Bmc Health Serv Res
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Bmc Health Serv Res · May 2017
Microblogging violent attacks on medical staff in China: a case study of the Longmen County People's Hospital incident.
A violent attack on medical staff in Guangdong Province, in which a female doctor at Longmen County People's Hospital (LCPH) was severely injured by a knife-wielding patient, has drawn significant public attention to the phenomenon of hospital violence and initiated discussions on how to resolve violence in hospitals. Social networking sites, such as Sina Weibo, a Chinese version of Twitter, have played a role in this public debate. The incident at LCPH provides an opportunity to examine how Weibo has been used in the debate about violence against medical staff in China. ⋯ Weibo users played a role in distributing news information about the violent incident at LCPH; however, the legal perspective is inadequately discussed in the debate, and discussion of constructive measures for protecting doctors and preventing hospital violence was rare. Our research suggests that critical challenges for the Chinese health care system will remain or become worse if no effective measures are implemented to prevent hospital violence.
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Bmc Health Serv Res · May 2017
Identified obstacles and prerequisites in telenurses' work environment - a modified Delphi study.
Telenursing is an expanding part of healthcare, staffed with registered nurses whose work environment is typical of a call centre. Work-related stress has been shown to be a major problem in nurses' work environments and of importance to the outcome of care, patient safety, nurse job satisfaction and burnout. Today, however, we have a limited understanding of and knowledge about the work environment for telenurses. The aim of the present study is to explore and reach consensus on perceived important obstacles and prerequisites in telenurses' work environment. ⋯ Managers need to enable telenurses to experience control in their work, provided with possibilities to control their work and to recover during work; shortening work time could improve their work environment. Limited possibilities to perform work might contribute to feelings of stress and inability to perform work.
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Bmc Health Serv Res · May 2017
ReviewWhat is the evidence for the management of patients along the pathway from the emergency department to acute admission to reduce unplanned attendance and admission? An evidence synthesis.
Globally, the rate of emergency hospital admissions is increasing. However, little evidence exists to inform the development of interventions to reduce unplanned Emergency Department (ED) attendances and hospital admissions. The objective of this evidence synthesis was to review the evidence for interventions, conducted during the patient's journey through the ED or acute care setting, to manage people with an exacerbation of a medical condition to reduce unplanned emergency hospital attendance and admissions. ⋯ There is no clear evidence that specific interventions along the patient journey from ED arrival to 72 h after admission benefit ED re-attendance or readmission. Interventions targeted at high-risk patients, particularly the elderly, may reduce ED utilization and warrant future research. Some interventions showing effectiveness in reducing unplanned ED attendances and admissions are delivered by appropriately trained personnel in an environment that allows sufficient time to assess and manage patients.
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Bmc Health Serv Res · May 2017
Cervical cancer treatment costs and cost-effectiveness analysis of human papillomavirus vaccination in Vietnam: a PRIME modeling study.
Cervical cancer is currently the leading cause of cancer mortality among women in South Vietnam and the second leading cause of cancer mortality in North Vietnam. Human papillomavirus (HPV) vaccination has the potential to substantially decrease this burden. The World Health Organization (WHO) recommends that a cost-effectiveness analysis of HPV vaccination is conducted before nationwide introduction. ⋯ HPV vaccine introduction appears to be economically attractive only if Vietnam is able to procure the vaccine at Gavi prices. This highlights the importance of initiating a nationwide vaccination programme while such prices are still available.
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Bmc Health Serv Res · May 2017
Crisis checklists for in-hospital emergencies: expert consensus, simulation testing and recommendations for a template determined by a multi-institutional and multi-disciplinary learning collaborative.
'Failure to rescue' of hospitalized patients with deteriorating physiology on general wards is caused by a complex array of organisational, technical and cultural failures including a lack of standardized team and individual expected responses and actions. The aim of this study using a learning collaborative method was to develop consensus recomendations on the utility and effectiveness of checklists as training and operational tools to assist in improving the skills of general ward staff on the effective rescue of patients with abnormal physiology. ⋯ Emergency checklists custom-designed for general ward patients have the potential to guide the treatment speed and reliability of responses for emergency management of patients with abnormal physiology while minimizing the risk of adverse events. Interventional trials are needed.