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1.
Rev. enferm. UERJ ; 28: e50353, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1122745

RESUMO

Objetivo: estabelecer relações entre os fundamentos Nightingaleanos na sustentabilidade de uma clínica de cuidado humano em diálogo com conceitos que sustentam duas atuais políticas de saúde brasileiras. Conteúdo: a ciência da enfermagem se afirma em uma abordagem holística do ser humano, com vistas à saúde integral, ressaltando a pessoa na sua dimensão física, mental, emocional e espiritual. Este princípio sustenta práticas humanizadas de cuidado e também integrativas, na proposição de cuidados integrais centrados na pessoa e relacionamento terapêutico para promover a saúde e o bem-estar. As fontes principais foram a obra seminal de Nigthingale, teorias de enfermagem, textos aplicados da Política Nacional de Humanização e de Práticas Integrativas e Complementares de Saúde. Conclusão: os princípios básicos do cuidado propostos por Nightingale refletem-se em atuais políticas de saúde, contribuindo para ampliar a autonomia dos profissionais de enfermagem, na oferta de cuidados baseados em conceitos próprios, em favor de uma Enfermagem Integrativa e Humana.


Objective: to establish relations between Nightingale fundamentals on the sustainability of human clinical care in dialogue with concepts underpinning two of Brazil's current health policies. Content: nursing science is grounded on a holistic approach of the human being, with a view to comprehensive health, emphasizing subjects in their physical, mental, emotional and spiritual dimensions. This principle underpins integrative, humanized care practices in proposing comprehensive care centered on the human person and a therapeutic relationship designed to promote health and wellbeing. The main sources were Nightingale's seminal work, nursing theories, and applied texts from Brazil's National Policy of Humanization and Integrative, Complementary Healthcare Practices. Conclusion: The basic health care principles proposed by Nightingale, reflected in current health policies, contribute to expanding the autonomy of nursing personnel in the providing care based on concepts specific to nursing, in favor of Integrative, Human Nursing.


Objetivo: establecer relaciones entre los fundamentos de Nightingale sobre la sostenibilidad de la atención clínica humana en diálogo con los conceptos que sustentan dos de las políticas de salud actuales de Brasil. Contenido: la ciencia de la enfermería se fundamenta en un enfoque holístico del ser humano, con miras a la salud integral, enfatizando los sujetos en sus dimensiones física, mental, emocional y espiritual. Este principio sustenta las prácticas de atención integral y humanizada al proponer una atención integral centrada en la persona humana y una relación terapéutica orientada a promover la salud y el bienestar. Las fuentes principales fueron el trabajo fundamental de Nightingale, las teorías de enfermería y los textos aplicados de la Política Nacional de Humanización y Prácticas de Atención Integrativa y Complementaria de Salud de Brasil. Conclusión: Los principios básicos del cuidado de la salud propuestos por Nightingale, reflejados en las políticas de salud vigentes, contribuyen a ampliar la autonomía del personal de enfermería en la prestación de cuidados basados en conceptos propios de la enfermería, a favor de la Enfermería Integrativa, Humana.


Assuntos
Humanos , Teoria de Enfermagem , Humanização da Assistência , Política de Saúde , Terapias Complementares , Brasil , Padrões de Prática em Enfermagem , Saúde Holística , Cuidados de Enfermagem
2.
J Cross Cult Gerontol ; 35(4): 493-500, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33015728
3.
PLoS Med ; 17(10): e1003150, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33027246

RESUMO

BACKGROUND: Evidence for the effectiveness of continuous quality improvement (CQI) in resource-poor settings is very limited. We aimed to establish the effects of CQI on quality of antenatal HIV care in primary care clinics in rural South Africa. METHODS AND FINDINGS: We conducted a stepped-wedge cluster-randomised controlled trial (RCT) comparing CQI to usual standard of antenatal care (ANC) in 7 nurse-led, public-sector primary care clinics-combined into 6 clusters-over 8 steps and 19 months. Clusters randomly switched from comparator to intervention on pre-specified dates until all had rolled over to the CQI intervention. Investigators and clusters were blinded to randomisation until 2 weeks prior to each step. The intervention was delivered by trained CQI mentors and included standard CQI tools (process maps, fishbone diagrams, run charts, Plan-Do-Study-Act [PDSA] cycles, and action learning sessions). CQI mentors worked with health workers, including nurses and HIV lay counsellors. The mentors used the standard CQI tools flexibly, tailored to local clinic needs. Health workers were the direct recipients of the intervention, whereas the ultimate beneficiaries were pregnant women attending ANC. Our 2 registered primary endpoints were viral load (VL) monitoring (which is critical for elimination of mother-to-child transmission of HIV [eMTCT] and the health of pregnant women living with HIV) and repeat HIV testing (which is necessary to identify and treat women who seroconvert during pregnancy). All pregnant women who attended their first antenatal visit at one of the 7 study clinics and were ≥18 years old at delivery were eligible for endpoint assessment. We performed intention-to-treat (ITT) analyses using modified Poisson generalised linear mixed effects models. We estimated effect sizes with time-step fixed effects and clinic random effects (Model 1). In separate models, we added a nested random clinic-time step interaction term (Model 2) or individual random effects (Model 3). Between 15 July 2015 and 30 January 2017, 2,160 participants with 13,212 ANC visits (intervention n = 6,877, control n = 6,335) were eligible for ITT analysis. No adverse events were reported. Median age at first booking was 25 years (interquartile range [IQR] 21 to 30), and median parity was 1 (IQR 0 to 2). HIV prevalence was 47% (95% CI 42% to 53%). In Model 1, CQI significantly increased VL monitoring (relative risk [RR] 1.38, 95% CI 1.21 to 1.57, p < 0.001) but did not improve repeat HIV testing (RR 1.00, 95% CI 0.88 to 1.13, p = 0.958). These results remained essentially the same in both Model 2 and Model 3. Limitations of our study include that we did not establish impact beyond the duration of the relatively short study period of 19 months, and that transition steps may have been too short to achieve the full potential impact of the CQI intervention. CONCLUSIONS: We found that CQI can be effective at increasing quality of primary care in rural Africa. Policy makers should consider CQI as a routine intervention to boost quality of primary care in rural African communities. Implementation research should accompany future CQI use to elucidate mechanisms of action and to identify factors supporting long-term success. TRIAL REGISTRATION: This trial is registered at ClinicalTrials.gov under registration number NCT02626351.


Assuntos
Infecções por HIV/prevenção & controle , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Cuidado Pré-Natal/normas , Carga Viral/estatística & dados numéricos , Adulto , Fármacos Anti-HIV/uso terapêutico , Feminino , Infecções por HIV/sangue , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Soropositividade para HIV/diagnóstico , Humanos , Ciência da Implementação , Padrões de Prática em Enfermagem , Gravidez , Atenção Primária à Saúde , Avaliação de Processos em Cuidados de Saúde , Melhoria de Qualidade , Indicadores de Qualidade em Assistência à Saúde , RNA Viral/sangue , População Rural , África do Sul , Gestão da Qualidade Total , Adulto Jovem
4.
N Z Med J ; 133(1524): 111-118, 2020 10 30.
Artigo em Inglês | MEDLINE | ID: mdl-33119574

RESUMO

This article discusses the three types of nurse prescriber currently registered in New Zealand (nurse practitioners, registered nurse prescribers (RNP) in primary health and specialty teams and registered nurse prescribers (RNPCH) in community health). It also provides an overview of the evolution of each group, as well as a summary of the current legislation, prescribing restrictions and models of supervision required for each type of prescriber.


Assuntos
Prescrições de Medicamentos , Regulamentação Governamental , Legislação de Medicamentos , Profissionais de Enfermagem , Enfermeiras e Enfermeiros , Padrões de Prática em Enfermagem , História do Século XX , História do Século XXI , Humanos , Legislação de Medicamentos/história , Nova Zelândia , Profissionais de Enfermagem/legislação & jurisprudência , Enfermeiras e Enfermeiros/legislação & jurisprudência
5.
Soins ; 65(845): 43-45, 2020 May.
Artigo em Francês | MEDLINE | ID: mdl-32862966

RESUMO

The article explores the private practice nursing profession from the angle of gender. The methodology is based on cross-referencing data taken from statistical and field surveys. The results show that men and women practise differently. Training paths, careers and professional activities are shaped by the caregivers' gender.


Assuntos
Mobilidade Ocupacional , Prática Privada de Enfermagem , Padrões de Prática em Enfermagem/estatística & dados numéricos , Feminino , Humanos , Masculino , Fatores Sexuais
6.
Can J Nurs Res ; 52(3): 199-208, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32893692

RESUMO

Precision health is the integration of personal genomic data with biological, environmental, behavioral, and other information relevant to the care of a patient. Genetics and genomics are essential components of precision health. Genetics is the study of the effects of individual genes, and genomics is the study of all the components of the genome and interactions between genes, environmental factors, and other psychosocial and cultural factors. Knowledge about the role of genetics and genomics on health outcomes has increased substantially since the completion of the human genome project in 2003. Insights about genetics and genomics obtained from bench science are now having positive clinical implications on patient health outcomes. Nurses have the potential to make distinct contributions to precision health due to their unique role in the health care system. In this article, we discuss gaps in the development of precision health in nursing and how nursing can expand the definition of precision health to actualize its potential. Precision health plays a role in nursing practice. Understanding this connection positions nurses to incorporate genetic and genomic knowledge into their nursing practice.


Assuntos
Padrões de Prática em Enfermagem/organização & administração , Medicina de Precisão/enfermagem , Genética , Genômica , Humanos
7.
J Wound Ostomy Continence Nurs ; 47(5): 439-444, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32970029

RESUMO

BACKGROUND: Providing health care at a distance has evolved over the past decades, resulting in a myriad of terms and styles of care delivery. Telehealth is defined as any health care service delivered at a distance. Nursing services have been delivered by a wide range of specialty nurses for many years using various technological formats. Clinical experience suggests that few WOC nurses had extensively adopted these technologies and principles into their practice as recently as 2019. However, the COVID-19 pandemic of 2020 has forced both administrators and clinicians to rapidly adapt or introduce telemedicine technologies to deliver specialty care including WOC nurse services. CASES: Three WOC nurses were chosen to describe the use of telehealth technologies to illustrate opportunities for WOC nurses to integrate telehealth nursing into a health care setting. Two adapted telehealth technology into their practice before the pandemic, and one started telehealth practice as a means to provide care after the onset of the pandemic. Disadvantages and advantages are discussed to provide further information regarding WOC patient care using these technologies. CONCLUSION: The pandemic crisis has accelerated the need for health care to reimagine the delivery of care to patients. Telehealth technologies and principles have emerged as essential for WOC nurses to deliver safe and effective care.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Papel do Profissional de Enfermagem , Pneumonia Viral/epidemiologia , Padrões de Prática em Enfermagem/organização & administração , Especialidades de Enfermagem/organização & administração , Telemedicina/organização & administração , Assistência Ambulatorial , Serviços de Assistência Domiciliar , Humanos , Pandemias
8.
West J Emerg Med ; 21(5): 1095-1101, 2020 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-32970560

RESUMO

The unprecedented COVID-19 pandemic has resulted in rapidly evolving best practices for transmission reduction, diagnosis, and treatment. A regular influx of new information has upended traditionally static hospital protocols, adding additional stress and potential for error to an already overextended system. To help equip frontline emergency clinicians with up-to-date protocols throughout the evolving COVID-19 crisis, our team set out to create a dynamic digital tool that centralized and standardized resources from a broad range of platforms across our hospital. Using a design thinking approach, we rapidly built, tested, and deployed a solution using simple, out-of-the-box web technology that enables clinicians to access the specific information they seek within moments. This platform has been rapidly adopted throughout the emergency department, with up to 70% of clinicians using the digital tool on any given shift and 78.6% of users reporting that they "agree" or "strongly agree" that the platform has affected their management of COVID-19 patients. The tool has also proven easily adaptable, with multiple protocols being updated nearly 20 times over two months without issue. This paper describes our development process, challenges, and results to enable other institutions to replicate this process to ensure consistent, high-quality care for patients as the COVID-19 pandemic continues its unpredictable course.


Assuntos
Betacoronavirus , Tomada de Decisão Clínica/métodos , Infecções por Coronavirus/terapia , Sistemas de Apoio a Decisões Clínicas , Serviços Médicos de Emergência/métodos , Pneumonia Viral/terapia , Atitude do Pessoal de Saúde , Protocolos Clínicos , Árvores de Decisões , Eficiência , Emergências , Humanos , Internet , Pandemias , Padrões de Prática em Enfermagem/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Desenvolvimento de Programas , São Francisco
9.
Med Care ; 58(10): 934-941, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32925417

RESUMO

BACKGROUND: Primary care practices increasingly include nurse practitioners (NPs), in addition to physicians. Little is known about how the patient mix and clinical activities of colocated physicians and NPs compare. OBJECTIVES: To describe the clinical activities of NPs, compared with physicians. RESEARCH DESIGN: We used claims and electronic health record data from athenahealth Inc., on primary care practices in 2017 and a cross-sectional analysis with practice fixed effects. SUBJECTS: Patients receiving treatment from physicians and NPs within primary care practices. MEASURES: First, we measured patient characteristics (payer, age, sex, race, chronic condition count) and visit characteristics (new patient, scheduled duration, same-day visit, after-hours visit). Second, we measured procedures performed and diagnoses recorded during each visit. Finally, we measured daily quantity (visit volume, minutes scheduled for patient care, total work relative value units billed) of care. RESULTS: Relative to physicians, NPs treated younger and healthier patients. NPs also had a larger share of patients who were female, non-White, and covered by Medicaid, commercial insurance, or no insurance. NPs scheduled longer appointments and treated more patients on a same-day or after-hours basis. On average, "overlapping" services-those performed by NPs and physicians within the same practice-represented 92% of all service volume. The small share of services performed exclusively by physicians reflected greater clinical intensity. On a daily basis, NPs provided fewer and less intense visits than physicians within the same practice. CONCLUSIONS: Our findings suggest considerable overlap between the clinical activities of colocated NPs and physicians, with some differentiation based on intensity of services provided.


Assuntos
Profissionais de Enfermagem/estatística & dados numéricos , Padrões de Prática em Enfermagem/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Atenção Primária à Saúde/organização & administração , Adolescente , Adulto , Idoso , Registros Eletrônicos de Saúde , Feminino , Humanos , Cobertura do Seguro/estatística & dados numéricos , Masculino , Medicaid , Pessoa de Meia-Idade , Estados Unidos
10.
Policy Polit Nurs Pract ; 21(4): 222-232, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32910736

RESUMO

Across the United States, nursing practice acts (NPAs) have been revised to include provisions that promote full practice authority (FPA) for nurse practitioners (NPs). Such revisions provide a mechanism to better utilize the full scope of NP services to address growing demands for access to health care. Modernized NPAs that facilitate FPA for NPs are imperative, especially now with the unprecedented health care crisis that the world now faces: Coronavirus Disease 2019. This is the first known study to use an embedded single-case study design, guided by the Kingdon policy stream model, to provide a detailed account of how stakeholders for NP FPA determine the appropriate time to pursue legislative changes to NP scope of practice regulations. Qualitative data analysis revealed four themes which comprised the components considered by stakeholders during their decision-making processes related to NP FPA: participants, problem, policy development, and politics. Themes were further collapsed within concepts from the Kingdon model to form the case description. Study findings can be used to increase the competency among NP FPA stakeholders in determining the timing of legislative pursuits for regulatory change.


Assuntos
Betacoronavirus , Infecções por Coronavirus/enfermagem , Profissionais de Enfermagem/legislação & jurisprudência , Pneumonia Viral/enfermagem , Padrões de Prática em Enfermagem/legislação & jurisprudência , Autonomia Profissional , Política de Saúde/legislação & jurisprudência , Humanos , Pandemias , Estados Unidos
13.
Enferm. foco (Brasília) ; 11(1,n.esp): 58-61, ago. 2020.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1116343

RESUMO

Objetivo: Refletir sobre a teoria ambientalista de Florence Nightingale, contextualizando a enfermagem moderna frente suas origens e o desenvolvimento de sua prática. Método: Estudo reflexivo, de perspectiva histórica e que utiliza a pesquisa documental como método de investigação. Tomou por base especialmente artigos de periódicos científicos e livros clássicos sobre a história da enfermagem e suas concepções, sem limite de data de publicação. Resultados: O texto percorre desde as origens do cuidado ligadas à religiosidade, a perda da hegemonia da igreja quando as religiosas foram expulsas dos hospitais até a figura de Florence Nightingale como precursora da enfermagem moderna, destacando a Teoria Ambientalista, relacionando-a a prática de comportamentos no enfrentamento da atual pandemia. Conclusões: Discorrer sobre a história da enfermagem e sua trajetória profissional a partir de seus marcos clássicos é necessário, inclusive para a compreensão de dogmas e paradigmas que ainda são inerentes à sua prática. (AU)


Objective: To reflect about Florence Nightingale's environmental theory, contextualizing the modern Nursing in view of its origins and the development of its practice. Method: A reflective study, from a historical perspective, using documentary research as an investigation method. It was based mainly on scientific articles and classic books on the history of nursing and its conceptions, without limit on the date of publication. Results: The text goes since the origins of care linked to religiosity, the lost of hegemony of the church when the nuns were expelled from hospitals until the figure Tof Florence Nightingale as a precursor of modern nursing, highlighting the Environmental Theory, relating it to the practice of behaviors in facing the current pandemic. Conclusions: To talk about the history of nursing and its professional trajectory since its classic demarcation is necessary, including the understanding of dogmas and paradigms that are still inherent to its practice. (AU)


Objetivo: Reflexionar sobre la teoría ambiental de Florence Nightingale, contextualizando la enfermería moderna en vista de sus orígenes y el desarrollo de su práctica. Método: Estudio reflexivo, desde una perspectiva histórica, que utiliza la investigación documental como método de investigación. Se basó principalmente en artículos de revistas científicas y libros clásicos sobre la historia de la enfermería y sus concepciones, sin límite en la fecha de publicación. Resultados: El texto va desde los orígenes de la atención vinculada a la religiosidad, la pérdida de la hegemonía de la iglesia cuando las monjas fueron expulsadas de los hospitales hasta la figura de Florence Nightingale como precursora de la enfermería moderna, destacando la teoría ambiental, relacionándola con la práctica de comportamientos frente a la pandemia actual. Conclusiones: Es necesario hablar sobre la historia de la enfermería y su trayectoria profesional desde sus hitos clásicos, incluso para comprender los dogmas y paradigmas que aún son inherentes a su práctica. (AU)


Assuntos
História da Enfermagem , Teoria de Enfermagem , Enfermagem , Padrões de Prática em Enfermagem
14.
Curr Med Sci ; 40(4): 602-607, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32767261

RESUMO

This study aims to develop the expert consensus on nurse's human caring for Corona Virus Disease 2019 (COVID-19) patients in different sites, and thus provide a guideline on providing whole process and systematic caring for COVID-19 patients. Based on the frontline experiences of human caring for COVID-19 patients and the review of literature, the initial draft of consensus was made and finalized after online meeting and revisions. The experts reached consensus on the following parts: terms and definitions, principles of human caring for COVID-19 patients, and human caring measures for COVID-19 patients in different sites. The expert consensus is practical, concise, and reasonable for guiding the nurses providing human caring for COVID-19 patients, as well as other similar infectious diseases.


Assuntos
Betacoronavirus , Infecções por Coronavirus/enfermagem , Cuidados de Enfermagem/métodos , Pneumonia Viral/enfermagem , China/epidemiologia , Consenso , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Prova Pericial , Humanos , Pandemias , Planejamento de Assistência ao Paciente , Isolamento de Pacientes , Pneumonia Viral/epidemiologia , Padrões de Prática em Enfermagem , Quarentena , Enfermagem em Reabilitação
15.
Stroke Vasc Neurol ; 5(3): 302-307, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32817272

RESUMO

Coronavirus pandemic is the most important public health event in the world currently. Patients with coronavirus disease 2019 (COVID-19) in a critical state are at risk of progressing rapidly into many serve complications; they require a high level of care from ICU nurses. How to avoid the virus to infect health care worker is also a critical issue. Based on the summarized experience of Chinese health workers, literature review and clinical practice, this article introduced donning and doffing of personal protective equipment (PPE) protocol and some keypoints of nursing critical care in patients with coronavirus disease 2019 (COVID-19): caring of patients requiring intubation and ventilation, venous thromboembolism (VTE) prevention, caring of patients on ECMO, caring for patients requiring enteral nutrition, psychological support and nursing management of COVID-19 ICU. This article introduced a useful protocol of donning and doffing personal protective equipment to protect health care workers, and provided key points for the ICU nurses how to take care of COVID-19 patients.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/enfermagem , Enfermagem de Cuidados Críticos , Controle de Infecções , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Unidades de Terapia Intensiva , Exposição Ocupacional/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/enfermagem , Padrões de Prática em Enfermagem , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Interações Hospedeiro-Parasita , Humanos , Saúde do Trabalhador , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Fatores de Proteção , Medição de Risco , Fatores de Risco , Virulência
16.
Medicine (Baltimore) ; 99(27): e20967, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629706

RESUMO

BACKGROUND: Hypertension is a silent disease of the masses with an increasing prevalence and poor control rates. This study aims to establish and test the efficacy of a nurse-led hypertension management model in the community. METHODS: A single-blind, randomized controlled trial was performed. 156 hypertensive patients with uncontrolled blood pressure were equally and randomly allocated into 2 groups. Patients in the study group received a 12-week period of hypertension management. Blood pressure, self-care behaviors, self-efficacy, and satisfaction were assessed at the start of recruitment, 12 and 16 weeks thereafter. RESULTS: After the intervention, blood pressure of patients in the study group had greater improvement in self-care behaviors and a higher level of satisfaction with the hypertensive care compared to the control group (both P < .05). CONCLUSIONS: The nurse-led hypertension management model is feasible and effective for patients with uncontrolled blood pressure in the community.


Assuntos
Serviços de Saúde Comunitária/organização & administração , Hipertensão/enfermagem , Padrões de Prática em Enfermagem/normas , Idoso , Anti-Hipertensivos/uso terapêutico , Feminino , Humanos , Hipertensão/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Autocuidado , Autoeficácia , Método Simples-Cego
17.
JCO Glob Oncol ; 6: 1017-1023, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32634067

RESUMO

PURPOSE: After coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO, a response from the Italian Health System to react to an unprecedented condition became necessary and sudden. The COVID-19 pandemic has required oncologists to redefine clinical organization and patient management. The purpose of our study was to document the difficulties emerging during the SARS-CoV-2 pandemic in Italian oncology. METHODS: We broadcasted an electronic survey to oncologic health care professionals. It consisted of 45 questions ranging from individual perception of pandemic management by hospital centers to physicians' and nurses' psychological distress and patient care. RESULTS: A total of 383 oncology health workers participated in the survey. The majority were female (71.8%) and from central Italy (46.2%). Impressively, a total of 357 (93%) participants declared the oncologic department reorganized routine clinical activity, but only 40.5% were adequately trained about the required procedures; 20% of the survey respondents think they have not received adequate and timely protective devices. CONCLUSION: Our survey demonstrated the flexibility of oncologic teams. However, the emergency response quality has been heterogeneous, and several drawbacks have emerged from the first analyses investigating how the world of oncology changes in the COVID-19 pandemic. Information, protection, testing, and training of health care professionals are key words that should be kept in mind to encourage recovery after this tragedy and to be ready to face a similar emergency in the future.


Assuntos
Atitude do Pessoal de Saúde , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Padrões de Prática em Enfermagem/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Angústia Psicológica , Adulto , Idoso , Betacoronavirus , Assistência à Saúde , Feminino , Hospitais , Humanos , Controle de Infecções , Itália/epidemiologia , Masculino , Oncologia , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/psicologia , Oncologistas/psicologia , Enfermagem Oncológica , Serviço Hospitalar de Oncologia/organização & administração , Pandemias , Inquéritos e Questionários
19.
Diabetes Res Clin Pract ; 166: 108288, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32615277

RESUMO

BACKGROUND: The prevalence and incidence of Type 2 Diabetes mellitus (T2DM) are significantly increasing in Nigeria. Effective management of the condition, in clinical settings, can be achieved with a minimal financial cost, but this is often overlooked. It is crucial to understand organisational factors influencing non-pharmacological management of T2DM in Nigerian public hospitals for effective management of patients diagnosed with the condition. AIM: To examine healthcare delivery services influencing patient management and seek approaches to heighten optimisation of patient health outcomes. METHODS: Adopting a qualitative case study design, we used the Constant Comparative Method and semi-structured questions to interview17 nurses in public hospitals across Lagos. Using the five stages of the Framework Analysis process, the transcribed interviews were thematically analysed. RESULTS: Nurses suggested that a complex, multifaceted system constituted organisational factors influencing T2DM management in public hospitals across Lagos, Nigeria. Specific factors identified were levels of available information and knowledge, relationship, policy and decision-making management. These factors were, in turn, linked to political, infrastructural, health professional and the environments within which patients were given health services. CONCLUSIONS: The study revealed a significant gap in the organisation of care for individuals diagnosed with T2DM in public hospitals across Lagos. Timely and affordable strategies have been highlighted to secure effective care delivery to patients.


Assuntos
Assistência à Saúde/organização & administração , Diabetes Mellitus Tipo 2/terapia , Serviços de Saúde/normas , Hospitais Públicos/organização & administração , Enfermeiras e Enfermeiros , Percepção , Adulto , Atitude do Pessoal de Saúde , Tomada de Decisões Gerenciais , Assistência à Saúde/normas , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/enfermagem , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Hospitais Públicos/normas , Hospitais Públicos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Enfermeiras e Enfermeiros/organização & administração , Enfermeiras e Enfermeiros/psicologia , Enfermeiras e Enfermeiros/normas , Enfermeiras e Enfermeiros/estatística & dados numéricos , Padrões de Prática em Enfermagem/organização & administração , Padrões de Prática em Enfermagem/normas , Padrões de Prática em Enfermagem/estatística & dados numéricos , Pesquisa Qualitativa , Fatores Socioeconômicos , Inquéritos e Questionários , Resultado do Tratamento
20.
J Assoc Nurses AIDS Care ; 31(4): 392-404, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32604219

RESUMO

In eastern and southern Africa, much is unknown about implementation of nurse-initiated and managed antiretroviral therapy (NIMART). The purpose of this study was to identify perceived barriers and facilitators of NIMART for the prevention of mother-to-child transmission and pediatric HIV services in high-volume, high HIV-burden health facilities across this region. A total of 211 nurses, midwives, and nurse midwives and 62 supervisors from 30 health facilities in 11 countries participated in this mixed-methods evaluation. The findings show that although nurses, midwives, and nurse midwives clearly had the authority to provide NIMART services, they did not necessarily feel that they were well prepared and supported to do so. Deficits in supportive supervision and clinical mentorship were viewed as substantial challenges to effective provision of NIMART for the prevention of mother-to-child transmission and pediatric HIV services-particularly with respect to pediatric HIV services. Health facilities have important opportunities to advance NIMART practice through strengthening these aspects of in-service support.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Terapia Antirretroviral de Alta Atividade/métodos , Infecções por HIV/tratamento farmacológico , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Mentores , Enfermeiras Obstétricas , Papel do Profissional de Enfermagem , Padrões de Prática em Enfermagem/estatística & dados numéricos , Feminino , Humanos , Entrevistas como Assunto , Tocologia , Pesquisa Qualitativa
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