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1.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47997

RESUMO

Governos de todo o mundo produzem grandes quantidades de dados relevantes para políticas públicas. Entretanto, raramente esses dados se transformam em informações úteis à tomada de decisões a respeito de questões de alta complexidade que marcam a atualidade e que exigem intervenções baseadas em evidências e orientadas para resultados. Por outro lado, a formulação, o monitoramento e a avaliação de programas, projetos e políticas públicas são processos que exigem informações. Nesse contexto, a iniciativa SmarlLab surgiu para construir conhecimento relevante para políticas públicas de promoção do trabalho decente com o uso de um recurso público de baixíssimo custo: dados públicos abertos. A iniciativa conjunta do MPT e da OIT Brasil deu origem à Plataforma SmartLab, que tem fortalecido a cooperação com organizações governamentais, não-governamentais e internacionais que atuam na promoção dessa agenda e que precisam de informações para tomar decisões sobre as ações que desenvolvem. Por meio de Observatórios Digitais, a plataforma beneficia também a comunidade científica, que passa a ter acesso a informações com facilidade sem precedentes para pesquisa. Além disso, o fluxo público de informações para tomada de decisões baseadas em evidências e orientadas para resultados beneficia a sociedade civil em geral. A Iniciatvia SmartLab, como um fórum multidisciplinar de fomento da gestão transparente de políticas públicas, funda-se no conceito de prática inteligente. Por definição, uma prática inteligente (smart practice) aproveita uma oportunidade latente de gerar valor público gratuitamente ou com baixíssimo custo, de forma replicável e com recursos que em geral as organizações já possuem, na lógica da obtenção de algo a custo tendente a zero - "something-for-nothing". Dados públicos disponíveis e que não são utilizados em todo o seu potencial têm, quando disponíveis, baixíssimo ou nenhum custo de aproveitamento. Por outro lado, tecnologias abertas (open source) e gratuitas podem auxiliar na transformação do dado em informação e a informação em conhecimento que possa ser consumido, compreendido e utilizado. A iniciativa Smartlab permite o mapeamento de déficits de trabalho decente em todas as suas dimensões por meio de um esforço colaborativo de pesquisa e gestão do conhecimento, com ênfase em disciplinas como direito, sociologia, estatística, demografia, economia, econometria e ciência de dados.


Assuntos
Direito ao Trabalho , Condições de Trabalho , Carga de Trabalho/estatística & dados numéricos
2.
J Coll Physicians Surg Pak ; 30(10): 164-167, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33291196

RESUMO

OBJECTIVE:  To evaluate the effect of COVID-19 on the working of a tertiary care hospital. STUDY DESIGN: Audit study. PLACE AND DURATION OF STUDY:  Services Hospital, Lahore from 1st March to 30th June 2020. METHODOLOGY:  We calculated and compared various parameters of hospital working. Two time periods were selected. The study period was defined as the time after first confirmed case of COVID-19 in Pakistan. The control period was defined as one year prior to the first case being reported, taken from 1st March 2019 to 29th February, 2020. The parameters we studied included were number of number of hospital admissions, emergency patients, OPD patients, major surgeries, total surgeries, radiological investigations done, laboratory investigations done, births and mortalities. All parameters were calculated by taking monthly average during each time period and then compared. RESULTS:   A decrease in almost all parameters was seen when the cases of the two time periods were compared. There was a decrease in the average hospital admission by 51%, while the patients seen in OPD fell by almost 60%. A slight decrease of 25% was seen in the cases presenting to the emergency. The most marked decrease was in the elective surgeries, which was 66% closely followed by average monthly mortality which decreased by 64%. Average monthly minor surgeries and births were decreased by 33% and 35%, respectively. CONCLUSION:  There had been a decrease in the number of patients presenting to the hospital across the board with the most marked increase being in elective surgeries. Key Words: COVID-19, Hospital working, Patient load, Elective surgery.


