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PLoS One ; 16(11): e0260050, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34793537


BACKGROUND: Working in the nursing sector is accompanied by great physical and mental health burdens. Consequently, it is necessary to develop target-oriented, sustainable profession-specific support and health promotion measures for nurses. OBJECTIVES: The present review aims to give an overview of existing major health problems and violence experiences of nurses in different settings (acute care hospitals, long-term care facilities, and home-based long-term care) in Germany. METHODS: A systematic literature search was conducted in PubMed and PubPsych and completed by a manual search upon included studies' references and health insurance reports. Articles were included if they had been published after 2010 and provided data on health problems or violence experiences of nurses in at least one care setting. RESULTS: A total of 29 studies providing data on nurses health problems and/or violence experience were included. Of these, five studies allowed for direct comparison of nurses in the settings. In addition, 14 studies provided data on nursing working in acute care hospitals, ten on nurses working in long-term care facilities, and four studies on home-based long-term care. The studies either conducted a setting-specific approach or provided subgroup data from setting-unspecific studies. The remaining studies did not allow setting-related differentiation of the results. The available results indicate that mental health problems are the highest for nurses in acute care hospitals. Regarding violence experience, nurses working in long-term care facilities appear to be most frequently affected. CONCLUSION: The state of research on setting-specific differences of nurses' health problems and violence experiences is insufficient. Setting-specific data are necessesary to develop target-group specific and feasible interventions to support the nurses' health and prevention of violence, as well as dealing with violence experiences of nurses.

Economia da Enfermagem/tendências , Enfermagem/tendências , Violência no Trabalho/tendências , Economia da Enfermagem/estatística & dados numéricos , Alemanha , Instalações de Saúde , Promoção da Saúde , Hospitais , Humanos , Seguro Saúde , Assistência de Longa Duração , Saúde Mental , Recursos Humanos de Enfermagem , Exame Físico , Instituições de Cuidados Especializados de Enfermagem
Am J Phys Med Rehabil ; 100(9): 906-917, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34415887


ABSTRACT: The need for home care services is expanding around the world with increased attention to the resources required to produce them. To assist decision making, there is a need to assess the cost-effectiveness of alternative programs within home care. Electronic searches were performed in five databases (before February 2020) identifying 3292 potentially relevant studies that assessed new or enhanced home care interventions compared with usual care for adults with an accompanying economic evaluation. From these, 133 articles were selected for full-text screening; 17 met the inclusion criteria and were analyzed. Six main areas of research were identified including the following: alternative nursing care (n = 4), interdisciplinary care coordination (n = 4), fall prevention (n = 4), telemedicine/remote monitoring (n = 2), restorative/reablement care (n = 2), and one multifactorial undernutrition intervention study. Risk of bias was found to be high/weak (n = 7) or have some concerns/moderate (n = 6) rating, in addition to inconsistent reporting of important information required for economic evaluations. Both health and cost outcomes had mixed results. Cost-effective interventions were found in two areas including alternative nursing care and reablement/restorative care. Clinicians and decision makers are encouraged to carefully evaluate the quality of the studies because of issues with risk of bias and incomplete reporting of economic outcomes.

Análise Custo-Benefício , Serviços de Assistência Domiciliar/economia , Vida Independente/economia , Acidentes por Quedas/prevenção & controle , Adulto , Economia da Enfermagem , Humanos , Desnutrição/dietoterapia , Equipe de Assistência ao Paciente/economia , Telemedicina/economia
Stroke ; 52(10): 3325-3334, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34233463


