scholarly journals Impact of A Simulation-Based Training on Self Assessed Nursing Performance in Anaphylactic Shock Management: A Pre-Post Educational Intervention Study

2021 ◽  
Author(s):  
Qi Ren ◽  
Fang Chen ◽  
Huijuan Zhang ◽  
Juanhua Tu ◽  
Xiaowei Xu ◽  
...  
Keyword(s):  
Intravenous Infusion ◽  
Anaphylactic Shock ◽  
Signs And Symptoms ◽  
Rapid Response Team ◽  
Clinical Competency ◽  
Simulation Design ◽  
Structured Interviews ◽  
Airway Patency ◽  
New Nurses ◽  
Simulation Based

Abstract Background The New Nurses who lack the ability to recognize and manage anaphylactic shock can endanger the patients. In this study, we explored the effect of a simulated scenario designed to improve nurses’ understanding of their roles and responsibilities during the rescue of a patient with anaphylactic shock. Methods The program of a simulation-based training was designed to teach learners to recognize the signs and symptoms of anaphylactic shock, place the patient in the correct position, stop ongoing intravenous infusion of the antibiotic which trigger the anaphylactic shock, restart an intravenous infusion on a new infusion apparatus, give 100% oxygen via a nasal cannula or mask, preserve airway patency, call the rapid response team (RRT), and correctly administer the medications prescribed by the clinician. Instructors evaluated each learner’s skills and behaviors by using a clinical competency questionnaire. All learners then completed the Chinese version of the Simulation Design Scale (SDS) and participated in semi-structured interviews with their instructors after the training. Results All learners showed significant improvements in the 6 competencies assessed by the clinical competency questionnaire after the simulation-based training (all P<0.001). Scores on the SDS revealed that the learners were highly satisfied with all aspects of the simulation-based training (the 20 satisfaction rates were all above 90.00%). During the semi-structured interviews, new graduated nurses reported that simulation-based training in the management of anaphylactic shock was extremely important and would guide them in clinical practice. Conclusions The simulation-based training in anaphylactic shock is a potentially viable and effective method to teach new registered nurses to manage clinical incidents.

scholarly journals Impact of a Simulation-Based Training on Self Assessed Nursing Performance in Anaphylactic Shock Management: A Pre-Post Educational Intervention Study

2021 ◽  
Author(s):  
Qi Ren ◽  
Fang Chen ◽  
Huijuan Zhang ◽  
Juanhua Tu ◽  
Xiaowei Xu ◽  
...  
Keyword(s):  
Intravenous Infusion ◽  
Anaphylactic Shock ◽  
Signs And Symptoms ◽  
Rapid Response Team ◽  
Clinical Competency ◽  
Simulation Design ◽  
Structured Interviews ◽  
Airway Patency ◽  
Simulation Based ◽  
Response Team

Abstract Background: The New Nurses who lack the ability to recognize and manage anaphylactic shock can endanger the patients. In this study, we explored the effect of a simulated scenario designed to improve nurses’ understanding of their roles and responsibilities during the rescue of a patient with anaphylactic shock.Methods: The program of a simulation-based training was designed to teach learners to recognize the signs and symptoms of anaphylactic shock, place the patient in the correct position, stop ongoing intravenous infusion of the antibiotic which trigger the anaphylactic shock, restart an intravenous infusion on a new infusion apparatus, give 100% oxygen via a nasal cannula or mask, preserve airway patency, call the rapid response team (RRT), and correctly administer the medications prescribed by the clinician. Instructors evaluated each learner’s skills and behaviors by using a clinical competency questionnaire. All learners then completed the Chinese version of the Simulation Design Scale (SDS) and participated in semi-structured interviews with their instructors after the training.Results: All learners showed significant improvements in the 6 competencies assessed by the clinical competency questionnaire after the simulation-based training (all P<0.001). Scores on the SDS revealed that the learners were highly satisfied with all aspects of the simulation-based training (the 20 satisfaction rates were all above 90.00%). During the semi-structured interviews, new graduated nurses reported that simulation-based training in the management of anaphylactic shock was extremely important and would guide them in clinical practice.Conclusions: The simulation-based training in anaphylactic shock is a potentially viable and effective method to teach new registered nurses to manage clinical incidents.

scholarly journals Which triggers could support timely identification of primary antibody deficiency? A qualitative study using the patient perspective

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lisanne M. A. Janssen ◽  
Kim van den Akker ◽  
Mohamed A. Boussihmad ◽  
Esther de Vries
Keyword(s):  
Respiratory Infections ◽  
Diagnostic Delay ◽  
Signs And Symptoms ◽  
Negative Influence ◽  
Primary Antibody ◽  
Emotional Impact ◽  
Structured Interviews ◽  
Timely Treatment ◽  
The Way

Abstract Background Patients with predominantly (primary) antibody deficiencies (PADs) commonly develop recurrent respiratory infections which can lead to bronchiectasis, long-term morbidity and increased mortality. Recognizing symptoms and making a diagnosis is vital to enable timely treatment. Studies on disease presentation have mainly been conducted using medical files rather than direct contact with PAD patients. Our study aims to analyze how patients appraised their symptoms and which factors were involved in a decision to seek medical care. Methods 14 PAD-patients (11 women; median 44, range 16-68 years) were analyzed using semi-structured interviews until saturation of key emergent themes was achieved. Results Being always ill featured in all participant stories. Often from childhood onwards periods of illness were felt to be too numerous, too bad, too long-lasting, or antibiotics were always needed to get better. Recurrent or persistent respiratory infections were the main triggers for patients to seek care. All participants developed an extreme fatigue, described as a feeling of physical and mental exhaustion and thus an extreme burden on daily life that was not solved by taking rest. Despite this, participants tended to normalize their symptoms and carry on with usual activities. Non-immunologists, as well as patients, misattributed the presenting signs and symptoms to common, self-limiting illnesses or other ‘innocent’ explanations. Participants in a way understood the long diagnostic delay. They know that the disease is rare and that doctors have to cover a broad medical area. But they were more critical about the way the doctors communicate with them. They feel that doctors often don’t listen very well to their patients. The participants’ symptoms as well as the interpretation of these symptoms by their social environment and doctors had a major emotional impact on the participants and a negative influence on their future perspectives. Conclusions To timely identify PAD, ‘pattern recognition’ should not only focus on the medical ‘red flags’, but also on less differentiating symptoms, such as ‘being always ill’ and ‘worn out’ and the way patients cope with these problems. And, most important, making time to really listen to the patient remains the key.