Assuntos
/epidemiologia , Emergências , Serviço Hospitalar de Emergência/estatística & dados numéricos , Pandemias , Centros de Atenção Terciária/estatística & dados numéricos , Carga de Trabalho/estatística & dados numéricos , Humanos , Paquistão/epidemiologia , Estudos Retrospectivos
3.
BMC Public Health ; 20(1): 1636, 2020 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-33138798

RESUMO

BACKGROUND: In this study, we aimed to evaluate the impact of the COVID-19 epidemic on the workload and mental health of Iranian medical staff using the General Health Questionnaire (GHQ-12) and NASA -Task Load Index (NASA-TLX) Questionnaire between March and April 2020, respectively. METHODS: The present cross-sectional study was conducted from March 5th to April 5th, 2020. To evaluate the workload and mental health of participants NASA-TLX and GHQ-12 online questionnaires were distributed. Data were entered into software SPSS (Version 23) and T-test, ANOVA, Regression methods were used for data analysis. RESULTS: Health workers who encountered COVID- 19 patients, were subjected to more task load compared to those who had no contact with COVID- 19 patients at the workplace (p <  0.001). In terms of the subscale score of NASA-TLX, nurses had more scores in mental pressure, physical pressure, time pressure (temporal), and frustration compared to the other jobs (p <  0.05). Moreover, nurses had significantly more workload compared to the other jobs. CONCLUSIONS: Type of job, the shift of work, educational level, and facing COVID-19 affected the score of NASA-TLX. NASA-TLX scores were higher in nursing compared to the scores of other health staff groups. The results of this study indicate that the scores of NASA-TLX and GHQ-12 among staff who had contact with COVID-19 patients were significantly higher than those who did not face COVID-19 patients. We suggested that a comprehensive assistance should be provided to support the well-being of healthcare workers especially nurses and healthcare workers who treated COVID-19 patients.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Epidemias , Pessoal de Saúde/psicologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Carga de Trabalho/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Inquéritos e Questionários , Adulto Jovem
4.
Can J Surg ; 63(5): E454-E459, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33107817

RESUMO

SUMMARY: Small surgical residency programs like plastic surgery can be challenging environments to accommodate parental leave. This study aimed to report the experiences, attitudes and perceived support of Canadian plastic surgery residents, recent graduates and staff surgeons with respect to pregnancy and parenting during training. Residents and staff surgeons were invited via email to participate in an online survey. The results presented here explore experiences of pregnancy and parental leave of current plastic surgery residents and staff surgeons. Residents' and staff surgeons' perceptions of program director support, policies, negative comments and the impact of parental leave on the workload of others were also explored. Although the findings suggest that there may be improvements in the support of program directors, there continues to be a negative attitude in surgical culture toward pregnancy during residency. The perceived confusion of respondents with respect to programspecific policies emphasizes the need for open conversations and standardization of parental leave.


Assuntos
Atitude do Pessoal de Saúde , Internato e Residência/estatística & dados numéricos , Licença Parental/estatística & dados numéricos , Gravidez/psicologia , Cirurgia Plástica/educação , Adulto , Canadá , Feminino , Humanos , Internato e Residência/organização & administração , Masculino , Pessoa de Meia-Idade , Diretores Médicos/psicologia , Políticas , Gravidez/estatística & dados numéricos , Cirurgiões/psicologia , Cirurgiões/estatística & dados numéricos , Cirurgia Plástica/psicologia , Cirurgia Plástica/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Carga de Trabalho/psicologia , Carga de Trabalho/estatística & dados numéricos
5.
Can J Surg ; 63(5): E475-E482, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33107818

RESUMO

BACKGROUND: American studies have shown that higher provider and hospital volumes are associated with reduced risk of mortality following colorectal surgical interventions. Evidence from Canada is limited, and to our knowledge only a single study has considered outcomes other than death. We describe associations between provider surgical volume and all-cause mortality and postoperative complications following colorectal surgical interventions in New Brunswick. METHODS: We used hospital discharge abstracts linked to vital statistics, the provincial cancer registry and patient registry data. We considered all admissions for colorectal surgeries from 2007 through 2013. We used logistic regression to identify odds of dying and odds of complications (from any of anastomosis leak, unplanned colostomy, intra-abdominal sepsis or pneumonia) within 30 days of discharge from hospital according to provider volume (i.e., total interventions performed over the preceding 2 years) adjusted for personal, contextual, provider and hospital characteristics. RESULTS: Overall, 9170 interventions were performed by 125 providers across 18 hospitals. We found decreased odds of experiencing a complication following colorectal surgery per increment of 10 interventions performed per year (odds ratio 0.94, 95% confidence interval 0.91-0.96). We found no associations with mortality. Associations remained consistent across models restricted to cancer patients or to interventions performed by general surgeons and across models that also considered overall hospital volumes. CONCLUSION: Our results suggest that increased caseloads are associated with reduced odds of complications, but not with all-cause mortality, following colorectal surgery in New Brunswick. We also found no evidence of volume having differential effects on outcomes from colon and rectal procedures.


