Rambam Health Care Campus

About: Rambam Health Care Campus is a healthcare organization based out in Haifa, Israel. It is known for research contribution in the topics: Population & Cancer. The organization has 2498 authors who have published 3715 publications receiving 104362 citations. The organization is also known as: Rambam Hospital & Bet ha-ḥolim ha-memshalti Rambam.

Between standardisation and resilience: nurses' emergent risk management strategies during handovers

Abstract: Aims and objectives In this study, we aimed to understand how nurses manage handovers at shift change and to identify the working strategies they employ to maintain patients' safety. Background Nursing handovers at shift change are potentially hazardous for patients' quality of care. The nurses on the outgoing and incoming shifts need accurate understanding of the patient's current state, under circumstances that are frequently turbulent and time constrained. Design Qualitative study. Method Eighteen nurses working in a central Israeli hospital participated in the study. Data were collected through in-depth semi-structured interviews, conducted over a 10-month period in 2011–2012. The interviews were tape-recorded and transcribed verbatim. Content analysis method was used. Results We revealed three interrelated themes: (1) Adaptation of declared handover goals to goals, which better fit the day-to-day routine of the ward; (2) Contextual turbulent circumstances, and (3) Strategies to optimise care for patients. Nurses on the outgoing shift developed organising strategies, ensuring efficient transmission of all important information; nurses on the incoming shift used cross-checking strategies to verify the accuracy of the received information. Conclusion A nursing handover is both vulnerable and resilient, given its imposed constraints. The handover should be restructured, assuring resilience in patients' care while also limiting the risk for vulnerability. Relevance to clinical practice Handover should be restructured so that it creates opportunities to cross-check the information against as many sources of information as possible. During handover, special time should be devoted to reading written reports and notes, preferably when the outgoing nurses are still on the ward or are accessible via e-mail or telephone. Team discussions should focus on achieving agreement about the order and manner of delivering concise information and facilitating shared understanding and trust among nurses.

Stress among charge nurses: tool development and stress measurement.

Abstract: The aim of this study was to develop and implement a tool for measuring the role stress of charge nurses. Tools are lacking regarding measurement of nursing role stressors, particularly for charge nurses. Based on focus groups and in-depth interviews with charge nurses within a large tertiary hospital, a charge nurse stress questionnaire was developed which measures six factors of stress: authority-responsibility conflict, patient-nurse interaction, deficient resources, managerial decision making, role conflict, and overload. The prominent stressors on charge nurses were specific to the role. Mean levels of stress were significantly higher for nurses who attended post-graduate clinical courses than for those who did not. The mean level of stress was higher for department nurse managers than for nurses without a managerial position. This tool was designed to measure charge nurse stress demonstrates reliability, and highlights the specific stressors demanded by the role. Preparation and ongoing support for fulfilling this position are recommended.

Lemierre's syndrome from odontogenic infection: Review of the literature and case description.

Abstract: Lemierre's syndrome (LS) is a rare potentially fatal sequel of head and neck infection, classically described as thrombophlebitis of the internal jugular vein (IJV) with cervical space infection extending into the thorax. Our objective was to answer the clinical question: "Does Lemierre syndrome (LS) from odontogenic infection differ from nonodontogenic LS in regard to clinical sequence, treatment, and survival." We reviewed the literature on the management of LS over the last two decades, with a focus on LS from odontogenic infection. Such a case is presented in order to portray the clinical sequence. Only 10 cases met the inclusion criteria (including the case presented). The recorded data were analyzed in comparison to large case series reviewing LS. Our data reflect the moderate differences in regard to IJV thrombosis and bacteriogram. There is an overall rise in published LS cases in the last 20 years. Odontogenic infection leading to LS is scarce, yet with survival rates similar to nonodontogenic LS. Repeated surgical interventions and aggressive wide spectrum antibiotic therapy remain the treatment of choice.

Pediatric Inflammatory Multisystem Syndrome With Central Nervous System Involvement and Hypocomplementemia Following SARS-COV-2 Infection.

Abstract: Pediatric inflammatory multisystem syndromes associated with Severe Acute Respiratory Syndrome Coronavirus 2 are emerging in recent reports. We describe a patient with critical illness consistent with atypical Kawasaki disease with cardiac dysfunction and abdominal involvement presenting weeks after Severe Acute Respiratory Syndrome Coronavirus 2 infection. Our patient showed unique central nervous system involvement with small vessel vasculitis and profound hypocomplementemia, both not previously reported in case descriptions and may hint at possible disease mechanisms.