Дисертації з теми "Emergency service personnel"
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1
Lukies, Rhonda. "Examination of prevalence rates of psychopathology and coping styles in a community sample of emergency service job candidates /." [St. Lucia, Qld.], 2006. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe19313.pdf.
2
Kling, Michael Patrick. "Needs Assessment for Mental Health Support Towards Emergency Medical Service (EMS) Personnel." Thesis, Regent University, 2021. http://pqdtopen.proquest.com/#viewpdf?dispub=27961789.
Анотація:
Understanding and assessing the needs of Emergency Medical Service (EMS) personnel and other first responders is crucial for providing these individuals with the resources needed within their community. The literature discusses how EMS personnel are at risk for psychological impairment due to routine exposure to traumatic events and occupational stressors within EMS organizations. Additionally, the research has supported the importance of positive coping abilities, organizational belongingness, and social support within the lives of EMS personnel to enable them to resiliently handle the occupational stress of their job. This study investigated the occupational needs of EMS providers to determine if they are receiving resources within their organization to cope with occupational stressors. Participants for this study comprised (n=153) paramedics and fire-fighters from the Tidewater EMS Council organization. A needs assessment was conducted to explore correlations between quality of life, resiliency, years of service, level of education, burnout, secondary traumatic stress, interpersonal support, positive and negative religious coping, and the occupational needs of EMS personnel. The results revealed that burnout (r=4.27**) and secondary traumatic stress (r.215*) were important factors for determining occupational turnover among EMS personnel. Furthermore, EMS providers reported occupational needs such as easier access to mental health, improved staff relations, adequate staffing, and improved shift hours are needed within their organization. Future research should explore differences in occupational needs with EMS providers among EMS organizations in metropolitan and rural communities. Keywords: Emergency Medical Services (EMS), Burnout, Occupational Stress, Traumatic Critical Incidents
3
Roberts, Craig Brendan. "The judgement of risk in traumatised and non-traumatised emergency medical service personnel." Thesis, Stellenbosch : Stellenbosch University, 2000. http://hdl.handle.net/10019.1/51990.
Анотація:
Thesis (MA) -- University of Stellenbosch, 2000.ENGLISH ABSTRACT: Judgement of risk for negative events in certain situations was investigated in a group of emergency medical service (EMS) personnel with a diagnosis of posttraumatic stress disorder (PTSD; n = 27) and a group without PTSD (n = 74). Participants completed the PTSD Symptom Scale: Self-Report version (Faa, Riggs, Dancu, & Rothbaum, 1993), an EMS work experiences questionnaire, the Beck Depression Inventory (Beck, Rush, Shaw, & Emery, 1979), and an event probability questionnaire designed to assess judgement of risk. Participants with PTSD overestimated amount of risk involved in comparison to participants without PTSD, thereby demonstrating a judgement bias for risk related events. The present study found that the judgement bias in PTSD participants extended to include not just external harm related events but also general negative events (without potential threatening/harmful consequences), negative social events, and negative workrelated events. Of the posttraumatic symptomatology assessed, avoidance symptomatology was found to be the best predictor of judgement bias. The results of the present study are discussed in terms of the cognitive clinical psychology theories of PTSD, which predict the manifestation of judgement bias in PTSD, and cognitive experimental psychology explanations of the effect of negative emotional states on judgement processes.
AFRIKAANSE OPSOMMING: Oordeeloor risiko vir negatiewe gebeurtenisse in sekere situasies is ondersoek by "n groep mediese nooddienspersoneel met "n diagnose van posttraumatiese stresversteuring (PTSV; n = 27) en "n groep sonder PTSV (n = 74). Deelnemers het die PTSD Symptom Scale: Self-Report version (Foa, Riggs, Dancu, & Rothbaum, 1993), "n mediese nooddiens werkservaringe-vraelys, die Beck Depression Inventory (Beck, Rush, Shaw, & Emery, 1979), en "n gebeurtenis-waarskynlikheidsvraelys wat opgestel is om oordeeloor risiko te meet, voltooi. Deelnemers met PTSV het die mate van risiko betrokke oorskat in vergelyking met deelnemers sonder PTSVen sodoende "n beoordelingsydigheid vir risiko-verbandhoudende situasies gedemonstreer. In die huidige studie is gevind dat beoordelingsydigheid by PTSV deelnemers nie beperk was tot eksterne skade-verbandhoudende gebeurtenisse nie, maar dat dit ook veralgemeen het na algemene negatiewe gebeurtenisse (sonder potensieel skadelike gevolge), negatiewe sosiale gebeurtenisse, en negatiewe werksverwante gebeurtenisse. Daar is gevind dat, wat PTSV-simptomatologie betref, vermyding die beste voorspeller van beoordelingsydigheid was. Die resultate van die huidige studie word bespreek in terme van kognitiewe klinies-sielkundige teorieë van PTSV, wat die aanwesigheid van beoordelingsydigheid voorspel, en kognitiewe eksperimentele-sielkunde verklarings van die effek van negatiewe emosionele toestande op beoordelingsprosesse.
4
Maher, Matthew J. "Service Length and Resilience as They Contribute to Burnout in Volunteer Emergency Service Personnel| A Quantitative Analysis." Thesis, Capella University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10977163.
Анотація:
The topic of the study was burnout amongst volunteer emergency service personnel in a Northeastern state. An understanding of the role burnout plays in emergency service professionals exists in the literature; however, the current research expanded the understanding by focusing on volunteers. Years of experience and resilience were studied to determine if a relationship exists with burnout. Data analysis consisted of multiple regression analyses conducted for each subscale of the Maslach Burnout Inventory – Human Services Survey (emotional exhaustion, depersonalization, and personal achievement) (Maslach, Jackson & Leiter, 1996). Results concluded that resilience, as measured by the Resilience Scale (Wagnild & Young, 1993), was found to be statistically significant in its ability to predict emotional exhaustion and personal achievement, at the p < .05 significance level. Resilience significantly predicted emotional exhaustion subscale scores of the Maslach Burnout Inventory – Human Services Survey, β= -.25, t(82) = -4.36, p < .001. Resilience and length of service when considered together also explained a significant proportion of variance in emotional exhaustion scores R2 = .92, F(2,82) = 9.65, p < .001. Resilience significantly predicted the personal accomplishment subscale, β = .21, t(82) = 5.19 p < .001. Resilience and length of service when considered together also explained a significant portion of the variance in personal exhaustion scores, R2 = .25, F(2,82) = 13.91, p < .001. Results concluded that resilience was not a statistically significant predictor of the depersonalization subscale; β = - .07, t(82) = -1.72, p = .090. Length of service was not considered to be a statistically significant predictor for the subscales (emotional exhaustion, depersonalization, and personal achievement) at the .05 alpha level. Resilience and length of service when considered together did not explain a significant portion of the variance in depersonalization scores; R2 = .04, F(2, 82) =1.90, p=.157. The regression analysis demonstrated that there was a low correlation between predictor variables of resilience, as measured by The Resilience Scale and length of service, r = .123. A stepwise regression analysis was also conducted and confirmed that the predictor variable of resilience held a greater control over the outcome variables in each regression analysis with a significant outcome. Study implications centered around a recognition that volunteer emergency service personnel can be affected by the work they perform in many similar ways as their paid counterparts. Further research is recommended to increase understanding of the relationship that other demographics and factors may play in the depletion of resilience and development of burnout in related professionals.
5
To, Wing-chow Raphael. "Emergency ambulance service in Hong Kong : a study of continuity and change /." Hong Kong : University of Hong Kong, 1999. http://sunzi.lib.hku.hk/hkuto/record.jsp?B21037899.
6
Shakespeare-Finch, Jane E. "Posttraumatic growth in emergency ambulance personnel: The roles of personality and coping." Thesis, Queensland University of Technology, 2003. https://eprints.qut.edu.au/117969/1/36793_Digitised%20Thesis.pdf.
Анотація:
It is the contention of the thesis that the experience of work-related trauma in emergency service personnel (i.e., Ambulance Officers) has the potential to act as a catalyst for significant positive changes (posttraumatic growth [PTG]). The research provides insight into a number of areas including socio-structural, personality, and coping variables, that are apparently related to these perceptions of PTG. A series of four studies, utilising a mixed-method design, investigated the presence, correlates, predictors, and dimensions of posttraumatic growth, in samples of Queensland Ambulance Service (QAS) officers (N = 566).
The first study examined the prevalence of positive and negative post-trauma outcomes in the QAS, the co-variation of these outcomes, and the extent to which positive changes can occur following the expe1ience of a work-related traumatic event. Results from both cross-sectional (n = 526 'seasoned' officers) and longitudinal (n = 23 'new recruits') data, demonstrated the presence of PTO in the officers as well as the co-existence of positive and negative post-trauma perceptions.
Having established the presence and prevalence of PTG in the QAS, the second and third studies aimed to identify variables related to PTG. These studies used the sample of 'seasoned' officers in the examination of socio-structural, personality, and coping variables, and their relationship to PTG. In the second study, certain socio-structural variables were demonstrated to produce significant mean differences in levels of PTG (e.g., women reported higher levels of PTG than men). Further, significant positive relationships were found between PTG and higher levels of extraversion, openness to experience, agreeableness, conscientiousness, optimism, hope, self-efficacy, and coping resources.
In the third study, factor analytic techniques were used to ascertain dimensions of coping and growth in the seasoned officer sample. Study three findings supported the multi-dimensional nature of coping and PTG and also demonstrated significant relationships between the four factors extracted from the Coping Responses in Rescue Workers Inventory (CRRWI), with all three of the Posttraumatic Growth Inventory (PTGI) factors present in this population. Additionally, the results provided evidence for significant relationships between vaiious personality dispositions and particular dimensions of coping, and between personality dispositions and the dimensions of PTG.
