Search

The management of hazardous waste is important and necessary to prevent the health of the personnel in charge of this management from being put at risk and to safeguard the environmental balance. For this reason, the objective of this case study was to evaluate the comprehensive management of hazardous hospital waste, which is generated at the Verdi Cevallos Balda hospital in the Portoviejo Canton, through the application of a descriptive approach, with a non-experimental design. Through a methodology with techniques such as observation sheets, the calculation of the number of kilograms that the hospital generates during a week, and a compliance check list regarding the current legal regulations of Ecuador. According to the results, within the comprehensive management of hazardous waste there is a total of 70.8 kg. Whose generation classification is 33% infectious biological waste, 26% sharps, 17% anatomopathological, 18% chemical and 6% radioactive waste. Compliance with current legal regulations regarding the management of hazardous waste was verified, whose compliance percentage is 70%, finding certain deficiencies for which improvement strategies were designed with the objective of improving the missing 30% of the waste in the short term. compliance in the operational management of hazardous solid waste within the Verdi Cevallos Balda hospital., La gestión de residuos peligrosos es importante y necesaria para evitar que se ponga en riesgo la salud del personal encargado de esta actividad y salvaguardar el equilibrio ambiental. Por tal motivo el presente caso de estudio tuvo como objetivo evaluar la gestión integral de los desechos hospitalarios peligrosos, que se generan en el hospital Verdi Cevallos Balda del Cantón Portoviejo, mediante la aplicación de un enfoque descriptivo, con diseño no experimental. Mediante una metodología con técnicas como fichas de observación, el cálculo de la cantidad de kilogramos que genera el hospital durante una semana, y un check list de cumplimiento acerca de la normativa legal vigente del Ecuador. De acuerdo a los resultados, dentro de la gestión integral de los desechos peligrosos se encuentra un total de 70.8 kg. Cuya clasificación de generación es de 33% de desechos biológicos infecciosos, 26% cortopunzantes, 17% anatomopatológicos, 18% químicos y el 6% de desechos radiactivos. Se verificó el cumplimiento de la normativa legal vigente acerca de la gestión de los residuos peligrosos cuyo porcentaje de cumplimiento es del 70%, encontrando ciertas deficiencias para las cuales se diseñaron estrategias de mejoras con el objetivo de mejorar a corto plazo el 30% faltante del cumplimiento en la gestión operativa de los residuos sólidos peligrosos dentro del hospital Verdi Cevallos Balda.

Introduction: Dignified treatment (DT) refers to the perception that patients or their family members have regarding the care and attention provided, considered a right when receiving medical care. Objective: To identify the level of perception of dignified treatment by nursing staff among patients in a public hospital in Michoacán. Method: Quantitative study, non-experimental, descriptive, and cross-sectional design with a sample of 65 hospitalized patients in July 2023. A satisfaction survey on dignified and appropriate treatment from the Ministry of Health was used, modified with dichotomous and Likert responses. Descriptive statistics, measures of central tendency, and dispersion were employed. Informed consent was obtained in accordance with the Regulations of the General Health Law on Health Research. Results: 58.5% were women; 33.8% aged 19-27 and 33.8% over 28; educational level: 41.5% completed secondary education; marital status: 43.1% single; 83.1% from urban areas; religion: 93.8% Catholic. 60% of hospitalized patients perceived nursing care as dignified. Conclusions: Dignified treatment is a tool that demonstrates the quality of care provided by nursing professionals and is perceived by patients as good treatment or friendly treatment., Introducción: El trato digno (TD): percepción que tiene el paciente o el familiar del trato y la atención proporcionada, también considerado como un derecho de los pacientes al recibir atención médica. Objetivo. Identificar el nivel de percepción del trato digno por enfermería de los pacientes de un hospital público de Michoacán. Método. Estudio cuantitativo, diseño no experimental, descriptivo y de corte transversal, muestra: 65 pacientes hospitalizados, en julio del 2023, se utilizó encuesta de satisfacción, trato digno y adecuado de la Secretaría de Salud, modificando con respuestas dicotómicas y Likert, se empleó estadística descriptiva, medidas de tendencia central y de dispersión, se aplicó consentimiento informado en apego al Reglamento de la Ley General de Salud en Materia de Investigación para la Salud. Resultados. Mujeres 58.5%; edad 33.8% de 19-27 años y 33.8% mayores de 28 años; del nivel de estudio: 41.5%, secundaria; estado civil; solteros 43.1%, zona de origen; urbano 83.1%, religión: católica 93.8%. de los pacientes hospitalizados 60% si percibieron el trato como digno por parte de enfermería Conclusiones. El trato digno es una herramienta que evidencia la calidad del cuidado de los profesionales enfermería y los pacientes loperciben como buen trato o trato amable.

Introduction: The World Health Organization (WHO) defines quality of care as the extent to which health services provided to people and populations improve their ability to maintain or improve their living conditions. Objective: Determine the user's perception of the quality of care of health services in the maternal and child area of a hospital. Materials and methods: A study were carried out with a quantitative, non-experimental, correlational analytical approach. A survey was conducted anonymously to 148 participants made up of users and companions. To collect information, magazines such as Scielo, Science Direct and Redalyc were used. The analysis of the data obtained was carried out using a database created in the IBM SPSS Statics 27.0 statistical software, and the Cronbach's Alpha test was used to measure the reliability of the data. Results: Of the total of 148 respondents, more than 60% agree with the dimensions evaluated, which indicates that in the maternal and child area they are satisfied with the quality of the services obtained by the institution and the staff of health. Conclusions: Empathy and communication are highlighted as important factors, in addition to the need for periodic satisfaction evaluations within the institution., Introducción: La Organización Mundial de la Salud (OMS) define la calidad de atención como la medida en que los servicios de salud proporcionados a las personas y las poblaciones mejoran la capacidad de estas, para mantener o mejorar su condición de vida. Objetivo: Determinar la percepción del usuario en la calidad de atención de los servicios de salud del área de materno infantil de un hospital. Materiales y métodos: Se realizó un estudio con un enfoque cuantitativo, no experimental, analítico correlacional. Se aplico una encuesta de forma anónima a 148 participantes conformados por usuarios y acompañantes. Para la recopilación de información se utilizaron de revistas como Scielo, Science Direct y Redalyc. El análisis de los datos obtenidos se realizó mediante una base de datos creada en el software estadístico de IBM SPSS Statics 27.0, y para medir la fiabilidad de los datos se utilizó el test Alfa de Cronbach. Resultados: Del total de 148 encuestados, más del 60% manifiestan estar de acuerdo en cuanto a las dimensiones evaluadas, lo que indica que en el área de materno infantil se encuentran satisfechos en cuanto a la calidad de los servicios obtenidos por la institución y el personal de salud. Conclusiones: Se destaca la empatía y la comunicación como factores de importancia, además de la necesidad de evaluaciones de satisfacción periódicas dentro de la institución.

Introduction. Stroke (stroke) is a medical condition that affects the brain and can result in disruption of blood flow to the brain, which can cause brain damage and various health complications. Aim. Explore the evidence in relation to the nursing role in the care of patients with stroke in hospital environments. Methodology. The present study is a systematic review of the literature located in the records of the Scielo, Pubmed, Semantic Scholar, Scopus WoS databases, including 19 studies for review, after applying inclusion and exclusion criteria according to the PRISMA-ScR 2020 guidelines, for the search, keywords were applied using descriptors in the field of health sciences (DeCS/MeSH): nursing role, nursing care, acute stroke. Results. 856 studies were identified, of which 400 studies were discarded due to duplication, of which 305 were discarded due to inconsistency with the title and summary of studies, leaving 19 studies with eligibility criteria for summary. Conclusion. The nursing role in the care of patients with stroke in hospital environments, improvement of physiological and biochemical parameters and in the prevention of complications in patients with stroke, training and constant updating of nurses, and systematization of nursing care are key aspects. to improve clinical outcomes., Introducción. El accidente cerebro vascular (ICTUS) es una condición médica que afecta al cerebro y puede resultar en la interrupción del flujo sanguíneo al cerebro, lo que puede causar daño cerebral y diversas complicaciones de salud. Objetivo. Explorar la evidencia en relación con el rol enfermero en la atención del paciente con ICTUS en entornos hospitalarios. Metodología. El presente estudio es revisión sistemática de la bibliografía ubicados en los registros de las bases de datos Scielo, Pubmed, Semantic Scholar, Scopus WoS, incluyendo a 19 estudios para revisión, luego de aplicar criterios de inclusión y exclusión según las pautas PRISMA-ScR 2020, para la búsqueda se aplicó palabras clave empleando descriptores en el campo de las ciencias de la salud (DeCS/MeSH): rol enfermero, atención de enfermería, ICTUS agudo. Resultados. Se identificaron 856 estudios, de ellos 400 estudios fueron descartados por duplicidad, de ellos 305 descartados por incongruencia con el título y resumen de estudios, quendo con 19 estudios con criterios de elegibilidad para resumen Conclusión. El rol enfermero en la atención del paciente con ICTUS en entornos hospitalarios, mejora de parámetros fisiológicos, bioquímicos y en la prevención de complicaciones en pacientes con ICTUS, la formación y actualización constante de las enfermeras, y la sistematización del cuidado de enfermería son aspectos clave para mejorar los resultados clínicos.

The objective of the research was to evaluate hospital marketing as a tool for quality of care at the Dr. Adolfo Pons Hospital. For its development, a survey was applied to a sample of 84 patients from the Dentistry Service. The instrument was the modified SERVQHOS Hospital Service Quality questionnaire, which consisted of 19 items based on a Likert scale ranging from 1 to 5 and 3 dichotomous response items (yes/no). In addition, an open question was included to make a suggestion to improve the quality of care. Results established that the level of patient satisfaction, health quality, equipment technology and information provided to the patient was much better than what patients expected. These findings coincide with what Drucker stated, for which the goal is to create satisfied customers. It is concluded that the quality of care can be measured through thistool applied in hospital marketing such as SERVQHOS, which can be applied periodically to know if patients are satisfied. Likewise, the design of a strategic digital marketing plan for the hospital's dental area is suggested, aimed at increasing knowledgeof the service, guaranteeing patient loyalty and trust, in addition to serving as a tool to strengthen oral education for citizens in general., El objetivo de la investigación fue evaluar el marketing hospitalario como herramienta para la calidad asistencial en el Hospital Dr. Adolfo Pons. Para el desarrollo su se aplicó una encuesta a una muestra de 84 pacientes del Servicio de Odontología. El instrumento ha sido el cuestionario para medir Calidad de Servicio Hospitalario SERVQHOS modificado, constó de 19 ítems a partir de en una escala Likert que va desde 1 a 5 y 3 ítems de respuesta dicotómica (si/no). Además, se incluyó una pregunta abierta, para realizar alguna sugerencia para mejorar la calidad de la atención. Resultados establecieron que el nivel de satisfacción de los pacientes, calidad sanitaria, tecnología de los equipos e información suministrado al paciente fue mucho mejor al que los pacientes esperaban. Estos resultados hallazgos coinciden con lo planteado por Drucker, para el cual la meta es crear clientes satisfechos. Se concluye que la calidad asistencial puede medirse a través de esta herramienta aplicada en el Marketing hospitalario como es el SERVQHOS, el cual puede aplicarse de manera periódica para conocer si los pacientes están satisfechos. Así mismo, se sugiere el diseño de un plan estratégico de marketing digital para el área odontológica del hospital, dirigido a incrementar el conocimiento del servicio, garantizar la fidelidad y confianza de los pacientes, además de servir como herramienta para fortalecer la educación bucal a la ciudadanía en general.

Esta investigación “Actualización de valores de actitud en personas con diagnóstico de insuficiencia renal crónica en tratamiento de hemodiálisis en el hospital Dr. Arturo Oñativia” fue desarrollada desde un enfoque cualitativo, con diseño fenomenológico, tomando una muestra intencional, no probabilística, para conocer y comprender las experiencias de las personas en tratamiento de hemodiálisis, conociendo si actualizan valores de actitud ante el diagnóstico y tratamiento de la insuficiencia renal crónica. Se desarrolló en el hospital público Dr. Arturo Oñativia en Salta capital en el último trimestre del año 2023 y principios del 2024, tomando como marco teórico la psicoterapia planteada por V. Frankl, la logoterapia. La muestra con la que se realizó el proceso de la investigación estuvo conformada por nueve participantes que están en tratamiento de hemodiálisis. Para la presente investigación se aplicaron diferentes instrumentos para la recolección de datos y el posterior análisis de la información, una entrevista fenomenológica y el Logo – test. A su vez, se accedió a las historias clínicas de los participantes para tener mayor información sobre los mismos. El objetivo general es, conocer si los valores de actitud se actualizan en personas con diagnóstico de insuficiencia renal crónica, en tratamiento de hemodiálisis, en el hospital Dr. Arturo Oñativia. Se concluyó que los nueve participantes de la muestra, logran actualizar sus valores de actitud apoyándose principalmente en los valores de experiencia. Sin embargo, se destaca que la participante seis, aunque sí actualizo sus valores de actitud, lo logró apoyada en un esfuerzo de voluntad. Esto se vio en la entrevista fenomenológica y en el Logo - test, que no se observó de la misma forma en los otros participantes. This research, "Attitude Values Update in Individuals Diagnosed with Chronic Kidney Disease Undergoing Hemodialysis Treatment at Dr. Arturo Oñativia Hospital," was developed from a qualitative approac, Fil: Naranjo de Sarapura, Eleonora María. Universidad Católica de Salta. Facultad de Artes y Ciencias; Argentina., Fil: Nuñez, Lucía Verónica. Universidad Católica de Salta. Facultad de Artes y Ciencias; Argentina.

Purpose: In the face of competition, hospitals must attract and retain the best talent, such as millennial doctors. This study seeks to assess the dimensions of employer branding that influence recruiting and retaining millennial doctors. Theoretical Framework: This study is grounded in the theoretical concepts of employer branding and generational work values. It specifically examines the influence of employer branding on job choice and retention among millennials, integrating theories from marketing, human resource management, and generational studies. Design/Methodology/Approach: The research adopts a quantitative methodology, surveying 265 millennial-generation doctors across several hospitals in Bandung, Indonesia. Data were collected through structured questionnaires focusing on various dimensions of value-based employer branding. Statistical analysis was used to evaluate the data and draw conclusions. Findings: The research found that Indonesian hospitals are generally perceived as having good value-based employer branding. Key dimensions that emerged as most critical for attracting and retaining millennial doctors include social, development, and application values. These findings suggest a distinct set of priorities and preferences among millennial medical professionals. Research, Practical & Social Implications: The study's results have implications for hospital management and policymakers. It highlights the importance of aligning employer branding strategies with the values and expectations of millennial doctors. Practically, it guides hospital leadership in policy formulation and establishing work practices that resonate with this demographic, potentially improving recruitment and retention rates. Originality/Value: This research contributes to the existing literature on employer branding and generational work values, specifically within the healthcare sector in Indonesia. Its novel focus on millennial doctors in Bandung hospitals provides fres

The rapid and concerning increase in global food waste has garnered much attention due to its profound social, economic, and environmental ramifications worldwide. Healthcare facilities significantly influence the food chain because of their considerable resource consumption, waste generation, and procurement capabilities. Furthermore, insufficient waste management procedures can have significant ecological repercussions, predominantly due to the carbon emissions generated while disposing of healthcare waste, which also encompasses food waste. The matter of food waste in hospital food services is a complex and multifaceted problem, influenced by a multitude of factors. Conversely, endeavors to mitigate food waste within hospital settings encountered substantial obstacles. The challenges encountered pertain to every facet of hospital services through the emphasis on sustainability. This literature review aims to examine the literature on hospital food waste and identify the gaps in the existing resources that concentrate on the factors that lead to food waste being produced in healthcare facilities and the possible solutions to this problem. The findings point to the contributing factors of hospital food waste, including food quality and quantity, patient satisfaction, patient characteristics and clinical condition, meal times and food from outside, and the environment surrounding the hospital. It also indicates that implementing strategies such as improving the food delivery system, design of the menu, implementing room service model, improving food quality and the presentation of the meal, recruiting food dietitians, improving the dining environment as well as promoting reuse, recycling, composting, and anaerobic digestion can all help reduce food waste. Since food waste generation is context-specific, study outcomes may vary. Therefore, reduction strategies may vary by circumstance. Future research requires more advanced analytical methodologies and specific study

Objective: Determine the relationship between the budget execution of financial transfers from the SIS (Seguro Integral de Salud) and the availability of medical supplies in third-level establishments of the Ministry of Health of Metropolitan Lima. Material and method: Analytical and cross-sectional study, carried out in the 20 level III establishments of the MINSA in Lima; Likewise, documentary information was used such as Closing Minutes of Financial Supervision of the Macroregional Management of the SIS from which information on budget execution was obtained and the availability of medical supplies was obtained from the Mundo IPRESS web portal (Institutions Providing Health Services). After evaluating normality with the Shapiro-Wilk test, the Spearman correlation test was used. Result: Overall budget execution was not related to the availability of medical supplies (rho=-0.014; p=0.955). The evaluation by components showed that budget execution on medicines was positively related to the availability of supplies (rho=0.417; p=0.045), which was also valid in the segmented analysis only for hospitals (rho: 0.594; p=0.032). Although budget execution in segmented materials and supplies for hospitals was related to the availability of supplies, this relationship was inverse (rho=-0.552; p=0.043). Conclusions: The general budget execution of financial transfers from the SIS was not related to the availability of medical supplies, but the spending component on medicines was, Objetivo: Determinar la relación entre la ejecución presupuestal de transferencias financieras del Seguro Integral de Salud (SIS) y la disponibilidad de suObjetivo: Determinar la relación entre la ejecución presupuestal de transferencias financieras del Seguro Integral de Salud (SIS) y la disponibilidad de suministros médicos en establecimientos de tercer nivel del Ministerio de Salud (MINSA) en Lima Metropolitana. Material y método: Estudio transversal, realizado en 20 establecimientos del nivel III en Lima Metropolitana. La información sobre ejecución presupuestal (total, en gastos de reposición, de medicamentos, y de materiales o insumos) se obtuvo de las Actas de Cierre de Supervisión Financiera de la Gerencia Macrorregional del SIS; mientras que la disponibilidad de suministros médicos (productos farmacéuticos, dispositivos médicos y/o productos sanitarios) fue recolectada del portal web Mundo IPRESS (por el acrónimo de Instituciones Prestadoras de Servicios de Salud). Para correlacionar ambos conceptos se utilizó el test de Spearman (rho), considerándose un valor p<0,05 como significativo. Resultados: La ejecución presupuestal global no se relacionó con la disponibilidad de suministros médicos (rho=-0,014; p=0,955). La evaluación por componentes evidenció que la ejecución presupuestal en medicamentos se relacionó positivamente con la disponibilidad de suministros (rho=0,417; p=0,045), lo cual también fue válido en el análisis solo para hospitales (rho: 0,594; p=0,032). Si bien la ejecución presupuestal en materiales e insumos para hospitales se relacionó con la disponibilidad de suministros, dicha relación fue inversa (rho=-0,552; p=0,043). Conclusiones: La ejecución presupuestal general de transferencias financieras del SIS no se relacionó con la disponibilidad de suministros médicos, a excepción del componente de gasto en medicamentos.

Introduction: Healthcare-associated infections (HAIs), also known as nosocomial infections or hospital-acquired infections, begin within 48 hours of hospitalization, within 30 days after hospital discharge, or 90 days after undergoing surgical procedures. Objective: The study aimed to describe the compliance with the five moments for hand hygiene (HH) of the healthcare workers (HCWs) in a hospital. Methods: A prospective observational study was conducted from June 1 to 30,2020 in a pediatric hospital. HCWs compliance with the five moments of HH was registered by direct observation blindly to the participants, using the fact sheet for HH of the WHO. In the rows, the five moments of contact with the patients were recorded: before touching a patient, before clean aseptic procedure, after body fluid exposure risk, after touching a patient and after touching patient surroundings. The actions performed, also was registered: hand washing, alcohol hand friction, omission, or use of gloves. Data were analyzed in SPSS V 21. The protocol was approved by the institutional review board. Results: During the study period, 2.595 observations to 104 HCWs were made. They were pediatric residents 38.5 %, nurses 32.7 % and pediatricians 28.8 %. A global compliance with the five moments of HH of the participants were 64.5% (1673/2595). Before touching a patient, the adherence was 86,9%. The nurses adhered in 69%, pediatrician in 68.6 % and the pediatric residents in 57.2%. Discussion: The global percentage of compliance with the five moments of HH of the medical and nursing staff of the pediatric hospital was 64.5%. Nurses had the highest percentage of adherence. Handwashing compliance was higher before contact with the patients., Introducción: Las infecciones asociadas a la atención médica (IAAS), también conocidas como infecciones nosocomiales o infecciones adquiridas en el hospital, comienzan dentro de las 48 horas posteriores a la hospitalización, dentro de los 30 días posteriores al alta hospitalaria o 90 días después de someterse a procedimientos quirúrgicos.Objetivo:El estudio tuvo como objetivo describir el cumplimiento con los cinco momentos para la higiene de manos (HH) de los trabajadores de la salud (TDS) en un hospital.Metodología:Se realizó un estudio observacional prospectivo del 1 al 30 de junio de 2020 en un hospital pediátrico. La adherencia de los TDS con los cinco momentos de HH fue registrada por observación directa de manera ciega a los participantes, utilizando la hoja informativa para HH de la OMS. En las filas se registraron los cinco momentos de contacto con los pacientes: antes de tocar a un paciente, antes de un procedimiento aséptico limpio, después de exponerse a fluidos corporales, después de tocar a un paciente y después de tocar el entorno del paciente. También se registraron las acciones realizadas: lavado de manos, fricción con alcohol en gel, omisión o uso de guantes. Los datos fueron analizados en SPSS V 21. El protocolo fue aprobado por el comité de ética institucional.Resultados:Durante el período de estudio, se realizaron 2,595 observaciones a 104 TDS. Eran residentes pediátricos en un 38.5%, enfermeras en un 32.7% y pediatras en un 28.8%. La adherencia global a los cinco momentos de HH de los participantes fue del 64.5% (1673/2595). Antes de tocar a un paciente, la adherencia fue del 86.9%. Las enfermeras se adhirieron en un 69%, los pediatras en un 68.6% y los residentes pediátricos en un 57.2%.Discusión:El porcentaje global de cumplimiento con los cinco momentos de HH del personal médico y de enfermería del hospital pediátrico fue del 64.5%. Las enfermeras tuvieron el mayor porcentaje de adherencia. El cumplimiento del lavado de manos fue mayor antes

Look-alike sound-alike (LASA) drugs cause a high proportion of medication errors in hospitals. Drug lists available in hospitals are diverse and complicated. Presently, each hospital has its own LASA drug list and unique management strategies to minimize and prevent LASA errors. Objective: This study aimed to explore the prevalence of LASA drug lists, types of LASA drugs, and categories of medication errors in hospitals in Thailand. Methods: For this cross-sectional study, questionnaires were developed and distributed along with a letter to 500 government hospitals (selected from a total of 1,309 hospitals) in Thailand via mail from April to June 2021. Data were analyzed using descriptive statistics (frequencies and percentages). Results: A total of 128 hospitals participated in this study (response rate: 25.60%), including 12 tertiary hospitals (9.38%), 33 secondary hospitals (25.78%), 24 large primary hospitals (18.75%), 51 small primary hospitals (39.84%), and eight private hospitals (6.25%). A total of 2,510 pairs of LASA drugs were identified, which included 1,674 (66.69%) tablets/capsules (Simvastatin 10-Simvastatin 20 pair had the highest frequency), 427 injections (17.01%) (Ceftriaxone-Ceftazidime pair had the highest frequency), 85 liquid dosage forms (3.39%) (Milk of magnesia-alum milk pair had the highest frequency), 74 special techniques in medicine (2.95%) (Seretide evohaler®-Seretide accuhaler® pair had the highest frequency), 49 external used drugs (1.95%) (Clotrimazole cream-Clobetasol cream pair had the highest frequency), and 28 powder dosage forms (1.12%) (ORS for pediatrics-ORS for adult pair had the highest frequency). Conclusion: Despite relevant awareness among healthcare professionals, LASA medication errors occur in hospitals. The most frequent similarities among LASA drugs were detected in their names/pronunciations, and the most common errors belonged to Category B.

OBJECTIVES: The COVID-19 pandemic placed health care personnel (HCP) at risk for stress, anxiety, burnout, and post-traumatic stress disorder (PTSD). To address this, hospitals developed programs to mitigate risk. The objectives of the current study were to measure the availability and use of these programs in a cohort of academic emergency departments (EDs) in the United States early in the pandemic and identify factors associated with program use. METHODS: Cross-sectional survey of ED HCP in 21 academic EDs in 15 states between June and September 2020. Site investigators provided data on the availability of 28 programs grouped into 9 categories. Individual support programs included: financial, workload mitigation, individual COVID-19 testing, emotional (e.g., mental health hotline), and instrumental (e.g., childcare) Clinical work support programs included: COVID-19 team communication (e.g., debriefing critical incident), patient-family communication facilitation, patient services (e.g., social work, ethics consultation), and system-level exposure reduction. Participants provided corresponding data on whether they used the programs. We used generalized linear mixed models clustered on site to measure the association between demographic and facility characteristics and program use. RESULTS: We received 1,541 survey responses (96% response rate) from emergency physicians or advanced practice providers, nurses, and nonclinical staff. Program availability in each of the 9 categories was high (>95% of hospitals). Program use was variable, with clinical work support programs used more frequently (28-50% of eligible HCP across categories) than individual employee support programs (6-13% of eligible HCP across categories). Fifty-seven percent of respondents reported that the COVID-19 pandemic had affected their stress and anxiety, and 12% were at elevated risk for PTSD. Program use did not significantly differ for HCP who reported symptoms of anxiety and/or stress comp

BackgroundWe aimed to characterize pain and analgesic use in a large contemporary cohort of patients with cirrhosis and to associate pain with unplanned health care utilization and clinical outcomes in this population.MethodsWe included all patients with cirrhosis seen in UCSF hepatology clinics from 2013 to 2020. Pain severity and location were determined using documented pain scores at the initial visit; "significant pain" was defined as moderate or severe using established cutoffs. Demographic, clinical, and medication data were abstracted from electronic medical records. Associations between significant pain and our primary outcome of 1-year unplanned health care utilization (ie, emergency department visit or hospitalization) and our secondary outcomes of mortality and liver transplantation were explored in multivariable models.ResultsAmong 5333 patients with cirrhosis, 32% had a nonzero pain score at their initial visit and 25% had significant (ie moderate/severe) pain. Sixty percent of patients with significant pain used ≥1 analgesic; 34% used opioids. Patients with cirrhosis with significant pain had similar Model for End-Stage Liver Disease-Sodium scores (14 vs. 13), but higher rates of decompensation (65% vs. 55%). The most common pain location was the abdomen (44%). Patients with abdominal pain, compared to pain in other locations, were more likely to have decompensation (72% vs. 56%). Significant pain was independently associated with unplanned health care utilization (adjusted odds ratio: 1.3, 95% CI: 1.1-1.5) and mortality (adjusted hazard ratio: 1.4, 95% CI: 1.2-1.6).ConclusionsPain among patients with cirrhosis is often not well-controlled despite analgesic use, and significant pain is associated with unplanned health care utilization and mortality in this population. Effectively identifying and treating pain are essential in reducing costs and improving quality of life and outcomes among patients with cirrhosis.

The aim of this project was to increase willingness to receive the influenza vaccine to the optimal rate of ≥ 70%. Low acuity adult patients who visited an Emergency Department (ED) were assessed regarding their willingness to receive the influenza vaccine before and after an educational intervention that included a provider recommendation and an educational handout. A total of seventy-six patients (n = 76) were assessed. Patients willingness to receive the influenza vaccine rose from 29% pre-intervention to 72% post-intervention without disrupting the clinical flow in a busy ED. Similar vaccine educational strategies can be applied to influenza and other vaccines in EDs  to increase vaccination willingness in patients, including those who use the ED as a primary point of contact for healthcare, decreasing the burden of influenza illness in the community.

Introduction: Emergency medicine (EM) was recognized as a specialty in Israel in 1999. Fifty-nine of the 234 (25%) attending physicians working in emergency departments (ED) nationwide in 2002 were board-certified emergency physicians (EP). A 2012 study revealed that 123/270 (45%) of ED attendings were EPs, and that there were 71 EM residents. The EPs primarily worked midweek morning shifts, leaving the EDs mostly staffed by other specialties. Our objective in this study was to re-evaluate the EP workforce in Israeli EDs and their employment status and satisfaction 10 years after the last study, which was conducted in 2012. Methods: We performed a three-part, prospective cross-sectional study: 1) a survey, sent to all EDs in Israel, to assess the numbers, level of training, and specialties of physicians working in EDs; 2) an anonymous questionnaire, sent to EPs in Israel, to assess their demographics, training, employment, and work satisfaction; and 3) interviews of a convenience sample of EPs analyzed by a thematic approach. Results: There were 266 board-certified EPs, 141 (53%) of whom were employed in EDs full-time or part-time. Sixty-two non-EPs also worked in EDs. The EPs were present in the EDs primarily during weekday morning shifts. There were 273 EM residents nationwide. A total of 101 questionnaires were completed and revealed that EPs working part-time in the ED worked fewer hours, received higher salaries, and had more years of experience compared to EPs working full time or not working in the ED. Satisfaction correlated only with working part time. Meaningful work, diversity, and rewarding relationships with patients and colleagues were major positive reasons for working in the ED. Feeling undervalued, carrying a heavy caseload, and having complicated relationships with other hospital departments were reasons against working in the ED. Conclusion: Our study findings showed an increase in the number of trained and in-training EPs, and a decrease in the perc

There is an urgent need for strategies to reduce the negative impacts of a warming climate on human health. Cooling urban neighborhoods by planting trees and vegetation and increasing albedo of roofs, pavements, and walls can mitigate urban heat. We used synoptic climatology to examine how different tree cover and albedo scenarios would affect heat-related morbidity in Los Angeles, CA, USA, as measured by emergency room (ER) visits. We classified daily meteorological data for historical summer heat events into discrete air mass types. We analyzed those classifications against historical ER visit data to determine both heat-related and excess morbidity. We used the Weather Research and Forecasting model to examine the impacts of varied tree cover and albedo scenarios on meteorological outcomes and used these results with standardized morbidity data algorithms to estimate potential reductions in ER visits. We tested three urban modification scenarios of low, medium, and high increases of tree cover and albedo and compared these against baseline conditions. We found that avoiding 25% to 50% of ER visits during heat events would be a common outcome if the urban environment had more tree cover and higher albedo, with the greatest benefits occurring under heat events that are moderate and those that are particularly hot and dry. We conducted these analyses at the county level and compared results to a heat-vulnerable, working-class Los Angeles community with a high concentration of people of color, and found that reductions in the rate of ER visits would be even greater at the community level compared to the county.

BACKGROUND: Paediatric laceration repair procedures are common in the ED; however, post-discharge recovery remains understudied. Perioperative research demonstrates that children exhibit maladaptive behavioural changes following stressful and painful medical procedures. This study examined post-discharge recovery following paediatric laceration repair in the ED. METHODS: This prospective observational study included a convenience sample of 173 children 2-12 years old undergoing laceration repair in a paediatric ED in Orange, California, USA between April 2022 and August 2023. Demographics, laceration and treatment data (eg, anxiolytic medication), and caregiver-reported child pre-procedural and procedural pain (Numerical Rating Scale (NRS)) were collected. On days 1, 3, 7 and 14 post-discharge, caregivers reported childrens pain and new-onset maladaptive behavioural changes (eg, separation anxiety) via the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery. Univariate and logistic regression analyses were conducted to identify variables associated with the incidence of post-discharge maladaptive behavioural change. RESULTS: Post-discharge maladaptive behavioural changes were reported in 43.9% (n=69) of children. At 1 week post-discharge, approximately 20% (n=27) of children exhibited maladaptive behavioural changes and 10% (n=13) displayed behavioural changes 2 weeks post-discharge. Mild levels of pain (NRS ≥2) were reported in 46.7% (n=70) of children on post-discharge day 1, 10.3% (n=14) on day 7 and 3.1% (n=4) on day 14. An extremity laceration (p=0.029), pre-procedural midazolam (p=0.020), longer length of stay (p=0.043) and post-discharge pain on day 1 (p<0.001) were associated with incidence of maladaptive behavioural changes. Higher pain on post-discharge day 1 was the only variable independently associated with an increased likelihood of maladaptive behavioural change (OR=1.32 (95% CI 1.08 to 1.61), p=0.001). CONCLUSION: Over 40% of childr

Aquest treball de final de grau detalla el disseny, el prototipatge i la implementació d’un sistema integrat de trucades pacient-infermeria i de control domòtic de l’enllumenat per a habitacions hospitalàries, especialment enfocat en una tipologia de pacient amb dificultats motrius. El sistema consta de dos mòduls, un amb interfície tàctil a través d’una pantalla i un de control per veu mitjançant el motor d’inferència DeepSpeech de reconeixement de veu que permet un processament local de la informació obtinguda, assegurant la protecció de dades sensibles. El sistema s’ha desenvolupat per a poder tenir una implementació dins d’una estructura ja existent, aprofitant les instal·lacions per evitar costos addicionals i llargues aturades del servei durant la instal·lació del mateix. Es proposa un sistema flexible, escalable i econòmic, amb l’objectiu de poder ser incorporat de manera efectiva a diferents entorns hospitalaris. A partir de l’ús de l’ordinador monoplaca Raspberry Pi, el sistema permet gestionar les peticions del pacient, entregant un control total de l’enllumenat de l’habitació i podent realitzar sol·licituds d’atenció a través de comunicació Wi-Fi cap a una base de dades vinculada amb el software utilitzat pel control d’infermeria referent. Aquesta solució permet monitoritzar l’origen de cada trucada, el tipus de petició del pacient i el control d’accés dels professional a l’habitació. La implementació d’aquestes funcionalitats s’han dut a terme en Python i SQL, codi obert, permeten la personalització de les funcionalitats per a una millor adaptació a cada centre en específic. El prototip s’ha provat dins d’un entorn mèdic a l’Hospital Municipal de Badalona. Amb la cohesió de l’equip de l’entitat, s’ha aconseguit implementar el sistema de manera efectiva, duent a terme aquesta integració i permetent validar la funcionalitat, escalabilitat i fiabilitat del sistema en condicions reals., Este trabajo de final de grado detalla el diseño, prototipado e implementación de un sistema integrado de llamadas paciente-enfermería y de control domótico de la iluminación para habitaciones hospitalarias, especialmente enfocado en una tipología de paciente con dificultades motoras. El sistema consta de dos módulos, uno con interfaz táctil a través de una pantalla y otro de control por voz mediante el motor de inferencia DeepSpeech de reconocimiento de voz que permite un procesamiento local de los datos obtenidos, asegurando la protección de datos sensibles. El sistema se ha desarrollado para poder tener una implementación dentro de una estructura ya existente, aprovechando las instalaciones para evitar costos adicionales y largas paradas del servicio durante la instalación del mismo. Se propone un sistema flexible, escalable y económico, con el objetivo de poder ser incorporado de manera efectiva en diferentes entornos hospitalarios. A partir del uso del ordenador monoplaca Raspberry Pi, el sistema permite gestionar las peticiones del paciente, entregando un control total de la iluminación de la habitación y pudiendo realizar solicitudes de atención a través de comunicación Wi-Fi hacia una base de datos vinculada con el software utilizado para el control de enfermería referente. Esta solución permite monitorear el origen de cada llamada, el tipo de petición del paciente y el control de acceso profesional a la habitación. La implementación de estas funcionalidades se ha realizado en Python y SQL, código abierto, lo que permite la personalización de las funcionalidades para una mejor adaptación a cada centro en específico. El prototipo se ha probado dentro de un entorno real en el Hospital Municipal de Badalona. Con la cohesión del equipo de la entidad, se ha logrado implementar el sistema de manera efectiva, realizando esta integración y permitiendo validar la funcionalidad, escalabilidad y fiabilidad del sistema en condiciones reales., This final year project details the design, prototyping, and implementation of an integrated patient-nurse call and room lighting control system for hospital settings, specifically aimed at patients with motor difficulties. The system consists of two modules, one with a touchscreen interface and another with voice control using the DeepSpeech inference engine for voice recognition that allows local processing of the data obtained, ensuring the protection of sensitive data. The system has been developed to be implemented within an existing structure, taking advantage of the facilities to avoid additional costs and long service interruptions during its installation. A flexible, scalable, and economical system is proposed, with the aim of being effectively incorporated into different hospital environments. Using the single-board computer Raspberry Pi, the system manages patient requests, providing total control of room lighting and enabling care requests through Wi-Fi communication to a database linked with the software used for nursing control. This solution allows monitoring the origin of each call, the type of patient request, and professional access control to the room. The implementation of these functionalities has been carried out in Python and SQL, open source, allowing the customization of functionalities for better adaptation to each specific medical center. The prototype has been tested in a real environment at the Hospital Municipal de Badalona. With the cohesion of the entity's team, the system has been effectively implemented, allowing this integration and validating the functionality, scalability, and reliability of the system in real conditions.

The microbiological quality of the air in the NICU and surgical rooms exceeds standards. The physical quality of the NICU and operating room exceeds the standard. This study aimed to determine the microbiological and physical quality of hospital room air (NICU room and surgical rooms) at Husada Prima Hospital, East Java Province. This research design was descriptive. Observation, field measurements, and laboratory tests collected data. The measurement results will be compared with RI Minister of Health Regulation No. 2 for 2023. The results of air microbiology sampling in the NICU, surgical room 1, and surgical room 2 still need to meet the requirements. The results of physical air quality measurements, namely temperature in the three rooms, humidity in the NICU room, lighting, and ventilation rate in the three rooms, must meet the requirements. The variables that meet the requirements are humidity in both operating rooms and lighting in the surgical room (Table 2). The condition of hospital facilities and buildings in the three rooms has met the requirements. The conclusion is that the room's air quality at Husada Prima Hospital, East Java Province, did not meet the criteria. The condition of the facilities and buildings was good. The hospital is advised to clean and repair air conditioners regularly, use humidifiers to maintain humidity in the room and increase or decrease lighting according to each room's needs., The microbiological quality of the air in the NICU and surgical rooms exceeds standards. The physical quality of the NICU and operating room exceeds the standard. This study aimed to determine the microbiological and physical quality of hospital room air (NICU room and surgical rooms) at Husada Prima Hospital, East Java Province. This research design was descriptive. Observation, field measurements, and laboratory tests collected data. The measurement results will be compared with RI Minister of Health Regulation No. 2 for 2023. The results of air microbiology sampling in the NICU, surgical room 1, and surgical room 2 still need to meet the requirements. The results of physical air quality measurements, namely temperature in the three rooms, humidity in the NICU room, lighting, and ventilation rate in the three rooms, must meet the requirements. The variables that meet the requirements are humidity in both operating rooms and lighting in the surgical room (Table 2). The condition of hospital facilities and buildings in the three rooms has met the requirements. The conclusion is that the room's air quality at Husada Prima Hospital, East Java Province, did not meet the criteria. The condition of the facilities and buildings was good. The hospital is advised to clean and repair air conditioners regularly, use humidifiers to maintain humidity in the room and increase or decrease lighting according to each room's needs.

The microbiological quality of the air in the NICU and surgical rooms exceeds standards. The physical quality of the NICU and operating room exceeds the standard. This study aimed to determine the microbiological and physical quality of hospital room air (NICU room and surgical rooms) at Husada Prima Hospital, East Java Province. This research design was descriptive. Observation, field measurements, and laboratory tests collected data. The measurement results will be compared with RI Minister of Health Regulation No. 2 for 2023. The results of air microbiology sampling in the NICU, surgical room 1, and surgical room 2 still need to meet the requirements. The results of physical air quality measurements, namely temperature in the three rooms, humidity in the NICU room, lighting, and ventilation rate in the three rooms, must meet the requirements. The variables that meet the requirements are humidity in both operating rooms and lighting in the surgical room (Table 2). The condition of hospital facilities and buildings in the three rooms has met the requirements. The conclusion is that the room's air quality at Husada Prima Hospital, East Java Province, did not meet the criteria. The condition of the facilities and buildings was good. The hospital is advised to clean and repair air conditioners regularly, use humidifiers to maintain humidity in the room and increase or decrease lighting according to each room's needs., The microbiological quality of the air in the NICU and surgical rooms exceeds standards. The physical quality of the NICU and operating room exceeds the standard. This study aimed to determine the microbiological and physical quality of hospital room air (NICU room and surgical rooms) at Husada Prima Hospital, East Java Province. This research design was descriptive. Observation, field measurements, and laboratory tests collected data. The measurement results will be compared with RI Minister of Health Regulation No. 2 for 2023. The results of air microbiology sampling in the NICU, surgical room 1, and surgical room 2 still need to meet the requirements. The results of physical air quality measurements, namely temperature in the three rooms, humidity in the NICU room, lighting, and ventilation rate in the three rooms, must meet the requirements. The variables that meet the requirements are humidity in both operating rooms and lighting in the surgical room (Table 2). The condition of hospital facilities and buildings in the three rooms has met the requirements. The conclusion is that the room's air quality at Husada Prima Hospital, East Java Province, did not meet the criteria. The condition of the facilities and buildings was good. The hospital is advised to clean and repair air conditioners regularly, use humidifiers to maintain humidity in the room and increase or decrease lighting according to each room's needs.

Objectives: Occupational stress is a common complaint in nurses, who perceived more sense of effort-reward imbalance (ERI). Suboptimal health status (SHS) is a state between health and disease. However, the correlation between ERI and SHS is unclear. Therefore, the aim of this study was to examine the prevalence of SHS and ERI and evaluate the relationship between ERI and SHS in clinical nurses by a cross-sectional study. Material and Methods: The current cross-sectional study was conducted through an online survey at Dongping People's Hospital in China. A total of 633 completed surveys were received. Effort-reward imbalance was measured by subscales of the ERI questionnaire. The SHS was measured by the Suboptimal Health Status Questionnaire - 25 (SHSQ-25). The relationship between ERI and SHS in nurses was subsequently assessed by Spearman's correlation coefficient and logistic regression model. Results: The mean age of the optimal health status (OHS) group (M±SD 26.3±7.3 years) was younger than the SHS group (M±SD 30.3±6.9 years). The prevalence of SHS was 54.5% (345/633). Female nurses aged ≥30 years, a junior college or university graduate educational level, smokers, and nurses without regular exercise were at a higher risk of SHS. In Spearman's correlation analysis, ERI reflected by the effort-reward ratio was correlated with SHSQ-25 score (r = 0.662, p < 0.001). In logistic regression, ERI was strongly associated with SHS after potential confounding factors adjusting (OR 27.924, 95% CI 22.845-34.132). Conclusions: The prevalence of SHS was significantly high in clinical nurses. Administrators should pay more attention to health status of female nurses aged ≥30 years, with a junior college or bachelor's degree, smoking, and without regular exercise to reduce the SHS and ERI.

OBJECTIVES: Intravenous medication errors continue to significantly impact patient safety and outcomes. This study sought to clarify the complexity and risks of the intravenous administration process. DESIGN: A qualitative focus group interview study. SETTING: Focused interviews were conducted using process mapping with frontline nurses responsible for medication administration in September 2020. PARTICIPANTS: Front line experiened nurses from a Japanese tertiary teaching hospital. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measure was to identify the mental models frontline nurses used during intravenous medication administration, which influence their interactions with patients, and secondarily, to examine the medication process gaps between the mental models nurses perceive and the actual defined medication administration process. RESULTS: We found gaps between the perceived clinical administration process and the real process challenges with an emphasis on the importance of verifying to see if the drug was ordered for the patient immediately before its administration. CONCLUSIONS: This novel and applied improvement approach can help nurses and managers better understand the process vulnerability of the infusion process and develop a deeper understanding of the administration steps useful for reliably improving the safety of intravenous medications.

El presente trabajo, enmarcado en calidad de Trabajo Final de Grado de la carrera Licenciatura en Psicología de la Universidad Católica de Salta, da cuenta de la Pasantía académica realizada en el Hospital Público de Autogestión San Bernardo en la ciudad de Salta durante los meses de febrero a junio del año 2023. El mismo refleja un esfuerzo de articulación teórico práctica entre los conceptos del Psicoanálisis lacaniano y las intervenciones del analista practicante a partir de la observación diaria de casos de Interconsultas sobre pacientes internados, atendidos desde el Programa funcional de Salud Mental. This work, framed as the Final Degree Project of the Bachelor's Degree in Psychology, of the Catholic University of Salta, accounts for the academic Internship carried out at San Bernardo Self-Management Public Hospital from February to June 2023 in the city of Salta. It reflects an effort of theoretical-practical articulation between the concepts of Lacanian Psychoanalysis and the interventions of the inter-analyst based on daily observation with cases of inpatients Consultation, cared for by the Functional Mental Health Program., Fil: Girón, Estefania Noel. Universidad Católica de Salta. Facultad de Artes y Ciencias; Argentina., Fil: Mintzer Vera, María Cecilia. Universidad Católica de Salta. Facultad de Artes y Ciencias; Argentina.

Hospitals use corporate communication to strengthen their relationships with stakeholders and build a reputed brand. This paper analyzes how these organizations manage smart technologies to promote their brand. We conducted a literature review about smart hospitals and branding processes; then, we defined 34 indicators to analyze how the 100 best hospitals in the world used smart technologies to promote their brands. We divided these indicators into four groups: a) patients and society; b) media companies; c) public authorities, suppliers, and shareholders; and d) employees. Our results revealed that most hospitals managed smart technologies to communicate with patients (7,09 criteria out of 11 applicable). We concluded that hospitals should reinforce their relationships with all stakeholders, accelerate digital transformation, and implement collective branding processes consistent with human values., Los hospitales recurren a la comunicación corporativa para fortalecer sus relaciones con los públicos y construir una marca reputada. Este artículo analiza cómo estas organizaciones usan las tecnologías inteligentes para promocionar su marca. Para ello, realizamos una revisión bibliográfica sobre los hospitales inteligentes y sus procesos de marca; después, definimos 34 indicadores para analizar cómo los 100 mejores hospitales del mundo gestionaban dichas tecnologías para fortalecer sus marcas. Posteriormente, clasificamos estos indicadores en 4 grupos: a) pacientes y sociedad; b) medios de comunicación; c) autoridades públicas, proveedores y accionistas; y d) empleados. Nuestros resultados revelaron que la mayoría de los hospitales utilizaban las tecnologías inteligentes para comunicase con los pacientes (7,09 criterios de 11 posibles). Concluimos que los hospitales deberían reforzar sus relaciones con todos los públicos, acelerar su transformación digital e implementar procesos de construcción de marca colectiva consistentes con los valores humanos.

El objetivo principal de este estudio es el de describir cómo se realizaban los cuidados de los pacientes en instalaciones militares españolas durante el periodo de la Primera República española (1873-1874). La investigación se ha realizado recuperando y estudiando mediante categorización el Reglamento de Hospitales Militares y ambulancias del Ejército del 19 de mayo de 1873 y refutando su aplicación con fuentes primarias del Archivo Naval de la Armada en Cartagena y otras fuentes bibliográficas. El Reglamento de hospitales y ambulancias de 1873 incorporó novedades en cuanto a la gestión hospitalaria militar y definía las competencias de cada categoría profesional y escalafón militar en cuanto a la atención sanitaria del paciente., The main objective of this study is describe how patient care was carried out in Spanish military facilities during the period of the First Spanish Republic (1873-1874). The research has been carried out by retrieving and studying by categorisation the Reglamento de Hospitales Militares y Ambulancias del ejército of May 19, 1873 and refuting its application with primary sources from the Archivo Naval de la Armada in Cartagena and other bibliographic sources. The 1873 Reglamento de Hospitales Militares y Ambulancias del ejército incorporated new developments in military hospital management and defined the competencies of each professional category and military rank in terms of patient care.

El conocimiento sobre alimentación en los hospitales de la edad moderna en España está sustentado en documentación de muy pocos centros, mayoritariamente de grandes urbes, siendo necesarias nuevas aportaciones para ampliar la evidencia existente. A tal objeto se ha analizado la documentación del hospital Santiago de Vitoria, un hospital y una ciudad más representativos de la mediana peninsular. Se ha hallado un inequívoco enfoque económico de la documentación sobre alimentos y la consignación de su adquisición solo recoge gastos extraordinarios, mayoritariamente alimentos destinados a la botica (80% de los asientos). La dieta basal solo nos es conocida por su descripción teórica, anotándose su gasto por número de raciones o su fracción. Se evidencia una supervisión triple en su preparación y administración, así como una cuidada prescripción médica de los alimentos en las dietas individualizadas. En conclusión, los gastos no evidencian el consumo efectivo ni tampoco representan la dieta real, pues la inmensa mayoría de los alimentos consignados estuvieron destinados a la botica y no a la alimentación de los enfermos. Debe preguntarse si los estudios precedentes, que utilizan también datos de gastos, no han hecho una mala interpretación de estos extrapolando erróneamente una dieta magnífica cuando, en el caso vitoriano, tuvo una composición de clases populares., Knowledge of hospital food in modern-age hospitals in Spain is based on documentation from very few centers, mostly in large cities, and new contributions are needed to expand the existing evidence. To this end, the documentation of the Santiago de Vitoria hospital has been analysed, a hospital and a city more representative of the peninsular median. An unequivocal economic focus has been found in the documentation on foodstuffs, and the record of their acquisition only includes extraordinary expenses, mainly foodstuffs destined for the apothecary's shop (80% of the entries). The basal diet is only known to us by its theoretical description, and its expenditure is recorded by number of portions or their fraction. There is evidence of triple supervision in its preparation and administration, as well as careful medical prescription of the food in the individualised diets. In conclusion, the expenditures do not show the actual consumption, nor do they represent the real diet, since the vast majority of the food items recorded were destined for the pharmacy and not for the feeding of the sick. It must be asked whether previous studies, which also use expenditure data, have not misinterpreted these data by wrongly extrapolating a magnificent diet when, in the case of Vitoria, it was made up of the working classes., O conhecimento da alimentação hospitalar nos hospitais da Idade Moderna em Espanha baseia-se na documentação de um número muito reduzido de centros, principalmente nas grandes cidades, e são necessárias novas contribuições para ampliar a evidência existente. Para o efeito, analisámos a documentação do hospital de Santiago de Vitoria, um hospital e uma cidade mais representativos da mediana peninsular. Na documentação relativa aos géneros alimentícios, encontramos um enfoque económico inequívoco, sendo que o registo da sua aquisição apenas inclui despesas extraordinárias, sobretudo géneros destinados à botica (80% das entradas). A dieta basal só nos é conhecida pela sua descrição teórica, e a sua despesa é registada pelo número de porções ou pela sua fração. Há indícios de uma tripla vigilância na sua preparação e administração, bem como de uma cuidadosa prescrição médica dos alimentos nas dietas individualizadas. Em conclusão, as despesas não mostram o consumo real nem representam a dieta real, uma vez que a grande maioria dos alimentos registados se destinava à farmácia e não à alimentação dos doentes. É de perguntar se estudos anteriores, que também utilizam dados de despesas, não terão interpretado mal estes dados, extrapolando erradamente uma dieta magnífica quando, no caso de Vitória, era constituída pelas classes populares.

Background and aims: Globally, hospital malnutrition prevalence is estimated at 20-50%, with little known about the situation in African hospitals. The aim of this scoping review was to appraise the current evidence base regarding the prevalence of adult hospital malnutrition and related assessment practices in an African context. Methods: A comprehensive and exhaustive search strategy was undertaken to search seven electronic bibliographic databases (including Africa-specific databases) from inception until August 2022 for articles/resources reporting on the prevalence of adult hospital malnutrition in an African setting. Two reviewers independently reviewed abstracts and full-text articles and data extraction was undertaken in duplicate. Results: We screened the titles and abstracts of 7537 records and included 28 studies. Most of the included studies were conducted in the East African region (n = 12), with ten studies from South Africa. Most studies were single-centre studies (n = 22; 79%), including 23 to 2126 participants across all studies. A variety of study populations were investigated with most described as medical and surgical populations (n = 14; 50%). Malnutrition risk prevalence was reported to be between 23% and 74%, using a variety of nutritional screening tools (including MNA-SF/LF, NRS-20 02, MUST, NRI, GNRI). Malnutrition prevalence was reported to be between 8% and 85%, using a variety of tools and parameters, including ASPEN and ESPEN guidelines, SGA, MNA-SF/LF, anthropometric and biochemical indices, with one study using the GLIM criteria to diagnose malnutrition. Conclusions: Both malnutrition risk and malnutrition prevalence are alarmingly high in African adult hospitalised patients. The prevalence of malnutrition differs significantly among studies, owing in part to the variety of tools used and variability in cut-offs for measurements, underscoring the importance of adopting a standardised approach. Realities in the African context include

BakgrundI dagsläget lever cirka 160 000 personer med demenssjukdom i Sverige. Demenssjukdom åtföljs inte sällan av beteendemässiga och psykiska symtom och det kan ibland vara svårt att avläsa symtom och få korrekt information från denna patientgrupp. I och med detta ökar risken för att dessa patienter inte får relevant vård. SyfteSyftet är att beskriva sjuksköterskors upplevelser av att vårda patienter med demenssjukdom på sjukhus. MetodMetoden är en kvalitativ litteraturöversikt. Sökningar har genomförts i tre vetenskapliga och omvårdnadsinriktade databaser. Artiklar som ingår har kvalitativ ansats och genomförts med individuella intervjuer och fokusgruppintervjuer. Kvalitetsgranskningen har genomförts efter en mall för kvalitativa studier. Analysmetoden som användes var Fribergs 5-stegs-metod. ResultatResultatet visar på brister i stöd, samarbete, tid, resurser, kunskap och ansvar samt att sjukhus har en opassande vårdmiljö. Det finns svårigheter att tolka och förstå demenssjuka patienter vilket begränsar möjligheterna att genomföra behandlingar. Sjuksköterskorna försökte individanpassa och säkerställa kontinuitet i omvårdnaden. Begränsningsåtgärder, tvång och våld förekom och sjuksköterskor kunde objektifiera samt uttrycka negativa attityder mot patientgruppen. SlutsatsResultatet visar en komplexitet i omvårdnaden som styrs av begränsningar i tid, resurser och kunskap om demenssjukdomar. Sjuksköterskorna upplever skuld och otillräcklighet att inte kunna utföra omvårdnaden av patienter med demens på ett adekvat och hjälpsamt sätt., BackgroundApproximately 160 000 people are living with dementia in Sweden. Dementia is often accompanied by behavioural and psychological symptoms, and it can be difficult to read symptoms and collect information from this group of patients. With this, the risk increases that these patients don´t get relevant care. AimThe aim was to study nurses’ experiences of caring for patients with dementia in hospitals. MethodThe method used is a qualitative literature review. Searches have been conducted in three scientific and nursing-oriented databases. The articles included in this review have all a qualitative design and have been conducted with individual interviews and focus group interviews. The audit used is a templet for qualitative studies. The analysis has followed Fribergs' five-step-analysis. ResultsThe results show limitations in support, cooperation, time, resources, knowledge and responsibility. Hospitals have an inappropriate care environment for people with dementia. There are difficulties to interpretate and understand these patients which limits the possibilities to carry out treatment. Nurses tried to individualize and ensure continuity in caring. Use of restraints and physical force were common, and nurses would objectify and express negative attitudes towards these patients. ConclusionsThe results show a complexity of caring that is strongly influenced of limitations in time, resources and knowledge of dementia. The nurses describe feelings of guilt and inadequacy for not being able to conduct nursing care to patients with dementia in an adequate and helpful way

Bakgrund: Palliativ vård ges till patienter i livets slutskede när det inte finns något ytterligare botemedel för personens sjukdom. Vårdformen innebär att patientens livskvalitet och välbefinnande sätts främst. Omvårdnad av patienter med palliativt vårdbehov behöver vara personcentrerad och fokuserad på både fysiska och existentiella behov. I sjukhusmiljö riskerar patienter vid livets slutskede att deras sjukdom kommer före den andliga vården och att stödet de får från sjuksköterskor inte kan möta deras behov. Syfte: Syftet är att beskriva erfarenheter av hur patienter med behov av palliativ vård upplever stöd från sjuksköterskor när de vårdas på sjukhus. Metod: Litteraturöversikt baserad på 13 vetenskapliga artiklar. Data analyserades systematisk för att sammanställa resultat. Resultat: Utifrån dataanalysen identifierades tre huvudkategorier: symptomlindring, vikten av delaktighet och vårdens organisation. Dessa innefattar underkategorier och beskriver patienter med palliativt vårdbehovs erfarenheter av stöd från sjuksköterskor på sjukhus. Slutsats: Patienter med palliativt vårdbehov upplevde det stöd de får från sjuksköterskor på sjukhus som negativ påverkad av tidsbrist. Omvårdnad av dessa patienter visade sig inte vara tillräckligt personcentrerad. Patienter påpekar brister i den existentiella vården på sjukhusavdelningar och otillräckligt engagemang hos sjuksköterskor. Patienter betonade att de ändå uppskattade sjuksköterskans roll i deras vård på sjukhus men önskade att de hade mer tid för att vara närvarande och ge mer utrymme för patienters egna uttryckta önskningar, Background: Palliative care is given to patients at the end of life when there is no further cure for the person's illness and means that the patient's quality of life and wellbeing are putting first. Care of palliative patients’ needs to be person-centred and focused on both physical and existential needs. In a hospital environment, patients at the end-of life risk that their illness comes before spiritual care and that the support they receive from registered nurses (RN) will not meet their needs. Aim: The aim is to describe experiences of how patients in need of palliative care experience support from RNs when they are cared for in hospital. Method: Literature review based on 13 scientific articles. Data were systematically analyzed to compile results. Results: Based on the data analysis, three main categories were identified: symptom relief, the importance of participation and organization of care. These include subcategories and describe palliative care patients' experiences of support from RNs in hospitals. Conclusions: Palliative patients experienced the support they receive from RNs in hospitals as negatively affected by the lack of time. End-of-life care was found to be insufficiently person-centered. Patients point out shortcomings in the existential care in hospital wards and insufficient commitment of RNs. Patients emphasized that they still appreciated the RN`s role in their care in hospital but wished they had more time to be present and give more space for patients' self-expression.

Background: Dementia is a group of diseases that predominantly affects cognition. The hospital environment is not always adapted to people with dementia, which is challenging since people with dementia might find difficulties expressing their problems and wishes. Informal caregivers of people with dementia experiences care as most optimal when a person-centered perspective is implemented by the staff. People with dementia wish to be treated as a unique individual, beyond their disease. Aim: The aim is to describe nurses’ experiences of caring for people with dementia in a hospital setting. Method: A general literature review was used where analysis of 8 qualitative and 3 quantitative articles where conducted. Results: Four themes were identified: the hospital environment´s effect on caring for people with dementia; person-centered treatment in the caring for people with dementia; inner and outer resources for dementia care and the role of informal caregivers in the care for people with dementia. All themes were associated with nurses’ experiences of dementia care. Conclusions: Nurses need an optimal environment and enough time for caring for people with dementia. Cooperation with informal caregivers and a person-centered approach is key. Nurses wish for more knowledge of caring and treating people with dementia., Bakgrund: Demenssjukdomar är en sjukdomsgrupp som framför allt påverkar personers kognition. Sjukhusmiljön är inte alltid anpassad för personer med demenssjukdom, vilket skapar utmaningar när de söker vård, särskilt eftersom det kan vara svårt för dem att uttrycka sina behov och problem. Anhöriga till personer med demenssjukdom beskriver att vården fungerar bäst när vårdpersonal använder ett personcentrerat förhållningssätt. Personer med demenssjukdom önskar bli behandlade som en unik individ bortom demenssjukdomen. Syfte: Syftet är att beskriva sjuksköterskors erfarenheter av att vårda personer med demenssjukdom på sjukhus. Metod: En allmän litteraturöversikt användes där analys av 8 kvalitativa och 3 kvantitativa artiklar utfördes. Resultat: Fyra teman framkom: sjukhusmiljöns påverkan på demensvården, personcentrerat bemötande i demensvården, inre och yttre resurser i demensvården och anhörigas roll i demensvården. Alla teman handlar om sjuksköterskors erfarenheter kopplat till olika aspekter av demensvård. Slutsats: Sjuksköterskor behöver en optimal miljö samt tillräckligt med tid för vårdandet av personer med demenssjukdom. Samarbete med anhöriga i vårdandet samt ett personcentrerat förhållningssätt är av stor vikt. Sjuksköterskor önskar mer kunskap inom vårdande och bemötande av personer med demenssjukdom.

Bakgrund Inom svensk, såväl som internationell lagstiftning fastslås att barnets bästa ska beaktas när hälso- och sjukvård ges till barn. Dessutom ska barnens inställning till den aktuella vården eller behandlingen så långt som möjligt klarläggas. Samtidigt är det en utmaning för vårdpersonalen att realisera detta i praktiken, då patientgruppen barn skiljer sig stort från vuxna i deras möjligheter att göra sin röst hörd. Barnets egna perspektiv behöver därför särskilt lyftas fram och tas i beaktning. Syfte Studiens syfte var att beskriva barns upplevelser och erfarenheter i samband med sjukhusvistelse. Metod En strukturerad litteraturstudie med inslag av den metodologi som används vid systematiska översikter där tolv vetenskapliga originalartiklar ligger till grund. Datainsamlingen har utförts i databaserna Pubmed och CINAHL. Resultat Resultatet identifierar de tre huvudkategorierna relationer, sjukvårdsinsatser och miljö. Sjukvårdspersonalen och familjen identifierades som två positiva och viktiga relationer för barn som vårdas på sjukhus. Åtgärder som orsakade smärta eller obehag var istället en starkt negativ upplevelse. Samtidigt var barn fortsatt nyfikna på åtgärderna och önskade erhålla information för att skapa förutsättningar till att aktivt delta i sin egen vård. Lek och sociala interaktioner var viktigt då det skapade distans till barnens roll som patient. En färgglad sjukhusmiljö med mjuka fluffiga textilier och som erbjöd avskildhet föredrogs. Slutsats Barnen uttryckte upplevelser och erfarenheter inom ett flertal områden. Resultatet visade på att deras åsikter och inställning till sin egen vård inte alltid togs i beaktning. När det gjordes visade det på positiva effekter. Med ett barncentrerat arbetssätt skulle barnens vård kunna anpassas utifrån patienternas önskan., Background Both Swedish and international law states that the best interests of the child should be considered when providing healthcare. Furthermore, children's own views on the care or treatment in question should be taken into consideration as far as possible. At the same time, it is a challenge for healthcare professionals to realize this in practice, as children as a patientgroup differ greatly from adults in their ability to express themselves. This indicates the need to highlight and take into account children’s own experiences while hospitalized. Aim The aim of the study was to describe children's experiences of hospital stay. Method A structured literature study with elements of the methodology used in systematic reviews based on twelve original scientific articles. The data collection has been carried out in the databases Pubmed and CINAHL. Results In the result, three main categories are identified: relationships, health care interventions and environment. Healthcare professionals and family were identified as two positive and important relationships for hospitalized children. Actions that caused pain or discomfort were instead a strongly negative experience. At the same time, children remained curious about the healthcare they were provided with and wished to receive information to enable them to actively participate in their own care. Playing and social interactions were importantas such activities created distance to the children's role as patients. A colorful hospital environment with soft fluffy textiles, while at the same time offering privacy, was preferred. Conclusions Childern expressed experiences in a number of areas. The result showed that their opinions and attitude towards their own care were not always taken into account. When it was done, it showed positive effects. With a child-centered approach, the children’s care could be adapt based on the patients’ wishes.

Background: Many elderly people today have dementia, and many people with dementia encounter health care services, including in elderly care or in hospitals. Previous research indicates that relatives feel that nurses' treatment and contact can affect their well-being, and that patients with dementia feel that the hospital is not adapted to their needs and that communication with nurses is difficult. Aim: To describe nurses' experiences of treatment of patients with dementia in hospitals. Method: A general literature study of 4 quantitative articles, 6 qualitative articles. The articles were collected from two different databases. Results: Nurses strive to establish a caring relationship with patients with dementia in order to offer good care. Some nurses found it easy and challenging to meet and communicate with patients with dementia, while some nurses found it demanding. Lack of time was identified as a factor that caused stress and anxiety in nurses when dealing with patients with dementia. Conclusion: The results show that nurses who had a care relationship with patients with dementia contributed to the experience of good treatment, despise this there are many factors that can affect nurses' treatment such as prioritizing patients, lack of time, knowledge, experience and aggressive behavior from patients with dementia.

Trauma är idag den vanligaste dödsorsaken bland personer i arbetsför ålder. För en patient som drabbas av trauma innebär att man på akutmottagningen tas emot av ett stort antal vårdpersonal. Arbetssättet som används vid traumaomhändertagande kännetecknas av effektivitet samt ett strukturerat arbetssätt för att kunna bedöma omfattningen av patientens skador och på ett snabbt och effektivt åtgärda dessa. Patienten som genomgår ett fysiskt trauma befinner sig i en utsatt situation, som sjuksköterska på en akutmottagning är det viktigt att inte glömma patientens omvårdnadsbehov i denna situation. Syftet med denna studie är att undersöka patientens upplevelse av traumaomhändertagandet på akutmottagningen. Som metod valde författarna att utföra en allmän litteraturöversikt för att svara på denna studies syfte. För att finna artiklar till resultatet utfördes sökningar i databaserna CINAHL och PubMed samt manuella sökningar. I resultatet inkluderades 15 vetenskapliga artiklar som publicerades mellan åren 2004–2023. Författarna använde sig av en integrativ analys som innebär att utifrån resultatet i de vetenskapliga artiklarna dra slutsatser och identifiera underliggande mönster för att sammanställa ett resultat. I resultatet av denna studie framkom det tre huvudkategorier: Patientens upplevda känslor under traumateamets omhändertagande, kommunikation och vårdpersonalens bemötande. Under huvudkategorierna framkom det även sex stycken underkategorier. I resultat framkommer att patienter generellt sätt är nöjda med det initiala omhändertagandet när stort fokus läggs på den enskilda patienten. Vidare framkommer det att inom vården finns det förbättringspotential gällande bemötande och samordning av den vidare vården. Slutsatsen av detta arbete är att kommunikationen har en stor betydelse för patientens upplevelse av traumaomhändertagandet och vidare vård efter det initiala omhändertagandet på akutmottagningen., Trauma is currently the most common cause of death among working-age individuals. When a patient experiences trauma, they are received by a large number of healthcare professionals in the emergency department. The approach used in trauma care is characterized by efficiency and a structured method to assess the extent of the patient’s injuries and promptly address them. Patients undergoing physical trauma are in a vulnerable situation, and as a nurse in an emergency department, it is important not to overlook their nursing needs in this situation. The purpose of this study is to examine the patient’s experience of the trauma care in the emergency department. The authors chose to conduct a general literature review as the method to address this study’s purpose. To find articles for the results, searches were conducted in the CINAHL and PubMed databases as well as manual searches. The results included 15 scientific articles published between 2004 and 2023. The authors used an integrative analysis to draw conclusions from the scientific articles’ results and identify underlying patterns to compile a result. The results of this study revealed three main themes: the patient’s experience of the initial care, communication, and the healthcare professionals’ approach. Within these main themes, six subcategories also emerged. The results indicate that patients are generally satisfied with the initial care when there is a strong focus on the individual patient. Furthermore, there is room for improvement in healthcare regarding attitude and coordination of further care. The conclusion of this work is that communication plays a significant role in the patient’s experience of the trauma care and subsequent care after the initial intervention.

Bakgrund Kognitiv sjukdom är förvärvade och bestående skador i hjärnan som påverkar personens förmåga att självständigt klara av sitt alldagliga liv i olika utsträckning. De fyra vanligaste diagnoserna är Alzheimers sjukdom, vaskulär demens, frontotemporallobsdemens och Lewy body demens. Ibland drabbas personer med kognitiv sjukdom av sjukdomstillstånd som kräver vård inom slutenvården. Slutenvården med sin sterila miljö är inte anpassad för personer med kognitiv sjukdom. Miljön i slutenvården är okänd och kan därför skapa oro hos den här patientgruppen. Syfte Syftet var att belysa sjuksköterskors erfarenheter av att vårda personer med kognitiv sjukdom inom slutenvården. Metod Metoden som använts är litteraturöversikt med induktiv ansats och resultatet består av femton artiklar som valts ut från artikelsökningar i två olika databaser, relevanta för forskning inom omvårdnad och hälsovetenskap. Artiklarna kvalitetsgranskades, analyserades enligt ett flödesschema och presenteras i tre kategorier med tio underkategorier. Resultat Litteraturöversiktens resultat visade att organisatoriska faktorer som tidsbrist, slutenvårdensmiljö och olika arbetssätt är något som påverkar sjuksköterskors erfarenheter av att vårdapersoner med kognitiv sjukdom. Det visade att sjuksköterskor har ett behov av kunskap och utbildning i kognitiva sjukdomar då upplevelsen är att kunskapen från grundutbildningen inte är tillräcklig. Det finns ett behov hos sjuksköterskor att kunna ge personer med kognitiv sjukdom en personcentrerad vård för att kunna säkerställa att personens behov blir tillgodosedda och då kan närstående vara till stor hjälp. Resultatet visade att sjuksköterskor har en viktig roll i att säkerställa att personer med kognitiv sjukdom får en god vård men det visade också att arbetsbelastningen på sjuksköterskor är hög. Slutsats Slutsatsen blir att slutenvårdens utformning och miljö borde anpassas efter personer med kognitiv sjukdom, att sjuksköterskor har ett behov av utbildning oc, Background Cognitive disorders are acquired and permanent damages to the brain which affects the person's ability to manage their everyday life to varying extent. Four of the most common diagnoses are Alzheimer's disease, vascular dementia, frontotemporal dementia and Lewy body dementia. People with cognitive disorders may become so ill that they need treatment in hospital. The sterile environment in hospitals is not adjusted for this patient group. It’s an unknown environment that may cause anxiety for them. Aim The aim of this literature review was to illuminate nurses' experience of caring for people with cognitive disorders in hospital wards. Method The method used was a literature review with an inductive approach and the result consists of fifteen articles from searches in two different databases which are relevant to research within nursing- and health science. The articles have been quality audited, analyzed and are presented in three main categories with ten subcategories. Results The results showed that organizational factors such as lack of time, hospital environment and different ways of working are affecting nurses' experiences of caring for people with cognitive disorders. It displays that nurses need more knowledge and education about cognitive disorders as they experience that the education they got in nursing school is not enough. There’s a need among nurses to give people with cognitive disorders a person centered care in order to fulfill the person's needs and in this part of caring the person’s next of kin can play an important role. The result displays that nurses play a big part in making sure that persons with cognitive disorders are properly cared for but also that the workload for nurses is high. Conclusion The conclusion is that hospital environment and design should be adjusted for people with cognitive disorders, that nurses need education and competence development and that everybody would profit from this in the end.

Purpose To elucidate mealtime experiences of children hospitalized with a malignant or severe non-malignant disorder —and their parents—after a gastrostomy tube insertion. Methods A qualitative design involving a child-centred care approach was used. Parents of children aged 1–18 years old who had received a gastrostomy tube during treatment for a malignant or non-malignant disorder were included, as were the children themselves when aged 5–18 years old. Semi-structured interviews with 21 families were carried out and a thematic analysis performed. Results The findings were presented in four themes: changed meal conditions, a troublesome sensory dimension, aggravating obstacles and solving the unmanageable. Hospitalization involves challenges regarding environmental aspects, hospital food and side effects, contributing to impaired nutritional intake and aggravated mealtime situations. Conclusions Hospital environment and hospital food have a profound impact on children's nutritional intake and mealtime situations. In addition, sensory aspects and side effects aggravate the child's motivation to eat, resulting in demanding meals. The families described a gastrostomy tube as a valuable strategy for improving mealtime situations.

OBJECTIVE: This study utilized the evidence-gap map method and critically examined the scope, methodologies, and focus of the studies that investigated the influence of the built environment on inpatient healthcare settings over a decade (2010-2021). METHODS: We conducted a systematic review per the preferred reporting items for systematic reviews and meta-analyses guidelines and surveyed 406 articles, primarily from North America and Europe. RESULTS: Our findings revealed a dominant focus on architectural features (73%), such as room design and ward layout. Comparatively, there was less emphasis on interior-, ambient-, social-, and nature-related features. Most previous studies explored multiple environmental features, which indicated the intricacy of this field. Research outcomes were diverse, with person-centered care (PCC) being the most frequently investigated, followed by safe care, emotional well-being, activity, and behavior. Furthermore, research methods varied considerably based on the study's outcomes and features. Clinical outcomes and safe care favored quantitative methods, activity and behavior favored mixed methods, and PCC favored qualitative research. CONCLUSION: This review provides an in-depth overview of the existing studies on healthcare design research and sheds light on the current trends and methodological choices. The insights garnered can guide future research, policy-making, and the development of healthcare facilities.

Background and aims: Globally, hospital malnutrition prevalence is estimated at 20-50%, with little known about the situation in African hospitals. The aim of this scoping review was to appraise the current evidence base regarding the prevalence of adult hospital malnutrition and related assessment practices in an African context. Methods: A comprehensive and exhaustive search strategy was undertaken to search seven electronic bibliographic databases (including Africa-specific databases) from inception until August 2022 for articles/resources reporting on the prevalence of adult hospital malnutrition in an African setting. Two reviewers independently reviewed abstracts and full-text articles and data extraction was undertaken in duplicate. Results: We screened the titles and abstracts of 7537 records and included 28 studies. Most of the included studies were conducted in the East African region (n = 12), with ten studies from South Africa. Most studies were single-centre studies (n = 22; 79%), including 23 to 2126 participants across all studies. A variety of study populations were investigated with most described as medical and surgical populations (n = 14; 50%). Malnutrition risk prevalence was reported to be between 23% and 74%, using a variety of nutritional screening tools (including MNA-SF/LF, NRS-20 02, MUST, NRI, GNRI). Malnutrition prevalence was reported to be between 8% and 85%, using a variety of tools and parameters, including ASPEN and ESPEN guidelines, SGA, MNA-SF/LF, anthropometric and biochemical indices, with one study using the GLIM criteria to diagnose malnutrition. Conclusions: Both malnutrition risk and malnutrition prevalence are alarmingly high in African adult hospitalised patients. The prevalence of malnutrition differs significantly among studies, owing in part to the variety of tools used and variability in cut-offs for measurements, underscoring the importance of adopting a standardised approach. Realities in the African context include

Background and aims: Globally, hospital malnutrition prevalence is estimated at 20-50%, with little known about the situation in African hospitals. The aim of this scoping review was to appraise the current evidence base regarding the prevalence of adult hospital malnutrition and related assessment practices in an African context. Methods: A comprehensive and exhaustive search strategy was undertaken to search seven electronic bibliographic databases (including Africa-specific databases) from inception until August 2022 for articles/resources reporting on the prevalence of adult hospital malnutrition in an African setting. Two reviewers independently reviewed abstracts and full-text articles and data extraction was undertaken in duplicate. Results: We screened the titles and abstracts of 7537 records and included 28 studies. Most of the included studies were conducted in the East African region (n = 12), with ten studies from South Africa. Most studies were single-centre studies (n = 22; 79%), including 23 to 2126 participants across all studies. A variety of study populations were investigated with most described as medical and surgical populations (n = 14; 50%). Malnutrition risk prevalence was reported to be between 23% and 74%, using a variety of nutritional screening tools (including MNA-SF/LF, NRS-20 02, MUST, NRI, GNRI). Malnutrition prevalence was reported to be between 8% and 85%, using a variety of tools and parameters, including ASPEN and ESPEN guidelines, SGA, MNA-SF/LF, anthropometric and biochemical indices, with one study using the GLIM criteria to diagnose malnutrition. Conclusions: Both malnutrition risk and malnutrition prevalence are alarmingly high in African adult hospitalised patients. The prevalence of malnutrition differs significantly among studies, owing in part to the variety of tools used and variability in cut-offs for measurements, underscoring the importance of adopting a standardised approach. Realities in the African context include

OBJECTIVE: This study utilized the evidence-gap map method and critically examined the scope, methodologies, and focus of the studies that investigated the influence of the built environment on inpatient healthcare settings over a decade (2010-2021). METHODS: We conducted a systematic review per the preferred reporting items for systematic reviews and meta-analyses guidelines and surveyed 406 articles, primarily from North America and Europe. RESULTS: Our findings revealed a dominant focus on architectural features (73%), such as room design and ward layout. Comparatively, there was less emphasis on interior-, ambient-, social-, and nature-related features. Most previous studies explored multiple environmental features, which indicated the intricacy of this field. Research outcomes were diverse, with person-centered care (PCC) being the most frequently investigated, followed by safe care, emotional well-being, activity, and behavior. Furthermore, research methods varied considerably based on the study's outcomes and features. Clinical outcomes and safe care favored quantitative methods, activity and behavior favored mixed methods, and PCC favored qualitative research. CONCLUSION: This review provides an in-depth overview of the existing studies on healthcare design research and sheds light on the current trends and methodological choices. The insights garnered can guide future research, policy-making, and the development of healthcare facilities.

Purpose To elucidate mealtime experiences of children hospitalized with a malignant or severe non-malignant disorder —and their parents—after a gastrostomy tube insertion. Methods A qualitative design involving a child-centred care approach was used. Parents of children aged 1–18 years old who had received a gastrostomy tube during treatment for a malignant or non-malignant disorder were included, as were the children themselves when aged 5–18 years old. Semi-structured interviews with 21 families were carried out and a thematic analysis performed. Results The findings were presented in four themes: changed meal conditions, a troublesome sensory dimension, aggravating obstacles and solving the unmanageable. Hospitalization involves challenges regarding environmental aspects, hospital food and side effects, contributing to impaired nutritional intake and aggravated mealtime situations. Conclusions Hospital environment and hospital food have a profound impact on children's nutritional intake and mealtime situations. In addition, sensory aspects and side effects aggravate the child's motivation to eat, resulting in demanding meals. The families described a gastrostomy tube as a valuable strategy for improving mealtime situations.

Background and aims: Globally, hospital malnutrition prevalence is estimated at 20-50%, with little known about the situation in African hospitals. The aim of this scoping review was to appraise the current evidence base regarding the prevalence of adult hospital malnutrition and related assessment practices in an African context. Methods: A comprehensive and exhaustive search strategy was undertaken to search seven electronic bibliographic databases (including Africa-specific databases) from inception until August 2022 for articles/resources reporting on the prevalence of adult hospital malnutrition in an African setting. Two reviewers independently reviewed abstracts and full-text articles and data extraction was undertaken in duplicate. Results: We screened the titles and abstracts of 7537 records and included 28 studies. Most of the included studies were conducted in the East African region (n = 12), with ten studies from South Africa. Most studies were single-centre studies (n = 22; 79%), including 23 to 2126 participants across all studies. A variety of study populations were investigated with most described as medical and surgical populations (n = 14; 50%). Malnutrition risk prevalence was reported to be between 23% and 74%, using a variety of nutritional screening tools (including MNA-SF/LF, NRS-20 02, MUST, NRI, GNRI). Malnutrition prevalence was reported to be between 8% and 85%, using a variety of tools and parameters, including ASPEN and ESPEN guidelines, SGA, MNA-SF/LF, anthropometric and biochemical indices, with one study using the GLIM criteria to diagnose malnutrition. Conclusions: Both malnutrition risk and malnutrition prevalence are alarmingly high in African adult hospitalised patients. The prevalence of malnutrition differs significantly among studies, owing in part to the variety of tools used and variability in cut-offs for measurements, underscoring the importance of adopting a standardised approach. Realities in the African context include

Ilona Karmel was a Holocaust victim. She endured diseases, Nazi ‘madness’, and imprisonment in the Krakow Ghetto and in concentration camps in Poland and Germany. At the end of World War II, she was abandoned to die by the retreating German enemy. Nevertheless, Victory Day in 1945 saw the beginning of another period of infirmity and confinement for Karmel, who was hospitalized in Sweden to treat leg injuries she had suffered by the Nazis. This essay, bringing together disability and Holocaust studies, explores harrowing post-Shoah sequelae in Karmel’s life, as reflected in Stephania (1953). To recover her sense of self after the bloodletting and to make visible physical impairment in her novel, Karmel creates the fictional Stephania: A Polish patient with spinal curvature worsened during wartime captivity who seeks medical treatment in Stockholm, all the while refusing to accept her body’s disfigurement. This article examines how disability and voluntary hospital confinement are portrayed in the novel Stephania and connected with Holocaust trauma. Despite memories of pain and incarceration invading their minds as survivors, Karmel and her creation Stephania inescapably must come to terms with their respective postwar impairments, heal from their emotional wounds, and cling to life during and beyond their convalescences.

