scholarly journals How to do no harm: empowering local leaders to make care safer in low-resource settings

2021 ◽  
Vol 106 (4) ◽  
pp. 333-337
Author(s):  
Charles A Vincent ◽  
Mwanamvua Mboga ◽  
David Gathara ◽  
Fred Were ◽  
Rene Amalberti ◽  
...  
Keyword(s):  
Low Cost ◽  
Essential Element ◽  
Improve Patient Care ◽  
Companion Paper ◽  
Team Meetings ◽  
Safety Improvement ◽  
Do No Harm ◽  
Drug Doses ◽  
System Improvement ◽  
Local Leaders

In a companion paper, we showed how local hospital leaders could assess systems and identify key safety concerns and targets for system improvement. In the present paper, we consider how these leaders might implement practical, low-cost interventions to improve safety. Our focus is on making immediate safety improvements both to directly improve patient care and as a foundation for advancing care in the longer-term. We describe a ‘portfolio’ approach to safety improvement in four broad categories: prioritising critical processes, such as checking drug doses; strengthening the overall system of care, for example, by introducing multiprofessional handovers; control of known risks, such as only using continuous positive airway pressure when appropriate conditions are met; and enhancing detection and response to hazardous situations, such as introducing brief team meetings to identify and respond to immediate threats and challenges. Local clinical leaders and managers face numerous challenges in delivering safe care but, if given sufficient support, they are nevertheless in a position to bring about major improvements. Skills in improving safety and quality should be recognised as equivalent to any other form of (sub)specialty training and as an essential element of any senior clinical or management role. National professional organisations need to promote appropriate education and provide coaching, mentorship and support to local leaders.

Simulating Difficult Nurse Patient Relationships

2012 ◽  
pp. 141-156
Author(s):  
Peter Kandlbinder ◽  
Scott Brunero
Keyword(s):  
Mental Illness ◽  
General Hospital ◽  
Design Process ◽  
Nursing Staff ◽  
Low Cost ◽  
Hospital Setting ◽  
Improve Patient Care ◽  
Patient Behaviour ◽  
Patient Relationships ◽  
Improve Patient

Difficult nurse-patient relationships are an area where general nurses can improve their knowledge, confidence and skill. This chapter describes a user-centred approach used to create a low-cost e-simulation of a commonly occurring case of manipulative patient behaviour. This e-simulation required nurses to focus on specific problems, gain understanding about the possible causes, and use empathetic understanding of what was needed to improve patient care. Specific examples from our experience of including nurses from the very beginning of the design process illustrate how everyday technology can provide an authentic experience of difficult nurse-patient behaviours to prepare general nursing staff who are facing a higher incidence of mental illness in patients that are now in the general hospital setting.

A Shiny Surface and a Tainted Past

2013 ◽  
Author(s):  
Lars Öhrström
Keyword(s):  
Close Contact ◽  
Essential Element ◽  
Therapeutic Window ◽  
Law Firm ◽  
Award Winning ◽  
Do No Harm ◽  
The Us ◽  
Main Component ◽  
The Right

The day Erin Brockovich was driving in Reno and got hit by another driver, brought her in close contact not only with the bumper of the other car, but eventually also with the US legal system, and this would change her life completely. The day Steven Soderbergh asked Julia Roberts to play the part of Erin Brockovich in the film with the same name didn’t really change her life, one presumes, but it would show the world’s moviegoers and critics that the star and Academy Award winning actress of 1990 was really back on the right track. What is the link between these events? The answer is the element chromium. It was chromium that made law-firm clerk Brockovich start a David-against-Goliath struggle with the California energy conglomerate Pacific Gas and Electric Company, that made director Soderbergh make the blockbuster movie that gave Roberts an Oscar for best female actress in 2000 and revitalized her career. I will try not to spoil the picture for those who have not seen it, because it is well worth watching, but the fact that the good guys win in the end is probably not a surprise anyway. However, the role of chromium in this play is not at all evident. And are the good guys really the good guys? There is usually a proper amount of, and a proper place for, everything, and this includes the elements of the periodic table. The main component in steel, a material which has a role to play in this story, is iron, and while we sometimes have too low a level of this element in our bodies, too much of it will kill us. The same goes for chromium: we can’t live without it. Or so it was thought until very recently. It was supposed to help us to break down and metabolize sugars, and thus ‘chromium deficiency’ could possibly be related to diabetes. Now, while low levels seems to do no harm, there are still possibilities of a therapeutic window—that is, concentrations where it may do some good—but it does not any longer seem to be considered an essential element, although official consensus on this has not yet been proclaimed.

Developing a Process for Deploying Systemic Countermeasures at Unsignalized Intersections: Case Study of Virginia

2019 ◽  
Vol 2673 (9) ◽  
pp. 538-547
Author(s):  
Benjamin H. Cottrell ◽  
In-Kyu Lim
Keyword(s):  
Traffic Engineering ◽  
Low Cost ◽  
Chi Square ◽  
Interaction Detection ◽  
Improvement Plan ◽  
Systemic Analysis ◽  
Unsignalized Intersections ◽  
Stop Sign ◽  
Safety Improvement ◽  
Potential Risk Factors

This paper discusses the process used to develop a safety improvement plan for unsignalized intersections using systemic low-cost countermeasures. The scope of this project focused on unsignalized intersections with stop sign control on the minor approaches. The first objective was to perform an assessment of Virginia’s unsignalized intersection crashes over a five-year period to determine predominant crash trends and collision types to target for treatment. The four focus collision types with the highest frequency of crashes and the greatest potential reduction in crashes were 3-leg angle, 3-leg fixed object off the road, 4-leg angle and 4-leg rear end. Chi-square automatic interaction detection decision tree analysis was used to perform a systemic analysis to identify a group of intersections associated with potential risk factors related to the focus collision types. A tiered list of systemic countermeasures to deploy was developed. The countermeasures were intended to warn of the stop ahead, make the stop sign and stop location more visible on a minor street, and to warn of the intersection ahead on a major street. The potential for safety improvement measure was used to prioritize the candidate treatment intersections. Before deployment, a study of the intersection by district traffic engineering staff was planned to finalize the plan. The output from the research was a safety improvement plan to systemically deploy treatments to unsignalized intersections as part of the safety program.

scholarly journals Faecal contamination of water and fingertip-rinses as a method for evaluating the effect of low-cost water supply and sanitation activities on faeco-oral disease transmission. I. A case study in rural north-east Thailand

1990 ◽  
Vol 105 (2) ◽  
pp. 363-375 ◽  
Author(s):  
J. V. Pinfold
Keyword(s):  
Disease Transmission ◽  
Low Cost ◽  
Companion Paper ◽  
Oral Disease ◽  
North East ◽  
Water Handling ◽  
Hygiene Intervention ◽  
Faecal Bacteria

SUMMARYMost villagers in north-east Thailand carry water to their homes and store it in separate containers depending on its subsequent use. In one village, information on water use was collated with the bacteriological quality of stored water, water sources and fingertip-rinses. Stored water quality was a function of water-related activities rather than quality at source (P<0·0001). Specifically water used for toilet, washing dishes and cooking-related activities was much more contaminated with faecal bacteria than that used for drinking and cooking.Salmonellaspp. was significantly more common in water used for washing dishes than drinking (P<0·05).Escherichia colicontamination of fingertip-rinses was strongly associated with the individual's activity prior to testing (P<0·0001); child care, food and water-related activities produced much higher levels of fingertip contamination than others. Dirty utensils used for cooking and eating were usually left to soak and faecal bacterial growth occurred in this grossly contaminated soak-water. Cross-contamination via water handling was the main mechanism of stored water pollution. These results were used to develop a hygiene intervention study presented in a companion paper.

scholarly journals Adsorption of azo and anthraquinone dye by using watermelon peel powder and corn peel powder: equilibrium and kinetic studies

2019 ◽  
Vol 10 (1) ◽  
pp. 4706-4713
Keyword(s):  
Ph Value ◽  
Citrullus Lanatus ◽  
Low Cost ◽  
Industrial Effluent ◽  
Essential Element ◽  
Kinetic Studies ◽  
Color Removal ◽  
Batch Adsorption ◽  
Order Kinetic ◽  
Anthraquinone Dye

Clean water is an essential element for the survival of humans and nature. However, the tremendous growth in industrialization has degraded the water quality by introducing pollutants such as dyes into the main water bodies such as rivers. In this research, the locally collected agricultural wastes such as watermelon peel (Citrullus lanatus) and corn peel (Zea Mays) were tested on two types of synthetics dyes such Remazol Brilliant Violet 5R (RBV5) and Remazol Brilliant Blue R (RBBR). From the screening test, the watermelon peel achieved the highest color removal percentage with 44.8% and followed by corn’s peel with 18.89%. Both adsorbents were selected for the batch adsorption test by varying the parameters. Based on the results achieved from the batch adsorption test, the optimum removal of dye particles was achieved at the lowest concentration of dye solutions. The optimum pH value to achieve a high percentage of color removal is at pH3, which is acidic. In this case, the 3 g of adsorbent dosage achieved the highest percentage of color removal compared to 5 g. This could due to insufficient contact time. In addition, the chemical and physical characteristics of the adsorbents were analyzed using FESEM and FTIR respectively. By analyzing the surface texture and functional group, differences in the adsorbents before and after adsorption were noticed. Besides that, based on the obtained R2 values from the linear plotting, the Temkin isotherm model and pseudo-second-order kinetic model fitted well compared to other isotherm and kinetic models. In conclusion, the watermelon peel and corn peel are capable of removing dye particles in the industrial effluent under selective conditions with low cost while being environmentally friendly.

Design and Prototype Development of Quadrant Estimation Unit for Laser Beam Rider Guidance System

2020 ◽  
Vol 9 (03) ◽  
pp. 24970-24977
Author(s):  
Dr. Gunti Avinash ◽  
Saiseshu Reddy ◽  
P. Vijaya Poojitha
Keyword(s):  
Laser Beam ◽  
Beam Quality ◽  
Low Cost ◽  
Essential Element ◽  
Guidance System ◽  
Target Space ◽  
Laser Guidance ◽  
Atmospheric Transmission ◽  
Silicon Photodiode ◽  
Prototype Development

With the development of science and technology, precision-strike weapons are been considered to be important for winning victory and defending the country during war (or) attack. Laser guidance is one of the major methods to execute precision-strike in modern warfare. At present, the problems faced at the primary stage of Laser guidance has been solved with endeavors of countries. Several technical aspects of laser-beam riding guided system have been mature, such as atmosphere penetration of laser beam, clutter inhibition on ground, laser irradiator, encoding and decoding of laser beam. Further, laser beam quality, equal output power and atmospheric transmission properties are qualified for warfare situation. Riding guidance instrument is a crucial element of Laser-beam riding guided system and also in Radar-beam riding guiding system, and is also a essential element of airborne, vehicle-mounted and individual weapon. The optical system mainly consists of sighting module and laser-beam guided module. Photo detector (Quadrant detector) is the most important sensing device, and also the key to acquire the coordinate information of target space. Currently, in consideration of the 1064 nm of wavelength applied in all the semi-active laser guided weapons systems, lithium drifting silicon photodiode which is sensitive to 1064 nm of wavelength is used in photoelectric detector. Compared to Solid and gas laser, diode laser has many merits such as small volume, simple construction, light weight, long life, low cost and easy modulation.  The present work includes the study of Various ATGM, their guidance mechanism, particularly laser beam rider guidance. Study has been carried to understand the composition and operating principle of Laser-beam riding guided system. The present work also deals with prototype development of quadrant estimation unit required for Laser beam rider guidance.

scholarly journals Point-of-care diagnostics for noncommunicable diseases using synthetic urinary biomarkers and paper microfluidics

2014 ◽  
Vol 111 (10) ◽  
pp. 3671-3676 ◽  
Author(s):  
Andrew D. Warren ◽  
Gabriel A. Kwong ◽  
David K. Wood ◽  
Kevin Y. Lin ◽  
Sangeeta N. Bhatia
Keyword(s):  
Point Of Care ◽  
Low Cost ◽  
Medical Personnel ◽  
Cardiovascular Disorder ◽  
Companion Paper ◽  
Noncommunicable Diseases ◽  
Paper Test ◽  
Noninvasive Methods ◽  
Peptide Substrates

With noncommunicable diseases (NCDs) now constituting the majority of global mortality, there is a growing need for low-cost, noninvasive methods to diagnose and treat this class of diseases, especially in resource-limited settings. Molecular biomarkers combined with low-cost point-of-care assays constitute a potential solution for diagnosing NCDs, but the dearth of naturally occurring, predictive markers limits this approach. Here, we describe the design of exogenous agents that serve as synthetic biomarkers for NCDs by producing urinary signals that can be quantified by a companion paper test. These synthetic biomarkers are composed of nanoparticles conjugated to ligand-encoded reporters via protease-sensitive peptide substrates. Upon delivery, the nanoparticles passively target diseased sites, such as solid tumors or blood clots, where up-regulated proteases cleave the peptide substrates and release reporters that are cleared into urine. The reporters are engineered for detection by sandwich immunoassays, and we demonstrate their quantification directly from unmodified urine; furthermore, capture antibody specificity allows the probes to be multiplexed in vivo and quantified simultaneously by ELISA or paper lateral flow assay (LFA). We tailor synthetic biomarkers specific to colorectal cancer, a representative solid tumor, and thrombosis, a common cardiovascular disorder, and demonstrate urinary detection of these diseases in mouse models by paper diagnostic. Together, the LFA and injectable synthetic biomarkers, which could be tailored for multiple diseases, form a generalized diagnostic platform for NCDs that can be applied in almost any setting without expensive equipment or trained medical personnel.

Potential Savings Involved in the Purchase of Low-Cost, High-Volume Medical Commodities as Established from a Community Hospital Survey

1996 ◽  
Vol 9 (4) ◽  
pp. 24-29
Author(s):  
San W. Ng ◽  
Rosmin Esmail ◽  
William J. Sibbald ◽  
Gordon S. Doig
Keyword(s):  
Patient Care ◽  
Community Hospital ◽  
Care Delivery ◽  
Low Cost ◽  
Cost Savings ◽  
Improve Patient Care ◽  
High Volume ◽  
Health Technology ◽  
Substantial Cost ◽  
Improve Patient

Health technology refers to the instruments, equipment, drugs and procedures used in health care delivery, as well as the organizations supporting it. Health technology assessment, which is the process of conducting investigations to establish the criteria for efficacious, effective and efficient patient care, is becoming increasingly important in an era of diminishing resources. This survey of 39 community hospitals in southwestern Ontario found that improved purchasing strategies can result in substantial cost savings which can in turn be used to improve patient care. The study shows that optimizing the price of basic hospital commodities could save an average community hospital as much as $625,000 per year.

scholarly journals Effectiveness of Bi-lingual Multidisciplinary Simulation-based Training in Improving Communication and Breaking Bad-News Skills

2022 ◽  
Vol 2 (1) ◽  
pp. 76-82
Author(s):  
Baraa Tayeb ◽  
Jameel Abuelenain ◽  
Wadeeah Bahaziq ◽  
Loui Alsulimani ◽  
Abeer Arab ◽  
...  
Keyword(s):  
Communication Skills ◽  
Test Scores ◽  
Positive Impact ◽  
Essential Element ◽  
Improve Patient Care ◽  
Good Communication ◽  
Simulation Based ◽  
Post Test ◽  
Instructor Performance ◽  
Performance Satisfaction

Background: Healthcare worker (HCW)-patient communication is an essential element of every patient’s journey, and evidence links good communication with favourable patient experiences and outcomes. Simulation-based training (SBT) is a promising and effective tool to improve such communication. Aim: To develop a bilingual SBT programme in communication skills for all HCWs in an academic tertiary hospital, to improve patient care, experiences and outcomes. Methods: This was a quasi-experimental design, conducted in 2018 at King Abdulaziz University (KAU). We designed and delivered a bilingual, simulation-based, full-day course for HCWs (both clinical and administrative), and measured its impact by comparing pre- and post-course test scores, participant feedback, and instructor performance satisfaction indices. Results: We trained 318 HCWs over 15 days, using 10 instructors. Post-test scores showed individual and overall improvement. The average scores were 26.6% (14-40%) for the pre-test and 55.8% (37-70%) for the post-test, with an average improvement of 29% (P<0.005). Participant feedback was 77% positive and in favour of more training. The average instructor performance satisfaction score was 96.2% (92-99%). Conclusion: We demonstrated the positive impact of SBT on communication skills for both clinical and administrative HCWs. We also demonstrated the sustainability and scalability of this course.

Community Development and Collaboration at Salinas de Los Nueve Cerros, Guatemala

2013 ◽  
Vol 1 (2) ◽  
pp. 105-120 ◽  
Author(s):  
Brent Kerry Skoy Woodfill
Keyword(s):  
Community Development ◽  
Low Cost ◽  
Scientific Research ◽  
High Impact ◽  
Trial And Error ◽  
Political Landscape ◽  
Cost Development ◽  
Local Residents ◽  
Archaeological Project ◽  
Local Leaders

AbstractSince its founding in 2009 at the behest of local leaders, Proyecto Salinas de los Nueve Cerros has had the dual goals of scientific research and community development. Due to the regional political landscape, the initial goal of community-run ecotourism had to be abandoned. In its stead, the project has been seeking high-impact, low-cost development initiatives in collaboration with local villagers. The initiatives have had mixed levels of success, with best results in providing resources for multi-family wells and in organizing an ongoing lecture and workshop series detailing the results of the archaeological project. Through trial and error, project members have learned multiple lessons that can help other similar projects in the future. (1) Community investment in the project is essential, (2) as is the presence of a development specialist who can lead the efforts, leaving archaeologists to do archaeology. (3) Both the project and the local residents must have realistic expectations regarding the time the initiatives take and how ambitious they can be. (4) All of the initiatives must be informed by problems the locals themselves identify, and (5) it is possible to positively impact the region.

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