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Введение (актуальность). Современная система оказания скорой медицинской помощи предполагает развитие стационарного этапа, который представлен больницами скорой медицинской помощи. Значительная часть их работает как многопрофильные стационары, не имеют ни структуры стационарного отделения скорой медицинской помощи, ни технологии оказания скорой медицинской помощи. Анализ результатов работы в период пандемии Covid-19 – важный опыт для совершенствования здравоохранения страны, в том числе больниц скорой помощи. Целью исследования были SWOT-анализ особенностей функционирования больниц скорой помощи, определение стратегических направлений их развития. Материалы и методы. Материалом послужили данные федеральной государственной статистики (источники ФСН № 14 и 30, 2019-2021 гг.) 2-х многопрофильных стационаров, работающих в режиме больниц скорой помощи (24/7/365), в значительной степени сходных по уровню материально-технического обеспечения и профильности работы, но отличающихся по технологии организации приема пациентов и особенностям работы в период пандемии Covid-19. Использованы нормативный правовой, статистические и аналитические методы, SWOT-анализ. Результаты и обсуждение. Результат SWOT-анализа состоит в формулировании стратегических направлений развития больниц скорой помощи – приведения их деятельности в соответствие с Порядком оказания скорой медицинской помощи (стационарного ее этапа) в целях повышения доступности и качества медицинской помощи, экономической эффективности работы учреждения, решения задач государственной безопасности. Разработаны мероприятия по совершенствованию работы больниц скорой помощи. Заключение. Концепция развития стационарного отделения скорой медицинской помощи соответствует стратегии развития системы здравоохранения в нашей стране, ориентирована на наличие запросов (потребностей) развития отрасли и государства, нормативной правовой базы, направлена на использование имеющихся в отрасли ресурсов; учитывают текущую ситуацию, средства ее реализации и угрозы, имеющиеся в отрасли; позволяют эффективно использовать ресурсы организации; обеспечивает организации устойчивые конкурентные преимущества на рынке медицинских услуг; соответствует целям государственной безопасности готовности к работе при массовом поступлении больных (пострадавших) в условиях военного и мирного времени., Introduction. The modern emergency medical care system involves the development of an inpatient stage, which is represented by emergency hospitals. A significant part of them works as multidisciplinary hospitals, have neither the structure of the inpatient emergency department, nor the technology of providing emergency medical care. Analysis of the results of work during the Covid-19 pandemic is an important experience for improving the country's health care, including emergency hospitals. The purpose of the study was a SWOT analysis of the characteristics of the functioning of emergency hospitals, the determination of strategic directions for their development. Materials and methods. The material was the data of federal state statistics of 2 multidisciplinary hospitals operating in ambulance hospitals (24/7/365), which are largely similar in terms of logistics and work profiles, but differ in the technology of organization of patient admission and work features during the Covid-19 pandemic. Regulatory, statistical and analytical methods, SWOT analysis were used. Results and discussion. The result of the SWOT analysis consists in the formulation of strategic directions for the development of emergency hospitals bringing their activities in line with the Procedure for the provision of emergency medical care (inpatient stage thereof) in order to increase the availability and quality of medical care, the economic efficiency of the institution, and solving state security problems. Measures have been developed to improve the work of emergency hospitals. Conclusion. The concept of the development of an inpatient emergency department corresponds to the strategy for the development of the health care system in our country, is focused on the availability of requests (needs) for the development of the industry and the state, the regulatory legal framework, and is aimed at using the resources available in the industry; take into account the current situation, the means of its implementation and the threats available in the industry, allow you to effectively use the resources of the organization; provides organizations with sustainable competitive advantages in the medical services market; corresponds to the goals of state security readiness for work in case of mass admission of patients (victims) in wartime and peacetime conditions.

