.0 [23.0-47.0] days vs 25.0 [20.5-36.5] days, P = 0.0116) compared to those in the good-sleep group. An increased incidence of hospital-acquired infection (seven [9.3%] vs one [1.7%]) was observed in the poor-sleep group compared to the good-sleep group; however, this difference was not significant (P = 0.1316). In conclusion, poor sleep quality during hospitalization in COVID-19 patients with lymphopenia is associated with a slow recovery from lymphopenia and an increased need for ICU care.

Infecções por Coronavirus/sangue , Linfopenia/sangue , Pneumonia Viral/sangue , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Sono , Idoso , Betacoronavirus , Convalescença , Infecções por Coronavirus/complicações , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Feminino , Ambiente de Instituições de Saúde , Hospitalização , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Tempo de Internação , Linfopenia/complicações , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Estudos Retrospectivos , Distúrbios do Início e da Manutenção do Sono/complicações , Fatores de Tempo
J Med Internet Res ; 22(6): e11839, 2020 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-32530434


BACKGROUND: Conventional approaches to improve the quality of clinical patient imaging studies focus predominantly on updating or replacing imaging equipment; however, it is often not considered that patients can also highly influence the diagnostic quality of clinical imaging studies. Patient-specific artifacts can limit the diagnostic image quality, especially when patients are uncomfortable, anxious, or agitated. Imaging facility or environmental conditions can also influence the patient's comfort and willingness to participate in diagnostic imaging studies, especially when performed in visually unesthetic, anxiety-inducing, and technology-intensive imaging centers. When given the opportunity to change a single aspect of the environmental or imaging facility experience, patients feel much more in control of the otherwise unfamiliar and uncomfortable setting. Incorporating commercial, easily adaptable, ambient lighting products within clinical imaging environments allows patients to individually customize their environment for a more personalized and comfortable experience. OBJECTIVE: The aim of this pilot study was to use a customizable colored light-emitting diode (LED) lighting system within a clinical imaging environment and demonstrate the feasibility and initial findings of enabling healthy subjects to customize the ambient lighting and color. Improving the patient experience within clinical imaging environments with patient-preferred ambient lighting and color may improve overall patient comfort, compliance, and participation in the imaging study and indirectly contribute to improving diagnostic image quality. METHODS: We installed consumer-based internet protocol addressable LED lights using the ZigBee standard in different imaging rooms within a clinical imaging environment. We recruited healthy volunteers (n=35) to generate pilot data in order to develop a subsequent clinical trial. The visual perception assessment procedure utilized questionnaires with preprogrammed light/color settings and further assessed how subjects preferred ambient light and color within a clinical imaging setting. RESULTS: Technical implementation using programmable LED lights was performed without any hardware or electrical modifications to the existing clinical imaging environment. Subject testing revealed substantial variabilities in color perception; however, clear trends in subject color preference were noted. In terms of the color hue of the imaging environment, 43% (15/35) found blue and 31% (11/35) found yellow to be the most relaxing. Conversely, 69% (24/35) found red, 17% (6/35) found yellow, and 11% (4/35) found green to be the least relaxing. CONCLUSIONS: With the majority of subjects indicating that colored lighting within a clinical imaging environment would contribute to an improved patient experience, we predict that enabling patients to customize environmental factors like lighting and color to individual preferences will improve patient comfort and patient satisfaction. Improved patient comfort in clinical imaging environments may also help to minimize patient-specific imaging artifacts that can otherwise limit diagnostic image quality. TRIAL REGISTRATION: NCT03456895;

Cor/normas , Lasers Semicondutores/uso terapêutico , Iluminação/métodos , Assistência ao Paciente/métodos , Ambiente de Instituições de Saúde , Humanos , Internet , Projetos Piloto
J Clin Nurs ; 29(13-14): 2615-2625, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32279359


