Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 761
Filtrar
2.
Soins ; 65(849): 22-27, 2020 Oct.
Artigo em Francês | MEDLINE | ID: mdl-33357613

RESUMO

The militaryintensive care field hospital is a new tool set up by the military medical service as part of Operation Resilience to provide medical support in the regions of France most affected by the SARS-Cov-2 pandemic. Deployed in Mulhouse and Mayotte, this hospital facility is a functional intensive care unit set up to support an existing hospital structure. The caregivers and logistics specialists are all from the military medical service, active personnel or reservists, predominantly nurses. The implementation of this intensive care field hospital in a constrained environment requires an efficient provision of care in accordance with medical guidelines, while protecting the healthcare staff and, notably, the frontline nursing staff.


Assuntos
Unidades de Terapia Intensiva/organização & administração , Medicina Militar , Unidades Móveis de Saúde/organização & administração , Cuidados Críticos , França , Humanos , Militares
3.
J Am Med Dir Assoc ; 21(11): 1563-1567, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33138938

RESUMO

During the surge of Coronavirus Disease 2019 (COVID-19) infections in March and April 2020, many skilled-nursing facilities in the Boston area closed to COVID-19 post-acute admissions because of infection control concerns and staffing shortages. Local government and health care leaders collaborated to establish a 1000-bed field hospital for patients with COVID-19, with 500 respite beds for the undomiciled and 500 post-acute care (PAC) beds within 9 days. The PAC hospital provided care for 394 patients over 7 weeks, from April 10 to June 2, 2020. In this report, we describe our implementation strategy, including organization structure, admissions criteria, and clinical services. Partnership with government, military, and local health care organizations was essential for logistical and medical support. In addition, dynamic workflows necessitated clear communication pathways, clinical operations expertise, and highly adaptable staff.


Assuntos
Comportamento Cooperativo , Infecções por Coronavirus/epidemiologia , Unidades Móveis de Saúde/organização & administração , Pandemias , Pneumonia Viral/epidemiologia , Idoso , Betacoronavirus , Boston/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Admissão e Escalonamento de Pessoal/organização & administração , Instituições de Cuidados Especializados de Enfermagem , Cuidados Semi-Intensivos
4.
Biochem Med (Zagreb) ; 30(3): 030403, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-33071554

RESUMO

To fight the virus SARS-CoV-2 spread to Europe from China and to give support to the collapsed public health system, the Spanish Health Authorities developed a field hospital located in the facilities of Madrid exhibition centre (IFEMA) to admit and treat patients diagnosed with SARS-CoV-2 infectious disease (COVID-19). The Department of Laboratory Medicine of La Paz University Hospital in Madrid (LMD-HULP) was designated to provide laboratory services. Due to the emergency, the IFEMA field hospital had to be prepared for patient admission in less than 1 week and the laboratory professionals had to collaborate in a multidisciplinary group to assure that resources were available to start on time. The LMD-HULP participated together with the managers in the design of the tests portfolio and the integration of the healthcare information systems (IS) (hospital IS, laboratory IS and POCT management system). Laboratorians developed a strategy to quickly train clinicians and nurses on test requests, sample collection procedures and management/handling of the POCT blood gas analyser both by written materials and training videos. The IFEMA´s preanalytical unit managed 3782 requests, and more than 11,000 samples from March 27th to April 30th. Furthermore, 1151 samples were measured by blood gas analysers. In conclusion, laboratory professionals must be resilient and have to respond timely in emergencies as this pandemic. The lab's personnel selection, design and monitoring indicators to maintain and further improve the quality and value of laboratory services is crucial to support medical decision making and provide better patient care.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Unidades Móveis de Saúde/organização & administração , Pandemias , Pneumonia Viral , Cidades , Sistemas de Informação em Laboratório Clínico/organização & administração , Infecções por Coronavirus/epidemiologia , Assistência à Saúde , Necessidades e Demandas de Serviços de Saúde , Número de Leitos em Hospital , Sistemas de Informação Hospitalar/organização & administração , Hospitais Universitários/organização & administração , Humanos , Laboratórios Hospitalares/organização & administração , Recursos Humanos em Hospital/educação , Pneumonia Viral/epidemiologia , Testes Imediatos/organização & administração , Garantia da Qualidade dos Cuidados de Saúde/organização & administração , Espanha , Manejo de Espécimes
7.
Am J Public Health ; 110(9): 1304-1307, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32783737

