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1.
HNO ; 68(1): 25-31, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31690970

RESUMO

BACKGROUND: Logatomes, nonsensical combinations of consonants and vowels, are suitable for a precise capture and analysis of individual phonemes as fundamental modules of speech in audiometric diagnostics. OBJECTIVE: The aim of this prospective study was to capture the audiometric characteristics of a closed-set logatome test. The slope of the discrimination function at the speech reception threshold (SRT) and the reproducibility were analyzed. MATERIAL AND METHODS: A set of 102 intensity varied and randomized logatomes were presented in the form of consonant-vowel-consonant to 25 hearing unimpaired adults. The measurements were performed in a free field setting and were each repeated after a 2-week interval. The subjects were requested to repeat the heard logatome in a closed response test of 10 items per sound item on a touchscreen. RESULTS: The slope of the mean discrimination function at the SRT was on average 4%/dB; however, the mean discrimination function slope was steeper for the initial consonant than for the final one. The differences of the test and retest results at the SRT showed a standard deviation of 13% for consonants. These differences were normally distributed. There were no significant differences between test and retest. CONCLUSION: The slope of the discrimination function at the SRT appeared to be shallow but was comparable to established word tests. Finally, there was no evidence of a learning effect in the retest, which emphasizes the low redundancy of the speech material and makes it an attractive complementary option to routine audiometric diagnostics.


Assuntos
Testes Auditivos , Percepção da Fala , Teste do Limiar de Recepção da Fala , Adulto , Documentação , Humanos , Estudos Prospectivos , Reprodutibilidade dos Testes
2.
World Neurosurg ; 133: e819-e827, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31606500

RESUMO

BACKGROUND: The mortality index, or the ratio of observed to expected mortality, is a reported quality metric that has been assumed to directly reflect patient care. However, documentation and coding that does not use knowledge of how a reported mortality index is derived could reflect poorly on a hospital or service line. We present our effort at reducing the reported mortality index of neurosurgery and neurology patients within a neurocritical care unit through documentation and coding accuracy with direct incorporation of mortality modeling. METHODS: Using a reported method from Vizient Inc., we generated a spreadsheet tool to enable direct manipulation of the data to identify documentation and coding issues that influenced the reported mortality index in a retrospective set of patients. Subsequently, we implemented the prospective changes to documentation and coding and compared our calculated mortality index to the reported Vizient mortality index. RESULTS: Prospective implementation of the documentation and coding issues identified through our spreadsheet tool resulted in a drastic reduction of both our calculated and the reported Vizient mortality index. CONCLUSIONS: Incorporating knowledge of mortality index modeling into the documentation and coding resulted in impressive reductions in the reported mortality index for our patients, serving as a both an internal benchmark and a method of comparison with other institutions.


Assuntos
Cuidados Críticos/normas , Documentação/normas , Mortalidade Hospitalar , Procedimentos Neurocirúrgicos/mortalidade , Melhoria de Qualidade/normas , Humanos
3.
Forensic Sci Int ; 306: 110057, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31786515

RESUMO

BACKGROUND: Health professionals who work in emergency services must be prepared for the recognition, collection, storage, preservation and documentation of all physical traces related to injuries or crime, because failures in these processes may compromise any forensic analysis. We, therefore, investigated emergency health professionals' levels of knowledge about these processes and their abilities to implement them in practice during the care of victims of violence in an emergency unit of a specialized trauma hospital. METHODS: This was a survey to describe the knowledge of professionals working in the emergency department of the Sergipe Urgent Care Hospital (HUSE) in Sergipe state, Northeast Brazil about the preservation of forensic traces and their ability to implement the necessary related processes in practice. Their knowledge of the preservation of forensic materials and their abilities to implement the processes related to their preservation were assessed using the Portuguese version of the Questionnaire on the Preservation of Forensic Traces in Victim Assistance. RESULTS: A total of 144 health professionals completed the questionnaire, of whom 23 (16 %) were physicians, 33 (22.9 %) nurses and 88 (61.1 %) nursing technicians. Most physicians (15/65.2 %) reported knowing between 50 and 70 % of the required procedures, and the majority of nurses and nursing technicians knew less than 50 % (15/45.5 % and 72/81.8 %, respectively). Regarding their actual implementation, most physicians and nurses reported performing between 50 % and 70 % of the procedures (22/95.7 % and 15/45.5 %, respectively), while nursing technicians reported performing less than 50 % (55/62.5 %). CONCLUSION: Most professionals in the three professions (physician, nurse and nursing technician) knew less than 50 % of the required procedures for the documentation, collection and preservation of forensic traces, which explains the low implementation of most of the actions, particularly those related to the collection and preservation of traces.


