Effects of environmental distractors on nurse emergency triage accuracy: a pilot study protocol

Pilot and Feasibility Studies ◽

10.1186/s40814-020-00717-8 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Philippe Delmas ◽

Assunta Fiorentino ◽

Matteo Antonini ◽

Séverine Vuilleumier ◽

Guy Stotzer ◽

...

Keyword(s):

Pilot Study ◽

Large Scale ◽

Patient Flow ◽

Serious Game ◽

Control Group ◽

Emergency Nurses ◽

Research Areas ◽

Study Results ◽

The Impact ◽

And Task

Abstract Background The clinical decisions of emergency department triage nurses need to be of the highest accuracy. However, studies have found repeatedly that these nurses over- or underestimate the severity of patient health conditions. This has major consequences for patient safety and patient flow management. Workplace distractors such as noise and task interruptions have been pointed to as factors that might explain this inaccuracy. The use of a serious game reproducing the work environment during triage affords the opportunity to explore the impact of these distractors on nurse emergency triage accuracy, in a safe setting. Methods/design A pilot study with a factorial design will be carried out to test the acceptability and feasibility of a serious game developed specifically to simulate the triage process in emergency departments and to explore the primary effects of distractors on nurse emergency triage accuracy. Eighty emergency nurses will be randomized into four groups: three groups exposed to different distractors (A, noise; B, task interruptions; C, noise and task interruptions) and one control group. All nurses will have to complete 20 clinical vignettes within 2 h. For each vignette, a gold standard assessment will be determined by experts. Pre-tests will be conducted with clinicians and certified emergency nurses to evaluate the appeal of the serious game. Discussion Study results will inform the design of large-scale investigations and will help identify teaching, training, and research areas that require further development.

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Effects of environmental distractors on nurse emergency triage accuracy: a pilot study protocol

10.21203/rs.3.rs-15514/v3 ◽

2020 ◽

Author(s):

philippe delmas ◽

Assunta fiorentino ◽

matteo antonini ◽

severine Vuilleumier ◽

guy Stotzer ◽

...

Keyword(s):

Pilot Study ◽

Large Scale ◽

Patient Flow ◽

Serious Game ◽

Control Group ◽

Emergency Nurses ◽

Research Areas ◽

Study Results ◽

The Impact ◽

And Task

Abstract Background: The clinical decisions of emergency department triage nurses need to be of the highest accuracy. However, studies have found repeatedly that these nurses over- or underestimate the severity of patient health conditions. This has major consequences for patient safety and patient flow management. Workplace distractors such as noise and task interruptions have been pointed to as factors that might explain this inaccuracy. The use of a serious game reproducing the work environment during triage affords the opportunity to explore the impact of these distractors on nurse emergency triage accuracy, in a safe setting. Methods/Design: A pilot study with a factorial design will be carried out to test the acceptability and feasibility of a serious game developed specifically to simulate the triage process in emergency departments and to explore the primary effects of distractors on nurse emergency triage accuracy. Eighty emergency nurses will be randomized into four groups: three groups exposed to different distractors (A: noise, B: task interruptions, C: noise and task interruptions) and one control group. All nurses will have to complete 20 clinical vignettes within two hours. For each vignette, a gold standard assessment will be determined by experts. Pre-tests will be conducted with clinicians and certified emergency nurses to evaluate the appeal of the serious game. Discussion: Study results will inform the design of large-scale investigations and will help identify teaching, training and research areas that require further development.

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Effects of environmental distractors on nurse emergency triage accuracy: a pilot study

10.21203/rs.3.rs-15514/v1 ◽

2020 ◽

Author(s):

philippe delmas ◽

Assunta fiorentino ◽

matteo antonini ◽

severine Vuilleumier ◽

guy Stotzer ◽

...