Background and Purpose: Delirium is a common severe complication of stroke. We aimed to determine the cost-of-illness and risk factors of poststroke delirium (PSD). Methods: This prospective single-center study included n=567 patients with acute stroke from a hospital-wide delirium cohort study and the Swiss Stroke Registry in 2014. Delirium was determined by Delirium Observation Screening Scale or Intensive Care Delirium Screening Checklist 3 times daily during the first 3 days of admission. Costs reflected the case-mix index and diagnosis-related groups from 2014 and were divided into nursing, physician, and total costs. Factors associated with PSD were assessed with multiple regression analysis. Partial correlations and quantile regression were performed to assess costs and other factors associated with PSD. Results: The incidence of PSD was 39.0% (221/567). Patients with delirium were older than non-PSD (median 76 versus 70 years; P<0.001), 52% male (115/221) versus 62% non-PSD (214/346) and hospitalized longer (mean 11.5 versus 9.3 days; P<0.001). Dementia was the most relevant predisposing factor for PSD (odds ratio, 16.02 [2.83­90.69], P=0.002). Moderate to severe stroke (National Institutes of Health Stroke Scale score 16­20) was the most relevant precipitating factor (odds ratio, 36.10 [8.15­159.79], P<0.001). PSD was a strong predictor for 3-month mortality (odds ratio, 15.11 [3.33­68.53], P<0.001). Nursing and total costs were nearly twice as high in PSD (P<0.001). There was a positive correlation between total costs and admission National Institutes of Health Stroke Scale (correlation coefficient, 0.491; P<0.001) and length of stay (correlation coefficient, 0.787; P<0.001) in all patients. Quantile regression revealed rising nursing and total costs associated with PSD, higher National Institutes of Health Stroke Scale, and longer hospital stay (all P<0.05). Conclusions: PSD was associated with greater stroke severity, prolonged hospitalization, and increased nursing and total costs. In patients with severe stroke, dementia, or seizures, PSD is anticipated, and additional costs are associated with hospitalization.

Delírio/economia , Delírio/etiologia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/economia , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Efeitos Psicossociais da Doença , Economia da Enfermagem , Feminino , Humanos , Incidência , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Fatores de Risco , Convulsões/economia , Convulsões/etiologia , Acidente Vascular Cerebral/mortalidade , Suíça
Int J Palliat Nurs ; 27(4): 175, 2021 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-34169742
Cult. cuid ; 25(59): 1-8, Abr 27, 2021. ilus
Artigo em Espanhol | IBECS | ID: ibc-216270


En esta editorial se hace un repaso a la historia de la revista cultura de los cuidados. Se describen sus antecedentes, factores predisponentes, su origen y evolución a lo largo de un cuarto de siglo.(AU)

This editorial reviews the history of the culture of care publication. It describes its background, predisposing factors, its origin and evolution throughout a quarter of a century.(AU)

Este editorial revê a história da cultura da revista de cuidados. Descreve os seus antecedentes, factores predisponentes, a sua origem e evolução ao longo de um quarto de século.

História do Século XXI , Cuidados de Enfermagem , História da Enfermagem , Economia da Enfermagem , Educação em Enfermagem
Br J Nurs ; 30(4): 207, 2021 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-33641393
BMC Pregnancy Childbirth ; 21(1): 71, 2021 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-33478433


BACKGROUND: Traditional prenatal care includes up to 13 in person office visits, and the cost of this care is not well-described. Alternative models are being explored to better meet the needs of patients and providers. OB Nest is a telemedicine-enhanced program with a reduced frequency of in-person prenatal visits. The cost implications of connected care services added to prenatal care packages are unclear. METHODS: Using data from the OB Nest randomized, controlled trial we analyzed the provider and staff time associated with prenatal care in the traditional and OB Nest models. Fewer visits were required for OB Nest, but given the compensatory increase in connected care activity and supplies, the actual cost difference is not known. Nursing and provider staff time was prospectively recorded for all patients enrolled in the OB Nest clinical trial. Published 2015 national wages for healthcare workers were used to calculate the actual labor cost of providing either traditional or OB Nest prenatal care in 2015 US dollars. Overhead expenses and opportunity costs were not considered. RESULTS: Total provider cost was decreased caring for the OB Nest participants, but nursing cost was increased. OB Nest care required an average of 160.8 (+/- 45.0) minutes provider time and 237 (+/- 25.1) minutes nursing time, compared to 215.0 (+/- 71.6) and 99.6 (+/- 29.7) minutes for traditional prenatal care (P < 0.01). This translated into decreased provider cost and increased nursing cost (P < 0.01). Supply costs increased, travel costs declined, and overhead costs declined in the OB Nest model. CONCLUSIONS: In this trial, labor cost for OB Nest prenatal care was 34% higher than for traditional prenatal care. The increased cost is largely attributable to additional nursing connected care time, and in some practice settings may be offset by decreased overhead costs and increased provider billing opportunities. Future efforts will be focused on development of digital solutions for some routine nursing tasks to decrease the overall cost of the model. TRIAL REGISTRATIONS: Identifier: NCT02082275 .

