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1.
BMC Health Serv Res ; 24(1): 352, 2024 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-38504283

RESUMEN

BACKGROUND: Unfinished nursing care is becoming increasingly more of a concern in worldwide healthcare settings. Given their negative outcomes, it is crucial to continuously assess those nursing interventions that are commonly postponed or missed, as well as the underlying reasons and consequences. The worldwide COVID-19 pandemic has made it difficult for health facilities to maintain their sustainability and continuity of care, which has also influenced the unfinished nursing care phenomenon. However, no summary of the studies conducted during the COVID-19 pandemic was produced up to now. The main aim of this study was to systematically review the occurrence of, reasons for, and consequences of unfinished nursing care among patients in healthcare settings during the COVID-19 pandemic. METHODS: Systematic review registered in PROSPERO (CRD42023422871). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guideline and the Joanna Briggs Institute Critical Appraisal tool for cross-sectional studies were used. MEDLINE-PubMed, the Cumulative Index to Nursing and Allied Health Literature, and Scopus were searched from March 2020 up to May 2023, using keywords established in the field as missed care, unfinished nursing care, or implicit rationing. RESULTS: Twenty-five studies conducted mainly in European and Asiatic countries were included and assessed as possessing good methodological quality. The following tools were used: the MISSCARE Survey (= 14); the Basel Extent of Rationing of Nursing Care (= 1), also in its revised form (= 2) and regarding nursing homes (= 2); the Perceived Implicit Rationing of Nursing Care (= 4); the Intensive Care Unit-Omitted Nursing Care (= 1); and the Unfinished Nursing Care Survey (= 1). The order of unfinished nursing care interventions that emerged across studies for some countries is substantially in line with pre-pandemic data (e.g., oral care, ambulation). However, some interesting variations emerged at the country and inter-country levels. Conversely, labour resources and reasons close to the emotional state and well-being of nurses were mentioned homogeneously as most affecting unfinished nursing care during the pandemic. None of the studies investigated the consequences of unfinished nursing care. CONCLUSIONS: Two continents led the research in this field during the pandemic: Europe, where this research was already well established, and Asia, where this research is substantially new. While unfinished care occurrence seems to be based on pre-established patterns across Europe (e.g., regarding fundamentals needs), new patterns emerged across Asiatic countries. Among the reasons, homogeneity in the findings emerged all in line with those documented in the pre-pandemic era.


Asunto(s)
COVID-19 , Atención de Enfermería , Humanos , Estudios Transversales , Pandemias , COVID-19/epidemiología , Atención a la Salud , Casas de Salud
2.
Sci Rep ; 14(1): 3135, 2024 02 07.
Artículo en Inglés | MEDLINE | ID: mdl-38326403

RESUMEN

The problem of repeated epidemic fluctuations in the normalized prevention and control stage is revealed by data from January 20, 2020, to January 30, 2023. In order to improve the collaborative response of the public and government departments to public health emergencies and avoid repeated fluctuations of the epidemic, a tripartite evolutionary game model of the public, local government, and central government departments is constructed, focusing on the evolutionary paths and evolutionary stabilization strategies of the three subjects, and the influence of each element on the evolutionary results is simulated by numerical simulation in Matlab, and based on the inadequacy of the static reward and punishment mechanism, a dynamic Based on the shortcomings of static reward and punishment mechanism, dynamic reward and punishment mechanism is introduced to control the stability of the evolving system. The study shows that (1) with the increase of the initial willingness of the three parties, the rate of the public choosing the discretionary flow strategy slows down, and the collaborative prevention and control process can be accelerated. (2) The reward and punishment mechanism of central government departments has a positive incentive effect on the local government's strict prevention and control and the public's conscious isolation. Appropriately increasing rewards, formulating reasonable subsidy strategies, and increasing penalties for violations are conducive to the overall optimization of the system, and the punishment mechanism is most sensitive to the regulation of the public's discretionary mobility behavior. (3) Government departments' prevention and control costs can influence their enthusiasm for strict prevention and control and real-time supervision. Reducing the human resources cost, time cost, and financial cost of prevention and control is conducive to government departments performing their duties more responsibly. (4) The static punishment mechanism fails to make timely adjustments according to the strategy choice of each actor. It cannot control the stability of the evolving system. In contrast, the dynamic punishment mechanism considers the punishment parameters to link the casual isolation rate with the lenient prevention and control rate, which can effectively control the system's fluctuating instability and is the system's stability control strategy. Finally, combining theoretical and simulation analysis, management suggestions are made for controlling repeated fluctuations of the epidemic in practice, and the research limitations of this paper are explained.


Asunto(s)
COVID-19 , Administración de Residuos , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Salud Pública , Urgencias Médicas , China
3.
Diabetes Obes Metab ; 26(4): 1529-1539, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38284284

RESUMEN

AIMS: To identify and better understand themes related to why people living with obesity (PwO) in Canada may not use professional support and to explore potential strategies to address the challenges. METHODS: One-on-one interviews and online surveys, informed by the Theoretical Domains Framework, were conducted. A total of 20 PwO were interviewed and a separate group of 200 PwO were surveyed. Results from the interviews guided the development of the survey. Spearman's correlation analysis was performed to investigate the association between the theme domain scores of the PwO and their prior experience with obesity management strategies. RESULTS: The 200 PwO surveyed provided representation across Canada and were diverse in age, background and gender. The most prominent domains associated with use of professional support by PwO were: Intention (rs = -0.25; p < 0.01); Social/Professional Role and Identity (rs = -0.15; p < 0.05); and Optimism (rs = -0.15; p < 0.05). For example, PwO without professional support less often reported being transparent in obesity discussions, perceived obesity to be part of their identity, and expected to manage the illness long term. Many PwO hesitated to use various adjunctive therapies due to concerns about affordability, long-term effectiveness, and side effects. CONCLUSION: This study identified contextual, perception and resource considerations that contribute to healthcare decision-making and the use by PwO of professional support to manage obesity, and highlighted key areas to target with interventions to facilitate obesity management. Strategies such as consistent access to healthcare support and educational resources, as well as improved financial support may help PwO to feel more comfortable with exploring new strategies and take control of their healthcare.


Asunto(s)
Manejo de la Obesidad , Humanos , Obesidad/epidemiología , Obesidad/terapia , Canadá/epidemiología , Atención a la Salud , Encuestas y Cuestionarios
4.
Soc Sci Med ; 340: 116433, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38039765

RESUMEN

OBJECTIVE: Since the U.S. Supreme Court eliminated the federal right to abortion, there is a heightened need to understand public opinion about the criminalization of people who attempt to end their pregnancies outside the formal healthcare setting, referred to as self-managed abortion (SMA). We assessed U.S. attitudes about whether three forms of SMA should be legal, reported or punished: 1) using abortion pills obtained outside the healthcare system, 2) using other medications, drugs, herbs, or by drinking alcohol, and 3) using traumatic methods (inserting an object in their body or hitting their stomach). METHODS: From December 2021 to January 2022, we administered a national probability-based online survey to English- and Spanish-speaking people assigned female (AFAB, ages 15-49) or male at birth (AMAB, ages 18-49) regarding their attitudes about criminalizing SMA, using Ipsos' KnowledgePanel. We estimated weighted proportions and conducted multivariable regression analyses to identify characteristics associated with support for SMA legality and punishment (reporting to authorities, paying a fine or going to jail). RESULTS: A total of 7,016 AFAB and 360 AMAB completed the survey. People were less likely (p < .05) to agree that SMA using abortion pills should be illegal (34% of AFAB and 43% of AMAB) than other forms of SMA (36-48%), although over one-fifth were unsure (AFAB, 20-23% and AMAB, 24-27%). People were less likely to agree SMA using abortion pills should be criminalized than SMA using other drugs, medications, herbs, alcohol or by using traumatic methods. In multivariable analyses, AMAB and Christian religion were associated with agreeing that SMA using abortion pills should be illegal; people who identified as Hispanic/Latinx ethnicity and experienced medical mistreatment were less likely to agree SMA with medication abortion pills should be illegal. CONCLUSIONS: Public support for criminalizing SMA is complex and varied by SMA method and form of punishment.


Asunto(s)
Aborto Inducido , Automanejo , Embarazo , Recién Nacido , Femenino , Masculino , Humanos , Aborto Legal , Aborto Inducido/métodos , Actitud , Opinión Pública
5.
Prof Case Manag ; 29(2): 63-69, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38015812

RESUMEN

PURPOSE/OBJECTIVES: An increase in the use of remote therapeutic monitoring (RTM) has been spurred by nationwide factors including the COVID-19 pandemic, authorized reimbursement of RTM by the Centers for Medicare & Medicaid Services, and more frequent use of big data analytics in health care delivery. This article discusses the use of RTM by care teams at the point of care and explores the role of the case manager in RTM to address patients' unmet needs. PRIMARY PRACTICE SETTINGS: Although RTM may be utilized across inpatient and outpatient levels of care, this article focuses on outpatient care such as community clinics, provider groups, and home health care. FINDINGS/CONCLUSIONS: When implemented along with care management interventions, RTM applications have the potential to improve patient adherence, enhance communication between patients and their providers, streamline resource allocation, and address social determinants of health impacting patient care and outcomes. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: RTM reimbursement models are rapidly evolving, utilizing real-world and patient-reported data to identify and initiate timely, individualized solutions that meet the holistic needs of each patient. Use of an RTM system allows the case manager to build rapport with the patient while quickly identifying care gaps and delivering appropriate interventions that can maximize patient outcomes. RTM can drive savings and bring revenue to the system or practice while providing salient documentation of social determinants of health that can be addressed with validation of proven care coordination interventions.


Asunto(s)
COVID-19 , Manejo de Caso , Anciano , Humanos , Estados Unidos , Pandemias , Medicare , Atención a la Salud
6.
West J Nurs Res ; 46(2): 133-142, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38014816

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic has placed unparalleled pressure on many countries' healthcare systems, impacting the delivery of health and nursing care services. Despite the growing number of missed care studies during the pandemic, a broader perspective is essential when designing theory-driven strategies to improve nursing care delivery. This review aimed to synthesize evidence of missed nursing care during the COVID-19 pandemic in acute care settings through a systematic review and narrative synthesis. An electronic search of articles published since the emergence of the pandemic was conducted using 5 databases (Scopus, PubMed, Web of Science, CINAHL, and PsycINFO). A total of 470 articles were identified during the initial search, and 10 articles were included in the review. The sample sizes of the studies ranged from 37 to 536 nurses. Results of the content analysis were grouped into 5 categories: (1) prevalence of missed care, (2) frequency of missed care, (3) reasons for missed care, (4) nurses' and organizational variables contributing to missed care, and (5) work environment elements contributing to missed care. The review's findings revealed a shift in the nature of missed nursing care during the pandemic, with an emphasis on nursing care tasks vital for the recovery of patients with COVID-19. Despite the unique circumstances brought about by the pandemic, an inadequate nursing workforce continued to be identified as the primary reason for missed care, consistent with the pre-pandemic period.


Asunto(s)
COVID-19 , Atención de Enfermería , Personal de Enfermería , Humanos , Pandemias , Atención a la Salud
7.
BMJ Open ; 13(12): e079268, 2023 12 11.
Artículo en Inglés | MEDLINE | ID: mdl-38081663

RESUMEN

OBJECTIVES: In Aotearoa New Zealand (NZ), integration across the healthcare continuum has been a key approach to strengthening the health system and improving health outcomes. A key example has been four regional District Health Board (DHB) groupings, which, from 2011 to 2022, required the country's 20 DHBs to work together regionally. This research explores how this initiative functioned, examining how, for whom and in what circumstances regional DHB groupings worked to deliver improvements in system integration and health outcomes and equity. DESIGN: We used a realist-informed evaluation study design. We used documentary analysis to develop programme logic models to describe the context, structure, capabilities, implementation activities and impact of each of the four regional groupings and then conducted interviews with stakeholders. We developed a generalised context-mechanisms-outcomes model, identifying key commonalities explaining how regional work 'worked' across NZ while noting important regional differences. SETTING: NZ's four regional DHB groupings. PARTICIPANTS: Forty-nine stakeholders from across the four regional groupings. These included regional DHB governance groups and coordinating regional agencies, DHB senior leadership, Maori and Pasifika leadership and lead clinicians for regional work streams. RESULTS: Regional DHB working was layered on top of an already complex DHB environment. Organisational heterogeneity and tensions between local and regional priorities were key contextual factors. In response, regional DHB groupings leveraged a combination of 'hard' policy and planning processes, as well as 'soft', relationship-based mechanisms, aiming to improve system integration, population health outcomes and health equity. CONCLUSION: The complexity of DHB regional working meant that success hinged on building relationships, leadership and trust, alongside robust planning and process mechanisms. As NZ reorients its health system towards a more centralised model underpinned by collaborations between local providers, our findings point to a need to align policy expectations and foster environments that support connection and collegiality across the health system.


Asunto(s)
Atención a la Salud , Política de Salud , Liderazgo , Pueblo Maorí , Humanos , Nueva Zelanda , Atención a la Salud/organización & administración
8.
JMIR Hum Factors ; 10: e51691, 2023 12 19.
Artículo en Inglés | MEDLINE | ID: mdl-38113070

RESUMEN

BACKGROUND: Gestational diabetes mellitus (GDM) is a significant medical complication of pregnancy that requires close monitoring by a multidisciplinary health care team. The growing sophistication of mobile health (mHealth) technology could play a significant supporting role for women with GDM and health professionals (HPs) regarding GDM management. OBJECTIVE: This study included 2 phases. The aim of phase 1 was to explore the perceptions of HPs and women with GDM regarding the use of mHealth for GDM self-management and to identify their needs from these technologies. The aim of phase 2 was to explore the perceptions of women with GDM about their experiences with a state-of-the-art app for managing GDM that was offered to them during the COVID-19 lockdown. This phase aimed to understand the impact that COVID-19 has had on women's perceptions about using technology to manage their GDM. By combining both phases, the overall aim was to establish how perceptions about GDM self-management technology have changed owing to the pandemic restrictions and experience of using such technology. METHODS: In total, 26 semistructured interviews were conducted in 2 phases. In phase 1, overall, 62% (16/26) of the participants, including 44% (7/16) of HPs, 50% (8/16) of women with GDM, and 6% (1/16) of women in the postpartum period with GDM history participated in the interviews. In phase 2, overall, 38% (10/26) of women with GDM participated in the interviews. NVivo (QSR International) was used to extract qualitative data, which were subjected to thematic analysis. RESULTS: Phase 1 identified 3 themes from the interviews with women with GDM: fitting with women's lifestyle constraints, technology's design not meeting women's needs, and optimizing the technology's design to meet women's needs. Overall, 3 themes were derived from the interviews with HPs: optimizing the technology's design to improve the quality of care, technology to support women's independence, and limitations in the care system and facilities. Analysis of phase-2 interviews identified 2 further themes: enhancing the information and functionalities and optimizing the interface design. In both phases, participants emphasized a simple and user-friendly interface design as the predominant positive influence on their use of technology for GDM management. CONCLUSIONS: The combined findings underlined similar points. Poor usability, data visualization limitations, lack of personalization, limited information, and lack of communication facilities were the prime issues of current GDM self-management mHealth technology that need to be addressed. The analysis also revealed how women with GDM should play a vital role in gathering the requirements for GDM self-management technology; some needs were identified from in-depth discussion with women with GDM that would be missed without their involvement.


Asunto(s)
COVID-19 , Diabetes Gestacional , Automanejo , Embarazo , Femenino , Humanos , Diabetes Gestacional/terapia , Investigación Cualitativa , Atención a la Salud , Personal de Salud
9.
BMC Health Serv Res ; 23(1): 1265, 2023 Nov 16.
Artículo en Inglés | MEDLINE | ID: mdl-37974126

RESUMEN

BACKGROUND: Recent jail detention is a marker for trait and state suicide risk in community-based populations. However, healthcare providers are typically unaware that their client was in jail and few post-release suicide prevention efforts exist. This protocol paper describes an effectiveness-implementation trial evaluating community suicide prevention practices triggered by advances in informatics that alert CareSource, a large managed care organization (MCO), when a subscriber is released from jail. METHODS: This randomized controlled trial investigates two evidence-based suicide prevention practices triggered by CareSource's jail detention/release notifications, in a partial factorial design. The first phase randomizes ~ 43,000 CareSource subscribers who pass through any Ohio jail to receive Caring Contact letters sent by CareSource or to Usual Care after jail release. The second phase (running simultaneously) involves a subset of ~ 6,000 of the 43,000 subscribers passing through jail who have been seen in one of 12 contracted behavioral health agencies in the 6 months prior to incarceration in a stepped-wedge design. Agencies will receive: (a) notifications of the client's jail detention/release, (b) instructions for re-engaging these clients, and (c) training in suicide risk assessment and the Safety Planning Intervention for use at re-engagement. We will track suicide-related and service linkage outcomes 6 months following jail release using claims data. CONCLUSIONS: This design allows us to rigorously test two intervention main effects and their interaction. It also provides valuable information on the effects of system-level change and the scalability of interventions using big data from a MCO to flag jail release and suicide risk. TRIAL REGISTRATION: The trial is registered at clinicaltrials.gov (NCT05579600). Registered 27 June, 2023.


Asunto(s)
Cárceles Locales , Suicidio , Humanos , Programas Controlados de Atención en Salud , Ohio , Ensayos Clínicos Controlados Aleatorios como Asunto
10.
Nature ; 623(7989): 987-991, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-38030778

RESUMEN

Theories of innovation emphasize the role of social networks and teams as facilitators of breakthrough discoveries1-4. Around the world, scientists and inventors are more plentiful and interconnected today than ever before4. However, although there are more people making discoveries, and more ideas that can be reconfigured in new ways, research suggests that new ideas are getting harder to find5,6-contradicting recombinant growth theory7,8. Here we shed light on this apparent puzzle. Analysing 20 million research articles and 4 million patent applications from across the globe over the past half-century, we begin by documenting the rise of remote collaboration across cities, underlining the growing interconnectedness of scientists and inventors globally. We further show that across all fields, periods and team sizes, researchers in these remote teams are consistently less likely to make breakthrough discoveries relative to their on-site counterparts. Creating a dataset that allows us to explore the division of labour in knowledge production within teams and across space, we find that among distributed team members, collaboration centres on late-stage, technical tasks involving more codified knowledge. Yet they are less likely to join forces in conceptual tasks-such as conceiving new ideas and designing research-when knowledge is tacit9. We conclude that despite striking improvements in digital technology in recent years, remote teams are less likely to integrate the knowledge of their members to produce new, disruptive ideas.


Asunto(s)
Difusión de Innovaciones , Cooperación Internacional , Invenciones , Inventores , Patentes como Asunto , Investigadores , Informe de Investigación , Conjuntos de Datos como Asunto , Procesos de Grupo , Conocimiento , Patentes como Asunto/estadística & datos numéricos , Investigadores/organización & administración , Investigadores/psicología , Investigadores/tendencias , Informe de Investigación/tendencias , Red Social , Invenciones/clasificación , Invenciones/estadística & datos numéricos , Inventores/organización & administración , Inventores/psicología , Conducta Cooperativa
11.
J Acquir Immune Defic Syndr ; 94(4): 308-316, 2023 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-37851952

RESUMEN

BACKGROUND: The Bottom Up Project, a collaboration of clinical, community, and academic partners, consists of 7 major steps that leverage a health information exchange, a system for sharing patient health information, with real-time alerts to mobilize peer outreach workers to find and re-engage persons with HIV disconnected from care. Bottom Up faced implementation challenges in its start-up phase and produced effective responses leading to Project maturation, which we explore using a novel implementation science framework incorporating resilience. METHODS: We conducted semistructured interviews with implementation staff (N = 6) and meeting minutes and protocols document reviews (N = 35). The Consolidated Framework for Implementation Research and a novel resilience framework guided thematic and process analyses. The resilience framework consisted of the following 3 resilience types: absorptive to cope with adversity, adaptive to adjust as short-term solutions, and transformative to structurally change. RESULTS: The Project experienced 20 major challenges, 2-5 challenges per step. Challenges were multilevel and of chronic and crisis intensities. Implementers overcame challenges by leveraging multilevel factors that were absorptive, adaptive (most common), and transformative. DISCUSSION: Bottom Up matured by practicing consistency and flexibility. The Project maintained core operations while under crisis-level stress by strategically simplifying or "downshifting" activities. Transformational responses suggest that specific initiatives can catalyze organizational change. CONCLUSIONS: Bottom Up implementation demonstrates using diverse tactics to respond to challenges, thereby shaping Project development and in turn organizations. Applying resilience to Consolidated Framework for Implementation Research helps build awareness of active and dynamic processes promoting or impeding the growth and success of intervention-oriented Projects.


Asunto(s)
Atención a la Salud , Infecciones por VIH , Humanos , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/prevención & control , Ciudad de Nueva York , Atención a la Salud/organización & administración
12.
PLoS One ; 18(10): e0292286, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37856484

RESUMEN

Public procurement is an important bridge between public demand and market supply and may affect corporate behavior. However, in the advocacy of sustainable development, the extant research has rarely combined sustainable public procurement (SPP) with corporate ESG performance, to explore whether governments have contributed to the development of sustainable corporate performance through their sustainable procurement activities. This paper fills in the gap by matching the actual implementation of SPP of 42,369 projects in China over 2015~2020 with 20,125 corporate ESG performance data, to analyze the relationship between SPP implementation and corporate ESG performance. The results show that the implementation of SPP has a significant positive impact on corporate ESG performance. Further heterogeneity analysis reveals that the impact is stronger in China's eastern and central regions than in other regions, and corporates at a mature stage are more likely to follow the government sustainable behavior. In addition, the implementation of SPP has a long-term effect on corporate ESG performance. The above findings have important policy implications: firstly, there is a better role for government to play as the "invisible hand", to participate in the market economy; Specifically, SPP policy should be added to government policy tool box to improve corporate ESG performance in addition to disclosure requirement, and the SPP policy employed should in particular attend to the "missing sectors" of sustainability in SPP for the good of corporate ESG; secondly, the government should implement differentiated policies tailored to the region's economic development conditions and corporate development characteristics; thirdly, a long-term evaluation mechanism should be established so that the government can play a more long-term demonstration and leading role.


Asunto(s)
Organizaciones , Corporaciones Profesionales , Desarrollo Sostenible , China , Gobierno , Organizaciones/economía , Organizaciones/organización & administración , Política Pública , Corporaciones Profesionales/economía , Corporaciones Profesionales/organización & administración , Comercio/economía , Comercio/organización & administración , Desarrollo Sostenible/economía
13.
BMC Health Serv Res ; 23(1): 1087, 2023 Oct 11.
Artículo en Inglés | MEDLINE | ID: mdl-37821937

RESUMEN

BACKGROUND: Nearly 30 years post legalisation and introduction, midwifery is still not optimally integrated within the health system of Canada's largest province, Ontario. Funding models have been identified as one of the main barriers. METHODS: Using a constructivist perspective, we conducted a qualitative descriptive study to examine how antepartum, intrapartum, and postpartum funding arrangements in Ontario impact midwifery integration. We conceptualized optimal 'integration' as circumstances in which midwives' knowledge, skills, and model of care are broadly respected and fully utilized, interprofessional collaboration and referral support the best possible care for patients, and midwives feel a sense of belonging within hospitals and the greater health system. We collected data through semi-structured telephone interviews with midwives, obstetricians, family physicians, and nurses. The data was examined using thematic analysis. RESULTS: We interviewed 20 participants, including 5 obstetricians, 5 family physicians, 5 midwives, 4 nurses, and 1 policy expert. We found that while course-of-care-based midwifery funding is perceived to support high levels of midwifery client satisfaction and excellent clinical outcomes, it lacks flexibility. This limits opportunities for interprofessional collaboration and for midwives to use their knowledge and skills to respond to health system gaps. The physician fee-for-service funding model creates competition for births, has unintended consequences that limit midwives' scope and access to hospital privileges, and fails to appropriately compensate physician consultants, particularly as midwifery volumes grow. Siloing of midwifery funding from hospital funding further restricts innovative contributions from midwives to respond to community healthcare needs. CONCLUSIONS: Significant policy changes, such as adequate remuneration for consultants, possibly including salary-based physician funding; flexibility to compensate midwives for care beyond the existing course of care model; and a clearly articulated health human resource plan for sexual and reproductive care are needed to improve midwifery integration.


Asunto(s)
Atención a la Salud , Servicios de Salud Materna , Partería , Médicos de Familia , Femenino , Humanos , Embarazo , Servicios de Salud Materna/economía , Servicios de Salud Materna/organización & administración , Partería/economía , Partería/organización & administración , Ontario , Médicos de Familia/economía , Médicos de Familia/organización & administración , Investigación Cualitativa , Conocimientos, Actitudes y Práctica en Salud , Atención a la Salud/economía , Atención a la Salud/organización & administración
14.
Worldviews Evid Based Nurs ; 20(6): 559-573, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37743584

RESUMEN

BACKGROUND: Missed nursing care is defined as care that is delayed, partially completed, or not completed at all. The scenario created by the COVID-19 pandemic may have influenced multifactorial determinants related to the care environment, nursing processes, internal processes, and decision-making processes, increasing missed nursing care. AIM: This scoping review aimed to establish the quantity and type of research undertaken on missed nursing care during the COVID-19 pandemic. METHODS: This review was conducted following the Joanna Briggs Institute methodology for scoping reviews. We searched CINAHL, MEDLINE, Scopus, two national and regional databases, two dissertations and theses databases, a gray literature database, two study registers, and a search engine from November 1, 2019, to March 23, 2023. We included quantitative, qualitative, and mixed studies carried out in all healthcare settings that examined missed nursing care during the COVID-19 pandemic. Language restrictions were not applied. Two independent reviewers conducted study selection and data extraction. Disagreements between the reviewers were resolved through discussion or with an additional reviewer. RESULTS: We included 25 studies with different designs, the most common being acute care cross-sectional survey designs. Studies focused on determining the frequency and reasons for missed nursing care and its influence on nurses and organizational outcomes. LINKING EVIDENCE TO ACTION: Missed nursing care studies during the COVID-19 pandemic were essentially nurses-based prevalence surveys. There is an urgent need to advance the design and development of longitudinal and intervention studies, as well as to broaden the focus of research beyond acute care. Further research is needed to determine the impact of missed nursing care on nursing-sensitive outcomes and from the patient's perspective.


Asunto(s)
COVID-19 , Atención de Enfermería , Humanos , COVID-19/epidemiología , Pandemias , Estudios Transversales , Atención a la Salud
15.
Front Public Health ; 11: 1204275, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37744521

RESUMEN

The Coronavirus Disease-2019 (COVID-19) pandemic is not just a health crisis but also a social crisis. Confronted with the resurgence of variants with massive infections, the triggered activities from personal needs may promote the spread, which should be considered in risk management. Meanwhile, it is important to ensure that the policy responses on citizen life to a lower level. In the face of Omicron mutations, we need to sum up the control experience accumulated, adapting strategies in the dynamic coevolution process while balancing life resumption and pandemic control, to meet challenges of future crises. We collected 46 cases occurring between 2021 and 2022, mainly from China, but also including five relevant cases from other countries around the world. Based on case studies, we combine micro-view individual needs/behaviors with macro-view management measures linking Maslow's hierarchy of needs with the transmission chain of Omicron clusters. The proposed loophole chain could help identify both individual and management loopholes in the spread of the virus. The systematic actions that were taken have effectively combated these ubiquitous vulnerabilities at lower costs and lesser time. In the dynamic coevolution process, the Chinese government has made effective and more socially acceptable prevention policies while meeting the divergent needs of the entire society at the minimum costs. Systematic actions do help maintain the balance between individuals' satisfaction and pandemic containment. This implies that risk management policies should reasonably consider individual needs and improve the cooperation of various stakeholders with targeted flexible measures, securing both public health and life resumption.


Asunto(s)
COVID-19 , Control de Enfermedades Transmisibles , Política de Salud , Humanos , Pueblo Asiatico , China , COVID-19/genética , COVID-19/prevención & control , COVID-19/transmisión , COVID-19/virología , Gobierno , Mutación , Control de Enfermedades Transmisibles/métodos , Pandemias/prevención & control , Necesidades y Demandas de Servicios de Salud , Conducta Social , Gestión de Riesgos
16.
Pan Afr Med J ; 45: 116, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37745915

RESUMEN

As Nigeria battles the COVID-19 pandemic, systemic fraud within the health system may undermine the efforts to halt the devastating effect of the disease and the fight against COVID-19. Fraud is a major concern worldwide, especially in developing countries such as Nigeria, where it is widespread within the health system. The vulnerability of the Nigerian health system despite several efforts from relevant stakeholders, has consistently been underscored before the pandemic arose, raising serious concerns. These concerns include fraud, embezzlement, and mismanagement of funds, exploitation, lack of transparency in policymaking, cutting corners in procurement processes, and taking advantage of the healthcare workforce for personal benefits. Also, other involvements in the vulnerability of the Nigerian health system that are worrisome include stakeholders using the pandemic to their advantage to increase their private benefits, a short supply of vital health resources, fraudulent recruitment of the health workforce, and ineffective crisis management. This study explores fraud within the Nigerian health system, its impact and implications for health-system resilience as well as its response to the COVID-19 pandemic. Guided by agency theory, causes and impacts of fraud in the health system and its implications on the response to COVID-19 were explained. Systematic review method was employed; out of 1462 articles identified and screened dated from 1991 to 2021, sixty articles were included in the analysis and interpretation. Specific fraud interventions should focus on a weak and vulnerable health system, service delivery, high-risk institutionalized health workforce, and addressing issues of fraud within and outside the health system in order to curb the dreaded COVID-19 and its variants in Nigeria.


Asunto(s)
COVID-19 , Atención a la Salud , Fraude , Humanos , COVID-19/prevención & control , COVID-19/terapia , Fraude/economía , Fraude/prevención & control , Personal de Salud , Pandemias , Nigeria , Atención a la Salud/economía , Atención a la Salud/organización & administración , Atención a la Salud/normas
17.
RECIIS (Online) ; 17(3): 650-667, jul.-set. 2023.
Artículo en Portugués | LILACS, Coleciona SUS | ID: biblio-1517720

RESUMEN

Este artigo é parte do relatório de pesquisa de opinião, quantitativa, executada pela Unesp em parceria com o Conselho Municipal de Políticas para Mulheres, de Bauru-SP, sobre a violência doméstica, de junho a agosto de 2020. A investigação não probabilística, de caráter descritivo, teve como método de coleta de dados o questionário on-line. Seu objetivo foi levantar opiniões de mulheres, de modo a oferecer parâmetros para subsidiar ações de comunicação e publicitação dos serviços promovidos pela Rede de Enfrentamento à violência contra a mulher nessa cidade. Seus resultados constituíram um insumo fundamental para a divulgação de direitos, leis, medidas protetivas, campanhas e informativos de prevenção, e de visibilidade aos serviços dessa Rede. Eles permitiram orientar estratégias de comunicação balizadas na opinião da comunidade, adequadas às demandas e às necessidades de cada região observada na pesquisa, que possibilitaram monitorar e avaliar a Rede de Enfrentamento


This article is part of a report based on a survey carried out by Unesp in partnership with the Municipal Council of Policies for Women, Bauru-SP on domestic violence, from June to August 2020. The non-prob-abilistic research, of descriptive nature, used the online questionnaire to collect data. The survey was con-ducted to find out woman opinions, in order to offer parameters to support communication and publicity actions for the service provided by a network for combating violence against women in that city. Its results enerated fundamental information for dissemination of rights, laws, protective measures, campaigns and prevention, among other ways of giving visibility to the service provided by that network. They made possi-ble to plan communication strategies based on the community opinion, appropriate to demands and pecu-liar needs for each region approached by the survey, which enabled to monitor and evaluate that network


Este artículo es parte del informe cuantitativo de encuesta de opinión realizada por la Unesp en alianza con el Consejo Municipal de Políticas para Mujeres, Bauru-SP, sobre violencia intrafamiliar, desde junio hasta agosto de 2020. La investigación no probabilística, de naturaleza descriptiva, utilizó el cuestionario online para obtener datos. Su objetivo fue conocer la opinión de mujeres, con el fin de ofrecer parámetros para auxiliar acciones de comunicación y divulgar los servicios promovidos por una red de afrontamiento a la violencia contra las mujeres en aquella ciudad. Sus resultados generaron informaciones fundamentales para la difusión de derechos, leyes, medidas de protección, campañas y prevención, y visibilidad a los servicios de esa red. Permitieron orientar estrategias de comunicación basadas en la opinión de la comunidad, adecuadas a las demandas y necesidades de cada región observada en la encuesta, que posibilitaron monitorizar y evaluar aquella red


Asunto(s)
Humanos , Mujeres , Violencia Doméstica , Violencia contra la Mujer , Comunicación , Acceso a la Información , Análisis de Datos , Equidad de Género , COVID-19
18.
An. R. Acad. Nac. Farm. (Internet) ; 89(3): 307-314, Juli-Sep. 2023. tab
Artículo en Español | IBECS | ID: ibc-226788

RESUMEN

Introducción: La falsificación y/o adulteración de medicamentos es un problema de salud pública el cual cada día se ve más reflejado en el país; una forma de evitarlo ya sea en mínima escala, es la correcta utilización de las unidades de eliminación de medicamentos e insumos, ayudando así a una eficaz desnaturalización y destrucción de estos.Objetivo General:Reconocer la importancia de la prevención del comercio ilegal de medicamentos mediante la utilización de las unidades de eliminación de medicamentos e insumos, en las etapas de comercialización y destrucción del producto, en los municipios de Santiago de Cali, La Unión y Jamundí en el Departamento del Valle del Cauca.Objetivos Específicos:•Medir el grado de conocimiento de las unidades de eliminación de medicamentos e insumos en cuanto a su funcionalidad e impacto en la población de Santiago Cali y en el municipio de La Unión Valle.•Analizar la incidencia de hallazgos de medicamentos en el material de reciclaje y su nivel de comercialización en Santiago de Cali y Jamundí.Método:Se realizó un estudio descriptivo- comparativo, de corte transversal, con enfoque cuantitativo que incluyó una muestra de 171 personas del municipio de Santiago de Cali y 89 personas en el municipio de La Unión Valle; una muestra de 21 recicladores del municipio de Santiago de Cali y 20 recicladores del municipio de Jamundí. El estudio fue realizado entre octubre y noviembre del 2022. Se utilizaron dos cuestionarios validados, diligenciados uno de forma virtual (grupo A) y otro de forma presencial (grupo B), el cual fue desarrollado de forma voluntaria.Resultados: Respecto al grupo de personas encuestadas en el grupo A, 45 que equivalen al 26.3% del universo de la población encuestada en Cali tienen conocimiento de las unidades de eliminación de medicamentos e insumos, 126 personas que equivalen al 73.7% no tienen conocimiento acerca del mismo.(AU)


Introduction: Counterfeiting and/or adulteration of medicines is a public health problem which is increasingly reflected in the country; One way to avoid it, whether on a small scale, is the correct use of the blue dot, thus helping to effectively denature and destroy them.General Objective: Recognize the importance of preventing the illegal trade of medicines using the blue point, in the stages of commercialization and destruction of the product, in the municipalities of Santiago de Cali, La Unión and Jamundí in the Department of Valle del Cauca.Specific Objectives: Measure the degree of knowledge of the blue dot in terms of its functionality and impact on the population of Santiago Cali and the municipality of La Uniòn Valle.Analyze the incidence of drug display in recycling material and its level of commercialization in Santiago de Cali and Jamundi.Method: A descriptive-comparative, cross-sectional study was conducted, with a quantitative approach that included a sample of 171 people from the municipality of Santiago de Cali and eighty-nine people from the municipality of La Union Valle, a sample of twenty-one recyclers from the municipality of Santiago de Cali and twenty recyclers from the municipality of Jamundí. The study was conducted between October and November 2022. Two validated questionnaires were used, one completed online (group A) and the other in person (group B), which was developed voluntarily.Results: Regarding the group of people surveyed in group A, 45, equivalent to 26.3% of the universe of the population surveyed in Cali, are aware of the blue dot, while 126 people, equivalent to 73.7%, are unaware of it. In Unión Valle, 14 people, equivalent to 15.7%, know about the blue dot, while 75 people, equivalent to 84.3%, are unaware of it.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Farmacia/normas , Comercialización de Medicamentos , Composición de Medicamentos , Comercialización de Productos , Establecimiento Dispensador de Medicamentos , Fraude , Farmacias , Farmacia/organización & administración , Colombia , Acceso a Medicamentos Esenciales y Tecnologías Sanitarias
19.
Recurso de Internet en Inglés, Español | LIS - Localizador de Información en Salud | ID: lis-49418

RESUMEN

La Organización Panamericana de la Salud (OPS) publicó ayer una nota técnica con una actualización sobre los sublinajes de Ómicron recientemente identificados. Hasta la fecha, no hay evidencia de cambios significativos en el impacto para la salud pública de EG.5 y de BA.2.86.


Asunto(s)
COVID-19 , Organización Panamericana de la Salud/organización & administración
20.
Health Secur ; 21(5): 333-340, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37552816

RESUMEN

The congressionally authorized National Disaster Medical System Pilot Program was created in December 2019 to strengthen the medical surge capability, capacity, and interoperability of affiliated healthcare facilities in 5 regions across the United States. The COVID-19 pandemic provided an unprecedented opportunity to learn how participating healthcare facilities handled medical surge events during an active public health emergency. We applied a modified version of the Barbisch and Koenig 4-S framework (staff, stuff, space, systems) to analyze COVID-19 surge management practices implemented by healthcare stakeholders at 5 pilot sites. In total, 32 notable practices were identified to increase surge capacity during the COVID-19 pandemic that have potential applications for other healthcare facilities. We found that systems was the most prevalent domain of surge capacity among the identified practices. Systems and staff were discussed across all 5 pilot sites and were the 2 domains co-occurring most often within each surge management practice. These results can inform strategies for scaling up and optimizing medical surge capability, capacity, and interoperability of healthcare facilities nationwide. This study also specifies areas of surge capacity worthy of strategic focus in the pilot's planning and implementation efforts while more broadly informing the US healthcare system's response to future large-scale, medical surge events.


Asunto(s)
COVID-19 , Planificación en Desastres , Desastres , Estados Unidos , Humanos , Capacidad de Reacción , Pandemias/prevención & control , Atención a la Salud
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