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資源が少ない環境で,医療従事者の高品質なパフォーマンスをどのように達成し,維持できますか?
Alexander K Rowe1, Don de Savigny, Claudio F Lanata
1Malaria Branch, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Mailstop F22, 4770 Buford Highway, Atlanta, GA 30341-3724, USA. axr9@cdc.gov
Lancet (London, England)
|September 20, 2005
まとめ
低,中所得国における医療従事者のパフォーマンスの向上は極めて重要です. 監督とフィードバックを含む多面的な介入は有望ですが,政策を導き,世界的な健康成果を改善するために,より多くの費用対効果の研究が必要です.
科学分野:
- グローバル・ヘルス グローバル・ヘルス
- 保健システムの強化
- 健康のための人材 保健のための人材
背景:
- 低・中所得国 (LMICs) での医療介入の実施には,医療従事者が不可欠である.
- 医療従事者の不十分なパフォーマンスは,LMICにおける医療の提供に影響を及ぼす重大で広範な課題です.
研究 の 目的:
- 医療従事者のパフォーマンスの決定要因の概要を提示する.
- LMICにおける医療従事者のパフォーマンスを改善するための戦略に関する証拠をレビューする.
- 医療従事者のパフォーマンスを向上させるための研究課題と政策勧告を提案する.
主な方法:
- 低・中所得国における介入研究のレビュー.
- 医療従事者の実践に影響を与える要因に関する証拠の分析.
- 戦略と将来の研究を参考にするために,発見の合成.
主要な成果:
- 文書のガイドラインの単純な拡散は,しばしば効果的ではありません.
- 監督とフィードバック付きの監査は,一般的に効果的な戦略です.
- 多面的な介入は,単一の介入よりも効果的かもしれません.
- 厳格な費用対効果試験が欠けていて,緊急に必要である.
結論:
- 医療従事者のパフォーマンスを向上させるための効果的な戦略は存在しますが,文脈特有の適用が必要です.
- 根拠に基づいた政策立案には,さらなる研究,特に費用対効果に関する研究が不可欠です.
- 医療従事者の実績と健康上の成果を向上させるために,国際的協力と研究成果の実践化が推奨されています.
関連する概念動画
Healthcare Associated Infections II: Preventive Measures
Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
Hand hygiene
Asepsis is the practice of preventing or breaking the chain of infection. The nurse employs aseptic techniques to prevent the spread of microorganisms and reduce the risk of diseases. Hand hygiene is the cornerstone of aseptic techniques and is classified into medical and surgical asepsis. Medical asepsis includes hand hygiene and the use of gloves. Surgical asepsis, or the sterile technique, refers to practices that render and keep objects and areas free of microorganisms.
Hand washing...
Hand washing...
Handwashing I: Introduction and Types of Equipment
Handwashing is hand hygiene with plain or antimicrobial soap and water to physically remove dirt, organic material, and microorganisms. However, it may not kill all microorganisms. The handwashing procedure requires a hand wash basin, liquid soap, paper towels, a domestic waste bin, and disposable nail cleaner as optional equipment.
Hand wash basins in clinical areas should have faucets that can be turned on and off without using the hands; that is, they should be non-touch or lever-operated.
Hand wash basins in clinical areas should have faucets that can be turned on and off without using the hands; that is, they should be non-touch or lever-operated.
Cleaning, Sterilization, and Disinfection
Cleaning, disinfection, and sterilization are the methods that help to break the infection chain and prevent disease.
Cleaning
The cleaning process usually involves using water with detergents or enzymatic cleaner and removing foreign material from objects and surfaces, including organic material such as body fluids or inorganic material like soil. Cleaning is performed before high-level disinfection and sterilization because foreign materials on the cover of the devices interfere with process...
Cleaning
The cleaning process usually involves using water with detergents or enzymatic cleaner and removing foreign material from objects and surfaces, including organic material such as body fluids or inorganic material like soil. Cleaning is performed before high-level disinfection and sterilization because foreign materials on the cover of the devices interfere with process...
Standard Precaution
Standard precautions are the minimum infection control safeguards used while caring for all patients, irrespective of their disease condition. They help prevent the spread of common infectious microorganisms to healthcare workers, patients, and visitors in all healthcare settings.
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
Handwashing III: During the Procedure and Post-Procedure Steps
To wash hands properly, follow these steps:

