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FORMATION OF MOTIVATIONAL ATTITUDES OF PROFESSIONAL ACTIVITY OF ANESTHESIOLOGISTS-RESUSCITATORS 麻醉师—复苏员职业活动动机态度的形成
Q4 Medicine Pub Date : 2021-01-21 DOI: 10.24884/2072-6716-2020-21-4-36-42
К. S. Klyukovkin, S. A. Kozhin, L. V. Kochorova, М. V. Okulov, А. S. Klimahina
Goal and objectives. Through a comprehensive case study to identify motivating and demotivating factors of professional activity of an anesthesiologists-resuscitators, which will implement the personnel policy of the healthcare security industry with highly qualified specialists of this profile.Materials and methods. In 2019, 412 anesthesiologists and resuscitators from 20 multi-specialty hospitals in St. Petersburg were interviewed, and in 2020, 173 specialists from 8 hospitals were re-trained to treat patients with a new coronavirus infection. In sample populations, the deviation of the average value is 0.7%, while the acceptable reliability assessment of the results is up to 3.0%. The calculation of intensive and extensive indicators and the assessment of the reliability of their difference is made. A correlation analysis was used to assess the impact of a number of aspects of the professional activity of anesthesiologists and resuscitators on their job satisfaction.Results. Anesthesiologists and resuscitators are committed to their work, despite the presence of a negative background: increased emotional load (59.4%), chronic diseases received at work (43.6%). The main negative aspects of their work are «overstrain and fatigue at work» (47.8 per 100 respondents), «the salary does not correspond to the load» (43.6 per 100 respondents), «rudeness on the part of patients and their relatives» (40.1 per 100 respondents), «lack of organized legal protection in the event of conflict situations» (26.8 per 100 respondents). Proper monetary compensation is not always an unambiguous condition for doctors to be highly satisfied with their work — only 26.6% would be fully satisfied with the profession if the salary level met their expectations. The analysis of the positive aspects of professional activity of specialists showed a high significance of factors that have a bright emotional color: the most important are the ability to help people (52.3 per 100 respondents) and a good work team (60.8 per 100 respondents). Salary, the level of which is not marked by doctors among the main aspects of work, however, is stated as a motivating factor by 34.2 respondents out of 100 respondents. A study in 2020 revealed an even greater number of doctors experiencing overstrain and fatigue at work (95.3%, t=4.5, p<0.05, including 59.5% –at the limit of their capabilities), increased psycho-emotional load (86.3%, t=3.8, p<0.05).Conclusion. Most on the professional satisfaction of doctors and anaesthesiologists in Saint-Petersburg have a positive effect: the possibility of self-realization and professional growth (ρ=+0,9, p<0.05) and the wage (ρ=+0,8, p<0.05), the ability to help people (ρ=+0,7, p<0,05) and the presence of career prospects (ρ=+0,7, p<0,05). The greatest negative impact is caused by legal insecurity of specialists (ρ= -0,8, p<0,05), negative consequences of interaction with patients and their relatives (ρ= -0,7, p<0,05), abnormal load on specialists (ρ= -0
目标和目的。通过一个全面的案例研究,以确定麻醉师-复苏师的专业活动的激励和抑制因素,这将与这方面的高素质专家实施医疗安全行业的人事政策。材料和方法。2019年,对圣彼得堡20家多专科医院的412名麻醉师和复苏员进行了访谈;2020年,对8家医院的173名专家进行了再培训,以治疗新型冠状病毒感染患者。在样本总体中,平均值的偏差为0.7%,而结果的可接受可靠性评估高达3.0%。对集约指标和粗放指标进行了计算,并对其差值的可靠性进行了评价。相关分析用于评估麻醉医师和复苏员的专业活动对其工作满意度的影响。尽管存在负面背景,麻醉医师和复苏员仍致力于他们的工作:情绪负荷增加(59.4%),工作时患慢性病(43.6%)。他们工作的主要负面方面是“工作过度紧张和疲劳”(每100名受访者中有47.8人),“工资与工作量不符”(每100名受访者中有43.6人),“患者及其亲属的粗鲁”(每100名受访者中有40.1人),“在发生冲突情况时缺乏有组织的法律保护”(每100名受访者中有26.8人)。适当的金钱补偿并不总是医生对其工作高度满意的明确条件-如果工资水平符合他们的期望,只有26.6%的人会完全满意他们的职业。对专家专业活动积极方面的分析显示,具有鲜明情感色彩的因素具有很高的显著性:最重要的是帮助他人的能力(每100名受访者中有52.3人)和良好的工作团队(每100名受访者中有60.8人)。然而,在100名受访者中,有34.2名受访者认为工资是一个激励因素,而医生在工作的主要方面中并没有明显的工资水平。2020年的一项研究显示,更多的医生在工作中感到过度紧张和疲劳(95.3%,t=4.5, p<0.05,其中59.5% -达到其能力极限),心理情绪负荷增加(86.3%,t=3.8, p<0.05)。大多数对圣彼得堡的医生和麻醉师的职业满意度有积极影响:自我实现的可能性和专业成长(ρ=+0,9, p<0.05)和工资(ρ=+0,8, p<0.05),帮助别人的能力(ρ=+0,7, p<0.05)和职业前景的存在(ρ=+0,7, p<0.05)。最大的负面影响是由专家的法律不安全感(ρ= -0,8, p< 0.05),与患者及其亲属互动的负面后果(ρ= -0,7, p< 0.05),专家的异常负荷(ρ= -0,7, p< 0.05),需要为他们执行未指定的功能(ρ= -0,5, p< 0.05)造成的。
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引用次数: 3
THE USE OF SIMULATION MODELING TO OPTIMIZE THE OPERATION OF AN INPATIENT EMERGENCY DEPARTMENT IN A MULTIDISCIPLINARY HOSPITAL IN THE CONTEXT OF RE-PROFILING A MEDICAL INSTITUTION TO RECEIVE PATIENTS WITH A NEW CORONAVIRUS INFECTION 在重新分析医疗机构接收新型冠状病毒感染患者的背景下,利用仿真建模优化多学科医院住院急诊科的操作
Q4 Medicine Pub Date : 2021-01-21 DOI: 10.24884/2072-6716-2020-21-4-11-16
V. Teplov, E. A. Tsebrovskaya, S. S. Komedev, V. V. Kolomoitsev, E. A. Karpova, V. Belash, S. Bagnenko
This article presents the experience of the practical application of simulation modeling on the example of a model of an inpatient emergency department in working with a new coronavirus infection.
本文以新型冠状病毒感染的住院急诊科模型为例,介绍了仿真建模的实际应用经验。
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引用次数: 13
APPLICABILITY OF BIOMEDICAL PRODUCTS IN PATIENTS WITH DIABETIC FOOT SYNDROME 生物医药产品在糖尿病足综合征患者中的适用性
Q4 Medicine Pub Date : 2021-01-21 DOI: 10.24884/2072-6716-2020-21-4-63-69
A. Kolke, E. Zinoviev, V. V. Zavatskiĭ
Fast and cost-effective treatment of patients with diabetic foot syndrome (DFS) is still a great challenge today. The use of biomedical cell products (BCP) in this category of patients has its own pathogenetic orientation, however, it remains not fully understood and accepted. This review presents the results of numerous studies confirming the effectiveness of the use of BCP for the treatment of mainly superficial trophic defects in patients with neuropathic form of DFS. However, these technologies are still behaved to adjuvant therapies. There are no clear algorithms and regulations for the use of BCP in patients with DFS. It was shown that use of BCP accelerates the reparative processes of superficial trophic defects in patients with neuropathic form of DFS in combination with standard therapy and reduces the time of wound epithelization. In view of the complexity and high cost of BCP, it should be considered the possibility of their use in patients with a neuroischemic form of DFS of different grades by WIfI classification.
快速和具有成本效益的治疗糖尿病足综合征(DFS)患者今天仍然是一个巨大的挑战。在这类患者中使用生物医学细胞产品(BCP)有其自身的发病倾向,但尚未被完全理解和接受。这篇综述介绍了大量研究的结果,证实了BCP用于治疗神经病变型DFS患者主要是浅表营养缺陷的有效性。然而,这些技术仍然表现为辅助治疗。在DFS患者中使用BCP没有明确的算法和规定。研究表明,BCP与标准治疗联合使用可加速神经性DFS患者浅表营养缺陷的修复过程,并缩短创面上皮形成的时间。鉴于BCP的复杂性和高成本,应考虑其在不同WIfI分级的神经缺血性DFS患者中使用的可能性。
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引用次数: 1
PROGNOSTIC CRITERIA FOR SURGICAL AND EVACUATION TACTIC IN PATIENTS WITH POLYTRAUMA 多发创伤患者手术及疏散策略的预后标准
Q4 Medicine Pub Date : 2020-10-14 DOI: 10.24884/2072-6716-2020-21-3-18-23
A. I. Makhnovskiy, O. Ergashev, I. Barsukova, A. Miroshnichenko, R. R. Kasimov, M. V. Usaev
In order to develop criteria for substantiating surgical and evacuation tactics in patients with polytrauma in level II and III trauma centers, the existing prognostic scales for assessing the severity of the injury were studied and a comparative characteristic was given.
为了制定二级和三级创伤中心多发创伤患者手术和疏散策略的标准,研究了现有的评估损伤严重程度的预后量表,并给出了比较特征。
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引用次数: 1
THE FEATURES OF THE COURSE OF BURN DISEASE IN PATIENTS OF ELDERLY AND OLD AGE 中老年烧伤患者的病程特点
Q4 Medicine Pub Date : 2020-10-14 DOI: 10.24884/2072-6716-2020-21-3-54-57
A. Fayazov, R. S. Ajiniyazov
There were studied the course and frequency of complications of burn disease in 160 patients of elderly and older age. The results of the study showed that pneumonia was observed in 16.2% of patients. Along with this, it was noted that, against the background of a burn injury, there were observed exacerbation of concomitant disease, which leads to a burdened course of a burn disease and has an adverse effect on its course and outcome.
对160例中老年烧伤患者的病程及并发症发生率进行了分析。研究结果显示,16.2%的患者出现肺炎。与此同时,还注意到,在烧伤的背景下,观察到伴随疾病的恶化,这导致烧伤疾病的病程加重,并对其病程和结果产生不利影响。
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引用次数: 0
SYSTEM OF CONTINUOUS MEDICAL EDUCATION FOR THE EMERGENCY MEDICAL SERVICE MEDICAL PERSONNEL PERFORMED BY ELECTRONIC EDUCATIONAL TECHNOLOGIES. THE ROLE OF THE PROJECT DURING THE COVID‑19 PANDEMIC 应用电子教育技术对急诊医务人员进行继续医学教育的系统研究。项目在2019冠状病毒病大流行期间的作用
Q4 Medicine Pub Date : 2020-10-14 DOI: 10.24884/2072-6716-2020-21-3-4-10
N. Plavunov, O. Logvinova, A. B. Khisamov, A. Kolesnik, A. G. Buzin
The review paper presents experience of implementation of an educational project - the permanent education system of a large medical facility of Moscow city emergency medical system. Basic project features are given regarding it’s usage and role in pandemic period. We suppose the information given in the paper to be useful for specialists in the spheres of healthcare management in public administration, management of medical organizations and professional medical education.
本文介绍了莫斯科市紧急医疗系统大型医疗设施永久教育系统教育项目的实施经验。就其在疫情期间的用途和作用,给出了项目的基本特点。我们认为文中给出的信息对公共行政、医疗机构管理和专业医学教育领域的医疗管理专家有用。
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引用次数: 0
DISORDERS OF THE BRAIN IN PATIENTS WITH SEVERE BURN INJURY 严重烧伤患者的脑功能紊乱
Q4 Medicine Pub Date : 2020-10-14 DOI: 10.24884/2072-6716-2020-21-3-48-53
O. Orlova, L. P. Pivovarova, I. V. Osipova, O. Ariskina
Conducted an assessment of the level of consciousness on the Glasgow coma scale, sedation level on the Richmond scale of excitation and sedation, assessment on the ICDSC and CAM–ICU scales, as well as monitoring the blood levels of protein S100b, NSE, BNP, NT‑proBNP, procalcitonin, interleukins‑6, - 8 in 53 patients with burn disease to determine the timing and criteria for the development of cerebral insufficiency. It was determined that cerebral disorders develop already upon admission and persist up to 20 days of observation. The debut of early sepsis is associated with clinical and laboratory criteria for neurological deficit.
对53例烧伤患者进行格拉斯哥昏迷量表的意识水平评估,兴奋和镇静的Richmond量表的镇静水平评估,ICDSC和cami - icu量表评估,并监测血液中S100b蛋白、NSE、BNP、NT - proBNP、降钙素原、白细胞介素- 6、- 8的水平,以确定脑功能不全的发生时间和标准。确定入院时已出现脑障碍,并持续观察20天。早期败血症的首次亮相与神经功能障碍的临床和实验室标准有关。
{"title":"DISORDERS OF THE BRAIN IN PATIENTS WITH SEVERE BURN INJURY","authors":"O. Orlova, L. P. Pivovarova, I. V. Osipova, O. Ariskina","doi":"10.24884/2072-6716-2020-21-3-48-53","DOIUrl":"https://doi.org/10.24884/2072-6716-2020-21-3-48-53","url":null,"abstract":"Conducted an assessment of the level of consciousness on the Glasgow coma scale, sedation level on the Richmond scale of excitation and sedation, assessment on the ICDSC and CAM–ICU scales, as well as monitoring the blood levels of protein S100b, NSE, BNP, NT‑proBNP, procalcitonin, interleukins‑6, - 8 in 53 patients with burn disease to determine the timing and criteria for the development of cerebral insufficiency. It was determined that cerebral disorders develop already upon admission and persist up to 20 days of observation. The debut of early sepsis is associated with clinical and laboratory criteria for neurological deficit.","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81499179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
ENHANCEMENT AND DEVELOPMENT OF THE AMBULANCE SERVICES IN PAVLODAR REGION 加强和发展巴甫洛达尔地区的救护车服务
Q4 Medicine Pub Date : 2020-10-14 DOI: 10.24884/2072-6716-2020-21-3-39-43
K. K. Akhmentzhanov, S. Krylova
This article contains a historical overview on development of ambulance in Pavlodar, suggests the ways and methods for improvement of the organization of the ambulance, demonstrates the results of implantation of the ambulance reformation projects, and defines goals and algorithms for the advanced effectiveness of ambulance performance
本文概述了巴甫洛达尔市救护车发展的历史概况,提出了改进救护车组织的途径和方法,论证了救护车改革项目的实施效果,明确了提高救护车绩效的目标和算法
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引用次数: 0
EVALUATION OF DIAGNOSTIC QUALITY CRITERIA OF EMERGENCY CARE FOR DISEASES OF SURGICAL PROFILE AT EMERGENCY DEPARTMENTS 急诊科外科疾病急诊诊断质量标准评价
Q4 Medicine Pub Date : 2020-10-14 DOI: 10.24884/2072-6716-2020-21-3-11-17
R. Alimov, A. Miroshnichenko, E. L. Lataria, I. Turov
The article presents an analysis of diagnostic criteria of quality evaluation for emergency medicine and specialized medical care in emergency departments. The results of the study of emergency medicine care in compliance with quality evaluation criteria showed that in groupe of general criteria for quality evaluation it was achieved in 100 prc cases, in groupe of evaluation criteria of extent of medical aid - in 97,4 prc cases, n groupe of evaluation criteria of timely diagnosis and treatment — 98,2 prc. It also shows the high level of medical care in this department.
对急诊医学质量评价和专科医疗质量评价的诊断标准进行了分析。急诊医学服务符合质量评价标准的研究结果表明,一般质量评价标准组达到100例,医疗救助程度评价标准组达到97,4例,及时诊断和治疗评价标准组达到98,2例。这也显示了这个部门的医疗水平很高。
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引用次数: 0
THERAUPEUTIC AND TACTICAL MEASURES FOR ACUTE INFECTIOUS QUARANTINE DISEASES AT THE PRE-HOSPITAL STAGE OF MEDICAL CARE 急性传染性检疫性疾病院前医疗阶段的治疗与战术措施
Q4 Medicine Pub Date : 2020-10-14 DOI: 10.24884/2072-6716-2020-21-3-44-47
V. M. Shaytor, D. A. Zemlyanoy, M. V. Ponyatishina, A. Galustyan
The paper presents the basic ideas about quarantine infections, especially coronavirus infection, and proposes an algorithm for routing patients with COVID‑2019 at the prehospital stage of emergency and emergency care.
本文介绍了隔离感染特别是冠状病毒感染的基本思路,提出了一种针对院前急救和急救阶段COVID - 2019患者的路径算法。
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引用次数: 0
期刊
Sklifosovsky Journal Emergency Medical Care
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