scholarly journals Addressing multidrug resistant pathogens in pediatric palliative care patients—the nurses point of view: A qualitative study

2019 ◽  
Vol 34 (3) ◽  
pp. 349-357 ◽  
Author(s):  
Pia Schmidt ◽  
Almut Hartenstein-Pinter ◽  
Julia Wager ◽  
Carola Hasan ◽  
Boris Zernikow
Keyword(s):  
Palliative Care ◽  
Social Participation ◽  
Large Scale ◽  
Multidrug Resistant ◽  
Point Of View ◽  
Pediatric Palliative Care ◽  
Increased Risk ◽  
Control Versus ◽  
Multidrug Resistant Pathogens ◽  
Pathogen Colonization

Background: Multidrug resistant pathogens are a large-scale healthcare issue. In particular, children with life-limiting conditions have a significantly increased risk of multidrug resistant pathogen colonization. Official hygiene requirements recommend children, who are colonized with multidrug resistant pathogens, to be isolated. In the context of pediatric palliative care, such isolation adversely affects the aim of social participation. To overcome this challenge of conflicting interests on a pediatric palliative care inpatient unit, a hygiene concept for patients colonized with multidrug resistant pathogens, called PALLINI, was implemented. Aim: The aim of this study was to identify the nurses’ attitudes and opinions toward PALLINI. Methods: Nurses ( N = 14) from the pediatric palliative care unit were queried in guideline-oriented interviews. Interviews were analyzed qualitatively by means of content analysis. Results: The following four categories were identified: (1) safety, (2) effort, (3) quality of care, and (4) participation. All categories demonstrated ambivalence by nursing staff regarding PALLINI. Ambivalence arose from guaranteeing infection control versus noncompliance by the families, additional workload for patients with multidrug resistant pathogens versus lack of resources, impaired relationship with the parents versus enabling better care for the child, as well as enabling some limited contact versus the larger goal of genuine social participation. Despite this, nurses reported the importance of arranging everyday-life for the patients so that they experience as much social participation as possible. Conclusion: The implementation of a new hygiene concept is challenging. Despite positive reception of PALLINI from the nurses, ambivalence remained. Addressing these ambivalences may be critical to best implement the new hygiene concept.

scholarly journals Participatory Design of an Electronic Cross-Facility Health Record (ECHR) System for Pediatric Palliative Care: A Think-Aloud Study

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 839
Author(s):  
Theresa Sophie Busse ◽  
Chantal Jux ◽  
Sven Kernebeck ◽  
Larissa Alice Dreier ◽  
Dorothee Meyer ◽  
...  
Keyword(s):  
Palliative Care ◽  
Participatory Design ◽  
Point Of View ◽  
Pediatric Palliative Care ◽  
Health Record ◽  
Think Aloud ◽  
Information Communication ◽  
System A ◽  
Available Information ◽  
Patients Experience

Background: Pediatric palliative care (PPC) patients experience years of multisectoral and professional care. An electronic cross-facility health record (ECHR) system can support the immediate exchange of information among PPC professionals. Based on a needs assessment, a prototype ECHR system was developed. Methods: To evaluate potential users’ perspective regarding the system, a qualitative observational study was conducted consisting of a concurrent think-aloud session and a semi-structured qualitative interview. Results: Twenty PPC professionals (nurses, physicians) from specialized outpatient PPC teams, a PPC unit, and medical offices rated the ECHR system as a helpful tool to improve the exchange and collection of information, communication between PPC professionals, and treatment planning. From the user’s point of view, the basic logic of the ECHR system should be further adapted to improve the interaction of data remirrored from patient records of outpatient and inpatient care with those entered via the system. The users wished for further functions (text search) and content (information on therapies). Some content, such as the treatment process, needs to be further adapted. Conclusion: The developed ECHR system needs to be more specific in some features by offering all available information; while for other features, be less specific to offer a quick overview. The ability to share information promptly and automatically was seen as a tremendous improvement to the quality of care for PPC patients.