RESUMO

The University of Iowa Mobile Clinic (UIMC) is an interdisciplinary student-run free medical clinic founded in 2002. UIMC provides free health screenings, education, and basic services to underserved populations in Iowa: immigrants, refugees, migrant farmworkers, individuals experiencing homelessness, low-income individuals, and people who live in rural communities. Forty-four percent of patients surveyed use UIMC as their only source of care. Ninety-seven percent of patients surveyed rate care as excellent or good. UIMC is a crucial safety net health care resource in Iowa to improve health equity.


Assuntos
Assistência à Saúde/métodos , Área Carente de Assistência Médica , Unidades Móveis de Saúde/organização & administração , Estudantes de Ciências da Saúde , Educação em Saúde , Pessoas em Situação de Rua , Humanos , Iowa , Pessoas sem Cobertura de Seguro de Saúde , Refugiados , População Rural , Migrantes
8.
Front Med ; 14(5): 681-688, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32651936

RESUMO

Traditional Chinese medicine (TCM), an ancient system of alternative medicine, played an active role in the prevention and control of COVID-19 in China. It improved the clinical symptoms of patients, reduced the mortality rate, improved the recovery rate, and effectively relieved the operating pressure on the national medical system during critical conditions. In light of the current global pandemic, TCM-related measures might open up a new channel in the control of COVID-19 in other countries and regions. Here, we summarize the TCM-related measures that were widely used in China, including TCM guidelines, the Wuchang pattern, mobile cabin hospitals, integrated treatment of TCM and modern medicine for critical patients, and non-medicine therapy for convalescent patients, and describe how TCM effectively treated patients afflicted with the COVID-19. Effective TCM therapies could, therefore, be recommended and practiced based on the existing medical evidence from increased scientific studies.


Assuntos
Betacoronavirus/fisiologia , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus , Medicamentos de Ervas Chinesas , Medicina Tradicional Chinesa/métodos , Pandemias , Pneumonia Viral , Medicina Preventiva/métodos , Assistência ao Convalescente/métodos , Assistência ao Convalescente/organização & administração , China/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Medicamentos de Ervas Chinesas/classificação , Medicamentos de Ervas Chinesas/farmacologia , Humanos , Unidades Móveis de Saúde/organização & administração , Pandemias/prevenção & controle , Assistência ao Paciente/métodos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia
12.
Int J Equity Health ; 19(1): 59, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32357888

RESUMO

BACKGROUND: Mobile health clinics (MHCs) are recognized to facilitate access to healthcare services, especially in disadvantaged populations. Notwithstanding that in Europe a wide-ranging background in mobile screening units for cancer is shared, evidences about MHCs targeting also at other non-communicable diseases (NCDs) in universal health coverage systems are scarce. The aim of this study was to describe the population attracted with a MHC initiative and to assess the potential of this tool in prevention and control of NCDs. METHODS: Our MHC was set up in a railway wagon. Standard body measurements, finger-stick glucose, total cholesterol and blood pressure were recorded. Participants were asked about smoking, physical activity, diet, compliance to national cancer screening programmes and ongoing pharmacological treatment. One-to-one counselling was then provided. RESULTS: Participants (n = 839) showed a higher prevalence of overweight/obesity, insufficient intake of vegetables, sedentary lifestyle, and a lower compliance to cancer screening compared with reference population. Our initiative attracted groups at higher risk, such as foreigners, men and people aged from 50 to 69. The proportion of newly diagnosed or uncontrolled disease exceeded 40% of participants for both hypertension and hypercholesterolemia (7% for diabetes). Adherence rate to counselling was 99.4%. CONCLUSIONS: The MHC was effective in attracting hard-to-reach groups and individuals who may have otherwise gone undiagnosed. MHCs can play a complementary role also in universal coverage health systems, raising self-awareness of unreached population and making access to primary health care easier.


