Human resources in a healthcare institution as the management efficacy improvement factor

The article analyzes the current HR of the local healthcare organization. There was carried a SWOT-analysis of personnel management has been out, disclosed the main problems of the management system of a medical institution. Development strategies and an algorithm for improving personnel policy are formulated in order to increase the efficiency of management and the quality of medical care to the population.Purpose of the study. Is to analyze the current personnel policy, SWOT-analysis of personnel management, develop a strategies and set of practical recommendations for improving the management system of a public health institution while ensuring high quality medical services to the population.Materials and methods. An analysis of the personnel policy in a phthisiatric institution (Makeevka Municipal TB Dispensary, Donetsk region) was carried out, the heads of the main structural divisions were questioned. The analysis results are structured using the SWOT scale.Results. Based on the results of the sociological survey, the main advantages and disadvantages of personnel policy were identified, a SWOT analysis matrix was drawn up, and strategies for the development of a budgetary healthcare institution were developed. The breakthrough strategy is based on improving the material and technical base, attracting funding and investment, increasing the speed and quality of TB care at the regional level using information technology, while the survival strategy is based on increasing the income of health workers, social protection, improving working conditions and developing personnel motivation systems. The main recommendations include increasing the number of employees, creating a strategy for the formation of qualified personnel, improving the quality of the working environment, creating a favorable psycho-emotional climate, and developing an effective system of incentive payments.Conclusion. The medical industry is in dire need of modernization in order to improve personnel processes, financial, economic and regulatory support. The conducted research and developed recommendations will have a beneficial effect on the achievement of the main strategic goal - improving the health and quality of life of the population of the state.

Investigating nurses' professional identity construction in two health settings in New Zealand

<p>The increasing nursing shortage experienced in healthcare institutions alongsidethe communicative issuesrelated to multiculturalnursing teams have placed nurses at the centre of the stage in a growing body of healthcare-related research. In this context, the values, beliefs and conceptualizations which characterize a nurse‘s professional identity play a significant role in organizational life since they guide nurses‘ decisions on the kind of clinical practices they adopt and influence their work performance. However, there islittle empirical evidence on how nurses discursivelyconstruct their professional identity.To date most sociolinguistic research on professional identity in healthcare environments has focused on the power asymmetries characterising doctor-patient, doctor-nurse and nurse-patient discourse, largely disregarding nurse-nurse interaction. Thus, moving away from the traditional approach taken to this area of enquiry, this thesis considershow nurses from an array of ethnic backgrounds construct their professional identity throughdiscursive practices as they interact with other nurses in workplace meetings. The data for this study involve nurses and nurse managers in a ward of a public healthcare institution andata private healthcare institution in New Zealand. The data consist of audio and video recordings of four roster and five handover meetings from the hospital and four clinical and four staff meetings from the clinic, collected by employing Interactional Sociolinguistics as a methodological approach which provides anethnographic lensand afocus on context and culture. To investigate professional identity construction, the analysis takes a theoretical stance which draws on social constructionismand social identity theoryand exploresprofessional identity as it emerges within the boundaries of local interaction and practices. Nurses‘ professional identity formation is consideredin three interactional contexts, namely, voicing and responding to complaints, displaying professional expertise, and negotiating professional values. Findings demonstratethat nurses index multiple group membership alignments as a way to ̳indirectly‘ voice direct complaints and to respond to them in community-appropriate ways as they build in-group solidarity and rapport, and observe interactants‘ face needs.In addition, considerations ofthe use of question-answer adjacency pairs, medical jargon and rationality of case presentation show how expertise construction belongs in a dynamic continuum which is actively transited by nurses as they construct themselves and others as more or less expert on differentaspects of professional practice. Consideringnurses‘ expert claims astemporary, nurses are shown to construct multiple self and other subject positions at the local and wider community levels in order to achieve different interactional goals.This thesis also shows how, when evaluating professional practice, nurses negotiate their professional values at both local and wider community levels by indexing multiple group alignments and displaying expertise that positively construct their professional stance,and by using persuasion techniques that ascribe preferred professional images with the aim of standardising professional practices. Overall, theresearch highlights the partial nature of identity construction as other-initiatedclaims cause nurses to re-consider their stance in order to orienttowards a preferred professional image of themselves, makingsituationally motivated selections of their discursive resources to craft their identity claims.</p>

Investigating nurses' professional identity construction in two health settings in New Zealand

