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1.
Eur Rev Med Pharmacol Sci ; 24(21): 11381-11385, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33215459

RESUMO

OBJECTIVE: This study aims to discuss the effects of simulation training on improving the pre-examination, triage, prevention, and control of coronavirus disease 2019 (COVID-19), explain the psychological states of pre-examination and triage staff in general hospitals during the COVID-19 epidemic, and analyze relevant influencing factors. This study may serve as a reference of psychological consultation services to medical staff. SUBJECTS AND METHODS: This study included 60 nurses assigned in the pre-examination department, fever clinics, and isolation wards of a general hospital from January 26th to February 1st, 2020. Before assuming the posts, the nurses received simulation training on the clinical reception of suspected patients with COVID-19. Operation skills of the nurses before and after the training were assessed. RESULTS: The percent of passing significantly increased from 65% before the training to 98.33% after training (p<0.05). Training also significantly relieved the anxiety and depression of the nurses (p<0.05). CONCLUSIONS: Scenario-simulation training can increase the emergency abilities of pediatric nurses in the prevention and control of the COVID-19 epidemic and relieve the anxiety of nurses.


Assuntos
Infecções por Coronavirus/prevenção & controle , Controle de Infecções/organização & administração , Enfermeiras Pediátricas/psicologia , Estresse Ocupacional/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Treinamento por Simulação/organização & administração , Adulto , Ansiedade/prevenção & controle , Ansiedade/psicologia , Betacoronavirus/patogenicidade , Competência Clínica , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Depressão/prevenção & controle , Depressão/psicologia , Serviço Hospitalar de Emergência/organização & administração , Feminino , Hospitais Pediátricos/organização & administração , Humanos , Controle de Infecções/instrumentação , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Enfermeiras Pediátricas/organização & administração , Exposição Ocupacional/efeitos adversos , Estresse Ocupacional/psicologia , Equipamento de Proteção Individual , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Carga de Trabalho/psicologia , Adulto Jovem
2.
Eur Rev Med Pharmacol Sci ; 24(20): 10867-10873, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33155249

RESUMO

OBJECTIVE: To summarize the experience of three Chinese cities (Wuhan, Shanghai and Haikou) and provide a reference for global efforts to combat COVID-19 spread among children. MATERIALS AND METHODS: Through collecting the measures and outcomes of preventing and controlling COVID-19 in China's three hospitals, we compared the effect of different strategies. RESULTS: From January to March 2020, the number of suspected and confirmed COVID-19 cases in Wuhan increased exponentially, and Wuhan Children's Hospital as a whole was transformed into a designated quarantine and treatment facility, which is the "Wuhan Model". Shanghai has more children's hospitals with better capabilities to tackle public health emergency. Besides, it is far away from Wuhan and had a small caseload. Children's Hospital of Fudan University, a facility in Shanghai to treat pediatric infectious diseases, is famous for its well-equipped building for infectious disease treatment and professional medical team, and therefore no major transformation was required. That is the "Shanghai Model". Haikou is located on an island. Amid the outbreak, large numbers of tourists and travelers from Hubei had already arrived in Haikou. Hainan Women and Children's Medical Center, as the only pediatric care hospital in Hainan Province, did not have a separate building for infectious disease treatment. After a citywide survey of the medical resources and facilities available, a temporarily idle hospital 3 kilometers away from Hainan Women and Children's Medical Center was requisitioned as the quarantine and treatment facility for pediatric cases. That is the "Hainan Model". The three models enabled the treatment of all suspected and confirmed cases and no fatality was reported. CONCLUSIONS: The COVID-19 coping strategies for children should be designed according to the existing conditions of the local children's hospitals and the risk levels of the epidemic.


Assuntos
Infecções por Coronavirus/prevenção & controle , Hospitais de Isolamento/organização & administração , Hospitais Pediátricos/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adaptação Psicológica , Adolescente , Criança , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Lactente , Masculino
3.
J Nurs Adm ; 50(11): 605-611, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33105337

RESUMO

Bed flow decisions should be based on current information about capacity. The purpose of this project was to develop a real-time, enterprise-wide, capacity management dashboard. The dashboard successfully used information from the electronic medical record to create a comprehensive standardized data source, which was used to drive patient flow decisions optimizing bed space, allocating resources and maintaining safety.


