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2.
J Nurs Adm ; 51(3): 168-172, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33570375

RESUMO

This article describes an academic-clinical partnership program between a school of nursing and an American Nurse Credentialing Center Magnet®- and National Cancer Institute-designated Comprehensive Cancer Center based on a shared vision and multifaceted for optimal new graduate operating room (OR) recruitment and use of clinical partner resources. The program, now in its 3rd year, has a 100% retention rate among the cohorts. Implementing a multifaceted OR partnership program based on nursing theory is a strategy for workforce development to increase retention of new graduate OR nurses.


Assuntos
Bacharelado em Enfermagem/organização & administração , Hospitais de Ensino/organização & administração , Relações Interinstitucionais , Recursos Humanos de Enfermagem no Hospital/educação , Enfermagem de Centro Cirúrgico/educação , Enfermagem de Centro Cirúrgico/organização & administração , Sociedades de Enfermagem/organização & administração , Recursos Humanos/organização & administração , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , National Institutes of Health (U.S.) , Objetivos Organizacionais , Estados Unidos
6.
Ann Pharmacother ; 55(1): 44-51, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32578446

RESUMO

BACKGROUND: Inappropriate albumin use in clinical practice remains problematic. Health-systems face continued challenges in promoting cost-appropriate use. OBJECTIVE: To evaluate the clinical and economic impact of a clinical pharmacist-led intervention strategy targeting inappropriate albumin use in general ward patients. METHODS: A retrospective cohort study evaluated all adult (≥18 years) general ward patients administered ≥1 dose of albumin at a university medical center over a 2-year period. The intervention consisted of a clinical pharmacist-led strategy intervening on all albumin orders not in accordance with institutional guidelines. The primary end point was to compare inappropriate albumin utilization before and after implementation. Secondary end points compared the rates of inappropriate albumin use adjusted for hospital admission and patient-days as well as associated costs by appropriateness between study periods. RESULTS: A total of 4420 patients were screened, with 1971 (44.6%) patients meeting inclusion criteria. The clinical pharmacist strategy significantly reduced inappropriate albumin (grams) utilization by 86.0% (P < 0.001). A 7-fold reduction of inappropriate albumin administered adjusted for the number of patient admissions was found from the preimplementation period following clinical pharmacist intervention strategy implementation (415.3 ± 83.2 vs 57.5 ± 34.2 g per 100 general ward hospital admissions, respectively; P < 0.001). Also, the adjusted inappropriate albumin rate was reduced from 62.2 ± 12.3 to 8.6 ± 5.2 g per 100 patient-days in the preimplementation and postimplementation periods, respectively (P < 0.001). Annual cost savings were $421 455 overall, with $341 930 resulting from mitigation of inappropriate use. CONCLUSION AND RELEVANCE: Clinical pharmacist-led interventions significantly reduced inappropriate albumin use and costs in hospitalized patients.


Assuntos
Albuminas/economia , Uso de Medicamentos/economia , Prescrição Inadequada/economia , Serviço de Farmácia Hospitalar/normas , Adulto , Albuminas/uso terapêutico , Redução de Custos , Custos de Medicamentos , Uso de Medicamentos/estatística & dados numéricos , Feminino , Hospitalização/economia , Hospitais de Ensino/economia , Hospitais de Ensino/organização & administração , Humanos , Prescrição Inadequada/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Admissão do Paciente , Farmacêuticos/normas , Serviço de Farmácia Hospitalar/estatística & dados numéricos , Estudos Retrospectivos
7.
Soins ; 65(849): 18-21, 2020 Oct.
Artigo em Francês | MEDLINE | ID: mdl-33357612

RESUMO

The Legouest military training hospital is one of the eight hospitals of the armed forces health service. Situated in the Grand-Est region, one of the regions most affected by the COVID-19 epidemic in spring, it had to reorganise itself within a few days with its regional and national partners. While continuing to support forces sent abroad, to overseas territories or located in the East of France, the armed forces hospital had three major missions: the support of other military hospital facilities, the continued care of non-COVID patients and the care of patients affected by COVID-19 requiring non-intensive hospital care.


