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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
51

Analysis of accident and emergency services in Hong Kong: the level of inappropriate utilization and why?. / CUHK electronic theses & dissertations collection

January 2004 (has links)
Objectives: This study has been conducted to determine the levels of inappropriate use of the A&E for conditions that could be treated by GPs, the nature of the morbidity pattern of those conditions, the reasons why primary care services were not being utilized, and also examined the validity (i.e. sensitivity and specificity) of patient classifications undertaken by nurses at the time of admission within this local context. Study design and setting: A cross sectional study was conducted over a one year period and subjects were randomly selected from four A&E departments located across the four principle geographic regions of Hong Kong by stratified, two-stage sampling. Main outcome measure: The gold standard in differentiating true emergency cases and GP cases was based on a retrospective record review conducted independently by a panel of emergency physicians. A random sub-sample of those classified as GP cases was interviewed and compared to a matched (via morbidity status) sample of primary care patients who had attended a hospitals' GOPC in order to determine factors distinguishing these two patient groups. Multiple Logistic Regression was used to distinguish the difference between GP cases and matched GOPC primary care patients on significance and odds ratios of the variables. The morbidity pattern according to ICPC was tabulated and analysed for the 'true' A&E cases and non-urgent cases. Sensitivity, specificity and positive predictive values were computed for both non-weighted and weighted conditions. Results: The level of GP cases was found to be 57% with a significant higher proportion of patients in younger age group, and late evening. The morbidity pattern of those top 10 diagnoses of non-urgent cases was very similar to the Hong Kong general practice morbidity pattern for self limiting conditions. Closure of the clinic was the main reason for GP cases attending A&E. Other major reasons were deterioration of symptoms, GPs' inability to diagnose efficiently and patients' wish to continue medical treatment in the same hospital. Affordability was the most pronounced reason for utilising the GOPC, but did not apply to the A&E GP patients. The most accurate weighted nurses' triage classification had the average sensitivity of 75%, specificity of 65.7%, and positive predictive value of 54%. The most accurate weighted patients' self-triage classification yielded a sensitivity of 43.3%, specificity of 49.2%, and a positive predictive value of 38.6%. Conclusion: The reasons for high level of utilisation of A&E services are complex and reflect problems of delivery of GP services. There is an urgent need for the GPs to set up a network system to provide out of hours services, and also for a better interfacing between primary and secondary care, and between public and private sectors, so that patients can be referred back to GPs. The design and measures chosen for this study will help provide A&E policy makers and planners with relevant information for better addressing practical solutions. / Albert Lee. / Source: Dissertation Abstracts International, Volume: 73-01, Section: B, page: . / Thesis (M.D.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (leaves 137-151). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Appendix 4 in Chinese.
52

Caracterização dos pacientes readmitidos em um serviço de emergência / Characterization of the readmitted patients on emergency department

Valera, Rangel Biscaro 12 July 2005 (has links)
A grande procura pelo Serviço de Emergência e a conseqüente permanência dos pacientes em repetidas admissões representam entraves para os enfermeiros, os quais são responsáveis pelo gerenciamento desses serviços. Objetivos: Caracterizar o perfil dos pacientes readmitidos em um Serviço de Emergência de um hospital filantrópico; identificar o perfil sócio-demográfico e de morbidade dos pacientes readmitidos; caracterizar a utilização do Serviço de Emergência e identificar os fatores relacionados às readmissões. Casuística e Método: estudo transversal, descritivo e exploratório realizado em um Serviço de Emergência de um hospital filantrópico de ensino, de atenção terciária, na cidade de São Paulo. A amostra foi composta por pacientes maiores de 14 anos considerados internados no Serviço de Emergência, com mais de uma admissão, nos seis meses anteriores ao dia da coleta de dados. A coleta de dados foi realizada por meio de instrumento estruturado com questões abertas e fechadas, e as informações foram obtidas do prontuário do paciente e por entrevista direta ao paciente ou familiares, durante todo o mês de maio de 2004. Resultados: a incidência de readmissões foi de 23,3%. Houve predomínio de pacientes do sexo masculino (61,9%), idade de 40 a 90 anos (85,9%), baixa escolaridade (57,8%) e 46,7% pertenciam à área de regionalização do SUS para o serviço estudado. Quase a totalidade (92,8%) não era cadastrada no PSF, sendo que grande parte (45,4%) referiu desconhecer o programa. As principais hipóteses diagnósticas foram as doenças do aparelho circulatório (33,7%) seguidas pelas neoplasias (24,1%). A maioria dos pacientes (57,6%) foi readmitido com o mesmo diagnóstico e 23,9% devido a complicações. Na visão dos entrevistados, como fatores desencadeantes da readmissão, 40,9% referiram causas potencialmente evitáveis. A maioria dos entrevistados referiu que seu problema não foi resolvido na internação anterior, sendo o principal motivo a continuidade dos sintomas. Conclusões: A incidência de readmissões foi elevada, podendo ter sido ocasionada por evolução da doença crônico-degenerativa, idade avançada, baixo seguimento das orientações recebidas, complicações pós-operatórias, necessidade de cuidado domiciliar e não resolução do problema na admissão anterior / The great need for the Emergency Department and the resultant length of stay of the patients in repeated admissions become a hard situation for nurses, who are responsible for the administration on this units. Objectives: characterize the readmitted patients at the Emergency Department in a philanthropyc hospital; identify the socialdemographic and morbity profile of the readmitted patients; characterize the use of the Emergency Department; identify factors associated with readmissions. Methods: transversal, descriptive and exploratory study, at the Emergency Department on a tertiary health service of a philanthropic teaching hospital in São Paulo city, the sample was made by patients over fourteen years old that became inpatient at the Emergency Department, with over than one admission until six months before the data collection day. It was used an instrument with opened and closed questions for the data collection. Data were obtained from patient records and by interview to the patient or responsible, during May 2004. Results: the readmission incidence was 23,3%. The patients were predominantly males (61,9%), age 40 to 90 years old (85,9%), low level education (57,8%); 46,7% lived at areas regarding the regionalization of the health service. Almost of all (92,8%) wasn’t registered at Family Health Program, and a high proportion of patients (45,4%) were unaware of this program. The main diagnosis were circulatory disease (33,7%) followed by cancer (24,1%). Most of patients (57,6%) was readmitted with the same diagnosis and 23,9% due to complications. On the perception of 40,9% of the patients, the related factors to readmissions were classified as potentially avoidable causes. Conclusions: The readmission incidence was raised, it was can be caused by problems in adherence to treatment, gravity of chronic disease, not enough orientation, or by complications
53

Atitudes de profissionais de enfermagem de um serviço de emergência sobre o atendimento a pacientes alcoolizados / Attitudes of nursing professionals of an emergency service on the care of alcoholic patients

Tatiana Miranda Rodrigues 05 April 2018 (has links)
No presente estudo o objetivo foi avaliar as atitudes de profissionais de enfermagem, de um serviço de emergência, no atendimento a pacientes com problemas relacionados ao uso de álcool e realizar treinamento com esses profissionais. O local do estudo foi o Pronto-Socorro Adulto do Hospital de Clínicas da Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil. O desenho metodológico do estudo foi do tipo descritivo com abordagem quantitativa. O instrumento utilizado para coleta de dados foi o SAAPPQ e um questionário com informações sócio-demográficas, aplicado em 82 profissionais de enfermagem, incluindo técnicos e enfermeiros, no entanto, somente 73 profissionais responderam ao questionário. A maioria dos profissionais eram técnicos de enfermagem, muitos deles tinham curso superior concluído, do sexo feminino e com idade média de 37 anos. Na avaliação dos profissionais, as atitudes negativas foram relacionadas à satisfação com o trabalho (4,9±1,6) e atitudes positivas quanto à execução de tarefas específicas e autoestima (6,6±1,5). Em relação à formação profissional, os de nível superior mostraram-se menos motivados a trabalhar com pacientes com problemas relacionados ao uso do álcool, entretanto, aqueles que tinham algum curso de especialização em álcool e/ou drogas apresentaram melhores níveis na adequação ao trabalho e na execução de tarefas específicas e autoestima. Ao mensurar as atitudes dos profissionais relacionadas ao Compromisso terapêutico (motivação, satisfação e autoestima) e à Segurança Profissional (adequação e legitimidade), houve melhores níveis na função Segurança Profissional. O treinamento foi realizado no próprio ambiente de trabalho, com 64,3% de participação da equipe. Conclui-se, portanto, que a formação educacional para atuar no atendimento a pessoas com problemas relacionados ao álcool pode acarretar mudanças positivas significativas no conhecimento e atitudes dos profissionais de enfermagem / This study aimed to evaluate the attitudes of nursing professionals of an emergency service in the care of patients with problems related to alcohol use and to conduct a training with these professionals. The study site was the Adult Emergency Room of the Clinical Hospital of the Federal University at Triângulo Mineiro, in Minas Gerais, Brazil. The methodological design of the study is of the descriptive type with a quantitative approach. A questionnaire of sociodemographic information and SAAPPQ were used. The questionnaire applied to 82 nursing professionals, including technicians and nurses, however 73 professionals answered the questionnaire. Most of the professionals were nursing technicians, many of them had completed college degree, female with average age of 37 years. In the evaluation of professionals, negative attitudes were related to work satisfaction (4.9 ± 1.6) and positive attitudes regarding the performance of specific tasks and self-esteem (6.6 ± 1.5). Regarding professional training, those at higher education level were less motivated to work with patients with problems related to alcohol use, however, those who had some degree of specialization in alcohol and / or drugs had better levels of work adequacy and execution of specific tasks and self-esteem. When measuring the attitudes of professionals related to Therapeutic Commitment (motivation, satisfaction and self-esteem) and Role Security (adequacy and legitimacy), there were better levels in the Role Security function. The training was carried out in the work environment, with a 64.3% participation of the team. It is concluded that the educational training to act in the care of people with problems related to alcohol can lead to significant positive changes in the knowledge and attitudes of nursing professionals
54

The lived experience of occupational therapists in Scottish Accident and Emergency Departments

James, Kirstin January 2014 (has links)
Emergency Departments (EDs) deliver urgent treatment at the ‘front-door' of acute hospitals. In Scotland, occupational therapists have had an increasing presence in EDs, an emerging role with limited evidence to guide its development. There are no predetermined philosophies or existing theories of ED occupational therapy. Therefore, this exploratory study examined the lived experience of ED occupational therapists in order to make an original contribution to knowledge, and to inform practice. Ethical approval was granted from Glasgow Caledonian University. Research methods were framed by Interpretative Phenomenological Analysis (IPA), and purposive sampling was used to recruit nine ED occupational therapists from across Scotland. Individual, semi-structured interviews were audio-recorded and transcribed verbatim. Interview transcripts were analysed line-by-line and interpreted using IPA methods. Two over-arching themes emerged from the data. Theme 1: 'On the Factory Floor' captured the experience of working in an ED. EDs are highly organised, likened to factory production-lines, but also unpredictable, even chaotic. The participants contributed their professional skills to make sense of both the order and the chaos. Theme 2: 'A Stranger in a Strange Land' encapsulated what it was like to enter the ED environment, and the participants were still discovering how they might acculturate. They experienced EDs as challenging environments, which potentially threatened the delivery of occupational therapy in terms of its core-constructs. However, they were able to maintain the values of occupational therapy, though they applied them with constraints. In addition, challenges placed clinicians at high risk of burn-out. Despite this, there were personal and professional rewards, especially enjoyment, being valued and being recognised. Occupational therapy is still emerging in the ED context, professional identity is forming and models of practice are not fully developed. Implications arising from the study are discussed in relation to health policy, future research, occupational therapy practice and occupational therapy education.
55

Atitudes de profissionais de enfermagem de um serviço de emergência sobre o atendimento a pacientes alcoolizados / Attitudes of nursing professionals of an emergency service on the care of alcoholic patients

Rodrigues, Tatiana Miranda 05 April 2018 (has links)
No presente estudo o objetivo foi avaliar as atitudes de profissionais de enfermagem, de um serviço de emergência, no atendimento a pacientes com problemas relacionados ao uso de álcool e realizar treinamento com esses profissionais. O local do estudo foi o Pronto-Socorro Adulto do Hospital de Clínicas da Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil. O desenho metodológico do estudo foi do tipo descritivo com abordagem quantitativa. O instrumento utilizado para coleta de dados foi o SAAPPQ e um questionário com informações sócio-demográficas, aplicado em 82 profissionais de enfermagem, incluindo técnicos e enfermeiros, no entanto, somente 73 profissionais responderam ao questionário. A maioria dos profissionais eram técnicos de enfermagem, muitos deles tinham curso superior concluído, do sexo feminino e com idade média de 37 anos. Na avaliação dos profissionais, as atitudes negativas foram relacionadas à satisfação com o trabalho (4,9±1,6) e atitudes positivas quanto à execução de tarefas específicas e autoestima (6,6±1,5). Em relação à formação profissional, os de nível superior mostraram-se menos motivados a trabalhar com pacientes com problemas relacionados ao uso do álcool, entretanto, aqueles que tinham algum curso de especialização em álcool e/ou drogas apresentaram melhores níveis na adequação ao trabalho e na execução de tarefas específicas e autoestima. Ao mensurar as atitudes dos profissionais relacionadas ao Compromisso terapêutico (motivação, satisfação e autoestima) e à Segurança Profissional (adequação e legitimidade), houve melhores níveis na função Segurança Profissional. O treinamento foi realizado no próprio ambiente de trabalho, com 64,3% de participação da equipe. Conclui-se, portanto, que a formação educacional para atuar no atendimento a pessoas com problemas relacionados ao álcool pode acarretar mudanças positivas significativas no conhecimento e atitudes dos profissionais de enfermagem / This study aimed to evaluate the attitudes of nursing professionals of an emergency service in the care of patients with problems related to alcohol use and to conduct a training with these professionals. The study site was the Adult Emergency Room of the Clinical Hospital of the Federal University at Triângulo Mineiro, in Minas Gerais, Brazil. The methodological design of the study is of the descriptive type with a quantitative approach. A questionnaire of sociodemographic information and SAAPPQ were used. The questionnaire applied to 82 nursing professionals, including technicians and nurses, however 73 professionals answered the questionnaire. Most of the professionals were nursing technicians, many of them had completed college degree, female with average age of 37 years. In the evaluation of professionals, negative attitudes were related to work satisfaction (4.9 ± 1.6) and positive attitudes regarding the performance of specific tasks and self-esteem (6.6 ± 1.5). Regarding professional training, those at higher education level were less motivated to work with patients with problems related to alcohol use, however, those who had some degree of specialization in alcohol and / or drugs had better levels of work adequacy and execution of specific tasks and self-esteem. When measuring the attitudes of professionals related to Therapeutic Commitment (motivation, satisfaction and self-esteem) and Role Security (adequacy and legitimacy), there were better levels in the Role Security function. The training was carried out in the work environment, with a 64.3% participation of the team. It is concluded that the educational training to act in the care of people with problems related to alcohol can lead to significant positive changes in the knowledge and attitudes of nursing professionals
56

Evaluation of the LBJ Hospital Ask Your Nurse Advice Line

Johnson, Charles Dean, Jr. Begley, Charles E., Amick, Benjamin C. January 2008 (has links)
Thesis (M.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Masters Abstracts International, Volume: 47-01, page: . Adviser: Charles E. Begley. Includes bibliographical references.
57

Factors associated with hospital admission of elder cardiovascular patients in an emergency center.

Teegala, Shyam Mohan Reddy. Taylor, Wendell C. Granchi, Thomas. Chen, Chin-Hsing. Xiong, Momiao. January 2008 (has links)
Thesis (M.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Masters Abstracts International, Volume: 46-05, page: 2672. Adviser: Wendell C. Taylor. Includes bibliographical references.
58

Características da utilização do sistema de triagem de Manchester em uma unidade de emergência pediátrica / Characteristics of use the manchester triage system at a pediatric emergency unit

Amthauer, Camila January 2015 (has links)
O Sistema de Triagem de Manchester (STM) é um protocolo de classificação de risco que possibilita a rápida avaliação do paciente e determina uma categoria de risco conforme sua prioridade clínica, a partir da seleção de fluxogramas e discriminadores, indicando uma das cinco categorias e um tempo limite em que o paciente pode esperar para ser atendido. O estudo teve como objetivo geral caracterizar os atendimentos por meio da classificação de risco pelo Sistema de Triagem de Manchester em uma Emergência Pediátrica de um Hospital Universitário. Trata-se de um estudo quantitativo transversal, que incluiu todos os atendimentos da Emergência Pediátrica de um Hospital Universitário de Porto Alegre, no período de 01 de janeiro a 31 de dezembro de 2013, com idade inferior a 14 anos. Os dados referentes à classificação de risco foram obtidos por meio de uma query dos prontuários dos pacientes, solicitada para o Serviço de Arquivo Médico e Informação em Saúde. O Comitê de Ética e Pesquisa da instituição emitiu parecer favorável à realização do estudo. Foram respeitados os princípios éticos em saúde, conforme a Resolução do Conselho Nacional de Saúde n° 466/2012. Durante o período que compreendeu a pesquisa, foram realizados 10.921 atendimentos na Emergência Pediátrica, em sua maioria do sexo masculino, com idade entre 29 dias e dois anos, procedentes do município de Porto Alegre. A categoria de risco que prevaleceu foi a categoria Urgente, com 4.762 (43,6%) atendimentos. O fluxograma Pais Preocupados prevaleceu em relação aos demais, totalizando 2.446 (22,4%) atendimentos. Quanto aos discriminadores, houve prevalência do discriminador Evento Recente, com 1.671 (15,3%) atendimentos. Com relação ao desfecho dos pacientes, 49,1% foram direcionados para a Sala de Procedimentos Pediátrica e 12,7% para a Sala de Observação Pediátrica após a consulta médica e antes de receber alta ou ser encaminhados para internação no próprio hospital. Os pacientes que obtiveram alta domiciliar após a consulta médica somaram 4.161 (38,1%) pacientes e 1.136 (10,4%) pacientes foram encaminhados para internação após a classificação de risco e a primeira consulta médica. O maior número de internações aconteceu na Unidade de Internação Pediátrica (76,7%). Conhecer o perfil dos atendimentos na Emergência Pediátrica que passam pela classificação de risco de acordo com o STM auxilia o enfermeiro no planejamento de ações e intervenções em saúde baseadas nas necessidades de saúde de pacientes pediátricos, permitindo ao profissional direcionar seu atendimento às demandas que buscam assistência à saúde nos serviços de emergência, com qualidade e eficiência na atenção voltada à saúde da criança. / The Manchester Triage System (MTS) is a risk classification protocol which enables the fast evaluation of the patient and determines a risk category according to their clinical priority, from the selection of flowcharts and discriminators, indicating one of the five categories and a time limit in which the patient can wait to be seen. The main goal of the study was to characterize the treatments through the risk classification by the Manchester Triage System in a Pediatric Emergency at a University Hospital. It was a quantitative cross-sectional study, which included all the patients assisted at the Pediatric Emergency at a University Hospital, during the period of January 1st to December 31st of 2013, age group inferior to 14 years old. The data referring to the risk classification was obtained through a query of the patients’ records, requested at the Service of Medical Archives and Health Information (Serviço de Arquivo Médico e Informação em Saúde). The Research and Ethics Committee of the institution issued a favorable assent towards the performance of the study. The basic principles of health care ethics were respected, according to the Brazilian National Health Council Resolution nº 466/2012. During the period of the research, 10.921 treatments were performed at the Pediatric Emergency, in its majority of the male gender, ages between 29 days and two years old, coming from the city of Porto Alegre. The risk category that prevailed was the Urgent category, with 4.762 (43,6%) patients assisted. The Worried Parents flowchart prevailed in relation to the others, reaching a total of 2.446 (22,4%) patients assisted. As for the discriminators, there was a prevalence of the Recent Event one, with 1.671 (15,3%) patients assisted. In relation to the outcome of the patients, 49,1% were directed to the Pediatric Procedures Room and 12,7% to the Pediatric Observation Room after examination and before being discharged or being sent to hospitalization to hospital. The patients who received a discharge home after examination added a total of 4.161 (38,1%) patients and 1.136 (10,4%) patients were sent to hospitalization after the risk classification and the first medical examination. The highest number of hospitalizations happened at the Pediatric Hospitalization Unit (76,7%). Getting to know the profile of the treatments at the Pediatric Emergency that go through the risk classification according to MTS supports the nurse on the planning of action and interventions in health based on the health needs of pediatric patients, allowing the professional to direct his assistance towards the demands of search for health assistance at emergency services, with quality and efficiency in attention towards children’s health.
59

Características da utilização do sistema de triagem de Manchester em uma unidade de emergência pediátrica / Characteristics of use the manchester triage system at a pediatric emergency unit