Assuntos
Eficiência Organizacional , Registros Eletrônicos de Saúde , Hospitais Pediátricos/organização & administração , Criança , Humanos , Ohio
4.
Nurs Leadersh (Tor Ont) ; 33(3): 9-14, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33097100

RESUMO

During my career, I have had many mantras, including "I love to wonder what will happen tomorrow" and "It's all about relationships." Well, I have been rewarded in spades because nothing has been predictable or stable about our professional practice environments since COVID-19 infiltrated our organizations. I have been challenged to develop and implement changes at The Hospital for Sick Children - a 300-bed tertiary pediatric academic health sciences centre in Toronto, ON - that we had never contemplated before. I believe that staying true to my leadership values and core principles has been essential when taking on such challenges and staying afloat during these tumultuous times.


Assuntos
Infecções por Coronavirus/enfermagem , Hospitais Pediátricos/organização & administração , Relações Interprofissionais , Enfermeiras Administradoras/psicologia , Pandemias , Pneumonia Viral/enfermagem , Centros Médicos Acadêmicos/organização & administração , Criança , Infecções por Coronavirus/epidemiologia , Humanos , Liderança , Ontário/epidemiologia , Pneumonia Viral/epidemiologia , Centros de Atenção Terciária/organização & administração
5.
Emerg Med J ; 37(12): 773-777, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33127743

RESUMO

BACKGROUND: Public health mitigation strategies in British Columbia during the pandemic included stay-at-home orders and closure of non-essential services. While most primary physicians' offices were closed, hospitals prepared for a pandemic surge and emergency departments (EDs) stayed open to provide care for urgent needs. We sought to determine whether ED paediatric presentations prior and during the COVID-19 pandemic changed and review acuity compared with seasonal adjusted prior year. METHODS: We analysed records from 18 EDs in British Columbia, Canada, serving 60% of the population. We included children 0-16 years old and excluded those with no recorded acuity or discharge disposition and those left without being seen by a physician. We compared prepandemic (before the first COVID-19 case), early pandemic (after first COVID-19 case) and peak pandemic (during public health emergency) periods as well as a similar time from the previous year. RESULTS: A reduction of 57% and 70% in overall visits was recorded in the children's hospital ED and the general hospitals EDs, respectively. Average daily visits declined significantly during the peak-pandemic period (167.44±40.72) compared with prepandemic period (543.53±58.8). Admission rates increased mainly due to the decrease in the rate of visits with lower acuity. Children with complaints of 'fever' and 'gastrointestinal' symptoms had both the largest overall volume and per cent reduction in visits between peak-pandemic and prior year (79% and 74%, respectively). CONCLUSION: Paediatric emergency medicine attendances were reduced to one-third of normal numbers during the 2020 COVID-19 lockdown in British Columbia, Canada, with the reduction mainly seen in minor illnesses that do not usually require admission.


Assuntos
Infecções por Coronavirus/epidemiologia , Medicina de Emergência/organização & administração , Serviço Hospitalar de Emergência/organização & administração , Hospitais Pediátricos/organização & administração , Pneumonia Viral/epidemiologia , Adolescente , Betacoronavirus/patogenicidade , Colúmbia Britânica/epidemiologia , Criança , Pré-Escolar , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Emergências/epidemiologia , Medicina de Emergência/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/estatística & dados numéricos , Hospitais Pediátricos/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Pandemias/prevenção & controle , Admissão do Paciente/estatística & dados numéricos , Alta do Paciente/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Triagem/organização & administração , Triagem/estatística & dados numéricos
10.
Plast Reconstr Surg ; 146(4): 913-919, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32970013

RESUMO

BACKGROUND: Even before seeing a physician, patients must first gain access to the hospital system. At large hospitals with high patient volumes, access to specialty care can pose a particular challenge. This study examines the effects of specific initiatives to increase clinic capacity, appointment use, and ease of scheduling on both patient satisfaction and hospital revenue. METHODS: In 2017, a task force at a large, multidisciplinary pediatric hospital instituted a number of initiatives to increase patient access to ambulatory specialty clinics. Clinic sessions were standardized to a 4-hour template, and unscheduled, "held" appointment slots were required to be made available ("flipped") 72 hours before the appointment. A patient-centered electronic scheduling platform was also implemented. Patient satisfaction was assessed using Press Ganey scores. Revenue estimates were calculated for increases in "new" and "return" patient appointments. RESULTS: Total new appointment slots increased by over 44 percent, with over 53,000 appointments added annually. The number of held appointment slots declined by 93 percent. A total of 17,996 annual appointments were added in surgical subspecialties, and an additional 14,756 more surgical appointments were completed. Over 2000 appointments were scheduled by means of the online patient portal. Press Ganey "ease-of-scheduling" scores increased from 57 percent to 72 percent over the intervention period. Hospitalwide, these initiatives generated an estimated $8.3 million in revenue opportunity. CONCLUSION: Standardizing clinic sessions and optimizing clinic availability generates new appointment opportunities, improves patient experience, and increases hospital revenue.


