scholarly journals Work Characteristics of Acute Care Surgeons at a Swiss Tertiary Care Hospital: A Prospective One-Month Snapshot Study

2021 ◽  
Author(s):  
Claudine Di Pietro Martinelli ◽  
Tobias Haltmeier ◽  
Joël L. Lavanchy ◽  
Stéphanie F. Perrodin ◽  
Daniel Candinas ◽  
...  
Keyword(s):  
Acute Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Working Time ◽  
Care Hospital ◽  
Work Characteristics ◽  
Administrative Work ◽  
Surgery Patient ◽  
Emergency Interventions ◽  
Night Shifts

Abstract Background Multiple acute care surgery (ACS) working models have been implemented. To optimize resources and on-call rosters, knowledge about work characteristics is required. Therefore, this study aimed to investigate the daily work characteristics of ACS surgeons at a Swiss tertiary care hospital. Methods Single-center prospective snapshot study. In February 2020, ACS fellows prospectively recorded their work characteristics, case volume and surgical case mix for 20 day shifts and 16 night shifts. Work characteristics were categorized in 11 different activities and documented in intervals of 30 min. Descriptive statistics were applied. Results A total of 432.5 working hours (h) were documented and characterized. The three main activities ‘surgery,’ ‘patient consultations’ and ‘administrative work’ ranged from 30.8 to 35.9% of the documented working time. A total of 46 surgical interventions were performed. In total, during day shifts, there were 16 elective and 15 emergency interventions, during night shifts 15 emergency interventions. For surgery, two peaks between 10:00 a.m.–02:00 p.m. and 08:00 p.m.–11:00 p.m. were observed. A total of 225 patient were consulted, with a first peak between 08:00 a.m. and 11:00 a.m. and a second, wider peak between 02:00 p.m. and 02:00 a.m. Conclusion The three main activities ‘surgery,’ ‘patient consultations’ and ‘administrative work’ were comparable with approximately one third of the working time each. There was a bimodal temporal distribution for both surgery and patient consultations. These results may help to improve hospital resources and on-call rosters of ACS services.

scholarly journals Impact of legalization of Medical Assistance in Dying on the Use of Palliative Sedation in a Tertiary Care Hospital: A Retrospective Chart Review

2021 ◽  
pp. 104990912110304
Author(s):  
Amy Nolen ◽  
Rawaa Olwi ◽  
Selby Debbie
Keyword(s):  
Palliative Care ◽  
Acute Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Palliative Sedation ◽  
Palliative Care Unit ◽  
Care Hospital ◽  
Medical Assistance ◽  
Medical Assistance In Dying ◽  
Before And After

Background: Patients approaching end of life may experience intractable symptoms managed with palliative sedation. The legalization of Medical Assistance in Dying (MAiD) in Canada in 2016 offers a new option for relief of intolerable suffering, and there is limited evidence examining how the use of palliative sedation has evolved with the introduction of MAiD. Objectives: To compare rates of palliative sedation at a tertiary care hospital before and after the legalization of MAiD. Methods: This study is a retrospective chart analysis of all deaths of patients followed by the palliative care consult team in acute care, or admitted to the palliative care unit. We compared the use of palliative sedation during 1-year periods before and after the legalization of MAiD, and screened charts for MAiD requests during the second time period. Results: 4.7% (n = 25) of patients who died in the palliative care unit pre-legalization of MAiD received palliative sedation compared to 14.6% (n = 82) post-MAiD, with no change in acute care. Post-MAiD, 4.1% of deaths were medically-assisted deaths in the palliative care unit (n = 23) and acute care (n = 14). For patients who requested MAiD but instead received palliative sedation, the primary reason was loss of decisional capacity to consent for MAiD. Conclusion: We believe that the mainstream presence of MAiD has resulted in an increased recognition of MAiD and palliative sedation as distinct entities, and rates of palliative sedation increased post-MAiD due to greater awareness about patient choice and increased comfort with end-of-life options.

scholarly journals Coexistence of COVID-19 with Pregnancy: A Challenge to Manage

2020 ◽  
pp. 1-5
Author(s):  
Chhaya V. Verma ◽  
Chhaya V. Verma ◽  
Gayatri S. Jere ◽  
Suresh K. Patel ◽  
Rosemarie Desouza
Keyword(s):  
Acute Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Medical Team ◽  
Breathing Exercises ◽  
Contagious Nature ◽  
Increased Risk ◽  
Immunological Changes ◽  
Set Up

The number of Coronavirus Disease-19 (COVID-19) cases are on a rise globally due to the highly contagious nature of its causative agent Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2). Physiological and Immunological changes during pregnancy may put pregnant women at increased risk for severe COVID-19 respiratory infection which may require Intensive care. Along with medical management, physiotherapy interventions namely patient education, relaxation, breathing exercises, positioning in bed, and mobility exercises are an integral part of acute care set up. The aim of this report is to share our experience as a frontline physiotherapist working as an integral part of the medical team in a dedicated COVID-19 Government Tertiary Care Hospital in Mumbai. It highlights physiotherapy management of a COVID-19 patient, in her 24th week of gestation, in an Acute Care Set Up.

Confidence toward vaccination as reported by parents of children admitted to a tertiary care hospital in Riyadh, Saudi Arabia: A cross sectional study

Vacunas ◽  
2020 ◽  
Vol 21 (2) ◽  
pp. 95-104 ◽  
Author(s):  
Y.M. AlGoraini ◽  
N.N. AlDujayn ◽  
M.A. AlRasheed ◽  
Y.E. Bashawri ◽  
S.S. Alsubaie ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional
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