High frequency audiometry: sound suite versus hospital room

This paper discusses a study to assess and compare frequency audiometric thresholds obtained under two listening environments--a sound suite and a typical hospital room.

Newborn hearing screening: A retrospective analysis of hit and false positive rates in the NICU and how they are influenced by risk factors for hearing loss in a suburban birthing hospital

The purpose of this study was to evaluate the effectiveness of a hearing screening program, particularly focusing on hit and false positive rates in the NICU and WBN at a top-rated birthing hospital in Saint Louis, MO. Additionally, the study examined how these rates may be influenced by risk factors for hearing loss.

Physical and perceived noise levels within the neonatal intensive care unit of St. Louis Children's Hospital

This paper studies the success of the renovation of the Neonatal Intensive Care Unit at St. Louis Children's Hospital in reducing noise levels and improving the work environment.

Errors associated with the preparation of aseptic products in UK hospital pharmacies: lessons from the national aseptic error reporting scheme

Background Pharmacy aseptic units prepare and supply injectables to minimise risks. The UK National Aseptic Error Reporting Scheme has been collecting data on pharmacy compounding errors, including near-misses, since 2003. Objectives The cumulative reports from January 2004 to December 2007, inclusive, were analysed. Methods The different variables of product types, error types, staff making and detecting errors, stage errors detected, perceived contributory factors, and potential or actual outcomes were presented by cross-tabulation of data. Results A total of 4691 reports were submitted against an estimated 958 532 items made, returning 0.49% as the overall error rate. Most of the errors were detected before reaching patients, with only 24 detected during or after administration. The highest number of reports related to adult cytotoxic preparations (40%) and the most frequently recorded error was a labelling error (34.2%). Errors were mostly detected at first check in assembly area (46.6%). Individual staff error contributed most (78.1%) to overall errors, while errors with paediatric parenteral nutrition appeared to be blamed on low staff levels more than other products were. The majority of errors (68.6%) had no potential patient outcomes attached, while it appeared that paediatric cytotoxic products and paediatric parenteral nutrition were associated with greater levels of perceived patient harm. Conclusions The majority of reports were related to near-misses, and this study highlights scope for examining current arrangements for checking and releasing products, certainly for paediatric cytotoxic and paediatric parenteral nutrition preparations within aseptic units, but in the context of resource and capacity constraints.

Knowledge translation in Uganda : a qualitative study of Ugandan midwives' and managers' perceived relevance of the sub-elements of the context cornerstone in the PARIHS framework

BACKGROUND: A large proportion of the annual 3.3 million neonatal deaths could be averted if there was a high uptake of basic evidence-based practices. In order to overcome this 'know-do' gap, there is an urgent need for in-depth understanding of knowledge translation (KT). A major factor to consider in the successful translation of knowledge into practice is the influence of organizational context. A theoretical framework highlighting this process is Promoting Action on Research Implementation in Health Services (PARIHS). However, research linked to this framework has almost exclusively been conducted in high-income countries. Therefore, the objective of this study was to examine the perceived relevance of the subelements of the organizational context cornerstone of the PARIHS framework, and also whether other factors in the organizational context were perceived to influence KT in a specific low-income setting. METHODS: This qualitative study was conducted in a district of Uganda, where focus group discussions and semi-structured interviews were conducted with midwives (n = 18) and managers (n = 5) within the catchment area of the general hospital. The interview guide was developed based on the context sub-elements in the PARIHS framework (receptive context, culture, leadership, and evaluation). Interviews were transcribed verbatim, followed by directed content analysis of the data. RESULTS: The sub-elements of organizational context in the PARIHS framework--i.e., receptive context, culture, leadership, and evaluation--also appear to be relevant in a low-income setting like Uganda, but there are additional factors to consider. Access to resources, commitment and informal payment, and community involvement were all perceived to play important roles for successful KT. CONCLUSIONS: In further development of the context assessment tool, assessing factors for successful implementation of evidence in low-income settings--resources, community involvement, and commitment and informal payment--should be considered for inclusion. For low-income settings, resources are of significant importance, and might be considered as a separate subelement of the PARIHS framework as a whole.

A atitude como linha de ação do endomarketing: um estudo de caso sobre as possibilidades de aprendizagem para o hospital geral de Santo Antônio do Porto em Portugal

o objetivo deste estudo é verificar até que ponto o Endomarketing, por intermédio da sua linha de ação da atitude, pode contribuir para a expansão de um serviço orientado para o paciente, por parte dos funcionários do Hospital Geral de Santo António. Para responder a essa questão, analisamos a teoria do Endomarketing, sob o ponto de vista do seu criador (Saul Faingaus Bekin) e de outros autores, fazendo o seu contexto temporal e refletindo acerca da sua importância no setor público de saúde português. Os dados foram obtidos mediante uma pesquisa bibliográfica e documental e por intennédio da aplicação de um questionário a alguns funcionários da instituição analisada. Os resultados da pesquisa demonstram que, nessa instituição, já existe uma consciência em tomo da pertinência de um serviço orientado para o paciente, porém essa consciência deve ser mais efetiva e só pode ser realmente implantada com a aplicação do Endomarketing. Embora, para a maioria das pessoas inquiridas, comprometer, envolver, valorizar e qualificar ajudem a expandir um serviço orientado para o paciente, esses fatores não parecem ser os mais importantes para elas, o que nos leva a crer que talvez isto ocorra por esses fatores não serem levados em consideração o suficiente ao longo do seu cotidiano profissional, razão pela qual o Endomarketing se torna importante. Finalmente, foram detectadas grandes falhas ao nível da comunicação interna da instituição, o que também torna pertinente a aplicação de uma estratégia de Endomarketing.

A educação no processo de trabalho da enfermagem: o caso do hospital de ensino

It is in the work environment that occurs the relations of production, economy, personal development and professional growth. Thus, this environment characterizes for being a propitious way to the intellectual development diligent them. In this context, this study it had as objective to analyze the possibilities and challenges of the education to consist integrant part of the process of work of the nursing, in an education hospital. One is about a research of analytical matrix and qualitative boarding, that had as collaborating fifteen professionals of the nursing, middle- and upper-level, of a hospital of education in Natal/RN. It followed the metodológicos estimated ones of the thematic verbal history, which looks for to promote the agreement or clarification of determined situations, catching experiences of made use people to say on aspects of its life, keeping a commitment with the social context. The information then had been gotten by means of a research instrument that made possible the accomplishment of interviews, which had been marked anticipatedly and counted on the assent of that in they had participated. The interviews had been recorded in proper equipment, so that you say them of the collaborators transcribing and they were analyzed with the support of pertinent literature. The content of you say them was classified in empirical categories, as the nuclei of felt that they presented. With the analysis of the data, one evidenced that the education in the process of work of the nursing is something possible to occur, but that diverse they are the challenges that the same one has that to face to promote this phenomenon in its daily one of work. The collaborators had affirmed that the worker is necessary to remain itself permanently in study so that, thus, it grows professionally and improves its assistance. They had still affirmed that she is possible to work and to study, but that this requires determination of who intends such intention. E also guarantees that the diverse forms of education directed toward the care in nursing can have resolution, since that has collective compromising of the institution. This, as education hospital, recognizes to be necessary to possess one politics of education for its workers and is if considering implementation the same one through a structuralized program already. Therefore, the results of this research show the necessity of changes in the current scene where if they find the workers of nursing of the institution in study. These changes can be reached through one politics of investment in the workers, allowing, beyond other benefits, the reach of new knowledge that take them to a significant learning in favor of the population, reflecting in the quality of the given assistance

Hospital de Pediatria da UFRN: resgatando memórias na construção da história

This study deals with a historical, descriptive and exploratory approach aiming to recall the origin and trajectory of the Pediatrics Hospital at Universidade Federal do Rio Grande do Norte. This research also deals with the insertion of the nursing department in the same Hospital. This was realized through existing records and discourse collected through interview of professionals-doctors, nurses, midwifes, nursing attendants and psychologists. Thus, a network was established and consisted of qualified informants, composed through reference analysis. Data treatment and analysis was performed based on the collection of oral data. The data was considered according to the font s context, all of which depending on process of comprehension and interpretation. The research was based on the main theme, through oral history used in order to build a historical background. These main themes were then subdivided and other discourses were made present such as: the historical scene, the dream came true and the insertion of nursing, present in the history construction; all of which enabled the research. Thus, in this process, it was possible to identify the most important characters of the origin of children s health services organization and assistance at Rio Grande do Norte. It was possible to perceive that this institution aimed to initiate health services that dealt with an education for future generations. This was observed through the creation of the Faculty of Medicine of Natal and as a consequence, the installation of a Pediatrics Hospital that dealt with medical education. The research made evident that the nursing contributed for a structuring of quality health assistance towards children, even though the resources and working conditions were scarce, extensive work shifts and low professional qualification. It was observed that the there was change in the category s profile, once nurses were introduced in the service. Once this happened, changes in mentality, and innovative processes as well as professional conducts were established. The distinctive relation between acting and doing of doctors and nurses were also dealt with. Thus, the first item is done towards the idealization, projection and prescription. The second issue deals with concretization in realization of something that was not projected and realized, causing suffering and unsatisfaction. At the end, it was possible to confirm that oral history is a very rich element and it is possible through subjects that build history, through their perceptation of the facts and the context in that their are inside

Trajetória do hospital dia Dr. Elger nunes: um recorte histórico da psiquiatria e saúde mental no Rio Grande do Norte

In Brazil, the mental health network proposed by the Psychiatric Reform inserts the intermediate and replacement services in the pursuit of alignment or resocialization of patients with mental and behavioral disorder in the community. Was adopted, among other services, the Center for Psychosocial Care, Home Therapy, Sheltered Home, Day Hospital and psychiatric beds in general hospital. In this context, the State of Rio Grande do Norte implanted the Day Hospital Dr. Elger Nunes (HDEN) in Natal / RN in 1996, linked to State Department of Public Health. At HDEN happened a multi and interdisciplinary therapeutic work, besides being the scene of disciplinary practices, and extension projects for graduate courses in Higher Education Institutions in the city. However, with the process of decentralization of local services, the hospital was terminated by an administrative state act in 2006, leaving damage to the activities provided to users, disciplinary practices and extension activities. From this breakdown, the objective was to narrate the trajectory of HDEN through a multidisciplinary team of professionals and teachers who used it as a field of disciplinary practices. It is characterized as a documental and qualitative, backed in the technique of thematic oral history, following the phases: authorization of the interviewee, interview recording, transcription, textualization and transcreation of the material obtained. We used documents, ordinances, general reports of activities, among others, plus interviews to fifteen employees who used this service, being thirteen part of the multidisciplinary team of professionals and two graduation professors of health care area, nursing and medicine. The stories collected were organized according to the technique chosen, respecting its steps. In preparing the body subjected to ALCESTE computer program, priority was given to the vital tone for the formation of categories and classes elected by the program, structured in three thematic areas. In the first axis, called Trajectory of HDEN, were recalled the beginning of its activities, the steps of that time, their activities, and its actors - users, families, professionals, and teaching practices. The second axis has dealt with the process of extinction of HDEN, rescuing the feelings of employees, the main reasons given at the time and immediate postextinction scenario. And the third axis revealed in an articulated form the situation of mental health in Natal / RN, listing to the challenges and prospects for the psychosocial care, starting from the trajectory of HDEN with emphasis on activities. Moreover, the trajectory of HDEN provides recognition of the historical basis outlined in the constitution of the network of substitute services present in the current scenario of psychosocial care in the city of Natal and in RN.

O trabalho do enfermeiro de um hospital pediátrico de ensino e o SUS: desafios a enfrentar

This study analyzes the point of view of nurses working at a pediatric teaching hospital on their work process within the scope of the Brazilian unified healthcare system SUS, in order to identify factors that interfere with its development and find out how work relations are taking place between nurses, other nursing professionals and the multidisciplinary staff. It is a descriptive and analytical study, qualitative in nature, which starts with a consideration of a nurse s current practices and moves on to reflect on a perspective of transformation aiming at rethinking their work process pursuant to the principles of SUS. In order to attain these objectives, we decided on using the focal group as a data-collecting technique, which took place from November to December 2005, by using as instruments a questionnaire for the characterization of the persons being researched and a discussion outline. Theoretical support has approached transformations in the world of work, placing it in the context of healthcare and nursing and has tried, specifically, to understand the work process of a nurse engaged in the production of health services. Therefore, the discourse analysis of participants, in the light of theoretical support, has evinced an ambiguity inasmuch as though identified as such in their work process, nurses are also fulfilling multiple functions in health services. Through this study it has also been possible to identify several factors that interfere with the work of these professionals, including poor working conditions and excessive hiring of high school graduate interns as an attempt to make up for a meager nursing workforce, as well as reveal the possibilities brought about by the SUS in retargeting its professional practice to interdisciplinarity and integrality