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thank you very much thank you very much for the invitation
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good afternoon ladies and gentleman healthcare is not medical
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care we chose this title it's very provocative
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but we have to go back when we talk about the room
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care products while to you find in clinical packed is
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what i will go through in my presentation i
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was looking for a definition of health care
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only looking for a definition of health care was not very easy because you have that bastard but man
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off definitions and then what is medical care
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then i want to demonstrates what we find in clinical practised today
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then i want to demonstrate what kind of
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approach is needed in clinical project is
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and what are the requirements for dressings in that clinical protests
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when we talk about health care
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the definition
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i found one i liked the most and uh after all that stick metric medical dictionary
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yeah it says that the prevention the treatments and management of
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illness and the preservation of mental and physical well being
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through the services offered by the medical and allied health professions
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let's see what does this mean i said we have to
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prevention something very important in today's a health care system
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the treatments with their for example with the room trusting the management of the
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entire illness the preservation of the mental and physical well being and then
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this is offered by and medical and allied health professionals
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so it's and multi decent disciplinary team approach
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this should be healthcare
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medical care we have a professional treatment for
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illness or injury or another definition
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the portion of here under a tarp physicians direction
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so we have to treatments of illness for illness and injury or
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we have to care entire care aspect and that physicians direction
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what do we find in clinical practitioners those who work clinic clay if you go back is
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it more of focus on the healthcare sign or
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in that on that medical care sites
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one example
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l. eighteen forty six uh sixty four years old she's living alone in her
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flat in the inner earl area in the western part of switzerland
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but i had nurses are hypertension diabetes type too
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and five weeks ago she discovered coincidence slipped that she
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has a an an ulcer on her foot
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she went to the g. p. a. the cheap you put some
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costs is on this wound because this was for him to
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the rights decision and he wanted to to cure this wound like this
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this lady went to hurt by appetite but a
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bit taller just answered uh a cardiologist
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they took care of her as well but only her feel their fields
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so when we see this we have three different
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position um special to us is this health care
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and i want to say in europe we half and
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medical care system not a health care system
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why is this
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the focus it's mostly on disease and injury
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let's talk about disease and illness really you
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read this all over the the articles
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disease it's more the medical aspects that means diagnosis
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sector illness it's more the entire haitians
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the patient as a whole
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so
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what we find out what we need it's more the
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illness prevention the prevention and the health promotion
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the problem i can i can say that mostly also for switzerland we have
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a little budget for prevention the budget should be bigger because
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prevention it's not a very sexy subject prevention
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it's also difficult to evaluate to measure you're not a lot there's not
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a lot of literature out there that is talking about prevention
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it's coming more and more and this is more from the nursing sides
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as a society we have some adverse lifestyle behaviours such as
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what did you use today how to you eat normally
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and and what kind of stress level for example do you have
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if you want to have an increasing uh increasing our
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lifespan and an overall improving improvement of our health
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you have to adjust our personal behaviours and see to that inner on an
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early stage it's not only for us it's also for our patients
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what do we finds it in a in a clinical practised this
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that this environmental and to so it's a
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social economical aspects they are important
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especially they have a big impact on the work life balance not only for us
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also for patients and afterwards on the healing right off the rooms and
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a big impact has also to salary how much do they are um
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what can daily uh what kind of food for example
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can they buy to um have a healthy line
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when we go to the top for example to the
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w. h. l. c. what kinds off um
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a major cost a soft that to be fines
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you're very good to demonstrate for example cancer is
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number one followed by zero vascular diseases
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but do we go back or two we have time to go back
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further to look what causes these diseases
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i went to the literature and was looking more kind of studies do we find from europe i
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couldn't find any study but there are a lot of studies in the united states they demonstrates
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they're from the rank order to call so soft that like tobacco
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smoking hype lots uh an pressure oh wait et cetera
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but when we see that even down here with the alcohol use
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that low intake of fruits and vegetables or the low directory
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a fatty acids what is this this is mainly on our behaviours
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and here we are more on the on the side again this should be prevention
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doesn't work
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okay yeah
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so when we go back in history
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really know that in the nineteen hundred it's we had a lot
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of infectious diseases that were all causing death not the bins
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it's a on their their responsibility off could control weaver prevent me
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till we develop preventive uh techniques such ass clean will too
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to drink to clean for example the rooms and
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then of course we have to anticipate antibiotics
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nowadays we have other elements we have namely coronary
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artery disease this that become very prevalent
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one thing that is also good what we can hear a
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and z. from statistics that fewer people's they're smoking pot
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then we go back on the behaviour side we have more t. i. b. s. we
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have more heart diseases we have more stroke you have high blood pressure et cetera
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and these are all uh illnesses that last over a lifetime
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so our medical here says and dawson to you with
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half we deal only with little bits of help
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so we concentrate on our t. z. sits on the trauma us
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what we need it's more illness that means that
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people or getting older and older so
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we have more call the more beta patients
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patients with hypertension with diabetes et cetera
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so all just patients that are developing a brooms so that they
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need a broom dressing that is corresponding to the or illness
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at the other thing is the last thing as that
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at that type patients life that means the costs
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the costs are rising who's paying that we have more more patients in
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the outpatient sector if you want to offer a patient centred care
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we have to offer them a holistic mart it isn't you pretty team approach
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and with that i think we can approach to go to to that
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our patients have a a very nice very good uh here
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well we tens right now in our clinical that practised is
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that we have only single provider treatments as
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we saw all on this um
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on the case i was i was showing you that the patient had
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f. decision for her heart for for it uh
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and that general practitioner that was taking care
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of to do and and that the diet technologist that is taking care of the diabetes
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but we knew what we need is multiple providers and
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somebody that is taking care of the entire patient
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and that is talking with all the different kind of disciplines
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let's go back to this female patients what can we offer her
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as already said we can offer her a holistic care approach
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in rooms management this a holistic care approach as a philosophical orientation
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that is on the p. painting the fundamental holders of the human being
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it emphasises the importance of this that balance within the person
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and between the person and his her uh environments
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what's to be included in this holistic approach we
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have the entire a physiological opera and
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aspects that we uh dimensions that we
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involve the psychological sociological aspects
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economical aspects as well as the psychological and spiritual dimensions
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that provides an opportunity to assess the patient as a whole
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and in relation to her leaving and a context
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with a holistic approach we can uh it's it's uh it's in contrast
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to and modern medical model of approach of health and illness
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it considers this individual aspects of the patient
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within a the entire living context
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and it's what we need it's the evidence based treatments
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in rooms care we have a lot of studies
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but we do not have and good
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ballads clinical data we have a lot off case studies we
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have not a lot of or c. t.s for example
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and with these or c. t. is when you have to put intervention then we can
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offer the patient that into mention and it's not the over medication that means
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each discipline has his own and vision
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by focusing on wound care this holistic approach
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highlights the patient as a whole and not only the
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boomed and obviously the patients or the focus
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also the family and the environment factors are taken in consideration as we find
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wound care mostly into home care setting and the patient itself
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and the family is taking care of the rooms
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if you wanted to and assessments uh an
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holistic care assessment this is to optimise
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the healing by it takes into consideration all the factors that influence to care
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and to maximise the available source resources that we have
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we want to prevents fragmented and or inappropriate care
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individual patients and it contributes to have focus on cost effectiveness
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and a high quality of care for our patients
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i don't know how many times
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sorry
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there was a mixture with this lights uh_huh oh let's go uh it's
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give a little bit more focus on this holistic care approach
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this holistic care approach has several elements that or importance
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and most of my colleagues and uh off that physicians they say
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get me to that but yeah be to tap briefly
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read to you that not in depth for example that patients
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physical needs that disease is the functional capital capital t.
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the psychological needs what order fifty years of the patients when they have rooms
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what or if they are purely use do you want to have that is wound
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is healing is does always to go what are the social needs et cetera
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additionally we half the patients personal resources and empowerment
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how much is their income then we come back to this prevention what's kind of ability
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of involvement is is it possible for the patients
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because most of the rooms care takes
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at that at the home care in the tone kept setting is
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the family mall is the patients living by himself or herself
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patients a a living happy it's what already this patient for
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example i was walking each day with the dog
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so they have i we have to uh to to adjust our dressings treat her daily living
00:17:17
what are the room them perry room status that's this is more text a technical what or
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to sentence what's to be find their houses
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documents it's who is taking here um
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of that and efficient use of resources
00:17:35
for example what kind of dressings or available
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what kind of pressing or reimbursed
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this this uh this is an element that is very important within wound care
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when we go to dressings what's kind of dressings can be used
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in certain uh and uh for for for all these bins
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this is from a document and we've published a two year two three years ago
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from the european movement association and there we propose
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that we use safe products what is safe that
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we have and minimum a cultural effects
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it has to be easy not very sophisticated it's
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we need to products that are disposable
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we need products that reduce pain because most of the rooms are very painful
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you have to use products that have a wide range of application that means
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products second used in different basis of wound healing
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we have to and no tact that
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healthcare professionals when there is selecting
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dressings what's kind of pressing scanned they select they have to be and
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if and used to extend the ports of the dunes healing continuum
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they have to be dressings that should not stick on the doomed grounds
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unfortunately we see that and i in the everyday life
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and product start easy to use and access and especially to excess most
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of the patients they don't know where to get the doomed products
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and have to to the prevention off these uh uh
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not to cater a a recurrence for example
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we need to move products that enable the lowest overall cost
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most of the patients are paying the product out of their own pockets because it's not covered by
00:19:56
the health care insurance and of course we need
00:20:00
products that are you friendly when we summarise
00:20:05
what we see we have and what we finds in clinical
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practised we have more and medical system not healthcare system
00:20:18
what we have to go in which direction you have to
00:20:21
go it's in preventive we have to take care
00:20:25
an hour of the individual aspects of the
00:20:30
patient with in the living context
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we have to have a great to focus on the onus
00:20:37
is illness prevention to health promotion has to begin
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i say in childhood as early as possible
00:20:47
we have to recognise that chronic illnesses are the
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ones that not only last a lifetime part
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they are also to diseases that are driving to high costs of here
00:21:01
we need evidence based treatments this that means good solid start this
00:21:08
interventions that we can all for our patients be needs to cut up the
00:21:14
costs can uh brought down and can't be brought down quite substantially
00:21:19
through a better approach in a patient care so that everybody's
00:21:24
working together not each of us is doing something
00:21:30
that means we use a multi professionally team approach and
00:21:36
one thing i think that is more wishful thinking
00:21:39
that imploring needs to calculate enough time
00:21:43
for holistic assessment of each patient that for example room
00:21:48
to patients so that we can have an all
00:21:51
over the globe who who are you to pay she and then you have to do that

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Health care is more than medical care!
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Q&A - Health care is more than medical care!
Prof. Dr. Sebastian Probst, DClinPrac, RN, Professor of tissue viability and wound care at the University of Applied Sciences Western Switzerland, Geneva, Switzerland
April 5, 2017 · 2:29 p.m.

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