Assuntos
Doença Crônica/prevenção & controle , Assistência à Saúde/organização & administração , Promoção da Saúde/métodos , Unidades Móveis de Saúde/organização & administração , Telemedicina/métodos , Assistência de Saúde Universal , Idoso , Europa (Continente) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
14.
Anaesth Crit Care Pain Med ; 39(3): 361-362, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32360981

Assuntos
Betacoronavirus , Infecções por Coronavirus , Cuidados Críticos/organização & administração , Hospitais Militares/organização & administração , Unidades de Terapia Intensiva/organização & administração , Unidades Móveis de Saúde/organização & administração , Pandemias , Pneumonia Viral , /terapia , Idoso , Anestesia Geral/estatística & dados numéricos , Conversão de Leitos , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Cuidados Críticos/estatística & dados numéricos , Despacho de Emergência Médica/organização & administração , Feminino , França/epidemiologia , Hospitais com menos de 100 Leitos , Serviços Hospitalares Compartilhados/organização & administração , Hospitais Gerais/organização & administração , Hospitais Militares/estatística & dados numéricos , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Unidades de Terapia Intensiva/estatística & dados numéricos , Unidades de Terapia Intensiva/provisão & distribução , Intubação Intratraqueal/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Unidades Móveis de Saúde/estatística & dados numéricos , Doenças Profissionais/prevenção & controle , Pandemias/prevenção & controle , Admissão do Paciente/estatística & dados numéricos , Transferência de Pacientes/métodos , Transferência de Pacientes/estatística & dados numéricos , Equipamento de Proteção Individual , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Utilização de Procedimentos e Técnicas , Respiração Artificial/estatística & dados numéricos , /etiologia
15.
Int J Equity Health ; 19(1): 73, 2020 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-32429920

RESUMO

BACKGROUND: Mobile Clinics represent an untapped resource for our healthcare system. The COVID-19 pandemic has exacerbated its limitations. Mobile health clinic programs in the US already play important, albeit under-appreciated roles in the healthcare system. They provide access to healthcare especially for displaced or isolated individuals; they offer versatility in the setting of a damaged or inadequate healthcare infrastructure; and, as a longstanding community-based service delivery model, they fill gaps in the healthcare safety-net, reaching social-economically underserved populations in both urban and rural areas. Despite an increasing body of evidence of the unique value of this highly adaptable model of care, mobile clinics are not widely supported. This has resulted in a missed opportunity to deploy mobile clinics during national emergencies such as the COVID-19 pandemic, as well as using these already existing, and trusted programs to overcome barriers to access that are experienced by under-resourced communities. MAIN TEXT: In March, the Mobile Healthcare Association and Mobile Health Map, a program of Harvard Medical School's Family Van, hosted a webinar of over 300 mobile health providers, sharing their experiences, challenges and best practices of responding to COVID 19. They demonstrated the untapped potential of this sector of the healthcare system in responding to healthcare crises. A Call to Action: The flexibility and adaptability of mobile clinics make them ideal partners in responding to pandemics, such as COVID-19. In this commentary we propose three approaches to support further expansion and integration of mobile health clinics into the healthcare system: First, demonstrate the economic contribution of mobile clinics to the healthcare system. Second, expand the number of mobile clinic programs and integrate them into the healthcare infrastructure and emergency preparedness. Third, expand their use of technology to facilitate this integration. CONCLUSIONS: Understanding the economic and social impact that mobile clinics are having in our communities should provide the evidence to justify policies that will enable expansion and optimal integration of mobile clinics into our healthcare delivery system, and help us address current and future health crises.


Assuntos
Infecções por Coronavirus/epidemiologia , Unidades Móveis de Saúde/organização & administração , Pandemias , Pneumonia Viral/epidemiologia , Difusão de Inovações , Política de Saúde , Humanos , Modelos Organizacionais , Estados Unidos/epidemiologia
16.
Lancet ; 395(10232): 1305-1314, 2020 04 18.
Artigo em Inglês | MEDLINE | ID: mdl-32247320

RESUMO

Fangcang shelter hospitals are a novel public health concept. They were implemented for the first time in China in February, 2020, to tackle the coronavirus disease 2019 (COVID-19) outbreak. The Fangcang shelter hospitals in China were large-scale, temporary hospitals, rapidly built by converting existing public venues, such as stadiums and exhibition centres, into health-care facilities. They served to isolate patients with mild to moderate COVID-19 from their families and communities, while providing medical care, disease monitoring, food, shelter, and social activities. We document the development of Fangcang shelter hospitals during the COVID-19 outbreak in China and explain their three key characteristics (rapid construction, massive scale, and low cost) and five essential functions (isolation, triage, basic medical care, frequent monitoring and rapid referral, and essential living and social engagement). Fangcang shelter hospitals could be powerful components of national responses to the COVID-19 pandemic, as well as future epidemics and public health emergencies.


