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1.
Medicine (Baltimore) ; 100(2): e23670, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33466122

RESUMO

ABSTRACT: Patient safety is a fundamental aspect of a healthcare system. The aim of this study was to assess the perception and determinants of the patient safety culture of pharmacists in hospitals, in Riyadh, Saudi Arabia.A survey was conducted with pharmacists in the pharmacies of governmental, /military and private hospitals in Riyadh, Saudi Arabia. The pharmacy survey on patient safety culture questionnaire developed by Agency for Healthcare Research and Qualtity, a hard copy was distriuted to the pharmacists. The positive response rate (RR) was calculated and compared across hospitals using a chi-square test. The predictors of patient safety grades were identified using the generalized estimating equation. The data was analyzed using SAS.A total of 538 questionnaires were distributed, of which 411 responded (RR 76.4%). Of the participants, 229 (56%) were females. The majority 255 (62%) were in the 18 to 34 years age range, and 361 (88%) had a bachelor's degree. The majority of the sample 376 (92%) was a pharmacist. The Positive RR (PRR) ranged between (25.6%-74%). The highest PRR was observed in teamwork (74.4%), followed by 'staff, training and skills' (68%), and 'organizational learning continuous improvement' (66%). The lowest PRR was observed in 'staffing, work pressure, and pace' (25.5%). Comparing the PPR of the various healthcare sectors, the governmental hospitals scored the highest in all patient safety domains. Generalized Estimating Equation analysis showed that with increase in scores of all patient safety culture domains increased the likelihood of reporting a better patient safety grade, whereas respondents' demographic characteristics had no effect except the working experience years 6 years and above had odds of poor reporting of the patient safety grade (odds ratio = 2.54, 95% confience interval (1.543, 4.194), (P = .0003).The grades achieved in the various domains of patient safety culture by pharmacists in Riyadh are below the expected standard. The highest scores were achieved in teamwork, with the lowest scores in staffing, work pressure and pace. Overall, pharmacists in government hospital settings have a better perception of patient safety than their peers in other settings. These results provide the baseline evidence for developing future interventional studies aiming at improving patient safety culture in hospital pharmacy settings.


Assuntos
Cultura Organizacional , Segurança do Paciente/normas , Farmacêuticos/psicologia , Gestão da Segurança/organização & administração , Adolescente , Adulto , Idoso , Atitude do Pessoal de Saúde , Comunicação , Estudos Transversais , Feminino , Humanos , Capacitação em Serviço/organização & administração , Masculino , Erros de Medicação/prevenção & controle , Pessoa de Meia-Idade , Admissão e Escalonamento de Pessoal/organização & administração , Melhoria de Qualidade/organização & administração , Gestão da Segurança/normas , Arábia Saudita , Carga de Trabalho , Adulto Jovem
3.
Aerosp Med Hum Perform ; 92(2): 127-128, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33468295

RESUMO

INTRODUCTION: Noninferiority or equivalence testing are often used when comparing a novel pharmaceutical, operation, or procedure to the current standard designated as safe. Noninferiority and equivalence testing require estimates of a metric called delta: the margin of meaningful difference. Inappropriate delta margins can lead to invalid conclusions, thereby creating uncertainty about a studys scientific credibility. We recommend that a working group be convened with the following goals: 1) to evaluate delta values currently in use in aviation; 2) to determine if it is possible to develop a systematic, evidence-based, and replicable process to derive delta values based on statistical properties from population data, rather than a mixture of evidence- and opinion-based processes; and 3) based on the findings of the second goal, update the current delta values in use in aviation. This working group should include, at a minimum, government agencies and other key stakeholders using these values within operational settings.Lamp ACM, Rempe MJ, Belenky GL. Delta: the value that matters in fatigue risk management. Aerosp Med Hum Perform. 2021; 92(2):127128.


