Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 13.149
Filtrar
1.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(6): 641-648, 2020 Jun 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-32879120

RESUMO

OBJECTIVES: To understand the psychological status of the staff in a general hospital during the coronavirus disease 2019 and its influential factors, and to provide references for the mental health services to hospital staff. METHODS: Using star platform of questionnaire, the staff in the general hospital were investigated via Depression, Anxiety, Stress Scale (DASS-21), Social Support Rating Scale (SSRS) and Simplified Coping Style Questionnaire (SCSQ). The influential factors were discussed by descriptive analysis, rank sum test, single factor analysis, correlation analysis and multiple factors binary logistic regression analysis. RESULTS: A total of 2 060 valid questionnaires were collected. The negative emotions of nurses and cleaners were the most obvious. The depression scores, anxiety scores and stress scores for nurses and cleaners were 5.06±7.47, 6.36±7.84, 9.75±8.65, and 6.72±8.84, 4.51±6.56, 9.69±9.56, respectively. Multivariate binary logistic regression analysis showed that staff types, education levels, job status, economic situation and concerns on the supplies of protective goods were the main influential factors for depression; staff types, contacting status with infected patients, economic situation, concerns on the supplies of protective goods, history of disease were the main influential factors for anxiety; contacting status with infected patients, economic situation, concerns on the supplies of protective goods were the main influential factors for stress. CONCLUSIONS: There are differences in psychological characteristics among different groups of staff in the general hospital under the outbreak. Thus psychological protection and intervention measures should be formulated according to different groups and work status.


Assuntos
Infecções por Coronavirus/psicologia , Recursos Humanos em Hospital/psicologia , Pneumonia Viral/psicologia , Estresse Psicológico , Adaptação Psicológica , Ansiedade/diagnóstico , Betacoronavirus , China , Estudos Transversais , Depressão/diagnóstico , Surtos de Doenças , Hospitais Gerais , Humanos , Pandemias , Inquéritos e Questionários
2.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(6): 722-732, 2020 Jun 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-32879131

RESUMO

OBJECTIVES: To investigate the status and the related factors of nursing behaviors for pressure injury, and to provide the evidence for standardizing pressure injury management. METHODS: A total of 1 039 clinical nursing staff from 4 general hospitals in Changsha from December 1 to 30, 2017 were selected by a stratified random sampling procedure. Nurses' demographic information such as age, gender, title, educational attainment, and department were collected. We investigated the status of nursing behaviors on pressure injury by a self-designed questionnaire, assessed nurses' knowledge of pressure injury and nurses' attitude of pressure injury using the Pressure Ulcer Knowledge Test and Attitude towards Pressure Ulcer Prevention Instrument, respectively, compared the nursing behaviors on pressure injury with different backgrounds, used multiple linear regression to analyze the influential factors for nursing behaviors on pressure injury, and conducted the Pearson correlation analysis for nurses' knowledge, attitude, and behaviors on the pressure injury. RESULTS: The overall nursing behaviors score on pressure injury was 155.96±17.29. The 5 dimensional scores from high to low were: risk assessment (4.42±0.49), prevention actions (4.40±0.50), risk understanding (4.35±0.52), injury assessment and interventions (4.27±0.55), and health education (4.25±0.63). A significant difference was found in the nursing behavior scores of pressure injury among ages, lengths of service, education, and training times (all P˂0.05). There was no correlation between nurses' knowledge and behaviors (P=0.606). The nurses' attitude was positively correlated with their behaviors (r=0.307, P˂0.001), and the nurses' knowledge was also positively correlated with their attitudes (r=0.212, P˂0.001). The results of multiple linear regression showed that the length of service (≤5 years), training times (1-2 times), education (diploma or below), the scores of nurses' knowledge, and the scores of nurses' attitude were independent influencial factors of nurses' behaviors on pressure injury. CONCLUSIONS: The nursing staff in the general hospital of Changsha has a high level of nursing behaviors on pressure injury, and they has good sense of responsibility and confidence. However, personal competence in pressure injury is insufficient and still needs to be improved. The nursing managers should focus on the nurses' attitude and training frequency, increasing the experience in nursing the pressure injury and practical level, and arouse the highly educated nurses' enthusiasm and sense of accomplishment to prevent pressure injury, thus reducing the incidence of pressure injury.