Assuntos
Instituições de Assistência Ambulatorial/economia , Instituições de Assistência Ambulatorial/organização & administração , Agendamento de Consultas , Eficiência Organizacional/economia , Hospitais Pediátricos/economia , Hospitais Pediátricos/organização & administração , Satisfação do Paciente/estatística & dados numéricos , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Criança , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Estudos Retrospectivos
12.
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
13.
Rev. cuba. pediatr ; 92(3): e961, jul.-set. 2020. tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1126764

RESUMO

Introducción: La administración de fármacos es una práctica cotidiana de mucha responsabilidad ética, social y jurídica, que depende en gran proporción de la implementación de un sistema de seguridad. Objetivo: Evaluar el sistema de seguridad en la administración de fármacos en servicios pediátricos hospitalarios. Métodos: Investigación cuantitativa, descriptiva y transversal realizado en el Hospital Regional Lambayeque de Perú en 2016. Se estudió el universo de enfermeras que laboran en los servicios de hospitalización pediátricos y emergencias, 84 en total. A todas se les aplicó una adaptación del Cuestionario de Autoevaluación del Sistema de Seguridad en la Administración de Fármacos de los hospitales de España. Se calcularon valores absolutos y porcentajes para evaluar el nivel de implementación del sistema. De cada dimensión del cuestionario se hallaron los valores promedios, desviación estándar y valores mínimo y máximo. Resultados: El 40,5 por ciento de las enfermeras consideraron que el sistema de seguridad en la administración de fármacos en las áreas pediátricas se ha implementado parcialmente. Entre las 10 dimensiones de cuestionario, los valores promedios más altos correspondieron a factores del entorno (31,4± 8,3) y competencia y formación profesional (31,4± 8,9). Los promedios más bajos correspondieron a la educación del paciente y familia (9,0 ± 3,5), e información sobre los medicamentos (13,2± 3,8). Conclusiones: El sistema de seguridad en la administración de fármacos en unidades pediátricas del estudio se ha implementado parcialmente. Las dimensiones más críticas son la información sobre el fármaco y al familiar, aspectos que deben ser considerados en un plan de mejora(AU)


Introduction: The administration of drugs is a daily practice that implies big ethical, social and legal responsibilities which depend in a large proportion of a security system´s implementation. Objective: To evaluate the security system in the administration of drugs in hospital pediatric services. Methods: Quantitative, descriptive and cross-sectional research carried out at the Regional Hospital Lambayeque of Peru in 2016. It was studied the sample group of nurses (84 in total) working in the pediatric hospitalization and emergencies services. It was applied to all of them an adaptation of the Self-assessment Questionnaire on the Security System in the Administration of drugs in hospitals in Spain. Absolute values and percentages were calculated to assess the level of implementation of the system. For each dimension of the questionnaire, there were found the mean values, the standard deviation, and the minimum and maximum values. Results: 40.5 percent of the nurses considered that the security system in drugs administration in the pediatric areas has been partially implemented. Among the 10 dimensions of the questionnaire, the highest average values corresponded to environment´s factors (31.4 ± 8.3) and to competence and profesional training (31.4 ± 8.9). The lowest averages corresponded to the education of the patient and the family (9.0 ± 3.5), and information on the medicines (13.2 ± 3.8). Conclusions: The security system in the administration of drugs in pediatric units has been implemented partially. The most critical dimensions are the information on the drugs and the family related ones which are aspects that must be considered in an improvements plan(AU)


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Preparações Farmacêuticas/administração & dosagem , Segurança Computacional/normas , Hospitais Pediátricos/organização & administração , Saúde da Criança/normas , Epidemiologia Descritiva , Estudos Transversais , Estudos de Avaliação como Assunto , Cuidados de Enfermagem/métodos
14.
Transplantation ; 104(8): e236-e242, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32732842

