Alternate Care Sites for COVID-19 Patients: Experience from the H144 Hospital of the Health Service of the Principality of Asturias, Spain

Coronavirus disease 2019 (COVID-19) temporary hospitals, also called “alternate care sites” (ACS), as support to the health network have had uneven use. The World Health Organization (WHO) has published different recommendations in this regard. World-wide, many health services have improved their surge capacity with the implementation of new temporal hospital structures, but there have been few experiences of use over time despite representing an important element as support to the hospital network in the management of COVID-19 patients. In this article, the experiences are explained in the design, execution, and use of the temporal COVID-19 Hospital H144 of the Health Service of the Principality of Asturias (Sespa), with 144 beds, which was in operation from April 1 through July 1, 2020 (without admitting patients) and from November 12, 2020 through March 5, 2121, admitting a total of 334 COVID-19 patients (66% women; 34% men) and generating 3,149 hospital stays. Maximum occupancy was 74 patients. Mean stay was 9.42 days (MD = 3.99; [1-34]). At discharge, 126 patients (38%) went to a nursing home, 112 (33%) to their home, 40 (12%) were transferred to another hospital, and 56 (17%) died. The mean age of the admitted patients was 82.79 years (MD = 8.68; [29-104]) and was higher in women (85.09; MD = 7.57; P = .000) than in men (78.28; MD = 9.22). Some aspects to consider for future experiences of use have been: teamwork from different fields of knowledge (ie, architecture, engineering, medicine, and nursing) is essential for success; integration in the health system must be fully developed from different perspectives (ie, information system, logistics, medical records, or clinical procedures, among others); clear procedures for patient admission from different structures (ie, home, hospitals, nursing homes, or primary health care network) must combine with flexibility of use to adapt to new and unknown circumstances; and they must not compromise specialized staff availability in other health facilities.

Blockchain during COVID-19: The Technology to Help Society

At the end of 2019, a new coronavirus was reported in the form of unknown pneumonia: It was the beginning of the SARS-CoV-2 pandemic. It is crucial to develop the strategies to manage this new pandemic in order to improve their effectiveness, as opposed to the ones adopted in 2003 during the SARS pandemic. In 17 years, new digital technologies and tools have been created; therefore, we can take advantage of them in the social management of the pandemic. The aim of our paper is to evaluate how blockchain technology can be used and what advantages it brings in managing an emergency situation such as of the COVID-19 pandemic. In particular, the effects of the adoption of this technology will be assessed when applied both to the management of the information flow between health infrastructures, and to track monetary, technical, and medical supply donations to hospital structures. We therefore propose a high-level, decentralized architecture that assists in administrating large-scale information and stores the gathered data in a blockchain supervised by the authorities. The distrust suffered by institutions today, the fear experienced in the last year due to the pandemic, and the birth of a technology that allows for the creation of reliable networks, pose thoughtful challenges to be faced to recover trust and hope for the future again.

Hospital Processes and the Nurse-Patient Interaction in Breast Cancer Care. Findings from a Cross-Sectional Study

(1) Background: Evidence suggests that organizational processes of hospitals have an impact on patient-professional interactions. Within the nurse-patient interaction, nurses play a key role providing social support. Factors influencing the nurse-patient interaction have seldomly been researched. We aimed to examine whether the process organization in hospitals is associated with breast cancer patients’ perceived social support from nurses.; (2) Methods: Data analysis based on a cross-sectional patient survey (2979 breast cancer patients, 83 German hospitals) and information on hospital structures. Associations between process organization and perceived social support were analyzed with logistic hierarchical regression models adjusted for patient characteristics and hospital structures.; (3) Results: Most patients were 40–69 years old and classified with UICC stage II or III. Native language, age and hospital ownership status showed significant associations to the perception of social support. Patients treated in hospitals with better process organization at admission (OR 3.61; 95%-CI 1.67, 7.78) and during the hospital stay (OR 2.11; 95%-CI 1.04; 4.29) perceived significantly more social support from nurses.; (4) Conclusions: Designing a supportive nursing work environment and improving process organization in hospitals may create conditions conducive for a supportive patient-nurse interaction. More research is needed to better understand mechanisms behind the associations found.

Evaluation of Hospital's Emergency Departments According to User Requirements

Hospitals are large and complex structures that provide 24-hour healthcare. These structures, where many different functions are combined, are constantly changing and developing with innovations in health, technique, and economy. With the technological developments in the world, population growth, the desire to live healthier and longer, hospital structures are reshaped. These developments best define the changes made in programming according to the user needs. In order for hospital buildings to provide health services for many years, they must be durable and designed with developments in the future which can happen. Emergency departments are from the internal units of the hospital. The duty of the emergency department is to bring the patients to the emergency service, to make the first intervention to the patient according to the emergency situation, and to provide the best care to the patient by directing them to the required unit. The emergency department architecture must take into consideration human health while meeting patient and user needs. Emergency departments have evolved from the past to today in line with the new needs of the users. In this study, the space requirements and general design factors of emergency departments are explained.

DEVELOPMENT OF HUMAN RESOURCES IN MEDICAL INSTITUTIONS

The management of human resources is the main function of management in the organization. This defines the nature and the development of the Organization as a whole, modifies people's management in the working process to steer them towards the goals that the organization sets itself. The effective management of human resources requires the elaboration of clear strategies for the development of staff, managers with values and patterns of behaviour, corresponding to the stated values of the organization, who understand the significant effect of improving work to improve the human resources system in order to achieve better results. In order to achieve the objectives of an organization such as the Specialized Hospital of obstetrics and gynecology for active treatment Varna (SHOGAT), the leaders of each level need to know the theoretical-methodological foundations of the staff motivation, the legal framework for the action; To know and guide conflict resolution in hospital sectors. Knowing the patterns of motivation, the management raised the 100% satisfaction of its employees by improving the jobs and renovating the building stock. Managers in the medical institution work in the direction of engaging the personnel in the curative and diagnostic process, as well as in participating in the training process of the future cadres. This helps to plan labour resources on hospital structures and to select staff.The management and development of human resources is aimed at implementing the decision and implies forming in the managing system (the supervisors) the ability to properly influence the managed system (health teams) in order to ensure that the task is implemented by using the most effective methods and means.

Interés de la hipnosis médica en cirugía

El propósito de este artículo es dar a conocer la aplicación de la hipnosis médica como complemento a nuestro ámbito de trabajo. Desde su primer avatar conocido como magnetismo animal gracias a los trabajos de Mesmer en el siglo XVIII, ha cambiado su nombre su práctica y sus indicaciones. Históricamente la hipnosis ha evolucionado con altibajos, hasta finalmente ocupar los servicios hospitalarios en el mundo entero, gracias a los trabajos de Milton Erickson. La hipnosis dentro del contexto de las estructuras hospitalarias ha sido aplicada como terapia por psicoterapeutas. Actualmente otros profesionales de la salud pueden ejercer la hipnosis médica dentro de su especialidad, desde que tengan dicha formación complementaria. El empleo de la hipnosis como complemento a nuestra práctica anestésica, no es una novedad aunque en España no es una práctica difundida a diferencia del norte de Europa. Rigurosos estudios en neurociencias han investigado las modificaciones cerebrales bajo hipnosis a fin de explicar la vivencia del paciente. Las aplicaciones de la hipnosis en anestesia son múltiples; hipnosedación como complemento en técnicas anestésicas, gestión del stress, ansiedad, dolor, trabajo de parto y parto, estudios complementares de imagen etc. El beneficio y la eficacia que conseguimos no solo repercuten en mejorar el confort y la comunicación en el paciente sino también en el resto del equipo quirúrgico. ABSTRACT Medical hypnosis in surgery growing interest The purpose of this article is to report the application of medical hypnosis as a complement to our field of work. From its first incarnation, known as animal magnetism thanks to the works of Mesmer in the 18th century, its name, its practice and its indications have changed. Historically, hypnosis has evolved with ups and downs, until finally coming to occupy hospital services worldwide, thanks to the work of Milton Erickson. Within the context of hospital structures, hypnosis has been applied as a therapy by psychotherapists. Other health professionals can now practise medical hypnosis within their speciality, after they have had complementary training. The use of hypnosis as a complement to our anaesthesia practice is not novel, although it is not a widespread practice in Spain, unlike in northern Europe. Rigorous studies in neurosciences have investigated the brain modifications under hypnosis to explain the patient’s experience. There are various applications of hypnosis in anaesthesia: hypnosedation as a complement to anaesthetic techniques, management of stress, anxiety, pain, labour and delivery, complementary imaging studies, etc. The benefits and efficacy obtained not only result in improved comfort and communication for the patient, but also for the rest of the surgical team.

TRAINING OF STUDENTS IN THE PROFESSION

The motivation for an action is an internal condition that maintains, directs and stimulates a person's behavior by occupying a leading position in the structure of behavior and expression of personality. Personality motivation influences the different forms of human activity and perceptions, including learning. Heterogeneous is the essence of the personal motivating factors, forming the behavior – social, moral, behavioral, etc. The motivation for learning is seen as a focus on the individual countries of the learning process related to the internal attitude of the person to it. The motivation for training in the chosen profession was investigated for 75 students from the third and fourth course of the midwife, from Medical university Varna for the period 2017-2019, working as midwifery assistants in the hospital structures of the medical institutions in the town Varna. The motivation for learning to the chosen profession is large for 92% of respondents, as the leading motivating factor for 100% of them is the prestige of the profession. For 65% of working students, communication with patients is important in providing health care, and for 78% acquisition of professional skills and experience. The asked of the factors motivating them to succeed in training students unanimously indicated that exercising what they learned during the performance of their work is a leading factor, followed by tolerance, the respect they see from patients and the appreciation they receive strengthens their willingness to work and learn new skills. The trust that respondents receive from patients and staff is an engine of their willingness to engage in work on wards in hospital structures. The driving force and the opportunity for professional growth in acquiring professional competencies for the future professionals is an indicator that the chosen professional direction is realized for future realization and leads to increased Their satisfaction with their training choices.

IoT System for Detecting Input/Output Patient & Staff via RFID Technology

The Internet of Things (IoT) is a concept based on several technologies by connecting them to create a network of networks and a system of systems. It is composed of several and different objects such as Smartphone, Smart Watch, Smart refrigerator, Smart tv, etc. And it can guarantee quick access to information, this has had an enormous influence on the pace of contemporary daily life. It is possible to use IoT in critical areas as health for better management of hospital structures or to improve working conditions and staff performance in the hospital domain. This work proposes a solution allowing an improvement in term of management of inputs and outputs of the employees and patients and thus a better management within a hospital.