ACoRN: Acute Care of at-Risk Newborns

The Acute Care of at-Risk Newborns (ACoRN) program trains health care providers to stabilize that most challenging and enigmatic of medical patients: the unwell newborn. Early assessment, intervention, and management of at-risk or unstable infants can be critical for their survival and long-term health. Clinical care standards and educational programs to address these requirements are needed. The ACoRN program provides a unique, prioritized, and systematic approach to newborn stabilization for health care professionals with any degree of experience. ACoRN-trained providers learn to gather information, prioritize, intervene appropriately, and deliver high quality care to at-risk and unwell newborns in any setting. Because research and practice have advanced dramatically in recent years, the need for a new ACoRN text, the program’s centrepiece, became essential—hence the development of this new edition, which reflects current guidelines and evidence-based best practices. ACoRN teaches the concepts and skills required to stabilize unwell newborns through system-based algorithms (Sequences), each with its own chapter: respiratory, cardiovascular, neurology, surgical conditions, fluid and glucose, jaundice, thermoregulation, and infection. The ACoRN mnemonic defines stabilization steps and chapter structure: alerting signs, core steps, organization of care, response, next steps, and specific diagnosis and management. Each chapter includes educational objectives, key concepts, learning points, and at least one case scenario with questions and answers to reinforce content and learnings. This book is written for any health professional who may be required to participate in the stabilization of sick or preterm babies within their scope of practice.

2018 ◽  
Vol 9 (3) ◽  
pp. e41-55 ◽  
Author(s):  
Alexandre Coutin ◽  
Sarah Wright ◽  
Christine Li ◽  
Raymond Fung

Background: The transgender (trans) population faces multiple barriers in accessing health care, with knowledge deficits of health care providers contributing substantially. Trans patients report having to teach health care professionals about their own health needs.We compared perceptions of trans-care education and training across family medicine, psychiatry, endocrinology, and urology residency training programs at the University of Toronto.             Methods: We surveyed residents to assess their perceptions of and attitudes towards trans-care, exposure to trans patients, knowledge of trans-specific clinical care, and the state of trans-care education within their training. We used Likert scale data to identify patterns across residency programs. We collected open-ended responses to further explain quantitative findings where appropriate.Results: Of 556 residents approached, 319 participated (response rate = 57.4%). Nearly all endocrinology and psychiatry residents agreed that trans-care falls within their scope of practice, while only 71% and 50% of family medicine and urology residents did, respectively. Though participants were at different stages of their postgraduate training when surveyed, only 17% of all participants predicted they would feel competent to provide specialty-specific trans-care by the end of their residency and only 12% felt that their training was adequate to care for this population.Conclusion: Though the study revealed a willingness to serve this population, there was a lack of clinical exposure and trans-related teaching within postgraduate curricula resulting in feelings of unpreparedness to meet the health care needs of this underserved population. 


2019 ◽  
Vol 11 (4s) ◽  
pp. 152-157 ◽  
Author(s):  
Ayesha Khan ◽  
Stefanie S. Sebok-Syer ◽  
Hanna Linstadt ◽  
Megan Storm ◽  
Nadeem Modan ◽  
...  

ABSTRACT Background Access to a trained, competent health care workforce remains a challenge globally, particularly in rural settings. To bridge this gap, the World Health Organization calls for innovations in electronic learning and task shifting. Yet, these approaches are underutilized due to cost, challenges associated with implementing technology, and a lack of suitably educated trainees. Objective We explored the feasibility of the Acute Care Providers Project (ACPP) to remotely train community members to be health care providers in 2 sites: Haiti and India. Methods The ACP program is an asynchronous curriculum that provides core health content and a structured approach to clinical care through an electronic curriculum. The curriculum is reinforced with case-based practice and hands-on workshops for procedural skills. ACPP was deployed in rural Haiti and India. Evaluation of the program included multiple-choice pretests and posttests, an objective structured clinical examination (OSCE), and direct observation of skills. Results Four Haitian and 55 Indian trainees completed the course. In Haiti, mean scores were 34.8% (SD 12.4) on the pretest and 78.0% (SD 6.5) on the posttest (P = .004). Trainees scored 100% on the OSCE and passed the skills checklist. In India, mean scores were 16.5% (SD 3.9) on the pretest and 81.7% (SD 9.0) on the posttest (P < .001). Trainees scored a median of 91.8% (SD 3.95) on the OSCE and all passed the skills checklist. Conclusions The ACPP offers a scalable, replicable asynchronous curriculum to train lay individuals to provide basic health care in rural communities.


Author(s):  
Leigh A. Frame

Nutrition is a foundation of health and one of six pillars of Lifestyle Medicine. The importance of nutrition in clinical care is now widely recognized by health care professionals and the public. However, clinicians are not comfortable counselling their patients on nutrition due to inadequate or lack of training, leaving a significant need in patient care. This gap can be closed with evidence-based curricula in medical schools and in the trainings of other health care professionals. This communication presents the current state of nutrition knowledge in health care, emphasizing nutrition education for physicians, and presents a model of how pre- through post-professional health care providers may become proficient in nutrition counseling including appropriate referral to more specialized providers. With these skills, health care professionals will be able to initiate patient-centered lifestyle plans. This includes improving diet and utilization of team-based medicine and referrals.


2021 ◽  
pp. 089443932110257
Author(s):  
Md Irfanuzzaman Khan ◽  
Jennifer (M.I.) Loh

With the advent of telecommunication technologies and social media, many health care professionals are using social media to communicate with their patients and to promote health. However, the literature reveals a lacuna in our understanding of health care professionals’ perception of their behavioral intentions to use innovations. Using the Unified Technology Acceptance Framework (unified theory of acceptance and use of technology), in-depth interviews were conducted with 16 Australian health care experts to uncover their intent and actual use of social media in their medical practices. Results revealed that social media tools offered five significant benefits such as (i) enhanced communication between health care professionals and their patients, (ii) community support, (iii) enabled e-learning, (iv) enhanced professional network, and (v) expedited health promotion. However, result also revealed barriers to social media usage including (i) inefficiency, (ii) privacy concerns, (iii) poor quality of information, (iv) lack of trust, and (v) blurred professional boundary. Peer influence and supporting conditions were also found to be determinants of social media adoption behaviors among health care professionals. This study has important implications for health care providers, patients, and policy makers on the responsible use of social media, health promotion, and health communication. This research is also among the very few studies that explore Australian health care professionals’ intent and actual use of innovations within a health care setting.


Author(s):  
Shimaa A. Elghazally ◽  
Atef F. Alkarn ◽  
Hussein Elkhayat ◽  
Ahmed K. Ibrahim ◽  
Mariam Roshdy Elkhayat

Background: burnout syndrome is a serious and growing problem among medical staff. Its adverse outcomes not only affect health-care providers’ health, but also extend to their patients, resulting in bad-quality care. The COVID-19 pandemic puts frontline health-care providers at greater risk of psychological stress and burnout syndrome. Objectives: this study aimed to identify the levels of burnout among health-care professionals currently working at Assiut University hospitals during the COVID-19 pandemic. Methods: the current study adopted an online cross-sectional design using the SurveyMonkey® website for data collection. A total of 201 physicians were included and the Maslach Burnout Inventory (MBI) scale was used to assess the three burnout syndrome dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. Results: about one-third, two-thirds, and one-quarter of the respondents had high emotional exhaustion, high depersonalization, and low personal accomplishment, respectively. Younger, resident, and single physicians reported higher burnout scores. The personal accomplishment score was significantly higher among males. Those working more than eight hours/day and dealing with COVID-19 patients had significantly higher scores. Conclusion: during the COVID-19 pandemic, a high prevalence of burnout was recorded among physicians. Age, job title, working duration, and working hours/day were significant predictors for burnout syndrome subscale results. Preventive and interventive programs should be applied in health-care organizations during pandemics.


1994 ◽  
Vol 18 (2) ◽  
pp. 74-80 ◽  
Author(s):  
Helen Miramontes ◽  
Katie Tom ◽  
Marion Gillen

2009 ◽  
Vol 16 (3) ◽  
pp. 148-154 ◽  
Author(s):  
CA Graham ◽  
WO Kwok ◽  
YL Tsang ◽  
TH Rainer

Objective To explore why patients in Hong Kong seek medical advice from the emergency department (ED) and to identify the methods by which patients would prefer to be updated on the likely waiting time for medical consultation in the ED. Methods The study recruited 249 semi-urgent and non-urgent patients in the ED of Prince of Wales Hospital from 26th September 2005 to 30th September 2005 inclusive. A convenience sample of subjects aged ≥15 years old in triage categories 4 or 5 were verbally consented and interviewed by research nurses using a standardized questionnaire. Results From 1715 potential patients, 249 were recruited ad hoc (mean age 44 years [SD18]; 123 females). About 63% indicated that an acceptable ED waiting time was less than or equal to two hours, and 88% felt that having individual number cards and using a number allocation screen in the ED waiting area would be useful. Perceived reasons for attending the ED rather than other health care providers such as primary health care or the general outpatient clinic (GOPC) included: a desire for more detailed investigations (56%); a perception that more professional medical advice was given in the ED (35%); patients were under the continuing care of the hospital (19%); and patients were referred to the ED by other health care professionals (11%). Notably, 26% of participants had considered attending the GOPC prior to attending the ED. Patients educated to tertiary level expected a shorter waiting time than those educated to lesser degrees (p=0.026, Kruskal-Wallis test). Suggestions were made on how to provide a more pleasant ED environment for the wait for consultations, which included the provision of a television screen with sound in the waiting area (43%), more comfortable chairs (37%) and health care promotion programs (32%). Conclusion Patients chose ED services because they believed they would receive more detailed investigations and more professional medical advice than available alternatives. Clear notification of the likely waiting times and enhancement of comfort before consultation are considered desirable by patients. Enhanced public education about the role of the ED and making alternatives to ED care more accessible may be useful in reducing inappropriate ED attendances in Hong Kong.


2007 ◽  
Vol 13 (3) ◽  
pp. 29 ◽  
Author(s):  
Emily Mauldon

This paper reports on the attitudes of a sample of health care providers towards the use of telehealth to support rural patients and integrate rural primary health and urban hospital care. Telehealth and other information technologies hold the promise of improving the quality of care for people in rural and remote areas and for supporting rural primary health care providers. While seemingly beneficial for rural patients, study participants believed that telehealth remains underused and poorly integrated into their practice. In general, participants thought that telehealth is potentially beneficial but places constraints on their activities, and few actually used it. Published literature usually reports either on the success of telehealth pilot projects or initiatives that are well resourced and do not reflect the constraints of routine practice, or has an international focus limiting its relevance to the Australian context. Because of the paucity of systematic and generalisable research into the effects of the routine use of telehealth to support rural patients, it is unclear why health care professionals choose to provide such services or the costs and benefits they incur in doing so. Research and policy initiatives continue to be needed to identify the impact of telehealth within the context of Australian primary health care and to develop strategies to support its use.


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