Utilization of trained volunteers decreases 30-day readmissions for heart failure.

BACKGROUND: This study evaluated the effectiveness of using trained volunteer staff in reducing 30-day readmissions of congestive heart failure (CHF) patients. METHODS: From June 2010 to December 2010, 137 patients (mean age 73 years) hospitalized for CHF were randomly assigned to either: an interventional arm (arm A) receiving dietary and pharmacologic education by a trained volunteer, follow-up telephone calls within 48 hours, and a month of weekly calls; or a control arm (arm B) receiving standard care. Primary outcomes were 30-day readmission rates for CHF and worsening New York Heart Association (NYHA) functional classification; composite and all-cause mortality were secondary outcomes. RESULTS: Arm A patients had decreased 30-day readmissions (7% vs 19%; P < .05) with a relative risk reduction (RRR) of 63% and an absolute risk reduction (ARR) of 12%. The composite outcome of 30-day readmission, worsening NYHA functional class, and death was decreased in the arm A (24% vs 49%; P < .05; RRR 51%, ARR 25%). Standard-care treatment and hypertension, age ≥65 years and hypertension, and cigarette smoking were predictors of increased risk for readmissions, worsening NYHA functional class, and all-cause mortality, respectively, in the multivariable analysis. CONCLUSIONS: Utilizing trained volunteer staff to improve patient education and engagement might be an efficient and low-cost intervention to reduce CHF readmissions.

Acute pain and availability of analgesia in the prehospital emergency setting in Italy: a problem to be solved.

OBJECTIVES: The treatment of acute pain in the prehospital emergency setting remains a significant problem. We evaluated the incidence, site, and possible cause of acute pain in the prehospital period and also the current state of prehospital pain management by evaluating analgesic availability in emergency vehicles in Italy. METHODS: First aid volunteers documented the presence, intensity, and site of acute pain by questionnaire for over 3 months. Emergency service operations completed a questionnaire on analgesic availability in ambulances and helicopters. RESULTS: Pain symptoms were present in two-thirds of the patients (n = 383) and ranked as moderate to unbearable in 41.75%. Results of the analgesic availability survey indicate that 10.6% of the ambulance services carry no pain killers (including non-steroidal anti-inflammatory drugs [NSAIDs] and/or paracetamol) and 11.5% are without an opioid. The emergency helicopter survey showed a significant difference in analgesic availability compared with ambulances, with 97.6% having at least one opioid agent available (weak or strong). A wide geographical variation in the availability of analgesic agents in ambulance and helicopter services was seen. CONCLUSIONS: There is a high prevalence of pain among patients receiving prehospital emergency treatment in Italy and treatment for acute pain during emergency treatment of trauma patients is inadequate. All emergency vehicles, without distinction, should carry opioids and other analgesic drugs (NSAIDs and paracetamol) and there should be no geographic differences in the availability of pain medications.

Hospital-physician relations: two tracks and the decline of the voluntary medical staff model.

Data from the most recent Community Tracking Study (CTS) interviews in twelve nationally representative metropolitan areas indicate that hospitals are increasingly employing physicians, particularly specialists. Nonemployed physicians are separating from hospitals passively by refusing to serve on medical staff committees or take emergency department call, and actively by creating specialized facilities, such as ambulatory surgery centers (ASCs), to compete for hospitals' most profitable services. Employment is more common and physician-owned ASCs are less common in consolidated hospital markets. The interviews also suggest other factors motivating physician employment by, or separation from, hospitals, and likely consequences of these trends.

Las enfermeras y el voluntariado opinión y participación de profesionales de enfermería en ONG / Nurses and volunteer world. Participation and opinion in NGOs

La Cooperación Internacional (CI) y las Organizaciones No Gubernamentales (ONG) cuentan entre sus áreas de actuación con la Salud Pública, siendo relevante el papel que desempeñan. La opinión de la población general hacia ellas respalda en diferente medida su razón de ser y refleja su participación; sin embargo es muy escasa la información que se tiene sobre la opinión e inclusión de sectores específicos en ellas. Adicionalmente, el sector de las ONG españolas atraviesa un proceso de cambio en materia de recursos humanos a nivel voluntario y profesional. El objetivo de este estudio descriptivo transversal con cuestionario autoadministrado. fue conocer la opinión de los profesionales sanitarios que trabajan en un ámbito específico sobre aspectos básicos de la CI española con países en vías de desarrollo, explorando el conocimiento sobre las ONG, la colaboración actual y posible con ellas, la valoración de las campañas de sensibilización que llevan en la actualidad y explorar los factores sociodemográficos asociados al conocimiento y pertenencia en estas ONG. Entre los resultados destacó la similitud en el nivel de conocimiento de este colectivo profesional con el de la población general sobre los aspectos básicos de la CI española y las ONG con acciones en salud, incluso la participación en este tipo de organizaciones, tanto en pertenencia como tipo de vinculación. Sugiriendo la existencia de un modelo de relación entre la población y estas organizaciones que se cobija en una participación más pasiva que activa (AU)

El voluntariado hospitalario en España / Hospital voluntary service in Spain

Con el objetivo de conocer la realidad del voluntariado hospitalario en nuestro país, la Asociación para el Voluntariado en Europa ha promovido un estudio en el que han participado 15 Universidades españolas. Se han obtenido datos de un total de 55 hospitales y 76 asociaciones de voluntariado. Dos de las conclusiones extraídas son: las labores que realizan los voluntarios cubren una gran variedad de necesidades del enfermo y los beneficios que se desprende de esta colaboración no sólo repercuten positivamente en el paciente, sino también en: el propio voluntario, la familia del enfermo, el personal sanitario, el hospital e incluso en la sociedad (AU)

No disponible

Trends in volunteerism. A new way of managing volunteers furthers providers' goals.

Today's volunteers come from many walks of life--professionals, children, people with disabilities, and skilled tradespeople. Each has a special skill to offer in the spirit of volunteerism. To take advantage of the increasing number of volunteers, hospitals must begin to form more meaningful alliances with their communities. Healthcare volunteerism creates opportunities for renewed linkages between the community and the hospital. Hospitals should also look even closer to home--their own neighborhoods. Often staff fail to see their neighbors' failing conditions as services for the disadvantaged have declined. This creates ill will. But some hospitals are avoiding this by recruiting volunteers to help improve the lives of their yards, fixing up their houses, and fulfilling other needs. Another area where volunteers can be beneficial to the hospital is in political activism. Healthcare leaders, however, must discuss political issues with volunteers, and not keep them in the dark on issues of importance. Many volunteers are active politically and can give healthcare a voice in crucial matters.