Введение (актуальность). Пандемия новой коронавирусной инфекции 2019-2021 гг. стала серьезным испытанием системы здравоохранения страны. В этой ситуации она показала свои реальные возможности в современных условиях. Цель. Целью исследования был анализ динамики показателей оперативной работы больниц скорой помощи в период пандемии новой коронавирусной инфекции. Материалы и методы. Материалом послужили данные федеральной государственной статистики (источники ФСН № 14 и 30, 2019-2021 гг.) 2-х многопрофильных стационаров, работающих в режиме больниц скорой помощи (24/7/365), имеющих принципиальные структурно-функциональные особенности, связанные с наличием коек для пациентов с новой коронавирусной инфекцией. Использованы контент-анализ, нормативный правовой, статистические и аналитические методы. Результаты и обсуждение. Для стационара скорой помощи с развернутыми койками инфекционного профиля для пациентов с новой коронавирусной инфекцией было характерно значительное (в 2 раза) снижение показателей оперативной работы: числа операций (-42,0%) и числа оперированных пациентов (-51,3%), уменьшение числа операций с осложнениями (-95,5%) и умерших оперированных больных (-71,5%). Для стационара скорой помощи, не перепрофилированного для пациентов с новой коронавирусной инфекцией, было характерно увеличение числа операций (на 10,2%), оперированных пациентов (на 18,4%), а также показателей летальности (+40,8%), не связанных непосредственно с осложнениями оперативного лечения. Заключение. Динамика коечного фонда и схем маршрутизации пациентов, перераспределение объемов медицинской помощи между медицинскими организациями, санитарно-эпидемиологическая подготовка – важный опыт, который нам дала пандемия новой коронавирусной инфекции, позволяющий заложить организационный и научно-методический фундамент для дальнейшего развития, повысить готовность к работе в сложных условиях подобных пандемии новой коронавирусной инфекцией., Introduction. Pandemic of the new coronavirus infection 2019-2021 has become a serious test of the country's health care system. In this situation, she showed her real capabilities in modern conditions. Purpose. The purpose of the study: an analysis of the dynamics of the operational performance of emergency hospitals during a pandemic of a new coronavirus infection. Materials and methods. The material was the data of federal state statistics (2019-2021) of 2 multidisciplinary hospitals operating in ambulance hospitals (24/7/365), which have fundamental structural and functional features related to the availability of beds for patients with Covid 19. Content analysis, regulatory, statistical and analytical methods were used. The results of the study: For the NSR hospital with deployed infectious beds for patients with Covid 19, there was a significant (2-fold) decrease in the indicators of operative work: the number of operations (-42.0%) and the number of operated patients (-51.3%), a decrease in the number of operations with complications (-95.5%) and deceased operated patients (-71.5%). The NSR hospital, not repurposed for Covid 19, was characterized by an increase in the number of operations (by 10.2%), operated patients (by 18.4%), as well as mortality rates (+ 40.8%), not directly related to complications of surgical treatment. Conclusion. The dynamics of bed capacity and patient routing schemes, the redistribution of medical care between medical organizations, sanitary and epidemiological training an important experience that the pandemic of a new coronavirus infection gave us, which allows us to lay the organizational and scientific and methodological foundation for further development, to increase readiness for work in difficult conditions such as a pandemic with a new coronavirus infection.

Recently, emergency structures have been in the spotlight because of the coronavirus disease (COVID-19) pandemic. This research examines the use of modular integrated construction (MiC) in developing an emergency hospital for individuals with novel coronavirus-infected pneumonia (NCIP). The whole process of building is based on the modular design and assembly idea. The primary structure was constructed using the modular steel buildings (MSBs) concept to suit emergency structures’ functional qualities and quick construction needs. An intelligent operation and maintenance management platform was built utilizing 5G, AI, IoT (IoT), cloud, big data, an d other technologies. A BIM model was created to evaluate and compare the construction plan, develop the combined section and connection node plan, and complete the detailed design of assembled steel structures. On-site modularization of fundamental structural components and accessories is utilized in a flowing operating mode, where the housing and supporting installation are closely coordinated. The research results show that information and data interaction is the key to speedy building design and construction, with digital simulation in one stage and on-site assembly in a crammed way. The study findings may be used to build comparable structures faster, utilizing modular building techniques.

Background An ethics reflection group (ERG) is one of a number of ethics support services developed to better handle ethical challenges in healthcare. The aim of this article is to evaluate the significance of ERGs in psychiatric and general hospital departments in Denmark. Methods This is a qualitative action research study, including systematic text condensation of 28 individual interviews and 4 focus groups with clinicians, ethics facilitators and ward managers. Short written descriptions of the ethical challenges presented in the ERGs also informed the analysis of significance. Results A recurring ethical challenge for clinicians, in a total of 63 cases described and assessed in 3 ethical reflection groups, is to strike a balance between respect for patient autonomy, paternalistic responsibility, professional responsibilities and institutional values. Both in psychiatric and general hospital departments, the study participants report a positive impact of ERG, which can be divided into three categories: 1) Significance for patients, 2) Significance for clinicians, and 3) Significance for ward managers. In wards characterized by short-time patient admissions, the cases assessed were retrospective and the beneficiaries of improved dialogue mainly future patients rather than the patients discussed in the specific ethical challenge presented. In wards with longer admissions, the patients concerned also benefitted from the dialogue in the ERG. Conclusion This study indicates a positive significance and impact of ERGs; constituting an interdisciplinary learning resource for clinicians, creating significance for themselves, the ward managers and the organization. By introducing specific examples, this study indicates that ERGs have significance for the patients discussed in the specific ethical challenge, but mostly indirectly through learning among clinicians and development of clinical practice. More research is needed to further investigate the impact of ERGs seen from the perspectives of patients and relatives.

