Humán erőforrás helyzet a pszichiátrián

Nowadays, in all areas of health care, there is a lack of human resources nationwide. In some areas, lack of staff or lack of staff skills, dilution of skilled workers with less skilled workers affects quality provision to a greater extent. All forms of psychiatric care require well-prepared, permanent professional teams, in which the functioning of the workers is well-defined with professional boundaries. In the course of professional pre-qualification, they work not only with the acquired medical methods, but also with the so-called non-specific factors, their own personality. Lack or 'dilution' of professional teams not only prolongs care periods, generates additional costs, but also leads to increased use of their own personality, faster burnout. In terms of the lack of human resources, there is less and less talk about professional motivation, dedication and motivation, the presence and absence of which can be felt in patient care. One of the objectives of my questionnaire survey was to map the current situation in different areas of psychiatric care, as a secondary goal to evaluate the attitudes and subjective opinions of people working in different fields in relation to care.Napjainkban az egészségügyi ellátás minden területén országosan jellemző a humán erőforrás hiány. Egyes szakterületeken a személyzeti létszám hiány, vagy a személyzet felkészültségének hiánya, szakképzett dolgozók felhígulása kevésbé képzett dolgozókkal az minőségi ellátást hatványozottabb mértékben érinti. A pszichiátriai ellátás minden formája felkészült, állandó szakmai teameket kíván, melyben a dolgozók működése szakmai kompetencia határokkal jól körülírt. A szakmai előképzettség során nem csupán elsajátított medicinális módszerekkel, hanem úgy nevezett nem specifikus tényezőkkel, saját személyiségükkel is dolgoznak. A szakmai teamek létszámhiánya, vagy „felhígulása” nem csupán az ellátásra hat ki megnyúlt ápolási időket, egyéb többlet költségeket generálva, hanem saját személyiségük fokozottabb igénybevételéhez, gyorsabb kiégéshez vezet. A humán erőforrás hiánnyal fordított arányban egyre kevesebb szó esik a szakmai motivációról, elhivatottságról, indíttatásról, melynek jelenléte és hiánya egyaránt tetten érhető a beteg ellátás során. Kérdőíves vizsgálatom egyik célkitűzése az aktuális helyzet térképezése volt a pszichiátriai különböző területeinek vonatkozásában, másodlagos célként értékelem a különböző területeken dolgozók attitűdjét és szubjektív véleményét az ellátással kapcsolatosan. &nbsp

Humán erőforrás menedzsment az egészségügyi ellátó rendszerekben

Today’s lack of human resource becoming critical now and then has become perceivable beyond the national also among the private medical service providers. The human resource provision of certain professional areas represents in some cases such critically low numbers and sometimes also skills that safe medical attendance is also endangered. Where can the reasons hide? Nowadays transmigration of qualified workforce is typical. What possibilities are ensured in order to utilize and to keep the existing human resource more efficiently? The strengthening of the private sector can be observed as tendency, however due to the similar derivation it cannot compensate the lack of personnel resulting in the national institutes on the merits. The similar problem arises in privatized basic service as well. The transmigration of employees working on this area can be led back to several reasons, which are of key importance in the improvement of the system. Not only wage development and assurance of trainings are important, professional motivation, other human non-specific factors shall be investigated, the reconsideration of competence limits and escalation of tasks can become necessary, concerning other service providers (social tasks, community tasks etc.). The modification of tasks can be followed by the appearance of newer profession-specifics also in education, e.g. APN (Advanced Practice Nurse), which ensures the training of nurses of advanced competence. In summary we have to investigate the reasons for the lack of medical human resources. We have to take care for the retardation of the tendency, it is important to concentrate the available professional employee capacity to professional tasks in order to obtain quality work

Humán erőforrás menedzsment az egészségügyi ellátó rendszerekben

Today’s lack of human resource becoming critical now and then has become perceivable beyond the national also among the private medical service providers. The human resource provision of certain professional areas represents in some cases such critically low numbers and sometimes also skills that safe medical attendance is also endangered. Where can the reasons hide? Nowadays transmigration of qualified workforce is typical. What possibilities are ensured in order to utilize and to keep the existing human resource more efficiently? The strengthening of the private sector can be observed as tendency, however due to the similar derivation it cannot compensate the lack of personnel resulting in the national institutes on the merits. The similar problem arises in privatized basic service as well. The transmigration of employees working on this area can be led back to several reasons, which are of key importance in the improvement of the system. Not only wage development and assurance of trainings are important, professional motivation, other human non-specific factors shall be investigated, the reconsideration of competence limits and escalation of tasks can become necessary, concerning other service providers (social tasks, community tasks etc.). The modification of tasks can be followed by the appearance of newer profession-specifics also in education, e.g. APN (Advanced Practice Nurse), which ensures the training of nurses of advanced competence. In summary we have to investigate the reasons for the lack of medical human resources. We have to take care for the retardation of the tendency, it is important to concentrate the available professional employee capacity to professional tasks in order to obtain quality work.Today’s lack of human resource becoming critical now and then has become perceivable beyond the national also among the private medical service providers. The human resource provision of certain professional areas represents in some cases such critically low numbers and sometimes also skills that safe medical attendance is also endangered. Where can the reasons hide? Nowadays transmigration of qualified workforce is typical. What possibilities are ensured in order to utilize and to keep the existing human resource more efficiently? The strengthening of the private sector can be observed as tendency, however due to the similar derivation it cannot compensate the lack of personnel resulting in the national institutes on the merits. The similar problem arises in privatized basic service as well. The transmigration of employees working on this area can be led back to several reasons, which are of key importance in the improvement of the system. Not only wage development and assurance of trainings are important, professional motivation, other human non-specific factors shall be investigated, the reconsideration of competence limits and escalation of tasks can become necessary, concerning other service providers (social tasks, community tasks etc.). The modification of tasks can be followed by the appearance of newer profession-specifics also in education, e.g. APN (Advanced Practice Nurse), which ensures the training of nurses of advanced competence. In summary we have to investigate the reasons for the lack of medical human resources. We have to take care for the retardation of the tendency, it is important to concentrate the available professional employee capacity to professional tasks in order to obtain quality work

Humán erőforrás helyzet a pszichiátrián

Nowadays, in all areas of health care, there is a lack of human resources nationwide. In some areas, lack of staff or lack of staff skills, dilution of skilled workers with less skilled workers affects quality provision to a greater extent. All forms of psychiatric care require well-prepared, permanent professional teams, in which the functioning of the workers is well-defined with professional boundaries. In the course of professional pre-qualification, they work not only with the acquired medical methods, but also with the so-called nonspecific factors, their own personality. Lack or 'dilution' of professional teams not only prolongs care periods, generates additional costs, but also leads to increased use of their own personality, faster burnout. In terms of the lack of human resources, there is less and less talk about professional motivation, dedication and motivation, the presence and absence of which can be felt in patient care. One of the objectives of my questionnaire survey was to map the current situation in different areas of psychiatric care, as a secondary goal to evaluate the attitudes and subjective opinions of people working in different fields in relation to care

Erm(41)-dependent inducible resistance to azithromycin and clarithromycin in clinical isolates of Mycobacterium abscessus

Objectives The ribosomal methylase Erm(41) confers inducible resistance to macrolides in Mycobacterium abscessus. The aim of this work was to systematically study and compare drug susceptibility to clarithromycin and azithromycin in M. abscessus and Mycobacterium chelonae clinical isolates with a particular focus on inducible drug resistance. Methods Clinical isolates of M. abscessus subsp. abscessus (n = 21), M. abscessus subsp. bolletii (n = 16), M. abscessus subsp. massiliense (n = 10) and M. chelonae (n = 22) were characterized regarding their erm(41) and rrl genotypes and subjected to drug susceptibility testing (DST) for clarithromycin and azithromycin. Microdilution DST was performed in cation-adjusted Mueller-Hinton broth (pH 7.4) with readings at days 3, 7 and 12 and with pre-incubation at subinhibitory macrolide concentrations for erm(41) induction. In addition, the influence of variations in pH and growth medium on DST results was examined. Results MICs of azithromycin were consistently higher than those of clarithromycin. In strains with an inducible erm(41) gene, high median MICs of ≥256 mg/L on day 12 were observed for both clarithromycin and azithromycin. Inducible resistance was at least as pronounced for azithromycin as for clarithromycin. Conclusions Our findings do not support the suggestion of a preferential use of azithromycin over clarithromycin in order to limit inducible macrolide resistance. Both compounds provoked a comparable resistance phenotype in M. abscessus. Caution is needed when using either azithromycin or clarithromycin for treatment of M. abscessus infection

Practice guidelines for clinical microbiology laboratories: Mycobacteria

Mycobacteria are the causative organisms for diseases such as tuberculosis (TB), leprosy, Buruli ulcer, and pulmonary nontuberculous mycobacterial disease, to name the most important ones. In 2015, globally, almost 10 million people developed TB, and almost half a million patients suffered from its multidrug-resistant form. In 2016, a total of 9,287 new TB cases were reported in the United States. In 2015, there were 174,608 new case of leprosy worldwide. India, Brazil, and Indonesia reported the most leprosy cases. In 2015, the World Health Organization reported 2,037 new cases of Buruli ulcer, with most cases being reported in Africa. Pulmonary nontuberculous mycobacterial disease is an emerging public health challenge. The U.S. National Institutes of Health reported an increase from 20 to 47 cases/100,000 persons (or 8.2% per year) of pulmonary nontuberculous mycobacterial disease among adults aged 65 years or older throughout the United States, with 181,037 national annual cases estimated in 2014. This review describes contemporary methods for the laboratory diagnosis of mycobacterial diseases. Furthermore, the review considers the ever-changing health care delivery system and stresses the laboratory’s need to adjust and embrace molecular technologies to provide shorter turnaround times and a higher quality of care for the patients who we serve

Mycobacterium celatum Pulmonary Infection in the Immunocompetent: Case Report and Review

Mycobacterium celatum has been shown to cause disease in immunocompromised patients. We report a case of serious pulmonary infection caused by M. celatum in an apparently immunocompetent patient and review the characteristics of two other reported cases. Clinical and radiologic symptoms and signs included cough, malaise, and weight loss associated with cavitary lesions and pulmonary infiltrates. Although M. celatum is easy to detect in clinical specimens by liquid and solid media, it may be misidentified as a member of the M. tuberculosis complex or as M. xenopi. M. celatum pulmonary infection appears to respond to antimycobacterial chemotherapy, particularly with clarithromycin

Pulmonary Tuberculosis due to Mycobacterium bovis in Captive Siberian Tiger

We report the first case of pulmonary tuberculosis caused by Mycobacterium bovis subsp. caprae in a captive Siberian tiger, an endangered feline. The pathogen was isolated from a tracheal aspirate obtained by bronchoscopy. This procedure provided a reliable in vivo diagnostic method in conjunction with conventional and molecular tests for the detection of mycobacteria