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1.
BMC Health Serv Res ; 20(1): 1035, 2020 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-33176775

RESUMO

BACKGROUND: To cope with shortages of equipment during the COVID-19 pandemic, we established a nonprofit end-to-end system to identify, validate, regulate, manufacture, and distribute 3D-printed medical equipment. Here we describe the local and global impact of this system. METHODS: Together with critical care experts, we identified potentially lacking medical equipment and proposed solutions based on 3D printing. Validation was based on the ISO 13485 quality standard for the manufacturing of customized medical devices. We posted the design files for each device on our website together with their technical and printing specifications and created a supply chain so that hospitals from our region could request them. We analyzed the number/type of items, petitioners, manufacturers, and catalogue views. RESULTS: Among 33 devices analyzed, 26 (78·8%) were validated. Of these, 23 (88·5%) were airway consumables and 3 (11·5%) were personal protective equipment. Orders came from 19 (76%) hospitals and 6 (24%) other healthcare institutions. Peak production was reached 10 days after the catalogue was published. A total of 22,135 items were manufactured by 59 companies in 18 sectors; 19,212 items were distributed to requesting sites during the busiest days of the pandemic. Our online catalogue was also viewed by 27,861 individuals from 113 countries. CONCLUSIONS: 3D printing helped mitigate shortages of medical devices due to problems in the global supply chain.


Assuntos
Infecções por Coronavirus/epidemiologia , Equipamentos e Provisões/provisão & distribução , Pandemias , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/epidemiologia , Impressão Tridimensional , Hospitais , Humanos
5.
PLoS One ; 15(8): e0237014, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32745089

RESUMO

Modeling real-life transportation problems usually require the simultaneous incorporation of different variants of the classical vehicle routing problem (VRP). The periodic VRP (PVRP) is a classical extension in which routes are determined for a planning period of several days and each customer has an associated set of allowable visit schedules. This work proposes a unified model framework for PVRP that consists of multiple attributes or variants not previously addressed simultaneously, such as time-windows, time-dependence, and consistency -which guarantees the visits to customer by the same vehicle-, together with three objective functions that respond to the needs of practical problems. The numerical experimentation is focused on the effects of three factors: frequency, depot centrality, and the objective function on the performance of a general-purpose MILP solver, through the analysis of the achieved relative gaps. Results show higher sensitivity to the objective functions and to the problem sizes.


Assuntos
Equipamentos e Provisões/provisão & distribução , Transportes/métodos , Transportes/estatística & dados numéricos , Algoritmos , Modelos Teóricos , Fatores de Tempo
8.
Paediatr Respir Rev ; 35: 61-63, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32690356

RESUMO

There are significant logistical challenges to providing respiratory support devices, beyond simple oxygen flow, when centres run out of supplies or do not have these devices at all, such as in low resource settings. At the peak of the COVID-19 crisis, it was extremely difficult to import medical equipment and supplies, because most countries prohibited the medical industry from selling outside of their own countries. As a consequence, engineering teams worldwide volunteered to develop emergency devices, and medical experts in mechanical ventilation helped to guide the design and evaluation of prototypes. Although regulations vary among countries, given the emergency situation, some Regulatory Agencies facilitated expedited procedures. However, laboratory and animal model testing are crucial to minimize the potential risk for patients when treated with a device that may worsen clinical outcome if poorly designed or misused.


Assuntos
Pressão Positiva Contínua nas Vias Aéreas/instrumentação , Infecções por Coronavirus/terapia , Legislação de Dispositivos Médicos , Pneumonia Viral/terapia , Insuficiência Respiratória/terapia , Ventiladores Mecânicos/provisão & distribução , Betacoronavirus , Aprovação de Equipamentos , Reeducação Profissional , Desenho de Equipamento , Equipamentos e Provisões/provisão & distribução , Humanos , Ventilação não Invasiva/instrumentação , Pandemias , Admissão e Escalonamento de Pessoal , Respiração Artificial/instrumentação , Espanha
9.
Guatemala; MSPAS; 2 Rev; 9 jun. 2020. 15 p. graf.
Não convencional em Espanhol | LILACS, LIGCSA | ID: biblio-1129030