Assuntos
Competência Clínica , Documentação , Serviço Hospitalar de Emergência , Corpo Clínico Hospitalar , Recursos Humanos de Enfermagem no Hospital , Manejo de Espécimes , Adulto , Brasil , Vítimas de Crime , Feminino , Ciências Forenses , Humanos , Masculino , Inquéritos e Questionários , Violência/estatística & dados numéricos
4.
Gesundheitswesen ; 82(1): 100-106, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-29758573

RESUMO

BACKGROUND: Prospective analysis of assessment reports in otorhinolaryngology for the period 01-03-2011 to 31-03-2017 by the Health Advisory Boards in Lower Saxony and Bremen, Germany in relation to coding in the G-DRG-System. MATERIAL AND METHODS: The assessment reports were documented using a standardized database system developed on the basis of the electronic data exchange (DTA) by the Health Advisory Board in Lower Saxony. In addition, the documentation of the assessment reports according to the G-DRG system was used for assessment. Furthermore, the assessment of a case was evaluated once again on the basis of the present assessment documents and presented as an example in detail. RESULTS: During the period from 01-03-2011 to 31-03-2017, a total of 27,424 cases of inpatient assessments of DRGs according to the G-DRG system were collected in the field of otorhinolaryngology. In 7,259 cases, the DRG was changed, and in 20,175 cases, the suspicion of a DRG-relevant coding error was not justified in the review; thus, a DRG change rate of 26% of the assessments was identified over the time period investigated. CONCLUSIONS: There were different kinds of coding errors. In order to improve the coding quality in otorhinolaryngology, in addition to the special consideration of the presented "hit list" by the otorhinolaryngology departments, there should be more intensive cooperation between hospitals and the Health Advisory Boards of the federal states.


Assuntos
Grupos Diagnósticos Relacionados , Otolaringologia , Documentação , Alemanha , Otolaringologia/estatística & dados numéricos , Estudos Prospectivos
5.
N Z Med J ; 132(1488): 28-37, 2019 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-31851659

RESUMO

AIM: Incomplete and incorrect documentation of adverse drug reactions (ADRs) can restrict prescribing choices resulting in suboptimal pharmaceutical care. This study aimed to examine the quality of information held within electronic systems in a hospital setting, to determine the preciseness of ADR documentation, and identify discrepancies where multiple electronic systems are utilised. METHOD: Over a four-week period, consecutive patients admitted to the general medical ward at the study hospital had their electronic profiles reviewed. Patient demographic information (de-identified), ADR history and discrepancies between information sources (as recorded in all electronic systems utilised at initial prescribing) were recorded and analysed. RESULTS: Over the four-week period, 332 patient profiles were reviewed, and over 1,200 alerts were identified and analysed (including duplicates of ADR reactions). Of these patients, 151 (45.5%) had at least one documented allergy or intolerance which generated 585 reactions, relating to 526 unique events. A further 151 (45.5%) were classified as having no known (drug) allergies or intolerances; however, 20 (15%) of these patients did have at least one allergy documented in at least one other electronic system. The remaining 30 (9%) patients were classified as having an unknown allergy status and of those nine had allergies documented in at least one other electronic system. Further, most systems contained information duplication, which had not been addressed during the admission process. CONCLUSION: ADR information was both imprecise and inaccurate, as multiple discrepancies between ADR information recorded in different electronic patient management systems were found to exist. Information sharing between systems needs to be prioritised in order to allow full, accurate and complete ADR information to be collected, stored and utilised; both to reduce current inadequacies and to allow optimal pharmaceutical care.


Assuntos
Sistemas de Notificação de Reações Adversas a Medicamentos/normas , Documentação/normas , Troca de Informação em Saúde/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Centros de Atenção Terciária , Adulto Jovem
6.
Aust N Z J Public Health ; 43(6): 570-576, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31667984

RESUMO

OBJECTIVE: To investigate the under-identification of Indigenous∗ infants in death records and examine the impact of a multi-stage algorithm on disparities in sudden unexpected deaths in infancy (SUDI). METHODS: Data on SUDI in Queensland between 2010 and 2014 were linked to birth and death registrations, health data, and child protection and coronial records. An algorithm was applied to cases of SUDI and population data to derive Indigenous status. Numbers, proportions and rates of SUDI were compared. RESULTS: Using multiple sources of Indigenous status resulted in a 64.9% increase in the number of infants identified as Indigenous. The Indigenous SUDI rate increased by 54.3%, from 1.38 to 2.13 per 1,000 live births after applying the algorithm to SUDI and live births data. CONCLUSIONS: Applying an algorithm to both numerator and denominator data reduced numerator-denominator incompatibility, to more accurately report rates of Indigenous SUDI and measure the gap in Indigenous infant mortality. Implications for public health: Estimation of the true magnitude of the disparity is restricted by under-identification of Indigenous status in death records. Data linkage improved the reporting of Indigenous infant mortality. Accuracy in reporting of measures is integral to determining genuine progress towards Closing the Gap.


Assuntos
Mortalidade Infantil/etnologia , Grupo com Ancestrais Oceânicos , Morte Súbita do Lactente/etnologia , Algoritmos , Causas de Morte , Atestado de Óbito , Documentação/normas , Feminino , Humanos , Lactente , Recém-Nascido , Armazenamento e Recuperação da Informação , Masculino , Queensland/epidemiologia , Fatores de Risco , Morte Súbita do Lactente/epidemiologia
7.
Pan Afr Med J ; 33: 225, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692825

RESUMO

Drawing up the medical certificate is a crucial step in the judicial process. This judicial document should be drafted during a medical legal consultation. This study aims to evaluate the quality of medical certificates in a medico-judicial consultation and to study interpretative criteria of medical certificate validity. We conducted a retrospective study of patient's victims of intentional wounds and blows receiving a medico-judicial consultation at the Grand Yoff General Hospital, from April 2012 to February 2015. The whole of medical certificates were recorded on a survey form analyzed by Epi Info Version 6.04. The whole of the 249 certificates studied was printed in legible and understandable "Arial police 12". All the studied medical certificates included complete identification of the physician and the victim. The date and the time of aggression were written in 248 certificates (99.6%). The type of abuse suffered was specified on the whole of the 249 certificates: 164 brawls (65.9%), 64 unilateral aggressions (25.7%). The precise description and nature of the lesions was written in 246 certificates. The site of the lesions was established based on fixed anatomical landmarks in the various body plans. Medico-judicial consultation, coordinated by the forensic physician, helped to significantly improve the quality of the documents issued. The dissemination of these drafting practices and of the practices concerning the issuing of certificates is essential in particular in the regional hospital as part of an ongoing training or postgraduate training.