Acquisition of Multidrug-Resistant Organisms Among Hospital Patients Hospitalized in Beds Adjacent to Critically Ill Patients

2006 ◽  
Vol 27 (7) ◽  
pp. 675-681 ◽  
Author(s):  
Matan J. Cohen ◽  
Olga Anshelevich ◽  
David Raveh ◽  
Ellen Broide ◽  
Bernard Rudensky ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Medical Center ◽  
Multidrug Resistant ◽  
Incidence Rates ◽  
Critically Ill Patient ◽  
Do Not Resuscitate ◽  
Increased Risk ◽  
Multidrug Resistant Pathogens

Objective.To assess whether patients hospitalized in beds physically adjacent to critically ill patients are at increased risk to acquire multidrug-resistant pathogens.Design.Cohort study.Setting.Shaare Zedek Medical Center, a 550-bed medical referral center.Patients.From April to September 2004, we enrolled consecutive newly admitted patients who were hospitalized in beds adjacent to either mechanically ventilated patients or patients designated as “do not resuscitate” (DNR). For each of these patients, we also enrolled a control patient who was not hospitalized in a bed adjacent to a critically ill patient. We collected specimens from the anterior nares, the oral cavity, and the perianal zone at the time of admission and subsequently at 3-day intervals until discharge or death. Specimens were cultured on selective media to detect growth of antibiotic-resistant pathogens, includingAcinetobacter baumannii, methicillin-resistantStaphylococcus aureus(MRSA), extended-spectrum β lactamase (ESBL)–producing Enterobacteriaceae, and vancomycin-resistant enterococci (VRE).Results.We enrolled 46 neighbor-control pairs. Among neighbors and controls, respectively, the incidence rates for isolation ofA. baumanniiwas 8.3 and 4 isolations per 100 patient-days (relative risk [RR], 2.1 [95% confidence interval {CI}, 0.8-5.2];P= .12), the incidence rates for MRSA were 1.4 and 2.6 isolations per 100 patient-days (RR, 0.6 [95% CI, 0.1-2.3];P= .45), the incidence rates for ESBL-producing Enterobacteriaceae were 10.5 and 9 isolations per 100 patient-days (RR, 1.2 [95% CI, 0.6-2.4];P= .84), the incidence rates for VRE were 4.3 and 4.8 isolations per 100 patient-days (RR, 0.9 [95% CI, 0.3-2.4];P= 1), and the composite incidence rate was 21.7 and 16.2 isolations per 100 patient-days (RR, 1.3 [95% CI, 0.8-2.3];P= 0.3).Conclusions.In this pilot study, we did not detect an increased incidence rate of isolation of multidrug-resistant pathogens among patients hospitalized in beds adjacent to critically ill patients. Further studies with larger samples should be conducted in order to generate valid data and provide patients, physicians, and policy makers with a sufficient knowledge base from which decisions can be made.

Birlikte Yaşama Kültürü Çerçevesinde Avrupa Birliği ve Türkiye Politikaları: Suriyelilere Yönelik Tutumun Sultanbeyli Örneği Üzerinden Değerlendirilmesi

2017 ◽  
Vol 4 (1) ◽  
pp. 41-61
Author(s):  
Pelin Sönmez ◽  
Abulfaz Süleymanov
Keyword(s):  
Civil Wars ◽  
Large Scale ◽  
Social Acceptance ◽  
Point Of View ◽  
The Other ◽  
Syrian Refugees ◽  
The European Union ◽  
International Protection ◽  
Legal Structure ◽  
Turkish People

Türkiye, Cumhuriyet tarihinin en yoğun zorunlu göç dalgasını 2011 yılından bu yana süren Suriye Savaşı ile yaşamaktadır. Suriye vatandaşlarının geçici koruma statüsü altında Türkiye toplumuna her açıdan entegrasyonları günümüzün ve geleceğin politika öncelikleri arasında düşünülmelidir. Öte yandan ülkeye kabul edilen sığınmacıların kendi kültürel kimliğini kaybetmeden içinde yaşadığı ev sahibi topluma uyumu, ortak yaşam kültürünün gelişmesi açısından önem arz etmektedir. Bu makalede, "misafir" olarak kabul edilen Suriyeli vatandaşların Türk toplumunca kabul edilmeleri ve dışlanma risklerinin azaltılmasına yönelik devlet politikaları ortaya konularak, üye ve aday ülkelere göçmenlerin dışlanmasını önlemek için Avrupa Birliği (AB) tarafından sunulan hukuki yapı ve kamu hizmeti inisiyatifleri incelenmekte, birlikte yaşam kültürü çerçevesinde Suriyeli vatandaşlara yönelik  toplumsal kabul düzeyleri ele alınmaktadır. Çalışma iki ana bölümden oluşmaktadır: göçmen ve sığınmacılara karşı toplumsal dışlanmayı engellemek için benimsenen yasa ve uygulamaların etkisi ve İstanbul-Sultanbeyli bölgesinde Suriyeli sığınmacılarla ilgili toplumsal algı çalışmasının sonuçları. Bölgede ikamet eden Suriyelilere yönelik toplumsal kabul düzeyinin yüksek olduğu görülürken, halkın Suriyelileri kendilerine  kültürel ve dini olarak yakın hissetmesi toplumsal kabul düzeyini olumlu etkilemektedir. ABSTRACT IN ENGLISHAn evaluation of the European Union and Turkish policies regarding the culture of living togetherThis article aims to determine the level of social acceptance towards Syrians within the context of cohabitation culture by evaluating EU’s legal structure and public service initiatives in order to prevent Syrian refugees from being excluded in member and candidate countries and by revealing government policies on acceptance of Syrians as “guest” by Turkish society and minimizing the exclusion risks of them. This article consists of two main parts, one of which is based on the effects of law and practices preventing refugees and asylum seekers from social exclusion, and the other is on the results of social perception on Syrians in Sultanbeyli district of Istanbul. At the end of 5-years taking in Syrian War, it is obvious that most of more than 3 million Syrian with unregistered ones in Turkey are “here to stay”. From this point of view, the primary scope of policies should be specified in order to remove side effects of refugee phenomenon seen as weighty matter by bottoming out the exclusion towards those people. To avoid possible large-scale conflicts or civil wars in the future, the struggle with exclusion phenomenon plays a crucial role regarding Turkey’s sociological situation and developing policies. In the meaning of forming a model for Turkey, a subtitle in this article is about public services for European-wide legal acquis and practices carried out since 1970s in order to prevent any exclusion from the society. On the other hand, other subtitles are about legal infrastructure and practices like Common European Asylum and Immigration Policies presented in 2005, and Law on Foreigners and International Protection introduced in 2013. In the last part of the article, the results of a field survey carried out in a district of Istanbul were used to analyze the exclusion towards refugees in Turkey. A face-to-face survey was randomly conducted with 200 settled refugees in Sultanbeyli district of Istanbul, and their perceptions towards Syrian people under temporary protection were evaluated. According to the results, the level of acceptance for Syrians living in this district seems relatively high. The fact that Turkish people living in the same district feel close to Syrian refugees culturally and religiously affect their perception in a positive way: however, it is strikingly seen and understood that local residents cop an attitude on the refugees’ becoming Turkish citizens.

Methods of Network Planning and Management when Implementing Territory Planning Projects

2019 ◽  
pp. 49-54
Keyword(s):  
Large Scale ◽  
Housing Stock ◽  
Network Planning ◽  
Network Models ◽  
Point Of View ◽  
Residential Areas ◽  
Basic Principles ◽  
Planning And Management ◽  
Planning Project ◽  
Complex Process

The success of the Program of housing stock renovation in Moscow depends on the efficiency of resource management. One of the main urban planning documents that determine the nature of the reorganization of residential areas included in the Program of renovation is the territory planning project. The implementation of the planning project is a complex process that has a time point of its beginning and end, and also includes a set of interdependent parallel-sequential activities. From an organizational point of view, it is convenient to use network planning and management methods for project implementation. These methods are based on the construction of network models, including its varieties – a Gantt chart. A special application has been developed to simulate the implementation of planning projects. The article describes the basic principles and elements of modeling. The list of the main implementation parameters of the Program of renovation obtained with the help of the developed software for modeling is presented. The variants of using the results obtained for a comprehensive analysis of the implementation of large-scale urban projects are proposed.

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