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Introductie Alcoholproblematiek komt vaker voor bij ziekenhuispatiënten dan bij de algemene bevolking. Veel ziekenhuizen slagen er echter niet in om mensen met alcoholproblematiek op te sporen en hierbij te interveniëren. Het doel van dit onderzoek was een verkenning van belemmerende en bevorderende factoren die zorgprofessionals ervaren bij het in praktijk brengen van alcoholinterventies in ziekenhuizen. Daarnaast verkenden wij welke alcoholinterventies worden gebruikt in de geselecteerde ziekenhuizen en welke stakeholders daarbij betrokken zijn. Methode We hebben semigestructureerde telefonische interviews afgenomen met twintig zorgprofessionals die in, of met, zes algemene ziekenhuizen (samen)werkten. Resultaten Zorgprofessionals noemden belemmerende en bevorderende factoren op het gebied van protocol, motivatie, kennis en vaardigheden, patiëntkenmerken, interne en externe samenwerking/ondersteuning, middelen, rolgeschiktheid en maatschappelijke ondersteuning. Vijf categorieën van benaderingen om alcoholproblematiek op te sporen en hierbij in te grijpen, en achttien betrokken stakeholders van binnen en buiten het ziekenhuis werden geïdentificeerd. Conclusie Het realiseren van alcoholinterventies voor patiënten in Nederlandse ziekenhuizen lijkt nog in de kinderschoenen te staan. De respondenten benadrukken het belang van één duidelijk protocol voor de aanpak van alcoholproblematiek binnen ziekenhuizen, herhaalde trainingen rond alcoholgerelateerde kennis en vaardigheden, (klinische) champions die zorgprofessionals ondersteunen, en het ontwikkelen en onderhouden van de samenwerking met stakeholders binnen en buiten het ziekenhuis.

Background Non-moderated alcohol use is more prevalent among hospitalized patients compared to the general population. However, many hospitals fail to find and intervene with people with alcohol problems. We aimed to conduct an exploration of impeding and facilitating factors experienced by healthcare professionals in implementation of alcohol interventions in Dutch general hospitals. In addition, we explored the alcohol interventions used in the selected hospitals and involved stakeholders. Methods Through a qualitative study, semi-structured telephone interviews were conducted with twenty healthcare professionals working in or in collaboration with six different general hospitals. Results Healthcare professionals indicated impeding and facilitating factors in the areas of motivation, knowledge and skills, patient characteristics, protocol, internal and external collaboration/support, resources, role suitability and societal support. Five different categories of approaches to identify and intervene with non-moderated alcohol use and 18 involved stakeholders from both inside and outside the hospital were found. Conclusions Implementation of alcohol interventions for patients in Dutch general hospitals still seems to be in its infancy. Respondents emphasized the importance of one clear protocol on how to tackle alcohol problems within their hospital, repeated training on alcohol-related knowledge and skills, (clinical) “champions” that support healthcare professionals and developing and maintaining collaborations with stakeholders within and outside the hospital.

一般病院で身体拘束を受ける高齢者を対象に、看護師が身体拘束を必要と判断した理由と高齢者の特徴や治療などとの関連性を検討した。 / 1. 対象者は21病院180名で男性49％、平均年齢81.3±8.4歳、障害老人の日常生活自立度ランクA以下89％、認知症高齢者の日常生活自立度I以下85％であった。手術あり27％、安静の指示ありは46％であった。 / 2. 身体拘束の理由は点滴などの抜去64％、転倒・転落54％、安静が守れない40％などであった。 / 3. 「点滴などの抜去」の該当者ではランクC、指示が通じない、他者への意思伝達ができないが有意に多かった。「転倒・転落」ではランクB以上、転倒歴ありが有意に多かった。「安静が守れない」ではランクB以上、夜間の中途覚醒があり、指示が通じない、手術あり、安静の指示ありが有意に多かった。, This study investigated the reasons why nurses felt the need to use physical restraints on elderly restrained patients at general hospitals, and examined the relationship between these reasons and the characteristics and treatments of the elderly patients. / 1. The subjects were 180 patients at 21 hospitals, 49% males, mean age of 81.3±8.4 years, 89% with a Rank A and below in the 'independence degree of daily living for the disabled elderly' and 85% with a Rank I and below in the 'degree of independent living for the demented elderly' scale. A total of 27% of patients had a history of surgery and 46% were prescribed bed rest. / 2. The reasons for physically restraining patients were as follows : 64% for removal of intravenous lines, 54% to prevent overturning and falling, and 40% to maintain bed rest. / 3. Of the patients that required "removal of intravenous lines," a significantly large number of patients were Rank C or could not understand instructions or communicate their wishes. Among those who were at risk of "overturning and falling," a significantly large number of patients were Rank B and above or had a history of falling. Among those who could "not maintain bed rest," a significantly large number of patients were Rank B and above, experienced nocturnal awakening, could not understand instructions, had a history of surgery, or were prescribed bed rest.

