Burn Centers and the Multidisciplinary Team, Centralized Burn Care, and Burn Care Quality Control Work

2019 ◽  
pp. 115-121
Author(s):  
Folke Sjöberg ◽  
Ingrid Steinvall ◽  
Moustafa Elmasry
2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S35-S35
Author(s):  
Jeffrey E Carter ◽  
Herbert Phelan ◽  
Colleen M Ryan ◽  
James C Jeng ◽  
Kathryn Mai ◽  
...  

Abstract Introduction The COVID-19 pandemic has raised global awareness of healthcare resource limitations. Specifically, the pandemic has demonstrated that burn disaster planning should involve non-burn disasters that threaten staff, supplies, or space. The ABA facilitated bed counts with the assistance of regional disaster coordinators from April through August of 2020. Our analysis examines the impact of the pandemic on burn surge and bed capacity in the U.S. Methods Bed availability was obtained by the ABA regional disaster coordinators through an initiative by the Organization and Delivery of Burn Care Committee. Bed availability was defined as immediately available burn beds and categorized as adult, pediatric, or flexible. Surge capacity was defined as the maximum number of patients that a burn center could admit in a surge situation. Data was deidentified by the central office with descriptive statistics to determine bed availability and surge capacity trends regionally and nationally. Results Bed counts were performed 6 times from 04/17/2020 through 08/14/2020. Response rates from the 137 North American burn centers varied from 86–96%. At least 6 burn centers (5%) were either closed or converted for COVID patients during the initial two bed counts. The total number of adult or pediatric burn beds was 2,082. Total bed availability decreased from 845 at the first survey down to 572 beds at the last survey. Surge capacity baseline was 1,668 beds and decreased from 1,132 beds in the initial survey down to 833 beds in the final survey. Conclusions Our study demonstrates a significant impact on burn bed availability due to the COVID-19 pandemic with a 37% reduction in available burn beds from April to August and a 26% reduction in surge capacity. This study demonstrates a substantial reduction in bed availability during the pandemic with additional analysis in process to examine regional trends.


Author(s):  
W. C. Gao ◽  
H. T. Zhao ◽  
W. J. Mao ◽  
S. Yin ◽  
Z. B. Tian

Abstract. The fundamental geographic national condition monitoring uses high-resolution aerial and aerospace remote sensing images to produce digital orthophoto images, land cover classification, geographical and national conditions, databases, statistical analysis and other results to monitor land changes within China's territory, the cycle is once a year. At present, the achievements have been applied in the fields of natural resource management, environmental protection and governance, people's livelihood guarantee, emergency disaster relief, and so on, it is of great significance to provide integrated, standardized and reliable geographic information products to meet the needs of ecological civilization construction. In view of the actual situation of the geographical conditions of the country, such as the organizational mode of production, the technical methods and the requirements of the results, this paper discusses the innovative development of the quality control method, the quality control content, the results quality evaluation and software development, etc. , having established a basic quality control system for monitoring the geographical conditions of the country, and applied it in the quality control work of monitoring the geographical conditions of the country carried out in the past four years from 2016 to 2019, effectively guaranteeing the quality of the results, it also provides reference and reference for other important engineering quality control work.


Author(s):  
Sue Green

This chapter addresses the essential nursing responsibility to ensure that adequate nutritional care is offered to all patients, whether in hospital or community-based settings. To provide appropriate nutritional care to patients or clients, nurses must have a good knowledge and understanding of the principles of human nutrition, and be able to deliver nutritional support that is informed by current clinical guidelines and up-to-date evidence, as well as to evaluate that care. Healthcare organizations have a duty to ensure that patients and clients receive high-quality nutritional care. The Council of Europe (2003) has published guidelines on food and nutritional care in hospitals, and a recent Europe-wide campaign has been launched to improve nutritional care in all types of care facility (Ljungqvist et al., 2010). A European strategy to address obesity has also been launched (Commission of the European Communities, 2007). In England, the Care Quality Commission (CQC, 2010), which regulates care settings, has set national standards concerning nutrition. The provision of high-quality nutritional care involves a range of services and requires a multidisciplinary team approach. As a nurse, your role within the multidisciplinary team is fundamental in ensuring the delivery of appropriate nutritional care. In the UK, this is clearly identified by the incorporation of ‘Nutrition and Fluid Management’ within the Essential Skills Clusters for pre-registration nursing education (Nursing and Midwifery Council, 2010). Human nutrition is the study of nutrients and their effect on health, and the processes by which individuals obtain nutrients and use them for growth, metabolism, and repair. The term ‘human nutrition’ therefore incorporates many aspects of behaviour and physiology. The way in which the body obtains, ingests, digests, absorbs, and metabolizes nutrients is described in core anatomy and physiology textbooks (for example, Marieb and Hoehn, 2010), and it is important that a good knowledge and understanding of these processes is gained before considering the nursing management of nutritional care. This chapter considers the principles of human nutrition that underpin the nursing management of nutritional care and focuses on the key nursing interventions that you should be able to provide with confidence. The amount and type of nutrients that a person obtains influences his or her ‘nutritional status’.


2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S67-S67
Author(s):  
Tina L Palmieri ◽  
Kathleen S Romanowski ◽  
Soman Sen ◽  
David G Greenhalgh

Abstract Introduction Climate change, the encroachment of populations into wilderness, and carelessness have combined to increase the incidence of wildfire injuries. With the increased incidence has come an increase in the number of burn injuries. Prolonged extrication, delays in resuscitation, and the extreme fire and toxic air environment in a wildfire has the potential to cause more severe burn injury. The purpose of this study is to examine the demographics and outcomes of wildfire injuries and compare those outcomes to non-wildfire injuries. Methods Charts of patients admitted to a regional burn center during a massive wildfire in 2018 were reviewed for demographic, treatment, and outcome. We then obtained age, gender, and burn size matched controls from within 2 years of the incident, analyzed the same measures, and compared treatment and outcomes between the two groups. Results A total of 20 patients, 10 wildfire (WF) burns and 10 non-wildfire (NWF) burns, were included in the study. Age (59.6±7.8 WF vs. 59.4±7.4 years), total body surface area burn (TBSA) (14.9±4.7 WF vs. 17.2±0.9 NWF) and inhalation injury incidence (2 WF and 2 NWF) were similar between groups. Days on mechanical ventilation (24.3±19.4 WF vs. 9.4±9.8 NWF), length of stay (49.9±21.8 WF vs. 28.2±11.7 days) and ICU length of stay (43.0±25.6 WF vs 24.4±11.2 NWF) were higher in the WF group. WF patients required twice the number of operations. Mortality was similar in both groups (1 death/group). Conclusions Wildfire burn injuries, when compared to age, inhalation injury, and burn size matched controls, require more ventilatory support and have more operations. As a result, they have longer lengths of stay and have a prolonged ICU course. Burn centers should be prepared for the increased resource utilization that accompanies wildfire injuries. Applicability of Research to Practice All burn centers must be prepared for the possibility of wildfires and the increased resource utilzation that accompanies mass casualty events.


Author(s):  
David Parizh ◽  
Maleeh Effendi ◽  
Elizabeth Dale ◽  
Julia Slater

Abstract Given ever increasing ease of access to technology, the majority of adults first turn to the internet for medical advice. The world wide web is filled with user-generated content within multiple social media platforms that lack a governing body to validate the information’s accuracy and reliability. The authors performed a qualitative review of first-aid burn resources available on YouTube using two validated scales: Modified Discern and Global Quality Scale. A search was conducted using the term “burn treatment” on September 18, 2019. Of 120 reviewed videos, 59 met their inclusion criteria. 36% (n = 21) of the speakers had formal medical training, with only 12% (n = 7) identified as burn care professionals. The mean views originating from nonmedical speakers (162,675) were more than eight times that originating from burn centers (14,975). The quality of the videos was compared by video source, speaker, and specialty. Burn centers had the highest Modified Discern and Global Quality Scale scores, 2.91 and 2.86, respectively (P < .05). Additionally, the authors were able to demonstrate that there was a statistically significant higher quality of videos when the speaker was a burn care professional or had formal medical training. Unfortunately, their review demonstrated that videos originating from hospital systems and burn centers made up a minority of the online media content. These results illustrate an opportunity for improvement by way of increased content creation to bolster the online presence of the burn community and provide patients with more accurate information.


2017 ◽  
Vol 2_2017 ◽  
pp. 17-22
Author(s):  
Bushtyrev V.A. Bushtyrev ◽  
Zubkov V.V. Zubkov ◽  
Kuznetsova N.B. Kuznetsova ◽  
Barinova V.V. Barinova ◽  

2020 ◽  
Vol 5 (4) ◽  
pp. 20-25
Author(s):  
A. К. Iordanishvili ◽  
E. K. Barinov ◽  
I. B. Salmanov

Evaluation (including within the framework of medico-legal examination) of the quality and efectiveness of endodontic dental treatment is a matter of current interest in the clinical dentistry.Obiectives. Te aim of the work was to develop an algorithm of medico-legal examination in case of endodontic treatment, to test this algorithm in the work of the commissions of medical care quality control in the departments of therapeutic dentistry of outpatient dental clinics.Material and methods.Te material of the study was the reports of daily activities of dental clinics of various forms of ownership (municipal, departmental, private) in 3 regions of Russia (Moscow, St. Petersburg, Rostov-on-Don), including periodic reports and reference reports, ofcial statistical reports of the activities of the examined clinics, including registration books of the work of the commissions of the quality of medical care. Tese materials were used as a source of primary statistical information. Afer grouping of the information contained in them, the main data characterizing organization, condition and quality of endodontic care were recovered taking into account nosological entities: pulpitis and periodontitis. Taking into account the medical, statistical and analytical nature of the study, the main conclusions and recommendations were formulated on the basis of a retrospective study of these materials.Results. Based on the studies carried out and recommendations of the European Endodontic Association on provision of the standard of endodontic treatment, an algorithm for medico-legal examination of endodontic treatment was proposed. Tis algorithm allows to assess the quality and efectiveness of endodontic treatment of pulpitis and periodontitis in diferent terms (immediately afer treatment, remote period)Conclusion. Te use of the developed algorithm in clinical practice in internal quality control of endodontic care has shown its efectiveness. A large number of clinical cases of insufcient quality of endodontic treatment and its low efectiveness in the remote period indicate persistence of the potential for claims from patients. 


2019 ◽  
Vol 41 (4) ◽  
pp. 853-858
Author(s):  
Kavitha Ranganathan ◽  
Charles A Mouch ◽  
Michael Chung ◽  
Ian B Mathews ◽  
Paul S Cederna ◽  
...  

Abstract Timely treatment is essential for optimal outcomes after burn injury, but the method of resource distribution to ensure access to proper care in developing countries remains unclear. We therefore sought to examine access to burn care and the presence/absence of resources for burn care in India. We surveyed all eligible burn centers (n = 67) in India to evaluate burn care resources at each facility. We then performed a cross-sectional geospatial analysis using geocoding software (ArcGIS 10.3) and publicly available hospital-level data (WorldStreetMap, WorldPop database) to predict the time required to access care at the nearest burn center. Our primary outcome was the time required to reach a burn facility within India. Descriptive statistics were used to present our results. Of the 67 burn centers that completed the survey, 45% were government funded. More than 1 billion (75.1%) Indian citizens live within 2 hours of a burn center, but only 221.9 million (15.9%) live within 2 hours of a burn center with both an intensive care unit (ICU) and a skin bank. Burn units are staffed primarily by plastic surgeons (n = 62, 93%) with an average of 5.8 physicians per unit. Most burn units (n = 53, 79%) have access to hemodialysis. While many Indian citizens live within 2 hours of a burn center, most centers do not offer ICU and skin bank services that are essential for modern burn care. Reallocation of resources to improve transportation and availability of ICU and skin bank services is necessary to improve burn care in India.


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