Ethical Issues of Hospital Crowding Solutions

Braun, Brenda

doi:10.1016/j.jen.2011.04.015

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…While RV AGE hospitalization only describes the number of patients presenting at hospital with RV AGE, bed occupancy rather reflects the pressure that hospitals and health care workers face every day and specifically in periods of overlapping winter epidemics. Overcrowding occurs when new admissions for RV AGE exceed discharge of recovered patients, with adverse consequences such as lower quality of care [ 15 ], increased risk of nosocomial transmission among patients and healthcare workers (HCWs) [ 37 , 38 ], work stress [ 37 - 40 ], which may lead to hospital disruption with unsolved ethical and organizational issues [ 3 , 41 - 43 ].…”

Section: Discussionmentioning

confidence: 99%

Hospital bed occupancy for rotavirus and all cause acute gastroenteritis in two Finnish hospitals before and after the implementation of the national rotavirus vaccination program with RotaTeq®

Hartwig

Uhari

Renko

et al. 2014

BMC Health Serv Res

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BackgroundVaccination-impact studies of the live-attenuated pentavalent oral vaccine Rotateq® have demonstrated that the burden of rotavirus gastroenteritis has been reduced significantly after the introduction of RotaTeq® vaccination, but less is known about the benefit of this vaccination on hospital overcrowding.MethodsAs part of an observational surveillance conducted during the RV seasons 2000/2001 to 2011/2012, we analysed hospital discharge data collected retrospectively from two Finnish hospitals (Oulu and Tampere), concerning ICD 10 codes A00-09 (acute gastroenteritis, AGE) and A08.0 (rotaviral acute gastroenteritis RV AGE). We estimated the reduction in the number of beds occupied and analysed the bed occupancy rate, for RV AGE and all cause AGE, among 0–16 year-old children, before and after the implementation of the RV immunisation program.ResultsThe rate of bed days occupied for RV AGE was reduced by 86% (95% CI 66%-94%) in Tampere and 79% (95% CI 47%-92%) in Oulu after RV vaccination implementation. For all cause AGE, reduction was 50% (95% CI 29% to 65%) in Tampere and 70% (95% CI 58% to 79%) in Oulu. Results were similar among 0–2 year-old children. This effect was also observed on overcrowding in both hospitals, with a bed occupancy rate for all cause AGE >25% in only 1% of the time in Tampere and 9% in Oulu after the implementation of the immunisation program, compared to 13% and 48% in the pre-vaccination period respectively. After extrapolation to the whole country, the annual number of prevented hospitalizations for all cause AGE in the post-vaccination period in Finland was estimated at 1,646 and 2,303 admissions for 0–2 and 0–16 year-old children respectively.ConclusionsThis study demonstrated that universal RV vaccination is associated with a clear decrease in the number of bed days and occupancy rates for RV AGE and all cause AGE. Positive consequences include increase in quality of care and a better healthcare management during winter epidemics.

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Section: Discussionmentioning

confidence: 99%

Hospital bed occupancy for rotavirus and all cause acute gastroenteritis in two Finnish hospitals before and after the implementation of the national rotavirus vaccination program with RotaTeq®

Hartwig

Uhari

Renko

et al. 2014

BMC Health Serv Res

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“…미국 의학계어서는 American College of Emergency Physician (ACEP) 및 Society for Academic Emergency Medicine (SAEM), 그리고 Emergency Medicine Residents' Association (EMRA) 등에서 응급의 학과 의사를 위한 윤리 강령 및 지침을 제정해 놓고 있다 (7) . 게다가 의사를 위한 윤리 강령뿐 아니라 응급구조사 및 전 문응급간호사를 위한 윤리 강령 또한 개발되어 있는 상태 이다 (8) . (11) .…”

Section: 서 론unclassified

Perceptions about the Professional Ethics of EMT

Yun¹,

Lee²

2014

Fire Science and Engineering

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Complex ethical issues of Emergency Medical Techinician (EMT) out-of hospital emergency medical scene and the ER (Emergency Room) behaviors were studied. The survey was conducted by 500 EMT group members working in the field of ambulance work and general hospital and it was about their work ethics, discussions and solutions about the transferred patients, and ethics regarding Do Not Attempt Resuscitate (DNAR). The survey includes work ethics, awareness about the target job, a discussion on the transfer of patients, measures, and deathbed. Discussions about the patient's condition and diagnosis results were majorly absent during patient transportation at the emergency care scene. More than 90% of emergency care transfer were inappropriate. Sometimes, EMT working in the field facing morally unethical problems beyond their responsibility. When EMT, who can not make death diagnosis, received deathbed related DNAR issues, they gone through severe ethical conflicts. The institutional support and therapy for EMT was weak. In Korea, especially in the accident site, ethical issues education is more needed than DNAR prevalence of education and guidance. If ethics training and guidance are given to EMT, a lot of moral errors in the field can be resolved.

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Nurses’ Ethical Difficulties in Emergency Department*

Choe¹,

이경숙²,

Ham³

2012

Korean J Med Ethics

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The aim of this study was to explore the ethical difficulties experienced by emergency department nurses in hospital settings. Data were collected using in-depth interviews with a purposive sample of 12 nurses working in emergency department. The interviews were transcribed and analyzed using inductive thematic analysis to identify ethical difficulties. Four themes were emerged from the qualitative data: difficulty of advocacy for patients’ good, ethical disagreement, ethical immaturity, and ethical stress. This study will provide a theoretical basis for developing ethical guidelines that enable emergency room nurses to make decision ethically.

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Ethical Issues of Hospital Crowding Solutions

Cited by 3 publications

References 10 publications

Hospital bed occupancy for rotavirus and all cause acute gastroenteritis in two Finnish hospitals before and after the implementation of the national rotavirus vaccination program with RotaTeq®

Hospital bed occupancy for rotavirus and all cause acute gastroenteritis in two Finnish hospitals before and after the implementation of the national rotavirus vaccination program with RotaTeq®

Perceptions about the Professional Ethics of EMT

Nurses’ Ethical Difficulties in Emergency Department*

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