Economia da Enfermagem , Cuidado Pré-Natal/economia , Cuidado Pré-Natal/métodos , Telemedicina/economia , Adulto , Custos e Análise de Custo , Feminino , Humanos , Minnesota , Cuidados de Enfermagem/métodos , Cuidados de Enfermagem/estatística & dados numéricos , Gravidez , Telemedicina/estatística & dados numéricos , Adulto Jovem
Ann Ig ; 32(6): 599-607, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33175071


INTRODUCTION: The free-lance nurse, not bound to rigid organizational systems, can offer personalized assistance always respecting the rights of the person and of the profession. More recent graduates have decided to undertake the nursing profession by moving towards the free-lance nursing, considering it both as a career opening and as a professional opportunity, although this option never got much attention from the researchers in the Italian nursing scene. Free-lance nursing is now considered a valuable opportunity to develop a nursing career. This market is destined to grow for different reasons, such as an increasing chronicity of health conditions of more and more ageing population and the deficits of the National Health Service (Servizio Sanitario Nazionale - SSN) in community and home care. AIM: The aim of the study was to evaluate the correlation between the development of the free-lance nursing and the Italian socio-economic context. METHODS: The design of the study was descriptive - observational. Data collection and observation was carried out from January 2018 until April 2108. For the analysis a linear regression model was adopted to quantify a cause-effect relationship between one or more independent variables and the dependent variable which interprets the phenomenon investigated. The regression carried out was descriptive to analytically express the observed reality and represent it in a plausible way. The specification model was represented as: Free-lance nurses per capita = per capita income + Out of Pocket expense per capita + waiting lists in days + number of beds per inhabitants + NHS nurses per inhabitants. RESULTS: The estimate carried out had an R of 0.813, R-square equal to 0.6612, adjusted R-square 0.540 and standard error of the estimate 1.277, highlighting a correlation between the variables adopted in the model and a p = 0.005. From the analysis of the variables used, the average per capita income (p = 0.045) and the nurses working in the National Health Service /1,000 beds (p = 0.017) were statistically significant. CONCLUSIONS: It can be stated that the free-lance nursing profession is costly for patients and therefore develops more revenue where the average per capita income grows, but the research also seems to show that, where the National Health Service has too few nurses, the private demand increases in order to satisfy healthcare needs.

Economia da Enfermagem , Enfermeiras e Enfermeiros/estatística & dados numéricos , Enfermagem/métodos , Remuneração , Mobilidade Ocupacional , Causalidade , Demografia , Emprego , Gastos em Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde , Humanos , Renda , Itália , Modelos Lineares , Modelos de Enfermagem , Enfermeiras e Enfermeiros/classificação , Enfermeiras e Enfermeiros/economia , Enfermeiras e Enfermeiros/provisão & distribuição , Enfermagem/estatística & dados numéricos , Enfermagem/tendências , Saúde Pública/economia , Medicina Estatal/economia , Medicina Estatal/estatística & dados numéricos
Metas enferm ; 23(5): 71-78, jun. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-194591


