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1.
Artigo em Russo | MEDLINE | ID: mdl-33161668

RESUMO

The article, on the basis of experience of development of the Republic's first territorial system of medical quality management, presents basic organizational systemic principles of building quality management of medical activity and organizational model of system functioning. The listing of criteria and indices of assessing effectiveness of territorial system of managing quality and safety of medical activity is presented too. The purpose of developing such a system is formulated. The evidence base for actuality and feasibility of its organization is presented.


Assuntos
Modelos Organizacionais , Qualidade da Assistência à Saúde
2.
BMJ Open ; 10(10): e042392, 2020 10 31.
Artigo em Inglês | MEDLINE | ID: mdl-33130573

RESUMO

OBJECTIVES: The suspension of elective surgery during the COVID-19 pandemic is unprecedented and has resulted in record volumes of patients waiting for operations. Novel approaches that maximise capacity and efficiency of surgical care are urgently required. This study applies Markov multiscale community detection (MMCD), an unsupervised graph-based clustering framework, to identify new surgical care models based on pooled waiting-lists delivered across an expanded network of surgical providers. DESIGN: Retrospective observational study using Hospital Episode Statistics. SETTING: Public and private hospitals providing surgical care to National Health Service (NHS) patients in England. PARTICIPANTS: All adult patients resident in England undergoing NHS-funded planned surgical procedures between 1 April 2017 and 31 March 2018. MAIN OUTCOME MEASURES: The identification of the most common planned surgical procedures in England (high-volume procedures (HVP)) and proportion of low, medium and high-risk patients undergoing each HVP. The mapping of hospitals providing surgical care onto optimised groupings based on patient usage data. RESULTS: A total of 7 811 891 planned operations were identified in 4 284 925 adults during the 1-year period of our study. The 28 most common surgical procedures accounted for a combined 3 907 474 operations (50.0% of the total). 2 412 613 (61.7%) of these most common procedures involved 'low risk' patients. Patients travelled an average of 11.3 km for these procedures. Based on the data, MMCD partitioned England into 45, 16 and 7 mutually exclusive and collectively exhaustive natural surgical communities of increasing coarseness. The coarser partitions into 16 and seven surgical communities were shown to be associated with balanced supply and demand for surgical care within communities. CONCLUSIONS: Pooled waiting-lists for low-risk elective procedures and patients across integrated, expanded natural surgical community networks have the potential to increase efficiency by innovatively flexing existing supply to better match demand.


Assuntos
Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Cadeias de Markov , Modelos Organizacionais , Pandemias , Medicina Estatal/organização & administração , Listas de Espera , Adulto , Betacoronavirus , Redes Comunitárias/organização & administração , Infecções por Coronavirus/epidemiologia , Eficiência Organizacional , Procedimentos Cirúrgicos Eletivos/classificação , Inglaterra/epidemiologia , Acesso aos Serviços de Saúde , Humanos , Colaboração Intersetorial , Pneumonia Viral/epidemiologia , Estudos Retrospectivos , Medição de Risco , Medicina Estatal/estatística & dados numéricos
3.
Int J Biol Sci ; 16(15): 2828-2834, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33061799

RESUMO

During the novel coronavirus disease 2019 (COVID-19) outbreak, traditional face-to-face psychological interventions have been suspended due to high risks of rapid transmission. Developing an effective online model of psychological intervention is deemed necessary to deal with the mental health challenges brought up by this disease. An integrated psychological intervention model coined 'COVID-19 Psychological Resilience Model' was developed in Chengdu, China including live media, 24-hour hotline consultations, online video intervention and on-site crisis intervention sessions to provide services to those in need. A total of 45 episodes of live media programs on COVID-19 outbreak-related psychological problems were broadcasted with over 10 million views. A total of 4,236 hotline consultations were completed. More than 50% of the clients had positive feedback about the hotline consultations. A total of 223 cases received online video intervention, of which 84.97% were redirected from the hotline consultation and 15.03% from COVID-19-designated hospital and community-based observation spots. Seventy one-on-one psychological interventions were conducted with 39 COVID-19 patients, and one-third were treated with medication. Additionally, 5 training sessions were conducted to 98 frontline medical staff. This 'COVID-19 Psychological Resilience Model' is proven effective to the general population during the COVID-19 pandemic. We have greatly improved the overall mental health of our target population during the COVID-19 pandemic. This model could provide valuable experiences and serve as a reference guide for other countries to offer effective psychological intervention, and reduce detrimental negative mental health outcomes in public health emergency.