OBJECTIVE: This study utilized the evidence-gap map method and critically examined the scope, methodologies, and focus of the studies that investigated the influence of the built environment on inpatient healthcare settings over a decade (2010-2021). METHODS: We conducted a systematic review per the preferred reporting items for systematic reviews and meta-analyses guidelines and surveyed 406 articles, primarily from North America and Europe. RESULTS: Our findings revealed a dominant focus on architectural features (73%), such as room design and ward layout. Comparatively, there was less emphasis on interior-, ambient-, social-, and nature-related features. Most previous studies explored multiple environmental features, which indicated the intricacy of this field. Research outcomes were diverse, with person-centered care (PCC) being the most frequently investigated, followed by safe care, emotional well-being, activity, and behavior. Furthermore, research methods varied considerably based on the study's outcomes and features. Clinical outcomes and safe care favored quantitative methods, activity and behavior favored mixed methods, and PCC favored qualitative research. CONCLUSION: This review provides an in-depth overview of the existing studies on healthcare design research and sheds light on the current trends and methodological choices. The insights garnered can guide future research, policy-making, and the development of healthcare facilities.

Hospitals serve as critical environments for the management of diverse medical conditions, ranging from routine illnesses to life-threatening emergencies. However, alongside providing healthcare services, hospitals represent reservoirs for the transmission of microbial pathogens. Understanding the distribution and dynamics of pathogens within hospital settings is crucial for effective infection control and prevention strategies. Concurrently, the integration of cutting-edge technologies for the early detection and monitoring of target bacteria stands as a pivotal strategy in this battle against nosocomial infections. This critical review aims to provide a systematic insight into the main threatening microbes in hospitals and the detection of pathogens in different environments, ranging from intensive care units to general wards, including hospital entrances, bathrooms, high-touch surfaces, patient bed rails, medical equipment, and floors, which are often contaminated. We discuss recent scientific and technological advances in pathogen detection by exploring innovative methods that leverage nanotechnology to improve biosensing effectiveness and selectivity. This review is divided into sections focusing on various types of hospital environments, classes of mostly represented pathogens and kinds of available nanobiosensors. We include two comprehensive tables summarizing bacterial contamination in hospital wards and the materials and substrates associated with the nanobiosensors that have been developed. Eventually, we highlight the open challenges and perspectives in nanotechnology-based healthcare-environment monitoring and remediation as a promising solution to counteract pathogen emergence and spread.

Purpose: Delirium, a common medical emergency among hospitalized patients, requires effective detection and management protocols. This study aims to evaluate the delirium point prevalence and its management across Italian hospitals, categorized by delirium literacy levels. Additionally, it seeks to identify prevailing barriers and future priorities in delirium practice and research. Methods: We analyzed data from World Delirium Awareness Day (WDAD) on March 15th, 2023, collected by participating clinicians in Italian hospitals. High delirium literacy (HL) was determined based on the use of validated delirium assessment tools and the presence of a written protocol for delirium management. Conversely, low delirium literacy (LL) was determined by meeting only one or neither of these criteria. Results: Fifty-eight hospital wards participated in the survey, with 25 (43.1%) classified as HL. The overall reported point prevalence of delirium was found to be approximately 10%. Notably, the reported prevalence was twice as high in the HL group compared to the LL group. Despite minimal differences compared to the other group, the HL group demonstrated greater adherence to appropriate delirium management strategies, encompassing both non-pharmacological and pharmacological strategies. Critical gaps in delirium care emerged, including suboptimal management practices, barriers to implementing evidence-based strategies, and insufficient awareness and training among professionals. Conclusion: The study highlights the suboptimal identification and management of delirium among Italian hospitals, emphasizing the necessity of enhancing awareness and implementing evidence-based strategies. Addressing these shortcomings is crucial for optimizing delirium care, improving patient outcomes, and mitigating the burden of delirium in hospital settings.

Las escalas y test son elementos complementarios a la atención sanitaria de los pacientes y pretenden aportar ayuda al diagnóstico o apoyo a la decisión de tratamiento, así como estandarizar la comunicación con otros profesionales. Con este proyecto pretendemos que la Historia Clínica Electrónica hospitalaria incremente su calidad con la adición de escalas y test permitiendo un registro minucioso de las características del paciente y la creación de una red interdisciplinar que homogenice las características de distintos pacientes. El objetivo de este trabajo es conocer y consensuar diferentes test y escalas de uso frecuente en la práctica clínica médica para su posible inclusión en la HCE de Castilla y León. Se realizó un estudio observacional transversal entre noviembre y diciembre de 2023 mediante el diseño de un cuestionario que se repartió entre 7 especialidades (anestesia, digestivo, pediatría, psiquiatría, rehabilitación, urgencias y urología) del Hospital clínico Universitario de Valladolid y Hospital Universitario Rio Hortega para conocer los test y escalas utilizados con mayor frecuencia en su práctica clínica. El cuestionario de cada especialidad constaba de 4 ítems sociodemográficos y 6 test o escalas concretas de cada especialidad contrastadas previamente con facultativos de dichas especialidades y la literatura científica actual. Posteriormente fue distribuido entre los facultativos incluidos en el estudio de ambos hospitales de Valladolid. Se recogieron 180 cuestionarios correctamente cumplimentados. El porcentaje de respuesta (55%) fue ligeramente superior en el Hospital Clínico Universitario de Valladolid. Globalmente, sin tener en cuenta los hospitales, la especialidad con mayor índice de respuesta fue pediatría con un 21,7% de respuestas, seguida de psiquiatría y urgencias con un 17,8% y de digestivo con un 17,2% respectivamente. De los encuestados, 117 eran mujeres (el 65,0%) y 54 eran hombres (30%). Por edad, el grupo de 20-30 años fue el más par, Grado en Medicina

BakgrundI dagsläget lever cirka 160 000 personer med demenssjukdom i Sverige. Demenssjukdom åtföljs inte sällan av beteendemässiga och psykiska symtom och det kan ibland vara svårt att avläsa symtom och få korrekt information från denna patientgrupp. I och med detta ökar risken för att dessa patienter inte får relevant vård. SyfteSyftet är att beskriva sjuksköterskors upplevelser av att vårda patienter med demenssjukdom på sjukhus. MetodMetoden är en kvalitativ litteraturöversikt. Sökningar har genomförts i tre vetenskapliga och omvårdnadsinriktade databaser. Artiklar som ingår har kvalitativ ansats och genomförts med individuella intervjuer och fokusgruppintervjuer. Kvalitetsgranskningen har genomförts efter en mall för kvalitativa studier. Analysmetoden som användes var Fribergs 5-stegs-metod. ResultatResultatet visar på brister i stöd, samarbete, tid, resurser, kunskap och ansvar samt att sjukhus har en opassande vårdmiljö. Det finns svårigheter att tolka och förstå demenssjuka patienter vilket begränsar möjligheterna att genomföra behandlingar. Sjuksköterskorna försökte individanpassa och säkerställa kontinuitet i omvårdnaden. Begränsningsåtgärder, tvång och våld förekom och sjuksköterskor kunde objektifiera samt uttrycka negativa attityder mot patientgruppen. SlutsatsResultatet visar en komplexitet i omvårdnaden som styrs av begränsningar i tid, resurser och kunskap om demenssjukdomar. Sjuksköterskorna upplever skuld och otillräcklighet att inte kunna utföra omvårdnaden av patienter med demens på ett adekvat och hjälpsamt sätt., BackgroundApproximately 160 000 people are living with dementia in Sweden. Dementia is often accompanied by behavioural and psychological symptoms, and it can be difficult to read symptoms and collect information from this group of patients. With this, the risk increases that these patients don´t get relevant care. AimThe aim was to study nurses’ experiences of caring for patients with dementia in hospitals. MethodThe method used is a qualitative literature review. Searches have been conducted in three scientific and nursing-oriented databases. The articles included in this review have all a qualitative design and have been conducted with individual interviews and focus group interviews. The audit used is a templet for qualitative studies. The analysis has followed Fribergs' five-step-analysis. ResultsThe results show limitations in support, cooperation, time, resources, knowledge and responsibility. Hospitals have an inappropriate care environment for people with dementia. There are difficulties to interpretate and understand these patients which limits the possibilities to carry out treatment. Nurses tried to individualize and ensure continuity in caring. Use of restraints and physical force were common, and nurses would objectify and express negative attitudes towards these patients. ConclusionsThe results show a complexity of caring that is strongly influenced of limitations in time, resources and knowledge of dementia. The nurses describe feelings of guilt and inadequacy for not being able to conduct nursing care to patients with dementia in an adequate and helpful way

El siglo XIX fue para España un año de gran inestabilidad política con cambios desde el absolutismo hasta el liberalismo, y grandes reformas como la Constitución de 1812 y las desamortizaciones que transformaron la estructura social. En el marco sanitario se transita a un sistema público por las reformas legales de la Ley de Beneficencia de 1849 y la Ley General de Sanidad de 1855. Sin embargo, persistieron la falta de higiene, las epidemias y la escasez de recursos. El Hospital prestó a todo tipo de pobres y enfermos cuidados básicos, médicos, quirúrgicos y espirituales. La carga de trabajo de los cuidados básicos recaía sobre las Hijas de la Caridad., Grado en Enfermería

Bakgrund: Palliativ vård ges till patienter i livets slutskede när det inte finns något ytterligare botemedel för personens sjukdom. Vårdformen innebär att patientens livskvalitet och välbefinnande sätts främst. Omvårdnad av patienter med palliativt vårdbehov behöver vara personcentrerad och fokuserad på både fysiska och existentiella behov. I sjukhusmiljö riskerar patienter vid livets slutskede att deras sjukdom kommer före den andliga vården och att stödet de får från sjuksköterskor inte kan möta deras behov. Syfte: Syftet är att beskriva erfarenheter av hur patienter med behov av palliativ vård upplever stöd från sjuksköterskor när de vårdas på sjukhus. Metod: Litteraturöversikt baserad på 13 vetenskapliga artiklar. Data analyserades systematisk för att sammanställa resultat. Resultat: Utifrån dataanalysen identifierades tre huvudkategorier: symptomlindring, vikten av delaktighet och vårdens organisation. Dessa innefattar underkategorier och beskriver patienter med palliativt vårdbehovs erfarenheter av stöd från sjuksköterskor på sjukhus. Slutsats: Patienter med palliativt vårdbehov upplevde det stöd de får från sjuksköterskor på sjukhus som negativ påverkad av tidsbrist. Omvårdnad av dessa patienter visade sig inte vara tillräckligt personcentrerad. Patienter påpekar brister i den existentiella vården på sjukhusavdelningar och otillräckligt engagemang hos sjuksköterskor. Patienter betonade att de ändå uppskattade sjuksköterskans roll i deras vård på sjukhus men önskade att de hade mer tid för att vara närvarande och ge mer utrymme för patienters egna uttryckta önskningar, Background: Palliative care is given to patients at the end of life when there is no further cure for the person's illness and means that the patient's quality of life and wellbeing are putting first. Care of palliative patients’ needs to be person-centred and focused on both physical and existential needs. In a hospital environment, patients at the end-of life risk that their illness comes before spiritual care and that the support they receive from registered nurses (RN) will not meet their needs. Aim: The aim is to describe experiences of how patients in need of palliative care experience support from RNs when they are cared for in hospital. Method: Literature review based on 13 scientific articles. Data were systematically analyzed to compile results. Results: Based on the data analysis, three main categories were identified: symptom relief, the importance of participation and organization of care. These include subcategories and describe palliative care patients' experiences of support from RNs in hospitals. Conclusions: Palliative patients experienced the support they receive from RNs in hospitals as negatively affected by the lack of time. End-of-life care was found to be insufficiently person-centered. Patients point out shortcomings in the existential care in hospital wards and insufficient commitment of RNs. Patients emphasized that they still appreciated the RN`s role in their care in hospital but wished they had more time to be present and give more space for patients' self-expression.