Kinderkliniken werden als ein klassisches Handlungsfeld Klinischer Sozialer Arbeit erachtet. Diese Forschungsarbeit stellt einen anfänglichen Versuch dar, dieses für die Klinische Soziale Arbeit noch kaum erforschte Gebiet mit dem Fokus Kinderschutz zu untersuchen. Damit wird das Ziel verfolgt, wertvolle Informationen für die Weiterentwicklung der Klinischen Sozialen Arbeit im Kontext Kinderschutzarbeit an Kinderkliniken zu erhalten. Für die Beantwortung der Forschungsfrage wurden mit elf Klinischen Sozialarbeiter*innen aus acht unterschiedlichen Kinderkliniken in Österreich leidfadengestützte Interviews geführt und anschließend mit der Inhaltsanalyse nach Kuckartz ausgewertet. Mit dem Fokus auf den Beitrag der Klinischen Sozialen Arbeit in Bezug auf die Kinderschutzarbeit an österreichischen Kinderkliniken wird die Rolle der Klinischen Sozialen Arbeit aus Sicht der Klinischen Sozialarbeiter*innen dargestellt. Die Ergebnisse zeigen, dass die Klinische Soziale Arbeit, auf unterschiedlichen Ebenen, an einer professionellen und umfassenden Kinderschutzarbeit beteiligt ist. Die Klinischen Sozialarbeitenden gehen der Berücksichtigung und Behandlung der sozialen Risikofaktoren für Kindeswohlgefährdungen nach. Mit diesem Einsatz bei unmittelbaren bzw. möglichen Kinderschutzfälle strebt die Klinische Soziale Arbeit auf eine ganzheitliche Behandlung von Kindeswohlgefährdungen an. Zusätzlich setzen sie sich für die Weiterentwicklung und Verbesserung der klinikinternen Kinderschutzarbeit ein. Children's hospitals are considered a classical field of action for clinical social work. This research paper represents an initial attempt to examine this area, which has hardly been explored yet in regard to clinical social work, with a focus on child protection. The aim is to obtain valuable information for the further development of clinical social work in the context of child protection work at children's hospitals. In order to answer the research question, guideline-based interviews with eleven clinical social workers from eight different children's hospitals in Austria were conducted and subsequently analysed using the content analysis according to Kuckartz. Focusing on the contribution of clinical social work in relation to child protection work at Austrian children's hospitals, the role of clinical social work is presented from the perspective of clinical social workers. The results show that clinical social work, at different levels, is involved in professional and comprehensive child protection work. Clinical social workers follow up the consideration and treatment of risk factors for child welfare hazards which can be related to family lifestyles and living conditions. In addition, they stand up for further development and improvement of the clinic's internal child protection work. vorgelegt von: Stefanie Stockinger Wien, FH Campus Wien, Masterarb., 2021

Safety culture is the product of attitudes, skills and behavioral patterns, which are determinants in how professionals will adhere to health services, for maximum harm reduction and preventable risks. The objective of this research was to know the professionals' perception regarding the safety culture of the patient. An analytical cross-sectional study was conducted with patient care professionals. The questionnaire "Patient Safety Research in Hospitals" was applied. The dimensions with the highest positive response percentages were "Supervisor Expectations and Actions in Promoting Patient Safety," "Promotion and Continuous Learning," and "Teamwork in the Unit." Despite weaknesses, management's commitment to active actions to strengthen patient safety is noteworthy. La cultura de seguridad es el producto de actitudes, habilidades y patrones de comportamiento, que son decisivos en la forma en que los profesionales se adherirán a los servicios de salud, para la máxima reducción de daños y riesgos evitables. El objetivo de esta investigación fue conocer la percepción de los profesionales en relación con la cultura de seguridad del paciente. Se realizó un estudio analítico transversal con profesionales de la atención al paciente. Se aplicó el cuestionario "Investigación sobre seguridad del paciente en hospitales". Las dimensiones con los porcentajes más altos de respuestas positivas fueron "Expectativas y acciones de su supervisor para promover la seguridad del paciente", "Promoción y aprendizaje continuo" y "Trabajo en equipo en la unidad". A pesar de las debilidades, existe un compromiso por parte de la gerencia en acciones activas para fortalecer la seguridad del paciente. A cultura de segurança é o produto de atitudes, competências e padrões comportamentais, que são determinantes na forma com que os profissionais vão aderir aos serviços de saúde, para a redução máxima de danos e riscos evitáveis. O objetivo desta pesquisa foi de conhecer a percepção dos profissionais em relação à cultura de segurança do paciente. Realizou-se um estudo transversal analítico com profissionais da assistência ao paciente. Foi aplicado o questionário “Pesquisa sobre Segurança do Paciente em Hospitais”. As dimensões com os porcentuais de respostas positivas mais elevadas foram “Expectativas e ações do seu supervisor na promoção da segurança do paciente”, “Promoção e aprendizado contínuo” e “Trabalho em equipe na unidade”. Apesar das fragilidades, nota-se o empenho da gestão em ações ativas para o fortalecimento da segurança do paciente.

