La presente investigación tiene como objetivo: Identificar los factores que condicionan el ausentismo laboral de los profesionales de enfermería en el servicio de emergencias. La investigación se justifica porque se identificó al ausentismo en el trabajo como un indicador negativo para el cumplimiento de tareas y en la calidad de los servicios, debido a la interrupción del servicio, aumento de la sobrecarga de trabajo, que afectan en la imagen institucional. La metodología se basó en la Enfermería Basada en Evidencia, (búsqueda sistemática de una respuesta, basada en la investigación). La pregunta clínica fue. ¿Cuáles son los factores determinantes del ausentismo laboral de los profesionales de enfermería en el servicio de emergencias? Las fuentes de información fueron las bases de datos: Google, Scielo, Proquest, Cuiden Plus, Biblioteca Virtual De Salud, Descubridor Unal, se emplearon palabras claves como: Factores determinantes, ausentismo laboral, enfermeras y emergencias. Se seleccionó 09 artículos de investigación relacionadas al ausentismo laboral se aplicó la Guía de Validez y utilidad Aparente de Gálvez Toro, se seleccionó un estudio y para su evaluación se empleó la lista de validación de Astete. El estudio seleccionado dio respuesta que los factores: Condiciones de trabajo y contenido del trabajo son determinantes del ausentismo laboral. / The objective of this research is: Identify the factors that determine the work absenteeism of nursing professionals in the emergency service. The research is justified because absenteeism at work was identified as a negative indicator for the fulfillment of tasks and the quality of services, due to the interruption of service, increased work overload, which affects the institutional image. The methodology was based on Evidence-Based Nursing (systematic search for an answer, based on research). The clinical question was. What are the determining factors of work absenteeism of nursing professionals in the emergency service? The sources of information were the databases: Google, Scielo, Proquest, Cuiden Plus, Biblioteca Virtual De Salud, Descubridor Unal, keywords were used such as: Determining factors, work absenteeism, nurses and emergencies. 09 research articles related to work absenteeism were selected, the Validity and Apparent Utility Guide of Gálvez Toro was applied, one study was selected and the Astete validation list was used for its evaluation. The selected study answered that the factors: Working conditions and work contentare determinants ofwork absenteeism.

En förutsättning för en lyckad utryckning är uppdaterad och tillförlitlig vägdata. Bristfällig data kan leda till en kostsam situation när utryckningstiden rinner iväg, där både liv och pengar riskerar att gå förlorade. Tidigare situationer under utryckningar där datan varit ofullständig har lett till sådana konsekvenser, detta har visat på hur viktigt det är att prioritera arbetet med att uppdatera nödvändig data.  För att säkerställa att datan till blåljusaktörer är uppdaterad och tillförlitlig, började Trafikverket och Lantmäteriet, tillsammans med blåljusaktörer och Botkyrka kommun, år 2015 ta fram checklistan Blåljuskollen som fungerar som ett stöd till kommuner när de ajourhåller den data som används av blåljusaktörer vid utryckningar. Däremot är det få kommuner som faktiskt har slutfört Blåljuskollen.  Det finns tecken på att Blåljuskollen kräver mycket resurser och tid av kommunerna och att detta är en anledning till att få har genomfört den. Därför ämnar detta arbete att utreda vad som är kritisk data för att blåljusaktörer snabbt ska hitta rätt vid utryckningar, samt att undersöka om den befintliga datan i Blåljuskollen uppfyller detta syfte. En uppdatering av den datan som ingår i Blåljuskollen skulle kunna leda till att det blir enklare och motivationshöjande för kommuner att genomföra denna. Under arbetets gång har intervjuer genomförts med involverade aktörer för att ta reda på vad som är kritisk data för att blåljusaktörer snabbt ska hitta rätt.  Resultatet av arbetet visar att det finns punkter i Blåljuskollen som bör finnas kvar men även punkter som bör tas bort, samt punkter där det råder delade meningar om de är relevanta för Blåljuskollen eller ej. Dessutom finns det punkter som bör läggas till i Blåljuskollen. Arbetet visar även att det finns mycket arbete kvar att göra med Blåljuskollen för att den ska uppfylla sitt verkliga syfte; att minska utryckningstider och således rädda liv. / A prerequisite for successful emergency responses is updated and reliable data. Deficient data can lead to situations where response times are extended, which can put both lives and money at a risk. Unfortunately, this has shown in previous emergency responses where a lack of data has led to such consequences. These situations have demonstrated how important it is to prioritize the work with updating the required data.  