Assuntos
Recursos Humanos de Enfermagem no Hospital , Lesão por Pressão/epidemiologia , Lesão por Pressão/etiologia , Atitude do Pessoal de Saúde , China/epidemiologia , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Hospitais Gerais , Humanos , Inquéritos e Questionários
3.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(5): 489-494, 2020 May 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-32879095

RESUMO

To propose the architectural layout for the big general hospital in the face of public health emergencies, we analyzed the conditions, methods, problems and countermeasures for the reconstruction of the isolation ward from the existing medical building layout of a general hospital. The affected areas met the requirements of isolation ward in the reconstruction, and realized the corresponding partition and separation of people. But the cost of occupying the medical room should be concerned. General hospital should be alerted to potential risks of public health emergencies. The characteristics of different construction types, defects, and the function of the hospital should be considered in the construction, rebuilding, and expansion of the hospital, which shouldnot only meet the needs of the development of the hospital daily usage but also consider dealing with emergent public health events. We can adopt the reasonable layout, including setting up a firewall-like device between the channel and the floor, an ordinary ward at ordinary times, and an independent space for emergency by pulling down the gate. This strategy can not only avoid the problem of low utilization rate of the space occupied by the corresponding area in the ward for diseases spread by air and droplets, maximizing the efficiency of the medical site, but also avoid the problem of emergency response to the temporary reconstruction.


Assuntos
Emergências , Arquitetura de Instituições de Saúde , Hospitais Gerais , Saúde Pública , Serviço Hospitalar de Emergência , Humanos
4.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(5): 507-512, 2020 May 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-32879098

RESUMO

OBJECTIVES: To discuss the demands and countermeasures for outpatients and emergency patients during the outbreak of coronavirus disease 2019 (COVID-19) in large general hospital. METHODS: By analyzing patients' demands, outpatient service system and emergency system complemented each other with the help of "internet medical" to provide online medical treatment, self-diagnosed pneumonia program, online pharmacies, outpatient appointment and online pre-examination services, open green channels for special patients, and to provide referral services for critical patients. The COVID-19 suspected patients and other common fever patients were separated from other patients. RESULTS: From January 28 to March 1, we have received 26 000 patients online, 1 856 special patients, 2 929 suspected patients and common fever patients including 31 confirmed patients, 0 case of misdiagnosis and cross-infection. CONCLUSIONS: Targeting patient's demands and taking appropriate measures are effective on meeting the needs of outpatients' and emergency patients' medical services.


Assuntos
Infecções por Coronavirus/epidemiologia , Necessidades e Demandas de Serviços de Saúde , Hospitais Gerais/organização & administração , Pacientes Ambulatoriais , Pneumonia Viral/epidemiologia , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/prevenção & controle , Serviços Médicos de Emergência/organização & administração , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle
6.
Rev Saude Publica ; 54: 82, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32813870

RESUMO

OBJECTIVE To characterize the organization of Brazilian general hospitals that provide services to the Unified Health System using indicators that describe the main dimensions of hospital care. METHODS A 2015 cross-sectional observational study, comprising the range of general hospitals that serve the Unified Health System. We constructed the hospital indicators from two national administrative databases: the National Registry of Health Facilities and the Hospital Information System of the Unified Health System. The indicators include the main dimensions associated with hospital care: public-private mix, production, production factors, performance, quality, case-mix and geographic coverage. Latent class analysis of indicators with bootstrapping was used to identify hospital profiles. RESULTS We identified three profiles, with hospital size being the variable with the highest degree of belonging. Small hospitals show low occupancy rates (21.36%) and high participation of hospitalizations that could have been solved with outpatient care, besides attending only medium complexity cases. They receive few non-residents, indicating that they are mainly dedicated to the local population. Medium-sized hospitals are more similar to small-sized ones: about 100% of the visits are of medium complexity, low occupancy rate (45.81%), high rate of hospitalizations for primary care sensitive conditions (17.10%) and relative importance in the healthcare provision of non-residents (26%). Large hospitals provide high complexity care, have an average occupancy rate of 64.73% and show greater geographical coverage. CONCLUSIONS The indicators point to three hospital profiles, characterized mainly by the production scale. Small hospitals show low performance, suggesting the need to reorganize hospital care provision, especially at the municipal level. The set of proposed indicators includes the main dimensions of hospital care, providing a tool that can help to plan and continuously monitor the hospital network of the Unified Health System.