Assuntos
Aviação/estatística & dados numéricos , Fadiga , Gestão de Riscos/estatística & dados numéricos , Gestão da Segurança , Humanos
5.
Mymensingh Med J ; 30(1): 228-232, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33397880

RESUMO

Myositis ossificans (MO) is a condition where calcification occurs in the soft tissue as well as around the bone following fracture, vigorous exercise or trauma. Although it is a radiological diagnosis, it often leads physician to an incorrect or missed diagnosis as recurrent fracture. Frequently, it follows haemorrhage into the muscle in the tissue space. We report a 45 years old house-wife presented with the complaints of weakness of right side of body and pain with restricted range of motion (ROM) in right lower limb. She was a diagnosed case of recurrent stroke with rheumatic valvular heart disease. After discharge, vigorous physical exercise was done at home by local physiotherapist without appropriate guidance from physiatrist. Gradually pain was so severe that she didn't allow moving her right lower limb. Over the course of time, she became incapacite and bed bound. She denied any positive family history. With the hip and lower limb problems she consulted with orthopedic surgeon and was referred to Physical Medicine and Rehabilitation department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh for further management & rehabilitation. This case is presented to focus on hazard of being unguided, over-exercised and non-surgical management approach of this rare condition.


Assuntos
Calcinose , Miosite Ossificante , Bangladesh , Feminino , Humanos , Pessoa de Meia-Idade , Miosite Ossificante/diagnóstico por imagem , Miosite Ossificante/etiologia , Gestão da Segurança
6.
J Surg Res ; 257: 425-432, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32892141

RESUMO

BACKGROUND: Surgical debriefs help reduce preventable errors in the operating room (OR) leading to patient injury. However, compliance with debriefs remains poor. The objective of this study was to evaluate the role of structured feedback to surgeons in improving compliance with and quality of surgical debriefs. MATERIALS AND METHODS: Surgical cases at an 875-bed urban teaching hospital from January-June 2019 were audited via audio/video recording to evaluate debrief performance. Debriefs were evaluated for clinical completeness and teamwork quality via two structured forms. Surgeons received an evaluation of their debrief performance at two time points during the study period (February and April). Univariate and mixed-effects regression analyses were used to assess changes in debrief compliance and quality over time. RESULTS: A total of 878 surgical cases performed by 61 surgeons were reviewed: 198 (22.6%) cases during Period 1 (P1), 371 (42.3%) P2, and 309 (35.1%) P3. The rate at which a debrief occurred was 62.1% in P1, 73.0% in P2, and 82.2% in P3 (P < 0.001). Debriefs were 1.96 (95% CI 1.31-2.95, P = 0.001) times more likely to be completed during P2 and 3.21 (95% CI 2.07-5.04, P < 0.001) times more likely during P3 compared to P1. The percent of debriefs initiated by the lead surgeon increased from 59.8% in P1, to 80.0% in P2, to 81.5% in P3 (P < 0.001). CONCLUSIONS: Providing structured feedback to surgeons on their debrief performance was associated with improvements in compliance and completeness with debriefing protocols, OR teamwork and communication, and leadership and accountability from the lead surgeons.


Assuntos
Feedback Formativo , Cirurgia Geral/normas , Fidelidade a Diretrizes/estatística & dados numéricos , Gestão da Segurança/estatística & dados numéricos , Humanos , Salas Cirúrgicas/normas , Garantia da Qualidade dos Cuidados de Saúde , Melhoria de Qualidade
7.
J Nurs Adm ; 51(1): 12-18, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33278196

RESUMO

OBJECTIVE: To examine the association between organizational safety climate (OSC), in-hospital mortality (IM), and failure to rescue (FTR) in 2 hospitals, 1 with and 1 without crew-resource-management training. BACKGROUND: OSC is 1 of the most important organizational factors that promotes safety at work; however, there is a lack of research examining the relationship between OSC and patient deaths in hospitals. METHODS: We utilized a matched 2-group comparison of surgical patients and surveyed surgical staff to assess the relationship between OSC, FTR, and IM. RESULTS: The OSC assessment was completed by 261 surgical team members. A total of 1764 patients had at least 1 FTR complication; however, there was no association between OSC with FTR or IM for either hospital. CONCLUSIONS: Nurse leaders should remain vigilant in building work teams with strong hospital safety climates. More research is needed to explore the relationship between OSC and patient outcomes.


