Abstract 15: Public Access Defibrillators: Sex-Based Inequities in Access and Application

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Brian E Grunau ◽  
Emad Awad ◽  
Takahisa Kawano ◽  
Frank Scheuermeyer ◽  
Robert Stenstrom ◽  
...  
Keyword(s):  
Healthcare Facility ◽  
Public Access ◽  
Home Healthcare ◽  
Healthcare Facilities ◽  
Public Property ◽  
The North ◽  
Private Location ◽  
Residential Institutions ◽  
Adjusted Logistic Regression ◽  
Location Type

Introduction: It is unclear if the benefits of public access defibrillator (PAD) programs are similar between men and women. We investigated the location of out-of-hospital cardiac arrests (OHCA) stratified by sex to determine what proportion was eligible for PAD application. Second, we sought to determine if patient sex was associated with PAD utilization. Methods: We analyzed prospectively collected data from the North American Resuscitation Outcomes Consortium (ROC) Epistry dataset (2011 - 2015), excluding emergency medical services (EMS)-witnessed cases, those not treated by EMS, and children aged less than 10. We compared sex-based differences in public vs private location, and location type (street or highway, public building, place of recreation, industrial place, home residence, farm or ranch, healthcare facility, residential institution, other public property, or other private location). Among public location OHCAs with bystander interventions, we fit an adjusted logistic regression model to estimate the association between sex and PAD application. Results: Among the 61,473 cases, 20,933 (34%) were female, 30,353 had resuscitation attempted by bystander, and 13,597 had initial shockable rhythms. The OHCA incidence in a public location for women and men was 8.8% and 18%, respectively (95% CI for difference 8.7 - 9.7). Women had a significantly lower proportion of OHCAs on the street/highway, in public buildings, places of recreation, and farms, but a significantly higher proportion in the home, healthcare facilities, and residential institutions. Among public location OHCAs with bystander interventions, female sex was associated with a lower odds of bystander PAD application (adjusted OR 0.83, 95% CI 0.70-0.99). Conclusion: Women had fewer OHCAs in public locations eligible for PAD application. Further, among public OHCAs with bystander interventions, women were less likely to have PADs applied.

scholarly journals DEEP SCOPE: A Framework for Safe Healthcare Design

2021 ◽  
Vol 18 (15) ◽  
pp. 7780
Author(s):  
Ellen Taylor ◽  
Sue Hignett
Keyword(s):  
Human Factor ◽  
Healthcare Facility ◽  
Built Environments ◽  
Facility Design ◽  
Healthcare Facilities ◽  
Healthcare Design ◽  
Accident Causation ◽  
Healthcare Facility Design

Thinking in patient safety has evolved over time from more simplistic accident causation models to more robust frameworks of work system design. Throughout this evolution, less consideration has been given to the role of the built environment in supporting safety. The aim of this paper is to theoretically explore how we think about harm as a systems problem by mitigating the risk of adverse events through proactive healthcare facility design. We review the evolution of thinking in safety as a safety science. Using falls as a case study topic, we use a previously published model (SCOPE: Safety as Complexity of the Organization, People, and Environment) to develop an expanded framework. The resulting theoretical model and matrix, DEEP SCOPE (DEsigning with Ergonomic Principles), provide a way to synthesize design interventions into a systems-based model for healthcare facility design using human factors/ergonomics (HF/E) design principles. The DEEP SCOPE matrix is proposed to highlight the design of safe healthcare facilities as an ergonomic problem of design that fits the environment to the user by understanding built environments that support the “human” factor.

scholarly journals Efficiency of Health Care Risk Waste Management in Rural Healthcare Facilities of South Africa: An Assessment of Selected Facilities in Vhembe District, Limpopo Province

2019 ◽  
Vol 16 (12) ◽  
pp. 2199 ◽  
Author(s):  
Foluke C. Olaniyi ◽  
Jason S. Ogola ◽  
Takalani G. Tshitangano
Keyword(s):  
South Africa ◽  
Healthcare Facility ◽  
Study Data ◽  
Limpopo Province ◽  
Healthcare Facilities ◽  
The Public ◽  
Efficient Management ◽  
The Social ◽  
Vhembe District ◽  
And Storage

Waste generated form healthcare facilities is a potential source of health risks to the public, if it is not properly handled from the point of generation to disposal. This study was conducted to assess the efficiency of healthcare risk waste (HCRW) management in Vhembe District of Limpopo Province, South Africa. Fifteen healthcare facilities were selected in Vhembe District for this study. Data were obtained through in-depth interviews, semi-structured questionnaires, observation and pictures. Qualitative data were thematically analyzed, while the quantitative data were analyzed using the Statistical Package for the Social Sciences, version 25. In all the healthcare facilities; mismanagement of HCRW was noted at different points along the management chain. Poor segregation, overfilling of waste bins, inappropriate transportation and storage of waste in substandard storage rooms were observed in the facilities. All the waste from the district are transported to a private-owned treatment facility outside the district, where they are mainly incinerated. Enforcement of healthcare risk waste guidelines, provision of standardized equipment for temporary storage, empowerment of each healthcare facility to treat at least some of the waste, and employment of non-burn techniques for treatment of waste are recommended for more efficient management of healthcare risk waste in Vhembe District.

scholarly journals Flexibility during the COVID-19 Pandemic Response: Healthcare Facility Assessment Tools for Resilient Evaluation

2021 ◽  
Vol 18 (21) ◽  
pp. 11478
Author(s):  
Andrea Brambilla ◽  
Tian-zhi Sun ◽  
Waleed Elshazly ◽  
Ahmed Ghazy ◽  
Paul Barach ◽  
...  
Keyword(s):  
Case Studies ◽  
Assessment Tool ◽  
Healthcare Facility ◽  
Health Impact ◽  
Design Guidelines ◽  
Assessment Tools ◽  
Validity And Reliability ◽  
Evaluation Tool ◽  
Healthcare Operations ◽  
Healthcare Facilities

Healthcare facilities are facing huge challenges due to the outbreak of COVID-19. Around the world, national healthcare contingency plans have struggled to cope with the population health impact of COVID-19, with healthcare facilities and critical care systems buckling under the extraordinary pressures. COVID-19 has starkly highlighted the lack of reliable operational tools for assessing the level sof flexibility of a hospital building to support strategic and agile decision making. The aim of this study was to modify, improve and test an existing assessment tool for evaluating hospital facilities flexibility and resilience. We followed a five-step process for collecting data by (i) doing a literature review about flexibility principles and strategies, (ii) reviewing healthcare design guidelines, (iii) examining international healthcare facilities case studies, (iv) conducting a critical review and optimization of the existing tool, and (v) assessing the usability of the evaluation tool. The new version of the OFAT framework (Optimized Flexibility Assessment Tool) is composed of nine evaluation parameters and subdivided into measurable variables with scores ranging from 0 to 10. The pilot testing of case studies enabled the assessment and verification the OFAT validity and reliability in support of decision makers in addressing flexibility of hospital design and/or operations. Healthcare buildings need to be designed and built based on principles of flexibility to accommodate current healthcare operations, adapting to time-sensitive physical transformations and responding to contemporary and future public health emergencies.

scholarly journals Evacuation Data from a Hospital Outpatient Drill The Case Study of North Shore Hospital

2020 ◽  
Vol 5 ◽  
Author(s):  
Anass Rahouti ◽  
Ruggiero Lovreglio ◽  
Phil Jackson ◽  
Sélim Datoussaïd
Keyword(s):  
Built Environment ◽  
Fire Safety ◽  
Movement Time ◽  
Data Set ◽  
Healthcare Facilities ◽  
Staff Members ◽  
North Shore ◽  
The North ◽  
The Impact

Assessing the fire safety of buildings is fundamental to reduce the impact of this threat on their occupants. Such an assessment can be done by combining existing models and existing knowledge on how occupants behave during fires. Although many studies have been carried out for several types of built environment, only few of those investigate healthcare facilities and hospitals. In this study, we present a new behavioural data-set for hospital evacuations. The data was collected from the North Shore Hospital in Auckland (NZ) during an unannounced drill carried out in May 2017. This drill was recorded using CCTV and those videos are analysed to generate new evacuation model inputs for hospital scenarios. We collected pre-movement times, exit choices and total evacuation times for each evacuee. Moreover, we estimated pre-movement time distributions for both staff members and patients. Finally, we qualitatively investigated the evacuee actions of patients and staff members to study their interaction during the drill. The results show that participants were often independent from staff actions with a majority able to make their own decision.

scholarly journals Mapping physical access to healthcare for older adults in sub-Saharan Africa: A cross-sectional analysis with implications for the COVID-19 response

2020 ◽  
Author(s):  
Pascal Geldsetzer ◽  
Marcel Reinmuth ◽  
Paul O Ouma ◽  
Sven Lautenbach ◽  
Emelda A Okiro ◽  
...  
Keyword(s):  
Older Adults ◽  
Travel Time ◽  
Healthcare Facility ◽  
Access To Healthcare ◽  
Sub Saharan Africa ◽  
Travel Times ◽  
Healthcare Resources ◽  
Healthcare Facilities ◽  
Sub Saharan ◽  
Physical Access

Background: SARS-CoV-2, the virus causing coronavirus disease 2019 (COVID-19), is rapidly spreading across sub-Saharan Africa (SSA). Hospital-based care for COVID-19 is particularly often needed among older adults. However, a key barrier to accessing hospital care in SSA is travel time. To inform the geographic targeting of additional healthcare resources, this study aimed to determine the estimated travel time at a 1km x 1km resolution to the nearest hospital and to the nearest healthcare facility of any type for adults aged 60 years and older in SSA. Methods: We assembled a unique dataset on healthcare facilities' geolocation, separately for hospitals and any type of healthcare facility (including primary care facilities) and including both private- and public-sector facilities, using data from the OpenStreetMap project and the KEMRI Wellcome Trust Programme. Population data at a 1km x 1km resolution was obtained from WorldPop. We estimated travel time to the nearest healthcare facility for each 1km x 1km raster using a cost-distance algorithm. Findings: 9.6% (95% CI: 5.2% - 16.9%) of adults aged 60 and older years had an estimated travel time to the nearest hospital of longer than six hours, varying from 0.0% (95% CI: 0.0% - 3.7%) in Burundi and The Gambia, to 40.9% (95% CI: 31.8% - 50.7%) in Sudan. 11.2% (95% CI: 6.4% - 18.9%) of adults aged 60 years and older had an estimated travel time to the nearest healthcare facility of any type (whether primary or secondary/tertiary care) of longer than three hours, with a range of 0.1% (95% CI: 0.0% - 3.8%) in Burundi to 55.5% (95% CI: 52.8% - 64.9%) in Sudan. Most countries in SSA contained populated areas in which adults aged 60 years and older had a travel time to the nearest hospital of more than 12 hours and to the nearest healthcare facility of any type of more than six hours. The median travel time to the nearest hospital for the fifth of adults aged 60 and older years with the longest travel times was 348 minutes (IQR: 240 - 576 minutes) for the entire SSA population, ranging from 41 minutes (IQR: 34 - 54 minutes) in Burundi to 1,655 minutes (IQR: 1065 - 2440 minutes) in Gabon. Interpretation: Our high-resolution maps of estimated travel times to both hospitals and healthcare facilities of any type can be used by policymakers and non-governmental organizations to help target additional healthcare resources, such as new make-shift hospitals or transport programs to existing healthcare facilities, to older adults with the least physical access to care. In addition, this analysis shows precisely where population groups are located that are particularly likely to under-report COVID-19 symptoms because of low physical access to healthcare facilities. Beyond the COVID-19 response, this study can inform countries' efforts to improve care for conditions that are common among older adults, such as chronic non-communicable diseases.

scholarly journals Patient-perceived factors contributing to low tuberculosis cure rate at Greater Giyani healthcare facilities

2014 ◽  
Vol 19 (1) ◽  
Author(s):  
Nandzumuni V. Maswanganyi ◽  
Rachel T. Lebese ◽  
Ntsieni S. Mashau ◽  
Lunic B. Khoza
Keyword(s):  
Cultural Beliefs ◽  
Health Facilities ◽  
Limpopo Province ◽  
Home Healthcare ◽  
Cure Rate ◽  
Healthcare Facilities ◽  
Face To Face ◽  
Tb Treatment ◽  
Traditional Health ◽  
Cure Rates

Background: Compliance with tuberculosis (TB) treatment is unpredictable. Most patients do not comply because they do not see the importance of doing so, which is usually influenced by lack of knowledge.Objectives: The purpose of the study was to explore and describe the factors contributing to low TB cure rates in Greater Giyani Municipality, as viewed by patients.Method: The study was conducted in the Greater Giyani Municipality in Limpopo Province which had a TB cure rate ranging from 14% to 94%. The research design in this study was qualitative, exploratory, descriptive and contextual in nature. The population consisted of all TB patients diagnosed and referred for treatment and care in Primary Health Care (PHC) facilities. Non-probability purposive sampling was used to select TB patients and health facilities which had a cure rate lower than the national target of 85%. One patient was sampled from each PHC facility. An in-depth face-to-face interview was used to collect data using an interview guide.Results: The findings showed that most of the TB patients come from poor families, which makes it difficult for them to obtain financial and food security. The health facilities often run out of food supplements and TB medicine. Cultural beliefs about TB also lead to TB patients seeking assistance from traditional health practitioners and faith-based healers.Conclusion: There is a need to have a policy regarding how discharged tuberculosis patients on treatment are supervised when at home. Healthcare facilities should also ensure that there is enough medication for these patients as lack of medication can lead them to default. Agtergrond: Dit is onmoontlik om te bepaal of pasiënte by hulle tuberkulosebehandeling gaan hou. Die meeste pasiënte hou nie daarby nie omdat hulle nie die belangrikheid daarvan insien nie.Doelwitte: Die doel van die studie was om die faktore wat in die Groter Giyani Munisipaliteit tot lae genesingskoerse onder TB-pasiënte lei, te ondersoek en te beskryf, soos deur pasiënte gesien.Metode: Die studie is in die Groter Giyani Munisipaliteit in die Limpopo Provinsie gehou, waar die genesingskoers vir TB tussen 14% en 94% is. Die navorsing in hierdie studie was kwalitatief, verkennend, beskrywend en kontekstueel van aard. Die populasie het bestaan uit alle gediagnoseerde TB-pasiënte wat vir behandeling en sorg na primêre gesondheidsorgfasiliteite verwys is. Nie-waarskynlikheid, doelgerigte steekproefneming is gebruik om TB-pasiënte en gesondheidsfasiliteite te kies wat ’n laer genesingskoers as die nasionale doelwit van 85% het. Een pasiënt uit elke primêre gesondheidsorgfasiliteit is by die steekproef ingesluit. ‘n Diepgaande persoonlike onderhoud is gebruik om data met behulp van ‘n onderhoudgids in te samel.Resultate: Die bevindinge toon dat die meeste van die TB-pasiënte uit arm gesinne kom, wat dit vir hulle moeilik maak om finansiële en voedselsekerheid te hê. Die gesondheidsfasiliteite se voedselaanvullings en TB-medisyne raak dikwels op. Kulturele oortuigings oor TB lei ook daartoe dat TB-pasiënte by tradisionele gesondheidsorgpraktisyns en geloofsgebaseerde genesers hulp soek.Gevolgtrekking: Dit is nodig dat ‘n beleid oor toesig oor die behandeling van ontslaande TB-pasiënte wat tuis aansterk, opgestel word. Gesondheidsorgfasiliteite behoort ook seker te maak dat daar genoeg medisyne vir hierdie pasiënte is, aangesien ‘n gebrek aan medisyne daartoe kan lei dat die pasiënte ophou om hulle medikasie te gebruik.

scholarly journals 60 Opening the Narrative on Deprivation of Liberty for the Older Person in Residential Healthcare Facilities: A Legal and Ethical Dilemma

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Florence Hogan ◽  
Adrian Ahern
Keyword(s):  
Human Rights ◽  
Residential Care ◽  
Healthcare Providers ◽  
Community Support ◽  
Healthcare Facility ◽  
Moral Dilemmas ◽  
Legal Framework ◽  
Best Interest ◽  
Healthcare Facilities ◽  
The Individual

Abstract Background While many people enter residential care of their own free will and because it is their preference, the evidence tells us that there are also many who if they had the choice would remain in their own homes. Lack of appropriate community supports may provide some impetus to enter residential care. According to Care Alliance Ireland, an additional four million hours of homecare needs to be provided to cope with the successful ageing demographics, at a cost of €110 million. There is no statutory or common-law power to detain a patient in a Healthcare Facility outside of the application of the Mental Health Act 2001. This presents legal, ethical and moral dilemmas for Healthcare Providers when caring for a person who lacks capacity wishes to self - discharge. A duty of care obligates healthcare professionals to act in the best interest of the individual. Under the Health Act 2007 the requirement is to provide for a ‘safe discharge’. Pending advancement of the Assisted Decision Making (Capacity) Act 2015 which provides a statutory framework to assist and support individuals to make legally-binding agreements about their welfare, their property and affairs we are currently acting under the Lunacy Regulations (1871). Methods We developed a ‘Deprivation of Liberty’ form which enable comprehensive Interdisciplinary Team discussion and direction of care. Presumption of capacity, respect for the resident’s wishes and consideration of all possible supportive actions up to and including sourcing community support services were considered. Results This format has enabled comprehensive discussion and robust adherence to human rights for three residents thus far Conclusion The situation remains that there is no legal framework to guide healthcare providers currently. Using a Human Rights based approach is imperative to guide us while awaiting advancement of the ADMA (2015) and Deprivation of Liberty legislation to be included in this act.

scholarly journals How Medical Studies in Poland Prepare Future Healthcare Managers for Crises and Disasters: Results of a Pilot Study

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 202 ◽  
Author(s):  
Patrycja Misztal-Okońska ◽  
Krzysztof Goniewicz ◽  
Attila J. Hertelendy ◽  
Amir Khorram-Manesh ◽  
Ahmed Al-Wathinani ◽  
...  
Keyword(s):  
Public Health ◽  
Pilot Study ◽  
Online Survey ◽  
Medical Personnel ◽  
Healthcare Facility ◽  
Healthcare Organizations ◽  
Healthcare Facilities ◽  
Organization And Management ◽  
Proactive Management ◽  
Professional Assistance

In the event of a crisis, rapid and effective assistance for victims is essential, and in many cases, medical assistance is required. To manage the situation efficiently, it is necessary to have a proactive management system in place that ensures professional assistance to victims and the safety of medical personnel. We evaluated the perceptions of students and graduates in public health studies at the Medical University of Lublin, Poland, concerning their preparation and management skills for crises such as the COVID-19 pandemic. This pilot study was conducted in March 2020; we employed an online survey with an anonymous questionnaire that was addressed to students and graduates with an educational focus in healthcare organization and management. The study involved 55 people, including 14 men and 41 women. Among the respondents, 41.8% currently worked in a healthcare facility and only 21.7% of them had participated in training related to preparation for emergencies and disasters in their current workplace. The respondents rated their workplaces’ preparedness for the COVID-19 pandemic at four points. A significant number of respondents stated that if they had to manage a public health emergency, they would not be able to manage the situation correctly and not be able to predict its development. Managers of healthcare organizations should have the knowledge and skills to manage crises. It would be advisable for them to have been formally educated in public health or healthcare administration. In every healthcare facility, it is essential that training and practice of performing medical procedures in full personal protective equipment (PPE) be provided. Healthcare facilities must implement regular training combined with practical live scenario exercises to prepare for future crises.

Predictors of Rectal Carriage of Carbapenem-Resistant Enterobacteriaceae (CRE) among Patients with Known CRE Carriage at Their Next Hospital Encounter

2011 ◽  
Vol 32 (5) ◽  
pp. 497-503 ◽  
Author(s):  
Vered Schechner ◽  
Tali Kotlovsky ◽  
Jalal Tarabeia ◽  
Meital Kazma ◽  
David Schwartz ◽  
...  
Keyword(s):  
Screen Test ◽  
Healthcare Facility ◽  
Negative Control ◽  
Time Interval ◽  
Healthcare Facilities ◽  
Positive Screen ◽  
Carbapenem Resistant ◽  
History Of ◽  
Control Study ◽  
Carbapenem Resistant Enterobacteriaceae

Background.Carbapenem-resistant Enterobacteriaceae (CRE) are important extremely drug-resistant pathogens that have emerged during the past decade. Early identification and isolation of carriers are key components of an effective infection control strategy in healthcare facilities. Very little is known about the natural history of CRE carriage. We aimed to determine the predictors of a positive CRE rectal screen test among patients with known CRE carriage screened at their next hospital encounter.Methods.A case-control study was conducted. Sixty-six patients who tested positive for CRE carriage were surveyed for CRE rectal carriage at the next hospital encounter; screen-positive patients were compared with screen-negative control patients. Data were extracted from the patients' medical records and from the hospital computerized database.Results.Twenty-three case patients and 43 control patients were identified. Predictors for a positive CRE rectal carriage test were (1) prior fluoroquinolone use (odds ratio [OR], 4.27; 95% confidence interval [CI], 1.10–16.6), (2) admission from an institution or another hospital (OR, 4.04; 95% CI, 1.33–12.37), and (3) time interval less than or equal to 3 months since the first positive CRE test (OR, 3.59; 95% CI, 1.24–10.37). Among patients with no predictor variables, the likelihood of having a positive screen test at the next hospital encounter was 1/7. If they had at least 1 predictor, the likelihood increased to 1/2.Conclusions.Prior fluoroquinolone use, transfer from another healthcare facility, and admission less than or equal to 3 months since the first CRE isolation are predictors of persistent CRE rectal carriage. These predictors can be used in designing CRE prevention strategies.

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