Assuntos
Doenças do Colo/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologia , Doenças Retais/cirurgia , Carga de Trabalho/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Colo/cirurgia , Doenças do Colo/mortalidade , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Feminino , Mortalidade Hospitalar , Hospitais com Alto Volume de Atendimentos/estatística & dados numéricos , Hospitais com Baixo Volume de Atendimentos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Novo Brunswick/epidemiologia , Razão de Chances , Complicações Pós-Operatórias/etiologia , Doenças Retais/mortalidade , Reto/cirurgia , Sistema de Registros/estatística & dados numéricos , Resultado do Tratamento
6.
Cancer Cytopathol ; 128(12): 885-894, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33108683

RESUMO

BACKGROUND: To the authors' knowledge, the impact of the coronavirus disease 2019 (COVID-19) pandemic on cytopathology practices worldwide has not been investigated formally. In the current study, data from 41 respondents from 23 countries were reported. METHODS: Data regarding the activity of each cytopathology laboratory during 4 weeks of COVID-19 lockdown were collected and compared with those obtained during the corresponding period in 2019. The overall number and percentage of exfoliative and fine-needle aspiration cytology samples from each anatomic site were recorded. Differences in the malignancy and suspicious rates between the 2 periods were analyzed using a meta-analytical approach. RESULTS: Overall, the sample volume was lower compared with 2019 (104,319 samples vs 190,225 samples), with an average volume reduction of 45.3% (range, 0.1%-98.0%). The percentage of samples from the cervicovaginal tract, thyroid, and anorectal region was significantly reduced (P < .05). Conversely, the percentage of samples from the urinary tract, serous cavities, breast, lymph nodes, respiratory tract, salivary glands, central nervous system, gastrointestinal tract, pancreas, liver, and biliary tract increased (P < .05). An overall increase of 5.56% (95% CI, 3.77%-7.35%) in the malignancy rate in nongynecological samples during the COVID-19 pandemic was observed. When the suspicious category was included, the overall increase was 6.95% (95% CI, 4.63%-9.27%). CONCLUSIONS: The COVID-19 pandemic resulted in a drastic reduction in the total number of cytology specimens regardless of anatomic site or specimen type. The rate of malignancy increased, reflecting the prioritization of patients with cancer who were considered to be at high risk. Prospective monitoring of the effect of delays in access to health services during the lockdown period is warranted.


Assuntos
/prevenção & controle , Controle de Doenças Transmissíveis/normas , Laboratórios Hospitalares/estatística & dados numéricos , Patologia Clínica/estatística & dados numéricos , Carga de Trabalho/estatística & dados numéricos , Biópsia por Agulha Fina/estatística & dados numéricos , /virologia , Humanos , Laboratórios Hospitalares/tendências , Patologia Clínica/tendências , Sociedades Médicas/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos
7.
Inquiry ; 57: 46958020963711, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33034257

RESUMO

Brazil is in a critical situation due to the COVID-19 pandemic. Healthcare workers that are in the front line face challenges with a shortage of personal protective equipment, high risk of contamination, low adherence to the social distancing measures by the population, low coronavirus testing with underestimation of cases, and also financial concerns due to the economic crisis in a developing country. This study compared the impact of COVID-19 pandemic among three categories of healthcare workers in Brazil: physicians, nurses, and dentists, about workload, income, protection, training, feelings, behavior, and level of concern and anxiety. The sample was randomly selected and a Google Forms questionnaire was sent by WhatsApp messenger. The survey comprised questions about jobs, income, workload, PPE, training for COVID-19 patient care, behavior and feelings during the pandemic. The number of jobs reduced for all healthcare workers in Brazil during the pandemic, but significantly more for dentists. The workload and income reduced to all healthcare workers. Most healthcare workers did not receive proper training for treating COVID-19 infected patients. Physicians and nurses were feeling more tired than usual. Most of the healthcare workers in all groups reported difficulties in sleeping during the pandemic. The healthcare workers reported a significant impact of COVID-19 pandemic in their income, workload and anxiety, with differences among physicians, nurses and dentists.