Considering the limited information available, the aim of the study was to examine the prevalence and characteristics of inpatients with dementia in Belgian general hospitals. All admissions of inpatients aged at least 40 years with or without dementia were retrieved from the nationwide administrative hospital discharges database for the period 2010-2014. Admissions of inpatients aged 40 years or more with dementia have increased to reach 83,017 out of 1,285,593 admissions (6.46%) in general hospitals in 2014, mostly admitted through the emergency department (79.7%) and for another reason than dementia (85.9%). These patients stayed longer [19.2 days, standard deviation (sd) = 23.6, median = 13] than the average length of stay of patients of the same age (7.9 days, sd = 14.1, median = 17). Considering patients aged 75 years or more falling into the 20 most common pathology groups (of patients with dementia), the group with dementia spent 5 days more than the group without dementia. Patients admitted from home spent more time in hospital when they were discharged to a residential care facility than when they returned home (27.2 days versus 15.8 days). The in-hospital mortality was high in the first days of admission. The growing prevalence of patients with dementia in inpatient setting puts a high pressure on the hospital capacity planning and geriatric expertise. Moreover, as patients with dementia should be kept outside hospitals when possible for safety and quality matters, long-term organizational investments are required inside hospital and residential care settings as well as in community care.

Much of the information produced in hospitals is clinical, and stored for the purposes of documentation. In practice, most of it is never used. The potential of analytics is to reuse this information for other purposes. This is easier said than done, because of technical, semantic, legal and organizational hindrances. In particular, hospitals are not organized to leverage the value of big data. In this study we ask, how can we conceptualize analytics as an integrated part of hospital processes? And, how can we develop and organize an analytics capability in a large hospital? Our empirical evidence is a longitudinal study in a high-tech hospital in Norway, where we followed the development of an analytics capability, and assessed the organizational benefits. We offer two findings. First, we show how the analytics process interacts with the hospital logistics processes in a sense- and respond cycle. Second, we demonstrate how analytics capability is built on the institutionalized network of technology, an analytics team and the administrative and clinical decision makers. © 2019, Springer Science+Business Media, LLC, part of Springer Nature.

Background: Patient and visitor violence (PVV) is the most dangerous occupational hazard that health professionals must contend with. Staff training is recommended to prevent and manage PVV. There is minimal research focusing on risk factors associated with PVV in general hospital settings. Therefore, staff training is mostly based upon expert knowledge and knowledge from psychiatric and emergency settings. Objectives: This study investigates health professionals’ experiences with PVV in order to describe risk factors related to PVV that occur in general hospital settings. Design: A retrospective cross-sectional survey was conducted in 2007. Setting: A university general hospital in Switzerland. Participants: 2495 out of 4845 health professionals participated (58.0% nurses & midwives, 19.2% medical doctors, 3.6% physical therapists, occupational therapists & nutritionists, 6.1% ward secretaries, medical & radiology assistants, 6.3% nursing assistants or less qualified nursing staff and 5.1% other staff). All had direct patient contact and 82% were female. Methods: Data were collected via questionnaires using the Survey of Violence Experienced by Staff German-Version-Revised, the German version of the shortened Perception of Aggression Scale and the Perception of Importance of Intervention Skills Scale. Descriptive statistics and multiple logistic regression analyses were used. Results: Risk factors associated with PVV depend upon the form of violence. Those trained in aggression management and/or those who work predominantly with patients over 65 years of age experience twice as much PVV as others. Health professionals working in emergency rooms, outpatient units, intensive care units, recovery rooms, anesthesia, intermediate care and step-down units also experience PVV more often. When health professionals are older in age, are from the medical profession, are students, or when they have an attitude rating preventive measures as being less important and aggression