The third study also included the development and testing of a model of PTG in the QAS. A second order factor analysis provided statistical support for coping and PTO to remain measurement constructs in the proposed model of growth. A series of regressions were conducted establishing that total coping levels mediated between personality dispositions and total PTO levels. Structural Equation Modelling (SEM) was then used to investigate the strength of relationships between variables and the hypothesised pathway from personality dispositions to PTO, mediated by levels of coping. Results supported a very good data fit. A multisample SEM was then conducted to test the data fit with two groups of QAS officers divided on the basis of their experiences of trauma. No differences were detected between groups, supporting the salience of relationships between personality dispositions, coping, and PTO.
The fourth study in the series further explored coping in the QAS using matched pairs data (n = 80: 40 'new recruits and 40 'seasoned' officers) and the longitudinal data set (n = 23). The frequency with which 'seasoned' ambulance officers and 'new recruits' to the service use various coping resources, were found to differ between. However, following the first 18 months of service, the distinction between seasoned officers and new recruit frequency of use of coping resources, was no longer evident.
The thesis results support previous research about PTO with direct survivors of a traumatic experience, and studies examining personality and coping variables in emergency service populations, that were conducted within a deprivation approach to trauma research. Results also support the theoretical frameworks that have proposed an indirect relationship between personality factors, through coping, to PTO. Contributions to knowledge and practical applications provide implications for education and training programs in emergency services.
7
Galeano, Richard. "Understanding the health of operational personnel in an ambulance service: A mixed methods study." Thesis, Queensland University of Technology, 2019. https://eprints.qut.edu.au/134241/2/Richard_Galeano_Thesis%5B1%5D.pdf.
Анотація:
This mixed methods study was designed to review the health of ambulance operational personnel and to better understand the complex relationship between the organisation of the work and the working and organisational environment in which the work is done. The study found that the physical and mental health of ambulance operational personnel is worse than the Australian population due to the interplay of long working hours, shift work and a perceived lack of support. Ambulance services need to take a lead role in designing health support approaches that may better protect the health and wellbeing of ambulance operational personnel.
8
Deverell, Sally. "The relationship between personality and coping in a pre-employment emergency service organisation context /." [St. Lucia, Qld.], 2005. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18871.pdf.
9
To, Wing-chow Raphael, and 杜榮洲. "Emergency ambulance service in Hong Kong: a study of continuity and change." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1999. http://hub.hku.hk/bib/B31966020.
10
Grosvold, Katarina. "Debriefing as a moderator of stress : a study on the association between debriefing and stress, within emergency service personnel." Thesis, University West, Department of Social and Behavioural Studies, 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-1335.
11
Libby, Nicholas. "FALLING DOWN: THE INFLUENCE OF TRAFFIC PATTERNS AND AVAILABILITY OF EMERGENCY MEDICAL SERVICE PERSONNEL ON THE LETHALITY OF VIOL." Master's thesis, University of Central Florida, 2006. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/3110.
Анотація:
This study investigates the impact of traffic patterns and the availability of emergency medical services on the lethality of violent interpersonal encounters. Key situational and contextual factors are controlled using the criminal events perspective. Data were taken from the 2002 National Incident-Based Reporting System of the FBI, as well as from fire/rescue and EMS services of Memphis, TN, Cincinnati, OH, and Richmond, VA. Additive models of logistic regression analysis revealed that fire/rescue availability, firearm use, incidents arising out of arguments, outdoor locations, and victim gender are the most consistent predictors of whether or not a violent incident will result in a homicide.M.A.
Department of Sociology
Sciences
Applied Sociology
12
Hayes, Jared, and n/a. "Reducing the impact of decision complexity in ambulance command and control." University of Otago. Department of Information Science, 2008. http://adt.otago.ac.nz./public/adt-NZDU20080404.160620.
Анотація:
The overriding goal of this work was to present information to ambulance command and control (AC2) operators in a manner that complemented their dispatchers decision making processes whilst minimising the effects of a number of identified complexities. It was theorised that presenting information in this manner would improve the decision making performance of the dispatchers. The initial stages of this work involved identifying the strategies that AC2 operators use when making decisions regarding the allocation of ambulances to emergency incidents and the complexities associated with these decisions. These strategies were identified after the analysis of interviews with AC2 operators using an interview approach called the Critical Decision Method. The subsequent analysis of the interview transcripts using an Emergent Themes Analysis provided a significant number of insights regarding the decision making processes of the operators and the information required to support these decisions. Of particular significance was the importance of situation awareness in the decision making process. For example, when dispatchers have a sound understanding of incidents and additional factors such as the ambulances under their control, the dispatch decision becomes less complicated.
To extend the understanding of the dispatcher�s work in the communication centres, a number of factors that could contribute to the complexity of the dispatch task were identified from an additional analysis of the interview transcripts. However it was not possible to establish from this the contribution of these factors to the perceived complexity encountered by the operators. To address this, a questionnaire was circulated requiring dispatchers to rate the contribution of a number of factors to the complexity of the dispatch task and the frequency that these factors occurred. The results showed that the most prevalent factors related to a number of the cognitive processes that the dispatchers performed to manage the dispatch task. Such processes included determining the resource most likely to arrive at the scene of an emergency incident the quickest. There were also differences in regard to which areas of the dispatch process the dispatchers in the two centres considered to be the most complex.
The final stage of this research was the design of a prototype interface that complemented the decision making strategies used by the dispatchers and addressed the identified complexities. At this stage the scope of the research was narrowed to focus primarily on the resource assessment and allocation phases of the dispatch process and several of the complexities associated with these. The prototype interface made use of a novel display technology that allowed the presentation of information across two overlapping LCD displays (referred to as a Multi Layered Display (MLD)). To test the effectiveness of this display a laboratory experiment was conducted comparing the perfomance of participants using the MLD with participants using a Single Layered Display (SLD) that presented the same information. The results indicated that in almost all cases the participants using the multi layer display performed better. However these differences did not prove to be significant.
13
Brereton, John. "An evaluation of introducing advanced airway skills in the Western Australian Ambulance Service." University of Western Australia. Emergency Medicine Discipline Group, 2004. http://theses.library.uwa.edu.au/adt-WU2005.0065.
Анотація:
[Truncated abstract] Objective: To investigate the demographics, success rate of application, nature and frequency of complication and the survival outcome of patients receiving advanced airway management in the pre-hospital setting. Design: Prospective observational cohort study. Participants: Patients who were attended to by St. John Ambulance Paramedics in the Perth Metropolitan area and selected regional areas within Western Australia. The patients were unconscious, unresponsive with no gag reflex and where application of an advanced airway would improve ventilation. Methods: Ambulance Paramedics received mannequin training within the classroom environment on the techniques for the application of the Endo-Tracheal Tube and the Laryngeal Mask Airway. The indication for the application of an advanced airway was any patient whose ventilation may be improved by intubation. These patients would be either deeply unconscious and areflexic, long term transport, severely injured (especially head injured) or cardiac arrest patients. Results: ... Paramedic assessment demonstrated that 14 (7.4%) 3 patients had an improvement in outcome. Of the 14 patients, 5 (2.7%) cardiac arrest patients survived to discharge from hospital compared to a 2.1 % survival rate for all cardiac arrest cases attended by the WAAS in 2002. Conclusion: Ambulance Paramedics can successfully apply an advanced airway apparatus in the pre-hospital environment. There was no statistical significance to demonstrate whether the introduction of advanced airway skills was beneficial or detrimental to patient survival outcome.
14
Ringnell, Katarina, and Britt-Louice Vince. "Vårdpersonalens attityder till och erfarenheter om personer med psykisk ohälsa inom akutsjukvård : en litteraturöversikt." Thesis, Sophiahemmet Högskola, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-2638.
Анотація:
Psykisk ohälsa är utbrett inom samhället och riskerar att påverka individers hälsolitteracitet negativt. Samsjukligheten för psykisk ohälsa är hög och personer med psykisk ohälsa löper stor risk att drabbas av andra sjukdomar. För att kunna ge personcentrerad vård krävs att vårdpersonal synliggör och tillgodoser psykiska behov i lika hög utsträckning som fysiska. Situationen inom akutsjukvården är ansträngd och en stor del av patienters klagomål som anmäls handlar om bristande kommunikation. Trots att personer med psykisk ohälsa har rätt till jämlik vård ses förbättringsbehov inom somatisk vård.Syftet var att beskriva vårdpersonalens attityder och erfarenheter avseende personer med psykisk ohälsa inom akutsjukvård. Metoden var en litteraturöversikt och genomfördes med hjälp av databassökningar i PubMed, Cinahl och PsycINFO samt manuell sökning. Sjutton kvalitativa och kvantitativa vetenskapliga originalartiklar inkluderades i litteraturöversikten. Resultatet visade att vårdpersonalens attityder gentemot personer med psykisk ohälsa var negativ inom akutsjukvård. Attityderna varierade beroende på vilket psykiskt ohälsotillstånd som åsyftades. Attityder till att personer med psykisk ohälsa inte hörde hemma inom akutsjukvård förekom och uppfattningen om att personer med psykisk ohälsa fick sämre vård jämfört med andra patienter lyftes fram. Vårdpersonal upplevde att attityder till personer med psykisk ohälsa hade förbättrats över tid men att stigmatisering fortfarande existerade. Erfarenheter och upplevelser som framkom i resultatet var bristande kompetens i form av okunskap om psykisk ohälsa och oförmåga att kunna ge likvärdig vård och omvårdnad till personer med psykisk ohälsa. Arbetsmiljö och arbetsbelastning var framträdande faktorer i vårdpersonalens erfarenheter och upplevelser om personer med psykisk ohälsa. Tidspress och personalbrist framhävdes som orsaker som påverkade vården av personer med psykisk ohälsa negativt, liksom bristfälliga lokaler. Känslor som frustration, rädsla och oro beskrevs av vårdpersonal. Kommunikation med personer med psykisk ohälsa ansågs nödvändig men svår med tanke på olika tillstånd av psykisk ohälsa. Utbildning i psykisk ohälsa efterlystes av vårdpersonalen. Slutsatsen var att på grund av vårdpersonalens negativa attityder till personer med psykisk ohälsa finns det anledning att utveckla medvetenheten och kunskap kring psykisk ohälsa för att kunna utveckla vård och omvårdnad inom akutsjukvård.Mental illness is widespread in society and could affect individuals mental health literacy negative. The co-morbidity of mental disorders is high, and people with mental illness are likely to suffer from other diseases. In order to provide person-centered care requires health professionals identifies and meet the psychological needs to the same extent as physical. The situation in emergency care is strained and a large part of the patients' complaints are notified about a lack of communication. Despite the fact that people with mental illness have the right to equal care a need for improvement is seenin somatic care. The aim was to describe the health professionals' attitudes and experiences regarding persons with mental illness in emergency care. The method was in form of literature review and was carried out with database searches in PubMed, Cinahl and PsycINFO and manual. Seventeen qualitative and quantitative scientific original articles were included. The results showed that the nursing staff attitudes towards people with mental illness were negative in emergency care. Attitudes varied depending on the mental illness as alluded. Attitudes towards people with mental illness do not belong in emergency care occurred, and the perception that people with mental illness got not as goodcare than other patients was highlighted. Health professionals felt thatthe attitudes to people with mental health had improved over time but that stigma still existed. Experiences that emerged in the result was a lack of expertise in the form of ignorance about mental illness and the inability to provide equal care and nursing for people with mental illness. Time for caringand workload were prominent factors in health professionals' experiences and perceptions of taking careof people with mental illness. Time pressure and staff shortages were highlighted as factors that affectedthe care of people with mental health negatively, as well as flawed premises. Emotions like frustration, fear and anxiety was described by health professionals. Communication with people with mental illness was considered necessary but difficult given the various states of mental illness. Training in mental health was wishedby the health professionals. The conclusion showed that because of the health professionals' negative attitudes towards people with mental illness, it is necessary to develop awareness and knowledge about mental health to develop health care and nursing in emergency care.