Bakgrund Malnutrition är associerad med en förändring av livskvalitén, depressioner, förlängd sjukhusvistelse och förkortad överlevnad. Den här masteruppsatsen beskriver studien av ett förbättringsarbete drivet av ett förbättringsteam på två avdelningar som vårdar patienter med hematologiska, onkologiska och lungsjukdomar. Syfte Syftet med förbättringsarbetet är att förbättra hälsotillståndet genom förbättrad nutritionsprocess. Syftet med studien av förbättringsarbetet är att beskriva hur förbättringsteamet genom sitt arbete skapar engagemang på avdelningen. Metod Förbättringsarbetet har drivits med hjälp av Nolans förbättringsmodell, PDSA-cykler samt kartläggning av mikrosystemet utifrån 5P-modellen. En fallstudie har genomförts som inkluderar semistrukturerade intervjuer med efterföljande innehållsanalys samt enkäter med kvantitativa resultat. Resultat Förbättringsarbetets resultat visar på att fler energiregistreringar genomförs, men ännu ses ingen påverkan på det dagliga energiintaget. Resultatet av innehållsanalysen beskriver hur förbättringsteamet har påverkat förbättringsarbetet utifrån tre följande tema: existens och dynamik, individanpassad vägvisare samt delad förståelse för målet. Slutsats Studien av förbättringsarbetet visar att förbättringsarbetet har bidragit till en ökad kunskapsnivå inom nutrition både i förbättringsteamet och på avdelningen. Studien visar också att ett dynamiskt förbättringsteam har möjlighet att påverka kulturen på avdelningen genom att öka engagemanget. Background Malnutrition is associated with decreased quality of life, depression, prolonged hospitalization and shortened lifetime. This master thesis describes the study of improvement through involving an improvement team working in two medical departments that treat patients with hematological, oncological and lung diseases. Purpose The purpose of the quality improvement is to support better health by improving the nutrition process. The purpose of the study is to describe how the improvement team through its work creates commitment int the department. Method Nolan’s model with PDSA-cycles and description of microsystem with 5P-model are used for the improvement. A case study that included semi-structured interviews was performed with content analysis. An employee questionnaire regarding nutrition knowledge was also performed which provided quantitative data. Results The result of the improvement shows a greater number of cost registrations but not jet higher daily intakes of energy. The result of the study describes how the improvement team has affected the improvement work based on the following themes: existence and dynamics, individualized guide and shared understanding of the goal. Conclusion The study of the improvement work shows that the improvement work has contributed to an increased level of knowledge in nutrition both in the improvement team and in the department. The study also shows that a dynamic improvement team can influence the culture of the department by increasing commitment

Background An ethics reflection group (ERG) is one of a range of ethics support services developed to better handle ethical challenges in healthcare. The aim of this article is to evaluate the implementation process of interdisciplinary ERGs in psychiatric and general hospital departments in Denmark. To our knowledge, this is the first study of ERG implementation to include both psychiatric and general hospital departments. Methods The implementation and evaluation strategies are inspired by action research, using a qualitative approach and systematic text condensation of 28 individual interviews and 4 focus groups with clinicians, ethics facilitators and ward managers. Results The implementation process was influenced by both structural factors and factors related to clinicians having different values, interests and experiences. Structural barriers and promotors in the process to implement ERG included the following sub-categories: Organizational factors, recruitment and training of ethics facilitators, the deliberation model, planning and recruitment of participants to the ERGs, the support of the ward managers and the project group. Barriers and promotors found among clinicians included the following sub-categories: Expectations and pre-understandings of ERGs, understandings of a physician’s job, challenges experienced by ethics facilitators. At the end of the study, when it was decided that the ERGs should be continued, the implementation strategies were remodeled by the participants to meet new challenges. Conclusion The study of ERG implementation identified important structural and professional barriers and promotors that are likely to be relevant to anyone wanting to implement ethics support services across various types of healthcare services.

