scholarly journals Validação da definição de termos identificados em registros eletrônicos de enfermagem de um hospital universitário/ Validation of the definition of terms identified in electronic records of nursing of a university hospital

2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Rodrigo Guerra Leal ◽  
Cláudia Regina Biancato Bastos ◽  
Ana Luzia Rodrigues ◽  
Sandra Maria Bastos Pires ◽  
Deborah Ribeiro Carvalho ◽  
...  
Keyword(s):  
University Hospital ◽  
Electronic Records ◽  
Definition Of

Este estudo objetivou validar a definição de termos registrados por enfermeiros na evolução do paciente de um hospital universitário, com base na Classificação Internacional para as Práticas de Enfermagem (CIPE®). A base empírica foi composta por 15 termos não constantes na CIPE®, extraídos das evoluções registradas por enfermeiros em prontuário eletrônico do paciente, de um hospital da região Sul do país. As definições foram analisadas por 36 enfermeiros, por meio da proporção de concordância geral de utilização e do Índice de Validade de Conteúdo (IVC) geral e por princípios de definição terminológica. Os termos “anasarca”, “equimose” e “posição de Fowler” atingiram proporção de concordância geral de utilização acima de 80%, enquanto agonia obteve a menor proporção (25%). A variável ocupação não interferiu no resultado, porém enfermeiros com menor tempo de atuação na instituição reconheceram a utilização de mais seis termos. A definição dos termos “anasarca” e “equimose” foi validada com IVC de 0,98 e 0,90, respectivamente; por outro lado, a de posição de Fowler não foi validada (IVC = 0,67), tendo sido limitada por sua concisão. Concluiu-se que o reconhecimento ou não de termos por enfermeiros assistenciais é determinado pelas características da clientela assistida na instituição.

Association of medical futility with do-not-resuscitate (DNR) code status in hospitalised patients

2021 ◽  
pp. medethics-2020-106977
Author(s):  
Christoph Becker ◽  
Alessandra Manzelli ◽  
Alexander Marti ◽  
Hasret Cam ◽  
Katharina Beck ◽  
...  
Keyword(s):  
Significant Proportion ◽  
Medical Futility ◽  
University Hospital ◽  
Main Diagnosis ◽  
Do Not Resuscitate ◽  
Clinical Frailty Scale ◽  
Code Status ◽  
Probability Of Survival ◽  
Hospitalised Patients ◽  
Definition Of

Guidelines recommend a ‘do-not-resuscitate’ (DNR) code status for inpatients in which cardiopulmonary resuscitation (CPR) attempts are considered futile because of low probability of survival with good neurological outcome. We retrospectively assessed the prevalence of DNR code status and its association with presumed CPR futility defined by the Good Outcome Following Attempted Resuscitation score and the Clinical Frailty Scale in patients hospitalised in the Divisions of Internal Medicine and Traumatology/Orthopedics at the University Hospital of Basel between September 2018 and June 2019. The definition of presumed CPR futility was met in 467 (16.2%) of 2889 patients. 866 (30.0%) patients had a DNR code status. In a regression model adjusted for age, gender, main diagnosis, nationality, language and religion, presumed CPR futility was associated with a higher likelihood of a DNR code status (37.3% vs 7.1%, adjusted OR 2.99, 95% CI 2.31 to 3.88, p<0.001). In the subgroup of patients with presumed futile CPR, 144 of 467 (30.8%) had a full code status, which was independently associated with younger age, male gender, non-Christian religion and non-Swiss citizenship. We found a significant proportion of hospitalised patients to have a full code status despite the fact that CPR had to be considered futile according to an established definition. Whether these decisions were based on patient preferences or whether there was a lack of patient involvement in decision-making needs further investigation.

scholarly journals The Factors affecting the implementation of electronic training in health care organization in Saudi Arabia: The case of King Abdulaziz university hospital: العوامل المؤثرة في تطبيق التدريب الإلكتروني في المنظمات الصحية- دراسة تطبيقية على موظفي مستشفى جامعة الملك عبد العزيز الإداريين بالمملكة العربية السعودية

2019 ◽  
Vol 3 (10) ◽  
Author(s):  
Sabah Abdullah Alsomali  ,   Amira AbdulAziz Alghamdi
Keyword(s):  
Health Care Organization ◽  
General Information ◽  
University Hospital ◽  
Care Organization ◽  
Health Organizations ◽  
Factors Affecting ◽  
King Abdulaziz University ◽  
Definition Of ◽  
Study Hypothesis ◽  
Significant Factors

The current study focused on the definition of electronic training and the importance of electronic training in the health organizations. The study main objective was to study the most significant factors that are affecting the electronic training application in the health organizations. The researcher used both a descriptive and analytical methods in her study. A questionnaire was used as a tool for data collection; the questionnaire was divided into two sections. The first section contained questions about general information that included: sex – age- qualification – experience in years – computer skills. The second section dealt with questions related to the study hypothesis. This section consists of four parts as follows: The first part included 11 statements about the reality of the electronic training in the health organizations in the present, which is considered the dependent variable in this study. The second part consists of 15 statements; the third part consists of 13 statements. The fourth part consists of 8 statements. These parts addressed the most significant factors that affected the implementation of the electronic training in the health organizations. These were the independent variables of the study. The questionnaire was distributed to a study sample of (368) employee in the hospital. A (200) questionnaire were collected on a rate of 54%. The Results of the study showed that the infrastructure for the Information technology and the government's tends towards the digital society were the most important factors that primarily affect the possibility of applying the electronic training in the health organizations. The main recommendations of the study were: the need for a support from the high and senior management in the king Abdul Aziz University hospital to adopt the electronic application of the electronic training and manage the resistance of change that many organization faces. The necessity of the electronic training for all the staff on computers skills. Finally, the importance of having a unit for the technical support king Abdul Aziz University hospital.

scholarly journals Workshops as a democratic proposal in order to change the supervision work in nursing

2018 ◽  
Vol 71 (4) ◽  
pp. 2050-2054 ◽  
Author(s):  
Maria Silvia Teixeira Giacomasso Vergílio ◽  
Vanessa Pellegrino Toledo ◽  
Eliete Maria Silva
Keyword(s):  
Action Research ◽  
Intervention Strategy ◽  
Public University ◽  
University Hospital ◽  
Work Context ◽  
Work Process ◽  
Communication Failure ◽  
Hospital Nursing ◽  
Definition Of

ABSTRACT Objective: to report the experience of developing workshops as an intervention strategy in an action research, aiming to review the work of supervision in hospital nursing. Method: to report of the experience of planning, developing and evaluating workshops with a psychosocial approach. Three workshops were held, in a reserved place, with the participation of 21 supervisors of a public university hospital. Each workshop was organized with heating, day work, closure with syntheses and consensus. Results: the work provided the exchange of experiences, reflections and proposals for difficulties identified in the work process that distract supervisors from the management of assistance such as communication failure, reworking and lack of definition of assignments in the team. Conclusion: the dynamics of the workshops favored supervisors to propose solutions to the difficulties of their practice in a more democratic and participative way, through dialogical interactions, sharing of the feelings pertinent to the work context and establishing consensus for the completion of the task.

scholarly journals Duration of Methicillin-ResistantStaphylococcus aureusCarriage, According to Risk Factors for Acquisition

2006 ◽  
Vol 27 (11) ◽  
pp. 1206-1212 ◽  
Author(s):  
Jonas Marschall ◽  
Kathrin Mühlemann
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
University Hospital ◽  
Modifiable Risk Factor ◽  
Lower Probability ◽  
Increased Risk ◽  
Antibiotics Use ◽  
Definition Of

Objective.To examine the duration of methicillin-resistant Staphylococcus aureus (MRSA) carriage and its determinants and the influence of eradication regimens.Design.Retrospective cohort study.Setting.A 1,033-bed tertiary care university hospital in Bern, Switzerland, in which the prevalence of methicillin resistance amongS. aureusisolates is less than 5%.Patients.A total of 116 patients with first-time MRSA detection identified at University Hospital Bern between January 1, 2000, and December 31, 2003, were followed up for a mean duration of 16.2 months.Results.Sixty-eight patients (58.6%) cleared colonization, with a median time to clearance of 7.4 months. Independent determinants for shorter carriage duration were the absence of any modifiable risk factor (receipt of antibiotics, use of an indwelling device, or presence of a skin lesion) (hazard ratio [HR], 0.20 [95% confidence interval {CI}, 0.09-0.42]), absence of immunosuppressive therapy (HR, 0.49 [95% CI, 0.23-1.02]), and hemodialysis (HR, 0.08 [95% CI, 0.01-0.66]) at the time MRSA was first MRSA detected and the administration of decolonization regimen in the absence of a modifiable risk factor (HR, 2.22 [95% CI, 1.36-3.64]). Failure of decolonization treatment was associated with the presence of risk factors at the time of treatment (P= .01). Intermittent screenings that were negative for MRSA were frequent (26% of patients), occurred early after first detection of MRSA (median, 31.5 days), and were associated with a lower probability of clearing colonization (HR, 0.34 [95% CI, 0.17-0.67]) and an increased risk of MRSA infection during follow-up.Conclusions.Risk factors for MRSA acquisition should be carefully assessed in all MRSA carriers and should be included in infection control policies, such as the timing of decolonization treatment, the definition of MRSA clearance, and the decision of when to suspend isolation measures.

Postoperative Acute Kidney Injury: Focus on Renal Recovery Definitions, Kidney Disease Progression and Survival

2019 ◽  
Vol 49 (3) ◽  
pp. 175-185 ◽  
Author(s):  
Thorir E. Long ◽  
Solveig Helgadottir ◽  
Dadi Helgason ◽  
Gisli H. Sigurdsson ◽  
Tomas Gudbjartsson ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Propensity Score ◽  
Matched Control ◽  
Kidney Injury ◽  
Renal Recovery ◽  
University Hospital ◽  
Control Group ◽  
One Year ◽  
Definition Of

Background: The aim of this study was to examine different definitions of renal recovery following postoperative acute kidney injury (AKI) and how these definitions associate with survival and the development and progression of chronic kidney disease (CKD). Methods: This was a retrospective study of all patients who underwent abdominal, cardiothoracic, vascular, or orthopedic surgery at a single university hospital between 1998 and 2015. Recovery of renal function following postoperative AKI was assessed comparing 4 different definitions: serum creatinine (SCr) (i) < 1.1 × baseline, (ii) 1.1–1.25 × baseline, (iii) 1.25–1.5 × baseline, and (iv) > 1.5 × baseline. One-year survival and the development or progression of CKD within 5 years was compared with a propensity score-matched control groups. Results: In total, 2,520 AKI patients were evaluated for renal recovery. Risk of incident and progressive CKD within 5 years was significantly increased if patients did not achieve a reduction in SCr to < 1.5 × baseline (hazard ratio [HR] 1.50; 95% CI 1.29–1.75) and if renal recovery was limited to a fall in SCr to 1.25–1.5 × baseline (HR 1.32; 95% CI 1.12–1.57) within 30 days. The definition of renal recovery that best predicted survival was a reduction in SCr to < 1.5 × baseline within 30 days. One-year survival of patients whose SCr decreased to < 1.5 × baseline within 30 days was significantly better than that of a propensity score-matched control group that did not achieve renal recovery (85 vs. 71%, p < 0.001). Conclusions: These findings should be considered when a consensus definition of renal recovery after AKI is established.

scholarly journals Management of ophthalmic surgical instruments and processes optimization: mixed method study

2020 ◽  
Vol 41 ◽  
Author(s):  
Daniela Silva dos Santos Schneider ◽  
Ana Maria Müller de Magalhães ◽  
Cecilia Helena Glanzner ◽  
Elisabeth Gomes da Rocha Thomé ◽  
João Lucas Campos de Oliveira ◽  
...  
Keyword(s):  
Mixed Method ◽  
Qualitative Approach ◽  
Surgical Instruments ◽  
University Hospital ◽  
Mixed Method Study ◽  
Southern Brazil ◽  
Material Management ◽  
Aim Analysis ◽  
Management Method ◽  
Definition Of

ABSTRACT Aim: Analysis of the use of ophthalmic instruments during surgical procedures in order to propose a material management method. Method: Mixed method study, sequential exploratory design, performed from January to June 2015, at a university hospital in southern Brazil. First, a qualitative approach was held from brainstorming and field observation. Themes were grouped into thematic categories. By connection, the quantitative stage happened through matrix arrangement and linear programming, culminating in the instrument management proposal. Results: Given categories - instruments reorganization according to the time of the surgical procedure and the need surgical instruments for in each procedure - guided the definition of existing restrictions and application of mathematical models. There was an average reduction of 13.10% in the number of surgical instruments per tray and an increase of 17.88% in surgical production. Final considerations: This proposal allowed the rationalization and optimization of ophthalmic instruments, favoring sustainability of the organization.

scholarly journals Awareness and Level of Knowledge About Surgical Site Infections and Risks of Wound Infection Among Medical Physicians in King Abdulaziz University Hospital: Cross-Sectional Study (Preprint)

2018 ◽  
Author(s):  
Wahbi Albishi ◽  
Marwan Ahmad Albeshri ◽  
Hatan Hisham Mortada ◽  
Khaled Alzahrani ◽  
Rakan Alharbi ◽  
...  
Keyword(s):  
Wound Infection ◽  
Wound Care ◽  
Quality Care ◽  
Surgical Site Infections ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cross Sectional ◽  
King Abdulaziz University ◽  
Level Of Knowledge ◽  
Definition Of

BACKGROUND Surgical site infections (SSIs) are one of the leading causes of death, and its prevention is a key element of applying the concept of patient safety and quality care. OBJECTIVE This study aimed to assess the level of knowledge about SSIs and risks of wound infection among medical physicians in King Abdulaziz University Hospital. METHODS All surgical and medical consultants, specialists, residents, and medical interns were invited to participate in the study. A 20-Item multiple-choice questionnaire was developed by reviewing the previous literature and with the help of a group of certified surgeons to assess the level of knowledge in all participants. RESULTS A total of 119 doctors were included in this study. Among all respondents, 92 (77.3%) were intern doctors, 16 (13.4%) were resident doctors, and 11 (9.2%) were specialist doctors. Moreover, 66 (55.5%) doctors knew the definition of SSI. Only one-quarter, that is, 30 (25.2%) doctors knew about the incidence of SSI. In addition, 8 doctors (6.7%) had good knowledge, 75 (63.0%) had fair knowledge, and 36 (30.2%) had poor knowledge regarding SSI according to this study. CONCLUSIONS Level of knowledge about SSIs and risks of wound infections among medical physicians should be improved to ensure better wound care and quality care for the patients.

scholarly journals Give Time or Take Action? Clinical Challenges of Prolonged Labour: Perspectives from Tanzania

2020 ◽  
Author(s):  
Aase Irene Høifødt ◽  
Johanne Mamohau Egenberg Huurnink ◽  
Signe Egenberg ◽  
Deodatus Amedeus Massay ◽  
Bariki Mchome ◽  
...  
Keyword(s):  
Qualitative Content Analysis ◽  
University Hospital ◽  
Prolonged Labour ◽  
Nulliparous Women ◽  
Northern Tanzania ◽  
Increased Risk ◽  
Professional Perspective ◽  
Nurse Midwives ◽  
Group Interviews ◽  
Definition Of

Abstract Background: Globally, some evidence suggests that up to one third of nulliparous women experience delay in the first stage of labour. Diagnosing prolonged labour is complicated by uncertainty related to the definition of both onset of labour and normal labour progression.Prolonged labour inhabits an increased risk of poor neonatal and maternal outcomes. To our knowledge, few studies have assessed the clinical challenges of prolonged labour from a health care professional perspective. In this study we aim to improve understanding of how clinical challenges related to prolonged labour are perceived by doctors and nurse-midwives in Tanzania. Methods: A qualitative study with group interviews of either doctors (2 interviews) or nurse-midwives (7 interviews). A qualitative content analysis was performed. The study setting comprised one zonal consultant university hospital and one regional referral hospital in Northern Tanzania. Results: A total of 37 respondents, among them 32 registered nurse-midwives and 5 doctors, all with experience from labour ward. Five categories emerged. Challenges were expressed in relation to 1) various ways of understanding prolonged labour, 2) assessing progress in labour, 3) monitoring foetal heart rate, 4) appropriate intervention at the appropriate time and 5) working as a team. Conclusions: The study provides a broader understanding of the clinical challenges encountered by nurse-midwives and doctors when managing prolonged labour. The grounds on which decisions are made, are somewhat inconsistent. The respondents request clear guidelines and frequent training.

scholarly journals Incidence and Causes of Failed Spinal Anesthesia

2020 ◽  
Vol 3 (2) ◽  
pp. 50-54
Author(s):  
Ahmet Yüksek ◽  
Ökkeş Hakan Miniksar ◽  
Mehtap Honca ◽  
Hakan Öz
Keyword(s):  
Spinal Anesthesia ◽  
Failure Rate ◽  
Sensory Block ◽  
Obstetric Anesthesia ◽  
University Hospital ◽  
High Rate ◽  
Failure Rates ◽  
Cause Of Failure ◽  
Technical Operation ◽  
Definition Of

Introduction: Spinal anesthesia (SA) is one of the most frequently applied anesthesia procedures today. However, SA failure rate varies between 1 and 17%. The age of the patient, the position at which the procedure is performed, or the characteristics of the technical operation can affect success. In this study, we aimed to compare the most frequent SA failures according to the types of surgery and causes of failure. The results of SA procedures performed in a university hospital were compare to those published in the current literature. Materials and Methods: After obtaining ethics committee ­approval for our study, the hospital archives were examined retrospectively for 1 year with respect to SA procedures. SA application and failure rates were examined. Three or more SA attempts, failed dural puncture, or unsuccessful injection, and anesthesia applications that did not provide sufficient sensory block for surgery despite successful drug treatment were defined as failure. Results: Of all anesthesia procedures, SA was applied at a rate of 23.5%. Our SA failure rate was calculated as 16.6%. Considering a single surgical procedure, obstetric anesthesia was the most common surgery with failed SA (28.7%). The most common cause of failure was insufficient analgesia (32.9%). Discussion: SA failure rates were observed to be in a variable distribution range in the literature, and in some studies, SA failure was defined as a block that did not occur despite a full dose and successful injection, and this rate was found to be 3.9%. The high rate in our study group may be explained by differences in the definition of SA: blocks performed with several trials and any block that could not be applied were also recorded as SA failure. The reasons for failing to apply this procedure is an issue that is worth examining also in terms of patient satisfaction and safety, which is an important issue. Conclusion: Although the definition of unsuccessful SA is confusing, SA failure rates are worth examining and improving for each hospital.

The Existential Dimension of Palliative Care: The Mirror Effect of Death on Life

2020 ◽  
pp. 003022282095218
Author(s):  
Frédérique Drillaud ◽  
Camille Saussac ◽  
Florence Keusch ◽  
Danièle Lafaye ◽  
Hélène Bely ◽  
...  
Keyword(s):  
Palliative Care ◽  
Mirror Effect ◽  
Palliative Care Unit ◽  
University Hospital ◽  
Spiritual Dimension ◽  
Existential Suffering ◽  
Definition Of ◽  
Existential Dimension ◽  
Spiritual Suffering ◽  
Insight Into

The WHO has included the spiritual dimension in its definition of palliative care since 1990, but this dimension is frequently confused with notions of religion. Yet, the spiritual suffering experienced by palliative care patients is primarily a matter of existential suffering. The objective of this study was to examine the ways in which the existential dimension was manifested in the experiences of those present in a palliative care unit. This anthropological monograph was conducted in a palliative care unit in a French University Hospital. The existential dimension appears to reside in the connections between individuals and the proximity of death appears to shed new light on the meaning of life. The mirror effect of death on life, could serve to encourage greater appreciation of the value of our connections with others, and the desire to take care of others, which offers new insight into forms of solidarity and social organisation.

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