SALBIS es un grupo de investigación interdisciplinar, interuniversitario e internacional de la Universidad de León. Se crea en 2011, con objeto de liderar la investigación en salud y bienestar centrado en la persona y la sociedad. La mayoría de sus miembros son enfermeras con perfiles híbridos (antropólogas, psicólogas, humanistas, etc.) que enriquecen la perspectiva investigadora. Sus doctorados se han desarrollado en Enfermería, Psicología, Biomedicina, etc. Las líneas de investigación son: planificación estratégica sanitaria, redes, bienestar, movilidad y movimiento, e innovación tecnológica y salud. Para SALBIS, el conocimiento generado debe ser: responsable con la sociedad, sostenible en el tiempo, y compartido tanto con las administraciones públicas como con las empresas. Los miembros del grupo están muy sensibilizados con acercar sus experiencias investigadoras a la sociedad, motivando en la curiosidad científica, y mostrando sus logros con la finalidad de llevarlos a la práctica. La Enfermería ha supuesto, para el grupo SALBIS, la sensibilidad y la eficiencia en el cuidado, y una perspectiva ilusionante para crear sociedades saludables y felices

SALBIS is an interdisciplinary, inter-university and international research group in the Universidad de León. It was created in 2011, with the aim of leading research in health and wellbeing focused on the person and the society. The majority of its members are nurses with crossover profiles (anthropologists, psychologists, humanists, etc.), who enrich the research perspective. They have doctorate degrees in Nursing, Psychology, Biomedicine, etc. The lines of research are: strategic healthcare planning, networks, wellbeing, mobility and movement, and technological innovation and health. For SALBIS, the knowledge generated must be: responsible with society, sustainable over time, and shared both with local authorities and companies. The group members are highly aware of the need to bring their research experiences close to society, motivating scientific curiosity, and showing their achievements with the aim of putting them into practice. For the SALBIS Group, Nursing has represented sensitivity and efficiency in healthcare, and an exciting perspective to create healthy and happy societies

Humanos , Indicadores de Desenvolvimento Sustentável/métodos , Seguridade Social , Pesquisa Interdisciplinar/organização & administração , Ciência de Dados/métodos , Economia da Enfermagem , Pesquisa Interdisciplinar/economia , Estratégias de Saúde Locais , Sistemas de Saúde/organização & administração
Implement Sci ; 15(1): 38, 2020 05 25.
Artigo em Inglês | MEDLINE | ID: mdl-32450898


BACKGROUND: In the last decade, there is an increasing focus on detecting and compiling lists of low-value nursing procedures. However, less is known about effective de-implementation strategies for these procedures. Therefore, the aim of this systematic review was to summarize the evidence of effective strategies to de-implement low-value nursing procedures. METHODS: PubMed, Embase, Emcare, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar were searched till January 2020. Additionally, reference lists and citations of the included studies were searched. Studies were included that described de-implementation of low-value nursing procedures, i.e., procedures, test, or drug orders by nurses or nurse practitioners. PRISMA guideline was followed, and the 'Cochrane Effective Practice and Organisation of Care' (EPOC) taxonomy was used to categorize de-implementation strategies. A meta-analysis was performed for the volume of low-value nursing procedures in controlled studies, and Mantel-Haenszel risk ratios (95% CI) were calculated using a random effects model. RESULTS: Twenty-seven studies were included in this review. Studies used a (cluster) randomized design (n = 10), controlled before-after design (n = 5), and an uncontrolled before-after design (n = 12). Low-value nursing procedures performed by nurses and/or nurse specialists that were found in this study were restraint use (n = 20), inappropriate antibiotic prescribing (n = 3), indwelling or unnecessary urinary catheters use (n = 2), ordering unnecessary liver function tests (n = 1), and unnecessary antipsychotic prescribing (n = 1). Fourteen studies showed a significant reduction in low-value nursing procedures. Thirteen of these 14 studies included an educational component within their de-implementation strategy. Twelve controlled studies were included in the meta-analysis. Subgroup analyses for study design showed no statistically significant subgroup effect for the volume of low-value nursing procedures (p = 0.20). CONCLUSIONS: The majority of the studies with a positive significant effect used a de-implementation strategy with an educational component. Unfortunately, no conclusions can be drawn about which strategy is most effective for reducing low-value nursing care due to a high level of heterogeneity and a lack of studies. We recommend that future studies better report the effects of de-implementation strategies and perform a process evaluation to determine to which extent the strategy has been used. TRIAL REGISTRATION: The review is registered in Prospero (CRD42018105100).

Educação Continuada em Enfermagem/organização & administração , Ciência da Implementação , Sobremedicalização/prevenção & controle , Enfermagem/normas , Economia da Enfermagem , Educação Continuada em Enfermagem/normas , Humanos , Sobremedicalização/economia , Indicadores de Qualidade em Assistência à Saúde
Dis Colon Rectum ; 63(6): 837-841, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32168094


BACKGROUND: Most hospitals in the United States are reimbursed for colectomy via a bundled payment based on the diagnosis-related group assigned. Enhanced recovery after surgery programs have been shown to improve the value of colorectal surgery, but little is known about the granular financial tradeoffs required at individual hospitals. OBJECTIVE: The purpose of this study is to analyze the index-hospitalization impact on specific cost centers associated with enhanced recovery after surgery implementation for diagnosis-related groups commonly assigned to patients undergoing colon resections. DESIGN: We performed a single-institution retrospective, nonrandomized, preintervention (2013-2014) and postintervention (2015-2017) analysis of hospital costs. SETTING: This study was conducted at an academic medical center. PATIENTS: A total of 1297 patients with diagnosis-related group 330 (colectomy with complications/comorbidities) and 331 (colectomy without complications/comorbidities) were selected. MAIN OUTCOME MEASURES: The primary outcome was total index-hospitalization cost. Secondary outcomes included specific cost center expenses. RESULTS: Total median cost for diagnosis-related group 330 in the pre-enhanced recovery after surgery group was $24,111 ($19,285-$28,658) compared to $21,896 ($17,477-$29,179) in the enhanced recovery after surgery group, p = 0.01. Total median cost for diagnosis-related group 331 in the pre-enhanced recovery after surgery group was $19,268 ($17,286-$21,858) compared to $18,444 ($15,506-$22,847) in the enhanced recovery after surgery group, p = 0.22. When assessing cost changes after enhanced recovery after surgery implementation for diagnosis-related group 330, operating room costs increased (p = 0.90), nursing costs decreased (p = 0.02), anesthesia costs increased (p = 0.20), and pharmacy costs increased (p = 0.08). For diagnosis-related group 331, operating room costs increased (p = 0.001), nursing costs decreased (p < 0.001), anesthesia costs increased (p = 0.03), and pharmacy costs increased (p = 0.001). LIMITATIONS: This is a single-center study with a pre- and postintervention design. CONCLUSIONS: The returns on investment at the hospital level for enhanced recovery after surgery implementations in colorectal surgery result largely from cost savings associated with decreased nursing expenses. These savings likely offset increased spending on operating room supplies, anesthesia, and medications. See Video Abstract at IMPACTO DE LA IMPLEMENTACIÓN DEL PROTOCOLO DE RECUPERACIÓN MEJORADA DESPUÉS DE CIRUGÍA EN EL COSTO DE LA HOSPITALIZACIÓN ÍNDICE EN CENTROS ESPECÍFICOS: La mayoría de los hospitales en los Estados Unidos son reembolsados por la colectomía a través de un paquete de pago basado en el grupo de diagnóstico asignado. Se ha demostrado que los programas de recuperación después de la cirugía mejoran el valor de la cirugía colorrectal, pero se sabe poco sobre las compensaciones financieras granulares que se requieren en los hospitales individuales.El objetivo de este estudio es analizar el impacto del índice de hospitalización en centros de costos específicos asociados con la implementación de RMDC para grupos relacionados con el diagnóstico comúnmente asignados a pacientes que se someten a resecciones de colon.Realizamos un análisis retrospectivo, no aleatorio, previo (2013-2014) y posterior a la intervención (2015-2017) de los costos hospitalarios de una sola institución.Centro médico académico.Un total de 1. 297 pacientes con diagnóstico relacionado con el grupo 330 (colectomía con complicaciones/comorbilidades) y 331 (colectomía sin complicaciones/comorbilidades).El resultado primario fue el índice total de costos de hospitalización. Los resultados secundarios incluyeron gastos específicos del centro de costos.El costo medio total para el grupo relacionado con el diagnóstico de 330 en el grupo de recuperación pre-mejorada después de la cirugía fue de $24,111 ($19,285- $28,658) en comparación con $21,896 ($17,477- $29,179) en el grupo de recuperación mejorada después de la cirugía, p = 0.01. El costo medio total para DRG 331 en el grupo de recuperación pre-mejorada después de la cirugía fue de $19,268 ($17,286- $21,858) en comparación con $18,444 ($15,506-$22,847) en el grupo de recuperación mejorada después de la cirugía, p = 0.22. Al evaluar los cambios en los costos después de una recuperación mejorada después de la implementación de la cirugía para el grupo 330 relacionado con el diagnóstico, los costos de la sala de operaciones aumentaron (p = 0.90), los costos de enfermería disminuyeron (p = 0.02) los costos de anestesia aumentaron (p = 0.20) y los costos de farmacia aumentaron (p = 0.08). Para el grupo 331 relacionado con el diagnóstico, los costos de la sala de operaciones aumentaron (p = 0.001), los costos de enfermería disminuyeron (p < 0.001) los costos de anestesia aumentaron (p = 0.03) y los costos de farmacia aumentaron (p = 0.001).Este es un estudio de un solo centro con un diseño previo y posterior a la intervención.El retorno de la inversión a nivel hospitalario para una recuperación mejorada después de la implementación de la cirugía en la cirugía colorrectal se debe en gran parte al ahorro de costos asociado con la disminución de los gastos de enfermería. Es probable que estos ahorros compensen el aumento de los gastos en suministros de quirófano, anestesia y medicamentos. Consulte Video Resumen en (Traducción-Dr. Gonzalo Hagerman).

