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1.
S Afr Med J ; 110(6): 466-468, 2020 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-32880554

RESUMO

Personal protective equipment (PPE) is key to protecting healthcare workers from COVID-19 infection, but the pandemic has disrupted supply chains globally and necessitated rapid review of the scientific evidence for PPE re-use. In South Africa, where the COVID-19 epidemic is still developing, healthcare facilities have a short window of opportunity to improve PPE supply chains, train staff on prudent PPE use, and devise plans to track and manage the inevitable increases in PPE demand. This article discusses the available PPE preservation strategies and addresses the issue of decontamination and re-use of N95 respirators as a last-resort strategy for critical shortages during the pandemic.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pessoal de Saúde , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias/prevenção & controle , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/epidemiologia , Descontaminação/métodos , Instalações de Saúde , Humanos , Pneumonia Viral/epidemiologia , África do Sul/epidemiologia
2.
J Bras Nefrol ; 42(2 suppl 1): 12-14, 2020 Aug 26.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32877492

RESUMO

Patients with Chronic Kidney Disease are among those individuals at increased risk for developing more serious forms of Covid-19. This increased risk starts in the pre-dialysis phase of the disease. Providing useful information for these patients, in language that facilitates the understanding of the disease, can help nephrologists and other healthcare professionals to establish a more effective communication with these patients and help minimize contagion and the risks of serious illness in this population.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Educação de Pacientes como Assunto/normas , Pneumonia Viral/prevenção & controle , Insuficiência Renal Crônica/complicações , Atividades Cotidianas , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Procedimentos Cirúrgicos Eletivos , Higiene das Mãos/métodos , Higiene das Mãos/normas , Instalações de Saúde , Pessoal de Saúde , Humanos , Nefrologia/normas , Espaço Pessoal , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Diálise Renal , Fatores de Risco , Avaliação de Sintomas
4.
Malawi Med J ; 32(1): 19-23, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32733655

RESUMO

Background: Globally, critical illness causes up to 45 million deaths every year. The burden is highest in low-income countries such as Malawi. Critically ill patients require good quality, essential care in emergency departments and in hospital wards to avoid negative outcomes such as death. Little is known about the quality of care or the availability of necessary resources for emergency and critical care in Malawi. The aim of this study was to assess the availability of resources for emergency and critical care in Malawi using data from the Service Provision Assessment (SPA). Methods: We conducted a secondary data analysis of the SPA - a nationwide survey of all health facilities. We assessed the availability of resources for emergency and critical care using previously developed standards for hospitals in low-income countries. Each health facility received an availability score, calculated as the proportion of resources that were present. Resource availability was sub-divided into the seven a-priori defined categories of drugs, equipment, support services, emergency guidelines, infrastructure, training and routines. Results: Of the 254 indicators in the standards necessary for assessing the quality of emergency and critical care, SPA collected data for 102 (40.6%). Hospitals had a median resource availability score of 51.6% IQR (42.2-67.2) and smaller health facilities had a median of 37.5% (IQR 28.1-45.3). For the category of drugs, the hospitals' median score was 62.0% IQR (52.4-81.0), for equipment 51.9% IQR (40.7-66.7), support services 33.3% IQR (22.2-77.8) and emergency guidelines 33.3% IQR (0-66.7). SPA did not collect any data for resources in the categories of infrastructure, training or routines. Conclusion: Hospitals in Malawi lack resources for providing emergency and critical care. Increasing data about the availability of resources for emergency and critical care and improving the hospital systems for the care of critically ill patients in Malawi should be prioritized.


Assuntos
Cuidados Críticos/estatística & dados numéricos , Estado Terminal/terapia , Serviço Hospitalar de Emergência/normas , Recursos em Saúde/provisão & distribução , Qualidade da Assistência à Saúde/normas , Estado Terminal/mortalidade , Serviço Hospitalar de Emergência/estatística & dados numéricos , Pesquisas sobre Serviços de Saúde , Instalações de Saúde/estatística & dados numéricos , Acesso aos Serviços de Saúde , Humanos , Malaui/epidemiologia , Inquéritos e Questionários
5.
West Afr J Med ; 37(4): 335-341, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32835393

RESUMO

BACKGROUND: The successful outcome of any pregnancy depends on a well formulated and implemented ANC, which to a larger extent also depends on its functional and operational continuum of care, that is affordable, accessible and of high quality during and after pregnancy and childbirth. Defective ANC, in terms of coverage and quality, has been shown to be associated with unfavourable pregnancy outcome. OBJECTIVE: To determine the maternal and perinatal outcome(Obstetric performance) of booked and referred pregnant women who though, booked for ANC in lower health care facilities but were delivered at our facility. METHODS: The is a retrospective and cross-sectional study conducted at Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu, Nigeria from the 1st of January 2017 to 31st of December 2018. RESULTS: The booked were significantly older than the unbooked (29.4±5.0 vs 28.5±5.5; P=0.001), while 47.6% and 35.3 % were nulliparous in the study and control groups respectively. Majority of the booked (69.3%) and the unbooked (59.3%) were aged 25-34 years. The mean Apgar scores at one minute were 7.0±2.0 and 4.7±3.1(P<0.001) for the booked and unbooked respectively while at five minutes they were 8.6±1.9 and 6.4±3.6 (P<0.001) for the booked and unbooked respectively and the differences were statistically significant at one and five minutes. The proportion of maternal deaths were higher among the unbooked than the booked (2.6% vs 0.4%; P<0.001), maternal morbidity ( 8.1% vs 2.5%; P<0.001) and fetal deaths (40.6% vs 6.3%; P<0.001) CONCLUSION: In all the indices and parameters compared between the two groups the unbooked patients (control) performed poorly and this is surprising despite the huge resources extended to secondary and primary health care delivery services in Nigeria.


Assuntos
Instalações de Saúde , Resultado da Gravidez , Adulto , Estudos Transversais , Parto Obstétrico , Feminino , Humanos , Nigéria , Gravidez , Cuidado Pré-Natal , Estudos Retrospectivos
6.
West Afr J Med ; 37(4): 418-422, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32835406

RESUMO

BACKGROUND: Several stroke studies in West Africans have demonstrated a high proportion of haemorrhagic stroke and poor outcomes. This may be due to the socioeconomic status of patients and inadequate clinical care. Outcomes may well be different if more informed patients treated in better facilities are studied. OBJECTIVE: To study the pattern of stroke and stroke outcomes in African patients attending a private hospital in Sierra Leone METHODS: 150 consecutive African stroke patients admitted to a private hospital in Sierra Leone were studied. Demographic details, risk factors, clinical features including blood pressure were recorded. CT scans, ECG, serum cholesterol, and blood sugar were done. Patients were reviewed at day 30 and Rankin scores allocated. Two sample independent t-test was used to compare means, and chi square to compare variables. RESULTS: Hypertension was the most common risk factor present in 77.6% of patients prior to admission with diabetes in 29.5%. Other risk factors include previous stroke (11.7%), smoking (6.3%), hypercholesterolemia (23.4%), high alcohol intake (28.8%) and lack of exercise according to self-evaluation (87.5%). 76.3% of patients had ischaemic and 18.2% haemorrhagic stroke. 41% of patients aged 50 years or less had haemorrhagic stroke and 9.3% of patients had atrial fibrillation. In-patient mortality was 10.6%. CONCLUSION: Stroke types and outcomes are different from those generally reported from the sub-region. This may well be due to the population studied, and the level of care provided by a private facility. Socio-economic factors, literacy and clinical care are likely determinants of stroke types and outcomes in African patients. . More detailed studies to confirm the effects of socioeconomic factors on stroke pattern and outcomes in Africa are needed.


Assuntos
Acidente Vascular Cerebral , Instalações de Saúde , Humanos , Hipertensão , Pessoa de Meia-Idade , Instalações Privadas , Fatores de Risco , Serra Leoa
7.
Rev Infirm ; 69(262): 33-35, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32838864

RESUMO

Although initiatives for reducing the carbon footprint of care facilities exist, they remain underdeveloped in terms of the current climate threat. Nurses must be involved in the decisions and initiatives taken to reduce the impact of their organisation on the environment and encourage caregivers to adopt a long lasting ecological approach.


Assuntos
Aquecimento Global/prevenção & controle , Enfermeiras e Enfermeiros/psicologia , Pegada de Carbono , Instalações de Saúde , Humanos
8.
BMC Infect Dis ; 20(1): 594, 2020 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-32787869

RESUMO

BACKGROUND: Implementation of an effective Tuberculosis Routine Surveillance System in low-income countries like Tanzania is problematic, despite being an essential tool for the detection and effective monitoring of drug resistant tuberculosis. Long delays in specimen transportation from the facilities to reference laboratory and results dissemination back to the health facilities, result in poor patient management, particularly where multidrug-resistant tuberculosis disease is present. METHODS: Following a detailed qualitative study, a pilot intervention of a revised Tuberculosis Routine Surveillance System was implemented in Mwanza region, Tanzania. This included the use of rapid molecular methods for the detection of both tuberculosis and drug resistance using Xpert MTB/RIF in some Mwanza sites, the use of Xpert MTB/RIF and Line Probe Assay at the Central Tuberculosis Reference Laboratory, a revised communication strategy and interventions to address the issue of poor form completion. A before and after comparison of the intervention on the number of drug resistant tuberculosis cases identified and the time taken for results feedback to the requesting site was reported. RESULTS: The revised system for previously treated cases tested at the Central Reference Laboratory was able to obtain the following findings; the number of cases tested increased from 75 in 2016 to 185 in 2017. The times for specimen transportation from health facilities to the reference laboratory were reduced by 22% (from 9 to 7 days). The median time for the district to receive results was reduced by 36% (from 11 to 7 days). Overall the number of drug resistant tuberculosis cases starting treatment increased by 67% (from 12 to 20). CONCLUSION: Detection of drug resistance could significantly be enhanced, and delays reduced by introduction of new technologies and improved routine surveillance system, including better communication using mobile applications such as 'WhatsApp' and close follow-ups. A larger scale study is now merited to ascertain if these benefits are robust across different contexts.


Assuntos
Diagnóstico Tardio/prevenção & controle , Testes Diagnósticos de Rotina/métodos , Monitoramento Epidemiológico , Mycobacterium tuberculosis/genética , Tuberculose Resistente a Múltiplos Medicamentos/diagnóstico , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Antibióticos Antituberculose/uso terapêutico , Comunicação , Farmacorresistência Bacteriana Múltipla , Instalações de Saúde , Humanos , Laboratórios , Mycobacterium tuberculosis/isolamento & purificação , Técnicas de Amplificação de Ácido Nucleico/métodos , Projetos Piloto , Estudos Prospectivos , Pesquisa Qualitativa , Rifampina/uso terapêutico , Manejo de Espécimes/métodos , Tanzânia/epidemiologia , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico
10.
Lima; Perú. Ministerio de Salud; 20200700. 54 p. ilus, tab.
Monografia em Espanhol | LILACS, LIPECS | ID: biblio-1103021

RESUMO

El documento contiene las disposiciones técnico administrativas para el uso de Equipos de Protección Personal para el trabajador de las Instituciones Prestadoras de Servicios de Salud a fin de reducir los riesgos de transmisión de enfermedades.


Assuntos
Pessoal de Saúde , Normas Técnicas , Equipamento de Proteção Individual , Instalações de Saúde
13.
PLoS One ; 15(7): e0235696, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32634164

RESUMO

BACKGROUND: Non-communicable diseases (NCDs) are increasingly prevalent in low- and middle-income countries. Successful management requires consistent access to appropriate medicines. Availability of NCD medicines is generally low, especially in the public sector, however, little is known about other factors affecting access. We explored barriers and facilitators of access to medicines for diabetes and hypertension at public and private health facilities in Uganda. METHODS: We conducted a qualitative descriptive study at six public hospitals and five private health facilities in different regions of Uganda. Data collection included 36 in-depth interviews and 14 focus group discussions (n = 128) among purposively selected adult outpatients with diabetes and/or hypertension and 26 key informant interviews with healthcare workers and patient association leaders. Transcripts were coded and emerging themes identified using the Framework method. RESULTS: Four main themes emerged: Stocking of medicines and supplies, Financial factors, Individual behaviour and attitudes, and Service delivery at health facilities. Stocking of medicines and supplies mainly presented barriers to access at public facilities including frequent stockouts, failure to stock certain medicines and low quality brands often rejected by patients. Financial factors, especially high cost of medicines and limited insurance coverage, were barriers in private facilities. Free service provision was a facilitator at public facilities. Patients' confusion resulting from mixed messages and their preference for herbal treatments were cross-sector barriers. While flexibility in NCD service provision was a facilitator at private facilities, provider burnout and limited operating hours were barriers in public facilities. Patient-driven associations exist at some public facilities and help mitigate inadequate medicine stock. CONCLUSION: Access to NCD medicines in Uganda is influenced by both health system and patient factors. Some factors are sector-specific, while others cross-cutting between public and private sectors. Due to commonalities in barriers, potential strategies for overcoming them may include patient-driven associations, public-private partnerships, and multi-modal health education platforms.


Assuntos
Diabetes Mellitus/tratamento farmacológico , Instalações de Saúde , Acesso aos Serviços de Saúde , Hipertensão/tratamento farmacológico , Doenças não Transmissíveis/tratamento farmacológico , Pessoal de Saúde , Hospitais Privados , Hospitais Públicos , Humanos , Aceitação pelo Paciente de Cuidados de Saúde , Uganda
14.
BMC Public Health ; 20(1): 1038, 2020 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-32605547

RESUMO

BACKGROUND: Institutions are a recommended setting for dietary interventions and nutrition policies as these provide an opportunity to improve health by creating healthy food environments. In Australia, state and territory governments encourage or mandate institutions in their jurisdiction to adopt nutrition policies. However, no work has analysed the policy design across settings and jurisdictions. This study aimed to compare the design and components of government-led institutional nutrition policies between Australian states and territories, determine gaps in existing policies, and assess the potential for developing stronger, more comprehensive policies. METHODS: Government-led institutional nutrition policies, in schools, workplaces, health facilities and other public settings, were identified by searching health and education department websites for each Australian state and territory government. This was supplemented by data from other relevant stakeholder websites and from the Food Policy Index Australia website. A framework for monitoring and evaluating nutrition policies in publicly-funded institutions was used to extract data and a qualitative analysis of the design and content of institutional nutrition policies was performed. Comparative analyses between the jurisdictions and institution types were conducted, and policies were assessed for comprehensiveness. RESULTS: Twenty-seven institutional nutrition policies were identified across eight states and territories in Australia. Most policies in health facilities and public schools were mandatory, though most workplace policies were voluntary. Twenty-four included nutrient criteria, and 22 included guidelines for catering/fundraising/advertising. While most included implementation guides or tools and additional supporting resources, less than half included tools/timelines for monitoring and evaluation. The policy design, components and nutrient criteria varied between jurisdictions and institution types, though all were based on the Australian Dietary Guidelines. CONCLUSIONS: Nutrition policies in institutions present an opportunity to create healthy eating environments and improve population health in Australia. However, the design of these policies, including lack of key components such as accountability mechanisms, and jurisdictional differences, may be a barrier to implementation and prevent the policies having their intended impact.


Assuntos
Governo , Política Nutricional , Austrália , Instalações de Saúde , Humanos , Pesquisa Qualitativa , Instituições Acadêmicas , Local de Trabalho
15.
J Am Med Dir Assoc ; 21(7): 954-957, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32674827

RESUMO

The COVID-19 pandemic's greatest impact is among older adults. Management of the situation requires a systemic response, and post-acute care (PAC) can provide an adequate mix of active treatment, management of associated geriatric syndromes and palliative care, both in the acute phase, and in post-COVID-19 recovery. In the region of Catalonia, Spain, selected PAC centers have become sites to treat older patients with COVID-19. Referrals come from the emergency department or COVID-19 wards of the acute reference hospitals, nursing homes, or private homes. We critically review the actions taken by Parc Sanitari Pere Virgili, a PAC facility in Barcelona, to manage the pandemic, including its administration, health care, communication, psychological support, and ethical frameworks. We believe that the strategies we used and the lessons we learned can be useful for other sites and countries where similar adaptation of existing facilities may be implemented.


Assuntos
Assistência Integral à Saúde/organização & administração , Infecções por Coronavirus/epidemiologia , Instalações de Saúde/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde , Pneumonia Viral/epidemiologia , Cuidados Semi-Intensivos/organização & administração , Centros de Atenção Terciária/organização & administração , Idoso , Infecções por Coronavirus/prevenção & controle , Feminino , Geriatria/métodos , Humanos , Masculino , Inovação Organizacional , Pandemias/prevenção & controle , Pandemias/estatística & dados numéricos , Pneumonia Viral/prevenção & controle , Espanha , População Urbana
16.
BMC Infect Dis ; 20(1): 484, 2020 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-32640996

RESUMO

BACKGROUND: Health-care workers (HCWs) are an epidemiological group with increased exposure to tuberculosis (TB), especially at health-care facilities (HCFs) with poor TB infection control in high-TB-burden settings. China is a high-TB-burden country, and the comprehensive measures for stopping TB transmission at some HCFs were not implemented well owing to limited resources and other factors. The purpose of this study was to review risk of occupational exposure to TB among HCWs and its change trend, and identify epidemiological characteristics of pulmonary tuberculosis (PTB) among HCWs in Henan, central part of China. METHODS: A retrospective cohort study was conducted from 2010 to 2017. All HCWs and teachers in Henan were enrolled to the study as exposed group and non-exposed control group, respectively. Relative risk (RR), attributable risk (AR) and AR percent (AR%) were used to measure the association between the occupational exposure and PTB, and estimated with Poisson regression. RESULTS: The study results showed a total of 1663 cases of PTB were reported among the HCWs in Henan, accounting for 3.2‰ of all PTB cases reported in the whole population, and annual incidence rate of PTB among HCWs declined by 34% from 2010 to 2017. Over the eight years, the incidence rate of PTB among HCWs was 43.7 cases per 100,000 person-years (PYs), significantly higher than that among teachers (18.8 cases/100,000 PYs), and RR, AR and AR% were estimated to 2.3, 24.9 cases per 100,000 PYs and 57%, respectively. Among HCWs, males were more likely to suffer from PTB than females (adjusted RR: 1.3; 95%CI: 1.2-1.4), and HCWs aged under 25 years had the highest relative risk over all age groups with adjusted RR equaling to 8.3 (95%CI: 6.9-9.9) calculated with those aged 45-54 years as the reference. CONCLUSIONS: Although overall incidence rate of PTB among HCWs showed decreasing temporal trends over the period of 2010-2017, attributable risk of occupational exposure to TB among HCWs did not decrease in Henan, and TB infection at HCFs for males, young or senior HCWs, especially for young HCWs is of much concern.


Assuntos
Pessoal de Saúde , Controle de Infecções/métodos , Exposição Ocupacional , Tuberculose Pulmonar/epidemiologia , Tuberculose Pulmonar/prevenção & controle , Adulto , China/epidemiologia , Feminino , Instalações de Saúde , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis , Estudos Retrospectivos , Fatores de Risco , Professores Escolares , Tuberculose Pulmonar/microbiologia , Tuberculose Pulmonar/transmissão , Adulto Jovem
17.
Stud Health Technol Inform ; 272: 123-126, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32604616

RESUMO

Robotic-assisted surgery has been actively applied in several fields of minimally invasive surgery, and its use in cancer treatment is increasing. This technology has diffused rapidly, despite high costs and limited reimbursement. Studies have proven the positive results of robotic surgery for patients' quality of life. The objective of this article is to describe the impacts of robotic-assisted cancer surgery adoption at the Brazilian National Cancer Institute. A single qualitative case study was conducted with a descriptive approach, and to have triangulation, data were collected from 3 different sources - participant observation, technical reviews, and seven semi-structured interviews with the main actors involved in the case - and analyzed through content analysis. Despite the considerable costs associated with robotic surgery, this innovation dramatically decreases the length of hospital stay and reduces complications and rehabilitates the patient in a much faster way.


Assuntos
Laparoscopia , Procedimentos Cirúrgicos Robóticos , Brasil , Instalações de Saúde , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos , Qualidade de Vida
18.
Stud Health Technol Inform ; 272: 155-158, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32604624

RESUMO

A secure data collection infrastructure was implemented in which Health Level-7 (HL7) Fast Healthcare Interoperative Resources (FHIR) was applied according to standardized electronic medical record (EMR) storage. This infrastructure aims to facilitate rapid secondary use of EMR data in cross-institutional analyses on the basis of the Standardized Structured Medical Information eXchange (SS-MIX), Japan's domestic standard for EMR export. Existing EMR storage comprised enormous numbers of HL7 v2 messages; therefore, the user interface and database structure are basically defined according to the HL7 v2 data types and message structures, causing difficulty in rapid extraction for researches by clinicians. To solve this problem, we are trying to enhance some user interface with HL7 FHIR, which needs SS-MIX items to be mapped through HL7 FHIR resources. We investigated definition gaps between HL7 FHIR and SS-MIX messages, and report a developed user interface with HL7 FHIR to query against existing storage.


