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1.
Br J Nurs ; 29(1): 28-34, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31917951

RESUMO

A study was conducted to explore whether fatigue, workload, burnout and the work environment can predict the perceptions of patient safety among critical care nurses in Oman. A cross-sectional predictive design was used. A sample of 270 critical care nurses from the two main hospitals in the country's capital participated, with a response rate of 90%. The negative correlation between fatigue and patient safety culture (r= -0.240) indicates that fatigue has a detrimental effect on nurses' perceptions of safety. There was also a significant relationship between work environment, emotional exhaustion, depersonalisation, personal accomplishment and organisational patient safety culture. Regression analysis showed that fatigue, work environment, emotional exhaustion, depersonalisation and personal accomplishment were predictors for overall patient safety among critical care nurses (R2=0.322, F=6.117, P<0.0001). Working to correct these predictors and identifying other factors that affect the patient safety culture are important for improving and upgrading the patient safety culture in Omani hospitals.


Assuntos
Atitude do Pessoal de Saúde , Enfermagem de Cuidados Críticos/organização & administração , Recursos Humanos de Enfermagem no Hospital/psicologia , Cultura Organizacional , Segurança do Paciente , Adulto , Esgotamento Profissional/epidemiologia , Estudos Transversais , Fadiga/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Omã/epidemiologia , Carga de Trabalho , Local de Trabalho , Adulto Jovem
2.
J Dent Educ ; 84(1): 97-104, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31977092

RESUMO

Assessment in competency-based dental education continues to be a recognized area for growth and development within dental programs around the world. At the joint American Dental Education Association (ADEA) and the Association for Dental Education in Europe (ADEE) 2019 conference, Shaping the Future of Dental Education III, the workshop on assessment was designed to continue the discussion started in 2017 at the ADEA-ADEE Shaping the Future of Dental Education II.1 The focus of the 2019 conference involved examining the potential of entrustable professional activities (EPAs) and current thinking about workplace-based assessment (WBA) within competency-based education in the 21st century. Approximately 30 years ago, George Miller wrote about the assessment of competence in medical education and challenged faculty to reach for higher levels of assessment than knowledge or skill.2 Acknowledging that no one assessment method can result in a valid assessment of competence, Miller proposed a four-level framework for assessment. The lowest level involves measuring what students know ("knows"), followed by assessment of the skill with which knowledge is applied in relevant tasks or problems ("knows how"). Next is an assessment of task performance in standardized settings ("shows how"), and finally, the highest level assesses the student's performance in the unstandardized clinical workplace ("does"). The 2019 assessment workshop focused on advances in the assessment of learners in the unstandardized workplace-the highest level of Miller's assessment pyramid ("does"). Research has shown that dental education has struggled to implement assessment strategies that meet this level.3 The workshop brought together individuals from around the world, with an interest in assessment in dental education, to consider how assessment in the "does" level, specifically EPAs and WBA, factors into competence assessment in dentistry/dental education.


Assuntos
Educação Baseada em Competências , Educação em Odontologia , Competência Clínica , Europa (Continente) , Previsões , Humanos , Local de Trabalho
3.
JAMA Netw Open ; 3(1): e1920092, 2020 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-31995218

RESUMO

Importance: In Canada, approximately 81% of residents of nursing homes live with mild to severe cognitive impairment. Care needs of this population are increasingly complex, but resources, such as staffing, for nursing homes continue to be limited. Staff risk missing or rushing care tasks and interfering with quality of care and life. Objective: To assess the association of work environment with missing and rushing essential care tasks in nursing homes. Design, Setting, and Participants: This cross-sectional study used survey data collected from a random sample of 93 urban nursing homes in Western Canada, stratified by health region, owner-operator model, and facility size, between May and December 2017. All 5411 eligible care aides were invited to participate, and 4016 care aides agreed and completed structured, computer-assisted interviews in person. Analyses were conducted from July 4, 2018, to February 27, 2019. Main Outcomes and Measures: Self-reported number of essential care tasks missed (range, 0-8) or rushed (range, 0-7) in the most recent shift. Two-level random intercept hurdle regressions controlled for care aide, care unit, and nursing home characteristics. Results: Of 4016 care aides, 2757 (68.7%) were 40 years or older, 3574 (89.1%) were women, and 1353 (66.3%) spoke English as an additional language. For their most recent shift, 2306 care aides (57.4%) reported missing at least 1 essential care task and 2628 care aides (65.4%) reported rushing at least 1 essential care task. Care aides on units with more favorable work environments (eg, more effective leadership, better work culture, higher levels of buffering resources) were less likely to miss any care tasks (odds ratio, 1.59; 95% CI, 1.34-1.90; P < .001) and less likely to rush any care task (odds ratio, 1.66; 95% CI, 1.38-1.99; P < .001). Conclusions and Relevance: This study found that rates of missed and rushed essential care in Canadian nursing homes were high and were higher in units with less favorable work environments. This finding suggests that work environment should be added to the list of modifiable factors associated with improving nursing home care, as it may be an important pathway for improving quality of care. Further research is needed to understand associations of missed and rushed care and of improving work environments with outcomes among residents of nursing homes.


Assuntos
Assistentes de Enfermagem/psicologia , Casas de Saúde/organização & administração , Carga de Trabalho/psicologia , Adulto , Canadá , Estudos Transversais , Humanos , Qualidade da Assistência à Saúde/normas , Local de Trabalho/psicologia
5.
Ann R Coll Surg Engl ; 102(1): 36-42, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31660752

RESUMO

INTRODUCTION: The temporal patterns and unit-based distributions of trauma patients requiring surgical intervention are poorly described in the UK. We describe the distribution of trauma patients in the UK and assess whether changes in working patterns could provide greater exposure for operative trauma training. METHODS: We searched the Trauma Audit and Research Network database to identify all patients between 1 January 2014 to 31 December 2016. Operative cases were defined as all patients who underwent laparotomy, thoracotomy or open vascular intervention. We assessed time of arrival, correlations between mechanism of injury and surgery, and the effect of changing shift patterns on exposure to trauma patients by reference to a standard 10-hour shift assuming a dedicated trauma rotation or fellowship. RESULTS: There were 159,719 patients from 194 hospitals submitted to the Network between 2014 and 2016. The busiest 20 centres accounted for 57,568 (36.0%) of cases in total. Of these 2147/57,568 patients (3.7%) required a general surgical operation; 43% of penetrating admissions (925 cases) and 2.2% of blunt admissions (1222 cases). The number of operations correlated more closely with the number of penetrating rather than blunt admissions (r = 0.89 vs r = 0.51). A diurnal pattern in trauma admissions enabled significant increases in trauma exposure with later start times. CONCLUSIONS: Centres with high volume and high penetrating rates are likely to require more general surgical input and should be identified as locations for operative trauma training. It is possible to improve the number of trauma patients seen in a shift by optimising shift start time.


Assuntos
Educação de Pós-Graduação em Medicina/métodos , Cirurgia Geral/educação , Admissão do Paciente/estatística & dados numéricos , Traumatologia/educação , Ferimentos e Lesões/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Inglaterra , Feminino , Hospitais com Alto Volume de Atendimentos , Humanos , Irlanda , Masculino , Pessoa de Meia-Idade , Admissão e Escalonamento de Pessoal/organização & administração , Admissão e Escalonamento de Pessoal/estatística & dados numéricos , Estudos Retrospectivos , Jornada de Trabalho em Turnos/estatística & dados numéricos , Fatores de Tempo , Centros de Traumatologia/organização & administração , Centros de Traumatologia/estatística & dados numéricos , País de Gales , Local de Trabalho/organização & administração , Local de Trabalho/estatística & dados numéricos , Ferimentos e Lesões/cirurgia
6.
Eur J Dent Educ ; 24(1): 109-120, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31618492

RESUMO

INTRODUCTION: In the United Kingdom, policy and guidance changes regarding the role of dental therapists (DTs) were implemented in recent years with a view to changing dental care to a more preventive-focussed, teamwork approach. However, success in the adoption of this model of working has been varied. AIMS: Adopting a realist approach, our aim was, to examine the use of DTs in general dental practices in Wales, exploring what works, why, how and in what circumstances. MATERIALS AND METHODS: The research comprised two stages. (a) A structured literature search, dual-coding papers for high-level factors describing the conditions or context(s) under which the mechanisms operated to produce outcomes. From this, we derived theories about how skill-mix operates in the general dental service. (b) Six case studies of general dental practices (three with a dental therapist/three without a dental therapist) employing a range of skill-mix models incorporating semi-structured interviews with all team members. We used the case studies/interviews to explore and refine the theories derived from the literature. RESULTS: Eighty-four papers were coded. From this coding, we identified seven theories which reflected factors influencing general dental practices within three broad contexts: the dental practice as a business, as a healthcare provider and as a workplace. We tested these theories in interviews with 38 dental team members across the six care studies. As a result, we amended five of the theories. CONCLUSION: Our analysis provides theory about outcomes that DTs may facilitate and the mechanisms that may assist the work of DTs within different contexts of general dental practice.


Assuntos
Assistência Odontológica , Odontologia Geral , Pessoal de Saúde , Humanos , Reino Unido , Local de Trabalho
8.
J Nurs Adm ; 50(1): 52-58, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31804408

RESUMO

OBJECTIVE: To describe the impact of the implementation of interprofessional shared governance and a caring professional practice model (Relationship-Based Care [RBC]) on the staff's self-report of caring, work engagement, and workplace empowerment over a 4-year time frame. BACKGROUND: Shared or interprofessional governance has moved mainstream within healthcare settings, particularly within agencies seeking to sustain high reliability in the offering of quality patient care services and/or interest in meeting Magnet standards or embarking upon the Pathway to Excellence. Nurse leaders report that organizations having implemented shared governance thrive, citing professional governance as key to workplace engagement and empowerment, particularly related to quality care initiatives. Transition to interprofessional shared governance structures typically takes 2 to 3 years. It is unknown whether related outcome variables are sustainable over time. METHODS: Utilizing Watson's theory of human caring and appreciative inquiry as underlying frameworks, a longitudinal, quantitative study design was employed. Interprofessional focus groups and introductory sessions were offered to inform and engage all personnel within the medical center. Motivated units were identified, professional shared governance council members elected, and unit-specific education provided. Quality improvement initiatives were facilitated within unit councils, and formal leadership programs to enhance project guidance and to support staff empowerment skills for the managers of the units that were up-and-running were provided. Preimplementation and postimplementation measurements of staff's caring, workplace engagement and work empowerment were assessed, compared, and trended across units over time. RESULTS: Only work empowerment scores among staff working within RBC units were sustainable and increased progressively and significantly over time. Work engagement levels initially rose and then stabilized over time. Caring levels remained stable despite the implementation of a caring professional practice model. Statistically significant correlations were noted between work engagement and empowerment, followed by the relationship between work engagement and caring, followed by the relationship between empowerment and caring. CONCLUSIONS: The sustainability of work empowerment is likely related to the periodic provision of education for leaders regarding leading within an empowered work environment. A stronger focus on staff caring, particularly within quality improvement initiatives, with leadership guidance, will be paramount moving forward.


Assuntos
Empatia , Padrões de Prática em Enfermagem/normas , Governança Compartilhada de Enfermagem , Local de Trabalho , Humanos , Melhoria de Qualidade , Inquéritos e Questionários , Estados Unidos
9.
Nurs Educ Perspect ; 41(1): 33-36, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31860483

RESUMO

AIM: The aim was to establish a correlation between burnout and lack of empowerment in associate degree nursing faculty and their creativity in the classroom. METHOD: A descriptive, quantitative research study was completed. An email with a survey link was sent to members of the National Organization for Associate Degree Nursing asking for anonymous, voluntary participation and inviting members to forward to additional faculty; 217 participants completed the survey in its entirety. Pearson correlation and multiple linear regression tests were completed on the data. RESULTS: Statistically significant (personal burnout, p = .004; work burnout, p = .003; student burnout, p = .000) relationships were found between burnout and creativity. No relationship was established between lack of empowerment and creativity. CONCLUSION: Nursing faculty who perceived feelings of burnout were less motivated or engaged in their workplace, including interactions with students, which was directly correlated to a decrease in perceived feelings of creativity.


Assuntos
Esgotamento Profissional , Criatividade , Docentes de Enfermagem , Estudos Transversais , Docentes de Enfermagem/psicologia , Humanos , Inquéritos e Questionários , Local de Trabalho
10.
Int J Radiat Oncol Biol Phys ; 106(1): 146-156, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31521718

RESUMO

PURPOSE: Human papillomavirus (HPV)-associated oropharyngeal cancer (OPC) commonly affects people of working age, yet there is limited data regarding the return-to-work experience in this cohort. This study aimed to investigate the proportion of survivors currently working after completion of radiation therapy and to explore potential facilitators and barriers to working after treatment. METHODS: A cross-sectional, single-institutional study was undertaken at the Peter MacCallum Cancer Centre, a comprehensive cancer center in Melbourne, Victoria, Australia. Eligible participants were 18 to 65 years old at diagnosis, were employed at or within the 3 months before diagnosis, and had completed curative treatment for HPV-associated OPC ≥4 months before enrollment. Participants completed a paper-based survey to assess baseline demographics, employment status, and quality of life (QOL; Functional Assessment of Cancer Therapy Head and Neck). Open-ended questions explored factors affecting return to work. Associations between current employment status and various disease, treatment, and demographic variables and with QOL were examined. Free-text items were analyzed by summarizing content analysis. RESULTS: Of 93 participants approached, 68 responded (73.1%). Mean age was 54.1 years (range, 39-64 years), and 89.7% were male. Most participants (67.6%) had stage II disease and were treated with chemoradiation (85.3%). Mean time after treatment was 2.6 years (range, 0.3-9.1 years). Fifty-eight of 68 participants (85.3%) were working at enrollment; median time to return to work was 6.0 months (interquartile range, 4-10 months); 45 (77.6%) were in the same role and 35 (60.3%) worked the same number of hours. Ten participants were not working, 3 had retired, 5 reported persistent and significant treatment toxicity preventing employment. Survivors currently working reported higher physical, functional, and global QOL scores. Access to leave and support from treating doctors were facilitators for return to work, whereas fatigue was frequently reported as a barrier to returning to work. CONCLUSION: With time, the majority of participants with HPV-associated OPC will return to work after radiation therapy. Attention to symptom management and support from the workplace may enable more successful return to work.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Emprego/estatística & dados numéricos , Neoplasias Orofaríngeas/terapia , Infecções por Papillomavirus/complicações , Qualidade de Vida , Retorno ao Trabalho/estatística & dados numéricos , Adulto , Sobreviventes de Câncer/psicologia , Quimiorradioterapia/efeitos adversos , Quimiorradioterapia/estatística & dados numéricos , Estudos Transversais , Fadiga/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Orofaríngeas/patologia , Neoplasias Orofaríngeas/virologia , Papillomaviridae , Pesquisa Qualitativa , Aposentadoria/estatística & dados numéricos , Retorno ao Trabalho/psicologia , Licença Médica/estatística & dados numéricos , Apoio Social , Inquéritos e Questionários , Fatores de Tempo , Vitória , Tolerância ao Trabalho Programado , Local de Trabalho
11.
BMC Infect Dis ; 19(1): 1044, 2019 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-31822267

RESUMO

Scrub typhus is an important arthropod-borne disease causing significant acute febrile illness by infection with Orientia spp.Using a risk-based approach, this review examines current practice, the evidence base and regulatory requirements regarding matters of biosafety and biosecurity, and presents the case for reclassification from Risk Group 3 to Risk Group 2 along with recommendations for safe working practices of risk-based activities during the manipulation of Orientia spp. in the laboratory.We recommend to reclassify Orientia spp. to Risk Group 2 based on the classification for RG2 pathogens as being moderate individual risk, low community risk. We recommend that low risk activities, can be performed within a biological safety cabinet located in a Biosafety Level (BSL) 2 core laboratory using standard personal protective equipment. But when the risk assessment indicates, such as high concentration and volume, or aerosol generation, then a higher biocontainment level is warranted. For, the majority of animal activities involving Orientia spp., Animal BSL 2 (ABSL2) is recommended however where high risk activities are performed including necropsies, Animal BSL (ABSL3) is recommended.


Assuntos
Contenção de Riscos Biológicos/classificação , Orientia tsutsugamushi/patogenicidade , Tifo por Ácaros/transmissão , Guias como Assunto , Humanos , Pesquisa , Medição de Risco , Tifo por Ácaros/diagnóstico , Local de Trabalho
13.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi ; 37(11): 823-826, 2019 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-31826546

RESUMO

Objective: To understand the occupational hazard and distribution of silica dust (free SiO(2)≥10%) in the workplace environment of the enterprises in Fengxian District, and to provide scientific basis for improving the working environment and protecting the physical and mental health of the workers. Methods: Individual sampling monitoring and on-site labor hygiene investigation were conducted on 421 workers involved in 87 silicon dust enterprises in the jurisdiction from 2014 to 2018, and measured concentration-time weighted average (C(TWA)) . Results: The results showed that the range of the C(TWA) was (0.021~17.000) mg/m(3), the median was 1.600 mg/m(3), and the qualified rate of 30.88%. The difference of total dust concentration was statistically significant in different years (Z=38.831, P<0.05) . The qualified rate of small-scale enterprises is higher than that of medium-scale enterprises (χ(2)=9.472, P<0.05) . The qualified rate of other domestic enterprises is higher than that of private enterprises and foreign enterprises (χ(2)=10.089, P<0.05) . The acceptance rate of metal products manufacturing is lower than that of general equipment manufacturing and other manufacturing enterprises (χ(2)=64.626, P<0.05) . The qualification rate of natural ventilation is higher than that of mechanical ventilation (χ(2)=6.278, P<0.05) . Conclusion: The enterprises involved in silicon production in Fengxian District need to further strengthen the production process reform and improve the ventilation and dust removal protection measures. Widely carry out the publicity of occupational disease prevention and control law, conduct targeted pre-job training, improve workers' awareness of self-protection, and protect the occupational health of workers in many ways.


Assuntos
Poeira , Exposição Ocupacional , Dióxido de Silício , Local de Trabalho , Poeira/análise , Humanos , Exposição Ocupacional/análise , Saúde do Trabalhador , Dióxido de Silício/análise , Local de Trabalho/normas
14.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi ; 37(11): 839-842, 2019 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-31826550

RESUMO

Objective: To investigation on the occupational hazardous factors exposed to the female workers, from 14 prefectures and municipalities in Gansu province. Methods: The survey was conducted from June to October 2015. A total of 8 538 female employees from 30 enterprises in 14 prefectures and cities of the province were selected by cluster sampling method. The occupational hazard factors were investigated and analyzed statistically. Results: The survey found that the proportion of female workers in Gansu province who are exposed to chemical and physical harmful factors at the same time is relatively large. Most female workers are exposed to 2-4 occupational hazards, and women who are exposed to 3 and 4 chemical harmful factors account for 28.8 % and 38.0 %, respectively. Women workers who were exposed to two or three physical factors at the same time accounted for 59.44 per cent, while 61.5% were exposed to two biological factors at the same time. The number of female workers exposed to two or three physical factors at the same time and the number of four and five physical factors at the same time after being tested by χ(2). The difference is statistically significant (χ(2)= 8.17, P<0.05) . The difference in the number of female workers who simultaneously exposed 3 and 4 chemical factors and simultaneously exposed 2 and 5 or more chemical factors is statistically significant (χ(2)=11.26, P<0.05) . There was no significant difference in the exposure of female workers to biological factors. Conclusion: This survey shows that the exposure of female workers in Gansu Province to occupational hazards is not optimistic. We should strengthen enterprise supervision and improve the working environment and conditions of female workers.


Assuntos
Exposição Ocupacional , Feminino , Humanos , Doenças Profissionais/prevenção & controle , Exposição Ocupacional/estatística & dados numéricos , Inquéritos e Questionários , Local de Trabalho/estatística & dados numéricos
15.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi ; 37(11): 858-861, 2019 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-31826556

RESUMO

Objective: To establish the method for determination of tungsten and insoluble compounds in the air of workplace by inductively coupled plasma optical emission spectrometry (ICP-OES) . Methods: The tungsten and insoluble compounds were digested by microwave digestion apparatus using nitric acid and hydrofluoric acid, detected by ICP-OES. Results: The linearity of tungsten and insoluble compounds (as tungsten) were good at the range of 0.16-100.0 µg/ml, the minimum quantitation concentration was 0.11 mg/m(3), the recovery was ranged from 81.9%-97.1%, the RSD of intra-and inter-batch precision were 0.5%-2.5% and 1.2%-4.4%, respectively. Conclusion: The determination method meet the requirement of analysis and apply to the determination of tungsten and insoluble compounds in the air of workplace.


Assuntos
Monitoramento Ambiental , Análise Espectral , Tungstênio , Local de Trabalho , Micro-Ondas , Tungstênio/análise
16.
Rev Saude Publica ; 53: 101, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31800912

RESUMO

OBJECTIVE: To evaluate the effectiveness of interventions aimed at the prevention of risk factors and incidence of type 2 diabetes in the workers population. METHODS: Systematic review of interventions aimed at adult workers at risk of type 2 diabetes published in Medline, Embase, Web of Science, Central Cochrane Registry of Controlled Trials, and Lilacs. Randomized trials, quasi-experimental research and cohort studies were selected; in English, Spanish and Portuguese; published from 2000 to 2017. Intervention effectiveness was evaluated concerning the incidence of type 2 diabetes and a significant reduction in body weight, or another anthropometric or metabolic parameter. RESULTS: 3,024 articles were generated, of which 2,825 that did not answer the research question were eliminated, as well as 130 that did not evaluate original interventions, 57 carried out outside the workplace and two reviews; so that 10 selected items remained. Interventions based on structured programs previously evaluated and integrated into the workplace had a favorable impact on the reduction of body weight and other risk factors. CONCLUSIONS: The effectiveness of lifestyle interventions for the prevention of type 2 diabetes should be based on structured programs with proven effectiveness and adapted to the workplace, with employer participation in the provision of schedules and work environments.


Assuntos
Diabetes Mellitus Tipo 2/etiologia , Diabetes Mellitus Tipo 2/prevenção & controle , Saúde do Trabalhador , Comportamento de Redução do Risco , Local de Trabalho , Peso Corporal , Feminino , Humanos , Masculino , Fatores de Risco , Comportamento Sedentário
18.
BMJ ; 367: l6446, 2019 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-31852676

RESUMO

OBJECTIVE: To determine the validity of the superstition that utterance of the word "quiet" in a clinical setting increases workload. DESIGN: Prospective randomised controlled non-inferiority study. SETTING: Microbiology department of a large teaching hospital in Lancashire, UK. PARTICIPANTS: Two members of the medical microbiology team carried out the duty work on any given week day and an on-call team member on any weekend day. 29 days were assigned in which staff were to say "Today will be a quiet day" and 32 days were assigned in which staff were to refrain from saying the word "quiet" in any context. INTERVENTIONS: Each day was randomly allocated to either saying "Today will be a quiet day" (intervention group) or refraining from saying the word "quiet" (control group) in any context. MAIN OUTCOME MEASURES: The primary outcome was mean overall workload: a composite of number of clinically related telephone calls, clinically significant results, or validated results processed by the duty medical microbiology team during a 24 hour period referred to collectively as "clinical episodes." A difference of 30 clinical episodes was considered as the margin of non-inferiority. Secondary outcomes included the individual components of the primary outcome. RESULTS: Workload was measured each day over a 61 day period (1 May to 30 June 2019). A mean 139.0 clinical episodes occurred on control days compared with 144.9 on days when the experimental intervention was uttered, a difference of 5.9 (95% confidence interval-12.9 to 24.7). The upper bound was less than the specified margin of 30, providing evidence for non-inferiority. No evidence of a difference in workload was found between interventions with any of the four components, whether considering unadjusted or adjusted analyses, or looking at the subgroups of week days or weekends. CONCLUSIONS: The study findings refute the long held superstition that utterance of the word "quiet" impacts on clinical workload, and therefore it should not be avoided. In the era of considerable staff shortages and increased work related stress, doctors should look to other methods to increase resilience and protect their wellbeing and mental health. TRIAL REGISTRATION: Lancashire Teaching Hospitals NHS Foundation Trust's research department SE-259.


Assuntos
Pessoal de Saúde/psicologia , Superstições/psicologia , Carga de Trabalho/psicologia , Local de Trabalho/psicologia , Adaptação Psicológica , Adulto , Feminino , Humanos , Linguagem , Masculino , Estudos Prospectivos
19.
Medicine (Baltimore) ; 98(50): e18352, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852137

RESUMO

Improvement in patient safety culture requires constant attention. This study aimed to identify hospital-level elements related to patient safety culture, such as patient safety management systems, activities and work environments.Two questionnaire surveys were administered to hospitals in Japan in 2015 and 2016. The first survey aimed to determine which hospitals would allow their staff to respond to a questionnaire survey. The second survey aimed to measure the patient safety culture in those hospitals. Patient safety culture was assessed using the Hospital Survey on Patient Safety Culture (HSOPS). The relationship of hospital-level patient safety culture with the aforementioned elements in each hospital was analyzed.The response rate to the first survey was 22% (721/3270), and 40 eligible hospitals were selected from the respondents. The second survey was administered to healthcare workers in those 40 hospitals, and the response rate was 94% (3768/4000). The proportion of respondents who had 7 or more days off each month was related to the scores of 7 composites and the Patient Safety Grade of HSOPS. Both the presence of a mission statement describing patient safety and the proportion of respondents who participated in in-house patient safety workshops at least twice annually were related to the scores of 5 composites and the Patient Safety Grade of HSOPS.Our study suggests that the number of days off each month, the presence of a hospital patient safety mission statement, and the participation rate in in-house patient safety workshops might be key factors in creating a good patient safety culture within each hospital.


Assuntos
Cultura Organizacional , Segurança do Paciente , Recursos Humanos em Hospital/psicologia , Gestão da Segurança , Local de Trabalho/psicologia , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Feminino , Pesquisas sobre Serviços de Saúde , Hospitais , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
20.
Med Lav ; 110(S1): 24-35, 2019 Dec 06.
Artigo em Italiano | MEDLINE | ID: mdl-31846444

RESUMO

INTRODUCTION: The Clinica del Lavoro, the first clinic for occupational diseases of the world, was inaugurated in Milan on 20 March 1910; its first director was Luigi Devoto, who was in charge until 1935. The purpose of this work is to review the activities of industrial hygiene and toxicology carried out at the Clinica del Lavoro under the guidance of Devoto. METHODS: Documents published by the Istituti Clinici di Perfezionamento, a group of clinics of which the Clinica del Lavoro was part, record the birth and organization of this structure and the presence of a laboratory of chemistry; documents by Devoto and other authors were also retrieved to extrapolate specific information on activities of industrial hygiene and toxicology. RESULTS: The Clinica del Lavoro, at the time of its inauguration, included four laboratories: of chemistry, clinical physics, histopathology and bacteriology. The chemistry lab was located on the first floor and was composed of 6 well-lit rooms, modernly equipped with work benches that could accommodate 12 people. In Devoto's view, the chemistry laboratory, supported by that of clinical physics, had to assess the toxicological properties of chemicals commonly found in the workplace and to reveal the mechanisms of induction of damage to humans. In the first 30 years of activity, the Clinica del Lavoro investigated various diseases deriving from exposure to chemical agents, including saturnism, or lead intoxication, mercurialism, phosphorism, benzolism, sulfocarbonism, dust diseases. Several assays were developed and applied to measure toxicants in different biological and environmental mean as evidenced by scientific publications starting from 1920. CONCLUSION: In Devoto's view, industrial hygiene and toxicology were essential tools for the research and prevention of occupational diseases since the first years of activity of the Clinica del Lavoro.


Assuntos
Intoxicação por Chumbo , Doenças Profissionais , Saúde do Trabalhador , Medicina do Trabalho , História do Século XX , Humanos , Itália , Saúde do Trabalhador/história , Medicina do Trabalho/história , Local de Trabalho
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