Risk management and healthcare policy
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Risk Manag Healthc Policy · Jan 2015
Disaster risk profile and existing legal framework of Nepal: floods and landslides.
Nepal has a complicated geophysical structure that is prone to various kinds of disasters. Nepal ranks the most disaster-prone country in the world and has experienced several natural calamities, causing high property and life losses. Disasters are caused by natural processes, but may be increased by human activities. ⋯ The new proposed act seems to take a much broader approach to disaster management. With a long-term vision of managing disaster risk in the country, the Government of Nepal has begun the Nepal Risk Reduction Consortium (NRRC) in collaboration with development and humanitarian partners. In order to improve the vulnerability of Nepal, an early warning system, mainstreaming disasters with development, research activities, community participation and awareness, and a rainfall monitoring system must all be a focus.
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Risk Manag Healthc Policy · Jan 2014
The initial success rate of cardiopulmonary resuscitation and its associated factors in patients with cardiac arrest within 24 hours after anesthesia for an emergency surgery.
To determine the initial success rate and its associated factors on cardiopulmonary resuscitation (CPR) in patients with cardiac arrest within 24 hours after receiving anesthesia for an emergency surgery. ⋯ Patients undergoing anesthesia for an emergency surgery are at risk for perioperative cardiac arrest with high mortality which requires immediate CPR. Our results have confirmed that early detection of cardiac arrest by vigilant electrocardiogram monitoring and prompt management with a qualified team are important factors in improving the success of CPR. Emergency surgical patients at risk for cardiac arrest should be promptly managed, with facilities available not only during the operation but also during the pre- to postoperative period.
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Risk Manag Healthc Policy · Jan 2014
ReviewRealizing universal health coverage for maternal health services in the Republic of Guinea: the use of workforce projections to design health labor market interventions.
Universal health coverage requires a health workforce that is available, accessible, and well-performing. This article presents a critical analysis of the health workforce needs for the delivery of maternal and neonatal health services in Guinea, and of feasible and relevant interventions to improve the availability, accessibility, and performance of the health workforce in the country. ⋯ Guinea will need to scale up its recruitment efforts in order to improve health workforce availability. Targeted labor market interventions need to be planned and executed over several decades to correct entrenched distortions and mismatches between workforce need, supply, and demand. The case of Guinea illustrates how to design and operationalize HRH interventions based on workforce projections to accompany and facilitate universal health coverage reforms.
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Risk Manag Healthc Policy · Jan 2014
Association of positive fluid balance and cardiovascular complications after thoracotomy for noncancer lesions.
The purpose of this study was to explore the influence of positive fluid balance on cardiovascular complications after thoracotomy for noncancer lesions. ⋯ Positive fluid balance was a significant risk factor for cardiovascular complications. Strategies to minimize positive fluid balance during surgery for patients at high risk of cardiovascular complications include preparing adequate blood and blood products, considering appropriate hemoglobin level as a transfusion trigger, and adjusting the optimal dose of local anesthetic for intraoperative thoracic epidural analgesia.
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Risk Manag Healthc Policy · Jan 2014
Incidence of and factors associated with perioperative cardiac arrest within 24 hours of anesthesia for emergency surgery.
To determine the incidence of and factors associated with perioperative cardiac arrest within 24 hours of receiving anesthesia for emergency surgery. ⋯ The perioperative incidence of cardiac arrest within 24 hours of anesthesia for emergency surgery was high and associated with multiple factors such as young age (≤2 years old), cardiovascular and respiratory comorbidities, increasing ASA physical status classification, preoperative shock, and surgery site. Perioperative care providers, including surgeons, anesthesiologists, and nurses, should be prepared to manage promptly this high risk group of surgical patients.