Assuntos
Ocupação de Leitos/estatística & dados numéricos , Assistência à Saúde/organização & administração , Hospitalização/estatística & dados numéricos , Hospitais Gerais/organização & administração , Brasil , Estudos Transversais , Humanos
7.
BMC Surg ; 20(1): 190, 2020 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-32847559

RESUMO

BACKGROUND: Novel coronavirus pneumonia (NCP) outbreak in Wuhan, China in early 2020, resulted in over 80 thousand infections in China. At present, NCP has an explosive growth in the world. Surgeons could refuse selective operation during the outbreak, but they must face the emergency operation. We hope to avoid the spread of NCP while ensuring efficient treatment of emergency cases. METHODS: The data of patients with incarcerated hernia admitted to Beijing Chaoyang Hospital during NCP epidemic were analyzed and compared with those in 2019. All cases were divided into NCP group and 2019 group. The operation data and inpatient protection process of emergency cases were analyzed. Result During the NCP epidemic, 17 cases with incarcerated hernia were treated in our department. A Total of 263 cases of the same disease were admitted in 2019. There was no significant difference in age, gender, BMI and hernia type between two groups. No significant difference was observed between the two groups in operation method and hospital stay. The waiting time for emergency operation of NCP group was significantly longer than that of 2019 group (P = 0.002). A buffer ward was set up by administrator of hospital during NCP outbreak. Hospitals were divided into "Red area, Yellow area and Green area" artificially, and strict screening consultation system was implemented. There was no case of SARS-nCoV-2 infection in medical staff. CONCLUSION: It was safe and effective to carry out emergency operation on the premise of screening, protection and isolation during the NCP epidemic. The increased waiting time for operation due to NCP screening did not threaten medical safety of emergency incarcerated hernia patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Hérnia Abdominal/cirurgia , Herniorrafia , Hospitais Gerais , Controle de Infecções/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Emergências , Serviço Hospitalar de Emergência , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Seleção de Pacientes , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Estudos Retrospectivos
8.
Crit Care Nurs Q ; 43(4): 413-427, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32833778

RESUMO

As the confirmed cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to grow with over 1 million documented infections in the United States alone, researchers and health care workers race to find effective treatment options for this potentially fatal disease. Mortality remains high in patients whose disease course requires mechanical ventilation and admission to intensive care units. While focusing on therapies to decrease mortality is essential, we must also consider the logistical hurdles faced with regard to safely and effectively delivering treatment while limiting the risk of harm to hospital staff and other noninfected patients. In this article, we discuss aspects of surge planning, considerations in limiting health care worker exposure, the logistics of medication delivery in a uniform and consolidated manner, protocols for delivering emergent care in a rapidly deteriorating coronavirus disease-2019 (COVID-19) patient, and safe practices for transporting infected patients.


Assuntos
Protocolos Clínicos , Infecções por Coronavirus/terapia , Hospitais Gerais/organização & administração , Exposição Ocupacional/prevenção & controle , Pneumonia Viral/terapia , Gestão da Segurança/organização & administração , Capacidade de Resposta ante Emergências/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecção Hospitalar/prevenção & controle , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Unidades de Terapia Intensiva/organização & administração , Pandemias , Pennsylvania/epidemiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão
9.
J Pregnancy ; 2020: 2926097, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32685212

RESUMO

Background: Unplanned pregnancy is a fundamental concept that is used to recognize the fertility of populations and the unmet need for contraception and family planning. Unplanned pregnancy happened mainly due to the results of not using contraception or inconsistent or incorrect use of effective methods. Reducing the number of unplanned pregnancy endorses reproductive health mainly by reducing the number of times a woman is exposed to the risk of pregnancy and childbearing. Objective: This study is aimed at assessing the magnitude of unplanned pregnancy and associated factors among pregnant mothers attending antenatal care at Suhul General Hospital, Northern Ethiopia. Methods: A facility-based cross-sectional study design was conducted among pregnant mothers visiting antenatal care follow-up from February to April 2018 at Suhul General Hospital, Shire, and Northern Ethiopia. The study participants were selected using a systematic sampling method, and the data was collected using a pretested structured questionnaire through face-to-face interviews. Bivariate and multivariate logistic regression analyses were done to determine the association of each independent variable with the dependent variable. Result: The magnitude of unplanned pregnancy among 379 pregnant mothers was 20.6%. Unmarried women [AOR: 4.73, 95% CI: (1.56, 14.33)], age above forty [AOR: 4.17, 95% CI: (1.18, 14.6)], had no history of unplanned pregnancy [AOR: 3.26 95% CI: (1.65, 6.44)], and unemployed [AOR: 6.79; 95% CI: (2.05, 22.46)] were the variables significantly associated with the magnitude of unplanned pregnancy. Conclusion and Recommendation. The findings of this study showed that the magnitude of unplanned pregnancy was high and age, marital status, occupation, and history of unplanned pregnancy were statistically associated with an unplanned pregnancy. There is seeming necessity to plan strategies of communication within couples or individuals on reproductive especially on fertility and promote family planning methods.


Assuntos
Taxa de Gravidez , Gravidez não Planejada , Fatores Etários , Estudos Transversais , Etiópia/epidemiologia , Feminino , Promoção da Saúde , Hospitais Gerais , Humanos , Gravidez , Educação Sexual , Desemprego
10.
Clin Rheumatol ; 39(9): 2817-2821, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32712743

RESUMO

COVID-19 has significantly affected healthcare systems around the world. To prepare for this unprecedented emergency, elective patient care was put on hold across the National Health Service (NHS). Rheumatology service had to be reorganised with a cancellation of elective clinics and clinical reconfiguration to continue to deliver care to patients, support frontline, and prevent viral transmission. The rheumatology community's responsibility of providing a continuity of care for patients had to be balanced with measures to reduce the risk of viral transmission and also protection of both the patients and staff. We describe our experience of delivering rheumatology service as recommended by the National Institute for Health and Care Excellence (NICE NG167) guidelines at a district general hospital during the current pandemic. Key Points • Prepare to deliver a rapid mass communication; ensure email and mobile phones registered in patients' records; enable access to text and video messaging. • To ensure wider access to innovative digital technology in clinical practice; implement telephone and video consultations where appropriate. • To consider setting up community OP clinics, for example, mobile and satellite clinics.


Assuntos
Infecções por Coronavirus/epidemiologia , Assistência à Saúde/métodos , Pneumonia Viral/epidemiologia , Doenças Reumáticas/terapia , Reumatologia/métodos , Telemedicina , Administração Intravenosa , Assistência Ambulatorial , Antirreumáticos/uso terapêutico , Betacoronavirus , Continuidade da Assistência ao Paciente , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Substituição de Medicamentos , Hospitais de Distrito , Hospitais Gerais , Humanos , Infusões Subcutâneas , Enfermeiras e Enfermeiros , Pandemias/prevenção & controle , Admissão e Escalonamento de Pessoal , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Reumatologistas , Medição de Risco , Medicina Estatal , Reino Unido
11.
PLoS One ; 15(7): e0234684, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32702006

RESUMO

OBJECTIVE: To describe the clinical features, outcomes, and molecular epidemiology of an outbreak of multidrug resistant (MDR) A. baumannii. METHODS: We performed a retrospective analysis of all MDR A. baumannii isolates recovered during an outbreak from 2011 to 2015 in a tertiary care cancer hospital. Cases were classified as colonized or infected. We determined sequence types following the Bartual scheme and plasmid profiles. RESULTS: There were 106 strains of A. baumannii isolated during the study period. Sixty-six (62.3%) were considered as infection and 40 (37.7%) as colonization. The index case, identified by molecular epidemiology, was a patient with a drain transferred from a hospital outside Mexico City. Ninety-eight additional cases had the same MultiLocus Sequence Typing (MLST) 758, of which 94 also had the same plasmid profile, two had an extra plasmid, and two had a different plasmid. The remaining seven isolates belonged to different MLSTs. Fifty-three patients (50%) died within 30 days of A. baumanniii isolation: 28 (20%) in colonized and 45 (68.2%) in those classified as infection (p<0.001). In multivariate regression analysis, clinical infection and patients with hematologic neoplasm, predicted 30-day mortality. The molecular epidemiology of this outbreak showed the threat posed by the introduction of MDR strains from other institutions in a hospital of immunosuppressed patients and highlights the importance of adhering to preventive measures, including contact isolation, when admitting patients with draining wounds who have been hospitalized in other institutions.


Assuntos
Infecções por Acinetobacter/tratamento farmacológico , Infecções por Acinetobacter/mortalidade , Infecção Hospitalar/epidemiologia , Acinetobacter baumannii/genética , Acinetobacter baumannii/isolamento & purificação , Acinetobacter baumannii/patogenicidade , Adulto , Idoso , Estudos de Casos e Controles , Surtos de Doenças , Resistência a Múltiplos Medicamentos/fisiologia , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Farmacorresistência Bacteriana Múltipla/genética , Feminino , Hospitais Gerais , Humanos , Masculino , México , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Epidemiologia Molecular/métodos , Tipagem de Sequências Multilocus/métodos , Plasmídeos/efeitos dos fármacos , Plasmídeos/genética , Estudos Retrospectivos , Análise de Sequência de DNA/métodos , beta-Lactamases/genética
12.
J Am Med Dir Assoc ; 21(7): 928-932.e1, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32674821

RESUMO

OBJECTIVES: To determine the association between frailty and short-term mortality in older adults hospitalized for coronavirus disease 2019 (COVID-19). DESIGN: Retrospective single-center observational study. SETTING AND PARTICIPANTS: Eighty-one patients with COVID-19 confirmed by reverse-transcriptase polymerase chain reaction (RT-PCR), at the Geriatrics department of a general hospital in Belgium. MEASUREMENTS: Frailty was graded according to the Rockwood Clinical Frailty Scale (CFS). Demographic, biochemical, and radiologic variables, comorbidities, symptoms, and treatment were extracted from electronic medical records. RESULTS: Participants (N = 48 women, 59%) had a median age of 85 years (range 65-97 years) and a median CFS score of 7 (range 2-9); 42 (52%) were long-term care residents. Within 6 weeks, 18 patients died. Mortality was significantly but weakly associated with age (Spearman r = 0.241, P = .03) and CFS score (r = 0.282, P = .011), baseline lactate dehydrogenase (LDH; r = 0.301, P = .009), lymphocyte count (r = -0.262, P = .02), and RT-PCR cycle threshold (Ct, r = -0.285, P = .015). Mortality was not associated with long-term care residence, dementia, delirium, or polypharmacy. In multivariable logistic regression analyses, CFS, LDH, and RT-PCR Ct (but not age) remained independently associated with mortality. Both age and frailty had poor specificity to predict survival. A multivariable model combining age, CFS, LDH, and viral load significantly predicted survival. CONCLUSIONS AND IMPLICATIONS: Although their prognosis is worse, even the oldest and most severely frail patients may benefit from hospitalization for COVID-19, if sufficient resources are available.


