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1.
Rev Esp Salud Publica ; 932019 Aug 01.
Artigo em Espanhol | MEDLINE | ID: mdl-31363078

RESUMO

BACKGROUND: Emergency services are specialized in population's severe illness care. However, the increasing trend of chronic patients which in some cases require of palliative care, has lead to a higher influx of this type of patients in emergency services, thus growing the rate of deaths consequently. How is this fact perceived by the health professionals and which strategies they count on to face patients' death? The aim of this work was to deeply review the perception and the strategies to face patients' death in the end-of-life (EOL) at emergency services. METHODS: Systematic review of qualitative studies was made according to PRISMA statements. Research was performed in the following bibliographic databases: Pubmed, Web of Science, Scopus, EMBASE, CINAHL, VHL Regional portal, Cuiden, COCHRANE LIBRARY and JBI. Inclusion criteria were as follows: Physicians and Nurses with at least one year of working experience as health professionals, Pediatric care excluded. Methodological quality, data extraction and its inclusion process was made in agreement with the tools described in JBI. RESULTS: The extracted findings were structured and added in 4 thematic categories: 1) Priority of professional attention according to the causes and origin of patient's death; 2) Environmental barriers in the department hindering attention at the EOL; 3) professionals' emotions dealing with patients' death; 4) Professional strategies dealing with patient' death. CONCLUSIONS: Health care professionals (Physicians and nurses) face more efficiently patients' death when is caused by a critic disease than when is caused by chronic/palliative diseases. Environment and the lack of training have been identified as factors that difficult end-of-life attention in emergency services.


Assuntos
Atitude do Pessoal de Saúde , Medicina de Emergência/organização & administração , Serviço Hospitalar de Emergência , Pessoal de Saúde , Assistência Terminal/organização & administração , Atenção , Serviços Médicos de Emergência , Humanos , Enfermeiras e Enfermeiros , Médicos , Pesquisa Qualitativa
4.
West J Emerg Med ; 20(2): 386-392, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30881562

RESUMO

Introduction: Patients with substance use disorders (SUDs) frequently seek emergency care, and the emergency department (ED) may be their only point of contact with the healthcare system. While the ED visit has been increasingly recognized as providing opportunity for interventions around substance use, many questions remain. Methods: In December 2016 the Coalition on Psychiatric Emergencies (CPE) convened the first Research Consensus Conference on Acute Mental Illness, which consisted of clinical researchers, clinicians from emergency medicine, emergency psychiatry, emergency psychology, representatives from governmental agencies and patient advocacy groups. Background literature review was conducted prior to the meeting, and questions were iteratively focused, revised, voted on and ranked by perceived importance using nominal group method. Results: The main goal of the SUD workgroup was to identify research priorities and develop a research agenda to improve the early identification of and management of emergency department (ED) patients with SUDs with the goal of improving outcomes. This article is the product of a breakout session on "Special Populations: Substance Use Disorder." The workgroup identified with high consensus six research priorities for their importance related to the care of ED patients with SUDs in these overall domains: screening; ED interventions; the role of peer navigators; initiation of SUD management in the ED; specific patient populations that may impact the effectiveness of interventions including sociogenerational and cultural factors; and the management of the acutely intoxicated patient. Conclusion: Emergency providers are increasingly recognizing the important role of the ED in reducing adverse outcomes associated with untreated SUDs. Additional research is required to close identified knowledge gaps and improve care of ED patients with SUD.


Assuntos
Consenso , Medicina de Emergência/organização & administração , Serviço Hospitalar de Emergência/organização & administração , Pesquisa sobre Serviços de Saúde , Transtornos Relacionados ao Uso de Substâncias/terapia , Educação , Feminino , Humanos , Masculino , Transtornos Relacionados ao Uso de Substâncias/diagnóstico
5.
West J Emerg Med ; 20(2): 403-408, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30881564

RESUMO

Introduction: Emergency departments (ED) manage a wide variety of critical medical presentations. Traumatic, neurologic, and cardiac crises are among the most prevalent types of emergencies treated in an ED setting. The high volume of presentations has led to collaborative partnerships in research and process development between experts in emergency medicine (EM) and other disciplines. While psychosis is a medical emergency frequently treated in the ED, there remains a paucity of evidence-based literature highlighting best practices for management of psychotic presentations in the ED. In the absence of collaborative research, development of best practice guidelines cannot begin. A working group convened to develop a set of high-priority research questions to address the knowledge gaps in the care of psychotic patients in the ED. This article is the product of a subgroup considering "Special Populations: Psychotic Spectrum Disorders," from the 2016 Coalition on Psychiatric Emergencies first Research Consensus Conference on Acute Mental Illness. Methods: Participants were identified with expertise in psychosis from EM, emergency psychiatry, emergency psychology, clinical research, governmental agencies, and patient advocacy groups. Background literature reviews were performed prior to the in-person meeting. A nominal group technique was employed to develop group consensus on the highest priority research gaps. Following the nominal group technique, input was solicited from all participants during the meeting, questions were iteratively focused and revised, voted on, and then ranked by importance. Results: The group developed 28 separate questions. After clarification and voting, the group identified six high-priority research areas. These questions signify the perceived gaps in psychosis research in emergency settings. Questions were further grouped into two topic areas: screening and identification; and intervention and management strategies. Conclusion: While psychosis has become a more common presentation in the ED, standardized screening, intervention, and outcome measurement for psychosis has not moved beyond attention to agitation management. As improved outpatient-intervention protocols are developed for treatment of psychosis, it is imperative that parallel protocols are developed for delivery in the ED setting.


Assuntos
Medicina de Emergência/organização & administração , Serviço Hospitalar de Emergência/organização & administração , Transtornos Psicóticos/diagnóstico , Consenso , Pesquisa sobre Serviços de Saúde , Humanos , Programas de Rastreamento
6.
Artigo em Inglês | MEDLINE | ID: mdl-30832448

RESUMO

In October 2018, at Asia Pacific Conference for Disaster Medicine (APCDM), an expert meeting to identify key research needs was organized by the World Health Organization (WHO) Centre for Health Development (WHO Kobe Centre (WKC)), convening the leading experts from Asia Pacific region, WHO, WHO Thematic Platform for Health Emergency and Disaster Risk Management (Health-EDRM) Research Network (TPRN), World Association for Disaster and Emergency Medicine (WADEM), in collaboration with Asia Pacific Conference for Disaster Medicine (APCDM) and Japan International Cooperation Agency (JICA). International experts, who were pre-informed about the meeting, contributed experience-based priority issues in Health-EDRM research, ethics, and scientific publication. Two moderators, experienced in multi-disciplinary research interacted with discussants to transcribe practical issues into related methodological and ethical issues. Each issue was addressed in order to progress research and scientific evidence in Health-EDRM. Further analysis of interactive dialogues revealed priorities for action, proposed mechanism to address these and identified recommendations. Thematic discussion uncovered five priority areas: (1) the need to harmonize Health-EDRM research with universal terms and, definitions via a glossary; (2) mechanisms to facilitate and speed up ethical review process; (3) increased community participation and stakeholder involvement in generating research ideas and in assessing impact evaluation; (4) development of reference materials such as possible consensus statements; and (5) the urgent need for a research methods resource textbook for Health-EDRM addressing these issues.


Assuntos
Medicina de Desastres/normas , Planejamento em Desastres/normas , Medicina de Emergência/normas , Projetos de Pesquisa/normas , Medicina de Desastres/ética , Medicina de Desastres/organização & administração , Planejamento em Desastres/organização & administração , Medicina de Emergência/ética , Medicina de Emergência/organização & administração , Guias como Assunto , Humanos , Agências Internacionais/organização & administração , Cooperação Internacional , Japão , Organização Mundial da Saúde/organização & administração
7.
J Health Organ Manag ; 33(1): 93-109, 2019 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-30859915

RESUMO

PURPOSE: The purpose of this paper is to describe the structure and impact of a Queensland Research Support Network (RSN) in emergency medicine (EM). DESIGN/METHODOLOGY/APPROACH: This paper presents a descriptive summary of EM networks, network evaluations and the structure and development of the Emergency Medicine Foundation's (EMF) RSN in Queensland, including an observational pre- and post-study of research metrics. FINDINGS: In two years, the RSN supported 33 Queensland emergency departments (EDs), of which 14 developed research strategies. There was an increase in research active clinicians, from 23 in 2015 to 181 in 2017. Collaborator engagement increased from 9 in 2015 to 276 in 2017 as did the number of research presentations, from 6 in 2015 to 61 in 2017. EMF experienced a growth in new researchers, with new investigators submitting approximately 60 per cent of grant applications in 2016 and 2017. EMF also received new applications from a further three HHS (taking EMF-funded research activity from 8 to 11 HHS). RESEARCH LIMITATIONS/IMPLICATIONS: This paper describes changes in KPIs and research metrics, which the authors attribute to the establishment of the RSN. However, it is possible that attribution bias plays a role in the KPI improvements. SOCIAL IMPLICATIONS: This network has actively boosted and expanded EM research capacity and capability in Queensland. It provides services, in the form of on-the-ground managers, to develop novice clinician-researchers, new projects and engage entire EDs. This model may be replicated nationwide but requires funding commitment. ORIGINALITY/VALUE: The RSN improves front-line clinician research capacity and capability and increases research activity and collaborations with clear community outcomes. Collaborations were extended to community, primary health networks, non-government organisations, national and international researchers and academic institutions. Evaluating and measuring a network's benefits are difficult, but it is likely that evaluations will help networks obtain funding.


Assuntos
Pesquisa Biomédica/organização & administração , Fortalecimento Institucional , Medicina de Emergência/organização & administração , Comportamento Cooperativo , Pesquisa sobre Serviços de Saúde , Humanos , Organizações , Queensland
8.
Crit Care Med ; 47(4): e286-e291, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30855331

RESUMO

OBJECTIVES: Critical care medicine is a medical specialty where women remain underrepresented relative to men. The purpose of this study was to explore perceived drivers (i.e., influencing factors) and implications (i.e., associated consequences) of gender inequity in critical care medicine and determine strategies to attract and retain women. DESIGN: Qualitative interview-based study. SETTING: We recruited participants from the 13 Canadian Universities with adult critical care medicine training programs. PARTICIPANTS: We invited all faculty members (clinical and academic) and trainees to participate in a semistructured telephone interview and purposely aimed to recruit two faculty members (one woman and one man) and one trainee from each site. Interviews were transcribed verbatim, and two investigators conducted thematic analysis. INTERVENTIONS: Not applicable. MEASUREMENTS AND MAIN RESULTS: Three-hundred seventy-one faculty members (20% women, 80% men) and 105 trainees (28% women, 72% men) were invited to participate, 48 participants were required to achieve saturation. Participants unanimously described critical care medicine as a specialty practiced predominantly by men. Most women described experiences of being personally or professionally impacted by gender inequity in their group. Postulated drivers of the gender gap included institutional and interpersonal factors. Mentorship programs that span institutions, targeted policies to support family planning, and opportunities for modified role descriptions were common strategies suggested to attract and retain women. CONCLUSIONS: Participants identified a gender gap in critical care medicine and provided important insight into the impact for personal, professional, and group dynamics. Recommended improvement strategies are feasible, map broadly onto reported drivers and implications, and are applicable to critical care medicine and more broadly throughout medical specialties.


Assuntos
Escolha da Profissão , Medicina de Emergência/organização & administração , Médicas/organização & administração , Recursos Humanos/organização & administração , Adulto , Canadá , Cuidados Críticos/organização & administração , Feminino , Humanos , Liderança , Masculino , Pesquisa Qualitativa , Fatores Sexuais , Sexismo/estatística & dados numéricos
9.
Am J Health Syst Pharm ; 76(Supplement_1): S21-S27, 2019 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-30753314

RESUMO

Purpose: The purpose of this survey-based research project is to identify factors, including prior training, institution demographics, and pharmacist prioritization of services that may impact variability in practice among emergency medicine (EM) pharmacists. Methods: An electronic survey was available for 6 weeks. Participants were contacted through professional membership directories. Survey questions addressed EM pharmacist training and institution demographics. Pharmacists were asked to define the frequency with which they performed ASHP-identified best practice services. Results: Responses were received by 208 pharmacists (response rate = 9.4%) who were primarily from academic (48.1%) or community (47.6%) emergency departments (EDs). Pharmacists working in an academic ED were more likely to have EM postgraduate year 2 training (27.8%) compared to a community ED (11.2%) (p = 0.0182). Pharmacists practicing in an academic emergency department (ED) reported participating in traumas, care for boarded patients, and performing scholarly activities more frequently (p < 0.01) and medication reconciliations less frequently (p < 0.01) than those in a community ED. Most EM pharmacists reported postgraduate year 1 training (45.7%) as compared to postgraduate year 2 EM (18.3%) or critical care (13.7%) pharmacy residency training. Conclusion: Institution and ED demographics as well as pharmacist level of training can affect the frequency of services provided in the ED setting.


Assuntos
Serviços Médicos de Emergência/organização & administração , Medicina de Emergência , Farmacêuticos , Educação em Farmácia , Medicina de Emergência/educação , Medicina de Emergência/métodos , Medicina de Emergência/organização & administração , Prioridades em Saúde , Humanos , Farmacêuticos/organização & administração , Inquéritos e Questionários
12.
Acad Emerg Med ; 26(3): 303-316, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30667132

RESUMO

OBJECTIVES: Organizations to promote career networking and mentorship among women are recommended as a best practice to support the recruitment and retention of women physicians; however, the impact of such organizations is unknown. Our primary objective is to describe the impact of a national woman-focused organization for academic emergency physicians on retention and advancement. METHODS: We conducted semistructured interviews of past and present organization leaders, as well as members at varying stages in their careers. Physicians with experience in qualitative methods conducted interviews and coded all transcripts using inductive content analysis techniques. Themes were reviewed and discussed to ensure consensus. RESULTS: We performed 17 interviews lasting 20 to 30 minutes each, resulting in 476 total minutes of transcript. Participants represented varying stages of career experience, ranging from 2 to 35 years since residency completion (median = 9.5 years). Median years of participation in the woman-focused organization was 10 years. Over half (53%) of participants were past presidents of the organization. The dominant themes encompassed facilitating academic advancement through scholarly productivity, leadership experiences, awards, and promotions; mentorship and sponsorship; peer support and collaborations; reduced professional isolation; and initiatives to address systemic gender inequities and challenges, including strategies to navigate bias, promote pay equity, and advocate for family-friendly workplace policies. DISCUSSION: Active participation in a woman-focused professional organization enhances members' career retention and advancement by creating opportunities and relationships that facilitate leadership, enabling scholarly work to advance equity and inclusion, and cultivating a sense of belonging. While challenges and barriers persist, the myriad benefits of a women-focused professional organization reported by members and leaders represent important steps toward greater equity for women and other underrepresented groups in academic medicine.


Assuntos
Medicina de Emergência/organização & administração , Liderança , Médicas/organização & administração , Sociedades Médicas/organização & administração , Mobilidade Ocupacional , Docentes de Medicina/organização & administração , Feminino , Humanos , Mentores , Pesquisa Qualitativa
13.
Acad Emerg Med ; 26(3): 286-292, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30664286

RESUMO

OBJECTIVES: The objective was to identify the effects of gender and other predictors of change in the salary of academic emergency physicians over a four sequential time period of survey administration, across a sample of physicians within different emergency departments (EDs) and within states representing the four main geographical regions of the United States. METHODS: This was a successive cross-sectional observational study of EDs in the United States using an annual salary survey distributed to all Association of Academic Chairs in Emergency Medicine (AACEM) and Academy of Administrators in Academic Emergency Medicine (AAAEM) members in 2013, 2015, 2016, and 2017 with a sample size of 7,102 respondents over all time periods. The primary variable of interest was the adjusted base salary, calculated to be the full-time effort of the physician without any enhancements (e.g., without stipend, release time, extra hours). Institutional predictive variables included U.S. region that ED was in and if the site was an academic or community academic hybrid ("community") ED. Individual level variables included gender, academic rank, years at academic rank, years at rank within the ED, and primary duty (clinical or other). A series of Wilcoxon tests were conducted to determine if the unadjusted difference in salaries by gender for each year of the survey were significantly different. The effects of relative change in adjusted base salary over time were assessed using a mixed-effects regression model, with institutional- and individual-level predictors included in the model. RESULTS: Data were provided by 81 departments across the four geographic regions of the United States (Northeast, South, West, and Midwest). Most of the survey respondents across the four time periods of administration were male (65%) and reported primary clinical appointments at an academic ED (94%). Overall salaries increased across the four time points of the data with an overall relative 10.8% (95% confidence interval [CI] = 9.6%-12%) change in median salary between 2013 and 2017; the relative percentage change for female respondents was 10.6% (95% CI = 9.4%-11.85%) and 11.1% (95% CI = 10.2%-12%) for males. Within survey years, not adjusting for academic rank, the median salary increase for males was higher ($226,746 in 2013 to $252,000 in 2017) than females ($217,000 in 2013 to $240,000 in 2017), with significance at all four time points (Z = 6.33, p < 0.001), with a median average salary gap of $12,000 in 2017. In the predictive model that adjusted for covariates, gender significantly predicted median adjusted salary, with males earning significantly more than females (F(1) = 22.5, p < 0.001). CONCLUSIONS: Despite previously published data showing an inappropriate gender salary gap in emergency medicine, this gap has remained essentially unchanged over the past 4 years.


Assuntos
Medicina de Emergência/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Docentes de Medicina/estatística & dados numéricos , Salários e Benefícios/estatística & dados numéricos , Estudos Transversais , Medicina de Emergência/organização & administração , Serviço Hospitalar de Emergência/organização & administração , Feminino , Humanos , Masculino , Distribuição por Sexo , Inquéritos e Questionários , Estados Unidos
14.
West J Emerg Med ; 20(1): 98-99, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30643609

RESUMO

Gender disparities exist in academic emergency medicine (EM). We developed and implemented a female EM physician group - Women in Academic Emergency Medicine (WAM) - to support female EM residents, fellows, and faculty. The goal of WAM is to provide a support system through mentorship, education, and outreach. A targeted needs assessment was completed to identify goals and objectives specific to our department. In the first full year of implementation, WAM hosted eight events, including three topical dinners and one formal panel. Of 42 female faculty and residents, 40 (95%) attended at least one WAM event, and all (20/20) of the female faculty strongly supported WAM. WAM advocated for increased female physician representation on the department's Physician Executive Leadership Group and preservation of dedicated lactation space in the emergency department. Using a needs assessment, the process of developing WAM can be replicated in any department to create a female physician group.


Assuntos
Medicina de Emergência/organização & administração , Determinação de Necessidades de Cuidados de Saúde , Médicas , Docentes de Medicina , Feminino , Humanos , Internato e Residência
15.
Am J Emerg Med ; 37(4): 744-745, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30527916

RESUMO

Despite the fact that emergency care can impact health of populations, the global epidemiology of emergencies in children and adults is unknown and substantial variation exists in emergency infrastructure among different nations, especially among the low and middle income countries. Various research networks which are etiology specific or subspecialty specific, including emergency care based networks have positively impacted the health of populations. However, emergency departments (ED) in low and middle income counties are underrepresented in most international networks. Creation of a global ED based research network will help generate generalizable evidence that can then be translated into locally relevant evidence-based guidelines, nurture future researchers in emergency medicine, standardize training/education and improve patient outcomes by reducing variation in clinical care.


Assuntos
Serviços Médicos de Emergência/organização & administração , Medicina de Emergência/organização & administração , Pesquisa sobre Serviços de Saúde/organização & administração , Países em Desenvolvimento , Serviços Médicos de Emergência/normas , Medicina de Emergência/normas , Serviço Hospitalar de Emergência , Humanos , Objetivos Organizacionais
17.
Eur J Emerg Med ; 26(4): 295-300, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29958243

RESUMO

INTRODUCTION: Twenty-one new Danish emergency departments (EDs) were established following a 2007 policy reform that included ED autonomy to self-organize. The aim of this study was to describe the organization of the 21 departments and their organizational challenges. PARTICIPANTS AND METHODS: We used a qualitative design based on COREQ guidelines. All 21 EDs participated, and 123 semi-structured interviews with hospital and ED leaders, physicians, nurses, and secretaries were performed between 2013 and 2015. We used the framework matrix method to investigate the ED goals, setting, structure, staff, task coordination, and incentive structure. RESULTS: We identified three generic models (virtual, hybrid, and independent). All had goals of high quality of care and high efficiency. The virtual model was staffed by junior physicians and tasks were coordinated by other departments. The hybrid model was staffed by junior physicians and senior physicians according to other departments and the ED. The ED coordinated all activities. The independent model was staffed by junior physicians and senior physicians, and activities were coordinated by the ED. Of the EDs, 19 utilized different organizational models at different times during a 24-h period and on weekdays and weekends. The main challenge of the virtual and hybrid models was high dependency on other departments. The main challenge of the independent model was establishing a high level of quality of emergency medicine. DISCUSSION AND CONCLUSION: We identified three organizational ED models (virtual, hybrid, and independent). Nineteen EDs used more than one organizational model depending on the time of day or day of the week.


Assuntos
Medicina de Emergência/organização & administração , Serviço Hospitalar de Emergência/organização & administração , Política de Saúde/legislação & jurisprudência , Equipe de Assistência ao Paciente/organização & administração , Qualidade da Assistência à Saúde , Dinamarca , Feminino , Humanos , Entrevistas como Assunto , Masculino , Modelos Organizacionais , Inovação Organizacional , Formulação de Políticas , Pesquisa Qualitativa
18.
Eur J Emerg Med ; 26(3): 168-173, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29240569

RESUMO

OBJECTIVES: Paediatric patients receive less procedural sedation and analgesia (PSA) in the emergency department compared with adults, especially in countries where emergency medicine is at an early stage of development. The objectives of this study were to evaluate the adverse events and efficacy of paediatric PSA in a country with a recent establishment of emergency medicine and to describe which factors aided implementation. METHODS: This is a prospective, multicentre, observational study of paediatric patients undergoing PSA by the first trained emergency physicians (EPs) in The Netherlands. A standardized data collection form was used at all participating hospitals to collect data on adverse events, amnesia, pain scores, and procedure completion. A survey was used to interpret which factors had aided PSA implementation. RESULTS: We recorded 351 paediatric PSA. The mean age was 9.5 years (95% confidence interval: 9.1-10.0). Esketamine was most frequently used (42.4%), followed by propofol (34.7%). The adverse event rate was low (3.0%). Amnesia was present in 86.8%. The median pain score was 2 (out of 10) for patients without amnesia. Procedures were successfully completed in 93.9% of the cases. CONCLUSION: Paediatric PSA provided by the first EPs in The Netherlands showed appropriate levels of sedation and analgesia with a high rate of procedure completion and a low rate of adverse events. Our paper suggests that EPs provided with a proper infrastructure of mentorship, training and guidelines can implement effective paediatric PSA.


Assuntos
Analgesia/métodos , Sedação Consciente/métodos , Serviço Hospitalar de Emergência/organização & administração , Manejo da Dor/métodos , Adolescente , Criança , Pré-Escolar , Intervalos de Confiança , Medicina de Emergência/organização & administração , Feminino , Humanos , Masculino , Países Baixos , Pediatria/métodos , Padrões de Prática Médica , Propofol/uso terapêutico , Estudos Prospectivos , Medição de Risco , Resultado do Tratamento
19.
Anaesthesist ; 67(12): 895-900, 2018 12.
Artigo em Alemão | MEDLINE | ID: mdl-30511109

RESUMO

At the 121st German Physicians Conference 2018 in Erfurt a resolution to accept the full amendment of the (draft) further training regulations (MWBO) was adopted and the State Medical Councils were requested to include them in their respective areas of responsibility. Therefore, the nationwide implementation of the supraspeciality (ZWB) for clinical acute and emergency medicine has been officially finalized. After consultation with the German Medical Council (BÄK) concerning the format, both the new MWBO 2018 and now the content of the ZWB are available as of 15 November 2018.The Physicians Conference resolution and anchoring of the new ZWB clinical acute and emergency medicine in the MWBO were preceded by a process lasting approximately 10 years. The concept of the ZWB clinical acute and emergency medicine, which was scrutinized by the Standing Committee on "medical further training" and the board of the BÄK and presented for approval, was essentially developed by representatives of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI) and the German Society for Interdisciplinary Emergency and Acute Medicine (DGINA) in consultation with the BÄK. A consensus was finally reached in September 2017 in cooperation with those German specialist societies with a high proportion of emergency patients.In addition to the title, definition, and minimum requirements for applying the ZWB, the content was processed according to the European curriculum for emergency medicine. The structural prerequisites have now been approved, the Standing Committee has configured the content, and the complete MWBO 2018 has been successfully presented, such that the ZWB clinical acute and emergency medicine is expected to be implemented in the individual Federal States within the next 1-2 years.This article describes the history and development of ZWB clinical acute and emergency medicine in Germany and outlines future perspectives.


Assuntos
Medicina de Emergência/educação , Medicina de Emergência/organização & administração , Currículo , Assistência à Saúde , Serviços Médicos de Emergência/organização & administração , Medicina de Emergência/normas , Serviço Hospitalar de Emergência , Alemanha , Humanos
20.
Emergencias (Sant Vicenç dels Horts) ; 30(6): 424-432, dic. 2018. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-179715

RESUMO

Desde hace 15 años, el Área de Urgencias del Hospital Clínic de Barcelona, en colaboración con CAPSBE (su centro de salud adyacente), el Sistema d'Emergències Mèdiques y la Univesitat de Barcelona, viene realizando ininterrumpidamente unas jornadas anuales dirigidas a alumnos de último curso de enseñanza secundaria obligatoria (ESO), de una duración de 4 horas, y en las que se abordan los aspectos organizativos de la atención médica urgente (en atención primaria, prehospitalaria y hospitalaria) en Barcelona, así como los principales motivos de consulta médica urgente en los adolescentes (drogas, accidentes de tráfico, trastornos psiquiátricos y de conducta alimentaria, y urgencias ginecológicas). La actividad se enmarca dentro del desarrollo de una cultura de responsabilidad social corporativa y de transmisión de conocimiento a la comunidad en la que estos centros sanitarios desarrollan su actividad habitual. Las jornadas tienen una finalidad divulgativa y proporcionan claves que puedan generar tanto la reflexión individual del alumnado como el debate conjunto posterior en la escuela. Durante estos 15 años han participado del curso 56 centros de ESO y 10.260 alumnos de entre 15 y 18 años. El objetivo del presente artículo es recoger los aspectos fundamentales de esta actividad, conocer la opinión de los alumnos y profesores de ESO, y analizar si han existido cambios significativos en estas opiniones durante este periodo de tiempo, con la finalidad de que otros servicios de urgencias puedan plantearse la instauración de actividades similares que les permitan una interacción con la comunidad educativa de su entorno


For 15 years without interruption, the emergency department of the Hospital Clínic de Barcelona has been holding annual educational sessions for students in their last year of obligatory secondary school. The sessions are organized in collaboration with 3 other entities: the primary care center affiliated with the hospital and serving the area and adjacent to it (THE CAPSBE), the city's emergency ambulance service, and the University of Barcelona. Each year the session lasts 4 hours and covers such content as the organization of the city's emergency medical care (at primary care centers, in prehospital settings, and at the hospital) and the main reasons adolescents require emergency care (related to drugs, traffic accidents, psychiatric disorders, eating disorders, and gynecologic problems). The project seeks to develop the students' sense of social responsibility and to transfer knowledge to the community where the organizers carry out their usual work. The sessions are educational, providing key information intended to encourage individual reflection as well as debate in the student community outside of school hours. A total of 56 secondary schools and 12 260 students between the ages of 15 and 18 years old have participated thus far. This article presents a basic outline of the sessions, reports feedback from the students and their teachers, and analyzes whether there have been significant changes in their opinions over time. Our purpose is to provide information useful to other emergency health services that might consider starting similar programs in which they can interact with their community schools


Assuntos
Humanos , Masculino , Feminino , Adolescente , Promoção da Saúde/métodos , Educação em Saúde , Medicina de Emergência/organização & administração , Estudantes , Saúde do Adolescente , Prevenção de Doenças
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