Assuntos
Infecções por Coronavirus , Emergências , Arquitetura de Instituições de Saúde , Hospitais Especializados , Unidades Móveis de Saúde , Pandemias , Pneumonia Viral , Betacoronavirus , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Controle de Custos , Surtos de Doenças , Hospitais Especializados/organização & administração , Hospitais Especializados/estatística & dados numéricos , Humanos , Controle de Infecções , Unidades Móveis de Saúde/organização & administração , Unidades Móveis de Saúde/estatística & dados numéricos , Isolamento de Pacientes , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia
17.
Biosci Trends ; 14(3): 212-214, 2020 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-32238673

RESUMO

During the COVID-19 outbreak, China made great progress in controlling the epidemic, and the number of confirmed and suspected cases continues to decrease thanks to the various efforts employed. Mobile field hospitals have played a huge role in the centralized management of patients and they have effectively reduced transmission. This article describes some of our experiences operating mobile field hospitals in order to provide a reference and to better inform countries that are dealing with this crisis.


Assuntos
Infecções por Coronavirus/terapia , Unidades Móveis de Saúde/organização & administração , Pneumonia Viral/terapia , Betacoronavirus , China , Infecções por Coronavirus/diagnóstico por imagem , Humanos , Pandemias , Pneumonia Viral/diagnóstico por imagem
20.
Int J Equity Health ; 19(1): 40, 2020 03 20.
Artigo em Inglês | MEDLINE | ID: mdl-32197637

RESUMO

BACKGROUND: Mobile health clinics serve an important role in the health care system, providing care to some of the most vulnerable populations. Mobile Health Map is the only comprehensive database of mobile clinics in the United States. Members of this collaborative research network and learning community supply information about their location, services, target populations, and costs. They also have access to tools to measure, improve, and communicate their impact. METHODS: We analyzed data from 811 clinics that participated in Mobile Health Map between 2007 and 2017 to describe the demographics of the clients these clinics serve, the services they provide, and mobile clinics' affiliated institutions and funding sources. RESULTS: Mobile clinics provide a median number of 3491 visits annually. More than half of their clients are women (55%) and racial/ethnic minorities (59%). Of the 146 clinics that reported insurance data, 41% of clients were uninsured while 44% had some form of public insurance. The most common service models were primary care (41%) and prevention (47%). With regards to organizational affiliations, they vary from independent (33%) to university affiliated (24%), while some (29%) are part of a hospital or health care system. Most mobile clinics receive some financial support from philanthropy (52%), while slightly less than half (45%) receive federal funds. CONCLUSION: Mobile health care delivery is an innovative model of health services delivery that provides a wide variety of services to vulnerable populations. The clinics vary in service mix, patient demographics, and relationships with the fixed health system. Although access to care has increased in recent years through the Affordable Care Act, barriers continue to persist, particularly among populations living in resource-limited areas. Mobile clinics can improve access by serving as a vital link between the community and clinical facilities. Additional work is needed to advance availability of this important resource.


Assuntos
Unidades Móveis de Saúde/organização & administração , Unidades Móveis de Saúde/estatística & dados numéricos , Atenção Primária à Saúde/organização & administração , Atenção Primária à Saúde/estatística & dados numéricos , Adolescente , Adulto , Criança , Pré-Escolar , Grupos de Populações Continentais , Grupos Étnicos , Feminino , Organização do Financiamento/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Lactente , Masculino , Pessoas sem Cobertura de Seguro de Saúde , Pessoa de Meia-Idade , Grupos Minoritários , Unidades Móveis de Saúde/economia , Atenção Primária à Saúde/economia , Fatores Socioeconômicos , Estados Unidos , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA