Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.776
Filtrar
2.
Acad Med ; 95(1): 104-110, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31299036

RESUMO

PURPOSE: To characterize the methods of inpatient consult communication, given new communication modalities; to explore residents' and fellows' perspectives on the ideal consult and how this consult could affect their teaching, learning, and patient safety; and to identify barriers to and strategies for optimizing consultations. METHOD: Using qualitative grounded theory, the authors conducted semistructured focus groups with pediatric residents and fellows at Lucile Packard Children's Hospital at Stanford University from October 2016 to September 2017, using questions developed by expert consensus to address study objectives. Sessions were audiorecorded and transcribed verbatim. Two authors independently coded the transcripts and reconciled codes to develop categories and themes using constant comparison. The third author validated the codes, categories, and themes. To ensure trustworthiness, participants edited the themes for accuracy. RESULTS: Twenty-seven residents and 16 fellows participated in 7 focus groups (3 with residents, 4 with fellows). Four themes emerged: (1) Many forms of communication are successfully used for initial inpatient consult recommendations (in person, phone, text messages, notes in electronic medical records); (2) residents and fellows prefer in-person communication for consults, believing it leads to improved teaching, learning, and patient safety; (3) multiple strategies can optimize consults regardless of communication modality; and (4) how residents frame the initial consult affects the interaction and can increase fellow engagement, which leads to more fellow teaching, residents' improved understanding, and better patient care. CONCLUSIONS: Residents and fellows believe that structured initial consults conducted in person improve teaching, learning, and patient care. Several strategies exist to optimize this process.


Assuntos
Sistemas de Comunicação no Hospital/tendências , Pacientes Internados/estatística & dados numéricos , Internato e Residência/normas , Encaminhamento e Consulta/normas , Confiabilidade dos Dados , Educação de Pós-Graduação em Medicina/métodos , Estudos de Avaliação como Assunto , Feminino , Grupos Focais , Humanos , Aprendizagem/fisiologia , Masculino , Segurança do Paciente/normas , Pediatria , Encaminhamento e Consulta/tendências , Ensino/estatística & dados numéricos , Ensino/tendências , Estados Unidos/epidemiologia
3.
Med J Aust ; 211(11): 514-517, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31813173

RESUMO

OBJECTIVES: To determine whether gendered symbols on patient call bells are restricted to our hospital or are examples of an international practice that perpetuates gender stereotypes and occupational segregation. SETTING: Multicentre, international study of hospital equipment, 2018. MAIN OUTCOME MEASURE: Types of symbols on patient call bells. RESULTS: We received 56 responses from 43 hospitals in eight countries across five continents: 37 devices included female-specific images, nine included gender-neutral images, and ten did not use imagery (for example, button-only devices). No call bells included male-specific images. CONCLUSION: Female symbols on patient call bells are an international phenomenon. Only female or gender-neutral images are used, indicating bias in their design, manufacture, and selection. Female symbols may reinforce gender stereotypes and contribute to occupational segregation and reduced equity of opportunity. We suggest alternative symbols. Individual action with coloured marker pens may provide a pragmatic short term, albeit provocative, solution. While call bell design has only a minor impact on patients, everyday bias affects all staff and society in general.


Assuntos
Sistemas de Comunicação no Hospital/estatística & dados numéricos , Defesa do Paciente/estatística & dados numéricos , Sexismo , Viés , Feminino , Saúde Global , Humanos , Masculino , Preferência do Paciente/estatística & dados numéricos , Satisfação do Paciente
4.
BMC Health Serv Res ; 19(1): 992, 2019 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-31870370

RESUMO

BACKGROUND: Frequent pages can disrupt workflow, interrupt patient care, and may contribute to physician burnout. We hypothesized that paging volumes followed consistent temporal trends, regardless of the medical or surgical service, reflecting systems based issues present in our hospitals. METHODS: A retrospective review of the hospital paging systems for 4 services at The Ottawa Hospital was performed. Resident paging data from April 1 to July 31, 2018 were collected for services with a single primary pager number including orthopaedic surgery, general surgery, neurology, and neurosurgery. Trends in paging volume during the 4-month period were examined. Variables examined included the location of origin of the page (emergency room vs. inpatient unit), and day/time of the page. RESULTS: During the study period, 25,797 pages were received by the 4 services, averaging 211 (± Standard Deviation (SD) 12) pages per day. 19,371 (75%) pages were from in-patient hospital units, while 6426 (24%) were pages from the emergency room. The median interval between pages across all specialties was 22:30 min. Emergency room pages peaked between 16:30 and 20:00, while in-patient units peaked between 17:30 and 18:30. CONCLUSIONS: Each service experienced frequent paging with similar patterns of marked increases at specific times. This study identifies areas for future study about what the factors are that contribute to the paging patterns observed.


Assuntos
Sistemas de Comunicação no Hospital/estatística & dados numéricos , Médicos/psicologia , Centros de Atenção Terciária , Esgotamento Profissional , Canadá , Humanos , Assistência ao Paciente , Estudos Retrospectivos , Fluxo de Trabalho
5.
J Nurs Manag ; 27(7): 1554-1562, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31435994

RESUMO

AIM: We sought nurse managers' perspectives on challenges and opportunities with technology and how it may influence communication and leadership. BACKGROUND: e-Leadership is a conceptual framework used to understand and teach organisational leaders about the application of technology to leadership. Technology is integral to leadership, yet little is understood about how nurse managers may use this technology and how they negotiate the complexity of the multiple communication systems currently in use. METHODS: Sixteen nurse managers from individual hospitals within a large US healthcare system participated in qualitative open-ended interviews and focus groups. RESULTS: Four themes emerged from the qualitative data regarding the nurse managers' perspectives of e-Leadership and their use of information and communication technologies: (a) Can't live without it, (b) Too much, too many, (c) Poor onboarding education and (d) Difficulty maintaining virtual relationships. IMPLICATIONS FOR NURSING MANAGEMENT: Effective and safe patient care is dependent on multiple technology applications that require significant knowledge and practice. Nursing leadership may consider the need for more supported mentorship, and engaging programs to educate nurse managers about the dozens of applications required to effectively manage and lead. For technology to be used to its full potential it should be designed with nursing involvement.


Assuntos
Sistemas de Comunicação no Hospital/normas , Liderança , Enfermeiras Administradoras/psicologia , Percepção , Idoso , Feminino , Grupos Focais/métodos , Sistemas de Comunicação no Hospital/tendências , Humanos , Relações Interprofissionais , Entrevistas como Assunto/métodos , Masculino , Pessoa de Meia-Idade , Enfermeiras Administradoras/tendências , Pesquisa Qualitativa
6.
Rev. Hosp. Ital. B. Aires (2004) ; 39(2): 36-42, jun. 2019. tab.
Artigo em Espanhol | LILACS | ID: biblio-1047848

RESUMO

La comunicación efectiva dentro de las organizaciones es uno de los factores más importantes para lograr un trabajo positivo y eficaz. Se realizó una investigación cuyo objetivo fue identificar y describir las herramientas de comunicación en el área de Quirófano Central del Hospital Italiano de Buenos Aires y las distintas perspectivas de los instrumentadores quirúrgicos respecto de su utilización. Métodos: se realizó un estudio de corte transversal con un componente de observación participativa de los medios de comunicación y una encuesta a los instrumentadores quirúrgicos de la institución. Resultados: se identificaron ocho tipos de herramientas de comunicación en el área quirúrgica. El correo electrónico (e-mail) como herramienta de comunicación es muy utilizado según los instrumentadores quirúrgicos, pero estos sugirieron otras herramientas más directas, como reuniones y capacitaciones solas o en combinación para determinados tipos de información. Conclusiones: los instrumentadores quirúrgicos utilizan una amplia gama de medios de comunicación en el área quirúrgica. La distribución de preferencias según el tipo de información indica que la elección de estos medios debería ser personalizada. (AU)


Effective communication within organizations is one of the most important factors to achieve a positive and effective work. An investigation was carried out and its objective was to identify and describe the communication tools in the surgical area of the Hospital Italiano de Buenos Aires and the different perspectives of the surgical nurses regarding its use. Methods: a cross-sectional study was carried out with a component of participative observation of the communication tools and a survey of the surgical nurses of the institution. Results: eight types of communication tools were identified in the surgical area. The implementation of email as a communication tool is widely used by surgical nurses, but they suggested other more direct tools such as meetings and training sessions alone or in combination for certain types of information. Conclusions: Surgical nurses use a wide range of communication tools in the surgical area. The distribution of preferences according to the type of information indicates that the choice of these tools should be personalized. (AU)


Assuntos
Humanos , Auxiliares de Cirurgia/tendências , Sistemas de Informação em Salas Cirúrgicas/organização & administração , Sistemas de Comunicação no Hospital/organização & administração , Salas Cirúrgicas/organização & administração , Sistemas de Informação em Salas Cirúrgicas/normas , Sistemas de Informação em Salas Cirúrgicas/estatística & dados numéricos , Comunicação , Congressos como Assunto , Correio Eletrônico/instrumentação , Capacitação Profissional
7.
Bull Cancer ; 106(6): 514-526, 2019 Jun.
Artigo em Francês | MEDLINE | ID: mdl-31126678

RESUMO

The emergence of oral cancer treatment in oncology has shifted patient follow-up from the hospital to the home. This trend has resulted in an increase in phone and e-mail interactions initiated by patients, but also by pharmacists, by liberal nurses, by general practitioners, and an increase in calls to the emergency response services (SAMU) both for real or perceived emergencies. This increased volume of patient and pharmacist communication has caused significant disruption in the daily activity of affected oncology departments and in particular of the secretariats. The procedures for formulating and securing appropriate responses within a short time frame are generally not established, and as a result, there is a risk that decisions made could be inappropriate for the patient's situation, especially in the case of complications.. Tracking responses to phone calls is necessary and answers should be noted in the medical file, including side effects, in particular the serious AEs for a good quality of care. This guideline describes best practices for oncologists who manage "incoming" calls from patients or professionals involved in the care pathway.


Assuntos
Antineoplásicos/uso terapêutico , Correio Eletrônico , Serviço Hospitalar de Emergência/organização & administração , Sistemas de Comunicação no Hospital/organização & administração , Neoplasias/tratamento farmacológico , Serviço Hospitalar de Oncologia/organização & administração , Guias de Prática Clínica como Assunto , Telefone , Administração Oral , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Continuidade da Assistência ao Paciente , Serviço Hospitalar de Emergência/estatística & dados numéricos , Assistência Domiciliar , Humanos , Comunicação Interdisciplinar , Serviço Hospitalar de Oncologia/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde , Equipe de Assistência ao Paciente
8.
Rev Gaucha Enferm ; 40(spe): e20180337, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31038605

RESUMO

OBJECTIVE: To analyze the perception of health professionals and companions/family about the development of communication for patient safety in pediatric hospitalizations. METHOD: It is an exploratory-descriptive study with a qualitative approach, performed in pediatric clinical-surgical hospitalization units of three hospitals in Porto Alegre, RS, Brazil. 44 health professionals and 94 companions of hospitalized children participated in the study, to a total of 138 participants. Data collection took place between 2016 and 2017, through semi-structured interviews. A thematic content analysis was used. RESULTS: Two categories emerged: "Barriers to an effective communication", addressing the failures and difficulties in the communication process and "Tools to improve communication", that present recommendations for improvements, especially instrumentalization of the companion/family member. CONCLUSIONS: The barriers to an effective communication involve several factors, and effective communication strategies can assist in the development of improvements for pediatric patient safety.


Assuntos
Criança Hospitalizada , Barreiras de Comunicação , Sistemas de Comunicação no Hospital/organização & administração , Segurança do Paciente , Adolescente , Atitude do Pessoal de Saúde , Criança , Pré-Escolar , Família/psicologia , Amigos/psicologia , Comunicação em Saúde , Humanos , Lactente , Relações Interprofissionais , Entrevistas como Assunto , Equipe de Assistência ao Paciente , Recursos Humanos em Hospital/psicologia , Relações Profissional-Família , Relações Profissional-Paciente , Pesquisa Qualitativa
9.
Rev Gaucha Enferm ; 40(spe): e20180341, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31038606

RESUMO

OBJECTIVE: To analyze the registry of the Transfer Note (NT) and the emission of the Modified Early Warning Score (MEWS) performed by the nurse in adult patients transferred from the Emergency Service as an effective communication strategy for patient safety. METHOD: A cross-sectional retrospective study developed at a teaching hospital in the South of Brazil that evaluated 8028 electronic medical records in the year 2017. A descriptive analysis was performed. RESULTS: NT reached the institutional target of 95% in January and February, falling below the target in other months. The MEWS measurement was performed in 85.6% (n = 6,870) of the medical records. Of these patients, 96.8% (n = 6,652) had unchanged MEWS. CONCLUSION: NT and MEWS are inserted in the work of the nurse, however, actions are needed to qualify patient safety, improving effective communication and therefore reducing the possibility of occurrence of adverse events.


Assuntos
Sistemas de Comunicação no Hospital , Registros Hospitalares , Avaliação em Enfermagem , Registros de Enfermagem , Segurança do Paciente , Transferência de Pacientes/organização & administração , Gestão de Riscos/métodos , Índice de Gravidade de Doença , Adulto , Brasil , Estudos Transversais , Registros Eletrônicos de Saúde , Serviço Hospitalar de Emergência , Controle de Formulários e Registros , Sistemas de Comunicação no Hospital/organização & administração , Hospitais de Ensino/organização & administração , Humanos , Papel do Profissional de Enfermagem , Indicadores de Qualidade em Assistência à Saúde , Estudos Retrospectivos , Medição de Risco , Gestão de Riscos/organização & administração
10.
Pediatrics ; 143(4)2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30890559

RESUMO

BACKGROUND AND OBJECTIVES: Paging is a primary mode of communication in hospitals, but message quality varies. With this project, we aimed to standardize paging, thus improving end user (EU) satisfaction, patient safety, and efficiency. Objectives were to increase the percent of pages containing 6 critical elements (CEs) (ie, the sender's first and last name, a 7-digit callback number, patient name, room number, and urgency indicator [information only, call, or come] to 90%); improve EU satisfaction to 80% rating paging communication as good or excellent; and decrease the frequency of safety events related to paging. METHODS: This multidisciplinary, system-wide quality improvement study was conducted at our stand-alone academic children's hospital. CEs were determined by EU consensus. Outcome measures were inclusion of all 6 CEs, provider satisfaction, and frequency of safety events. Process measures were inclusion of individual CEs and appropriateness and timeliness of response to pages. Balancing measures included number of work-arounds (WAs). Interventions included education, engineering a platform with required fields, and optimization enhancements. Statistical process control charts (p-charts; XmR) were used to track the impact of interventions. RESULTS: Special-cause improvement was noted in use of all 6 CEs (4.4%-79.7%) and individual CEs. EU satisfaction improved from 50% to 85% rating paging communication as good or excellent. Safety events related to paging remain infrequent. Specific WA use decreased by 60%. CONCLUSIONS: System-wide use of required fields produced significant improvement in inclusion of all 6 CEs and EU satisfaction. WAs were curbed by improving the ease of CE incorporation. Required fields should be considered at institutions seeking improved paging communication.


Assuntos
Sistemas de Comunicação no Hospital/normas , Hospitais Pediátricos/normas , Avaliação de Resultados em Cuidados de Saúde , Melhoria de Qualidade , Centros Médicos Acadêmicos , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Comunicação Interdisciplinar , Masculino , Padrões de Referência , Wisconsin
11.
Health Secur ; 17(1): 27-34, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30779610

RESUMO

High-consequence pathogens create a unique problem. To provide effective treatment for infected patients while providing safety for the community, a series of 10 high-level isolation units have been created across the country; they are known as Regional Ebola and Special Pathogen Treatment Centers (RESPTCs). The activation of a high-level isolation unit is a highly resource-intensive activity, with effects that ripple across the healthcare system. The incident command system (ICS), a standard tool for command, control, and coordination in domestic emergencies, is a command structure that may be useful in a biocontainment event. A version of this system, the hospital emergency incident command system, provides an adaptable all-hazards approach in healthcare delivery systems. Here we describe its utility in an operational response to safely care for a patient(s) infected with a high-consequence pathogen on a high-level isolation unit. The Johns Hopkins Hospital created a high-level isolation unit to manage the comprehensive and complex needs of patients with high-consequence infectious diseases, including Ebola virus disease. The unique challenges of and opportunities for providing care in this high-level isolation unit led the authors to modify the hospital incident command system model for use during activation. This system has been tested and refined during full-scale functional and tabletop exercises. Lessons learned from the after-action reviews of these exercises led to optimization of the structure and implementation of ICS on the biocontainment unit, including improved job action sheets, designation of physical location of roles, and communication approaches. Overall, the adaptation of ICS for use in the high-level isolation unit setting may be an effective approach to emergency management during an activation.


Assuntos
Contenção de Riscos Biológicos/métodos , Serviços Médicos de Emergência/organização & administração , Doença pelo Vírus Ebola/terapia , Arquitetura Hospitalar/métodos , Controle de Infecções/métodos , Corpo Clínico Hospitalar/educação , Doença pelo Vírus Ebola/transmissão , Sistemas de Comunicação no Hospital , Humanos , Isolamento de Pacientes , Centros de Atenção Terciária
12.
Comput Inform Nurs ; 37(4): 229-234, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30664031

RESUMO

Qualitative reports of hands-free communication devices highlight numerous improvements in communication. The purpose of this study was to assess both usability and satisfaction scores at approximately 1 year after the implementation of a hands-free communication device at two different large military facilities. To do this, a survey that included the System Usability Scale and questions to assess satisfaction with regard to use, quality, and user satisfaction was provided to staff at both of these facilities. System usability scores indicated moderate satisfaction (61.7 at facility A, 63.8 at facility B). User satisfaction rated highest levels of agreement with the hands-free devices as an important system and being useful (35%-37% at facility A, 46% at facility B). Scores regarding improving the quality of work (A = 12%, B = 16%); safety of patients (A = 23%, B = 29%); and ability to do their job in a timely manner (A = 23%, B = 29%) were the lowest. The results highlight the potential benefits of Vocera for improving communication within the healthcare team. Given the large percentage of staff turnover at both of these facilities, the sustained benefit of hands-free devices will require ongoing training and continued evaluation of workflow processes.


Assuntos
Atitude do Pessoal de Saúde , Sistemas de Comunicação no Hospital/organização & administração , Satisfação Pessoal , Tecnologia sem Fio , Adulto , Comunicação , Eficiência Organizacional , Feminino , Hospitais Militares , Humanos , Masculino , Recursos Humanos de Enfermagem no Hospital/psicologia , Inquéritos e Questionários , Fatores de Tempo
13.
J Clin Neurosci ; 61: 66-72, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30455134

RESUMO

Indicator of response urgency (page tag), paging domains, distribution of pages by time of the day, and factors associated with neurocritical care paging remain elusive and were examined in this study. We examined the association between patient, neurocritical care workflow characteristics, and paging domains on frequency of paging using Student's t-test, Chi-square test, and analysis of covariance. A total of 1852 patients generated 36,472 pages. The most common page tagging was "for your information" (n = 15067, 41.3%), while 2.8% (n = 1006) pages were tagged urgent. Paging was most frequent for cardiovascular (12.2%), pain, agitation, distress (6.9%) and sodium (5.3%) concerns. Paging frequency was highest for mechanically ventilated patients (p < 0.001), those with indwelling intracranial pressure monitor (p < 0.04), arterial catheter (p < 0.001), central venous access catheter (p < 0.001), and in those with lower Glasgow Coma Score (p < 0.001). Patients admitted between 18:00-06:00 (aOR 1.47, 95% CI 1.16-1.86) and 14:30-18:00 (aOR 1.46, 95% CI 1.14-1.86), and sodium (aOR 1.52, 95% CI 1.39-1.66), and cardiovascular concerns (aOR 1.24, 95% CI 1.15-1.32) were associated with higher night time paging frequency. Incorporating paging domains in daily workflow and their impact on outcome of paging on escalation of clinical care and patient outcomes warrants further examination.


Assuntos
Cuidados Críticos/estatística & dados numéricos , Sistemas de Comunicação no Hospital/estatística & dados numéricos , Pacientes/estatística & dados numéricos , Fluxo de Trabalho , Humanos , Monitorização Neurofisiológica/estatística & dados numéricos
14.
Rev. gaúch. enferm ; 40(spe): e20180337, 2019.
Artigo em Português | LILACS | ID: biblio-1004108

RESUMO

Resumo OBJETIVO Analisar a percepção de profissionais de saúde e acompanhantes/familiares quanto ao desenvolvimento da comunicação para a segurança do paciente em internações pediátricas. MÉTODO estudo exploratório-descritivo, qualitativo, realizado em unidades de internação clínico-cirúrgicas pediátricas de três hospitais de Porto Alegre, RS, Brasil. Participaram do estudo 44 profissionais de saúde e 94 acompanhantes de crianças hospitalizadas, totalizando 138 participantes. A coleta ocorreu no período de 2016 a 2017, por meio de entrevistas semiestruturadas. Realizou-se análise de conteúdo do tipo temática. RESULTADOS Emergiram duas categorias: "Barreiras para a Comunicação Efetiva" que abordou as falhas e dificuldades no processo de comunicação e "Ferramentas para Qualificar a Comunicação" que apresenta recomendações para as melhorias, em especial, instrumentalização do acompanhante/familiar. CONCLUSÕES As barreiras para a comunicação efetiva envolvem múltiplos fatores e as estratégias de comunicação efetiva podem auxiliar no desenvolvimento de melhorias para a segurança do paciente pediátrico.


Resumen OBJETIVO Analizar la percepción de profesionales de salud y acompañantes/familiares con respecto al desarrollo de la comunicación para la seguridad del paciente en internaciones pediátricas. MÉTODO Estudio exploratorio-descriptivo, cualitativo, realizado en unidades de internación clínico-quirúrgicas pediátricas de tres hospitales de Porto Alegre, RS, Brasil. Participaron del estudio 44 profesionales de salud y 94 acompañantes de niños hospitalizados, totalizando 138 participantes. La recolección ocurrió en el período de 2016 a 2017, por medio de entrevistas semiestructuradas. Se realizó un análisis de contenido del tipo temático. RESULTADOS Surgieron dos categorías: "Barreras para la comunicación efectiva" que abordo las fallas y dificultades en el proceso de comunicación y "Herramientas para calificar la comunicación" que presenta recomendaciones para mejorías, em particular, instrumentalización del acompañante/familiar. CONCLUSIONES Las barreras para la comunicación efectiva envuelven diversos factores y las estrategias de comunicación efectiva pueden ayudar en el desarrollo de mejorías para la seguridad del paciente pediátrico.


Abstract OBJECTIVE To analyze the perception of health professionals and companions/family about the development of communication for patient safety in pediatric hospitalizations. METHOD It is an exploratory-descriptive study with a qualitative approach, performed in pediatric clinical-surgical hospitalization units of three hospitals in Porto Alegre, RS, Brazil. 44 health professionals and 94 companions of hospitalized children participated in the study, to a total of 138 participants. Data collection took place between 2016 and 2017, through semi-structured interviews. A thematic content analysis was used. RESULTS Two categories emerged: "Barriers to an effective communication", addressing the failures and difficulties in the communication process and "Tools to improve communication", that present recommendations for improvements, especially instrumentalization of the companion/family member. CONCLUSIONS The barriers to an effective communication involve several factors, and effective communication strategies can assist in the development of improvements for pediatric patient safety.


Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Adolescente , Criança Hospitalizada , Barreiras de Comunicação , Segurança do Paciente , Sistemas de Comunicação no Hospital/organização & administração , Equipe de Assistência ao Paciente , Recursos Humanos em Hospital/psicologia , Relações Profissional-Família , Relações Profissional-Paciente , Atitude do Pessoal de Saúde , Família/psicologia , Entrevistas como Assunto , Pesquisa Qualitativa , Amigos/psicologia , Comunicação em Saúde , Relações Interprofissionais
15.
Rev. gaúch. enferm ; 40(spe): e20180341, 2019. tab, graf
Artigo em Português | LILACS | ID: biblio-1004113

RESUMO

Resumo OBJETIVO Analisar o registro da Nota de Transferência (NT) e a emissão do Modified Early Warning Score (MEWS) realizados pelo enfermeiro em pacientes adultos transferidos do Serviço de Emergência como estratégia de comunicação efetiva para a segurança do paciente. MÉTODO Estudo transversal retrospectivo desenvolvido em um hospital de ensino no Sul do Brasil que avaliou 8028 prontuários eletrônicos no ano de 2017. Procedeu-se a análise descritiva. RESULTADOS A realização da NT atingiu a meta institucional de 95% nos meses de janeiro e fevereiro, ficando abaixo da meta nos demais meses. A mensuração do MEWS foi realizada em 85,6% (n=6.870) dos prontuários. Destes pacientes, 96,8% (n=6.652) possuíam MEWS não alterado. CONCLUSÃO A NT e o MEWS estão inseridos no trabalho do enfermeiro, no entanto, são necessárias ações com vistas a qualificar a segurança do paciente, melhorando a comunicação efetiva e, por conseguinte, diminuindo a possibilidade de ocorrências de eventos adversos.


Resumen OBJETIVO Analizar el registro, realizado por el enfermero, la Nota de Transferencia (NT) y la emisión del Modified Early Warning Score (MEWS) en pacientes adultos transferidos del Servicio de Emergencia como estrategia de comunicación efectiva para la seguridad del paciente. MÉTODO Estudio transversal retrospectivo desarrollado en un hospital de enseñanza en el sur de Brasil que evaluó 8028 históricos electrónicos en el año 2017. Se llevó a cabo el análisis descriptivo. RESULTADOS La realización de la NT alcanzó la meta institucional del 95% en los meses de enero y febrero, quedando por debajo de la meta en los demás meses. La medición del MEWS se realizó en el 85,6% (n = 6.870) de los históricos. De estos pacientes, el 96,8% (n = 6.652) poseía MEWS no alterado. CONCLUSIÓN La NT y el MEWS están insertos en el trabajo del enfermero, sin embargo es necesario acciones con miras a calificar la seguridad del paciente, para mejor la comunicación efectiva y, por consiguiente, disminuir la posibilidad de ocurrencia de eventos adversos.


Abstract OBJECTIVE To analyze the registry of the Transfer Note (NT) and the emission of the Modified Early Warning Score (MEWS) performed by the nurse in adult patients transferred from the Emergency Service as an effective communication strategy for patient safety. METHOD A cross-sectional retrospective study developed at a teaching hospital in the South of Brazil that evaluated 8028 electronic medical records in the year 2017. A descriptive analysis was performed. RESULTS NT reached the institutional target of 95% in January and February, falling below the target in other months. The MEWS measurement was performed in 85.6% (n = 6,870) of the medical records. Of these patients, 96.8% (n = 6,652) had unchanged MEWS. CONCLUSION NT and MEWS are inserted in the work of the nurse, however, actions are needed to qualify patient safety, improving effective communication and therefore reducing the possibility of occurrence of adverse events.


Assuntos
Humanos , Adulto , Gestão de Riscos/métodos , Índice de Gravidade de Doença , Registros Hospitalares , Registros de Enfermagem , Transferência de Pacientes/organização & administração , Segurança do Paciente , Avaliação em Enfermagem , Gestão de Riscos/organização & administração , Brasil , Estudos Transversais , Estudos Retrospectivos , Medição de Risco , Indicadores de Qualidade em Assistência à Saúde , Papel do Profissional de Enfermagem , Serviço Hospitalar de Emergência , Registros Eletrônicos de Saúde , Controle de Formulários e Registros , Sistemas de Comunicação no Hospital/organização & administração , Hospitais de Ensino/organização & administração
16.
Rev. Rol enferm ; 41(11/12,supl): 21-25, nov.-dic. 2018. tab
Artigo em Inglês | IBECS | ID: ibc-179936

RESUMO

Communication between the nurse and the patient's family is a significant aspect of nursing practice. This paper presents the results of a research aimed to characte-rize problematic situations that occur in the relations involving nurses and patients' relatives: I) the type and frequency with which nurses deal with problematic situa-tions involving the patient's relatives in the context of their professional activity; II) the level of difficulty in dealing with these situations; and III) the psychological exhaustion they cause. The research focused on nurses of two clinical services of a public hospital: an In-tensive Care Unit and an Emergency Department. The methodological approach to this study is quantitative and has a descriptive and correlational nature. A question-naire was elaborated for the collection of data, contemplating questions related to the objective of the research. From a total of 99 nurses of the two clinical services, 50 were interviewed. The results show that there are statistically significant differences between the two services regarding the frequency with which nurses are threatened and intimi-dated, being more frequent in the emergency department. The insistent demand for information on the part of the family members constitutes the situation with greater occurrence and, simultaneously, the situation that causes greater impact on nurses. The lack of preparation stands out for the way it correlates with the wea-riness of nurses caused by requests of confidential information by the family on the patient's health status (rs = -0,473; p < 0.05) and the insistent search for information on the part of the relatives (rs = -0.416; p < 0.05)


No disponible


Assuntos
Humanos , Relações Enfermeiro-Paciente , Relações Profissional-Família , Barreiras de Comunicação , Informação de Saúde ao Consumidor/organização & administração , Sistemas de Comunicação no Hospital/tendências , Resolução de Problemas , Conflito Psicológico
17.
Appl Nurs Res ; 44: 1-5, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30389052

RESUMO

BACKGROUND: Alphanumeric paging is underutilized, despite being the standard mode of communication between physicians and nurses at many hospitals across the United States. OBJECTIVE: We hypothesized that an educational program designed to teach optimal alphanumeric paging behavior in conjunction with providing nurses with alphanumeric pagers would improve the quality and efficiency of nurse pages. METHODS: We implemented an educational program to teach nurses about optimal alphanumeric paging, defined as including four important components-patient identification, clinical scenario, sender identification, and callback number. We also provided each nurse with their own unique pager. Alphanumeric paging logs were reviewed prior to the intervention (baseline study period), and again following implementation of the intervention (intervention study period). Questionnaires were also completed by resident-physicians and nurses before and after implementation. RESULTS: During the intervention period, the percentage of ideal pages increased, and the percentage of suboptimal pages decreased. Compared to baseline, pages during the intervention period more often included patient identity, clinical scenario, and page-sender. Resident-physicians rated the paging-system's impact on patient care and job satisfaction more highly, and reported that disruptions and nurse accessibility were less of a problem during the intervention period compared to baseline. Nurses reported less problems with disruptions, ignored pages, miscommunication, and contentious relationships with resident-physicians. CONCLUSIONS: This study underscores the importance of two-way communication, which can be achieved without expensive technology. Creative use of old technology, such as providing nurses with traditional pagers, can improve communication and workflow, and potentially quality of care and patient safety.


Assuntos
Comunicação , Sistemas de Comunicação no Hospital , Internato e Residência/métodos , Invenções , Recursos Humanos de Enfermagem no Hospital/educação , Assistência ao Paciente/métodos , Segurança do Paciente , Centros Médicos Acadêmicos/métodos , Adulto , Educação Médica/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Médicos , Estados Unidos
18.
Sci Rep ; 8(1): 15697, 2018 10 24.
Artigo em Inglês | MEDLINE | ID: mdl-30356067

RESUMO

Human communication is commonly represented as a temporal social network, and evaluated in terms of its uniqueness. We propose a set of new entropy-based measures for human communication dynamics represented within the temporal social network as event sequences. Using real world datasets and random interaction series of different types we find that real human contact events always significantly differ from random ones. This human distinctiveness increases over time and by means of the proposed entropy measures, we can observe sociological processes that take place within dynamic communities.


Assuntos
Comunicação , Entropia , Relações Interpessoais , Modelos Teóricos , Rede Social , Bases de Dados Factuais , Correio Eletrônico/tendências , Processos Grupais , Sistemas de Comunicação no Hospital/tendências , Humanos , Relações Médico-Paciente , Estudantes/psicologia , Envio de Mensagens de Texto/tendências
19.
Pediatr. aten. prim ; 20(79): 261-267, jul.-sept. 2018.
Artigo em Espanhol | IBECS | ID: ibc-180954

RESUMO

La comunicación de malas noticias es un tema importante para la comunidad médica. En nuestra práctica clínica diaria estamos informando a nuestros pacientes y sus padres sobre diagnósticos, procesos y tratamientos, sin darnos cuenta de que pueden suponer un cambio radical en sus vidas. En este artículo se pretende contestar a cómo y cuándo decirle al paciente o a los padres que sospechamos que algo no está bien. Para ello, trabajamos con dos casos clínicos reales. Exploramos sus circunstancias, investigamos las etapas de la comunicación y los factores que influyen en ella (etapas de Buckman). Analizamos por qué lo hacemos mal y cómo deberíamos hacerlo mejor. Concluimos con un decálogo resumen que nos sirva de guía rápida en estas situaciones


Delivering bad news is increasingly relevant for the medical community. In our clinical practice we confront patients and their parents with diagnoses, processes and treatments, without realizing that they can be facing radical changes in their lives. This article aims to answer how and when communicate to our patients or their parents that we suspect that something is not right. To accomplish this goal we will work with two clinical cases. We will explore their circumstances. We will investigate the stages of communication and the factors involved in the process (Buckman stages). We will analyze why we do it wrong and how to do it better. We'll conclude with a decalogue that will serve as a quick guide in these situations


Assuntos
Humanos , Feminino , Recém-Nascido , Revelação da Verdade/ética , Comunicação em Saúde/métodos , Sistemas de Comunicação no Hospital/ética , Empatia , Relações Profissional-Família , Acesso à Informação , Atitude do Pessoal de Saúde , Enquadramento Psicológico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA