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Nessipkhan A, Matsuda N, Takamura N, Oriuchi N, Ito H, Kiguchi M, Nishihara K, Tamaru T, Awai K, Kudo T. Occupational radiation exposure among medical personnel in university and general hospitals in Japan. Jpn J Radiol 2024:10.1007/s11604-024-01579-3. [PMID: 38705937 DOI: 10.1007/s11604-024-01579-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/20/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVE This study aimed to compare the occupational radiation exposure of medical workers between general hospitals and university hospitals. METHODS Radiation exposure data from three hospitals in Hiroshima city, including one university hospital and two general hospitals, were collected using personal dosimeters. Monthly radiation doses were analyzed, and the annual sum of radiation exposure dose was calculated for 538 subjects in general hospitals and 1224 subjects in the university hospital. To assess the impact of locality, additional data from Nagasaki University Hospital and Fukushima Medical University Hospital were included for comparative analysis. Professional affiliations, such as doctors, nurses, and radiological technologists, were considered in the evaluation. RESULTS The study revealed slight but significant differences in radiation doses between general and university hospitals. In general hospitals, except for radiological technologists, a slightly higher radiation dose was observed compared to university hospitals. Despite the annual increase in the use of medical radiation, the majority of hospital workers in both settings adhered to safety guidelines, with occupational radiation exposure remaining below the limit of detection (LOD). Workers who involved in fluoroscopic procedure, whether at university or general hospitals, had higher radiation doses than those who did not. CONCLUSION The study's primary conclusion is that workers in general hospitals experience a slight but significantly higher radiation dose and a lower percentage below the LOD compared to university hospitals. The observed difference is attributed to the greater workload at general hospitals than at university hospitals, and also may be due to the different nature of university hospital and general hospital. University hospitals, characterized by greater academic orientation, tend to benefit from comprehensive support systems, specialized expertise, and advanced technology, leading to more structured and regulated radiation control. These findings provide a basis for targeted interventions, improved safety protocols.
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Affiliation(s)
- Arman Nessipkhan
- Department of Radioisotope Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto 1-12-4, Nagasaki, 852-8523, Japan.
| | - Naoki Matsuda
- Department of Radiation Biology and Protection, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Noboru Takamura
- Department of Global Health, Medicine and Welfare, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Noboru Oriuchi
- Advanced Clinical Research Center, Fukushima Global Medical Science Center, Fukushima Medical University, Fukushima, Japan
| | - Hiroshi Ito
- Department of Radiology, Faculty of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Masao Kiguchi
- Department of Clinical Support, Hiroshima University Hospital, Hiroshima, Japan
| | - Kiyoto Nishihara
- Department of Radiological Technology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Takayuki Tamaru
- Department of Radiology, JA Hiroshima General Hospital, Hiroshima, Japan
| | - Kazuo Awai
- Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takashi Kudo
- Department of Radioisotope Medicine, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
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Rosengren K, Friberg M. Organisational and leadership skills towards healthy workplaces: an interview study with registered nurses in Sweden. BMC Nurs 2024; 23:56. [PMID: 38243228 PMCID: PMC10797899 DOI: 10.1186/s12912-024-01732-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 01/11/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND According to shortage of registered nurses, organisational and leadership aspects grounded in person-centrered approach, are highlighted to ensure high quality of care. Therefore, it is interesting to develop knowledge regarding registered nurses working environment. AIM The aim of the study was to investigate registered nurses' reason to end their employment at a university hospital setting (internal medicine, emergency department). METHOD Qualitative content analysis with an inductive methodological approach was used to analyse registered nurses' experiences regarding their former employment. Inclusion criteria; all nurses (n = 55) who ended employment during one year (first of July 2020-30th of June 2021) were invited, and 38 semi-structured interviews were conducted. RESULTS Three categories were identified: Limited organisational support, Lack of visible leadership, and Limited healthy working environment, followed by six subcategories: Longing for organisational support, Being a tile in a box, Need for professional relationship, Limitation of supportive leadership, Imbalance of work versus personal life, and Ethical stress. CONCLUSION To improve registered nurses working environment and commitment to work, balance between time at work and personal life is significant. Therefore, organisational support and leadership skills grounded in a person-centred approach are crucial to develop a healthy working environment. A person-centred leadership could improve collaboration and shared decision-making in partnership with those involved, managers, nurses, and team members.
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Affiliation(s)
- Kristina Rosengren
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE-405 30, Sweden.
- Centre for Person-centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE-405 30, Sweden.
- Department of Internal Medicine, Sahlgrenska University Hospital, Mölndal, Sweden.
| | - Malin Friberg
- Department of Internal Medicine, Sahlgrenska University Hospital, Mölndal, Sweden
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Amponsah OKO, Ayisi-Boateng NK, Nagaraja SB, Nair D, Muradyan K, Hedidor GK, Labi AK, Opare-Addo MNA, Sarkodie E, Buabeng KO. Adherence to Prescribing Indicators at a District Hospital in Ghana: Do We Match WHO Standards? Int J Environ Res Public Health 2022; 19:12260. [PMID: 36231554 PMCID: PMC9566632 DOI: 10.3390/ijerph191912260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/16/2022] [Accepted: 09/24/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: Rational use of medicines (RUM) and their assessment are important to ensure optimal use of resources and patient care in hospitals. These assessments are essential to identifying practice gaps for quality improvement. (2) Methods: Assessment of adherence to WHO/International Network for Rational Use of Drugs core prescribing indicators among outpatients in 2021 was conducted at the University Hospital of the Kwame Nkrumah University of Science and Technology in the Ashanti Region of Ghana. We reviewed electronic medical records (EMR) of 110,280 patient encounters in the year which resulted in 336,087 medicines prescribed. (3) Results: The average number of medicines prescribed per encounter was three, with generics being prescribed in 76% of prescriptions. Injections were prescribed in 7% of encounters while 90% of medicines were from Ghana's Essential Medicines List, 2017. (4) Conclusions: With the exception of patient encounters with injections, none of the prescribing indicators assessed in this study met WHO optimum levels, providing targets for quality improvement in RUM. Implementing prescribing guides and policies, regular audits and feedback as well as continuous professional development training may help to improve prescribing practices in the hospital.
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Affiliation(s)
- Obed Kwabena Offe Amponsah
- Department of Pharmacy Practice, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana
| | - Nana Kwame Ayisi-Boateng
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana
| | | | - Divya Nair
- International Union Against TB and Lung Disease (The Union), 75006 Paris, France
| | - Karlos Muradyan
- Tuberculosis Research and Prevention Center, Yerevan 0014, Armenia
| | - George Kwesi Hedidor
- WHO Country Office, Ghana, 7 Ameda Street, Roman Ridge, Accra P.O. Box MB 142, Ghana
| | - Appiah-Korang Labi
- WHO Country Office, Ghana, 7 Ameda Street, Roman Ridge, Accra P.O. Box MB 142, Ghana
| | | | - Emmanuel Sarkodie
- University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana
| | - Kwame Ohene Buabeng
- Department of Pharmacy Practice, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana
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Griewing S, Wagner U, Lingenfelder M, Fischer R, Kalder M. Chronological development of in-patient oncology in times of COVID-19: a retrospective analysis of hospitalized oncology and COVID-19 patients of a German University Hospital. J Cancer Res Clin Oncol 2022; 149:2551-2558. [PMID: 35771262 PMCID: PMC9244885 DOI: 10.1007/s00432-022-04044-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 04/26/2022] [Indexed: 11/19/2022]
Abstract
Purpose The goal of this study is to examine the chronological development of hospitalized oncology and COVID-19 patients, and compare effects on oncology sub-disciplines for pre-pandemic (2017–19) and pandemic (2020–21) years in the setting of a German university maximum care provider. Methods Data were retrospectively retrieved from the hospital performance controlling system for patient collectives with oncological main (nOnco) and COVID-19 secondary diagnosis (nCOVID-19). Data analysis is based on descriptive statistical assessment. Results The oncology patient collective (nOnco = 27,919) shows a decrease of hospitalized patients for the whole pandemic (− 4% for 2020 and − 2,5% for 2021 to 2019). The number of hospitalized COVID-19 patients increases from first to second pandemic year by + 106.71% (nCOVID-19 = 868). Maximum decline in monthly hospitalized oncology patients amounts to − 19% (May 2020) during the first and − 21% (December 2020) during the second lockdown. Relative monthly hospitalization levels of oncology patients reverted to pre-pandemic levels from February 2021 onwards. Conclusion The results confirm a decline in hospitalized oncology patients for the entire pandemic in the setting of a maximum care provider. Imposed lockdown and contact restrictions, rising COVID-19 case numbers, as well as discovery of new virus variants have a negative impact on hospitalized treated oncological patients.
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Affiliation(s)
- Sebastian Griewing
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany. .,Chair of General Business Administration, Institute for Health Care Management e.V., Philipps-University Marburg, Universitätsstraße 24, 35037, Marburg, Germany.
| | - Uwe Wagner
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - Michael Lingenfelder
- Chair of General Business Administration, Institute for Health Care Management e.V., Philipps-University Marburg, Universitätsstraße 24, 35037, Marburg, Germany
| | - Rebecca Fischer
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany
| | - Matthias Kalder
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany
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Maile EJ, Mitra M, Ovseiko P, Dopson S. Merger and post-merger integration at Oxford University Hospitals: mixed-methods evaluation and lessons learned. J Health Organ Manag 2022; ahead-of-print. [PMID: 35015386 DOI: 10.1108/jhom-01-2021-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Hospital mergers are common in the United Kingdom and internationally. However, mergers rarely achieve their intended benefits and are often damaging. This study builds on existing literature by presenting a case study evaluating a merger of two hospitals in Oxford, United Kingdom with three distinct characteristics: merger between two university hospitals, merger between a generalist and specialist hospital and merger between two hospitals of differing size. In doing so, the study draws practical lessons for other healthcare organisations. DESIGN/METHODOLOGY/APPROACH Mixed-methods single-case evaluation. Qualitative data from 19 individual interviews and three focus groups were analysed thematically, using constant comparison to synthesise and interpret findings. Qualitative data were triangulated with quantitative clinical and financial data. To maximise research value, the study was co-created with practitioners. FINDINGS The merger was a relative success with mixed improvement in clinical performance and strong improvement in financial and organisational performance. The merged organisation received an improved inspection rating, became debt-free and achieved Foundation Trust status. The study draws six lessons relating to the contingencies that can make mergers a success: (1) Develop a strong clinical rationale, (2) Communicate the change strategy widely and early, (3) Increase engagement and collaboration at all levels, (4) Be transparent and realistic about the costs and benefits, (5) Be sensitive to the feelings of the other organisation and (6) Integrate different organizational cultures effectively. ORIGINALITY/VALUE This case study provides empirical evidence on the outcome of merger in a university hospital setting. Despite the relatively positive outcome, there is no strong evidence that the benefits could not have been achieved without merger. Given that mergers remain prevalent worldwide, the practical lessons might be useful for other healthcare organisations considering merger.
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Affiliation(s)
- Edward John Maile
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Mahima Mitra
- Saïd Business School, University of Oxford, Oxford, UK
| | - Pavel Ovseiko
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Sue Dopson
- Saïd Business School, University of Oxford, Oxford, UK
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Fraeyman N, de Bacquer D, Clays E, Fiers T, Godderis L, Verhaeghe R, Viaene L, Mortier E. Analysis of ergonomic occupational accidents and near misses in a large Belgian university hospital. Acta Clin Belg 2021; 77:938-944. [PMID: 34905466 DOI: 10.1080/17843286.2021.2015553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Health-care organizations are facing a high burden of ergonomic occupational accidents, and prevention is a continuous point of interest. In this manuscript, we describe the characteristics of ergonomic accidents in a large Belgian university hospital and discuss the value of near misses. METHODS Combining databases, we identified the frequency [number of accidents × 106 hours worked per year], severity (number of days off work × 103 hours worked per year), and profile of the victims of occupational ergonomic accidents (with absence from work) or incidents or near-misses (without absence from work). Ergonomic accidents and incidents include slips, trips, falls, injurious body movements, overexertion, and handling heavy weights. RESULTS In a period of 23 years, we noticed a significant decrease in the frequency of ergonomic accidents (from about 7 to about 4 standard units), without changes in the severity. The decrease in the frequency of accidents is mirrored by an increase in the frequency of incidents (from about 4 to about 6 standard units). Female and older employees are more vulnerable to accidents, and the frequency was between two and four times higher for employees mostly involved in manual tasks compared to employees mostly involved in managerial tasks. The profile of the victims and the causes of accidents and incidents were identical. CONCLUSION Although it is premature to assume a cause-consequence relationship between incidents and accidents, it is tempting to speculate that the increased ratio of the frequencies of incidents over accidents might be one of the variables reflecting the adequacy of preventive measures and the growth of safety behavior.
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Affiliation(s)
- Norbert Fraeyman
- Environmental Department [Milieudienst], University Hospital, Gent University, Gent, Belgium
| | - Dirk de Bacquer
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Gent University, Gent University Hospital, Gent, Belgium
| | - Els Clays
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Gent University, Gent University Hospital, Gent, Belgium
| | - Tom Fiers
- Clinical Chemistry Laboratory, Gent University Hospital, Gent University, Gent, Belgium
| | - Lode Godderis
- Leuven University, Department of Public Health and Primary Care, Faculty of Medicine, University Hospital Leuven, Gasthuisberg Campus, Leuven, Belgium
| | - Rik Verhaeghe
- Central Administration, Secretariat of the Board of Governors, Faculty of Medicine and Health Sciences, University Hospital, Gent University, Gent, Belgium
| | - Leen Viaene
- Safety Department [Preventiedienst], University Hospital, Gent University, Gent, Belgium
| | - Eric Mortier
- Central Administration, Secretariat of the Board of Governors, Faculty of Medicine and Health Sciences, University Hospital, Gent University, Gent, Belgium
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Verhees MJM, Engbers RE, Landstra AM, Bouwmans GAM, Koksma JJ, Laan RFJM. Optimizing teacher basic need satisfaction in distributed healthcare contexts. Adv Health Sci Educ Theory Pract 2021; 26:1581-1595. [PMID: 34218366 PMCID: PMC8610950 DOI: 10.1007/s10459-021-10061-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 06/26/2021] [Indexed: 05/09/2023]
Abstract
Optimizing teacher motivation in distributed learning environments is paramount to ensure high-quality education, as medical education is increasingly becoming the responsibility of a larger variety of healthcare contexts. This study aims to explore teaching-related basic need satisfaction, e.g. teachers' feelings of autonomy, competence and relatedness in teaching, in different healthcare contexts and to provide insight into its relation to contextual factors. We distributed a digital survey among healthcare professionals in university hospitals (UH), district teaching hospitals (DTH), and primary care (PC). We used the Teaching-related Basic Need Satisfaction scale, based on the Self-Determination theory, to measure teachers' basic needs satisfaction in teaching. We studied relations between basic need satisfaction and perceived presence of contextual factors associated with teacher motivation drawn from the literature. Input from 1407 healthcare professionals was analyzed. PC healthcare professionals felt most autonomous, UH healthcare professionals felt most competent, and DTH healthcare professionals felt most related. Regardless of work context, teachers involved in educational design and who perceived more appreciation and developmental opportunities for teaching reported higher feelings of autonomy, competence, and relatedness in teaching, as did teachers who indicated that teaching was important at their job application. Perceived facilitators for teaching were associated with feeling more autonomous and related. These results can be utilized in a variety of healthcare contexts for improving teaching-related basic need satisfaction. Recommendations for practice include involving different healthcare professionals in educational development and coordination, forming communities of teachers across healthcare contexts, and addressing healthcare professionals' intentions to be involved in education during job interviews.
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Affiliation(s)
- M J M Verhees
- Radboudumc Health Academy, Radboudumc, Gerard van Swietenlaan 2, 6525 GB, Nijmegen, The Netherlands.
| | - R E Engbers
- Radboudumc Health Academy, Radboudumc, Gerard van Swietenlaan 2, 6525 GB, Nijmegen, The Netherlands
| | | | - G A M Bouwmans
- Radboudumc Health Academy, Radboudumc, Gerard van Swietenlaan 2, 6525 GB, Nijmegen, The Netherlands
| | - J J Koksma
- Radboudumc Health Academy, Radboudumc, Gerard van Swietenlaan 2, 6525 GB, Nijmegen, The Netherlands
| | - R F J M Laan
- Radboudumc Health Academy, Radboudumc, Gerard van Swietenlaan 2, 6525 GB, Nijmegen, The Netherlands
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Murata N, Fukamachi D, Matsumoto N, Tachibana E, Oiwa K, Matsumoto M, Kojima T, Ichikawa M, Nomoto K, Arima K, Okumura Y. Clinical outcomes for intracoronary imaging strategies at different medical facilities in Japanese patients with coronary artery disease: the SAKURA imaging PCI Registry. Heart Vessels 2021; 37:12-21. [PMID: 34363517 DOI: 10.1007/s00380-021-01896-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 06/25/2021] [Indexed: 11/27/2022]
Abstract
The relationships between intracoronary imaging modalities and outcomes among Japanese patients with coronary artery disease (CAD) based on the type of medical facility providing outpatient care remain unclear. In this multicenter prospective study (SAKURA PCI Registry), we aimed to investigate the clinical outcomes of patients with CAD who underwent percutaneous coronary intervention (PCI) between April 2015 and December 2018. In this registry, we investigated differences in patient characteristics, intracoronary imaging modalities, and clinical outcomes between two types of medical facilities. Of the 414 patients enrolled in this registry, 196 were treated at two university hospitals, and 218 were treated at five community hospitals (median follow-up 11.0 months). The primary endpoint was clinically relevant events (CREs), including a composite of all-cause death, non-fatal myocardial infarction, clinically driven target lesion revascularization, stent thrombosis, stroke, and major bleeding. Patients treated at university hospitals had higher rates of diabetes (50% vs. 38%, p = 0.015) and malignant tumors (12% vs. 6%, p = 0.015) and more frequent use of multiple intracoronary imaging modalities than patients treated at community hospitals (21% vs. 0.5%, p < 0.001). The Kaplan-Meier incidence of CREs at 1 year was comparable between university hospitals and community hospitals (8.8% vs. 7.3%, p = 0.527, log-rank test). Despite the relatively higher risk among patients in university hospitals with frequent use of multi-intracoronary imaging modalities, adverse clinical events appeared to be comparable between patients with CAD treated at university and community hospitals in Japan.
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Affiliation(s)
- Nobuhiro Murata
- Department of Medicine, Division of Cardiology, Nihon University Itabashi Hospital, Nihon University School of Medicine, Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Daisuke Fukamachi
- Department of Medicine, Division of Cardiology, Nihon University Itabashi Hospital, Nihon University School of Medicine, Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Naoya Matsumoto
- Department of Cardiology, Nihon University Hospital, Tokyo, Japan
| | | | - Koji Oiwa
- Yokohama Chuo Hospital, Kanagawa, Japan
| | | | | | | | | | - Ken Arima
- Kasukabe Municipal Hospital, Saitama, Japan
| | - Yasuo Okumura
- Department of Medicine, Division of Cardiology, Nihon University Itabashi Hospital, Nihon University School of Medicine, Ohyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.
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Nishizaki Y, Nozawa K, Shinozaki T, Shimizu T, Okubo T, Yamamoto Y, Konishi R, Tokuda Y. Difference in the general medicine in-training examination score between community-based hospitals and university hospitals: a cross-sectional study based on 15,188 Japanese resident physicians. BMC Med Educ 2021; 21:214. [PMID: 33858403 PMCID: PMC8050907 DOI: 10.1186/s12909-021-02649-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/05/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The general medicine in-training examination (GM-ITE) is designed to objectively evaluate the postgraduate clinical competencies (PGY) 1 and 2 residents in Japan. Although the total GM-ITE scores tended to be lower in PGY-1 and PGY-2 residents in university hospitals than those in community-based hospitals, the most divergent areas of essential clinical competencies have not yet been revealed. METHODS We conducted a nationwide, multicenter, cross-sectional study in Japan, using the GM-ITE to compare university and community-based hospitals in the four areas of basic clinical knowledge". Specifically, "medical interview and professionalism," "symptomatology and clinical reasoning," "physical examination and clinical procedures," and "disease knowledge" were assessed. RESULTS We found no significant difference in "medical interview and professionalism" scores between the community-based and university hospital residents. However, significant differences were found in the remaining three areas. A 1.28-point difference (95% confidence interval: 0.96-1.59) in "physical examination and clinical procedures" in PGY-1 residents was found; this area alone accounts for approximately half of the difference in total score. CONCLUSIONS The standardization of junior residency programs and the general clinical education programs in Japan should be promoted and will improve the overall training that our residents receive. This is especially needed in categories where university hospitals have low scores, such as "physical examination and clinical procedures."
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Affiliation(s)
- Yuji Nishizaki
- Medical Technology Innovation Center, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
- Department of Medical Education, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Keigo Nozawa
- Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, 6-3-1 Niijuku, Katsushika-ku, Tokyo, 125-8585, Japan
| | - Tomohiro Shinozaki
- Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, 6-3-1 Niijuku, Katsushika-ku, Tokyo, 125-8585, Japan
| | - Taro Shimizu
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, 880 Kitakobayashi, Mibumachi, Shimotuga-gun, Tochigi, 321-0293, Japan
| | - Tomoya Okubo
- Research Division, National Center for University Entrance Examinations, 2-19-23 Komaba, Meguro-ku, Tokyo, 153-8501, Japan
| | - Yu Yamamoto
- Division of General Medicine, Center for Community Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Ryota Konishi
- Education Adviser Japan Organization of Occupational Health and Safety, 1-1 Kiduki Sumiyoshi-cho, Nakahara-ku, Kawasaki-shi, Kanagawa, 211-0021, Japan
| | - Yasuharu Tokuda
- General Internal Medicine, Muribushi Okinawa for Teaching Hospitals, 3-42-8 Iso, Urasoe-shi, Okinawa, 901-2132, Japan
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Ishimoto H, Ikeda T, Kadooka Y. Factors related to satisfaction of cancer patients with transfer arrangements made by university hospitals at the end-of-life in Japan: a cross-sectional questionnaire survey of bereaved family members. Support Care Cancer 2020; 29:3091-3101. [PMID: 33057817 DOI: 10.1007/s00520-020-05822-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/07/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Cancer patients in university hospitals often face a difficult decision regarding transfer to other care settings at the end-of-life. Arrangements for a satisfying transfer are important for reducing the psychosocial impact of the transition, but few studies have evaluated this aspect. This study aimed to identify factors related to the satisfying arrangement of transfers to other care settings from university hospitals. METHODS A total of 400 bereaved family members of cancer patients in Japan participated in this cross-sectional web-based questionnaire survey. Statistical methods including decision tree analysis were conducted to identify factors significantly associated with satisfying transfer arrangements. RESULTS More than 60% of cancer patients were satisfied with the transfer arrangements made by university hospitals. Decision tree analysis revealed that the factor most significantly associated with satisfaction with transfer arrangements was "satisfaction with contents of the explanation about transfer." The following significant factors were also extracted: "timing of being informed of transfer," "presence of primary care physician," and "presence of trustworthy staff." "Satisfaction with overall care from university hospital staff" and "involvement of palliative care team" were identified as factors contributing to a high degree of satisfaction with transfer arrangements. CONCLUSION In order to make satisfying transfer arrangements from university hospitals for cancer patients at the end-of-life, healthcare professionals should provide satisfactory explanations about the transfer process in order to meet the information needs of patients. To be effective, healthcare professionals should initiate transfer arrangements prior to cancer treatment, while simultaneously building trusting relationships with patients.
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Affiliation(s)
- Hiroko Ishimoto
- Department of Bioethics, Kumamoto University Graduate School of Medical Sciences, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan.
| | - Tokunori Ikeda
- Laboratory of Clinical Pharmacology and Therapeutics, Sojo University Faculty of Pharmaceutical Sciences, 4-22-1 Ikeda, Nishi-ku, Kumamoto, 860-0082, Japan
- Department of Medical Information Sciences and Administration Planning, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yasuhiro Kadooka
- Department of Bioethics, Kumamoto University Faculty of Life Sciences, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
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Bentellis I, Colomb F, Drogrey M, Canac B, Tibi B, Ahallal Y, Mendel L, Shaikh A, Amiel J, Levraut J, Chevallier D, Durand M. [Assessment of a post-emergency pathway with early urological regulation]. Prog Urol 2020; 30:1051-9. [PMID: 33055003 DOI: 10.1016/j.purol.2020.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 05/09/2020] [Accepted: 06/13/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Urological emergencies represent 7 % of the outpatients at the emergency department (ED). We assessed the effect of setting up a post-emergency consultation (CPU) after deferred urological medical regulation. METHODS All patients admitted to the ED in a university center over the period December 2017 to July 2018 and for whom a CPU was scheduled were included. The regulation concerned the date of CPU and supplementary exams. The main outcome was the ability to provide an efficient response according to a predefined grid of specific solutions. RESULTS One hundred and twenty-eight patients were included. The median age was 57 years (18-97). Efficacy of the CPU was 76 %. This rate was lower in no-show patients or consulting for rare and complex motives (47 %, n=60). The no-show were not reachable on the first call in 51.6 % of cases, with a similar age and motives distribution to the others. Only 6,9 % (n=128) of all consultants (n=1863) had been referred to the CPU by emergency physicians. The decision was a second consultation in 70 % (48), a new exam in 10 % (7), deferred emergency surgery in 12 % (8) and finally 18 % (12) of no follow-up. CONCLUSION CPU following early regulation by a urologist provides an effective response in 76 % of situations. Assessment of "no-shows" helped to identify groups at risk. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Se Young Choi
- Department of Urology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, Korea
| | - Tae-Hyoung Kim
- Department of Urology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, Korea.
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Viottini E, Politano G, Fornero G, Pavanelli PL, Borelli P, Bonaudo M, Gianino MM. Determinants of aggression against all health care workers in a large-sized university hospital. BMC Health Serv Res 2020; 20:215. [PMID: 32178674 PMCID: PMC7077118 DOI: 10.1186/s12913-020-05084-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 03/09/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The paper aims to describe the 3-year incidence (2015/17) of aggressive acts against all healthcare workers to identify risk factors associated to violence among a variety of demographic and professional determinants of assaulted, and risk factors related to the circumstances surrounding these events. METHODS A retrospective observational study of all 10,970 health workers in a large-sized Italian university hospital was performed. The data, obtained from the "Aggression Reporting Form", which must be completed by assaulted workers within 72 h of aggression, were collected for the following domains: worker assaulted (sex, age class, years worked); profession (nurses, medical doctors, non-medical support staff, administrative staff, midwives); aggressive acts (activity type during aggressive acts, season, time and location of aggressive acts); and type of aggressive acts (verbal, non-verbal, consequences, aggressors). RESULTS Three hundred sixty-four (3.3%) workers experienced almost one aggression. The majority of the assaulted workers were female (77.5%), had worked for 6/15 years and were Nurses (64.3%). The majority of aggressive acts occurred during assistance and patient care (38.2%), in the spring and during the afternoon/morning shifts and took place in locations where patients were present (47.3%). The most prevalent aggression type was verbal (76.9%). The patient was the most common aggressor (46.7%). 56% of those assaulted experienced interruptions in their work. Being female, being < 50 years of age, having worked for 6-15 years were significant risk factors for aggression. Midwives suffered the highest risk of experiencing aggression (RR = 12.95). The risk analysis showed that non-verbally aggressive acts were related to assistance and patient care with respect to activity type, to the presence of patients and during the spring and afternoon/evening. CONCLUSIONS The findings suggest the parallel use of future qualitative studies to clarify the motivation behind aggression. These suggestions are needed for the implementation of additional adequate prevention strategies on either an organizational or a personal level.
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Affiliation(s)
- Elena Viottini
- San Giovanni Bosco Hospital, ASL Città di Torino, P.zza Donatore di Sangue, 3, 10154, Turin, Italy
| | - Gianfranco Politano
- Department of Control and Computer Engineering, Politecnico di Torino, Corso Duca degli Abruzzi, 24, 10129, Turin, Italy
| | - Giulio Fornero
- Dipartimento Qualità e Sicurezza dei percorsi di Diagnosi e Cura, AOU Città della salute e della Scienza Teaching Hospital, corso Bramante, 88, 10126, Turin, Italy
| | - Pier Luigi Pavanelli
- Sicurezza Ed Ambiente (S.P.P.), AOU Città della salute e della Scienza, Teaching Hospital, corso Bramante, 88, 10126, Turin, Italy
| | - Paola Borelli
- Dipartimento Qualità e Sicurezza dei percorsi di Diagnosi e Cura, AOU Città della salute e della Scienza Teaching Hospital, corso Bramante, 88, 10126, Turin, Italy
| | - Marco Bonaudo
- Department of Public Health Sciences and Pediatrics, Università di Torino, Via Santena 5 bis, 10126, Turin, Italy.
| | - Maria Michela Gianino
- Department of Public Health Sciences and Pediatrics, Università di Torino, Via Santena 5 bis, 10126, Turin, Italy
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Tamim H, Zeineldine S, Tabbara F, Khoury S, Akiki Z, Khansa S, Taher A. Structure and evaluation of a residency research program in a university hospital. BMC Med Educ 2019; 19:406. [PMID: 31694614 PMCID: PMC6836359 DOI: 10.1186/s12909-019-1858-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 10/28/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Most academic medical institutions lack a structured program that provides residents with an in-depth research training. The objectives of this paper are to describe a comprehensive residency research program at a university hospital, and to assess the pre- post-self-assessment of research capabilities of resident for the evaluation of the program. METHODS The residency research program (RRP) was implemented in 2011 as an essential component of the residency program at the American University of Beirut Medical Center. Categorical residents are required to carry out a research project and go through all the steps of the research process from identifying a topic to writing a manuscript. As for evaluating the program, data were collected from residents who graduated between 2014 and 2016 using a questionnaire, which included the overall evaluation of the program, self-assessment on research-related tasks pre- and post- joining the program, as well as general recommendations. The mean scores on the five-point Likert scale were transformed into percentages (0-100%). The average was calculated and the difference in the means was reported. RESULTS Overall, 103 residents from the different clinical departments were included in this study. Residents' self-assessment showed a 19.3% improvement in research-related tasks before and after completion of the RRP (P < 0.0001). Most of the residents have either published or are in the process of publishing their projects (34 and 55.3%, respectively). Time management was the most reported challenge. Generally, the program was evaluated positively. CONCLUSION The RRP is a unique, well-structured program, encompassing residents from various clinical departments, which enhances residents' research capabilities.
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Affiliation(s)
- Hani Tamim
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Salah Zeineldine
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Faysal Tabbara
- Emergency Department, American University of Beirut Medical Center, Beirut, Lebanon
| | - Samia Khoury
- Ann Romney Center for Neurologic Diseases, Brigham and Women’s Hospital and Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA 02115 USA
- Abu Haidar Neuroscience Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Zeina Akiki
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Sara Khansa
- Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ali Taher
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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15
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Miller C, Ausserer J, Putzer G, Hamm P, Herff H, Wenzel V, Paal P. [Publications by university Departments of Anaesthesiology from Germany, Austria and Switzerland in 2011-2015 : Scientific publications by university hospitals in D‑A-CH]. Anaesthesist 2019; 68:294-302. [PMID: 30941445 DOI: 10.1007/s00101-019-0582-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 02/19/2019] [Accepted: 03/01/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND This study presents a count of publications and citations for all articles published by university Departments of Anaesthesiology in Germany, Austria and Switzerland between 2011 and 2015. The results were compared with former analyses of these countries from 2001-2010 as well as similar international studies. METHODS We performed a PubMed search based on PERL-scripts for all publications originating from university Departments of Anaesthesiology in Germany, Austria and Switzerland between 2011 and 2015. According to their author's affiliation, articles were assigned to their affiliated university department. Publications were considered an original article if the category of publication was classified as original research in PubMed. Predatory journals were omitted by using PubMed-listed journals only. Data of citations was retrieved from Thomson Reuter's ISI Web of Knowledge. The following indicators were reported: the number of publications and original articles (counting each author and first authors only) and the share of original articles out of all publications. With regard to citations, we reported the overall number, the percentage of publications, which were cited at least once and the median of citations per publication and per original article as well as the calculated h-index. RESULTS The 47 university Departments of Anaesthesiology published 4.697 articles between 2011 and 2015, which make up 89% of all anaesthesiology research originating from Germany, Austria and Switzerland (overall 5.284 publications). Of these, 1.037 (22%) were classified as original articles. Considering only articles with first authors, equalizing a change of PubMed's affiliation field policy in 2012 to compare the numbers with previous periods, 3.709 publications and 821 original articles were published. 90% of all publications and 96% of original articles, respectively, were cited at least once. Publications were cited six times, while original articles were cited nine times. The university department of Anaesthesiology in Zurich published most (n = 245), while most original articles were published in Vienna (n = 77). The highest share of original articles was achieved by Vienna (37%). Publications from Berlin - Benjamin Franklin and Jena (11 citations per publication) and original articles from Essen (23,5 citations per original article) achieved the highest citation rates. DISCUSSION In contrast to the worldwide increasing trend, the number of publications of the university Departments of Anaesthesiology in Germany, Austria and Switzerland stagnated. The share of original articles out of all publications continues to decline in comparison to 2001-2010 (-6%). Despite this, original articles were cited more frequently and thus had a higher value for the scientific community. The reasons of the decrease in the number of original articles remain unclear and require further investigation to reverse this negative trend. CONCLUSION Strategies to foster academic work in anaesthesiology in Germany, Austria and Switzerland are required.
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Affiliation(s)
- C Miller
- Abteilung für Anästhesie und Intensivmedizin, Krankenhaus Barmherzige Brüder Salzburg, Paracelsus Medizinische Privatuniversität, Salzburg, Österreich.
| | - J Ausserer
- Universitätsklinik für Anästhesie und Intensivmedizin, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - G Putzer
- Universitätsklinik für Anästhesie und Intensivmedizin, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - P Hamm
- Universitätsklinik für Anästhesie und Intensivmedizin, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - H Herff
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universität zu Köln, Köln, Deutschland
| | - V Wenzel
- Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Klinikum Friedrichshafen, Medizin Campus Bodensee, Akademisches Lehrkrankenhaus der Eberhard-Karls-Universität Tübingen, Friedrichshafen, Deutschland
| | - P Paal
- Abteilung für Anästhesie und Intensivmedizin, Krankenhaus Barmherzige Brüder Salzburg, Paracelsus Medizinische Privatuniversität, Salzburg, Österreich
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Bolliger M, Kroehnert JA, Molineus F, Kandioler D, Schindl M, Riss P. Experiences with the standardized classification of surgical complications (Clavien-Dindo) in general surgery patients. Eur Surg 2018; 50:256-261. [PMID: 30546385 PMCID: PMC6267508 DOI: 10.1007/s10353-018-0551-z] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 07/07/2018] [Indexed: 11/30/2022]
Abstract
Background The standardized Clavien-Dindo classification of surgical complications is applied as a simple and widely used tool to assess and report postoperative complications in general surgery. However, most documentation uses this classification to report surgery-related morbidity and mortality in a single field of surgery or even particular intervention. The aim of the present study was to present experiences with the Clavien-Dindo classification when applied to all patients on the general surgery ward of a tertiary referral care center. Methods We analyzed a period of 6 months of care on a ward with a broad range of general and visceral surgery. Discharge reports and patient charts were analyzed retrospectively and reported complications rated according to the most recent Clavien-Dindo classification version. The complexity of operations was assessed with the Austrian Chamber of Physicians accounting system. Results The study included 517 patients with 817 admissions, of whom 463 had been operated upon. Complications emerged in 12.5%, of which 19% were rated as Clavien I, 20.7% as Clavien II, 13.8% as Clavien IIIa, 27.6% as Clavien IIIb, 8.6% as Clavien IVa, and 10.3% as Clavien V. No Clavien grade IVb complication occurred within the investigation. Patients having undergone more complex surgery or with higher scores experienced significantly longer lengths of hospital stay. Conclusion The Clavien-Dindo classification can easily be used to document complication rates in general surgery, even though this collective was not included in the original validation studies of Clavien et al. and consisted of more heavily impaired patients.
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Affiliation(s)
- M Bolliger
- Division of General Surgery, Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - J-A Kroehnert
- Division of General Surgery, Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - F Molineus
- Division of General Surgery, Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - D Kandioler
- Division of General Surgery, Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - M Schindl
- Division of General Surgery, Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - P Riss
- Division of General Surgery, Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
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Heyd R, Eis-Hübinger AM, Berger A, Bierbaum S, Pietzonka S, Wenzel JJ, Huzly D, Keppler OT, Panning M. Retrospective analysis of clinical and virological parameters of influenza cases at four university hospitals in Germany, 2015. Infection 2017; 45:349-354. [PMID: 28316058 DOI: 10.1007/s15010-017-1008-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 03/13/2017] [Indexed: 02/05/2023]
Abstract
We conducted a retrospective observational study at four German university hospitals of patients with laboratory-confirmed influenza in 2014/2015. Overall, a fatality rate of 8% was observed. Significantly more A(H1N1)pdm09 patients were admitted to ICU compared to those with A(H3N2). However, fatal outcome was not significantly increased among A(H1N1)pdm09 cases. Nosocomial infections were seen in 17% of cases. Systematic collection of data from hospitals will complement national influenza surveillance.
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Affiliation(s)
- Robert Heyd
- Institute of Clinical Microbiology and Hygiene, Regensburg University Medical Centre, Regensburg, Germany
| | | | - Annemarie Berger
- Institute for Medical Virology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Sibylle Bierbaum
- Institute for Virology, Medical Center - University of Freiburg, Hermann-Herder-Str. 11, 79014, Freiburg, Germany
| | - Sandra Pietzonka
- Institute of Virology, University of Bonn Medical Centre, Bonn, Germany
| | - Jürgen J Wenzel
- Institute of Clinical Microbiology and Hygiene, Regensburg University Medical Centre, Regensburg, Germany
| | - Daniela Huzly
- Institute for Virology, Medical Center - University of Freiburg, Hermann-Herder-Str. 11, 79014, Freiburg, Germany
| | - Oliver T Keppler
- Institute of Virology, University of Bonn Medical Centre, Bonn, Germany.,Max von Pettenkofer-Institut, Virology, Ludwig Maximilian University of Munich, Munich, Germany
| | - Marcus Panning
- Institute for Virology, Medical Center - University of Freiburg, Hermann-Herder-Str. 11, 79014, Freiburg, Germany.
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Drozdova OV. [Status and problems of postgraduate dental education]. Stomatologiia (Mosk) 2017; 96:64-67. [PMID: 29260769 DOI: 10.17116/stomat201796664-67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- O V Drozdova
- Moscow State Medical Dental University named A.I. Evdokimov, Moscow, Russia
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Haddad J, Kalbacher E, Piccard M, Aubry S, Chaigneau L, Pauchot J. [Evaluation of the management of soft tissue sarcomas in Franche-Comté since the establishment of a multidisciplinary meeting at University Hospital. About 47 cases]. ANN CHIR PLAST ESTH 2016; 62:15-22. [PMID: 27777135 DOI: 10.1016/j.anplas.2016.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 09/19/2016] [Indexed: 01/22/2023]
Abstract
GOALS OF STUDY A multidisciplinary meeting (RCP) dedicated to the treatment of sarcoma was established in Franche-Comte in 2010. The goals of the study are: (a) To evaluate the treatment of sarcomas by confrontation with the existing literature; (b) To evaluate the influence of the multidisciplinary meeting on the management of sarcomas by hospitals at the regional level. MATERIALS AND METHODS This is a retrospective single center study from 2010 to 2015 on patients with sarcoma and peripheral soft tissue drawn from a Netsarc database (National Network of sarcomas) and communicating cancer record. A database Cleanweb especially dedicated is created. RESULTS Forty-seven patients were included: ten sarcomas at the upper member 26 to the lower limbs, 11 on the trunk. Forty patients were operated on: ten out of the university hospital, 28 at the university hospital and two in a coordinating center. Ninety percent of patients treated at the university hospital were in accordance with the recommandations. None of the patients operated out of the university hospital benefited from medical care in accordance to the recommendations. There is an increase in the number of files sent by the hospitals out of the university hospital discussed in multidisciplinary meeting, before treatment. CONCLUSION The creation of a dedicated multidisciplinary meeting sarcoma improves the medical management of these tumors and decreases inappropriate medical managements thanks to a better education of the regional physicians.
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Affiliation(s)
- J Haddad
- Service de chirurgie orthopédique, traumatologique et plastique, chirurgie de la main, CHU Jean-Minjoz, 1, boulevard Flemming, 25030 Besançon, France
| | - E Kalbacher
- Service d'oncologie médicale, CHU Jean-Minjoz, 1, boulevard Flemming, 25030 Besançon, France
| | - M Piccard
- Service d'épidémiologie et d'hygiène hospitalière, CHU de Dijon, 21079 Dijon cedex, France
| | - S Aubry
- Service de radiologie A, CHU Jean-Minjoz, 1, boulevard Flemming, 25030 Besançon, France
| | - L Chaigneau
- Service d'oncologie médicale, CHU Jean-Minjoz, 1, boulevard Flemming, 25030 Besançon, France
| | - J Pauchot
- Service de chirurgie orthopédique, traumatologique et plastique, chirurgie de la main, CHU Jean-Minjoz, 1, boulevard Flemming, 25030 Besançon, France.
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Giæver F, Lohmann-Lafrenz S, Løvseth LT. Why hospital physicians attend work while ill? The spiralling effect of positive and negative factors. BMC Health Serv Res 2016; 16:548. [PMID: 27716317 PMCID: PMC5050593 DOI: 10.1186/s12913-016-1802-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 09/20/2016] [Indexed: 11/18/2022] Open
Abstract
Background Recurrent reports from national and international studies show a persistent high prevalence of sickness presence among hospital physicians. Despite the negative consequences reported, we do not know a lot about the reasons why physicians choose to work when ill, and whether there may be some positive correlates of this behaviour that in turn may lead to the design of appropriate interventions. The aim of this study is to explore the perception and experience with sickness presenteeism among hospital physicians, and to explore possible positive and negative foundations and consequences associated with sickness presence. Methods Semi-structured interviews of 21 Norwegian university hospital physicians. Results Positive and negative dimensions associated with 1) evaluation of illness, 2) organizational structure, 3) organizational culture, and 4) individual factors simultaneously contributed to presenteeism. Conclusions The study underlines the inherent complexity of the causal chain of events affecting sickness presenteeism, something that also inhibits intervention. It appears that sufficient staffing, predictability in employment, adequate communication of formal policies and senior physicians adopting the position of a positive role model are particularly important. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1802-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Fay Giæver
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Lise Tevik Løvseth
- Department of Research and Development, Division of Mental Health Care, St Olav University Hospital, P box 3008 Lade, 7441, Trondheim, Norway.
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Sfeir F, Villanueva P, Tagle P. History of the Neurosurgery Department of Pontificia Universidad Catolica, Santiago, Chile. World Neurosurg 2016; 97:645-651. [PMID: 27535633 DOI: 10.1016/j.wneu.2016.07.116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 07/27/2016] [Accepted: 07/30/2016] [Indexed: 11/16/2022]
Abstract
Pontificia Universidad Católica de Chile's medical school was founded in 1929. An interest in neurosurgical development arose in the minds of the Dean, Dr. Cristobal Espíldora, and the Chief of Surgery, Dr. Rodolfo Rencoret, in 1946. They encouraged and supported Dr. J. Ricardo Olivares to specialize in Neurosurgery with Professor H. Olivecrona in Stockholm, Sweden. The first neurosurgical procedure in the Hospital Clínico de la Universidad Católica was performed in 1950. Since then, intensive efforts have been made to develop neurosurgery and its science. As a result, it is now a center capable of achieving high-quality standards in vascular, oncologic, and endoscopic neurosurgery; stereotactic and radiosurgery; complex spine surgery; pediatric neurosurgery; and epilepsy surgery. This article tells the story of a university hospital neurosurgery service in a country at the southern end of the world and how it became one of the most important neurosurgical centers in Chile and South America.
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Affiliation(s)
- Felipe Sfeir
- Neurosurgery and Neurology Service, Hospital de Puerto Montt, Puerto Montt, Chile.
| | - Pablo Villanueva
- Department of Neurosurgery, Division of Neuroscience, Hospital Clínico Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
| | - Patricio Tagle
- Department of Neurosurgery, Division of Neuroscience, Hospital Clínico Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
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Kone V, Lecomte F, Randriamanana D, Pourriat JL, Claessens YE, Vidal-Trecan G. Impact of a pilot team on patients' pain reduction and satisfaction in an emergency department: A before-and-after observational study. Rev Epidemiol Sante Publique 2016; 64:59-66. [PMID: 26968458 DOI: 10.1016/j.respe.2015.11.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 09/24/2015] [Accepted: 11/25/2015] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Pain management and patient satisfaction were targeted in the emergency department of a Paris university hospital. In 1999, 77.0% of patients complained of pain on arrival and more than half of patients did not experience pain relief at discharge. The purpose of the study was to evaluate the outcomes of the implementation of a team piloting pain management on pain reduction and pain care satisfaction. METHOD Two cross-sectional surveys (04/10/1999 to 19/10/1999 and 03/04/2007 to 18/04/2007) were conducted before and after a team piloting pain management was deployed in the emergency department. Consecutive patients age 18 years and older who visited the department suffering from pain were given structured questionnaires that validated scales scoring pain upon arrival and at discharge. Patients' files were analyzed using structured forms. The parameters associated with pain reduction and patient satisfaction were sought. RESULTS In 2007, 65.0% of patients had their pain relieved vs. 35.1% in 1999 (P<0.001); 60.2% were satisfied with the pain care received vs. 39.8%. Pain management (e.g. waiting time ≤ 20 min: 47.6% vs. 20.8%; interventions on pain before the physician's examination: 63.0% vs. 13.8%; and pain reassessment after intervention: 13.8% vs. 4.5%) improved. Both pain reduction and patient satisfaction were significantly associated with intervention before the physician's examination. Pain reduction was independently and positively associated with time of survey, triage level (depending on the severity of their condition), pain intensity on arrival, and negatively associated with discharge without hospitalization. Satisfaction was independently and positively associated with waiting time before examination (0-20 min) and the absence of procedural pain. CONCLUSION The implementation of a team piloting pain management seemed to have had positive effects on pain management in the emergency department. However, respectively, 56.2% and 39.8% of patients remained without pain relief and dissatisfied with pain management at the end of their visit.
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Affiliation(s)
- V Kone
- Public health unit: risk management and quality of care, Paris Centre University Hospital Group, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - F Lecomte
- Emergency department, Paris Centre University Hospital, AP-HP, 75014 Paris, France
| | - D Randriamanana
- Public health unit: risk management and quality of care, Paris Centre University Hospital Group, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - J-L Pourriat
- Emergency department, Paris Centre University Hospital, AP-HP, 75014 Paris, France; Department of public health, faculty of medicine, Paris Descartes University, Sorbonne Paris Cité, 75006 Paris, France
| | - Y-E Claessens
- Emergency department, Paris Centre University Hospital, AP-HP, 75014 Paris, France; Department of public health, faculty of medicine, Paris Descartes University, Sorbonne Paris Cité, 75006 Paris, France
| | - G Vidal-Trecan
- Public health unit: risk management and quality of care, Paris Centre University Hospital Group, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Department of public health, faculty of medicine, Paris Descartes University, Sorbonne Paris Cité, 75006 Paris, France; Research unit (Inserm U1153) methods team, methods of therapeutic evaluation of chronic diseases, research center epidemiology and biostatistics, Sorbonne Paris Cité, 75004 Paris, France.
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23
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Torabipour A, Arab M, Zeraati H, Rashidian A, Sari AA, Sarzaiem MR. Multivariate Analysis of Factors Influencing Length of Hospital Stay after Coronary Artery Bypass Surgery in Tehran, Iran. Acta Med Iran 2016; 54:124-133. [PMID: 26997600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
Length of hospital stay (LOS) is a key indicator for hospital management. Reducing hospital stay is a priority for all health systems. We aimed to determine the length of hospital stay following Coronary Artery Bypass Surgery (CABG) based on its clinical and non-clinical factors. A cross-sectional study of 649 consecutive patients who underwent coronary artery bypass graft surgery was conducted in Imam Khomeini and Shariati university hospitals, Tehran, Iran. Data was analyzed by using non-parametric univariate tests and multiple linier regression models. Thirty seven independent variables including pre-operative, intra-operative and post-operative variables were analyzed. Finally, an appropriate model was constructed based on the associated factors. The results showed that 70.3% of the patients were male, and the mean age of the patients was 59.3 ± 10.4 years. The Mean (±SD) and median of the LOS were 11.7 ± 7.1 and 9 days, respectively. Of 37 investigated variables, 24 qualitative and quantitative variables were significantly associated with length of stay (p<0.05). Multiple linear regression analysis showed that independent variables including age, medical insurance type, body mass index, and prior myocardial infarction; admission day, admission season, Cross-clamp time, pump usage, admission type, the number of laboratory tests and the number of specialty consultation had more effect on the hospital stay. We concluded that some significant factors influencing hospital stay after CABG were predictable and modifiable by hospital managers and decision makers to manage hospital beds.
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Affiliation(s)
- Amin Torabipour
- Department of Health Services Management, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. AND Department of Health Economics & Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Arab
- Department of Health Economics & Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hojjat Zeraati
- Department of Epidemiology & Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iranq
| | - Arash Rashidian
- Department of Health Economics & Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Akbari Sari
- Department of Health Economics & Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmuod Reza Sarzaiem
- Department of Cardiac Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Schwartzberg D, Ivanovic S, Patel S, Burjonrappa SC. We thought we would be perfect: medication errors before and after the initiation of Computerized Physician Order Entry. J Surg Res 2015; 198:108-14. [PMID: 26027541 DOI: 10.1016/j.jss.2015.03.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 02/26/2015] [Accepted: 03/04/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Because the Institute of Medicine demanded health care improvement, electronic medical records have been implemented with the hopes of eliminating iatrogenic injury caused by avoidable mistakes. Electronic orders and electronic medical records survived its initial slow adoption and have since had a myriad of identifiable flaws as it becomes incorporated nationally. MATERIALS AND METHODS This retrospective study at a university teaching hospital analyzed all medication order errors (OEs) for the 26 wk of paper-order entries before computer physician order entry (CPOE) and 26 weeks after CPOE was initiated. All OEs were included and documented by month as well as severity using standard taxonomy. RESULTS Results indicated that CPOE yielded a significant increase in overall medication OE with five of six severity categories remaining the same or increasing in OE. Severity categories A and E saw a significant increase once CPOE began (P < 0.01). Pre-CPOE OEs were 1741, whereas Post-CPOE OEs were 2226, showing an increase in overall medication errors (P < 0.01). After CPOE began, the cumulative successive errors recorded were 112, 290, 267, 307, 412, 399, and 439 with an R(2) value of 0.849 and a P value of 0.003 in the analysis of variance to test regression relation. CONCLUSIONS As CPOE adapts for its real-world applications, it may eventually prove useful in reducing errors; however, perfection and error free order entry will not be achieved unless objective data analysis guides its evolution.
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Affiliation(s)
| | - Sasa Ivanovic
- St. George's University, School of Medicine, St. George's, Grenada
| | - Sheetal Patel
- Department of Surgery, Newark Beth Israel Medical Center and Children's Hospital of New Jersey, Newark, New Jersey
| | - Sathyaprasad C Burjonrappa
- Department of Surgery, Newark Beth Israel Medical Center and Children's Hospital of New Jersey, Newark, New Jersey.
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Pérez-Cebrián M, Suárez-Varela MMM, Font-Noguera I, Monte-Boquet E, Poveda-Andrés JL, Martín-Moreno JM, Rubio-López N, Ruiz-Rojo E, Llopis-González A. Study on the Linezolid Prescription According to the Approval of Indication in a University Hospital. Iran J Pharm Res 2015; 14:857-64. [PMID: 26330874 PMCID: PMC4518114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Indications for linezolid use are nosocomial or community-acquired pneumonia and skin infections or soft tissue infection caused by gram-positive microorganisms, but new recommendations may emerge. It is important to balance benefits with risks because severe adverse events have been described in patients taking linezolid treatment. Accordingly, we evaluated the suitability of linezolid prescription according to approval of indication by evaluating the presence of drug-related problems (DRP) in a University hospital. DRP were identified in 36 patients (50.0%). In most cases, they were related to known or established indications (15 patients, 20.8%), to safety (5 patients, 6.9%), and to both in others (16 patients, 22.2%). No DRP were recorded, which modified linezolid efficacy. DRP were significantly higher in the patients treated by an approved indication in Spain (63.3%) than in those treated by an unapproved indication in Spain (28.6%). We concluded that new studies about extending linezolid indications may be necessary.
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Affiliation(s)
| | - María M. Morales Suárez-Varela
- Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain. ,Center for Public Health Research (CSISP), Valencia, Spain.,Corresponding author: E-mail:
| | | | | | | | - Jose María Martín-Moreno
- Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, Spain.
| | - Nuria Rubio-López
- Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain. ,Center for Public Health Research (CSISP), Valencia, Spain.
| | - Elias Ruiz-Rojo
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain. ,Conselleria de Sanidad, Valencia, Spain.
| | - Agustín Llopis-González
- Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain. ,Center for Public Health Research (CSISP), Valencia, Spain.
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Fafliora E, Bampalis VG, Lazarou N, Mantzouranis G, Anastassiou ED, Spiliopoulou I, Christofidou M. Bacterial contamination of medical devices in a Greek emergency department: impact of physicians' cleaning habits. Am J Infect Control 2014; 42:807-9. [PMID: 24775562 DOI: 10.1016/j.ajic.2014.03.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 03/14/2014] [Accepted: 03/14/2014] [Indexed: 10/25/2022]
Abstract
We investigated the bacterial contamination of physicians' stethoscopes, electrocardiography machines, cardiac monitors, and pulse oximeters, as well as physicians' self-reported cleaning habits in the emergency department of a university hospital. Among 100 devices evaluated (stethoscopes included), 99% developed a positive bacterial culture. Coagulase-negative staphylococci predominated (80.3%). Only 13% of physicians reported cleaning their stethoscope after each patient examination; multinomial regression analysis found less contamination on those stethoscopes (P < .001). Studies on the implementation of hygiene measures are needed.
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Cornu P, Steurbaut S, De Beukeleer M, Putman K, van de Velde R, Dupont AG. Physician's expectations regarding prescribing clinical decision support systems in a Belgian hospital. Acta Clin Belg 2014; 69:157-64. [PMID: 24820921 DOI: 10.1179/2295333714y.0000000015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Developing and implementing clinical decision support systems (CDSSs) is time-consuming and costly. Therefore, prioritization of the most relevant systems is warranted. The physician's perceived usefulness has been identified as a decisive reason for using CDSSs. The objective of this study was to investigate the physician's perceived usefulness of different types of CDSSs and to identify the user needs and expectations regarding future CDSSs. METHODS Cross-sectional single-centre survey among physicians with a clinical assignment in a university hospital. Physicians were questioned about their current experiences with drug prescribing and the perceived usefulness and desired features of future CDSSs. RESULTS One hundred and sixty-four physicians completed the survey (52·6%). The majority acknowledged that it is very difficult to take all relevant information into account when prescribing drugs. Drug-drug interaction checking, drug-allergy checking, and dosing guidance were considered as most useful. Automated clinical guidelines and adverse drug event monitoring were considered as least useful. The user-friendliness of the systems, clinical relevance of the alerts, and prevention of alert fatigue were perceived as important aspects for a successful implementation. CONCLUSIONS From the physicians' perspective drug-drug interaction checking, drug-allergy checking, and dosing guidance should receive the highest priority for development and implementation. Because the perceived usefulness has been identified as a decisive reason for using CDSSs, it seems feasible to take into account this prioritization when developing and implementing CDSSs. In order to overcome the physicians' perceived disadvantages, attention should go to the development of user-friendly systems that deliver clinical relevant alerts.
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Martin L, Pillot P, Bardonnaud N, Lillaz J, Chabannes E, Bernardini S, Guichard G, Bittard H, Kleinclauss F. [Evaluation of the activity of a urological emergency unit in university hospital]. Prog Urol 2013; 24:62-6. [PMID: 24365631 DOI: 10.1016/j.purol.2013.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Revised: 06/03/2013] [Accepted: 06/06/2013] [Indexed: 10/26/2022]
Abstract
AIM OF THE STUDY To determine the epidemiology of urological emergencies in a university hospital and the interest of a dedicated urological emergency unit. PATIENTS AND METHODS In 2008, a dedicated urological emergency unit was individualized in our department of urology. We conducted a retrospective study including all patients consulting in this unit in 2009 with epidemiological, clinical and therapeutic data. RESULTS During 2009, 1257 patients consulted in this unit. Main diagnoses were acute urinary retention (303, 24.11%), renal colic (219, 17.42%), urinary infections (278, 22.11%), postoperative complications (141, 11.22%), symptomatic benign prostate hyperplasia (65, 5.17%), genitourinary cancers (61, 4.85%), trauma of urinary apparel (41, 3.26%), and spermatic cords torsion (10, 0.8%). In 99 cases (7.88%) diagnosis did not involved the urinary system. The treatment was surgical in 213 (17.7%) cases, technical procedure under local anesthesia in 368 (29.3%) and a medical treatment in 675 (53.7%) cases. Six hundred and sixty (52.5%) patients were managed ambulatory whereas 596 (47.5%) needed hospitalization. CONCLUSION The opening of a dedicated urological emergency unit lead to 1257 emergency consultations. Frequent etiologies were acute urinary retention, renal colic and urinary infection. The creation of this unit allowed to register and to valorize this emergency activity through the ATU emergency amount.
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Affiliation(s)
- L Martin
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard A.-Fleming, 25000 Besançon, France; UFR SMP, université de Franche-Comté, 25000 Besançon, France
| | - P Pillot
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard A.-Fleming, 25000 Besançon, France
| | - N Bardonnaud
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard A.-Fleming, 25000 Besançon, France; UFR SMP, université de Franche-Comté, 25000 Besançon, France
| | - J Lillaz
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard A.-Fleming, 25000 Besançon, France; UFR SMP, université de Franche-Comté, 25000 Besançon, France
| | - E Chabannes
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard A.-Fleming, 25000 Besançon, France
| | - S Bernardini
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard A.-Fleming, 25000 Besançon, France
| | - G Guichard
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard A.-Fleming, 25000 Besançon, France
| | - H Bittard
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard A.-Fleming, 25000 Besançon, France; UFR SMP, université de Franche-Comté, 25000 Besançon, France
| | - F Kleinclauss
- Service d'urologie et transplantation rénale, CHRU de Besançon, 3, boulevard A.-Fleming, 25000 Besançon, France; UFR SMP, université de Franche-Comté, 25000 Besançon, France; UMR 1098, 25000 Besançon, France.
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Mohsin R. Performance of clinical clerks doing paediatric rotations in a community hospital versus a university hospital. Paediatr Child Health 2008; 12:761-4. [PMID: 19030461 DOI: 10.1093/pch/12.9.761] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2007] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Most clinical clerks (third-year medical students) do their paediatric rotation at the IWK Health Centre, the Dalhousie University-affiliated tertiary care paediatric institution in Halifax, Nova Scotia. Due to limited space, some clerks are sent to community hospitals in the provinces of New Brunswick and Prince Edward Island. These community hospitals are different in terms of the academic environment and the availability of paediatric subspecialty services. OBJECTIVE To compare performance of clinical clerks doing paediatric rotations in community hospitals (group I) with those in a university hospital (group II). METHODS The end-of-rotation test scores on the 45 single correct answer multiple choice questions and the three 15 min objective structured clinical examinations in group I (n=54) and group II (n=124) for two consecutive academic years were studied. The end-of-rotation comments by the clerks in group I were examined to assess the quality of their experience. RESULTS For the two academic years, the cumulative mean +/- SD scores for multiple choice questions and objective structured clinical examinations were 82.82+/-7.47 and 70.82+/-11.37, respectively, in group I compared with 83.03+/-7.74 and 69.02+/-11.23 in group II. There were no significant differences in the results between the two groups. No difference in results was seen when the scores were analyzed separately for each of the academic years. The clerks in group I rated their experience as positive. CONCLUSIONS Clerks doing paediatric rotations in community hospitals perform as well and receive similar educational benefits as those at university hospitals. Community hospitals can provide a quality experience for paediatric clerkship training.
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Affiliation(s)
- Rashid Mohsin
- Department of Paediatrics, Undergraduate Medical Education, Dalhousie University, Halifax, Nova Scotia
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