Colectomia/economia , Cirurgia Colorretal/economia , Recuperação Pós-Cirúrgica Melhorada/normas , Implementação de Plano de Saúde/métodos , Hospitalização/economia , Adulto , Idoso , Anestesia/economia , Anestesia/estatística & dados numéricos , Estudos de Casos e Controles , Colectomia/efeitos adversos , Grupos Diagnósticos Relacionados/economia , Economia da Enfermagem/estatística & dados numéricos , Farmacoeconomia/estatística & dados numéricos , Equipamentos e Provisões/economia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados não Aleatórios como Assunto/métodos , Salas Cirúrgicas/economia , Salas Cirúrgicas/estatística & dados numéricos , Período Pós-Operatório , Período Pré-Operatório , Estudos Retrospectivos , Estados Unidos/epidemiologia
J Wound Care ; 29(2): 120-127, 2020 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-32058851


OBJECTIVE: Hospital-acquired pressure ulcers (PU) have a substantial negative impact on patients and continue to impose a cost burden on hospital providers. Since the incidence of fragility fracture is growing, driven by the increase in the older population, it is expected that the overall incidence of associated complications will also increase accordingly. The aim of this economic evaluation was to determine whether the use of a multilayer, silicone-adhesive polyurethane foam dressing (ALLEVYN LIFE, Smith & Nephew, UK) alongside standard prevention (SP) for the prevention of PUs in older patients with hip fractures is a cost-effective strategy, compared with SP alone. METHOD: A decision-analytic model was constructed to determine the incremental cost and effectiveness of the foam dressing strategy from the perspectives of the Italian and US hospital systems. We also performed one-way and probabilistic sensitivity analyses. RESULTS: The foam dressing intervention was found to be cost saving and more effective than SP in both Italy and the US. Switching to foam dressing and standard prevention would result in an expected cost saving of €733 per patient in Italy and $840 per patient in the US, reducing the per-patient cost of treating PUs by 37-69% and 36-68%, respectively. The one-way and probabilistic sensitivity analyses demonstrate that the strategy remains dominant over a range of values of the input variables. CONCLUSION: The foam dressing intervention is likely to be a cost-effective strategy compared with standard prevention alone.

Bandagens/economia , Fraturas do Quadril/enfermagem , Fraturas por Osteoporose/enfermagem , Poliuretanos/uso terapêutico , Lesão por Pressão/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Análise Custo-Benefício , Técnicas de Apoio para a Decisão , Economia da Enfermagem , Humanos , Itália , Poliuretanos/economia , Lesão por Pressão/economia , Lesão por Pressão/enfermagem , Estados Unidos
PLoS One ; 15(2): e0226329, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32053627


This study uses YouTube content to explore trends in nursing start-ups. YouTube content can be used to understand the current trends regarding interest and awareness in various fields. The study was conducted in three stages: text mining, Delphi survey, and comparison. The frequency and degree centrality of keywords were analyzed in the text mining stage. In the Delphi survey, the 100 most frequent keywords were classified using a synthesis framework for nursing start-ups. In the comparison stage, the results of text mining and the Delphi survey were matched using a 2x2 matrix. Text mining identified "area," "business," "competence," "idea," and "success" as the most commonly used keywords. The keywords that showed the highest level of classification agreement in Delphi were "motivation," "advice," "obstacle," "business," "charisma," and "result." In the comparison using a 2x2 matrix, "dream," "idea," "opportunity," "leadership," "success," "benefit," and "satisfaction" emerged. The results indicate that interest in nursing start-ups develops at an early stage. In order to encourage nursing start-ups, it is necessary to strengthen business skills such as finance and budgeting, establish active policy support for such start-ups, and develop new nursing start-up items appropriate for the Fourth Industrial Revolution.

Comércio/tendências , Economia da Enfermagem , Enfermagem/tendências , Mídias Sociais/estatística & dados numéricos , Comércio/economia , Comércio/estatística & dados numéricos , Análise de Dados , Mineração de Dados , Técnica Delfos , Humanos , Enfermagem/estatística & dados numéricos
Ciênc. Saúde Colet. (Impr.) ; 25(1): 223-232, jan. 2020.
Artigo em Inglês | LILACS | ID: biblio-1055793


Abstract The study presents the current profile of Peruvian nursing, its professional construction and its dilemmas, emphasizing its socio-cultural features. To this end, an extensive literature was reviewed, interviewing nurses in key positions and analyzing secondary source data. This study keeps its distance from other studies on health care professions as a workforce, to analyze the low social legitimacy of the nursing profession despite being the great operator of health care services in Peru. This resulting psychological overload, additionally to the work overload is reflected in job dissatisfaction, stress, burnout, intention of changing careers, and a strong desire to migrate. As a result, Peruvian nursing has opted for three alternatives: a) resilience, which means to adapt to this unfavorable situation; b) abandoning the profession, or leaving the country; and c) reaction, which gathers all manifestations of the profession against abandonment, informality, and mediocrity. In conclusion, the biggest challenge of professions given low social value is the recognition and not only the salary redistribution. This significant challenge for Peruvian nursing does not mainly relate to legal professionalization, but professionalism, which must result in greater legitimacy and autonomy.

