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      Gestão de recursos das unidades de terapia intensiva em tempos de pandemia por COVID-19 Translated title: Intensive Care Unit Resource Management in Times of the COVID-19 Pandemic Translated title: Gestión de recursos de las unidades de cuidados intensivos en tiempos de pandemia por COVID-19

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          Abstract

          Resumo: Objetivo: Analisar aspectos de gestão em recursos das unidades de terapia intensiva (UTI) em tempos de COVID-19 na microrregião Cariri cearense. Método: Estudo descritivo do tipo transversal em quatro hospitais da microrregião do Cariri, com 91 profissionais da equipe interdisciplinar que atuam em UTI desde o início da pandemia. A pesquisa foi realizada através de e-mail, Instagram e/ou WhatsApp e os dados analisados em teste do qui-quadrado, teste-T e gráfico de clusters. Resultados: Acerca dos recursos humanos, 73,6 % dos profissionais realizaram curso de manejo do paciente em UTI durante a COVID-19 e 67,0 % sobre controle de infecções relacionados a serviços de saúde. Um 64,8 % conseguiram lidar como as dificuldades na UTI, 69,2 % foram remanejados de outros setores hospitalares para atender demandas da UTI e grande parte dos profissionais (76,9 %) não tiveram aporte psicológico para a pandemia. Nos recursos estruturais, 100 % dos leitos de UTI adulto foram ocupados durante a pandemia, apresentando diferença entre antes e durante, durante e após a crise com aumento exponencial da capacidade de leitos (p<0,001), e não apresentando diferenças significativas em momentos antes e após a pandemia (p=0,035). Recursos materiais estiveram em escassez e diminuição, como equipamentos de proteção individual, oxigênio, medicamentos, entre outros. Conclusão: Foi possível identificar a reorganização dos recursos humanos, materiais e estruturais dos hospitais da pesquisa. Houve aumento exponencial de leitos durante a crise pandêmica quando comparado a capacidade relatada pelos profissionais de momentos antes da pandemia. Portanto, esta pesquisa contribui para o conhecimento de gestão em saúde e reestruturação hospitalar em tempos de pandemia.

          Translated abstract

          Abstract: Objective: To analyze resource management aspects in intensive care units (ICU) in times of COVID-19 in Cariri microregion of Ceará. Methods: Descriptive cross-sectional study in four hospitals in the Cariri microregion, with 91 professionals from interdisciplinary teams who have been working in the ICU since the beginning of the pandemic. Research was conducted through email, Instagram and/or WhatsApp and the data were analyzed in the chi-square test, T-test and cluster chart Results: Regarding human resources, 73.6 % of professionals took a course on patient management in ICU during COVID-19 and 67.0 % on control of healthcare-associated infections. Of these professionals, 64.8 % were able to deal with the difficulties in the ICU, 69.2 % were relocated from other hospital sectors to meet ICU demands and most professionals (76.9 %) did not have psychological support for the pandemic. In structural resources, 100 % of adult ICU beds were occupied during the pandemic, presenting a difference between before and during, during and after the crisis with an exponential increase in bed capacity (p<0.001), and showing no significant differences in moments before and after the pandemic (p=0.035). Material resources were in short supply and decreased, such as personal protective equipment, oxygen, medicines, among others Conclusion: Identifying the reorganization of human, material and structural resources was possible in the researched hospitals. There has been an exponential increase in beds during the pandemic crisis when compared to the capacity reported by staff from moments before the pandemic. Therefore, this research contributes to the knowledge of health management and hospital restructuring in pandemic times

          Translated abstract

          Resumen: Objetivo: Analizar aspectos de la gestión de recursos de las unidades de cuidados intensivos (UCI) en tiempos de COVID-19 en la microrregión de Cariri, Ceará Método: Estudio descriptivo transversal en cuatro hospitales de la microrregión de Cariri, con 91 profesionales del equipo interdisciplinario que trabajan en UCI desde el inicio de la pandemia. La encuesta se realizó por correo electrónico, Instagram y/o WhatsApp y los datos se analizaron mediante la prueba chi-cuadrado, prueba T y gráfico de conglomerados Resultados: Respecto a los recursos humanos, el 73.6 % de los profesionales realizó un curso de manejo de pacientes en UCI durante la COVID-19 y el 67.0 % sobre control de infecciones relacionadas con los servicios sanitarios. El 64.8 % pudo hacer frente a las dificultades en la UCI, el 69,2 % fue reasignado de otros sectores hospitalarios para atender las demandas de la UCI y la mayoría de los profesionales (76.9 %) no tuvo apoyo psicológico para la pandemia. En cuanto a los recursos organizativos, el 100 % de las camas de la UCI de adultos estuvieron ocupadas durante la pandemia, con una diferencia entre antes y durante, durante y después de la crisis, con un aumento exponencial de la capacidad de camas (p<0,001), y sin diferencias significativas entre antes y después de la pandemia (p=0,035). Los recursos materiales escasearon y disminuyeron, como equipos de protección personal, oxígeno, medicamentos, entre otros Conclusión: Se pudo identificar la gestión de los recursos humanos, materiales y organizativos en los hospitales encuestados. Hubo un aumento exponencial de camas durante la crisis pandémica en comparación con la capacidad reportada por los profesionales antes de la pandemia. Por lo tanto, esta investigación contribuye al conocimiento de la gestión sanitaria y la reestructuración hospitalaria en tiempos de pandemia

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          STROBE initiative: guidelines on reporting observational studies.

          Reporting of observational studies is often inadequate, hampering the assessment of their strengths and weaknesses and, consequently, the generalization of study results. The initiative named Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) developed a checklist of 22 items, the STROBE Statement, with recommendations about what should be included in a more accurate and complete description of observational studies. Between June and December 2008, a group of Brazilian researchers was dedicated to the translation and adaptation of the STROBE Statement into Portuguese. The present study aimed to show the translation into Portuguese, introduce the discussion on the context of use, the potential and limitations of the STROBE initiative.
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            COVID-19: unidades de terapia intensiva, ventiladores mecânicos e perfis latentes de mortalidade associados à letalidade no Brasil

            O acelerado aumento do número de casos de doença pelo novo coronavírus (COVID-19) exige que os países aumentem as vagas nas unidades de terapia intensiva (UTI). Doenças respiratórias, neoplasias, cardiopatias, hipertensão e diabetes aumentam sua letalidade. O estudo objetivou identificar tanto as regiões com as maiores taxas de mortalidade específica por essas doenças quanto as com maior escassez de UTI e ventiladores pulmonares. Foi realizado um estudo ecológico transversal, as unidades de análise foram as Regiões de Saúde no Brasil. A fonte de dados foi o Departamento de Informática do SUS - DATASUS (Cadastro Nacional de Estabelecimentos de Saúde - 2019, Sistemas de Informação de Mortalidade - 2017 e Projeções Populacionais - 2017). Foram calculadas as taxas por 100 mil habitantes de mortalidade específica para hipertensão, neoplasias, diabetes, doenças cardíacas e respiratórias, leitos de UTI total, leitos de UTI privados, leitos de UTI do Sistema Único de Saúde (SUS) e ventiladores do SUS. O perfil de mortalidade foi determinado pela análise de perfis latentes, e a análise de clusters dos leitos e ventiladores foi feita pelo método de varredura espacial. Mapas de Kernel foram construídos para a visualização dos dados. O nível de significância foi de 5%. Observou-se quatro perfis latentes de mortalidade. As regiões de saúde com as maiores médias na mortalidade estão localizadas em regiões cuja escassez de leitos de UTI e de ventiladores foi visualizada, especialmente, em partes das regiões Nordeste, Sudeste e Sul. A localização espacial das regiões com maior mortalidade e com escassez de leitos de UTI/ventiladores requer a atenção dos gestores e planejadores públicos, para o enfrentamento eficiente e equânime da epidemia no Brasil.
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              Psychological distress and burnout among healthcare worker during COVID-19 pandemic in India—A cross-sectional study

              Background COVID-19 has inundated the entire world disrupting the lives of millions of people. The pandemic has stressed the healthcare system of India impacting the psychological status and functioning of health care workers. The aim of this study is to determine the burnout levels and factors associated with the risk of psychological distress among healthcare workers (HCW) engaged in the management of COVID 19 in India. Methods A cross-sectional study was conducted from 1 September 2020 to 30 November 2020 by telephonic interviews using a web-based Google form. Health facilities and community centres from 12 cities located in 10 states were selected for data collection. Data on socio-demographic and occupation-related variables like age, sex, type of family, income, type of occupation, hours of work and income were obtained was obtained from 967 participants, including doctors, nurses, ambulance drivers, emergency response teams, lab personnel, and others directly involved in COVID 19 patient care. Levels of psychological distress was assessed by the General health Questionnaire -GHQ-5 and levels of burnout was assessed using the ICMR-NIOH Burnout questionnaire. Multivariable logistic regression analysis was performed to identify factors associated with the risk of psychological distress. The third quartile values of the three subscales of burnout viz EE, DP and PA were used to identify burnout profiles of the healthcare workers. Results Overall, 52.9% of the participants had the risk of psychological distress that needed further evaluation. Risk of psychological distress was significantly associated with longer hours of work (≥ 8 hours a day) (AOR = 2.38, 95% CI(1.66–3.41), income≥20000(AOR = 1.74, 95% CI, (1.16–2.6); screening of COVID-19 patients (AOR = 1.63 95% CI (1.09–2.46), contact tracing (AOR = 2.05, 95% CI (1.1–3.81), High Emotional exhaustion score (EE ≥16) (AOR = 4.41 95% CI (3.14–6.28) and High Depersonalisation score (DP≥7) (AOR = 1.79, 95% CI (1.28–2.51)). About 4.7% of the HCWs were overextended (EE>18); 6.5% were disengaged (DP>8) and 9.7% HCWs were showing signs of burnout (high on all three dimensions). Conclusion The study has identified key factors that could have been likely triggers for psychological distress among healthcare workers who were engaged in management of COVID cases in India. The study also demonstrates the use of GHQ-5 and ICMR-NIOH Burnout questionnaire as important tools to identify persons at risk of psychological distress and occurrence of burnout symptoms respectively. The findings provide useful guide to planning interventions to mitigate mental health problems among HCW in future epidemic/pandemic scenarios in the country.
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                Author and article information

                Journal
                ech
                Enfermería: Cuidados Humanizados
                Enfermería (Montevideo)
                Facultad de Ciencias de la Salud - Universidad Católica del Uruguay. (Montevideo, , Uruguay )
                1688-8375
                2393-6606
                2023
                : 12
                : 2
                : e3341
                Affiliations
                [3] Ceará orgnameUniversidade Regional do Cariri Brazil
                [2] Ceará orgnameUniversidade Regional do Cariri Brazil
                [1] Ceará orgnameUniversidade Regional do Cariri Brazil luis.reis@ 123456urca.br
                [4] Ceará orgnameUniversidade Regional do Cariri Brazil
                Article
                S2393-66062023000201209 S2393-6606(23)01200201209
                10.22235/ech.v12i2.3341
                d88dac48-c84b-40d5-bc5c-269e50c08308

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 06 May 2023
                : 21 September 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 24, Pages: 0
                Product

                SciELO Uruguay

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                Artigos Originais

                hospital administration,personnel management,material resource management,unidades de terapia intensiva,COVID-19,reestruturação hospitalar,administração hospitalar,gestão de recursos humanos,gestão de recursos materiais,unidades de cuidados intensivos,reestructuración hospitalaria,administración hospitalaria,gestión de recursos humanos,gestión de recursos materiales,intensive care units,hospital restructuring

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