Assuntos
Hospitais Militares/organização & administração , Hospitais de Ensino/organização & administração , Pandemias , França , Humanos , Militares
9.
Artigo em Inglês | MEDLINE | ID: mdl-33050318

RESUMO

In Italy, the coronavirus disease 2019 (COVID-19) emergency took hold in Lombardy and Veneto at the end of February 2020 and spread unevenly among the other regions in the following weeks. In Tuscany, the progressive increase of hospitalized COVID-19 patients required the set-up of a regional task force to prepare for and effectively respond to the emergency. In this case report, we aim to describe the key elements that have been identified and implemented in our center, a 1082-bed hospital located in the Pisa district, to rapidly respond to the COVID-19 outbreak in order to guarantee safety of patients and healthcare workers.


Assuntos
Infecções por Coronavirus/prevenção & controle , Surtos de Doenças/prevenção & controle , Hospitais de Ensino/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/epidemiologia , Humanos , Itália/epidemiologia , Pneumonia Viral/epidemiologia
10.
Acta Biomed ; 91(3): e2020027, 2020 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-32921746

RESUMO

In order to continue the oncological surgical activity and the surgical emergencies, we have elaborated a reorganization of the surgical department. In particular, differentiated pathways for COVID-19 and NON-COVID-19 patients were promptly planned. This arrangement has involved structural and organizational changes almost daily, with great efforts of the health personnel, but allowing our hospital to be the only one in the area still able to guarantee patients safe access to surgical treatment.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Surtos de Doenças , Emergências , Hospitais de Ensino/organização & administração , Pneumonia Viral/epidemiologia , Centro Cirúrgico Hospitalar/organização & administração , Comorbidade , Humanos , Itália/epidemiologia , Pandemias
11.
Crit Care Nurs Q ; 43(4): 468-479, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32833781

RESUMO

The COVID-19 pandemic presented an unprecedented opportunity to test the emergency management plan of one large urban teaching hospital. In this article, a detailed description of the hospital's surge planning process with lessons learned has been provided.


Assuntos
Infecções por Coronavirus/epidemiologia , Hospitais de Ensino/organização & administração , Hospitais Urbanos/organização & administração , Enfermeiras Administradoras/psicologia , Pandemias , Pneumonia Viral/epidemiologia , Capacidade de Resposta ante Emergências/organização & administração , Humanos , Pennsylvania/epidemiologia
12.
Am Surg ; 86(6): 611-614, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32683967

RESUMO

The coronavirus epidemic has taken the world by storm and has overwhelmed health systems in a number of first world countries. As a consequence, individual communities in the United States and the world have had to develop response plans to meet this extreme challenge. In these circumstances and in an effort to best prepare for the community's needs, it becomes necessary to critically analyze the specific and unique aspects of individual regions, their population characteristics and demographics, and the geography of the area. Once assessed, these data may be applied to formulating best practices for a given community and resource pool. The following manuscript describes how this challenge was met in a large tertiary care teaching hospital located in rural West Virginia.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Hospitais de Ensino/organização & administração , Pandemias , Saúde da População Rural , Centros de Atenção Terciária/organização & administração , Humanos , Pobreza , Centro Cirúrgico Hospitalar/organização & administração , Procedimentos Cirúrgicos Operatórios , West Virginia/epidemiologia
13.
Elife ; 92020 06 19.
Artigo em Inglês | MEDLINE | ID: mdl-32558644

RESUMO

Previously, we showed that 3% (31/1032)of asymptomatic healthcare workers (HCWs) from a large teaching hospital in Cambridge, UK, tested positive for SARS-CoV-2 in April 2020. About 15% (26/169) HCWs with symptoms of coronavirus disease 2019 (COVID-19) also tested positive for SARS-CoV-2 (Rivett et al., 2020). Here, we show that the proportion of both asymptomatic and symptomatic HCWs testing positive for SARS-CoV-2 rapidly declined to near-zero between 25th April and 24th May 2020, corresponding to a decline in patient admissions with COVID-19 during the ongoing UK 'lockdown'. These data demonstrate how infection prevention and control measures including staff testing may help prevent hospitals from becoming independent 'hubs' of SARS-CoV-2 transmission, and illustrate how, with appropriate precautions, organizations in other sectors may be able to resume on-site work safely.


