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[PMID]:28904696
[Au] Autor:Odhiambo J; Rwabukwisi FC; Rusangwa C; Rusanganwa V; Hirschhorn LR; Nahimana E; Ngamije P; Hedt-Gauthier BL
[Ad] Endereço:Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda.
[Ti] Título:Health worker attrition at a rural district hospital in Rwanda: a need for improved placement and retention strategies.
[So] Source:Pan Afr Med J;27:168, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The shortage and maldistribution of health care workers in sub-Saharan Africa is a major concern for rural health facilities. Rural areas have 63% of sub-Saharan Africa population but only 37% of its doctors. Although attrition of health care workers is implicated in the human resources for health crisis in the rural settings, few studies report attrition rates and risk factors for attrition in rural district hospitals in sub-Saharan Africa. METHODS: We assessed attrition of health care workers at a Kirehe District Hospital in rural Rwanda. We included all hospital staff employed as of January 1, 2013 in this retrospective cohort study. We report the proportion of staff that left employment during 2013, and used a logistic regression to assess individual characteristics associated with attrition. RESULTS: Of the 142 staff employed at Kirehe District Hospital at the start of 2013, 31.7% (n=45) of all staff and 81.8% (n=9) of doctors left employment in 2013. Being a doctor (OR=10.0, 95% CI: 1.9-52.1, p=0.006) and having up to two years of experience at the hospital (OR=5.3, 95% CI: 1.3-21.7, p=0.022) were associated with attrition. CONCLUSION: Kirehe District Hospital experienced high attrition rates in 2013, particularly among doctors. Opportunities for further training through Rwanda's Human Resources for Health program in 2013 and a two-year compulsory service program for doctors that is not linked to interventions for rural retention may have driven these patterns. Efforts to link these programs with rural placement and retention strategies are recommended.
[Mh] Termos MeSH primário: Emprego/estatística & dados numéricos
Hospitais de Distrito/recursos humanos
Reorganização de Recursos Humanos/estatística & dados numéricos
Recursos Humanos em Hospital/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Estudos de Coortes
Feminino
Seres Humanos
Modelos Logísticos
Masculino
Corpo Clínico Hospitalar/estatística & dados numéricos
Estudos Retrospectivos
Serviços de Saúde Rural/recursos humanos
Serviços de Saúde Rural/organização & administração
Ruanda
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170915
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.168.11943


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[PMID]:28674586
[Au] Autor:Ngaroua; Eloundou NJ; Djibrilla Y; Asmaou O; Mbo AJ
[Ad] Endereço:Service de Chirurgie, Hôpital Régional de Ngaoundéré, Cameroun.
[Ti] Título:[Epidemiological, clinical aspects and management of urethral stenosis in adult patients in a District Hospital in Ngaoundéré, Cameroon].
[Ti] Título:Aspects épidémiologiques, cliniques et prise en charge de sténose urétrale chez l'adulte dans un Hôpital de District de Ngaoundéré, Cameroun..
[So] Source:Pan Afr Med J;26:193, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:fre
[Ab] Resumo:INTRODUCTION: The aim was to determine the epidemiological, clinical aspects and the management of these patients in Ngaoundere Protestant Hospital (HPN). METHODS: We conducted a retrospective review of complete medical records of patients hospitalized for urethral stenosis in the Department of Urology at the Protestant Hospital of Ngaoundéré over a one-year period (January 2013 to January 2014). RESULTS: Out of 69 registered medical records, a total of 57 patients files (all male) were identified for review. The average age was 52.6 (19 -85 years). The most represented age group was 41-60 years. Urethral stenosis accounted for 0.6% of consultations, 11.36 % of surgical hospitalizations and 6.96% of surgical procedures. Dysuria (70, 17%) was the main reason for consultation. Etiologies included infections (52,63%), traumas (26.32%) and iatrogenic problems (21.05%). All patients underwent CBEU which allowed to isolate gonococci (14,03%) and Escherichia coli (21.05%), the remainder of the urine culture was sterile (64.91%). 28 patients (49.12%) underwent retrograde uretrocystography (RUC), of whom 26 with anterior stenosis (92,85%). Internal endoscopic urethrotomy (IEU) was the most common surgical procedure (58%). Stenosis mainly occurred at the level of the bulbar and peno-bulbar regions. The rate of healing was 87,73% vs 12.27% of recurrences. CONCLUSION: Urethral stenosis is frequent in the Protestant Hospital of Ngaoundéré; patients requiring medical consultations are often in complex medical conditions. Internal endoscopic urethrotomy has shown plausible results.
[Mh] Termos MeSH primário: Disuria/epidemiologia
Endoscopia/métodos
Estreitamento Uretral/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Camarões/epidemiologia
Cistografia/métodos
Disuria/etiologia
Hospitais de Distrito
Seres Humanos
Masculino
Meia-Idade
Recidiva
Estudos Retrospectivos
Estreitamento Uretral/etiologia
Estreitamento Uretral/cirurgia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170717
[Lr] Data última revisão:
170717
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170705
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.26.193.9669


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[PMID]:28388951
[Au] Autor:Hategeka C; Mwai L; Tuyisenge L
[Ad] Endereço:ETAT+ Program, Rwanda Paediatric Association, Kigali, Rwanda. celestin.hategeka@alumni.ubc.ca.
[Ti] Título:Implementing the Emergency Triage, Assessment and Treatment plus admission care (ETAT+) clinical practice guidelines to improve quality of hospital care in Rwandan district hospitals: healthcare workers' perspectives on relevance and challenges.
[So] Source:BMC Health Serv Res;17(1):256, 2017 Apr 07.
[Is] ISSN:1472-6963
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: An emergency triage, assessment and treatment plus admission care (ETAT+) intervention was implemented in Rwandan district hospitals to improve hospital care for severely ill infants and children. Many interventions are rarely implemented with perfect fidelity under real-world conditions. Thus, evaluations of the real-world experiences of implementing ETAT+ are important in terms of identifying potential barriers to successful implementation. This study explored the perspectives of Rwandan healthcare workers (HCWs) on the relevance of ETAT+ and documented potential barriers to its successful implementation. METHODS: HCWs enrolled in the ETAT+ training were asked, immediately after the training, their perspective regarding (i) relevance of the ETAT+ training to Rwandan district hospitals; (ii) if attending the training would bring about change in their work; and (iii) challenges that they encountered during the training, as well as those they anticipated to hamper their ability to translate the knowledge and skills learned in the ETAT+ training into practice in order to improve care for severely ill infants and children in their hospitals. They wrote their perspectives in French, Kinyarwanda, or English and sometimes a mixture of all these languages that are official in the post-genocide Rwanda. Their notes were translated to (if not already in) English and transcribed, and transcripts were analyzed using thematic content analysis. RESULTS: One hundred seventy-one HCWs were included in our analysis. Nearly all these HCWs stated that the training was highly relevant to the district hospitals and that it aligned with their work expectation. However, some midwives believed that the "neonatal resuscitation and feeding" components of the training were more relevant to them than other components. Many HCWs anticipated to change practice by initiating a triage system in their hospital and by using job aids including guidelines for prescription and feeding. Most of the challenges stemmed from the mode of the ETAT+ training delivery (e.g., language barriers, intense training schedule); while others were more related to uptake of guidelines in the district hospitals (e.g., staff turnover, reluctance to change, limited resources, conflicting protocols). CONCLUSION: This study highlights potential challenges to successful implementation of the ETAT+ clinical practice guidelines in order to improve quality of hospital care in Rwandan district hospitals. Understanding these challenges, especially from HCWs perspective, can guide efforts to improve uptake of clinical practice guidelines including ETAT+ in Rwanda.
[Mh] Termos MeSH primário: Medicina de Emergência/educação
Serviço Hospitalar de Emergência/normas
Triagem/métodos
[Mh] Termos MeSH secundário: Criança
Competência Clínica/normas
Educação Médica/métodos
Feminino
Hospitais de Distrito/normas
Seres Humanos
Lactente
Masculino
Corpo Clínico Hospitalar/educação
Corpo Clínico Hospitalar/normas
Reorganização de Recursos Humanos/estatística & dados numéricos
Guias de Prática Clínica como Assunto
Qualidade da Assistência à Saúde/normas
Ressuscitação/métodos
Ressuscitação/normas
Ruanda
Triagem/normas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170815
[Lr] Data última revisão:
170815
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170409
[St] Status:MEDLINE
[do] DOI:10.1186/s12913-017-2193-4


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[PMID]:28384148
[Au] Autor:Liu Q; Ranta AA; Abernethy G; Barber PA
[Ad] Endereço:Trainee Intern, Departments of Neurology, Auckland City Hospital and University of Auckland.
