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1.
Medicine (Baltimore) ; 99(44): e22959, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126364

RESUMO

INTRODUCTION: Type 2 diabetes mellitus is responsible for high mortality and morbidity globally and in India. India has high prevalence of the condition and the burden is set to increase exponentially in the next decade. Indians traditionally reside in rural or semi-urban areas with limited access to healthcare facilities. To overcome this, the government has introduced a cadre of health workers called Accredited Social Health Activists (ASHA) for such areas. These workers were initially trained to provide maternal & infant care but now need improved competence training to improve type 2 diabetes screening & management in these locations. The objective of the study is to assess the competence training provided to ASHA workers at the chosen study sites. METHODOLOGY: A cluster randomized control trial has been designed. It will be conducted across 8 centers in Hyderabad & Rangareddy districts of Telangana, India. The training will be provided to ASHA workers. The tool used for training will be developed from existing sources with an emphasis on topics which require training. The training will be delivered across 6 months at each center as a classroom training. Each participant's baseline competence will be recorded using a questionnaire tool and a practical evaluation by trained public health experts. The same experts will use the same tools to assess the training post the intervention. DISCUSSION: This trial will evaluate the use of health worker training as a tool for improving the clinical competence in relation to type 2 diabetes mellitus. We anticipate that the module will provide a greater understanding of type 2 diabetes mellitus, the importance of screening of both disease and complications and improved skills for the same. The study has received the ethical approval form the Institutional Ethics Committee of the Indian Institute of Public Health Hyderabad. The registration number is: IIPHH/TRCIEC/218/2020. The trial has also been registered under the Clinical trial registry of India (CTRI) on 27 July 2020. The registration number of the trial is: CTRI/2020/07/026828. The URL of the registry trial is: http://ctri.nic.in/Clinicaltrials/showallp.php?mid1=45342&EncHid=&userName=CTRI/2020/07/026828.


Assuntos
Competência Clínica , Agentes Comunitários de Saúde/educação , Diabetes Mellitus Tipo 2/terapia , Capacitação em Serviço/métodos , Competência Clínica/normas , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/prevenção & controle , Feminino , Humanos , Índia , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
J Allergy Clin Immunol Pract ; 8(9): 2845-2850, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32711118

RESUMO

In the wake of the COVID-19 pandemic and massive disruptions to daily life in the spring of 2020, in May 2020, the Centers for Disease Control (CDC) released guidance recommendations for schools regarding how to have students attend while adhering to principles of how to reduce the risk of contracting SARS-CoV-2. As part of physical distancing measures, the CDC is recommending that schools who traditionally have had students eat in a cafeteria or common large space instead have children eat their lunch or other meals in the classroom at already physically distanced desks. This has sparked concern for the safety of food-allergic children attending school, and some question of how the new CDC recommendations can coexist with recommendations in the 2013 CDC Voluntary Guidelines on Managing Food Allergy in Schools as well as accommodations that students may be afforded through disability law that may have previously prohibited eating in the classroom. This expert consensus explores the issues related to evidence-based management of food allergy at school, the issues of managing the health of children attending school that are acutely posed by the constraints of an infectious pandemic, and how to harmonize these needs so that all children can attend school with minimal risk from both an infectious and allergic standpoint.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Epinefrina/uso terapêutico , Hipersensibilidade Alimentar/tratamento farmacológico , Hipersensibilidade Alimentar/prevenção & controle , Capacitação em Serviço/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Serviços de Saúde Escolar , Adolescente , Agonistas alfa-Adrenérgicos/uso terapêutico , Anafilaxia , Centers for Disease Control and Prevention, U.S. , Criança , Pessoal de Educação/educação , Humanos , Guias de Prática Clínica como Assunto , Instituições Acadêmicas , Estados Unidos
4.
Arch Gynecol Obstet ; 302(3): 585-593, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32661755

RESUMO

PUPROSE: An emergency caesarean section is a potentially life-threatening situation both for the mother and the newborn. Non-technical skills can be improved by simulation training and are necessary to manage this urgent situation successfully. The objective of this study was to investigate, if training of emergency caesarean section can be transferred into daily work to improve the outcome parameters pH an APGAR of the newborn. METHODS: In this pre-post study, 141 professionals took part in a training for emergency caesarean section. Participants received a questionnaire, based on the tools "Training Evaluation Inventory" and "Transfer Climate Questionnaire" 1 year after training. Outcome data of the newborn were collected from the hospitals information system. RESULTS: Except the scale "extinction", Cronbach's alpha was higher than 0.62. All scales were rated lower than 2.02 on a 5-point Likert Scale (1 = fullest approval; 5 = complete rejection). "Negative reinforcement" was rated with 2.87 (SD 0.73). There were no significant differences in outcome data prior. The questionnaire fulfils criteria for application except the scale "extinction". CONCLUSION: The presented training course was perceived as useful by the professionals and attitudes toward training were positive; the content was positively reinforced in practice 1 year after training. Parameters of the newborn did not change. It is conceivable that other outcome parameters (e.g. posttraumatic stress disorder) are addressed by the training. The development of relevant outcome parameters for the quality of emergency sections needs further investigation.


Assuntos
Cesárea/educação , Serviços Médicos de Emergência/métodos , Capacitação em Serviço/métodos , Comunicação Interdisciplinar , Adulto , Cesárea/estatística & dados numéricos , Avaliação Educacional , Emergências , Tratamento de Emergência , Feminino , Alemanha , Humanos , Recém-Nascido , Equipe de Assistência ao Paciente , Gravidez , Inquéritos e Questionários , Adulto Jovem
7.
Otolaryngol Head Neck Surg ; 163(2): 271-274, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32482155

RESUMO

OBJECTIVE: To determine if rapid implementation of simulation training for the nasopharyngeal swab procedure can increase provider confidence regarding procedure competency. METHODS: A simulation training exercise was designed as a departmental initiative to improve competency performing nasopharyngeal swabs during the COVID-19 pandemic. Sixty-one health care workers attended teaching sessions led by the Department of Otorhinolaryngology on proper nasopharyngeal swab technique. After a brief lecture, participants practiced their swab technique using a high-fidelity airway simulation model. Pre- and postintervention self-evaluations were measured via standardized clinical competency questionnaires on a 5-point Likert scale ranging from "No knowledge, unable to perform" up to "Highly knowledgeable and confident, independent." RESULTS: Forty-six participants in this study submitted pre- and postintervention self-assessments. Postintervention scores improved on average 1.41 points (95% CI, 1.10-1.73) out of 5 from a mean score of 3.13 to 4.54 (P < .0001). This reflects a large effect size with a Glass's delta value of 1.3. DISCUSSION: Lecture coupled with simulation-based teaching can significantly improve health care workers' confidence in performing nasopharyngeal swabs. Proper training for frontline workers performing swabs for COVID-19 is essential to improving testing accuracy and can be achieved in a simple and timely manner. IMPLICATIONS FOR PRACTICE: To meet the testing needs of the growing pandemic, many health care workers who are unfamiliar with nasopharyngeal swabs have been asked to perform this test. Simulation-based teaching sessions may improve health care workers' confidence and help prevent false-negative results. This intervention is easily reproducible in any setting where frequent nasopharyngeal swab testing occurs. LEVEL OF EVIDENCE/STUDY DESIGN: Prospective cohort study.


Assuntos
Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Nasofaringe/virologia , Recursos Humanos em Hospital/educação , Pneumonia Viral/diagnóstico , Treinamento por Simulação , Betacoronavirus/genética , Chicago , Infecções por Coronavirus/epidemiologia , Educação Continuada em Enfermagem , Humanos , Capacitação em Serviço/métodos , Pandemias , Pneumonia Viral/epidemiologia , Estudos Prospectivos , Centro Cirúrgico Hospitalar , Centros de Atenção Terciária
8.
Pediatr Crit Care Med ; 21(8): e485-e490, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32459793

RESUMO

OBJECTIVES: The coronavirus disease 2019 pandemic has required that hospitals rapidly adapt workflows and processes to limit disease spread and optimize the care of critically ill children. DESIGN AND SETTING: As part of our institution's coronavirus disease 2019 critical care workflow design process, we developed and conducted a number of simulation exercises, increasing in complexity, progressing to intubation wearing personal protective equipment, and culminating in activation of our difficult airway team for an airway emergency. PATIENTS AND INTERVENTIONS: In situ simulations were used to identify and rework potential failure points to generate guidance for optimal airway management in coronavirus disease 2019 suspected or positive children. Subsequent to this high-realism difficult airway simulation was a real-life difficult airway event in a patient suspected of coronavirus disease 2019 less than 12 hours later, validating potential failure points and effectiveness of rapidly generated guidance. MEASUREMENTS AND MAIN RESULTS: A number of potential workflow challenges were identified during tabletop and physical in situ manikin-based simulations. Experienced clinicians served as participants, debriefed, and provided feedback that was incorporated into local site clinical pathways, job aids, and suggested practices. Clinical management of an actual suspected coronavirus disease 2019 patient with difficult airway demonstrated very similar success and anticipated failure points. Following debriefing and assembly of a success/failure grid, a coronavirus disease 2019 airway bundle template was created using these simulations and clinical experiences for others to adapt to their sites. CONCLUSIONS: Integration of tabletop planning, in situ simulations, and debriefing of real coronavirus disease 2019 cases can enhance planning, training, job aids, and feasible policies/procedures that address human factors, team communication, equipment choice, and patient/provider safety in the coronavirus disease 2019 pandemic era.


Assuntos
Infecções por Coronavirus/terapia , Intubação Intratraqueal/métodos , Pneumonia Viral/terapia , Treinamento por Simulação/métodos , Fluxo de Trabalho , Betacoronavirus , Humanos , Capacitação em Serviço/métodos , Masculino , Pandemias , Adulto Jovem
9.
Recurso na Internet em Inglês | LIS - Localizador de Informação em Saúde | ID: lis-47275

RESUMO

Since onset of the Novel Coronavirus (COVID-19) the Pan American Health Organization/World Health Organization (PAHO/WHO) Office for Barbados and Eastern Caribbean Countries (ECC) has actively assisted countries to prepare and respond to the virus.


Assuntos
Barbados/epidemiologia , Kit de Reagentes para Diagnóstico/normas , Betacoronavirus , Capacitação em Serviço/métodos
10.
Virchows Arch ; 477(5): 755-756, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32270299

RESUMO

The vast increase of technical, diagnostic, and treatment possibilities and deepened understanding of molecular biology has revolutionized diagnosis and treatment of cancer and thus has great impact on pathology. Different professionals are responsible for proper evaluation of the results and their translating into an accurate diagnosis and appropriate treatment. Next to expertise, a close interaction between clinical molecular biologists, pathologists, and oncologists is required; it is crucial that these professionals speak "the same language." Key to this is communication skills and creating possibilities for collaboration in a meaningful context. Here, we present an interprofessional, educational workshop model and we describe the parameters that contribute to effective learning by specialists.


Assuntos
Comportamento Cooperativo , Educação Médica Continuada/métodos , Capacitação em Serviço/métodos , Relações Interprofissionais , Aprendizagem , Oncologistas/educação , Patologistas/educação , Atitude do Pessoal de Saúde , Competência Clínica , Congressos como Assunto , Humanos , Oncologistas/psicologia , Patologistas/psicologia , Especialização , Desenvolvimento de Pessoal
11.
Artigo em Inglês | MEDLINE | ID: mdl-32306707

RESUMO

PURPOSE: The Accreditation Council for Graduate Medical Education (ACGME) requires all residency programs to provide increasing autonomy as residents progress through training, known as graded responsibility. However, there is little guidance on how to implement graded responsibility in practice and a paucity of literature on how it is currently implemented in emergency medicine (EM). We sought to determine how emergency medicine (EM) residency programs apply graded responsibility across a variety of activities and to identify which considerations are important in affording additional responsibilities to trainees. METHODS: We conducted a cross-sectional study of EM residency programs using a 23-question survey that was distributed by email to 162 ACGME-accredited EM program directors. Seven different domains of practice were queried. RESULTS: We received 91 responses (56.2% response rate) to the survey. Among all domains of practice except for managing critically ill medical patients, the use of graded responsibility exceeded 50% of surveyed programs. When graded responsibility was applied, post-graduate year (PGY) level was ranked an "extremely important" or "very important" consideration between 80.9% and 100.0% of the time. CONCLUSION: The majority of EM residency programs are implementing graded responsibility within most domains of practice. When decisions are made surrounding graded responsibility, programs still rely heavily on the time-based model of PGY level to determine advancement.


Assuntos
Acreditação , Competência Clínica , Medicina de Emergência/educação , Serviço Hospitalar de Emergência/normas , Capacitação em Serviço/métodos , Internato e Residência , Certificação , Estudos Transversais , Educação de Pós-Graduação em Medicina , Humanos , Diretores Médicos , Médicos , Inquéritos e Questionários , Estados Unidos
12.
Anaesthesia ; 75(8): 1096-1104, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32275766

RESUMO

Ultrasound imaging of the lung and associated tissues may play an important role in the management of patients with COVID-19-associated lung injury. Compared with other monitoring modalities, such as auscultation or radiographic imaging, we argue lung ultrasound has high diagnostic accuracy, is ergonomically favourable and has fewer infection control implications. By informing the initiation, escalation, titration and weaning of respiratory support, lung ultrasound can be integrated into COVID-19 care pathways for patients with respiratory failure. Given the unprecedented pressure on healthcare services currently, supporting and educating clinicians is a key enabler of the wider implementation of lung ultrasound. This narrative review provides a summary of evidence and clinical guidance for the use and interpretation of lung ultrasound for patients with moderate, severe and critical COVID-19-associated lung injury. Mechanisms by which the potential lung ultrasound workforce can be deployed are explored, including a pragmatic approach to training, governance, imaging, interpretation of images and implementation of lung ultrasound into routine clinical practice.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Sistemas Automatizados de Assistência Junto ao Leito , Competência Clínica , Humanos , Capacitação em Serviço/métodos , Pandemias , Ultrassonografia/métodos , Ultrassonografia/normas
13.
Sch Psychol ; 35(2): 111-117, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32105139

RESUMO

Evidence-based classroom management practices have profound effects on student outcomes. Yet teachers commonly struggle to effectively implement these practices, imploring the provision of implementation supports within a multitiered framework for promoting teachers' practices. Few studies have examined the effects of Tier I implementation supports for classroom management, and none have examined universal implementation within naturalistic school contexts and used strategies that go beyond a "train and hope" approach. Employing a sample of urban, elementary, general education classrooms, this study offers a pilot evaluation of a Tier I implementation support package for promoting teachers' delivery of effective praise for students' behavior. Preliminary results suggest the implementation support package was linked with increases in teachers' behavior-specific praise, heightened praise-to-correction ratios, and increases in students' on-task behavior. Future directions of empirical and practical development are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Assuntos
Comportamento Infantil/psicologia , Capacitação em Serviço/métodos , Relações Interpessoais , Professores Escolares/psicologia , Estudantes/psicologia , Capacitação de Professores/métodos , Adulto , Criança , Humanos , Mid-Atlantic Region , Projetos Piloto , Ensino/psicologia , População Urbana
14.
Sch Psychol ; 35(2): 137-145, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32105140

RESUMO

Despite growing interest in formative assessment of teacher practices, research on rates of change in teachers' practices is sparse. This is the first study to examine the characteristics of observed change in classroom practices using the Classroom Strategies Assessment System (CSAS) across alternative schedules of data collection during instructional coaching. Our primary objectives included examining (a) the magnitude, variability, and precision of estimates of average rates of change in teacher practices and (b) the impact of data collection duration (i.e., number of weeks of data collection) and density (i.e., the number of classroom observations per week) on the precision of estimates of rates of change over time. A sample of teachers (N = 63) participating in instructional coaching was observed 14 times during coaching using the CSAS. Findings revealed a significant gradual improvement in strategy use, with significant between-teacher variation in rates of change. The frequency of observations was associated with the precision of estimates for average rates of change across teachers and for individual teachers, providing initial guidance on minimum number of observations required to monitor change in practice over time. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Assuntos
Capacitação em Serviço/métodos , Tutoria/métodos , Competência Profissional/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde/métodos , Capacitação de Professores/métodos , Adulto , Feminino , Humanos , Masculino , Professores Escolares
15.
Sch Psychol ; 35(2): 118-127, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31916788

RESUMO

This study tested the Wellness Enhancing Physical Activity in Young Children (WE PLAY) program, a 4-week online preschool teacher training, on children's moderate-to-vigorous physical activity (MVPA). In this cluster RCT, six Head Start preschools were randomized to an intervention and comparison group. Children's MVPA was measured using accelerometers at pre- and posttest. The magnitude of the difference in MVPA between groups at posttest was small, but in the expected direction: Δ min/hour = 1.60, 95% CI [-0.97, 4.18], p = .22, Cohen's d = 0.32. We observed a pre/post within group increase in average minutes per hour of MVPA in school with a medium effect size for the intervention group: Δ mean min/hour = 2.09, 95% CI [0.51, 3.67], p = .0096, Cohen's d = 0.42. An increase was not seen for the comparison group: Δ mean min/hour = 0.44, 95% CI [-0.70, 1.59], p = .45, Cohen's d = 0.07. WE PLAY children in 6 hr/day programs gained 63 min of MVPA per week in school, providing preliminary evidence of the benefits of WE PLAY on children's physical activity levels. WE PLAY deserves further testing with larger groups of children and teachers. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Assuntos
Instrução por Computador/métodos , Exercício Físico , Promoção da Saúde/métodos , Capacitação em Serviço/métodos , Avaliação de Programas e Projetos de Saúde/métodos , Capacitação de Professores/métodos , Acelerometria , Adulto , Pré-Escolar , Análise por Conglomerados , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Professores Escolares
16.
Sch Psychol ; 35(2): 128-136, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31916789

RESUMO

The purpose of this study was to examine the treatment effects of the Incredible Years Teacher Classroom Management (IY TCM), a universal classroom management intervention, on the outcomes of children with aggressive behavior in elementary school. Classroom management has been demonstrated as a factor in either escalating children's aggressive behavior or decreasing those problematic behaviors. Participants included 1,817 students (Grade K to 3) and 105 teachers from nine elementary schools in a large urban Midwestern school district. Teachers were randomly assigned to receive IY TCM or to a wait-list comparison group. The hypotheses were that baseline levels of aggression would moderate the relationship between intervention status and outcomes. Findings indicated the hypothesized moderation effect on several outcome variables; specifically, children with baseline aggression problems who were in IY TCM classrooms had significantly improved math achievement, emotional regulation, prosocial behaviors, and observed aggression in comparison to similar peers in the control classrooms. Implications for practice and future research based on the findings are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Assuntos
Agressão/psicologia , Comportamento Infantil/psicologia , Capacitação em Serviço/métodos , Avaliação de Programas e Projetos de Saúde/métodos , Capacitação de Professores/métodos , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos , Ensino , População Urbana
17.
J Assoc Nurses AIDS Care ; 31(1): 3-11, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31834102

RESUMO

The scaling of Option B+ services, whereby all pregnant women who test HIV positive are started on lifelong antiretroviral therapy upon diagnosis regardless of CD4 T-cell count, is ongoing in many high HIV burden, low-resource countries. We developed and evaluated a tablet-based mobile learning (mLearning) training approach to build Option B+ competencies in frontline nurses in central Mozambique. Its acceptability and impact on clinical skills were assessed in maternal child health nurses and managers at 20 intervention and 10 control clinics. Results show that skill and knowledge of nurses at intervention clinics improved threefold compared with control clinics (p = .04), nurse managers at intervention clinics demonstrated a 9- to 10-fold improvement, and nurses reported strong acceptance of this approach. "mLearning" is one viable modality to enhance nurses' clinical competencies in areas with limited health workforce and training budgets. This study's findings may guide future scaling and investments in commercially viable mLearning solutions.


Assuntos
Fármacos Anti-HIV/administração & dosagem , Telefone Celular , Competência Clínica , Infecções por HIV/tratamento farmacológico , Pessoal de Saúde/educação , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Capacitação em Serviço/métodos , Enfermeiras e Enfermeiros/psicologia , Complicações Infecciosas na Gravidez/tratamento farmacológico , Adulto , Fármacos Anti-HIV/uso terapêutico , Terapia Antirretroviral de Alta Atividade , Feminino , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Aprendizagem , Aplicativos Móveis , Moçambique , Gravidez , População Rural , População Urbana
19.
J Nurses Prof Dev ; 36(1): 2-6, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31790014

RESUMO

To streamline competency assessment documentation during orientation, we developed a comprehensive, three-phase plan, consisting of a tiered skills acquisition model, entrustable professional activities, and the full incorporation of Donna Wright's recommendations for initial competency development, allowing for the transition away from the traditional skills checklist (Wright, 2005). We were able to reduce orientation time and preceptor confusion while increasing orientation process satisfaction by the end of our revisions.


Assuntos
Capacitação em Serviço/métodos , Confiança/psicologia , Competência Clínica/normas , Competência Clínica/estatística & dados numéricos , Documentação/métodos , Humanos , Capacitação em Serviço/normas , Capacitação em Serviço/tendências , Preceptoria/métodos
20.
Unfallchirurg ; 123(6): 435-442, 2020 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-31538205

RESUMO

BACKGROUND: Emergency exit and escape routes in public buildings, such as schools, hospitals and administrative offices are controlled by legal rules and regulations. Thereby escape from the building is very well organized in cases of internal threats (e.g. fire, active shooter and hostage situations). Complex buildings with numerous rooms are a special challenge to emergency and law enforcement personnel. Without additional means of orientation a targeted localization of the incident is not possible in many cases. MATERIAL AND METHODS: An extended literature search for guidance and building orientation systems, which enable an intuitive orientation and guidance for emergency personnel was performed. RESULTS: Only three German systems were identified that enable orientation and reliable guidance of emergency personnel within buildings. All three systems, i.e. uniform orientation system schools (EOS), color guidance system (FLS) and the Gütersloh model (GM) were derived from shooting incidents in schools in 2009. Based on a systematic labeling of all rooms, stairways, exits and entrances, ad hoc orientation and guidance of law enforcement and emergency personnel is possible. CONCLUSION: For targeted localization of an internal incident there only seem to be three German systems worldwide that enable an intuitive and immediate orientation and guidance within buildings. An increasing threat of worldwide terrorism and the fact that hospitals are seen as crucial infrastructures for attacks by terrorists make the implementation of guidance and orientation systems in hospitals urgently necessary. This is the first review dealing with this topic.


Assuntos
Capacitação em Serviço/métodos , Aplicação da Lei/métodos , Administração de Recursos Humanos em Hospitais/métodos , Recursos Humanos em Hospital/educação , Violência no Trabalho/prevenção & controle , Planejamento em Desastres/métodos , Emergências , Humanos , Terrorismo/prevenção & controle
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