Humanizing intensive nursing care for people with COVID-19

Objective: to understand the impact of music on the intensive care for COVID-19 as an instrument to humanize assistance from the perspective of nurses who work on assistance. Methods: qualitative study carried out with seven intensive care nurses working in the COVID-19 Intensive Care Unit of a public state hospital. Sample reached through theoretical saturation. Data were collected using interviews through the on-line application WhatsApp, guided by a semi-structured guide. Results: the following discursive categories emerged: Feelings of health professionals and humanized actions in intensive care; Music therapy to provide integral care for people with COVID-19 in the score of intensive care; Living in the moment; Music therapy as an instrument for spirituality in the intensive care environment. Conclusion: the nursing intensive care did not only carry out a biological treatment, but considered all aspects of the human being, using to do so humanization by music.

A comparison of spleen size measured by ultrasound in a random population sample and a matched sample of patients at a university hospital, and the determination of normal values and influencing factors

Objectives This study aimed to compare spleen sizes in a hospital and a population sample using ultrasound and define normal values and factors influencing spleen size. Methods Both samples’ spleen sizes (n = 1520) were measured using ultrasound under the same conditions. Blood counts and other laboratory parameters were determined under the same conditions in both samples. Results In the hospital sample (n = 760), the mean spleen size was 114.7 mm, and in the population sample (n = 760), it was 99.1 mm. In both, spleen size in men was significantly higher than in women (p < 0.0001) and influenced by body height, weight, and BMI (body mass index) (p < 0.0001). In the hospital sample, there was a correlation with higher values for ALT (p = 0.0160), AST (p = 0.0394), AP (p = 0.0482), and ferritin (p = 0.0008) and lower values for HDL (p = 0.0091) and thrombocytes (p < 0.0001). In the multivariate analysis, higher values for AP (p = 0.0059) and lower values for hemoglobin (p = 0.0014) and thrombocytes (p = 0.0001) were found. Stratified for sex (men, women), spleen size increased with higher values for ALT (p = 0.0116, p = 0.0113), AST (p = 0.0014, p = 0.0113), and AP (p = 0.0001, p = 0.0012), and with lower values of hemoglobin (p = 0.0057, p = 0.0016), thrombocytes (p < 0.0001, p = 0.0003), and albumin (p = 0.0029, p = 0.0432). In women, there was a discordant correlation with red blood cells (p = 0.0005) and a concordant correlation with GGT (p = 0.0241), and in men discordant correlations with cholesterol (p = 0.0010) and HDL (p = 0.0404). Conclusions The already proven impact of anthropometric data on spleen size was confirmed. The role of laboratory values should be further analyzed.

Evaluating the Effectiveness of NoteAid in a Community Hospital Setting: Randomized Control Trial (Preprint)

BACKGROUND Interventions to define medical jargon have been shown to improve Electronic Health Record (EHR) note comprehension among crowdsourced participants on Amazon Mechanical Turk (AMT). However, AMT participants may not be representative of the general population nor patients who are most at-risk for low health literacy. OBJECTIVE In this work we assess the efficacy of an intervention (NoteAid) on EHR note comprehension for participants in a community hospital setting. METHODS Participants were recruited from Lowell General Hospital (LGH), a community hospital in Massachusetts, to take the ComprehENotes test, a web-based test of EHR note comprehension. Participants were randomly assigned to control (85) or intervention (89) groups to take the test without or with NoteAid, respectively. For comparison, we used a sample of 200 participants recruited from AMT to take the ComprehENotes test (100 control and 100 intervention). RESULTS 174 participants were recruited from LGH, 200 participants were recruited from AMT. Participants in both intervention groups (community hospital and AMT) scored significantly higher than participants in the control groups (P < 0.001). The average score for the community hospital participants was significantly lower than the average score for the AMT participants (P < 0.001), consistent with the lower education levels in the community hospital sample. Education level had a significant effect on scores for the community hospital participants (P < 0.0005). CONCLUSIONS Use of NoteAid was associated with significantly improved EHR note comprehension in both community hospital and AMT samples. Our results demonstrate the generalizability of ComprehENotes as a test of EHR note comprehension and the effectiveness of NoteAid for improving EHR note comprehension.

Budaya Organisasi, Motivasi Kerja Terhadap Kinerja Karyawan Dengan Kepuasan Kerja Sebagai Variabel Intervening Pada Rumah Sakit Semen Gresik

Background - Hospitals as a health service organization in order to "survive" must have a good service management system so that the impact on employee performance can meet the demands of the community's needs. Objectives - This study aims to determine the extent of job satisfaction and employee performance at Semen Gresik Hospital which is influenced by organizational culture and work motivation.Design / Methodology / Approach - The object of this study is Semen Gresik Hospital. Sample in this study used a purposive sampling method with the provisions of respondents who worked more than 5 years while through the formula Slovin determined the number of research samples of 219 respondents. Statistical tests use path analysis.Results and Discussion - Based on the results of the analysis prove that organizational culture and motivation directly and indirectly influence employee performance and job satisfaction, the findings of organizational culture have a smaller coefficient on employee performance and job satisfaction compared to work motivation and based on analysis testing The path of organizational culture has a total value smaller than work motivation. So the results of the study concluded that organizational culture and motivation can increase job satisfaction and employee performance.Conclusion - All hypotheses this study are proven and can be accepted. Organizational Culture, work motivation has direct and indirect effects on employee performance and job satisfaction.Research Implications - It is hoped that the results of this study can contribute to knowledge and hospital management to pay attention to organizational culture and work motivation to improve employee performance and employee satisfaction at work.

Measuring and optimising the efficiency of community hospital inpatient care for older people: the MoCHA mixed-methods study

Background Community hospitals are small hospitals providing local inpatient and outpatient services. National surveys report that inpatient rehabilitation for older people is a core function but there are large differences in key performance measures. We have investigated these variations in community hospital ward performance. Objectives (1) To measure the relative performance of community hospital wards (studies 1 and 2); (2) to identify characteristics of community hospital wards that optimise performance (studies 1 and 3); (3) to develop a web-based interactive toolkit that supports operational changes to optimise ward performance (study 4); (4) to investigate the impact of community hospital wards on secondary care use (study 5); and (5) to investigate associations between short-term community (intermediate care) services and secondary care utilisation (study 5). Methods Study 1 – we used national data to conduct econometric estimations using stochastic frontier analysis in which a cost function was modelled using significant predictors of community hospital ward costs. Study 2 – a national postal survey was developed to collect data from a larger sample of community hospitals. Study 3 – three ethnographic case studies were performed to provide insight into less tangible aspects of community hospital ward care. Study 4 – a web-based interactive toolkit was developed by integrating the econometrics (study 1) and case study (study 3) findings. Study 5 – regression analyses were conducted using data from the Atlas of Variation Map 61 (rate of emergency admissions to hospital for people aged ≥ 75 years with a length of stay of < 24 hours) and the National Audit of Intermediate Care. Results Community hospital ward efficiency is comparable with the NHS acute hospital sector (mean cost efficiency 0.83, range 0.72–0.92). The rank order of community hospital ward efficiencies was distinguished to facilitate learning across the sector. On average, if all community hospital wards were operating in line with the highest cost efficiency, savings of 17% (or £47M per year) could be achieved (price year 2013/14) for our sample of 101 wards. Significant economies of scale were found: a 1% rise in output was associated with an average 0.85% increase in costs. We were unable to obtain a larger community hospital sample because of the low response rate to our national survey. The case studies identified how rehabilitation was delivered through collaborative, interdisciplinary working; interprofessional communication; and meaningful patient and family engagement. We also developed insight into patients’ recovery trajectories and care transitions. The web-based interactive toolkit was established [http://mocha.nhsbenchmarking.nhs.uk/ (accessed 9 September 2019)]. The crisis response team type of intermediate care, but not community hospitals, had a statistically significant negative association with emergency admissions. Limitations The econometric analyses were based on cross-sectional data and were also limited by missing data. The low response rate to our national survey means that we cannot extrapolate reliably from our community hospital sample. Conclusions The results suggest that significant community hospital ward savings may be realised by improving modifiable performance factors that might be augmented further by economies of scale. Future work How less efficient hospitals might reduce costs and sustain quality requires further research. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 1. See the NIHR Journals Library website for further project information.

The Effect of Stress and Workload on Near Miss / KNC Events and Their Impacts on Nurse's Performance Inpatient Installation

The role of nurses is huge in conducting nursing care under the existing Standard Operational Procedure (SPO). If it complies with the established standards, then the incident almost injured or even the KNC did not occur. Job stress can occur in nursing care for patients. Workloads which include quantitative workloads, qualitative workloads, physical workloads, psychological workloads, social workloads. This study aims to determine the effect of work stress on nurses’ workload on the incidence of near injury / KNC and its impact on the performance of nurse’s inpatient installations. This type of research is quantitative research with a cross-sectional approach. The population is all nurses in the Inpatient Services at Kumala Siwi Kudus General Hospital. Sample 68 nurses, using total sampling. This type of research is quantitative research with a cross-sectional approach. Based on the data processing that has done, the results can be used to answer the hypothesis in this study. Hypothesis testing in this study was conducted by looking at the value of T-Statistics and the value of P-Values. The research hypothesis can be accepted if the P-Values value < 0.05. Hypothesis 1: Near Miss, Events Affecting Performance P Values 0.009 results are acceptable; Hypothesis 2 Stress affecting Near Miss Events/KNC P values result in 0.008. Hypothesis 3 Stress affecting performance P values 0,035 are acceptable.

Gambaran Rerata Kadar Kalsium Dan Fosfor Pada Pasien Yang Menjalani Hemodialisis Di Rumah Sakit Anna Medika Bekasi

Background: Chronic Kidney Disease (CKD) is a pathophysiological process with a diverse etiology, resulting in slow progressive kidney function. Hemodialysis is used as a therapy to replace deteriorating renal function. PGK has high mortality and morbidity, because it can cause various complications, one of the complications of PGK is the regulation of mineral settings, especially calcium and phosphate. Methods: The type of research in this study is descriptive quantitative with cross sectional study design. The population in this study were PGK patients undergoing hemodialysis at Anna Medika Bekasi Hospital. Sample selection using simple random sampling technique with condition to fulfill inclusion criteria. Secondary data retrieval (medical record). Results: From 55 samples were 32 patients (58.2%) with hypocalcemia category, 14 patients (25.4%) with normal calcium level, 9 patients (16.4%) with hypercalcemia category, 10 patients (18.2%) with hypophosphatemia category, 4 patients (7.3% ) with normal phosphorus levels and 41 patients (74.5%) by category. Of 32 patients (58.2%) hypocalcemia and 41 (74.5%) hyperphosphatemia which decreased calcium along with a rise in phosphorus by 22 patients (40%). Conclusion: In this study it was found that patients were more likely to have hypocalcemia and hyperphosphatemia. Less than half the patients had decreased levels of calcium along with elevated levels of phosphorus.