848 resultados para language, communication, patient safety
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This proposal is a non-quantitative study based on a corpus of real data which offers a principled account of the translation strategies employed in the translation of English film titles into Spanish in terms of cognitive modeling. More specifically, we draw on Ruiz de Mendoza and Galera’s (2014) work on what they term content (or low-level) cognitive operations, based on either ‘stands for’ or ‘identity’ relations, in order to investigate possible motivating factors for translations which abide by oblique procedures, i.e. for non-literal renderings of source titles. The present proposal is made in consonance with recent findings within the framework of Cognitive Linguistics (Samaniego 2007), which evidence that this linguistic approach can fruitfully address some relevant issues in Translation Studies, the most outstanding for our purposes being the exploration of the cognitive operations which account for the use of translation strategies (Rojo and Ibarretxe-Antuñano 2013: 10), mainly expansion and reduction operations, parameterization, echoing, mitigation and comparison by contrast. This fits in nicely with a descriptive approach to translation and particularly with skopos theory, whose main aim consists in achieving functionally adequate renderings of source texts.
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This is the first time a multidisciplinary team has employed an iterative co-design method to determine the ergonomic layout of an emergency ambulance treatment space. This process allowed the research team to understand how treatment protocols were performed and developed analytical tools to reach an optimum configuration towards ambulance design standardisation. Fusari conducted participatory observations during 12-hour shifts with front-line ambulance clinicians, hospital staff and patients to understand the details of their working environments whilst on response to urgent and emergency calls. A simple yet accurate 1:1 mock-up of the existing ambulance was built for detailed analysis of these procedures through simulations. Paramedics were called in to participate in interviews and role-playing inside the model to recreate tasks, how they are performed, the equipment used and to understand the limitations of the current ambulance. The use of Link Analysis distilled 5 modes of use. In parallel, an exhaustive audit of all equipment and consumables used in ambulances was performed (logging and photography) to define space use. These developed 12 layout options for refinement and CAD modelling and presented back to paramedics. The preferred options and features were then developed into a full size test rig and appearance model. Two key studies informed the process. The 2005 National Patient Safety Agency funded study “Future Ambulances” outlined 9 design challenges for future standardisation of emergency vehicles and equipment. Secondly, the 2007 EPSRC funded “Smart Pods” project investigated a new system of mobile urgent and emergency medicine to treat patients in the community. A full-size mobile demonstrator unit featuring the evidence-based ergonomic layout was built for clinical tests through simulated emergency scenarios. Results from clinical trials clearly show that the new layout improves infection control, speeds up treatment, and makes it easier for ambulance crews to follow correct clinical protocols.
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This research addressed practice related problems from a medico-legal perspective and aims to provide a working tool that aids GPs to comply with best practice protocols. The resulting bag was developed in collaboration with General Practitioners, clinicians and members of the Medical Defense Union. Using proven methods developed within the Healthcare & Patient Safety Lab (e.g. DOME, Ambulance) to establish an evidence-based brief, this research used task, equipment and consumables analysis to determine minimum requirements and preferred layouts for task optimisation. The research established that clinicians require three distinct functions in their workspace: laying out, organisation and information retrieval. Feedback from clinicians indicates that this working tool allows them to access information and equipment wherever they may be and suggests an improvement from current practice. The research is now into a second year where the design of the bag will be refined and tested. Lifestyle and demographic changes such as the ageing population and increased prevalence of chronic diseases require more consistent standards of primary care, and care that is well coordinated and integrated (Imison, et al., 2011). Many guidelines exist relating to general practice and the doctor’s bag (NSLMC, 2008, RACGP, 2010, RCGP, 2008 and Hiramanek, 2004), however there is no standard in the UK that regulates the shape and materials of the bag or its contents. Doctors may use any sort of vessel to transport their equipment and consumables to a patient’s location. Furthermore, treating a patient in their own home, outside an ideal clinical environment, presents its own complications. A looks-like, works-like bag prototype and information system that will be used in clinical trials, the results of which will determine the manufacturing of a new, standardised bag for clinical treatment used by members of the Medical Defence Union.
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Tecnologia em saúde: Aplicação de conhecimento e competências sob a forma de dispositivos médicos, medicamentos, vacinas, procedimentos e sistemas desenvolvidos para resolver um problema de saúde e melhorar a qualidade de vida. Classificação das TS - 1. Natureza material: medicamentos, equipamentos, procedimentos médicos e cirúrgicos, sistemas de suporte, sistemas organizacionais e de gestão. 2. Propósito: prevenção, diagnóstico, tratamento, reabilitação. 3. Estadio de difusão: futura, experimental, investigacional, estabelecida, obsoleta. Como sabemos que uma tecnologia tem melhores resultados clínicos ou se causa mais danos do que benefícios? Efetividade clínica e económica.
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Wrongdoing in health care is harmful action that jeopardizes patient safety and can be targeted at the patient or employees. Wrongdoing can vary from illegal, unethical or unprofessional action to inappropriate behavior in the workplace. Whistleblowing can be considered as a process where wrongdoing is suspected or oberved in health care by health care professionals and disclosed to the party that can influence the wrongful action. Whistleblowing causes severe harm to the whistleblower and to the object of whistleblowing complaint, to their personnel life and working community. The aim of this study was to analyze whistleblowing process in Finnish health care. The overall goal is to raise concern about wrongdoing and whistleblowing in Finnish health care. In this cross-sectional descriptive study the data were collected (n = 397) with probability sampling from health care professionals and members of The Union of Health and Social Care Professionals in Finland Tehy. The data were collected with questionnaire: “Whistleblowing -väärinkäytösten paljastaminen terveydenhuollossa” developed for this study and by using Webropol questionnaire -software during 26.6.-17.7.2015. The data were analyzed statistically. According to the results of this study health care professionals had suspected (67 %) and observed (66 %) wrongdoing in health care, more often than once a month (30%). Mostly were suspected (37 %) and observed (36%) inadequacy of the personnel and least violence toward the patient (3 %). Wrongdoing was whistle blown (suspected 29 %, observed 40 %) primarily inside the organization to the closest supervisor (76 %), face-to-face (88 %). Mostly the whistle was blown on nurses’ wrongdoing (58 %). Whistleblowing act didn’t end the wrongdoing (52 %) and whistleblowing had negative consequences to the whistleblower such as discrimination by the manager (35 %). Respondents with work experience less than ten years (62 %), working in temporary position (75 %) or in management position (88 %) were, more unwilling to blow the whistle. Whistleblowing should be conducted internally, to the closest manager in writing and anonymously. Wrongdoing should be dealt between the parties involved, and written warning should ensue from wrongdoing. According to the results of this study whistleblowing on wrongdoing in health care causes negative consequences to the whistleblower. In future, attention in health care should be paid to preventing wrongdoing and enhancing whistleblowing in order to decrease wrongdoing and lessen the consequences that whistleblowers face after blowing the whistle.
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A elaboração da proposta da presente Norma teve o apoio científico de Anabela Graça e André Coelho.
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Background The quest for continuous improvement of the quality of provided care is the objective of nursing care. However, the insertion and permanence of a peripheral venous catheter has been associated to complications, thus making a systematic evaluation of the performance of professionals and the management of health services important. Objective: Analyse complications that caused removal of intravenous catheters. Methods A prospective study with 64 patients of a health service of Portugal, from July to September/2015. Included patients with age 18 years, with a peripheral venous catheter. Descriptive analysis using SPSS. Ethical requirements were met. Results Two hundred three (203) intravenous catheters, in 64 patients, most elderly (section 95.3 %), with mean age of 80 years were evaluated. The catheters remained inserted between one and 12 days (mean 2 days), 66 % of the devices were removed because of complications, such as: removal by the patient (17.7 %), obstruction (17.2 %), infiltration (14.8 %), phlebitis (9.4 %) and fluid exiting the insertion site (6.4 %). The prevalence of obstruction and infiltration per patient was respectively 36 % and 39 %. Conclusions Obstruction and infiltration were the complications of higher prevalence that led to the removal and reinsertion of a new peripheral venous catheter with the possibility of increased pain, infection and hospital costs. Faced with the risk of compromising patient safety and being able to contribute to the improvement of health care, we suggest the inclusion of obstruction and infiltration in the indicators of quality of care, in order to have systematic evaluation of results, (re)plan and implement preventive measures.
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Introdução: A notificação de eventos tornou-se um importante instrumento para a melhoria da qualidade no sistema de saúde. Partilhar a ocorrência de eventos na área dos cuidados de saúde é fundamental para a implementação de mecanismos de prevenção que aumentem a segurança do doente. Objetivo: Conhecer a adesão dos enfermeiros à notificação de eventos nos serviços de internamento e unidades de cuidados intensivos de um hospital central. Metodologia: Estudo exploratório descritivo, com abordagem quantitativa. Resultados: Relativamente aos eventos em que o dano é trágico, a grande maioria das vezes são notificados. Em relação à queda, todos os profissionais com quem ocorreu este evento, notificaram. Os enfermeiros apontam como principais barreiras à notificação de eventos: o esquecimento decorrente do excesso de trabalho; a evolução do evento tornar desnecessária a notificação e a aplicação informática para notificação ser complicada, não ser intuitiva. Conclusões: Após a recolha de dados verificamos, que quando ocorrem eventos, os enfermeiros notificam-nos poucas vezes. Os resultados obtidos apontam algumas orientações para a melhoria da cultura de segurança na instituição, ressalvando-se a necessidade de formação na área da segurança e da notificação antes de o evento acontecer.
Resumo:
Wrongdoing in health care is harmful action that jeopardizes patient safety and can be targeted at the patient or employees. Wrongdoing can vary from illegal, unethical or unprofessional action to inappropriate behavior in the workplace. Whistleblowing can be considered as a process where wrongdoing is suspected or oberved in health care by health care professionals and disclosed to the party that can influence the wrongful action. Whistleblowing causes severe harm to the whistleblower and to the object of whistleblowing complaint, to their personnel life and working community. The aim of this study was to analyze whistleblowing process in Finnish health care. The overall goal is to raise concern about wrongdoing and whistleblowing in Finnish health care. In this cross-sectional descriptive study the data were collected (n = 397) with probability sampling from health care professionals and members of The Union of Health and Social Care Professionals in Finland Tehy. The data were collected with questionnaire: “Whistleblowing -väärinkäytösten paljastaminen terveydenhuollossa” developed for this study and by using Webropol questionnaire -software during 26.6.-17.7.2015. The data were analyzed statistically. According to the results of this study health care professionals had suspected (67 %) and observed (66 %) wrongdoing in health care, more often than once a month (30%). Mostly were suspected (37 %) and observed (36%) inadequacy of the personnel and least violence toward the patient (3 %). Wrongdoing was whistle blown (suspected 29 %, observed 40 %) primarily inside the organization to the closest supervisor (76 %), face-to-face (88 %). Mostly the whistle was blown on nurses’ wrongdoing (58 %). Whistleblowing act didn’t end the wrongdoing (52 %) and whistleblowing had negative consequences to the whistleblower such as discrimination by the manager (35 %). Respondents with work experience less than ten years (62 %), working in temporary position (75 %) or in management position (88 %) were, more unwilling to blow the whistle. Whistleblowing should be conducted internally, to the closest manager in writing and anonymously. Wrongdoing should be dealt between the parties involved, and written warning should ensue from wrongdoing. According to the results of this study whistleblowing on wrongdoing in health care causes negative consequences to the whistleblower. In future, attention in health care should be paid to preventing wrongdoing and enhancing whistleblowing in order to decrease wrongdoing and lessen the consequences that whistleblowers face after blowing the whistle.
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Measuring and fulfilling user requirements during medical device development will result in successful products that improve patient safety, improve device effectiveness and reduce product recalls and modifications. Medical device users are an extremely heterogeneous group and for any one device the users may include patients, their carers as well as various healthcare professionals. There are a number of factors that make capturing user requirements for medical device development challenging including the ethical and research governance involved with studying users as well as the inevitable time and financial constraints. Most ergonomics research methods have been developed in response to such practical constraints and a number of these have potential for medical device development. Some are suitable for specific points in the device cycle such as contextual inquiry and ethnography, others, such as usability tests and focus groups may be used throughout development. When designing user research there are a number of factors that may affect the quality of data collected including the sample of users studied, the use of proxies instead of real end-users and the context in which the research is performed. As different methods are effective in identifying different types of data, ideally more than one method should be used at each point in development, however financial and time factors may often constrain this.
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MATCH (Multidisciplinary Assessment of Technology Centre for Healthcare) is a new collaboration in the UK that aims to support the healthcare sector by creating methods to assess the value of medical devices from concept through to mature product. A major aim of MATCH is to encourage the inclusion of the user throughout the product lifecycle in order to achieve devices that truly meet the requirements of their users. A review of the published literature indicates that user requirements are mainly collected during the design and evaluation stage of the product lifecycle whilst other areas, including the concept stage, have less user involvement. Complementing the literature review is an in-depth consultation with the medical device industry, which has identified a number of barriers encountered by companies when attempting to capture user requirements. These will be addressed by a number of case study projects, performed in collaboration with our industrial partners, that will examine the application and utility of different approaches to collecting and analysing data on user requirements. MATCH is focused on providing advice to device developers on how to select and apply methods that have maximum theoretical strength, practical application, cost-effectiveness and likelihood of wide sector acceptance. Feedback will be sought in order to ensure that the needs of the diverse medical device sector are met.
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Dissertação de Mestrado para obtenção do grau de Mestre em Design de Comunicação, apresentada na Universidade de Lisboa - Faculdade de Arquitectura.
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A segurança é um princípio fundamental nos cuidados prestados e exige um complexo sistema de sinergias e um amplo leque de ações para a melhoria da qualidade. É indiscutível que a ocorrência de erros cria uma preocupação constante para os profissionais, sendo primordial fomentar uma cultura de segurança. Este artigo tem por objetivo identificar os fatores determinantes na segurança e qualidade dos cuidados de Enfermagem. Realizou-se uma revisão da literatura, utilizando descritores “Segurança do doente”, “Cultura de Segurança”, “Enfermagem”, “Qualidade dos Cuidados”, emergindo 309 artigos. Efetou-se uma pesquisa na PubMed, SciELO, Web of Science, com artigos publicados entre janeiro de 2010 e março de 2016. Foram selecionados 11 artigos que respondiam à questão de investigação “Quais os fatores determinantes da segurança e qualidade dos cuidados de Enfermagem?“. Dos 11 artigos seleccionados emergiram duas temáticas: a consciencialização do erro e a criação de uma cultura de segurança nas organizações. Este estudo evidencia que a ocorrência de erros constitui uma ameaça à qualidade dos cuidados e segurança dos utentes, contudo, a consciencialização dos riscos e a aplicação de medidas para o desenvolvimento de uma cultura de segurança contribui para a diminuição da frequência e severidade dos erros nas instituições de saúde.