• Title/Summary/Keyword: Hospital unit

Search Result 2,531, Processing Time 0.03 seconds

Quality Over Volume: Modeling Centralization of Gastric Cancer Resections in Italy

  • Lorenzon, Laura;Biondi, Alberto;Agnes, Annamaria;Scrima, Ottavio;Persiani, Roberto;D'Ugo, Domenico
    • Journal of Gastric Cancer
    • /
    • v.22 no.1
    • /
    • pp.35-46
    • /
    • 2022
  • Background: The correlation between hospital volume and postoperative outcomes has led to the centralization of complex procedures in several countries. However, the results reported in relation to gastric cancer (GC) are contradictory. This study aimed to analyze GC surgical volumes and 30-day postoperative mortality in Italy and to provide a simulation for modeling centralization of GC resections based on district case volumes. Methods: A national registry was used to identify all GC resections, record mortality rates, and track the national in-border GC resection health travel. Hospitals were grouped according to caseload. Centralization of all GC procedures performed within the same district was modeled. The outcome measures were a minimal volume of 25 GC resections/year and the 30-day postoperative mortality. Results: In 2018, 5,873 GC resections were performed in 498 Italian hospitals (mean resections per hospital per year: 11.8); the postoperative mortality rate (5.51%) was tracked from 2016-2018. GC resection health travel ranged from 2% to 50.5%, with a significant (P<0.001) difference between northern and central/southern Italy. The mean mortality rate was 7.7% in hospitals performing one to 3 GC resections per year, compared with 4.7% in those with >17 GC resections/year (P≤0.01). Most Italian districts achieved 25 procedures/year after centralization; however, 66.3% of GC cases in southern Italy vs. 42.2% in central and 52.7% in the northern regions (P<0.001) required reallocation. Conclusion: Postoperative mortality after GC resection correlated with hospital volume. Despite health travel, most Italian districts can reach a high-volume threshold, but discrepancies in mortality rates are alarming.Trial RegistrationResearch Registry Identifierresearchregistry6869

Male Breast Carcinoma: Epidemiology, Risk Factors and Current Therapeutic Approaches

  • Zygogianni, Anna G.;Kyrgias, George;Gennatas, Costantinos;Ilknur, Aytas;Armonis, Vassilios;Tolia, Maria;Papaloukas, Christos;Pistevou, Gompaki;Kouvaris, John;Kouloulias, Vassilios
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.13 no.1
    • /
    • pp.15-19
    • /
    • 2012
  • Male breast cancer is a very rare disease with an incidence of about 0.5-1% comparing with the one of female breast cancer but relatively little is known about its cause. Treatment strategies for breast cancer in males are derived from studies performed among females. The probable reasons behind the frequent, late diagnoses presented at stages III or IV might be the lack of awareness. The rarity of the disease precludes large prospective randomized clinical trials. This study reviews male breast cancer and its risk factors, recommendations for diagnosis and the management of patients with male breast cancer.

A Study on Nursing Unit Culture, Efficiency on Nursing Performance, Job Satisfaction and Turnover Intention (간호단위문화와 간호업무수행, 직무만족 및 이직의도와의 관계)

  • Kim, So-In;Kim, Jeong-Ah
    • Journal of Korean Academy of Nursing Administration
    • /
    • v.3 no.2
    • /
    • pp.17-40
    • /
    • 1997
  • The purpose of this descriptive, correlational study was to identify, describe the patterns of nursing unit culture, nursing performance, job satisfaction and turnover intention in the hospital setting, and to analyze the relationships between nursing unit culture, nursing performance, job satisfaction and turnover intention among the characteristic of the subjects The subject consisted of 223 nurses who were employed in medical & surgical units of 3 different University hospitals in Seoul. Data collection was done in November, 1996 by means of questionnaire. The instruments used for this study were the questionnaire based on the Nursing unit cultural assessment tool developed by Coeling(1993), Nursing performance scale used by Yoon(1991), Job satisfaction scale developed by Slavitt, et al.(1978) and Turnover intention scale used by Lee(1995). The data were analyzed by percentage distribution. Pearson correlation coefficient and ANOVA. The summarized results were as follows: 1. There was significant differences in the nursing unit culture between individual cultural behavior and group cultural behavior. 2. There was positive correlation between nursing unit culture, nursing performance and job satisfaction. 3. There was negative correlation between nursing unit culture and turnover intention. 4. There was significant difference in nursing performance efficiency according to the age, educational level, professional carrier in the nursing unit, in the hospital. 5. There was significant difference in turnover intention according to the age, educational level. According to these results, the following implications can be made ; 1. It needs to study on the nursing unit culture in other size hospitals and compare them to these results. 2. It is necessary to assess nursing unit culture and endeaveor good climate for the nursing organizational outcomes and prepare the training course of leadership of nurse manager. 3. In nursing administration, there should be an emphasis on assessment of staff nurses' cultural behavior in case of nurses' orientation, allocation, recruitment, continuning education, so that staff nurses' performance and job satisfaction will be increased and trunover intention will be decreased.

  • PDF

Spinal Arteriovenous Fistula with Progressive Paraplegia after Spinal Anaesthesia

  • Baltsavias, Gerasimos;Argyrakis, Nikolaos;Matis, Georgios K.;Mpata-Tshibemba, Stephanie
    • Journal of Korean Neurosurgical Society
    • /
    • v.55 no.2
    • /
    • pp.106-109
    • /
    • 2014
  • A case of an iatrogenic spinal arteriovenous fistula with progressive paraplegia in a young woman is reported. The fistula was eventually created after repetitive lumbar punctures performed in the process of spinal anaesthesia. Her symptoms were progressed to paraplegia over a period of 2 years. The digital subtraction angiography demonstrated a single-hole fistula, involving the anterior spinal artery and vein. The lesion was occluded by embolization with immediate improvement. The potential mechanism is discussed.

Management of Enteral Nutrition in the Pediatric Intensive Care Unit: Prokinetic Effects of Amoxicillin/Clavulanate in Real Life Conditions

  • Chiusolo, Fabrizio;Capriati, Teresa;Erba, Ilaria;Bianchi, Roberto;Atti, Marta Luisa Ciofi degli;Picardo, Sergio;Diamanti, Antonella
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.23 no.6
    • /
    • pp.521-530
    • /
    • 2020
  • Purpose: Malnutrition is a common feature in critically ill children. Enteral nutrition (EN) is the main strategy to nutritionally support critical ill children, but its use can be hindered by the development of intolerance. The study aimed to assess the effectiveness and safety of amoxicillin/clavulanate (A/C) to treat EN intolerance. Methods: We retrospectively evaluated patients admitted to the pediatric intensive care unit from October 2018 to October 2019. We conducted a case-control study: in the first 6 months (October 2018-April 2019) we implemented the nutritional protocol of our Institution with no drug, whereas in the second half (May 2019-October 2019) we employed A/C for 1 week at a dose of 10 mg/kg twice daily. Results: Twelve cases were compared with 12 controls. At the final evaluation, enteral intake was significantly higher than that at baseline in the cases (from 2.1±3.7 to 66.1±27.4% of requirement, p=0.0001 by Wilcoxon matched-pairs signed rank test) but not in the controls (from 0.2±0.8 to 6.0±14.1% of the requirement, p=NS). Final gastric residual volume at the end of the observation was significantly lower in the cases than in the controls (p=0.0398). The drug was well tolerated as shown by the similar safety outcomes in both cases and controls. Conclusion: Malnutrition exposes critically ill children to several complications that affect the severity of disease course, length of stay, and mortality; all may be prevented by early EN. The development of intolerance to EN could be addressed with the use of A/C. Future prospective clinical trials are needed to confirm these conclusions.

Evaluation of Appropriateness of Blood Order Based on Crossmatching to Transfusion Ratio in Elective Surgery (선택적 수술에서 교차시험/수혈비를 활용한 혈액요청의 적정성 평가에 관한 연구)

  • Chang, Young Do;Kim, Jae Soo;Kim, Min Jung;Rho, Tae Jun;Lee, Sang Il
    • Korean Journal of Clinical Laboratory Science
    • /
    • v.36 no.2
    • /
    • pp.158-162
    • /
    • 2004
  • The over-preparation of blood for elective surgery causes some problems such as returning of blood, inefficient task and loss of reagents. In recent blood transfusion practice, there has been changing patterns of blood use in elective surgery as various side effects of transfusion have become known and operation techniques are developed. This study was performed to evaluate the optimal utilization of blood for various elective and/or emergency surgery. We surveyed the quantity of blood transmitted to wards, returned to blood bank, and the number of crossmatching test done for the elective surgery of the patients at the D. University Hospital, the tertiary teaching hospital from August 1, 2001 to October 31, 2001. Crossmatched to transfusion ratio (C/T ratio) was calculated, in which C means the unit of accomplished crossmatching test and T means the unit of transfused blood component. The unit of transfused blood was analysed in terms of issuing time, sex, age, clinical department, and blood component type. The usage of bloods for the emergency surgery was also analyzed. In our study, C/T ratio was highest on Monday (1.54) and Tuesday (1.53), and higher in female patients(1.54) than in male patients (1.32). No significant relationship was observed between age groups. Among clinical departments, thoracic and cardiovascular surgery showed the highest C/T ratio (1.54). From above results, we could be sure that the management of transfusion practice was relatively appropriate in recent years, although the entire introduction of type and screen (T&S) method was desirable. If the T&S method is performed, the C/T ratio would be almost 1.00 and it would also relieve the duty of blood bank.

  • PDF

The Experiences of Family Caregiving in a Chronic Care Unit

  • Cho, Myung-Ok
    • Journal of Korean Academy of Nursing
    • /
    • v.35 no.8
    • /
    • pp.1461-1475
    • /
    • 2005
  • Purpose. The main purpose of this critical ethnography was to examines the process and discourses through which family caregivers experience while caring for their sick family member in a hospital. Methods. This was achieved by conducting in-depth interviews with 12 family caregivers, and by observing their caring activities and daily lives in natural settings. The study field was a unit for neurologic patients. Data was analyzed using taxonomy, discourse analysis, and proxemics. All research work was iteratively processed from March 2003 to December 2004. Results. Constant comparative analysis of the data yielded the process of becoming a successful family caregiver: encountering the differences and chaos as novice; constructing their world of skilled caregivers; and becoming a hospital family as experienced caregivers. During the process of becoming an experienced hospital family, the discourse of family centered idea guided their caring behaviors and daily lives. Conclusion. The paternalistic family caregivers struggled, cooperated, and harmonized with the patriarchal world of professional health care system. During this process of becoming hospital family, professional nurses must act as cultural brokers between the lay family caring system and the professional caring system.

Stepwise Training for Reconstructive Microsurgery: The Journey to Becoming a Confident Microsurgeon in Singapore

  • Ramachandran, Savitha;Ong, Yee-Siang;Chin, Andrew Y.H.;Song, In-Chin;Ogden, Bryan;Tan, Bien-Keem
    • Archives of Plastic Surgery
    • /
    • v.41 no.3
    • /
    • pp.209-212
    • /
    • 2014
  • Microsurgery training in Singapore began in 1980 with the opening of the Experimental Surgical Unit. Since then, the unit has continued to grow and have held microsurgical training courses biannually. The road to becoming a full-fledged reconstructive surgeon requires the mastering of both microvascular as well as flap raising techniques and requires time, patience and good training facilities. In Singapore, over the past 2 decades, we have had the opportunity to develop good training facilities and to refine our surgical education programmes in reconstructive microsurgery. In this article, we share our experience with training in reconstructive microsurgery.

Real-Time Pleural Elastography: Potential Usefulness in Nonintubated Video-Assisted Thoracic Surgery

  • Tacconi, Federico;Chegai, Fabrizio;Perretta, Tommaso;Ambrogi, Vincenzo
    • Journal of Chest Surgery
    • /
    • v.54 no.5
    • /
    • pp.433-435
    • /
    • 2021
  • Pleural adhesions are a major challenge in standard and nonintubated video-assisted thoracic surgery. The currently available imaging techniques help to assess the presence and extent of pleural adhesions, but do not provide information on tissue deformability, which is crucial for intraoperative management. In this report, we describe the utilization of real-time elastography mapping of pleural adhesions. This technique enabled us to detect areas with softer adhesions, and helped establish the surgical plan in a difficult case of a patient scheduled for nonintubated video-assisted thoracic surgery.

Study on Hospital Environmental Causes Affected the Mother′s Comfort After Her Child Birth (산욕부 안위에 영향을 미치는 병원환경 요인에 관한 연구)

  • 변수자
    • Journal of Korean Academy of Nursing
    • /
    • v.8 no.1
    • /
    • pp.1-15
    • /
    • 1978
  • The Purpose of this study is to examine closely the causes influenced upon the comfort and recovery of the woman delivered of a child in the hospital at the same time to understand environmental status of hospitals in order to promote mother's health recovery, and to improve hospital environment by emphasizing the meaning of environment and health before the medical staff and hospital administrative authority. In the method of servery of the research, 165 post paestum patients have been randomly selected who were accommodated and delivered their babies at OB(obstetric ) & GY (Gynecologic) unit the 7 general hospitals for the period of 6 December 1976 through 17 December 1976. As for the survey, it has been used of Questionnaire where we have 65 items in the respect of personal environment in the hospital such as trusting nurse, ability, reliability, kindness and etiquette of nurse and tile character of nurse the relationship with patients the other respect of physical environment included 9f temperature, moisture. air-ventilation lightening noise, cleanness. facilities, and the third realm being of mother's hearth ground to have the following conclusion 1. The feature of the collected personnel they are from OB or GY sects of from OB unit of the other 5 hospitals except the two general hospitals of the college or school Otherwise the rate of the patients to nurses would be 9 : 1. As for the nurses'ground it would be appeared of 20-25 years of age as the 76%. either 3 year course or 4 year course in the education would be each 50% and less than 2 year experience case would record as of 60 %. In the respect of hospital physical environmental status, there we have two hospitals without any thermometers, on the other han4 nowhere there's hygrometer, otherwise, the lightening is normal or over than normal As for the structure of noise protection the corridors're, generally speaking worse than rooms, nerver hueless, there's no ventilating system in the hospitals. The rooms'repainted in white and yellow, light green white, or green color. The patient's clothing were in green pink blue, light green or in white co for. There're not anything special in both decoration and equipments. Most of them used tall beds except in one hospital 2. To the extent of perception of patient's hatch 9round and hospital environment it is presented that they perceived nurse's ability in highest in total human variable, though perceived kindness or etiquette in the lowest otherwise, comparatively high in total average. 3. In the respect of physical environment it is highest perceived of lightening terms, otherwise, lowest perceived of air ventilation and total average became lowest than the one of the original record 4. To ages, in the respect of hatch ground rather old aged mother than the younger one has perceived that nurse would be trusting, in good service character, able, at the same time, liable, Otherwise, in physical environment regardless of age, they perceived lightening in high and remarkably lower in ventilation As a result of the examination of the difference in hospital environment to each age it is appeared of statistical difference at 5% level of ability in the personal environment otherwise little difference as for physical environment 5. In the respect of perceiving level to educational standard it is highly perceived of personal environment for higher ranking group rather than lower group in the educational standard. In case of physical environment it is highly perceived for lower level group rather than higher level group in educational background. The variables which have statistical significance at 5% level are from trusting kindness, etiquette and total kindness, etiquette and total all significance at 5% level are from trusting, kindness, etiquette and total human environment variable in personal environment, otherwise, there's little difference in the physical environment. 6. The perceiving level due to times of admission and accommodation at the hospital would be cleared out as gradual higher perception both physical and personal environment in the hospital. At 5% significant level of the ventilation condition in physical environmental variable it is presented of meaningful difference otherwise, there we have little difference both in Personal variable and other one. 7. In accordance with living standard, the perception degree of personal environment in tee hospital would be inclined to increase to higher living standard on the other hand, in case of the physical environment, the perception level world increase to lower living standard At 5 % level, the trustuariable and total scores in the personal eicuironmectal variable there appeared a meaningful/ significant difference otherwise, there presented little difference both in physical environmental and other variable to the living standard 8. Pertaining to family unit, the mother of an independent family unit perceived highly in all respect of the personal and the physical environment in the hospital rather than the woman of succeeding family unit. At 5 % level there appeared a difference in the respect of kindness and etiquette both in personal environment variable, on the other hand, there hardly marked a difference between other variable and physical environmental one. 9. The degree of perception to comforting level has little connection with a statistical difference the age, educational level hospital admitting times, living standard or family unit. 10. The most effective variable to mother's comforting level will be nurse's ability, reliability, trusting manner, and total physical environment variable in order.

  • PDF