Clinical characteristics of 54 medical staff with COVID-19: A retrospective study in a single center in Wuhan, China.

In December 2019, an outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection occurred in Wuhan, and rapidly spread to worldwide, which has attracted many people's concerns about the patients. However, studies on the infection status of medical personnel is still lacking. A total of 54 cases of SARS-Cov-2 infected medical staff from Tongji Hospital between 7 January and 11 February 2020 were analyzed in this retrospective study. Clinical and epidemiological characteristics were compared between different groups by statistical method. From 7 January to 11 February 2020, 54 medical staff of Tongji Hospital were hospitalized due to coronavirus disease 2019 (COVID-19). Most of them were from other clinical departments (72.2%) rather than emergency department (3.7%) or medical technology departments (18.5%). Among the 54 patients with COVID-19, the distribution of age had a significant difference between non-severe type and severe/critical cases (median age: 47 years vs 38 years; P = .0015). However, there was no statistical difference in terms of gender distribution and the first symptoms between theses two groups. Furthermore, we observed that the lesion regions in SARS-Cov-2 infected lungs with severe-/critical-type of medical staff were more likely to exhibit lesions in the right upper lobe (31.7% vs 0%; P = .028) and right lung (61% vs 18.2%; P = .012). Based on our findings with medical staff infection data, we suggest training for all hospital staff to prevent infection and preparation of sufficient protection and disinfection materials.

Assesment of psychosocial work conditions of nurses at selected hospital wards.

BACKGROUND: Good organisation of work, clear division of responsibilities, support from superiors are factors that positively influence the satisfaction of the profession. The purpose of the work was the assessment of psychosocial working conditions of nurses. MATERIAL AND METHODS: The research included 388 nurses working at surgical wards, medical treatment wards, and psychiatric wards. The research method was a diagnostic survey carried out by means of a questionnaire called Psychosocial Work Conditions. The obtained results were statistically analysed. RESULTS: Nearly a half of the nurses considers the requirements at work as moderate, and 36.66% as high. Nurses from medical treatment wards indicate the highest level of requirements. Nurses working at psychiatric wards and in a shift system significantly more often feel the requirements relating to overload and resulting from a conflict of roles. Nurses working in the profession for more than 10 years considerably more often describe the level of behavioural control as high in comparison to those working for a shorter time. Regardless of the character of a ward, nurses most often (44.33%) assess the support from co-workers as average, and 1/5 considered this as low. CONCLUSIONS: The results indicate the correctness of introducing psychosocial training for professionally active nurses.

Patient safety climate in 92 US hospitals: differences by work area and discipline.

BACKGROUND: Concern about patient safety has promoted efforts to improve safety climate. A better understanding of how patient safety climate differs among distinct work areas and disciplines in hospitals would facilitate the design and implementation of interventions. OBJECTIVES: To understand workers' perceptions of safety climate and ways in which climate varies among hospitals and by work area and discipline. RESEARCH DESIGN: We administered the Patient Safety Climate in Healthcare Organizations survey in 2004-2005 to personnel in a stratified random sample of 92 US hospitals. SUBJECTS: We sampled 100% of senior managers and physicians and 10% of all other workers. We received 18,361 completed surveys (52% response). MEASURES: The survey measured safety climate perceptions and worker and job characteristics of hospital personnel. We calculated and compared the percent of responses inconsistent with a climate of safety among hospitals, work areas, and disciplines. RESULTS: Overall, 17% of responses were inconsistent with a safety climate. Patient safety climate differed by hospital and among and within work areas and disciplines. Emergency department personnel perceived worse safety climate and personnel in nonclinical areas perceived better safety climate than workers in other areas. Nurses were more negative than physicians regarding their work unit's support and recognition of safety efforts, and physicians showed marginally more fear of shame than nurses. For other dimensions of safety climate, physician-nurse differences depended on their work area. CONCLUSIONS: Differences among and within hospitals suggest that strategies for improving safety climate and patient safety should be tailored for work areas and disciplines.

What's in a name? The process on renaming a neuroscience department.

In recent years Huntington Hospital in Pasadena, California has effectively merged a variety of programs under the auspices of a single department. While these separate programs share certain similarities in terms of procedure and technology, a problem has arisen in terms of departmental identity. The department name was becoming a misnomer in that the department's original designation, a sleep lab, did not take into account the additional neurodiagnostic testing being offered. To combat this, an effort was made to rename the department in such a way that would reflect changes in programs and services while also providing an overall sense of community within the department. Procedurally, the renaming was designed as an all-encompassing staff project. During the presentation of the project, staff discussed the mission as well as vision statement of Huntington Hospital. The staff was supplied with a list of all diagnostic procedures and programming currently being offered. Correlations between services were accented and a two-week timeline was established to allow staff time to brainstorm. Ultimately, the benefits of the naming contest were twofold: first, department members gained an understanding of all aspects of the department, and second, the combined input created an overall sense of departmental unity amongst the staff.

