scholarly journals Understanding perceptions and factors involved in do not resuscitate (DNR) decision making in the emergency department of a low-resource country: a mixed-methods study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e038915
Author(s):  
Kiran Azizi ◽  
Shahan Waheed ◽  
Rubina Barolia ◽  
Naveed Ahmed ◽  
Madiha Ismail
Keyword(s):  
Decision Making ◽  
Emergency Department ◽  
Healthcare Professionals ◽  
Group Discussion ◽  
Cross Sectional Study ◽  
Do Not Resuscitate ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Depth Interviews ◽  
Low Resource Country

IntroductionDo not resuscitate (DNR) decision making is an integral component of emergency medicine practice. There is a paucity of data, protocols and guidelines regarding the perceptions and barriers that are involved in the interactions among healthcare professionals, patients and their caregivers regarding DNR decision making. The aim of this study is, therefore, to explore the perceptions and factors influencing DNR decision making in the emergency department and to evaluate the use of a context-based protocol for DNR decision making.Methods and analysisThis will be a sequential mixed method study beginning with qualitative research involving in-depth interviews (IDIs) with patient family members and focus group discussion with healthcare professionals. The consensual qualitative approach will be used to perform a thematic analysis to the point of saturation. The expected outcome will be to identify key themes that suggest perceptions and factors involved in DNR decision making. After piloting, the derived protocol will then be used with a different group of individuals (150 healthcare professionals) who meet the eligibility criteria in a quantitative cross-sectional study with universal sampling. Data will be analysed using NVIVO in the qualitative phase and SPSS V.19 in the quantitative phase. The study findings will support the development of a standardised protocol for DNR decision making for healthcare professionals in the emergency department.Ethics and disseminationThe proposal was reviewed by the ethics review committee (ERC) of the institution (ERC # 2020-1551-7193). The project is an institution SEED grant recipient PF139/0719. The results will be disseminated among participants, patient communities and healthcare professionals in the institution through seminars, presentations, brochures and emails. The findings will be published in a highly accessed peer-reviewed medical journal and will be presented at international conferences.

How common are Chinese patients with multimorbidity involved in decision making and having a treatment plan? a cross-sectional study

2019 ◽  
Author(s):  
Kam Pui Lee ◽  
Samuel Yeung Shan Wong ◽  
Benjamin Hon Kei Yip ◽  
Eliza Lai Yi Wong ◽  
Dicken Chan ◽  
...  
Keyword(s):  
Decision Making ◽  
Outpatient Clinic ◽  
Healthcare Professionals ◽  
Treatment Plan ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Chinese Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Specialist Outpatient Clinic

Abstract Background Creating a treatment plan (TP) through shared decision making (SDM) with healthcare professionals, is of paramount importance for patients with multimorbidity. This study aims to estimate the prevalence of SDM and TP in patients with multimorbidity, and study the association between SDM/TP with demographics and patients’ confidence to manage their diseases.Method This cross-sectional study used an internationally recognized survey. 1,032 patients aged 60 or above with multimorbidity, were recruited from a specialist outpatient clinic, general outpatient clinic (GOPC) and a geriatric day hospital. The proportion of patients reported to have SDM and TP were estimated. Associations between the presence of SDM/TP and patients’ demographic data, and the confidence level to manage their illnesses, were then studied using logistic regression.Results The prevalence of SDM and TP were 35.8% and 82.1%, respectively. The presence of TP was associated with receiving healthcare from the same doctor or in the same facilities, and being recruited from GOPC. Presence of SDM (OR 1.381, p=0.054) and TP(OR 2.195, p<0.0001) were associated with enhanced confidence in dealing with diseases.Conclusion Most people with multimorbidity had TP in Hong Kong, but fewer patients had SDM.Practice implications: Ways to promote SDM in HK are needed.

Prevalence and Characteristics of Staphylococcus aureus Colonization among Healthcare Professionals in an Urban Teaching Hospital

2010 ◽  
Vol 31 (6) ◽  
pp. 574-580 ◽  
Author(s):  
Marie-Carmelle Elie-Turenne ◽  
Helen Fernandes ◽  
José R. Mediavilla ◽  
Marnie Rosenthal ◽  
Barun Mathema ◽  
...  
Keyword(s):  
Emergency Department ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Healthcare Professionals ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cross Sectional ◽  
Clerical Workers

Objective.To determine the prevalence of asymptomatic carriage of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) among healthcare professionals (HCPs) who experience varying degrees of exposure to ambulatory patients and to genetically characterize isolates.Methods.This single-center, cross-sectional study enrolled 256 staff from the intensive care units, emergency department, and prehospital services of an urban tertiary care university hospital in 2008. Occupational histories and nasal samples for S. aureus cultures were obtained. S. aureus isolates were genetically characterized with the use of spa typing and screened for mecA. MRSA isolates underwent further characterization.Results.S. aureus was isolated from 112 of 256 (43.8%) HCPs, including 30 of 52 (57.7%) paramedics, 51 of 124 (41.1%) nurses, 11 of 28 (39.3%) clerical workers, and 20 of 52 (38.5%) physicians. MRSA was isolated from 17 (6.6%) HCPs, including 1 (1.9%) paramedic, 13 (10.5%) nurses, 1 (3.6%) clerical worker, and 2 (3.8%) physicians. Among S. aureus isolates, 15.2% were MRSA. MRSA prevalence was 9.6% (12/125) in emergency department workers, 5.1% (4/79) in intensive care unit workers, and 1.9% (1/52) in emergency medical services workers. Compared with paramedics, who had the lowest prevalence of methicillin resistance among S. aureus isolates (1 of 30 [3.3%] isolates), nurses, who had the highest prevalence (13 of 51 [25.4%] isolates), had an odds ratio of 9.92 (95% confidence interval, 1.32-435.86; P = .02) for methicillin resistance. Analysis of 15 MRSA isolates revealed 7 USA100 strains, 6 USA300 strains, 1 USA800 strain, and 1 EMRSA-15 strain. All USA300 strains were isolated from emergency department personnel.Conclusions.The observed prevalence of S. aureus and MRSA colonization among HCPs exceeds previously reported prevalences in the general population. The proportion of community-associated MRSA among all MRSA in this colonized HCP cohort reflects the distribution of the USA300 community-associated strain observed increasingly among US hospitalized patients.

scholarly journals Development and Validation of a Trigger Tool for Identifying Drug-Related Emergency Department Visits

2021 ◽  
Vol 18 (16) ◽  
pp. 8572
Author(s):  
Sung-Hee Hwang ◽  
Young-Mi Ah ◽  
Kwang-Hee Jun ◽  
Jae-Woo Jung ◽  
Min-Gyu Kang ◽  
...  
Keyword(s):  
Emergency Department ◽  
Adverse Drug Events ◽  
Group Discussion ◽  
Cross Sectional Study ◽  
Emergency Department Visits ◽  
Cross Sectional ◽  
Trigger Tool ◽  
Three Phase ◽  
Ed Visits ◽  
Development And Validation

There are various trigger tools for detecting adverse drug events (ADEs), however, a drug-related emergency department (ED) visit trigger tool (DrEDTT) has not yet been developed. We aimed to develop and validate a DrEDTT with a multi-center cohort. In this cross-sectional study, we developed the DrEDTT consisting of 28 triggers through a comprehensive literature review and three phase expert group discussion. Next, we evaluated the performance of the DrEDTT by applying it to relevant medical records retrieved from four hospitals from January 2016 to June 2016. Two experts performed an in-depth chart review of a 25% of random sample of trigger flagged and unflagged ED visits and a true ADE was determined through causality assessment. Among 66,564 patients who visited the ED for reasons other than traffic accident and trauma during the study period, at least one trigger was found in 21,268 (32.0%) patients. A total of 959 true ADE cases (5.8%) were identified from a randomly selected 25% of ED visit cases. The overall positive predictive value was 14.0% (range: 8.3–66.7%). Sensitivity and specificity of DrEDTT were 77.7% and 70.4%, respectively. In conclusion, this newly developed trigger tool might be helpful to detect ADE-related ED visits.

Usability of a tablet computer designed for older adults: a qualitative approach based on an intra-hospital living-lab for healthcare (Preprint)

2020 ◽  
Author(s):  
Guillaume Sacco ◽  
Pauline Carliez ◽  
Frédéric Noublanche ◽  
Romain Simon ◽  
Anne Renaudin ◽  
...  
Keyword(s):  
Older Adults ◽  
Geriatric Patients ◽  
Healthcare Professionals ◽  
Cross Sectional Study ◽  
Satisfaction Score ◽  
Tablet Computer ◽  
Sectional Study ◽  
Cross Sectional ◽  
System Usability Scale ◽  
Perceived Usability

BACKGROUND Usability is the keystone in the evolution of tablet technology in healthcare. The Ardoiz® tablet has been designed with a simplified interface for older adults. OBJECTIVE To assess the perceived usability and satisfaction of the Ardoiz® tablet. METHODS We conducted a mixed methods with cross-sectional study using System Usability Scale (SUS), satisfaction score and workshops, including geriatric patients, healthcare professional and caregivers. RESULTS Between September 25, 2019 and March 11, 2020, 58 participants were included in a cross-sectional study (including 38 patients, mean ±SD 85±6 years, 66% women), 26 in workshops (including 5 patients, mean ±SD 86.4±2.9, 40% women). The SUS was 74±12/100, the satisfaction score was 2.8±0.9/4, with 59% of satisfied participants with the use of Ardoiz® pads. The intent to acquire remained low with 18% (n=6) of participants who would be interested in acquiring the tablet. This tablet computer seemed to be difficult to use by geriatric patients and healthcare professionals, mainly because of its complex homepage. Nevertheless, former caregivers and healthcare professionals thought that the tablet could be of great interest to hospitals for leisure and medical use. The main feedback in order to improve the tablet is to simplify the home page with fewer and more static icons (without switching). CONCLUSIONS Notwithstanding the usability of the tablet, the intent to acquire of Ardoiz® tablet remained low. The interface should be simplified for older adults in order to improve usability and adherence. CLINICALTRIAL NCT04091152

scholarly journals Knowledge, attitudes, and practices of Cameroonian physicians with regards to acute pain management in the emergency department: a multicenter cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Paul Owono Etoundi ◽  
Junette Arlette Metogo Mbengono ◽  
Ferdinand Ndom Ntock ◽  
Joel Noutakdie Tochie ◽  
Dominique Christelle Anaba Ndom ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Acute Pain ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Acute Pain Management ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Knowledge Attitudes And Practices

scholarly journals Assessment of Knowledge, Practice and Attitude about Biomedical Waste Management among Healthcare Professionals during COVID-19 Crises in Al-Ahsa

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 747
Author(s):  
Sahbanathul Missiriya Jalal ◽  
Fahima Akhter ◽  
Amal Ismael Abdelhafez ◽  
Ahmed Mansour Alrajeh
Keyword(s):  
Work Experience ◽  
Healthcare Professionals ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Cross Sectional ◽  
Biomedical Waste ◽  
Respiratory Therapists ◽  
Global Pandemic ◽  
Before And After ◽  
Knowledge Practice

Biomedical waste (BMW) management is an essential practice of healthcare professionals (HCPs) for preventing health and also environmental hazards. Coronavirus disease (COVID-19) has become a global pandemic, posing significant challenges for healthcare sectors. A cross-sectional study was performed to assess the knowledge, practice, and attitude on BMW management among HCPs when taking care of patients with COVID-19 and associated with demographic variables. From Al-Ahsa healthcare sectors, 256 HCPs were selected randomly, of which 105 (41%) had excellent knowledge, 87 (34%) had good knowledge, and 64 (25%) had poor knowledge with a mean score of 13.1 ± 3.6. A higher mean score was (14.4 ± 3.2) obtained by physicians, and (13.6 ± 3.8) nurses than the other HCPs. Regarding practice, 72 (28.1%) HCPs used and discarded PPE while handling biomedical wastes. Additionally, 88 (34.4%) followed proper hand hygiene before and after each procedure and whenever needed. Physicians, nurses, and respiratory therapists had a more favorable attitude than other HCPs. There was a statistically significant association found among knowledge level and educational qualification (p < 0.0001), gender (p < 0.001), and work experience (p < 0.05). Emphasis is needed to train all HCPs regarding proper BMW management during this pandemic to prevent infection transmission.

scholarly journals Evaluation of the Use of Shared Decision Making in Breast Cancer: International Survey

2021 ◽  
Vol 18 (4) ◽  
pp. 2128
Author(s):  
Marta Maes-Carballo ◽  
Manuel Martín-Díaz ◽  
Luciano Mignini ◽  
Khalid Saeed Khan ◽  
Rubén Trigueros ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Shared Decision Making ◽  
Health Professionals ◽  
Cross Sectional Study ◽  
Shared Decision ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Professional Societies ◽  
New Policies

Objectives: To assess shared decision-making (SDM) knowledge, attitude and application among health professionals involved in breast cancer (BC) treatment. Materials and Methods: A cross-sectional study based on an online questionnaire, sent by several professional societies to health professionals involved in BC management. There were 26 questions which combined demographic and professional data with some items measured on a Likert-type scale. Results: The participation (459/541; 84.84%) and completion (443/459; 96.51%) rates were high. Participants strongly agreed or agreed in 69.57% (16/23) of their responses. The majority stated that they knew of SDM (mean 4.43 (4.36–4.55)) and were in favour of its implementation (mean 4.58 (4.51–4.64)). They highlighted that SDM practice was not adequate due to lack of resources (3.46 (3.37–3.55)) and agreed on policies that improved its implementation (3.96 (3.88–4.04)). The main advantage of SDM for participants was patient satisfaction (38%), and the main disadvantage was the patients’ paucity of knowledge to understand their disease (24%). The main obstacle indicated was the lack of time and resources (40%). Conclusions: New policies must be designed for adequate training of professionals in integrating SDM in clinical practice, preparing them to use SDM with adequate resources and time provided.

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