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1.
Adv Skin Wound Care ; 34(6): 293-300, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33979817

RESUMO

GENERAL PURPOSE: To introduce the 15 recommendations of the International Ostomy Guideline (IOG) 2020, covering the four key arenas of education, holistic aspects, and pre- and postoperative care; and to summarize key concepts for clinicians to customize for translation into their practice. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant will:1. Analyze supporting evidence for the education recommendations in the IOG 2020.2. Identify a benefit of the International Charter of Ostomate Rights.3. Distinguish concepts related to pre- and postoperative ostomy-related care.4. Select a potential barrier to IOG 2020 guideline implementation.


Assuntos
Pessoal de Saúde/educação , Estomia/reabilitação , Guias de Prática Clínica como Assunto/normas , Humanos , Equipe de Assistência ao Paciente/organização & administração , Higiene da Pele/métodos , Cicatrização
2.
Stud Health Technol Inform ; 281: 1021-1022, 2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34042831

RESUMO

The 4th industrial revolution of informatics and data is an important factor of modern health care provision. The WHO, the EU and other governmental authorities have recognised the new needs. The health care professionals face this change in daily work. The higher education community has responded on time with a wide range of relevant programs. In order to achieve the best results for health care related educational programs an evaluation procedure is needed. In this work a brief part of the evaluation of a Health Informatics program is presented.


Assuntos
Informática Médica , Currículo , Educação em Saúde , Pessoal de Saúde/educação , Promoção da Saúde , Humanos , Avaliação de Programas e Projetos de Saúde
3.
BMC Infect Dis ; 21(1): 486, 2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34039304

RESUMO

BACKGROUND: In countries with a high tuberculosis incidence such as Gabon, healthcare workers are at enhanced risk to become infected with tuberculosis due to their occupational exposure. In addition, transmission can occur between patients and visitors, if a tuberculosis infection is not suspected in time. Knowledge about tuberculosis and correct infection control measures are therefore highly relevant in healthcare settings. METHODS: We conducted an interviewer-administered knowledge, attitude and practice survey amongst healthcare workers in 20 healthcare facilities at all levels in the Moyen-Ogooué province, Gabon. Correctly answered knowledge questions were scored and then categorised into four knowledge levels. Additionally, factors associated with high knowledge levels were identified. Fisher's Exact test was used to identify factors associated with high knowledge levels. RESULTS: A total of 103 questionnaires were completed by various healthcare personnel. The most-frequently scored category was 'intermediate knowledge', which was scored by 40.8% (42/103), followed by 'good knowledge' with 28.2% (29/103) and 'poor knowledge' with 21.4% (22/103) of participating healthcare workers, respectively. 'Excellent knowledge' was achieved by 9.7% (10/103) of the interviewees. Apart from the profession, education level, type of employing healthcare facility, as well as former training on tuberculosis were significantly associated with high knowledge scores. Attitudes were generally positive towards tuberculosis infection control efforts. Of note, healthcare workers reported that infection control measures were not consistently practiced; 72.8% (75/103) of the participants were scared of becoming infected with tuberculosis, and 98.1% saw a need for improvement of local tuberculosis control. CONCLUSIONS: The survey results lead to the assumption that healthcare workers in the Moyen-Ogooué province are at high risk to become infected with tuberculosis. There is an urgent need for improvement of tuberculosis infection control training for local healthcare personnel, particularly for less trained staff such as assistant nurses. Furthermore, the lack of adequate infection control measures reported by staff could possibly be correlated with a lack of adequate facility structures and protective equipment and requires further investigation.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/estatística & dados numéricos , Tuberculose/prevenção & controle , Adulto , Estudos Transversais , Feminino , Gabão/epidemiologia , Instalações de Saúde/estatística & dados numéricos , Pessoal de Saúde/educação , Pessoal de Saúde/psicologia , Humanos , Controle de Infecções/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/prevenção & controle , Inquéritos e Questionários , Tuberculose/epidemiologia , Tuberculose/transmissão
5.
J Hosp Infect ; 112: 104-107, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33864893

RESUMO

Personal protective equipment (PPE) is essential for healthcare worker (HCW) safety. Conservation of PPE for clinical use during the COVID-19 pandemic reduced its availability for training, necessitating an innovative approach to sourcing high physical resemblance PPE (HPR-PPE). We present a case study of crowd-sourcing of HPR-PPE to train HCWs. Survey results indicated that HPR-PPE enabled high-fidelity practise of PPE application and removal, aided procedure recall, improved user confidence and was sufficiently similar to medical-grade PPE. HPR-PPE provided a novel and cost-effective alternative. We also demonstrated that medical-grade PPE can be sourced from non-medical institutions and businesses during a pandemic.


Assuntos
/prevenção & controle , Pessoal de Saúde/educação , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Equipamento de Proteção Individual/provisão & distribução , Estudos de Casos e Controles , Crowdsourcing , Equipamentos Médicos Duráveis , Humanos , Controle de Infecções/instrumentação , Pesquisa Qualitativa , Dispositivos de Proteção Respiratória , Treinamento por Simulação
6.
Cochrane Database Syst Rev ; 4: CD012060, 2021 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-33871067

RESUMO

BACKGROUND: In healthcare settings, health care workers (HCWs) are at risk of acquiring infectious diseases through sharps injuries and splash exposures to blood or bodily fluids. Education and training interventions are widely used to protect workers' health and safety and to prevent sharps injuries. In certain countries, they are part of obligatory professional development for HCWs. OBJECTIVES: To assess the effects of education and training interventions compared to no intervention or alternative interventions for preventing sharps injuries and splash exposures in HCWs. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, NHSEED, Science Citation Index Expanded, CINAHL and OSH-update (from all time until February 2016). In addition, we searched the databases of Global Health, AustHealth and Web of Science (from all time until February 2016). The original search strategy was re-run in November 2019, and again in February 2020. In April 2020, the search strategy was updated and run in CINAHL, MEDLINE, Scopus and Web of Science (from 2016 to current). SELECTION CRITERIA: We considered randomized controlled trials (RCTs), cluster-randomized trials (cluster-RCTs), controlled clinical trials (CCTs), interrupted time series (ITS) study designs, and controlled before-and-after studies (CBA), that evaluated the effect of education and training interventions on the incidence of sharps injuries and splash exposures compared to no-intervention. DATA COLLECTION AND ANALYSIS: Two authors (SC, HL) independently selected studies, and extracted data for the included studies. Studies were analyzed, risk of bias assessed (HL, JL) , and pooled using random-effect meta-analysis, where applicable, according to their design types. As primary outcome we looked for sharps injuries and splash exposures and calculated them as incidence of injuries per 1000 health care workers per year. For the quality of evidence we applied GRADE for the main outcomes. MAIN RESULTS: Seven studies met our inclusion criteria: one cluster-RCT, three CCTs, and three ITS studies. The baseline rates of sharps injuries varied from 43 to 203 injuries per 1000 HCWs per year in studies with hospital registry systems. In questionnaire-based studies, the rates of sharps injuries were higher, from 1800 to 7000 injuries per 1000 HCWs per year.  The majority of studies utilised a combination of education and training interventions, including interactive demonstrations, educational presentations, web-based information systems, and marketing tools which we found similar enough to be combined. In the only cluster-RCT (n=796) from a high-income country, the single session educational workshop decreased sharps injuries at 12 months follow-up, but this was not statistically significant either measured as registry-based reporting of injuries (RR 0.46, 95% CI 0.16 to 1.30, low-quality evidence) or as self-reported injuries (RR 0.41, 95% CI 0.14 to 1.21, very low-quality evidence) In three CCTs educational interventions decreased sharps injuries at two months follow-up (RR 0.68, 95% CI 0.48 to 0.95, 330 participants, very low-quality evidence). In the meta-analysis of two ITS studies with a similar injury rate, (N=2104), the injury rate decreased immediately post-intervention by 9.3 injuries per 1000 HCWs per year (95% CI -14.9 to -3.8). There was a small non-significant decrease in trend over time post-intervention of 2.3 injuries per 1000 HCWs per year (95% CI -12.4 to 7.8, low-quality evidence). One ITS study (n=255) had a seven-fold higher injury rate compared to the other two ITS studies and only three data points before and after the intervention. The study reported a change in injury rate of 77 injuries per 1000 HCWs (95% CI -117.2 to -37.1, very low-quality evidence) immediately after the intervention, and a decrease in trend post-intervention of 32.5 injuries per 1000 HCWs per year (95% CI -49.6 to -15.4, very low quality evidence). None of the studies allowed analyses of splash exposures separately from sharps injuries. None of the studies reported rates of blood-borne infections in patients or staff. There was very low-quality evidence of short-term positive changes in process outcomes such as knowledge in sharps injuries and behaviors related to injury prevention.  AUTHORS' CONCLUSIONS: We found low- to very low-quality evidence that education and training interventions may cause small decreases in the incidence of sharps injuries two to twelve months after the intervention. There was very low-quality evidence that educational interventions may improve knowledge and behaviors related to sharps injuries in the short term but we are uncertain of this effect. Future studies should focus on developing valid measures of sharps injuries for reliable monitoring. Developing educational interventions in high-risk settings is another priority.


Assuntos
/prevenção & controle , Pessoal de Saúde/educação , Exposição Ocupacional/prevenção & controle , Ferimentos Perfurantes/prevenção & controle , Estudos Controlados Antes e Depois , Ensaios Clínicos Controlados como Assunto , Humanos , Análise de Séries Temporais Interrompida , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Ferimentos Perfurantes/epidemiologia
7.
BMC Med Educ ; 21(1): 245, 2021 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-33926419

RESUMO

BACKGROUND: Access to high quality continuing professional development (CPD) is necessary for healthcare professionals to retain competency within the ever-evolving worlds of medicine and health. Most low- and middle-income countries, including Rwanda, have a critical shortage of healthcare professionals and limited access to CPD opportunities. This study scoped the literature using review articles related to the use of information and communication technology (ICT) and video conferencing for the delivery of CPD to healthcare professionals. The goal was to inform decision-makers of relevant and suitable approaches for a low-income country such as Rwanda. METHODS: PubMed and hand searching was used. Only review articles written in English, published between 2010 and 2019, and reporting the use of ICT for CPD were included. RESULTS: Six review articles were included in this study. Various delivery modes (face to face, pure elearning and blended learning) and technology approaches (Internet-based and non-Internet based) were reported. All types of technology approach enhanced knowledge, skills and attitudes. Pure elearning is comparable to face-to-face delivery and better than 'no intervention', and blended learning showed mixed results compared to traditional face-to-face learning. Participant satisfaction was attributed to ease of use, easy access and interactive content. CONCLUSION: The use of technology to enhance CPD delivery is acceptable with most technology approaches improving knowledge, skills and attitude. For the intervention to work effectively, CPD courses must be well designed: needs-based, based on sound educational theories, interactive, easy to access, and affordable. Participants must possess the required devices and technological literacy.


Assuntos
Educação Médica Continuada , Pessoal de Saúde , Comunicação , Educação Continuada , Feminino , Pessoal de Saúde/educação , Humanos , Gravidez , Ruanda , Tecnologia
9.
BMC Med Educ ; 21(1): 220, 2021 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-33879150

RESUMO

BACKGROUND: Interprofessional practice (IPP) has been shown to contribute to quality service provision and improved health outcomes. This knowledge has led to the integration of interprofessional education into course curricula for many health-care disciplines. Offering interprofessional education in rural areas to students undertaking work integrated learning placements is challenging particularly because of the diversity of students and placement dates combined with the student focus on the assessable placement curriculum. This research investigated and evaluated the utility of an escape room as an educational modality that facilitates learning whilst providing a supportive and motivating learning environment. Our project focused on the acquisition of interprofessional practice knowledge and experience by a health professional student cohort. METHODS: This study used the novel intervention of an escape room combined with an interactive teaching session to test student engagement and learning about interprofessional practice and teamwork. The research used a mixed methods single group pre-post design. RESULTS: Fifty students (78% female) from seventeen universities and seven professions participated in teams of three to six members. Most participants (66%) had not previously completed an escape room. The results showed that the intervention provided effective and engaging learning and was intrinsically appealing to students despite its non-assessable nature. Individual student reflection on their participation showed developing insight into the critical importance of clear communication and intentional team member collaboration in the provision of effective interprofessional practice. CONCLUSIONS: The escape room intervention added value to the placement curriculum and proved flexible for a heterogeneous student cohort.


Assuntos
Competência Clínica , Currículo , Pessoal de Saúde/educação , Relações Interprofissionais , Estudantes/psicologia , Adulto , Educação de Graduação em Medicina/métodos , Avaliação Educacional/métodos , Feminino , Humanos , Aprendizagem , Masculino , Aprendizagem Baseada em Problemas , População Rural
10.
Nurse Pract ; 46(5): 34-43, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33882042

RESUMO

ABSTRACT: In this second article of a three-part series, we explore how stakeholders can be educated on the use of telehealth technology and telemedicine. We address the need for staff and patient support for the transition to telehealth and offer suggestions to NPs for appropriate presentation and interaction with interdisciplinary teams and patients regarding telehealth.


Assuntos
Profissionais de Enfermagem/psicologia , Telemedicina/organização & administração , Pessoal de Saúde/educação , Humanos , Relações Interprofissionais , Relações Enfermeiro-Paciente , Educação de Pacientes como Assunto , Participação dos Interessados
11.
Mayo Clin Proc ; 96(4): 1033-1040, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33814072

RESUMO

Breast cancer remains the most common cancer in women in the United States. For certain women at high risk for breast cancer, endocrine therapy (ET) can greatly decrease the risk. Tools such as the Breast Cancer Risk Assessment Tool (or Gail Model) and the International Breast Cancer Intervention Study risk calculator are available to help identify women at increased risk for breast cancer. Physician awareness of family history, reproductive and lifestyle factors, dense breast tissue, and history of benign proliferative breast disease are important when identifying high-risk women. The updated US Preventive Services Task Force and American Society of Clinical Oncology guidelines encourage primary care providers to identify at-risk women and offer risk-reducing medications. Among the various ETs, which include tamoxifen, raloxifene, anastrozole, and exemestane, tamoxifen is the only one available for premenopausal women aged 35 years and older. A shared decision-making process should be used to increase the usage of ET and must be individualized. This individualized approach must account for each woman's medical history and weigh the benefits and risks of ET in combination with the personal values of the patient.


Assuntos
Anastrozol/administração & dosagem , Neoplasias da Mama/prevenção & controle , Antagonistas de Estrogênios/administração & dosagem , Pessoal de Saúde/educação , Medicina Preventiva/educação , Cloridrato de Raloxifeno/administração & dosagem , Moduladores Seletivos de Receptor Estrogênico/administração & dosagem , Tamoxifeno/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/epidemiologia , Currículo , Tomada de Decisão Compartilhada , Educação Médica Continuada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medicina Preventiva/métodos , Medição de Risco , Fatores de Risco , Estados Unidos/epidemiologia
12.
WMJ ; 120(S1): S70-S73, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33819408

RESUMO

BACKGROUND: Motivated by racial injustice and COVID-19 disparities, health care and medical education are accelerating efforts to address racism and eliminate health disparities. METHODS: In consultation with a community partner, an interprofessional physician-led team prioritized and completed an 8-hour anti-racism training adapted for online delivery during a pandemic. RESULTS: Sixty-four percent of enrollees (25/36) completed the survey, 98% rated the training as valuable, 92% would recommend it to a colleague, 88% reported it would improve their clinical care, and 68% thought their ability to create an inclusive environment increased. DISCUSSION: Virtual anti-racism training is a valuable learning experience. Tools for adapting trainings on high-risk or emotionally charged topics to a virtual format are offered by participants and session leaders.


Assuntos
/epidemiologia , Educação Médica , Medicina de Família e Comunidade/educação , Pessoal de Saúde/educação , Racismo , Adulto , Relações Comunidade-Instituição , Educação a Distância , Feminino , Disparidades em Assistência à Saúde , Humanos , Masculino , Pandemias , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários , Wisconsin/epidemiologia
13.
Artigo em Russo | MEDLINE | ID: mdl-33901381

RESUMO

The article presents the results of comparative analysis of educational potential of participants of the scientific and educational medical cluster «North Caucasus¼. The differences in average unified state examination score of students of educational institutions - participants of the cluster, teaching staff with academic degrees, educational literature and other indices are examined. It is noted that the toughening of unified state examination procedure implementation and increase of number of applicants entering through target admission, resulted in certain decrease of average score of unified state examination in entrants. At the same time, measures undertaken by the cluster members targeting the improvement of the values of indices of educational organizations functioning monitored by Rosobrnadzor alter the trend in condition of educational potential of the cluster "North Caucasus" in a positive way.


Assuntos
Educação Médica , Pessoal de Saúde , Pessoal de Saúde/educação , Humanos , Instituições Acadêmicas , Estudantes
14.
Sci Prog ; 104(2): 368504211009670, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33878962

RESUMO

As the coronavirus disease 2019 (COVID-19) spreads globally, hospital departments will need take steps to manage their treatment procedures and wards. The preparations of high-risk departments (infection, respiratory, emergency, and intensive care unit) were relatively well within this pandemic, while low-risk departments may be unprepared. The spine surgery department in The First Affiliated Hospital of Anhui Medical University in Hefei, China, was used as an example in this study. The spine surgery department took measures to manage the patients, medical staff and wards to avoid the cross-infection within hospital. During the outbreak, no patients or healthcare workers were infected, and no treatment was delayed due to these measures. The prevention and control measures effectively reduced the risk of nosocomial transmission between health workers and patients while providing optimum care. It was a feasible management approach that was applicable to most low-risk and even high-risk departments.


Assuntos
/prevenção & controle , Controle de Infecções/métodos , Pandemias , Isolamento de Pacientes/organização & administração , Isoladores de Pacientes/provisão & distribução , /patogenicidade , /diagnóstico , /transmissão , China/epidemiologia , Infecção Hospitalar/prevenção & controle , Desinfecção/métodos , Desinfecção/organização & administração , Pessoal de Saúde/educação , Humanos , Controle de Infecções/organização & administração , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/métodos , Procedimentos Ortopédicos/instrumentação , Procedimentos Ortopédicos/métodos , Isolamento de Pacientes/métodos , Quartos de Pacientes/organização & administração , Equipamento de Proteção Individual/provisão & distribução , Coluna Vertebral/cirurgia
15.
Pan Afr Med J ; 38: 75, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33889241

RESUMO

Introduction: birth attendants' retention of knowledge and skills of neonatal resuscitation post-training can prevent birth asphyxia by repeatedly applying neonatal resuscitation guidelines. This study assessed primary healthcare workers' retention of knowledge and skills of basic neonatal resuscitation. Methods: in 28 primary health centres, 106 birth attendants had their knowledge and skills assessed following a one-day neonatal resuscitation training. The evaluation was before, immediately after training, at three months (a subset of participants) and six months. Paired t-tests were used to compare mean scores at two different evaluation times. Results: the mean baseline knowledge and skills scores were 35.22% ± 12.90% and 21.40% ± 16.91% respectively. Immediately after training, it increased to 81.48% ± 7.05% and 87.40% ± 13.97% respectively (p=0.0001). At three months, it decreased to 55.37% ± 20.50% and 59.11% ± 25.55% respectively (p=0.0001), at six months it was 55.77% ± 14.28% and 60.38% ± 19.79% respectively (p=0.0001). Following immediate post-training at 6 months, knowledge and skills scores increased to 94.91 ± 7.28% and 96.02 ± 4.50% respectively (p=0.0001). No participant had adequate knowledge and one had adequate skills at baseline. The proportion of those with adequate knowledge and skills markedly increased immediate post-training but decreased remarkably at three-month and at six-month evaluations respectively. 99.1% had adequate knowledge and all had adequate skills immediate post-training at 6 months. Conclusion: neonatal resuscitation training led to an improvement in knowledge and skills with suboptimal retention at three to six months post-training. Re-training improved knowledge and skills. We recommend that the retention of knowledge and skills could improve by retraining and mentoring at least 3-6 monthly.


Assuntos
Asfixia Neonatal/terapia , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/educação , Ressuscitação/educação , Adulto , Competência Clínica , Feminino , Pessoal de Saúde/normas , Humanos , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Nigéria , Guias de Prática Clínica como Assunto , Atenção Primária à Saúde , Estudos Prospectivos , Ressuscitação/normas , Fatores de Tempo
16.
Nurse Educ Today ; 101: 104889, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33865191

RESUMO

BACKGROUND: Use of academic electronic medical records is internationally recognised as a means for preparing health professional students for the digital healthcare environment. Reported practice benefits include skills for electronic documentation, health informatics, point-of-care clinical decision support systems, as well as preparation for information technology-enabled clinical settings, while challenges include lack of access to simulation software, faculty-related barriers, limited finances and educational software costs. However, little is known about best practices related to its use within pre-licensure or entry-to-practice nursing curricula and impact on clinical practice outcomes. OBJECTIVE: This review sought to explore how academic electronic medical records are used in entry-to-practice nursing curricula. DESIGN: A scoping review guided by the Joanna Briggs Institute three-step search strategy, exploring existing publications and grey literature. INCLUSION CRITERIA: Quantitative and qualitative studies related to use of academic electronic medical records in pre-licensure nurse education. INFORMATION SOURCES: A range of databases were searched including CINAHL, Medline, Proquest Central, ERIC, ScienceDirect, PubMed, IOS Press, as well as grey literature, reference lists and handsearching. REVIEW METHODS: The search yielded 580 articles, from which inductive thematic analysis of 34 included studies was conducted. RESULTS: Included articles were nine qualitative, 21 quantitative and five mixed methods studies. Most originated from the USA. Academic electronic medical records are mainly used to teach documentation, safe use of health technology, and for clinical preparation. Most are used for fundamental or junior levels courses, with problem-based learning and simulation embedded. Institution's technology resources and faculty capability are essential to implementation. CONCLUSIONS: There is a need for more research that examines optimal timing and duration of use of academic electronic medical records in curricula, and their impact on critical thinking and clinical performance. Finally, there is a need to explore greater academic-clinical partnerships in the education process.


Assuntos
Registros Eletrônicos de Saúde , Pessoal de Saúde , Competência Clínica , Currículo , Docentes , Pessoal de Saúde/educação , Humanos
17.
Int J Health Plann Manage ; 36(S1): 168-173, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33764595

RESUMO

The Western Cape province was the early epicentre of the coronavirus disease 2019 pandemic in South Africa and on the African continent. In this short article we report on an initiative set up within the provincial Department of Health early in the pandemic to facilitate collective learning and support for health workers and managers across the health system, emphasising the importance of leadership, systems resilience, nonhierarchical learning and connectedness. These strategies included regular and systematic engagement with organised labour, different ways of gauging and responding to staff morale, and daily 'huddles' for raid learning and responsive action. We propose three transformational actions that could deliver health systems that protect staff during good times and in times of system shocks. (a) Continuously invest in building the foundations of system resilience in good times, to draw on in an acute crisis situation. (b) Provide consistent leadership for an explicit commitment to supporting health workers through decisive action across the system. (c) Optimise available resources and partners, act on improvement ideas and obstacles. Build trusting relationships amongst and across actors.


Assuntos
Pessoal de Saúde/educação , Ensino , Interface Usuário-Computador , Assistência à Saúde/organização & administração , Humanos , Liderança , Pandemias , África do Sul
18.
BMC Pregnancy Childbirth ; 21(1): 190, 2021 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-33676439

RESUMO

INTRODUCTION: Bedouin women in Israel confront a challenging circumstance between their traditional patriarchal society and transition to modernity. In terms of reproductive health, they face grave disparities as women, pregnant women and mothers. In this article we aim to understand the challenges of Bedouin women who work as mediators in the promotion of Bedouin women's perinatal health. We explore their challenges with the dual and often conflictual role as health peer-instructors-mediators in mother-and-child clinics, and also as members of a Bedouin community, embodying a status as women, mothers, and family caretakers. Drawn upon a feminist interpretative framework, the article describes their challenges in matters of perinatal health. Our research question is: how do women who traditionally suffer from blatant gender inequality utilize health-promotion work to navigate and empower themselves and other Bedouin women. METHODS: Based on an interpretive feminist framework, we performed narrative analysis on eleven in-depth interviews with health mediators who worked in a project in the Negev area of Israel. The article qualitatively analyses the ways in which Bedouin women mediators narrate their challenging situations. RESULTS: This article shows how difficult health mediators' task may be for women with restricted education who struggle for autonomy and better social and maternal status. Through their praxis, women mediators develop a critical perspective without risking their commitments as women who are committed to their work as well as their society, communities, and families. These health mediators navigate their ways between the demands of their employer (the Israeli national mother and child health services) and their patriarchal Bedouin society. While avoiding open conflictual confrontations with both hegemonic powers, they also develop self-confidence and a critical and active approach. CONCLUSIONS: The article shows the ways by which the mediator's activity involved in perinatal health-promotion may utilize modern perinatal medical knowledge to increase women's awareness and autonomy over their pregnant bodies and their role as caregivers. We hope our results will be applicable for other women as well, especially for women who belong to other traditional and patriarchal societies.


Assuntos
Árabes/psicologia , Promoção da Saúde , Serviços de Saúde Materna , Assistência Perinatal , Gestantes , Saúde da Mulher , Cuidadores/ética , Cuidadores/psicologia , Características da Família/etnologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Pessoal de Saúde/educação , Pessoal de Saúde/ética , Pessoal de Saúde/psicologia , Promoção da Saúde/ética , Promoção da Saúde/métodos , Humanos , Lactente , Israel/etnologia , Serviços de Saúde Materna/ética , Serviços de Saúde Materna/tendências , Mães/psicologia , Aceitação pelo Paciente de Cuidados de Saúde , Assistência Perinatal/ética , Assistência Perinatal/métodos , Assistência Perinatal/tendências , Gravidez , Gestantes/etnologia , Gestantes/psicologia , Direitos da Mulher/ética
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