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Comparing Healthcare Facilities to Demographic Standards in the Pakistani Rural Environment 巴基斯坦农村地区医疗设施与人口标准的比较
Pub Date : 2024-08-09 DOI: 10.3390/hospitals1010010
M. A. H. Talpur
The population of Pakistan is increasing, with approximately 2% growth. Over the years, the country’s healthcare system has struggled to meet the needs of the population. Nevertheless, because of shortages compared to population distribution, people are facing primary healthcare challenges, specifically in rural environments. Because of the absence of standard health services, the quality of the health sector deteriorated over time. Therefore, this study aims to compute the shortage of health facilities in Badin, Pakistan, per local health standards. The information related to available health institutes was obtained from the office of the Director-General Health Office with the help of a questionnaire. The current population was determined, and the same was projected up to the year 2035 with the help of a compound interest model. The linear model was executed and found to be significant, with the values of R = 0.996, R2 = 0.991, and Sig. F-change = 0.000. The Badin sub-region needed 201 basic health units, 37 rural health centers, and 746 dispensaries. The public health institutes were found unavailable as per demographic standards. This research set a platform for local authorities to take certain actions in framing essential policies to curtail the shortage of health institutions. This study is significant, as it confers existing and futuristic health institute demands. This research can serve as a model for remote sub-regions to address primary healthcare issues, including the fight against diseases and viruses. This research may also contribute to sustainable goal number 3, i.e., Good Health and Well-being.
巴基斯坦人口不断增长,增长率约为 2%。多年来,该国的医疗保健系统一直在努力满足人口的需求。然而,由于与人口分布相比医疗资源短缺,人们面临着初级医疗保健方面的挑战,尤其是在农村地区。由于缺乏标准的医疗服务,随着时间的推移,卫生部门的质量每况愈下。因此,本研究旨在根据当地卫生标准计算巴基斯坦巴丁市医疗设施的短缺情况。在调查问卷的帮助下,我们从卫生局局长办公室获得了现有医疗机构的相关信息。在复利模型的帮助下,确定了当前的人口数量,并对 2035 年的人口数量进行了预测。执行线性模型后发现,R = 0.996、R2 = 0.991 和 Sig.F-change = 0.000。巴丁次区域需要 201 个基本保健单位、37 个农村保健中心和 746 个药房。根据人口统计标准,巴丁没有公共卫生机构。这项研究为地方当局提供了一个平台,以采取某些行动,制定基本政策,减少医疗机构的短缺。这项研究意义重大,因为它明确了现有和未来的医疗机构需求。这项研究可作为偏远次区域解决初级医疗保健问题(包括抗击疾病和病毒)的典范。这项研究还有助于实现可持续发展目标 3,即 "良好的健康和福祉"。
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引用次数: 0
Transformational Leadership—Quality Achievements and Benefits for the Healthcare Organizations: A Scoping Review 变革型领导的质量成就和对医疗机构的益处:范围审查
Pub Date : 2024-07-26 DOI: 10.3390/hospitals1010008
Eleni Tsapnidou, M. Kelesi, Michael Rovithis, Georgios Katharakis, Georgia Gerogianni, Chrysoula Dafogianni, Georgia Toylia, G. Fasoi, A. Stavropoulou
Effective nursing leadership is critical for healthcare organizations’ sustainability as nurse leaders influence many organizational aspects, including staff retention, quality of care, resource management, and development. The aim of this study is to highlight the quality achievements and benefits that transformational leadership may have for healthcare organizations. An extensive literature search has been conducted through MEDLINE and Scopus. The 6-stage framework proposed by Arksey and O’Malley was applied, guided the scoping review process. Data extracted from the included studies were systematically charted. This approach allowed for a comprehensive understanding of the advantages of transformational leadership in healthcare organizations. Of the 1245 searched articles, 26 encountered the study’s inclusion criteria. Analysis of the studies led to the formulation of two thematic categories, namely, (a) transformational leadership and human resources and (b) transformational leadership and healthcare delivery. Results indicated that transformational nursing leadership can benefit healthcare organizations in terms of effective resource management, high quality of care, and sustainability. Visionary leaders support staff retention, innovation, and research and promote organizational status and development. Through continuous support and training, transformational nurse leaders can ensure nurses’ job satisfaction and engagement, patients’ satisfaction, the best therapeutic outcomes, and high levels of organizational achievement.
有效的护理领导力对医疗机构的可持续发展至关重要,因为护士长会影响机构的许多方面,包括员工留任、护理质量、资源管理和发展。本研究旨在强调变革型领导力可能为医疗机构带来的质量成就和益处。我们通过 MEDLINE 和 Scopus 进行了广泛的文献检索。采用了 Arksey 和 O'Malley 提出的 6 阶段框架来指导范围界定审查过程。从纳入的研究中提取的数据被系统地制成图表。这种方法有助于全面了解变革型领导力在医疗机构中的优势。在搜索到的 1245 篇文章中,有 26 篇符合研究的纳入标准。对这些研究进行分析后,形成了两个主题类别,即:(a)变革型领导力与人力资源;(b)变革型领导力与医疗服务。研究结果表明,变革型护理领导力可使医疗机构在有效资源管理、高质量护理和可持续发展方面受益。具有远见卓识的领导者支持留住员工、创新和研究,并促进组织的地位和发展。通过持续的支持和培训,变革型护士领导可以确保护士的工作满意度和参与度、患者满意度、最佳治疗效果以及高水平的组织成就。
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引用次数: 0
Investigation of Nursing Errors in Greek Pediatric Hospitals 希腊儿科医院护理差错调查
Pub Date : 2024-07-03 DOI: 10.3390/hospitals1010007
Despoina Pappa, E. Evangelou, I. Koutelekos, Evangellos Dousis, G. Toulia, A. Stavropoulou, Nikoletta Margari, Anna Giga, Eftychia Ferentinou, Konstantina Chasaki, Aggeliki Bilali, A. Zartaloudi, Chrysoula Dafogianni
Background: Adverse events are a prevalent occurrence across pediatric healthcare environments, and patient safety is intricately tied to nursing errors due to nurses’ consistent presence and interaction with patients, which surpasses that of any other healthcare professional. This research sought to explore the factors influencing errors as perceived by pediatric nurses in Greek hospital settings. Methods: Clinical pediatric nurses voluntarily and anonymously completed a specialized structured survey, utilizing the Taxonomy of Error, Root Cause Analysis, and Practice-responsibility (TERCAP) tool, which delineates the circumstances surrounding errors occurring during clinical practice. Results: Among the participants employed in the pediatric department, 80.8% (n = 84) reported experiencing an error at their workplace. Notably, in 48.7% (n = 38) of these instances, the error was attributed to themselves (personal responsibility), while in 78.9% (n = 56) of cases, it was linked to errors committed by other colleagues in the clinic. As reported by participants in pediatric departments, the primary factors contributing to potential error occurrence include the absence or inadequacy of orientation and training for new staff (43.2%), the absence of a standardized protocol for resolving disagreements (39%), insufficient ongoing training (38.3%), and breakdowns in interdisciplinary communication (21%). Conclusions: By classifying errors based on various criteria such as outcomes, processes, cognitive reasoning, ethical considerations, and importance, this study presents a holistic framework for examining pediatric nurses’ errors from diverse perspectives. Through this classification approach, the study establishes a foundation for tailored interventions targeting particular aspects of errors and their root causes in pediatric departments.
背景:不良事件是儿科医疗环境中的普遍现象,由于护士始终在患者身边并与患者进行互动,患者安全与护理差错密切相关,这一点超过了其他任何医疗专业人员。本研究旨在探讨希腊医院儿科护士认为影响护理差错的因素。研究方法临床儿科护士自愿匿名完成了一项专门的结构化调查,调查使用了 "错误分类、根源分析和实践责任(TERCAP)"工具,该工具描述了临床实践中发生错误的相关情况。结果显示在受雇于儿科部门的参与者中,80.8%(n = 84)的人表示在工作场所发生过错误。值得注意的是,其中 48.7%(n = 38)的错误归咎于自己(个人责任),而 78.9%(n = 56)的错误则与诊所其他同事所犯的错误有关。根据儿科部门参与者的报告,导致潜在错误发生的主要因素包括:缺乏对新员工的指导和培训或培训不足(43.2%)、缺乏解决分歧的标准化协议(39%)、持续培训不足(38.3%)以及跨学科沟通中断(21%)。最后得出结论:通过根据结果、过程、认知推理、伦理考虑和重要性等不同标准对错误进行分类,本研究提出了一个从不同角度研究儿科护士错误的整体框架。通过这种分类方法,本研究为针对儿科错误的特定方面及其根源进行有针对性的干预奠定了基础。
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引用次数: 0
Impact of Program Region and Prestige on Industry Supplemental Earnings for Pediatric Orthopedic Surgery Fellowships in the United States: A Retrospective Analysis 项目地区和声望对美国小儿矫形外科研究员行业补充收入的影响:回顾性分析
Pub Date : 2024-06-04 DOI: 10.3390/hospitals1010006
Abhinav R. Balu, Anthony N. Baumann, Grayson M. Talaski, Faheem Pottayil, Kempland C. Walley, A. Anastasio, Keith D. Baldwin
Introduction: With the passage of the Physician Payment Sunshine Act, there has been increased transparency regarding the industrial financial relations that physicians have. Orthopedic surgeons have been highly studied in this domain with approximately 50% of all orthopedic surgeons engaging in industrial financial relationships. Furthermore, an increasing number of orthopedic surgeons are seeking fellowship training with pediatric fellowship programs gaining popularity in recent years. The purpose of this study is to evaluate the impact various pediatric orthopedic fellowship programs have on industry earnings and academic productivity. Methods: Pediatric orthopedic fellowship programs were identified via the Orthopedic Society of North America (POSNA) website. Information on individual fellowship programs was obtained from their respective websites. Academic productivity was measured via an aggregate of all employed physicians’ H-index at a specific fellowship as found on the Scopus website. The Open Payments Database (OPD) website was used to assess lifetime industry earnings. Other variables such as Newsweek or Doximity ranking were taken directly from relevant websites. Statistical analysis was performed using a Kruskal–Wallis test with Bonferroni correction and Mann–Whitney U-test. Results: A total of 43 pediatric orthopedic surgery fellowships in the United States were identified with a total of 392 physicians as fellowship faculty. Complete OPD and H-index information were available for 336 of those physicians (85.7%). On average, there were 7.81 ± 5.18 physicians and 1.56 ± 0.93 fellows per program. The mean combined physician H-index was 117.23 ± 122.51, and the mean combined physician lifetime supplemental earnings in dollars was $646,684.37 ± $1,159,507.17. There was no significant relationship between region of pediatric orthopedic fellowship, Newsweek ranking of affiliated hospital, Doximity ranking of affiliated hospital, presence of MBA program, type of program (public, private, mixed), and the lifetime industry earnings or academic productivity of program graduates. Conclusions: Despite the observed lack of statistical significance, there were clear trends observed with fellowship programs in the northeast and west coast regions being the highest earning and fellowship programs with top 10 Newsweek ranking of affiliated hospital having by far the greatest industry earnings. Sample size limitations likely prevented the detection of statistical significance. Future studies should examine if any relation exists when accounting for type of industry payment received and case volume per fellowship program.
导言:随着《医生薪酬阳光法案》的通过,医生的产业财务关系的透明度有所提高。矫形外科医生在这一领域的研究较多,约有 50% 的矫形外科医生有产业财务关系。此外,越来越多的骨科医生开始接受研究员培训,近年来儿科研究员培训项目越来越受欢迎。本研究旨在评估各种小儿骨科研究金项目对行业收入和学术生产力的影响。方法:通过北美骨科协会(POSNA)网站确定小儿骨科研究金项目。有关各个研究金项目的信息来自其各自的网站。学术生产力是通过Scopus网站上特定奖学金项目中所有受聘医生的H指数总和来衡量的。开放支付数据库(OPD)网站用于评估终身行业收入。其他变量如《新闻周刊》或 Doximity 排名则直接取自相关网站。统计分析采用 Kruskal-Wallis 检验和 Bonferroni 校正以及 Mann-Whitney U 检验。结果:美国共有 43 家小儿骨科外科研究中心,共有 392 名医生担任研究中心教员。其中 336 名医生(85.7%)有完整的 OPD 和 H 指数信息。每个项目平均有 7.81 ± 5.18 名医生和 1.56 ± 0.93 名研究员。医生H-指数的平均值为117.23±122.51,医生终身补充收入的平均值为646,684.37±1,159,507.17美元。小儿骨科奖学金的地区、附属医院的新闻周刊排名、附属医院的 Doximity 排名、是否有 MBA 项目、项目类型(公立、私立、混合)与项目毕业生的终生行业收入或学术生产力之间没有明显关系。结论:尽管缺乏统计学意义,但仍可观察到明显的趋势,即东北部和西海岸地区的研究金项目收入最高,附属医院在《新闻周刊》排名前十的研究金项目的行业收入最高。由于样本量的限制,很可能无法发现统计意义。未来的研究应考察在考虑行业支付类型和每个研究金项目的病例量时是否存在任何关系。
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引用次数: 0
Confused about Rehabilitation? Multi-Faceted Approaches for Brain Injured Patients in a Confusional State 对康复感到困惑?针对处于困惑状态的脑损伤患者的多方面方法
Pub Date : 2024-05-09 DOI: 10.3390/hospitals1010005
Jesper Fabricius, Anna Birthe Andersen, Gitte Lindegård Munk, Hanne Kaae Kristensen
Post-injury confusional state is a common phenomenon following acquired brain injury. A multi-faceted approach for decreasing confusion is recommended, but there is a paucity of research related to non-pharmacological management. The main objective was to present a conceptual model of multi-faceted approaches for confusion, and secondly to investigate the rehabilitation outcome following these approaches. The setting is a specialized ward for rehabilitation of patients with severe cognitive difficulties following acquired brain injury. The conceptual model encompasses neurobehavioral strategies, pharmacological treatment, engagement in meaningful occupations, next of kin involvement, organizational demands, the physical environment, along with differential diagnostics. Patient cases are provided to illustrate the impact of each approach. A total of 141 of 281 patients were in a confusional state at admission. At discharge, 62% had emerged from the confusional state. Patients in a confusional state due to traumatic brain injury and subarachnoid hemorrhage had clinically important differences of >22 points in the functional independence measure from admission to discharge, following rehabilitation efforts based on the conceptual model. No clinically important difference was seen in patients with non-SAH stroke and patients with other types of brain injuries. The proposed conceptual model should be further evaluated in complex intervention studies.
