62 Are Junior Doctors aware about Risks of Falls in the Hospital

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv13-iv17
Author(s):  
Ng Chai Chen ◽  
Gar Mit Chong ◽  
Aruna Karthigayan
Keyword(s):  
Risk Factor ◽  
Assessment Tool ◽  
Falls Prevention ◽  
Junior Doctors ◽  
Physical Restraints ◽  
Validated Questionnaire ◽  
Level Of Knowledge ◽  
Intervention Team ◽  
Hospital Acquired ◽  
Falls Management

Abstract Introduction Falls are a leading cause of hospital acquired injuries. Junior doctors play a role as part of the multidisciplinary team, to prevent in-hospital falls and reduce harm following a fall. This study is to determine junior doctors’ level of knowledge regarding in-hospital falls. Methods A self-constructed and validated questionnaire was delivered to junior doctors during their weekly teaching session in the first 2weeks of May2019. It comprised of 1) Demography of participants 2) In- hospital falls prevention 3) In-hospital falls management. Correct responses from junior doctors working less than 1year and those more than 1year were compared. Results 46% of the junior doctors responded to the questionnaire. Only 9.5% (n=23) had exposure to a course on management of falls. 82% of them (n=218) were not aware of Malaysia National Falls Guideline, whilst only a quarter of the responders (n=67) heard about the presence of Fall Intervention Team. Less than 50% junior doctors were aware of the use of Morse Fall Scale as a standardised risk assessment tool. More than 50% of the correct responses are from more experienced junior doctors. 63.4% answered “Depression is a risk factor for falls” correctly, which represented the lowest of all the items. The second lowest item was “lines/catheters is a risk factor for falls”. The item which had the highest percentage of correct answers was “dizziness/vertigo is a risk factor for falls”, accounting for 260 subjects (98%). 56% of housemen considered physical restraints as part of fall intervention in hospital. Conclusion The more experienced junior doctors had better knowledge about falls in the hospital, however from this study it is shown that it is still lacking. Continuing medical education should be an avenue where in-hospital falls is emphasized, and their knowledge is regularly updated.

Knowledge and Attitude of Teachers in Selected Malaysian Primary School towards Dental Injuries

2018 ◽  
Vol 15 (2) ◽  
pp. 51
Author(s):  
Syazwani Hassan ◽  
Nur Nabila Zulkifly ◽  
Annapurny Venkiteswaran ◽  
Rohaida Abdul Halim
Keyword(s):  
Primary School ◽  
Primary Schools ◽  
Tertiary Education ◽  
Primary School Teachers ◽  
Storage Media ◽  
Validated Questionnaire ◽  
First Aid Training ◽  
Level Of Knowledge ◽  
Knowledge And Attitude ◽  
Dental Injuries

To ascertain the level of knowledge among primary school teachers towards the management of traumatic dental injuries (TDIs) in school and to determine the preference among teachers regarding the education tools that can be used to increase awareness and knowledge among them. A total of 150 teachers from primary schools in three different districts were included in the study and they were given self-administered questionnaires to be filled. The validated questionnaire was distributed randomly in the selected schools. The questionnaire included two scenarios comprising of tooth fracture and avulsion. Questions regarding awareness and management of these scenarios were asked. All 150 participants answered the questionnaire; of these 74% were females 26% were males. 64% of the participants had received tertiary education. Although 70% of teachers had obtained first aid training, only 9.3% of them had received training regrading dental injuries. About 53% of participants knew the correct answer for the appropriate response to fractured tooth and only 35.3% managed to correctly answer the question related to appropriate response to an avulsed tooth. Only 38.7% knew about appropriate rinsing solution and a mere 4.7% were familiar with proper storage media. Even though the teachers have poor knowledge regarding management of dental injuries, it is reassuring to know that 93% of them are keen on further training and awareness. More educational programmes need to be introduced to empower the teachers with the relevant knowledge required to deal with dental emergencies.

Components of a risk assessment tool for prevention and control of bovine respiratory disease in preweaned dairy calves

2020 ◽  
pp. 1-7
Author(s):  
Sharif S. Aly ◽  
Betsy M. Karle ◽  
Deniece R. Williams ◽  
Gabriele U. Maier ◽  
Sasha Dubrovsky
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Risk Factor ◽  
Respiratory Disease ◽  
Scoring System ◽  
Prevention And Control ◽  
Assessment Tool ◽  
Bovine Respiratory Disease ◽  
And Control ◽  
Management Changes

Abstract Bovine respiratory disease (BRD) is the leading natural cause of death in US beef and dairy cattle, causing the annual loss of more than 1 million animals and financial losses in excess of $700 million. The multiple etiologies of BRD and its complex web of risk factors necessitate a herd-specific intervention plan for its prevention and control on dairies. Hence, a risk assessment is an important tool that producers and veterinarians can utilize for a comprehensive assessment of the management and host factors that predispose calves to BRD. The current study identifies the steps taken to develop the first BRD risk assessment tool and its components, namely the BRD risk factor questionnaire, the BRD scoring system, and a herd-specific BRD control and prevention plan. The risk factor questionnaire was designed to inquire on aspects of calf-rearing including management practices that affect calf health generally, and BRD specifically. The risk scores associated with each risk factor investigated in the questionnaire were estimated based on data from two observational studies. Producers can also estimate the prevalence of BRD in their calf herds using a smart phone or tablet application that facilitates selection of a true random sample of calves for scoring using the California BRD scoring system. Based on the risk factors identified, producers and herd veterinarians can then decide the management changes needed to mitigate the calf herd's risk for BRD. A follow-up risk assessment after a duration of time sufficient for exposure of a new cohort of calves to the management changes introduced in response to the risk assessment is recommended to monitor the prevalence of BRD.

Imipenem Resistance in Pseudomonas aeruginosa Emergence, Epidemiology, and Impact on Clinical and Economic Outcomes

2010 ◽  
Vol 31 (1) ◽  
pp. 47-53 ◽  
Author(s):  
Ebbing Lautenbach ◽  
Marie Synnestvedt ◽  
Mark G. Weiner ◽  
Warren B. Bilker ◽  
Lien Vo ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Risk Factor ◽  
Hospital Stay ◽  
Hospital Cost ◽  
Independent Risk Factor ◽  
Multivariable Analysis ◽  
Economic Outcomes ◽  
Imipenem Resistance ◽  
Hospital Acquired ◽  
Control Study

Background.Pseudomonas aeruginosa is one of the most common gram-negative hospital-acquired pathogens. Resistance of this organism to imipenem complicates treatment.Objective.To elucidate the risk factors for imipenem-resistant P. aeruginosa (IRPA) infection or colonization and to identify the effect of resistance on clinical and economic outcomes.Methods.Longitudinal trends in prevalence of IRPA from 2 centers were characterized during the period from 1989 through 2006. For P. aeruginosa isolates obtained during the period from 2001 through 2006, a case-control study was conducted to investigate the association between prior carbapenem use and IRPA infection or colonization, and a cohort study was performed to identify the effect of IRPA infection or colonization on mortality, length of stay after culture, and hospital cost after culture.Results.From 1989 through 2006, the proportion of P. aeruginosa isolates demonstrating resistance to imipenem increased from 13% to 20% (P< .001, trend). During the period from 2001 through 2006, there were 2,542 unique patients with P. aeruginosa isolates, and 253 (10.0%) had IRPA isolates. Prior carbapenem use was independently associated with IRPA infection or colonization (adjusted odds ratio [OR], 7.92 [95% confidence interval {CI}, 4.78-13.11]). Patients with an IRPA isolate recovered had higher in-hospital mortality than did patients with an imipenem-susceptible P. aeruginosa isolate (17.4% vs 13.4%; P = .01). IRPA infection or colonization was an independent risk factor for mortality among patients with isolates recovered from blood (adjusted OR, 5.43 [95% CI, 1.72-17.10]; P = .004) but not among patients with isolates recovered from other anatomic sites (adjusted OR, 0.78 [95% CI, 0.51-1.21]; P = .27). Isolation of IRPA was associated with longer hospital stay after culture (P<.001) and greater hospital cost after culture (P<.001) than was isolation of an imipenem-susceptible strain. In multivariable analysis, IRPA infection or colonization remained an independent risk factor for both longer hospital stay after culture (coefficient, 0.20 [95% CI, 0.04-0.36]; P = .02) and greater hospital cost after culture (coefficient, 0.30 [95% CI, 0.06-0.54]; P = .02).Conclusions.The prevalence of IRPA infection or colonization has increased significantly, with important implications for both clinical and economic outcomes. Interventions to curb this continued increase and strategies to optimize therapy are urgently needed.

Abstract P73: Comparison of Hospital-Acquired Anemia and TIMI Bleeding for Mortality Prediction in Patients with Acute Myocardial Infarction

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Adam C Salisbury ◽  
Amit P Amin ◽  
Karen P Alexander ◽  
Frederick A Masoudi ◽  
Yan Li ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
At Risk ◽  
Assessment Tool ◽  
Mortality Prediction ◽  
Logistic Regression Models ◽  
Net Reclassification Improvement ◽  
Risk Patients ◽  
Poor Outcomes ◽  
Hospital Acquired

Background: In-hospital bleeding and new onset, hospital acquired anemia (HAA) are both associated with higher mortality in acute myocardial infarction (AMI). Since bleeding is variably defined and often poorly documented, HAA could be a better method to identify at-risk patients, if its prognostic ability were at least as good as documented bleeding. We directly compared the association of HAA and TIMI bleeding with 1-year mortality. Methods: Among 2,803 AMI patients who were not anemic at admission in the 24-center TRIUMPH registry, the presence and severity of HAA and TIMI bleeding were prospectively collected to identify their relative discrimination of 1-year mortality. Logistic regression models, accounting for clustering using generalized estimating equations, were fit for 1) no bleeding, TIMI minimal, minor and major bleeding and 2) no HAA, mild (hemoglobin (Hgb) > 11 g/dl), moderate (Hgb 9 - 11 g/dl) and severe HAA (Hgb < 9 g/dl). Discrimination was compared using c-statistics and reclassification was assessed using the integrated discrimination improvement (IDI), which measures a model's improvement in average sensitivity without sacrificing average specificity vs. another model, and the continuous net reclassification improvement (NRI), to identify the proportion of patients correctly reclassified by the HAA model. Results: HAA was more common (mild: 33%, moderate: 10%, severe 2%) than TIMI bleeding (minimal: 5%, minor: 3%, major 1%). Over 1-year follow-up, 111 patients (4%) died. The HAA model was superior to TIMI bleeding model for 1-year mortality prediction (c-statistic 0.60 vs. 0.51, p<0.001). The IDI of the HAA vs. the bleeding model was 0.009 (95% CI 0.005 - 0.014) and the relative IDI was 0.26 (26% better average discrimination), with a NRI of 0.32 (0.13-0.50) - 17% of patients with events were correctly reclassified to a higher risk while 14% of patients without events were correctly reclassified to a lower risk by the HAA model. Conclusions: HAA is better than TIMI bleeding for identifying 1-year mortality after AMI hospitalization, and may better identify patients without recognized bleeding who are also at risk for poor outcomes. HAA may be useful to identify high-risk patients and as a quality assessment tool.

Parental Perception of the Role of Color Additives in Food on Children's Behavior in Jazan Region of Saudi Arabia

2020 ◽  
Vol 19 (3) ◽  
pp. 308-311
Author(s):  
Hafiz A. Makeen ◽  
Saad S. Alqahtani ◽  
Nawazish Alam ◽  
Santhosh J. Menachery ◽  
Rabea M. Ageeli ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Harmful Effect ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Children's Behavior ◽  
Food And Beverages ◽  
Validated Questionnaire ◽  
Level Of Knowledge ◽  
Coloring Agents ◽  
Artificial Food Colors

Natural and artificial food colors are widely used in a variety of food products. This study was designed to assess the awareness and perception of coloring agents present in food and beverages on children's behavior among people of Jazan, Saudi Arabia. A cross-sectional study was conducted on representative samples of 387 married people from different places in Jazan region of Saudi Arabia from August to December 2019. The study utilized a validated questionnaire consisting of 12 questions to gather the information from 387 participants (52.9% males and 47.03% females). Approximately 77% were young adults; belong to age group of 26-45 years (P = 0.000). Majority (40.5%) of them had four or more children (P = 0.000). While significant level of knowledge about the use of foods and beverages containing coloring agent was found in the participants (P = 0.001), they were not aware that it may affect the child's health. Only 24.7% were able to tell the name of a coloring agent (P = 0.001). Significant percentage (88.9%) of parents reported about child hyperactivity after consumption of specific type of food and beverages, particularly fizzy drinks (35.61%), chocolates (31.82%), and sweets and candy (30.3%). Target populations were considered to be aware of presence of coloring agent in food and beverages used by their children regularly but they are not much aware of its harmful effect on long-term use.

scholarly journals Development of a Risk Assessment Tool for Falls Prevention in Hospital Inpatients Based on the Medication Appropriateness Index (MAI) and Modified Beer's Criteria

2012 ◽  
Vol 3 (1) ◽  
Author(s):  
Martha M. Rumore ◽  
Georgeta Vaidean
Keyword(s):  
Medication Review ◽  
Assessment Tool ◽  
Inappropriate Prescribing ◽  
Falls Prevention ◽  
Beers Criteria ◽  
Medication Appropriateness Index ◽  
Assessment Index ◽  
Advantages And Disadvantages ◽  
Hospital Inpatients ◽  
Elderly Hospitalized Patients

Medication review is an essential component of comprehensive falls assessment. A medication review by pharmacists can assist to identify and notify prescribers of medications that require adjustment or discontinuation. Beers Criteria and the Medication Assessment Index (MAI) are explicit and implicit inappropriate prescribing (IP) tools, respectively. While the Beers Criteria has been applied to falls prevention, the MAI has not. Developing alternative falls prevention tools has been spurned by both the desire to overcome limitations of the Beers Criteria, coupled with the need for implicit criteria which includes consideration for patient äóñspecific clinical judgement. A literature search and review of the Beers Criteria and MAI tools revealed advantages and disadvantages of each. Using combined explicit/implicit falls assessment criteria using both the Beers Criteria and MAI as a framework, a falls specific inappropriate prescribing (FASPIP) tool for use in elderly hospitalized patients was developed. Validation of the FASPIP in the clinical setting is needed.   Type: Review

scholarly journals Assessing knowledge of genetics in undergraduate students in Quito, Ecuador

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 290
Author(s):  
David Ortega-Paredes ◽  
César Larrea-Álvarez ◽  
Michelle Herrera ◽  
Esteban Fernandez-Moreira ◽  
Marco Larrea-Álvarez
Keyword(s):  
Undergraduate Students ◽  
Public Institutions ◽  
Capital City ◽  
Personal Genomic ◽  
Actual Knowledge ◽  
National Education ◽  
Highly Educated ◽  
Validated Questionnaire ◽  
Private And Public ◽  
Level Of Knowledge

Knowledge of genetics is crucial for understanding genetic and genomic tests and for interpreting personal genomic information. Despite this relevance, no data are available about the level of knowledge of genetics in an Ecuadorian population. This investigation sought to survey such knowledge in undergraduate students affiliated with private and public institutions in Quito, the capital city of Ecuador. A total of 350 individuals responded to a validated questionnaire measuring knowledge of genetics. Scores ranged from 45% to 87% (mean: 66.8%), and students achieved slightly better results when asked about genetics and diseases (mean score: 68.3%) than when asked about genetic facts (mean score: 64.9%). Additionally, no significant differences in performance were found among students from private and public institutions. Surprisingly, the lower score obtained (45%) was from a question about how chromosomes are passed to the next generation. The highly educated status of the surveyed population could explain the overall adequate results; nonetheless, the possibility that the correct responses were given by chance cannot be ignored. Therefore, the actual knowledge of genetics among the participants might be less than that revealed by the percentages of correct answers. Consequently, to achieve the goal of ensuring informed decision-making concerning genetic and genomic tests, it seems evident that the national education programs of Ecuador require improvement in teaching of genetic concepts.

Junior doctors' experience and knowledge of procedures in compulsory psychiatric admissions in Ireland

2001 ◽  
Vol 18 (1) ◽  
pp. 21-23 ◽  
Author(s):  
Geraldine Swift ◽  
M Nasir ◽  
John D Sheehan ◽  
Patricia R Casey
Keyword(s):  
Response Rate ◽  
Real Life ◽  
Current Debate ◽  
Junior Doctors ◽  
Legal Requirements ◽  
Training Scheme ◽  
Psychiatric Admissions ◽  
Mental Health Legislation ◽  
Level Of Knowledge ◽  
Health Legislation

AbstractObjectives: Prompted by the current debate in Ireland regarding involuntary detention, we undertook a survey of psychiatric trainees to examine their level of knowledge of the legislation governing such admissions.Method: Eighty psychiatric trainees working in centres affiliated to a particular training scheme were invited to complete a purpose-designed instrument.Results: Response rate was 52/80. Trainees were well informed concerning the procedures necessary to initiate detention. Their knowledge of the legal indications for involuntary detention and restrictions on its duration was patchy.Conclusions: We suggest that training in the area of mental health legislation needs to be increased and to focus on satisfying legal requirements in real-life scenarios.

scholarly journals The validity of the Annual Review of Competence Progression: a qualitative interview study of the perceptions of junior doctors and their trainers

2017 ◽  
Vol 110 (3) ◽  
pp. 110-117 ◽  
Author(s):  
Rowena Viney ◽  
Antonia Rich ◽  
Sarah Needleman ◽  
Ann Griffin ◽  
Katherine Woolf
Keyword(s):  
Assessment Tool ◽  
Medical Training ◽  
Annual Review ◽  
Junior Doctors ◽  
Postgraduate Medical Training ◽  
Medical Graduates ◽  
Qualitative Interview Study ◽  
Negative Perceptions ◽  
Positive Experiences ◽  
Graduate Trainees

Objective To investigate trainee doctors’ and trainers’ perceptions of the validity of the Annual Review of Competence Progression (ARCP) using Messick’s conceptualisation of construct validity. Design Qualitative semi-structured focus groups and interviews with trainees and trainers. Setting Postgraduate medical training in London, Kent Surrey and Sussex, Yorkshire and Humber, and Wales in November/December 2015. Part of a larger study about the fairness of postgraduate medical training. Participants Ninety-six trainees and 41 trainers, comprising UK and international medical graduates from Foundation, General Practice, Medicine, Obstetrics and Gynaecology, Psychiatry, Radiology, and Surgery, at all levels of training. Main outcome measures Trainee and trainer perceptions of the validity of the ARCP as an assessment tool. Results Participants recognised the need for assessment, but were generally dissatisfied with ARCPs, especially UK graduate trainees. Participants criticised the perceived tick-box nature of ARCPs as measuring clerical rather than clinical ability, and which they found detrimental to learning. Trainees described being able to populate their e-portfolios with just positive feedback; they also experienced difficulty getting assessments signed off by supervisors. ARCPs were perceived as poor at identifying struggling trainees and/or as discouraging excellence by focussing on minimal competency. Positive experiences of ARCPs arose when trainees could discuss their progress with interested supervisors. Conclusions Trainee and trainer criticisms of ARCPs can be conceptualised as evidence that ARCPs lack validity as an assessment tool. Ongoing reforms to workplace-based assessments could address negative perceptions of the ‘tick-box’ elements, encourage constructive input from seniors and allow trainees to demonstrate excellence as well as minimal competency, while keeping patients safe.

Hospital-Acquired Delirium

2021 ◽  
pp. 41-46
Author(s):  
Sara C. LaHue ◽  
Morris Levin
Keyword(s):  
Risk Factor ◽  
Clinical Outcomes ◽  
Serious Illness ◽  
Hospital Acquired

Delirium is becoming increasingly recognized as a symptom of serious illness as well as a risk factor for poor clinical outcomes in its own right. This case provides a framework for these often nebulous presentations.

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