<p>The increasing nursing shortage experienced in healthcare institutions alongsidethe communicative issuesrelated to multiculturalnursing teams have placed nurses at the centre of the stage in a growing body of healthcare-related research. In this context, the values, beliefs and conceptualizations which characterize a nurse‘s professional identity play a significant role in organizational life since they guide nurses‘ decisions on the kind of clinical practices they adopt and influence their work performance. However, there islittle empirical evidence on how nurses discursivelyconstruct their professional identity.To date most sociolinguistic research on professional identity in healthcare environments has focused on the power asymmetries characterising doctor-patient, doctor-nurse and nurse-patient discourse, largely disregarding nurse-nurse interaction. Thus, moving away from the traditional approach taken to this area of enquiry, this thesis considershow nurses from an array of ethnic backgrounds construct their professional identity throughdiscursive practices as they interact with other nurses in workplace meetings. The data for this study involve nurses and nurse managers in a ward of a public healthcare institution andata private healthcare institution in New Zealand. The data consist of audio and video recordings of four roster and five handover meetings from the hospital and four clinical and four staff meetings from the clinic, collected by employing Interactional Sociolinguistics as a methodological approach which provides anethnographic lensand afocus on context and culture. To investigate professional identity construction, the analysis takes a theoretical stance which draws on social constructionismand social identity theoryand exploresprofessional identity as it emerges within the boundaries of local interaction and practices. Nurses‘ professional identity formation is consideredin three interactional contexts, namely, voicing and responding to complaints, displaying professional expertise, and negotiating professional values. Findings demonstratethat nurses index multiple group membership alignments as a way to ̳indirectly‘ voice direct complaints and to respond to them in community-appropriate ways as they build in-group solidarity and rapport, and observe interactants‘ face needs.In addition, considerations ofthe use of question-answer adjacency pairs, medical jargon and rationality of case presentation show how expertise construction belongs in a dynamic continuum which is actively transited by nurses as they construct themselves and others as more or less expert on differentaspects of professional practice. Consideringnurses‘ expert claims astemporary, nurses are shown to construct multiple self and other subject positions at the local and wider community levels in order to achieve different interactional goals.This thesis also shows how, when evaluating professional practice, nurses negotiate their professional values at both local and wider community levels by indexing multiple group alignments and displaying expertise that positively construct their professional stance,and by using persuasion techniques that ascribe preferred professional images with the aim of standardising professional practices. Overall, theresearch highlights the partial nature of identity construction as other-initiatedclaims cause nurses to re-consider their stance in order to orienttowards a preferred professional image of themselves, makingsituationally motivated selections of their discursive resources to craft their identity claims.</p>

Role of anti-inflammatory drugs in the complex therapy of patients with carpal tunnel syndrome

Introduction. Carpal tunnel syndrome (CTS) is a neurological disease associated with tunnel mononeuropathies. There are various proven treatment regimens for patients with the use of conservative and surgical methods of treatment. Studies devoted to a comparative analysis of the effectiveness of methods of conservative therapy in patients with CTS are not enough to choose a treatment strategy.Purpose of the study. To study the therapeutic efficacy of wearing a wrist orthosis with and without the use of NSAIDs in the treatment of patients with CTS.Materials and methods. The study involved 40 patients (the average age of the participants was 32.8 ± 4.3 years) with a primary diagnosis of CTS, who were admitted to the neurological department of of the St Petersburg State Budgetary Healthcare Institution “Elizavetinskaya Hospital”, the Department of Medical Rehabilitation of St. Petersburg State Budgetary Healthcare Institution “St. Luke’s Clinical Hospital” in the period from 2017 to 2021. Patients were randomized into two comparable groups for complex conservative treatment and observation for 2 months of the dynamics of neurological symptoms, pain scale, QuickDASH questionnaire and neurophysiological parameters. The first group of patients received NSAIDs (Nimesil), 1 sachet (100 mg of nimesulide) twice a day after meals for 4 weeks, and the second group – NSAIDs with the imposition of a wrist orthosis for 4 weeks.Results. The study involved 40 patients. The average age of the participants was 32.8 ± 4.3 years (range from 20 to 48 years). Neurophysiological indicators in the studied groups at the screening stage were comparable: distal latency of the M-response (DLMO), ms; the amplitude of the negative peak of the M-response, mV; sensory latency (SL), ms and sensory impulse conduction velocity (SSPI), m / s: 5.7, 5.3, 3.5 and 31.8 in the first group and 5.4, 5.5, 3.8 and 32.4 in the second group (p > 0.05 when comparing the corresponding parameters). After the course of treatment, significant changes in the analyzed parameters were revealed (p < 0.05).Conclusions. In patients who received nimesulide and wore a wrist brace, the effectiveness of treatment was higher.

An Otorhinolaryngology Perspective Into a Hospital COVID-19 Cluster

In this commentary, we share our experience of a COVID-19 cluster which developed within a frontline healthcare facility designated for treating COVID-19 patients. We provide an Otorhinolaryngology perspective into the key challenges, analyses and responses. We discuss how we identified and isolated infected patients and staff, uncovered the responsible COVID-19 variant strain B1.617.2 and instituted various measures to overcome this cluster. The measures include ceasing non-essential services, limiting transfers of patients, a heightened stance of personal protective equipment, ring-fencing of staff and enhanced COVID-19 testing. With rapid hospital wide efforts, there were no new non-isolated cases from our hospital cluster 3 days after the wards were locked down. The cluster which developed on 28-April-2021 was closed on 6-Jun-2021, with 48 cases, ten of whom were healthcare workers. Some of these lessons may be useful for consideration should another healthcare institution face a similar crisis in the future.

