ABSENTEEISM IN NURSING IN THE FACE OF COVID-19: A COMPARATIVE STUDY IN A HOSPITAL FROM SOUTHERN BRAZIL

Objective: To compare absenteeism in Hospital Nursing before and during the COVID-19 pandemic. Method: A cross-sectional study. It involved compilation of the records of absence from Nursing work at a university hospital in southern Brazil in March, April and May 2019 (n=622) and during the same period in 2020 (n=475). The data were analyzed by means of descriptive and analytical statistics. Results: Both periods presented the same absence frequencies in women (98.4%;98.3%), aged between 40 and 49 years old (47.9%;44.8%) and working in wards for adults (30.7%;29.2%). Absenteeism-Disease was the most prevalent cause (48.4%;48%). The absolute number of absence cases was higher in the prepandemic period;however, the time in days and hours lost, as well as the absenteeism rate (13.9;18.6%), was significantly higher (p-value<0.001) in the current pandemic period. Conclusion: The COVID-19 pandemic exerted an impact on the increase in Hospital Nursing absenteeism. © 2022, Universidade Federal de Santa Catarina. All rights reserved.

Relational Capital and Organisational Resilience

In the current context, marked by the challenges of the digital transformation, the climate emergency, the risks of the Covid-19 pandemic and the economic and health crisis, resilience emerged as a concept explaining how societies, systems, and subsystems can respond to shocks and better manage the inherent risks that are constantly changing. With the digital transformation and the increasing use of the internet by organisations, relational capital has emerged as one of the components of intellectual capital with greater relevance for the resilience and agility of organisations. Through the most recent literature review, this study explores the relationship between relational capital and firms’ resilience indicators. The results provide empirical evidence for the positive relationship between the two concepts and present the basis for developing an auditing framework of organisational resilience. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Introduction

We live in a world plagued by cyclical crises where challenges constantly emerge, demanding agility in response and adaptation. The advent of the COVID-19 crisis, which quickly spread worldwide, has accelerated transformations and anticipated many challenges in work. The crisis put even more in evidence the limitations of health systems, the precariousness of many jobs, and housing insufficiency, pointing to the fragility of human life and the global vulnerability of the planet. Many ethical and social issues were raised, making us realise that centuries of an economy centred on economic power had postponed a human-centred and environmentally responsible model. Governments and society, in general, seem to have realised that People, the Planet, and the Prosperity, as presented by the United Nations’ Sustainable Development Goals, could not continue to be ignored to the detriment of greater economic and political interests. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

HELLP syndrome and disseminated intravascular coagulation (DIC) in COVID-19 pregnancy: Hemostatic balance challenge

Background: HELLP syndrome is associated with advanced stage pre-eclampsia, and leads to disseminated intravascular coagulation (DIC) in up to 39%. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection has also been linked to an excessive inflammatory/immune response and different phenotypic hemostatic derangements. The following case report aims to establish a connection between a hemostatic disorder found in a COVID-19 pregnant woman with an associated HELLP Syndrome. Case Report: A 33-year-old woman with a dichorionic diamniotic twin pregnancy with no relevant previous history is admitted for premature membrane rupture, ongoing for 4 hours, and fever.Blood sample workup and point of care thromboelastometry revealed: normal hemoglobin, lymphopenia, thrombocytopenia, global increase of clotting times, hypofibrinogenemia, D-dimer increase and elevated hepatic enzymology levels;rare schizocytes in the peripheral blood smear;and positive RT-PCR result for SARS-CoV2.After diagnosing one intrauterine fetal death by ultrasound, the patient was submitted to an emergent cesarean delivery. Although there were no surgical complications, multiple hemoderivatives were transfused. Postoperatively, severe clinical worsening ensued and imagiological evidence highlighted the presence of a hemoperitoneum, herego an exploratory laparotomy followed suit. The neonate died due to multiorgan failure and hemorrhagic shock, while positive for SARS-CoV2. On the eighth day the patient was discharged from hospital. Discussion: This case report features a patient with DIC during pregnancy, fulfilling some criteria for HELLP Syndrome. Additionally, COVID-19 disease and intrauterine fetal death might have contributed to the pathophysiological state, on account of an immunological/inflammatory exacerbated response causing thrombotic microangiopathy, clotting factors deficiency and hyperfibrinolysis. There may not be possible to exclude the synergical contribution of all previously characterised elements to the development of the clinical context. Therefore, this raises the possibility that COVID- 19 might be a new perioperative challenge, giving rise to the impairment of previously known obstetric emergencies.