Background: Patient and visitor violence (PVV) is the most dangerous occupational hazard that health professionals must contend with. Staff training is recommended to prevent and manage PVV. There is minimal research focusing on risk factors associated with PVV in general hospital settings. Therefore, staff training is mostly based upon expert knowledge and knowledge from psychiatric and emergency settings. Objectives: This study investigates health professionals’ experiences with PVV in order to describe risk factors related to PVV that occur in general hospital settings. Design: A retrospective cross-sectional survey was conducted in 2007. Setting: A university general hospital in Switzerland. Participants: 2495 out of 4845 health professionals participated (58.0% nurses & midwives, 19.2% medical doctors, 3.6% physical therapists, occupational therapists & nutritionists, 6.1% ward secretaries, medical & radiology assistants, 6.3% nursing assistants or less qualified nursing staff and 5.1% other staff). All had direct patient contact and 82% were female. Methods: Data were collected via questionnaires using the Survey of Violence Experienced by Staff German-Version-Revised, the German version of the shortened Perception of Aggression Scale and the Perception of Importance of Intervention Skills Scale. Descriptive statistics and multiple logistic regression analyses were used. Results: Risk factors associated with PVV depend upon the form of violence. Those trained in aggression management and/or those who work predominantly with patients over 65 years of age experience twice as much PVV as others. Health professionals working in emergency rooms, outpatient units, intensive care units, recovery rooms, anesthesia, intermediate care and step-down units also experience PVV more often. When health professionals are older in age, are from the medical profession, are students, or when they have an attitude rating preventive measures as being less important and aggression

Patient and visitor violence (PVV) in general hospitals is an underestimated problem. The dissertation investigates the occurrence and factors of this workplace hazard. Over half of the participating 2495 health professionals experienced PVV in the past year. Risk factors are connected to the personal characteristics of those involved, the interaction and the situation. Medical doctors experienced less violence than other health professionals. Young or inexperienced staff or staff working in emergency settings experienced more. Physical injuries occurred in 15% of the incidences. Verbal violence was emotionally upsetting for almost all participants and most for who had experienced physical violence. In general the research results showed that strong institutional policies and procedures against patient and visitor violence are important in order to increase staff’s feeling of safety and in order to reduce the frequency of patient and visitor violence. Focused training for specific staff groups, workplaces and interdisciplinary teamwork would also be beneficial.

Patient and visitor violence (PVV) in general hospitals is an underestimated problem. The dissertation investigates the occurrence and factors of this workplace hazard. Over half of the participating 2495 health professionals experienced PVV in the past year. Risk factors are connected to the personal characteristics of those involved, the interaction and the situation. Medical doctors experienced less violence than other health professionals. Young or inexperienced staff or staff working in emergency settings experienced more. Physical injuries occurred in 15% of the incidences. Verbal violence was emotionally upsetting for almost all participants and most for who had experienced physical violence. In general the research results showed that strong institutional policies and procedures against patient and visitor violence are important in order to increase staff’s feeling of safety and in order to reduce the frequency of patient and visitor violence. Focused training for specific staff groups, workplaces and interdisciplinary teamwork would also be beneficial.

A draft of a lease and agreement between Walker County Hospital District of Walker County, Texas and Huntsville Memorial Hospital, in which the District leases an existing 112-bed acute care general hospital located in Huntsville to the Huntsville Memorial Hospital and further agrees to construct another 140-bed acute care general hospital.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of a lease and agreement between Walker County Hospital District of Walker County, Texas and Huntsville Memorial Hospital, in which the District leases an existing 112-bed acute care general hospital located in Huntsville to the Huntsville Memorial Hospital and further agrees to construct another 140-bed acute care general hospital.

A draft of a lease and agreement between Walker County Hospital District of Walker County, Texas and Huntsville Memorial Hospital, in which the District leases an existing 112-bed acute care general hospital located in Huntsville to the Huntsville Memorial Hospital and further agrees to construct another 140-bed acute care general hospital.

A draft of a lease and agreement between Walker County Hospital District of Walker County, Texas and Huntsville Memorial Hospital, in which the District leases an existing 112-bed acute care general hospital located in Huntsville to the Huntsville Memorial Hospital and further agrees to construct another 140-bed acute care general hospital.

A draft of a lease and agreement between Walker County Hospital District of Walker County, Texas and Huntsville Memorial Hospital, in which the District leases an existing 112-bed acute care general hospital located in Huntsville to the Huntsville Memorial Hospital and further agrees to construct another 140-bed acute care general hospital.

A draft of a lease and agreement between Walker County Hospital District of Walker County, Texas and Huntsville Memorial Hospital, in which the District leases an existing 112-bed acute care general hospital located in Huntsville to the Huntsville Memorial Hospital and further agrees to construct another 140-bed acute care general hospital.

A draft of a lease and agreement between Walker County Hospital District of Walker County, Texas and Huntsville Memorial Hospital, in which the District leases an existing 112-bed acute care general hospital located in Huntsville to the Huntsville Memorial Hospital and further agrees to construct another 140-bed acute care general hospital.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of a lease and agreement between Walker County Hospital District of Walker County, Texas and Huntsville Memorial Hospital, in which the District leases an existing 112-bed acute care general hospital located in Huntsville to the Huntsville Memorial Hospital and further agrees to construct another 140-bed acute care general hospital.

A draft of a lease and agreement between Walker County Hospital District of Walker County, Texas and Huntsville Memorial Hospital, in which the District leases an existing 112-bed acute care general hospital located in Huntsville to the Huntsville Memorial Hospital and further agrees to construct another 140-bed acute care general hospital.

A draft of a lease and agreement between Walker County Hospital District of Walker County, Texas and Huntsville Memorial Hospital, in which the District leases an existing 112-bed acute care general hospital located in Huntsville to the Huntsville Memorial Hospital and further agrees to construct another 140-bed acute care general hospital.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of a lease and agreement between Walker County Hospital District of Walker County, Texas and Huntsville Memorial Hospital, in which the District leases an existing 112-bed acute care general hospital located in Huntsville to the Huntsville Memorial Hospital and further agrees to construct another 140-bed acute care general hospital.

A draft of a lease and agreement between Walker County Hospital District of Walker County, Texas and Huntsville Memorial Hospital, in which the District leases an existing 112-bed acute care general hospital located in Huntsville to the Huntsville Memorial Hospital and further agrees to construct another 140-bed acute care general hospital.

A draft of a lease and agreement between Walker County Hospital District of Walker County, Texas and Huntsville Memorial Hospital, in which the District leases an existing 112-bed acute care general hospital located in Huntsville to the Huntsville Memorial Hospital and further agrees to construct another 140-bed acute care general hospital.

A draft of a lease and agreement between Walker County Hospital District of Walker County, Texas and Huntsville Memorial Hospital, in which the District leases an existing 112-bed acute care general hospital located in Huntsville to the Huntsville Memorial Hospital and further agrees to construct another 140-bed acute care general hospital.

A draft of a lease and agreement between Walker County Hospital District of Walker County, Texas and Huntsville Memorial Hospital, in which the District leases an existing 112-bed acute care general hospital located in Huntsville to the Huntsville Memorial Hospital and further agrees to construct another 140-bed acute care general hospital.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of a lease and agreement between Walker County Hospital District of Walker County, Texas and Huntsville Memorial Hospital, in which the District leases an existing 112-bed acute care general hospital located in Huntsville to the Huntsville Memorial Hospital and further agrees to construct another 140-bed acute care general hospital.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of a lease and agreement between Walker County Hospital District of Walker County, Texas and Huntsville Memorial Hospital, in which the District leases an existing 112-bed acute care general hospital located in Huntsville to the Huntsville Memorial Hospital and further agrees to construct another 140-bed acute care general hospital.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.

A draft of an Indenture of Mortgage and Deed of Trust from Walker County Hospital District to Unnamed Trustee, detailing the obligations and responsibilities of each party in the agreement.