Assuntos
Documentação/normas , Medicina Legal/legislação & jurisprudência , Violência/legislação & jurisprudência , Adolescente , Adulto , Idoso , Agressão , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Médicos/organização & administração , Estudos Retrospectivos , Senegal , Adulto Jovem
11.
Heart Surg Forum ; 22(5): E423-E428, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31596724

RESUMO

Although many believe that the phrase "First, do no harm" was part of the Hippocratic Oath, in fact it was not. This phrase, often written in Latin ("Primum non Nocere"), seems to have first appeared in medical writing in the 17th century. However, it is obvious that many therapeutic interventions do cause at least some harm with hopes of benefitting patients in the long run. This balancing of initial harm in hope of eventual benefit is never more apparent than in the case of invasive procedures, though other examples abound, such as the administration of chemotherapy. The ethical concept of nonmaleficence, which traces its origins to the concept of primum non nocere, accurately acknowledges the concept of the need to strive to do more good than harm. Thus, it is apparent that, in a surgical operation, the surgeon is proposing to cause harm, initially, to the patient in hopes of creating an outcome that results in more good than harm. Therefore, the process of obtaining consent from the patient for a surgical operation acknowledges the fact that harm will, in fact, be inflicted on that patient, with the hope that, on balance, this harm will result in a greater overall good for the patient. It is for this reason that the modern concepts of informed consent have developed.


Assuntos
Juramento Hipocrático , Consentimento Livre e Esclarecido , Procedimentos Cirúrgicos Operatórios , Comunicação , Documentação , Humanos , Consentimento Livre e Esclarecido/ética , Consentimento Livre e Esclarecido/legislação & jurisprudência , Educação de Pacientes como Assunto , Cuidados Pré-Operatórios , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Resultado do Tratamento , Recusa do Paciente ao Tratamento , Revelação da Verdade
12.
Tidsskr Nor Laegeforen ; 139(13)2019 Sep 24.
Artigo em Norueguês, Inglês | MEDLINE | ID: mdl-31556532

RESUMO

BACKGROUND: Combination of drugs is the main cause of fatal overdose, and polydrug use is associated with greater treatment needs. This study investigates the prevalence and registration of multiple substance dependence. MATERIAL AND METHOD: Substance dependence diagnoses for 147 inpatients at the Department of Addiction Treatment, Oslo University Hospital were registered and reassessed with a focus on the ICD-10 diagnosis F19 (chaotic intake of multiple substances). The resulting diagnoses were also assessed according to ICD-11. RESULTS: Altogether 116 (79 %) out of 147 patients were addicted to two or more drugs. Only 22 (15 %) out of 147 were diagnosed with F19, but this figure increased to 52 (35 %) after reassessment. Using ICD-11 we found a prevalence of the diagnosis 6C4F (multiple substance dependence) of 79 %. INTERPRETATION: We found an underreporting of the ICD-10 diagnosis F19. It is important to use the F19 diagnosis, because polydrug use is underreported, even though it predicts overdose, prognosis and treatment needs.


Assuntos
Documentação/normas , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Humanos , Classificação Internacional de Doenças , Registros Médicos , Noruega/epidemiologia , Prevalência
13.
Artigo em Alemão | MEDLINE | ID: mdl-31562539

RESUMO

Reports on adverse effects of chemical substances and mixtures (poisonings in the broader sense) are of great importance both for the improvement of medical care as well as for substance and product safety and for medical education and training. Case reports are the basis of toxicovigilance, i.e. the detection and assessment of poisoning risks in a community arising from clinical cases. Reports on poisonings are created mainly by medical doctors, but also by toxicologically trained nurses and non-medical scientists of poison centres and toxicology labs.In this article, basic terms of clinical toxicology are explained and the important roles of reporting on poisoning are described.Standards for poisoning reporting are partly developed. Reports differ in structure, information content and the degree of assignment of evaluation categories (administrative, clinical, product safety, e.g. agent group, degree of poisoning severity, causality). Methodologically, a distinction is made between detailed individual case reports and aggregated case series with little clinical information.As a result, case reports have recently been used to describe novel intoxications (e.g. new psychoactive substances [NPSs]). Case series facilitated the detection of poisoning outbreaks (sealant spray, ciguatera fish poisoning) and novel products with increased risk of poisoning (e.g. liquid laundry detergent capsules). Systematic toxicovigilance at the national level in Germany will be considerably improved by a national register of poisoning planned at German Federal Institute for Risk Assessment (BfR). For a European toxicovigilance scheme, the recently developed EuPCS product category system forms an important basis.