AIMS AND OBJECTIVES: To describe the risk and frequency of challenges in acute care nursing, and the practice priorities in Australian hospital wards based upon expert consensus. BACKGROUND: Health care is facing increasing demands that are negatively impacting upon the safety and quality of nursing care. DESIGN: Delphi Method. METHOD: A three-round electronic Delphi method was used to collect and synthesise expert consensus opinion of 30 participants in Rounds One and Two of the survey, and 12 participants in Round Three. The study was carried out from July to December 2016. This study complied with the STROBE checklist. RESULTS: High patient acuity or complexity, as well as inadequate bed space on wards, are "very high" risks that occur "often" and "very often," respectively. The pressure to admit patients, delayed medical review and patient boarding are all "high" risks that occur "often." Though only occurring "sometimes," inadequate numbers and skill mix of staff, suboptimal communication and early or inappropriate discharge all pose a "very high" risk to patient care. CONCLUSION: The key practice priorities for nurse managers should include the design, implementation and evaluation of sustainable system-wide frameworks, processes and models of care that address patient boarding, communication and discharge processes, job satisfaction, staffing numbers and expertise. RELEVANCE TO CLINICAL PRACTICE: This study provides a description of the challenges that face acute care nursing in the provision of safe and high-quality care.

Enfermagem de Cuidados Críticos/normas , Qualidade da Assistência à Saúde/normas , Austrália , Consenso , Técnica Delfos , Ambiente de Instituições de Saúde/normas , Humanos , Masculino , Relações Enfermeiro-Paciente , Inquéritos e Questionários
J. nurs. health ; 10(4): 20104037, abr.2020.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1145284


Objetivo: refletir sobre as contribuições da Teoria Ambientalista na pandemia do novo Coronavírus. Método: estudo teórico-reflexivo, sustentado em revisão narrativa e na Teoria Ambientalista, sobre as formas de prestação de cuidados e organização dos serviços de saúde durante a pandemia do novo Coronavírus. Resultados: os conceitos Ambiente e Saúde-Doença revelaram-se fundamentais para se pensar a (re)organização dos serviços de saúde e dos domicílios, como formas de cuidado e controle ambiental. Complementarmente, os conceitos Enfermagem e Sociedade, permitiram refletir sobre a necessidade de incluir novas formas de cuidado, que considerem a utilização das tecnologias e dos ambientes virtuais, para alcançar a população. Conclusão: foi possível visualizar as articulações entre os conceitos expostos pela Teoria Ambientalista e a pandemia do novo Coronavírus, mostrando a atualidade da relação destes. (AU)

Objective:to reflect on the contributions of the Environmental Theory in the new Coronavirus pandemic. Method: theoretical-reflectivestudy,supported bya narrative review and the Environmental Theory, on the waysof providing care and organization of health services during the pandemic of the new Coronavirus. Results: the concepts Environment and Health-Disease proved to be fundamental to think about the (re) organization of health services and households, as forms of care and environmental control. In addition, the concepts of Nursing and Society, allowed reflection on the need to include new forms of care, which consider the use of technologies and virtual environments, to reach the population. Conclusion: it was possible to visualize the articulations between the concepts exposed by the Environmental Theory and the pandemic of the new Coronavirus, showing the currentness of their relationship.(AU)

Objetivo: reflexionar sobre los aportes de la Teoría Ambiental en la pandemia del nuevo Coronavirus.Método: estudio teórico-reflexivo,respaldado por unarevisión narrativa y la Teoría Ambiental, sobre las formas debrindaratención y organización de los servicios de salud durante la pandemia del nuevo Coronavirus.Resultados: los conceptos Medio Ambiente y Salud-Enfermedad resultaron fundamentales para pensar la (re) organización de los servicios de salud y los hogares, como formas de cuidado y control ambiental. Además, los conceptos de Enfermería y Sociedad, permitieron reflexionar sobre la necesidad de incluir nuevas formas de atención, que consideren el uso de tecnologías y entornos virtuales, para llegar a la población. Conclusión: fue posible visualizar las articulaciones entre los conceptos expuestos por la Teoría Ambiental y la pandemia del nuevo Coronavirus, mostrando la actualidad de su relación.(AU)

Teoria de Enfermagem , Infecções por Coronavirus , Ambiente de Instituições de Saúde
Pediatrics ; 145(4)2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32205465


It is crucial that all children are provided with high-quality and safe health care. Pediatric inpatient needs are unique in regard to policies, equipment, facilities, and personnel. The intent of this clinical report is to provide recommendations for the resources necessary to provide high-quality and safe pediatric inpatient medical care.

