Federal Hospital Research Articles

Perspectives of man submitted to penectomy

Objective: this article aims to describe the perspectives of patient submitted submitted to penectomy and to know the perspectives of this patient after the penectomy. Methods: its a case study realized in a federal hospital of Rio de Janeiro city with two patients who were admitted to the hospital during 2017 and underwent to penectomy surgery. The data collection was realized during 2018 with a semi-structured interview. The participants were protected by the ethics principles established by the resolution 466/ 2012 of the National Health Council and this study was approved under the number 2.769.381. Results: it was found that penectomy in this case studies was the only therapy. Thereby, the desire of being among their family and to extend their life was determinants to adhere the therapy. Conclusion: it was concluded that even with the changes in their body, the penectomy was realized to extend the life.

Predictors of Seclusion and Restraint Following Injurious Assaults on Psychiatric Units.

The aim of this study was to describe use of seclusion and restraint after injurious assaults by psychiatric inpatients in U.S. hospitals, including examination of hospital, unit, assaultive patient, and assault characteristics as predictors of seclusion/restraint use. Data from 2004 to 2017 on 23,630 injurious assaults reported by 747 psychiatric units in 482 general hospitals were analyzed. Odds of seclusion, odds of three restraint types (device, hold, pharmacological), and duration of seclusion and device restraint were modeled as functions of hospital, unit, assaultive patient, and assault characteristics. Compared with teaching hospitals, nonteaching hospitals had lower rates of seclusion but higher rates of all three types of restraint. Seclusion and restraint rates were lower in government hospitals and hospitals in metropolitan settings. Pharmacological restraint was most common in for-profit hospitals; seclusion was most common in nonprofit hospitals. Episodes of seclusion and device restraint were approximately 20% shorter in teaching hospitals than in nonteaching hospitals and lasted markedly longer in federal government hospitals. Hospitals in metropolitan settings reported 30% longer time spent in seclusion, on average. Involuntary admission was associated with higher odds of seclusion, device restraint, and hold. Female patients were less likely than males to be restrained with a device, and their seclusion and device restraint episodes tended to be shorter. The number of persons injured in an assault predicted odds of seclusion and all three types of restraint. The maximum level of injury sustained predicted odds of seclusion, device restraint, and hold, as well as duration of both seclusion and device restraint. Odds of seclusion/restraint were lower when the most severely injured person was a patient rather than a clinical health care worker. Inconsistencies were observed in seclusion and restraint use, which varied by hospital type, patient sex and admission status, maximum level of injury sustained, and type of person most severely injured. Thus, there may be room for improvement in hospital and unit policies and practices. More comprehensive data are needed for further research on use of seclusion and restraint in response to incidents other than injurious assault.

Sepsis Among Medicare Beneficiaries: 2. The Trajectories of Sepsis, 2012-2018.

To distinguish characteristics of Medicare beneficiaries who will have an acute inpatient admission for sepsis from those who have an inpatient admission without sepsis, and to describe their further trajectories during and subsequent to those inpatient admissions. Analysis of paid Medicare claims via the Centers for Medicare and Medicaid Services DataLink Project. All U.S. acute care hospitals, excepting federal hospitals (Veterans Administration and Defense Health Agency). Medicare beneficiaries, 2012-2018, with an inpatient hospital admission including one or more explicit sepsis codes. None. Prevalent diagnoses in the year prior to the inpatient admission; healthcare contacts in the week prior to the inpatient admission; discharges, transfers, readmissions, and deaths (trajectories) for 6 months following discharge from the inpatient admission. Beneficiaries with no sepsis inpatient hospital admission for a year prior to an index hospital admission for sepsis were nearly indistinguishable by accumulated diagnostic codes from beneficiaries who had an index hospital admission without sepsis. Although the timing of healthcare services in the week prior to inpatient hospital admission was similar among beneficiaries who would be admitted for sepsis versus those whose inpatient admission did not include a sepsis code, the setting differed: beneficiaries destined for a sepsis admission were more likely to have received skilled nursing or unskilled nursing (e.g., nursing aide for activities of daily living) care. In contrast, comparing beneficiaries who had been free of any inpatient admission for an entire year and then required an inpatient admission, acute inpatient stays that included a sepsis code led to more than three times as many deaths within 1 week of discharge, with more admissions to skilled nursing facilities and fewer discharges to home. Comparing all beneficiaries who were admitted to a skilled nursing facility after an inpatient hospital admission, those who had sepsis coded during the index admission were more likely to die in the skilled nursing facility; more likely to be readmitted to an acute inpatient hospital and subsequently die in that setting; or if they survive to discharge from the skilled nursing facility, they are more likely to go next to a custodial nursing home. Although Medicare beneficiaries destined for an inpatient hospital admission with a sepsis code are nearly indistinguishable by other diagnostic codes from those whose admissions will not have a sepsis code, their healthcare trajectories following the admission are worse. This suggests that an inpatient stay that included a sepsis code not only identifies beneficiaries who were less resilient to infection but also signals increased risk for worsening health, for mortality, and for increased use of advanced healthcare services during and postdischarge along with an increased likelihood of an inpatient hospital readmission.

Sepsis Among Medicare Beneficiaries: 3. The Methods, Models, and Forecasts of Sepsis, 2012–2018*

To evaluate the impact of sepsis, age, and comorbidities on death following an acute inpatient admission and to model and forecast inpatient and skilled nursing facility costs for Medicare beneficiaries during and subsequent to an acute inpatient sepsis admission. Analysis of paid Medicare claims via the Centers for Medicare & Medicaid Services DataLink Project (CMS) and leveraging the CMS-Hierarchical Condition Category risk adjustment model. All U.S. acute care hospitals, excepting federal hospitals (Veterans Administration and Defense Health Agency). All Part A/B (fee-for-service) Medicare beneficiaries with an acute inpatient admission in 2017 and who had no inpatient sepsis admission in the prior year. None. Logistic regression models to determine covariate risk contribution to death following an acute inpatient admission; conventional regression to predict Medicare beneficiary sepsis costs. Using the Hierarchical Condition Category risk adjustment model to illuminate influence of illness on outcome of inpatient admissions, representative odds ratios (with 95% CIs) for death within 6 months of an admission (referenced to beneficiaries admitted but without the characteristic) are as follows: septic shock, 7.27 (7.19-7.35); metastatic cancer and acute leukemia (Hierarchical Condition Category 8), 6.76 (6.71-6.82); all sepsis, 2.63 (2.62-2.65); respiratory arrest (Hierarchical Condition Category 83), 2.55 (2.35-2.77); end-stage liver disease (Hierarchical Condition Category 27), 2.53 (2.49-2.56); and severe sepsis without shock, 2.48 (2.45-2.51). Models of the cost of sepsis care for Medicare beneficiaries forecast arise approximately 13% over 2 years owing the rising enrollments in Medicare offset by the cost of care per admission. A sepsis inpatient admission is associated with marked increase in risk of death that is comparable to the risks associated with inpatient admissions for other common and serious chronic illnesses. The aggregate costs of sepsis care for Medicare beneficiaries will continue to increase.

Idiopathic granulomatous mastitis: Literature review and retrospective analysis of the sample at hospital federal da lagoa from 2013 to 2017

Introduction: Idiopathic Granulomatous Mastitis (IGM) is a benign inflammatory, rare and chronic condition. It constitutes about 24% of all breast inflammatory diseases, and its recurrence ranges from 16% to 50%. Its etiology was not completely elucidated. Breastfeeding and local trauma can be present. Other hypotheses include the use of oral contraceptives, hyperprolactinemia, smoking, infection, autoimmune diseases and alpha 1 antitrypsin deficiency. Objectives: To analyze data from patients in Hospital Federal da Lagoa diagnosed with IGM, and compare the results with the literature. METHOD: We conducted a retrospective analysis of the medical charts in Hospital da Lagoa, Rio de Janeiro, between 2013 and 2017, and identified 15 women, aged between 21 and 76 years, with IGM. RESULT: Of the 15 patients, 14 (93.3%) were tested for mastitis caused by common germs and Koch’s bacillus. Thoracic x-ray, PPD and culture were performed, and one patient tested positive for BK. Of the 14 patients with negative result for secondary infection, one was pregnant, one had HIV, and the other 12 (85.7%) did not present any specificities. At physical examination, 10 women (66.6%) had ulcer, 9 (60%) had a palpable nodule. Eleven patients (73.3%) had undergone an ultrasound, 5 (45.4%) with BIRADS 4; 4 (36.3%) with BIRADS 3; one patient (9%), BIRADS 2, and two (18.1%), BIRADS 1. In the mammography of the first appointment, 7 (46.6%) had records int he medical chart. Three (42.8%) with BIRADS zero; 2 (28.5%), BIRADS 3; one (14.3%), BIRADS 4, and another one (14.3%), BIRADS. Six patients were submitted to some surgical treatment (40%); regarding medicine treatment, 10 patients had records. One (10%) received RIP scheme; 4 (40%) received antibiotic therapy; two (20%), a combination of antibiotics and corticoids (oral); one (10%), a combination of methotrexate with topic and oral corticoid; two (20%, topic corticoid. Conclusion: By comparing the medical charts’ review with the literature, the results regarding clinical presentation, diagnosis and treatment are similar. The histopathological study is gold standard for diagnostic confirmation, and the medicinal conduct with regular follow-up is the best treatment.

Occupational exposure to sharp instrument injuries in a federal hospital.

Introduction:Occupational exposure to potentially contaminated sharp instruments can result in the transmission of several pathogens and diseases. It is therefore necessary to investigate the factors that lead to these events and the interventions that can be used to address them.Objectives:To assess and describe the frequency of occupational exposure to sharps injury among employees of the Instituto Nacional de Câncer José Alencar Gomes da Silva in 2017 and 2018.Methods:This was a cross-sectional, exploratory and descriptive study based on the records of occupational accidents involving exposure to biological materials and the reports made to the Institute’s Occupational Health Division.Results:A total of 108 incidents were reported, 87 of which involved sharp instruments. Most accidents occurred in the surgical ward, and involved medical staff. The findings revealed low adherence to clinical and laboratory follow-up protocols. There were several errors in data entry and high rates of missing data for important characteristics of the accidents and victims, which prevented a more thorough description of these incidents.Conclusions:This study revealed several aspects of occupational accidents, victims and follow-up procedures, allowing for the discussion of strategies that could improve the reporting, prevention and management of these events.

Impacto da pandemia de COVID-19 em um programa de residência médica em pediatria no município do Rio de Janeiro

INTRODUCTION: In March 2020, the COVID-19 pandemic - a disease caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) was decreed. Since then, there has been a need for adaptations in the pediatric medical residency program (MRP) at a federal hospital in the city of Rio de Janeiro. METHODS: Retrospective observational study whose objective was to describe the modifications in the pediatric MRP at a federal hospital resulting from the COVID-19 pandemic. RESULTS: Our pediatric MRP implemented adaptations such as: postponement of outpatient consultations; reduction in the number of residents allocated to the wards; temporary suspension of external rotations except for maternity rotation; training for proper dressing and undressing procedures; removal of residents with chronic diseases, pregnancy and those with suspected COVID-19; implementation of remote consultation and educational activities in a virtual environment. Data from March, April, May, and June 2020 were analyzed. During this period, 4 residents from pediatrics were removed due to chronic diseases or pregnancy. Of the 37 remaining residents of the PRM, 27 (73%) were removed due to issues related to COVID-19 (suspected COVID-19 or psychological stress). Of these, coronavirus infection was confirmed in 15 residents (40.5%). CONCLUSION: The pandemic caused the removal of many residents on suspicion of COVID-19 and alteration of the services routines. There was a significant reduction in outpatient consultations and suspension of face-to-face theoretical activities. In any case, the adoption of digital platforms for remote consultations and teaching activities allowed the maintenance of patient care and continued medical education.

Coinfecção por SARS-CoV-2 e S. aureus em pacientes internados em UTI pediátrica de hospital federal no Rio de Janeiro: relato de dois casos clínicos

A Residência Pediátrica (RP) é uma revista eletrônica trimestral, em publicação contínua, da Sociedade Brasileira de Pediatria (SBP), disponível em português e inglês, destinada aos médicos residentes de nossa especialidade, áreas afins e aos pediatras. O conteúdo da revista pode ser acessado livremente. A missão da RP é contribuir para a formação acadêmica dos residentes e incentivá-los a uma participação ativa na produção científica sobre temas pediátricos e relacionados à adolescência.

Job satisfaction among health professionals in a federal tertiary hospital in Nigeria.

Job satisfaction of health workers is essential in building up employee motivation and efficiency. The objective of this study is to ascertain the level of job satisfaction among health professionals in a federal tertiary health institution in Nigeria. This study was done at the National Orthopedic Hospital, Enugu (NOHE), in south-east Nigeria. Two hundred and thirty-six health workers were recruited from the various clinical departments via a systematic sampling technique. A questionnaire documenting relevant sociodemographic data and assessing the level of satisfaction with the financial remunerations, working conditions, infrastructure and equipment, learning and academic sponsorships, welfare packages, and performance appraisal systems was administered to them. The findings revealed a relatively low level of job satisfaction among the staff of NOHE especially with regards to financial remuneration, working conditions, tools and infrastructure, learning and training opportunities/sponsorship, leadership style, and welfare packages with increasing dissatisfaction in that order. However, the average staff is satisfied with the performance appraisal system as regards promotion. The majority of the clinical staff have a low level of job satisfaction. A review of the salary structure of health professionals as well as improving the working conditions, tools, and infrastructures in the hospital is needed.

Predictive model of hospitalization for children and adolescents with chronic disease

Describe a predictive model of hospitalization frequency for children and adolescents with chronic disease. A decision tree-based model was built using a database of 141 children and adolescents with chronic disease admitted to a federal public hospital; 18 variables were included and the frequency of hospitalization was defined as the outcome. The decision tree obtained in this study could properly classify 80.85% of the participants. Model reading provided an understanding that situations of greater vulnerability such as unemployment, low income, and limited or lack of family involvement in care were predictors of a higher frequency of hospitalization. The model suggests that nursing professionals should adopt prevention actions for modifiable factors and authorities should make investments in health promotion for non-modifiable factors. It also enhances the debate about differentiated care to these patients.

Perceptions of adolescents with cancer undergoing palliative care about their illness process

To understand the perception of adolescents with cancer undergoing palliative cares about their illness process. An exploratory and qualitative study, per formed at a federal public hospital specialized in oncology disease in Rio de Janeiro, through interviews with nine adolescents aged 12 to 20 years old, from July to August 2017. Data was submitted to thematic analysis and the theoretical framework was Hildegard Peplau's Theory of Interpersonal Relationships. Three categories emerged: Living the difficult moment of the trajectory of the disease; Feeling the social isolation and that life has stopped; and Overcoming the difficult stage of the disease. They addressed the trajectory of the disease since the diagnosis, with the awakening of feelings of isolation and stagnation of life. Moreover, they highlighted the overcoming power of these adolescents. The study made it possible to know the difficulties experienced during the course of the disease, providing subsidies for the practice of nurses to happen in a sensitive, individualized manner and focused on the individual's need thus enhancing comfort and quality of life.

The Federal Effort to Desegregate Southern Hospitals and the Black-White Infant Mortality Gap

In 1966, Southern hospitals were barred from participating in Medicare unless they discontinued their long-standing practice of racial segregation. Using data from five Deep South states and exploiting county-level variation in Medicare certification dates, we find that gaining access to an ostensibly integrated hospital had no effect on the Black-White infant mortality gap, although it may have discouraged small numbers of Black mothers from giving birth at home attended by a midwife. These results are consistent with descriptions of the federal hospital desegregation campaign as producing only cosmetic changes and illustrate the limits of anti-discrimination policies imposed upon reluctant actors.

Hand hygiene in high-complexity sectors as an integrating element in the combat of Sars-CoV-2.

to perform a situational diagnosis of the behavior of health professionals concerning hand hygiene practices in highly-complex sectors. this quantitative and retrospective study was based on reports (2016 and 2017) of Adult and Pediatric ICUs of a Federal hospital in Rio de Janeiro. one thousand two hundred fifty-eight opportunities for hand hygiene were analysed. The chance of professionals sanitizing hands in Pediatric ICUs is 41.61% higher than in Adult ICUs. Concerning proper hand hygiene, the medical team had a 39.44% lower chance than the nursing team. Others had a 30.62% lower chance when compared to the nursing team. The moment "after contact with the patient" presented 4.5275 times the chance in relation "before contact with the patient". in front of hand hygiene recommendations to control COVID-19, diagnostic assessment and previous analysis of the behavior of professionals proved to be positive.

The Federal Effort to Desegregate Southern Hospitals and the Black-White Infant Mortality Gap

In 1966, Southern hospitals were barred from participating in Medicare unless they discontinued their long-standing practice of racial segregation. Using data from five Deep South states and exploiting county-level variation in Medicare certification dates, we find that gaining access to an ostensibly integrated hospital had no effect on the Black-White infant mortality gap. Similarly, there is little evidence that the federal hospital desegregation campaign contributed to the trend towards in-hospital births among Southern Black mothers. These results are consistent with descriptions of the campaign as producing only cosmetic changes and illustrate the limits of anti-discrimination policies imposed upon reluctant actors.

Fatores de risco maternos para toxoplasmose numa maternidade pública do nordeste do brasil

Introduction: Vertical transmission by Toxoplasma gondii usually occurs in women who are infected for the first time during pregnancy. Screening for toxoplasmosis during pregnancy is one of the measures adopted in our country as a form of prevention. Objective: To investigate maternal risk factors associated with gestational toxoplasmosis in a large maternity hospital located in Fortaleza-Ceará. Methodology: This is an observational, quantitative comparative study conducted in a federal public maternity hospital located in Fortaleza, Ceará, Brazil in 2014. Data collection occurred from January to March 2014, through the analysis of medical records. guided by a data collection instrument. The research project was submitted to the Assis Chateaubriand School Maternity Research Ethics Committee (MEAC), and was approved in the register 513.392 / 2014-14. Results: The sample analyzed was established by high risk pregnant women aged 13 to 40 years. The diagnosis of toxoplasmosis was predominant in the age group between 20 and 30 years. As managers diagnosed with toxoplasmosis reside mainly in the interior of Ceará with statistically significant difference compared to pregnant women residing in the capital. Conclusion: It can be concluded that the analysis analyzed as the variables that were associated with toxoplasmosis were: residing within the state, gestational week between 13 to 27 weeks, normal sharing and using positive IgG serology for toxoplasmosis.

Gerenciamento de risco em bombas de infusão

Introduction: The increasing incidence of problems related to medical care equipment – infusion pumps. Objective: To make a situational diagnosis regarding the preventive maintenance of peristaltic volumetric infusion pumps. Method: Descriptive, quantitative research, conducted in a federal hospital in the city of Rio de Janeiro from April to June 2017. Results: 371 peristaltic volumetric infusion pumps of two different brands.Regarding the record of the last preventive maintenance identified, less than 10.0% of the equipment studied had maintenance on the day, 54.5% (n = 202) had a record of expired preventive maintenance, 5.9% (n = 22) had an unreadable record of preventive maintenance and 29.9% (n = 111) had no record of preventive maintenance. Conclusions: This situational diagnosis revealed an outdated technology park, with a significant lag in relation to the validity of preventive maintenance of peristaltic volumetric infusion pumps. The improvement actions began with the updating of the patrimony data referring to the quantity of peristaltic volumetric infusion pumps of the hospital. Subsequently, equipment with expired, ineligible and absent preventive maintenance was gradually collected for replacement. Finally, a monitoring of the conditions of the peristaltic volumetric infusion pumps was initiated so that there is a continuous control of the conditions of this equipment.

Clinical Characteristics of Brazilian Patients with Paroxysmal Nocturnal Hemoglobinuria and Changing Prognosis with Eculizumab

Introduction: Paroxysmal nocturnal hemoglobinuria (PNH) is a nonmalignant clonal disease of hematopoietic cells due to acquired mutations in the phosphatidylinositol glycan class A (PIG-A) gene, which is required for glycosylphosphatidylinositol (GPI) anchor biosynthesis. This leads to partial or complete absence of all GPI-linked proteins, who are complement regulatory proteins, resulting in an increased sensitivity of the red blood cells to the action of complement. PNH is characterized by signs and symptoms related to intravascular hemolysis, hypercoagulability state, and varying degrees of medullary insufficiency. The anti-complement therapy radically changed the PNH patients outcomes. However, there are little data on the clinical characteristics of PNH in Latin American countries. Methods: We performed a retrospective analysis of 109 patients with PNH clone followed from January 1987 until July 2019 in two Brazilian centers: Universidade Federal de Sao Paulo and Hospital Sirio Libanes (Sao Paulo-Brazil). Most patients (88%) were evaluated while the others had lost follow up or died and data was obtained from their medical reports. Patients were separated into 3 groups: classical PNH (n=44) PNH associated with other bone marrow disorder(n=12), and subclinical PNH, defined as PNH clone (at least 0.01% of cells with PNH clone) associated with another bone marrow disorder (n=53, aplastic anemia in 95% of cases). Median follow up was 60 months (range: 3-394). Results: Median age at diagnosis was 41 years (range: 18-81), and 51% were male. Among the 56 patients with hemolytic PNH, 86% had fatigue, 66% hemoglobinuria, 45% abdominal pain and 16% dysphagia. Venous thromboembolism was observed in 14 cases (25%), with abdominal thrombosis in 7 cases (50%). Seven patients (13%) had arterial thrombosis (stroke or transient ischemic attack). Only 5 patients (10%) in the hemolytic group had acute renal failure and needed dialysis therapy due to a hemolytic crisis, but progressed to recovery of renal function after the event. No patient in this series had moderate or severe chronic kidney disease. Most hemolytic patients (73%) were treated with eculizumab, with a median time from diagnosis to the start of eculizumab of 25 months (range: 2-275). All eculizumab-treated patients had significant reduction in intravascular hemolysis with lactate dehydrogenase (LDH) normalization. Most had significant improvement in anemia, with increase in the median hemoglobin from 9.1 g/dL before treatment to 11.7 g/dL after eculizumab. The vast majority (94%) became transfusion-independent. Overall survival (OS) at 5 years was 100% at 5 years for classical PNH (n=44), 89% for subclinical PNH (n=53) and 71% for PNH associated with another bone marrow disease (n=12). Conclusion: The clinical data and the distribution of the three subtypes of PNH in this study in this large series of Brazilian PNH patients were similar to other published series, except for a lower frequency of venous or arterial thrombosis in hemolytic patients before eculizumab treatment and a lower frequency of chronic kidney disease in our series. We also confirmed in our series the efficacy of eculizumab in controlling hemolysis and PNH-related complications and death risk. Disclosures No relevant conflicts of interest to declare.

Analysis of the cost of care for children and adolescents with medical complex chronic conditions.

This paper aimed to identify the use of technology and to analyze the cost of hospital care for children and adolescents with medical complex chronic conditions at a public federal hospital specialized in high-complexity pediatric care, and was performed concomitantly with a prospective cohort study conducted over a one-year period. It included 146 patients with complex medical chronic conditions and 37 non-chronic patients. The analysis showed that most patients had, on average, two hospitalizations a year and were diagnosed with diseases related to at least two organic systems. Catheters, drains and gastrostomy were the most common technologies used. Median direct costs of patients with medically complex chronic conditions were higher than those of non-chronic patients when comparing the use of technology. The study shows high hospitalization cost to these patients. Technology use and hospitalization care costs documentation yields more data to support decision-makers in the planning, managing, and financing of pediatric health policies.

GESTÃO DO LIXO ELETRÔNICO MÉDICO-HOSPITALAR EM HOSPITAIS PÚBLICOS FEDERAIS

O avanço tecnológico e a obsolescência programada, combinados com o elevado consumo de equipamentos eletrônicos, produzem uma grande quantidade de resíduos desses produtos. Como, ao ser descartado inadequadamente, esse e-lixo pode ser um risco ao homem e ao meio ambiente, a preocupação com sua destinação tem aumentado junto à sociedade e aos governos. Este estudo tem por objetivo verificar a gestão do lixo eletrônico médico hospitalar em hospitais públicos federais do Rio de Janeiro. Foi realizada uma pesquisa qualitativa, com finalidade descritiva, utilizando pesquisa de campo. Os resultados apontam que: a maioria dos hospitais estudados utiliza os equipamentos o máximo possível e só se desfaz deles quando não há mais possibilidade de mantê-los; a doação dos equipamentos é o desfazimento mais comum; os entraves burocráticos são o maior obstáculo; e os hospitais de pesquisa, em comparação com os assistenciais, investem em aparelhos tecnologicamente mais modernos. Para trabalhos futuros, é recomendado fazer uma análise mais abrangente sobre a gestão de outros tipos de equipamentos eletrônicos, com a finalidade de verificar se as dificuldades são as mesmas

Shift work sleep disorders and associated factors among nurses at federal government hospitals in Ethiopia: a cross-sectional study

ObjectiveThe current study was conducted to assess the prevalence and associated factors of shift work sleep disorder among nurses working at Ethiopian federal government hospitals in Addis Ababa.MethodsAn institutional-based, cross-sectional...