Application of a Novel PM Model to Assess the Risk of Clostridioides difficile Infections in Medical Facilities as a Tool for Improving the Quality of Health Services and the Safety of Patients

Infections with multi-drug resistant microorganisms associated with the provision of health services have become an acute problem worldwide. These infections cause increased morbidity as well as mortality and are a financial burden for the healthcare system. Effective risk management can reduce the spread of infections and thus minimize their number in hospitalized patients. We have developed a new approach to the analysis of hazards and of exposure to the risk of adverse events by linking the patient’s health record system to the entire infrastructure of the hospital unit. In this study, using the developed model, we focused on infections caused by the Clostridioides difficile bacterium, as they constitute a significant number of nosocomial infections in Poland and worldwide. The study was conducted in a medical facility located in the central part of Poland which provides tertiary care. In the proposed PM model, a risk analysis of hospital acquired infections at the Intensive Care and Anesthesiology Unit combined with the hospital’s technical facilities and organizational factors was conducted. The obtained results indicate the most critical events which may have an impact on potential hazards or risks which may result from the patient’s stay at the specific ward. Our method can be combined with an anti-problem approach, which minimizes the critical level of infection in order to determine the optimal functioning of the entire hospital unit. Research has shown that in most situations the spread dynamics of nosocomial infections can be controlled and their elimination may be attempted. In order to meet these conditions, the persons responsible for the daily operation of the medical facility and its individual wards have to indicate potential events and factors which present a risk to the hospitalized patients. On the basis of a created spreadsheet directions for improvement may be finally established for all potential events, their frequency may be minimized, and information may be obtained on actions which should be undertaken in a crisis situation caused by the occurrence of a given phenomenon. We believe that the proposed method is effective in terms of risk reduction, which is important for preventing the transmission of multi-drug resistant microorganisms in the hospital environment.

The effect of progressive muscle relaxation on reducing restless legs syndrome among patients undergoing haemodialysis in a satellite/hospital unit in Indonesia

Introducción: La relajación muscular se considera una terapia alternativa para el síndrome de las piernas inquietas (SPI). Objetivo: Determinar el efecto de la relajación muscular progresiva (RMP) sobre el síndrome de piernasinquietas en pacientes sometidos a hemodiálisis. Metodología: Se llevó a cabo un estudio con diseño cuasi-experimental en la unidad de hemodiálisis. Lamuestra reclutada fue de 12 encuestados tanto en el grupo de intervención como en el de control, siendo elmuestreo de conveniencia. El instrumento de investigación utilizado fue la Escala Internacional del Grupo de Estudio del SPI. Resultados: En el grupo de intervención, las puntuaciones medias del SPI antes y después fueron de22,92 y 17,42, respectivamente. En el grupo de control, las puntuaciones medias del SPI antes y despuésde la intervención fueron de 24,33 y 23,50, respectivamente. La RPM fue eficaz para mejorar el SPI (p<0,005). Conclusión: La RMP podría ser una alternativa para reducir el SPI en pacientes sometidos a hemodiálisis. Se necesitan estudios futuros para aclarar los hallazgos utilizando métodos más robustos y un tamaño de muestra mayor.

In Search of Autonomy: Dancing With Rules

Purpose: Autonomy in organisations cannot exist without rules nor relationships. Yet, previous research tends to elicit understandings of autonomy as freedom from external constraints to enact free individual will. And there are numerous positive effects related to autonomy at work. But research has not kept pace with modern-day organisations that are highly flexible and dynamic. Current understandings of autonomy are static. Autonomy is mainly regarded as something individuals possess, more or less constricted by rules. Our purpose is to contribute a more flexible and practice-oriented concept of autonomy to answer the research question: How is autonomy developed and practiced in relation to formal rules in high-risk organisations?Design: To investigate autonomy as a dynamic and flexible concept, we draw on two case studies comprised of a total of 52 interviews and more than 10 h of observation. The cases include a factory and a hospital unit.Findings: We suggest, based on the data, that autonomy is a relational phenomenon. We suggest four different autonomy-rule dynamics: Passive, loyal, self-promoting, and co-generative learning.Research Implications: Regarding autonomy as relational rather than individual contributes to our understanding of organisations as always in the making. In this, we emphasise the interactive element of autonomy.Practical Implications: Practitioners and managers may use our suggestions to work with autonomy in a different way, spurring creativity and improvisation by constructively using rules.Originality: Little research has paid attention to the concept of autonomy (despite its importance), and arguably, a trend in the available research concerns a commodification of the phenomenon, primarily aligning autonomy with (degrees of) negative freedom and individual decision making. We unpack the concept with attention to interaction – what we have called dancing with rules.

A INFLUÊNCIA DA FÉ NO TRATAMENTO DE PACIENTES ONCOLÓGICOS

The cancer has been studied for a long time and some conclusions of these illness should be associate of many reasons. According some researches, this illness has been considered one of the biggest public health problem around the world and with many cases registered. Everybody who is in front of possibility to positive diagnostic of cancer can be negative feelings or thoughts about the future and their uncertainties. The psychologist should contribute with the mental process by using technical knowledge to help people and mental impacts caused because the illness and contribute with a complete care identifying potentials psychical disorders. In this process the faith becomes a significant alternative to the treatment, could result in trust and power of balance. The faith should be represented part of a process to understand and take on lidding with the cancer, improving the life quality and intensifying the struggle of illness. The focus on this studying was identifying the influence of faith on oncological patients’ treatment on hospital unit in São Paulo from capital. It was about a qualitative research and were considered seven people with the same repetitive talks after had been interviewed. The people selection was random, inside the hospital and all of participants was interviewed following a guide prepared before of the researches. The analyses results were produced about the “Talk Analyses or Speech Analyses” making the categories. In terms of expected results, the faith was considered a positive alternative and source to face or to feel of cancer. The faith phenomenon can contribute significantly to the cancer treatment process.

OCULAR MANIFESTATIONS IN LABORATORY CONFIRMED COVID-19

Background: Scarce literature has been published thus far regarding ocular findings in the COVID-19. Methods: All patients were confirmed by SARS-CoV-2 real-time reverse transcriptase– polymerase chain reaction (RT-PCR) of nasopharynx or oropharynx swab specimens collected at an isolation facility, fever clinic, or hospital unit designated for suspected cases pending confirmation. Results: Overall, 25 patients (25.00%) had various ocular symptoms during COVID-19 infection. Among those with ocular symptoms, 19 patients (76.00%) presented with increased conjunctival discharge, including white mucoid (6 [24.00%]), thin watery (3 [12.00%]) and yellow-green purulent (11 [44.00%]) discharge, and with conjunctival congestion (2 [8.00%]). Other ocular manifestations contained ocular pain (3 [12.00%]), tearing (1 [4.00%]), and eyelid swelling (1 [4.00%]). Conclusion: We concluded that common ocular manifestations were conjunctival discharge, eye rubbing, and conjunctival congestion. Keywords: COVID-19, Ocular, Eye.