Títeres: sus usos en salud y enseñanza en Enfermería

Health promotion uses education as a tool to help individuals and the community achieve full physical, mental, and social well-being. In this educational task, different strategies, methodologies and educational resources have been used, one of which is education using puppets, with satisfactory results. However, there is limited experience as regards the training of health professionals in techniques and strategies for carrying out an educational activity using puppets. The limited results presented in the literature show isolated innovations in the training of nurses. Although these have resulted in satisfactory experiences for students and teachers, they are not included in the curricula as a resource that should be learned by future professionals that will carry out educational activities in the community.     

Determinants in the number of staff in hospitals’ maintenance departments: a multivariate regression analysis approach

To date, there are no broadly accepted or accurate models to determine appropriate staffing [levels] for clinical engineering departments (CEDs). The purpose of this study is to determine what the determinants of the staffing levels are (total number of full time equivalents (FTEs)) in CEDs in healthcare organisations. In doing so, we used a cross-sectional exploratory approach by using a multivariate regression model over a secondary source of data information from the AAMI Benchmarking Solutions—Healthcare Technology Management database. Two hundred and one healthcare organisations were included in our study. Our study revealed that on average, there are almost 14 biomedical technicians (BMETs) per clinical engineer and one FTE per 1083.72 devices (SD 545.69). The results of this study also revealed that the total number of devices and the total technology management hours devoted to these devices positively affects the number of FTEs in a CED, whereas the hospital complexity, measured by healthcare organisation patient discharges matters inversely. The most important factor that matters in the number of FTEs in CEDs was the total technology management hours devoted to devices. A value of explained variance (i.e. R²) of 85% was obtained, indicating the strong power of the prediction accuracy of our multivariate regression model.     

Projecting future supply and demand for physical therapists in Japan using system dynamics

ObjectivesJapan is the oldest country in the world, and its demand for medical care is expected to increase. Although a clear vision regarding the supply and demand for physical therapy services is necessary, there has been no research that forecasts the supply and demand for physical therapists in Japan. Consensus has not been reached on whether the supply of physical therapists is sufficient. This study projects this supply and demand to provide medical policymakers with basic data.MethodsA system dynamics model was created to predict the number of physical therapists working in hospitals and clinics in Japan from 2014 to 2040. The future demand for physical therapy was estimated using the rehabilitation service utilization data from Open National Database, a publicly available nationwide health claims database. Sufficiency rates (supply/demand) were calculated, and sensitivity analysis was conducted on supply-related parameters.ResultsThe number of physical therapists was projected to be 1.74 and 2.54 times greater in 2025 and 2040, respectively, than in 2014. The sufficiency rates were 1.72, 2.39, and 3.30 in 2015, 2025, and 2040, respectively. The sensitivity analysis revealed that attrition rates had the greatest effects on sufficiency.ConclusionsAlthough the current supply appears to be needed, considering the expected increase and uncertainty in medical needs. However, there is a possibility of a future oversupply, especially after 2025, when the rate of increase in demand will lessen. Further studies are required to evaluate the distribution of physical therapists among regions and specialties.     

基于数据包络分析的老年科护理人力资源效率评价指标构建

目的运用数据包络分析法,构建科学、合理、适合评价老年科护理人力资源效率的指标,以客观评价老年科护理人力资源利用效率。方法采用文献分析法和半结构访谈法初步构建评价老年科护理人力资源效率的初级指标体系,采用专家咨询筛选和调整指标,运用聚类分析法得到最终的老年科护理人力资源效率评价指标。结果构建的基于包络分析模型的老年科护理人力资源效率的评价指标为4个:投入指标为专科护士数,产出指标为产生专科护士数占比、患者满意度、护理安全事件发生率。结论构建基于包络分析模型的老年科护理人力资源效率评价指标,便于老年科护理管理者对护理人力资源效率进行客观评价并掌握实际情况,也为其他专科护理人力资源效率评价指标构建提供借鉴。     

Healthcare resource utilization,treatment patterns,and cost of care among patients with thermal burns and inpatient autografting in two large privately insured populations in the United States

The current standard of care for severe burns includes autografting; however, there is scarce knowledge regarding the long-term economic burden associated with thermal burns and inpatient autografting. The objective of this study was to characterize healthcare resource utilization, treatment patterns, and cost of care for thermal burn patients in two large privately insured populations in the United States who underwent inpatient autografting between 01/01/2011 and 06/30/2016. Patient demographics, clinical characteristics, healthcare resource utilization, and total cost were examined during baseline (one year before the initial hospitalization with autografting) and two-year evaluation period. There was a substantial economic burden on thermal burn patients who received inpatient autografts (HIRD® database [HIRD]: N = 371, mean age = 39.6 years, male = 67.1%; MarketScan® database [MarketScan]: N = 698, mean age = 38.2 years, male = 63.3%) in the year 1 evaluation period (HIRD: mean = $184,805; MarketScan: mean = $155,272), which was mainly driven by the initial hospitalization with autografting (HIRD: mean = $157,384 and MarketScan: mean = $131,470). The percentage of patients with burn-related healthcare resource utilization and average burn-related costs were considerably reduced in the year 2 evaluation period (HIRD: mean = $3020; MarketScan: mean = $1990). Consistent with previous studies, mean length of hospital stay (days) and mean total medical costs generally increased as the percentage of total body surface area burned increased.     

突发公共卫生事件时儿童专科医院人力资源应急调配策略

文章在阐述了医院人力资源应急调配概念的基础上,结合2019年的突发公共卫生事件,分析了儿童专科案例医院人力资源应急调配存在的困难,并重点介绍了医院人力资源应急调配的主要策略。