Paramedical Personnel Research Articles

Poisoning with Local Anesthetics Following Circumcision : A Case Report

Introduction: Circumcision or posthectomy is the removal of the foreskin, this act seems commonplace practiced by paramedical personnel or unqualified traditional practitioners who may cause significant complications. Objective: Our work aimed to highlight one of the complications of this act which must remain a supervised medical act. Observation: We report the case of a 2-month-old infant who presented with complications related to anesthesia. the clinic was dominated by convulsions and alteration of the state of consciousness 15 minutes after circumcision in this well infant carrying without any particular history. The evolution was favorable thanks to support rapid and urgent about 20 minutes with the cessation of convulsions and a return to consciousness, the patient was monitored for 48 hours then return home was indicated due to the absence other complications. Conclusion: Circumcision is a widespread act throughout the world either by medical necessity or by religious tradition. its trivialization and its practice by non-experts, explains the multiple complications observed.

Разработка системы управления конфликтами в отделении реанимации и интенсивной терапии многопрофильного стационара с помощью LEAN-технологий: пилотное исследование.

Objective: to develop and evaluate the effectiveness of a conflict management system using the example of the intensive care unit of a multidisciplinary hospital Materials and methods. The study was conducted on the basis of City Clinical Hospital No. 1 named after. N. I. Pirogov, resuscitation and intensive care units in 2023. The study included 74 department employees‑42 medical (34 male (80.9%) and 8 female (19.1%), and 47 nursing staff: 12 male (25.3%) and 35 female (74.5%). In order to identify the presence of conflict situations (incidents), their causes and factors provoking them, questionnaires were developed: questionnaire 1—initial assessment (input) and questionnaire 2—assessment of the results of the proposed conflict management model. analysis of operational activities, a Gantt chart was drawn up for medical and paramedical personnel, a comparative and statistical analysis of the results was performed and an algorithm for making management decisions was developed. Results. A tool for identifying conflict situations in a universal electronic form has been created. According to the survey results: conflicts do occur, they are regular, and the participants in the conflicts are department employees. The main cause of conflicts is the conditions of daily operating activities and non-compliance with ethical and deontological standards. Losses in the provision of medical care were identified and assessed: defects in the provision of medical care (defects); waiting is the time before the provision of medical services; untapped potential of employees; transport losses. An algorithm for managing conflicts and preventing future incidents has been developed and implemented. Conclusions. The study demonstrated the need for clear organization of operational activities; formation of protocols for improving professional competencies; formation of a motivational system; creation of an information analytical system for control and monitoring of current processes.

Nursing staff in armed conflicts of the past and present

The article is devoted to the work of paramedical personnel in conditions of active hostilities, both in the historical aspect and in the military conflict of the present time. The working conditions of paramedical personnel in a combat situation and the objective difficulties in providing medical care, as well as the requirements for physical, special and military training, are reflected.

Intentional Insulin Overdose and Depression in Subjects with and Without Diabetes Mellitus: A Commentary.

Insulin is an essential medication for people with type 1 diabetes mellitus and for some people with type 2 diabetes. Interestingly, insulin abuse has been reported as a mode of suicide, not only among people with diabetes, but also among their relatives, and among medical and paramedical personnel who have access to insulin. The aim of the present commentary was to raise awareness of potential depression-related intentional insulin overdose and its complications, as well as of the diagnosis and treatment of this entity. Insulin overdose may lead to severe and prolonged hypoglycemia, hypoglycemic coma, and death. Moreover, hypokalemia, hypomagnesemia, hypophosphatemia, and elevated liver enzymes are common. Insulin overdose should be suspected among people with diabetes in case of unexplained prolonged hypoglycemia and among people without diabetes who exhibit hypoglycemia and may have access to diabetic medications. The ratio of insulin to C-peptide helps distinguish exogenous insulin administration from endogenous secretion. The cornerstone of therapy is prompt administration of concentrated glucose infusions for days with simultaneous oral intake, when possible, and intense glucose monitoring to prevent hypoglycemia. Moreover, monitoring of serum electrolyte levels is recommended. Finally, psychiatric evaluation aiming at early identification of depression and suicidality is of paramount importance.

Assessment of the level of herd immunity to measles virus, chickenpox and hepatitis B among medical workers in an infectious diseases hospital

Herd immunity is formed through vaccination in a certain group of people, the purpose of which is to prevent infection and spread of infectious diseases. Thanks to vaccination, the incidence of some infections has decreased several times, especially among risk groups. We consider medical personnel who are in constant contact with patients of various diseases to be one of the risk groups. The study analyzed data from 250 employees of an anti-tuberculosis dispensary, among whom the proportion of women was 86.0 %. The mean age was 51 ± 7.8 years. Among those surveyed, the share of doctors was 16.4 %, paramedical personnel — 37.2 %, junior medical personnel — 24.0 %, general non-medical personnel — 22.4 %. A selection was made from medical documentation on vaccination of dispensary employees (sanitary records, extracts from outpatient cards, vaccination certificates). The data was entered into the database, analysis was carried out using licensed software version Statistica 13. The purpose of our study was to study collective immunity against measles, chickenpox and viral hepatitis B among employees of an anti-tuberculosis hospital. All employees were found to have high titers of post-vaccination immunity to measles (3.1±4.1 IU/ml) and chickenpox (9.1±0.8 mIU/ml). Post-vaccination immunity to hepatitis B differed among those examined. 18.1 % of employees did not have postvaccination protective antibodies. In 16.4 %, the level of anti-HBsAg was low, which made it possible to immediately formulate and carry out revaccination against viral hepatitis B among these employees. In the majority of medical personnel, the titer of anti-HBs was sufficient. Preventive measures and high-quality work of epidemiologists are an extremely important link in the work of all medical institutions. Where the infection spreads spontaneously, where human will does not interfere, the level and collective susceptibility of the population are the main limiting factors of the epidemic process.

Main trends in providing medical personnel to the state healthcare system of the Russian Federation

The purpose of this study is to analyze trends in the provision of medical personnel to the state health care system during the implementation of state programs and national projects in the field of health care. Materials and methods. Statistical collections of the Ministry of Health of Russia for 2012–2023, regulatory legal acts, passport of national project. Methods of descriptive statistics and analytical were used. Results. A reduction in indicators of the supply of doctors, paramedical personnel and the ratio of doctor/nursing medical personnel and a discrepancy between their target values established in state programs and national projects for the development of healthcare was revealed. Differences in the values of target indicators of state programs and national projects have been identified. Conclusion. The need to take urgent measures to eliminate the reduction in the supply of medical personnel has been identified. Differences in the dynamics of staffing indicators indicate the heterogeneity of the level of development of regions and their preparedness for events within the framework of state programs and national projects to achieve target indicators. Measures are needed to eliminate territorial imbalances, as well as to search for mechanisms to equalize differences between the constituent entities of the Russian Federation. Differences in the values of indicators for achieving the goals of state programs and national projects complicate their assessment and determine the need to form a hierarchy of state programs and national projects, as well as the development of scientifically based target indicators, taking into account regional characteristics and the needs of the population for medical care.

On the question of electrical safety in physiotherapy rooms: protective grounding of electrical equipment

Abstract. The article discusses current issues of electrical safety in medical and preventive organizations. Goal: to attract the attention of physiotherapy specialists to the correct organization of protective grounding as the main means of preventing electrical injuries. Material and research: modern regulatory framework for the technical operation of electrical installations of electrical energy consumers in medical premises, the selection and use of electrical equipment and grounding devices, the frequency of inspections, measurements and tests, passports of grounding devices. Conclusion. It seems important to carry out measures to prevent accidents during the operation of physiotherapeutic equipment in each physiotherapy unit. To increase the level of organization of work on electromedical devices. Exclude the admission of personnel to the work of paramedical personnel without mandatory verification of the implementation of organizational and technical measures in the preparation of workplaces. Health care facilities should regularly hold occupational safety days, during which health care personnel should learn cardiopulmonary resuscitation skills, which today can be done in multidisciplinary accreditation and simulation centers of medical universities and academies.