15
Ohara, Renato. "Caracterização do perfil assistencial dos pacientes adultos de um pronto-socorro." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-07102009-144258/.
Анотація:
O pronto socorro é uma unidade do hospital destinada à assistência a pacientes externos com ou sem risco de morte, que necessitam de atendimento imediato, cujo funcionamento se dá nas 24 horas do dia sendo fundamental a determinação do número necessário de profissionais de enfermagem para prestar assistência com qualidade satisfatória, pois a falta de profissionais de enfermagem com diferentes níveis de formação e a sobrecarga de trabalho aumentam o risco de ocorrência de falhas com prejuízo da qualidade na assistência ao paciente. Os instrumentos de classificação de pacientes são utilizados pela enfermagem em qualquer unidade assistencial e estabelecem as características da população assistida de acordo com a necessidade de cuidados requerida, sendo indispensável para a determinação das necessidades de pessoal e alocação quantitativa e qualitativa dos mesmos. Com o objetivo de caracterizar o perfil assistencial dos pacientes adultos durante a internação no pronto-socorro como um dos subsídios para o dimensionamento do pessoal de enfermagem desenvolveu-se uma pesquisa exploratória no método do estudo de caso, em um pronto-socorro, clínico e cirúrgico, de um hospital geral, público estadual que possui 24 leitos de observação e dez leitos na unidade de atendimento de emergências, localizado no extremo leste do município de São Paulo que trabalha com demanda espontânea do usuário. Os sujeitos da pesquisa foram os pacientes adultos internados na unidade de emergência e nas salas de observação durante o mês de janeiro de 2009, os dados foram coletados por meio da aplicação do instrumento de classificação de pacientes de Fugulin (2002) que avalia nove áreas de cuidado (Estado mental, Oxigenação, Sinais Vitais, Motilidade, Deambulação, Alimentação, Cuidado Corporal, Eliminação e Terapêutica). Foram realizadas 1.228 avaliações, sendo verificados 91 pacientes na categoria de cuidados intensivos, 75 na categoria de cuidados semi-intensivos, 245 com alta dependência para assistência de enfermagem, 272 com complexidade assistencial intermediária e 545 com a mínima. Houve a constatação de muitos pacientes da psiquiatria internados no pronto-socorro a espera de vagas para internação na unidade especializada requerendo da equipe de enfermagem uma assistência diferenciada para a manutenção da integridade física desses pacientes. Verificou-se por meio do número médio mensal de atendimentos realizados que a maioria dos usuários do pronto-socorro não necessitava de internação mas foram atraídos para esse serviço em busca de consultas de rotina acabando por sobrecarregar a equipe multiprofissional que atua nessa unidade que apresentou uma taxa de ocupação média acima da previsão dos leitos oficiais disponíveis tornando a planta física inadequada para pacientes e profissionais devido às internações em macas pelos corredores, reflexo da falta de um serviço de regulação.The emergency medical service is the hospital ward designated to outpatient care with or without death risk for those who need immediate care, whose attendance is 24 hours a day, being essential the determination of a required number of nursing professionals for delivering satisfactory quality care, since the lack of nursing professionals with different levels of background and work overload increase the risk of errors, impairing the quality of patient care. The instruments of patient classification are used by nursing in any care ward and set up the characteristics of the population assisted, according to the need of care required, being vital for determining the personnel needs and its quantitative and qualitative allocation. Aiming to characterize the adult patient care profile throughout the admission at the emergency medical service, as a support for nursing personnel dimensioning, it was developed an exploratory research in a study of case method, at a clinic and surgical emergency room of a general, public state hospital that holds 24 observation beds and 10 beds at the emergency attendance ward, located at the extreme east of São Paulo city and which works with spontaneous demand of users. The subjects of research were adult patients admitted at the emergency ward and the observation rooms throughout the month of January, 2009. Data was collected through the application of an instrument of patient classification by Fugulin (2002), which evaluates nine care areas (Mental Status, Oxygenation, Vital Signs, Motility, walking, Feeding, Body Care, Elimination and Therapeutics). It was made 1228 evaluations, in which 91 patients in the intensive care category were verified, 75 in the semiintensive care, 245 with high dependence of nursing care, 272 with intermediate care complexity and 545 with minimal one. There was the evidence of many psychiatric patients admitted in the emergency room waiting for a vacancy in the specialized ward requiring from the nursing staff special care for keeping the physical integrity of those patients. It was verified by the monthly average number of attendance that most emergency room users didnt need admission, but they were attracted to this service in search for routine appointments, leading to overload the multi-professional team that works in this ward, which presented an average occupancy rate above the prediction of official beds available, making the physical space inadequate for patients and professionals, due to the admissions in beds spread in corridors, result of lack of service control.
16
McKenna, Wayne J. "Fatigue, ambulance perspectives in a comparative study between air and road transports." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2002. https://ro.ecu.edu.au/theses/727.
Анотація:
The study of fatigue in the health and transport sectors has predominantly been focused on night shift or day shift operations. This study has been applied to the hours of operation of Ambulance Officers who perform both night and day shifts, while also being required for on-call. The Officer on-call is on stand-by between shifts, to be available to respond for duties from the completion of one shift until the commencement of the next, usually a ten-hour shift. Studies of a similar focus have not been identified so a comparison of these specific findings has not been possible. However trends in sleep debt, peaks in the drive for sleep and recognition of fatigue are consistent with findings of other studies. The initial impetus for the study, to compare the degree of fatigue between air and road long distance transports, provided no significant output. The data collected did however provide clear identification of the various precipitators of fatigue in the Ambulance Officers workplace. To adequately address the hazard of fatigue, the introduction of integrated systems that address sleep deprivation and circadian cycles are required to aid in managing fatigue. The identification and control of fatigue in the workplace is to the benefit of both the employer and the employee. The study consists of fourteen Ambulance Officers utilising both road and helicopter transport mechanisms to undertake transfers to major medical facilities. The Officers were required to answer questionnaires at the completion of each shift to record the precipitators and indicators of fatigue. Findings indicate there is no significant difference between the levels of fatigue induced by air or road transport. The influences of the time of day and the degree of sleep deprivation are however indicative of fatigue in the individual. Day shifts accounted for 70% of data collected with results of fatigue as more prevalent in the 1501-1800 hours period, coinciding with a trough in performance and alertness. Their adherence to non-performance indicators suggests an unwillingness to identify anomalies in their performance or an inability to self-determine a level of fatigue. Performance of duty during "on-call periods" induces sleep deprivation that may develop into a sleep debt if the restorative sleep is not obtained. Individuals generally function for 16-hollrs and sleep for 8-hours, to replenish the organism. When this ratio is redistributed the individual develops a sleep debt and left unaddressed develops into fatigue. Performance of long distance transports and reliance on on-call officers removes their ability to address their sleep debt. The introduction of rescheduling of transports and fatigue breaks reduces the influence of fatigue in the Ambulance Officers workplace. The magnitude of fatigue is only evident when the consequences are realised. Officers performing transfers on empty expressways can wander on the lanes with only a fright to remember the experience. However a patient, of the belief that they are safe when in an Ambulance, will have more to remember if the expressway has a car in the other lane. Fatigue is evident in the Ambulance Officers workplace and remedies to address it, which incorporate a Safety Management System, have been outlined in the recommendations of the study.
17
Wheater, Kerry Lee. "Spouses’ experience of secondary trauma among emergency services personnel." University of the Western Cape, 2016. http://hdl.handle.net/11394/5004.
Анотація:
Magister Artium (Social Work) - MA(SW)Emergency services personnel are potentially exposed to events involving trauma, suffering and tragedy on a daily basis, which could consequently lead to secondary trauma and post- traumatic stress symptoms. The images and feelings that are associated with continuously being exposed to traumatic situations are not limited to the emergency services personnel, who are primarily exposed to the event, but these events can also have an effect on the significant others in their environment, such as their spouses. The aim of this study was to explore and describe the experiences of secondary trauma among the spouses of emergency services personnel. The research study followed a qualitative research approach, which provided in-depth descriptions and understandings of the participants’ secondary trauma experiences. The research design was explorative and descriptive in nature. Purposive sampling was used to select eight (8) participants, who were the spouses of emergency services personnel. The data was collected by means of semi-structured individual interviews and was analysed according to Creswell. Various research findings indicated that secondary trauma was prevalent in the emergency services industry and, in this current study, most participants indicated that it impacted their marital relationships. The experiences of secondary trauma among the spouses of emergency services personnel stemmed from their partners’ repeated exposure to trauma, managing everyday job stress, safety fears, behavioural changes, dealing with their partners’ emotional reactivity and emotional withdrawal from the family, following trauma exposure. Based on some of the suggestions provided by all the participants, the researcher concluded the study with recommendations for future practice and future research, the main recommendation being that organisational support systems be made available to spouses and families of emergency services personnel.
18
Millar, Bernadette Theresa. "Becoming and being: a critical realist study into the emergence of identity in emergency medical science students, and the construct of graduate attributes." Thesis, Rhodes University, 2014. http://hdl.handle.net/10962/d1013175.
Анотація:
This critical realist thesis seeks to understand how student, graduate and professional identities emerge in Emergency Medical Science (EMS) students at a South African University of Technology (UoT) as well as in professional paramedics in the Emergency Medical Care Services (EMCS). It further considers the construct of graduate attributes (GAs) and its relationship to emergence of identity and influence on curriculum design. The research design is that of a case study. The theoretical framework is critical realism whose depth ontology posits three domains of reality. Causal powers and generative mechanisms exist in the Real domain which cause events or phenomena to emerge in the Actual domain that are experienced in the Empirical domain. Using retroduction one may come to explore some of the causes for the event. Using Bhaskar’s concepts of identity, the self, absence and emergence, ontology and four-planar social being, a Bhaskarian explanatory framework of identity to explore the emergence of identity has been created. In exploring graduate attributes, a critical realist question is posed: “What must the world be like for GAs to exist” to explore the possibilities of the existence of GAs. It was found that student identity emerges diachronically in three moments, while professional paramedic identity starts to emerge during the third year of study mainly through the structure, culture and agency of workplace-based learning. In answer to the critical realist question it was found that GAs emerge from the neoliberalist commodification of universities. In seeking an alternative to GAs, traits and attitudes were explored. It was found that these emerge from curriculum, interplay of departmental structure, culture and agency of and from students’ being which makes them ontologically radically different from GAs. This study concludes that student, graduate and professional identities emerge from a person’s core constellational identity diachronically within four-planar social being and the interplay of structure, culture and agency. GAs cannot be related to the emergence of identity and curriculum design because of their ontology; however, if traits and attitudes are substituted for GAs, a close relationship does exist between emergence of identity, traits and attitudes and curriculum design.
19
Carlson, Greg P. "Hostile workplace violence directed toward rural emergency medical services (EMS) personnel /." Menomonie, WI : University of Wisconsin--Stout, 2007. http://www.uwstout.edu/lib/thesis/2007/2007carlsong.pdf.
20
Shum, Kwok-leung, and 沈國良. "The relationship between management and staff in the Fire Services Department: the case of the ambulancemen." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1997. http://hub.hku.hk/bib/B31965635.
21
Jackson, Aaron Hugh. "The impact of cognitive development on compassion fatigue in emergency response personnel." W&M ScholarWorks, 2004. https://scholarworks.wm.edu/etd/1550154098.
22
Shum, Kwok-leung. "The relationship between management and staff in the Fire Services Department : the case of the ambulancemen /." Hong Kong : University of Hong Kong, 1997. http://sunzi.lib.hku.hk/hkuto/record.jsp?B18596824.
23
Snyder, Hal Steven 1959. "AN EVALUATION OF COUNSELING SERVICES FOR FIRE DEPARTMENT PERSONNEL." Thesis, The University of Arizona, 1986. http://hdl.handle.net/10150/276426.
24
McLernon, Michelle Yvonne. "Risk Propensity, Self-Efficacy and Driving Behaviors Among Rural, Off-Duty Emergency Services Personnel." OpenSIUC, 2014. https://opensiuc.lib.siu.edu/dissertations/837.
Анотація:
Emergency medical services personnel work in a fast-paced, stressful environment requiring rapid, efficient response to critical situations, creating unique safety considerations within the workforce. With an occupational fatality rate notably higher than average, most of which are attributed to vehicular crashes, compounded by risks faced on rural roadways, rural EMS personnel face unique driving challenges that may be exacerbated by the very traits, self-efficacy and risk propensity, that may have initially drawn them to the profession. The purpose of this study was to identify the extent to which rural EMS personnel engage in off-duty, risky driving behaviors and to examine the relationship between these behaviors and their levels of risk propensity as well as their self-efficacy relative to driving. A cross-sectional, quantitative study was conducted to explore the relationship between the variables. A 63-item survey was completed by 227 rural EMS personnel. The statistical model resulting from this study identifies risky-driving self-efficacy and risk propensity as significant predictors of engaging in risky driving behaviors, with self-efficacy emerging as the strongest predictor. The predictive model fit well within the Social Cognitive Theory construct of triadic reciprocity, providing a platform from which to develop mitigating strategies to foster systemic as well as behavioral changes, while tailoring interventions to highly self-efficacious, risk-taking individuals who gravitate toward risky professions, including rural EMS personnel.
25
Siu, Jennifer C. W. "Screening for psychological adjustment in emergency services job candidates / Jennifer C. W. Siu." [St. Lucia, Qld.], 2005. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18461.pdf.
26
Bosman, Justice Selvyn. "Principles of physics implicit in emergency medical rescue education and operational practice: a case study of motor vehicle related rescue." Thesis, Cape Peninsula University of Technology, 2019. http://hdl.handle.net/20.500.11838/2967.
Анотація:
Thesis (Master of Emergency Medical Care (MEMC))--Cape Peninsula University of Technology, 2019Introduction: Road traffic injuries are the ninth leading cause of death globally. Projections indicate that without new and sustained commitment globally to preventing such injuries, the situation will only worsen. Motor vehicle rescue does not lend itself to the prevention of road traffic incidents but through ensuring that all incidents are managed using sound evidence could contribute in positive outcomes for victims. It is unknown what contribution rescue education makes to the body of medical rescue knowledge in South Africa. Aims: The aim of this research was to investigate the relevance and scope of the principles of physics within medical rescue specifically in the context of motor vehicle rescue. It appears that current traditional methods of presenting rescue training, which is mainly procedural and technical, may contribute to 'segmented' learning. Research Methodology: Using an interpretive research design, multiple qualitative methodologies were employed. This methodological triangulation was intended to improve construct validity and trustworthiness of findings. A modified Delphi process through which questionnaires was repeatedly distributed to rescue experts was employed. Process tracing was used to evaluate the developed typical motor vehicle rescue case scenario narrative for underpinnings of the principles of physics. The Bachelor Emergency Medical Care Physics and Extrication subject guides was evaluated for its educational alignment during the document analysis. Legitimation Code theory as a theoretical framework was utilised to appraise the knowledge gap. Results & Discussion: Motor vehicle rescue incident may not always present in a similar manner due to various factors and influences. Development of the typical motor vehicle case narrative from which its physics principles could be identified was imperative. Most motor vehicle rescue related training occur with the vehicle in the upright orientation on all four wheels. This manner of frequent training may restrict rescue practitioners from moving beyond their 'typical' training knowledge when the situation presents a typical. The thematic document analysis of the BEMC Physics and Extrication subject guides lacked the necessary coherence which is required for a professional degree. It was deemed void of certain threshold concepts and structure which would allow the student to move between the theoretical and contextual knowledge. Motor vehicle rescue subject guides and most textbooks on the topic leaned towards a procedural and very technically detailed pedagogy, to the extent that it could contribute to segmented learning. Conclusion: Developing curricula that is underpinned by a theoretically sound evidence base would promote credibility of a qualification. Curricula by design inform the teaching, learning and the competencies which would ultimately be assessed. Professional degrees are intended to develop practitioners who would graduate with the knowledge and competencies to adapt to situations. In addition, graduate attributes of lifelong learning, reflective practice and the ability to contribute to the development of new knowledge is secondary to the goal of qualification attainment.
27
Woods, Ginger Lee. "Post Traumatic Stress Symptoms and Critical Incident Stress Debriefing (CISD) in Emergency Medical Services (EMS) Personnel." Digital Commons @ East Tennessee State University, 2007. https://dc.etsu.edu/etd/2035.
Анотація:
EMS personnel were examined for Post Traumatic Stress symptoms and the usefulness of Critical Incident Stress Debriefing (CISD) using the Los Angeles Symptom Checklist (LASC) and a demographics questionnaire. This study revealed that women in this group show higher PTSD symptoms than male coworkers. Level of Training (LOT) of the EMS provider did not demonstrate a significant difference in whether a provider developed PTSD. EMS personnel receiving debriefing actually suffered greater levels of PTSD than those that did not receive debriefing. And 16% of EMS providers in this study suffered from PTSD, while approximately 20% suffered from partial PTSD or PTSS. The results suggest that there are high levels of PTSD within the EMS community, especially in women. This study also suggests that CISD does not help with PTSD symptoms and may actually worsen them.
28
Kisthardt, Adam M. "Selecting hostage negotiators for the Pennsylvania State Police Special Emergency Response Team an examination of methods of personnel selection /." Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only. Instructions for remote access, 2000. http://www.kutztown.edu/library/services/remote_access.asp.
Анотація:
Thesis (M.P.A.)--Kutztown University of Pennsylvania, 2000.Source: Masters Abstracts International, Volume: 45-06, page: 2946. Typescript. Abstract precedes thesis as, preliminary leaves [2-3]. Includes bibliographical references (leaves 89-90).
29
Cash, Rebecca E. "Sleep, Stress, and Ideal Cardiovascular Health: Prevalence and Associations among Emergency Medical Services Personnel and US Adults." The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1574690546135181.
30
Boldt, Faith Joy. "The Relationship between Personal Factors, Work Factors, PTSD, and Suicide Ideation in Emergency Medical Service Providers." TopSCHOLAR®, 2016. http://digitalcommons.wku.edu/theses/1625.
Анотація:
EMS providers work in a high-stress environment and are routinely exposed to critical incidents. Many providers are left to deal with the chronic stress on their own, either because of lack of effective employer-based programs or a culture that discourages its use. The extent to which these factors -- as well as personal characteristics such as resilience, PTG, and coping skills -- influence PTSD and suicide ideation among EMS providers has not been well studied among EMS providers. An online survey was administered to a convenience sample of EMS providers. Of the 2,683 respondents, more than one quarter (27.7%) met the PTSD criteria of 50 or higher on the PCL-M. Close to half of the respondents (42.0%) reported having contemplated suicide in the last six months. Of those who had contemplated suicide in the last 30 days, nearly one third (27.1%) thought about suicide 10 or more days in the last 30 days. EMS culture and resilience were negatively associated with PTSD, while positive associations were found with some coping styles. PTSD scores and suicide ideation frequency were highest when post-incident services were not available in the workplace. No significant relationships were found between personal factors and suicide ideation.
31
Van, Tonder Bernardus Hermanus. "An investigation into the validity and reliability of an instrument for the assessment of clinical performance during work integrated learning of emergency medical care students at the University of Johannesburg." Thesis, Cape Peninsula University of Technology, 2016. http://hdl.handle.net/20.500.11838/2610.
Анотація:
Thesis (MTech (Emergency Medical Care))--Cape Peninsula University of Technology, 2016.Background - As emergency medical care students approach the exit level of their four-year qualification, additional focus get placed on assessment of their ability provide patient care in the real world pre-hospital emergency care environment. Upon graduation, there is no opportunity for newly graduated emergency care practitioners to complete an internship programme. The assessment of clinical competence is therefore regarded as a critically important and invaluable activity within the academic unit. Academic staff within the Emergency Medical Care department at UJ recognised the need for the development of a standardised assessment instrument to purposefully assess pre-hospital clinical performance and developed an assessment instrument referred to as the University of Johannesburg Clinical Performance Assessment Instrument (UJ CPAI). Having developed the UJ CPAI it became necessary and important to scientifically investigate and evaluate the extent to which the CPAI (as a newly developed instrument) meets the requirements of what is considered to be a "good assessment instrument". For this reason investigation of the validity, reliability and end-user support for the implementation of the UJ CPAI became the central aim and focus of this study.
32
Mcguire-Wolfe, Christine Michelle. "Practices and Factors Influencing Sharps Use and Safety in a Suburban FIre Department and Among Emergency Medical Services Personnel." Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4541.
Анотація:
Needlestick injuries (NSIs) are a recognized risk for occupationally-related transmission of bloodborne pathogens (BBP). The occurrence of NSIs and BBP exposures among firefighters (FFs) and emergency medical services (EMS) personnel has been documented.
The purposes of this study were: 1) to define the problem of NSI among FFs and EMS personnel in a suburban fire department (FD) and identify practices and factors that influence sharps use and safety; 2) design and implement and intervention to promote safer sharps device usage; and 3) to measure the effectiveness of the intervention among FFs and EMS personnel.
A multi-phase, mixed methods approach was used that included a diagnosis phase that utilized a mixed methods exploratory design, an intervention period, and a quantitative evaluation phase that used a before and after evaluation design. In the diagnosis phase, data regarding sharps device practices were obtained through a count of discarded sharps devices. Qualitative data regarding sharps practices and factors which influenced those practice were obtained via focus groups. The PRECEDE/PROCEED model (PPM) was used as the theoretical framework for assessment, planning, implementation, and evaluation of an intervention to increase the occurrence of safer sharps device behaviors and decrease the frequency of riskier sharps device behaviors. The evaluation phase included a post-intervention sharps count and a post-intervention survey to assess changes in sharps practices and the impact of the intervention.
During the baseline sharps count, 2743 sharps devices were counted and classified according to pre-established categories of safer or risky behaviors for NSI. Altered safety devices on IV stylets were the highest count for unsafe behaviors (n=105), followed by recapped traditional needles (n= 53). A statistically significant increase in risky behaviors was observed in discarded sharps from engines, as opposed to ambulances, among all sharps devices combined (p=0.000) and IV stylets (p=0.000). When comparing advanced life support (ALS) medications to all other medications, a statistically significant increase in unsafe behaviors occurred among all sharps devices combined (p=0.000) and prefilled syringes (p=0.000). Input from eight focus groups of firefighters allowed for identification of multiple themes which guided the development of an intervention.
The intervention included distribution of a hands-on training kit and booklet, expansion of an existing required BBP training, and posters to increase awareness regarding NSI prevention.
In the evaluation phase, a total of 2178 sharps devices were counted and classified in a post-intervention sharps count. Altered safety devices on IV stylets were the highest count of unsafe behaviors (n=50). Recapped traditional needles were the second highest count of unsafe behaviors (n=27), but experienced an 18.7% drop in frequency when compared to baseline. When comparing riskier behaviors to the pre-intervention baseline sharps count, statistically significant decreases in risky behaviors were observed in all sharps devices combined ( 2=25.71, p=0.000), IV stylets (2=16.87, p=0.000), and traditional needles (=5.07, p=0.024).
A post-intervention survey, consisting of 15 Likert scale questions, was returned by 165 out of 383 active field personnel (41.3%). Results indicated high frequencies of strongly agree and somewhat agree responses regarding risk perception; the importance of using safer needle devices; the impact of the intervention on safer needle practices and sharps safety awareness.
Critical predisposing, reinforcing, enabling, and environmental factors which influenced sharps device practices were identified. This study identified factors and practices which influenced unsafe sharps device behaviors. Due to the statistically significant decreases in risky behavior in the post-intervention sharps count and the positive responses in the post-intervention survey, it can be concluded that the intervention did positively impact sharps device behavior and reduced the risk of NSI. The implications of the study are numerous and include a need to explore these practices and factors at other fire departments and EMS agencies, address gaps in regulations; promote research targeting FFs and EMS personnel in regard to NSI, and promote a nationwide effort to prevent NSI among emergency responders.
33
Behnke, Alexander [Verfasser]. "Psychotraumatic Stress Among Emergency Medical Services Personnel: Its Psychological and Biological Correlates and Implications for Health Management / Alexander Behnke." Ulm : Universität Ulm, 2021. http://d-nb.info/1238147623/34.
34
Henkin, S. M. M. (Stephen Maurice Michael). "Personal scorecards : a performance management model for aligning personal goals and objectives to organisational strategy within the Cape Town Fire and Emergency Service." Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/52995.
Анотація:
Thesis (MPA)--University of Stellenbosch, 2002.ENGLISH ABSTRACT: The City of Cape Town has adopted the Balanced Scorecard as an organisational performance management system. Presently the system has only been implemented as a pilot project in the top three management levels of the organisation. The question then becomes one of how can individual obj ectives be aligned with the organisation's strategic objectives in this scenario. The purpose of this research is to propose a performance management model based on the Balanced Scorecard that aligns individual goals and objectives to those of the organisation. The study is in the form of a case study and specifically applies to the City of Cape Town Fire and Emergency Service. The foundation of the research is based on the creation of a sound theoretical base relating to organisational and individual performance management and the Balanced Scorecard. Once this understanding has been created the next step is to describe the development and implementation of the Balanced Scorecard project within the Cape Town context. This is the point of departure for the proposal of a Personal Scorecard performance management model. Data is to be collected via a process of semi-structured interviews and questionnaires. The information gained during the interviews created the framework within which the Personal Scorecard model was proposed. The questionnaire was used to pilot the main component of the Personal Scorecard model, namely the objective setting process. This created an opportunity to test the hypotheses made as the Personal Scorecard was developed. Once all of the components have been combined into the performance management model this research will be concluded with the presentation of recommendations relating to the knowledge gained during the model development process and alternative applications for the Personal Scorecard will be discussed.
AFRIKAANSE OPSOMMING: Die Stad Kaapstad het die "Balanced Scorecard" as 'n organisasie prestasie bestuursmeganisme aanvaar. Huidiglik is die meganisme net in die boonste drie bestuurs vlakke van die organisasie in gebruik geneem. Die kwessie wat geantwoord moet word is hoe individuele doelwitte met die van die organisasie versoen kan word in hierdie spesifieke scenario. Die doel van hierdie navorsing is om n prestasie bestuursmodel voor te stel wat op die "Balanced Scorecard" gebaseer is en individuele doelwitte met die van die organisasie versoen. Hierdie studie neem die vorm van 'n gevallestudie en is spesifiek gerig op die Stad Kaapstad Brand and Nooddienste. Die fondament van hierdie navorsing is gebaseer op die skepping van 'n sterk teoretiese basis met verband tot organisasie- en individuele prestasie bestuur en die "Balanced Scorecard". Die volgende stap is om die Balanced Scorecard ontwikkeling en uitvoering projek van die Stad te beskryf. Hierdie word die vertrekpunt vir die voorgestelde "Personal Scorecard" prestasie bestuursmodel. Data word versamel deur middel van semi-gestruktureerde onderhoude en vraelyste. Die inligting wat gedurende die onderhoude vesamel is het die raamwerk geskep waarin die "Personal Scorecard" voorgestel is. Die vraelyste is gebruik om die hoof bestanddeel van die "Personal Scorecard" model te loods namelik die doelwitstellendemeganisme. Hierdie proses het die geleentheid geskep om die hipotese wat gedurende die ontwikeling van die "Personal Scorecard" gemaak is, te toets. Na hierdie komponente gëintegreer is binne die prestasie bestuursmodel sal die navorsing afgesluit word met aanbevelings gebaseer op die kennis wat gedurende die modelontwikkeling proses versamel is en alternatiewe gebruike vir die "Personal Scorecard" sal bespreek word.
35
Norling, Lisa, and Helena Hansen. "Sjuksköterskors upplevelse av mötet med personer som är påverkade av alkohol och droger på en akutmottagning." Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-8694.
Анотація:
Syftet med studien var att belysa hur sjuksköterskor som arbetar på en akutmottagning upplever mötet med patienter som är påverkade av alkohol och droger. En kvalitativ intervjustudie med semistrukturerad intervjuguide genomfördes. Materialet transkriberades och analyserades genom kvalitativ innehållsanalys. Sju sjuksköterskor som arbetar på en akutmottagning i Mellansverige deltog i studien. Det framkom att informanterna känner empati för påverkade patienter vilka samtidigt beskrivs som opålitliga. Sjuksköterskorna är på sin vakt då patienterna snabbt kan bli aggressiva och hotfulla om de upplever sig bli provocerade. Sjuksköterskorna behöver ibland värja sig mot påverkade patienter som utsätter dem för oönskad fysisk kontakt och de upplever det som en trygghet att ta hjälp av väktare eller polis vid behov. Känslor som osäkerhet, frustration, irritation, olust och ilska väcks hos sjuksköterskorna i mötet med patientgruppen men de eftersträvar att bemöta alla lika. Trots detta uppges påverkade patienter behandlas annorlunda, prioriteras lägre och tas inte riktigt på allvar. Trots att sjuksköterskorna upplever att påverkade patienter är oberäkneliga och framkallar osäkerhetskänslor känner de empati för dessa individer. Ett professionellt bemötande eftersträvas men trots det antyds att toleransen är låg gentemot påverkade patienter. Vidare utbildning välkomnas och tros kunna bidra till bättre omvårdnad av en komplex patientgrupp.The aim of this study was to illustrate how nurses working in an emergency department experience meeting with patients under the influence of alcohol and drugs. A qualitative study was undertaken with a semi-structured interview guide. Data was transcribed and analyzed by qualitative content analysis. Seven nurses who work in an emergency department in central Sweden participated in the study. It was found that nurses feel empathy for patients under the influence of substances, although they also described them as unreliable. Several nurses described themselves as being on guard as patients can become aggressive and threatening, and that situations can quickly turn when the patients perceive themselves to be provoked. When nurses are exposed to unwanted physical contact they sometimes need to defend themselves. When it is warranted, the help of security or the police can offer some degree of comfort. The nurses are experiencing feelings of insecurity, frustration, irritation, unease and anger in the encounter with this group of patients, but retain their professionalism and strive to treat everyone equally. Despite this it is indicated that patients under the influence of substances are treated differently from other patients, are a lower priority and are not taken as seriously. Although patients under the influence of substances may appear volatile and threatening nurses feel much empathy. A professional approach is sought but despite that it is suggested that the tolerance is low in relation to patients under the influence of substances. Further education is welcomed and is believed to contribute to better care for a complex population of patients.
36
Chavez, Huertas Jully Carolina. "Revisión crítica : participación del personal de enfermería en el triaje intrahospitalario en el servicio de emergencias." Bachelor's thesis, Universidad Católica Santo Toribio de Mogrovejo, 2017. http://tesis.usat.edu.pe/handle/usat/977.
Анотація:
Para la organización de los servicios de urgencias, es necesario contar con personal capacitado para realizar una evaluación inicial de pacientes teniendo como finalidad clasificar de alguna manera, procurando un acceso rápido, ordenado y dirigido atendiendo con prioridad a los pacientes con mayor gravedad, ese personal podría ser el personal de enfermería. Por la que surge una inquietud de realizar una investigación de revisión crítica ,con un nivel de evidencia II y su grado de recomendación es B ya que el nivel de evidencia alcanzado muestra opiniones basadas en experiencias clínicas, estudios descriptivos, observaciones clínicas y su grado de recomendación presenta buena evidencia de que la medida es eficaz y los beneficios superan ampliamente a los perjuicios y porque cumple con los parámetros dentro de lo establecido para que sea una investigación bien sustentada y porque menciona el respaldo del comité de ética. Para revisar este trabajo se ha utilizado como metodología la Enfermería Basada en Evidencia (EBE), esta metodología nos lleva a la práctica diaria en la cual encontramos algunas veces esta problemática a nivel local en el servicio de emergencia del Hospital II Chulucanas –Piura. Realizándose la presente EBE titulada: Participación de enfermería en el triaje intrahospitalario de emergencias/urgencias, teniendo como objetivo identificar y formalizar la participación de enfermería en el triaje como su función. Estableciéndose como resultado que la enfermera tiene conocimientos y habilidades específicas para definir la prioridad de servicio, nivel de atención, que corresponden desde el conocimiento y la mirada de usuario administrativo y clínico, a las habilidades de intuición y de la comunicación por lo cual su participación en el triaje de emergencia es necesaria. En la revisión se concluye que SI se puede dar respuesta a la pregunta formulada, existen evidencias contundentes, por ello se dice que los resultados responden a nuestra pregunta.Trabajo de investigación
37
Bonilla, Erich Jimenez. "We Are Constantly Expected To Disregard Ourselves And Our Personal Needs: Addressing The Daily Stressors Of Private Emergency Medical Services." CSUSB ScholarWorks, 2019. https://scholarworks.lib.csusb.edu/etd/910.
Анотація:
ABSTRACT
Background Private Emergency Medical Services serve a vital role in the community, as such they are subject to job related stress. Currently, there is a limited amount of research related to the stressors related to the job.
Objective The purpose of this study was to define the type of daily stressors faced by Private EMS personnel and investigate how they impact their Sense of Coherence.
Study Design A mixed methods approach was used in this study to obtain the necessary data. Semi-structured one-on-one interviews were conducted with current employees of an EMS agency that provides 911 service in their area. After the interviews, the participants were administered a survey.
Participants/setting Current EMS employees were invited to participate in an interview, in a location and time of their choosing. Both Paramedics and Emergency Medical Technicians (EMT) were invited to participate.
Results Critical call incidents, while impacting the mental health of EMS provides, it does not impact them with the same magnitude of operational stress. Operational stress originates from the daily task, interactions and availability of resources. Operational stress was demonstrated to have a large impact on Sense of Coherence.
Conclusion Operational stress can have a larger impact on Sense of Coherence of EMS personnel. Research is needed to determine which EMS model helps mitigate the impacts of operational stress on the EMS personnel.
38
Guerrero, Suclupe Yaqueline Lizet. "Revisión crítica : riesgo psicosocial en el personal de enfermería de un servicio de emergencia hospitalario." Bachelor's thesis, Universidad Católica Santo Toribio de Mogrovejo, 2018. http://tesis.usat.edu.pe/handle/usat/1472.
Анотація:
La revisión crítica es una investigación de tipo secundario que tiene como objetivo: identificar el impacto de los riesgos psicosociales del trabajo en el personal de enfermería de un servicio de emergencia, cuyo ambiente de trabajo presenta exigencias altamente demandantes relacionado con una imprevisibilidad y complejidad de los pacientes atendidos. Estas áreas críticas caracterizadas por el ritmo frenético de las atenciones, sobrecarga laboral y contacto cotidiano con la enfermedad y la muerte pueden exponer a la enfermera a la aparición de perturbaciones en su salud mental. La metodología a utilizar es EBE (Enfermería Basada en Evidencias) con la interrogante: ¿Cuál es el impacto de los riesgos psicosociales en el personal de enfermería del servicio de emergencia? Se realizó búsqueda en SciELO, Google académico, Alicia- CONCYTEC, Google y biblioteca virtual. Se encontraron 10 de investigación de las cuales 03 pasaron el filtro de Gálvez Toro con metodología: 01 con (Estudio cuantitativo, de diseño descriptivo, transversal y comparativo.); 02 con (Estudio descriptivo cuantitativo.); 03 con (Diseño explicativo, transversal y comparativo con abordaje cuantitativo). Concluyendo que el nivel de impacto de riesgo psicosocial es alto en las dimensiones demanda psicológica y doble presencia en un 53.8% y 53% respectivamente. La alta demanda cognitiva, las exigencias psicológicas, el ritmo de trabajo acelerado, la complejidad de las tareas, las interrupciones en otros aspectos negativos determinan un ambiente psicosocial laboral generador de sobrecarga mental y de trabajo.Trabajo académico
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Boyer, Sophie. "Contribution à l'étude du rôle de l’hyponatrémie légère et chronique dans la survenue de la chute grave du sujet âgé fragile admis en unité de Médecine d'Urgence de la Personne Agée (MUPA)." Thesis, Limoges, 2018. http://www.theses.fr/2018LIMO0067/document.
Анотація:
Les chutes à domicile sont un signe précurseur de la perte d’autonomie et représentent un problème majeur de santé publique. La chute implique de multiples facteurs déterminant le risque de chute. Une meilleure connaissance des facteurs de risques de la chute est importante afin de prévenir les chutes ainsi que l’entrée en dépendance chez la personne âgée. Parmi ces facteurs de risques les facteurs biologiques sont peu étudiés. Mieux connaître ces facteurs biologiques permettrait de mieux orienter le diagnostic étiologique de la chute et donc de cibler les actions préventives personnalisées et de définir par des interventions environnementales (ex : l’activité physique, conseils nutritionnels) ou médicales, de prévenir le risque de chute et la perte d’autonomie qu’elle induit. L’hyponatrémie est le désordre électrolytique le plus fréquent rencontré en pratique gériatrique. Elle est définie par une concentration en Na dans le sérum inférieure à 136 mmol/L. L’hyponatrémie peut être divisée en 3 paliers : l’hyponatrémie chronique légère l’hyponatrémie modérée et l’hyponatrémie sévère. De récentes études ont montré que l’hyponatrémie chronique légère peut présenter chez les patients des signes cliniques significatifs et pourrait être associée à une altération des fonctions cognitives, à des troubles de la marche voire de fracture. Qu’elle est la prévalence de l’hyponatrémie chronique légère chez les patients admis à l’unité MUPA ? Qu’elle est l’association entre l’hyponatrémie chronique légère et la chute dans notre population ? La prévalence de l’hyponatrémie chronique légère est particulièrement élevée à l’unité MUPA. les patients admis à l’unité MUPA avec une hyponatrémie chronique légère à la prise de sang effectuée à l’arrivée dans l’unité ont un plus fort risque de chute grave. L’hyponatrémie chronique légère peut-être considérée comme un facteur de risque de la chute grave chez le sujet âgéFalls are a precursor to the loss of autonomy and represent a major public health problem. Falls involve multiple factors determining the risk of falling. A better knowledge of the risk factors of falls is important in order to prevent falls as well as loss of autonomy in the elderly. Among these risk factors, biological factors are poorly studied. Better knowing these biological factors would better guide the etiological diagnosis of the fall and therefore target personalized preventive actions and define environmental interventions (physical activity, nutritional counseling) or medical, to prevent the risk of falling and the loss of autonomy. Hyponatremia is the most common electrolyte disorder in geriatric practice. It is defined by a serum Na concentration of less than 136 mmol/L. Hyponatremia can be divided into 3 stages: mild chronic hyponatremia, moderate hyponatremia, and severe hyponatremia. Recent studies have shown that mild chronic hyponatremia may present significant clinical signs in patients and may be associated with impaired cognitive functions, gait disturbances and even fractures. What is the prevalence of mild chronic hyponatremia in patients admitted to MUPA unit? What is the association between mild chronic hyponatremia and falls in our population? Prevalence of mild chronic hyponatremia is particularly high at MUPA unit. Patients admitted to MUPA unit with mild chronic hyponatremia at the first blood test performed on arrival have a higher risk of serious falls. Mild chronic hyponatremia may be considered as a risk factor for serious falls in the elderly
40
Halldin, Anna, and Cecilia Hjalmarsson. "Faktorer av betydelse för säker överrapportering mellan personal inom ambulanssjukvård och akutmottagning : en litteraturstudie." Thesis, Sophiahemmet Högskola, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-3632.
Анотація:
Överrapportering mellan olika sjukvårdsinstanser är en komplex situation som utgör en risk för patienten. Överrapporteringen från personal inom ambulanssjukvård till personal verksamma på akutmottagning utgör ett extra stort riskmoment, då ambulanspersonalens information gällande patienten stundtals är den enda som finns att tillgå. I samband med överrapporteringen kan viktig information om patienten gå till spillo, något som kan medföra att nödvändig behandling fördröjs, vilket orsakar ett onödigt och förlängt lidande och i värsta fall att patienten avlider. Syftet var att beskriva faktorer av betydelse för säker överrapportering av patienter som anländer till akutmottagningen med ambulans. Metoden var en litteraturstudie innehållande 15 artiklar med kvalitativ och kvantitativ design, publicerade under 2000-talet. Sökningen efter artiklar genomfördes i databaserna PubMed och CINAHL samt genom manuell sökning. Analysen utfördes med hjälp av Polit och Becks (2016) niostegsmodell och via ett bedömningsunderlag granskades artiklarnas kvalitet. Resultatet visar på fyra teman; struktur, erfarenhet, arbetsmiljö och samarbete, som belyser de faktorer som har betydelse för patientsäkerheten i samband med överrapportering. Genom dessa teman framkom det bland annat att med hjälp av en strukturerad kommunikation via ett standardiserat rapporteringsverktyg, yrkeserfarenhet och utbildning, en lugn arbetsmiljö, ett kollegialt samarbete och med respekt för varandras professioner kan patientsäkerheten öka och riske för vårdskador minska. Slutsatsen var att struktur, erfarenhet och samverkan mellan involverade yrkesgrupper är centrala faktorer för att överrapporteringen ska ske på ett tillfredsställande sätt. Detta kan på ett knostnadseffektivt sätt öka patientsäkerheten på akutmottagningen i samband med överrapportering.
41
Diaz, Hayashida Doris Victoria. "Síndrome de Burnout y calidad del servicio en el personal médico de emergencia del HNGAI EsSalud. Lima 2017." Master's thesis, Universidad Nacional Mayor de San Marcos, 2019. https://hdl.handle.net/20.500.12672/11467.
Анотація:
Especifica la relación entre el síndrome de Burnout (SBO) y la calidad del servicio en los profesionales médicos del Hospital Nacional Guillermo Almenara Irigoyen (HNGAI) EsSalud, Lima 2017. El universo de interés muestreado fue de 100 médicos del HNGAI, EsSalud, que son todos los médicos del Servicio de Emergencia, por ser población censal no se consideró muestras. La metodología fue hipotéticodeductiva. Su diseño fue no experimental, de tipo descriptiva correlacional, tomado en un tiempo determinado, el instrumento SBO de Maslach y el cuestionario de Calidad de Parasuraman, con escala de Likert. El Tau_b de Kendall de -0.879 presenta relación negativa entre las variables con correlación elevada y significancia bilateral p=0.000, <0.01 (altamente significativo), descartando la HN y validando la HG. Esto nos permite concluir que el síndrome de Burnout tiene relación con la calidad del servicio en los profesionales médicos del HNGAI, EsSalud, Lima. 2017.Tesis
42
Cano, Sabrina Marianela, and Romina Haydee Cruz. "Desempeño eficaz del enfermero del servicio de emergencia pediátrica en la administración de medicamentos." Bachelor's thesis, Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Escuela de Enfermería, 2014. http://bdigital.uncu.edu.ar/6214.
Анотація:
En la práctica de enfermería, la utilización de principios, técnicas y procedimientos
constituyen un reto para todo tipo de profesión, sin embargo en el caso de
enfermería es preciso que el personal de enfermería esté apegado a los principios
teóricos indispensables para cada procedimiento, porque en caso contrario se
compromete la vida del paciente en cuestión, la idoneidad profesional y la institución
donde trabaja. Esta investigación radica en conocer la realidad del lugar donde
se trabaja con relación a la preparación de medicamentos endovenosos; así como
también se pretende contribuir al mejoramiento de las técnicas y procedimientos que
día a día el personal de enfermería del servicio de emergencia pone en práctica en
la preparación de medicamentos a través de la evaluación y educación en el
servicio.Fil: Cano, Sabrina Marianela. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Escuela de Enfermería..
Fil: Cruz, Romina Haydee. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Escuela de Enfermería..
43
Farnsworth, Jacob. "Benefits and Costs of Social Interactions Among Firefighters." Thesis, University of North Texas, 2010. https://digital.library.unt.edu/ark:/67531/metadc33149/.
Анотація:
Despite high levels of exposure, firefighter posttraumatic stress disorder (PTSD) rates are unclear. Likewise, questions remain regarding how social interactions and beliefs about emotion might interact to influence PTSD in firefighters. In this study, U.S. urban firefighters (N = 225) completed measures of social support, negative social interactions, and fear of emotion which were then used via regression analyses to predict PTSD symptoms. Each independent variable predicted PTSD beyond variance accounted for by demographic variables. Additionally, fear of emotion emerged as the strongest individual predictor of PTSD and a moderator of the relation between social interactions and PTSD symptoms. These findings emphasize the importance of beliefs about emotion; both in how these beliefs might influence the expression of PTSD symptoms, and in how the social networks of trauma survivors might buffer distress.
44
Barba, Salazar Daniela Del Milagro. "Revisión crítica : ¿mejora el nivel de conocimiento, la actitud del personal de salud del servicio de emergencia ante un sismo?" Bachelor's thesis, Universidad Católica Santo Toribio de Mogrovejo, 2018. http://hdl.handle.net/20.500.12423/2094.
Анотація:
La revisión crítica denominada: ¿mejora el nivel de conocimiento, la actitud del personal de salud del servicio de Emergencia ante un sismo?, tuvo como objetivo principal identificar la relación que existe entre el nivel de conocimiento y la actitud del personal de salud del servicio de emergencia ante un desastre producido por sismo, para lo cual se aplicó la metodología de enfermería basada en la evidencia y se trabajó hasta la tercera etapa; la búsqueda de información se desarrolló mediante la elección de palabras claves, registro escrito de búsqueda y la ficha para recolección bibliográfica. Se seleccionaron tres investigaciones a través de la lista de chequeo de validez aparente de Gálvez Toro. Para la revisión bibliográfica se seleccionó el trabajo de investigación denominado: “actitudes y conocimientos ante la ocurrencia de sismo en personal de salud en Ica, 2016”, se ha utilizado las 138 pautas detalladas de lectura crítica propuestas por Bobenrieth Astete. Teniendo en cuenta que, por el sistema GRADE, la investigación presenta un nivel de evidencia alto con un grado de recomendación 3C. Como resultado final, se puede decir que la investigación responde a la pregunta clínica planteada, debido a que existe una asociación entre las dos variables; siendo los conocimientos incorrectos un factor de riesgo para presentar una actitud negativa ante la prevención de sismo, además, influyen el grado universitario, el tener algún familiar con discapacidad, la falta de experiencia previa de un sismo, el bajo conocimiento sobre sismo y el no pertenecer a una brigada de emergencia.Trabajo académico
45
Carranza, Torres Jackeline Estrella. "Conocimiento del personal de enfermería sobre barreras protectoras de riesgos biológicos en el servicio de emergencia Hospital María Auxiliadora - 2015." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2016. https://hdl.handle.net/20.500.12672/5224.
Анотація:
Determina los conocimientos del personal de enfermería sobre las barreras protectoras de riesgos biológicos en el servicio de emergencia del Hospital Nacional María Auxiliadora durante el año 2015. El estudio es de tipo cuantitativo, nivel aplicativo y utiliza el método descriptivo de corte transversal. La población está conformada por todo el personal de enfermería que labora en el área de trauma shock y la unidad de cuidados especiales (UCE) del servicio de emergencia. La técnica es la encuesta y el instrumento el cuestionario. Concluye que el personal de enfermería conocer sobre las barreras protectoras físicas, químicas y biológicas.Trabajo académico
46
Carranza, Torres Jackeline Estrella. "Conocimiento del personal de enfermería sobre barreras protectoras de riesgos biológicos en el servicio de emergencia Hospital María Auxiliadora - 2015." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2016. https://hdl.handle.net/20.500.12672/5244.
Анотація:
Determina los conocimientos del personal de enfermería sobre las barreras protectoras de riesgos biológicos en el servicio de emergencia del Hospital Nacional María Auxiliadora - 2015. El estudio fué de tipo cuantitativo, nivel aplicativo, método descriptivo de corte transversal. La población estuvo conformada por todo el personal de enfermería que labora en el área de trauma shock y la unidad de cuidados especiales (UCE) del servicio de emergencia. La técnica fue la encuesta y el instrumento el cuestionario.Trabajo académico
47
Chávez, Bernal Luisa Isabel. "Clima organizacional y satisfacción laboral en el personal de enfermería del Servicio de Emergencia del Hospital Nacional Guillermo Almenara Irigoyen. Essalud. 2018." Master's thesis, Universidad Nacional Mayor de San Marcos, 2019. https://hdl.handle.net/20.500.12672/10535.
Анотація:
Determina la relación del clima organizacional y satisfacción laboral en el personal de enfermería del servicio de Emergencia del Hospital Nacional Guillermo Almenara Irigoyen. Essalud 2018. La población o universo de interés en esta investigación, está conformada por 90 enfermeras del Servicio de Emergencia del Hospital Nacional Guillermo Almenara Irigoyen. Essalud 2018, que corresponde al total de los profesionales de enfermería de la entidad, La muestra fue de 90 enfermeras del servicio objeto del estudio. En este caso como la muestra es igual a la población, no existe técnica de muestreo, se han estudiado las variables: Clima Organizacional y Satisfacción Laboral. El método empleado en la investigación fue el hipotético-deductivo. Esta investigación utilizó para su propósito el diseño no experimental de nivel correlacional, que recogió la información en un período específico, que se desarrolló al aplicar encuesta EDCO, de Acero Yussef para Clima Organizacional y la encuesta de Minsa para Satisfacción Laboral, ambos con escala de Likert, que brindaron información acerca de la relación que existe entre las variables de estudio en sus distintas dimensiones. El resultado del coeficiente de correlación Tau-b de Kendall de 0.695 indica que existe relación positiva entre las variables además se encuentra en el nivel de correlación moderada y siendo el nivel de significancia bilateral p=0.000<0.01 (altamente significativo), se rechaza la hipótesis nula y se acepta la hipótesis general; se concluye que: El Clima Organizacional se relaciona significativamente con la satisfacción laboral en el personal de enfermería del servicio de Emergencia del Hospital Nacional Guillermo Almenara Irigoyen. Essalud. 2018.Tesis
48
Vivanco, Naveros Grimaldo. "Conocimientos y prácticas que realizan los enfermeros en la aspiración de secreciones en pacientes intubados en el Servicio de Emergencia de Adultos HNERM. 2014." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2015. https://hdl.handle.net/20.500.12672/13489.
Анотація:
El objetivo del estudio fue determinar los conocimientos y prácticas que realizan los enfermeros en la aspiración de secreciones en pacientes intubados en el servicio de Emergencia de Adultos HNERM 2014. Material y Método. El estudio es de nivel aplicativo, tipo cuantitativo, método descriptivo de corte transversal. La muestra fue obtenida por muestreo probabilístico de proporciones para población finita y aleatoria simple conformada por 38. La técnica fue la encuesta y la observación, y los instrumentos fueron un formulario tipo cuestionario y la lista de chequeo, aplicado previo consentimiento informado. Resultados. Del 100% (38), 63% (24) conoce y 37% (14) no conoce. En cuanto a la práctica 68% (26) son inadecuadas y 32% (12) adecuada. Acerca de las practicas antes 39% (15) inadecuada y 61% (23) adecuadas; durante 34% (13) son inadecuadas y 66% (25) adecuadas, y después del procedimiento 34% (13) es inadecuada y 66% (25) adecuada. Conclusiones. El mayor porcentaje conoce que es necesario lubricar la punta de la sonda con agua destilada y una de las contraindicaciones es la obstrucción de la vía aérea por cuerpo extraño; y un porcentaje considerable no conocen que el primer paso que se realiza es valorar los signos vitales y estados de oxigenación del paciente; la práctica es adecuada ya que se lava las manos, repite el procedimiento hasta dejar libre de secreciones, y lo
inadecuado porque no verifica y usa sonda de aspiración apropiado para cada TET o TQT, omite observar y valorar la SatO2 y las cifras de signos vitales y no deja cómodo al paciente.Trabajo académico
49
Souliès, Dorian. "Le secours à personne : spatialiser, modéliser, outil d'aide à la décision : méthode d'optimisation de la localisation des moyens de secours à personne dans le cadre de la réalisation de documents de planification : application au département des Alpes-Maritimes." Thesis, Nice, 2015. http://www.theses.fr/2015NICE2034/document.
Анотація:
Le secours à personne (SAP) correspond aux missions que réalisent les pompiers français pour porter secours en urgence aux victimes. Comme la démographie médicale, le nombre de pompiers volontaires est en baisse, particulièrement dans les espaces périurbains et ruraux. Parallèlement, le nombre d’interventions de type SAP est en augmentation constante, ce qui engendre localement des tensions entre l’offre et la demande en secours. Une des solutions pour remédier à cette situation consiste à optimiser la localisation des moyens existants. Cependant, les méthodes mises en œuvre pour cela, par les professionnels, ne sont pas suffisamment intégrées, et celles développées par les chercheurs, pas suffisamment opérationnelles. L’objectif de cette recherche est donc de proposer une méthode d’optimisation des localisations, à la fois intégrée et opérationnelle. Le choix s’est porté vers les modèles de localisation-allocation, car ils permettent de prendre en compte, de manière globale, l’ensemble des paramètres entrant en jeu dans la localisation des secours, ainsi que les conséquences en chaîne que les choix de localisation peuvent entraîner. La démarche se décompose en trois étapes. La première consiste à réaliser un diagnostic du SAP. La deuxième consiste à choisir et préparer les données d’entrée du modèle et le paramétrer. La troisième consiste à réaliser différents grands scénarios d’optimisation possibles. Cette démarche a permis de mettre en exergue les besoins de méthodes et d’outils d’optimisation opérationnels et de démontrer l’intérêt des modèles de localisation-allocation comme aide à la réflexion pour l’optimisation de la localisation des moyens de SAPIn France, emergency rescue for victims is an integral part of the fire brigade missions. This is what we called the secours à personne (SAP). These last years, the number of volunteer firemen is in decline, particularly in the peri-urban and rural areas, which is not without consequence on the coverage of operational resources, especially since these sectors are already experiencing a decline in medical demography. At the same time, the number of SAP type of interventions is increasing. In this context, tensions between supply and demand for SAP tend to increase. One of the solutions envisaged to solve this situation is to optimize the location of existing resources. However, the methods implemented to this, by professionals, don’t prove to be sufficiently integrated, and those developed by researchers, not sufficiently operational. The main objective of this research is to propose an optimization method for localized SAP resources, both integrated and operational.The choice fell on the location-allocation models, because they take into account, overall, the set of parameters that come into play in the location of the emergency, and the consequences chain as location choices can result. The approach consists of three steps. The first is to make a diagnosis of SAP. The second is to select and prepare input data and configure the model. The third is to carry out various great scenarios optimization possible. This approach allowed, on one hand, to highlight the needs and methods of operational optimization tools, and on the other hand, to demonstrate the interest of the location-allocation models as an aid to reflection for optimizing localization of SAP resources
50
Sisniegas, Vergara César Edgardo, and García Denissa Pajuelo. "Propuesta de coaching personalista en la relación médico-paciente-familia para el servicio de emergencia de dos hospitales de Essalud de la red asistencial Lambayeque 2016-2017." Master's thesis, Universidad Católica Santo Toribio de Mogrovejo, 2017. http://tesis.usat.edu.pe/handle/usat/1154.
Анотація:
Objetivo: elaborar una propuesta de coaching para mejorar la relación-médico-paciente-familia (RMPF) con marco antropológico personalista, luego de caracterizar la RMPF en el servicio de emergencia de dos hospitales de ESSalud de la red asistencial de Lambayeque. Tipo de estudio: descriptivo, observacional, propositivo, cuantitativo. Se aplicó a médicos, pacientes y familiares el “cuestionario para medir la relación médico paciente” de Rodríguez y Mardones, validado en el servicio del campo clínico de la Pontificia Universidad Católica de Chile. Los resultados con diferencia significativa en la RMPF se encontraron en el aspecto conceptual deshumanización de la medicina por discriminación de tendencia homosexual del paciente, y en dos aspectos vivenciales: modelo paternalista (el médico no toma en cuenta el sentir y opinión de los pacientes, trabajo médico tecnicista y cientificista centrado solo en enfermedad y no en los problemas del paciente) y modelo legal (RMPF con documento previo firmado ante notario, paciente insatisfecho acude a abogado y RMPF es similar a contrato de compra venta). Conclusiones: La RMPF es deshumanizada, no empática por probable discriminación homosexual, tiene características del modelo paternalista, y desconfiada por la distorsión de aspectos contractuales y fiduciarios. Se propone un esquema de coaching clínico personalista basado en comunicación trascendente para establecer consultas positivas, utilizando aportes de la concepción de corporeidad como encarnación coesencial de la persona (Elio Sgreccia), ejercicio de la libertad y Gemüt (Edith Stein), la espiritualidad inspiradora en profesionales de la salud (José Kentenich) y el sentido de vida y muerte (Víctor Frankl), usando técnica de oportunidades empáticas potenciales.Tesis