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1.
J Public Health Manag Pract ; 28(1): E299-E306, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-33729198

RESUMO

OBJECTIVE: In response to the COVID-19 pandemic, hospitals have developed visitor restriction policies in order to mitigate spread of infection. We reviewed hospital visitor restriction policies for consistency and to develop recommendations to highlight fair and transparent restrictions, exceptions, and appeals in policy development and implementation. DESIGN: Collection and analysis of public-facing visitor restriction policies during the first 3 months of the pandemic. SETTING: General acute care hospitals representing 23 states across all 4 major regions of the United States. PARTICIPANTS: A cohort of the 70 largest hospitals by total bed capacity. MEASUREMENTS: Characteristics of visitor restriction policies including general visitor restriction statement, changes/updates to policies over time, exceptions to policies, and restrictions specific to COVID-19-positive patients. RESULTS: Sixty-five of the 70 hospitals reviewed had public-facing visitor restriction policies. Forty-nine of these 65 policies had general "no-visitor" statements, whereas 16 allowed at least 1 visitor to accompany all patients. Sixty-three of 65 hospitals included exceptions to their visitor restriction policies. Setting-specific exceptions included pediatrics, obstetrics/gynecology, emergency department, behavioral health, inpatient rehabilitation, surgery, and outpatient clinics. Exceptions that applied across settings included patients at end of life and patients with disabilities. CONCLUSION: Visitor restriction policies varied significantly among hospitals in this review. These variances create challenges in that their fair application may be problematic and ethical issues related to allocation may arise. Five recommendations are offered for hospitals revising or creating such policies, including that offering transparent, accessible, public-facing policies can minimize ethical dilemmas. In addition, hospitals would benefit from communicating with each other in the development of visitor policies to ensure uniformity and support patients and family members as they navigate hospital visitation.


Assuntos
COVID-19 , Pandemias , Criança , Feminino , Hospitais , Humanos , Políticas , Gravidez , SARS-CoV-2 , Estados Unidos , Visitas a Pacientes
2.
J Nurs Care Qual ; 37(1): 61-67, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-33852529

RESUMO

BACKGROUND: Lean management tools have proven effective in achieving high reliability in health care. LOCAL PROBLEM: Unstructured leader rounds, decentralized prevention bundle repositories, and unfavorable patient experience outcomes prompted leaders on a thoracic and cardiovascular surgery unit to find other methods to address these issues and positively impact outcomes. METHODS: Nurse sensitive indicator prevention bundles, root cause analysis tools, and best practices were used to develop Kamishibai Cards (K-Cards) for each measure targeted. INTERVENTIONS: K-Cards were implemented to standardize processes, engage patients in their care, and promote staff identification of barriers and solutions. RESULTS: Nurse-sensitive indicators and patient experience metrics were positively impacted by Kamishibai Rounding. K-Cards promote a state of continuous improvement, which supports sustainability of evidence-based practice and best practices that were implemented. CONCLUSIONS: K-Cards use high-reliability principles to standardize nursing practice to promote quality outcomes.


Assuntos
Melhoria de Qualidade , Visitas com Preceptor , Prática Clínica Baseada em Evidências , Hospitais , Humanos , Reprodutibilidade dos Testes
3.
Appl Ergon ; 98: 103533, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34419784

RESUMO

We evaluated the influence of organization, eldercare worker and care situation on the use of assistive devices during resident handling in eldercare work. We conducted a multi-level study among 20 nursing homes, 126 wards within the nursing homes, 549 eldercare workers within the wards, who performed a total of 1306 care episodes including 3695 resident handlings. The influence of organization (i.e. nursing home and ward), eldercare worker and care situation (i.e. care episode and resident handling) on the use of assistive devices was evaluated using variance components analysis and multivariate generalized linear mixed model. Nursing homes, wards, eldercare workers, care episodes and 'within care episode' all contributed to the total variance in use of assistive devices. Organizational factors and care situation factors were significantly associated with use of assistive devices. All levels of the nursing homes, but in particular care situation, influence the use of assistive devices during resident handling.


Assuntos
Casas de Saúde , Equipamentos de Autoajuda , Hospitais , Humanos
4.
Chemosphere ; 286(Pt 3): 131838, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34399260

RESUMO

In this study, Hospital wastewater was treated using a submerged aerobic fixed film (SAFF) reactor coupled with tubesettler in series. SAFF consisted of a column with an up-flow biofilter. The biological oxygen demand (BOD)5, chemical oxygen demand (COD), nitrate and phosphate were the chosen pollutants for evaluation. The pollutants removal efficiency was determined at varying organic loading rates and hydraulic retention time. The organic loading rate was varied between 0.25 and 1.25 kg COD m-3 d-1. The removal efficiency of SAFF and tubesettler combined was 75 % COD, 67 % BOD and 67 % phosphate, respectively. However, nitrate saw an increase in concentration by 25 %. SAFF contribution in the removal of COD, BOD5 and Phosphate was 48 %, 46 % and 29 %, respectively. While for accumulation of nitrate, it was responsible for 56%, respectively. Tubesettler performed better than SAFF with 52 %, 54 % and 69 % reduction of COD, BOD5 and phosphate, respectively. But in terms of nitrate, tubesettler was responsible for 44 % accumulation. The nutrient reduction decreased with an increase in the organic loading rate. Nitrification was observed in the SAFF and tubesettler, which indicated a well-aerated system. An anaerobic unit is required for completing the denitrification process and removing nitrogen from the effluent. The better performance of tubesettler over SAFF calls for necessitates extended retention time over design criteria. Further studies are beneficial to investigate the impact of pharmaceutical compounds on the efficiency of SAFF.


Assuntos
Reatores Biológicos , Águas Residuárias , Análise da Demanda Biológica de Oxigênio , Hospitais , Nitrificação , Nitrogênio , Eliminação de Resíduos Líquidos
5.
Infectio ; 25(4): 284-288, oct.-dic. 2021. tab
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1286723

RESUMO

Resumen Objetivo: Determinar los factores de riesgo a la infección en cavidad residual post quistectomía hepática en los pacientes del hospital Ramiro Prialé Prialé - EsSalud -Huancayo. Materiales y Métodos: Se realizó una cohorte retrospectiva, entre enero del 2014 y enero del 2018. Se utilizó una ficha de recolección de datos. Se obtuvieron los riesgos relativos (RR) crudos y ajustados, con intervalos de confianza al 95%. Resultados: Participaron 83 pacientes. El 41,2% de las mujeres presentaron infección en la cavidad postquistectomía y la mediana de edad de los pacientes infecta dos fue de 33 años. Los antecedentes patológicos que se relacionaron con la infección fueron obesidad o sobrepeso (62,5%), neoplasia previa (100%) y enferme dad inmunológica previa (31%). La infección en cavidad residual postquistectomía estuvo relacionada a la presencia de obesidad o sobrepeso, diabetes mellitus, neoplasia previa , cirugía previa y al uso de antibióticos posteriores a la cirugía. Conclusiones: La obesidad o sobrepeso, diabetes mellitus, haber padecido alguna neoplasia o cirugía previa y el uso de antibióticos luego de la cirugía; son factores de riesgo para la infección en cavidad residual postquistectomía hepática en los pacientes del Hospital Nacional Ramiro Prialé Prialé EsSalud de Huancayo, Perú.


Abstract Objective: To determine the risk factors with the infection in the residual cavity after hepatic cystectomy in the patients of the Ramiro Prialé Prialé hospital - EsSalud -Huancayo. Materials and Methods: A retrospective cohort was conducted, between January 2014 and January 2018. A data collection sheet was used. Crude and adjusted relative risks (RR) were obtained, with 95% confidence intervals. Results: 83 patients participated. 41.2% of women infected in the post-cystectomy cavity and the median age of infected patients was 33 years. The pathological antecedents that were related to the infection were obesity or overweight (62.5%), previous neoplasia (100%) and previous immune disease (31%). Post-cystectomy residual cavity infection was affected by the presence of obesity or overweight (aRR: 1.56; 95% CI: 1.15-2.13; p value = 0.005), diabetes mellitus (aRR: 2.67; 95% CI : 2.09-3.41; p value <0.001), previous neoplasia (aRR: 2.49; 95% CI: 1.94-3.20; p value <0.001), previous surgery (aRR: 1.49; 95% CI: 1.36-1.64; p value <0.001) and the use of post-surgery antibiotics (aRR: 2.14; 95% CI: 1.30-3.51; p value = 0.003) Conclusions: Obesity or overweight, diabetes mellitus, having suffered some neoplasia or previous surgery and the use of antibiotics after surgery; they are factors associated with infection in the residual post-cystectomy liver cavity in patients of the Ramiro Prialé Prialé EsSalud National Hospital in Huancayo, Peru.


Assuntos
Humanos , Feminino , Adulto , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Fatores de Risco , Infecções , Peru , Ranunculaceae , Diabetes Mellitus , Equinococose Hepática , Hospitais , Doenças do Sistema Imunitário , Neoplasias
6.
Infectio ; 25(4): 256-261, oct.-dic. 2021. tab, graf
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1286719

RESUMO

Resumen Objetivo: Determinar los factores de riesgo en adultos con COVID-19 en población rural andina durante 2020. Métodos: En este estudio de cohorte retrospectivo multicéntrico, incluimos a 184 pacientes adultos (≥18 años) con pruebas serológicas y moleculares para CO VID-19 de tres hospitales de la sierra peruana (Ancash y Apurímac) incluidos con sospecha clínica entre abril y junio. Se utilizó análisis descriptivos y regresión logística univariable para explorar los factores de riesgo asociados a los pacientes con COVID-19. Resultados: Del total de pacientes, 14 (7.6%) tuvieron SARS-CoV-2. En los pacientes infectados 12 (85.7%) fueron varones con promedio de edad de 47.3±21 años. Las comorbilidades estuvieron presentes en cerca de la tercera parte de pacientes, siendo la hipertensión y diabetes las más frecuentes (ambas 14.3%), y la sinto matología más frecuentes fueron fiebre y cefalea (57.2%). La regresión univariable mostró mayores probabilidades de infección con SARS-CoV-2 en la población rural andina asociada con la edad avanzada (OR: 1.1 IC95% 0.7-1.8; p=0,019), comorbilidades previas (OR: 1.7, IC95% 0.32-9.39; p=0,006), y sintomatología previa (OR: 49.8, IC95% 5.6-436.9; p=0,0011). Conclusiones: Los posibles factores de riesgo como la edad avanzada, las comorbilidades y sintomatología previas están relacionados con el desarrollo de CO VID-19 en población rural andina de Perú.


Abstract Objective: To determine the risk factors in adults with COVID-19 in the rural Andean population during 2020. Methods: This multicenter retrospective cohort study included 184 adult patients (≥18 years) with COVID-19's serological and molecular tests from three Hospitals in the Peruvian mountains (Ancash and Apurímac) included with clinical suspicion between April and June. Descriptive analysis and univariate logistic regression were used to explore the risk factors associated with patients with COVID-19. Results: Of total of patients, 14 (7.6%) had a SARS-CoV-2. In infected patients 12 (85.7%) were men with an average age of 47.3±21 years. Comorbidities were present in about a third of patients, with hypertension and diabetes being the most frequent (both 14.3%), and the most frequent symptoms were fever and hea dache (57.2%). Univariate regression showed higher probabilities of infection with SARS-CoV-2 in the rural Andean population associated with advanced age (OR: 1.1 95% CI 0.7 - 1.8; p = 0.019), previous comorbidities (OR: 1.7, 95%CI 0.32 - 9.39; p = 0.006), and previous symptoms (OR: 49.8, 95%CI 5.6 - 436.9; p = 0.0011). Conclusions: Possible risk factors such as advanced age, comorbidities and previous symptoms are related to the development of COVID-19 in the rural Andean population of Peru.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , COVID-19 , Peru , População Rural , Fatores de Risco , Estudos de Coortes , SARS-CoV-2 , Cefaleia , Hospitais , Hipertensão , Infecções
7.
Rev. enferm. UERJ ; 29: e52717, jan.-dez. 2021.
Artigo em Inglês, Português | LILACS | ID: biblio-1224536

RESUMO

Objetivo: compreender a construção dos significados da morte pelos profissionais de saúde frente ao cuidado à pessoa com câncer. Método: estudo qualitativo realizado em ambiente online, com a participação de 34 profissionais de saúde. Foram realizadas entrevistas semiestruturadas, interpretadas segundo análise temática. Resultados: duas categorias analíticas emergiram dos dados, indicando que os significados atribuídos à morte pelos participantes foram: como um processo inerente ao ciclo da vida humana, passagem para a outra vida, e fim do sofrimento tanto do paciente quanto dos profissionais de saúde. As dificuldades que apontaram em lidar com a morte se referem à falta de suporte psicológico, escassez de conhecimento sobre morte, cuidados paliativos e comunicação de más notícias. Conclusão: os profissionais construíram diferentes significados à morte de seus pacientes, tais como um processo natural da vida, vontade de um ser superior, passagem para uma nova existência e término do sofrimento dessas pessoas.


Objective: to understand the construction of meanings of death by healthcare professionals caring for people with cancer. Method: this qualitative study was carried out in an online environment through semi-structured interviews of 34 health professionals, which were interpreted using thematic analysis. Results: two analytical categories emerged from the data, indicating that the meanings attributed to death by the participants were: a process inherent in the human life cycle, a transition to the next life, and an end to the suffering of both patient and health professionals. The difficulties they pointed to in dealing with death related to lack of psychological support, lack of knowledge about death, palliative care, and communicating bad news. Conclusion: the professionals constructed different meanings to their patients' deaths: a natural process of life, the will of a higher being, a transition to a new existence, and an end to these people's suffering.


Objetivo: comprender la construcción de los significados de la muerte desde el punto de vista de los profesionales de la salud ante el cuidado a la persona con cáncer. Metodología: estudio cualitativo realizado en un entorno online, con la participación de 34 profesionales de la salud. Se realizaron entrevistas semiestructuradas, interpretadas según análisis temático. Resultados: de los datos surgieron dos categorías analíticas que indicaron que los significados atribuidos a la muerte por los participantes fueron: como u proceso inherente al ciclo de vida humano, transición a otra vida y fin al sufrimiento tanto del paciente como de los profesionales de la salud. Las dificultades que señalaron para afrontar la muerte se refieren a la falta de apoyo psicológico, escasez de conocimiento sobre la muerte, cuidados paliativos y comunicación de malas noticias. Conclusión: los profesionales han construido diferentes significados para la muerte de sus pacientes: un proceso natural de la vida, la voluntad de un ser superior, un paso a una nueva existencia y el fin del sufrimiento de estas personas.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Prática Profissional , Atitude Frente a Morte , Pessoal de Saúde , Morte , Oncologistas , Neoplasias , Cuidados Paliativos , Pessoal de Saúde/psicologia , Pesquisa Qualitativa , Oncologistas/psicologia , Hospitais , Neoplasias/psicologia
8.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48514

RESUMO

A publicação "Hospitales que curan el planeta", lançada em março de 2021 por Salud sin Daño, apresenta os esforços dos membros da Rede Global de Hospitais Verdes e Saudáveis (RGHVS) na América Latina para minizar o impacto ambiental em suas atividades e promover a saúde ambiental.


Assuntos
Relatório de Pesquisa , Hospitais
9.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48515

RESUMO

A Agenda Global para Hospitais Verdes e Saudáveis (AGHVS) se propõe a oferecer apoio a iniciativas em todo o mundo, visando promover maior sustentabilidade e saúde ambiental no setor saúde e assim fortalecer os sistemas de saúde em nível global.


Assuntos
Hospitais , Saúde Ambiental , Sistemas de Saúde
10.
BMC Health Serv Res ; 21(1): 1192, 2021 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-34732180

RESUMO

BACKGROUND: Among older adults, living alone is often associated with higher risk of Emergency Department (ED) admissions. However, older adults living alone are very heterogeneous in terms of health. As more older adults choose to live independently, it remains unclear if the association between living alone and ED admissions is moderated by health status. We studied the association between living alone and ED admission outcomes (number of admissions, inpatient days and inpatient costs) among older adults with and without multimorbidity. METHODS: We used data from 16,785 individuals of the third follow-up of the Singapore Chinese Health Study, a population-based cohort of older Singapore Chinese (mean age: 73(61-96) years). Participants were interviewed face-to-face from 2014 to 2016 for sociodemographic/health factors and followed-up for one year on ED admission outcomes using Singapore Ministry of Health's Mediclaim Database. We first applied multivariable logistic regression and two-part models to test if living alone is a risk factor for ED admission outcomes. We then ran stratified and joint effect analysis to examine if the associations between living alone and ED admission outcomes were moderated by multimorbidity. RESULTS: Compared to living with others, living alone was associated with higher odds of ED admission [Odds Ratio (OR) 1.28, 95 % Confidence Interval(CI) 1.08-1.51)], longer inpatient days (+0.61, 95 %CI 0.25-0.97) and higher inpatient costs (+322 USD, 95 %CI 54-591). The interaction effects of living arrangement and multimorbidity on ED admissions and inpatient costs were not statistically different, whereas the interaction between living arrangements and multimorbidity on inpatient days was borderline significant (p-value for interaction=0.050). Compared to those living with others and without multimorbidity, the relative mean increase was 1.13 inpatient days (95 %CI 0.39-1.86) for those living alone without multimorbidity, and 0.73 inpatient days ( 95 %CI 0.29-1.17) for those living alone with multimorbidity. CONCLUSIONS: Older adults living alone were at higher risk of ED admission and higher inpatient costs regardless of multimorbidity, while those living alone without multimorbidity had the longest average inpatient days. To enable aging in place while avoiding ED admissions, interventions could provide instrumental support and regular health monitoring to older adults living alone, regardless of their health status.


Assuntos
Serviço Hospitalar de Emergência , Vida Independente , Idoso , Hospitalização , Hospitais , Humanos , Multimorbidade
11.
Isr J Health Policy Res ; 10(1): 62, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34724976

RESUMO

BACKGROUND: The Covid-19 pandemic began in Israel on February 2020. Between February and October 2020, 2 periods of lockdown were imposed on Israeli population. OBJECTIVE: To assess the effect of the Covid-19 pandemic on visits to the emergency department (ED) and on hospitalizations in medical wards in Israel's Chaim Sheba Medical Center, and to compare the effect during the first and second lockdowns. METHODS: Data regarding the number of visits of non-Covid-19 patients to the ED and the number of admissions to the medical wards, were extracted from the computerized system of the hospital. Data were analyzed for patients' characteristics, length of stay in the medical wards, in hospital mortality and the rate of 7 and 30 days re-hospitalization, and compared to the same period during 2019. RESULTS: Total visits to the Sheba ED during March-October decreased by 18.5%. The most dramatic decrease occurred during the first lockdown. The number of patients admitted to the Sheba medical wards decreased by 28% (P < 0.05). The length of stay decreased from 3.69 days during 2019 to 3.42 days during 2020 (P < 0.01). The most pronounced decrease in the length of stay was observed during the second month of the first lockdown. During the pandemic, hospitalized patients at Sheba were older and were less likely to be males. The in-hospital absolute non-COVID mortality decreased from 913 to 858 respectively. CONCLUSIONS: The Covid-19 crisis emphasizes the role of medical wards in the care of complex patients. Medical wards in Israel were at the frontline of Israel's battle against this pandemic, while continuing to treat very complex non-Covid patients. To avoid burnout of the medical staff who treat very intensively complex patients, we believe these wards should be strengthen with specialists having expertise in treating these patients. Due to our insights, the Sheba medical Center is now redesigning the concept of how intensive care beds should be managed in a big tertiary center.


Assuntos
COVID-19 , Pandemias , Controle de Doenças Transmissíveis , Serviço Hospitalar de Emergência , Hospitalização , Hospitais , Humanos , Israel/epidemiologia , Masculino , SARS-CoV-2
12.
J Perinat Neonatal Nurs ; 35(4): 313-319, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34726647

RESUMO

Cesarean births have increased in the United States, accounting for approximately one-third of all births. There is concern that cesarean birth is overused, due to the wide variation in rates geographically and at different institutions within the same region. Despite the rising rate, there has not been an improvement in maternal or neonatal outcomes. Consequently, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine published recommendations aimed at the safe prevention of primary cesarean births in 2014. The purpose of this project was to identify the term singleton vertex cesarean birth rates in the Military Health System's hospitals; to compare the Military Health System's rate of term singleton vertex cesarean birth to published benchmarks; and to compare term singleton vertex cesarean birth rates over time and among facilities within the Military Health System to determine whether variation existed. This was a retrospective review of aggregate data reported by the National Perinatal Information Center. Data were analyzed over 9 years at 2-year intervals from 2011 through 2019 inclusively. The Military Health System exceeded national benchmarks for term singleton vertex cesarean birth rates and had less variation over time and among facilities.


Assuntos
Coeficiente de Natalidade , Serviços de Saúde Militar , Cesárea , Feminino , Hospitais , Humanos , Recém-Nascido , Gravidez , Estudos Retrospectivos , Estados Unidos/epidemiologia
13.
J Telemed Telecare ; 27(10): 615-624, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34726993

RESUMO

The patient, clinician and administration staff perspectives of telehealth (specifically videoconferencing) services provided by Allied Health Professions (AHP) at a large quaternary hospital were explored. The purpose was to understand stakeholders' perceptions of the service during initial COVID-19 restrictions and examine factors that influenced the implementation and sustained use of telehealth. A sequential mixed-methods approach was undertaken. Stage 1 involved surveys completed by patients (n = 109) and clinicians (n = 66) who received and provided care via telehealth, respectively, across six AHP departments. Stage 2 involved focus groups with clinicians (n = 24) and administrative staff (n = 13) to further examine implementation and sustainability factors.All participant groups confirmed that telehealth was a valid service model and valued the benefits it afforded, particularly during COVID-19 restrictions. Both patients and clinicians reported that not all AHP services could be delivered via telehealth and preferred a blended model of telehealth and in-person care. Increased administrative staff assistance was needed to support growing telehealth demand. Main factors to address are the need to expand AHP telehealth models and workforce/patient training, improve workflow processes and enhance technical support.Despite rapid implementation, telehealth experiences were overall positive. Study findings are being used to generate solutions to enhance and sustain AHP telehealth services.


Assuntos
COVID-19 , Telemedicina , Hospitais , Humanos , SARS-CoV-2 , Comunicação por Videoconferência
14.
J Craniofac Surg ; 32(8): e787-e790, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34727456

RESUMO

BACKGROUND: The length of hospital stays of patients undergoing orthognathic surgery depends on related local and systemic factors. Hematological changes resulting from orthognathic surgery, followed up in the postoperative period until hospital discharge, have neither yet been established for specific cases, nor for normal situations. This study aimed to describe the hemodynamic parameters of patients undergoing orthognathic surgery, considering a prediction of hospital discharge. A prospective analytical study was carried out on a sample of convenience for this purpose. METHODS: The erythrogram, leukogram, and platelet count were assessed 24 and 72 hours after surgery and compared with preoperative values. Intraoperative volume loss was also assessed. Inferential statistical analyses were performed as analysis of variance or Friedman test, paired Wilcoxon test, Mann-Whitney test, and 2-tailed Spearman correlation. RESULTS: The red blood cell count (mean ±â€Šstandard deviation [median]); (4.60 ±â€Š0.24 [4.56]), hemoglobin (12.82 ±â€Š1.03 [12.75]), hematocrit (39.51 ±â€Š3.47 [39.60]), and red cell distribution with (32.60 ±â€Š0.88 [33.05]) were higher preoperatively (P < 0.001). Mean corpuscular volume (83.87 ±â€Š5.63 [83.10]), mean corpuscular hemoglobin (27.50 ±â€Š1.47 [28.00]), leukocytes (6262.00 ±â€Š1448.36 [6380.00]). The volume loss varied between 463.87 and 752.13 mL (608.00 ±â€Š144.13 [630.00]). CONCLUSIONS: The results of the hematological evaluations corroborate the expectation of standard discharge from the hospital, with reflected changes resulting from volume loss and intense postoperative inflammatory response, even under the anti-inflammatory pharmacological effect.


Assuntos
Cirurgia Ortognática , Contagem de Eritrócitos , Hematócrito , Hospitais , Humanos , Alta do Paciente , Estudos Prospectivos
15.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi ; 39(10): 775-778, 2021 Oct 20.
Artigo em Chinês | MEDLINE | ID: mdl-34727661

RESUMO

Objective: To investigation noise annoyance among the exposed anesthesiologists, and to analyze the influencing factors of noise annoyance. Methods: From January to May 2017, cluster sampling was used to select 62 anesthesiologists from Peking University Third Hospital as the survey subjects. The Likert Scale (five-level) and the Visual Analog Scale (0-10 points) were used to conduct noise annoyance and noise sensitivity survey. Linear regression was used for multi-factor analysis to explore the influencing factors of noise annoyance. Results: The age of the research subjects was (32.3±6.1) years old, the working experience was 4.9 (2.0, 8.9) years, and the daily working hours were (9.8±2.8) h. The noise level in the operating room on the measurement day was (64.4±1.7) dB (A) . In the Likert Scale and the Visual Analog Scale, 88.7% (55/62) and 95.2% (59/62) anesthesiologists believed that operating room noise had adverse reactions, 6.5% (4/62) and 14.5% (9/62) anesthesiologists measured a high degree of annoyance. The results of linear regression analysis showed that noise sensitivity was an independent factor influencing the anesthesiologists' noise annoyance in the Likert Scale and the Visual Analog Scale (r=0.524, 0.700, P<0.05) . Conclusion: Noise in the operating room can cause anesthesiologists to feel annoyed and is a hidden danger to the quality of medical services, which should be paid attention to by the academic and management departments.


Assuntos
Anestesiologistas , Ruído dos Transportes , Adulto , Emoções , Exposição Ambiental , Hospitais , Humanos , Inquéritos e Questionários
16.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 43(5): 767-772, 2021 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-34728039

RESUMO

Objective To investigate the understanding of the head and face protection of the health care workers in operating room of Peking Union Medical College Hospital during the corona virus disease-19(COVID-19) pandemic.Methods The knowledge of head and face protection of health care workers in the operating room was evaluated based on the non-registered questionnaires for protection measures collected on-line.Results The survey was conducted in two phases.In the first phase(COVID-19 outbreak),153 questionnaires were collected.In the second phase(when Beijing lowered the emergency response to level 3 and normalized the epidemic prevention and control),101 questionnaires were collected.The results showed that 98% of health care workers had used any form of protective devices during the pandemic and anesthesiologists had the highest usage rate(93.0%)of ear-loop face mask with eye shield.During the pandemic,health care workers mainly used goggles(71.2%)for protection to diagnose and treat the patients with fever and ear-loop face mask with eye shield(56.2%)for protection to diagnose and treat the non-fever patients.In the first-and second-phase survey,43% and 68% of health care workers still used protection,and they mainly used face shield(50.0% and 56.5%)and ear-loop face mask with eye shield(56.1% and 68.1%).Conclusions During the pandemic,more than 90% of the health care workers in the operating room of Peking Union Medical College Hospital were aware of head and face protection.Different healthcare workers in the operating room had different choices of head and face protection,and more than 40% of them would still keep such protection during the normalized stage of pandemic prevention and control.


Assuntos
COVID-19 , Pandemias , Pessoal de Saúde , Hospitais , Humanos , Salas Cirúrgicas , SARS-CoV-2
17.
Acta Biomed ; 92(5): e2021427, 2021 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-34738570

RESUMO

Background and aim This study analyses the impact of the first two pandemic waves on surgical urgencies/emergencies and their consequences on an entire provincial hospital network's surgical activities. Methods  Clinical and epidemiological data of urgent/emergent surgical admissions and interventions in the Autonomous Province of Trento's hospital network were collected from the internal common electronic database. The investigation periods were March-May 2019 (reference period), March-May 2020 (phase-I), June - August 2020 (phase-II), and October - December 2020 (phase-III). The same data were divided and grouped for the six most represented diagnoses. Results: The number of admissions for surgical emergencies in the studied periods showed a sinusoidal trend. In the reference period of 2019, 957 patients were admitted in urgency, while in the three pandemic phases, urgent admissions were 511, 888 and 633 respectively (-47% in phase I, - 8% in phase II, -34% in phase III). This trend was also observed by stratifying admissions for single disease, except for gastrointestinal perforations and pancreatitis, which showed a slight increasing trend in phase-I. Among the studied population, the surgical rate was 35.2% in phase-I and 34.3% in phase-III; these data were significantly higher than in 2019 (25.6%).  Conclusions The effect of the COVID pandemic on surgical emergencies and urgencies (SUEs) was mainly indirect, manifesting itself with a significant reduction in the number of surgical admissions, particularly in phases-I and-III. Conversely, in the same phases, the surgical rate showed a significant increase compared to 2019.


Assuntos
COVID-19 , Pandemias , Emergências , Hospitais , Humanos , SARS-CoV-2
18.
J Clin Pediatr Dent ; 45(5): 344-351, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34740269

RESUMO

Some dental conditions that are presented to the pediatric emergency department need hospital inpatient admission to facilitate supportive care, provide dental treatment and monitor the physiologic state of the child. The decision to treat the pediatric dental patient as an outpatient or inpatient is very important to control the overuse of hospital resources and at the same time not placing the child at the risk of rapid deterioration. However, no available guidelines or validated measures for the correct decision to treat the patient in either inpatient or outpatient care settings that can be used specifically for pediatric dental patients presented to the emergency department. Up to date, the decision of admitting pediatric patients is usually based on the severity of illness that can be measured by using The Pediatric Risk of Admission (PRISA II) Score. This review gives an overview of indications and clinical criteria of hospital inpatient admission of pediatric patients subsequent to traumatic and non-traumatic dental conditions.


Assuntos
Hospitalização , Pacientes Internados , Criança , Serviço Hospitalar de Emergência , Hospitais , Humanos
20.
Front Public Health ; 9: 705354, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34733814

RESUMO

Objective: Frontline health-care workers and patients with COVID-19 have been identified as high-risk groups for psychological problems. Experience of working or staying in quarantine wards generated psychological stressors for health-care workers and patients with COVID-19. The present study aimed to investigate the psychological symptoms of hospitalized patients with COVID-19 and the health-care workers treating them during the outbreak period, examine the effects of psychological stressors on mental health in both populations and perceived coping resources for both sides. Methods: Three hundred and eleven health-care workers working in a COVID-19 designated hospital in Wuhan, China, and 148 hospitalized patients with COVID-19 in the same hospital participated in this cross-sectional survey conducted in February 2020. Psychological symptoms, psychological stressors, and perceived coping resources were reported by both groups. Results: Thirty-three percent of health-care workers and 35.2% of patients with COVID-19 had significant psychological symptoms that were indicative of a high risk for psychological disorders. Pandemic-related psychological stressors contributed to psychological symptoms for both populations. Concern about patients was one aspect of psychological stressors of frontline health-care workers and both groups perceived support from the opposite side as an important external coping resource. Conclusion: The results shed light on the need to provide psychological support to both frontline health-care workers and patients with COVID-19 and suggest enhancing the treatment alliance might be effective to improve mental health for both populations during the crisis.


Assuntos
COVID-19 , Quarentena , Estudos Transversais , Hospitais , Humanos , Pacientes Internados , SARS-CoV-2
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