Amthauer, Camila January 2015 (has links)
O Sistema de Triagem de Manchester (STM) é um protocolo de classificação de risco que possibilita a rápida avaliação do paciente e determina uma categoria de risco conforme sua prioridade clínica, a partir da seleção de fluxogramas e discriminadores, indicando uma das cinco categorias e um tempo limite em que o paciente pode esperar para ser atendido. O estudo teve como objetivo geral caracterizar os atendimentos por meio da classificação de risco pelo Sistema de Triagem de Manchester em uma Emergência Pediátrica de um Hospital Universitário. Trata-se de um estudo quantitativo transversal, que incluiu todos os atendimentos da Emergência Pediátrica de um Hospital Universitário de Porto Alegre, no período de 01 de janeiro a 31 de dezembro de 2013, com idade inferior a 14 anos. Os dados referentes à classificação de risco foram obtidos por meio de uma query dos prontuários dos pacientes, solicitada para o Serviço de Arquivo Médico e Informação em Saúde. O Comitê de Ética e Pesquisa da instituição emitiu parecer favorável à realização do estudo. Foram respeitados os princípios éticos em saúde, conforme a Resolução do Conselho Nacional de Saúde n° 466/2012. Durante o período que compreendeu a pesquisa, foram realizados 10.921 atendimentos na Emergência Pediátrica, em sua maioria do sexo masculino, com idade entre 29 dias e dois anos, procedentes do município de Porto Alegre. A categoria de risco que prevaleceu foi a categoria Urgente, com 4.762 (43,6%) atendimentos. O fluxograma Pais Preocupados prevaleceu em relação aos demais, totalizando 2.446 (22,4%) atendimentos. Quanto aos discriminadores, houve prevalência do discriminador Evento Recente, com 1.671 (15,3%) atendimentos. Com relação ao desfecho dos pacientes, 49,1% foram direcionados para a Sala de Procedimentos Pediátrica e 12,7% para a Sala de Observação Pediátrica após a consulta médica e antes de receber alta ou ser encaminhados para internação no próprio hospital. Os pacientes que obtiveram alta domiciliar após a consulta médica somaram 4.161 (38,1%) pacientes e 1.136 (10,4%) pacientes foram encaminhados para internação após a classificação de risco e a primeira consulta médica. O maior número de internações aconteceu na Unidade de Internação Pediátrica (76,7%). Conhecer o perfil dos atendimentos na Emergência Pediátrica que passam pela classificação de risco de acordo com o STM auxilia o enfermeiro no planejamento de ações e intervenções em saúde baseadas nas necessidades de saúde de pacientes pediátricos, permitindo ao profissional direcionar seu atendimento às demandas que buscam assistência à saúde nos serviços de emergência, com qualidade e eficiência na atenção voltada à saúde da criança. / The Manchester Triage System (MTS) is a risk classification protocol which enables the fast evaluation of the patient and determines a risk category according to their clinical priority, from the selection of flowcharts and discriminators, indicating one of the five categories and a time limit in which the patient can wait to be seen. The main goal of the study was to characterize the treatments through the risk classification by the Manchester Triage System in a Pediatric Emergency at a University Hospital. It was a quantitative cross-sectional study, which included all the patients assisted at the Pediatric Emergency at a University Hospital, during the period of January 1st to December 31st of 2013, age group inferior to 14 years old. The data referring to the risk classification was obtained through a query of the patients’ records, requested at the Service of Medical Archives and Health Information (Serviço de Arquivo Médico e Informação em Saúde). The Research and Ethics Committee of the institution issued a favorable assent towards the performance of the study. The basic principles of health care ethics were respected, according to the Brazilian National Health Council Resolution nº 466/2012. During the period of the research, 10.921 treatments were performed at the Pediatric Emergency, in its majority of the male gender, ages between 29 days and two years old, coming from the city of Porto Alegre. The risk category that prevailed was the Urgent category, with 4.762 (43,6%) patients assisted. The Worried Parents flowchart prevailed in relation to the others, reaching a total of 2.446 (22,4%) patients assisted. As for the discriminators, there was a prevalence of the Recent Event one, with 1.671 (15,3%) patients assisted. In relation to the outcome of the patients, 49,1% were directed to the Pediatric Procedures Room and 12,7% to the Pediatric Observation Room after examination and before being discharged or being sent to hospitalization to hospital. The patients who received a discharge home after examination added a total of 4.161 (38,1%) patients and 1.136 (10,4%) patients were sent to hospitalization after the risk classification and the first medical examination. The highest number of hospitalizations happened at the Pediatric Hospitalization Unit (76,7%). Getting to know the profile of the treatments at the Pediatric Emergency that go through the risk classification according to MTS supports the nurse on the planning of action and interventions in health based on the health needs of pediatric patients, allowing the professional to direct his assistance towards the demands of search for health assistance at emergency services, with quality and efficiency in attention towards children’s health.
60