Assuntos
Mortalidade/tendências , Cultura Organizacional , Quartos de Pacientes/normas , Gestão da Segurança , Correlação de Dados , Gestão de Recursos da Equipe de Assistência à Saúde , Humanos , Quartos de Pacientes/organização & administração , Sudeste dos Estados Unidos
8.
Waste Manag ; 121: 87-94, 2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33360309

RESUMO

A valid, standardized tool for assessing workplace safety can help organizations and employers to detect potential safety risks. This is crucial to improve safety and protect employees and production against accidents and injuries. As no such tool has so far been developed for the waste management industry, this study aimed to establish the psychometric properties and the concurrent validity of the 11-item Brief Norwegian Safety Climate Inventory (Brief NORSCI). A cross-sectional questionnaire study was conducted with 543 workers from the formal Norwegian waste management industry. Exploratory and confirmatory factor analyses showed that the Brief NORSCI exhibited good psychometric properties. Replicating previous validation studies of the inventory, the findings suggested a three-factor structure reflecting Individual intention and motivation, Management's prioritization of safety, and Safety routines. The three first-order factors of the inventory could be combined in a composite second-order safety climate factor. Both the overall composite score and the three subscales correlated in the expected directions with measures of job characteristics (i.e., job demands and resources), leadership, social climate, and severe accidents, thus indicating high concurrent validity. This study supported the validity and reliability of the Brief NORSCI as an assessment tool to measure both individual safety perceptions and group level safety climate among waste management workers. The findings suggest that application of the Brief NORSCI as a safety assessment tool may contribute to the development of a stronger safety profile among organizations and companies in waste management.


Assuntos
Gestão da Segurança , Gerenciamento de Resíduos , Estudos Transversais , Humanos , Noruega , Percepção , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
9.
Surg Clin North Am ; 101(1): 29-36, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33212077

RESUMO

This article discusses the processes, interventions, and methods by which health care systems can change the culture of their workplace to promote safety. The importance of this culture shift is discussed, as well as an organizational approach, highlighting the importance of investment of time and resources to the cause. Efforts must include an educational focus on patient safety where a culture of patient safety is emphasized. This attitude along with several specific key interventions, including, measurement, teamwork, briefings, checklists, and developmental infrastructure, are discussed.


Assuntos
Segurança do Paciente/normas , Gestão da Segurança/métodos , Procedimentos Cirúrgicos Operatórios/normas , Humanos
10.
Nursing ; 51(1): 65-69, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33346621

RESUMO

PURPOSE: To investigate the use of toilet alarms among patients at an increased risk for falls in inpatient settings while allowing for privacy and maintaining safety. METHODS: Pre- and postsurvey data were collected among patients in the intervention and control groups, as well as among the healthcare staff, to determine perceptions of privacy and safety. RESULTS: Each participant group was compared according to the participants' responses to the pre- and postsurveys. On average, the intervention group perceived increased levels of privacy and safety compared with the control group. Staff also indicated increased privacy and safety. CONCLUSION: Additional research is necessary, but patient satisfaction, privacy, and dignity may be augmented by using toilet alarms in hospital settings.


Assuntos
Aparelho Sanitário , Alarmes Clínicos , Hospitais , Gestão da Segurança/métodos , Acidentes por Quedas/prevenção & controle , Humanos , Privacidade , Medição de Risco
11.
Arch. prev. riesgos labor. (Ed. impr.) ; 23(4): 415-429, oct.-dic. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-197173

RESUMO

OBJETIVO: Los Indicadores Positivos de Esfuerzo Preventivo (IPEP) reflejan aspectos centrales de la cultura preventiva; existen evidencias respecto a la validez predictiva de algunos de estos respecto a los accidentes de trabajo. Éste es el caso del Organizational Performance Metric (OPM) desarrollado por el Institute for Work and Health (IWH) de Canadá, cuestionario en inglés, corto y ampliamente validado internacionalmente. El objetivo es obtener una versión adaptada transculturalmente de la herramienta OPM, traducida al castellano y analizar su fiabilidad estadística, validez y consistencia interna. MÉTODO: Tras un proceso de traducción y retro traducción con un panel de expertos, se cumplimentaron en Navarra, España, 478 cuestionarios. Se calculó el estadístico alfa de Cronbach, las correlaciones bivariadas, el índice de correlación intraclase (ICC) y un análisis factorial exploratorio a los ocho ítems que lo forman. RESULTADOS: el análisis muestra una alta fiabilidad (alfa de Cronbach=0,863) y validez interna (ICC = 0,842) de la herramienta. El análisis factorial confirma un único factor latente entre los ocho ítems del cuestionario. CONCLUSIONES: El cuestionario obtenido (OPM-Esp) constituye un instrumento válido como indicador positivo de esfuerzo preventivo para las empresas españolas. Su reducido tamaño y fácil aplicación lo hacen especialmente útil en el ámbito laboral. Su predictibilidad respecto a los accidentes de trabajo deberá valorarse para el entorno español


