Download or read book Evaluation du temps de passage des patients en zone de surveillance de tr s courte dur e au centre r gional universitaire des urgences du CHU de Dijon written by Iulia-Alexandra Popescu and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: La durée de passage aux urgences des patients est multifactorielle et est impactée en partie par le nombre de lits disponibles en aval. L'objectif du présent travail est d'évaluer la durée de passage des patients après leur prise en charge médicale au Centre Régional Universitaire des Urgences (CRUU) en particulier au niveau de la Zone de Surveillance de Très Courte Durée (ZSTCD). Entre le 13/04/2016 et le 10/05/2016, des données sur les caractères sociodémographiques, les soins prodigués et les raisons du placement en ZSTCD ont été colligées afin d'évaluer l'organisation du service. L'âge moyen des patients en ZSTCD est de 65,1 ± 23,2 ans. La durée moyenne de placement en ZSTCD est de 230 ± 255 min et les tranches horaires principales sont 12h-16h (25,8%), 20h-0h (20,8%). Enfin 28,2% des patients restent plus de 50% du temps de passage total aux urgences en ZSTCD. Les principaux actes réalisés sont une surveillance de l'hémodynamique (26,6%), de la douleur (20%), des actes d'hospitalité (15,1%) et l'administration de médicaments (12,2%). Environ un tiers des patients sont en attente d'un lit d'hospitalisation, 60% d'un examen complémentaire (biologie, imagerie) et 5,6% d'un état compatible avec un retour à domicile. L'utilité de positionner un infirmier et/ou un aide-soignant dans cette zone reste un point de débat au vu du nombre d'actes effectués. L'évaluation de la ZSTCD doit être cependant réalisée conjointement avec celle de l'Unité d'Observation de Courte Durée. Malgré un biais d'exhaustivité, ce travail met en lumière les axes d'amélioration possibles uniquement dépendants du CRUU sans préjuger des améliorations sur l'aval des urgences.
Download or read book Evaluation des pratiques professionnelles written by Mathieu Bruneau and published by . This book was released on 2014 with total page 146 pages. Available in PDF, EPUB and Kindle. Book excerpt: Devant une surcharge des services d’urgence, de nombreuses voies d’organisation ont vu le jour. Dans l’optique d’une réduction des temps d’attente et de passage des patients, nous avons élaboré une réorganisation du circuit court des urgences du CHU de Dijon via la mise en place d’un circuit ultra court. Un protocole de coopération a été conçu pour que les attelles plâtrées et les pansements soient réalisés, après formation, par un Aide Soignant Diplômé d’Etat à la place d’un médecin. Nous avons évalué ce procédé par une étude comparative rétrospective entre 2012 et 2013. Les résultats montrent une amélioration des temps d’attente globaux de 12 minutes et une réduction des temps de passage de 60 minutes au maximum, tout diagnostic confondu. Cette nouvelle organisation de travail est appréciée des patients qui la considèrent comme excellente pour 42% d’entre eux. Par l’introduction d’un transfert de compétences entre médecin et aides soignants, nous démontrons l’amélioration du service rendu aux patients. La diminution du temps de prise en charge des malades et la valorisation d’une profession paramédicale sont les effets bénéfiques de notre réorganisation. La modification de ces pratiques professionnelles s’inscrit dans l’optimisation des soins dispensés aux urgences.
Download or read book Impact de la mise en place d un protocole de prise en charge des syncopes au service d accueil des urgences SAU du Centre Hospitalier Universitaire CHU de Dijon sur la prescription d examens compl mentaires written by Florian Perraud and published by . This book was released on 2020 with total page 70 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction : les syncopes sont un motif de consultation fréquent aux urgences et leur évaluation a connu des évolutions régulières. Néanmoins, leur prise en charge reste disparate. Un protocole de prise en charge basé sur les recommandations de l'ESC de 2018 a été élaboré et mis en place au SAU du CHU de Dijon. Le critère de jugement principal était le nombre d'examens complémentaires prescrits. Les critères de jugements secondaires étaient les temps de passage au SAU et de prise en charge médicale, ainsi que le taux de diagnostic final. Matériel et méthode : il s'agit d'une étude observationnelle, rétrospective, monocentrique, menée d'octobre 2019 à juin 2020, comparant deux périodes avant et après mise en place du protocole. Nous avons inclus les patients qui consultaient au SAU pour une syncope et analysé les critères de jugement cités ci-dessus. Résultats : 43 patients (âge moyen 74,1±17,8 ans) ont été inclus pendant la phase 1 et 35 (68,3±21,2 ans) pendant la phase 2. Il n'y a pas eu de diminution (95,3% vs 85,7%, p=0,23) du taux de bilans biologiques prescrits après mise en place du protocole. Le taux de syncope de cause inconnue n'a pas non plus diminué entre les deux phases (46,5% vs 31,4%, p=0,25). Une analyse en sous-groupe menée sur la prise en charge des urgentistes n'a pas retrouvé de diminution du taux de syncope de cause inconnue (43,8% vs 21,4%, p=0,09). La durée moyenne de prise en charge médicale est passée de 242±165min à 200±167min (p=0,09) post protocole. Conclusion : le protocole n'a pas diminué le nombre de bilans biologiques prescrits ni la durée de prise en charge des patients et le taux diagnostic en fin de prise en charge n'a pas été amélioré.
Download or read book Health System Performance Comparison an Agenda for Policy Information and Research written by Irene Papanicolas and published by McGraw-Hill Education (UK). This book was released on 2013-06-16 with total page 418 pages. Available in PDF, EPUB and Kindle. Book excerpt: International comparison of health system performance has become increasingly popular, made possible by the rapidly expanding availability of health data. It has become one of the most important levers for prompting health system reform. Yet, as the demand for transparency and accountability in healthcare increases, so too does the need to compare data from different health systems both accurately and meaningfully. This timely and authoritative book offers an important summary of the current developments in health system performance comparison. It summarises the current state of efforts to compare systems, and identifies and explores the practical and conceptual challenges that occur. It discusses data and methodological challenges, as well as broader issues such as the interface between evidence and practice. The book draws out the priorities for future work on performance comparison, in the development of data sources and measurement instruments, analytic methodology, and assessment of evidence on performance. It concludes by presenting the key lessons and future priorities, and in doing so offers a rich source of material for policy-makers, their analytic advisors, international agencies, academics and students of health systems.
Download or read book Historical Disaster Experiences written by Gerrit Jasper Schenk and published by Springer. This book was released on 2017-03-20 with total page 430 pages. Available in PDF, EPUB and Kindle. Book excerpt: Historical disaster research is still a young field. This book discusses the experiences of natural disasters in different cultures, from Europe across the Near East to Asia. It focuses on the pre-industrial era and on the question of similarities, differences and transcultural dynamics in the cultural handling of natural disasters. Which long-lasting cultural patterns of perception, interpretation and handling of disasters can be determined? Have specific types of disasters changed the affected societies? What have people learned from disasters and what not? What adaptation and coping strategies existed? Which natural, societal and economic parameters play a part? The book not only reveals the historical depth of present practices, but also reveals possible comparisons that show globalization processes, entanglements and exchanges of ideas and practices in pre-modern times.
Download or read book Diffusion in Materials DIMAT 2011 written by Igor Bezverkhyy and published by Trans Tech Publications Ltd. This book was released on 2012-04-12 with total page 600 pages. Available in PDF, EPUB and Kindle. Book excerpt: The International Conference on Diffusion in Materials (DIMAT) is the benchmark conference series for diffusion in solids. DIMAT 2011 was organized by the University of Bourgogne in association with CNRS, Dijon (France). The conference showcased new results concerning theoretical tools as well as applied research approaches. Diffusion processes affect all types of materials: nanomaterials, materials for energy, metallurgy, glasses and ceramics, but each requires its own numerical tools. Volume is indexed by Thomson Reuters CPCI-S (WoS). This volume comprises most of the contributions presented at DIMAT 2011: 4 plenary lectures delivered by famous high-level scientists plus 88 contributions in the form of keynote lectures, talks and posters.
Download or read book Watsuji Tetsuro s Rinrigaku written by Tetsur? Watsuji and published by SUNY Press. This book was released on 1996-01-01 with total page 398 pages. Available in PDF, EPUB and Kindle. Book excerpt: Watsuji Tetsuro's Rinrigaku (literally, the principles that allow us to live in friendly community) has been regarded as the definitive study of Japanese ethics for half a century. In Japan, ethics is the study of human being or ningen. As an ethical being, one negates individuality by abandoning one's independence from others. This selflessness is the true meaning of goodness.
Download or read book Crop Wild Relative Conservation and Use written by and published by CABI. This book was released on 2008 with total page 712 pages. Available in PDF, EPUB and Kindle. Book excerpt: Crop wild relatives (CWR) are species closely related to crop plants which can contribute beneficial traits such as pest or disease resistance and yield improvement. Through an examination of national, regional and global context of CWR, this text presents methodologies and case studies that provide recommendations for global conservation and use.