Assuntos
Técnicas de Laboratório Clínico/estatística & dados numéricos , Infecções por Coronavirus/transmissão , Pessoal de Saúde , Programas de Rastreamento/estatística & dados numéricos , Doenças Profissionais/prevenção & controle , Pandemias , Pneumonia Viral/transmissão , Adulto , Doenças Assintomáticas , Betacoronavirus/genética , Betacoronavirus/isolamento & purificação , Infecções Comunitárias Adquiridas/transmissão , Busca de Comunicante , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Inglaterra/epidemiologia , Características da Família , Feminino , Unidades Hospitalares , Hospitais de Ensino/organização & administração , Hospitais de Ensino/estatística & dados numéricos , Hospitais Universitários/organização & administração , Hospitais Universitários/estatística & dados numéricos , Humanos , Controle de Infecções , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Masculino , Programas de Rastreamento/organização & administração , Pessoa de Meia-Idade , Nasofaringe/virologia , Doenças Profissionais/epidemiologia , Pandemias/prevenção & controle , Admissão do Paciente/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Prevalência , Avaliação de Programas e Projetos de Saúde , Reação em Cadeia da Polimerase em Tempo Real , Avaliação de Sintomas
14.
J Plast Reconstr Aesthet Surg ; 73(6): 1174-1205, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32359857

RESUMO

COVID-19 is presenting a colossal challenge to frontline NHS staff. This paper highlights how plastic surgery teams can use their diverse skills and resources in times of crisis. Through effective strategy and leadership we present how we are adapting as a department to serve our plastic surgery patients, other hospital teams and the Trust.


Assuntos
Infecções por Coronavirus/epidemiologia , Hospitais de Ensino/organização & administração , Pandemias , Pneumonia Viral/epidemiologia , Procedimentos Cirúrgicos Reconstrutivos , Betacoronavirus , Infecções por Coronavirus/transmissão , Infecção Hospitalar/prevenção & controle , Assistência à Saúde , Humanos , Liderança , Corpo Clínico Hospitalar , Pneumonia Viral/transmissão , Medicina Estatal , Estudantes de Medicina , Centro Cirúrgico Hospitalar/organização & administração , Reino Unido
17.
BMC Health Serv Res ; 20(1): 301, 2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32293438

RESUMO

BACKGROUND: Research on organizational justice in hospitals in African countries are limited despite being important for workforce performance and hospital operational efficiency. This paper investigated perceptions and predictors of organizational justice among health professionals in academic hospitals in South-east Nigeria. METHODS: The study was conducted in two teaching hospitals in Enugu State, South-east Nigeria using mixed-methods design. Randomly sampled 360 health professionals (doctors = 105, nurses = 200 and allied health professionals, AHPs = 55) completed an organizational justice scale. Additionally, semi-structured, in-depth interview with purposively selected 18 health professionals were conducted. Univariate and bivariate statistics and multivariable linear regression were used to analyze quantitative data. Statistical significance was set at alpha 0.05 level. Qualitative data were analyzed thematically using NVivo 11 software. RESULTS: The findings revealed moderate to high perception of different dimensions of organizational justice. Doctors showed the highest perception, whereas AHPs had the least perception. Among doctors, age and education predicted distributive justice (adjusted R2 = 22%); hospital ownership and education predicted procedural justice (adjusted R2 = 17%); and hospital ownership predicted interactional justice (adjusted R2 = 42%). Among nurses, age, gender and marital status predicted distributive justice (adjusted R2 = 41%); hospital ownership, age and gender predicted procedural justice (adjusted R2 = 28%); and hospital ownership, age, marital status and tenure predicted interactional justice (R2 = 35%). Among AHPs, marital status predicted distributive justice (adjusted R2 = 5%), while hospital ownership and tenure predicted interactional justice (adjusted R2 = 15%). Qualitative findings indicate that nurses and AHPs perceive as unfair, differences in pay, access to hospital resources, training, work schedule, participation in decision-making and enforcement of policies between doctors and other health professionals due to medical dominance. Overall, supervisors have a culture of limited information sharing with, and disrespectful treatment of, their junior colleagues. CONCLUSION: Perceptions of organizational justice range from moderate to high and predictors vary among different healthcare professionals. Addressing specific socio-demographic factors that significantly influenced perceptions of organizational justice among different categories of health professionals and departure from physician-centered culture would improve perceptions of organizational justice among health professionals in Nigeria and similar settings.


Assuntos
Hospitais de Ensino/organização & administração , Cultura Organizacional , Recursos Humanos em Hospital/psicologia , Justiça Social , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Percepção , Recursos Humanos em Hospital/estatística & dados numéricos , Pesquisa Qualitativa , Adulto Jovem
19.
Rev Saude Publica ; 54: 23, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32049212

RESUMO

OBJECTIVE: To describe some characteristics of the 97 teaching hospitals participating in the Projeto de Aprimoramento e Inovação no Cuidado e Ensino em Obstetrícia e Neonatologia (Apice ON-Project for Improvement and Innovation in Care and Teaching in Obstetrics and Neonatology). METHODS: The semester prior to the beginning of the program was adopted as the baseline to evaluate the subsequent structural and processes changes of this project. Secondary data from the first half of 2017 were extracted from the National Registry of Health Establishments (NRHE), the Hospital Information System and the Sistema de Informações sobre Nascidos Vivos (SINASC-Live Birth Information System). RESULTS: Before the implementation of the project, only 66% of the hospitals had a Baby-friendly Hospital Initiative, only 3% offered special accommodations for high-risk pregnant women, mothers and their newborns, and 45.4% hospitals adopted the skin-to-skin contact; 97% hospitals had separate rooms for pre-labor and vaginal delivery (93%), not following the recommendations of the Ministry of Health; nine hospitals (9%) had no rooming-in; there were few obstetrics nurses (less than 1% of professionals enrolled in the NRHE), and in only six hospitals the proportion of births assisted by this professional was above 50% of vaginal deliveries, while in eight this percentage ranged between 15% and 50%; the average cesarean section rate was 42%, ranging between 37.6% (Southeast) and 49.1% (Northeast); ten hospitals did not charge for companions according to inpatient hospital authorization. CONCLUSION: The study strengthens the relevance of the Apice ON project as an inducer of change of the care model in teaching hospitals and, therefore, as a strategy for the implementation of the national public policy represented by the Stork Network.


Assuntos
Maternidades/organização & administração , Hospitais de Ensino/organização & administração , Programas Nacionais de Saúde/organização & administração , Neonatologia/educação , Obstetrícia/educação , Brasil , Cesárea/normas , Parto Obstétrico/normas , Feminino , Maternidades/normas , Hospitais de Ensino/normas , Humanos , Recém-Nascido , Trabalho de Parto , Nascimento Vivo , Programas Nacionais de Saúde/normas , Neonatologia/normas , Obstetrícia/normas , Período Pós-Parto , Gravidez
20.
Acad Med ; 95(4): 559-566, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31913879

RESUMO

PURPOSE: Changing market forces increasingly are leading academic medical centers (AMCs) to form or join health systems. But it is unclear how this shift is affecting the tripartite academic mission of education, research, and high-quality patient care. To explore this topic, the authors identified and characterized the types of health systems that owned or managed AMCs in the United States in 2016. METHOD: The authors identified AMCs as any general acute care hospitals that had a resident-to-bed ratio of at least 0.25 and that were affiliated with at least one MD- or DO-granting medical school. Using the Agency for Healthcare Research and Quality 2016 Compendium of U.S. Health Systems, the authors also identified academic-affiliated health systems (AHSs) as those health systems that owned or managed at least one AMC. They compared AMCs and other general acute care hospitals, AHSs and non-AHSs, and AHSs by type of medical school relationship, using health system size, hospital characteristics, undergraduate and graduate medical education characteristics, services provided, and ownership. RESULTS: Health systems owned or managed nearly all AMCs (361, 95.8%). Of the 626 health systems, 230 (36.7%) met the definition of an AHS. Compared with other health systems, AHSs included more hospitals, provided more services, and had a lower ratio of primary care doctors to specialists. Most AHSs (136, 59.1%) had a single, shared medical school relationship, whereas 38 (16.5%) had an exclusive medical school relationship and 56 (24.3%) had multiple medical school relationships. CONCLUSIONS: These findings suggest that several distinct types of relationships between AHSs and medical schools exist. The traditional vision of a medical school having an exclusive relationship with a single AHS is no longer prominent.


Assuntos
Educação de Pós-Graduação em Medicina/organização & administração , Educação de Graduação em Medicina/organização & administração , Hospitais de Ensino/organização & administração , Centros Médicos Acadêmicos/organização & administração , Pesquisa Biomédica , Hospitais Gerais/organização & administração , Hospitais Pediátricos/organização & administração , Hospitais com Fins Lucrativos/organização & administração , Hospitais Públicos/organização & administração , Hospitais Filantrópicos/organização & administração , Humanos , Qualidade da Assistência à Saúde , Provedores de Redes de Segurança/organização & administração , Faculdades de Medicina/organização & administração
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