Potential survivability of prehospital injury deaths in New Zealand: a cross-sectional study

2020 ◽  
pp. injuryprev-2019-043408
Author(s):  
Bridget Kool ◽  
Rebbecca Lilley ◽  
Gabrielle Davie ◽  
Brandon de Graaf ◽  
Pararangi Reid ◽  
...  
Keyword(s):  
New Zealand ◽  
Hospital Care ◽  
Cross Sectional Study ◽  
Insufficient Information ◽  
Injury Death ◽  
Cross Sectional ◽  
Advanced Level ◽  
Physical Injuries ◽  
Level Hospital ◽  
Do So

IntroductionAcknowledging a notable gap in available evidence, this study aimed to assess the survivability of prehospital injury deaths in New Zealand.MethodsA cross-sectional review of prehospital injury death postmortems (PM) undertaken during 2009–2012. Deaths without physical injuries (eg, drownings, suffocations, poisonings), where there was an incomplete body, or insufficient information in the PM, were excluded. Documented injuries were scored using the AIS and an ISS derived. Cases were classified as survivable (ISS <25), potentially survivable (ISS 25–49) and non-survivable (ISS >49).ResultsOf the 1796 cases able to be ISS scored, 11% (n=193) had injuries classified as survivable, 28% (n=501) potentially survivable and 61% (n=1102) non-survivable. There were significant differences in survivability by age (p=0.017) and intent (p<0.0001). No difference in survivability was observed by sex, ethnicity, day of week, seasonality or distance to advanced-level hospital care. ‘Non-survivable’ injuries occurred more commonly among those with multiple injuries, transport-related injuries and aged 15–29 year. The majority of ‘survivable’ cases were deceased when found. Among those alive when found, around half had received either emergency medical services (EMS) or bystander care. One in five survivable cases were classified as having delays in receiving care.DiscussionIn New Zealand, the majority of injured people who die before reaching hospital do so from non-survivable injuries. More than one third have either survivable or potentially survivable injuries, suggesting an increased need for appropriate bystander first aid, timeliness of EMS care and access to advanced-level hospital care.

Preventable injury deaths: identifying opportunities to improve timeliness and reach of emergency healthcare services in New Zealand

2017 ◽  
Vol 24 (5) ◽  
pp. 384-389 ◽  
Author(s):  
Rebbecca Lilley ◽  
Bridget Kool ◽  
Gabrielle Davie ◽  
Brandon de Graaf ◽  
Shanthi N Ameratunga ◽  
...  
Keyword(s):  
New Zealand ◽  
Hospital Care ◽  
Healthcare Services ◽  
Care Providers ◽  
Cross Sectional ◽  
Advanced Level ◽  
Fatal Injury ◽  
Timely Access ◽  
Serious Injury ◽  
Level Hospital

BackgroundTraumatic injury is a leading cause of premature death and health loss in New Zealand. Outcomes following injury are very time sensitive, and timely access of critically injured patients to advanced hospital trauma care services can improve injury survival.ObjectiveThis cross-sectional study will investigate the epidemiology and geographic location of prehospital fatal injury deaths in relation to access to prehospital emergency services for the first time in New Zealand.Design and study populationElectronic Coronial case files for the period 2008–2012 will be reviewed to identify cases of prehospital fatal injury across New Zealand.MethodsThe project will combine epidemiological and geospatial methods in three research phases: (1) identification, enumeration, description and geocoding of prehospital injury deaths using existing electronic injury data sets; (2) geocoding of advanced hospital-level care providers and emergency land and air ambulance services to determine the current theoretical service coverage in a specified time period and (3) synthesising of information from phases I and II using geospatial methods to determine the number of prehospital injury deaths located in areas without timely access to advanced-level hospital care.DiscussionThe findings of this research will identify opportunities to optimise access to advanced-level hospital care in New Zealand to increase the chances of survival from serious injury. The resulting epidemiological and geospatial analyses will represent an advancement of knowledge for injury prevention and health service quality improvement towards better patient outcomes following serious injury in New Zealand and similar countries.

scholarly journals Geographical and population disparities in timely access to prehospital and advanced level emergency care in New Zealand: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e026026 ◽  
Author(s):  
Rebbecca Lilley ◽  
Brandon de Graaf ◽  
Bridget Kool ◽  
Gabrielle Davie ◽  
Papaarangi Reid ◽  
...  
Keyword(s):  
New Zealand ◽  
Population Density ◽  
Hospital Care ◽  
Advanced Level ◽  
Zealand Population ◽  
Rapid Access ◽  
Emergency Medical ◽  
Geographical Access ◽  
Timely Access ◽  
Level Hospital

ObjectiveRapid access to advanced emergency medical and trauma care has been shown to significantly reduce mortality and disability. This study aims to systematically examine geographical access to prehospital care provided by emergency medical services (EMS) and advanced-level hospital care, for the smallest geographical units used in New Zealand and explores national disparities in geographical access to these services.DesignObservational study involving geospatial analysis estimating population access to EMS and advanced-level hospital care.SettingPopulation access to advanced-level hospital care via road and air EMS across New Zealand.ParticipantsNew Zealand population usually resident within geographical census meshblocks.Primary and secondary outcome measuresThe proportion of the resident population with calculated EMS access to advanced-level hospital care within 60 min was examined by age, sex, ethnicity, level of deprivation and population density to identify disparities in geographical access.ResultsAn estimated 16% of the New Zealand population does not have timely EMS access to advanced-level hospital care via road or air. The 700 000 New Zealanders without timely access lived mostly in areas of low-moderate population density. Indigenous Māori, New Zealand European and older New Zealanders were less likely to have timely access.ConclusionsThese findings suggest that in New Zealand, geographically marginalised groups which tend to be rural and remote communities with disproportionately more indigenous Māori and older adults have poorer EMS access to advanced-level hospitals. Addressing these inequities in rapid access to medical care may lead to improvements in survival that have been documented for people who experience medical or surgical emergencies.

scholarly journals Knowledge and perceptions of cardiopulmonary resuscitation amongst New Zealand podiatrists: a web-based survey

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Angela Brenton-Rule ◽  
Daniel Harvey ◽  
Kevin Moran ◽  
Daniel O’Brien ◽  
Jonathon Webber
Keyword(s):  
New Zealand ◽  
Cardiopulmonary Resuscitation ◽  
Life Support ◽  
Survival Rates ◽  
Sudden Cardiac Arrest ◽  
Cross Sectional Study ◽  
Trial Registration ◽  
Cross Sectional ◽  
Web Based ◽  
The Past

Abstract Background Podiatrists in New Zealand have a duty of care to assist patients in an emergency, and current cardiopulmonary resuscitation (CPR) certification is a requirement for registration. However, it is unknown how competent and confident podiatrists are in administering CPR and how they would respond in an emergency. Having a health professional who has a competent knowledge of CPR and skills in basic life support, can improve survival rates from sudden cardiac arrest. Therefore, the aim of this study was to survey New Zealand podiatrists to determine their CPR knowledge and qualifications; beliefs about the application of CPR; and perceptions of their competency in CPR. Methods This cross-sectional study used a web-based survey. Participants were New Zealand registered podiatrists with a current annual practising certificate. The 31-item survey included questions to elicit demographic information, CPR practice and attitudes, and CPR knowledge. Responses were collected between March and August 2020. Results 171 podiatrists responded to the survey. 16 % of the podiatrists (n = 28) had performed CPR in an emergency, with a 50 % success rate. Participants were predominantly female (n = 127, 74 %) and working in private practice (n = 140,82 %). Nearly half of respondents were younger than 40 years (n = 75,44 %) and had less than 10 years of clinical experience (n = 73, 43 %). Nearly all (n = 169,97 %) participants had received formal CPR training in the past two years, with 60 % (n = 105) receiving training in the past 12 months. Most respondents (n = 167,98 %) self-estimated their CPR ability as being effective, very effective, or extremely effective. Participants’ knowledge of CPR was variable, with the percentage of correct answers for CPR protocol statements ranging between 20 and 90 %. Conclusions This study provides the first insight into New Zealand podiatrists’ CPR knowledge and perceptions. Podiatrists were found to have high levels of CPR confidence but demonstrated gaps in CPR knowledge. Currently, New Zealand registered podiatrists require biennial CPR re-certification. However, resuscitation authorities in New Zealand and overseas recommend an annual update of CPR skills. Based on this study’s findings, and in line with Australia and the United Kingdom, the authors recommend a change from biennial to annual CPR re-certification for podiatrists in New Zealand. Trial registration The study was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620001144909).

scholarly journals Family involvement and patient-experienced improvement and satisfaction with care: a nationwide cross-sectional study in Danish psychiatric hospitals

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marie Louise Svendsen ◽  
Trine Ellegaard ◽  
Karoline Agerbo Jeppesen ◽  
Erik Riiskjær ◽  
Berit Kjærside Nielsen
Keyword(s):  
Psychiatric Hospital ◽  
Hospital Care ◽  
Psychiatric Hospitals ◽  
Cross Sectional Study ◽  
Satisfaction With Care ◽  
Sectional Study ◽  
Cross Sectional ◽  
Caregiver Relationship ◽  
Patient Reported ◽  
Caregiver Involvement

Abstract Background Randomised controlled trials suggest that family therapy has a positive effect on the course of depression, schizophrenia and anorexia nervosa. However, it is largely unknown whether a positive link also exists between caregiver involvement and patient outcome in everyday psychiatric hospital care, using information reported directly from patients, i.e. patient-reported experience measures (PREM), and their caregivers. The objective of this study is to examine whether caregiver-reported involvement is associated with PREM regarding patient improvement and overall satisfaction with care. Methods Using data from the National Survey of Psychiatric Patient Experiences 2018, we conducted a nationwide cross-sectional study in Danish psychiatric hospitals including patients and their caregivers who had been in contact with the hospital (n = 940 patients, n = 1008 caregivers). A unique patient identifier on the two distinct questionnaires for the patient and their caregiver enabled unambiguous linkage of data. In relation to PREM, five aspects of caregiver involvement were analysed using logistic regression with adjustment for patient age, sex and diagnosis. Results We consistently find that high caregiver-reported involvement is statistically significantly associated with high patient-reported improvement and overall satisfaction with care with odds ratios (OR) ranging from 1.69 (95% confidence interval (CI) 0.95–2.99) to 4.09 (95% CI 2.48–6.76). This applies to the following aspects of caregiver-reported involvement: support for the patient-caregiver relationship, caregiver information, consideration for caregiver experiences and the involvement of caregivers in decision making. No statistically significant association is observed regarding whether caregivers talk to the staff about their expectations for the hospital contact. Conclusion This nationwide study implies that caregiver involvement focusing on the patient-caregiver relationship is positively associated with patient improvement and overall satisfaction with care in everyday psychiatric hospital care.

MS prevalence in New Zealand, an ethnically and latitudinally diverse country

2010 ◽  
Vol 16 (12) ◽  
pp. 1422-1431 ◽  
Author(s):  
Bruce V Taylor ◽  
John F Pearson ◽  
Glynnis Clarke ◽  
Deborah F Mason ◽  
David A Abernethy ◽  
...  
Keyword(s):  
New Zealand ◽  
Environmental Factors ◽  
Latitudinal Gradient ◽  
Population Level ◽  
Cross Sectional Study ◽  
European Population ◽  
Multiple Sources ◽  
Cross Sectional ◽  
The North ◽  
Mcdonald Criteria

Background: The prevalence of multiple sclerosis (MS) is not uniform, with a latitudinal gradient of prevalence present in most studies. Understanding the drivers of this gradient may allow a better understanding of the environmental factors involved in MS pathogenesis. Method: The New Zealand national MS prevalence study (NZMSPS) is a cross-sectional study of people with definite MS (DMS) (McDonald criteria 2005) resident in New Zealand on census night, 7 March 2006, utilizing multiple sources of notification. Capture—recapture analysis (CRA) was used to estimate missing cases. Results: Of 2917 people with DMS identified, the crude prevalence was 72.4 per 100,000 population, and 73.1 per 100,000 when age-standardized to the European population. CRA estimated that 96.7% of cases were identified. A latitudinal gradient was seen with MS prevalence increasing three-fold from the North (35°S) to the South (48°S). The gradient was non-uniform; females with relapsing—remitting/secondary-progressive (RRMS/SPMS) disease have a gradient 11 times greater than males with primary-progressive MS ( p < 1 × 10-7). DMS was significantly less common among those of Māori ethnicity. Conclusions: This study confirms the presence of a robust latitudinal gradient of MS prevalence in New Zealand. This gradient is largely driven by European females with the RRMS/SPMS phenotype. These results indicate that the environmental factors that underlie the latitudinal gradient act differentially by gender, ethnicity and MS phenotype. A better understanding of these factors may allow more targeted MS therapies aimed at modifiable environmental triggers at the population level.

scholarly journals Knowledge, Performance, and Attitude Towards Mask Use to Prevent and Control COVID-19 Outbreak Among a Group of Iranian People: A Cross-sectional Study

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Abdolhamid Tajvar ◽  
Teamur Aghamolaei ◽  
Shokrollah Mohseni ◽  
Anahita Fakherpour ◽  
Zabihollah Damiri ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Educational Levels ◽  
Final Score ◽  
Knowledge And Attitude ◽  
And Performance ◽  
And Control ◽  
Do So ◽  
Good Attitude

Background: Due to the pandemic, COVID-19 cases and deaths are increasing unexpectedly and precipitately. More importantly, asymptomatic carriers could infect healthy people through sneezing, coughing, and talking. Therefore, mask usage is required to prevent and control COVID-19. Objectives: This study was aimed at examining the knowledge, attitude, and performance levels (KAP) of the Iranian population regarding mask usage to prevent and control the COVID-19 outbreak during a one-month period from early April to early May 2020. Methods: A researcher-made, validated, and reliable questionnaire consisting of 30 questions on knowledge, attitude, and performance regarding mask usage was utilized. Data collection was performed through the online method. To do so, the online questionnaire link was provided for the participants via social networks. The correct and wrong answers were scored 1 and 0 points, respectively. The final score of each dimension was calculated and classified as 0 - 50% (low), 51 - 75% (moderate), and 75% > (good). Results: A total of 1581 participants took part in the study. Although the participants had good attitude (74%) and performance (70.80%), but only 13.70% of them had good knowledge regarding mask usage. Also, significant differences were found between the participants’ knowledge and higher educational levels (P < 0.001). There were significant associations between the participants’ age, gender, educational level, and job and their knowledge and attitude levels (P < 0.05). Besides, female participants had higher performance scores than did male participants (P < 0.001). The participants with governmental jobs had significantly higher performance than unemployed ones (P < 0.001). Conclusions: The participants obtained low KAP scores; therefore, it is required to train and inform the society and enhance their KAP levels via social media regarding the importance of mask usage, including proper donning, doffing, cleaning, disinfection, and safely and hygienic disposal procedures of masks to prevent and control COVID-19.

scholarly journals Acceptance Rates and Beliefs toward COVID-19 Vaccination among the General Population of Pakistan: A Cross-Sectional Survey

2021 ◽  
Author(s):  
Farah Yasmin ◽  
Waleed Asghar ◽  
Maryam Salma Babar ◽  
Hiba Khan ◽  
Shoaib Ahmad ◽  
...  
Keyword(s):  
General Population ◽  
Cross Sectional Study ◽  
Vaccine Hesitancy ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Public ◽  
Polio Vaccination ◽  
Acceptance Rates ◽  
To Receive ◽  
Do So

Developing countries like Pakistan have previously suffered from barriers to acceptance of vaccination by the public because of financial and belief barriers. This study aims to explore these beliefs and highlight concerns regarding vaccine hesitancy in the general population of Pakistan since they are a hindrance to an effective coronavirus disease-19 (COVID-19) immunization in the country. A cross-sectional study was performed involving 1,778 participants from all four provinces of Pakistan. Results from the study showed more than half of the participants to be unsure of the safety (50%) and efficacy (51%) of the vaccine, whereas 42% were concerned about the side effects of the vaccine. About 72% of the respondents planned to get vaccinated, whereas 28% refused to do so. Internationally made imported vaccines were more trusted by the participants. Forty-four percent of the participants agreed to receive the vaccine upon recommendation from a physician. Lastly, participants who believed in the efficacy of the polio vaccination also considered the COVID-19 vaccine to be safe and effective.

scholarly journals Knowledge and practices regarding infection control among nurses in secondary level hospital

2021 ◽  
Vol 6 (4) ◽  
pp. 731-737
Author(s):  
Ringku Das ◽  
Ashees Kumar Saha ◽  
Priti Kana Barua ◽  
Jay Priya Borua ◽  
Nasima Akhter ◽  
...  
Keyword(s):  
Infection Control ◽  
Sampling Technique ◽  
Secondary Level ◽  
Cross Sectional Study ◽  
Knowledge Level ◽  
Cross Sectional ◽  
Face To Face ◽  
Control Education ◽  
Strongly Agree ◽  
Level Hospital

Infection control and standard precautions is evidence-based practices that can reduce the risk of transmission of microorganisms. Infection control education is a fundamental component of the Nursing curriculum. A cross-sectional study was conducted to assess the level of knowledge and practices regarding infection control among nurses in secondary level hospital at 250 beds Chittagong General Hospital and Fouzderhat TB Hospital, Chittagong. The study period was 1st January to 31st December 2018. Total 182 nurses were included in this study. The respondents were selected by purposive sampling technique and data were collected by face to face interview. The study was found that (78.0%) respondents had fair knowledge and (90.2%) had fair practices regarding infection control. The study also revealed that, 161 (88.5%) respondents awarded about hand washing, 179 (98.4%) respondents were concerned about waste management and 93 (51.1%) respondents agree and 85 (46.7%) respondents strongly agree about PPE use is important. Significant statistical difference was found between working experience and knowledge level. This study can be concluded that in spite of practice level regarding infection control, nurses had fair knowledge level. These finding suggest that nurse knowledge and practice regarding infection control need further improvement. Asian J. Med. Biol. Res. December 2020, 6(4): 731-737

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