Assuntos
Atitude do Pessoal de Saúde , Betacoronavirus , Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Pneumonia Viral/psicologia , Carga de Trabalho/psicologia , Adulto , Brasil , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pandemias , Pneumonia Viral/epidemiologia , Carga de Trabalho/estatística & dados numéricos , Local de Trabalho/estatística & dados numéricos
8.
JAMA Netw Open ; 3(10): e2018104, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33125494

RESUMO

Importance: Electronic consultation (e-consultation) is increasingly being adopted to expand access to specialty care and reduce health care costs. Little is known about clinicians' perceptions of using e-consultations, which may be associated with program adoption. Objective: To identify perceptions of primary care clinicians in the US Veterans Health Administration (VHA) system about e-consultation and workload. Design, Setting, and Participants: A qualitative study using semistructured interviews was conducted from September 2017 through March 2018 in a national sample of VHA primary care clinics in the US. Participants were primary care clinicians who had at least 300 total patient encounters from July 2016 to June 2017, including at least 1 e-consultation request. A convenience sample of participants was recruited using email invitations. Deductive and inductive content analysis were used to identify themes. Data were analyzed from October 2017 to April 2018. Exposures: Use of e-consultation. Main Outcomes and Measures: Primary care clinician perspectives regarding e-consultation and their workload. Results: A total of 34 primary care clinicians enrolled working across 27 VHA clinical sites were included; 9 (26%) were between ages 40-49 years; 23 (68%) were female. Three themes were identified. First, the process of entering, tracking, and following up on e-consultations added a time burden to primary care clinicians. Second, e-consultation was perceived to shift diagnostic and follow-up responsibilities from specialists to primary care clinicians. Third, e-consultations were thought to improve the timeliness and quality of care provided despite a perceived increase in workload. Conclusions and Relevance: In this study, participants perceived e-consultation as valuable for patient care but also as an increase in their workload. Further work is warranted to quantify the workload increase on clinician burnout, job satisfaction, and turnover.


Assuntos
Atitude do Pessoal de Saúde , Atitude Frente aos Computadores , Registros Eletrônicos de Saúde/estatística & dados numéricos , Médicos/psicologia , Atenção Primária à Saúde/métodos , Carga de Trabalho/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde/estatística & dados numéricos , Pesquisa Qualitativa , Encaminhamento e Consulta/estatística & dados numéricos , Estados Unidos , Serviços de Saúde para Veteranos Militares/estatística & dados numéricos , Carga de Trabalho/estatística & dados numéricos
10.
Sci Rep ; 10(1): 14934, 2020 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-32913272

RESUMO

Long work hours among physicians is a worldwide issue in the healthcare arena. Previous studies have largely focused on the work hours of resident physicians rather than those of attending physicians. The purpose of this study was to investigate total work hours and the composition of those work hours for attending physicians across different hospital settings and across different medical specialties through a nationwide survey. This included examining differences in physician workload and its composition with respect to different hospital characteristics, and grouping medical specialties according to the work similarities. A cross-sectional self-reported nationwide survey was conducted from June to September of 2018, and the two questionnaires were distributed to all accredited hospitals in Taiwan. The number of physician work hours in different types of duty shifts were answered by medical specialty in each surveyed hospital. Each medical specialty in a hospital filled only one response for its attending physicians. The findings reveal that the average total work hours per week of an attending physician is around 69.1 h, but the total work hours and their composition of different duty shifts varied among hospital accreditation levels, geographic locations, emergency care responsibilities, and medical specialties. Because of the variance in the number and composition of attending physicians' work hours, adjusting physician work hours to a reasonable level will be a major challenge for health authority and hospital managers.