[Sensitivity of Staphylococcus aureus strains isolated from the patients of the SP ZOZ Hospital in Nidzica to bacteriocidal agents]. / Lekowrazliwosc szczepów Staphylococcus aureus wyizolowanych od pacjentów szpitala SP ZOZ w Nidzicy.

The aim of this study was to evaluate a frequency of isolation and antimicrobial susceptibility testing of Staphylococcus aureus strains isolated from clinical specimens obtained from patients hospitalized in different hospital wards (SP ZOZ) in Nidzica from 01. 09. 2000 to 31. 12. 2003. During over three years 716 Staphylococcus aureus strains were cultured out of 15517 clinical specimens supplied to the Bacteriological Laboratory of SP ZOZ in Nidzica. S. aureus strains were isolated from 4.6% of examined samples. Samples were collected from patients hospitalized in all wards (five wards). Analysis of susceptibility to antimicrobial agents of identified S. aureus strains was performed. Seventy strains (9.8%) were metihicillin-resistant (MRSA). One hundred twenty four strains (17.3%) revealed inducible resistance to macrolides, linkosamides and streptogramins B (MLS, mechanism). The greatest activity in vitro against clinical S. aureus strains showed glycopeptide antibiotic--vancomycin (100% of susceptible strains). Clinical S. aureus strains isolated from patients of hospital in Nidzica are in the majority susceptible to antibiotics/chemotherapeutics, except of penicillin. Percentage of methicillin-resistant strains (MRSA) is not high (<10). Nevertheless, constant monitoring of a drug susceptibility of nosocomial S. aureus strains is important, considering the necessity of control of current epidemiological and therapeutic situation.

Lack of patients? A hypothesis for understanding discrepancies between hospital resources and productivity.

BACKGROUND: Despite a substantial increase in hospital resources, increased hospital admissions and out-patient visits, long waiting lists have been a significant problem in Norwegian health care. A detailed analysis of the development in resource allocation and productivity at St. Olavs University Hospital in central Norway was therefore undertaken. METHODS: Resource allocation and patient volume was analysed during the period 1995 to 2001. Data were analysed both for emergency and elective admissions as well as outpatient visits specified into new referrals and follow-up consultations. RESULTS: Full time employee equivalents for doctors and nurses increased by 36.6% and 25.9%, respectively, and all employees by 28.1%. However, admitted patients, outpatient consultations and surgical procedures only increased by 10%, 15% and 8.3%, respectively. Thus, the productivity for each hospital employee, defined as operations pr. surgeon, outpatient consultations pr. doctor etc. was significantly reduced. A striking finding was that although the number of outpatient consultations increased, the number of new referrals actually went down and the whole increase in activity at the outpatient clinics could be explained by a substantial increase in follow-up consultations. This trend was more evident in the surgical departments, where some departments actually showed a reduction in total outpatient consultations. CONCLUSION: In view of the slow increase in hospital activity in spite of a significant increase in resources, it can be speculated that patient volume might be a limiting factor for hospital activity. The health market (patient population) might not be big enough in relation to the investments in increased production capacity (equipment and manpower).

Prescribing practice in a Swiss primary and secondary acute care hospital.

QUESTIONS UNDER STUDY: Little is known about the prescribing behaviour of physicians in hospitals. This analysis, using data based on Computerised Physician Order Entry (CPOE), was performed to evaluate prescription patterns, to analyse possible over-prescribing of drugs and to assess the compliance with therapy-guidelines. METHODS: Within a 12 month period, 68,133 prescriptions in three departments were analysed with respect to drug class, duration of therapy, dosage, administration route, patient's age, patient's length of stay and number of prescriptions per patient. RESULTS: On average, each patient received 12 drugs. A steady increase in the number of prescribed drugs can be seen between the age of 20 and 85. The median duration of intravenously administered antibiotics was 4.0 days, the median duration of antibiotic therapy was 9.5 days. DISCUSSION: On average, patients were taking 5 drugs on a regular basis on admission to hospital. This number was doubled during the hospital stay where patients were prescribed 12 drugs on average. On discharge 6 drugs were prescribed and thus a reasonable reduction was made. Surgical and Internal Medicine wards were using very similar drug classes. Concerning the use of low molecular-weight heparin, guidelines were widely adhered to whereas proton-pump-inhibitors were prescribed too often and the duration of intravenous antibiotic therapy tended to be too long.

Hospital competition, resource allocation and quality of care.

BACKGROUND: A variety of approaches have been used to contain escalating hospital costs. One approach is intensifying price competition. The increase in price based competition, which changes the incentives hospitals face, coupled with the fact that consumers can more easily evaluate the quality of hotel services compared with the quality of clinical care, may lead hospitals to allocate more resources into hotel rather than clinical services. METHODS: To test this hypothesis we studied hospitals in California in 1982 and 1989, comparing resource allocations prior to and following selective contracting, a period during which the focus of competition changed from quality to price. We estimated the relationship between clinical outcomes, measured as risk-adjusted-mortality rates, and resources. RESULTS: In 1989, higher competition was associated with lower clinical expenditures levels compared with 1982. The trend was stronger for non-profit hospitals. Lower clinical resource use was associated with worse risk adjusted mortality outcomes. CONCLUSIONS: This study raises concerns that cost reductions may be associated with increased mortality.