Criança Hospitalizada , Recursos em Saúde , Qualidade da Assistência à Saúde , Adolescente , Manuseio das Vias Aéreas/normas , Criança , Pré-Escolar , Tratamento de Emergência/instrumentação , Equipamentos e Provisões Hospitalares , Família , Ambiente de Instituições de Saúde , Humanos , Lactente , Informática Médica , Segurança do Paciente , Ressuscitação/instrumentação
Gac Med Mex ; 156(1): 47-52, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32026871


Background: User satisfaction is key to define and assess the quality of care; however, there is no patient satisfaction rapid scale in Mexico. Our objective was to determine the validity and consistency of an outpatient department user satisfaction rapid scale (ERSaPaCE). Method: Comparative, observational, cross-sectional, prolective study. In phase 1, a rapid scale model was developed, which was submitted to experts in medical care for assessment; the instrument was pilot-tested in 10-patient groups, using as many rounds as required until it obtained 20 approvals. In phase 2, the resulting questionnaire and the Outpatient Service User Satisfaction (SUCE) scale were applied to outpatient department users. ERSaPaCE was reapplied by telephone 10 days later. Descriptive statistics, Cronbach's a, Spearman's correlation and intra-class correlation coefficient (ICC) were used. Results: Two-hundred patients were recruited, out of which 53 % were aged 31-60 years; 51.5 % were women and 48.5 % men, all of them users of the outpatient services from 13 specialties. Cronbach's a for ERSaPaCE was 0.608, whereas ICC was 0.98 (p = 0.000). Convergent validity was 0.681 (p = 0.000) using Spearman's rho. Conclusion: ERSaPaCE was a valid and consistent instrument for the assessment of outpatient department user satisfaction.

Assistência Ambulatorial/normas , Pacientes Ambulatoriais/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Qualidade da Assistência à Saúde , Inquéritos e Questionários , Adolescente , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Feminino , Ambiente de Instituições de Saúde/normas , Serviço de Limpeza/normas , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais/psicologia , Admissão do Paciente , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Adulto Jovem
Br J Nurs ; 29(1): 8, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31917933


Tracy Doherty, Assistant Director of Infection Prevention & Control, Our Lady of Lourdes Hospital, Drogheda, Co Louth, discusses the maintenance of a clean healthcare environment.

Infecção Hospitalar/etiologia , Ambiente de Instituições de Saúde , Infecção Hospitalar/prevenção & controle , Ambiente de Instituições de Saúde/normas , Serviço Hospitalar de Limpeza/normas , Humanos , Controle de Infecções
Environ Geochem Health ; 42(5): 1487-1496, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31643010


This study evaluates indoor air concentrations of CO2, NO2, and O3 and their relationship to other indoor environmental factors in facilities with occupants susceptible to air contaminants, such as hospitals, senior specialized hospitals, elderly care facilities, and postnatal care centers. Indoor air samples were collected from 82 indoor facilities in South Korea and organized by region. Spearman's correlation and Kruskal-Wallis analyses were employed to examine the relationship among and differences between contaminants in the indoor facilities and indoor/outdoor differences of NO2 and O3 concentrations. Significant correlations were found between CO2 and NO2 concentrations (r2 = 0.176, p < 0.01), as well as NO2 and O3 concentrations (r2 = - 0.289, p < 0.0001). The indoor/outdoor concentration ratios in the indoor facilities were 0.73 for NO2 and 0.25 for O3. CO2 and NO2 displayed the highest mean concentrations during spring, while O3 displayed the highest and lowest mean concentrations during fall and summer, respectively. The calculated hazard quotient (HQ) for NO2 was higher than the acceptable level of 1 in postnatal care centers, thus posing a health risk for children. Study results indicate that efficient ventilation is required to reduce indoor contaminants in multiple healthcare facilities. This study provides a novel approach toward health risk assessment for indoor facilities with susceptible occupants on a large geographical scale.