Assuntos
Medicina/estatística & dados numéricos , Médicos/psicologia , Qualidade da Assistência à Saúde/normas , Estresse Psicológico/epidemiologia , Tolerância ao Trabalho Programado/psicologia , Carga de Trabalho/estatística & dados numéricos , Estudos Transversais , Humanos , Inquéritos e Questionários , Taiwan/epidemiologia
11.
Cancer Cytopathol ; 128(12): 895-904, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32931161

RESUMO

BACKGROUND: The purpose of the current study was to examine the impact of coronavirus disease 2019 (COVID-19) on various aspects of cytology practice in the Asia-Pacific region. METHODS: An online questionnaire was distributed to cytopathology laboratories in 24 Asia-Pacific countries to explore the impact of restrictive measures on access to health care, use of general and personal protective equipment (PPE), and changes in cytology workflow and workload from February to April 2020. RESULTS: A total of 167 cytopathology laboratories from 24 countries responded to the survey; the majority reported that restrictive measures that limited the accessibility of health care services had been implemented in their cities and/or countries (80.8%) and their hospitals (83.8%). The respondents noted that COVID-19 had an impact on the cytologic workflow as well as the workload. Approximately one-half of the participants reported the implementation of new biosafety protocols (54.5%) as well as improvements in laboratory facilities (47.3%). Rearrangement or redeployment of the workforce was reported in 53.3% and 34.1% of laboratories, respectively. The majority of the respondents reported a significant reduction (>10%) in caseload associated with both gynecological (82.0%) and nongynecological specimens (78.4%). Most laboratories reported no significant change in the malignancy rates of both gynecological (67.7%) and nongynecological specimens (58.7%) compared with the same period in 2019. CONCLUSIONS: The results of the survey demonstrated that the COVID-19 pandemic resulted in a significant reduction in the number of cytology specimens examined along with the need to implement new biosafety protocols. These findings underscore the need for the worldwide standardization of biosafety protocols and cytology practice.


Assuntos
/prevenção & controle , Controle de Doenças Transmissíveis/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Laboratórios Hospitalares/organização & administração , Patologia Clínica/organização & administração , Ásia , /transmissão , Controle de Doenças Transmissíveis/instrumentação , Mão de Obra em Saúde/organização & administração , Mão de Obra em Saúde/normas , Mão de Obra em Saúde/estatística & dados numéricos , Humanos , Laboratórios Hospitalares/normas , Laboratórios Hospitalares/estatística & dados numéricos , Estados do Pacífico , Pandemias/prevenção & controle , Patologia Clínica/normas , Patologia Clínica/estatística & dados numéricos , Equipamento de Proteção Individual/normas , Inquéritos e Questionários/estatística & dados numéricos , Carga de Trabalho/estatística & dados numéricos
12.
Ann Glob Health ; 86(1): 112, 2020 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-32944509

RESUMO

Background: Although "social isolation" protects the life and health of Vietnamese citizens from the adverse effects of the COVID-19 pandemic, it also triggers massive reductions in the economic activities of the country. Objective: our study aimed to identify negative impacts of COVID-19 on occupations of Vietnamese people during the first national lockdown, including the quality and quantity of jobs as well as adverse problems at work due to COVID-19. Methods: A cross-sectional study using web-based platforms was conducted during the first time of social isolation in Vietnam at the beginning of April 2020. We utilized a respondent-driven sampling technique to select 1423 respondents from 63 cities and provinces over Vietnam. Exploratory factor analysis (EFA) was used to define sub-domains of perceived impacts of COVID-19 on occupations. Findings: Approximately two-thirds of respondents reported decreases in their income (61.6%), and 28.2% reported that their income deficit was 40% and above. The percentage of female individuals having decreased revenue due to COVID-19 was higher than that of male respondents (65.2% and 54.7%, respectively). "Worry that colleagues exposed to COVID-19 patients" and "Being alienated because employment-related to COVID-19" accounted for the highest score in each factor. Compared to healthcare workers, being self-employed/unemployed/retired were less likely to suffer from "Increased workload and conflicts due to COVID-19" and "Disclosure and discrimination related to COVID-19 work exposure." Conclusion: Our study revealed a drastic reduction in both the quality and quantity of working, as well as the increased fear and stigmatization of exposure to COVID-19 at workplaces. Health protection and economic support are immediate targets that should be focused on when implementing policies and regulations.