Caracterização dos pacientes readmitidos em um serviço de emergência / Characterization of the readmitted patients on emergency department

Rangel Biscaro Valera 12 July 2005 (has links)
A grande procura pelo Serviço de Emergência e a conseqüente permanência dos pacientes em repetidas admissões representam entraves para os enfermeiros, os quais são responsáveis pelo gerenciamento desses serviços. Objetivos: Caracterizar o perfil dos pacientes readmitidos em um Serviço de Emergência de um hospital filantrópico; identificar o perfil sócio-demográfico e de morbidade dos pacientes readmitidos; caracterizar a utilização do Serviço de Emergência e identificar os fatores relacionados às readmissões. Casuística e Método: estudo transversal, descritivo e exploratório realizado em um Serviço de Emergência de um hospital filantrópico de ensino, de atenção terciária, na cidade de São Paulo. A amostra foi composta por pacientes maiores de 14 anos considerados internados no Serviço de Emergência, com mais de uma admissão, nos seis meses anteriores ao dia da coleta de dados. A coleta de dados foi realizada por meio de instrumento estruturado com questões abertas e fechadas, e as informações foram obtidas do prontuário do paciente e por entrevista direta ao paciente ou familiares, durante todo o mês de maio de 2004. Resultados: a incidência de readmissões foi de 23,3%. Houve predomínio de pacientes do sexo masculino (61,9%), idade de 40 a 90 anos (85,9%), baixa escolaridade (57,8%) e 46,7% pertenciam à área de regionalização do SUS para o serviço estudado. Quase a totalidade (92,8%) não era cadastrada no PSF, sendo que grande parte (45,4%) referiu desconhecer o programa. As principais hipóteses diagnósticas foram as doenças do aparelho circulatório (33,7%) seguidas pelas neoplasias (24,1%). A maioria dos pacientes (57,6%) foi readmitido com o mesmo diagnóstico e 23,9% devido a complicações. Na visão dos entrevistados, como fatores desencadeantes da readmissão, 40,9% referiram causas potencialmente evitáveis. A maioria dos entrevistados referiu que seu problema não foi resolvido na internação anterior, sendo o principal motivo a continuidade dos sintomas. Conclusões: A incidência de readmissões foi elevada, podendo ter sido ocasionada por evolução da doença crônico-degenerativa, idade avançada, baixo seguimento das orientações recebidas, complicações pós-operatórias, necessidade de cuidado domiciliar e não resolução do problema na admissão anterior / The great need for the Emergency Department and the resultant length of stay of the patients in repeated admissions become a hard situation for nurses, who are responsible for the administration on this units. Objectives: characterize the readmitted patients at the Emergency Department in a philanthropyc hospital; identify the socialdemographic and morbity profile of the readmitted patients; characterize the use of the Emergency Department; identify factors associated with readmissions. Methods: transversal, descriptive and exploratory study, at the Emergency Department on a tertiary health service of a philanthropic teaching hospital in São Paulo city, the sample was made by patients over fourteen years old that became inpatient at the Emergency Department, with over than one admission until six months before the data collection day. It was used an instrument with opened and closed questions for the data collection. Data were obtained from patient records and by interview to the patient or responsible, during May 2004. Results: the readmission incidence was 23,3%. The patients were predominantly males (61,9%), age 40 to 90 years old (85,9%), low level education (57,8%); 46,7% lived at areas regarding the regionalization of the health service. Almost of all (92,8%) wasn’t registered at Family Health Program, and a high proportion of patients (45,4%) were unaware of this program. The main diagnosis were circulatory disease (33,7%) followed by cancer (24,1%). Most of patients (57,6%) was readmitted with the same diagnosis and 23,9% due to complications. On the perception of 40,9% of the patients, the related factors to readmissions were classified as potentially avoidable causes. Conclusions: The readmission incidence was raised, it was can be caused by problems in adherence to treatment, gravity of chronic disease, not enough orientation, or by complications

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