Poluição do Ar em Ambientes Fechados/análise , Dióxido de Carbono/análise , Dióxido de Nitrogênio/análise , Ozônio/análise , Adulto , Idoso , Poluição do Ar em Ambientes Fechados/efeitos adversos , Criança , Monitoramento Ambiental/métodos , Feminino , Instalações de Saúde , Ambiente de Instituições de Saúde , Hospitais , Humanos , Lactente , Recém-Nascido , Exposição por Inalação/efeitos adversos , Pessoa de Meia-Idade , Casas de Saúde , República da Coreia , Medição de Risco/métodos , Estações do Ano
Gerontologist ; 60(5): 859-867, 2020 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-31773144


BACKGROUND AND OBJECTIVES: Thriving has been described as a multidimensional concept that can be used to explore place-related well-being; however, there has been limited research into the meaning of thriving in aged care. This study aimed to illuminate meanings of thriving as narrated by persons living in nursing homes. RESEARCH DESIGN AND METHODS: Narrative interviews were conducted with 21 persons residing in a rural Australian nursing home. The interviews were audio-recorded, transcribed, and interpreted using a phenomenological hermeneutic approach. RESULTS: Meanings of thriving could be understood as: Striving toward acceptance of being in a nursing home while maintaining a positive outlook; Feeling supported and cared for while maintaining a sense of independence; Balancing opportunities for solitude and company while living with others; and, Feeling a sense of home while residing in an institutional environment. The meanings of thriving, as presented through the interpretive lens of Gaston Bachelard's "Poetics of Space," encompassed having access to literal, metaphorical, and symbolic doors, as well as having the freedom to open, close, and use these doors however the person wishes. DISCUSSION: Exploring meanings of thriving in nursing homes could contribute towards understanding and implementing positive life-world constructs in research and practice. These findings could be used to inform and enhance person-centered care practices by maximizing opportunities for persons residing in nursing homes to have options and choices, and the agency to make decisions where possible, in relation to their everyday care and living environment.

Narração , Casas de Saúde , Satisfação Pessoal , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Austrália , Emoções , Feminino , Ambiente de Instituições de Saúde , Hermenêutica , Humanos , Masculino , Saúde Mental , Pesquisa Qualitativa , Qualidade de Vida , Autocuidado
Complement Med Res ; 27(2): 97-104, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31751994


BACKGROUND: Preterm infants are vulnerable humans requiring much care and attention. They may be exposed to irregular noise, light, and odor in the neonatal intensive care unit for a period of several weeks or months. This study was carried out to determine the effect of individualized developmental care on physiological parameters, growth, and transition to oral feeding in preterm infants. METHODS: The study was a randomized controlled trial. The sample comprised premature infants meeting the inclusion criteria. They were randomly assigned to four groups: the maternal voice group, the breast milk odor (BMO) group, the incubator cover (IC) group, and the control group. RESULTS: No statistically significant difference was found between the groups in terms of weight, height, and head circumference at time of discharge. Mean SO2 values were statistically higher in the IC group than the other groups; however, the heart rate and respiratory rate were not statistically different in a significant sense between the groups. The briefest duration of transition to total oral feeding was seen in the BMO group. CONCLUSION: Individualized developmental care practices based on the results of these interventions are likely to support the care of preterm infants. Breast milk odor may ease the transition to breastfeeding.