Assuntos
Controle de Doenças Transmissíveis , Infecções por Coronavirus , Recessão Econômica/estatística & dados numéricos , Emprego/estatística & dados numéricos , Pandemias , Pneumonia Viral , Adulto , Betacoronavirus , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Estudos Transversais , Feminino , Humanos , Renda/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Pandemias/economia , Pandemias/prevenção & controle , Pneumonia Viral/economia , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Controle Social Formal/métodos , Vietnã/epidemiologia , Desempenho Profissional , Carga de Trabalho/estatística & dados numéricos
14.
Intern Med J ; 50(8): 1000-1003, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32881225

RESUMO

An increase in coronavirus disease (COVID-19) infections prompted Level 4 lockdown throughout New Zealand from 25 March 2020. We have investigated trends in coronary and electrophysiology (EP) procedures before and during this lockdown. The number of acute procedures for ST elevation myocardial infarction remained stable. In contrast, the number of in-patient angiograms and percutaneous intervention procedures fell by 53% compared with the previous 4 weeks in 2020 and by 56% compared with the corresponding period in 2019. Further study is required to determine the reasons for these trends.


Assuntos
Serviço Hospitalar de Cardiologia , Infecções por Coronavirus , Controle de Infecções/estatística & dados numéricos , Pandemias , Intervenção Coronária Percutânea , Pneumonia Viral , Infarto do Miocárdio com Supradesnível do Segmento ST , Betacoronavirus , Eletrofisiologia Cardíaca/métodos , Eletrofisiologia Cardíaca/tendências , Serviço Hospitalar de Cardiologia/organização & administração , Serviço Hospitalar de Cardiologia/estatística & dados numéricos , Angiografia Coronária/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Masculino , Pessoa de Meia-Idade , Nova Zelândia/epidemiologia , Pandemias/prevenção & controle , Intervenção Coronária Percutânea/métodos , Intervenção Coronária Percutânea/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Infarto do Miocárdio com Supradesnível do Segmento ST/epidemiologia , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Carga de Trabalho/estatística & dados numéricos
16.
Radiat Oncol ; 15(1): 226, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993690

RESUMO

BACKGROUND: COVID-19 in Italy has led to the need to reorganize hospital protocols with a significant risk of interruption to cancer treatment programs. In this report, we will focus on a management model covering the two phases of the COVID-19 emergency, namely lockdown-phase I and post-lockdown-phase II. METHODS: The following steps were taken in the two phases: workload during visits and radiotherapy planning, use of dedicated routes, measures for triage areas, management of suspected and positive COVID-19 cases, personal protective equipment, hospital environments and intra-institutional meetings and tumor board management. Due to the guidelines set out by the Ministry of Health, oncological follow-up visits were interrupted during the lockdown-phase I; consequently, we set about contacting patients by telephone, with laboratory and instrumental exams being viewed via telematics. During the post-lockdown-phase II, the oncological follow-up clinic reopened, with two shifts operating daily. RESULTS: By comparing our radiotherapy activity from March 9 to May 4 2019 with the same period in 2020 during full phase I of the COVID-19 emergency, similar results were achieved. First radiotherapy visits, Simulation Computed Tomography and Linear Accelerator treatments amounted to 123, 137 and 151 in 2019 compared with 121, 135 and 170 in 2020 respectively. There were no cases of COVID-19 positivity recorded either in patients or in healthcare professionals, who were all negative to the swab tests performed. CONCLUSION: During both phases of the COVID-19 emergency, the planned model used in our own experience guaranteed both continuity in radiotherapy treatments whilst neither reducing workload nor interrupting treatment and, as such, it ensured the safety of cancer patients, hospital environments and staff.


Assuntos
Infecções por Coronavirus/prevenção & controle , Controle de Infecções/métodos , Neoplasias/radioterapia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Radioterapia (Especialidade)/estatística & dados numéricos , Betacoronavirus , Continuidade da Assistência ao Paciente/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Hospitais , Humanos , Itália/epidemiologia , Pneumonia Viral/epidemiologia , Radioterapia (Especialidade)/organização & administração , Carga de Trabalho/estatística & dados numéricos
17.
Nephrol Nurs J ; 47(4): 343-346, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32830940

RESUMO

Peritoneal dialysis transfer sets (extension lines) are replaced every six to nine months to minimize peritoneal dialysis catheter complications. The aim of this study was to compare a revised non-bag transfer set exchange procedure with the standard bag exchange procedure on nursing time, costs, and safety. Thirty-three people were randomized to two groups - a standard bag exchange procedure group (n = 16) and a non-bag transfer set exchange procedure group (n = 17). The standard bag exchange procedure took a median of 32 minutes (interquartile range [IQR] 25 to 38 minutes) compared to the non-bag transfer set exchange procedure of 6 minutes (IQR 4 to 8 minutes) (p Ò 0.0001). There was one episode of peritonitis in each group within the 72-hour follow-up period. The average cost of the non-bag transfer set exchange procedure was $24.54 lower, a 37% cost reduction. This study has shown the revised non-bag transfer set replacement procedure appears to be safe, consume less participant and staff time, and decreases costs.