RESUMO

BACKGROUND: Proper care of young children in need of kidney transplant (KT) requires many skilled professionals and an expensive hospital structure. Small children have lesser access to KT. METHODS: We describe a strategy performed in Brazil to enable and accelerate KT in children ≤15 kg based on the establishment of one specialized transplant center, focused on small children, and cooperating with distant centers throughout the country. Actions on 3 fronts were implemented: (a) providing excellent medical assistance, (b) coordinating educational activities to disseminate expertise and establish a professional network, and (c) fostering research to promote scientific knowledge. We presented the number and outcomes of small children KT as a result of this strategy. RESULTS: Three hundred forty-six pediatric KTs were performed in the specialized center from 2009 to 2017, being 130 in children ≤15 kg (38%, being 41 children ≤10 kg) and 216 in >15 kg (62%). Patient survival after 1 and 5 years of the transplant was 97% and 95% in the "small children" group, whereas, in the "heavier children" group, it was 99% and 96% (P = 0.923). Regarding graft survival, we observed in the "small children" group, 91% and 87%, whereas in the "heavier children" group, 94% and 87% (P = 0.873). These results are comparable to the literature data. Groups were similar in the incidence of reoperation, vascular thrombosis, posttransplant lymphoproliferative disease, and estimated glomerular filtration rate. CONCLUSIONS: The strategy allowed an improvement in the number of KT in small children with excellent results. We believe this experience may be useful in other locations.


Assuntos
Rejeição de Enxerto/epidemiologia , Hospitais Pediátricos/organização & administração , Falência Renal Crônica/cirurgia , Transplante de Rim/estatística & dados numéricos , Tempo para o Tratamento/organização & administração , Adolescente , Peso Corporal/fisiologia , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Seguimentos , Taxa de Filtração Glomerular/fisiologia , Rejeição de Enxerto/etiologia , Rejeição de Enxerto/fisiopatologia , Sobrevivência de Enxerto/fisiologia , Implementação de Plano de Saúde , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/estatística & dados numéricos , Hospitais Pediátricos/estatística & dados numéricos , Humanos , Incidência , Falência Renal Crônica/mortalidade , Falência Renal Crônica/fisiopatologia , Transplante de Rim/efeitos adversos , Masculino , Avaliação de Programas e Projetos de Saúde , Análise de Sobrevida , Fatores de Tempo , Resultado do Tratamento
16.
Hosp Pediatr ; 10(9): 810-819, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32847961

RESUMO

The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread quickly across the globe, creating unique and pressing challenges for today's physicians. Although this virus disproportionately affects adults, initial SARS-CoV-2 infection can present a significant disease burden for the pediatric population. A review of the literature yields descriptive studies in pediatric patients; however, no evidence-based or evidence-informed guidelines for the diagnosis and treatment of the hospitalized pediatric patient have been published in peer-reviewed journals. The authors, working at a quaternary care children's hospital in the national epicenter of the SARS-CoV-2 pandemic, found an urgent need to create a unified, multidisciplinary, evidence-informed set of guidelines for the diagnosis and management of coronavirus disease 2019 in children. In this article, the authors describe our institutional practices for the hospitalized pediatric patient with confirmed or suspected initial SARS-CoV-2 infection. The authors anticipate that developing evidence-informed and institution-specific guidelines will lead to improvements in care quality, efficiency, and consistency; minimization of staff risk of exposure to SARS-CoV-2; and increased provider comfort in caring for pediatric patients with SARS-CoV-2 infection.


Assuntos
Betacoronavirus , Bem-Estar da Criança/estatística & dados numéricos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Procedimentos Clínicos/organização & administração , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Criança , Difusão de Inovações , Gerenciamento Clínico , Hospitais Pediátricos/organização & administração , Humanos , Pandemias , Equipe de Assistência ao Paciente/organização & administração
17.
Int J Eat Disord ; 53(11): 1774-1779, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32715512

RESUMO

The 2019 novel coronavirus disease (COVID-19) pandemic has forced many eating disorder medical stabilization units to consider adjustments that uphold both the quality of care delivered to patients while also observing social distancing public health directives for patients and staff. To date, inpatient facilities for eating disorders (both medical stabilization units and higher level of care facilities) have not needed to consider how to translate services to electronic platforms, given that most of these programs have in-person staff. We outline our transition to telehealth broadly, emphasizing some unexpected benefits of using telehealth services that we plan on integrating into our work-flow post COVID-19. These may be useful for other higher level of care eating disorder programs, including medical stabilization units, residential, partial hospitalization, and intensive outpatient programs. We also highlight aspects of transition that have been more challenging for this particular patient population, warranting the need for in-person services.


Assuntos
Infecções por Coronavirus/prevenção & controle , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Hospitalização , Hospitais Pediátricos/organização & administração , Controle de Infecções/organização & administração , Serviços de Saúde Mental/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Telemedicina/organização & administração , Adolescente , California , Terapia Combinada , Feminino , Humanos , Controle de Infecções/métodos , Masculino , Telemedicina/métodos , Adulto Jovem
18.
An Pediatr (Barc) ; 93(5): 343.e1-343.e8, 2020 Nov.
Artigo em Espanhol | MEDLINE | ID: mdl-32646797

RESUMO

SARS-CoV-2 pandemic dimension has affected the Hospital Pediatrics Medicine assistance in our country. New challenges generated by COVID-19 require a series of proactive measures, based on existing scientific knowledge and standards of good practice, that allow the Pediatric Hospital services readiness and operability. Hospital Internal Pediatrics, as responsible of integral care of the hospitalized child, plays a leading role in the new hospital model emerging from this crisis. This review analyzes the impact of the current SARS-CoV-2 epidemic on pediatric care, and perspective of new COVID-19 outbreaks in coexistence with other viral infections. Changes secondary to pandemic involved in Hospital Pediatric units, how to prepare for future epidemics, also the involvement of pediatric units in adult care and the possible opportunities for improvement need to be revised. Assistance of patients with chronic complex conditions in epidemic circumstances, safety aspects, opportunities for teaching and ethical considerations are reviewed. The Spanish Society of Hospital Pediatrics Medicine offers with this article a series of resources for Internal Pediatric Medicine practitioners responsible to face next challenges in pediatric hospitalization units.


Assuntos
Infecções por Coronavirus , Assistência à Saúde/métodos , Hospitalização , Hospitais Pediátricos/organização & administração , Pandemias , Pediatria/métodos , Pneumonia Viral , Betacoronavirus , Criança , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Assistência à Saúde/organização & administração , Saúde Global , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Pandemias/prevenção & controle , Pediatria/organização & administração , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle
19.
Pediatr Infect Dis J ; 39(9): e221-e225, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32639459

RESUMO

BACKGROUND: In Italy, the response to coronavirus disease 2019 (COVID-19) pandemic upgraded from social distancing on February 23, 2020, to national lockdown on March 11, 2020. We described how the pandemic affected a tertiary care children hospital with a dedicated COVID-19 regional center. METHODS: We analyzed the characteristics of emergency department (ED) visits, urgent hospitalizations and severe acute respiratory syndrome (SARS)-COV-2 reverse transcription-polymerase chain reaction testing, and COVID-19 patients across 3 response phases: before the first Italian case, before national lockdown and during lockdown. RESULTS: ED visits decreased from a daily mean of 239.1 before the first COVID-19 Italian case, to 79.6 during lockdown; urgent hospitalizations decreased from 30.6 to 21.2. As of April 20, 2020, 1970 persons were tested for SARS-CoV-2 reverse transcription-polymerase chain reaction and 2.6% were positive. Positive rates were 1.2% in the ED, 21.1% in the COVID center and 0.5% in other wards. The median age of COVID-19 patients (N = 33) was 6.7 years, 27% had coexisting conditions and 79% were related to family clusters. CONCLUSIONS: The pandemic strongly impacted on the use of hospital services, with a 67% reduction in ED visits and a 31% reduction in urgent hospitalizations. Separating the flows of suspected patients from all other patients, and centralization of suspected and confirmed cases in the COVID center enabled to control the risk of nosocomial SARS-CoV-2 transmission. Delay in hospital use for urgent care must be avoided, and clear communication on infection prevention and control must be provided to families. Further studies are needed to assess how the reduction in hospital use affected children healthcare needs during the pandemic.


Assuntos
Defesa Civil , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Adolescente , Assistência Ambulatorial , Betacoronavirus/isolamento & purificação , Criança , Pré-Escolar , Infecções por Coronavirus/terapia , Infecções por Coronavirus/virologia , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Hospitalização/estatística & dados numéricos , Hospitais Pediátricos/organização & administração , Hospitais Pediátricos/estatística & dados numéricos , Humanos , Lactente , Itália/epidemiologia , Masculino , Pandemias , Pneumonia Viral/terapia , Pneumonia Viral/virologia , Centros de Atenção Terciária/organização & administração , Centros de Atenção Terciária/estatística & dados numéricos
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