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2.
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
3.
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
4.
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
5.
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
6.
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
7.
Otolaryngol Clin North Am ; 53(6): 1139-1151, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33039097

RESUMO

This review summarizes the challenges and adaptations that have taken place in rhinology and facial plastics in response to the ongoing coronavirus disease-19 pandemic. In particular, the prolonged exposure and manipulation of the nasal and oral cavities portend a high risk of viral transmission. We discuss evidence-based recommendations to mitigate the risk of viral transmission through novel techniques and device implementation as well as increasing conservative management of certain pathologies.


Assuntos
Infecções por Coronavirus/prevenção & controle , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Controle de Infecções/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Rinoplastia/métodos , Ritidoplastia/métodos , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Masculino , Boca/virologia , Cavidade Nasal/virologia , Saúde do Trabalhador , Pandemias/estatística & dados numéricos , Segurança do Paciente , Pneumonia Viral/epidemiologia , Rinoplastia/efeitos adversos , Ritidoplastia/efeitos adversos , Gestão da Segurança/métodos
10.
PLoS One ; 15(9): e0239141, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32956383

RESUMO

Disruptive behavior by passengers delayed at airport terminals not only affects personal safety but also reduces civil aviation efficiency and passenger satisfaction. This study investigated the causal mechanisms of disruptive behavior by delayed passengers in three aspects: environmental, managerial, and personal. Data on flight delays at Shenzhen Airport in 2018 were collected and analyzed. The main factors leading to disruptive behavior by delayed passengers were identified, and an early warning model for disturbances was developed using multiple logistic regression and a back-propagation(BP) neural network. The results indicated that the proposed model and method were feasible. Compared to the logistic regression model, the BP neural network model had advantages in predicting disturbances by delayed passengers, showing higher prediction accuracy. The BP network weight analysis method was used to obtain the influence weight of each factor on behavior change of delayed passengers. The influence weight of different factors was obtained, providing an assistant decision-making method to address disruption from flight-delayed passengers.


Assuntos
Aviação/organização & administração , Modelos Psicológicos , Comportamento Problema/psicologia , Gestão da Segurança/métodos , Viagem/psicologia , Tomada de Decisões Gerenciais , Humanos , Modelos Logísticos , Redes Neurais de Computação , Satisfação Pessoal , Fatores de Tempo
11.
Chin J Traumatol ; 23(5): 274-279, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32921558

RESUMO

PURPOSE: Child injuries are a public health concern globally. Injury surveillance systems (ISSs) have beneficial impact on child injury prevention. There is a need for evidence-based consensus on frameworks to establish child ISSs. This research aims to investigate the key components of a child ISS for Iran and to propose a framework for implementation. METHODS: Data were gathered through interview with experts using unstructured questions from January 2017 to December 2018 to identify child ISS functional components. Qualitative data were analyzed using content analysis method. Then, modified Delphi method was used to validate the functional components. Based on the outcomes of the content analysis, a questionnaire with closed questions was developed and presented to a group of experts. Consensus was achieved in two rounds. RESULTS: In round I, 117 items reached consensus. In round II, 5 items reached consensus and were incorporated into final framework. Consensus was reached for 122 items comprising the final framework and representing 7 key components: goals of the system, data sources, data set, coalition of stakeholders, data collection, data analysis and data distribution. Each component consisted of several sub-components and respective elements. CONCLUSION: This agreed framework will assist in standardizing data collection, analysis and distribution, which help to detect child injury problems and provide evidence for preventive measures.


Assuntos
Gestão da Segurança/métodos , Inquéritos e Questionários , Ferimentos e Lesões/prevenção & controle , Adolescente , Criança , Pré-Escolar , Análise de Dados , Coleta de Dados , Feminino , Humanos , Lactente , Irã (Geográfico) , Masculino
13.
Dermatol Online J ; 26(8)2020 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-32941709

RESUMO

Dermatologic surgeons are at increased risk of contracting SARS-COV-2. At time of writing, there is no published standard for the role of pre-operative testing or the use of smoke evacuators, and personal protective equipment (PPE) in dermatologic surgery. Risks and safety measures in otolaryngology, plastic surgery, and ophthalmology are discussed. In Mohs surgery, cases involving nasal or oral mucosa are highest risk for SARS-COV-2 transmission; pre-operative testing and N95 masks should be urgently prioritized for these cases. Other key safety recommendations include strict control of patient droplets and expanded pre-clinic screening. Dermatologic surgeons are encouraged to advocate for appropriate pre-operative tests, smoke evacuators, and PPE. Future directions would include national consensus guidelines with continued refinement of safety protocols.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Dermatologistas , Doenças Profissionais/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Gestão da Segurança/métodos , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Procedimentos Cirúrgicos Eletivos , Humanos , Cirurgia de Mohs/efeitos adversos , Cirurgia de Mohs/métodos , Doenças Profissionais/epidemiologia , Procedimentos Cirúrgicos Oftalmológicos/métodos , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Equipamento de Proteção Individual , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Cuidados Pré-Operatórios , Procedimentos Cirúrgicos Reconstrutivos/métodos , Fumaça/prevenção & controle
14.
Arch. prev. riesgos labor. (Ed. impr.) ; 23(3): 343-356, jul.-sept. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-194120

RESUMO

OBJETIVO: Evaluar diferencias entre la detección de incidentes o eventos adversos (I/EA) en una mutua laboral, mediante una herramienta tipo Trigger Tool (TT) y una plataforma de notificación voluntaria (SNEA). MÉTODOS: La población de estudio es la población trabajadora atendida ambulatoriamente en una mutua laboral de Enero a Septiembre del 2016. Se seleccionaron los casos declarados como I/EA según si el evento no ha afectado al paciente o por el contrario le ha afectado, a través del SNEA (n = 21 casos). Por otro lado, se seleccionaron aleatoriamente 20 historias clínicas por mes donde se aplicó la herramienta TT (180 casos). Se adaptaron 11 triggers para detectar I/EA. Se revisaron las 201 historias clínicas buscando la existencia de triggers. Se obtuvo la concordancia entre el sistema SNEA y el TT utilizando la proporción de concordancia positiva (I/EA), proporción de concordancia negativa (no I/EA) e índice Kappa. RESULTADOS: TT detectó casos de I/EA en el 41,3% de las revisiones mientras que el SNEA 10,3% (p < 0,001). El índice Kappa ofreció un valor de concordancia baja (Kappa = 0,12) lo que denota la pequeña coincidencia de sucesos adversos detectados por ambos sistemas. La proporción de concordancia negativa fue mayor que la de concordancia positiva (74,5% frente a un 26,9%). El sistema SNEA detectó menos I/EA y sobre todo se trata de menos incidentes. Por el contrario, el sistema TT detectó mayor número de I/EA y especialmente EA. CONCLUSIONES: Trigger Tool es una herramienta recomendable para la detección de incidentes


OBJECTIVE: To evaluate differences between the detection of incidents or adverse events (I/AE) using a Trigger Tool (TT) and voluntary notification platform (SNEA). METHODS: The study population is the working population attended on an outpatient basis in an Insurance Company ("mutua") from January to September 2016. The cases declared as Incident or Adverse Event (I / AE) were selected through the SNEA (21 cases), according to whether the event has not affected the patient or on the contrary has affected him. On the other hand, 20 clinical histories per month were randomly selected where the TT was applied (180 cases). The 201 clinical histories were reviewed looking for the existence of triggers. The agreement between the SNEA system and the TT was evaluated using proportion of positive agreement (I/EA), proportion of negative agreement (not I/EA) and Kappa index. RESULTS: TT detected I/EA cases in 41.3% of the revisions while the SNEA was 10.3% (p < 0.001). The Kappa index showed a low concordance value (Kappa = 0.12), which indicates the small coincidence of I/EA detected by both systems. The proportion of negative agreement was greater than that of positive agreement (74.5% versus 26.9%). The SNEA system detected less I/ EA and above all it deals with fewer incidents. On the contrary, the TT system detected a greater number of I EA and especially EA


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Pacientes Ambulatoriais/estatística & dados numéricos , Segurança do Paciente/estatística & dados numéricos , Gestão de Riscos/métodos , Gestão da Segurança/métodos , Gestão da Segurança/estatística & dados numéricos , Estudos Transversais
15.
Pediatr. aten. prim ; 22(87): 263-271, jul.-sept. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194298

RESUMO

INTRODUCCIÓN: durante la pandemia de COVID-19, el uso de equipos y dispositivos de protección por parte de los profesionales es fundamental para evitar la transmisión de la infección en el colectivo de sanitarios. MATERIAL Y MÉTODOS: el Grupo Laboral-Profesional de la Asociación Española de Pediatría de Atención Primaria (AEPap) ha realizado una encuesta a los vocales autonómicos de la AEPap para conocer la disponibilidad que han tenido los pediatras de Atención Primaria (PAP) de sistemas de protección frente a la enfermedad, y las pruebas diagnósticas realizadas para el diagnóstico de los contagios de los PAP. RESULTADOS: en marzo de 2020, solo en el 32% de las comunidades autónomas (CC. AA.), los pediatras tenían sistemas de protección adecuados. En abril ascendió al 70%. En todas las CC. AA. se han registrado casos de PAP enfermos, aunque es difícil cuantificar el número de afectados. De las que tenemos datos, sumando el número de pediatras enfermos conocido, más test de reacción en cadena de la polimerasa (PCR) positivo, los que han estado en aislamiento y los ingresados, la cifra asciende al 7,65% de la cifra total de PAP. Los test rápidos serológicos o PCR o ambos se han realizado en seis comunidades los últimos días de abril y en otras seis los primeros días de mayo. Entre las CC. AA. de las que hay información, Aragón es la única comunidad en la que no se ha realizado test. Se ha correlacionado la disponibilidad de los sistemas de protección y el gasto sanitario. CONCLUSIONES: los sistemas de protección han sido insuficientes. Las CC. AA. con mayor gasto sanitario han contado más precozmente con sistemas de protección adecuados. Han resultado infectados PAP en todas las comunidades autónomas, especialmente en Madrid, Castilla y León y Comunidad Valenciana. La detección de profesionales afectos por la infección ha sido tardía


INTRODUCTION: during the COVID-19 pandemic, the use of protective equipment and devices by professionals is essential to prevent transmission of the infection in the healthcare community. METHODS: the Professional Labor Working group of the Spanish Association of Primary Care Pediatrics (AEPap) has carried out a survey of the autonomous members of the AEPap to find out the availability for primary care pediatricians (PCP) of protection elements against the disease, the diagnostic measures carried out on the professionals for the diagnosis of infections in the PCP. RESULTS: during the month of March, in 32% of the autonomous communities (CC. AA.), pediatricians had adequate means of protection, which in April amounted to 70%. Sick cases of PCP have been registered in all the CC. AA., although it is difficult to quantify the number of patients affected. According to our data, adding the positive test patients, those who have been in isolation and those admitted, the figure rises up to 7.65%. Rapid serological tests or PCR or both have been carried out in 6 communities in the last days of April and in 6 others in the first days of May. The only community in which it has not been carried out is that of Aragon. The availability of protection systems and health expenditure have been correlated. CONCLUSIONS: protection systems have been insufficient. The CC. AA. with the highest health expenditure have had adequate protection systems earlier. PCP have been infected in all the autonomous communities, especially in Madrid, Castilla y León and Valencia. The detection of affected professionals by the infection has been late


Assuntos
Humanos , Criança , Infecções por Coronavirus/prevenção & controle , Síndrome Respiratória Aguda Grave/prevenção & controle , Vírus da SARS/isolamento & purificação , Hospitais Pediátricos/organização & administração , Gestão da Segurança/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Infecções por Coronavirus/epidemiologia , Síndrome Respiratória Aguda Grave/epidemiologia , Vírus da SARS/patogenicidade , Cuidado da Criança/métodos , Pandemias/estatística & dados numéricos , Atenção Primária à Saúde/organização & administração , Precauções Universais/métodos , Pessoal de Saúde/estatística & dados numéricos , Espanha/epidemiologia
16.
Am J Nurs ; 120(9): 26-35, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32858695

RESUMO

PURPOSE: This study sought to evaluate nurses' knowledge and comfort with assessing inpatients' access to firearms and providing education on firearm safety and storage. Facilitators and barriers to such assessment, as well as best methods for educating nurses and patients on firearm safety and storage, were also explored. METHODS: Nurses from a general medical unit and a psychiatric unit at a large urban hospital were invited to complete a 22-question online survey. Descriptive statistics were computed to analyze survey responses for each unit. RESULTS: Forty-two nurses-21 from each unit-participated. More than 50% of nurses on each unit were unfamiliar with state law on safe gun storage, and none had prior training in educating others on firearm safety and storage. Compared with nurses on the psychiatric unit, those on the general medical unit were less comfortable asking patients about firearm access and safe gun storage. Several facilitators and barriers to assessment emerged. Facilitators identified by similar numbers of nurses on each unit included receiving relevant education and having educational information available for patients. Nurses on both units also endorsed having a safety protocol and a documentation policy in place. Barriers identified by similar numbers of nurses on each unit included lack of adequate knowledge about firearm safety and lack of patient educational materials. More medical unit than psychiatric unit nurses also named lack of time and not knowing what to do with collected information. More than 80% of nurses on each unit reported that they would feel comfortable providing patients with information on safe firearm storage if it were available; a pamphlet was endorsed most often as the best method. A one-hour class involving the security department and other disciplines was the top endorsed nurse learning strategy. CONCLUSIONS: Findings from this study highlighted several factors, including nursing specialty, that may influence inpatient assessment of firearm access and safe gun storage. These results can help inform hospital policies and nursing education initiatives aimed at improving safe gun storage practices among patients and the general public.


Assuntos
Armas de Fogo , Conhecimentos, Atitudes e Prática em Saúde , Papel do Profissional de Enfermagem , Recursos Humanos de Enfermagem no Hospital/psicologia , Gestão da Segurança/métodos , Ferimentos por Arma de Fogo/prevenção & controle , Adulto , Feminino , Humanos , Masculino , Relações Enfermeiro-Paciente , Inquéritos e Questionários , Estados Unidos , Ferimentos por Arma de Fogo/enfermagem , Ferimentos por Arma de Fogo/psicologia
17.
J Perinat Med ; 48(9): 959-964, 2020 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-32809968

RESUMO

Objectives We describe a standardized, scalable outpatient surveillance model for pregnant women with COVID-19 with several objectives: (1) to identify and track known, presumed, and suspected COVID-positive pregnant patients both during their acute illness and after recovery, (2) to regularly assess patient symptoms and escalate care for those with worsening disease while reducing unnecessary hospital exposure for others, (3) to educate affected patients on warning symptoms, hygiene, and quarantine recommendations, and (4) to cohort patient care, isolating stable infected patients at home and later within the same physical clinic area upon their return to prenatal care. Methods Pregnant women in an urban public hospital system with presumed or confirmed COVID-19 were added to a list in our electronic medical record as they came to the attention of providers. They received a series of phone calls based on their illness severity and were periodically assessed until deemed stable. Results A total of 83 patients were followed between March 19 and May 31, 2020. Seven (8%) were asymptomatic, 62 (75%) had mild disease, 11 (13%) had severe disease, and three (4%) had critical illness. Conclusions We encourage others to develop and utilize outpatient surveillance systems to facilitate appropriate care and to optimize maternal and fetal well-being.


Assuntos
Assistência Ambulatorial/métodos , Betacoronavirus , Infecções por Coronavirus/complicações , Infecções por Coronavirus/terapia , Pneumonia Viral/complicações , Pneumonia Viral/terapia , Complicações Infecciosas na Gravidez/terapia , Gestão da Segurança/métodos , Infecções por Coronavirus/prevenção & controle , Feminino , Hospitais Públicos , Humanos , Pandemias/prevenção & controle , Isolamento de Pacientes/métodos , Pneumonia Viral/prevenção & controle , Gravidez , Cuidado Pré-Natal/métodos , Índice de Gravidade de Doença , Telemedicina
18.
Health Aff (Millwood) ; 39(10): 1812-1821, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32816600

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic continues to devastate US nursing homes. Adequate personal protective equipment (PPE) and staffing levels are critical to protect nursing home residents and staff. Despite the importance of these basic measures, few national data are available concerning the state of nursing homes with respect to these resources. This article presents results from a new national database containing data from 98 percent of US nursing homes. We find that more than one in five nursing homes reports a severe shortage of PPE and any shortage of staff. Rates of both staff and PPE shortages did not meaningfully improve from May to July 2020. Facilities with COVID-19 cases among residents and staff, as well as those serving more Medicaid recipients and those with lower quality scores, were more likely to report shortages. Policies aimed at providing resources to obtain additional direct care staff and PPE for these vulnerable nursing homes, particularly in areas with rising community COVID-19 case rates, are needed to reduce the national COVID-19 death toll.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pessoal de Saúde/estatística & dados numéricos , Casas de Saúde/organização & administração , Casas de Saúde/provisão & distribução , Pandemias/prevenção & controle , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/epidemiologia , Bases de Dados Factuais , Transmissão de Doença Infecciosa/prevenção & controle , Feminino , Humanos , Controle de Infecções/organização & administração , Masculino , Determinação de Necessidades de Cuidados de Saúde , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Estudos Retrospectivos , Gestão da Segurança/métodos , Estados Unidos , Populações Vulneráveis/estatística & dados numéricos
19.
Hum Factors ; 62(7): 1077-1086, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32741224

RESUMO

OBJECTIVE: To describe user-centered voting systems that would support the safe conduct of voting in a pandemic environment. BACKGROUND: The COVID-19 pandemic has complicated our democratic processes. Voters and poll workers feel threatened by the potential dangers of voting in business-as-usual polling stations. Indeed, significant problems were encountered in the recent 2020 primary elections in Wisconsin, where the National Guard had to be mobilized because so few poll workers reported to work, and more than 90% of polling places had to remain closed. METHOD: We describe a number of possible user-centered solutions that would help protect voters and poll workers in times of pandemic, and also report the results of a survey that asked voters and poll workers about what kinds of systems might make them willing to vote. RESULTS: Political as well as safety considerations will need to be considered as these safer voting solutions are designed since, surprisingly, the kinds of solutions preferred depend on the political affiliation of the voters. CONCLUSION: Human factors professionals have a large role to play in realizing the safe, successful implementation of these user-centered systems. Good human factors analysis can help minimize the risk to voters and poll workers. Moreover, human factors methods can help safeguard democracy by creating safe and well-engineered environments that are conducive to voting in the age of pandemics. APPLICATION: Creating safe and effective voting solutions that protect voters and poll workers during pandemic outbreaks is crucial to the preservation of democracy.


Assuntos
Infecções por Coronavirus/prevenção & controle , Democracia , Ergonomia/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Política , Infecções por Coronavirus/transmissão , Humanos , Pneumonia Viral/transmissão , Gestão da Segurança/métodos , Análise de Sistemas , Estados Unidos
20.
JACC Cardiovasc Imaging ; 13(7): 1615-1626, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32646721
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