FEATURES OF DIAGNOSIS AND TREATMENT OF ILIOPSOITIS IN A PATIENT WITH DIABETES MELLITUS. CLINICAL CASE

A clinical case of iliopsoitis detected during hospitalization in the endocrinology department of the Healthcare Institution "Grodno University Clinic" is presented. The article describes the tactics of examination and successful treatment of iliopsoitis in a patient with diabetes mellitus and SARS-CoV-2.

The Diagnosis of Brain Death

Organ transplantation is impossible without donation which is performed both intra vitam and posthumously. Each case of multi-organ collection provides help to 4 to 6 patients. We believe that presentation of modern algorithms for diagnosing brain death is quite feasible, and such information can be useful not only for anesthesiologists, but also for doctors of other specialties. This paper presents materials related to organ donation. Diagnostic criteria for human brain death, as well as the procedure for ascertaining human brain death and the actions of doctors of healthcare institutions in relation to persons who are in these institutions and who have clinical indications for the diagnosis of brain death, are determined by "The procedure for cancellation of active measures to maintain the patient's life…". Active measures (ventilation, infusion therapy and vasopressor support, etc.) to support the patient's life are cancelled after the patient's brain death is ascertained, except for cases where the deceased person is considered a potential donor. Verification of the human brain death is carried out by the case management team of the healthcare institution involving, if necessary, members of consultative and diagnostic mobile team, specialists of other healthcare institutions. The head of the healthcare institution is responsible for timely and proper engagement and work of the case management team. The responsible person determines the membership of the case management team by making an appropriate entry in the case record and is responsible for its work. An anesthesiologist and a neurologist (neurosurgeon) who have at least 5 years of practical experience in the specialty are engaged in the case management team to ascertain brain death in persons over 18 years of age. Physicians involved in the removal of human anatomical materials and transplantation thereof, as well as transplant coordinator, may not be included in the case management team.

How does job mobility relate to work commitment among rural healthcare workers? a cross-sectional study in western China

Background Rural healthcare workers (RHWs) are the core of the rural health system. The antecedents of turnover of RHWs have been well studied, but little is known about the consequences of job mobilities among RWHs. This study aimed to identify the association between job mobility and the work commitment of RHWs in China. Methods Based on a three-stage random sampling method, a cross-sectional survey was conducted in 11 western provinces in China. A total of 3783 RHWs, consisting of 2245 doctors and 1538 nurses, were included in our study. Confirmatory factor analysis, Pearson’s chi-squared test, one-way ANOVA, linear regression analysis, and binary logistic regression analysis were performed for data analyses. Results 46.3% of RHWs reported the experience of job mobility in the past. Work commitment of RHWs was not very high; specifically, the mean scores of pride in, concern for, and dedication to work were 3.54, 3.81, and 3.61 (out of a maximum of 5), respectively, and 29.9% presented turnover intent. RHWs’ overall experience of job mobility in the past was significantly associated with an increased odds of having the turnover intent. With respect to the last job mobilities of RHWs, the last job changes that occurred in the last 3 years, especially these lateral (i.e., job changes between two healthcare institutions at the same hierarchical level) and upward (i.e., job changes from a healthcare institution at a lower hierarchical level to current institution) mobilities, were significantly associated with a high level of work commitment (i.e., pride in, concern for, and dedication to work) among RHWs. However, the lateral mobilities in the last four to 5 years and the downward mobilities (i.e., job changes from a healthcare institution at a higher hierarchical level to current institution) 6 years ago or more significantly increased the odds of having turnover intent among RHWs, and RHWs whose last job changes were other mobilities (i.e., job changes from a non-healthcare institution to a healthcare institution) in the last four to 5 years reported had a significantly low level of pride in and concern for work and an increased odds of having the turnover intent. Conclusions The study suggests that the overall experience of job mobility in the past is a threat to RHWs’ work commitment to their current healthcare institutions. The honeymoon-hangover pattern exists in the association between a single job change and RHWs’ work commitment. Managers of rural healthcare institutions should pay more attention to these RHWs with the experience of job mobility to enhance their work commitment.

Impact of organizational culture on the occupational health of specialists in socionomic professions

Socionomic professions refer to People to People occupations based on communication and interaction. Socionomic professions are distinguished by the peculiarities of the conditions, means, object, and product of labor. The study involved 3,500 healthcare professionals (including 1,320 doctors and 2,180 nurses) from 30 healthcare organizations in Moscow and Moscow region. As diagnostic techniques, we used I.D. Ladanov's methodolody "Level of organizational culture development", focused on revealing the level of organizational culture development in a healthcare institution, and a set of techniques for assessing the occupational health of healthcare professionals allowing us to determine the features of their psychological and emotional state, the level of self-esteem ("Psychological portrait of a healthcare professional"), stress resistance (Emotional stability questionnaire) and degree of satisfaction with work (methodology by N.V. Kalinina and M.I. Lukyanova). The study results showed the feasibility of developing and implementing targeted programs to establish and develop its organizational culture in each healthcare institution.