scholarly journals P-EGS11 The Theatre Training Checklist: A Toolkit to Revive Post Pandemic Operative Training

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Joanna Aldoori ◽  
Andrew Robson ◽  
Adam Al-Attar ◽  
Josh Burke ◽  
Lolade Giwa ◽  
...  
Keyword(s):  
Negative Impact ◽  
Patient Positioning ◽  
Recovery Phase ◽  
Operating Theatre ◽  
Instructional Video ◽  
Training Environment ◽  
Multiprofessional Team ◽  
Training Requirements ◽  
Significant Negative Impact ◽  
Limited Opportunity

Abstract Background The COVID-19 pandemic has had a significant negative impact on operative surgical training, with trainee logbook numbers reduced by more than 50% compared to 2019. The operating theatre is expensive, costing approximately £1200 per hour to run. It is a crucial learning environment for many different trainees: anaesthetists, surgeons, operation department practitioners and surgical first assistants. For individuals to achieve their training requirements, the operating theatre as a training environment must be shared between all trainees. This requires excellent teamwork and leadership. The recovery phase of the COVID-19 pandemic is a unique opportunity to adopt novel training strategies.  Methods The Theatre Training Checklist is a simple framework that aims to facilitate awareness, understanding, coordination and cooperation of training for all members of the team (Figure 1). It is a practical strategy that can be adopted in any setting. Usually, trainers discuss informally with their trainees about their individual Skills, Experience, Expectationsand what is Achievable in a planned theatre list (SEEA). However, there currently is limited opportunity to discuss this between different disciplines and the wider team. This tool aims to refine communication, optimize training, manage expectations and ensure equity across the board. The checklist has been introduced and trialed locally.  Results The checklist is completed at the start of the list during the theatre brief. It identifies all trainees and their specific needs within the operating theatre session to the whole team. An agreed strategy is developed on how to achieve identified training goals (figure 2). Sometimes it may not be possible to allow a trainee to perform a particular procedure. However, other opportunities for training in theatre exist, such as: patient positioning, choice of equipment, types of techniques, discussions around consenting and complications etc. Feedback undertaken from the multiprofessional team after local trialing of the checklist has been positive.  Conclusions The Theatre Training Checklist aims to create dialogue and shared understanding of training needs among all parties within the operating theatre. The Theatre Training Checklist Toolkit is available for use and consists of the checklist tool and an instructional video. The Theatre Training checklist is being piloted in some centers and we hope to have the opportunity to present some early findings at AUGIS 2021.

scholarly journals 448 The Impact of Noise in the Operating Theatre: A Review of the Evidence

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
R J W Mcleod ◽  
L Wilks ◽  
S Davies ◽  
H A Elhassan
Keyword(s):  
Negative Impact ◽  
Noise Pollution ◽  
Operating Theatre ◽  
Task Completion ◽  
Training Environment ◽  
Surgical Performance ◽  
Surgeon Experience ◽  
Operating Theatres ◽  
Team Functioning ◽  
The Impact

Abstract Background Noise has been recognised to have a negative impact on performance and wellbeing in many settings. Average noise levels have been found to range between 51-79 dB in operating theatres. Despite this, there is little research investigating the effect of noise on surgical team functioning. Method A literature review to look at the impact of noise in the operating theatre was performed on MEDLINE which included the search terms ‘noise’ OR ‘distraction’ AND ‘technical skill’ OR ‘Surgical skill’ OR ‘Operating Room’. 10 of 307 articles identified were deemed relevant. Results 8 of 10 studies found noise to be detrimental to communication and surgical performance, particularly regarding total errors and time to task completion. No studies found noise to be beneficial. Two studies found case irrelevant verbal communication to be a frequent form of noise pollution in operating theatres; this is both perceived by surgeons to be distracting and delays patient care. Noise was most harmful to trainees. Conclusions Noise and irrelevant verbal communications were both found to be harmful to surgical performance, surgeon experience and team functioning. The worsened effect on the trainee exposes an urgent need to address noise pollution in the training environment.

Comparison of Time spent between an electronic and a paper-based laboratory information system by laboratorians at a polyclinic in Greater Accra, Ghana: A time-motion study

2020 ◽  
Author(s):  
Philip Boakye
Keyword(s):  
Information System ◽  
Negative Impact ◽  
Laboratory Information System ◽  
Time Motion ◽  
Accessible Information ◽  
Motion Study ◽  
Significant Difference ◽  
Significant Negative Impact ◽  
Key Issues ◽  
Motion Studies

The acceptance of electronic laboratory information system (LIS) is gradually increasing in developing countries. However, the issue of time effectiveness due to computerization is less clear as there is fewer accessible information. One of the key issues for laboratorians is their indecision with LISs’ would-be effect of time on their work. A polyclinic in Ghana was in the process of implementing electronic LIS. Several of the laboratorians did not have knowledge and skill in computing and there were disagreeing views on the time effectiveness of the LIS after implementation. The management of the polyclinic laboratory was concerned to assess time advantageousness of recording data when using the electronic LIS compared with paper-based LIS. <div><br></div><div>Five randomly selected laboratorians were provided two sheets of paper with tables to document the time they spent for both paper-based and electronic LIS. Data were collected for a total of 230 records,115 electronic LIS and 115 paper-based LIS. The t-test (mean-comparison test) was computed to compare the means of both electronic and paperbased LIS times. </div><div><br></div><div>There was a statistical significant difference in the time spent between electronic and paper-based LIS. The time spent between paper-based and electronic LIS was 0.41 minutes (95% CI 0.15 to 0.66) longer than in electronic LIS. </div><div><br></div><div>LIS can be adopted in polyclinics without having significant negative impact on time spent between electronic and paper-based LIS. More time–motion studies that include laboratorians are however necessary in order to get a more complete picture of time spent between electronic and paper-based LIS. </div>

ASSESSMENT OF THE SPATIOTEMPORAL DYNAMICS OF THE MACROPHYTE THICKET ECOSYSTEMS IN THE NEVA BAY AND THE ADJACENT WATERS OF THE EASTERN GULF OF FINLAND

2017 ◽  
Author(s):  
Ekaterina Maksimova ◽  
Ekaterina Maksimova ◽  
Vladimir Zhigulsky ◽  
Vladimir Zhigulsky ◽  
Vladimir Shuisky ◽  
...  
Keyword(s):  
Aquatic Vegetation ◽  
Temporal Dynamics ◽  
Negative Impact ◽  
Spatiotemporal Dynamics ◽  
Gulf Of Finland ◽  
Active Growth ◽  
Nesting Sites ◽  
Significant Negative Impact ◽  
And Migration ◽  
Neva Bay

The macrophyte thicket ecosystems of higher aquatic vegetation in the Neva Bay (NB) and Eastern Gulf of Finland (EGoF) perform many important roles, including acting as the habitats, nesting sites and migration sites for aquatic and semi-aquatic birds, creating the specific conditions necessary for the spawning and growth of many species of fish, and taking part in the self-purification of the aquatic ecosystems. Many anthropogenic disturbances, hydraulic works in particular, have a significant negative impact on these macrophyte thicket ecosystems. In recent years, the active growth of a new type of macrophyte thicket has been observed in the NB. This is due to the aftereffects of the construction of the Saint Petersburg Flood Prevention Facility Complex (FPFC). It is quite likely that the total macrophyte thicket area in these waters is currently increasing. In the future, it will be necessary to assess the environmental impacts of the hydraulic works on the macrophyte thicket of the NB and EGoF, taking into account the background processes of the spatiotemporal dynamics of the reed beds in the waters in question. To do this, it will be necessary to carry out a comprehensive study of these ecosystems and identify patterns in their spatial and temporal dynamics. The program of the study has been developed and is currently being implemented by Eco-Express-Service, a St. Petersburg eco-design company.

On the Major Differences between the Banking Systems of the EAEU States

2020 ◽  
Vol 26 (4) ◽  
pp. 397-406
Author(s):  
T. E. Chekanova
Keyword(s):  
Financial Stability ◽  
Systems Approach ◽  
Negative Impact ◽  
Banking Regulation ◽  
Member States ◽  
Banking Systems ◽  
Significant Negative Impact ◽  
The Difference ◽  
The Government ◽  
Major Factors

The presented study examines the problems of integration of the national banking systems of the member states of the Eurasian Economic Union (EAEU).Aim. The study aims to examine the major differences in various aspects of functioning of banking systems in the EAEU member states in terms of their impact on integration processes.Tasks. The author identifies the most prominent features of the banking systems of the EAEU states; reveals the depth of the existing differences through a comparative analysis of various indicators of national banking systems; outlines ways of overcoming integration problems associated with differences in the banking sectors of the Union states.Methods. This study is based on universal general scientific methods and elements of comparative, functional, and economic analysis within the framework of a systems approach. The author uses regulatory documents and banking reports of the EAEU states, statistical and analytical materials of the Eurasian Economic Commission (EEC), and data of Moody’s international rating agency.Results. The study identifies a number of aspects that contain the major differences in the functioning of banking systems in the EAEU member states; highlights the disproportions in the scale, level of development, financial stability, and risks of the banking spheres of the Union states; comparatively analyzes the proportion of banking and non-banking structures in the system and the share of the government and non-resident companies in the capital of banks; marks the difference in the pricing of banking services; determines differences in the existing approaches to banking regulation and the established standards; analyzes the major differences in the legislative acts of the central banks and governments of the EAEU member states and in the terms and definitions used. According to the results of the study, the major factors hindering the development of integration processes between the banking systems of the EAEU states are identified.Conclusions. The existing differences between the banking systems of the EAEU countries are diverse and multifaceted. The author states that the aspects addressed in this study have a significant negative impact on the further development of integration processes, describing the major directions and actions of the member states aimed at minimizing the exiting differences, which are required to facilitate the convergence of the states and the transition towards a common financial market.

scholarly journals Reserved Bed Program Reduces Neurosciences Intensive Care Unit Capacity Strain: An Implementation Study

Neurosurgery ◽  
2019 ◽  
Vol 86 (1) ◽  
pp. 132-138
Author(s):  
Christopher D Shank ◽  
Nicholas J Erickson ◽  
David W Miller ◽  
Brittany F Lindsey ◽  
Beverly C Walters
Keyword(s):  
Intensive Care ◽  
Economies Of Scale ◽  
Negative Impact ◽  
The United States ◽  
Fiscal Year ◽  
Implementation Study ◽  
Service Line ◽  
Hospital Units ◽  
Significant Negative Impact ◽  
Operational Issues

Abstract BACKGROUND Neurosciences intensive care units (NICUs) provide institutional centers for specialized care. Despite a demonstrable reduction in morbidity and mortality, NICUs may experience significant capacity strain with resulting supraoptimal utilization and diseconomies of scale. We present an implementation study in the recognition and management of capacity strain within a large NICU in the United States. Excessive resource demand in an NICU creates significant operational issues. OBJECTIVE To evaluate the efficacy of a Reserved Bed Pilot Program (RBPP), implemented to maximize economies of scale, to reduce transfer declines due to lack of capacity, and to increase transfer volume for the neurosciences service-line. METHODS Key performance indicators (KPIs) were created to evaluate RBPP efficacy with respect to primary (strategic) objectives. Operational KPIs were established to evaluate changes in operational throughput for the neurosciences and other service-lines. For each KPI, pilot-period data were compared to the previous fiscal year. RESULTS RBPP implementation resulted in a significant increase in accepted transfer volume to the neurosciences service-line (P = .02). Transfer declines due to capacity decreased significantly (P = .01). Unit utilization significantly improved across service-line units relative to theoretical optima (P &lt; .03). Care regionalization was achieved through a significant reduction in “off-service” patient placement (P = .01). Negative externalities were minimized, with no significant negative impact in the operational KPIs of other evaluated service-lines (P = .11). CONCLUSION Capacity strain is a significant issue for hospital units. Reducing capacity strain can increase unit efficiency, improve resource utilization, and augment service-line throughput. RBPP implementation resulted in a significant improvement in service-line operations, regional access to care, and resource efficiency, with minimal externalities at the institutional level.

scholarly journals The Influence of Urban Sprawl on Air Pollution and the Mediating Effect of Vehicle Ownership

Processes ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 1261
Author(s):  
Aiping Tao ◽  
Qun Liang ◽  
Peng Kuai ◽  
Tao Ding
Keyword(s):  
Air Pollution ◽  
Urban Sprawl ◽  
Negative Impact ◽  
Empirical Support ◽  
Mediating Effect ◽  
Vehicle Ownership ◽  
Mediating Role ◽  
Effect Model ◽  
Significant Negative Impact ◽  
The Impact

Based on the panel data of 224 prefecture-level and above cities in China from 2003 to 2016, this paper empirically studies the impact of urban sprawl on air pollution and introduces a mediating effect model to test the mediating role of vehicle ownership concerning the impact of urban sprawl on air pollution. The research in this paper arrives at three conclusions. First, urban sprawl has a significant positive effect on air pollution, and this conclusion is still valid after solving the endogeneity problem and conducting a robustness test. Second, the results of mediating effect test show that urban sprawl indirectly affects air pollution through the partial mediating effect of vehicle ownership. By removing the mediating effect, urban sprawl has a significant negative impact on air pollution, indicating that the mediating effect of vehicle ownership is higher concerning the impact of urban sprawl on air pollution. Third, further panel quantile regression results show that the higher the level of air pollution, the weaker the mediating effect of vehicle ownership and the stronger the direct effect of urban sprawl on air pollution. These conclusions can provide some empirical support for solving the air pollution problems caused by urban sprawl in China.

scholarly journals Risk Factors, Pattern and Outcome of Motorcycle-associated Head Injury in Sokoto: An Analysis of 184 Cases

2021 ◽  
Author(s):  
Henry Olayere Obanife ◽  
Nasiru Jinjiri Ismail ◽  
Ali Lasseini ◽  
Bello B. Shehu ◽  
Ega J. Otorkpa
Keyword(s):  
Developing Countries ◽  
Head Injury ◽  
Road Traffic ◽  
Negative Impact ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Incidence And Mortality ◽  
Male Female Ratio ◽  
Significant Negative Impact

Abstract Background Road traffic accident (RTA) is the eighth leading cause of death worldwide. Motorcycle-associated head injury is the leading cause of road traffic associated morbidity and mortality in developing countries. Even though the incidence and mortality of head injury from motor cycle crash is on the increase in developing countries, especially in the African continent, most of the studies published in the literature on this subject matter took place in the developed Western countries. Methods This is a retrospective cross-sectional study of data from patients managed in our institution between December 2014 and November 2016. Results One hundred and eighty-four patients were analyzed. None of the patients used safety helmet for protection. The mean age was 27.6 ± 17.2 years with male female ratio of 6.7:1. Lone crash by cyclists and collisions accounted for 66.8% and 33.1% of the cases, respectively. Passengers and riders comprised 75% of the patients, while 25% were vulnerable pedestrians. The most frequently abused substance by the patients was tramadol (65.52%). Severe head injury and pupillary abnormality were found in 23.9% and 45.5% of the patients, respectively. Cranial CT scan showed abnormalities in 40.2% of the patients. Surgery was done in 28.3% of the patients with mortality rate of 20.7%. Conclusions The use of motorcycle as a mean of transportation has caused significant negative impact on the society. Young people, who constitute the workforce, are majorly affected, and this invariably leads to a serious economic burden on the concerned families and communities.

scholarly journals 764 Human Factors in Operative Theatres During the Covid-19 Pandemic: A Cross-sectional Analysis of Operating Theatre Staff Experiences in a Regional Centre

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
L E Murchison ◽  
R Anbarasan ◽  
A Mathur ◽  
M Kulkarni
Keyword(s):  
Human Factors ◽  
Online Survey ◽  
Situational Awareness ◽  
Negative Impact ◽  
High Stress ◽  
Operating Theatre ◽  
Free Text ◽  
Cross Sectional ◽  
Chi Squared ◽  
Theatre Staff

Abstract Introduction In the already high-risk, high-stress environment of the operating theatre, operating during Covid-19 has brought its own unique challenges. Communication, teamwork and anxiety related new operating practices secondary to Covid-19 are hypothesised to have a negative impact on patient care. Method We conducted a single-centre online survey of operating theatre staff from 22nd June–6th July 2020. Respondents completed 18 human factors questions related to COVID-19 precautions including communication, teamwork, situational awareness, decision making, stress, fatigue, work environment and organisational culture. Questions consisted of yes/no responses, multiple choice and Likert items. Kruskall-Wallis tests, Chi-Squared, Mann Whitney U tests, Spearman’s correlation coefficient, lambda and Cramer’s V tests were used. Free-text responses were also reviewed. Results 116 theatre staff responded. Visual (90.5%), hearing/ understanding (96.6%) difficulties, feeling faint/lightheaded (66.4%) and stress (47.8%) were reported. Decreased situational awareness was reported by 71.5% and correlated with visors (r = 0.27 and p = 0.03) and FFP2/3 mask usage (r = 0.29 and p = 0.01). Reduced efficiency of theatre teams was reported by 75% of respondents and 21.5% felt patient safety was at greater risk due to Covid-19 precautions in theatre. Conclusions Organisational adjustments are required, and research focused on development of fit-for-purpose personal protective equipment (PPE).

Money growth variability and output: evidence with credit card-augmented Divisia monetary aggregates

2020 ◽  
Vol 24 (5) ◽  
Author(s):  
Jinan Liu ◽  
Apostolos Serletis
Keyword(s):  
Financial Stability ◽  
Credit Card ◽  
Negative Impact ◽  
Balance Sheet ◽  
Credit Cards ◽  
Money Growth ◽  
Monetary Policies ◽  
Growth Variability ◽  
Significant Negative Impact ◽  
Growth Volatility

Abstract We reexamine the effects of the variability of money growth on output, raised by Mascaro and Meltzer (1983), in the era of the increasing use of alternative payments, such as credit cards. Using a bivariate VARMA, GARCH-in-Mean, asymmetric BEKK model, we find that the volatility of the credit card-augmented Divisia M4 monetary aggregate has a statistically significant negative impact on output from 2006:7 to 2019:3. However, there is no effect of the traditional Divisia M4 growth volatility on real economic activity. We conclude that the balance sheet targeting monetary policies after the financial crisis in 2007–2009 should pay more attention on the broad credit card-augmented Divisia M4 aggregate to address economic and financial stability.

The Impact of the Business Environment on the Formalization of Informal Firms. The Case of Kosovo

Südosteuropa ◽  
2020 ◽  
Vol 68 (4) ◽  
pp. 505-529
Author(s):  
Kujtim Zylfijaj ◽  
Dimitar Nikoloski ◽  
Nadine Tournois
Keyword(s):  
Negative Impact ◽  
Positive Impact ◽  
Business Environment ◽  
Positive Influence ◽  
Policy Implications ◽  
Tax Reforms ◽  
Firm Level ◽  
Characteristics Analysis ◽  
Significant Negative Impact ◽  
The Impact

AbstractThe research presented here investigates the impact of the business environment on the formalization of informal firms, using firm-level data for 243 informal firms in Kosovo. The findings indicate that business-environment variables such as limited access to financing, the cost of financing, the unavailability of subsidies, tax rates, and corruption have a significant negative impact on the formalization of informal firms. In addition, firm-level characteristics analysis suggests that the age of the firm also exercises a significant negative impact, whereas sales volume exerts a significant positive impact on the formalization of informal firms. These findings have important policy implications and suggest that the abolition of barriers preventing access to financing, as well as tax reforms and a consistent struggle against corruption may have a positive influence on the formalization of informal firms. On the other hand, firm owners should consider formalization to be a means to help them have greater opportunities for survival and growth.

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