Assuntos
Intoxicação por Ciguatera , Documentação , Envenenamento , Animais , Surtos de Doenças , Peixes , Alemanha , Humanos , Medição de Risco
14.
West J Emerg Med ; 20(5): 818-821, 2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31539340

RESUMO

INTRODUCTION: Suicide is the 10th leading cause of death in the United States. An estimated 50% of these deaths are due to firearms. Suicidal ideation (SI) is a common complaint presenting to the emergency department (ED). Despite these facts, provider documentation on access to lethal means is lacking. Our primary aim was to quantify documentation of access to firearms in patients presenting to the ED with a chief complaint of SI. METHODS: This was a cross-sectional study of consecutive patients, nearly all of whom presented to an academic, urban ED with SI during July 2014. We collected data from all provider documentation in the electronic health record. Primary outcome assessed was whether the emergency physician (EP) team documented access to firearms. Secondary outcomes included demographic information, preexisting psychiatric diagnoses, and disposition. RESULTS: We reviewed 100 patient charts. The median age of patients was 38 years. The majority of patients had a psychiatric condition. EPs documented access to firearms in only 3% of patient charts. CONCLUSION: EPs do not adequately document access to firearms in patients with SI. There is a clear need for educational initiatives regarding risk-factor assessment and counseling against lethal means in this patient cohort.


Assuntos
Documentação , Serviço Hospitalar de Emergência/legislação & jurisprudência , Armas de Fogo/legislação & jurisprudência , Médicos/estatística & dados numéricos , Ideação Suicida , Suicídio/prevenção & controle , Adulto , Idoso , Aconselhamento , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Suicídio/legislação & jurisprudência , Estados Unidos , Adulto Jovem
15.
Bioanalysis ; 11(15): 1383-1385, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31490105

RESUMO

Biography Boris Gorovits is a Senior Director of the Bioanalytical lab at Pfizer. Boris earned his PhD in Enzymology from the Moscow State University and later completed postdoctoral research studies in protein biophysics at the Medical Center, University of Texas at San Antonio, TX, USA. In 2000, Boris joined Wyeth Research (later Pfizer Inc) to work as a bioanalytical group lead with a growing scope of responsibilities. Currently, he leads the Bioanalytical group within Biomedicine Design department which is responsible for many aspects of the Regulated and Nonregulated Bioanalytical support for the pan-Pfizer Biotherapeutic portfolio. Boris co-chairs Pfizer internal Immunogenicity Expert Working Group, which is responsible for review of the biotherapeutic immunogenicity risk assessment and mitigation strategies. Recently, Boris has been actively involved in industry discussions focusing on PK and immunogenicity assessment, bioanalytical support of various biotherapeutic modalities, including mAbs, bi-specific antibodies, antibody-drug conjugates, ADCs and gene therapy. Boris is proud to be an active member of the American Association of Pharma Scientists. This interview was conducted by Sankeetha Nadarajah, Managing Commissioning Editor of Bioanalysis, at the AAPS ICH-M10 Public Consultation Workshop (Silver Spring, MD, USA), 11 June 2019.


Assuntos
Técnicas de Química Analítica , Guias como Assunto , Consenso , Documentação , Laboratórios , Estados Unidos , United States Food and Drug Administration
16.
Bioanalysis ; 11(15): 1379-1382, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31490110

RESUMO

Biography Mark E Arnold, PhD, is Director of Science for Covance Laboratories. In that role, he develops the bioanalytical strategy for immune-, cell-based, quantitative polymerase chain reaction (qPCR) and LC-MS/MS assays to quantify drugs and metabolites, antidrug antibodies and biomarkers in animal and clinical samples for pharmacokinetic and pharmacodynamic assessments. Mark was previously Executive Director of Bioanalytical Sciences at Bristol-Myers Squibb. He received a BS (biology) from Indiana University of Pennsylvania and PhD (pharmacology) from the University of Pittsburgh. For more than 30 years, Mark has been involved in the evolving field of bioanalysis, including the science and the review and interpretation of regulations and guidance. He co-chaired the AAPS Crystal City V and VI Workshops on the US 'FDA Draft Revised Guidance on Bioanalytical Method Validation' and 'Biomarkers'. He is actively involved in the Land O'Lakes Bioanalytical Conference and American Association of Pharmaceutical Scientists (AAPS, named Fellow in 2014). Mark has over 100 peer-reviewed publications, and numerous invited podium presentations. This interview was conducted by Sankeetha Nadarajah, Managing Commissioning Editor of Bioanalysis.