Organization of orthopaedic trauma services: a survey of the Orthopaedic Trauma Association.

OBJECTIVES: This study was undertaken to collect information about the organization of orthopaedic trauma services in different types of hospitals, with particular emphasis on hospital support arrangements in different practice situations. DESIGN: A survey was sent to all members of the Orthopaedic Trauma Association (OTA) as part of the organization's newsletter. Fractoids. In addition, the survey was distributed by the OTA's E-mail discussion list, ORT-1. MAIN OUTCOME MEASUREMENTS: The survey included questions about the size and nature of the hospital, resident involvement, academic affiliation, number of orthopaedic physician staff, training of the staff, presence of an organized orthopaedic trauma service, distribution of call and patients, and hospital support. RESULTS: Fifty-seven responses were received from North American centers, of which six were duplications. Responses came from institutions of all types and sizes, although most came from urban, Level 1 trauma centers with academic affiliation. Twenty-nine hospitals had a designated orthopaedic trauma service, and twenty-six had a director. Eighteen institutions had ancillary staff (nurses, physician's assistants, etc.) assigned to the orthopaedic trauma service. Hospitals with an academic affiliation were statistically more likely to have a designated orthopaedic trauma service and to distribute trauma patients by subspecialty expertise. In hospitals with a designated orthopaedic trauma service or director, it was more common to have ancillary support staff and to have it funded by the hospital, although the differences did not rise to statistical significance. CONCLUSIONS: There are differences in organization of orthopaedic trauma care between hospitals, which may be related to hospital size, academic affiliation, and orthopaedic department organization. Further study is necessary to determine whether organizational differences translate into differences in patient outcome after trauma.

Desempeño de los recursos humanos de enfermería en la primera cátedra de Clínica Médica Sala B del Hospital de Clínicas

Estudio descriptivo del desempeño de las enfermeras de la 1ra Cátedra de Clínica Médica en el Hospital de Clínicas-Sala B. Presenta consideraciones teóricas sobre su formación, normas de desempeño, actualización, y capacitación. Describe las características de su trabajo y el perfil

Sistema técnico y administrativo del servicio de nutrición del Colegio Militar de Ejército "Cnl. , Gualberto Villarroel" / Technical and administrative System of the Servicio de Nutrition of the Military School of Army \"Cnl. Gualberto Villarroel\"

La pesente Memoria profesional, presenta una descripción de la actividad laboral desarrollada en la Clínica San marcos, Proyecto Concern internacional, Clínica Aramayo, pro Sud y Ejército de Bolivia, Habiendo realizado funciones técnico administrativas, dietoterápicas y de investigación en el área clínica y de salud pública, con cargos diversos tanto dependientes del Director y Administrador y acargo de aproximadamente diez dependientes. Durante el desempeño laboral en el Colegio Militar de Ejército "Cnl. Gualberto Villarroel" he realizado un diagnóstico del Sistema Administrativo del Servicio de Nutrición, el mismo que no se encontraba en condiciones regulares, además el manejo se realizaba empiricamente y el personal no contaba con capacitación adecuada...

[Drug resistance in nosocomial strains of staphylococci to methicillin]. / Lekowrazliwosc szpitalnych szczepów gronkowców metycylinoopornych.

The aim of the present study was the analysis of drug susceptibility of MRSA and MRCNS strains isolated from patients hospitalized in 14 wards of the State Clinical Hospital No 1 in Warsaw. The strains were identified (ID 32 STAPH), and their susceptibility to antimicrobial agents (ATB STAPH) was determined in ATB system (bioMérieux, France). Four methods were applied to confirm the resistance to methicillin: ATB-plus system, disc-diffusion method (Oxa 1 microgram, Oxoid, U.K.), Crystal MRSA ID (Becton Dickinson-BBL, USA) and agar screen test in TSA medium (Difco, USA) with methicillin (25 mg/l, Sigma, USA). 108 Staphylococcus spp. strains were found in 300 clinical specimens. 56 strains were methicillin-resistant (52%). Among methicillin-resistant strains 13 MRSA, 28 MRSE and 15 of other species were found. All MRSA strains were susceptible to vancomycin, teicoplanin and fusidic acid. MRCNS were susceptible first of all to vancomycin (43/43), minocycline (42/43) and pristinamycin (42/43). On the basis of the obtained results it can be stated that methicillin-resistant staphylococci occur in hospital wards. The greatest number of methicillin-resistant strains was cultured from patients hospitalized in surgery wards (32), methicillin-resistant strains much more frequently occur among coagulase-negative staphylococci, especially in Staphylococcus epidermis. Glycopeptide antibiotics are most active against isolated MRSA strains. The most active therapeutic agent against MRCNS is vancomycin.