1000 resultados para hospital resilience


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We investigated the effects of annual burning since 1952, triennial burning since 1973, fire exclusion since 1946 and infrequent wildfire (one fire in 61 years) on woody understorey vegetation in a dry sclerophyll eucalypt forest, south-eastern Queensland, Australia. We determined the influence of these treatments, and other site variables (rainfall, understorey density, topsoil C : N ratio, tree basal area, distance to watercourse and burn coverage) on plant taxa density, richness and composition. The richness of woody understorey taxa 0–1 m in height was not affected by burning treatments, but richness of woody plants 1–7.5 m in height was lower in the annually burnt treatment than in the triennially burnt treatment from 1989 to 2007. Fire frequency and other site variables explained 34% of the variation in taxa composition (three taxon groups and 10 species), of which 33% of the explained variance was explained by fire treatment and 46% was explained by other site variables. Annual burning between 1974 and 1993 was associated with lower understorey densities mainly due to reduced densities of eucalypts 1–7.5 m in height. Triennial burning during the same period was associated with higher densities of eucalypts 0–7.5 m in height relative to the annually burnt and unburnt treatments. Most woody taxa persisted in the frequently burnt treatments through resprouting mechanisms (e.g. lignotuberous regeneration), and fire patchiness associated with low-intensity burning was also found to be important. Persistence of plants <1 m tall demonstrates the resilience of woody taxa to repeated burning in this ecosystem, although they mainly exist in a suppressed growth state under annual burning.

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- Objectives Falls are the most frequent adverse event reported in hospitals. Patient and staff education delivered by trained educators significantly reduced falls and injurious falls in an older rehabilitation population. The purpose of the study was to explore the educators’ perspectives of delivering the education and to conceptualise how the programme worked to prevent falls among older patients who received the education. - Design A qualitative exploratory study. - Methods Data were gathered from three sources: conducting a focus group and an interview (n=10 educators), written educator notes and reflective researcher field notes based on interactions with the educators during the primary study. The educators delivered the programme on eight rehabilitation wards for periods of between 10 and 40 weeks. They provided older patients with individualised education to engage in falls prevention and provided staff with education to support patient actions. Data were thematically analysed and presented using a conceptual framework. - Results Falls prevention education led to mutual understanding between staff and patients which assisted patients to engage in falls prevention behaviours. Mutual understanding was derived from the following observations: the educators perceived that they could facilitate an effective three-way interaction between staff actions, patient actions and the ward environment which led to behaviour change on the wards. This included engaging with staff and patients, and assisting them to reconcile differing perspectives about falls prevention behaviours. - Conclusions Individualised falls prevention education effectively provides patients who receive it with the capability and motivation to develop and undertake behavioural strategies that reduce their falls, if supported by staff and the ward environment.