Trends in bed occupancy for inpatients with diabetes before and after the introduction of a diabetes inpatient specialist nurse service

Aims: To compare diabetes bed occupancy and inpatient length of stay, before and after the introduction of a dedicated diabetes inpatient specialist nurse (DISN) service in a large UK Hospital. Methods: We analysed bed occupancy data for medical or surgical inpatients for 6 years (1998–2004 inclusive), with a DISN service in the final 2 years. Excess bed days per diabetes patient were derived from age band, specialty, and seasonally matched data for all inpatients without diabetes. We also analysed the number of inpatients with known diabetes who did not have diabetes recorded as a discharge diagnosis. Results: There were 14 722 patients with diabetes (9.7% of all inpatients) who accounted for 101 564 occupied bed days (12.4% of total). Of these, 18 161 days (17.8%) were excess compared with matched patients without diabetes, and were concentrated in those < 75 years old. Mean excess bed days per diabetes inpatient under 60 years of age was estimated to be 1.9 days before the DISN appointment, and this was reduced to 1.2 bed days after the appointment (P = 0.03). This is equivalent to 700 bed days saved per year per 1000 inpatients with diabetes under 60 years old, with an identical saving for those aged 61–75 years (P = 0.008), a saving of 1330 diabetes bed days per year by one DISN. Excess diabetes bed occupancy was 167 excess bed days per year per 1000 patients with diabetes in the local population after the DISN appointment. One quarter of the known Type 2 diabetes population were admitted annually, but one quarter of patients had no diagnostic code for diabetes. Conclusions: Diabetes excess bed occupancy was concentrated in patients < 75 years old, and this was reduced notably following the introduction of a DISN service

Validação da nomenclatura diagnóstica de enfermagem direcionada ao pré-natal: base CIPESC® em Curitiba - PR Validación de la nomenclatura diagnóstica de enfermería direccionada al periodo de embarazo: base CIPESC® en Curitiba - PR Validating the nomenclature diagnosis of pre-natal nursing: base CIPESC® in Curitiba

É de fundamental importância uma linguagem específica da profissão e a CIPESC® -Classificação Internacional para as Práticas de Enfermagem em Saúde Coletiva tem como um dos objetivos desvelar a atuação dos enfermeiros na saúde coletiva. No Brasil, a ABEn, responsável pela classificação, encontrou na Secretaria Municipal da Saúde de Curitiba - PR aliada para efetiva implantação. O objetivo deste artigo foi validar a nomenclatura dos 52 diagnósticos de enfermagem do pré-natal - base CIPESC® - Curitiba. É um estudo exploratório-descritivo, desenvolvido com enfermeiras assistenciais e com experts na área de gineco-obstetrícia e terminologia. Os resultados foram apresentados pelo Índice de Concordância por meio de freqüência absoluta, todas as definições foram validadas, porém necessitam de adequações à linguagem cotidiana. As enfermeiras apresentam dificuldades para inter-pretar intervenção de enfermagem na promoção do bem-estar, sendo premente a discussão do conceito de promoção à saúde e o processo saúde-doença na saúde coletiva.<br>Es de fundamental importancia un lenguaje específico de la profesión y la CIPESC® -Clasificación Internacional para las Prácticas de Enfermería en Salud Colectiva que tiene como uno de los objetivos desvedar la actuación de los enfermeros en la salud colectiva. En Brasil, la ABEn, responsable por la clasificación, encontró como aliada para realizar la efectiva implantación la Secretaria Municipal de la Salud de Curitiba - PR. El objetivo de este artículo fue validar la nomenclatura de los 52 diagnósticos de enfermería del periodo de embarazo - base CIPESC® - Curitiba. Es un estudio exploratorio-descriptivo, desarrollado con enfermeras asistenciales y con experts en el sector de ginecología-obstetricia y terminología. Los resultados fueron presentados por el Índice de Concordancia por medio de la frecuencia absoluta, todas las definiciones fueron validadas, sin embargo, necesitan de adecuaciones para el lenguaje cotidiano. Las enfermeras presentan dificultades para interpretar la intervención de enfermería en la promoción del bienestar, siendo apremiante la discusión del concepto de promoción a la salud y el proceso salud-enfermedad en la salud colectiva.<br>The existence of a specific language for the profession is essential, and the International Nursing Practice Classification in Collective Health (CIPESC, in the Portuguese-language acronym) has as one of its goals the classification of the work of nurses in collective health. In Brazil, the Brazilian Nursing Association (ABEn, in the Portuguese-language acronym), responsible for the classification, found in the Municipal Secretary of Health of Curitiba, in the State of Paraná, an ally for its effective implantation. The purpose of this article was to validate the nomenclature of the 52 diagnoses of pre-natal Nursing - CIPESC base - in Curitiba. It is an exploratory-descriptive study developed with assisting nurses and experts in the area of gynecology obstetrics and terminology. The results were presented through the Consonance Index through absolute frequency. All the definitions were validated, but they need to be adjusted to the daily language. The nurses show difficulty in interpret nursing intervention in the promotion of well-being, and it is urgent to discuss the concept of health promotion and the health-illness process in collective health

Fish avoidance of ships during acoustic surveys tested with quiet uncrewed surface vessels

Acoustic surveys to estimate fish biomass and abundance are a major component of many fisheries monitoring programs. An important bias in acoustic surveys is that fish may avoid the survey vessel. Here, we utilized quiet uncrewed surface vessels (USVs) equipped with 120 kHz split beam echosounders to evaluate fish responses to motorized survey vessels. Two of these USVs were deployed in Lakes Michigan and Huron in summer 2021 and compared against three motorized vessels used in conventional fisheries acoustic surveys. Paired comparisons employed vessel-drone passes that provided the opportunity to observe fish response as vessels approached and then overtook their quiet USV counterparts. Sound originating from the vessels was primarily in the 10–1000 Hz range. Overall received sound pressure levels for ships at the closest pass were 100 dB (re 1 µPa @ 1 m) for one and 133–134 dB for the other two vessels. In contrast, sound originating from the USV was not detectable over ambient noise. We examined acoustic data from the USVs for potential changes in total acoustic backscatter, average target depth, and average in situ target strength as vessels approached. We observed weak evidence of an avoidance response by fish to the vessel with the loudest noise profile and highest survey speed but not for the other two vessels. We also compared acoustic data from 33 2-km transects surveyed by both vessels and the USVs, finding few differences between vessel and USV data for water depths between 5 and 80 m. Results from this work suggest that acoustics estimates of fishes in Lakes Michigan and Huron (primarily alewife, rainbow smelt, and bloater) are largely consistent among the vessels used in these two lakes for standard acoustic surveys and that fish avoidance is minimal in water depths \u3e 5 meters