scholarly journals Stakeholder opinion on the proposal to introduce ‘treat and referral’ into the Irish emergency medical service

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Brian Power ◽  
Gerard Bury ◽  
John Ryan
Keyword(s):  
Emergency Medicine ◽  
Care Pathway ◽  
Significant Finding ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Clinical Level ◽  
After Care ◽  
On Line ◽  
Line Survey ◽  
Advanced Paramedics

Abstract Background The Irish ambulance services have traditionally transported all patients following an emergency (112/999) call, regardless of acuity, to an emergency department (ED). A proposal to introduce Treat and Referral, an established care pathway in some jurisdictions, is under active consideration in Ireland. This will present a significant change. Stakeholder engagement is recognised as an essential component of management of such change. This study has conducted a multicentre, cross-sectional survey exploring opinions on the introduction of Treat and Referral among key Irish stakeholders; consultants in emergency medicine, paramedics and advanced paramedics. Methods Public-sector consultants in emergency medicine (EM), registered paramedics and advanced paramedics, in Ireland at the time of the study, were invited to complete an on-line survey. Results A significant finding was that 90% of both cohorts (EM consultants and registered paramedic practitioners) support written after-care instructions being given to referred patients, that > 83% agree that Treat and Referral will reduce unnecessary ambulance journeys and that 70% are in favour of their own family member being offered Treat and Referral. Consensus was reached between respondents that Treat and Referral would improve care and increase clinical judgement of practitioners. Differences were identified in relation to the increased availability of ambulances locally, that only adults should be included, and that research was required to extend Treat and Referral beyond the index conditions. There was no consensus on whether general practitioners (GPs) should be directly informed. Conclusions This study identified that the Irish healthcare practitioners surveyed are supportive of the introduction of Treat and Referral into Ireland. It also affords healthcare policymakers the opportunity to address the concerns raised, in particular the clinical level which will be targeted for inclusion in this extended scope of practice.

scholarly journals Stakeholder Opinion on the proposal to introduce ‘Treat and Referral’ into the Irish Emergency Medical Service.

2019 ◽  
Author(s):  
Brian Power ◽  
Gerard Bury ◽  
John Ryan
Keyword(s):  
Emergency Medicine ◽  
Care Pathway ◽  
Significant Finding ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
After Care ◽  
On Line ◽  
Survey Results ◽  
Line Survey ◽  
Advanced Paramedics

Abstract Background: The Irish ambulance services have traditionally transported all patients following an emergency (112/999) call, regardless of acuity, to an ED. A proposal to introduce Treat and Referral, an established care pathway in some jurisdictions, is under active consideration in Ireland. This will present a significant change. Stakeholder engagement is recognised as an essential component of management of such change. This study has conducted a multicentre, cross-sectional survey exploring opinions on the introduction of Treat and Referral among key Irish stakeholders; consultants in emergency medicine, paramedics and advanced paramedics. Methods: Public-sector consultants in emergency medicine, registered paramedics and advanced paramedics, in Ireland at the time of the study, were invited to complete an on-line survey. Results: A significant finding was that 90% of both cohorts (EM consultants and PHECC practitioners) support written after-care instructions being given to referred patients, that > 83% agree that Treat and Referral will reduce unnecessary ambulance journeys and that 70% are in favour of their own family member being offered Treat and Referral. Consensus was reached between respondents that Treat and Referral would improve care and increase clinical judgement of practitioners. Differences were identified in relation to the increased availability of ambulances locally, that only adults should be included, and that research was required to extend Treat and Referral beyond the index conditions. There was no consensus on whether GPs should be directly informed. Conclusions: This study identified that the Irish healthcare practitioners surveyed are supportive of the introduction of Treat and Referral into Ireland. It also affords healthcare policymakers the opportunity to address the concerns raised, in particular the clinical level which will be targeted for inclusion in this extended scope of practice.

scholarly journals P033: Procedural skills training in emergency medicine physicians within the Edmonton zone: a needs assessment

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S76-S76
Author(s):  
R. Schonnop ◽  
B. Stauffer ◽  
A. Gauri ◽  
D. Ha
Keyword(s):  
Emergency Medicine ◽  
Emergency Departments ◽  
Continuing Professional Development ◽  
Skills Training ◽  
Procedural Skill ◽  
Cross Sectional Survey ◽  
Procedural Skills ◽  
Cross Sectional ◽  
Health Region ◽  
Perceived Importance

Introduction: Procedural skills are a key component of an emergency physician's practice. The Edmonton Zone is a health region that comprises twelve tertiary, urban community and rural community emergency departments (EDs) and represents over three hundred emergency physicians. This study describes the current attitudes toward procedural skill competency, current procedural skill practices, and the role for educational skills training sessions among emergency medicine physicians within a geographical health region. Methods: Multicenter descriptive cross-sectional survey of all emergency medicine physicians working at 12 emergency departments within the Edmonton Zone in 2019 (n = 274). The survey underwent several phases of systematic review; including item generation and reduction, pilot testing, and clinical sensibility testing. Survey items addressed current procedural skill performance frequency, perceived importance and confidence, current methods to maintain competence, barriers and facilitating factors to participation in a curriculum, preferred teaching methods, and desired frequency of practice for each procedural skill. Results: Survey response rate was 53.6%. Variability in frequency of performed procedures was apparent across the type of hospital sites. For majority of skills, there was a significantly positive correlation between the frequency at which a skill was performed and the perceived confidence performing said skill. There was inconsistency and no significant correlation with perceived importance, perceived confidence, or frequency performing a given skill and the desired frequency of training for that skill. Course availability (76.2%) and time (72.8%) are the most common identified barriers to participation in procedural skills training. Conclusion: This study summarized the current emergency department procedural skill practices and attitudes toward procedural skill competency and an educational curriculum among emergency medicine physicians in Edmonton. This represents a step towards targeted continuing professional development in the growing realm of competency-based medical education.

scholarly journals Efeito da gamificação na intenção de uso de treinamentos on-line: uma adaptação do modelo UTAUT aplicado no TRT-2

2019 ◽  
Vol 12 (3) ◽  
pp. 472
Author(s):  
Ludmilla Cavarzere de Oliveira ◽  
Luis Hernan Contreras Pinochet ◽  
Ricardo Luiz Pereira Bueno ◽  
Mauri Aparecido de Oliveira
Keyword(s):  
Structural Equation ◽  
Statistical Significance ◽  
Learning By Doing ◽  
Equation Modeling ◽  
Intention To Use ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Regional Labor ◽  
On Line ◽  
Facilitating Conditions

The objective of this research was to analyze the effect of gamification on intention to use online training from the partial validation of the UTAUT model for qualification of members and servers of the Regional Labor Court of the 2nd Region (TRT-2). The study analyzed the relationship between constructs performance expectancy, effort expectancy, facilitating conditions, and familiarity with the intention to use gaming in distance media.  This was conducted through an empirical application, which used the Structural Equation Modeling (SEM) for data analysis. The research was a single cross-sectional survey, carried out with TRT-2 members and servers who participated in the distance-feeding course ‘Healthy Living’ in 2015. Of the four hypotheses, only familiarity (F) was not significant as it did not serve as a behavioral intentions (BI) predictor of gamification for distance learning courses. Some explanations for such phenomenon may be career promotion and additional qualifications, learning by doing and sample size. The results confirmed that most hypotheses have a high statistical significance of the structural paths and have demonstrated that the model proposed in this study is consistent and can be applied in future studies with appropriate adjustments.

scholarly journals Concepção e divulgação de um e-survey para pesquisa em administração aplicada em enfermagem

2020 ◽  
Vol 20 (80) ◽  
Author(s):  
Quevellin Alves dos Santos Francisco ◽  
Maria Regina Martinez
Keyword(s):  
Surveys And Questionnaires ◽  
Survey Study ◽  
Nursing Administration ◽  
Cross Sectional Survey ◽  
Online Surveys ◽  
Cross Sectional ◽  
Nursing Managers ◽  
Data Collection Instrument ◽  
On Line ◽  
Quantitative Descriptive

Design and divulgation of an e-survey for research in nursing administration Análise do processo de concepção e divulgação de um e-survey desenvolvido como instrumento de coleta de dados para um estudo quantitativo, descritivo, de corte transversal, do tipo survey, que resultou na dissertação de mestrado “Participação dos gestores de enfermagem na gestão de pessoas: um estudo do tipo survey”. As etapas da elaboração do e-survey foram: concepção, divulgação e envio do questionário através de uma rede social entre os anos de 2018 e 2019. As pesquisas on-line aproximam pesquisadores-participantes, porém garantem privacidade e comodidade. Para estas pesquisas é primordial a definição de um trajeto metodológico, pois os resultados obtidos podem ser usados para tomar decisões importantes no âmbito da prática da enfermagem.Palavras-chave: Inquéritos e Questionários; Enfermagem; Serviços On-Line; Pesquisa em Enfermagem; Internet ABSTRACTProcess analysis the conception and dissemination of an e-survey developed as a data collection instrument of a quantitative, descriptive, cross-sectional Survey study, which resulted in the master dissertation “Participation of nursing managers in management. of people: a Survey study”. The stages of the preparation of the e-survey were conception, dissemination and sending of the questionnaire through a social network between 2018 and 2019. Online surveys bring research participants closer together but guarantee privacy and convenience. For this research it is essential to define a methodological path because the results can be used to make important decisions in the scope of nursing practice.Keywords: Surveys and Questionnaires; Nursing; Online services; Nursing research; Internet

scholarly journals The Clinical Need for New Diagnostics in the Identification and Management of Patients with Suspected Sepsis in UK NHS Hospitals: A Survey of Healthcare Professionals

Antibiotics ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 737
Author(s):  
Amanda Winter ◽  
William Stephen Jones ◽  
A. Joy Allen ◽  
D. Ashley Price ◽  
Anthony Rostron ◽  
...  
Keyword(s):  
Healthcare Professionals ◽  
Care Pathway ◽  
Cross Sectional Survey ◽  
Suspected Sepsis ◽  
Cross Sectional ◽  
Blood Tests ◽  
Clinical Scenarios ◽  
Initial Identification ◽  
Uk National Health Service ◽  
Rule Out

Development of a new diagnostic is ideally driven by an understanding of the clinical need that the test addresses and the optimal role the test will have within a care pathway. This survey aimed to understand the clinical need for new sepsis diagnostics and to identify specific clinical scenarios that could be improved by testing. An electronic, cross-sectional survey was circulated to UK National Health Service (NHS) doctors and nurses who care for patients with suspected sepsis in hospitals. Two hundred and sixty-five participants completed the survey, representing 64 NHS Trusts in England. Sixty-seven percent of respondents suggested that the major cause of delay was during the initial identification of sepsis and the subsequent recognition of patients who were deteriorating. Existing blood tests did not enhance the confidence of consultants making their diagnoses. Those surveyed identified a role for a near-patient test to “rule out” suspected sepsis and, thereby, stop or postpone use of antibiotics. Current diagnostic tests are slow, non-specific, and do not reliably identify patients with a high suspicion of sepsis. As a result, they have a limited use in patient management and antibiotic stewardship. Future development of sepsis diagnostics should focus on overcoming these limitations.

scholarly journals Are midwives ready to fight vaccine hesitancy? First results from an Italian cross-sectional study

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Massimi ◽  
A Rosso ◽  
C De Vito ◽  
C Marzuillo ◽  
V Baccolini ◽  
...  
Keyword(s):  
Ad Hoc ◽  
Care Pathway ◽  
Herd Immunity ◽  
Vaccine Hesitancy ◽  
Accurate Information ◽  
Teachable Moment ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Level Of Knowledge ◽  
Childhood Vaccines

Abstract Background Pregnancy is widely recognized as a ’teachable moment’ since attitudes and beliefs about childhood vaccines are not completely structured. Among healthcare workers (HCWs), midwives play a pivotal role in the maternal care pathway and should have a key role also in promoting opportunities of discussion and correct information about vaccinations. Methods We conducted a cross-sectional survey to assess knowledge and attitudes of a sample of Italian midwives towards vaccinations. A questionnaire was designed ad hoc and sent electronically to midwives members of the professional register of Rome. Results Preliminary results on data collected from 140 midwives (mean age 37.32, DS ± 11.61; mean years on the job: 11.94 DS ± 12.78) who completed the survey showed a heterogeneous level of knowledge: only 50% of the sample indicated the correct threshold of vaccination coverage for herd immunity, while safety of multiple shots and of the additives contained in vaccines was reported by 61% and 31% of respondents, respectively. Only 41% of midwives had identified the pertussis vaccine as one of the vaccinations recommended during pregnancy. Attitudes were generally positive: 84% of respondents recognized recommended vaccines as effective and 86% as one of the safest health interventions. However, vaccinations against MMR and Varicella were perceived as useful by 86% and 71% of the midwives, while 89% and 77%, respectively, would recommend them to parents (compared to 96% in case of hexavalent). Globally, 79% of respondents would agree with the introduction of mandatory vaccinations for HCWs in maternity wards. Conclusions Midwives show some gaps in the knowledge on vaccinations. The final results of this study will be used to build specific and tailored training programs directed to midwives involved in pregnancy management. This may help them to transfer the correct vaccination information for the empowerment and the growth of vaccine literacy. Key messages Pregnancy is a strategic teachable moment to influence attitudes regarding childhood vaccinations and healthcare professionals must be trained to be the vehicle of the most accurate information. Specific under- and post-graduate training courses on vaccinations directed to midwives are strongly needed to ensure good level of knowledge on this topic.

scholarly journals Extent of awareness regarding periodontal disease in diabetic patients among medical interns

2015 ◽  
Vol 05 (04) ◽  
pp. 017-021
Author(s):  
Roshni Jaiswal ◽  
Nina Shenoy ◽  
Biju Thomas
Keyword(s):  
Diabetes Mellitus ◽  
Periodontal Disease ◽  
Strong Relationship ◽  
Diabetic Patients ◽  
Significant Finding ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Interns ◽  
Relationship Of ◽  
Prevalence Of Diabetes Mellitus

Abstract Background: Diabetes mellitus is a metabolic disorder characterized by hyperglycemia due to defective secretion or activity of insulin Prevalence of diabetes mellitus has tripled since 1970, hence it is a significant finding for dental professionals, as evidence from clinical research showing a strong relationship between diabetes and periodontal disease is mounting. In fact, periodontitis is often referred to as the sixth complication of diabetes. Objective : To assess the extent of awareness of periodontal disease in diabetic patients, among medical interns. Methods: A cross sectional survey containing 21 questions was answered by 150 medical interns from Mangalore, Karntaka. Conclusion: The results of this survey indicate that medical interns have thorough knowledge about diabetes and its complications; however, their awareness about periodontal disease in diabetic patients is limited thus further emphasis should be given to the dissemination of knowledge about the inter-relationship of diabetes and periodontal health.

Emergency medicine registrar training in Africa: overview of programmes, faculty and sustainability

2020 ◽  
pp. emermed-2019-208668
Author(s):  
Abena Obenewaa Akomeah ◽  
Hendry Robert Sawe ◽  
Juma A Mfinanga ◽  
Michael S Runyon ◽  
Erin Elizabeth Noste
Keyword(s):  
Emergency Medicine ◽  
Training Programme ◽  
Descriptive Statistics ◽  
African Countries ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Career Options ◽  
Survey Responses ◽  
Collaborative Efforts ◽  
Registrar Training

BackgroundThe specialty of emergency medicine (EM) is new in most African countries, where emergency medicine registrar (residency) programmes (EMRPs) are at different stages of evolution and little is known about the programmes. Identifying and describing these EMRPs will facilitate planning for sustainability, collaborative efforts and curriculum development for existing and future programmes. Our objective was to identify and provide an overview of existing EMRPs in Africa and their applicant requirements, faculty characteristics and plans for sustainability.MethodsWe conducted a descriptive cross-sectional survey of Africa’s EMRPs between January and December 2017, identifying programmes through an online search supplemented by discussions with African EM leaders. Leaders of all identified African EMRPs were invited to participate. Data were collected prospectively using a structured survey and are summarised with descriptive statistics.ResultsWe identified 15 programmes in 12 countries and received survey responses from 11 programmes in 10 countries. Eight of the responding EMRPs began in 2010 or later. Only 36% of the EMRPs offer a 3-year programme. Women make up an average of 33% of faculty. Only 40% of EMRPs require faculty to be EM specialists. In smaller samples that reported the relevant data, 67% (4/6) of EMRPs have EM specialists who trained in that EMRP programme making up more than half of their faculty; 57% of Africa’s 288 EMRP graduates to date are men; and an average of 39% of EMRP graduates stay on as faculty for 78% (7/9) of EMRPs.ConclusionEMRPs currently produce most of their own EM faculty. Almost equal proportions of men and women have graduated from a predominantly >3-year training programme. Graduates have a variety of opportunities in academia and private practice. Future assessments may wish to focus on the evolution of these programme’ curricula, faculty composition and graduates’ career options.

scholarly journals P078: Handover education in Canadian adult and pediatric emergency medicine residencies: a national survey and needs assessment

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S104-S105
Author(s):  
P. Lee ◽  
I. Rigby ◽  
S.J. McPherson
Keyword(s):  
Emergency Department ◽  
Emergency Medicine ◽  
Patient Care ◽  
Pediatric Emergency ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Risk Period ◽  
Hand Off ◽  
Pediatric Inpatient ◽  
Didactic Lecture

Introduction: Emergency department handover is a high-risk period for patient safety. A recent study showed a decreased rate of preventable adverse events and errors after implementation of a resident hand-off bundle on pediatric inpatient wards. In a 2013 survey by the Canadian Associations of Internes and Residents, only 11% of residents in any discipline stated they received a formal teaching session on handover. Recently, the CanMEDS 2015 Physician Competency Framework has added safe and skillful transfer of patient care as a new proficiency within the collaborator role. We hypothesize that significant variation exists in the current delivery and evaluation of handover education in Canadian EM residencies. Methods: We conducted a descriptive, cross-sectional survey of Canadian residents enrolled in the three main training streams of Emergency Medicine (FRCP CCFP-EM, PEM). The primary outcome was to determine which educational modalities are used to teach and assess handover proficiency. Secondarily, we described current sign-over practices and perceived competency at patient handover. Results: 130 residents completed the survey (73% FRCP, 19% CCFP-EM, 8% PEM). 6% of residents were aware of handover proficiency objectives within their curriculum, while 15% acknowledged formal evaluation in this area. 98% of respondents were taught handover by observation of staff or residents on shift, while 55% had direct teaching on the job. Less than 10% of respondents received formal sessions in didactic lecture, small group or simulation formats. Evaluation of handover skills occurred primarily by on shift observation (100% of respondents), while 3% of residents had received assessment through simulation. Local centre handover practices were variable; less than half of residents used mnemonic tools, written or electronic adjuncts. Conclusion: Canadian EM residents receive variable and sparse formal training and assessment on emergency department handover. The majority of training occurs by on shift observation and few trainees receive instruction on objective tools or explicit patient care standards. There exists potential for further development of standardized objectives, utilization of other educational modalities and formal assessments to better prepare residents to conduct safer patient handoffs.

Practice of Peritoneal Dialysis Catheter Flushing in Australia and New Zealand: Multi-Center Cross-Sectional Survey

2017 ◽  
Vol 38 (2) ◽  
pp. 98-103 ◽  
Author(s):  
Yeoungjee Cho ◽  
Neil Boudville ◽  
Suetonia C. Palmer ◽  
Josephine S.F. Chow ◽  
Carmel M. Hawley ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
New Zealand ◽  
Clinical Care ◽  
Peritoneal Dialysis Catheter ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Effective Interventions ◽  
Catheter Obstruction ◽  
Catheter Malfunction ◽  
On Line

Background Evidence of effective interventions to prevent peritoneal dialysis (PD) catheter malfunction before first use is presently insufficient to guide clinical care. Regular flushing of the PD catheter (e.g. before PD commencement) has been adopted by some practitioners in the belief that it will prevent catheter obstruction and/or malfunction. The aim of this study was to characterize and evaluate PD catheter flushing practices across Australian and New Zealand PD units. Methods An on-line survey was distributed to all 62 PD units in Australia (12 August 2016; n = 51) and New Zealand (2 February 2017; n = 11), with questions relating to PD catheter flushing practices, audit, and outcomes. Results Forty-nine units of variable size (< 16 to > 100 patients) completed the survey (79% response rate). All centers flushed PD catheters at some stage after insertion as routine unit practice. Forty-one units (84%) routinely flushed during periods of PD rest at varying intervals ranging from alternate daily to monthly. The type and volume of solution used to flush varied between units. Units that practised routine flushing of PD catheters were almost twice as likely to audit their catheter-related outcomes (66% vs 38%, p = 0.23) and more likely to have reported blocked catheters in the preceding 12 months (84% vs 0%, p = 0.01) compared with those units that did not routinely flush PD catheters. Thirty units (61%) regularly audited and monitored catheter-related outcomes. Conclusions This study identified a wide variation in center practices relating to PD catheter flushing. Drawing conclusions about any relationship between flushing practices and clinical outcomes was impeded by the relatively low uptake of regular auditing and monitoring of catheter-related outcomes across surveyed units. Evaluation of the benefits and harms of standardized PD catheter flushing practices on patient outcomes in a randomized trial is needed to guide practice.

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