Assuntos
Infecções por Coronavirus/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Fragilidade/mortalidade , Mortalidade Hospitalar , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Bélgica/epidemiologia , Estudos de Coortes , Infecções por Coronavirus/prevenção & controle , Feminino , Idoso Fragilizado , Avaliação Geriátrica , Hospitalização/estatística & dados numéricos , Hospitais Gerais , Humanos , Incidência , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Estudos Retrospectivos
13.
Ann Glob Health ; 86(1): 70, 2020 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-32676299

RESUMO

Background: In December 2019, early cases of COVID-19 were identified in Wuhan, China. By late January 2020, it was evident that COVID-19 was rapidly spreading and represented a national health emergency. In order to contain the spread of COVID-19, China adopted a centralized treatment plan by appointing designated hospitals in each region. Shantou Central Hospital is a Grade A Class A general hospital in Guangdong Province. It was appointed as a provincial COVID-19 designated treatment hospital on January 21, 2020, to provide all COVID-19-related treatments for the city of Shantou. The nursing department at Shantou Central Hospital is fully responsible for hospital nursing administration, nursing human resource management, nursing quality management, and all nursing tasks related to hospital medical care, nursing, teaching, scientific research, preventive healthcare, and so on. Objective: To summarize the role of nursing management in transforming a general hospital into a designated hospital for treatment of COVID-19 patients. Methods: We undertook a series of nursing management measures in the strategic phase and the implementation phase. Findings: Through a series of nursing management measures, all COVID-19 patients admitted to our hospital were cured and discharged. All non-COVID-19 patients and staff hospitalized during the same period were not infected with the virus. During this period, our hospital completed 7,466 operations. Hence, our nursing management measures were effective. Conclusions: Our efficient nursing management system, first of all, effectively mobilized all available manpower; secondly, up-skilled and trained personnel within a very short period of time; thirdly, provided reliable logistical support for front-line protection equipments; and finally, motivated nurses during this very difficult time to make a significant positive contribution to the fight against COVID-19 pandemic.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/enfermagem , Hospitais Gerais/organização & administração , Recursos Humanos de Enfermagem no Hospital/organização & administração , Pneumonia Viral/epidemiologia , Pneumonia Viral/enfermagem , Betacoronavirus , China/epidemiologia , Eficiência Organizacional , Humanos , Pandemias
14.
Kidney Blood Press Res ; 45(4): 612-622, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32712607

RESUMO

INTRODUCTION: Severe acute respiratory viral infections are frequency accompanied by multiple organ dysfunction, including acute kidney injury (AKI). In December 2019, the coronavirus disease 2019 (COVID-19) outbreak began in Wuhan, Hubei Province, China, and rapidly spread worldwide. While diffuse alveolar damage and acute respiratory failure are the main features of COVID-19, other organs may be involved, and the incidence of AKI is not well described. We assessed the incidence and clinical characteristics of AKI in patients with laboratory-confirmed COVID-19 and its effects on clinical outcomes. METHODS: We conducted a multicenter, retrospective, observational study of patients with COVID-19 admitted to two general hospitals in Wuhan from 5 January 2020 to 21 March 2020. Demographic data and information on organ dysfunction were collected daily. AKI was defined according to the KDIGO clinical practice guidelines. Early and late AKI were defined as AKI occurring within 72 h after admission or after 72 h, respectively. RESULTS: Of the 116 patients, AKI developed in 21 (18.1%) patients. Among them, early and late AKI were found in 13 (11.2%) and 8 (6.9%) patients, respectively. Compared with patients without AKI, patients with AKI had more severe organ dysfunction, as indicated by a higher level of disease severity status, higher sequential organ failure assessment (SOFA) score on admission, an increased prevalence of shock, and a higher level of respiratory support. Patients with AKI had a higher SOFA score on admission (4.5 ± 2.1 vs. 2.8 ± 1.4, OR 1.498, 95% CI 1.047-2.143 ) and greater hospital mortality (57.1% vs. 12.6%, OR 3.998, 95% CI 1.088-14.613) than patients without AKI in both the univariate and multivariate analyses. Patients with late AKI, but not those with early AKI, had a significantly prolonged length of stay (19.6 vs. 9.6 days, p = 0.015). CONCLUSION: Our findings show that admission SOFA score was an independent risk factor for AKI in COVID-19 patients, and patients with AKI had higher in-hospital mortality. Moreover, AKI development after 72 h of admission was related to prolonged hospitalization time.