Keyword(s):

Pilot Study ◽

Large Scale ◽

Clinical Decision Making ◽

Clinical Decision ◽

Serious Game ◽

Control Group ◽

Emergency Nurses ◽

Group B ◽

Experimental Group ◽

Nurse Triage

Abstract Background: Patient safety is a top priority of the health professions. In emergency departments, the clinical decision making of triage nurses must be of the highest reliability. However, studies have repeatedly found that nurses over- or undertriage a considerable portion of cases, which can have major consequences for patient management. Among the factors that might explain this inaccuracy, workplace distractors have been pointed to without ever being the focus of specific investigation, owing in particular to the challenge of assessing them in care settings. Consequently, the use of a serious game reproducing a work environment comprising distractors would afford a unique opportunity to explore their impact on the quality of nurse emergency triage. Methods/Design : A factorial design will be used to test the acceptability and feasibility of a serious game created to explore the primary effects of distractors on emergency nurse triage accuracy. A sample of 80 emergency nurses will be randomised across three experimental groups exposed to different distractor conditions and one control group not exposed to distractors. Specifically, experimental group A will be exposed to noise distractors only; experimental group B to task interruptions only; and experimental group C to both types combined. Each group will engage in the serious game to complete 20 clinical vignettes in two hours. For each clinical vignette, a gold standard will be determined by experts. Pre-tests will be planned with clinicians and specialised emergency nurses to examine their interaction with the first version of the serious game. Discussion : This study will shed light on the acceptability and feasibility of a serious game in the field of emergency triage. It will also advance knowledge of the possible effects of exposure to common environmental distractors on nurse triage accuracy. Finally, this pilot study will inform planned large-scale studies of emergency nurse practice using serious games.

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The Infant Cuddler Study: Evaluating the effectiveness of volunteer cuddling in infants with neonatal abstinence syndrome

Paediatrics & Child Health ◽

10.1093/pch/pxz127 ◽

2019 ◽

Vol 25 (7) ◽

pp. 414-418

Author(s):

Amanda Hignell ◽

Karen Carlyle ◽

Catherine Bishop ◽

Mary Murphy ◽

Teresa Valenzano ◽

...

Keyword(s):

Pilot Study ◽

Length Of Stay ◽

Focus Groups ◽

Positive Impact ◽

Surrogate Marker ◽

Neonatal Abstinence Syndrome ◽

Control Group ◽

Abstinence Syndrome ◽

Study Results ◽

The Impact

Abstract Objectives St. Michael’s Hospital launched a volunteer cuddling program for all infants admitted into the neonatal intensive care unit in October 2015. The program utilizes trained volunteers to cuddle infants when caregivers are not available. This was a pilot study to assess the impact of a volunteer cuddle program on length of stay (LOS) and feasibility of implementation of the program. Methods A mixed methods approach was utilized to measure both quantitative and qualitative impact. A pilot cohort study with a retrospective control group assessed the feasibility of implementing a volunteer cuddling program for infants with neonatal abstinence syndrome (NAS). Length of stay was used as a surrogate marker to measure the impact of cuddling on infants being treated for Neonatal Abstinence Syndrome. Focus groups using semi-structured interviews were conducted with volunteers and nurses at the end of the pilot study. Results LOS was reduced by 6.36 days (U=34, P=0.072) for infants with NAS in the volunteer cuddling program. Focus groups with both bedside nurses and program volunteers described a positive impact of cuddling programs on infants, families, staff, and volunteers alike. Conclusions The study results suggest that the volunteer cuddling program may reduce LOS in infants with NAS and have potential economic savings on hospital resources. However, larger prospective cohort studies are needed to confirm these results.

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Advances of 2nd Life Applications for Lithium Ion Batteries from Electric Vehicles Based on Energy Demand

Sustainability ◽

10.3390/su13105726 ◽

2021 ◽

Vol 13 (10) ◽

pp. 5726

Author(s):

Aleksandra Wewer ◽

Pinar Bilge ◽

Franz Dietrich

Keyword(s):

Life Cycle ◽

Lithium Ion Batteries ◽

Electric Vehicles ◽

Energy Demand ◽

Lithium Ion ◽

Life Cycles ◽

Future Research ◽

Research Areas ◽

Study Results ◽

The Impact

Electromobility is a new approach to the reduction of CO2 emissions and the deceleration of global warming. Its environmental impacts are often compared to traditional mobility solutions based on gasoline or diesel engines. The comparison pertains mostly to the single life cycle of a battery. The impact of multiple life cycles remains an important, and yet unanswered, question. The aim of this paper is to demonstrate advances of 2nd life applications for lithium ion batteries from electric vehicles based on their energy demand. Therefore, it highlights the limitations of a conventional life cycle analysis (LCA) and presents a supplementary method of analysis by providing the design and results of a meta study on the environmental impact of lithium ion batteries. The study focuses on energy demand, and investigates its total impact for different cases considering 2nd life applications such as (C1) material recycling, (C2) repurposing and (C3) reuse. Required reprocessing methods such as remanufacturing of batteries lie at the basis of these 2nd life applications. Batteries are used in their 2nd lives for stationary energy storage (C2, repurpose) and electric vehicles (C3, reuse). The study results confirm that both of these 2nd life applications require less energy than the recycling of batteries at the end of their first life and the production of new batteries. The paper concludes by identifying future research areas in order to generate precise forecasts for 2nd life applications and their industrial dissemination.

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Impact study of NOOR 1 project on the Moroccan territorial economic development

Renewable Energy and Environmental Sustainability ◽

10.1051/rees/2021008 ◽

2021 ◽

Vol 6 ◽

pp. 8

Author(s):

Amale Laaroussi ◽

Abdelghrani Bouayad ◽

Zakaria Lissaneddine ◽

Lalla Amina Alaoui

Keyword(s):

Economic Development ◽

Renewable Energy ◽

Economic Impact ◽

Large Scale ◽

Solar Power ◽

Local Level ◽

Concentrated Solar Power ◽

Professional Literature ◽

Study Results ◽

The Impact

Morocco is one of the countries investing more and more in Renewable Energy (RE) technologies to meet the growing demand for energy and ensure the security of supply in this sector. The number of solar projects planned and implemented, as well as solar thermal projects in the form of Concentrating Solar Power (CSP) installations is steadily increasing. Many of these installations are designed as large utility systems. In order to provide strong evidence on local, regional and even national impacts, this article examines the impacts of large-scale renewable energy projects on territorial development, based on a case study of the NOOR 1 (Concentrated Solar Power (CSP)) project in Ouarzazate, Morocco. The data collected during this study, conducted through semi-structured interviews with experts, stakeholders, local community representatives and combined with an analysis of documents provided by the NOOR 1 project managers, investors and consulting firms specialized in the field of Renewable Energy, provide detailed evidence on the type and magnitude of impacts on the economic development of the Moroccan southern region where the NOOR 1 plant is located. The data collected is analyzed using NVIVO software. The study results in a consolidated list of many impacts with varying levels of significance for different stakeholder groups, including farmers, youth, women, community representatives and small and medium firms owners. It should be noted that the importance of analyzing the economic impact of large infrastructure projects is widely recognized, but so far, there is little published in the academic and professional literature on the potential impacts of these projects at the local level. Even less information is available on the local impacts of large-scale project implementation in Morocco. While many macroeconomic studies have fed the recent surge in investment in RE projects with the promise of multiple social, economic, environmental, and even geopolitical benefits at the macro level, public debates and discussions have raised considerable doubts. The question of whether these promises would also leave their marks at the local level has also arisen. Despite these uncertainties, very few academics and practitioners have conducted research to empirically develop a good understanding of the impact of RE projects at the local level. To fill this research gap, the economic impact analysis of NOOR 1 provides a detailed empirical overview, which allows a better understanding of the effects that the infrastructure developments of Concentrated Solar Power (CSP) plants can have on the economic environment in which they are located.

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Hemostasis in Infertile Patients Participating in Assisted Reproduction Programmes

Doctor Ru ◽

10.31550/1727-2378-2021-20-6-6-11 ◽

2021 ◽

Vol 20 (6) ◽

pp. 6-11

Author(s):

A.O. Godzoeva ◽

◽

I.E. Zazerskaya ◽

V.S. Vlasov ◽

T.V. Vavilova ◽

...

Keyword(s):

Reproductive Technologies ◽

Control Group ◽

Study Group ◽

Study Objective ◽

Hemostasis System ◽

Fibrin Monomer ◽

Study Results ◽

Venous Thromboembolic Events ◽

The Impact ◽

Infertile Patients

Study Objective: To evaluate the impact of multifollicular ovarian stimulation in in vitro fertilisation (IVF) programmes on hemostasis. Study Design: perspective comparative study. Materials and Methods. The study included 68 patients divided into two groups: study group (n = 36) — infertile patients; control group (n = 32) — healthy non-pregnant women of reproductive age. The protocol with gonadotrophin releasing hormone antagonists was used for ovulation stimulation. Hemostasis system in study patients was evaluated in 2 weeks after embryos were transferred to uterus; in control group — on day 20–22 of menstrual period. For the study group, we evaluated clotting test parameters of hemostasis system, D-dimers (D-d) and fibrin monomer (FM). Study Results. We have not found statistically significant differences between hemostasis screening results of study groups. We have identified increase in pro-coagulatory properties of blood in the study group patients: increase in FM and D-d (р < 0.0001 in both cases). There is an association between study parameters and pregnancy (p < 0.001) and no association with obesity, age and infertility. Conclusion. In IVF programme, FM and D-d levels rise, evidencing hypercoagulation development. An increase in FM levels was even more significant and can be used as an early and specific fibrogenesis marker. Keywords: assisted reproductive technologies, fibrin monomer, D-dimer, hypercoagulation, venous thromboembolic events.

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Do automatic push notifications improve patient flow in the emergency department? analysis of an ED in a large medical center in Israel

PLoS ONE ◽

10.1371/journal.pone.0258169 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0258169

Author(s):

Daniel Trotzky ◽

Liron Posner ◽

Jonathan Mosery ◽

Aya Cohen ◽

Shiran Avisar ◽

...

Keyword(s):

Large Scale ◽

Medical Center ◽

Patient Flow ◽

Primary Objective ◽

Control Group ◽

Minimal Impact ◽

Notification System ◽

Patient Morbidity ◽

Improve Patient

Introduction Congestion in emergency departments [ED] is a significant challenge worldwide. Any delay in the timely and immediate medical care provided in the ED can affect patient morbidity and mortality. Our research analyzed the use of an innovative platform to improve patient navigation in the ED, as well as provide updated information about their care. Our hope is that this can improve ED efficiency and improve overall patient care. Objective The primary objective of our study was to determine whether the use of an automatic push notification system can shorten ‘length of stay’ (LOS) in the ED, improve patient flow, and decrease ED patient load. Methods This was a prospective cohort study utilizing data extrapolated from the electronic medical records of 2972 patients who visited the walk-in ED of a large-scale central hospital in Israel from January 17, 2021 to March 15, 2021. During this period, the automatic push text notification system was activated on a week-on week-off basis. We compared data from our experimental group with the control group. Results The results of this study indicate that the use of an automatic push notification system had a minimal impact on specific parameters of ED patient flow. Apart from a few significant reductions of specific timed-intervals during patients’ ED visit, the majority of results were not statistically significant. Conclusion This study concluded that the anticipated benefits of a push text notification system in the ED do not, at this stage, justify the system’s additional cost. We recommend a follow-up study to further investigate other possible benefits.

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Gender inequities in the online dissemination of scholars’ work

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.2102945118 ◽

2021 ◽

Vol 118 (39) ◽

pp. e2102945118

Author(s):

Orsolya Vásárhelyi ◽

Igor Zakhlebin ◽

Staša Milojević ◽

Emőke-Ágnes Horvát

Keyword(s):

Gender Gap ◽

Large Scale ◽

Gender Disparities ◽

Female Representation ◽

Scientific Impact ◽

The Public ◽

Research Areas ◽

Coauthorship Networks ◽

The Impact ◽

The Relationship

Unbiased science dissemination has the potential to alleviate some of the known gender disparities in academia by exposing female scholars’ work to other scientists and the public. And yet, we lack comprehensive understanding of the relationship between gender and science dissemination online. Our large-scale analyses, encompassing half a million scholars, revealed that female scholars’ work is mentioned less frequently than male scholars’ work in all research areas. When exploring the characteristics associated with online success, we found that the impact of prior work, social capital, and gendered tie formation in coauthorship networks are linked with online success for men, but not for women—even in the areas with the highest female representation. These results suggest that while men’s scientific impact and collaboration networks are associated with higher visibility online, there are no universally identifiable facets associated with success for women. Our comprehensive empirical evidence indicates that the gender gap in online science dissemination is coupled with a lack of understanding the characteristics that are linked with female scholars’ success, which might hinder efforts to close the gender gap in visibility.

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Communicative characteristics of general practitioner-led and nurse-led telephone triage at two Danish out-of-hours services: an observational study of 200 recorded calls

BMJ Open ◽

10.1136/bmjopen-2018-028434 ◽

2019 ◽

Vol 9 (6) ◽

pp. e028434 ◽

Cited By ~ 2

Author(s):

Emil Vilstrup ◽

Dennis Schou Graversen ◽

Linda Huibers ◽

Morten Bondo Christensen ◽

Anette Fischer Pedersen

Keyword(s):

General Practitioner ◽

Observational Study ◽

Large Scale ◽

Patient Flow ◽

Clinical Decision ◽

Secondary Outcome ◽

Telephone Triage ◽

Out Of Hours ◽

Safety Issues ◽

The Impact

ObjectivesOut-of-hours (OOH) telephone triage is used to manage patient flow, but knowledge of the communicative skills of telephone triagists is limited. The aims of this study were to compare communicative parameters in general practitioner (GP)-led and nurse-led OOH telephone triage and to discuss differences in relation to patient-centred communication and safety issues.DesignObservational study.SettingTwo Danish OOH settings: a large-scale general practitioner cooperative in the Central Denmark Region (n=100 GP-led triage conversations) and Medical Helpline 1813 in the Capital Region of Denmark (n=100 nurse-led triage conversations with use of a clinical decision support system).Participants200 audio-recorded telephone triage conversations randomly selected.Primary and secondary outcome measuresConversations were compared with regard to length of call, distribution of speaking time, question types, callers’ expression of negative affect, and nurses’ and GPs’ responses to callers’ negative affectivity using the Mann-Whitney U test and the Student’s t-test.ResultsCompared with GPs, nurses had longer telephone contacts (137s vs 264 s, p=0.001) and asked significantly more questions (5 vs 9 questions, p=0.001). In 36% of nurse-led triage conversations, triage nurses either transferred the call to a physician or had to confer the call with a physician. Nurses gave the callers significantly more spontaneous talking time than GPs (23.4s vs 17.9 s, p=0.01). Compared with nurses, GPs seemed more likely to give an emphatic response when a caller spontaneously expressed concern; however, this difference was not statistically significant (36% vs 29%, p=0.6).ConclusionsWhen comparing communicative parameters in GP-led and nurse-led triage, several differences were observed. However, the impact of these differences in the perspective of patient-centred communication and safety needs further research. More knowledge is needed to determine what characterises good quality in telephone triage communication.

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