To ensure that the data that the first responders use is updated and reliable, Trafikverket and Lantmäteriet, in collaboration with first responders and Botkyrka municipality, started to create the checklist Blåljuskollen in 2015. This checklist functions as a support for Swedish municipalities when updating the data that is being used by the first responders during their emergency responses. However, few municipalities have completed Blåljuskollen.  There are signs that Blåljuskollen requires a lot of resources and effort from the Swedish municipalities and that this is a reason that very few have completed the checklist. Therefore, this study aims to examine what critical data first responders need to navigate, as well as an examination of whether the existing data in Blåljuskollen satisfies its purpose or not. An update of the existing data in Blåljuskollen could lead to it being easier for the municipalities to complete it. The motivation to complete the checklist could also rise. During this study, interviews have been conducted with the involved actors to find out what data is critical for the first responders to navigate. The result of this study shows that there are elements in Blåljuskollen that should remain, however there are also elements with differing opinions whether they are relevant for Blåljuskollen or not. Furthermore, there are also elements that should be added to Blåljuskollen. This study also shows that the checklist still requires work to fulfill its purpose; to decrease emergency response times and therefore save lives.

Rapid changes in the healthcare environment increase the need for nurse practitioners to be motivated, knowledgeable and skilled in order to ensure quality patient care. Accident and emergency units are challenging environments and by ensuring that nurse practitioners work in an enabling environment, they should be motivated, skilled and knowledgeable and be able to think critically to enhance their own professional growth and emancipated practice. This in turn may increase the nurse practitioners’ job satisfaction, which in turn encourage job retention and may influence patient outcomes positively. A journey towards a shared vision namely “emancipatory practice development” was undertaken in an accident and emergency unit of a Level III public hospital. Following the diagnosis of an emergency situation, action research was applied to change the perceived toxic environment to an enabling environment. The study was conducted within the critical social theory paradigm and descriptive, explorative and contextual in nature. Both qualitative and quantitative approaches were utilised. Throughout the action research for practitioners project, collaboration enhanced the emancipation of the nurse leaders, as key drivers of the process, as well as the nurse practitioners. Short and long-term actions were planned, implemented and amended based on observations and reflection following each cycle of the project. During this process a toxic environment was changed to an enabling environment, in which nurse practitioners were retained and additional spin-offs followed. Guidelines for the application and implementation of the process as utilised in this study were compiled to guide others who experience similar challenges. / Health Sciences / D.Litt. et Phil. (Health Studies)

Fire fighters are involved in critical decision making situations, and under-performance and lack of job satisfaction due to burnout could adversely affect the welfare of the people that are being provided with the service. This study thus investigated the relationship between burnout and job satisfaction amongst operational fire fighters. Two measuring instruments were used: the Pines, Aronson & Kafry (1981) Burnout Index, and the Smith, Hulin and Kendall (1969) Job Descriptive Index. This study was conducted amongst 102 fire fighters working for a local authority. Through a literature review, burnout and job satisfaction were defined, and a link between the two constructs outlined. Through an empirical study, the relationship between burnout and job satisfaction was determined. Supporting evidence indicates a negative correlation between burnout and job satisfaction, as well as revealing social support amongst co-workers as being an important buffer against the effects of burnout. / Industrial and Organisational Psychology / M.A. (Industrial Psychology)

