A checklist for patient safety rounds at the care pathway level

Objective - To define a checklist that can be used to assess the performance of a department and evaluate the implementation of quality management (QM) activities across departments or pathways in acute care hospitals. Design - We developed and tested a checklist for the assessment of QM activities at department level in a cross-sectional study using on-site visits by trained external auditors. Setting and Participants - A sample of 292 hospital departments of 74 acute care hospitals across seven European countries. In every hospital, four departments for the conditions: acute myocardial infarction (AMI), stroke, hip fracture and deliveries participated. Main outcome measures - Four measures of QM activities were evaluated at care pathway level focusing on specialized expertise and responsibility (SER), evidence-based organization of pathways (EBOP), patient safety strategies and clinical review (CR). Results - Participating departments attained mean values on the various scales between 1.2 and 3.7. The theoretical range was 0-4. Three of the four QM measures are identical for the four conditions, whereas one scale (EBOP) has condition-specific items. Correlations showed that every factor was related, but also distinct, and added to the overall picture of QM at pathway level. Conclusion - The newly developed checklist can be used across various types of departments and pathways in acute care hospitals like AMI, deliveries, stroke and hip fracture. The anticipated users of the checklist are internal (e.g. peers within the hospital and hospital executive board) and external auditors (e.g. healthcare inspectorate, professional or patient organizations).

Fisheries Safety Management

Fisheries is one of the most dangerous professions in the world. Fatal accidents and injuries in the fisheries are characterized as well as particular circumstances that may cause or aggravate the risk of accidents. Aspects of safety management of fishing vessels are covered in this paper: areas of concern when doing a risk assessment in fishing vessels, fundamental elements on a safety management system for the fisheries and the need for international and national level instruments as well as legal and compulsory measures

An approach to health and safety in E.U. forestry operations – Hazards and preventive measures

Forestry in general and logging in particular continue to be among the three most hazardous sectors in European countries. The aim of this article is to characterize health and safety problems and solutions in E.U. forestry operations, and particularly in Portuguese operations. Forest types, production, employment and ownership are used to characterize the forest sector. Forestry accidents and health problems data are mentioned. Typical hazards associated to the nature of logging operations are systematized. Preventive measures, focused on a wide spectrum of measures, making safety considerations an integral feature of all operational activities from planning to organization to execution and supervision of work are emphasized in this article.

Da condição da génese do erro em enfermagem à segurança do cliente em serviços de urgência

Mestrado em Intervenção Sócio-Organizacional na Saúde - Área de especialização: Políticas de Administração e Gestão de Serviços de Saúde

Importance of program physical activity in quality of life in multiple sclerosis patients, six months after the intervention

Background: Multiple Sclerosis (MS) is a chronic disease of the central nervous system that affects more often young adults in the prime of his career and personal development, with no cure and unknown causes. The most common signs and symptoms are fatigue, muscle weakness, changes in sensation, ataxia, changes in balance, gait difficulties, memory difficulties, cognitive impairment and difficulties in problem solving MS is a relatively common neurological disorder in which various impairments and disabilities impact strongly on function and daily life activities. Purpose: The aim of this study is to examine the implications of an Intervention Program of Physical Activity (IPPA) in quality of life in MS patients, six months after the intervention.

Qualidade dos sistemas de informação no serviço de radiologia do Hospital de Curry Cabral: um estudo de caso

Mestrado em Intervenção Sócio-Organizacional na Saúde - Área de especialização: Políticas de Administração e Gestão de Serviços de Saúde

Safety and efficacy of fenproporex for obesity treatment: a systematic review

ABSTRACT OBJECTIVE To evaluate clinical evidence on the safety and efficacy of fenproporex for treating obesity. METHODS MEDLINE, LILACS and Cochrane Controlled Trials Register were searched as well as references cited by articles and relevant documents. Two authors independently assessed the studies for inclusion and regarding risk of bias, collected data, and accuracy. Eligible studies were all those placebo-controlled that provided data on the efficacy and safety of Fenproporex to treat obesity. RESULTS Only four controlled studies met the inclusion criteria. One randomized, placebo-controlled trial on Fenproporex was found on electronic databases. Three placebo-controlled studies (in non-indexed journals) were identified by hand-searching. Patients with cardiovascular and other comorbidities were excluded in all studies. Trials lasted from 40 to 364 days and doses ranged from 20 to 33.6 mg/d. All controlled studies found that weight loss among Fenproporex-treated patients was greater than that produced by the placebo, but drug effect was modest. Fenproporex produced additional weight reductions of 4.7 kg (one year), 3.8 kg (six months) and 1.55 kg (two months) in average, in relation to diet and exercise only (three trials). Insomnia, irritability, and anxiety were the most frequently reported side effects in the four studies. CONCLUSIONS There is a paucity of randomized, placebo-controlled trials on Fenproporex and those identified here present major methodological flaws. These studies suggest that Fenproporex is modestly effective in promoting weight loss. Nonetheless, they failed to provide evidence that it reduces obesity-associated morbidity and mortality. Data from these studies are insufficient to determine the risk-benefit profile of Fenproporex. Abuse potential and amphetamine-like adverse effects are causes for concern.

Plano de Emergência Interno do Instituto Superior de Engenharia do Porto

Mestrado em Engenharia Civil – Ramo Tecnologias da Construção

Integração num plano municipal de segurança rodoviária: Cidade da Amadora: Freguesia da Venteira

Trabalho de Projeto para obtenção do grau de Mestre em Engenharia na Área de Especialização em Vias de Comunicação e Transportes

Boas práticas de gestão de recursos humanos na hotelaria: um estudo exploratório no contexto português

Este estudo caracteriza as práticas de gestão de recursos humanos que são mais comummente promovidas procurando, também, conhecer o grau de intervenção que o gestor de recursos humanos tem na disseminação dessas práticas. Os dados foram recolhidos a partir de inquéritos por questionários realizados a uma amostra de 33 unidades hoteleiras localizadas em Portugal. Os resultados mostram que as práticas de Gestão de Recursos Humanos mais comuns são: contratação; comunicação e partilha da informação; formação profissional; higiene e segurança no trabalho; integração e acolhimento; e recrutamento e seleção. Estes resultados sugerem que as unidades hoteleiras portuguesas estão a utilizar práticas de gestão de recursos humanos congruentes com as que a literatura designa como boas práticas de gestão de recursos humanos. Baseado nos resultados, este artigo discute as principais implicações teóricas e práticas. Sugestões para futura pesquisa são também apresentadas.

Aplicação do Método SFA (Safety Function Analisys) a um. Posto de Transformação de Energia Eléctrica da Renova

Riscos Industriais e Emergentes, 2009 pp. 827-844

Estudo do impacte da institucionalização em lares na satisfação das necessidades humanas fundamentais : perspectiva dos idosos residentes

RESUMO O envelhecimento populacional, nos países ditos “desenvolvidos”, tem sido largamente discutido a nível internacional pelas suas implicações económicas, sociais e de saúde. Uma das prioridades de intervenção face a este fenómeno é promover o aumento de pessoas idosas autónomas inseridas no seu contexto social e familiar habitual. No entanto, nem sempre esse objectivo é atingido e a muitas pessoas idosas restam os lares, ou preferem-nos, como opção de alojamento e de satisfação das necessidades humanas fundamentais. O principal objectivo deste estudo foi procurar saber se a institucionalização no lar teve impacte na satisfação habitual das necessidades humanas fundamentais das pessoas idosas. Como objectivos secundários pretendeu-se complementar esta informação com alguns aspectos relacionados com o processo de institucionalização e perceber se existem diferenças significativas no que respeita ao sexo, grupo etário ou tempo de internamento. Foram incluídas no estudo 125 pessoas com 65 ou mais anos, residentes em 15 lares com alvará de iniciativa privada, pertencentes à Região de Lisboa e Vale do Tejo, no distrito de Setúbal. Os dados foram obtidos através de um questionário construído para o efeito pela autora. As principais conclusões do estudo apontaram para um impacte negativo da institucionalização na satisfação habitual de algumas necessidades que se enquadram no plano social, nomeadamente ocupar-se para se sentir útil, recrear-se e comunicar com os semelhantes. Nas diferentes necessidades, de uma forma geral, a institucionalização teve um impacte negativo no que respeita às dimensões relacionadas com privacidade e preferência individual. Por outro lado, a institucionalização parece ter tido um impacte positivo nas dimensões relacionadas com a segurança e a acessibilidade. Não foram encontradas diferenças significativas no que respeita ao número médio de respostas favoráveis ao lar ou à casa entre os grupos etários ou quanto ao tempo de internamento. Apesar disso, encontraram-se diferenças no que respeita ao grau de satisfação em residir num lar, sendo que o nível de satisfação com a institucionalização foi maior nas pessoas que residiam no lar há mais de um ano, comparativamente às que residiam no lar há um ano ou menos.-------------------------------------------- ABSTRACT: The ageing of the population of the more developed countries has been largely discussed internationally because of its economic, social and health implications. One of the priorities of intervention facing the ageing phenomenon is to promote the increase of autonomous elderly, within their usual social and familiar environment. Not always this goal is achieved and many elderly have nursing homes as option, or voluntary choose them, for lodgement and fundamental human needs satisfaction. The main goal of this study was to search whether the nursing home institutionalization had impact in the satisfaction of fundamental human needs. As secondary goals it was established to complement this information with some aspects of the institutionalization process, as well as to analyse if there were significant differences as far as sex, age groups or institutionalization time. The study sample included 125 individuals aged 65 years or more, living in 15 private nursing homes with approved legal certification, belonging to the Lisboa and Tagus Valley Region, in the district of Setúbal. Data were collected through a questionnaire designed for this study by the author. The main conclusions of this study pointed at a negative impact of institutionalization on the usual satisfaction of some human needs included at the social field, namely occupation, recreation and communication. At another level of needs, in a general way, institutionalization had negative impact concerning privacy and individual preferences dimensions. On the other hand, institutionalization appeared to have a positive impact in safety and accessibility dimensions. It was not found significant differences between age groups or institutionalization time as far as the average positive answers in favour to nursing home or house. Notwithstanding, there were differences relating to satisfaction in living at the nursing home being the satisfaction higher in residents who lived at the nursing home for more than a year, comparatively to those that lived at the nursing home for a year or less.

Portuguese strategy for occupational safety and health 2008-2012 for public administration : priorites for action, progress in the implementation of the proposed measures and their impact on occupational safety outcomes

Apresentação realizada no OH&S Forum 2011 - International Forum on Occupational Health and Safety: Policies, profiles and services, na Finlândia de, 20 a 22 Junho de 2011.

Fire safety barrier availability analysis

This paper shows several ways to analyse the performance of a safety barrier, depending on the objective to be achieved and present a method to analyse binary components usually present on sensor systems of safety barriers. An application example of a water-based fire system is presented and the Probability of Failure on Demand (PFD) of the sensor system is determined based on the analysis of pressure switches installed in this safety barrier. The knowledge of such information will allow the determination of safety barrier’s availability.

Manutenção e conservação de sinalização em autoestradas: caso de estudo: A8 autoestrada do oeste

Relatório de Estágio para obtenção de grau de Mestre em Engenharia Civil na Área de Especialização em Vias de Comunicação e Transportes