Performance-Based Design for Healthcare Facilities

Healthcare buildings are one of the most critical facilities in any country for their important roles just after an earthquake. In this context, working on the resistance of healthcare facilities against earthquake is of great importance for a probable future earthquake. However, in today’s world, in either private or governmental agencies, buildings earthquake resistant design is not within the primary criteria such as social facilities and architectural details need for the residents. While the structural system in any building are often considered the most important in the performance, it represent approximately only 20% of the total building cost. Consequently, structural engineers should look the seismic performance in an extensive context, looking at all the systems of the building than just the damage to structural items and life-safety. So to response to this issue, a next generation of seismic performance-based design methodology and tools have been outlined in the FEMAP58 documents to allow engineers to query out the seismic performance of an entire building in terms of future life loss, facility repair cost and repair time and that we summarized and applied in this chapter for a six (6) story special moment frame healthcare building

Sağlık Çalışanlarına Yönelik Şiddet: Olgu Serisi

Dünyada ve Türkiye’de sağlık çalışanlarına yönelik şiddet artarak önemli bir iş sağlığı problemi haline gelmektedir. Sağlık kuramlarındaki şiddet “Hasta, hasta yakınları ya da herhangi bir bireyden gelen, sağlık çalışanı için risk oluşturan; tehdit davranışı, sözel tehdit, ekonomik istismar, fiziksel saldırı, cinsel saldırıdan oluşan durum” olarak tanımlanmıştır. Çalışmamızda İstanbul Tıp Fakültesi Adli Tıp Anabilim Dalı Polikliniği’ne başvuran sağlık çalışanlarına yönelik şiddetin değerlendirilmesi amaçlanmaktadır. Hasta/yakını tarafından şiddet görme nedeni ile başvuran 5 sağlık çalışanı değerlendirildi. Olgular 26-47 yaşlarında olup, yaş ortalamaları 30.8 yıl idi. Olguların biri erkek, üçü doktor, biri hemşire, diğeri de hasta bakıcıydı. Muayenelerinde dört olguda olaya bağlı fiziksel şiddet bulgusu, dört olguda ise ruhsal travma bulgusu saptanmıştır. Sağlık politikaları değişiklikleri ile sağlık çalışanı ve hastaların karşı karşıya getirilmesi, basında tıbbi uygulama hatalarının ele alınış biçimi ve güvenli çalışma koşullarının sağlanamaması sonucunda sağlık çalışanı adeta sistemin tüm aksaklıklarının sorumlusu, şiddetin hedefi olmuştur. Sağlık çalışanlarının %72.6’sının çalıştıkları süre boyunca herhangi bir..

Neonatal Resuscitation Practices in Turkey: A Survey of the Turkish Neonatal Society and the Union of European Neonatal and Perinatal Societies

Objective: Optimal care in the delivery room is important to decrease neonatal morbidity and mortality. We aimed to evaluate neonatal resuscitation practices in Turkish centers. Materials and Methods: A cross-sectional survey consisted of a 91-item questionnaire focused on delivery room practices in neonatal resuscitation and was sent to 50 Turkish centers. Hospitals with <2500 and those with ≥2500 births/year were compared. Results: In 2018, approximately 240 000 births occurred at participating hospitals with a median of 2630 births/year. Participating hospitals were able to provide nasal continuous-positive- airway-pressure/high-flow nasal cannula, mechanical ventilation, high-frequency oscillatory ventilation, inhaled nitric oxide, and therapeutic hypothermia similarly. Antenatal counseling was routinely performed on parents at 56% of all centers. A resuscitation team was present at 72% of deliveries. Umbilical cord management for both term and preterm infants was similar between centers. The rate of delayed cord clamping was approximately 60% in term and late preterm infants. Thermal management for preterm infants (<32 weeks) was similar. Hospitals had appropriate equipment with similar rates of interventions and management, except conti nuous-positive-airway-pressure and positive-end-expiratory-pressure levels (cmH2O) used in preterm infants (P = .021, and P = .032). Ethical and educational aspects were also similar. Conclusions: This survey provided information on neonatal resuscitation practices in a sam- ple of hospitals from all regions of Turkey and allowed us to see weaknesses in some fields. Although adherence to the guidelines was high among centers, further implementations are required in the areas of antenatal counseling, cord management, and circulation assessment in the delivery room