Употребление психоактивных веществ (ПАВ) с немедицинскими целями является огромной медико-социальной, экономической проблемой, и становится наиболее частой причиной инфицирования ВИЧ. Наркозависимые лица представляют особо уязвимую группу для заражения. Цель исследования: изучить структуру веществ, вызвавших острые отравления у ВИЧ-инфицированных пациентов, госпитализированных в стационар скорой медицинской помощи. Пациенты и методы исследования: ретроспективно проанализированы структура острых отравлений химической этиологии (ООХЭ) и результаты освидетельствования на ВИЧ-инфекцию 19 061 пациента, госпитализированных (простая случайная выборка) в отделение лечения острых отравлений НИИ СП им. Н.В. Склифосовского (ОЛОО НИИ СП) в 2013-2016 гг. Диагноз ООХЭ верифицирован методом хромато-масс-спектрометрии. Диагностику ВИЧ-инфекции осуществляли с использованием иммуноферментного анализа и иммуноблотинга. Для попарного сравнения распределения частот выявляемости ВИЧ у лиц ООХЭ использовали точный тест Фишера. Различия оценивали как статистически значимые при p, The use of psychoactive substances (PS) with non-medical purposes is a huge medical, social and economic problem. It becomes the most frequent cause of HIV infection. Drug addict individuals are vulnerable group for HIV. Aim: study the structure of substances that caused acute poisoning in HIV-infected patients hospitalized in an emergency hospital. The object and methods: it has been retrospectively analyzed the structure of acute poisoning of chemical etiology (APCE) and prevalence of HIV infection among 19061 patients hospitalized (simple random sampling) at N.V. Sklifosovsky’s Research Institute for Emergency Medicine department of acute poisoning treatment (DAPT) in 2013-2016 years. The diagnosis of APCE was verified by chromatography-mass spectrometry. Diagnosis of HIV infection was carried out using immunoassay and immunoblot analysis. Fisher’s exact test was used for a pairwise comparison of the prevalence HIV in individuals with APCE. Differences were assessed as statistically significant at p, №1 (2018)

Fünfzig Millionen Menschen weltweit leben derzeit mit der Diagnose Demenz, die Tendenz ist steigend (vgl. WHO, 2018, S. 4). Ein Krankenhausaufenthalt birgt das Risiko einer Verschlechterung der kognitiven und funktionellen Fähigkeiten (vgl. Isfort et al., 2014, S. 741). Für Menschen mit Demenz ist es, um den Faktor 3,6 wahrscheinlicher in einem Krankenhaus behandelt zu werden (vgl. Pinkert, Holle, 2012, S. 731). Der Akutbereich ist nicht auf die Versorgung von Menschen mit Demenz ausgerichtet. Es werden adäquate Konzepte benötigt. Ziel dieser Masterarbeit ist die Situation, Demenz im Akutkrankenhaus, aus Sicht von Fachpersonen zu beschreiben. Die Betrachtung des Konzepts „Ehrenamtliche Demenzbegleitung“ trägt zur Strategieentwicklung und der Identifikation von Implementationsbedingungen bei. Einundzwanzig Fachpersonen verschiedener Bereiche der Akutversorgung werden mit Hilfe eines halbstrukturierten Interviewleitfadens, in vier Fokusgruppen befragt. Auswertungsmethode ist die zusammenfassende Inhaltsanalyse nach MAYRING (2015). Gesundheitsberufe fühlen sich durch den demografischen Wandel überrollt. Daraus resultieren multiple Belastungsfaktoren, auch für Menschen mit Demenz. Die Bedeutung von Kommunikation und von zu treffenden Maßnahmen wird deutlich. Das Konzept „Ehrenamtliche Demenzbegleitung“ beschreibt einen ehrenamtlichen Besuchsdienst der Menschen mit Demenz in Form von Gesprächen, Gesellschaft und individuellen Beschäftigungsangeboten, im Rahmen der Akutversorgung begleitet. Die Prävention von Verhaltenssymptomen sowie das Sicherheitsgefühl für Gesundheitsberufe und Menschen mit Demenz, durch Aufmerksamkeit, Aktivierung und eine unbefangene Beziehung, sind aus Sicht der befragten Fachpersonen Stärken dieses Konzepts. Es bietet die Chance der Fokussierung auf die demenzbetroffene Person, was die Qualität der Betreuung verbessert. Schwächen des Konzepts „Ehrenamtliche Demenzbegleitung“ sind laut Befragten die obligatorische Sympathie sowie mögliche Überforderung und Überfürsorglichkeit in der Begleitung. Gefahren im Setting Akutkrankenhaus sind das herausfordernde Zeitmanagement, die Definition des Tätigkeitsbereichs sowie der Balanceakt zwischen Kontinuität und Flexibilität. Bedingungen der Implementierung können der Umwelt, den beteiligten Menschen und der Gestaltung des Konzepts zugeordnet werden. Die Rolle der Führung im Implementationsprozess wird durch die Haltung zum Krankheitsbild Demenz bestimmt. Diese beeinflusst die innerbetriebliche Kommunikation und Organisation. „Ehrenamtliche Demenzbegleitung“ ist die Chance für Demenzsensibilität im Akutkrankenhaus. Worldwide fifty million people suffer from dementia. This number is increasing constantly (vgl. WHO, 2018, S. 4). Patients with dementia have a higher risk of cognitive and functional decline in hospital. At the same time, people with dementia are also 3.6 times likelier to be treated in an acute care setting (vgl. Pinkert, Holle, 2012, S. 731). This setting however, is not able to meet the complex needs of people with cognitive impairment. Hence, high quality strategies for a dementia-sensitive hospital are needed. The aim of this research is to explore dementia in emergency hospitals and the use of volunteers in dementia care. Professionals, working in different parts of the acute care setting, describe conditions for an implementation. To gather information, four focus groups were interviewed. In total, 21 professionals shared their perspectives using a semi-structured questionnaire. The systematic content analysis is based on MAYRING (2015). Professionals emphasize the demands through the demographic changes in society, causing multiple stress-factors for professionals and people with dementia. The importance of necessary actions is becoming apparent. In this context volunteering in dementia care as a concept, enfolds an honorary visiting service. Conversation, companionship and individual activities are provided to people with dementia throughout the acute care setting. The main strengths of this concept are the prevention of challenging behavior and the sense of safety for professionals and people with dementia due to attention and activation. The opportunity to focus on people with dementia is improving the quality of care. Excessive demands, overprotectiveness and the mandatory sympathy are possible impairments of volunteering in dementia care. Risks in the acute care setting referring this concept are the complex organization, the definition of the function and the balance between continuity and flexibility. The conditions of the implementation have to cover the concept itself, the environment and interacting individuals. For the implementation-process, the attitude of leading persons towards the diagnosis dementia, is described as significant. It influences communication and organization in the acute care setting. People with dementia challenge the acute care setting and volunteers are one possibility to put dementia-sensitivity to practice. vorgelegt von: Lisa Haslinger Wien, FH Campus Wien, Masterarb., 2018

