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2.
Metas enferm ; 23(9): 62-68, nov. 2020. graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-195353

RESUMO

La pandemia por COVID-19 ha mostrado la capacidad de adaptación del sistema sanitario español, poniendo en marcha medidas excepcionales e innovadoras como la creación de hoteles medicalizados. El objetivo a alcanzar consistía en liberar camas de hospital y garantizar el aislamiento de personas que o bien no disponían en sus domicilios de infraestructura para poder realizarlo tras el alta hospitalaria, o bien porque compartían hogar con personas vulnerables o frágiles, evitando de esta forma el contagio de los convivientes. El objetivo del presente trabajo es presentar la experiencia de haber medicalizado un hotel en la ciudad de Madrid vinculado al Hospital Universitario Gregorio Marañón (HGUGM) durante la primera ola pandémica de la COVID-19, desde el 19 de marzo hasta el 31 de mayo de 2020. Se aborda la puesta en marcha, contemplando los recursos materiales y humanos que se necesitaron, la organización, el desarrollo de la actividad y la humanización; así como los resultados de la experiencia. Fueron atendidos un total de 465 pacientes, con una estancia media de 10 días. La progresión de la ocupación se correspondió con la curva de contagios (pico máximo primera semana de abril: 146 pacientes). El personal de Enfermería realizó una media de 10 PCR por día, con un total de 817 pruebas. La participación en el estudio de seroprevalencia (Servicio de Microbiología del HGUGM) fue superior al 89% del personal de Enfermería, con un resultado de tres PCR positivas. En el contexto de la pandemia COVID-19, las enfermeras de la Comunidad de Madrid han demostrado estar capacitadas para habilitar espacios y lugares de atención a los pacientes en márgenes de tiempo de 48 h. Se formaron equipos multidisciplinares que funcionaron de forma eficiente, resolutiva y sin ningún conflicto


The COVID-19 pandemic has shown the adaptation ability of the Spanish Health System, through the implementation of exceptional and innovative measures such as the creation of medicalized hotels. The objective to be reached was the release of hospital beds, and ensuring isolation for people who had no infrastructure at home to be isolated after hospital discharge, or shared their home with vulnerable or fragile persons, thus preventing contagion among those living together. The objective of the present article is to present the experience of medicalizing a hotel in the city of Madrid, linked to the Hospital Universitario Gregorio Marañón (HGUGM), during the first wave of the COVID-19 pandemic, from March, 19th to May, 31st, 2020. Its implementation is addressed, considering the material and human resources required, its organization, the development of the activity and humanization, as well as the outcomes of the experience. In total, 465 patients were managed, with a mean 10-day stay. The occupation progression corresponded with the contagion curve (maximum peak during the first week of April: 146 patients). The Nursing staff performed a mean 10 PCR tests per day, with 817 tests in total. There was a >89% participation in the Seroprevalence Study (Microbiology Unit of the HGUGM) by the Nursing staff, with three positive PCR tests as outcome. In the context of the COVID-19 pandemic, the Community of Madrid nurses have demonstrated being qualified to provide spaces and places for patient care within a 48-hour margin. Multidisciplinary teams were formed, which worked in an efficient and operative way and without any conflicts


Assuntos
Humanos , Saneamento de Hotéis , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Betacoronavirus , Pandemias/prevenção & controle , Sistemas de Saúde/organização & administração , Isolamento de Pacientes/organização & administração , Recursos Humanos de Enfermagem/organização & administração , Humanização da Assistência , Espanha , Registros Eletrônicos de Saúde , Necessidades e Demandas de Serviços de Saúde/organização & administração , Necessidades e Demandas de Serviços de Saúde/normas
5.
Policy Polit Nurs Pract ; 21(3): 174-186, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32635838

RESUMO

In the United States, 1.4 million nursing home residents have been severely impacted by the COVID-19 pandemic with at least 25,923 resident and 449 staff deaths reported from the virus by June 1, 2020. The majority of residents have chronic illnesses and conditions and are vulnerable to infections and many share rooms and have congregate meals. There was evidence of inadequate registered nurse (RN) staffing levels and infection control procedures in many nursing homes prior to the outbreak of the virus. The aim of this study was to examine the relationship of nurse staffing in California nursing homes and compare homes with and without COVID-19 residents. Study data were from both the California and Los Angeles Departments of Public Health and as well as news organizations on nursing homes reporting COVID-19 infections between March and May 4, 2020. Results indicate that nursing homes with total RN staffing levels under the recommended minimum standard (0.75 hours per resident day) had a two times greater probability of having COVID-19 resident infections. Nursing homes with lower Medicare five-star ratings on total nurse and RN staffing levels (adjusted for acuity), higher total health deficiencies, and more beds had a higher probability of having COVID-19 residents. Nursing homes with low RN and total staffing levels appear to leave residents vulnerable to COVID-19 infections. Establishing minimum staffing standards at the federal and state levels could prevent this in the future.


Assuntos
Betacoronavirus , Infecções por Coronavirus/enfermagem , Casas de Saúde/organização & administração , Recursos Humanos de Enfermagem/organização & administração , Admissão e Escalonamento de Pessoal/estatística & dados numéricos , Pneumonia Viral/enfermagem , California , Humanos , Recursos Humanos de Enfermagem/provisão & distribução , Pandemias , Instituições de Cuidados Especializados de Enfermagem/organização & administração , Estados Unidos , Recursos Humanos
6.
J Clin Nurs ; 29(17-18): 3392-3402, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32533875

RESUMO

AIMS AND OBJECTIVES: To evaluate the process of implementing an oral care intervention in nursing homes in a Danish municipality. BACKGROUND: Older people with aged natural dentition require preventive and curative oral health care. An intervention based on principles of situated learning was implemented to establish closer cooperation between dental and nursing staff in nursing homes, leading to improved oral hygiene in nursing home residents. DESIGN: An embedded multiple-case study combined with principles of realist evaluation unfolded in three phases: Formulation of initial programme theory, Testing and Refining the programme theory. The COREQ checklist is followed in reporting. METHODS: Observations, six group interviews and 22 face-to-face interviews with dentists, dental practitioners, nursing home managers, care professionals and residents were conducted in three nursing homes (n = 41). RESULTS: Three main outcomes of a programme theory were identified, relating to (a) residents, in the form of new oral care routines; (b) interdisciplinary working, in the form of professional pride in performing sufficient oral care; (c) organisational level changes, in the form of increased interdisciplinary knowledge sharing. The overarching supportive mechanisms were the creation of relationships between residents, dental practitioners and care professionals as well as nursing home management taking responsibility for structure, planning and knowledge sharing. CONCLUSION: The situated learning perspective supported residents and care professionals' competencies in performing sufficient oral care. The shared oral care intervention supports an individual and multidisciplinary assessment of nursing home residents' ability to self-care concerning oral care. Contextual factors, supportive and restraining mechanisms influence the intervention's success. RELEVANCE TO CLINICAL PRACTICE: Understanding the complexity within interdisciplinary cooperation in primary nursing and unravelling the necessary properties to enhance nursing home residents' oral health care are areas of improvement for care service in nursing homes.


Assuntos
Instituição de Longa Permanência para Idosos/organização & administração , Casas de Saúde/organização & administração , Saúde Bucal/normas , Idoso , Idoso de 80 Anos ou mais , Dinamarca , Odontólogos/organização & administração , Feminino , Humanos , Comunicação Interdisciplinar , Recursos Humanos de Enfermagem/organização & administração , Saúde Bucal/educação , Avaliação de Processos em Cuidados de Saúde
7.
PLoS One ; 15(6): e0234874, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32574200

RESUMO

BACKGROUND: It is estimated that millions of patients are affected by healthcare associated infections (HAIs) each year. In Ghana, high prevalence of HAIs in relation to non-surgical (also called contaminated wounds) and surgical wounds (also called sterile wounds) is largely attributed to poor adherence to policy protocols for wound management by frontline clinical staff especially nurses. OBJECTIVE: Investigate the extent to which nursing staff adhere to the policy protocol for management of non-surgical and surgical wounds in selected public health facilities in Ghana. METHODOLOGY: This is an analytic case study among nursing staff (n = 140) in three government facilities in the Volta region of Ghana. Subjective and objective performance scores of staff on adherence proxies were compared using the Wilcoxon Signed-rank test, and univariate ordered logistic regression analysis used to predict staff likelihood of adherence to policy protocols on non-surgical and surgical wound management. FINDINGS: Overall, staff self-rated themselves higher on subjective performance proxies relative to their objective scores (p<0.05). Staff with more years of work experience did not translate into a higher likelihood of adhering to standard protocol on wound management (Coef. = -0.49, CI = -0.93-0.05, p = 0.036). Being a senior nursing officer relative to lower nursing ranks increased staff likelihood of complying particularly with standard policy protocol for management of non-surgical wounds (Coef. 5.27, CI = 0.59 9.95, p = 0.027). CONCLUSION: There is the need for accelerated in-service training for staff on standard protocols for wound management coupled with supportive supervisions. Staff adherence to standard quality care protocols should be a pre-requisite for licensing of health facilities by regulatory bodies like Health Facilities Regulatory Agency and National Health Insurance Authority.


Assuntos
Infecção Hospitalar/terapia , Implementação de Plano de Saúde , Hospitais Públicos/organização & administração , Recursos Humanos de Enfermagem/organização & administração , Ferimentos e Lesões/terapia , Adulto , Protocolos Clínicos/normas , Infecção Hospitalar/epidemiologia , Feminino , Gana/epidemiologia , Fidelidade a Diretrizes , Política de Saúde , Humanos , Masculino , Programas Nacionais de Saúde/normas , Recursos Humanos de Enfermagem/normas , Recursos Humanos de Enfermagem/estatística & dados numéricos , Prevalência , Qualidade da Assistência à Saúde , Inquéritos e Questionários/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Adulto Jovem
8.
Nurs Manag (Harrow) ; 27(4): 32-40, 2020 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-32543159

RESUMO

The emergence of coronavirus disease 2019 (COVID-19) has meant that nurse leaders need to respond rapidly and decisively to the demands and challenges of a pandemic in a context of increased staff shortages and limited resources. This article suggests essential leadership skills and characteristics that nurses can use to underpin effective leadership in a crisis, emphasising the importance of decision-making and emotional intelligence. It also addresses two important questions: 'what do leaders in a crisis need to do that differs from any other time?' and 'what does effective leadership look like in a crisis?'


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/enfermagem , Liderança , Enfermeiras Administradoras/psicologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/enfermagem , Tomada de Decisões , Recursos em Saúde/organização & administração , Recursos em Saúde/provisão & distribução , Humanos , Recursos Humanos de Enfermagem/organização & administração , Recursos Humanos de Enfermagem/provisão & distribução
10.
Nurs Manag (Harrow) ; 27(3): 22-27, 2020 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-32400142

RESUMO

Most research on resilience in healthcare systems such as the NHS is based on organisational crises, such as nurse shortages, an ageing workforce and financial restrictions. However, nursing can learn lessons from the past to consider how to become more resilient, particularly considering the 2020 COVID-19 pandemic. This article briefly looks at previous pandemics and disasters that have affected healthcare systems, as well as the 2020 COVID-19 pandemic, and considers how nurse leaders can support staff and show organisational resilience during such emergencies. The article also discusses how nurse leaders can develop their own resilience.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/enfermagem , Enfermeiras Administradoras/psicologia , Recursos Humanos de Enfermagem/organização & administração , Recursos Humanos de Enfermagem/psicologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/enfermagem , Resiliência Psicológica , Humanos , Relações Interprofissionais , Apoio Social , Medicina Estatal/organização & administração , Reino Unido/epidemiologia
11.
Postgrad Med ; 132(5): 479-484, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32276565

RESUMO

OBJECTIVES: This study compares two methods of providing CVD risk score on the percentage of appropriate statin therapy for primary prevention of CVD in family medicine clinics, according to the American Heart Association guidelines. METHODS: Participants were non-diabetic patients aged 40 to 75 with a recently ordered low-density lipoprotein (LDL) level, not on statin therapy and free of CVD. The first intervention is passive with a display of the score on the EMR in the vital signs section and lasted for three months. The second intervention is collaborative where the nurses calculate the risk score and displayed it to the physician along with therapy recommendations. Electronic health records were reviewed to randomly select medical charts of eligible patients. RESULTS: 162 charts were randomly selected out of 547 eligible charts and included in the analysis, including 60 charts for the baseline group. Among moderate-risk patients, the percentage of appropriate statin initiation was 0% at baseline and after intervention 1; yet it increased to (33.3% [7.5-70.1, 95% CI]) after intervention 2. Among high risk patients, percentage of appropriate statin initiation was 9.1% [0.1-41.3, 95% CI], 11.1% [1.4, 34.7, 95% CI] and 28.6% [8.4, 58.1, 95% CI] during baseline, intervention 1 and intervention 2, respectively. CONCLUSION: The provision of the CVD risk score alone as clinical decision support is not enough to improve statin initiation for primary prevention. The nurse collaboration can improve guideline-concordant statin initiation.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Tomada de Decisão Clínica/métodos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Recursos Humanos de Enfermagem/organização & administração , Melhoria de Qualidade/organização & administração , Adulto , Idoso , LDL-Colesterol/sangue , Feminino , Hemoglobina A Glicada , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Masculino , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem/normas , Guias de Prática Clínica como Assunto , Prevenção Primária , Melhoria de Qualidade/normas , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença
12.
Am J Nurs ; 120(4): 45-48, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32218047

RESUMO

Since the 1960s, plastic has been used in the production of medical equipment and products that improve patient comfort, safety, and treatment. Yet an unwelcome challenge has emerged in the years since: how to safely dispose of this material without negatively affecting human health and the environment. Working with medical devices and supplies that are constructed using plastics, nurses are at the forefront of this issue and must identify solutions, collaborate with other health care workers, and lead efforts to establish more sustainable options. This series is in collaboration with the Alliance of Nurses for Healthy Environments (https://envirn.org).


Assuntos
Conservação dos Recursos Naturais , Resíduos de Serviços de Saúde/efeitos adversos , Plásticos , Gerenciamento de Resíduos , Assistência à Saúde , Humanos , Recursos Humanos de Enfermagem/organização & administração
13.
Creat Nurs ; 26(1): 37-42, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-32024737

RESUMO

Health and social care for older people in Finland is increasingly provided in people's homes, leading to large caseloads of high-dependency patients for providers of home care, whose working conditions have deteriorated. Buurtzorg, a model of home care in the Netherlands that empowers caregivers to organize their own work processes, has shown promising results in terms of effectiveness and satisfaction of clients and caregivers. This article aims to provide insights about the challenges and effects of implementing self-organizing teams in three Finnish public health and social care organizations.


Assuntos
Cuidadores/psicologia , Eficiência Organizacional , Idoso Fragilizado/psicologia , Serviços de Assistência Domiciliar/organização & administração , Recursos Humanos de Enfermagem/organização & administração , Recursos Humanos de Enfermagem/psicologia , Equipe de Enfermagem/organização & administração , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Finlândia , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Pesquisa Qualitativa
14.
J Nurs Adm ; 50(2): 63-65, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31977943

RESUMO

The 2019 Association for Leadership Science in Nursing International Conference, Disruptive Innovation, was held in Los Angeles, California, with attendees from 30 US states, Canada, Brazil, and China. Presenters discussed the need for nurse leaders to advocate for health equity, lead evidence-based innovation, how robots and other technology are generating disruptive innovations in healthcare, and building strong academic-practice partnerships to address nursing workforce challenges. This article will report on these important insights.


Assuntos
Enfermagem Baseada em Evidências/organização & administração , Equidade em Saúde/organização & administração , Invenções , Enfermeiras Administradoras/organização & administração , Recursos Humanos de Enfermagem/organização & administração , Inovação Organizacional , Brasil , Canadá , China , Humanos , Liderança , Estados Unidos
16.
Comput Inform Nurs ; 38(1): 36-44, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31850937

RESUMO

Electronic health record systems have been widely implemented throughout healthcare settings over the last few years, and nurses rely on these systems to obtain information about patients, make clinical decisions, and deliver safe and appropriate care. Health information technology systems have electronic health record downtime episodes both due to scheduled maintenance and unforeseen circumstances. The ability to deliver safe and effective care during electronic health record downtime episodes is important, yet training on electronic health record downtime is rarely included for nursing staff. This quality improvement project implemented an electronic health record downtime training course and administered it to 50 onboarding nurses within the hospital facility. The participants indicated a positive perception of electronic health record downtime preparedness after the course offering related to ability to find and follow downtime procedures. However, no precourse metrics were obtained, and therefore it is uncertain if this positive perception is a direct result of the electronic health record downtime training course. While initial results are promising, further investigation will need to be conducted to determine training course effectiveness.


Assuntos
Enfermagem Baseada em Evidências , Capacitação em Serviço/organização & administração , Recursos Humanos de Enfermagem/educação , Melhoria de Qualidade , Adulto , Registros Eletrônicos de Saúde , Feminino , Hospitais , Humanos , Masculino , Recursos Humanos de Enfermagem/organização & administração , Adulto Jovem
18.
BMC Health Serv Res ; 19(1): 917, 2019 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-31783755

RESUMO

BACKGROUND: The workforce shortage is one of the major issues associated with the recovery of Minamisoma City in Fukushima Prefecture, after the Great East Japan Earthquake and the subsequent accidents at the Fukushima Daiichi Nuclear Power Plants in March 2011. While the radiation risks are often discussed as a major factor of evacuation, little is known about the actual reasons why the residents chose to evacuate, and what enables them to return. This study aims to find the essential factors for rebuilding the workforce in a post-disaster setting by analysing the residents' decisions about evacuation and the return to Minamisoma. In particular, we focus on the experiences of nurses as an example of healthcare workers, who play an important role in the disaster recovery. METHODS: The data were obtained through qualitative interviews in a semi-structured form with 25 nurses from four hospitals in Minamisoma City. The interview questions focused on the reasons of their decisions on evacuation and return. The data were analysed by a thematic approach to investigate the major factors which led them to evacuate and enabled them to return afterwards, as well as the support they needed to resettle. RESULTS: Nearly two-thirds of the interviewees chose to evacuate from Minamisoma with their family. Family conditions seem to be the predominant factor that influenced their decisions. In particular, having small children was a strong cause for evacuation. After a certain period of time, the nurses that evacuated were then faced with another decision about returning to the area; once again, having children, as well as other life factors, such as livelihoods, job opportunities and emotional attachment to the work, influenced this decision. On the other hand, radiation risk was a minor factor. Therefore, we analyse that improved support considering their life situations would contribute to the better retention of the nurses. CONCLUSIONS: We suggest measures such as parenting supports, ensuring job opportunities after return, and psychological support in the workplace as possible solutions for higher job retention.


Assuntos
Acidente Nuclear de Fukushima , Recursos em Saúde/organização & administração , Hospitais , Recursos Humanos de Enfermagem/provisão & distribução , Recursos Humanos/organização & administração , Humanos , Japão , Recursos Humanos de Enfermagem/organização & administração , Pesquisa Qualitativa , Local de Trabalho
20.
Assist Inferm Ric ; 38(3): 117-137, 2019.
Artigo em Italiano | MEDLINE | ID: mdl-31593149

RESUMO

. Nursing sensitive outcomes: the results of a multicentre study. INTRODUCTION: The relationship between staffing characteristics and nursing sensitive outcomes has been explored in several studies. AIMS: To assess the effect of staffing characteristics, nurses' wellbeing at work and hours of care on pressure sores, falls and physical restrains occurrence. METHODS: Longitudinal study including from February 2014 to June 2015 a total of 24110 consecutive patients and 2606 nurses of 134 units (geriatrics and medicine (GM), orthopedic-traumatology (OT) and rehabilitation and long-term care (LR) of 12 Italian regions. Data was collected up to 15 days for each included patient, and regarding the staff of each shift by ad hoc trained personnel. RESULTS: There is a large variability in both patients and nurses' characteristics across wards, as well as of outcomes, even in the same area (e.g., GM). Patients in GM received a mean of 144±35 minutes of care/day; 186±146 in OT and 140±40 in LR. The incidence of pressure sores was 5.3%±4.8% in GM; 5.1%±5.6% in OT and 8.6%±10.1% in LR. The incidence of falls was 1.9%±2.1% in GM, 0.8%±1% in OT and 2.9%±3.8% in LR. Restraints were used in 41.4%±30.3% of patients in GM, among 24.8%±23.4% in OT and 54.7%±29.7% in LR. The multilevel analyses confirmed the importance of clinical factors but also the positive effects of staff characteristics such as the number of expert nurses and the negative effects of a negative work environment, although with wide variations across settings have emerged. CONCLUSIONS: Staff characteristics related to work environment affect patient outcomes but the large variability across wards would require further stratification of the data to better understand and interpret the findings.


Assuntos
Acidentes por Quedas/estatística & dados numéricos , Recursos Humanos de Enfermagem/organização & administração , Lesão por Pressão/enfermagem , Restrição Física/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Itália , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Cuidados de Enfermagem/organização & administração , Recursos Humanos de Enfermagem/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde , Lesão por Pressão/epidemiologia , Fatores de Tempo
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