Assuntos
Registros Eletrônicos de Saúde , Troca de Informação em Saúde , Instalações de Saúde , Nível Sete de Saúde , Japão
19.
Nihon Koshu Eisei Zasshi ; 67(6): 390-398, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32612079

RESUMO

Objectives In Japan, the proportion of older people receiving end-of-life care in geriatric health services facilities (GHSF) is increasing. However, to our knowledge, there have been no previous studies investigating the relationship between the structure of GHSFs and the quality of end-of-life care evaluated by bereaved families.Methods We secondarily analyzed data from the survey done by the Japan Association of Geriatric Health Services Facilities (JAGHSF) in January 2014. Study subjects were 3 recently bereaved family members who had experienced planned end-of-life care at different facilities of the JAGHSF.The dependent variable was the bereaved family members' satisfaction with end-of-life care, which was obtained based on the best answer out of a 5 point scale for the question "Didn't you regret your family member's death immediately after he/she died?" The independent variables included schemes of explanation of patients' conditions at GHSF, management, and education of facilities and staff by doctors. We conducted a univariate analysis, followed by a multivariable logistic regression analysis.Results For the final analysis, we included 363 bereaved family members, of which 250 (68.9%) were satisfied with the end-of-life care. In a multivariable logistic regression analysis, family members' satisfaction was significantly associated with regular medical consultation by doctors for facility users (adjusted odds ratio 2.94, 95% CI 1.52-5.70), explanation about patients' conditions at the time of admission by facility staff other than doctors (2.07, 1.01-4.25), explanation about patients' conditions at the time of deterioration by facility staff other than doctors (3.12, 1.17-8.33), and stress management by doctors for facility staff (3.63, 1.84-7.16).Conclusions Respect for the roles of the facility staff other than doctors, such as the participation of facility staff in explaining situations for facility users and family members and management of facility staff stress, may improve satisfaction with end-of-life care among bereaved family members. More attention is needed for these factors to improve the quality of end-of-life care in GHSFs.


Assuntos
Luto , Família/psicologia , Instalações de Saúde , Serviços de Saúde para Idosos , Corpo Clínico , Satisfação Pessoal , Assistência Terminal , Engajamento no Trabalho , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Japão , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
20.
Int J Surg ; 80: 194-201, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32693151

RESUMO

BACKGROUND: After the emergence of Covid-19 in China, Hubei Province, the epidemic quickly spread to Europe. France was quickly hit and our institution was one of the first French university to receive patients infected with Sars-COV2. The predicted massive influx of patients motivated the cancellation of all elective surgical procedures planned to free hospitalization beds and to free intensive care beds. Nevertheless, we should properly select patients who will be canceled to avoid life-threatening. The retained surgical indications are surgical emergencies, oncologic surgery, and organ transplantation. MATERIAL AND METHODS: We describe the organization of our institution which allows the continuation of these surgical activities while limiting the exposure of our patients to the Sars Cov2. RESULTS: After 4 weeks of implementation of intra-hospital protocols for the control of the Covid-19 epidemic, 112 patients were operated on (104 oncology or emergency surgeries and 8 liver transplants). Only one case of post-operative contamination was observed. No mortality related to Covid-19 was noted. No cases of contamination of surgical care personnel have been reported. CONCLUSION: We found that the performance of oncological or emergency surgery is possible, safe for both patients and caregivers.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Centro Cirúrgico Hospitalar/organização & administração , Procedimentos Cirúrgicos Operatórios/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Procedimentos Cirúrgicos do Sistema Digestório , Procedimentos Cirúrgicos Eletivos/métodos , Emergências , Feminino , França/epidemiologia , Procedimentos Cirúrgicos em Ginecologia , Instalações de Saúde , Humanos , Transplante de Fígado/métodos , Pulmão/diagnóstico por imagem , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Otorrinolaringológicos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Melhoria de Qualidade , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Centros de Atenção Terciária , Tomografia Computadorizada por Raios X
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