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2.
BMC Gastroenterol ; 21(1): 98, 2021 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-33657994

RESUMO

BACKGROUND: Health care professionals in endoscopic labs have an elevated risk for COVID-19 infection, therefore, we aimed to determine the effect of current pandemic on the workflow and infection prevention and control strategies of endoscopy units in real-life setting. METHODS: All members of Hungarian Society of Gastroenterology were invited between 7 and 17 April 2020 to participate in this cross-section survey study and to complete an online, anonymous questionnaire. RESULTS: Total of 120 endoscopists from 83 institutes were enrolled of which 35.83% worked in regions with high cumulative incidence of COVID-19. Only 33.33% of them had undergone training about infection prevention in their workplace. 95.83% of endoscopists regularly used risk stratification of patients for infection prior endoscopy. While indications of examinations in low risk patients varied widely, in high-risk or positive patients endoscopy was limited to gastrointestinal bleeding (95.00%), removal of foreign body from esophagus (87.50%), management of obstructive jaundice (72.50%) and biliary pancreatitis (67.50%). Appropriate amount of personal protective equipment was available in 60.85% of endoscopy units. In high-risk or positive patients, surgical mask, filtering facepiece mask, protective eyewear and two pairs of gloves were applied in 30.83%, 76.67%, 90.00% and 87.50% of cases, respectively. Personal protective equipment fully complied with European guideline only in 67.50% of cases. CONCLUSIONS: Survey found large variability in indications of endoscopy and relative weak compliance to national and international practical recommendations in terms of protective equipment. This could be improved by adequate training about infection prevention.


Assuntos
/prevenção & controle , Endoscopia Gastrointestinal , Gastroenterologia/organização & administração , Unidades Hospitalares/organização & administração , Controle de Infecções/organização & administração , Fluxo de Trabalho , /epidemiologia , Estudos Transversais , Humanos , Hungria , Seleção de Pacientes , Equipamento de Proteção Individual
3.
Int J Palliat Nurs ; 27(1): 10-19, 2021 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-33629914

RESUMO

BACKGROUND: Children with life-limiting conditions have a high risk of colonisation with a multidrug-resistant organism (MDRO). To avoid the spread of hospital-aquired infections to other patients, children with a MDRO are moved to an isolated room or ward. However, such isolation prevents social participation, which may reduce the child's quality of life (QoL). To overcome this challenge of conflicting interests on a paediatric palliative care inpatient unit, a hygiene concept for patients colonised with MDRO, called PALLINI, was implemented. PALLINI advises that, instead of isolating the affected children, strict barrier nursing should be used. AIM: To identify the impact of a complex hygiene concept on children's and parents' QoL and social participation. METHODS: Cross-sectional mixed-methods research approach, comprising semi-structured interviews with parents and staff members, and a QoL-questionnaire focusing on the child which was completed by parents. FINDINGS: In paediatric patients with life-limiting conditions who have MDRO colonisation, using a complex hygiene protocol resulted in both benefits and barriers to social participation. However, the child's QoL did not appear to be affected. CONCLUSION: All staff members and families have to be familiar with the hygiene concept and the concept has to be self-explanatory and easy to apply.


Assuntos
Resistência a Múltiplos Medicamentos , Controle de Infecções/organização & administração , Qualidade de Vida , Participação Social , Doente Terminal , Criança , Pré-Escolar , Infecção Hospitalar/prevenção & controle , Estudos Transversais , Feminino , Unidades Hospitalares , Humanos , Lactente , Capacitação em Serviço , Entrevistas como Assunto , Masculino , Avaliação em Enfermagem , Cuidados Paliativos , Pais , Isolamento de Pacientes , Segurança do Paciente , Estereotipagem , Inquéritos e Questionários
4.
BMJ Open ; 11(2): e045000, 2021 02 24.
Artigo em Inglês | MEDLINE | ID: mdl-33627354

RESUMO

INTRODUCTION: COVID-19 pandemic has affected people all over the world. In this context, health disparities are already evident in becoming ill and dying from this condition, further accentuating historical racial inequalities. METHODS AND ANALYSIS: This protocol will be developed based on the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. For this, searches will be carried out in PubMed, Web of Science, Scopus, Lilacs and ScienceDirect databases searching for cross-sectional studies that assessed the prevalence of black people with COVID-19 at different levels of complexity. All cross-sectional studies that analysed the prevalence of COVID-19 in black people assisted in primary care, hospital wards and intensive care units will be included. The research will be carried out by two independent researchers who will identify the articles; they will exclude duplicate studies. Through blind evaluation, they will select the articles using the Rayyan QCRI application. The instrument proposed by Downs and Black will be used to assess the risk of bias. The meta-analyses will be performed according to the data conditions included. ETHICS AND DISSEMINATION: For this study's development, there is no need for an ethical appraisal considering that it is a systematic review that will use secondary studies. This study's findings will be disseminated through peer-reviewed publications, conference presentations and condensed summaries for main stakeholders and partners in the field. The database search is expected to begin on 1 February 2021. It is expected to complete the entire review process by 30 October 2021 TRIAL REGISTRATION NUMBER: CRD42020209079.


Assuntos
Afro-Americanos , Pandemias , Projetos de Pesquisa , /diagnóstico , Estudos Transversais , Unidades Hospitalares , Humanos , Unidades de Terapia Intensiva , Metanálise como Assunto , Prevalência , Atenção Primária à Saúde , Revisões Sistemáticas como Assunto
5.
MMWR Morb Mortal Wkly Rep ; 70(2): 56-57, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33444298

RESUMO

In July 2020, the Florida Department of Health was alerted to three Candida auris bloodstream infections and one urinary tract infection in four patients with coronavirus disease 2019 (COVID-19) who received care in the same dedicated COVID-19 unit of an acute care hospital (hospital A). C. auris is a multidrug-resistant yeast that can cause invasive infection. Its ability to colonize patients asymptomatically and persist on surfaces has contributed to previous C. auris outbreaks in health care settings (1-7). Since the first C. auris case was identified in Florida in 2017, aggressive measures have been implemented to limit spread, including contact tracing and screening upon detection of a new case. Before the COVID-19 pandemic, hospital A conducted admission screening for C. auris and admitted colonized patients to a separate dedicated ward.


Assuntos
/terapia , Candida/isolamento & purificação , Candidíase/epidemiologia , Surtos de Doenças , Unidades Hospitalares , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Florida/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade
6.
Gen Hosp Psychiatry ; 69: 126-128, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33431231

RESUMO

OBJECTIVE: A Canada-wide survey was disseminated to collect information regarding changes in processes related to providing care to patients on inpatient psychiatry units in response to the COVID-19 pandemic. Our aim was to share this information with those who have an interest in problem-solving these significant and unique challenges. METHOD: The survey was distributed through the Association of Chairs of Psychiatry of Canada to Department Heads of Psychiatry at all sixteen medical schools. Information was collected via SurveyMonkey April 26-May 9, 2020. Eleven psychiatrists representing 11 different Canadian city/centre/zone(s) completed the survey. RESULTS: Information was collected about process changes: physical separation on the wards, symptom and vital signs screening, testing, isolation, rationales for number of beds allocated for COVID-positive, -suspect and -negative patients and for selecting a particular hospital to provide care to these different groupings of patients. One subsection of the information is presented in this letter. Further information is available upon request. CONCLUSION: Similarities and differences existed between city/centre/zone(s) regarding approaches to providing care to patients on inpatient psychiatry wards. Significant preparation and consideration was put into determining necessary changes in response to this pandemic, and this is reflected in the information provided from each city/centre/zone.


Assuntos
Alocação de Recursos para a Atenção à Saúde , Número de Leitos em Hospital , Unidades Hospitalares , Unidade Hospitalar de Psiquiatria , Canadá , Planejamento Hospitalar , Humanos , Isolamento de Pacientes , Inquéritos e Questionários
7.
BMC Infect Dis ; 21(1): 116, 2021 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-33494707

RESUMO

BACKGROUND: The burden of cardiovascular (CV) complications in patients hospitalised for community-acquired pneumonia (CAP) is still uncertain. Available studies used different designs and different criteria to define CV complications. We assessed the cumulative incidence of acute of CV complications during hospitalisation for CAP in Internal Medicine Units (IMUs). METHODS: This was a prospective study carried out in 26 IMUs, enrolling patients consecutively hospitalised for CAP. Defined CV complications were: newly diagnosed heart failure, acute coronary syndrome, new onset of supraventricular or ventricular arrhythmias, new onset hemorrhagic or ischemic stroke or transient ischemic attack. Outcome measures were: in-hospital and 30-day mortality, length of hospital stay and rate of 30-day re-hospitalisation. RESULTS: A total of 1266 patients were enrolled, of these 23.8% experienced at least a CV event, the majority (15.5%) represented by newly diagnosed decompensated heart failure, and 75% occurring within 3 days. Female gender, a history of CV disease, and more severe pneumonia were predictors of CV events. In-hospital (12.2% vs 4.7%, p < 0.0001) and 30-day (16.3% vs 8.9%, p = 0.0001) mortality was higher in patients with CV events, as well as the re-hospitalisation rate (13.3% vs 9.3%, p = 0.002), and mean hospital stay was 11.4 ± 6.9 vs 9.5 ± 5.6 days (p < 0.0001). The occurrence of CV events during hospitalisation significantly increased the risk of 30-day mortality (HR 1.69, 95% CI 1.14-2.51; p = 0.009). CONCLUSION: Cardiovascular events are frequent in CAP, and their occurrence adversely affects outcome. A strict monitoring might be useful to intercept in-hospital CV complications for those patients with higher risk profile. TRIAL REGISTRATION: NCT03798457 Registered 10 January 2019 - Retrospectively registered.


Assuntos
Infecções Comunitárias Adquiridas , Infarto do Miocárdio/epidemiologia , Pneumonia Bacteriana , Idoso , Idoso de 80 Anos ou mais , Feminino , Unidades Hospitalares , Hospitalização , Humanos , Incidência , Itália/epidemiologia , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Infarto do Miocárdio/mortalidade , Prevalência , Estudos Prospectivos , Fatores de Risco
8.
Rev Esp Enferm Dig ; 113(2): 119-121, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33393333

RESUMO

The COVID-19 pandemic meant that the population-based colorectal cancer (CRC) screening programs had to be suspended. Modifications were made to the organization in order to reduce SARS-CoV-2 transmission. We report the experience of the Galician CRC screening program and patient safety results. Endoscopy was suspended between 13/03/2020 and 11/05/2020. After resumption, a total of 3,310 colonoscopies were performed (1,702 positive fecal occult blood tests and 1,608 endoscopy monitoring) and no SARS-CoV-2 infections were detected in the subsequent two weeks. Thus, resumption of activity associated with population screening was safe.


Assuntos
Colonoscopia , Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer , Unidades Hospitalares/organização & administração , Segurança do Paciente , Quarentena , Idoso , /prevenção & controle , Humanos , Pessoa de Meia-Idade , Espanha/epidemiologia
9.
Rev Esp Enferm Dig ; 113(2): 98-102, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33342217

RESUMO

INTRODUCTION: COVID-19 has altered the usual practice of medicine and the state of emergency declared in Spain on March 14th has considerably changed the activity of inflammatory bowel disease (IBD) units. The aim of this study was to evaluate the consequences of COVID-19 on the IBD Unit's activity and provide information on restructuring with available resources. METHODS: an observational study was performed in a referral hospital in Madrid (Spain). Type of appointment, loss of follow-up, hospital admission, treatment changes, endoscopic activity, surgeries and blood tests were evaluated between March 15th and May 15th, 2020. This data was compared with the usual activity a year before. RESULTS: among the 510 patients included, 476 (93.33 %) received had a remote consultation, representing an increase of 92.38 % compared with the previous year (0.95 %). There was a loss of follow-up in 26 patients (5.1 %) vs 15 (3.58 %) the previous year. A total of 60 (35.09 %) blood tests, 64 (76.19 %) endoscopies and all scheduled surgeries were suspended. Besides, 484 (94.9 %) patients remained adherent vs 417/419 (99.5 %) in the pre-pandemic period and 48 (9.41 %) reported symptoms of an IBD flare. Thirty-nine (7.6 %) patients developed symptoms suggestive of COVID-19. CONCLUSION: a large number of tests and on-site outpatient visit consultations were suspended. However, a rapid adaptation to telemedicine allowed these patients to be closely followed up. Although it was possible to maintain therapeutic compliance, with a loss to follow-up slightly higher than the previous year, suspensions and delays of tests could have significant negative consequences in the long term.


Assuntos
Doenças Inflamatórias Intestinais/terapia , Adulto , Assistência à Saúde , Feminino , Unidades Hospitalares , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Espanha/epidemiologia
10.
Nutr Hosp ; 38(1): 207-212, 2021 Feb 23.
Artigo em Espanhol | MEDLINE | ID: mdl-33319580

RESUMO

Introduction: Introduction: the SARS-CoV-2 pandemic has forced major organizational and care changes in the health system. However, in Spain, the circumstances suffered by the health professionals who have cared for pandemic patients from a clinical nutrition standpoint has remained unknown up to this moment. Objectives: the management and care changes made in clinical nutrition units in Spain, and their impact on clinical practice are described. Material and methods: a cross-sectional study was carried out using a survey directed at SENPE members (June 2020). Responses sent by health professionals in the field of clinical nutrition who had treated patients with COVID-19 in Spanish hospitals were included in the study. Resultados: a total of 116 survey forms were analyzed, mostly filled out by doctors (57.8 %) working at hospitals with more than 500 beds (56 %); 46 % of survey respondents were on telework. There was a nutritional care plan in 68 % of cases, such plan being present mainly in hospitals with more than 500 beds (p < 0.001). In these hospitals more specific diets for COVID-19 were implemented than in those under 500 beds: 18 (35.3 %) vs 44 (67.7 %), (p < 0.001). The use of recommendations issued by scientific societies was reported in 86 % of cases. Never or almost never could a satisfactory nutritional assessment be performed for 38.8 %. The prescription of nutritional supplements was not less than 50 %. Health workers rated their performance as satisfactory or very satisfactory (51.7 %), and this was not related to hospital size but to having implemented a COVID-19 diet (p < 0.05). Conclusions: clinical nutrition in Spain has responded to the COVID-19 pandemic with organizational and managerial changes and, although care has been clearly affected, some quality standards were ultimately maintained. Larger hospitals have had some advantages in making these adjustments.


Assuntos
/terapia , Unidades Hospitalares , Inquéritos Nutricionais , Terapia Nutricional , Estudos Transversais , Humanos , Espanha
11.
Esc. Anna Nery Rev. Enferm ; 25(1): e20200100, 2021. tab, graf
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1114763

RESUMO

RESUMO Objetivo identificar a ocorrência da morte nas unidades de cuidados, bem como analisar os registros e as atitudes dos enfermeiros frente à morte no contexto hospitalar. Método estudo quantitativo, descritivo, transversal, com participação de 900 enfermeiros de um hospital do Norte de Portugal. Com recurso à triangulação de fontes de dados, a coleta realizou-se de fevereiro a março de 2018 através de questionário e observação de registros efetuados pelos enfermeiros. Para análise dos dados, usou-se estatística descritiva e analítica. Resultados são as unidades de medicina que apresentam maior número de mortes, sendo no turno da noite que se registra um valor mais elevado de ocorrências. Com relação às atitudes dos enfermeiros frente à morte, à exceção do evitamento, todas as outras evidenciam tendência semelhante entre o grupo profissional, independentemente da sua área de atuação. Os registros de enfermagem apresentam maior incidência ao nível da função ao invés de focados no domínio da pessoa. Conclusão e implicações para a prática além da aquisição de conhecimentos através da participação em formações sobre a morte e o processo de morrer, o acompanhamento e apoio dos profissionais, poderão desempenhar um papel fundamental na preparação dos enfermeiros para cuidar das pessoas em fim de vida.


RESUMEN Objetivo identificar la ocurrencia de la muerte en unidades de cuidados y analizar registros y actitudes de los enfermeros frente a la muerte en el contexto hospitalario. Método estudio cuantitativo, descriptivo, transversal, con participación de 900 enfermeros de un hospital en el Norte de Portugal. Utilizando la triangulación de fuentes de datos, la recopilación se realizó de febrero a marzo de 2018 a través de cuestionario y observación de registros de enfermeros. Para el análisis, se utilizaron estadísticas descriptivas y analíticas. Resultados las unidades médicas presentan mayor número de muertes, con mayor número de ocurrencias en el turno nocturno. Con respecto a las actitudes de los enfermeros frente a la muerte, con excepción de la evitación, todas las demás muestran una tendencia similar entre el grupo profesional, independientemente de su área de especialización. Los registros de enfermería tienen una mayor incidencia a nivel de función, en lugar de centrarse en el dominio de la persona. Conclusión e implicaciones para la práctica además de la obtención de conocimiento sobre la muerte y el morir, el seguimiento y el apoyo de profesionales puede desempeñar un papel fundamental en la preparación de los enfermeros para cuidar a los enfermos en final de vida.


ABSTRACT Objective to identify the occurrence of death in the care units, as well as to analyze the nurses' records and attitudes towards death in the hospital context. Method quantitative, descriptive, cross-sectional study, with the participation of 900 nurses from a hospital in northern Portugal. Using data source triangulation, the collection took place from February to March 2018 through a questionnaire and observation of records made by nurses. For data analysis, descriptive and analytical statistics were used. Results it is the medical units that present the highest number of deaths, with the highest number of occurrences taking place in the night shift. Regarding the nurses' attitudes towards death, with the exception of avoidance, all the others show a similar trend among the professional group, regardless of their area of activity. Nursing records have a higher incidence at the function level rather than focusing on the person's domain. Conclusion and implications for the practic e: in addition to the acquisition of knowledge, through participation in training on death and the dying process, the monitoring and support of professionals, may play a fundamental role in preparing nurses to care of people at the end of life.


Assuntos
Humanos , Masculino , Feminino , Atitude Frente a Morte , Registros de Enfermagem , Morte , Unidades Hospitalares , Profissionais de Enfermagem , Pacientes , Enfermagem , Capacitação Profissional , Cuidados de Enfermagem
12.
Hosp Pediatr ; 11(3): e42-e47, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33361399

RESUMO

OBJECTIVES: The paucity of symptoms and the difficulties in wearing personal protective equipment make children a potential source of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection for health care workers (HCWs). Previous experience in pediatric settings reported high rate of intrahospital SARS-CoV-2 transmission in HCWs caring for children. We aimed at investigating the rate and determinants of SARS-CoV-2 infection among HCWs working in a regional reference center in the Southern Italy. METHODS: A prospective observational study was conducted to monitor the occurrence of SARS-CoV-2 infections among HCWs and investigate the relation between the infection rate and hours of exposure or number and characteristics of procedures, including nasopharyngeal swab, high-flow oxygen delivery, suctioning of airway secretions, sputum induction, and nebulizer administration. RESULTS: After 5 months of monitoring, 425.6 hours of SARS-CoV-2 exposure (18.5 hours per person), and 920 hospital procedures, no case of nosocomial transmission was reported among the 23 HCWs enrolled in the study. CONCLUSIONS: The application of stringent preventive measures, also outside the area dedicated to patients' care, can effectively control infection spreading also in pediatric settings.


Assuntos
/epidemiologia , Transmissão de Doença Infecciosa/prevenção & controle , Pessoal de Saúde , Unidades Hospitalares/estatística & dados numéricos , Pandemias , Equipamento de Proteção Individual , Adulto , Criança , Feminino , Humanos , Masculino , Estudos Prospectivos
14.
Soins Psychiatr ; 41(331): 16-20, 2020.
Artigo em Francês | MEDLINE | ID: mdl-33357662

RESUMO

The COVID-19 health crisis forced Charles-Perrens General Hospital in Bordeaux to convert a conventional psychiatric unit into a specific unit to care for patients with mental disorders who are potentially infected with the SARS-Cov-2 virus. Resources and competences from across the hospital were mobilised to enable the unit's health professionals to accomplish this mission. This article looks back at the experience.


Assuntos
/terapia , Unidades Hospitalares/organização & administração , Transtornos Mentais/terapia , /epidemiologia , França/epidemiologia , Humanos
15.
Ann Biol Clin (Paris) ; 78(6): 609-616, 2020 Dec 01.
Artigo em Francês | MEDLINE | ID: mdl-33361015

RESUMO

Confronted with the COVID-19 crisis, healthcare professionals have had to tackle an epidemic crisis of a huge magnitude for which they were not prepared. Medical laboratories have been on the front line, from collecting samples to performing the analysis required to diagnose this new pathology. Responding to the needs and to the urgency of the situation, the authorities relied on the network of private laboratories. In France, private laboratory medicine represents 70% of overall activity, and with a network of more than 4,000 local laboratories, private laboratory medicine has been the cornerstone of the « screen-trace-isolate ¼ strategy. This article gives feedback from private laboratory medicine professionals, directly involved in the reorganization carried out at the pre-analytical, analytical and post-analytical stages, during the crisis from March to October 2020.


Assuntos
/epidemiologia , Serviços de Laboratório Clínico/organização & administração , Pandemias , Setor Privado/organização & administração , Manejo de Espécimes/normas , /diagnóstico , Serviços de Laboratório Clínico/normas , Técnicas de Laboratório Clínico/instrumentação , Técnicas de Laboratório Clínico/métodos , Técnicas de Laboratório Clínico/normas , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Segurança de Equipamentos/métodos , Segurança de Equipamentos/normas , França/epidemiologia , Unidades Hospitalares/organização & administração , Humanos , Colaboração Intersetorial , Corpo Clínico/organização & administração , Corpo Clínico/normas , Segurança do Paciente/normas , Fase Pré-Analítica/métodos , Fase Pré-Analítica/normas , Setor Privado/normas , Manejo de Espécimes/métodos
16.
Rev Saude Publica ; 54: 145, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33331423

RESUMO

OBJECTIVE: To analyze the costs of a specialized service in Traditional Complementary and Integrative Medicines (TCIM) in Northeast Brazil to provide data on the cost linked to the implementation and maintenance of services of this nature and to identify the average cost per user for the Unified Health System. METHODS: This is a partial, descriptive, quantitative economic assessment, which used secondary data, later grouped in Microsoft Excel spreadsheets. The method used to analyze such costs was absorption costing, from which the service was divided into three costing centers: productive, administrative and auxiliary. RESULTS: After analyzing the data, the total cost of the service in 2014 was estimated at R$ 1,270,015.70, with a proportion of 79.69% of direct costs. The average cost per user in this period was R$ 36.79, considering the total of 34,521 users in individual and collective practices. CONCLUSIONS: The service has a cost per user compatible with a specialized service; however, TCIM offers a comprehensive and holistic approach, which can have a positive impact on quality of life.


Assuntos
Terapias Complementares , Unidades Hospitalares , Medicina Integrativa , Medicina Tradicional , Brasil , Terapias Complementares/economia , Custos e Análise de Custo , Unidades Hospitalares/economia , Humanos , Medicina Integrativa/economia , Medicina Tradicional/economia
17.
Pan Afr Med J ; 35(Suppl 2): 144, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33193959

RESUMO

Introduction: since the first spread of the novel coronavirus (COVID-19) in Morocco in March 2020, the Moroccan Health System underwent an important pressure and remarkable efforts were spent to provide efficient reactions to this emergency. Public hospitals have set adapted strategies dedicated to overcoming the overload of COVID-19 patients, and our Oncology and Hematology Center (OHC) has implemented a flexible adapted strategy aiming to reduce the burden of COVID-19. We report our single-center experience on the detailed infection control measures undertaken to minimize virus transmission. Methods: we reviewed all patients treated at the OHC from March 2nd to April 20th, 2020 as measures were taken since the detection of the first COVID-19 case to ensure the protection of patients and healthcare providers, especially a screening zone for any patient entering the center. The patient's data were retrospectively collected and anonymized. Results: we notified a significant decrease in patients' admissions during the lockdown period at the different units of our center. The screening area received a total of 5267 patients during our study period, with an average of 105 patients per day. Interestingly, no healthcare professional was infected and only 8 patients showed symptoms of fever and cough, and all of them had a negative test for COVID-19 (RT-PCR). Thus, the OHC is considered as a COVID-19 free center with zero cases among patients and healthcare providers. Conclusion: by having a 0% rate of infection, the efficiency of our measures is proven, but efforts are still needed as we have to measure the impact of this pandemic in our cancer management.


Assuntos
Betacoronavirus , Institutos de Câncer/organização & administração , Infecções por Coronavirus/epidemiologia , Neoplasias/terapia , Pandemias , Pneumonia Viral/epidemiologia , Técnicas de Laboratório Clínico , Continuidade da Assistência ao Paciente , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Gerenciamento Clínico , Feminino , Acesso aos Serviços de Saúde , Departamentos Hospitalares/estatística & dados numéricos , Unidades Hospitalares/estatística & dados numéricos , Humanos , Controle de Infecções/organização & administração , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Masculino , Programas de Rastreamento/organização & administração , Pessoa de Meia-Idade , Marrocos , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Estudos Retrospectivos
19.
Pediatrics ; 146(5)2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33033176

RESUMO

OBJECTIVES: To describe the practice of high-flow nasal cannula (HFNC) use in the pediatric ward setting across North America. METHODS: A survey was distributed through the Pediatric Research in Inpatient Settings Network, which represents 114 hospital sites. Questions included indication for HFNC use, flow and oxygen parameters, guideline availability, and use of outcomes measures. RESULTS: There was a response rate of 68% to the survey from sites representing all regions from the United States. Thirty-seven sites (48%) used HFNC in the pediatric ward setting. All 37 sites used HFNC for patients with bronchiolitis. All children's hospital sites providing HFNC on the wards had an on-site ICU, compared with only 60% of non-children's hospital sites (P = .003). Seventy-six percent of sites used local protocols, including parameters for patient assessment, initiation, weaning, and feeding practices. CONCLUSIONS: HFNC is used outside the ICU in nearly 50% of responding hospitals, with variation related to flow rate, feeding, and protocol use. HFNC is used for management of acute respiratory distress due to bronchiolitis, asthma, and pneumonia. Study findings suggest that HFNC is often used by pediatric hospitalists, but its use across North American hospitals remains variable and based on local consensus.


Assuntos
Unidades Hospitalares/estatística & dados numéricos , Oxigenoterapia/estatística & dados numéricos , Pediatria/estatística & dados numéricos , Asma/terapia , Bronquiolite/terapia , Canadá , Cateterismo/métodos , Cateterismo/estatística & dados numéricos , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos , Humanos , Oxigenoterapia/métodos , Pneumonia/terapia , Estados Unidos
20.
J Vasc Interv Radiol ; 31(11): 1857-1863, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33041175

RESUMO

PURPOSE: To assess changes in operational utilization following conversion of a single IR suite to a hybrid CT/angiography (Angio-CT) system at an academic tertiary care center. MATERIALS AND METHODS: The total number of interventional procedures and diagnostic CT examinations performed in 29 rooms (20 diagnostic radiology, 7 IR, 2 shared between divisions) was calculated in the 24 months before conversion of an IR suite to Angio-CT and 12 months after conversion. The total number of IR procedures (global IR/month) and diagnostic CT scans per month (global CT/month) in both before and after conversion periods was calculated and defined as baseline institutional growth. This was compared against the change in the number of IR procedures performed in the before and after periods in the converted room (Angio-CT/month) as well as the number of diagnostic CT scans performed in the shared rooms (shared CT/month). RESULTS: The percent change in global CT and global IR from the before to the after periods was 39.2% and 3.1%, respectively. Shared CT per month and Angio-CT per month increased by 46.7% and 12.0% across the same time periods, respectively. The ratio of the percent increase in Angio-CT per month to percent increase in global IR per month was 3.87. The ratio of the percent increase in shared CT per month to percent increase in global CT per month was 1.19. CONCLUSIONS: Operational utilization improved in both diagnostic radiology and IR sections following conversion of a conventional fluoroscopic IR suite to an Angio-CT room.


Assuntos
Agendamento de Consultas , Angiografia por Tomografia Computadorizada , Unidades Hospitalares/organização & administração , Radiografia Intervencionista , Serviço Hospitalar de Radiologia/organização & administração , Sistemas de Informação em Radiologia/organização & administração , Eficiência Organizacional , Fluoroscopia , Humanos , Estudos Retrospectivos , Fluxo de Trabalho , Carga de Trabalho
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