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1.
Artigo em Inglês | MEDLINE | ID: mdl-32365891

RESUMO

Recently, due to the coronavirus pandemic, many guidelines and anti-contagion strategies continue to report unclear information about the persistence of coronavirus disease 2019 (COVID-19) in the environment. This certainly generates insecurity and fear in people, with an important psychological component that is not to be underestimated at this stage of the pandemic. The purpose of this article is to highlight all the sources currently present in the literature concerning the persistence of the different coronaviruses in the environment as well as in medical and dental settings. As this was a current study, there are still not many sources in the literature, and scientific strategies are moving towards therapy and diagnosis, rather than knowing the characteristics of the virus. Such an article could be an aid to summarize virus features and formulate new guidelines and anti-spread strategies.


Assuntos
Betacoronavirus/fisiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Microbiologia Ambiental , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , COVID-19 , Infecções por Coronavirus/transmissão , Consultórios Odontológicos , Humanos , Edifícios de Consultórios Médicos , Pneumonia Viral/transmissão , Risco , SARS-CoV-2
2.
J Patient Saf ; 16(4): e317-e323, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-30516583

RESUMO

OBJECTIVE: The aim of the study was to examine whether miscarriage treatment-related morbidities and adverse events vary across facility types. METHODS: A retrospective cohort study compared miscarriage treatment-related morbidities and adverse events across hospitals, ambulatory surgery centers (ASCs), and office-based settings. Data on women who had miscarriage treatment between 2011 and 2014 and were continuously enrolled in their insurance plan for at least 1 year before and at least 6 weeks after treatment were obtained from a large national private insurance claims database. The main outcome was miscarriage treatment-related morbidities and adverse events occurring within 6 weeks of miscarriage treatment. Secondary outcomes were major events and infections. RESULTS: A total of 97,374 miscarriage treatments met inclusion criteria. Most (75%) were provided in hospitals, 10% ASCs, and 15% office-based settings. A total of 9.3% had miscarriage treatment-related events, 1.0% major events, and 1.5% infections. In adjusted analyses, there were fewer events in ASCs (6.5%) than office-based settings (9.4%) and hospitals (9.6%), but no significant difference between office-based settings and hospitals. There were no significant differences in major events between ASCs (0.7%) and office-based settings (0.8%), but more in hospitals (1.1%) than ASCs and office-based settings. There were fewer infections in ASCs (0.9%) than office-based settings (1.2%) and more in hospitals (1.6%) than ASCs and office-based settings. In analyses stratified by miscarriage treatment type, the difference between ASCs and office-based settings was no longer significant for miscarriages treated with procedures. CONCLUSIONS: Although there seem to be slightly more events in hospitals than ASCs or office-based settings, findings do not support limiting miscarriage treatment to particular settings.


Assuntos
Aborto Espontâneo/mortalidade , Procedimentos Cirúrgicos Ambulatórios/efeitos adversos , Aborto Espontâneo/etiologia , Adulto , Instituições de Assistência Ambulatorial , Feminino , Humanos , Estimativa de Kaplan-Meier , Edifícios de Consultórios Médicos , Morbidade , Gravidez , Estudos Retrospectivos
3.
Dermatol Surg ; 45 Suppl 2: S48-S56, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31764291

RESUMO

BACKGROUND: There is a paucity of data or publications in the literature on best practices for opening a new Mohs surgery unit. OBJECTIVE: The goal of this article is to be a "how to" guide for starting a Mohs and dermatologic surgery practice. MATERIALS AND METHODS: Two academic Mohs surgeons share their personal experiences and data from the literature. RESULTS: Topics discussed include picking a location and identifying space, equipment, staffing, regulatory practices, policies and procedures, marketing and outreach, patient experience, building culture, clinic efficiency, and vision. CONCLUSION: Although opening a new Mohs surgery unit is challenging, it can be rewarding to have the opportunity to develop best practices and systems that create a wonderful working environment and allow for exceptional care of patients.


Assuntos
Procedimentos Cirúrgicos Ambulatórios , Cirurgia de Mohs , Administração de Consultório/organização & administração , Neoplasias Cutâneas/cirurgia , Eficiência Organizacional , Humanos , Marketing de Serviços de Saúde , Edifícios de Consultórios Médicos/legislação & jurisprudência , Edifícios de Consultórios Médicos/organização & administração , Administração de Consultório/legislação & jurisprudência , Assistência Centrada no Paciente , Admissão e Escalonamento de Pessoal , Guias de Prática Clínica como Assunto
4.
J Patient Saf ; 15(4): 267-273, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-30138158

RESUMO

BACKGROUND: Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment or by leading to unnecessary or harmful treatment. OBJECTIVES: The aim of the study was to investigate the relationship between patient safety culture, health information technology (IT) implementation, and the frequency of problems that could lead to diagnostic errors in the medical office setting, such as unavailable test results, unavailable medical records, or unpursued abnormal results. METHODS: We used survey data from 925 medical offices nationwide that voluntarily submitted results to the 2012 Agency for Healthcare Research and Quality Medical Office Surveys on Patient Safety Culture database. At the office level, we ran a multivariate regression model to estimate the effect of culture on problem frequency while controlling for office-reported implementation levels of health IT, office characteristics such as the number of locations, and survey characteristics such as the percent of respondents that were physicians. RESULTS: The most frequent problem was "results from a lab or imaging test were not available when needed"; across 925 offices, the average was 15% reporting that it happened daily or weekly. Higher overall culture scores were significantly associated with fewer occurrences of each problem assessed. Compared with offices with completed health IT implementation, offices in the process of health IT implementation had higher frequency of problems. CONCLUSIONS: This study offers insight into how patient safety culture and health IT implementation in medical offices can influence the frequency of breakdowns in processes of care, thereby identifying potential vulnerabilities that can increase diagnostic errors.


Assuntos
Erros de Diagnóstico/estatística & dados numéricos , Informática Médica/métodos , Edifícios de Consultórios Médicos/normas , Segurança do Paciente/normas , Feminino , Humanos , Masculino
5.
Bull World Health Organ ; 96(3): 151-152, 2018 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-29531412

RESUMO

An Australian medical research centre and a Norwegian hospital have won acclaim for their healthy designs. Sima Barmania reports.


Assuntos
Arquitetura Hospitalar , Iluminação , Edifícios de Consultórios Médicos , Austrália , Hospitais , Humanos , Decoração de Interiores e Mobiliário , Médicos , Subida de Escada/fisiologia
6.
PLoS One ; 13(2): e0193221, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29462196

RESUMO

INTRODUCTION: Measuring patient experience is key when assessing quality of care but can be biased: A perceptual bias occurs when renovations of the interior design of a general practitioner (GP) office improves how patients assessed quality of care. The aim was to assess the length of perceptual bias and if it could be reproduced after a second renovation. METHODS: A GP office with 2 GPs in Switzerland was renovated twice within 3 years. We assessed patient experience at baseline, 2 months and 14 months after the first and 3 months after the second renovation. Each time, we invited a sample of 180 consecutive patients that anonymously graded patient experience in 4 domains: appearance of the office; qualities of medical assistants and GPs; and general satisfaction. We compared crude mean scores per domain from baseline until follow-up. In a multivariate model, we adjusted for patient's age, gender and for how long patients had been their GP. RESULTS: At baseline, patients aged 60.9 (17.7) years, 52% females. After the first renovation, we found a regression to the baseline level of patient experience after 14 months except for appearance of the office (p<0.001). After the second renovation, patient experience improved again in appearance of the office (p = 0.008), qualities of the GP (p = 0.008), and general satisfaction (p = 0.014). Qualities of the medical assistant showed a slight improvement (p = 0.068). Results were unchanged in the multivariate model. CONCLUSIONS: Interior renovation of a GP office probably causes a perceptual bias for >1 year that improves how patients rate quality of care. This bias could be reproduced after a second renovation strengthening a possible causal relationship. These findings imply to appropriately time measurement of patient experience to at least one year after interior renovation of GP practices to avoid environmental changes influences the estimates when measuring patient experience.


Assuntos
Edifícios de Consultórios Médicos , Satisfação do Paciente , Qualidade da Assistência à Saúde , Fatores Etários , Idoso , Medicina de Família e Comunidade , Feminino , Clínicos Gerais , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores Sexuais
7.
Clin Infect Dis ; 65(suppl_1): S4-S11, 2017 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-28859348

RESUMO

The idea of building hospitals to fight contagion was born with the lazarettos. At the time when the microorganisms were not yet known, the mechanisms of transmission of contagion were already well apprehended. Based on the same knowledge but thanks to new technologies, such hospitals have now been built downtown, next to the most highly performing technological plateau. Regrouping patient care, diagnostics, research, and development, the University Hospital Institute Méditerranée Infection building offers a wonderful tool to contain and understand contagion, in a well-designed setting, creating excellent working conditions that are attractive for interested scientists.


Assuntos
Doenças Transmissíveis/transmissão , Infecção Hospitalar/prevenção & controle , Arquitetura Hospitalar , Hospitais , Controle de Infecções , Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/microbiologia , Contenção de Riscos Biológicos , Infecção Hospitalar/microbiologia , Hospitais Universitários , Humanos , Edifícios de Consultórios Médicos
8.
Vaccine ; 35(22): 2943-2948, 2017 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-28433328

RESUMO

This study investigated the role of non-traditional locations in the decision to vaccinate for seasonal flu. We measured individuals' preferred location for seasonal flu vaccination by examining the National H1N1 Flu Survey (NHFS) conducted from late 2009 to early 2010. Our econometric model estimated the probabilities of possible choices by varying individual characteristics, and predicted the way in which the probabilities are expected to change given the specific covariates of interest. From this estimation, we observed that non-traditional locations significantly influenced the vaccination of certain individuals, such as those who are high-income, educated, White, employed, and living in a metropolitan statistical area (MSA), by increasing the coverage. Thus, based on the empirical evidence, our study suggested that supporting non-traditional locations for vaccination could be effective in increasing vaccination coverage.


Assuntos
Vacinas contra Influenza/administração & dosagem , Vacinação/estatística & dados numéricos , Adulto , Idoso , Escolaridade , Emprego , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Renda , Vacinas contra Influenza/provisão & distribuição , Masculino , Edifícios de Consultórios Médicos , Pessoa de Meia-Idade , Modelos Econométricos , Farmácia , Consultórios Médicos , Estações do Ano , População Urbana , Vacinação/métodos , Vacinação/psicologia , Cobertura Vacinal , Local de Trabalho
11.
HERD ; 8(4): 77-97, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26123969

RESUMO

OBJECTIVE: This study investigates effects of the newly built nonpatient-related buildings of a large university medical center on staff perceptions and whether the design objectives were achieved. BACKGROUND: The medical center is gradually renewing its hospital building area of 200,000 m.(2) This redevelopment is carefully planned and because lessons learned can guide design decisions of the next phase, the medical center is keen to evaluate the performance of the new buildings. METHOD: A pre- and post-study with a control group was conducted. Prior to the move to the new buildings an occupancy evaluation was carried out in the old setting (n = 729) (pre-study). Post occupation of the new buildings another occupancy evaluation (post-study) was carried out in the new setting (intervention group) and again in some old settings (control group) (n = 664). The occupancy evaluation consisted of an online survey that measured the perceived performance of different aspects of the building. Longitudinal multilevel analysis was used to compare the performance of the old buildings with the new buildings. RESULTS: Significant improvements were found in indoor climate, perceived safety, working environment, well-being, facilities, sustainability, and overall satisfaction. Commitment to the employer, working atmosphere, orientation, work performance, and knowledge sharing did not improve. The results were interpreted by relating them to specific design choices. CONCLUSION: We showed that it is possible to measure the performance improvements of a complex intervention being a new building design and validate design decisions. A focused design process aiming for a safe, pleasant and sustainable building resulted in actual improvements in some of the related performance measures.


Assuntos
Centros Médicos Acadêmicos/normas , Atitude do Pessoal de Saúde , Arquitetura Hospitalar , Decoração de Interiores e Mobiliário/normas , Saúde do Trabalhador/normas , Recursos Humanos em Hospital/psicologia , Centros Médicos Acadêmicos/organização & administração , Adulto , Ar Condicionado/métodos , Ar Condicionado/normas , Conservação dos Recursos Naturais/métodos , Tomada de Decisões Gerenciais , Eficiência Organizacional , Exercício Físico/fisiologia , Exercício Físico/psicologia , Humanos , Relações Interprofissionais , Laboratórios Hospitalares/organização & administração , Laboratórios Hospitalares/normas , Estudos Longitudinais , Masculino , Edifícios de Consultórios Médicos/organização & administração , Edifícios de Consultórios Médicos/normas , Pessoa de Meia-Idade , Análise Multinível , Ruído Ocupacional/prevenção & controle , Cultura Organizacional , Subida de Escada/fisiologia , Inquéritos e Questionários
12.
BMC Health Serv Res ; 15: 183, 2015 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-25928252

RESUMO

BACKGROUND: Health care infrastructure constitutes a major component of the structural quality of a health system. Infrastructural deficiencies of health services are reported in literature and research. A number of instruments exist for the assessment of infrastructure. However, no easy-to-use instruments to assess health facility infrastructure in developing countries are available. Present tools are not applicable for a rapid assessment by health facility staff. Therefore, health information systems lack data on facility infrastructure. METHODS: A rapid assessment tool for the infrastructure of primary health care facilities was developed by the authors and pilot-tested in Tanzania. The tool measures the quality of all infrastructural components comprehensively and with high standardization. Ratings use a 2-1-0 scheme which is frequently used in Tanzanian health care services. Infrastructural indicators and indices are obtained from the assessment and serve for reporting and tracing of interventions. The tool was pilot-tested in Tanga Region (Tanzania). RESULTS: The pilot test covered seven primary care facilities in the range between dispensary and district hospital. The assessment encompassed the facilities as entities as well as 42 facility buildings and 80 pieces of technical medical equipment. A full assessment of facility infrastructure was undertaken by health care professionals while the rapid assessment was performed by facility staff. Serious infrastructural deficiencies were revealed. The rapid assessment tool proved a reliable instrument of routine data collection by health facility staff. CONCLUSIONS: The authors recommend integrating the rapid assessment tool in the health information systems of developing countries. Health authorities in a decentralized health system are thus enabled to detect infrastructural deficiencies and trace the effects of interventions. The tool can lay the data foundation for district facility infrastructure management.


Assuntos
Atenção à Saúde/organização & administração , Edifícios de Consultórios Médicos/normas , Atenção Primária à Saúde , Gestão de Riscos/métodos , Gerenciamento Clínico , Instalações de Saúde/normas , Pessoal de Saúde , Hospitais de Distrito , Humanos , Projetos Piloto , Tanzânia
14.
Plast Surg Nurs ; 34(4): 167-70, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25461633

RESUMO

Proper cleaning of surgical instruments prior to sterilization is an essential objective in the surgical setting. Testing for the presence of adenosine triphosphate (ATP) on a cleaned instrument can help determine if it meets cleanliness requirements for sterilization. A program was piloted in our facility by using a commercial ATP testing system. In this article, our experience with the evaluation of available ATP testing systems, the implementation processes we used, and conclusions drawn from our procedures and results are described.


Assuntos
Trifosfato de Adenosina/análise , Procedimentos Cirúrgicos Eletivos , Edifícios de Consultórios Médicos , Testes Imediatos , Esterilização/métodos , Humanos , Esterilização/normas
18.
Int J Syst Evol Microbiol ; 63(Pt 4): 1512-1518, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22888186

RESUMO

A gram-positive, oxidase- and catalase-positive, strictly aerobic and motile bacterium, designated WS 4626(T), was isolated from a medical practice. Spherical endospores were formed terminally in swollen rods. The genomic DNA G+C content was 37.1 mol%. Cells contained iso-C15 : 0, anteiso-C15 : 0, iso-C17 : 1ω10c, anteiso-C17 : 0 and iso-C17 : 0 as the predominant cellular fatty acids and MK-7 and MK-6 as the major isoprenoid quinones. The major polar lipids were diphosphatidylglycerol, phosphatidylethanolamine and phosphatidylglycerol, the cell-wall peptidoglycan was type A4α, L-Lys-D-Asp and the major cell-wall sugar was xylose. The closest phylogenetic relatives were Lysinibacillus xylanilyticus XDB9(T) (96.7 % 16S rRNA gene sequence similarity) and Lysinibacillus odysseyi 34hs-1(T) (96.5 %). DNA-DNA relatedness between the isolate and L. odysseyi DSM 18869(T) was very low (6 %). On the basis of the data presented, strain WS 4626(T) represents a novel species of the genus Lysinibacillus, for which the name Lysinibacillus meyeri sp. nov. is proposed. The type strain is WS 4626(T) ( = DSM 25057(T) = LMG 26643(T)).


Assuntos
Microbiologia do Ar , Bacillaceae/classificação , Edifícios de Consultórios Médicos , Filogenia , Bacillaceae/genética , Bacillaceae/isolamento & purificação , Técnicas de Tipagem Bacteriana , Composição de Bases , Parede Celular/química , DNA Bacteriano/genética , Ambiente Controlado , Ácidos Graxos/análise , Alemanha , Dados de Sequência Molecular , Peptidoglicano/análise , RNA Ribossômico 16S/genética , Análise de Sequência de DNA , Esporos Bacterianos/isolamento & purificação , Vitamina K 2/análogos & derivados , Vitamina K 2/análise , Xilose/análise
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