RESUMO
AIM: To examine personal and organisational factors related to professional functioning of nurses and physicians during the COVID-19 pandemic. BACKGROUND: Exposure to COVID-19-related stressors has been associated with lower self-reported professional functioning among health care workers. METHODS: A cross-sectional study among 115 hospital workers during the COVID-19 pandemic in Israel was designed to explore (a) personal professional functioning, (b) clarity of guidelines, (c) work organisation by the management, and (d) health care workers' feeling of contribution to a global effort. RESULTS: A feeling of contribution to a global effort while treating patients with COVID-19 mediated the relationships between work organisation by the management and professional functioning (ß = .05, p < .05). The clarity of guidelines for routine procedures (ß = .21, p < .05) and a feeling of ß contribution to a global effort (ß = .34, p < .01) positively predicted professional functioning of nurses and physicians during COVID-19 pandemic (R2 = .19, p < .01). CONCLUSIONS: In order to achieve optimal functioning of health care workers in an emergency, managers should provide clear guidelines and promote workers' feelings of contribution to a global effort. IMPLICATIONS FOR NURSING MANAGEMENT: The provision of clear guidelines and protocols is essential for efficient emergency management. Expressing appreciation for health care workers and providing positive feedback may improve professional functioning.
Assuntos
COVID-19 , COVID-19/epidemiologia , Estudos Transversais , Pessoal de Saúde , Humanos , Israel/epidemiologia , Pandemias , Recursos Humanos em HospitalRESUMO
AIM: We studied the effect of the addition of an oral nutrition supplement (ONS) on the rate of hypoglyemia among hospitalized type 2 diabetes mellitus (DM) patients. METHODS: In this retrospective analysis, all DM patients with hypoalbuminemia (albumin < 3.5 g/dL) admitted to internal medicine "E" at Wolfson Medical Center between 1 June 2016 and 30 April 2017 were included. One bottle of ONS (Glucerna, 330 KCAL, 28 g carbohydrates, 17 g protein, 17 g fat) was added to the morning meal. The consumption of the ONS was verified during the morning rounds. All glucose measurements were recorded automatically in the patients' electronic medical records. A logistic regression model was used to evaluate the effect of the nutrition support on the occurrence of hypoglycemia. RESULTS: 218 patients (mean age 77.4 ± 12.0 years, 63.3% female, mean albumin 3.13 ± 0.32 g/dL), of whom 27.9% had documented hypoglycemia during hospitalization were included. The patients consumed 69.5% ± 37.1 of the ONS provided, and ONS was started 4.3 ± 5.3 days from admission. A logistic regression model indicated that age (Odds ratio [OR] 1.048, 95% CI 1.014-1.083, p = 0.005), insulin treatment (OR 3.059, 95% CI 1.497-6.251, p = 0.002), and the day of ONS started from admission (OR 1.094, 95% CI 1.021-1.173, p = 0.011) were associated with an increased risk of hypoglycemia. Complete consumption of the ONS was associated with a reduced risk of hypoglycemia: OR 0.364, 95% CI 0.149-0.890, p = 0.027. Age, other DM medications and serum albumin did not affect the risk. CONCLUSION: The intake of a complete serving of ONS may be associated with a reduction of the risk of hypoglycemia among diabetes in-patients with hypoalbuminemia.