TT-Topper: a low-cost infection barrier for tracheostomies

2020 ◽  
Vol 7 (1) ◽  
pp. 245-246
Author(s):  
Gaurav Gomez ◽  
Samuel Thomas ◽  
Kurian Zachariah
Keyword(s):  
Tracheostomy Tube ◽  
Healthcare Professionals ◽  
Low Cost ◽  
Clinical Care ◽  
Hospital Setting ◽  
Barrier Device

A simple, practical, low cost barrier device is presented called the TT-Topper (Tracheostomy Tube Topper) to protect healthcare professionals and other caregivers from droplet infection via tracheostomies. The testing of the device using an ultraviolet lit simulation is also demonstrated. The TT-Topper was found to be very effective in curbing droplet spread. It could be used with ease in the community as well as in the hospital setting and could potentially be an adjunct to routine protection standards in clinical care.

The changing role of GP clinicians working in community hospitals.

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696713
Author(s):  
David Seamark ◽  
Deborah Davidson ◽  
Helen Tucker ◽  
Angela Ellis-Paine ◽  
Jon Glasby
Keyword(s):  
Medical Care ◽  
Local Community ◽  
Community Hospital ◽  
Clinical Care ◽  
Hospital Setting ◽  
Community Hospitals ◽  
Recruitment Challenges ◽  
Acute Hospitals ◽  
Changing Role

BackgroundIn 2000 20% of UK GPs had admitting rights to community hospitals. In subsequent years the number of GPs engaged in community hospital clinical care has decreased.AimWhat models of medical care exist in English community hospitals today and what factors are driving changes?MethodInterviews with community hospital clinical staff conducted as part of a multimethod study of the community value of community hospitals.ResultsSeventeen interviews were conducted and two different models of medical care observed: GP led and Trust employed doctors. Factors driving changes were GP workload and recruitment challenges; increased medical acuity of patients admitted; fewer local patients being admitted; frustration over the move from ‘step-up’ care from the local community to ‘step-down’ care from acute hospitals; increased burden of GP medical support; inadequate remuneration; and GP admission rights removed due to bed closures or GP practices withdrawing from community hospital work.ConclusionMultiple factors have driven changes in the role of GP community hospital clinicians with a consequent loss of GP generalist skills in the community hospital setting. The NHS needs to develop a focused strategy if GPs are to remain engaged with community hospital care.

scholarly journals Mitigating Children’s Pain and Anxiety during Blood Draw Using Social Robots

Electronics ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 1211
Author(s):  
Matthijs H. J. Smakman ◽  
Koen Smit ◽  
Lotte Buser ◽  
Tom Monshouwer ◽  
Nigel van Putten ◽  
...  
Keyword(s):  
Healthcare Professionals ◽  
Young Patients ◽  
Hospital Setting ◽  
Social Robots ◽  
Social Robot ◽  
Blood Collection ◽  
Medical Procedure ◽  
Blood Draw ◽  
The Social ◽  
Children's Pain

Young pediatric patients who undergo venipuncture or capillary blood sampling often experience high levels of pain and anxiety. This often results in distressed young patients and their parents, increased treatment times, and a higher workload for healthcare professionals. Social robots are a new and promising tool to mitigate children’s pain and anxiety. This study aims to purposefully design and test a social robot for mitigating stress and anxiety during blood draw of children. We first programmed a social robot based on the requirements expressed by experienced healthcare professionals during focus group sessions. Next, we designed a randomized controlled experiment in which the social robot was applied as a distraction method to measure its capacity to mitigate pain and anxiety in children during blood draw in a children’s hospital setting. Children who interacted with the robot showed significantly lower levels of anxiety before actual blood collection, compared to children who received regular medical treatment. Children in the middle classes of primary school (aged 6–9) seemed especially sensitive to the robot’s ability to mitigate pain and anxiety before blood draw. Children’s parents overall expressed strong positive attitudes toward the use and effectiveness of the social robot for mitigating pain and anxiety. The results of this study demonstrate that social robots can be considered a new and effective tool for lowering children’s anxiety prior to the distressing medical procedure of blood collection.

scholarly journals Knowledge of healthcare professionals about rights of patient’s images

2015 ◽  
Vol 13 (2) ◽  
pp. 255-259 ◽  
Author(s):  
Bianca Rodrigues Caires ◽  
Maria Carolina Barbosa Teixeira Lopes ◽  
Meiry Fernanda Pinto Okuno ◽  
Cássia Regina Vancini-Campanharo ◽  
Ruth Ester Assayag Batista
Keyword(s):  
Observational Study ◽  
Teaching Hospital ◽  
Nursing Staff ◽  
Healthcare Professionals ◽  
Physical Therapists ◽  
Hospital Setting ◽  
Penal Code ◽  
Healthcare Organizations ◽  
Cross Sectional ◽  
The City

Objective To assess knowledge of healthcare professionals about capture and reproduction of images of patients in a hospital setting. Methods A cross-sectional and observational study among 360 healthcare professionals (nursing staff, physical therapists, and physicians), working at a teaching hospital in the city of São Paulo (SP). A questionnaire with sociodemographic information was distributed and data were correlated to capture and reproduction of images at hospitals. Results Of the 360 respondents, 142 had captured images of patients in the last year, and 312 reported seeing other professionals taking photographs of patients. Of the participants who captured images, 61 said they used them for studies and presentation of clinical cases, and 168 professionals reported not knowing of any legislation in the Brazilian Penal Code regarding collection and use of images. Conclusion There is a gap in the training of healthcare professionals regarding the use of patient´s images. It is necessary to include subjects that address this theme in the syllabus of undergraduate courses, and the healthcare organizations should regulate this issue.

scholarly journals Development and application of a swine model for training ultrasonography-guided central venous access

2020 ◽  
Vol 47 ◽  
Author(s):  
JACKSON VINÍCIUS DE LIMA BERTUOL ◽  
NATASHA LURE BUENO CAMARGO ◽  
FERNANDO ANTONIO CAMPELO SPENCER NETTO ◽  
ANDRÉ PEREIRA WESTPHALEN
Keyword(s):  
Porcine Model ◽  
Low Cost ◽  
Central Venous Access ◽  
Training Session ◽  
Hospital Setting ◽  
Venous Access ◽  
Human Anatomy ◽  
Swine Model ◽  
Central Venous ◽  
Hands On

ABSTRACT Introduction: simulation based teaching is a powerful tool in medical education, allowing hands on practice under a controlled environment and with repeated maneuvers. Central venous access venipuncture is one of the most frequent procedures carried out in the hospital setting, due to its various clinical indications and, when performed with the help of ultrasonography, the risk of adverse events is minimized. Aim: to develop, to describe and to test a porcine model that simulates the central venous access puncture aided by ultrasonography. Method: a low cost porcine model was developed to train medical students and residents on central venous access guided by ultrasonography. Both students and medical residents underwent a theoretical training regarding the model, followed by a hands-on training session. Afterwards, the participants assessed the model by answering a questionnaire. Results: there were 51 participants. The average score regarding the similarity between the model and the human anatomy was 9.15. When the characteristics were separately assessed, the mean scores regarding the similarity of the vessels, anatomic disposition and ultrasonographic characteristics as well as the venipuncture were, respectively, 9.27; 9.31; 9.54 and 8.86. Conclusion: The model was approved and considered appropriate for the training of central venous venipuncture by all the participants. Furthermore, it is a low cost, simple and reproducible model, that presents high similarity with the human anatomy. Therefore, it may be used as an aid to train people on ultrasonography guided central venous access.

scholarly journals Low Risk of COVID-19 Infection in an Ambulatory Gastrointestinal Endoscopy Center in Argentina

2021 ◽  
Vol 51 (2) ◽  
Author(s):  
José Tawil ◽  
Josie Libertucci ◽  
Ana Adet Caldelari ◽  
Irene Banchero ◽  
Sandra Canseco ◽  
...  
Keyword(s):  
General Population ◽  
Gastrointestinal Endoscopy ◽  
Healthcare Professionals ◽  
Hospital Setting ◽  
Low Risk ◽  
Risk Of Infection ◽  
Healthcare Staff ◽  
Future Health ◽  
Endoscopic Procedures ◽  
Staff Members

Background and Objectives. Since the onset of the COVID-19 pandemic, concerns have been raised regarding the risk of infection to both healthcare staff and patients during gastrointestinal endoscopy procedures. Given the importance of performing routine endoscopic procedures to an individual’s future health, we sought to estimate the risk of COVID-19 infection for healthcare staff and patients undergoing endoscopic studies at an ambulatory endoscopy center during the pandemic. Material and Methods. This is a prospective(and) analytical cohort study conducted in an ambulatory gastroenterology center located in the Autonomous City of Buenos Aires, Argentina. Patients undergoing different endoscopic procedures were evaluated for COVID-19 between April 14 and August 31, 2020. COVID-19 was also evaluated in all healthcare and associated staff during the same time period. The risk (cumulative incidence) of acquiring COVID-19 in all patients and staff was calculated. Results. Between April 14 and August 31, 2020, procedures were performed in 3,745 patients with a mean age of 51.12 years; 2,102 (56.18%) were male and 1,643 (43.82%) were female. Follow-up was completed in 3,492 patients, 18 of whom tested positive for COVID-19 standing for an incidence of 0.52% (95%CI 0.31 – 0.81%). Six (5.45%) out of 110 staff members were infected with COVID-19 (1 endoscopist, 4 endoscopy assistants and 1 administrative staff member). In this group, the incidence of positive tests for COVID-19 was 5.45% (95%CI: 2.03 – 11.50%). The increased rates of positive cases among our patients and healthcare professionals were respectively 7.9 and 23.6 times lower than in general population. Conclusion. During the study period, the proportion of COVID-19 infections in our ambulatory specialized in gastrointestinal endoscopy was low and much lower than that in the general population for both patients and healthcare professionals. Endoscopic procedures undertaken at this center were low risk, likely due to strict compliance with established pandemic protocols. Future studies should compare the risk of infection in the hospital setting.

scholarly journals Healthcare professionals’ practice and interactions in older peoples’ cross-sectoral clinical care trajectories when acutely hospitalized - a qualitative observation study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maiken Hjuler Persson ◽  
Christian Backer Mogensen ◽  
Jens Søndergaard ◽  
Helene Skjøt-Arkil ◽  
Pernille Tanggaard Andersen
Keyword(s):  
Decision Making ◽  
Older People ◽  
New Public Management ◽  
Healthcare Professionals ◽  
Clinical Care ◽  
Research Integrity ◽  
Care Practice ◽  
Observation Study ◽  
Person Centered Care ◽  
Centered Care

Abstract Background Healthcare services have become more complex, globally and nationally. Denmark is renowned for an advanced and robust healthcare system, aiming at a less fragmented structure. However, challenges within the coordination of care remain. Comprehensive restructures based on marketization and efficiency, e.g. New Public Management (NPM) strategies has gained momentum in Denmark including. Simultaneously, changes to healthcare professionals’ identities have affected the relationship between patients and healthcare professionals, and patient involvement in decision-making was acknowledged as a quality- and safety measure. An understanding of a less linear patient pathway can give rise to conflict in the care practice. Social scientists, including Jürgen Habermas, have highlighted the importance of communication, particularly when shared decision-making models were introduced. Healthcare professionals must simultaneously deliver highly effective services and practice person-centered care. Co-morbidities of older people further complicate healthcare professionals’ practice. Aim This study aimed to explore and analyse how healthcare professionals’ interactions and practice influence older peoples’ clinical care trajectory when admitted to an emergency department (ED) and the challenges that emerged. Methods This qualitative study arises from a hermeneutical stand within the interpretative paradigm. Focusing on the healthcare professionals’ interactions and practice we followed the clinical care trajectories of seven older people (aged > 65, receiving daily homecare) acutely hospitalized to the ED. Participant observations were combined with interviews with healthcare professionals involved in the clinical care trajectory. We followed-up with the older person by phone call until four weeks after discharge. The study followed the code of conduct for research integrity and is reported in accordance with the Standards for Reporting Qualitative Research (SRQR) guidelines. Results The analysis revealed four themes: 1)“The end justifies the means – ‘I know what is best for you’”, 2)“Basic needs of care overruled by system effectiveness”, 3)“Treatment as a bargain”, and 4)“Healthcare professionals as solo detectives”. Conclusion Dissonance between system logics and the goal of person-centered care disturb the healthcare practice and service culture negatively affecting the clinical care trajectory. A practice culture embracing better communication and more person-centered care should be enhanced to improve the quality of care in cross-sectoral trajectories.

Sensible use of observational clinical data

2011 ◽  
Vol 22 (1) ◽  
pp. 7-13 ◽  
Author(s):  
J Marc Overhage ◽  
Lauren M Overhage
Keyword(s):  
Health Care ◽  
Clinical Trials ◽  
Medical Research ◽  
Observational Data ◽  
Clinical Data ◽  
Low Cost ◽  
Clinical Care ◽  
Data Sets ◽  
Large Size ◽  
Health Care Operations

Observational data sets offer many potential advantages for medical research including their low cost, large size and generalisability. Because they are collected for clinical care and health care operations purposes, observational data sets have some limitations that must be considered in order to perform useful analyses. Sensible use of observational data sets can yield valuable insights, particularly when clinical trials are impractical.

Factors affecting patient and physician engagement in remote healthcare for heart failure: a systematic review (Preprint)

2021 ◽  
Author(s):  
Ahmed Al-Naher ◽  
Jennifer Downing ◽  
Kathryn A Scott ◽  
Munir Pirmohamed
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Health Outcomes ◽  
Healthcare Professionals ◽  
Clinical Care ◽  
Disease Process ◽  
Ease Of Use ◽  
Cochrane Library ◽  
User Engagement ◽  
Remote Care

BACKGROUND Adult chronic heart failure mainly affects an elderly population with multiple co-morbidities that often require frequent medical visits to prevent poor health outcomes. However the heart failure disease process reduces their independence by reducing mobility, exercise tolerance and cognitive decline. Remote care technologies can bridge the gap in care for these patients by allowing them to be followed up within the comfort of their home and encourage their self-care. However, patients, carers and healthcare professionals need to engage with the technology for it to be useful. OBJECTIVE This systematic review explored qualitative primary studies of remote care technologies used in heart failure, to determine the factors that affect user engagement with the technology. This is explored from the perspective of patients, carers, and healthcare professionals. METHODS Relevant studies published between 1/1/1990 – 19/9/2020 were identified from EMBASE, Ovid MEDLINE, Pubmed, Cochrane library and Scopus. These studies were then synthesized using thematic analysis. Relevant user experiences with remote care were extracted using line-by-line coding. These codes were summarised into secondary codes and core concepts, which were further merged into overarching themes that encapsulate user experience with remote care. RESULTS The review included 47 studies, which led to the generation of 5 overarching themes which affect engagement: (a) ‘Convenience’ relates to time saved by the intervention; (b) ‘Clinical Care’ relates to perceived quality of care and health outcomes; (c) ‘Communication’ involves feedback and interaction between patients, staff and carers; (d) ‘Education’ concerns the tailored information provided; and (e) ‘Ease of Use’ relates to accessibility and technical barriers to engagement. Each theme was applied to each user base of patient, carer and healthcare professional in a different manner. CONCLUSIONS The 5 themes identified highlight aspects of remote care that facilitate engagement, and should be considered in both future design and trials evaluating these technologies.

Abstract 134: Digital-AF II: Impact of Smartphone-Based Atrial Fibrillation Screening in the General Population for Primary Stroke Prevention

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Tine Proesmans ◽  
Peter Vanacker ◽  
Frederik H Verbrugge ◽  
Pieter Vandevoort ◽  
Matthieu Ruttgers ◽  
...  
Keyword(s):  
General Population ◽  
Stroke Prevention ◽  
Stroke Risk ◽  
Low Cost ◽  
Clinical Care ◽  
Heart Rhythm ◽  
Media Campaign ◽  
Risk Models ◽  
Novel Technologies ◽  
The Impact

Background: Opportunistic AF screening for primary stroke prevention is recommended in patients aged above 65 based on stroke risk models. Logistics hamper uniform screening with 12-lead ECG. Novel technologies, e.g. photoplethysmography-based (PPG) apps, may overcome this, providing readily available screening at low cost. We assessed the feasibility of smartphone screening and the impact on subsequent clinical care. Methods: A media campaign educated on AF, recruited subjects, and gave access to a PPG-based app to assess the heart rhythm. Subjects were instructed to measure twice daily for 8 days. An algorithm classified the traces as regular, possible AF, non-AF irregularity, or insufficient quality. PPGs of possible irregularities or AF were reviewed by medical technicians and cardiologists. If AF was confirmed, a physician visit was recommended. Questionnaires collected data on clinical care. Results: In 2 weeks, 62,821 subjects onboarded, resulting in 588,336 60-second PPG traces. The screened population was 49±15 years, 58% was male. In 791 subjects (1.3%), AF was diagnosed by the algorithm and offline confirmed. This group was older (62±11 years, p<0.001), more frequently male (76%, p<0.001) and had a higher CHA2DS2-VASc score (1.00±1.00 vs 2.00±2.00, p<0.001). The proportion with CHA2DS2-VASc ≥ 1 is 81.3% for the AF cohort vs 64.3% in non-AF cohort. The AF yield increased from 0.52% with 1 recording to 1.84% after 8 days. Of the AF patients, 335 (42%) were known, 373 (47%) newly identified, and 83 (11%) did not give this information. A physician was consulted by 138 (17%) newly identified patients, findings were confirmed in 71 (9%), 46 (6%) received antithrombotic therapy. Conclusion: This digital screening, targeting the general population and using only smartphones, demonstrates the feasibility to collect data in a scalable and low-cost way. Next to single timepoint ECG, twice-daily PPG may detect a significant number of asymptomatic AF patients.

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