Assuntos
Técnicas de Química Analítica , Guias como Assunto , Consenso , Documentação , Indústrias
17.
Lakartidningen ; 1162019 Sep 10.
Artigo em Sueco | MEDLINE | ID: mdl-31503322

RESUMO

According to the Swedish National Board of Health and Welfare, about 3200 people a year die due to accidents. Around 900 of these are classified as "Accidental exposure to other and unspecified factors". A more precise classification with the board has not been recorded in these cases due to incomplete death certificates. This study examined the death certificates for this group in 2016 and compared it to patient records. This study showed that most cases of incomplete classification are in instances of elderly persons who sustained a fall and subsequently died due to complications of the resulting injury. The doctor has in most cases not perceived the death as accidental.This study showed that there is a lack of knowledge among doctors in how to accurately complete a death certificate.


Assuntos
Acidentes por Quedas/mortalidade , Causas de Morte , Coleta de Dados/normas , Atestado de Óbito , Documentação/normas , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Competência Clínica/normas , Feminino , Humanos , Masculino , Registros Médicos/normas , Pessoa de Meia-Idade , Médicos/normas , Distribuição por Sexo , Suécia/epidemiologia , Fatores de Tempo
18.
BMC Health Serv Res ; 19(1): 642, 2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31492130

RESUMO

BACKGROUND: Malnutrition is a comprehensive challenge for the nursing home, home care- and home nursing sector. Nutritional care and the subsequent documentation are a common and multifaceted healthcare practice that requires that the healthcare professionals possess complex combinations of competencies in order to deliver high-quality care and treatment. The purpose of this study was to investigate how a varied group of healthcare professionals' perceive their own competencies within nutrition and documentation and how organizational structures influence their daily work and the quality of care provided. METHODS: Two focus groups consisting of 14 healthcare professionals were conducted. The transcribed focus group interviews was analyzed using the qualitative content analysis approach. RESULTS: Six categories were identified: 1) Lack of uniform and systematic communication affect nutritional care practices 2) Experience-based knowledge among the primary workforce influences daily clinical decisions, 3) Different attitudes towards nutritional care lead to differences in the quality of care 4) Differences in organizational culture affect quality of care, 5) Lack of clear nutritional care responsibilities affect how daily care is performed and 6) Lack of clinical leadership and priorities makes nutritional care invisible. CONCLUSIONS: The six categories revealed two explanatory themes: 1) Absent inter- and intra-professional collaboration and communication obstructs optimal clinical decision-making and 2) quality deterioration due to poorly-established nutritional care structure. Overall, the two themes explain that from the healthcare professionals' point of view, a visible organization that allocates resources as well as prioritizing and articulating the need for daily nutritional care and documentation is a prerequisite for high-quality care and treatment. Furthermore, optimal clinical decision making among the healthcare professionals are compromised by imprecise and unclear language and terminology in the patients' healthcare records and also a lack of clinical guidelines and standards for collaboration between different healthcare professionals working in nursing homes, home care or home nursing. The findings of this study are beneficial to support organizations within these settings with strategies focusing on increasing nutritional care and documentation competencies among the healthcare professionals. Furthermore, the results advocate for the daily involvement and support of leaders and managers in articulating and structuring the importance of nutritional care and treatment and the subsequent documentation.


Assuntos
Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Desnutrição/enfermagem , Casas de Saúde/normas , Competência Clínica/normas , Tomada de Decisão Clínica , Comunicação , Estudos Transversais , Assistência à Saúde/normas , Documentação , Feminino , Grupos Focais , Recursos em Saúde/estatística & dados numéricos , Serviços de Assistência Domiciliar/normas , Assistência Domiciliar/normas , Humanos , Liderança , Desnutrição/prevenção & controle , Estado Nutricional , Cultura Organizacional , Atenção Primária à Saúde/normas , Autoimagem
19.
J Forensic Leg Med ; 68: 101864, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31493720

RESUMO

A death certificate is an official document in which the medical practitioner primarily records the cause of death sequence, the time interval between the onset of the cause of death and death, and personal details of the deceased. Errors in death certificate documentation are not uncommon. We aim to review the common errors in writing the cause of death certificate in the Middle East. For this review, we searched the PubMed database using a comprehensive search strategy to identify studies from the Middle East that reported errors in the cause of death certification from inception to August 17, 2019. Of the 308 items initially identified, 5 were eligible for inclusion. These studies were reported from only a few countries (Saudi Arabia, Iran, Lebanon and Palestine) in the Middle East and did not represent all the countries geographically located in the Middle East. The Middle East is not immune to errors in the medical certification of the cause of death. The absence of the cause of death, inappropriate listing and sequencing of the causes of death, mentioning the mechanism or mode of death instead of the cause of death, absence of time interval between the onset of the cause of death and death, use of abbreviations and symbols instead of formal medical terminology, and absence of the certifying medical practitioner's signature were the commonly death certification errors observed in this regional literature review. Additional studies to assess death certification errors in all the Middle East countries are needed. Efforts should be made to compulsorily include the teaching and learning of the cause of death certification in the undergraduate medical curriculum. Interactive workshops on drafting the cause of death certificate should be periodically conducted for the benefit of the interns and residents.


Assuntos
Causas de Morte , Atestado de Óbito , Documentação , Erros Médicos , Humanos , Oriente Médio
20.
BMC Surg ; 19(1): 112, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412843

RESUMO

BACKGROUND: Many surgeons report passion for their work, but not all tasks are likely to be satisfying. Little is known about how hospital surgeons spend their days, how they like specific tasks, and the role of core tasks (i.e. surgery-related tasks) versus tasks that may keep them from core tasks (e.g., administrative work). This study aimed at a more detailed picture of hospital surgeons' daily work - how much time they spend with different tasks, how they like them, and associations with satisfaction. METHODS: Hospital surgeons (N = 105) responded to a general survey, and 81 of these provided up to five daily questionnaires concerning daily activities and their attractiveness, as well as their job satisfaction. The data were analyzed using t-tests, analysis of variance, as well as analysis of covariance and repeated measures analysis of variance for comparing means across tasks. RESULTS: Among 14 tasks, surgery-related tasks took 21.2%, patient-related tasks 21.7% of the surgeons' time; 10.4% entailed meetings and communicating about patients, and 18.6% documentation and administration. The remaining time was spent with teaching, research, leadership and management, and not task-related activities (e.g. walking between rooms). Surgery was rated as most (4.25; SD = .66), administration as least attractive (2.63; SD = .78). A higher percentage of administration predicted lower perceived legitimacy; perceived legitimacy of administrative work predicted job satisfaction (r = .47). Residents were least satisfied; there were few gender differences. CONCLUSIONS: Surgeons seem to thrive on their core tasks, most notably surgery. By contrast, administrative duties are likely perceived as keeping them from their core medical tasks. Increasing the percentage of medical tasks proper, notably surgery, and reducing administrative duties may contribute to hospital surgeons' job satisfaction.


Assuntos
Satisfação no Emprego , Cirurgiões/psicologia , Adulto , Pesquisa Biomédica , Comunicação , Documentação , Feminino , Administração Hospitalar , Humanos , Liderança , Masculino , Pessoa de Meia-Idade , Relações Médico-Paciente , Cirurgiões/organização & administração , Inquéritos e Questionários , Ensino , Carga de Trabalho
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