Assuntos
Lesão Renal Aguda/etiologia , Lesão Renal Aguda/terapia , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Lesão Renal Aguda/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/terapia , Progressão da Doença , Feminino , Mortalidade Hospitalar , Hospitais Gerais , Humanos , Incidência , Testes de Função Renal , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Insuficiência de Múltiplos Órgãos/etiologia , Insuficiência de Múltiplos Órgãos/terapia , Pandemias , Pneumonia Viral/mortalidade , Pneumonia Viral/terapia , Guias de Prática Clínica como Assunto , Estudos Retrospectivos , Resultado do Tratamento , Equilíbrio Hidroeletrolítico
17.
Farm Hosp ; 44(7): 5-10, 2020 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-32533661

RESUMO

The WHO declared the SARS- CoV-2 outbreak a pandemic in March 11, 2020.  Spain has been the third country with the highest number of reported cases of  COVID-19. In the face of the pandemic, the authorities of the Autonomous  Community of Madrid led an unprecedented transformation of hospital services  by increasing the number of beds available, setting up temporary field hospitals  in fairgrounds, and transforming hotels into support centers for patients with  mild symptoms of COVID-19. In the light that this crisis will continue to be a real threat for the years to come, our hospital pharmacies need to be better prepared for similar outbreaks in the future. During the COVID-19 pandemic, the  Department of Hospital Pharmacy of Hospital General Universitario Gregorio  Marañón has faced four challenges: an exponential increase in the demand for  resources, constant changes to therapeutic protocols and approaches, regulatory changes, and a dramatic impact on hospital staff (strain on human resources  and psychological impact). This article is aimed at describing the main  organizational changes implemented to the Department of Hospital Pharmacy of  Hospital GU Gregorio Marañón and its relationship with other hospital  pharmacies of the Community of Madrid. An account is provided of the strategies to be adopted for reorganizing a Department of Hospital Pharmacy and achieve a safe and effective use of medications. Strategies range from the creation of  integral hospital task groups (COVID-crisis task group, protocolization task  group, research task group) to the adaptation of the internal organization of the  Department of Hospital Pharmacy, which encompasses aspects related to  management and leadership; a communication plan (internal and external);  staff management, and the reorganization and adaptation of processes. People,  patients and professionals are at the core of these strategies. This paper is a  reflection on key factors of "humanization in COVID times".


Assuntos
Betacoronavirus , Infecções por Coronavirus , Pandemias , Serviço de Farmácia Hospitalar , Pneumonia Viral , Antivirais/provisão & distribução , Antivirais/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/prevenção & controle , Planejamento em Desastres , Recursos em Saúde , Necessidades e Demandas de Serviços de Saúde , Hospitais Gerais/organização & administração , Humanos , Controle de Infecções/organização & administração , Pandemias/prevenção & controle , Serviço de Farmácia Hospitalar/organização & administração , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/prevenção & controle , Relações Profissional-Paciente , Equipamentos de Proteção , Garantia da Qualidade dos Cuidados de Saúde , Espanha , Telemedicina
18.
Zhonghua Yi Xue Za Zhi ; 100(21): 1658-1661, 2020 Jun 02.
Artigo em Chinês | MEDLINE | ID: mdl-32486602

RESUMO

Objective: To investigate the timely return visit rates after first visits of adolescent clients to the psychiatric outpatient clinic in a general hospital and analyze the relevant factors. Methods: All adolescent clients firstly visited psychiatric outpatient clinic of the Third Affiliated Hospital of Sun Yat-sen University from May to October 2018 were surveyed. The timely return visit was defined as the return visit within one month after the first visit and the timely return visit rate (RVR) was calculated. Chi-square test and binary Logistic regression were used to compare the RVR subgroup differences and relevant factors. Reasons for non-attendance at the return visit were acquired by the telephone follow-up. Results: A total of 1 121 cases were enrolled, with an age of (16.0±1.6) years, 85.8% of them were students, and the overall RVR was 62.7% (703/1 121). The highest RVR was found in those who hoped for drug treatment (69.8%) and the lowest in those who did not accept drug treatment (55.8%) (χ(2)=9.028, P=0.029). The highest RVR was found in hospitalized patients (97.6%), followed by outpatient pharmacotherapy group (61.2%) and keeping observation and self-adjustment group (45.3%) (χ(2)=82.269, P<0.001). The RVR of patients prescribed mood stabilizers was significantly higher than that of non-users (χ(2)=9.498, P=0.002). Logistic regression analysis showed the main factors that affect the timely return visit included treatment regimens and prescribing of mood stabilizers. Results of telephone follow-up of clients with non-attendance showed that the main reasons were symptoms alleviation (68.4%) and various visiting barriers (14.3%). Conclusions: Clients with active attitude towards pharmacotherapy, hospitalization and using mood stabilizers in outpatient have higher RVR rates. Insufficient understanding of systemic therapy remains the main reason why the clients fail to attend the return visit in time.


Assuntos
Hospitalização , Hospitais Gerais , Adolescente , Instituições de Assistência Ambulatorial , Humanos , Modelos Logísticos , Pacientes Ambulatoriais
19.
Am J Infect Control ; 48(8): 918-921, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32504761

RESUMO

It is currently a critical period for the prevention and control of the COVID-19 pandemic. Since the medical waste disposal could be an important way to control the source of infection, standardization, and strict implementation of the management of COVID-19 related medical waste should be with careful consideration to reduce the risk of epidemic within hospitals. This study illustrates the practice of medical waste disposal responding to the 2019-2020 novel coronavirus pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Controle de Infecções/normas , Eliminação de Resíduos de Serviços de Saúde/normas , Resíduos de Serviços de Saúde/efeitos adversos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Betacoronavirus/patogenicidade , Hospitais Gerais/normas , Humanos
20.
Cardiovasc Ther ; 2020: 2509875, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32565908

RESUMO

Introduction: Beta-blocker use evaluation is a performance method that focuses on the evaluation of beta-blocker use processes to achieve optimal patient outcomes. Several studies conducted in different hospitals revealed a high incidence of inappropriate prescription of beta-blockers among hospitalized patients. Therefore, it is important to identify inappropriate beta-blocker prescribing since they may increase the risk of hospitalizations. Despite this, there was no study conducted related to drug use evaluation of beta-blockers in Nedjo general hospital (NGH). Thus, this study was aimed at assessing the use evaluation of beta-blockers in medical wards of NGH. Methods: A retrospective cross-sectional study was conducted at medical wards of NGH from January 1, 2016, to December 31, 2017. Results: Out of the total of 149 medical record of patients that contains beta-blockers, 84 (56.37%) were males and about one-third (31.54%) of the patients ages were between 41 and 50 years. Propranolol was the most commonly prescribed beta-blocker (62.76%), and 94.56% of beta-blockers were prescribed with correct indication. There were about 51%, 46.31%, 64.43%, and 46.98% of beta-blockers prescribed with the correct dose, duration, frequency, and route of administration, respectively. Regarding the routes of administration, 70 (46.98%) of them were prescribed with the correct route. Most drugs interacting were propranolol with cimetidine 26 (68.42%), and the most frequent condition for which beta-blockers were prescribed was hypertension (32.89%). Conclusion: Overall, there was an inappropriate use of beta-blockers in terms of dosage and durations. So, prescribers of NGH should strictly adhere to the national treatment guideline when prescribing medications. Additionally, drug information centers have proved useful and effective in promoting rational drug use. Hence, it should be recommended for general use.


Assuntos
Antagonistas Adrenérgicos beta/uso terapêutico , Hospitais Gerais/tendências , Prescrição Inadequada/tendências , Serviço de Farmácia Hospitalar/tendências , Padrões de Prática Médica/tendências , Adolescente , Antagonistas Adrenérgicos beta/efeitos adversos , Adulto , Estudos Transversais , Interações Medicamentosas , Revisão de Uso de Medicamentos/tendências , Etiópia , Feminino , Fidelidade a Diretrizes/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Estudos Retrospectivos , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA