Stick and Tell A Survey of Emergency Medicine Residents and Needlestick Exposures

2013 ◽  
Vol 34 (10) ◽  
pp. 1116-1118 ◽  
Author(s):  
Jessica Zuraw ◽  
Gretchen Sanford ◽  
Lori Winston ◽  
Shu Chan

An estimated 400,000–800,000 sharps-related injuries occur among healthcare workers (HCWs) annually in the United States. The risk of needlestick exposure may be particularly high among emergency medicine (EM) residents, who are learning new procedures in a relatively uncontrolled environment. Despite the potentially serious consequences of percutaneous injuries (PCIs), practitioners in training often down-play the occurrence of PCIs and do not report exposures.Current literature implies that underreporting of needlestick injuries is multifactorial. By not seeking care after needlesticks occur and thereby delaying treatment, residents incur more risk from exposures. We sought to elucidate the underlying issues that might contribute to this lack of reporting needlestick injuries. Using an anonymous survey, we collected information regarding factors that contributed to sustaining a PCI as well as perceived barriers that prevented residents from reporting these exposures. This information is desirable for both residency programs and employee health departments to reduce the occurrence of unreported exposures.The survey contained 19 questions, and all subjects were EM residents from the 8 Accreditation Council for Graduate Medical Education–accredited programs in the state of Illinois during the period January–February 2011. The voluntary survey was distributed via e-mail and through a paper version distributed at a regional EM residency conference.

2012 ◽  
Vol 4 (2) ◽  
pp. 165-169 ◽  
Author(s):  
Diana S. Curran ◽  
Pamela B. Andreatta ◽  
Xiao Xu ◽  
Clark E. Nugent ◽  
Samantha R. Dewald ◽  
...  

Abstract Introduction Residency programs seek to match the best candidates with their positions. To avoid ethical conflicts in this process, the National Residency Matching Program (NRMP or Match) has rules regarding appropriate conduct, including guidelines on contact between candidates and programs. Our study examined communication between obstetrics and gynecology (Ob-Gyn) programs and residency candidates after interviewing and prior to ranking. Methods Ob-Gyn program directors in the United States were sent a self-administered survey via e-mail. Data were collected and analyzed using descriptive methods to examine communication practices of these programs. Results The response rate was 40%. The findings showed that respondents had variable interpretations of the NRMP rules and suggest that programs may be communicating their match intentions especially to favored candidates. Respondents' open text comments highlighted program directors' frustrations with current NRMP rules. Discussion NRMP communication rules are intended to minimize pressure on residency candidates. Our findings suggest they may be leading to unforeseen stresses on program directors and candidates. Conclusions As educational leaders in medicine, we must consider what professional communications are acceptable without increasing the pressure on candidates during the ranking and match process.


2018 ◽  
Vol 10 (1) ◽  
pp. 51-55 ◽  
Author(s):  
David Diller ◽  
Lalena M. Yarris

ABSTRACT Background  Twitter is increasingly recognized as an instructional tool by the emergency medicine (EM) community. In 2012, the Council of Residency Directors in Emergency Medicine (CORD) recommended that EM residency programs' Twitter accounts be managed solely by faculty. To date, little has been published regarding the patterns of Twitter use by EM residency programs. Objective  We analyzed current patterns in Twitter use among EM residency programs with accounts and assessed conformance with CORD recommendations. Methods  In this mixed methods study, a 6-question, anonymous survey was distributed via e-mail using SurveyMonkey. In addition, a Twitter-based search was conducted, and the public profiles of EM residency programs' Twitter accounts were analyzed. We calculated descriptive statistics and performed a qualitative analysis on the data. Results  Of 168 Accreditation Council for Graduate Medical Education–accredited EM programs, 88 programs (52%) responded. Of those programs, 58% (51 of 88) reported having a program-level Twitter account. Residents served as content managers for those accounts in the majority of survey respondents (61%, 28 of 46). Most programs did not publicly disclose the identity or position of their Twitter content manager. We found a wide variety of applications for Twitter, with EM programs most frequently using Twitter for educational and promotional purposes. There is significant variability in the numbers of followers for EM programs' Twitter accounts. Conclusions  Applications and usage among EM residency programs are varied, and are frequently not consistent with current CORD recommendations.


2020 ◽  
Vol 13 (1) ◽  
pp. 25-30
Author(s):  
Jessica Poulsen ◽  
Kylea Liese

BackgroundWith the high rates of unintended pregnancy and associated maternal morbidity and mortality in the United States, particularly among poor and minority women, it is imperative that all individuals have information about and access to long-acting reversible contraception (LARC) methods in the immediate postpartum period.ObjectiveThe creation of a framework to provide guidance, address barriers, and dispel myths associated with the implementation of an immediate postpartum LARC program.MethodsA multistep approach to develop a framework to guide planning and implementation of an immediate postpartum LARC program. A literature review, telephone and e-mail interviews with clinical experts involved with successful implementation of immediate postpartum LARC programs, development of a list of interdisciplinary specialists, and steps required to initiate a change in current practice.ResultsThe provision of a framework to guide the planning and implementation of an immediate postpartum LARC program to streamline the process while addressing perceived barriers and myths.ConclusionsAddressing the lack of knowledge about LARCs, financial concerns, and absence of a standardized framework related to planning and implementation of this complex process will hopefully begin the process of making effective and reliable contraception available.Implications for NursingThe use of a standardized framework to guide the implementation of an immediate postpartum LARC program provides the potential for easier access to LARC methods in this critical time period.


2009 ◽  
Vol 24 (3) ◽  
pp. 247-252 ◽  
Author(s):  
Nelson Tang ◽  
Kim Fredericksen ◽  
Lauren Sauer ◽  
Buddy Kozen ◽  
Horace Liang ◽  
...  

AbstractObjective:The appropriate activation and effective utilization of air-medical transport (AMT) services is an important skill for emergency medicine physicians in the United States.Previous studies have demonstrated variability with regards to emergency medical services (EMS) experience during residency training. This study was designed to evaluate the nature and extent of AMT training of the emergency medicine residency programs in the United States.Methods:An identity-unlinked survey of the program directors of all Accreditation Committee for Graduate Medical Education (ACGME) approved emergency medicine residency programs was conducted.The survey focused on EMS and AMT resident training opportunities and was conducted in two phases (1999 and 2006) using near-identical methodologies.Results:Response rates of 82% and 84% were achieved in 1999 and 2006, respectively. Percentages of programs offering AMT experiences were similar between the two study phases (76% in 1999 and 65% in 2006). The roles of residents during AMT experiences ranged widely between observer-only, active team member, and medical director/team leader in both 1999 and 2006. Compared to those in 1999, programs in 2006 demonstrated a greater frequency of EMS rotations being provided earlier, by year of training during emergency medicine residency. Residencies located in non-metropolitan centers only were slightly more likely to offer AMT training than were those in metropolitan locations.Conclusions:A majority of emergency medicine residency programs offer AMT experience that includes both scene responses and inter-facility transports. The role of residents during AMT training varies widely, as does the timing of their experiences during residency. The geographical locations of programs do not appear to impact the availability of AMT training.


2020 ◽  
Vol 21 (2) ◽  
pp. 423-428
Author(s):  
Al'ai Alvarez ◽  
Anne Messman ◽  
Melissa Platt ◽  
Megan Healy ◽  
Elaine Josephson ◽  
...  

Introduction: Academic Emergency Medicine (EM) departments are not immune to natural disasters, economic or political forces that disrupt a training program’s operations and educational mission. Due process concerns are closely intertwined with the challenges that program disruption brings. Due process is a protection whereby an individual will not lose rights without access to a fair procedural process. Effects of natural disasters similarly create disruptions in the physical structure of training programs that at times have led to the displacement of faculty and trainees. Variation exists in the implementation of transitions amongst training sites across the country, and its impact on residency programs, faculty, residents and medical students. Methods: We reviewed the available literature regarding due process in emergency medicine. We also reviewed recent examples of training programs that underwent disruptions. We used this data to create a set of best practices regarding the handling of disruptions and due process in academic EM. Results: Despite recommendations from organized medicine, there is currently no standard to protect due process rights for faculty in emergency medicine training programs. Especially at times of disruption, the due process rights of the faculty become relevant, as the multiple parties involved in a transition work together to protect the best interests of the faculty, program, residents and students. Amongst training sites across the country, there exist variations in the scope and impact of due process on residency programs, faculty, residents and medical students. Conclusion: We report on the current climate of due process for training programs, individual faculty, residents and medical students that may be affected by disruptions in management. We outline recommendations that hospitals, training programs, institutions and academic societies can implement to enhance due process and ensure the educational mission of a residency program is given due consideration during times of transition.


2021 ◽  
Vol 22 (5) ◽  
pp. 1110-1116
Author(s):  
Stephen Villa ◽  
Natasha Wheaton ◽  
Steven Lai ◽  
Jaime Jordan

Introduction: Radiology training is an important component of emergency medicine (EM) education, but its delivery has been variable. Program directors have reported a lack of radiology skills in incoming interns. A needs assessment is a crucial first step toward improving radiology education among EM residencies. Our objective was to explore the current state of radiology education in EM residency programs. Methods: This was a cross-sectional survey study of all Accreditation Council for Graduate Medical Education-accredited EM programs in the United States. Program leadership completed an online survey consisting of multiple choice, Likert scale, and free-response items. We calculated and reported descriptive statistics. Results: Of eligible EM programs, 142/252 (56%) completed the survey including 105 postgraduate year (PGY) 1-3 and 36 PGY 1-4 programs. One respondent opted out of answering demographic questions. 23/141 (16%) were from the Western region, 29/141 (21%) were from the North Central region, 14/141 (10%) were from the South-Central region, 28/141 (20%) were from the Southeast region, and 47/141 (33%) were from the Northeast region. A total of 88/142 (62%) of responding programs did not have formal radiology instruction. Of the education that is provided, 127/142 (89%) provide it via didactics/lectures and 115/142 (81%) rely on instruction during clinical shifts. Only 51/142 (36%) provide asynchronous opportunities, and 23/142 (16%) have a dedicated radiology rotation. The majority of respondents reported spending 0-2 hours per month on radiology instruction (108/142; 76%); 95/141 (67%) reported that EM faculty “often” or “always” provide radiology instruction; 134/142 (95%), felt that it was “extremely” or “very important” for ED providers to be able to independently interpret radiograph results; and 129/142 (90.84%) either “sometimes” or “always” rely on their independent radiograph interpretations to make clinical decisions. The radiology studies identified as most important to be able to independently interpret were radiographs obtained for lines/tubes, chest radiographs, and radiographs obtained for musculoskeletal-related complaints. Conclusion: A minority of EM residency programs have formal instruction in radiology despite the majority of responding program leadership believing that these are important skills. The most important curricular areas were identified. These results may inform the development of formal radiology curricula in EM graduate medical education.


2018 ◽  
Vol 32 (4) ◽  
pp. 412-421 ◽  
Author(s):  
Erin L. Thompson ◽  
P. S. S. Rao ◽  
Christopher Hayes ◽  
Catherine Purtill

Background: The Centers for Disease Control and Prevention (CDC) reports a 200% escalation in the rate of opioid overdose deaths in the United States. Unfortunately, Ohio has been deemed the epicenter of the nation’s opioid epidemic. In 2015, Ohio passed a bill that permits a pharmacist to distribute naloxone without a prescription. Objectives: This survey was aimed to discover pharmacists’ knowledge of naloxone and Ohio law, perceived barriers that may prohibit naloxone dispensing, and Ohio pharmacists’ general confidence, comfort, perception, and experience dispensing naloxone per physician protocol. Methods: Pharmacists’ knowledge of naloxone and Ohio law pertaining to dispensing naloxone; perceived barriers to naloxone distribution; and overall experience, willingness, comfort, and perceptions of personally supplying naloxone were assessed using multiple-choice and Likert-type scale questions through an e-mail survey. Results: Overall, Ohio pharmacists were knowledgeable about naloxone and displayed confidence in their training and ability to provide patient education on naloxone. Pharmacists were less certain about Ohio law pertaining to naloxone distribution, especially those who have been in practice longer. Pharmacists indicated several barriers to dispensing naloxone and the need for more training. Younger pharmacists were more likely to report a concern with clientele who would frequent their pharmacy and moral and ethical concerns as barriers to dispensing naloxone. Conclusion: Additional educational programs should be delivered to Ohio pharmacists to inform them of the state law and policies. Continuing education programs that review substance abuse and attempt to reduce social stigma may assist with increasing naloxone distribution to those in need, especially, if directed toward younger pharmacists in Ohio.


2019 ◽  
pp. 248-256 ◽  

Objectives: To evaluate whether a web-based educational intervention improved personal protective equipment (PPE) use among oncology nurses who handle hazardous drugs. Sample & Setting: From 2015 to 2017, the authors partnered with 12 ambulatory oncology settings in the United States to enroll 396 nurses, 257 of whom completed baseline and primary endpoint surveys. Methods & Variables: In a cluster randomized controlled trial, 136 nurses in control settings received a one-hour educational module on PPE use with quarterly reminders, and 121 nurses in treatment settings received the control intervention plus tailored messages to address perceived barriers and quarterly data gathered on hazardous drug spills across all study settings. The primary outcome was nurse-reported PPE use. Results: Control and intervention sites had suboptimal PPE use before and after the intervention. No significant differences were observed in PPE use knowledge or perceived barriers. Participants reported high satisfaction with the study experience. Implications for Nursing: Hazardous drug exposure confers notable health risks to healthcare workers. To improve hazardous drug handling, occupational healthcare workers, health systems, and professional organizations should consider coordinated efforts to implement policy and practice changes.


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