Download or read book Seed Conservation written by Roger D. Smith and published by Royal Botanic Gardens Kew. This book was released on 2003 with total page 1052 pages. Available in PDF, EPUB and Kindle. Book excerpt: "This book is a review of the current scientific knowledge that underpins seed banking, a technology which plays a key role in the conservation of both domesticated and non-domesticated plant speices..."--Publisher description.
Download or read book Molecular Mechanisms of Hormone Action written by Gesellschaft für Biologische Chemie. Colloquium and published by . This book was released on 1989 with total page 224 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Relational Psychodynamic Psychotherapy Supervision written by and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: "In Relational Psychodynamic Psychotherapy Supervision, guest expert supervisor, Dr. Joan E. Sarnat, demonstrates and discusses this approach to supervision. The goal of relational psychodynamic supervision is to create a more experiential, participatory, and relationship-focused form of supervision, one that not only provides usable psychotherapeutic knowledge and skills, but also facilitates the emotional and relational development that is essential to becoming an effective psychodynamic psychotherapist. In this video, Sarnat and her supervisee engage in a supervisory session, and host Dr. Hanna Levenson interviews them about their work together, exploring the constructs of this model and the nature of the supervisory relationship. In the session, Dr. Sarnat's supervisee conveys that she is frustrated by how her patient is discounting her during the termination phase of therapy. By becoming aware of and working with her own feelings of frustration within the session, Dr. Sarnat demonstrates the art of using a reenactment to help the supervisee deepen her awareness and thereby facilitate the therapy."--
Download or read book Lucan s Egyptian Civil War written by Jonathan Tracy and published by Cambridge University Press. This book was released on 2014-09-22 with total page 305 pages. Available in PDF, EPUB and Kindle. Book excerpt: Explores how a cultural clash between traditional Pharaonic and latter-day Ptolemaic Egypt is used to mirror the Roman civil war.
Download or read book Psychoanalysis and Projective Methods in Personality Assessment written by Benoît Verdon and published by Hogrefe Publishing. This book was released on 2020 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Unique synthesis from the French School of psychoanalytical projective methods This unique book synthesizes the work of leading thinkers of the French School of psychoanalytical projective methods in personality assessment. The French School is a direct successor to Rorschach's and Murray's original approaches using the Rorschach Test and the Thematic Apperception Test (TAT). Underlying this method is the idea of the coexistence of conscious and unconscious processes, of opposite instinctual pairs, and of agents that are ruled by conflicts (Freud). Transitional activity is seen as part of an intermediate space, a mediator space, and bearer of messages between the subject and the clinician (Winnicott). This book brings to life the important contributions of the French School, firstly exploring its theories and methods and then its clinical applications. Detailed case studies from different stages of life examine the psychopathology of everyday life with its severe and disabling states of suffering. Contemporary advances in research and clinical work are presented, and the groundbreaking early work of Nina Rausch de Traubenberg, Vica Shentoub, and Rosine Debray are also critically reread and discussed. Clinical tools adapted for clinicians and researchers in the appendices include a useful schema to facilitate the interpretation of the Rorschach and TAT together, a list of latent solicitations for the TAT, and the current version of the TAT Scoring Grid. This book is essential reading for clinical psychologists, psychiatrists, psychotherapists, researchers, and students interested in applying psychoanalytical theory to projective methods"--
Download or read book Technocratic Dreaming written by Paul James and published by . This book was released on 1990 with total page 248 pages. Available in PDF, EPUB and Kindle. Book excerpt: Technocratic dreaming of very fast trains and Japanese designer cities.
Download or read book Trends in Vital Food and Control Engineering written by Ayman Hafiz Amer Eissa and published by . This book was released on 2012 with total page 304 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is an example of a successful addition to the literature of bioengineering and processing control within the scientific world. The book is divided into twelve chapters covering: selected topics in food engineering, advances in food process engineering, food irradiation, food safety and quality, machine vision, control systems and economics processing. All chapters have been written by renowned professionals working in food engineering and related disciplines.
Download or read book Annales Bogorienses written by and published by . This book was released on 1997 with total page 378 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book A Wife in Musashino written by Ooka Shohei and published by U of M Center for Japanese Studies. This book was released on 2004 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: A rich and subtle portrait of postwar Japanese family and social life
