Many affected counties have had experienced a shortage of personal protective equipment (PPE) during the coronavirus disease (COVID-19) pandemic. We aimed to investigate the needs of healthcare ...professionals and the technical difficulties faced by them during the initial outbreak. A cross-sectional web-based survey was conducted among the healthcare workforce in the most populous cities from three Latin American countries in April 2020. In total, 1,082 participants were included. Of these, 534 (49.4%), 263 (24.3%), and 114 (10.5%) were physicians, nurses, and other professionals, respectively. At least 70% of participants reported a lack of PPE. The most common shortages were shortages in gown coverall suits (643, 59.4%), N95 masks (600, 55.5%), and face shields (569, 52.6%). Professionals who performed procedures that generated aerosols reported shortages more frequently (p<0.05). Professionals working in the emergency department and primary care units reported more shortages than those working in intensive care units and hospital-based wards (p<0.001). Up to 556 (51.4%) participants reported the lack of sufficient knowledge about using PPE. Professionals working in public institutions felt less prepared, received less training, and had no protocols compared with their peers in working private institutions (p<0.001). Although the study sample corresponded to different hospital centers in different cities from the participating countries, sampling was non-random. Healthcare professionals in Latin America may face more difficulties than those from other countries, with 7 out of 10 professionals reporting that they did not have the necessary resources to care for patients with COVID-19. Technical and logistical difficulties should be addressed in the event of a future outbreak, as they have a negative impact on healthcare workers. Clinical trial registration: NCT04486404.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
This study analyzed the frequency and intensity of acute stress among health professionals caring for COVID-19 patients in four Latin American Spanish-speaking countries during the outbreak. A ...cross-sectional study involved a non-probability sample of healthcare professionals in four Latin American countries. Participants from each country were invited using a platform and mobile application designed for this study. Hospital and primary care workers from different services caring for COVID-19 patients were included. The EASE Scale (SARS-CoV-2 Emotional Overload Scale, in Spanish named Escala Auto-aplicada de Sobrecarga Emocional) was a previously validated measure of acute stress. EASE scores were described overall by age, sex, work area, and experience of being ill with COVID-19. Using the Mann-Whitney U test, the EASE scores were compared according to the most critical moments of the pandemic. Univariate and multivariate analysis was performed to investigate associations between these factors and the outcome 'acute stress'. Finally, the Kruskal-Wallis was used to compare EASE scores and the experience of being ill. A total of 1372 professionals responded to all the items in the EASE scale: 375 (27.3%) Argentines, 365 (26.6%) Colombians, 345 (25.1%) Chileans, 209 (15.2%) Ecuadorians, and 78 (5.7%) from other countries. 27% of providers suffered middle-higher acute stress due to the outbreak. Worse results were observed in moments of peak incidence of cases (14.3 ± 5.3 vs. 6.9 ± 1.7, p < 0.05). Higher scores were found in professionals in COVID-19 critical care (13 ± 1.2) than those in non-COVID-19 areas (10.7 ± 1.9) (p = 0.03). Distress was higher among professionals who were COVID-19 patients (11.7 ± 1) or had doubts about their potential infection (12 ± 1.2) compared to those not infected (9.5 ± 0.7) (p = 0.001). Around one-third of the professionals experienced acute stress, increasing in intensity as the incidence of COVID-19 increased and as they became infected or in doubt whether they were infected. EASE scale could be a valuable asset for monitoring acute stress levels among health professionals in Latin America.ClinicalTrials: NCT04486404.
Background
The psychological impact of the COVID-19 pandemic on healthcare professionals has been widely studied, along with different strategies to minimize it. However, professionals’ assessment of ...the social support received and the factors that mitigated their fear of contagion have not been described. This study aimed to assess healthcare professionals’ satisfaction with the social support and information received and their efforts to self-isolate to avoid infecting loved ones in Chile, Colombia, and Ecuador.
Methods
A cross-sectional online survey, conducted from July to September 2020 in three Latin American countries, elicited healthcare professionals’ satisfaction with social support from colleagues, their community, the media, and scientific societies; as well as the information received about the evolution of the pandemic and measures to avoid contagion. The EASE scale was used to measure acute stress.
Results
Survey responses were received from 700 professionals. The response rate per country exceeded the estimated sample size except in the case of Colombia, which was 81.4%. In general, peer support was highly valued, though satisfaction was lower in high-risk units (
p
< 0.001). Those who directly assisted COVID-19 patients perceived the least community support (
p
= 0.023). Professionals from high-risk units (
p
= 0.013) and those who experienced greater acute stress (
p
= 0.05) assigned the lowest rating to the information offered by the centre on the pandemic. Men perceived more support from colleagues and better information from the centre than women (
p
< 0.05). Just 10.7% of professionals changed their residence during the pandemic, but those who worked in high-risk areas self-isolated more frequently (
p
= 0.026).
Conclusion
In the early stages of the COVID-19 pandemic, healthcare professionals in Chile, Colombia, and Ecuador greatly valued the support received from their peers. Being infected with COVID-19, working in high-risk areas, experiencing higher self-reported acute stress, and having an infected co-worker were predictors for self-isolation to protect their relatives. These results point to the appropriateness of putting in place institutional resources based on peer support and specific communication strategies and action protocols to build resilience and responsiveness to future health crises.
Objectives To explore speaking up behaviours, barriers to openly expressing patient safety concerns, and perceived psychological safety climate in the clinical setting in which healthcare trainees ...from Ibero-America were receiving their practical training. Methods Cross-sectional survey of healthcare trainees from Colombia, Mexico, and Spain (N = 1,152). Before the field study, the Speaking Up About Patient Safety Questionnaire (SUPS-Q) was translated into Spanish and assessed for face validity. A confirmatory factor analysis was conducted to establish the construct validity of the instrument, and the reliability was assessed. The SUPS-Q was used to evaluate voice behaviours and the perceived psychological safety climate among Ibero-American trainees. Descriptive and frequency analyses, tests for contrasting means and proportions, and logistic regression analyses were performed. Results Seven hundred and seventy-one trainees had experience in clinical settings. In the previous month, 88.3% had experienced patient safety concerns, and 68.9% had prevented a colleague from making an error. More than a third had remained silent in a risky situation. Perceiving concerns, being male or nursing student, and higher scores on the encouraging environment scale were associated with speaking up. Conclusion Patient safety concerns were frequent among Ibero-American healthcare trainees and often silenced by personal and cultural barriers. Training in speaking up and fostering safe interprofessional spaces is crucial.
Background Patient safety is a fundamental aspect of health care practice across global health systems. Safe practices, which include incident reporting systems, have proven valuable in preventing ...the recurrence of safety incidents. However, the accessibility of this tool for health care discipline students is not consistent, limiting their acquisition of competencies. In addition, there is no tools to familiarize students with analyzing safety incidents. Gamification has emerged as an effective strategy in health care education. Objective This study aims to develop an incident reporting system tailored to the specific needs of health care discipline students, named Safety Incident Report System for Students. Secondary objectives included studying the performance of different groups of students in the use of the platform and training them on the correct procedures for reporting. Methods This was an observational study carried out in 3 phases. Phase 1 consisted of the development of the web-based platform and the incident registration form. For this purpose, systems already developed and in use in Spain were taken as a basis. During phase 2, a total of 223 students in medicine and nursing with clinical internships from universities in Argentina, Brazil, Colombia, Ecuador, and Spain received an introductory seminar and were given access to the platform. Phase 3 ran in parallel and involved evaluation and feedback of the reports received as well as the opportunity to submit the students’ opinion on the process. Descriptive statistics were obtained to gain information about the incidents, and mean comparisons by groups were performed to analyze the scores obtained. Results The final form was divided into 9 sections and consisted of 48 questions that allowed for introducing data about the incident, its causes, and proposals for an improvement plan. The platform included a personal dashboard displaying submitted reports, average scores, progression, and score rankings. A total of 105 students participated, submitting 147 reports. Incidents were mainly reported in the hospital setting, with complications of care (87/346, 25.1%) and effects of medication or medical products (82/346, 23.7%) being predominant. The most repeated causes were related confusion, oversight, or distractions (49/147, 33.3%) and absence of process verification (44/147, 29.9%). Statistically significant differences were observed between the mean final scores received by country (P<.001) and sex (P=.006) but not by studies (P=.47). Overall, participants rated the experience of using the Safety Incident Report System for Students positively. Conclusions This study presents an initial adaptation of reporting systems to suit the needs of students, introducing a guided and inspiring framework that has garnered positive acceptance among students. Through this endeavor, a pathway toward a safety culture within the faculty is established. A long-term follow-up would be desirable to check the real benefits of using the tool during education. Trial Registration Trial Registration: ClinicalTrials.gov NCT05350345; https://clinicaltrials.gov/study/NCT05350345
Introducción: conocer la percepción del clima de seguridad al interior de los servicios quirúrgicos es una tarea importante para establecer acciones que reduzcan el riesgo de eventos adversos durante ...la atención del paciente. Objetivo: Caracterizar el clima de seguridad en los servicios quirúrgicos de cuatro instituciones de salud de Santander. Materiales y métodos: Estudio observacional de corte transversal. Se aplicó el instrumento Hospital Survey on Patient Safety. Los resultados se reportaron como los promedios de repuestas positivas y negativas. Se analizaron las características asociadas a las dimensiones con mayores puntajes de percepción negativa. Resultados: participaron 164 trabajadores. Las dimensiones con mayor percepción positiva fueron prácticas seguras (84 %), dotación de personal (83,2 %) y aprendizaje organizacional (78,4 %). Las dimensiones con percepción desfavorable fueron respuesta no punitiva al error (40,2 %), carga de trabajo (51,7 %), comunicación (54,3 %) y transiciones y transferencias entre servicios (58,1 %). Se encontró asociación entre una baja percepción en las transiciones y transferencias entre servicios con la contratación por prestación de servicios y con el cargo Médico Especialista y Anestesiólogo. Los bajos puntajes en comunicación se asociaron a la contratación gremial. No se encontraron factores asociados para las dimensiones respuesta no punitiva al error y carga de trabajo. Conclusiones: La percepción sobre clima seguridad en general es considerada positiva, aunque existen oportunidades de mejora. Los factores como tipo de contratación y cargo se asociaron a una percepción negativa de clima de seguridad. Los trabajadores se sienten juzgados al reportar eventos adversos.
Resumen Introducción: Conocer la percepción del clima de seguridad al interior de los servicios quirúrgicos es una tarea importante para establecer acciones que reduzcan el riesgo de eventos adversos ...durante la atención del paciente. Objetivo: Caracterizar el clima de seguridad en los servicios quirúrgicos de cuatro instituciones de salud de Santander. Materiales y métodos: Estudio observacional de corte transversal. Se aplicó el instrumento Hospital Survey on Patient Safety. Los resultados se reportaron como los promedios de repuestas positivas y negativas. Se analizaron las características asociadas a las dimensiones con mayores puntajes de percepción negativa. Resultados: Participaron 164 trabajadores. Las dimensiones con mayor percepción positiva fueron prácticas seguras (84 %), dotación de personal (83,2 %) y aprendizaje organizacional (78,4 %). Las dimensiones con percepción desfavorable fueron respuesta no punitiva al error (40,2 %), carga de trabajo (51,7 %), comunicación (54,3 %) y transiciones y transferencias entre servicios (58,1 %). Se encontró asociación entre una baja percepción en las transiciones y transferencias entre servicios con la contratación por prestación de servicios y con el cargo Médico Especialista y Anestesiólogo. Los bajos puntajes en comunicación se asociaron a la contratación gremial. No se encontraron factores asociados para las dimensiones respuesta no punitiva al error y carga de trabajo. Conclusiones: La percepción sobre clima seguridad en general es considerada positiva, aunque existen oportunidades de mejora. Los factores como tipo de contratación y cargo se asociaron a una percepción negativa de clima de seguridad. Los trabajadores se sienten juzgados al reportar eventos adversos.
La pandemia por la COVID-19 visibilizó las profundas inequidades en salud y la necesidad de desarrollar redes de inteligencia colectiva para el abordaje de los determinantes sociales que influyen en ...las enfermedades infecciosas y en la garantía del derecho a la salud. Adicionalmente, numerosos estudios indican que los determinantes sociales de la salud son responsables del 30 al 55% de los desenlaces en salud (1,2). El objetivo de este proyecto es contribuir al monitoreo epidemiológico comunitario, a la gestión integral del riesgo en salud y al empoderamiento comunitario, articulado con la formación de líderes juveniles en salud y mediado por el desarrollo y uso colectivo de una aplicación móvil. El proceso de construcción sigue el modelado de orientación de tecnologías por objetivos específicos y la metodología de aplicaciones móviles (3), la cual inició en noviembre del 2020 con la definición de requerimientos mediante el diseño de historias de usuario y el desarrollo del sistema backend. Posteriormente, se realizaron las pruebas de funcionalidad y el seguimiento está en curso para identificar los aspectos problemáticos y las necesidades específicas de la población rural de Puerto Wilches, Santander. Se construyó una arquitectura de lanzamiento escalonado con los módulos de interacción comunitaria, temas de salud, monitoreo de condiciones priorizadas en salud y teleorientación con profesionales de medicina familiar y salud pública de la Universidad de Santander, articulados con los líderes juveniles formados dentro del proyecto. Hasta el momento, el proyecto ha logrado formar a 20 líderes juveniles comunitarios en salud de Puerto Wilches de manera participativa y ha vinculado a 11 profesores, 33 médicos familiares en formación y 114 estudiantes de medicina de la Universidad de Santander, de manera presencial y virtual. Los principales problemas de salud identificados por los líderes juveniles fueron el consumo de tabaco y sustancias psicoactivas, la contaminación ambiental y las enfermedades de transmisión sexual. A partir de este diagnóstico comunitario se están ajustando los contenidos en la aplicación móvil y la actividad de educación para la salud por parte de los líderes comunitarios. Adicionalmente, se está recolectando la información para el monitoreo y teleorientación mediada por telefonía móvil. Dentro de los resultados se espera aumentar la participación comunitaria y el empoderamiento en salud y disminuir las brechas de acceso en la población a la teleorientación en salud. Además, se espera articular las actividades con la red de prestadores de servicios de la región y la autoridad sanitaria para promover la protección social de la población rural de Puerto Wilches, contribuyendo al cumplimiento del Plan Decenal de Salud Pública de Colombia y los Objetivos de Desarrollo Sostenible.
New trends in food are emerging in response to consumer awareness of the relationship between food and health, which has triggered the need to generate new alternatives that meet the expectations of ...the market. Revolutionary fields such as nanotechnology have been used for the encapsulation of nutritional ingredients and have great potential for the management of food additives derived from fruits and plant species. Turmeric, a spice that has been used as a dyeing agent, is recognized for its properties in Ayurveda medicine. This article aims to provide an overview of the characteristics of turmeric as an ingredient for the food industry, including its properties as a coloring agent, antioxidant, and functional ingredient. This article also highlights the potential of nanotechnology to enhance these properties of turmeric and increase the possibilities for the application of its components, such as cellulose and starch, in the development of nanostructures for food development.
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