Aleitamento Materno , Recém-Nascido Prematuro/crescimento & desenvolvimento , Recém-Nascido Prematuro/psicologia , Leite Humano , Olfato , Têxteis , Voz , Meio Ambiente , Feminino , Ambiente de Instituições de Saúde , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Masculino , Mães , Planejamento de Assistência ao Paciente
J Infect Public Health ; 13(5): 800-805, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31831394


OBJECTIVE: The objective of this study is to explore the bacterial distribution characteristics of air and bed environment in patients with cerebrovascular diseases and to analyze the relationship between bacterial distribution and nosocomial infection in patients with cerebrovascular diseases. METHODS: In this study, the inpatients with cerebrovascular diseases who suffer from nosocomial infection are taken as the research objects. The pathogenic characteristics of the air environment in the ward and the environment in the bed unit are monitored, and the samples of cerebrovascular patients are collected for identification and drug sensitivity detection. The changes of the number of pathogens in different seasons are statistically compared, and the drug sensitivity test results of various pathogens are analyzed. RESULTS: In large wards, the number of pathogens in the air environment in winter is significantly higher than that in spring. In summer, the number of pathogens in pillow environment is significantly more than that in small wards. Gram-negative bacilli are the main pathogens in the four seasons, followed by Gram-positive cocci and less fungal infections. Among them, Staphylococcus aureus is the main Gram-positive coccus, which is sensitive to vancomycin and other therapeutic drugs, and resistant to erythromycin and other therapeutic drugs. Gram-negative bacteria are mainly Klebsiella pneumoniae and Pseudomonas aeruginosa. K. pneumoniae is sensitive to imipenem, tekacillin, meropenem and ceftitam, and resistant to ampicillin. P. aeruginosa is sensitive to cefuroxime ester, cefazolin and cefuroxime sodium. It is resistant to ampicillin, ceftitam, compound sinomine and ampicillin plus sulbactam. Candida albicans is the main fungus, which is sensitive to ketoconazole, fluconazole, amphotericin and nystatin. CONCLUSION: The number of pathogenic bacteria in the ward environment of patients with cerebrovascular disease is affected by the size of the room and season. The main pathogenic bacteria are Gram-negative bacilli, followed by Gram-positive cocci and less fungal infections.

Antibacterianos/uso terapêutico , Transtornos Cerebrovasculares/epidemiologia , Infecção Hospitalar/epidemiologia , Ambiente de Instituições de Saúde , Estações do Ano , Antibacterianos/farmacologia , Transtornos Cerebrovasculares/tratamento farmacológico , Transtornos Cerebrovasculares/microbiologia , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Infecção Hospitalar/prevenção & controle , Farmacorresistência Bacteriana , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Humanos , Klebsiella pneumoniae/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Pseudomonas aeruginosa/efeitos dos fármacos , Staphylococcus aureus/efeitos dos fármacos
Ann Surg ; 271(5): 958-961, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-30601253


OBJECTIVE: The primary objective of this study was to evaluate the utility, clinical impact, and work flow of a new trauma hybrid operating theater. SUMMARY BACKGROUND DATA: The potential utility and clinical benefit of hybrid operating theaters are increasingly postulated. Unfortunately, the clinical outcomes and efficiencies of these environments remain unclear. METHODS: All severely injured patients who were transferred to the hybrid suite for emergent intervention between 2013 and 2017 were compared to consecutive prehybrid patients. Standard statistical methodology was employed (P < 0.05 = significant). RESULTS: One hundred sixty-nine patients with severe injuries (mean ISS = 23; hemodynamic instability = 70%; hospital/ICU stay = 12 d; mortality = 14%) were transferred urgently to the hybrid suite. Most were young (38 yrs) males (84%) with blunt injuries (51%). Combined hybrid trauma procedures occurred in 18% of cases (surgery (82%) and angiography (11%) alone). Procedures within the hybrid suite included: laparotomy (57%), extremity (14%), thoracotomy/sternotomy (12%), angioembolization of the spleen/pelvis/liver/other (9%), neck (9%), craniotomy (4%), and aortic endostenting (6%). Compared with historical controls, use of the hybrid suite resulted in shorter arrival to intervention and total procedure times (P < 0.05). A clear benefit for survival was evident (42% vs. 22%). CONCLUSIONS: Availability of a hybrid environment for severely injured patients reduces time to intervention, total procedural duration, blood product transfusion and salvages a small subset of patients who would not otherwise survive. The cost associated with a hybrid suite remains prohibitive for many centers.

Ambiente de Instituições de Saúde , Salas Cirúrgicas/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde , Ferimentos e Lesões/cirurgia , Adulto , Transfusão de Componentes Sanguíneos/estatística & dados numéricos , Canadá , Feminino , Humanos , Escala de Gravidade do Ferimento , Tempo de Internação/estatística & dados numéricos , Masculino , Duração da Cirurgia , Estudos Prospectivos , Tempo para o Tratamento/estatística & dados numéricos
Goiânia; Cegraf UFG; 2020. 48 p. ilus.
Monografia em Português | LILACS, Coleciona SUS, Inca, CONASS, SES-GO | ID: biblio-1100218


Baseado em informações oficiais já disponíveis, "Orientações para boas práticas em alimentação e nutrição hospitalar no enfrentamento da COVID-19" foi elaborado por um grupo de profissionais nutricionistas do Brasil, atuantes em diversas áreas (clínica, hospitalar, unidades de alimentação e nutrição, docência e pesquisa universitária, consultoria em gestão de qualidade e segurança de alimentos), com o objetivo de contribuir com as adaptações nos processos de trabalho de nutricionistas e gestores de unidades hospitalares. Apresenta orientações: quanto à higienização de ambientes e materiais específicos, quanto aos cuidados no transporte e distribuição de refeições, dicas também para profissionais de saúde que trabalham na área de isolamento, orientações para os pacientes hospitalizados e apresenta condutas de avaliação nutricional. O resultado do trabalho foi de reforçar a condutas adequadas e contribuir significativamente com a segurança alimentar e nutricional de pacientes e colaboradores

Based on official information already available, "Guidelines for good practices in food and hospital nutrition in coping with COVID-19" was prepared by a group of nutritionists from Brazil, working in several areas (clinic, hospital, food and nutrition units, teaching and university research, consultancy in quality management and food safety), in order to contribute to adaptations in the work processes of nutritionists and hospital unit managers. It presents guidelines: regarding the cleaning of specific environments and materials, regarding care in the transportation and distribution of meals, tips also for health professionals working in the isolation area, guidelines for hospitalized patients and presents nutritional assessment procedures. The result of the work was to reinforce adequate conduct and significantly contribute to the food and nutritional security of patients and employees

Humanos , Administração de Recursos Humanos em Hospitais/métodos , Nutrição de Grupos de Risco , Administração dos Cuidados ao Paciente , Higiene dos Alimentos , Avaliação Nutricional , Nutrição Enteral , Infecções por Coronavirus/dietoterapia , Boas Práticas de Distribuição , Higiene das Mãos , Administração de Materiais no Hospital/métodos , Ambiente de Instituições de Saúde
Acta Paul. Enferm. (Online) ; 33: eAPE20190243, 2020. tab
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1100876


Resumo Objetivo Avaliar a confiabilidade e a validade da versão brasileira da Practice Environment Scale entre técnicos e auxiliares de enfermagem. Métodos Estudo metodológico, transversal, realizado com 91 profissionais selecionados de maneira aleatória. As seguintes variáveis foram avaliadas: ambiente da prática profissional da enfermagem (por meio da versão brasileira da Practice Environment Scale ), exaustão emocional (por uma subescala do Inventário de Burnout de Maslach), satisfação profissional e clima de segurança (por meio de duas subescalas do Safety Attitudes Questionnaire Short - Form ), percepção da qualidade do cuidado e intenção de deixar o emprego. Para avaliar a confiabilidade das subescalas da Practice Environment Scale e a validade, foram calculados, respectivamente, o coeficiente alfa de Cronbach e o coeficiente de correlação de Spearman entre as subescalas da Practice Environment Scale e as demais variáveis em estudo. Resultados O coeficiente alfa de Cronbach variou de 0,70 a 0,88 entre as subescalas da Practice Environment Scale , sendo que todas obtiveram correlação significante com as variáveis exaustão emocional, satisfação profissional, clima de segurança, percepção da qualidade do cuidado e intenção de deixar o emprego. Conclusão O instrumento demonstrou evidências de confiabilidade e validade satisfatórias para avaliar o ambiente da prática desses profissionais. A disponibilização de um instrumento validado que mensura o ambiente da prática de um maior contingente de profissionais da enfermagem pode auxiliar os gestores a implementarem e avaliarem estratégias que influenciem a melhoria dos resultados com pacientes, profissionais e instituições.

Resumen Objetivo Evaluar la confiabilidad y la validez de la versión brasileña de la Practice Environment Scale entre técnicos y auxiliares de enfermería. Métodos Estudio metodológico, transversal, realizado con 91 profesionales seleccionados de manera aleatoria. Se evaluaron las siguientes variables: ambiente de la práctica profesional de enfermería (mediante la versión brasileña de la Practice Environment Scale ), agotamiento emocional (por una subescala del Inventario Burnout de Maslach), satisfacción profesional y clima de seguridad (mediante dos subescalas del Safety Attitudes Questionnaire Short - Form ), percepción de la calidad del cuidado e intención de dejar el trabajo. Para evaluar la confiabilidad de las subescalas de la Practice Environment Scale y la validez, se calcularon, respectivamente, el coeficiente alfa de Cronbach y el coeficiente de correlación de Spearman entre las subescalas de la Practice Environment Scale y las demás variables en estudio. Resultados El coeficiente alfa de Cronbach tuvo una variación de 0,70 a 0,88 entre las subescalas de la Practice Environment Scale , y todas obtuvieron correlación significativa con las variables agotamiento emocional, satisfacción profesional, clima de seguridad, percepción de la calidad del cuidado e intención de dejar el trabajo. Conclusión El instrumento demostró evidencias de confiabilidad y validez satisfactorias para evaluar el ambiente de la práctica de estos profesionales. Poner a disposición un instrumento validado que mide el ambiente de la práctica de un mayor contingente de profesionales de la enfermería puede ayudar a los gestores a implementar y evaluar estrategias que influyan en la mejora de los resultados con pacientes, profesionales e instituciones.

Abstract Objective Evaluate the reliability and validity of the Brazilian version of the Practice Environment Scale among nursing technicians and aides. Methods This is a methodological cross-sectional study with 91 randomly selected nursing professionals. The following variables were evaluated: nursing practice environment (using the Brazilian version of the Practice Environment Scale), emotional exhaustion (using the Maslach Burnout Inventory subscale), job satisfaction, and safety climate (using two subscales of the Safety Attitudes Questionnaire - Short Form), perception of care quality, and intention to leave employment. To assess the reliability and validity of subscales of the Practice Environment Scale, Cronbach's alpha coefficient and Spearman's correlation coefficient were calculated, respectively, between the subscales of the Practice Environment Scale and the other study variables. Results Cronbach's alpha coefficient ranged from 0.70 to 0.88 among the subscales of the Practice Environment Scale, and all subscales presented a significant correlation with the variables of emotional exhaustion, job satisfaction, safety climate, perception of care quality, and intention to leave employment. Conclusion The instrument showed evidence of satisfactory reliability and validity in the assessment of the nursing practice environment. A validated instrument that measures the practice environment of a larger number of nursing professionals can help administrators implement and evaluate strategies to improve the results of patients, nursing professionals, and institutions.

Humanos , Masculino , Feminino , Adulto , Prática Profissional , Reprodutibilidade dos Testes , Estudo de Validação , Técnicos de Enfermagem , Ambiente de Instituições de Saúde , Assistentes de Enfermagem , Estudos Transversais