OBJECTIVE: Safety positive performance indicators (PPI) reflect key aspects of safety culture; some of them also have predictive validity for occupational injuries. This is the case of the Organizational Performance Metric (OPM), developed by the Canadian Institute for Work & Health (IWH), a short, widely validated international English language questionnaire. The objective of this study was to obtain a transculturally adapted Spanish language version of the OPM, and to analyze its statistical reliability, validity and internal consistency. METHOD: After a translation and back translation process was performed by an expert panel, 478 questionnaires were completed in Navarra, Spain. We calculated the Cronbach alpha coefficient, bivariate correlations and the intra-class correlation coefficient (ICC) and performed exploratory factorial analysis of all eight items. RESULTS: Data show the new tool has high reliability (Cronbach alpha = 0.863) and internal validity (ICC = 0.842). The factorial analysis confirmed a single latent factor among the eight items of the questionnaire. CONCLUSIONS: the adapted questionnaire (OPM-Esp) constitutes a valid instrument for use as an indicator of safety performance in Spanish companies. Its brevity and simplicity make it especially useful in the work environment. Its ability to predict occupational injuries should be tested in the Spanish context


Assuntos
Humanos , Cultura Organizacional , Gestão da Segurança/normas , Inquéritos e Questionários/normas , Características Culturais , Psicometria , Reprodutibilidade dos Testes , Canadá , Espanha
12.
PLoS One ; 15(12): e0243056, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33315928

RESUMO

Implementation of effective programs to improve occupational safety should be linked to an understanding of the specific nature of the given job. The aim of the research was to compare occupational groups with different job-related specificities: industrial production line workers, retail workers and mine rescuers, in terms of their assessment of the work safety climate. The survey covered 2,995 respondents with diversified demographic characteristics. The study used an abridged version of the Safety Climate Questionnaire by Znajmiecka-Sikora (2019) to assess 10 separate safety climate dimensions. The results of the MANOVA multivariate analysis, Wilks' multivariate F-tests and univariate F tests prove that there is a statistically significant difference between the respondents representing the three occupational groups collectively in terms of global assessment of all work safety climate dimensions, and also indicate significant differences between workers belonging to the three occupational groups in terms of their assessment of the individual dimensions of the work safety climate, except the organization's occupational health and safety management policy as well as technical facilities and ergonomics, which may be due to the universality of the requirements set for organizations with regard to these two aspects of safe behavior. The differences observed in the assessment of the remaining work safety climate dimensions induces one to promote more differentiated and individualized activities, taking into account the work specificity and the nature of the threats occurring in the respective working environment of the representatives of the different occupations. The difference in assessment of the work safety climate found in the research encourages one to create practical programs for safety, not only in the procedural and technical dimension, but also in the social and psychological one.


Assuntos
Ocupações/classificação , Gestão da Segurança/métodos , Local de Trabalho/psicologia , Feminino , Humanos , Masculino , Saúde do Trabalhador , Cultura Organizacional , Fatores de Risco , Inquéritos e Questionários
13.
Artigo em Inglês | MEDLINE | ID: mdl-33352866

RESUMO

Safety supervision aims to safeguard the overall interests of the corporation, and ensure its safety production together with sustainable development. It is the key to reducing accident rates, and safeguarding employees' safety and corporate property. The establishment of safety supervision system requires specify strategies. However, it is difficult to determine such strategies in an objective manner under complex environments. Therefore, first, this paper combined an external factor evaluation matrix (EFEM) and an internal factor evaluation matrix (IFEM) to analyze the internal and external safety environments faced by X Group Corporation (XGC). Second, the strength-weakness-opportunity-threat (SWOT) approach was employed to qualitatively analyze and explore the alternative safety supervision strategies. Following this, the most attractive strategies were selected from alternatives by using the quantitative strategic planning matrix (QSPM), namely construction of the safety culture system, clarification of modes and organizational structure of safety supervision, and improvement of the safety performance evaluation system. These strategies were subsequently applied in the construction and improvement of the XGC's safety supervision system. This study can provide reliable theoretical and methodological support for the establishment of corporations' safety supervision systems.


Assuntos
Organizações , Gestão da Segurança , China
14.
S Afr Med J ; 0(0): 13162, 2020 12 09.
Artigo em Inglês | MEDLINE | ID: mdl-33334390

RESUMO

BACKGROUND: Given the global shortage of N95 filtering facepiece respirators (FFP2 in Europe) during the COVID-19 pandemic, KN95 masks (Chinese equivalent of the N95 and FFP2) were imported and distributed in South Africa (SA). However, there are hardly any published independent safety data on KN95 masks. OBJECTIVES: To evaluate the seal, fit and filtration efficiency of several brands of KN95 masks marketed for widespread use in SA healthcare facilities, using standardised testing protocols. METHODS: The verifiability of manufacturer and technical details was first ascertained, followed by evaluation of the number of layers comprising the mask material. The testing protocol involved a directly observed positive and negative pressure user seal check, which if passed was followed by qualitative fit testing (sodium saccharin) in healthy laboratory or healthcare workers. Quantitative fit testing (3M) was used to validate the qualitative fit testing method. The filtration efficacy and integrity of the mask filter material were evaluated using a particle counter-based testing rig utilising aerosolised saline (expressed as filtration efficacy of 0.3 µm particles). Halyard FLUIDSHIELD 3 N95 and 3M 1860 N95 masks were used as controls. RESULTS: Twelve KN95 mask brands (total of 36 masks) were evaluated in 7 participants. The mask type and manufacturing details were printed on only 2/12 brands (17%) as per National Institute of Occupational Safety and Health and European Union regulatory requirements. There was considerable variability in the number of KN95 mask layers (between 3 and 6 layers in the 12 brands evaluated). The seal check pass rate was significantly lower in KN95 compared with N95 masks (1/36 (3%) v. 12/12 (100%); p<0.0001). Modification of the KN95 ear-loop tension using head straps or staples, or improving the facial seal using Micropore 3M tape, enhanced seal test performance in 15/36 KN95 masks evaluated (42%). However, none of these 15 passed downstream qualitative fit testing compared with the control N95 masks (0/15 v. 12/12; p<0.0001). Only 4/8 (50%) of the KN95 brands tested passed the minimum filtration requirements for an N95 mask (suboptimal KN95 filtration efficacy varied from 12% to 78%, compared with 56% for a surgical mask and >99% for the N95 masks at the 0.3 µm particle size). CONCLUSIONS: The KN95 masks tested failed the stipulated safety thresholds associated with protection of healthcare workers against airborne pathogens such as SARS-CoV-2. These preliminary data have implications for the regulation of masks and their distribution to healthcare workers and facilities in SA.


Assuntos
Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Teste de Materiais/métodos , Exposição Ocupacional/prevenção & controle , /epidemiologia , Desenho de Equipamento/métodos , Desenho de Equipamento/normas , Análise de Falha de Equipamento , Humanos , Gestão da Segurança/organização & administração , África do Sul/epidemiologia
15.
S Afr Med J ; 0(0): 13182, 2020 12 14.
Artigo em Inglês | MEDLINE | ID: mdl-33334391

RESUMO

BACKGROUND: The COVID-19 pandemic has led to the implementation of restrictive policies on theatre procedures, with profound impacts on service delivery and theatre output. OBJECTIVES: To quantify these effects at a tertiary hospital in KwaZulu-Natal Province, South Africa. METHODS: A retrospective review of morbidity and mortality data was conducted. The effects on emergency and elective caseload, intensive care unit (ICU) admissions from theatre, theatre cancellations and regional techniques were noted. RESULTS: Theatre caseload decreased by 30% from January to April 2020 (p=0.02), ICU admissions remained constant, and theatre cancellations were proportionally reduced, as were the absolute number of regional techniques. CONCLUSIONS: The resulting theatre case deficit was 1 260 cases. It will take 315 days to clear this deficit if four additional surgeries are performed per day.


Assuntos
Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Controle de Infecções , Centro Cirúrgico Hospitalar , Atenção Terciária à Saúde , Adulto , /prevenção & controle , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Política de Saúde , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Masculino , Mortalidade , Determinação de Necessidades de Cuidados de Saúde , Inovação Organizacional , Gestão da Segurança/tendências , África do Sul/epidemiologia , Centro Cirúrgico Hospitalar/organização & administração , Centro Cirúrgico Hospitalar/estatística & dados numéricos , Atenção Terciária à Saúde/organização & administração , Atenção Terciária à Saúde/tendências
16.
Rev. senol. patol. mamar. (Ed. impr.) ; 33(4): 130-136, oct.-dic. 2020. graf
Artigo em Espanhol | IBECS | ID: ibc-192959

RESUMO

OBJETIVO: Describir las medidas adoptadas dentro del plan de contingencia del COVID-19 respecto a la biopsia selectiva de ganglio centinela (BSGC) y analizar su impacto sobre la actividad asistencial. METODOLOGÍA: Estudio cualitativo, descriptivo y retrospectivo de BSGC realizadas durante el período del 14/03 al 11/05 de 2020. Análisis de las medidas tomadas para minimizar las probabilidades de contagio y resultados de PCR de pacientes y personal. Comparativa de casos con los realizados en el mismo período de 2019. Actividad diaria de linfogammagrafía y de cirugía radioguiada (CRG) por indicación médica. Cálculo numérico y porcentual de CRG por hospital y recursos humanos diarios de medicina nuclear requeridos. RESULTADOS: Se realizaron 42 intervenciones con BSGC, un 31,1% menos que en 2019. La indicación médica de cáncer de mama experimentó el mayor descenso de actividad (n=18, 41,9%). Del total de CRG, Hospital Clínic realizó el 45,2%, Hospital Maternitat el 31,0%, Hospital Plató el 16,7% y Hospital Sant Joan de Déu el 7,1% restante. En relación con los recursos humanos, la planificación inicial se cumplió en un 77% de los días. El total de los controles PCR a pacientes (n=42) y personal de CRG (n=9) dio resultado negativo. CONCLUSIONES: El COVID-19 influyó negativamente en la actividad asistencial de la BSGC del Hospital Clínic, pero fue compensado por una planificación acertada, basada en el análisis previo de los procesos del procedimiento, que permitió adaptar los recursos de material y personal a las circunstancias cambiantes, otorgándole una flexibilidad que posibilitó el cumplimiento de la programación establecida


OBJECTIVE: To describe the measures taken within the COVID-19 contingency plan concerning sentinel lymph node biopsy (SNB) procedures and to assess their impact on healthcare activity. METHODOLOGY: Qualitative, descriptive and retrospective study of SNB procedures conducted during the lockdown period of COVID-19 (14/03 to 11/05 2020). Analysis of measures taken to minimise the chances of contagion and PCR outcomes of patients and staff. Comparison with SNB procedures conducted in the same time interval in 2019. Daily activity of lymphoscintigraphy and radioguided surgery (RGS) by medical indication. Numerical and percentage calculation of RGS by hospital and daily requirements for human resources in nuclear medicine. RESULTS: Forty-two SNB were performed, representing 31.1% less than those conducted in the same period in 2019. The medical indication of breast cancer showed the greatest activity decrease (n=18, 41.9%). RGS was performed in 45.2% of patients in Hospital Clínic, 31.0% in Maternitat, 16.7% in Plató and 7.1% in Sant Joan de Déu Hospital. Concerning the human resources required, the initial planning was accomplished in 77% of the days (24/31). All the PCR samples from patients (n=42) and RGS staff (n=9) were negative for COVID-19. CONCLUSIONS: COVID-19 negatively influenced the healthcare activity of SNB in Hospital Clínic, but was compensated by adequate planning, based on prior analysis of the procedure's processes, which allowed adaptation of material and personnel resources to the changing circumstances. This allowed flexibility, which in turn enabled compliance with the established schedule


Assuntos
Humanos , Neoplasias da Mama/patologia , Biópsia de Linfonodo Sentinela/estatística & dados numéricos , Infecções por Coronavirus/prevenção & controle , Reação em Cadeia da Polimerase/estatística & dados numéricos , Cirurgia Assistida por Computador/estatística & dados numéricos , Linfocintigrafia/estatística & dados numéricos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Precauções Universais/métodos , Pandemias/estatística & dados numéricos , Biópsia de Linfonodo Sentinela/métodos , Estudos Retrospectivos , Serviço Hospitalar de Medicina Nuclear/estatística & dados numéricos , Gestão da Segurança/métodos
17.
PLoS One ; 15(12): e0243464, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33373371

RESUMO

Injuries are a leading cause of death and disability among children. Numerous injury prevention strategies have been successful in high-income countries, but the majority of unintentional injuries happen to children living in low- and middle-income countries (LMICs). This project aims to delineate the childhood injury prevention initiatives in LMICs. For inclusion, peer-reviewed articles needed to address unintentional injury, include children <18, assess a prevention-related intervention, contain a control group, and be published after 1988. Two pairs of reviewers evaluated articles independently to determine study eligibility. 74 articles were included. 30 studies addressed road traffic injuries, 11 drowning, 8 burns, 3 falls, 8 poisonings, and 21 an unspecified injury type. The findings show positive effects on injury outcome measures following educational interventions, the need for longer follow-up periods after the intervention, the need for effectiveness trials for behavior change, and the need for an increase in injury prevention services in LMICs. This is the first systematic review to summarize the prevention initiatives for all types of childhood unintentional injuries in LMICs. Increased attention and funding are required to go beyond educational initiatives with self-reported measures and little follow-up time to robust interventions that will reduce the global burden of unintentional injuries among children.


Assuntos
Ferimentos e Lesões/prevenção & controle , Acidentes de Trânsito/prevenção & controle , Queimaduras/prevenção & controle , Criança , Bases de Dados Factuais , Países em Desenvolvimento , Humanos , Equipamentos de Proteção/normas , Gestão da Segurança
18.
Pan Afr Med J ; 35(Suppl 2): 148, 2020.
Artigo em Francês | MEDLINE | ID: mdl-33193963

RESUMO

Sub-Saharan African countries have been hit by the Coronavirus 2019 pandemic (COVID-19) since March 2020. Besides the resulting health and economic disasters is the psycho-socio-cultural problem related with the management of corpses of people dead from the disease, which might hinder the implementation of the response strategy. In Cameroon for instance, the current corpse management policy is very disputed. In fact, although they were recently made more flexible, the restrictions applied to burials still ban any transfer of dead bodies between cities. In light of the African cultural considerations of dead persons, the disputes observed between the families and the health personnel, the legislation and the available scientific evidence, this article analyses the risks and benefits of allowing families to bury their relatives. It thereafter suggests solutions that reconcile dignity (by allowing families to bury their dead relatives in their homes) and safety (by ensuring a sealed handling and the surveillance by a judiciary police officer). Applying these solutions could improve the population's trust towards the health system, and positively contribute to COVID-19 case prevention, identification and management.


Assuntos
Atitude Frente a Morte , Betacoronavirus , Sepultamento , Cadáver , Infecções por Coronavirus/prevenção & controle , Rituais Fúnebres , Práticas Mortuárias , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , África ao Sul do Saara/epidemiologia , Sepultamento/ética , Sepultamento/legislação & jurisprudência , Camarões , Infecções por Coronavirus/transmissão , Cultura , Transmissão de Doença Infecciosa/legislação & jurisprudência , Transmissão de Doença Infecciosa/prevenção & controle , Família , Humanos , Práticas Mortuárias/ética , Práticas Mortuárias/legislação & jurisprudência , Pessoalidade , Pneumonia Viral/transmissão , Opinião Pública , Medição de Risco , Gestão da Segurança/ética , Gestão da Segurança/legislação & jurisprudência , Gestão da Segurança/métodos
19.
BMC Oral Health ; 20(1): 301, 2020 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-33148254

RESUMO

BACKGROUND: The aim of this paper is to assess an innovative risk score for common dental procedures, based on the most recent contaminant SARS-CoV-2. After scoring the level of infection risk, safety procedures, advice and personal protective equipment (PPE) are recommended for the dental team in each dental practice. METHODS: The authors of this research analysed 42 common dental procedures on the basis of known transmission risks. In increasing order, many consider the parameters leading to different risk scores for the dental team and patients for each procedure to be: direct contact with saliva (score 1), direct contact with blood (score 2), production of low levels of spray/aerosol via air-water syringes (score 3), the production of high levels of spray/aerosol from rotating, ultrasound and piezoelectric tools (score 4); and the duration of the procedure, which may increase the risk of procedures producing droplets and aerosols. RESULTS: Using this innovative risk-scoring system, the authors classified the different dental procedures according to low, medium or high risk: low (1-3), medium (4-5), high (≥ 6). A safety protocol for each procedure was thereafter matched with the calculated risk level. CONCLUSIONS: The innovative risk-scoring system presented in this research permits the reclassification of dental procedures according to the infection risk level. Consequently, specific procedures, previously considered as entry level, will now merit revision. This paper also highlighted an effective and routine clinical tool for general dentists and oral medicine practitioners.


Assuntos
Infecções por Coronavirus/epidemiologia , Odontologia/métodos , Odontologia/normas , Pneumonia Viral/epidemiologia , Medição de Risco/métodos , Gestão da Segurança , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Humanos , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle
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