Geriatric health care in rural India: HR issues and public policy constraints

Purpose The purpose of this paper is to emphasize the need for holistic geriatric health care in rural India. Many older people in Indian villages suffer from chronic ailments without any relief or intervention because of inaccessible and unaffordable health-care services. This paper explores how holistic health care can be assured for older people in Indian villages. Design/methodology/approach This paper is based on reflections of the authors who have had experiences as caregivers to older persons within their respective families rooted in the Indian villages. Besides, they interacted with 30 older persons (18 males and 12 females in the age group of 60–80 years) living in the villages in three states of India, namely, Haryana, Rajasthan and Madhya Pradesh to develop a comprehensive viewpoint on the need of geriatric health care in rural India. Relevant reports, newspaper articles and research papers were also reviewed while developing viewpoints on such an important topic. Findings Geriatric health-care facilities in rural India are abysmal. The older people in the villages cannot leverage health-care facilities that are generally inaccessible, inadequate and unaffordable. Even the government support for medical treatment is minuscule. Furthermore, there is lack of trained health-care professionals at all levels, namely, doctors, nurses and paramedic personnel. Training opportunities in geriatrics are also negligible. The scenario vis-à-vis geriatric health care in rural India can be upturned by increasing public spending on health-care infrastructure, increasing numbers of health-care professionals and expanding training programmes in geriatrics. Originality/value This paper is based on the critical reflections of the authors as well as their informal interactions with some of the older people in the Indian villages.

Emergency Reporting System via Smartphone the Case Study of the Rajamangala University of Technology Thanyaburi (RMUTT)

The major objective of this research project is to develop a smartphone-based emergency reporting system, the case study of the Rajamangala University of Technology Thanyaburi (RMUTT). This was about to be the preliminary source for first aid instructions for major system users: students and paramedic staff (ambulance drivers and medical attendants). RMUTT’s students, faculties, and staff can not only report in case of any accidents or emergencies but also follow the system-provided first aid instructions. Paramedic staff can be reported to and can reply to the reporters. The development tools for websites and mobile applications are the Visual Studio Code with MySQL and phpMyAdmin as database engine. The overall 16 system functional features were tested for accuracy, and all were 100% accurate, which means that the system was comprehensively developed where all system objectives were satisfied. The expert evaluation result was a GOOD level ( = 4.43) where the 0.48 in standard deviation (S.D. = 0.48) means no significance. System evaluation by major users (paramedic personnel) is in GOOD level ( = 4.24) where the where the 0.71 in standard deviation (S.D. = 0.71) implied the significance.

The importance of collaborative work of paramedical personnel and doctors

The importance of collaborative work of paramedical personnel and doctors

Perceptions of medical and para-medical personnel on biomedical waste management

La gestion des déchets médicaux est une préoccupation mondiale de Santé Publique. Notre étude a consisté à déterminer les perceptions des acteurs médicaux et paramédicaux sur la gestion des déchets biomédicaux. Pour collecter les données dont nous avions besoin pour cette étude, nous avons fait usage de la méthode d’enquête, comme instrument nous avons utilisé un questionnaire. Les caractéristiques sociodémographiques, Gestion des déchets biomédicaux et les effets néfastes liés à la mauvaise gestion des déchets hospitaliers / biomédicaux sont les paramètres observés durant l’étude. Les résultats observés sont ; pour les caractéristiques sociodémographiques 54% des enquêtés sont du sexe masculin, 68% des enquêtés sont dans le tranche d’âge 20 et 49 ans, 48% de nos enquêtés ont un niveau de formation universitaire ; pour le paramètre gestion des déchets biomédicaux : 79% disent qu’il existe une politique de gestion des déchets au sein de leur formation sanitaire, 74%.des enquêtés affirment qu’il y a une mauvaise gestion de la politique des déchets et 56% des déchets sont produits par services médicaux et enfin pour le paramètre effets néfastes liés à la mauvaise gestion des déchets hospitaliers / biomédicaux, les résultats suivants ont été constatés : 60% de nos enquêtés affirment que le déficit budgétaire est la cause de la mauvaise gestion de déchets, les enquêtés ont pour la plupart indexé les risques traumatiques et infectieux 40% ainsi que les risques chimiques 22% sont à la base risques liés au mauvais transport des déchets biomédicaux et 56% de nos enquêtés affirment que la prolifération des moustiques et autres bestioles nuisibles et la prolifération des nuisances écologiques sont les conséquences d’une mauvaise gestion des déchets hospitaliers/ biomédicaux.

Dukungan Keluarga untuk Kepatuhan Pengobatan Tuberkulosis Paru

This study aims to investigate family support for compliance with pulmonary tuberculosis treatment. The method used in this research is systematic observation. The research results showed that out of 1,870 articles, 15 articles in this study found that the implementation of family support was not optimal in relation to four important points in family support such as support (informational, instrumental, emotional, and assessment). In conclusion, when the family always provides support in the form of information, emotions, appreciation, and also plays a role for tuberculosis patients, then this encouragement will influence their psychology, so that it will encourage them physically to take medication regularly and adopt a healthy lifestyle as an effort to achieve successful treatment. Apart from that, it is necessary to pay attention to policies, health programs, support for medical and paramedical personnel. Keywords: Family Support, Compliance, Pulmonary Tuberculosis

Perceived Environmental Health Effects of Clinical Waste Disposal in Ahoada Local Government Area of Rivers State Nigeria

The study examined the perceived health effects of clinical waste disposal in Adoada East Local Government Area of Rivers State, Nigeria on people. Purposive and random sampling techniques were employed for the collection of the data set comprising a sample size of 184 respondents selected from health/medical personnel, cleaners in health facilities, waste handlers, nurses, midwives, and doctors through structured questionnaires including basic statistical techniques using a criterion of 2.50 on the 4-point Likert scale. The result of the various analyses conducted revealed that the major types of waste generated from hospitals and medical facilities are needles, syringes scalpels, blades, and lancets, including placentas and other human tissues as well as papers, plastics, and glasses. The analysis from the returned questionnaires further indicates that the main methods of clinical waste disposal and treatment of used medical instruments/tools (autoclaving) include open burning of clinical wastes such as paper, plastic, cans, etc. The implications of the observed poor and inappropriate disposal of clinical waste in the study area include a high risk of infection among health/medical personnel and the spread of communicable diseases in the neighborhood. Given the depth of the analysis and the results generated, the study recommends the deployment of more qualified medical and para-medical personnel to the local government health facilities and the provision of modern equipment to tackle the rising cases of infectious diseases and community health associated with improper clinical waste disposal in the study area.

ANALISA ASSESMEN STANDAR PELAYANAN KESEHATAN DI INSTALASI GAWAT DARURAT RS PKU MUHAMMADIYAH SRUWENG TAHUN 2012

Government regulations governing the technical requirements contained in the emergency room in RI KEPMENKES NO. 856/Menkes/SK/IX/2009 Standards governing the ER (emergency room) .This study aims to find out analysis of assessment results PKU Muhammadiyah Hospital emergency room services Sruweng and compliance with the standards according to KEPMENKES RI NUMBER 856/Menkes/SK/IX/2009 Standards governing the ER Hospital. The study is qualitative research case study design. Research subjects were all medical and paramedical personnel who served in the emergency room, facilities and existing facilities and services in the IGD. Method of data collection is done by using the instruments of observation checklist with a list of statements of service standards according to IGD Kepmenkes No. 856/Menkes/SK/IX/2009, further in-depth interviews. The results the assessment conducted in PKU Muhammadiyah Hospital ER Sruweng through field observations and interviews were IGD service has exceeded the standard level of I is by achieving 103.50% and the achievement of outcomes assessment for level II emergency room services is quite high is 88.81%. Conclusion is more than the standard level I. However, to reach higher level is level II, IGD PKU Muhammadiyah Hospital Sruweng still require improvement and development to meet the service standards.

МОНИТОРИНГ УРОВНЯ АНТИТЕЛ ПРОТИВ ВИРУСА КОРИ СРЕДИ ПЕРСОНАЛА УЧРЕЖДЕНИЙ ЗДРАВООХРАНЕНИЯ ОБЛАСТНОГО ЦЕНТРА В 2023 г.

Background. In 2023, measles incidence has worsened in the world and the European region. The purpose of the study is to assess the strength of immunity against the measles virus based on the level of antibodies among students and staff of healthcare institutions of the regional center in 2023. Material and methods. The object of the study was different categories of medical workers (students, doctors, nurses, orderlies, paramedical personnel) of city/regional healthcare institutions in Grodno, who were examined for the content of measles antibodies. Determination of the level of IgG to the measles virus in blood serum was carried out by ELISA using Vector-Best test systems (Russia). The level was considered protective with an IgG titer of more than 0.18 IU/ml, uncertain (gray zone ELISA) with an IgG titer of 0.11-0.18 IU/ml, the absence of a protective antibody level was observed with an IgG titer of less than 0.11 IU/ml. Results. In 2023, the non-immune proportion of personnel working in the city's healthcare system, who did not have a protective level of specific antibodies, amounted to 15.3%, which creates additional risks of the spread of measles in the region and in healthcare institutions when providing medical care. The most vulnerable age group is medical workers aged 19 to 50 years. Сonclusions. The significant difference in the strength of immunity against measles among personnel of various healthcare institutions necessitates an additional assessment of the strength of immunity in all healthcare workers as well as individual preventive vaccination for persons with no protective level of antibodies.

Long-term efficacy of a continuity-of-care treatment model for patients with severe mental illness who transition from in-patient to out-patient services.

Despite its significance, ensuring continuity of care demands substantial resources, which might not be readily accessible in many public healthcare systems. Studies indicate that continuity of care remains uncertain in numerous healthcare systems. This study aimed to assess the effectiveness of a continuity-of-care model for patients with severe mental illness (SMI), providing seamless treatment from discharge from a closed ward to subsequent psychiatric, psychological and rehabilitation services. Data from patients discharged before (1 January to 31 December 2018) and after (1 June 2021 to 31 May 2022) full implementation of the model were analysed and compared in terms of average duration of hospital stay, emergency department visits within 90 days of discharge, readmission rate within a year post-discharge and initiation of rehabilitation process. In the post-implementation period (n = 482), the average admission time significantly decreased from 30.51 ± 29.72 to 26.77 ± 27.89 days, compared with the pre-implementation period (n = 403) (P = 0.029). Emergency department visits within 90 days following discharge decreased from 38.70 to 26.35% of discharged patients (P < 0.001). The rate of readmission decreased from 50.9 to 44.0% (P = 0.041) for one readmission and from 28.3 to 22.0% (P = 0.032) for two readmissions in the year following discharge. Additionally, the proportion of patients entering formal rehabilitation increased from 7.94 to 12.03% (P = 0.044). This study highlights the effectiveness of a continuity-of-care model spearheaded by senior psychiatrists and involving paramedical personnel. These findings underscore the significant potential of the model to substantially enhance mental health services and outcomes. Moreover, they emphasise its relevance for patients, clinicians and policy makers.

The evolution of personnel potential of Oblast leading health care institution

The state health care policy in Russia is directed at improving medical care quality and population satisfaction with it. The functioning of medical organizations beloning to national health care system has determinative impact on population health. The increasing of level of organization of their functioning is imposible without target manpower policy, upgrading qualification and professionalism of health care workers. The purpose of the study was to analyze personnel potential of Oblast clinical hospital, as one of leading health care institutiond of the Astrakhan Oblast. The methodologies of statistical, logical and system analysis were applied. The study used method of continuous sampling and was carried out in 2012-2021. The information sources included forms of the Federal statistical monitoring № 30 "Information on the medical organization" and № 17 "Information on medical and pharmaceutical workers". The absolute and mean values, extensive parameters modeling structure and methods of dynamic series construction were applied. The study revealed positive dynamics of increasing of number of established posts on 33.7%. The number of physical persons of hospital medical personnel (the basic increase made up to 40%) increased. It resulted in decreasing of combining jobs coefficient and in increasing of staff efficiency employment. The women consisted 65.2% of all working physicians. The mean age made 43.2 years among phycians and 41.7 years among paramedical personnel. The ratio 1.5:1 of paramedical personnel to physicians in staff list is negative factor. Alongside, ratio of physical persons of paramedical personnel and physicians decreases. It testifies necessity of increasing both established posts and involvement of more physical persons to work on paramedical personnel rates.

Assessment of Healthcare Workers' Knowledge to Occupational hazards in Some Hospitals of Thi-Qar Governorate /Iraq

Employees in the healthcare industry operate in one of the riskiest workplaces Healthcare employees suffer a number of dangers as a result of their job last activities in addition to the usual workplace-related risks. These risks come from a variety of sources including biological, physical, psychological, and chemical agents. The study's objectives were to investigate the levels of knowledge held by medical and paramedical personnel regarding occupational dangers in their workplaces. Moreover, the relationships between various demographic characteristics of these staff members and their knowledge of such hazards were investigated. A descriptive cross-sectional study was carried out in hospitals, During the period of November 5th, 2022 to February 10th, 2023. A number of 355 people were participated in the study, information about (Knowledge) the data was collected through a structured questionnaire and the data was collected using self-report Technique. Regarding the Knowledge, the results of the present study showed that all responses regarding the preceding domain had a moderate evaluation. Also, the result show that the health care worker knowledge impact with education level and the year of age and year of experience. Depending on the collected results, it can be concluded that the medical and paramedical staff had below good (moderate) Knowledge regarding the occupational hazards in their working environment.

For the sake of the children: The Lady Muriel Paget’s Mission to the Baltic States (1920–1922)

ABSTRACT A private organization created and managed by a devoted founder, Muriel Paget’s Mission to the Baltic States developed a welfare programme merging Paget’s pre-war charity work and the main agenda of post-war humanitarianism. In managing the mission’s activities, Paget distinguished between relief and rehabilitation. While rehabilitation practices were an extension of the pre-war work in which Paget had been involved, child welfare measures reflected the understanding of rehabilitation as a cultural colonization project. Accordingly, Paget envisaged the intervention of the mission as a necessary tool for ‘modernizing’ the attitudes of mothers and knowledge of local medical and paramedical personnel alike, and, therefore, enabling the growth of healthy young generations and the implementation of a new ‘modern’ mothering culture for both mothers and healthcare workers. In this, Paget’s Mission demonstrates significant continuity with analogous British humanitarian practices of that period as a particular intersection of liberal internationalism and imperialism.

The brief characteristic of manpower potential in health care of Greece, Spain, Bulgaria

The article presents brief descriptive review of manpower resources in health care of Greece, Spain and Bulgaria. It is noted that countries differ in redundancy of specialists at relative deficiency of general practitioners. The medical personnel of analyzed countries are characterized by aging, tendency to migration to other countries, deficiency of paramedical personnel and excess of required number of dentists that is especially pronounced in Bulgaria. Furthermore, accessibility of medical care is reduced by limits of number of patients per one physician established for specified time period in Greece. The salary level of physicians in these countries varies from minimal (Greece, Bulgaria) to maximal in Spain. At that, training of medical personnel is implemented according to Bologna system (bachelor course, magistracy, etc.) and is characterized by long period (4-5 years) of training physician for independent work.