Aims and objectives The aim was to describe nurses' experiences of patients' sleep at an emergency hospital and their perceptions of sleep-promoting interventions. Background Promotion of patients' sleep during hospital care is an important intervention for the nursing profession. To promote sleep and to initiate sleep-promoting interventions, nurses need basic knowledge about sleep and its physiology. Therefore, it is of importance to explore and expand knowledge about how nurses experience patients′ sleep and how they perceive working with it while providing care. Design A qualitative descriptive design was used. Methods Data were collected from four focus groups and seven individual interviews. A total of twenty-two registered nurses participated. Data were analysed using a qualitative content analysis. Results Nurses expressed a desire and an ambition to work in ways that promote patients' sleep during hospitalisation. Nurses reported that health care services and emergency hospitals were not organised according to patients' perspective and needs. Furthermore, they did not have opportunities to work effectively to promote sleep according to the patients' wishes. Several nurses stated that they did not have sufficient knowledge about sleep and that they did the best they could under prevailing circumstances. Nurses emphasised the importance of sleep for patients and that it was an area that should be given far greater priority. Conclusions The results indicate that nurses currently have insufficient knowledge about sleep and sleep-promoting interventions. These aspects of nursing is based on personal experience and common sense rather than being evidence based. Furthermore, sleep as a nursing topic needs to be developed and given more focus in order for nurses to be able to deliver high quality care at emergency hospitals. Relevance to clinical practice Nurses require more knowledge and education to gain deeper understanding of sleep and to deliver evidence-based, high quality care.

Combined trauma is a topical medico-social problem of the society, one of actual problems of medicine. Interest to her has especially grown lately in connection with increase of quantity of victims with such kinds of damages.Methods. Case records of 5482 patients with combined traumatic brain injury from which at 2724 (46, 66 %) the scull trauma, were on treatment in polytrauma department in the Kharkov city emergence hospital during the period with 2010 on 2014 has been established and analyzed.Result. Trauma as a result of road accident have received from 44,7 to 50,2 % of victims, at falling from height a trauma have received from 12,5 to 17,4 % of patients. The parity to a sexual sign in different years remains at one level and made: 68, 4–71, 7 % of men and 31, 6–28, 3 % of women accordingly. Victims of young and middle age make the most part. Alcohol in blood at receipt has been found out in 32, 5 % of victims, and at patients with an easy combined traumatic brain injury this indicator has made 25, 3 %, and with heavy combined scull trauma alcohol in blood has been found out in patients in 37, 2 % of cases.Conclusions. It is shown that skull-skeleton, skull-thoracic and skull-multiply traumas play the leading role in structure of light traumas, and skull-multiply trauma play the leading role in hard multiply skull trauma and it needs more attention from doctors of all specialties

OBJETIVO: Determinar o perfil da violência sofrida pelo idoso atendido em serviço de emergência do Hospital da Restauração (HR), em Recife-PE. METODOLOGIA: Estudo epidemiológico, descritivo, quantitativo de corte transversal. Foram analisados todos os prontuários médicos referentes aos atendimentos em cirurgia geral, ortopedia e clínica médica realizados na emergência de adultos do HR entre 1º de janeiro e 31 de dezembro de 2007, disponibilizados pelo Serviço de Arquivo Médico, totalizando 72.232 prontuários. RESULTADOS: Do total de prontuários analisados, foram registrados 79 casos de violência contra o idoso. Destes, 63,3% do sexo masculino. A faixa etária predominante foi compreendida entre 60-70 anos (72,2%). Em 81,1% dos prontuários, não houve registro sobre vínculo empregatício ou situação previdenciária do agredido. Em relação ao local de residência da vítima, a maioria (46,8%) residia em Recife-PE. Quanto ao levantamento de dados sobre o agressor, quando este foi citado (3,7%), todos pertenciam ao sexo masculino, sendo notificada a relação com a vítima em um único caso (filho). O tipo de violência mais frequente foi a física (97,5%). Quanto à natureza da lesão, a mais comum foi a contusão (27,8%). Os sítios de lesão mais acometidos foram a face (35,4%), crânio (31,6%) e extremidades (22,8%). Em relação ao instrumento, os contundentes foram os mais utilizados (29,1%), seguido dos perfuro-cortantes (19%). O mês de janeiro prevaleceu com o maior número de atendimentos (21,6%) e os casos de violência ocorreram principalmente na sexta-feira (16,1%), quarta-feira (17,7%), sábado (17,7%) e domingo (17,7%). CONCLUSÃO: O idoso vítima de violência foi principalmente homem, com faixa etária de 60-70 anos. O tipo de violência mais frequente foi a física, especialmente contusão em face ou crânio, ocorrendo mais no fim de semana.

Combined trauma is a topical medico-social problem of the society, one of actual problems of medicine. Interest to her has especially grown lately in connection with increase of quantity of victims with such kinds of damages.Methods. Case records of 5482 patients with combined traumatic brain injury from which at 2724 (46, 66 %) the scull trauma, were on treatment in polytrauma department in the Kharkov city emergence hospital during the period with 2010 on 2014 has been established and analyzed.Result. Trauma as a result of road accident have received from 44,7 to 50,2 % of victims, at falling from height a trauma have received from 12,5 to 17,4 % of patients. The parity to a sexual sign in different years remains at one level and made: 68, 4–71, 7 % of men and 31, 6–28, 3 % of women accordingly. Victims of young and middle age make the most part. Alcohol in blood at receipt has been found out in 32, 5 % of victims, and at patients with an easy combined traumatic brain injury this indicator has made 25, 3 %, and with heavy combined scull trauma alcohol in blood has been found out in patients in 37, 2 % of cases.Conclusions. It is shown that skull-skeleton, skull-thoracic and skull-multiply traumas play the leading role in structure of light traumas, and skull-multiply trauma play the leading role in hard multiply skull trauma and it needs more attention from doctors of all specialties, Проанализировано 2724 истории болезни потерпевших с сочетанной черепно-мозговой травмой, которые находились на лечении в отделении политравмы больницы скорой помощи г. Харькова в 2010-2014 гг. Показано, что в структуре легкой сочетанной ЧМТ ведущее место занимает кранио-скелетная, кранио-торакальная и кранио-множественная травма, а в случаях тяжелой сочетанной ЧМТ первое место занимает кранио-множественная травма, которая требует особого внимания врачей всех специальностей.

医療制度改革がすすむなかで､急性期型病院の平均入院日数は､短縮化の傾向にある。この状況のもとで病院ソーシャルワーカーには、少ないソーシャルワーク介入の回数でより大きな介入効果をあげることが期待されている。このことから、病院ソーシャルワーカーや研究者にもとめられる研究課題は、効果的な短期介入モデルや初期介入モデルの生成にある。しかし、このモデル生成以前に､急性期型病院におけるソーシャルワーク介入の頻度に関する研究は行われていない。そのために、本研究では、急性期型病院での患者・家族に対するソーシャルワーク介入の頻度を明らかにする。本研究をすすめるために、急性期型病院として機能しているある市立病院におけるソーシャルワーク介入の頻度を調査した。その結果、1ケースに対するソーシャルワーク介入が平均3.2回であることが明らかにされた。また、全ケースの86.2％が、５回以下のソーシャルワーク介入で終結していることも明らかにされた。今後の研究課題は、短期介入モデルや初期介入モデルの生成を試みることにある。, Amidst the continuing reforms being made in the health care system, the average duration of hospitalization at emergency hospitals is tending to become shorter. Under these circumstances, hospital social workers are being expected to produce substantial intervenient effects despite fewer opportunities for intervention. Consequently, the task confronting hospital social workers and researchers is to produce effective models of short-term and early intervention. However, before attempting to produce such models, it is necessary to investigate the frequency of social work intervention at emergency hospitals. In order to accomplish this, this study determined the frequency of social work intervention directed at patients and their families at emergency hospitals. In order to conduct this study, a survey was conducted of the frequency of intervention by social workers at a municipal hospital functioning as an emergency hospital. As a result, social workers were determined to intervene with a single case for 3.2 sessions on average. In addition, social workers completed their intervention in five sessions or less in 86.2% of all cases. In the future, a study will be conducted in an attempt to produce models of short-term and early intervention models.

OBJETIVO: Determinar o perfil da violência sofrida pelo idoso atendido em serviço de emergência do Hospital da Restauração (HR), em Recife-PE. METODOLOGIA: Estudo epidemiológico, descritivo, quantitativo de corte transversal. Foram analisados todos os prontuários médicos referentes aos atendimentos em cirurgia geral, ortopedia e clínica médica realizados na emergência de adultos do HR entre 1º de janeiro e 31 de dezembro de 2007, disponibilizados pelo Serviço de Arquivo Médico, totalizando 72.232 prontuários. RESULTADOS: Do total de prontuários analisados, foram registrados 79 casos de violência contra o idoso. Destes, 63,3% do sexo masculino. A faixa etária predominante foi compreendida entre 60-70 anos (72,2%). Em 81,1% dos prontuários, não houve registro sobre vínculo empregatício ou situação previdenciária do agredido. Em relação ao local de residência da vítima, a maioria (46,8%) residia em Recife-PE. Quanto ao levantamento de dados sobre o agressor, quando este foi citado (3,7%), todos pertenciam ao sexo masculino, sendo notificada a relação com a vítima em um único caso (filho). O tipo de violência mais frequente foi a física (97,5%). Quanto à natureza da lesão, a mais comum foi a contusão (27,8%). Os sítios de lesão mais acometidos foram a face (35,4%), crânio (31,6%) e extremidades (22,8%). Em relação ao instrumento, os contundentes foram os mais utilizados (29,1%), seguido dos perfuro-cortantes (19%). O mês de janeiro prevaleceu com o maior número de atendimentos (21,6%) e os casos de violência ocorreram principalmente na sexta-feira (16,1%), quarta-feira (17,7%), sábado (17,7%) e domingo (17,7%). CONCLUSÃO: O idoso vítima de violência foi principalmente homem, com faixa etária de 60-70 anos. O tipo de violência mais frequente foi a física, especialmente contusão em face ou crânio, ocorrendo mais no fim de semana. OBJECTIVE: To determine the profile of violence suffered by elderly assisted at the emergency department. METHODOLOGY: Epidemiological, descriptive, quantitative cross-sectional study. Were analyzed all medical records of care provided in General Surgery, Orthopedics and Internal Medicine in adult emergency between January 1st and December 31, 2007, provided by the Service Medical Records, totaling 72,232 records. RESULTS: There were 79 cases of violence against elderly, of which 63.3% were male. The predominant age group was between 60-70 years old (72.2%). In 81.1% of the medical charts there was no records of employment. Regarding residence of the victim, the majority (46.8%) lived in Recife city, Pernambuco state, Brazil. About data of the offender, when it was quoted (3.7%), all of them were males, reported being the relationship with the victim in a unique case (child). The most frequently found violence was physical (97.5%). The most common injury was contusion (27.8%). The sites of injury most affected were face (35.4%), head (31.6%) and extremities (22.8%). In relation to the instruments, blunt was used in 29.1%, followed by piercing-cutting (19%). January had the highest number of attendances (21.6%). Violence occurred mainly on Fridays (16.1%), Saturdays (17.7%) and Sundays (17.7%). CONCLUSION: The elderly victim of violence is primarily male, ranging 60-70 years of age. The most frequent type of violence is physical, especially in face or skull injury, occurring over the weekend.