Articles: hospitals.
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Multicenter Study Comparative Study
Structural and process indicators of nutritional care: a comparison between Austrian hospitals and nursing homes.
The aim of this study was to describe and compare structural and process indicators of nutritional care in Austrian hospitals and nursing homes. ⋯ The study demonstrated that nursing homes fulfilled more structural indicators and performed nutritional screening at admission more often than hospitals. Nevertheless, the prevalence of malnutrition was high in the two settings and a substantial number of malnourished patients/residents received no nutritional intervention at all. These results show the necessity for improvements in the nutritional care in Austria, for instance, through the routine use of nutritional screening tools followed by tailored nutritional interventions in patients/residents in need.
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Multicenter Study
Pain assessment and intensity in hospitalized children in Canada.
Numerous acute pediatric pain assessment measures exist; however, pain assessment is not consistently performed in hospitalized children. The objective of this study was to determine the nature and frequency of acute pain assessment in Canadian pediatric hospitals and factors influencing it. Pain assessment practices and pain intensity scores documented during a 24-hour period were collected from 3,822 children aged 0 to 18 years hospitalized on 32 inpatient units in 8 Canadian pediatric hospitals. Pain assessment was documented at least once within the 24 hours for 2,615/3,822 (68.4%) children; 1,097 (28.7%) with a pain measure alone, 1,006 (26.3%) using pain narratives alone, and 512 (13.4%) with both a measure and narrative. Twenty-eight percent of assessments were conducted with validated measures. The mean standardized pain intensity score was 2.6/10 (SD 2.8); however, 33% of the children had either moderate (4-6/10) or severe (7-10/10) pain intensity recorded. Children who were older, ventilated, or hospitalized in surgical units were more likely to have a pain assessment score documented. Considerable variability in the nature and frequency of documented pain assessment in Canadian pediatric hospitals was found. These inconsistent practices and significant pain intensity in one-third of children warrant further research and practice change. ⋯ This article presents current pediatric pain assessment practices and data on pain intensity in children in Canadian pediatric hospitals. These results highlight the variability in pain assessment practices and the prevalence of significant pain in hospitalized children, highlighting the need to effectively manage pain in this population.
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Gigiena i sanitariia · Sep 2012
Multicenter Study Comparative Study[Prevalence and characteristics of the "burnout syndrome" of the medical staff of cancer and TB institutions of Primorskiĭ Kraĭ].
As 50 doctors and 70 nurses in oncologic dispensaries as well 90 doctors and 110 nurses in tuberculosis dispensaries in Primorye have been studied on the basis of voluntary testing methods supposed by C. Maslach and V. V. ⋯ In nursing professional burnout syndrome developed significantly more frequently in the more severe form, and with less seniority of professional activity. The dependence of burning on the age and professional experience is more common for physicians. There is an urgent need to study the epidemiology of the "burnout syndrome" and identify ways to prevent the formation of social syndrome in medical personnel.
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Critical care medicine · Sep 2012
Multicenter Study Comparative StudyDespite variation in volume, Veterans Affairs hospitals show consistent outcomes among patients with non-postoperative mechanical ventilation.
To assess the relationship between volume of nonoperative mechanically ventilated patients receiving care in a specific Veterans Health Administration hospital and their mortality. ⋯ Veterans Health Administration hospitals caring for lower volumes of mechanically ventilated patients do not have worse mortality. Mechanisms underlying this finding are unclear, but, if elucidated, may offer other integrated health systems ways to overcome the disadvantages of small-volume centers in achieving good outcomes.
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Multicenter Study Comparative Study
Pediatric observation status: are we overlooking a growing population in children's hospitals?
Inpatient administrative datasets often exclude observation stays, as observation is considered to be outpatient care. The extent to which this status is applied to pediatric hospitalizations is not known. ⋯ Children admitted under observation status make up a substantial proportion of acute care hospitalizations. Analyses of inpatient administrative databases that exclude observation stays likely result in an underestimation of hospital resource utilization for children.