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[PMID]:29210185
[Au] Autor:Camlin CS; Charlebois ED; Geng E; Semitala F; Wallenta J; Getahun M; Kampiire L; Bukusi EA; Sang N; Kwarisiima D; Clark TD; Petersen ML; Kamya MR; Havlir DV
[Ad] Endereço:University of California, San Francisco, CA, USA.
[Ti] Título:Redemption of the "spoiled identity:" the role of HIV-positive individuals in HIV care cascade interventions.
[So] Source:J Int AIDS Soc;20(4), 2017 Dec.
[Is] ISSN:1758-2652
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The concept of "therapeutic citizenship" has drawn attention to ways in which public testimony, the "story-telling in the public sphere" undertaken by people living with HIV (PLHIV), has shaped the global response to the epidemic. This paper presents qualitative findings from two large studies in eastern Africa that reveal how the advent of population-based HIV testing campaigns and efforts to accelerate antiretroviral "treatment for all" has precipitated a rapidly expanding therapeutic citizenship "project," or social movement. The title of this paper refers to Goffman's original conceptualization of stigma as a social process through which a person's identity is rendered "spoiled." METHODS: Data were derived from qualitative studies embedded within two clinical trials, Sustainable East African Research in Community Health (SEARCH) (NCT# 01864603) in Kenya and Uganda, and START-ART (NCT# 01810289) in Uganda, which aimed to offer insights into the pathways through which outcomes across the HIV care continuum can be achieved by interventions deployed in the studies, any unanticipated consequences, and factors that influenced implementation. Qualitative in-depth semi-structured interviews were conducted among cohorts of adults in 2014 through 2015; across both studies and time periods, 217 interviews were conducted with 166 individuals. Theoretically informed, team-based analytic approaches were used for the analyses. RESULTS: Narratives from PLHIV, who have not always been conceptualized as actors but rather usually as targets of HIV interventions, revealed strongly emergent themes related to these individuals' use of HIV biomedical resources and discourses to fashion a new, empowered subjecthood. Experiencing the benefits of antiretroviral therapy (ART) emboldens many individuals to transform their "spoiled" identities to attain new, valorized identities as "advocates for ART" in their communities. We propose that the personal revelation of what some refer to as the "gospel of ARVs," the telling of personal stories about HIV in the public sphere and actions to accompany other PLHIV on their journey into care, is driven by its power to redeem the "spoiled identity:" it permits PLHIV to overcome self-stigma and regain full personhood within their communities. CONCLUSIONS: PLHIV are playing an unanticipated but vital role in the successful implementation of HIV care cascade interventions.
[Mh] Termos MeSH primário: Infecções por HIV/terapia
Papel do Doente
Estigma Social
[Mh] Termos MeSH secundário: Adulto
Grupo com Ancestrais do Continente Africano
Continuidade da Assistência ao Paciente
Feminino
Infecções por HIV/tratamento farmacológico
Infecções por HIV/psicologia
Seres Humanos
Quênia
Masculino
Meia-Idade
Quartos de Pacientes
Pesquisa Qualitativa
Identificação Social
Uganda
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.1002/jia2.25023


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[PMID]:25816380
[Au] Autor:Healy S; Manganelli J; Rosopa PJ; Brooks JO
[Ad] Endereço:Greenville Health System, Greenville, SC, USA.
[Ti] Título:An Exploration of the Nightstand and Over-the-Bed Table in an Inpatient Rehabilitation Hospital.
[So] Source:HERD;8(2):43-55, 2015.
[Is] ISSN:1937-5867
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: This study seeks to determine where patients in a rehabilitation hospital keep the greatest percentage of their belongings, that is, in/on the nightstand or on the over-the-bed table. BACKGROUND: This study provides an inventory of patient items located on the over-the-bed table and in/on the nightstand. Understanding the functions of furnishings within the patient room is key for future preparation for designing a next-generation over-the-bed table or for redesigning a more useful nightstand. METHODS: The contents on the top of the nightstand; the contents in the top, middle, and bottom drawers of the nightstand; items next to the nightstand; and the contents on the over-the-bed table within patient rooms were inventoried and placed into categories using similar, patient item categories as the Brooks et al. (2011) study, which examined the contents of the nightstand and the over-the-bed table in assisted living and skilled nursing facilities. RESULTS: Overall, patients in a rehabilitation hospital had a greater percentage of their belongings on the top of the nightstand as compared to their belongings located in all three combined drawers of the nightstand. Overall, patients had a greater percentage of their belongings located on the over-the-bed table as compared to their belongings located on the nightstand. CONCLUSIONS: Tabletop surface area was used extensively in patient rooms at a rehabilitation hospital, but nightstand drawers were underutilized.
[Mh] Termos MeSH primário: Pacientes Internados/psicologia
Decoração de Interiores e Mobiliário/normas
Quartos de Pacientes/normas
Centros de Reabilitação/normas
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Análise de Variância
Feminino
Seres Humanos
Decoração de Interiores e Mobiliário/estatística & dados numéricos
Masculino
Meia-Idade
Quartos de Pacientes/organização & administração
Quartos de Pacientes/estatística & dados numéricos
Centros de Reabilitação/organização & administração
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180126
[Lr] Data última revisão:
180126
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150328
[St] Status:MEDLINE
[do] DOI:10.1177/1937586714565612


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[PMID]:25816378
[Au] Autor:Locatelli SM; Turcios S; LaVela SL
[Ad] Endereço:Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL, USA Center for Evaluation of Practices and Experiences of Patient-Centered Care, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL, USA sara.locatelli@va.gov.
[Ti] Título:Optimizing the patient-centered environment: results of guided tours with health care providers and employees.
[So] Source:HERD;8(2):18-30, 2015.
[Is] ISSN:1937-5867
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To examine providers' perspectives on the care environment and patient-centered care (PCC) through the eyes of the veteran patient, using guided tours qualitative methodology. BACKGROUND: Environmental factors, such as attractiveness and function, have the potential to improve patients' experiences. Participatory qualitative methods allow researchers to explore the environment and facilitate discussion. METHODS: Guided tours were conducted with 25 health care providers/employees at two Veterans Affairs (VA) health care facilities. In guided tours, participants lead the researcher through an environment, commenting on their surroundings, thoughts, and feelings. The researcher walks along with the participant, asking open-ended questions as needed to foster discussion and gain an understanding of the participant's view. Participants were asked to walk through the facility as though they were a veteran. Tours were audio recorded, with participant permission, and transcribed verbatim by research assistants. Three qualitative researchers were responsible for codebook development and coding transcripts and used data-driven coding approaches. RESULTS: Participants discussed physical appearance of the environment and how that influences perceptions about care. Overall, participants highlighted the need to shed the "institutional" appearance. Differences between VA and non-VA health care facilities were discussed, including availability of private rooms and staff to assist with navigating the facility. They reviewed resources in the facility, such as the information desk to assist patients and families. Finally, they offered suggestions for future improvements, including improvements to waiting areas and quiet areas for patients to relax and "get away" from their rooms. CONCLUSIONS: Participants highlighted many small changes to the care environment that could enhance the patient experience. Additionally, they examined the environment from the patient's perspective, to identify elements that enhance, or detract from, the patient's care experience.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Pessoal de Saúde/psicologia
Hospitais de Veteranos/normas
Decoração de Interiores e Mobiliário/normas
Assistência Centrada no Paciente/normas
Quartos de Pacientes/normas
[Mh] Termos MeSH secundário: Adulto
Feminino
Hospitais de Veteranos/organização & administração
Seres Humanos
Entrevistas como Assunto
Diretórios de Sinalização e Localização/normas
Masculino
Assistência Centrada no Paciente/métodos
Assistência Centrada no Paciente/organização & administração
Quartos de Pacientes/organização & administração
Pesquisa Qualitativa
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180126
[Lr] Data última revisão:
180126
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150328
[St] Status:MEDLINE
[do] DOI:10.1177/1937586714565610


  4 / 2358 MEDLINE  
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[PMID]:25816185
[Au] Autor:Manganelli J; Threatt A; Brooks JO; Healy S; Merino J; Yanik P; Walker I; Green K
[Ti] Título:Confirming, Classifying, and Prioritizing Needed Over-the-Bed Table Improvements via Methodological Triangulation.
[So] Source:HERD;8(1):94-114, 2014.
[Is] ISSN:1937-5867
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: This article presents the results of a qualitative study that confirmed, classified, and prioritized user needs for the design of a more useful, usable, and actively assistive over-the-bed table. BACKGROUND: Manganelli et al. (2014) generated a list of 74 needs for use in developing an actively assistive over-the-bed table. This present study assesses the value and importance of those needs. METHODS: Fourteen healthcare subject matter experts and eight research and design subject matter experts engaged in a participatory and iterative research and design process. A mixed methods qualitative approach used methodological triangulation to confirm the value of the findings and ratings to establish importance. Open and closed card sorts and a Delphi study were used. Data analysis methods included frequency analysis, content analysis, and a modified Kano analysis. RESULTS: A table demonstrating the needs that are of high importance to both groups of subject matter experts and classification of the design challenges each represents was produced. Through this process, the list of 74 needs was refined to the 37 most important need statements for both groups. CONCLUSIONS: Designing a more useful, usable, and actively assistive over-the-bed table is primarily about the ability to position it optimally with respect to the user for any task, as well as improving ease of use and usability. It is also important to make explicit and discuss the differences in priorities and perspectives demonstrated between research and design teams and their clients.
[Mh] Termos MeSH primário: Decoração de Interiores e Mobiliário/instrumentação
Decoração de Interiores e Mobiliário/métodos
Quartos de Pacientes
[Mh] Termos MeSH secundário: Técnica Delfos
Seres Humanos
Nigéria
Pesquisa Qualitativa
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150328
[St] Status:MEDLINE
[do] DOI:10.1177/193758671400800108


  5 / 2358 MEDLINE  
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[PMID]:28468641
[Au] Autor:Dale KD; Tay EL; Trauer JM; Trevan PG; Denholm JT
[Ad] Endereço:Victorian Tuberculosis Program, The Peter Doherty Institute for Infection and Immunity, Victoria, Australia. katie.dale@mh.org.au.
[Ti] Título:Comparing tuberculosis management under public and private healthcare providers: Victoria, Australia, 2002-2015.
[So] Source:BMC Infect Dis;17(1):324, 2017 05 03.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Private healthcare providers are important to tuberculosis (TB) management globally, although internationally there are reports of suboptimal management and disparities in treatment commencement in the private sector. We compared the management of TB patients receiving private versus public healthcare in Victoria, an industrialised setting with low tuberculosis (TB) incidence. METHODS: Retrospective cohort study: 2002-2015. Private healthcare provision was included as an independent variable in several multivariate logistic and Cox proportional hazard regression models that assessed a range of outcome variables, encompassing treatment commencement delays, management and treatment outcomes. RESULTS: Of 5106 patients, 275 (5.4%) exclusively saw private providers, and 4714 (92.32%) public. Private care was associated with a shorter delay to presentation (HR 1.36, p = 0.065, 95% CI 1.02-2.00). Private patients were less likely to have genotypic testing (OR 0.66, p = 0.009, 95% CI 0.48-0.90), those with pulmonary involvement were less likely to have a sputum smear (OR 0.52, p = 0.011, 95% CI 0.31-0.86) and provided samples were less likely to be positive (OR 0.54, p = 0.070, 95% CI 0.27-1.05). Private patients with extrapulmonary TB were less likely to have a smear sample (OR 0.7, 95% CI 0.48-0.90, p = 0.009) and radiological abnormalities (OR 0.71, p = 0.070, 95% CI 0.27-1.05). Treatment commencement delays from presentation were comparable for cases with pulmonary involvement and extrapulmonary TB, although public extrapulmonary TB patients received radiological examinations slightly earlier than private patients (HR 0.79, p = 0.043, 95% CI 0.63-0.99) and public patients with pulmonary involvement from high burden settings commenced treatment following an abnormal CXR more promptly than their private counterparts (HR 0.41, p = 0.011, 95% CI 0.21-0.81). Private patients were more likely to receive <4 first-line medications (OR 2.17, p = 0.001, 95% CI 1.36-3.46), but treatment outcomes were comparable between sectors. CONCLUSIONS: The differences we identified are likely to reflect differing case-mix as well as clinician practice. Sputum smear status was an important covariable in our analysis; with its addition we found no significant disparity in the health-system delay to treatment commencement between sectors. Our study highlights the importance of TB programs engaging with private providers, enabling comprehensive data collection that is necessary for thorough and true comparison of TB management and optimisation of care.
[Mh] Termos MeSH primário: Setor Privado/estatística & dados numéricos
Setor Público/estatística & dados numéricos
Tuberculose/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Feminino
Pessoal de Saúde
Seres Humanos
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Quartos de Pacientes
Modelos de Riscos Proporcionais
Estudos Retrospectivos
Escarro/microbiologia
Tuberculose/epidemiologia
Tuberculose/mortalidade
Tuberculose Pulmonar/tratamento farmacológico
Tuberculose Pulmonar/mortalidade
Vitória
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180120
[Lr] Data última revisão:
180120
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-017-2421-x


  6 / 2358 MEDLINE  
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[PMID]:29045423
[Au] Autor:Vena A; Bouza E; Valerio M; Padilla B; Paño-Pardo JR; Fernández-Ruiz M; Díaz Martín A; Salavert M; Mularoni A; Puig-Asensio M; Muñoz P; CANDIPOP Project
[Ad] Endereço:Clinical Microbiology and Infectious Disease Division, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
[Ti] Título:Candidemia in non-ICU surgical wards: Comparison with medical wards.
[So] Source:PLoS One;12(10):e0185339, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Candidemia acquired outside critical care or hematological areas has received much attention in recent years; however, data on candidemia in surgical departments are very scarce. Our objectives were to describe episodes of candidemia diagnosed in surgical wards and to compare them with episodes occurring in medical wards. We performed a post hoc analysis of a prospective, multicenter study implemented in Spain during 2010-2011 (CANDIPOP project). Of the 752 episodes of candidemia, 369 (49.1%) occurred in patients admitted to surgical wards (165, 21.9%) or medical wards (204, 27.2%). Clinical characteristics associated with surgical patients were solid tumor as underlying disease, recent surgery, indwelling CVC, and parenteral nutrition. Candidemia was more commonly related to a CVC in the surgical than in the medical wards. The CVC was removed more frequently and early management was more appropriate within 48 hours of blood sampling in the surgical patients. Overall, 30-day mortality in the surgical departments was significantly lower than in medical wards (37.7% vs. 15.8%, p<0.001). Multivariate analysis revealed admission to a surgical ward and appropriate early management of candidemia as factors independently associated with a better outcome. We found that approximately 50% of episodes of candidemia occurred in non-hematological patients outside the ICU and that clinical outcome was better in patients admitted to surgical wards than in those hospitalized in medical wards. These findings can be explained by the lower severity of underlying disease, prompt administration of antifungal therapy, and central venous catheter removal.
[Mh] Termos MeSH primário: Candidemia/epidemiologia
Unidades de Terapia Intensiva
Quartos de Pacientes/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Idoso
Demografia
Feminino
Hospitalização
Seres Humanos
Modelos Logísticos
Masculino
Análise Multivariada
Fatores de Risco
Procedimentos Cirúrgicos Operatórios/mortalidade
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171019
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185339


  7 / 2358 MEDLINE  
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[PMID]:28981515
[Au] Autor:Joshi R; Mortel HV; Feijs L; Andriessen P; Pul CV
[Ad] Endereço:Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands.
[Ti] Título:The heuristics of nurse responsiveness to critical patient monitor and ventilator alarms in a private room neonatal intensive care unit.
[So] Source:PLoS One;12(10):e0184567, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:AIM: Alarm fatigue is a well-recognized patient safety concern in intensive care settings. Decreased nurse responsiveness and slow response times to alarms are the potentially dangerous consequences of alarm fatigue. The aim of this study was to determine the factors that modulate nurse responsiveness to critical patient monitor and ventilator alarms in the context of a private room neonatal intensive care setting. METHODS: The study design comprised of both a questionnaire and video monitoring of nurse-responsiveness to critical alarms. The Likert scale questionnaire, comprising of 50 questions across thematic clusters (critical alarms, yellow alarms, perception, design, nursing action, and context) was administered to 56 nurses (90% response rate). Nearly 6000 critical alarms were recorded from 10 infants in approximately 2400 hours of video monitoring. Logistic regression was used to identify patient and alarm-level factors that modulate nurse-responsiveness to critical alarms, with a response being defined as a nurse entering the patient's room within the 90s of the alarm being generated. RESULTS: Based on the questionnaire, the majority of nurses found critical alarms to be clinically relevant even though the alarms did not always mandate clinical action. Based on video observations, for a median of 34% (IQR, 20-52) of critical alarms, the nurse was already present in the room. For the remaining alarms, the response rate within 90s was 26%. The median response time was 55s (IQR, 37-70s). Desaturation alarms were the most prevalent and accounted for more than 50% of all alarms. The odds of responding to bradycardia alarms, compared to desaturation alarms, were 1.47 (95% CI = 1.21-1.78; <0.001) while that of responding to a ventilator alarm was lower at 0.35 (95% CI = 0.27-0.46; p <0.001). For every 20s increase in the duration of an alarm, the odds of responding to the alarm (within 90s) increased to 1.15 (95% CI = 1.1-1.2; p <0.001). The random effect per infant improved the fit of the model to the data with the response times being slower for infants suffering from chronic illnesses while being faster for infants who were clinically unstable. DISCUSSION: Even though nurses respond to only a fraction of all critical alarms, they consider the vast majority of critical and yellow alarms as useful and relevant. When notified of a critical alarm, they seek waveform information and employ heuristics in determining whether or not to respond to the alarm. CONCLUSION: Amongst other factors, the category and duration of critical alarms along with the clinical status of the patient determine nurse-responsiveness to alarms.
[Mh] Termos MeSH primário: Alarmes Clínicos
Unidades de Terapia Intensiva Neonatal
Monitorização Fisiológica/enfermagem
Segurança do Paciente
Quartos de Pacientes
Respiração Artificial/enfermagem
[Mh] Termos MeSH secundário: Heurística
Seres Humanos
Lactente
Recém-Nascido
Terapia Intensiva Neonatal
Tempo de Reação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171022
[Lr] Data última revisão:
171022
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171006
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0184567


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[PMID]:28885136
[Au] Autor:Jiang L; Ng HL; Ho HJ; Leo YS; Prem K; Cook AR; Chen MI
[Ad] Endereço:Saw Swee Hock School of Public Health, National University of Singapore and National University Health System,Singapore,Singapore.
[Ti] Título:Contacts of healthcare workers, patients and visitors in general wards in Singapore.
[So] Source:Epidemiol Infect;145(14):3085-3095, 2017 10.
[Is] ISSN:1469-4409
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:To characterize contacts in general wards, a prospective survey of healthcare workers (HCWs), patients and visitors was conducted using self-reported diary, direct observation and telephone interviews. Nurses, doctors and assorted HCWs reported a median of 14, 18 and 15 contact persons over one work shift, respectively. Within 1 h, we observed 3·5 episodes with 25·6 min of cumulative contact time for nurses, 2·9 episodes and 22·1 min for doctors and 5·0 episodes with 44·3 min for assorted-HCWs. In interactions with patients, nurses had multiple brief episodes of contact; doctors had fewer episodes and less cumulative contact time; assorted-HCWs had fewer contact episodes of longer durations (than for nurses and doctors). Assortative mixing occurred amongst HCWs: those of the same HCW type were the next most frequent class of contact after patients. Over 24-h, patients contacted 14 persons with 23 episodes and 314·5 min of contact time. Patient-to-patient contact episodes were rare, but a maximum of five were documented from one patient participant. 22·9% of visitors reported contact with patients other than the one they visited. Our study revealed differences in the characteristics of contacts among different HCW types and potential transmission routes from patients to others within the ward environment.
[Mh] Termos MeSH primário: Quartos de Pacientes/estatística & dados numéricos
Pacientes/estatística & dados numéricos
Recursos Humanos em Hospital/estatística & dados numéricos
Centros de Atenção Terciária
Visitas a Pacientes/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Infecção Hospitalar/transmissão
Feminino
Seres Humanos
Masculino
Meia-Idade
Modelos Teóricos
Estudos Prospectivos
Singapura
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171125
[Lr] Data última revisão:
171125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170909
[St] Status:MEDLINE
[do] DOI:10.1017/S0950268817002035


  9 / 2358 MEDLINE  
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[PMID]:28834937
[Au] Autor:Hollenback R; Simpson A; Mueller L
[Ad] Endereço:At Penrose Hospital in Colorado Springs, Colo., Robert Hollenback is the clinical manager of the gastroenterology lab, Audrey Simpson is the clinical nurse educator for medical/surgical units, and Linda Mueller is the permanent charge nurse.
[Ti] Título:Falls simulation room: Do you see what your patient sees?
[So] Source:Nursing;47(9):65-67, 2017 09.
[Is] ISSN:1538-8689
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Acidentes por Quedas/prevenção & controle
Simulação por Computador
Recursos Humanos de Enfermagem/educação
Quartos de Pacientes
[Mh] Termos MeSH secundário: Seres Humanos
Pesquisa em Educação de Enfermagem
Pesquisa em Avaliação de Enfermagem
Pesquisa Metodológica em Enfermagem
Medição de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170824
[St] Status:MEDLINE
[do] DOI:10.1097/01.NURSE.0000522020.45924.3a


  10 / 2358 MEDLINE  
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[PMID]:28750010
[Au] Autor:Tiruvoipati R; Botha J; Fletcher J; Gangopadhyay H; Majumdar M; Vij S; Paul E; Pilcher D; Australia and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group
[Ad] Endereço:Department of Intensive Care Medicine, Frankston Hospital, Frankston, Victoria, Australia.
[Ti] Título:Intensive care discharge delay is associated with increased hospital length of stay: A multicentre prospective observational study.
[So] Source:PLoS One;12(7):e0181827, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Some patients experience a delayed discharge from the intensive care unit (ICU) where the intended and actual discharge times do not coincide. The clinical implications of this remain unclear. OBJECTIVE: To determine the incidence and duration of delayed ICU discharge, identify the reasons for delay and evaluate the clinical consequences. METHODS: Prospective multi-centre observational study involving five ICUs over a 3-month period. Delay in discharge was defined as >6 hours from the planned discharge time. The primary outcome measure was hospital length stay after ICU discharge decision. Secondary outcome measures included ICU discharge after-hours, incidence of delirium, survival to hospital discharge, discharge destination, the incidence of ICU acquired infections, revocation of ICU discharge decision, unplanned readmissions to ICU within 72 hours, review of patients admitting team after ICU discharge decision. RESULTS: A total of 955 out of 1118 patients discharged were included in analysis. 49.9% of the patients discharge was delayed. The most common reason (74%) for delay in discharge was non-availability of ward bed. The median duration of the delay was 24 hours. On univariable analysis, the duration of hospital stay from the time of ICU discharge decision was significantly higher in patients who had ICU discharge delay (Median days-5 vs 6; p = 0.003). After-hours discharge was higher in patients whose discharge was delayed (34% Vs 10%; p<0.001). There was no statistically significant difference in the other secondary outcomes analysed. Multivariable analysis adjusting for known confounders revealed delayed ICU discharge was independently associated with increased hospital length of stay. CONCLUSION: Half of all ICU patients experienced a delay in ICU discharge. Delayed discharge was associated with increased hospital length of stay.
[Mh] Termos MeSH primário: Unidades de Terapia Intensiva
Tempo de Internação
Alta do Paciente
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Criança
Delírio/epidemiologia
Feminino
Seres Humanos
Incidência
Masculino
Meia-Idade
Quartos de Pacientes
Estudos Prospectivos
Fatores de Tempo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171009
[Lr] Data última revisão:
171009
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0181827



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