Assuntos
Infecções por Coronavirus/psicologia , Serviços de Saúde Mental/organização & administração , Pneumonia Viral/psicologia , Resiliência Psicológica , Estresse Psicológico/psicologia , Telemedicina/métodos , Betacoronavirus , China/epidemiologia , Surtos de Doenças , Acesso aos Serviços de Saúde , Linhas Diretas , Humanos , Internet , Modelos Organizacionais , Modelos Psicológicos , Pandemias , Psicoterapia/métodos , Estresse Psicológico/terapia
4.
BMJ Open ; 10(10): e041886, 2020 10 29.
Artigo em Inglês | MEDLINE | ID: mdl-33122327

RESUMO

OBJECTIVES: (1) Understanding the characteristics of online learning experiences of Chinese undergraduate medical students; (2) Investigating students' perceptions of ongoing online education developed in response to COVID-19 and (3) Exploring how prior online learning experiences are associated with students' perceptions. DESIGN: Students' familiarity with online learning modes and corresponding perceived usefulness (PU) according to their previous experiences were investigated using an online survey. The survey also collected data on students' perceptions through their evaluation of and satisfaction with current online learning. SETTING: In response to the educational challenges created by COVID-19, medical schools in China have adopted formal online courses for students. PARTICIPANTS: The questionnaire was sent to 225 329 students, of whom 52.38% (118 080/225 329) replied, with valid data available for 44.18% (99 559/225 329). METHODS: Pearson correlations and t-tests were used to examine the relationship between familiarity and PU. Multiple linear regression and logistic regression analyses were used to determine the impact of prior learning experiences and its interactions with gender, area, learning phase and academic performance on students' perceptions. RESULTS: Students' PU had a significant positive correlation with their familiarity with online learning modes (p<0.01). Students' evaluation of and satisfaction with their current online education were positively associated with their familiarity (ß=0.46, 95% CI 0.45 to 0.48, p<0.01; OR 1.14, 95% CI 1.13 to 1.14, p<0.01) with and PU (ß=3.11, 95% CI 2.92 to 3.30, p<0.01; OR 2.55, 95% CI 2.37 to 2.75, p<0.01) of online learning. Moreover, the higher the students' learning phases, the lower the associations between PU and students' evaluation of and satisfaction with ongoing online education. CONCLUSIONS: Medical students in China have experiences with various online learning modes. Prior learning experiences are positively associated with students' evaluation of and satisfaction with current online education. Higher learning phases, in which clinical practices are crucial, and high academic performance led to lower evaluation and satisfaction scores.


Assuntos
Infecções por Coronavirus , Educação a Distância/métodos , Educação de Graduação em Medicina , Modelos Educacionais , Determinação de Necessidades de Cuidados de Saúde , Pandemias , Pneumonia Viral , Betacoronavirus , China , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Educação de Graduação em Medicina/organização & administração , Educação de Graduação em Medicina/tendências , Feminino , Humanos , Masculino , Modelos Organizacionais , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pesquisa Qualitativa , Percepção Social , Estudantes de Medicina/psicologia , Adulto Jovem
5.
Assist Inferm Ric ; 39(3): 118-121, 2020.
Artigo em Italiano | MEDLINE | ID: mdl-33077980

RESUMO

. Care path for non-deferred elective hospitalizations in cardiology in the Covid-19 period. INTRODUCTION: The novel coronavirus-19 (Covid-19) has rapidly resulted in a global pandemic. Our hospital had to postpone all elective admissions to increase capacity for COVID-19 patients. Therefore, a rearrangement of the elective admissions was necessary to guarantee a restart of ordinary procedures. AIM: To describe the organizational model adopted for elective procedures during the Covid-19 pandemic, to guarantee maximum safety for patients and healthcare workers. METHODS: Patients on waiting list for cardiac procedures were rearranged based on risks prioritization. Procedure of coronary angiography and cardiac devices (PM and ICD) implants or replacement took priority upon other cardiac procedures. Each patient underwent a telephone nurse triage to assess for any covid-19 symptoms. The hospital admissions were organized in accordance with health and safety measures declared by the National Institute of Health, with different paths according to the swab results. RESULTS: A total of 66 patients were contacted and 40 accepted the hospital admission (26 refused it, for fear of infection or covid-19 related family problems). No patient resulted positive to the nasal swab. CONCLUSIONS: In view of the impact on the health care system of this new pandemic, the choice of an appropriate pathway which can preserve patients' safety is essential, while guaranteeing the treatment of problems, such as cardiovascular diseases, with a high mortality rate.


Assuntos
Infecções por Coronavirus/epidemiologia , Hospitalização/estatística & dados numéricos , Admissão do Paciente/estatística & dados numéricos , Planejamento de Assistência ao Paciente , Pneumonia Viral/epidemiologia , Cardiologia/estatística & dados numéricos , Hospitais , Humanos , Modelos Organizacionais , Pandemias , Listas de Espera
6.
J Nurs Adm ; 50(11): 565-570, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33074956

RESUMO

OBJECTIVE: The aim of this study was to analyze perceptions and experiences of clinicians implementing the patient-centered medical home (PCMH). BACKGROUND: The PCMH model focuses on several important concepts, including team-based care management as well as care coordination and continuity among providers and across settings of care. METHODS: A qualitative analysis of data collected in 2016 from primary care personnel through a national survey was conducted. RESULTS: Four themes were found consistent with care management and care coordination: the importance of teamwork and optimized team member roles, need for adequate prioritization of care management and care coordination, need to refine tools and resources supporting care management and care coordination, and challenges with managing and coordinating care with and across complex systems. CONCLUSIONS: Successful implementation requires adequate support for teamwork and ensuring team members can work according to their clinical competency. Nurses practicing in expanded roles need clear role guidelines and adequate time to function in these roles.


Assuntos
Continuidade da Assistência ao Paciente , Assistência Centrada no Paciente , Atenção Primária à Saúde/organização & administração , Competência Clínica , Humanos , Modelos Organizacionais , Equipe de Assistência ao Paciente , Pesquisa Qualitativa
7.
AIDS ; 34(12): 1761-1763, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32889851

RESUMO

: As coronavirus disease 2019 (Covid-19) restrictions upend the community bonds that have enabled African communities to thrive in the face of numerous challenges, it is vital that the gains made in community-based healthcare are preserved by adapting our approaches. Instead of reversing the many gains made through locally driven development partnerships with international funding agencies for other viral diseases like HIV, we must use this opportunity to adapt the many lessons learned to address the burden of Covid-19. Programs like the Academic Model Providing Access to Healthcare are currently leveraging widely available technologies in Africa to prevent patients from experiencing significant interruptions in care as the healthcare system adjusts to the challenges presented by Covid-19. These approaches are designed to preserve social contact while incorporating physical distancing. The gains and successes made through approaches like group-based medical care must not only continue but can help expand upon the extraordinary success of programs like President's Emergency Plan for AIDS Relief.


Assuntos
Infecções por Coronavirus/prevenção & controle , Assistência à Saúde/organização & administração , Modelos Organizacionais , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Síndrome de Imunodeficiência Adquirida/prevenção & controle , África , Infecções por Coronavirus/epidemiologia , Governo Federal , Infecções por HIV/prevenção & controle , Humanos , Cooperação Internacional , Pneumonia Viral/epidemiologia
9.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 32(8): 897-899, 2020 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-32912400

RESUMO

Traditional Chinese medicine (TCM) has a long history in treating infectious diseases, and the form of intervention varies with different medical conditions and disease types. "The battle field of Chinese doctor for anti-epidemic" was formed in fighting against severe acute respiratory syndrome (SARS) epidemics in China, and from the battle, valuable experiences of using TCM for prevention and treatment had been obtained. During responding to coronavirus disease 2019 (COVID-19) epidemics, we followed the principle of keeping summary and perfection while treament. And a whole process of TCM pattern or a model was organized, including early prevention in communities, cluster intervention in isolated places, comprehensive intervention in mobile cabin hospitals, centralized treatment in designated hospitals and rehabilitation support in rehabilitation posts. Thus, the innovation of whole process of TCM intervention was involved in the "trench warfare" strategy and platform system for prevention and treatment of new infectious COVID-19 epidemics. At different stages or conditions, different TCMs were used to play advantageous roles to solve various problems and elevate the effects of prevention and treatment of the disease. The construction of TCM mobile cabin hospitals was an innovation of organization form that might offset the constraints in technology and scale of simple community isolation or simple hospital treatment, exploring a new way for TCM to cope with public health emergencies.


Assuntos
Infecções por Coronavirus/prevenção & controle , Epidemias , Medicina Tradicional Chinesa , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Humanos , Modelos Organizacionais , Pneumonia Viral/epidemiologia
11.
Heart ; 106(20): 1549-1554, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32868279

RESUMO

The established processes for ensuring safe outpatient surveillance of patients with known heart valve disease (HVD), echocardiography for patients referred with new murmurs and timely delivery of surgical or transcatheter treatment for patients with severe disease have all been significantly impacted by the novel coronavirus pandemic. This has created a large backlog of work and upstaging of disease with consequent increases in risk and cost of treatment and potential for worse long-term outcomes. As countries emerge from lockdown but with COVID-19 endemic in society, precautions remain that restrict 'normal' practice. In this article, we propose a methodology for restructuring services for patients with HVD and provide recommendations pertaining to frequency of follow-up and use of echocardiography at present. It will be almost impossible to practice exactly as we did prior to the pandemic; thus, it is essential to prioritise patients with the greatest clinical need, such as those with symptomatic severe HVD. Local procedural waiting times will need to be considered, in addition to usual clinical characteristics in determining whether patients requiring intervention would be better suited having surgical or transcatheter treatment. We present guidance on the identification of stable patients with HVD that could have follow-up deferred safely and suggest certain patients that could be discharged from follow-up if waiting lists are triaged with appropriate clinical input. Finally, we propose that novel models of working enforced by the pandemic-such as increased use of virtual clinics-should be further developed and evaluated.


Assuntos
Assistência Ambulatorial/tendências , Infecções por Coronavirus , Doenças das Valvas Cardíacas , Pandemias , Pneumonia Viral , Triagem , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Doenças das Valvas Cardíacas/epidemiologia , Doenças das Valvas Cardíacas/terapia , Humanos , Modelos Organizacionais , Inovação Organizacional , Pacientes Ambulatoriais , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Triagem/métodos , Triagem/organização & administração
12.
J Prim Health Care ; 12(3): 193-194, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32988439

RESUMO

COVID-19 pandemic highlighted the importance of public, universal and equal access health-care, and reminded us that challenges are always incumbent for health-care systems. Because accessible and universal health-care systems will be critical into the future, it will be crucial to earmark adequate resources, fostering the financing of sectors that for many years have been neglected such as primary care and public health, and investments in new models of care and in health-related workforce.


Assuntos
Infecções por Coronavirus/epidemiologia , Acesso aos Serviços de Saúde/organização & administração , Pneumonia Viral/epidemiologia , Atenção Primária à Saúde/organização & administração , Cobertura Universal do Seguro de Saúde/organização & administração , Betacoronavirus , Mudança Climática , Humanos , Itália/epidemiologia , Modelos Organizacionais , Pandemias
13.
J Cardiovasc Med (Hagerstown) ; 21(9): 654-659, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32740498

RESUMO

OBJECTIVE: By the end of February 2020, the COVID-19 pandemic infection had spread in Northern Italy, with thousands of patients infected. In Lombardy, the most affected area, the majority of public and private hospitals were dedicated to caring for COVID-19 patients and were organized following the 'Hub-and-Spoke' model for other medical specialties, like cardiac surgery and interventional procedures for congenital cardiac disease (CHD). Here, we report how the congenital cardiac care system was modified in Lombardy and the first results of this organization. METHODS: We describe a modified 'Hub-and-Spoke' model - that involves 59 birthplaces and three specialized Congenital Cardiac Centers -- and how the hub center organized his activity. We also reported the data of the consecutive cases hospitalized during this period. RESULTS: From 9 March to 15 April, we performed: a total of 21 cardiac surgeries, 4 diagnostic catheterizations, 3 CT scans, and 2 CMR. In three cases with prenatal diagnosis, the birth was scheduled. The spoke centers referred to our center six congenital cardiac cases. The postop ExtraCorporeal Membrane Oxygenation support was required in two cases; one case died. None of these patients nor their parents or accompanying person was found to be COVID-19-positive; 2 pediatric intensivists were found to be COVID-19-positive, and needed hospitalization without mechanical ventilation; 13 nurses had positive COVID swabs (4 with symptoms), and were managed and isolated at home. CONCLUSION: Our preliminary data suggest that the model adopted met the immediate needs with a good outcome without increased mortality, nor COVID-19 exposure for the patients who underwent procedures.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Serviço Hospitalar de Cardiologia , Infecções por Coronavirus , Cardiopatias Congênitas , Controle de Infecções , Pandemias , Assistência Perinatal , Pneumonia Viral , Betacoronavirus/isolamento & purificação , Procedimentos Cirúrgicos Cardíacos/métodos , Procedimentos Cirúrgicos Cardíacos/estatística & dados numéricos , Serviço Hospitalar de Cardiologia/organização & administração , Serviço Hospitalar de Cardiologia/tendências , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Feminino , Cardiopatias Congênitas/epidemiologia , Cardiopatias Congênitas/cirurgia , Humanos , Recém-Nascido , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Itália/epidemiologia , Masculino , Modelos Organizacionais , Inovação Organizacional , Pandemias/prevenção & controle , Assistência Perinatal/métodos , Assistência Perinatal/organização & administração , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Cuidados Pós-Operatórios/métodos , Gravidez
14.
Crit Care Nurs Clin North Am ; 32(3): 407-419, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32773182

RESUMO

Academicians who maintain a critical care clinical practice encounter numerous stressors, especially during the COVID-19 pandemic, which can influence well-being. This article provides historical perspectives on the stressors inherent in working in the critical care environment as well as the stressors of working in the academic environment. It proposes the application of the synergy model as a framework to help improve the well-being of academicians who practice and teach critical care. The most valuable strategy to improve professional well-being is for organizations to take a systems approach. The article focuses on approaches that are potentially within each individual's control.


Assuntos
Enfermagem de Cuidados Críticos/educação , Cuidados Críticos/psicologia , Educação em Enfermagem/organização & administração , Docentes de Enfermagem/psicologia , Estresse Psicológico/prevenção & controle , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/enfermagem , Docentes de Enfermagem/organização & administração , Humanos , Modelos Organizacionais , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/enfermagem , Estresse Psicológico/epidemiologia
16.
J Nurs Adm ; 50(9): 481-488, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32804705

RESUMO

A pediatric teaching hospital developed a comprehensive leadership training program for midlevel nurse leaders with varying levels of management knowledge and experience. Content was based on American Organization for Nursing Leadership nurse manager competencies and data from a comprehensive needs assessment. Learners identified differentiating between leadership and management, influencing behavior, managing change, and communication as areas of increased confidence. This program is applicable to any hospital with multiple midlevel nurse leaders new to the role.


Assuntos
Liderança , Determinação de Necessidades de Cuidados de Saúde/organização & administração , Enfermeiras Administradoras/educação , Desenvolvimento de Pessoal , Comunicação , Difusão de Inovações , Hospitais Pediátricos , Humanos , Modelos Organizacionais , Enfermeiras Administradoras/organização & administração
17.
BMC Public Health ; 20(1): 1235, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32795290

RESUMO

BACKGROUND: The Icelandic Prevention Model (IPM) is a collaborative upstream model that was designed to influence risk and protective factors related to substance use within the community, school, peer and family contexts. By engaging whole communities, the IPM has been found to be effective in reducing youth substance use behaviours across Iceland. As an extension to the IPM's participatory approach, this research will examine how youth involvement can enhance outcomes. In addition, this research will evaluate whether the IPM approach is beneficial for mental health promotion and general youth wellbeing. METHODS: The present research protocol applies the bioecological model within a participatory mixed-method case study design to examine the implementation of the IPM in a rural community in Canada. This study was designed to identify whether the Icelandic substance use prevention model is effective in reducing substance use and promoting mental health and development for Canadian youth. It will also explore how to engage youth within the approach and how this adaptation influences implementation and outcomes. DISCUSSION: The findings from this study will contribute to our understanding of upstream prevention of youth substance use and will be used to support scaling of the IPM across Canada.


Assuntos
Modelos Organizacionais , Prevenção Primária/organização & administração , População Rural , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Adolescente , Canadá , Feminino , Humanos , Masculino , Projetos de Pesquisa
18.
Med Teach ; 42(10): 1123-1127, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32776858

RESUMO

The current global crises, including climate, COVID-19, and environmental change, requires global collective action at all scales. These broad socio-ecological challenges require the engagement of diverse perspectives and ways of knowing and the meaningful engagement of all generations and stages of personal and professional development. The combination of systems thinking, change management, quality improvement approaches and models, appreciative/strength-based approaches, narratives, storytelling and the strengths of Indigenous knowledges, offer synergies and potential that can set the stage for transformative, strengths-based education for sustainable healthcare (ESH). The need for strong leadership to enact a vision for ESH is outlined here with the intent to enable and nurture the conditions for change, ultimately improving health and well-being across generations.


Assuntos
Infecções por Coronavirus/epidemiologia , Assistência à Saúde/organização & administração , Educação Médica/organização & administração , Pneumonia Viral/epidemiologia , Betacoronavirus , Humanos , Relações Interprofissionais , Modelos Organizacionais , Pandemias , Integração de Sistemas
19.
Nefrología (Madrid) ; 40(4): 453-460, jul.-ago. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-190836

RESUMO

Se describe la experiencia de un hospital terciario y cuatro centros concertados de hemodiálisis adscritos al mismo durante la epidemia de COVID-19. Se resume la organización asistencial que se ha llevado a cabo y el curso clínico de los 16 casos de COVID-19 en pacientes en hemodiálisis. La aplicación conjunta de medidas que incluyen el cribado de pacientes, la investigación precoz de casos posibles, el aislamiento de los casos confirmados, en investigación o en contactos, así como la utilización de medidas de protección individuales, han permitido controlar la epidemia. Se compara el curso clínico de estos 16 pacientes con la serie publicada por el Hospital Universitario de Wuhan y con los datos del registro de infecciones COVID-19 de la Sociedad Española de Nefrología. En nuestra experiencia, y a diferencia de lo comunicado por el centro de Wuhan, la enfermedad COVID-19 en los pacientes en hemodiálisis es grave en un porcentaje importante de los casos y la letalidad, elevada, es mayormente causada por la propia infección. Las medidas de contención de la epidemia son eficaces


The experience of a tertiary hospital and four hemodialysis centers attached to it during the COVID-19 epidemic is described. The organization of care that has been carried out and the clinical course of the 16cases of COVID-19 in hemodialysis patients are summarized. The joint application of measures, including patient screening, the early investigation of possible cases, the isolation of confirmed, investigational or contact cases, as well as the use of individual protection measures, has enabled the epidemic to be controlled. The clinical course of these 16patients is compared with the series published by the Wuhan University Hospital and with the data from the COVID-19 infection registry of the Spanish Society of Nephrology. In our experience, and unlike what was reported by the Wuhan Center, COVID-19 disease in hemodialysis patients is severe in a significant percentage of cases, and high lethality is mostly caused by the infection itself. Measures to contain the epidemic are effective


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Unidades Hospitalares de Hemodiálise/normas , Administração dos Cuidados ao Paciente , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Centros de Atenção Terciária , Modelos Organizacionais , Grupos de Risco
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