Introdução: O estrato da população com 60 anos ou mais está crescendo mais rapidamente do que grupos etários mais jovens em todo o mundo. Há um aumento desproporcional nas visitas de idosos aos serviços médicos de emergência (SME), com taxas mais altas de resultados adversos. Objetivos: Descrever as características sociodemográficas do usuário do SME de um hospital terciário e investigar diferenças nos desfechos por sexo e idade. Desenho: Estudo analítico observacional transversal. Fonte de dados: Dados administrativos eletrônicos de saúde (2009 a 2013). Local do estudo: Pronto-Socorro do Instituto Central do Hospital das Clínicas, São Paulo, Brasil. Participantes: 222.387 adultos que visitaram o serviço de emergência terciária uma ou mais vezes durante o período. Métodos: As principais variáveis categóricas foram sexo, ano e faixa etária, que incluiu \"adultos jovens\": 18 a 39 anos; \"adultos maduros\": 40-59; \"idosos jovens\": 60-79; e \"muito idosos\": 80- 109. As variáveis contínuas foram idade, tempo de internação e tempo de permanência na UTI. Os desfechos foram hospitalização, estadia na Unidade de Terapia Intensiva (UTI) e óbito. Análise estatística: Calculamos a estatística descritiva; em seguida, construímos modelos lineares mistos generalizados (GLMM) para cada desfecho e estimamos as razões de chances (odds ratios - OR) com intervalo de confiança de 95% para as variáveis categóricas independentes. O nível de significância foi estabelecido em 5%, com correção de Bonferroni. Resultados: Analisamos 333.028 atendimentos consecutivos não programados no SME. A proporção dos atendimentos atribuídos aos adultos jovens diminuiu anualmente (44,4% para 38,2%), enquanto a de pessoas com 60 anos ou mais aumentou (24,1% para 29,9%). Os OR para internação, internação em UTI e mortalidade associada a idosos foram 3,49 (IC 95% = 3,15-3,87), 1,27 (1,15-1,39) e 5,93 (5,29-6,66) respectivamente, tendo como referência adultos jovens. O sexo masculino foi discretamente associado a hospitalização (OR= 1.37, IC 95%=1,30-1,44) e a mortalidade (OR=1.14, IC 95%=1,07-1,21). O tempo de permanência na UTI e o tempo de internação não diferiram entre os grupos etários. Conclusões: Entre 2009 e 2013, diminuiu a proporção de visitas dos adultos jovens no SME, enquanto a das pessoas com 60 anos ou mais cresceu. As taxas de hospitalização e de mortalidade aumentaram com a idade em ambos os sexos. A idade é um fator de risco relevante para hospitalização e mortalidade, mas não para internação em UTI. Os muito idosos correm maior risco e demandam estratificação adicional em subgrupos / Background: The stratum of the population aged 60 years or over is growing faster than younger age-groups worldwide. There is a disproportional increase in Emergency Department (ED) visits by older people, with higher rates of adverse outcomes. Objectives: To describe the sociodemographic characteristics of ED users in a tertiary hospital and to investigate differences in outcomes by sex and age. Design: Observational cross-sectional analytic study. Data source: Administrative electronic health data (2009 to 2013). Setting: The ED of the Instituto Central do Hospital das Clínicas, São Paulo, Brazil. Participants: 222,387 adults who visited the tertiary ED one or more times during the period. Measurements: The main categorical variables were sex, year and age-group, which included \'young adults\': 18-39 years; \'adults\': 40-59; \'young-older adults\': 60-79; and \'old-older adults\': 80- 109. The continuous variables were age, length of hospital stay (LOS) and length of Intensive Care Unit stay (LIS). Outcomes were hospitalization, use of intensive care unit (ICU) and mortality. Statistical analysis: We calculated descriptive statistics; then, built generalized linear mixed models for each outcome to produce estimated Odds Ratios (95% confidence interval) for independent categorical variables. The significance level was 5% with Bonferroni correction. Results: We analyzed 333,028 consecutive unscheduled ED visits. The proportion of visits attributed to young adults decreased annually (44.4% to 38.2%), while those of people aged 60 or over increased (24.1% to 29.9%). ORs for hospitalization, intensive care use and mortality associated with old-older adults were 3.49 (95% CI= 3.15-3.87), 1.27 (1.15-1.39) and 5.93 (5.29-6.66) respectively, with young adults as the reference. Male sex was weakly associated with hospitalization (OR= 1.37, 95%CI=1,30-1,44) and mortality (OR=1.14, 95%CI=1,07-1,21). LOS and LIS did not differ among age groups. Conclusions: Between 2009 and 2013, the proportion of \'young adults\' ED visits reduced while those of people aged 60 or over increased. Hospitalization, ICU stay and mortality rates increased with age. Age is an important risk factor for hospitalization and mortality, but not for ICU admission. Old-older people are at the greatest risk and demand further subgroup stratification

No description available.