伤后意识模糊是后天性脑损伤后的一种常见现象。建议采用多方面的方法来减少意识模糊,但与非药物治疗相关的研究却很少。本研究的主要目的是提出一种治疗精神错乱的多元方法的概念模型,其次是调查采用这些方法后的康复效果。研究环境是一个专门为后天性脑损伤后出现严重认知障碍的患者提供康复治疗的病房。概念模型包括神经行为策略、药物治疗、从事有意义的职业、近亲参与、组织要求、物理环境以及鉴别诊断。我们还提供了一些病例来说明每种方法的影响。在 281 名患者中,共有 141 名患者在入院时处于意识模糊状态。出院时,62%的患者已经摆脱了意识混乱状态。因创伤性脑损伤和蛛网膜下腔出血而处于意识模糊状态的患者,在根据概念模型进行康复治疗后,从入院到出院,其功能独立性指标的临床意义差异大于 22 分。而非蛛网膜下腔出血脑卒中患者和其他类型脑损伤患者则没有临床重要差异。所提出的概念模型应在复杂的干预研究中进一步评估。
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引用次数: 0
Intermediate Care for Patient-Centered Care, Shared Decision Making, and Hospital Discharge Support in a Japanese Acute Care Hospital: A Cross-Sectional Study 日本一家急诊医院的以患者为中心的中间护理、共同决策和出院支持:横断面研究
Pub Date : 2024-05-01 DOI: 10.3390/hospitals1010004
Y. Goto, Hisayuki Miura
[Background] Intermediate care is a limited-time service founded on patient-centered care (PCC) that ensures continuity and quality of care during the transition between home and acute care services, promotes recovery, and restores independence and confidence. In Japan, systematic education on intermediate care for care providers is lacking. [Method] The present study explored the relationship between a Japanese scale used to evaluate individualized discharge support skills, a Japanese version of a tool for evaluating intermediate care based on PCC, and a tool that measures the shared decision making of care providers, which is the pinnacle of PCC. [Results] Clear correlations were found between the concepts evaluated using these three tools. Some concepts were not correlated between the Japanese scale that evaluated individualized discharge support skills and intermediate care based on PCC. [Conclusions] Elucidating the perspectives that help expand discharge care to intermediate care based on PCC will contribute to future education on intermediate care for Japanese care providers and to enriching patient-centered intermediate care.
[背景] 中间护理是一种以患者为中心的限时服务(PCC),它能确保家庭护理和急症护理服务之间过渡期间护理的连续性和质量,促进康复,并恢复患者的独立性和信心。在日本,护理提供者缺乏系统的中间护理教育。[方法]本研究探讨了用于评估个体化出院支持技能的日语量表、基于 PCC 的中间护理评估工具的日语版本以及衡量护理提供者共同决策(PCC 的顶峰)的工具之间的关系。[结果]使用这三种工具评估的概念之间存在明显的相关性。日本的量表评估的是个性化出院支持技能,与基于 PCC 的中间护理之间的某些概念并不相关。[结论]阐明有助于将出院护理扩展到基于 PCC 的中间护理的观点,将有助于今后对日本护理提供者进行中间护理教育,并丰富以患者为中心的中间护理。
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引用次数: 0
A Molecule from Madness: An Exploration into Patients’ Illnesses through West Texas Polio 来自疯狂的分子:通过西德克萨斯州脊髓灰质炎对患者疾病的探索
Pub Date : 2023-07-16 DOI: 10.3390/hospitals1010003
J. Kopel
Neurology holds a unique perspective that embodies the art of capturing a patient’s story. Despite medical advancements, many neurological conditions leave patients permanently impaired. This sudden loss of independence can be demoralizing and, in most cases, directly changes a person’s identity. It is therefore a necessary part of a neurologist’s trade to know their patient’s history—their story. Their tales reveal intimate details of their personality changes, memory loss, sensory deprivation, and movement disorders. A true neurologist is a person that remains vulnerable through their willingness to take a history—the story of their patient—and remain curious, vulnerable, and compassionate through their journey to heal and comfort the patient. To understand the patient’s illness experience in neurology, the underlying themes of patient recovery (compassion, determination, and patience) are explored with regard to the neurological patient’s experience. These themes are then expanded to include the neurology patient’s mental perceptions of themselves, and their illness’ influences over their identity, recovery, and daily life. In addition to the patient’s experience, the neurologist’s awareness and emotional response to the patient’s illness experience can provide an opportunity to develop a strong therapeutic bond with their patient and improve patient outcomes. Given that their neurological impairment causes a loss of independence and control over their identity and self-worth, neurologists can incorporate the patient’s experience into their management and treatment, to better address their emotional and spiritual needs as they come to terms with their identity.
神经病学具有独特的视角,体现了捕捉患者故事的艺术。尽管医学取得了进步,但许多神经系统疾病会使患者永久受损。这种突然失去独立性可能会让人士气低落,在大多数情况下,会直接改变一个人的身份。因此,了解患者的病史——他们的故事是神经学家职业的必要组成部分。他们的故事揭示了他们性格变化、记忆力丧失、感官剥夺和运动障碍的细节。一个真正的神经科医生是这样一个人,他愿意记录一段历史——病人的故事——并在治愈和安慰病人的过程中保持好奇、脆弱和富有同情心。为了了解患者在神经病学中的疾病经历,我们结合神经病学患者的经历探讨了患者康复的基本主题(同情心、决心和耐心)。然后,这些主题被扩展到包括神经病学患者对自己的心理感知,以及他们的疾病对他们的身份、康复和日常生活的影响。除了患者的经历之外,神经学家对患者疾病经历的意识和情绪反应也可以提供一个机会,与患者建立牢固的治疗联系,改善患者的预后。考虑到他们的神经损伤会导致他们失去独立性,失去对身份和自我价值的控制,神经学家可以将患者的经验纳入他们的管理和治疗中,以更好地满足他们在接受身份时的情感和精神需求。
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引用次数: 0
Obstetric Violence in Italy 意大利的产科暴力
Pub Date : 2023-06-29 DOI: 10.3390/hospitals1010002
Marina Di Lello Finuoli
This essay focuses on so-called obstetric violence, i.e., the medical malpractice consisting of disrespect and/or abuses to the detriment of women during their labor or when they give birth, as well as during health care services concerning the sexual and reproductive sphere. The main goal is to start a debate on a topic already considered by foreign lawmakers, also for punishment purposes. After an empirical-criminological survey of the cases and the misconduct to be labelled as “obstetric violence”, this essay analyses the legal tools available in Italy. From a law reform perspective, the author reflects on the (non-criminal) strategies to prevent distortions of the doctor–patient relationship as well as on the harm to women’s self-determination and dignity, particularly in respect of the rules on informed consent.
这篇文章的重点是所谓的产科暴力,即在分娩或分娩期间以及在性和生殖领域的保健服务期间对妇女的不尊重和(或)虐待构成的医疗事故。主要目的是就外国议员已经考虑过的话题展开辩论,也是出于惩罚目的。在对这些案件和被贴上“产科暴力”标签的不当行为进行实证犯罪学调查后,本文分析了意大利可用的法律工具。从法律改革的角度来看,作者反思了防止医患关系扭曲的(非刑事)战略,以及对妇女自决和尊严的伤害,特别是在知情同意规则方面。
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引用次数: 0
Hospitals: A Journal Title with Many Meanings and One Vision 《医院:一个具有多种含义和一个愿景的期刊标题》
Pub Date : 2022-11-09 DOI: 10.3390/hospitals1010001
A. Oliva, Al Ozonoff, Matteo Caputo, S. Grassi
“Hospitals” as a name for a journal might appear simply as an umbrella term for healthcare-relevant research [...]
“医院”作为期刊的名称可能只是医疗保健相关研究的总称[…]
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引用次数: 0
Laundry. 衣服。
Pub Date : 2020-09-08 DOI: 10.2307/j.ctv1595ndt.60
T. Peterson
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引用次数: 0
期刊
Hospitals
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