Resumo O estudo apresenta o perfil atual da enfermagem peruana, sua construção profissional e seus dilemas, enfatizando suas características socioculturais. Para tanto, foi realizada extensa revisão de literatura, entrevistas com profissionais de enfermagem em posições-chave e análise de dados de fontes secundárias. O estudo distancia-se dos estudos das profissões da saúde como força de trabalho, a fim de analisar a baixa legitimidade social da profissão de enfermagem, apesar de ser a grande operadora de serviços no Peru. Isso produz uma sobrecarga psicológica, que se soma à sobrecarga de trabalho e se reflete em insatisfação no trabalho, estresse, burnout, desejo de mudar de carreira ou migrar. Diante disso, a enfermagem peruana optou por três saídas: a) resiliência, que representa adaptação; b) abandono, ou saída do país ou profissão; e c) a reação, que agrupa todas as manifestações contra o abandono à informalização e à mediocrização. Conclui-se que as profissões de baixo valor social têm como desafio central o reconhecimento profissional e não apenas a redistribuição salarial. Esse desafio central da enfermagem peruana não está centralmente ligado à sua profissionalização legal, mas ao seu profissionalismo, que trará maior legitimidade e autonomia.

Salários e Benefícios/estatística & dados numéricos , Economia da Enfermagem , Processo de Enfermagem , Peru , Emprego , Estresse Ocupacional
Med Mal Infect ; 50(3): 252-256, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31387813


OBJECTIVE: Staphylococcusaureus is involved in around 20% of nosocomial pneumonia cases. Vancomycin used to be the reference antibiotic in this indication, but new molecules have been commercialized, such as linezolid. Previous studies comparing vancomycin and linezolid were based on models. Comparing their real costs from a hospital perspective was needed. METHODS: We performed a bicentric retrospective analysis with a cost-minimization analysis. The hospital antibiotic acquisition costs were used, as well as the laboratory test and administration costs from the health insurance cost scale. The cost of each hospital stay was evaluated using the national cost scale per diagnosis related group (DRG), and was then weighted by the stay duration. RESULTS: Fifty-eight patients were included. All bacteria identified in pulmonary samples were S. aureus. The cost of nursing care per stay with linezolid was €234.10 (SD=91.50) vs. €381.70 (SD=184.70) with vancomycin (P=0.0029). The cost of laboratory tests for linezolid was €172.30 (SD=128.90) per stay vs. €330.70 (SD=198.40) for vancomycin (P=0.0005). The acquisition cost of linezolid per stay was not different from vancomycin based on the price of the generic drug (€54.92 [SD=20.54] vs. €40.30 [SD=22.70]). After weighting by the duration of stay observed, the mean cost per hospital stay was €47,411.50 for linezolid and €57,694.0 for vancomycin (NSD). CONCLUSION: These results, in favor of linezolid, support other former pharmacoeconomic study based on models. The mean cost per hospitalization stay was not statistically different between the two study groups, but a trend in favor of linezolid is emerging.

Infecção Hospitalar/tratamento farmacológico , Linezolida/economia , Pneumonia Estafilocócica/tratamento farmacológico , Vancomicina/economia , Idoso , Custos e Análise de Custo , Infecção Hospitalar/economia , Infecção Hospitalar/enfermagem , Grupos Diagnósticos Relacionados , Custos de Medicamentos , Economia da Enfermagem , Feminino , França , Hospitalização/economia , Hospitais Urbanos/economia , Humanos , Infusões Intravenosas/economia , Tempo de Internação/economia , Linezolida/administração & dosagem , Linezolida/uso terapêutico , Masculino , Pessoa de Meia-Idade , Pneumonia Estafilocócica/economia , Pneumonia Estafilocócica/enfermagem , Estudos Retrospectivos , Staphylococcus aureus/efeitos dos fármacos , Vancomicina/administração & dosagem , Vancomicina/uso terapêutico