RESUMO

Este documento de orientación provisional procura fortalecer la respuesta de los servicios hospitalarios y a nivel domiciliar ante la posibilidad de tener casos en el país de COVID-19, especialmente en la parte de prevención de la transmisión a del fortalecimiento de las precauciones estándar para la prevención y control de infecciones, con énfasis en el lavado de manos y el uso de equipo protección personal por parte del personal de salud. Además, provee orientaciones para organizar los servicios hospitalarios para adecuar áreas de aislamiento, cuidados intermedios y áreas de triage. El documento también orienta para la proyección de costos de insumos: Material medico quirúrgico, medicamentos, recursos humanos, entre otros como preparación para la respuesta.


Assuntos
Humanos , Masculino , Feminino , Serviços Hospitalares , Desinfecção das Mãos , Controle de Infecções/organização & administração , Infecções por Coronavirus/prevenção & controle , Pacientes , Preparações Farmacêuticas , Organizações , Pessoal de Saúde , Proteção Pessoal , Equipamentos e Provisões/provisão & distribução , Recursos Humanos
10.
Hastings Cent Rep ; 50(3): 22, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32596914

RESUMO

The emergence of Covid-19 in the United States has revealed a critical weakness in the health care system in the United States. The majority of people in the nation receive health care via employment-based health insurance from providers in a competitive market. However, neither employment-based health care nor a competitive health care market can adequately provide treatment during a global pandemic. Employment-based health care will fail to provide care for a large number of people in any destabilizing economic event, including a pandemic. Competitive for-profit health care systems distribute limited goods based on markets rather than health care needs. If a global pandemic results in unusually high demand for specific medical supplies, then these will be distributed suboptimally. The combined risk of suboptimal distribution of needed goods and a significant drop in health care access in a global pandemic indicates that the U.S. health care system has serious vulnerabilities that need to be addressed.


Assuntos
Infecções por Coronavirus/epidemiologia , Equipamentos e Provisões/provisão & distribução , Planos de Assistência de Saúde para Empregados/organização & administração , Alocação de Recursos para a Atenção à Saúde/ética , Pneumonia Viral/epidemiologia , Betacoronavirus , Planos de Assistência de Saúde para Empregados/ética , Humanos , Pandemias , Estados Unidos/epidemiologia
11.
Farm Hosp ; 44(7): 21-23, 2020 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-32533664

RESUMO

Medical devices have become essential to the prevention and control of the  COVID-19 pandemic, being crucial for health professionals and patients in  particular, and the population in general. It is important to be aware of the laws  that regulate the management, distribution, and control of medical devices.  Article 82 of the Spanish Law 29/2006 on Guarantees and Rational Use of  Medicines and Medical Devices establishes that it is the responsibility of Hospital  Pharmacy Services "to participate in and coordinate the purchase of medicines and medical devices in the hospital to ensure an efficient acquisition  and rational use of medical devices". For this reason, working groups of the Spanish Society of Hospital Pharmacy and other scientific societies have issued technical guidelines and consensus statements to provide technical support and updated information on the use of masks, individual  protection equipments and other medical devices. In addition, the shortage of  medical devices caused by the high demand has resulted in the uncontrolled  production and distribution of medical devices. This phenomenon, added to the  fraudulent selling of medical devices, highlights the need for a closer surveillance of the market to guarantee the efficacy and safety of available medical devices. A rational use of medical devices is necessary to ensure the availability and safety of these products, which requires the involvement of  different stakeholders, including hospital pharmacists. Thus, it is essential that  hospital pharmacists receive specific training in technical aspects concerning the possession and use of medical devices. This will help guarantee an effective and safe use of medical products. The acquisition and use of medical  devices requires a keen understanding of the technical and legal aspects  concerning these products, which makes hospital pharmacists essential for the  integral management of medical devices.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Equipamentos e Provisões , Pandemias , Serviço de Farmácia Hospitalar , Pneumonia Viral , Equipamentos de Proteção , Certificação , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Aprovação de Equipamentos , Equipamentos e Provisões/normas , Equipamentos e Provisões/provisão & distribução , Previsões , Fraude , Necessidades e Demandas de Serviços de Saúde , Humanos , Controle de Infecções/instrumentação , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Pandemias/prevenção & controle , Serviço de Farmácia Hospitalar/organização & administração , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Equipamentos de Proteção/provisão & distribução , Ventiladores Mecânicos/provisão & distribução
12.
Farm Hosp ; 44(7): 53-56, 2020 06 13.
Artigo em Inglês | MEDLINE | ID: mdl-32533672

RESUMO

In response to the SARS-CoV-2 pandemic, the Hospital Pharmacy Services have  quickly adapted to respond to a critical situation characterized by the constant  and continuous admission of patients with severe pneumonia who needed  treatment, requiring a transformation of the hospital in order to increase the  number of hospital and critical beds. Moreover, other out-ofhospital spaces have  been transformed into hospitalization units to absorb the large number of  patients that had to be treated and isolated. To guarantee the distribution of  medicines and the quality of the pharmaceutical care, drug distribution systems,  such as unit dose and automated dispensing systems, have undergone  transformations. Standard stocks were assigned for COVID units, and different  dispensing circuits to avoid the risk of cross-contamination between COVID and  non-COVID units were created, as well as disinfection protocols for medication  transport systems and medication return protocols. All this without forgetting  COVID treatment protocol's changes that were affected by the availability of the  drugs. The increase in the number of beds in out-of-hospital spaces, such as  field hospitals, hotels, socio-medical centers and nursing homes, has challenged  Pharmacy Services, since new medication dispensing and conciliation circuits  have been created forcing the increase of pharmacy staff's presence and  modifying work shifts, to afford all the new tasks successfully. Development of  contingency plans for the different Pharmacy Service activities and providing  fluent communication channels are key elements for crisis situations or health  emergencies such as the current pandemic.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Pandemias , Farmacêuticos , Serviço de Farmácia Hospitalar/organização & administração , Pneumonia Viral , Desinfecção , Armazenamento de Medicamentos , Prescrição Eletrônica , Equipamentos e Provisões/provisão & distribução , Previsões , Necessidades e Demandas de Serviços de Saúde , Número de Leitos em Hospital , Unidades Hospitalares , Humanos , Unidades de Terapia Intensiva , Sistemas de Medicação no Hospital/organização & administração , Alta do Paciente , Admissão e Escalonamento de Pessoal , Recursos Humanos
14.
Biosci Trends ; 14(4): 231-240, 2020 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-32389940

RESUMO

Coronavirus disease 19 (COVID-19) has become a pandemic around the world. With the explosive growth of confirmed cases, emergency medical supplies are facing global shortage, which restricts the treatment of seriously ill patients and protection of medical staff. Taking China, the United States, Australia, and Canada as examples, this study compares and analyzes the reserve and supply systems of emergency medical supplies and problems exposed in response to the COVID-19 epidemic. Some common problems were found, such as insufficient types and quantities of emergency medical supplies in reserve, insufficient emergency production capacity, and imperfect command mechanism for emergency supplies deployment and transportation. A sound reserve system of emergency medical supplies is the basis and guarantee for dealing with public health emergencies such as major outbreaks. Based on the comparison of systems and practical experience, countries around the world should further improve the reserve and supply system of emergency medical supplies, and improve the coordination and cooperation mechanism for emergency supplies for international public health emergencies, so as to cope with increasingly severe public health emergencies in the context of globalization.


Assuntos
Infecções por Coronavirus/terapia , Serviços Médicos de Emergência , Equipamentos e Provisões/provisão & distribução , Pneumonia Viral/terapia , Estoque Estratégico , Austrália , Betacoronavirus , Canadá , China , Humanos , Pandemias , Estados Unidos
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