Abstract 14218: Post-Cardiac Arrest Care Delivery Varies Widely Across Institutions Belonging to the PediRES-Q Collaborative

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Jessica A Barreto ◽  
Jesse Wenger ◽  
Maya Dewan ◽  
Alexis A Topjian ◽  
Joan S Roberts
Keyword(s):  
Cardiac Arrest ◽  
Care Delivery ◽  
Chi Square ◽  
Neurological Outcomes ◽  
Pediatric Resuscitation ◽  
Order Sets ◽  
Neurological Exam ◽  
Chi Square Test ◽  
Common Barriers ◽  
Training Opportunities

Introduction: Despite national pediatric post-cardiac arrest care (PCAC) guidelines to improve survival and neurological outcomes, there are limited studies describing PCAC delivery in pediatric institutions. The objective of this study was to describe reported PCAC delivery in pediatric institutions. We hypothesized that there would be variability in PCAC processes across institutions. Methods: An IRB-approved REDCap survey was distributed electronically to the lead resuscitation investigator at each institution belonging to the international Pediatric Resuscitation Quality Improvement collaborative (PediRES-Q). Data were summarized using descriptive statistics. A chi-square test was used to compare categorical data. Results: Twenty-four of 47 centers completed the survey (51%). Most respondents (58%) belonged to large centers (≥1000 annual PICU admissions). Two-third (67%) of centers reported using no specific selection criteria to initiate PCAC with the other third employing order sets, paper forms, or institutional guidelines. Smaller centers (<1000 annual PICU admissions) more frequently reported the use of attending-directed care for PCAC initiation/delivery (80%) versus larger centers (57%), p = 0.04. Common PCAC targets included temperature (96%), glucose (75%), and age-based blood pressure (88%). Most PCAC included EEG (75%) but neuroimaging was only included at 46% of centers. Duration of PCAC was either tailored to clinical improvement and neurological exam (54%) or time-based (45%). Only 25% of centers reported having a mechanism for evaluating PCAC adherence. Common barriers to effective PCAC implementation included lack of time and limited training opportunities (Figure 1). Conclusions: There is wide variation in PCAC delivery among surveyed pediatric institutions. Targeting common themes such as standardization of PCAC initiation and bundle components and implementing adherence evaluation could improve PCAC.

scholarly journals HUBUNGAN PENDIDIKAN DAN MASA KERJA DENGAN KETERAMPILAN PERAWAT MELAKUKAN TINDAKAN BANTUAN HIDUP DASAR

2018 ◽  
Vol 5 (2) ◽  
pp. 139-144
Author(s):  
Vera Sesrianty
Keyword(s):  
Cardiac Arrest ◽  
Head Injuries ◽  
Respiratory Arrest ◽  
P Value ◽  
Emergency Nurses ◽  
Chi Square ◽  
Design Data ◽  
Emergency Case ◽  
Study Approach ◽  
Chi Square Test

Emergency nurses connect knowledge with skills to deal with life-threatening patients. The high number of emergency case visits such as respiratory arrest and cardiac arrest in each country is one of the impacts in the failure of emergency cases handling which is generally caused by failure to recognize risks, delays in handling, and lack of facilities and knowledge and skills of medical and paramedical personnel. Based on data obtained at the IGD and ICU RSUD Lubuk Sikaping, during 2016 there were 146 people experiencing emergency with the division of 62 people with respiratory failure, 52 heavy head injuries and 32 cardiac arrest, most died. The purpose of this research is to identify factors related to nurse skill in performing BHD action in IGD Room and ICU of Lubuk Sikaping Hospital. This research uses descriptive analytic method with corelation study approach design. Data processing using Chi Square test, with a sample of 30 respondents. The result of statistical test, it can be concluded that there is correlation of education level factor with BHD action, p value = 0,007 (p = P <α) the existence of time factor relationship with BHD action, p value = 0,000 (p <α) IGD Room and ICU of Lubuk Sikaping Hospital 2017. Suggestion in this research is the result of this research Can add insight and knowledge about the management of BHD properly so that emergency patients can be helped well.

Managerial and Operational Hindrances to Polio Eradication: A Case Study of Tehsil Katlang, Mardan, Pakistan

2020 ◽  
Vol 3 (2) ◽  
pp. 48-58
Author(s):  
Muhammad Zahid ◽  
Seema Zubair ◽  
Arshad Khan Bangash
Keyword(s):  
Quantitative Research ◽  
Health Department ◽  
Polio Eradication ◽  
Cold Chain ◽  
Chi Square ◽  
National Immunisation ◽  
Public Health Professionals ◽  
Study Results ◽  
Chi Square Test ◽  
Training Opportunities

The study aims to analyse managerial and operational hindrances to polio eradication process in Tehsil Katlang, District Mardan using quantitative research method i.e. questionnaire and statistical analysis. A sample size of 200 respondents i.e. polio workers of health department, staff of WHO and UNICEF are selected through proportionate stratified random technique. Bi-variate analyses are conducted with the help of Chi-square test. The study results concludes a significant association between polio eradication process and maintenance of cold chain, lack of transportation facility to polio staff, accessibility with reference to locality, training opportunities of polio workers, lack of trained public health professionals, workers dissatisfaction from salaries, timely payment of NIDs remuneration, unnecessary bureaucratic interventions and influences in Expended Program on Immunisation (EPI), lack of proper evaluation of National Immunisation Days (NIDs) campaign and security threats to polio workers. Further, a non-significant association is ascertained between polio eradication and timely availability of vaccines to EPI workers, effects of load shedding on maintenance of cold chain and proper monitoring of NIDs campaign. The findings state that the program needs proper management process for cold chain and transportation facilities. Salaries of the workers need to be increased and NIDs remuneration needs to pay on time. Various training programs should be initiated for workers and shortage of staff should be removed. Security arrangements for polio workers may be enhanced.

A comparison of two models of multidisciplinary lung cancer care within a community-based healthcare system.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 36-36
Author(s):  
Meghan Meadows ◽  
Meredith Ray ◽  
Matthew Smeltzer ◽  
Nicholas Faris ◽  
Carrie Fehnel ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Care ◽  
Cox Regression ◽  
Care Delivery ◽  
Smoking Status ◽  
Multidisciplinary Care ◽  
Chi Square ◽  
Community Healthcare ◽  
Lung Cancer Patients ◽  
Chi Square Test

36 Background: The Multidisciplinary Thoracic Oncology Conference (MTOC) model is easier to implement than the Multidisciplinary Clinic (MDC) model, but does not directly involve patients in decision-making. We compared the processes and outcomes of lung cancer care between patients discussed in a weekly MTOC versus those seen in a MDC. Methods: Prospective observational study of thoroughness of staging, stage confirmation (defined as biopsy of the stage-defining lesion), National Comprehensive Cancer Network guideline-concordant treatment, overall (OS) and event-free (EFS) survival of lung cancer patients in a community healthcare system’s MDC and MTOC from 2014-2019. We used the chi-square test and multivariable logistic regression to evaluate guideline-concordant treatment and stage confirmation; Kaplan-Meier curves and multivariable Cox regression were used to evaluate OS and EFS. We adjusted models for age, sex, race, insurance, smoking status, and histology. Results: 614 patients received care in MDC; 571 in MTOC. MDC patients were older (median age: 69 vs. 67); less likely to be active smokers (44% vs. 47%; p=0.03); more likely to have bimodal (98% v 95%, p=0.02) and trimodal staging (60% v 46%, p<0.0001). The stage-confirmation rate (OR: 1.55; 95% CI: 1.22-1.96) and mediastinal stage confirmation rate (OR: 1.55; 95% CI: 1.23-1.95) were both significantly higher in MDC, even after adjustment (aOR: 1.60; 95% CI: 1.25-2.03); (aOR: 1.58, 95% CI: 1.25-2.00). A higher proportion of patients received guideline-concordant treatment in MDC than in MTOC (82% vs. 73%; OR: 1.63; 95% CI: 1.21-2.20) even after adjustment (aOR: 1.64; 95% CI: 1.20-2.24). However, MTOC patients had significantly better OS (p=0.03) and EFS (p=0.001) than MDC patients and a lower hazard of death (HR: 0.81; 95% CI: 0.67-0.98), even after adjusting for confounding variables (aHR: 0.79 95%CI: 0.66-0.95). Conclusions: Although the processes of lung cancer care delivery were better in MDC than in MTOC, survival was better in MTOC. Patient selection may have played a role in these survival differences. The MTOC model, as implemented, seems competitive with the MDC model and is worthy of further exploration as a more feasible model of multidisciplinary care. [Table: see text]

Abstract 181: Patterns of Waveform and Energy Use in Defibrillation for Cardiac Arrest: Insights from the Get With The Guidelines-Resuscitation Registry

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Preston M Schneider ◽  
Wenhui Liu ◽  
Gary K Grunwald ◽  
Paul S Chan ◽  
Brahmajee K Nallamothu ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Energy Use ◽  
National Registry ◽  
Study Cohort ◽  
Chi Square ◽  
Frequent Use ◽  
Biphasic Waveform ◽  
Chi Square Test ◽  
Get With The Guidelines ◽  
Hospital Cardiac Arrest

Background: Early defibrillation for termination of life-threatening arrhythmias is key to survival of cardiac arrest. Biphasic waveform defibrillation has been suggested as superior to monophasic waveform defibrillation, but little is known about trends in defibrillation waveform and energy used for in-hospital cardiac arrest. Methods: Within Get With The Guidelines-Resuscitation, a national registry of in-hospital cardiac arrest, we identified subjects over age 18 with an in-hospital cardiac arrest due to ventricular fibrillation or pulseless ventricular tachycardia between 2005 and 2012. We restricted the study cohort to this time period, as defibrillation waveform and energy were not captured prior to 2005. We examined calendar year trends in defibrillation waveform and energy of first defibrillation attempt using the chi-square test. Results: A total of 22,108 patients from 504 facilities were identified. In 2005, in which there were 2898 in-hospital cardiac arrest cases, 1911 (66%) events were treated with biphasic defibrillation and 987 (34%) with monophasic defibrillation. By 2012, nearly all (97% [1460/1502]) events were treated with biphasic defibrillation; p for trend < 0.0001 (see Figure). For biphasic defibrillation, the predominant energy used for first defibrillation attempt was 200 J (55.91% of events) with 150 J being the next most common (18.21% of events) with a trend toward more frequent use of 200 J (p < 0.0001). Conclusion: Biphasic defibrillation at 200 J is now the predominant waveform and energy used for initial defibrillation during in-hospital cardiac arrest. Additional work is needed to determine if a rise in use of biphasic defibrillation is improving outcomes.

scholarly journals PENGETAHUAN REMAJA TENTANG RESUSITASI JANTUNG PARU BERHUBUNGAN DENGAN EFIKASI DIRI REMAJA DI SMK NEGERI 2 SINGOSARI MALANG

2020 ◽  
Vol 8 (1) ◽  
pp. 116
Author(s):  
Dudella Desnani Firman Yasin ◽  
Ahsan Ahsan ◽  
Septi Dewi Racmawati
Keyword(s):  
Cardiac Arrest ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test ◽  
Relationship Of ◽  
The Relationship ◽  
Hospital Cardiac Arrest ◽  
Very High

The focus of current global health problems is the death rate that occurs outside the Hospital Out-of-Hospital Cardiac Arrest (OHCA) due to cardiac arrest. Every year the incidence rate is very high and increasing. Delay in reporting and providing Lung Resuscitation can result in death. Providing knowledge about CPR is expected to reduce mortality due to cardiac arrest. The purpose of this study was to determine the relationship of knowledge with adolescent self-efficacy in performing Pulmonary Resuscitation. The research design used was cross-sectional study. The research location is SMK Negeri 2 Singosari Malang. The number of respondents was 110 respondents taken by purposive sampling technique. Data analysis using chi-square test that is knowledge obtained p = 0.003 (p

Airway management during out-of-hospital cardiac arrest; a prospective observational study comparing I-gel® and LTS-D ™

2020 ◽  
Author(s):  
Maja Lønvik ◽  
Odd Eirik Elden ◽  
Mats Lunde ◽  
Trond Nordseth ◽  
Karin Bakkelund ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Airway Management ◽  
Success Rate ◽  
Clinical Performance ◽  
Airway Device ◽  
Supraglottic Airway ◽  
Chi Square ◽  
Ambulance Personnel ◽  
Chi Square Test ◽  
Hospital Cardiac Arrest

Abstract Background: Airway management in patients with out of hospital cardiac arrest (OHCA) is important and several methods are used. The establishment of a supraglottic airway device (SAD) is a common technique used during OHCA. Two types of SAD are routinely used in Norway; the Kings LTS-D™ and the I-gel®. The aim of this study was to compare the clinical performance of these two devices in terms of difficulty and number of attempts before successful insertion.Methods: All adult patients with OHCA, in whom ambulance personnel used a SAD over a one-year period in the ambulance services of Central Norway, were included. After the event, a questionnaire was completed and the personnel responsible for the airway management were interviewed. Primary outcomes were number of attempts until successful placement of SAD and graded difficulty of insertion. Secondary outcomes were specified challenges with the SAD at insertion. Intergroup differences were compared using Chi-square test for multiple groups.Results: Two hundred and fifty patients were included, of whom 191 received I-gel and 59 received LTS-D. Overall success rate was significantly higher in I-gel (86 %) compared to LTS-D (75%, p = 0,043). The difficulties of insertion were significantly lower among patients receiving I-gel (easy 80 %, medium 13 % and difficult 7 %) compared to LTS-D (easy 51 %, medium 22 % and difficult 27 %, p < 0,001). Conclusions: Overall success rate was significantly higher and the difficulty in insertion was significantly lower in the I-gel group compared to the LTS-D in patients with OHCA.

Abstract 150: Small Variations in Defibrillation Electrode Placement Affect Shock Success

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Alexander Esibov ◽  
Sharon B Melnick ◽  
Fred W Chapman ◽  
Joseph L Sullivan ◽  
Gregory P Walcott
Keyword(s):  
Cardiac Arrest ◽  
Primary Outcome ◽  
Electrode Placement ◽  
Secondary Outcome ◽  
Electrode Position ◽  
Success Rates ◽  
Chi Square ◽  
In Series ◽  
Chi Square Test ◽  
Energy Dose

Background: Defibrillation is essential in treating cardiac arrest patients with ventricular fibrillation (VF). The success of the shock in terminating VF depends on many previously studied factors, including waveform and energy dose. It has been observed clinically that defibrillation electrode placement varies widely. The goal of this study was to assess the effect of small differences in defibrillation electrode placement on first shock defibrillation success rates in swine. Methods: In 10 anesthetized swine weighing 32.7 ± 2.5 kg (mean ± standard deviation), electrode pads were attached at 3 different symmetric positions: the medial edge of each electrode was placed 3% (2.1 ± 0.1 cm), 7% (4.7 ± 0.1 cm), or 11% (7.5 ± 0.2 cm) around the circumference of the chest from mid-sternum (Fig. 1). Biphasic impedance-compensated shocks were delivered through the pads with a 50-ohm resistor added in series to replicate human impedance. The order of the 3 positions was block randomized for each experiment. At each electrode position, 24 episodes were run: VF was electrically induced and up to 2 shocks were delivered. Primary outcome was defined as successful VF termination after the first shock; secondary outcome was the cumulative success of both the first and second shock. Results: Across all experiments, at the 3%, 7%, and 11% positions, first shock success was 38.3% (92/240), 48.3% (116/240), and 36.7% (88/240) (p = 0.02, Chi-square Test); cumulative 2-shock success was 59.6% (143/240), 63.8% (153/240), and 55.4% (133/240) (p = 0.18), respectively. The lowest first shock success was at the 3% position in 6 of 10 animals, at the 11% position in 4 of 10 animals, and never at the 7% position. Conclusions: Small changes in electrode pad placement can significantly affect defibrillation shock success. Although anatomic differences may prevent the existence of one optimal electrode position, one position may be more effective for VF termination than another in a given patient.

Hubungan Antara Menyusui Dengan Involusi Uterus Pada Ibu Nifas Fisiologis Di RSIA Aura Syifa Kabupaten Kediri

1970 ◽  
Vol 5 (2) ◽  
pp. 64
Author(s):  
Eny Sendra ◽  
Dewi Indriani
Keyword(s):  
Breast Feeding ◽  
Sampling Technique ◽  
Chi Square ◽  
Cross Sectional ◽  
Fisher Test ◽  
Key Word ◽  
Chi Square Test ◽  
The Moment

Breast feeding is giving milk to be drunk to the baby from the breast. Uterus involution is a process how the uterus return to the condition back, before pregnanting after bearing. At the moment of suckling, happens a stimulus and brings the hormones out, such as oksitosin uses not only to stimulate some muscles constraction but also to stimulate the uterus, so that the process of uterus involution happens foster. According to the explanations above, the research aimed to know about the correlation between breast feeding and uterus involution. This research’s design was, cross sectional by the population of all childbirth mothers approximately 50 persons / month. By using accidental sampling technique we got 21 sample respondents. The place of research in RSIA Aura Syifa in Kediri Regency on 16th until 22nd of June 2009. From this research’s result, we got 14 persons (66,67%) with normal uterus involution, suckled in a good way, one person (4,67%) with normal uterus involution, suckled in a wrong way, 2 persons (9,52%) with abnormal uterus involution, suckled in a good way and 4 persons (19,05%) with abnormal uterus involution, suckled in a wrong way. Statistic test which used chi-square test, counted the probability frequency in advance, from that we got 3 columns with the score, less than 5, so that chi-square can not be continued and by doing exact fisher test, the score was 0,001. Because P with the grade mistake 0,05 smaller, so the conclusion was “Ho” is rejected, it meant “there was correlation between suckling and uterus involution”. Key Word : Breast feeding, uterus involution

FAKTOR PERSONAL YANG BERHUBUNGAN DENGAN KOMITMEN ORGANISASI PERAWAT RSUD EMBUNG FATIMAH BATAM

2020 ◽  
Vol 5 (3) ◽  
pp. 875
Author(s):  
Asfri Sri Rahmadeni
Keyword(s):  
Organizational Commitment ◽  
Turnover Rate ◽  
Sampling Technique ◽  
Hospital Nurses ◽  
Test Results ◽  
Personal Factors ◽  
High Turnover ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test

<p class="Normal1"><em>Commitment is the attitude or behavior of likes or dislikes shown by someone against the organization at work. Indonesia is recorded as a nurse who has a low organizational commitment (76%) so it harms services. This phenomenon in the hospital can be seen from the indicator of the high turnover rate of nurses which reaches 30.9% which exceeds the standard &lt;5%. Many factors affect organizational commitment. The purpose of this study was to analyze the Personal Factors Associated with Organizational Commitment of Hospital Nurses. This study is a cross-sectional analytic study and purposive sampling technique with a sample of 59 nurses. Chi-Square test results obtained personal factors that have a relationship with organizational commitment Nurse Hospital is age with p = 0,000 and education with p = 0,000, personal factors not related to organizational commitment are gender p = 1,053 and years of service with p = 1,147. Hospitals should conduct research/surveys on Organizational Commitment periodically as an evaluation material in the context of the organization's development and development in the future</em>.</p>

GAMBARAN INDEKS LARVA AEDES AEGYPTI DI BUFFER WILAYAH KERJA BANDARA SEPINGGAN BALIKPAPAN

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Abdurrakhman abdurrakhman Abdurrakhman
Keyword(s):  
Aedes Aegypti ◽  
Buffer Zone ◽  
Chi Square ◽  
Cross Sectional ◽  
Breeding Sites ◽  
Dengue Disease ◽  
Vector Borne Diseases ◽  
Transportation Equipment ◽  
Chi Square Test ◽  
Larvae Density

ABSTRACT : The House index and Container Index in the buffer area of ​​the working area of ​​Balikpapan Sepinggan Airport is still above 1%, so the potential for the spread of dengue disease. Mobilization of people, goods and transportation equipment will increasingly affect the transmission of disease in ports and airports, especially for vector-borne diseases. This study aims to analyze the risk factors associated with larvae density of Aedes aegypti and describe the larvae index in the buffer zone of the Sepinggan Balikpapan Airport This study was a descriptive study with a cross sectional design. The sample in this study was 121 houses with a proportionate stratified random sampling, the research location was in the buffer zone of Sepinggan Balikpapan Airport in November 2018. The variables studied were houses with positive larvae containers, breeding sites and PSN behavior and larvasidation. The data was analyzed using the chi square test. There was a relationship between houses with larvae positive Aedes aegypti, behavior of Mosquito Nest Eradication (PSN) and larvasidation with larvae density of Aedes aegypti but not for breeding sites (p = 0.00 and 95% CI = 0.64), and   (p = 0.00 and 95% CI = 0.34). The description of several Aedes aegypti larvae index, namely House Index (HI) = 57.02%, Container Index (CI) = 24.36%, Bruteau Index (BI) = 148.76, and Flick Free Numbers (ABJ) = 42.98 %. Houses with larvae of Aedes aegypti larvae and PSN and larvasidation behavior were associated with larvae density of Aedes aegypti. The index of HI, CI and BI larvae is of high value so there is a risk of DBD transmission

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