Current Issue : January - March Volume : 2018 Issue Number : 1 Articles : 6 Articles
Background: Health care associated infections (HAIs) are a source of concern worldwide. No health service in any\ncountry can be considered HAI risk-free. However, there is scarcity of data on the risks to which both patients and\nhealth workers are subject in non-hospital settings. The aim of this study was to identify issues that determine the\nadherence of professionals to precautions for preventing transmission of microorganisms in primary health care.\nMethod: This was a qualitative study, using focus groups of primary health care staff, in two Brazilian municipalities.\nThe data were analysed using content analysis.\nResults: Four focus groups were conducted with 20 professionals (11 community health workers, 5 nursing\nassistants and 4 nurses), and the analysed content was organized into four thematic categories. These categories\nare: low risk perception, weaknesses in knowledge, insufficient in-service training and infrastructure limitations.\nParticipants expressed their weaknesses in knowledge of standard and transmission based precautions, mainly for\nhand hygiene and tuberculosis. A lack of appropriate resources and standardization in sharps disposal management\nwas also highlighted by the participants.\nConclusion: The study points out the need to provide in-service training for professionals on the transmission of\nmicroorganisms in primary health care to ensure adequate level of risk perception and knowledge. Further\nrecommendations include investment to improve infrastructure to facilitate adherence to precautions and to\nminimize the risk of disease transmission for both patients and health care workers...
Objective: To propose approaches to improve nursing handoffs for surgical\npatients, including standardization. Background: Handoffs, or the transfer of\naccountability and patient information, can generate potential risks for patient\nsafety. Standardization has been proposed to help improve handoffs. Methods:\nAfter observing 333 nursing handoffs in the surgical wards of our institution,\nwe conducted a thematic content analysis, comparing and contrasting\nthe observations. Results: Handoff processes, including the use of support\ntools, varied among the observations. Common themes in the handoff content\nsuggested possibilities of standardization. About half of the 51 interruptions\noccurring during the observed handoffs were by healthcare professionals.\nConclusions: Standardization to improve handoffs should address both the\ncontent and the process. Interruptions were common and should be avoided\nwhenever possible. Future studies should also consider the use of mobile applications\nto support handoffs and clinical documentation....
It is well known that Helicobacter pylori (H. Pylori) is a major cause of chronic active gastritis in both children and\nadults. There are a variety of tests for detection of H. pylori infection, however, in medicine, the only way to diagnose\nthe existence of H. pylori microbe is doing endoscopy which is painful and insufferable for young children [1]. To\nsolve this problem, some machine learning classifiers have been used here to diagnose the existence of this\ninfection. As we will see, using machine learning classifier for diagnose the existence of H. pylori is an alternative\nmethod to avoid painful endoscopy. One hundred patient related data has been used from previous published study.\nThere are twenty features in this dataset, such as: abdominal pain and nausea. We have further investigated the\ncontribution of each single feature by using leave-one-feature-out model, where in each experiment one feature was\nremoved from all features model. This model can help us to see how the features interact and how the most and the\nleast informative features can be found, respectively....
Background: Little is known about the intention formation process regarding\nthe use of tracheostomy and invasive ventilation (TIV) in amyotrophic lateral\nsclerosis (ALS) patients in the course of disease progression. Objective: To\nclarify the intention formation process in the use of TIV in ALS patients for\nthe purpose of providing decision-making support. Methods: We conducted\na follow-up study of 14 patients using semi-structured interviews, participant\nobservation, and medical records review. Results: The patients� various intentions\nregarding the use of TIV were formed as their symptoms progressed\n(e.g., declining motor, swallowing, and respiratory functions). Other factors\ninfluencing their decision were their considerations, such as their ability to\ncommunicate after receiving TIV treatment, the degree of support they would\nreceive from professionals after TIV treatment, palliative care for physical\ndistress, value of life after TIV treatment, and to what degree they would be a\nburden on their families. Conclusion: Patients� intentions regarding the use\nof TIV were diverse and changeable. The decision of whether or not to use\nTIV was made out of conviction as well as considering individual experiences\nof symptom progression and quality of life after TIV use....
Background: Low back pain (LBP) as a musculoskeletal disorder is one of the most common occupational injuries\nin nurses but there isnââ?¬â?¢t any valid measure of the prevalence of LBP in Iranian nursing. In order to increase the\npower and improve the estimates of the prevalence of LBP in Iranian nurses, a comprehensive meta-analysis was\ncarried out. A summary measure of all studies conducted in this field was found and distributions of LBP were\nevaluated based on different variables.\nMethods: Inclusion criteria included articles with prevalence of LBP in Iranian nurses, who had at least six months\nof work experience without any trauma, injuries to spine, or any underlying disease. The keywordsââ?¬Å?prevalence, low\nback pain, nursesââ?¬Â, and ââ?¬Å?Iranââ?¬Â were used as part of this search. Databases such as Pubmed, Web of Science, Science\ndirect, Scopus, IranMedex, Irandoc, Magiran, SID, CIVILICA, IMEMR and Google scholar were searched up to and\nincluding 15 June 2016. For data extraction a form was designed that included the following variables: Author\nnames, province, sample size, age, gender, marital status, work experience, body mass index, job type, smoking\nstatus, work schedule, year of publication, type of standard questionnaire, prevalence of LBP, studiesââ?¬â?¢ quality score\nand climate classifications. Data analysis was carried out using fixed and random effects model. Heterogeneity\nbetween studies was assessed by using the I2 and Q tests.\nResults: In all 1250 articles were identified and 22 articles with 9347 participants met the inclusion criteria for metaanalyses\nafter filtering. The prevalence of low back pain during their working life and during the last year, was\nestimated at 63% (95% Confidence Interval (CI): 57.4ââ?¬â??68.5) and 61.2% (95% CI: 55.7ââ?¬â??66.7) respectively. The\nprevalence rate of this disorder was 58.7% (95% CI: 35.8ââ?¬â??81.7) and 60.4% (95% CI: 52.2ââ?¬â??68.6) among men and\nwomen respectively. Furthermore, prevalenceââ?¬â?¢s of LBP were 59.5% in wards nurses, 50.3% in operating room\ntechnicians, and 39.4% in aid nurses.\nConclusions: The results showed the high prevalence of LBP injury in nurses, especially female nurses. The effect of\nmusculoskeletal disorders such as LBP may be reduced by considering proper observation of the principles of\nergonomics in the workplace, performing physical examinations on a regular basis, identifying risk factors in the\nadvancement of musculoskeletal disorders and then trying to fix them....
Background: Quality of life in persons with dementia is, in large part, dependent on the quality of care they\nreceive. Investigating both subjective and objective aspects of quality of care may reveal areas for improvement\nregarding their care, which information may ultimately enable persons with dementia to remain living in their own\nhomes while maintaining quality of life. The aim of this study was to 1) describe self-reported quality of life in\npersons with dementia at risk of nursing home admission. 2) describe subjective and objective aspects of quality of\ncare, 3) investigate the significance of quality of care for quality of life.\nMethods: A cross-sectional interview study design was used, based on questionnaires about quality of life\n(QoL-AD) and different aspects of quality of care (CLINT and quality indicators). The sample consisted of 177\npersons with dementia living in urban and rural areas in Sk�¥ne County, Sweden. Descriptive and comparative\nstatistics (Mann-Whitney U-test) were used to analyse the data.\nResults: Based upon Lawtonâ��s conceptual framework for QoL in older people, persons with pain showed\nsignificantly lower quality of life in the dimensions behavioural competence (p = 0.026) and psychological\nwellbeing (p = 0.006) compared with those without pain. Satisfaction with care seemed to have a positive effect on\nquality of life. The overall quality of life was perceived high even though one-third of the persons with dementia\nhad daily pain and had had a weight loss of â�¥4% during the preceding year. Furthermore, 23% of the persons with\ndementia had fallen during the last month and 40% of them had sustained an injury when falling.\nConclusion: This study indicates need for improvements in home care and services for persons with dementia at\nrisk for nursing home admission. Registered nurses are responsible for nursing interventions related to pain, patient\nsafety, skin care, prevention of accidents, and malnutrition. Therefore, it is of great importance for nurses to have\nknowledge about areas that can be improved to be able to tailor interventions and thereby improve quality of care\noutcomes such as quality of life in persons with dementia living at home....
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