Introdução: O estrato da população com 60 anos ou mais está crescendo mais rapidamente do que grupos etários mais jovens em todo o mundo. Há um aumento desproporcional nas visitas de idosos aos serviços médicos de emergência (SME), com taxas mais altas de resultados adversos. Objetivos: Descrever as características sociodemográficas do usuário do SME de um hospital terciário e investigar diferenças nos desfechos por sexo e idade. Desenho: Estudo analítico observacional transversal. Fonte de dados: Dados administrativos eletrônicos de saúde (2009 a 2013). Local do estudo: Pronto-Socorro do Instituto Central do Hospital das Clínicas, São Paulo, Brasil. Participantes: 222.387 adultos que visitaram o serviço de emergência terciária uma ou mais vezes durante o período. Métodos: As principais variáveis categóricas foram sexo, ano e faixa etária, que incluiu \"adultos jovens\": 18 a 39 anos; \"adultos maduros\": 40-59; \"idosos jovens\": 60-79; e \"muito idosos\": 80- 109. As variáveis contínuas foram idade, tempo de internação e tempo de permanência na UTI. Os desfechos foram hospitalização, estadia na Unidade de Terapia Intensiva (UTI) e óbito. Análise estatística: Calculamos a estatística descritiva; em seguida, construímos modelos lineares mistos generalizados (GLMM) para cada desfecho e estimamos as razões de chances (odds ratios - OR) com intervalo de confiança de 95% para as variáveis categóricas independentes. O nível de significância foi estabelecido em 5%, com correção de Bonferroni. Resultados: Analisamos 333.028 atendimentos consecutivos não programados no SME. A proporção dos atendimentos atribuídos aos adultos jovens diminuiu anualmente (44,4% para 38,2%), enquanto a de pessoas com 60 anos ou mais aumentou (24,1% para 29,9%). Os OR para internação, internação em UTI e mortalidade associada a idosos foram 3,49 (IC 95% = 3,15-3,87), 1,27 (1,15-1,39) e 5,93 (5,29-6,66) respectivamente, tendo como referência adultos jovens. O sexo masculino foi discretamente associado a hospitalização (OR= 1.37, IC 95%=1,30-1,44) e a mortalidade (OR=1.14, IC 95%=1,07-1,21). O tempo de permanência na UTI e o tempo de internação não diferiram entre os grupos etários. Conclusões: Entre 2009 e 2013, diminuiu a proporção de visitas dos adultos jovens no SME, enquanto a das pessoas com 60 anos ou mais cresceu. As taxas de hospitalização e de mortalidade aumentaram com a idade em ambos os sexos. A idade é um fator de risco relevante para hospitalização e mortalidade, mas não para internação em UTI. Os muito idosos correm maior risco e demandam estratificação adicional em subgrupos / Background: The stratum of the population aged 60 years or over is growing faster than younger age-groups worldwide. There is a disproportional increase in Emergency Department (ED) visits by older people, with higher rates of adverse outcomes. Objectives: To describe the sociodemographic characteristics of ED users in a tertiary hospital and to investigate differences in outcomes by sex and age. Design: Observational cross-sectional analytic study. Data source: Administrative electronic health data (2009 to 2013). Setting: The ED of the Instituto Central do Hospital das Clínicas, São Paulo, Brazil. Participants: 222,387 adults who visited the tertiary ED one or more times during the period. Measurements: The main categorical variables were sex, year and age-group, which included \'young adults\': 18-39 years; \'adults\': 40-59; \'young-older adults\': 60-79; and \'old-older adults\': 80- 109. The continuous variables were age, length of hospital stay (LOS) and length of Intensive Care Unit stay (LIS). Outcomes were hospitalization, use of intensive care unit (ICU) and mortality. Statistical analysis: We calculated descriptive statistics; then, built generalized linear mixed models for each outcome to produce estimated Odds Ratios (95% confidence interval) for independent categorical variables. The significance level was 5% with Bonferroni correction. Results: We analyzed 333,028 consecutive unscheduled ED visits. The proportion of visits attributed to young adults decreased annually (44.4% to 38.2%), while those of people aged 60 or over increased (24.1% to 29.9%). ORs for hospitalization, intensive care use and mortality associated with old-older adults were 3.49 (95% CI= 3.15-3.87), 1.27 (1.15-1.39) and 5.93 (5.29-6.66) respectively, with young adults as the reference. Male sex was weakly associated with hospitalization (OR= 1.37, 95%CI=1,30-1,44) and mortality (OR=1.14, 95%CI=1,07-1,21). LOS and LIS did not differ among age groups. Conclusions: Between 2009 and 2013, the proportion of \'young adults\' ED visits reduced while those of people aged 60 or over increased. Hospitalization, ICU stay and mortality rates increased with age. Age is an important risk factor for hospitalization and mortality, but not for ICU admission. Old-older people are at the greatest risk and demand further subgroup stratification

International mass sports gatherings like the FIFA (Federation Internationale de Football Association) World Cup Soccer and Olympics can cause great challenges to local healthcare systems and emergency medical services. History has shown that disasters do occur during these events, whether on a small or large scale. Disaster Management Practitioners from the public health perspective widely recognize that poor planning and a range of other underlying factors, create conditions of vulnerability. These result in insufficient capacity or measures to reduce hazards’ potentially negative consequences. The eThekwini District has to be prepared in the event of a mass disaster. Pre-empting and planning for disasters will lead to the safety and security of our citizens. The aim of this study was to undertake a baseline survey (in a total number of eleven public sector hospitals) to assess the state of hospital readiness, medical preparedness, and emergency care in preparation for the 2010 FIFA World Cup Soccer in the eThekwini District. A general assessment tool in the form of a standard questionnaire, and a walkthrough visit with a checklist, was used to collect data. There is no previous study conducted at the eThekwini District to assess requirements for an international event in terms of a mass disaster. South Africa is a developing country, and this was the first time any developing country had hosted a sporting event on such a large magnitude thus there are no international standards on sports disaster management by any other developing countries to generalise to eThekwini District. The current disaster management operational plan that is being used for the World Cup is based on a United Kingdom integrated management philosophy tool. The study herein adopted a public health approach and incorporates the Yokohama Strategy within its tool along with the use of HMIMMS and MIMMS in the assessment of the clinical criteria. The perceived minimum requirements suggested by the hospitals and a Provincial Task Team, from the Provincial Health Disaster Management office, was used as a guideline. The study showed that although disaster plans and policies are in situ, there still exists a need for resources to be directed toward skills training, attraction and retention of healthcare professionals, revitalisation of emergency and theatre areas and the commissioning of more isolation units. The results of the study would enable the District Office to note any shortcomings and lack of resources in public sector hospitals. The study outcome would be important for the implementation of any strategic planning to aid the hospitals in preparation for mass disasters that may occur during the 2010 FIFA World Cup Soccer. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2010.

Critical Incident Stress (CIS) in emergency workers and in victims of crises is widely held to be the possible precursor to Post Traumatic Stress Disorder (PTSD) if left unattended. Indeed, the symptoms for CIS and PTSD overlap in all category areas. Today, the commonly used treatment for trauma in emergency workers is Critical Incident Stress Management (CISM). This system of interventions includes a debriefing session which facilitates people to fully remember the trauma events and their own reactions to it. CISM models were conceived and designed within and from a typically white, western viewpoint. However, one agency in Vancouver, First Nations Emergency Services Society (FNESS), provides CISM debriefing interventions and training to Native emergency workers and Native victims of crises. The purpose of this study was to document how Native participants perceived the CISM model as FNESS presented it and to understand whether the intervention was culturally meaningful for the First Nations participants in the CISM sessions. This study examined whether the mainstream CISM model, which is currently used by this agency, is culturally meaningful for populations of another culture receiving it. Narrative interviews were conducted with participants to determine their reactions to the session, their feelings regarding information presented, and their ability to make cultural meaning of the experience. Narrative analysis was used to determine themes across individuals. Theoretical implications of this research include addressing the gap in the literature of the subjective experiences of participants in CISM; no studies have used a purely qualitative methodology to study this topic. Also, this study looked at the important issue of the cross-cultural application of a mainstream intervention, particularly for a population with a history of complex traumas. Practical implications include providing information into the perceived effectiveness of the FNESS approach to a CISM framework and providing an opportunity for recipients' opinions to be heard.

La création d'un centre d'appel d'urgence pour les sourds et malentendants a nécessité la conception et la mise en place d'un dispositif sociotechnique ad hoc respectant la diversité de leurs pratiques de communication. Ancrée dans ce projet technique mené afin de rendre accessible une institution organisée autour de l'interaction téléphonique, cette recherche fut l'occasion de conduire une réflexion croisée sur les dispositifs techniques de communication appréhendés comme outil de travail et outil d'accessibilité. À partir de matériaux issus d'une enquête ethnographique réalisée dans les centres d'appel d'urgence que nous faisons dialoguer avec des traces de l'activité de conception, nous interrogeons, dans un même élan, le rôle que tiennent ces dispositifs dans l'écologie des situations ainsi que la manière dont ils définissent en actes la dynamique contemporaine de prise en compte environnementale du handicap. Au travers de ce questionnement deux grandes thématiques sont explorées : le travail en situation de communication médiatisée et le processus reformulation des pratiques engagé par la conception et la mise en service d'un dispositif technique d'accessibilité. Pour ce faire, nous nous appuyons sur des travaux de recherche ancrés dans la théorie de l'action située et en sociologie de la science et des techniques que nous articulons à la littérature scientifique portant sur le handicap et, plus spécifiquement, sur la surdité. Détaillant finement les multiples cours d'action en nous attachant notamment à rematérialiser les pratiques interactionnelles, nous démontrons en quoi les dispositifs techniques de communication participent d'une armature invisible qui fait système et contribue à organiser et pérenniser les pratiques ; armature que nous appréhendons à travers la notion d'infrastructure communicationnelle. Ainsi, nous proposons cette dernière notion comme outil conceptuel pour appréhender l'introduction de nouveaux dispositifs dans les organisations et pour accompagner une réflexion sur l'accessibilité-en-pratiques. / Creating an emergency call centre dedicated to deaf and hard of hearing users has required the design and implementation of a specific socio-technical system in order to take into account the diversity of their communication practices. Our research is grounded on such technical project specifically oriented towards the accessibility to an organization acting mainly through telephonic interactions and therefrom emerged for us the opportunity to conduct a cross-reflection on socio-technical devices apprehended as a working tool and an accessibility tool. Based on elements obtained through an ethnographic study conducted in emergency call centres which has given empirical material that we are bringing into discussion with traces of the process of the product design, we are questioning the place and status of communication devices in the local environment. Along with this questioning, we are also observing how communication devices practically achieve accessibility within the social model of disability. Two main themes are therefore explored: the organization of work activities in situations of mediated communication and the process, engaged by the design and implementation of an accessibility device, by which conventional practices are reformulated. To do so, we draw on conceptual tools and works from Situated action theory and Sociology of science and technology. We also mobilize Disability and Deaf Studies literature. Through a refined description of the multiple courses of action and a subtle attention to the materiality of interactional practices, we demonstrate that communication technical devices are a piece of an heterogeneous assembly, that make sense in situation, and act as an invisible scaffolding that organize and stabilize communication practices. We propose to designate this form of stabilization under the name of communicational infrastructure and to use it as a conceptual tool for approaching the introduction of new communication devices in organizations and to support a reflection on accessibility-in-practices