[Ti] Título:Provision of stroke thrombolysis services in New Zealand: changes between 2011 and 2016.
[So] Source:N Z Med J;130(1453):57-62, 2017 Apr 07.
[Is] ISSN:1175-8716
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:AIMS: To obtain an overall picture of the organisation of stroke thrombolysis provision in New Zealand hospitals and compare changes between 2011 and 2016. METHODS: Surveys were distributed to all New Zealand district health boards (DHBs) in 2011 and 2016, and included questions about the infrastructure, staffing, training, guidelines and audit provided for stroke thrombolysis. RESULTS: Responses were received from all DHBs, with 86% offering stroke thrombolysis in 2011 and 100% in 2016. In 2016, thrombolysis rosters of large DHBs (those with a population >250,000 people) had a mean (range) of 14 (5-34) clinicians, approximately double that of medium-sized DHBs (population 125-250,000) who had eight (3-15) and small DHBs (population <125,000) with seven, (2-13) clinicians. While a similar distribution of senior medical officer clinical specialty was seen across medium and small DHBs in both years, large DHBs in 2016 had a higher number of neurologists (5, 1-12) and an increasing number of general physicians (8, 0-30) rostered to provide thrombolysis compared to 2011. Thrombolysis services at medium and small DHBs are chiefly managed by general physicians and geriatricians, while telestroke support was only available in three medium-sized DHBs. In 2016, all hospitals had developed thrombolysis guidelines and audited thrombolysed patients in the National Stroke Thrombolysis Register, which is an improvement compared with 2011 when only seven (39%) DHBs reported regular audit. Challenges in staffing and training remain greatest in smaller and geographically isolated DHBs. CONCLUSION: While there have been improvements in the provision of stroke thrombolysis throughout New Zealand, regional variations in service quality remains. The needs for better solutions to geographical barriers and formal training must be addressed as priorities.
[Mh] Termos MeSH primário: Isquemia Encefálica/tratamento farmacológico
Fibrinolíticos/uso terapêutico
Acesso aos Serviços de Saúde/tendências
Hospitais de Distrito/organização & administração
Corpo Clínico Hospitalar/organização & administração
Acidente Vascular Cerebral/tratamento farmacológico
[Mh] Termos MeSH secundário: Plantão Médico/tendências
Isquemia Encefálica/complicações
Fibrinolíticos/efeitos adversos
Clínicos Gerais/educação
Clínicos Gerais/provisão & distribuição
Acesso aos Serviços de Saúde/organização & administração
Hospitais de Distrito/tendências
Seres Humanos
Auditoria Médica/tendências
Corpo Clínico Hospitalar/educação
Corpo Clínico Hospitalar/tendências
Neurologistas/educação
Neurologistas/provisão & distribuição
Nova Zelândia
Política Organizacional
Admissão e Escalonamento de Pessoal
Guias de Prática Clínica como Assunto
Acidente Vascular Cerebral/etiologia
Telemedicina/tendências
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Fibrinolytic Agents)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170418
[Lr] Data última revisão:
170418
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170407
[St] Status:MEDLINE


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[PMID]:28384144
[Au] Autor:Keet O; Chisholm S; Goodson J; Browne T
[Ad] Endereço:Intensive Care, Tauranga Hospital, Tauranga.
[Ti] Título:A retrospective observational study of mortality rates in elderly patients with shock in a New Zealand district hospital ICU.
[So] Source:N Z Med J;130(1453):29-34, 2017 Apr 07.
[Is] ISSN:1175-8716
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:AIM: Admitting very elderly, critically ill patients to ICU is controversial. We compared our mortality data in a subgroup of elderly patients to internationally published outcomes. METHODS: Tauranga Hospital ICU retrospectively investigated their mortality outcomes for patients with septic shock. The ANZICS adult database (AORTIC), Tauranga Hospital computer records and medical records were used to identify the study cohort and provide information on demographics, admission times and shock types between January 2009 and December 2014. Patients were divided into groups; not old (<74 years), old (75-84 years) and very old (>85 years) to compare survival statistics at ICU discharge, hospital discharge, 28 days, six months and 12 months. RESULTS: Patients in the >85 year group at Tauranga ICU had a 38.5% survival. CONCLUSION: With careful selection, elderly patients with septic shock may have an acceptable outcome.
[Mh] Termos MeSH primário: Hospitais de Distrito/estatística & dados numéricos
Unidades de Terapia Intensiva/estatística & dados numéricos
Choque Séptico/mortalidade
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Bases de Dados Factuais
Feminino
Seres Humanos
Masculino
Nova Zelândia/epidemiologia
Alta do Paciente/estatística & dados numéricos
Estudos Retrospectivos
Choque Cardiogênico/mortalidade
Taxa de Sobrevida
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1704
[Cu] Atualização por classe:171114
[Lr] Data última revisão:
171114
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170407
[St] Status:MEDLINE


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[PMID]:28335406
[Au] Autor:Caggiano S; Ullmann N; De Vitis E; Trivelli M; Mariani C; Podagrosi M; Ursitti F; Bertolaso C; Putotto C; Unolt M; Pietravalle A; Pansa P; Mphayokulela K; Lemmo MI; Mkwambe M; Kazaura J; Duse M; Nieddu F; Azzari C; Cutrera R
[Ad] Endereço:Respiratory Unit, Bambino Gesù Children's Hospital, 00165 Rome, Italy. serena.caggiano@opbg.net.
[Ti] Título:Factors That Negatively Affect the Prognosis of Pediatric Community-Acquired Pneumonia in District Hospital in Tanzania.
[So] Source:Int J Mol Sci;18(3), 2017 Mar 13.
[Is] ISSN:1422-0067
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:Community-acquired pneumonia (CAP) is still the most important cause of death in countries with scarce resources. All children (33 months ± 35 DS) discharged from the Pediatric Unit of Itigi Hospital, Tanzania, with a diagnosis of CAP from August 2014 to April 2015 were enrolled. Clinical data were gathered. Dried blood spot (DBS) samples for quantitative real-time polymerase chain reaction (PCR) for bacterial detection were collected in all 100 children included. Twenty-four percent of patients were identified with severe CAP and 11% died. Surprisingly, 54% of patients were admitted with a wrong diagnosis, which increased complications, the need for antibiotics and chest X-rays, and the length of hospitalization. Comorbidity, found in 32% of children, significantly increased severity, complications, deaths, need for chest X-rays, and oxygen therapy. Malnourished children (29%) required more antibiotics. Microbiologically, Streptococcus pneumonia (S. p.), Haemophilus influenza type b (Hib) and Staphylococcus aureus (S. a.) were the bacteria more frequently isolated. Seventy-five percent of patients had mono-infection. Etiology was not correlated with severity, complications, deaths, oxygen demand, or duration of hospitalization. Our study highlights that difficult diagnoses and comorbidities negatively affect clinical evolution. S. p. and Hib still play a large role; thus, implementation of current vaccine strategies is needed. DBS is a simple and efficient diagnostic method for bacterial identification in countries with scarce resources.
[Mh] Termos MeSH primário: Infecções Comunitárias Adquiridas/epidemiologia
Hospitais de Distrito
Pneumonia Bacteriana/epidemiologia
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Infecções Comunitárias Adquiridas/diagnóstico
Infecções Comunitárias Adquiridas/microbiologia
Infecções Comunitárias Adquiridas/mortalidade
Comorbidade
Feminino
Seres Humanos
Lactente
Recém-Nascido
Tempo de Internação
Masculino
Fenótipo
Pneumonia Bacteriana/diagnóstico
Pneumonia Bacteriana/microbiologia
Pneumonia Bacteriana/mortalidade
Prognóstico
Fatores de Risco
Índice de Gravidade de Doença
Tanzânia/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170420
[Lr] Data última revisão:
170420
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170325
[St] Status:MEDLINE


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[PMID]:28330467
[Au] Autor:Ambikile JS; Iseselo MK
[Ad] Endereço:Department of Clinical Nursing, Muhimbili University of Health & Allied Sciences (MUHAS), P.O. Box 65004, Dar es Salaam, Tanzania. joelambikile@yahoo.com.
[Ti] Título:Mental health care and delivery system at Temeke hospital in Dar es Salaam, Tanzania.
[So] Source:BMC Psychiatry;17(1):109, 2017 Mar 23.
[Is] ISSN:1471-244X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Low and middle income countries face many challenges in meeting mental health needs in their regions. Treatment of patients with mental disorders is inadequate in most of these countries and majority of individuals with severe mental disorders remain untreated. The bad news is that mental health problems in these countries are on the rise due to socioeconomic challenges being faced. Regardless of guidelines and directives provided by WHO for organizing mental health services, these countries continue to face many challenges in the effort to cater for mental health needs. Such challenges include lack of human resource for mental health especially at primary health care level, inadequate training of human resource for mental health, misplacement of human resource for mental health, lack of drugs, wrong priorities, problematic insurance coverage for mental disorders, and stigma. This study aimed at exploring mental health care and delivery system at Temeke district hospital, and how services were organized to meet the increasing mental health needs of its population. METHODS: A qualitative study was conducted at Temeke hospital in Dar es Salaam, involving 7 in-depth interviews with mental health care providers, 7 in-depth interviews with mentally ill patients, and 2 focus group discussions with caregivers. A convenient sampling procedure was used to select participants for the study. All interviews were audio-recorded in Kiswahili and transcribed. A qualitative Content Analysis was used to analyze data after translation with the aid of Nvivo 10 software. RESULTS: Three main themes were identified. These were resource challenges, environmental/system challenges, and satisfaction with mental health services. Temeke health facility faced resource and environmental/system challenges, and there were mixed feelings on satisfaction with services. Funding and priority issues were found to mainly affect delivery of appropriate services to clients. CONCLUSION: Health facilities that provide mental health services in the community need to be well equipped with necessary resources to meet the vast needs of people they serve. Having a political will, improving the health systems governance for mental health, and priority setting, are necessary to address the challenges experienced in the delivery of mental health services.
[Mh] Termos MeSH primário: Assistência à Saúde/estatística & dados numéricos
Países em Desenvolvimento
Transtornos Mentais/terapia
Serviços de Saúde Mental/provisão & distribuição
[Mh] Termos MeSH secundário: Estudos Transversais
Feminino
Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos
Hospitais de Distrito
Seres Humanos
Masculino
Transtornos Mentais/diagnóstico
Transtornos Mentais/epidemiologia
Transtornos Mentais/psicologia
Meia-Idade
Pesquisa Qualitativa
Tanzânia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170324
[St] Status:MEDLINE
[do] DOI:10.1186/s12888-017-1271-9


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[PMID]:28251631
[Au] Autor:Suisted P; Chittenden B
[Ad] Endereço:Department of Women's and Children's Health, Tauranga Hospital, Bay of Plenty District Health Board, Tauranga, New Zealand.
[Ti] Título:Perioperative outcomes of total laparoscopic hysterectomy at a regional hospital in New Zealand.
[So] Source:Aust N Z J Obstet Gynaecol;57(1):81-86, 2017 Feb.
[Is] ISSN:1479-828X
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Total laparoscopic hysterectomy (TLH) is established as a safe method of hysterectomy, with a satisfactory patient experience. However, most published data derive from high-volume centres with experienced teams. It is not clear whether these data translate to smaller centres? AIMS: To evaluate the implementation of a minimally invasive option for hysterectomy at a regional public hospital in New Zealand. MATERIALS AND METHODS: Prospective audit of 120 cases of TLH over three years. We retrospectively compared outcomes to the same number of abdominal (AH) and vaginal hysterectomy (VH). RESULTS: TLH and AH were predominantly performed for heavy menstrual bleeding (65 and 64%) and VH for prolapse (54%). The largest uteri were AH (range 30-3400 g), TLH (35-550) then VH (21-256). Compared to TLH, both AH and VH had shorter mean operating theatre times (TLH 126.8 ± 44.8 min, AH 103.2 ± 32.8 and VH 93 ± 26.9), longer mean hospital stay (TLH 51.3 ± 21.3 h, AH 101.9 ± 36.6 and VH 75.1 ± 31.3) and increased mean blood loss (TLH 153 ± 116.1 mL, AH 517 ± 672.3 and VH 244 ± 206.8). One TLH was converted to laparotomy and one required interval laparoscopy. Major complications (2.5%) were lowest in the TLH group and were consistent with large international series. CONCLUSIONS: TLH would appear to be a safe and effective local option. The outcomes for patients at a regional general hospital can replicate the results of larger centres.
[Mh] Termos MeSH primário: Hospitais de Distrito
Histerectomia/métodos
Laparoscopia
Útero/patologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Perda Sanguínea Cirúrgica
Conversão para Cirurgia Aberta
Feminino
Seres Humanos
Histerectomia/efeitos adversos
Histerectomia Vaginal/efeitos adversos
Laparoscopia/efeitos adversos
Tempo de Internação
Auditoria Médica
Meia-Idade
Nova Zelândia
Duração da Cirurgia
Tamanho do Órgão
Período Perioperatório
Estudos Prospectivos
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170324
[Lr] Data última revisão:
170324
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170303
[St] Status:MEDLINE
[do] DOI:10.1111/ajo.12570


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[PMID]:28251628
[Au] Autor:Nippita TA; Roberts CL; Nicholl MC; Morris JM
[Ad] Endereço:Clinical and Population Perinatal Health, Kolling Institute, St Leonards, New South Wales, Australia.
[Ti] Título:Induction of labour practices in New South Wales hospitals: Before and after a statewide policy.
[So] Source:Aust N Z J Obstet Gynaecol;57(1):111-114, 2017 Feb.
[Is] ISSN:1479-828X
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:Midwifery Unit Managers completed surveys in 2008 and 2014 to determine methods of induction of labour. There was an increase in balloon catheter use for cervical ripening (rate difference 37%, P = 0.007). Currently, all respondent hospitals have an oxytocin protocol; district hospitals had a significant increase in use of post-maturity protocols (rate difference = 40%, P = 0.01) but there was no change in use of prostaglandin protocols.
[Mh] Termos MeSH primário: Fidelidade a Diretrizes/tendências
Hospitais de Distrito/normas
Trabalho de Parto Induzido/tendências
Ocitócicos/administração & dosagem
Centros de Atenção Terciária/normas
[Mh] Termos MeSH secundário: Protocolos Clínicos
Dinoprosta/administração & dosagem
Feminino
Idade Gestacional
Seres Humanos
Trabalho de Parto Induzido/métodos
New South Wales
Ocitocina/administração & dosagem
Guias de Prática Clínica como Assunto
Gravidez
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Oxytocics); 50-56-6 (Oxytocin); B7IN85G1HY (Dinoprost)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170324
[Lr] Data última revisão:
170324
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170303
[St] Status:MEDLINE
[do] DOI:10.1111/ajo.12575


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[PMID]:28165791
[Au] Autor:Parwaiz H; Perera R; Creamer J; Macdonald H; Hunter I
[Ad] Endereço:ST1 Clinical Fellow, Department of Vascular Surgery, Taunton and Somerset NHS Foundation Trust, Taunton TA1 5DA.
[Ti] Título:Improving documentation in surgical operation notes.
[So] Source:Br J Hosp Med (Lond);78(2):104-107, 2017 Feb 02.
[Is] ISSN:1750-8460
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Accurate documentation in surgical operation notes is crucial in facilitating the postoperative care of surgical patients and forms an important medicolegal document. This study audited the quality and completeness of documentation in surgical operation notes at a single district general hospital against the Royal College of Surgeons (2014) Good Surgical Practice guidelines, and looked to improve clinical practice through improved compliance with these guidelines. METHOD: A total of 101 operation notes were audited from a variety of surgical specialities in November 2014 (cycle 1) and 100 notes in May 2015 (cycle 2). Documentation was audited against 19 standards found in the Royal College of Surgeons guidelines. The results were presented at the trust clinical governance meeting. Interventions included clinician education, aide memoires in theatres and the introduction of a new operation note. RESULTS: Six of the 19 standards had >90% compliance in cycle 1 and 12 out of 19 in cycle 2. There were dramatic improvements in documentation in many fields including time (4% to 60%, P<0.0001), elective or emergency procedure (1% to 83%, P<0.0001), problems or complications (67% to 100%, P=0.016), estimated blood loss (2% to 73%, P<0.0001), antibiotic prophylaxis (47% to 96%, P<0.0001), venous thromboembolism prophylaxis (43% to 83%, P<0.0001) and signature (78% to 97%, P<0.0001). CONCLUSIONS: This audit has demonstrated that significant improvements in documentation in operation notes can be achieved through simple interventions. The introduction of an improved operation note that addresses each standard from the Royal College of Surgeons guidelines helped to guide clinicians to include important and relevant information.
[Mh] Termos MeSH primário: Documentação/normas
Melhoria de Qualidade
Procedimentos Cirúrgicos Operatórios
[Mh] Termos MeSH secundário: Inglaterra
Controle de Formulários e Registros
Fidelidade a Diretrizes
Hospitais de Distrito
Seres Humanos
Estudos Prospectivos
Especialidades Cirúrgicas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170619
[Lr] Data última revisão:
170619
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170207
[St] Status:MEDLINE
[do] DOI:10.12968/hmed.2017.78.2.104



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