Assuntos
Diálise Peritoneal/métodos , Diálise Peritoneal/enfermagem , Cateterismo/efeitos adversos , Custos e Análise de Custo , Humanos , Pesquisa em Avaliação de Enfermagem , Diálise Peritoneal/efeitos adversos , Diálise Peritoneal/economia , Peritonite/etiologia , Peritonite/prevenção & controle , Resultado do Tratamento , Carga de Trabalho/estatística & dados numéricos
18.
BMC Public Health ; 20(1): 1281, 2020 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-32843005

RESUMO

BACKGROUND: In the present investigation the study protocol and the results at baseline of a workplace intervention are reported. It is hypothesised that the reduction of the physical and psychosocial workload of healthcare workers increases 1 their self-assessed physical and mental work ability, and 2. clients' satisfaction with care. METHODS: Two-arm, cluster-randomised trial. Outcome data on workers and clients are collected in questionnaires at baseline, and two follow-ups between 2019 and 2021. Participants of the interventions are healthcare workers of 11 healthcare providers in Germany. At baseline, the intervention arm comprised 22 clusters (n = 174 workers); the control arm, 47 clusters (n = 276). The intervention consists of interviews and workshops, in which employees propose measures aiming to reduce the physical and psychosocial load, and strengthen resources at work. The primary outcome is the workers' physical and mental work ability. The secondary outcome is the clients' satisfaction with care. RESULTS: There was no evidence of substantial differences between trial arms at baseline concerning the outcomes. The design effect estimates for physical and mental work ability were 1.29 and 1.05, respectively. At the end of the trial, effect sizes of at least 0.30 and 0.27 at the 80% power and 5% significance levels can be attained. CONCLUSIONS: The results suggest that the implementation of the study design has been satisfactory. The intervention is expected to provide evidence of relatively small to medium-size effects of the intervention activities on the work ability of healthcare workers and the clients' satisfaction with care. TRIAL REGISTRATION: Registration trial DRKS00021138 on the German Registry of Clinical Studies (DRKS), retrospectively registered on 25 March, 2020.


Assuntos
Pessoal de Saúde/psicologia , Satisfação do Paciente/estatística & dados numéricos , Carga de Trabalho/psicologia , Carga de Trabalho/estatística & dados numéricos , Local de Trabalho/organização & administração , Adolescente , Adulto , Feminino , Alemanha , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Projetos de Pesquisa , Inquéritos e Questionários , Adulto Jovem
19.
BMC Health Serv Res ; 20(1): 799, 2020 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-32847598

RESUMO

BACKGROUND: Transformational leadership style is considered to be of importance to increase patient safety, to facilitate a balance between job resources and job demands, and to create a sound patient safety culture within health care services. However, there is limited research assessing these associations within the context of nursing homes. The aim of this study was to assess the association between transformational leadership, job demands and job resources; and patient safety culture and employees' overall perception of patient safety in nursing homes. METHOD: A cross-sectional survey of employees in four Norwegian nursing homes was conducted (N = 165). Multiple hierarchical regression analysis was used to assess the explained variance of transformational leadership, job demands and job resources on patient safety culture and overall perception of patient safety. RESULTS: Transformational leadership explained 47.2% of the variance in patient safety culture and 25.4% of overall perception of patient safety, controlling for age and gender (p < 0.001). Additionally, job demands and job resources explained 7.8% of patient safety culture and 4.7% of overall perception of patient safety (p < 0.001). CONCLUSION: Implementing transformational leadership style may be important in creating and sustaining sound patient safety culture in nursing homes. Furthermore, leaders should make an effort to facilitate a good work environment with an optimal balance between job demands and job resources, as this in turn might have a positive influence on patient safety culture.


Assuntos
Liderança , Casas de Saúde/organização & administração , Segurança do Paciente , Gestão da Segurança/organização & administração , Carga de Trabalho/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega
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