scholarly journals How do they learn: types and characteristics of medical and healthcare student engagement in a simulation-based learning environment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yashuang Wang ◽  
Yan Ji
Keyword(s):  
Student Engagement ◽  
Learning Environment ◽  
Thematic Analysis ◽  
Emotional Experience ◽  
Deep Understanding ◽  
Structured Interviews ◽  
Healthcare Students ◽  
Interactive Engagement ◽  
Simulation Based ◽  
Medical And Healthcare

Abstract Background Student engagement can predict successful learning outcomes and academic development. The expansion of simulation-based medical and healthcare education creates challenges for educators, as they must help students engage in a simulation-based learning environment. This research provides a reference for facilitators of simulation teaching and student learning in medical and health-related majors by providing a deep understanding of student engagement in a simulation-based learning environment. Methods We conducted semi-structured interviews with ten medical and healthcare students to explore their learning types and characteristics in a simulation-based learning environment. Thematic analysis was used to analyse the data. Results The interviews were thematically analysed to identify three types of student engagement in the simulation-based learning environment: reflective engagement, performance engagement, and interactive engagement. The analysis also identified eight sub-themes: active, persistent, and focused thinking engagement; self-directed-learning thinking engagement with the purpose of problem solving; active “voice” in class; strong emotional experience and disclosure; demonstration of professional leadership; interaction with realistic learning situations; support from teammates; and collegial facilitator-student interaction. Conclusions The student interview and thematic analysis methods can be used to study the richness of student engagement in simulation-based learning environments. This study finds that student engagement in a simulation-based learning environment is different from that in a traditional environment, as it places greater emphasis on performance engagement, which combines both thinking and physical engagement, as well as on interactive engagement as generated through interpersonal interactions. Therefore, we suggest expanding the learning space centring around “inquiry”, as it can help strengthen reflective communication and dialogue. It also facilitates imagination, stimulates empathy, and builds an interprofessional learning community. In this way, medical and healthcare students can learn through the two-way transmission of information and cultivate and reshape interpersonal relationships to improve engagement in a simulation-based learning environment.

scholarly journals Patient’s experience of psoriatic arthritis: a conceptual model based on qualitative interviews

RMD Open ◽  
2020 ◽  
Vol 6 (3) ◽  
pp. e001321
Author(s):  
Alexis Ogdie ◽  
Kaleb Michaud ◽  
Miroslawa Nowak ◽  
Rachel Bruce ◽  
Sarah Cantor ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Conceptual Model ◽  
Patient Experience ◽  
Qualitative Interviews ◽  
Signs And Symptoms ◽  
Structured Interviews ◽  
Skin Symptoms ◽  
Patient’S Experience ◽  
Significant Burden

IntroductionPsoriatic arthritis (PsA) is a heterogeneous chronic inflammatory musculoskeletal disorder that manifests as peripheral arthritis, dactylitis, enthesitis and spondylitis. PsA results in significant burden that impacts quality of life of patients. We examined the signs, symptoms and impacts reported by patients with PsA, to characterise the patient experience of PsA and develop a conceptual model representing this patient experience.MethodsSemi-structured interviews were conducted with patients with PsA recruited through the FORWARD databank. Spontaneous and probed signs, symptoms and impacts of PsA were assessed. Patients rated the disturbance of these concepts on their lives using a scale from 0 (‘does not disturb’) to 10 (‘greatly disturbs’). Signs, symptoms and impacts reported by >80% of patients with a disturbance rating of ≥5 were defined as salient concepts. Recruitment continued until concept saturation was achieved.Results19 patients with PsA were interviewed. The interviews elicited 42 symptoms of which 8 had not been identified in a previous literature review encompassing 15 relevant articles. The most salient signs and symptoms elicited in the interviews were joint pain, skin symptoms, stiffness, swollen/inflamed joints and fatigue all with moderate to high disturbance ratings (range: 5.5–7.8). The most salient impacts were sleep disturbance, physical disability, effects on daily activities and feelings of frustration with also moderate to high disturbance ratings (range: 6.1–7.4).ConclusionsThe interviews highlighted the adverse impact PsA has on the patient’s life and may inform on outcome variables or areas suitable to be assessed in PsA studies.

Computer analysis of non verbal behavioral parameters in unipolar major depression

2011 ◽  
Vol 26 (S2) ◽  
pp. 1712-1712
Author(s):  
V.V. Enatescu ◽  
V.R. Enatescu ◽  
I. Enatescu
Keyword(s):  
Artificial Intelligence ◽  
Automatic System ◽  
Dimensional Space ◽  
Signs And Symptoms ◽  
Unipolar Depression ◽  
Diagnostic Value ◽  
Structured Interviews ◽  
Behavioral Parameters ◽  
Unipolar Major Depression ◽  
Depressive States

Background and aimsBeside the interpretation and processing of content of communication, an important part of psychiatric diagnosis is made on behavioral signs and symptoms. While the semantic assessment of the content of thinking through communication was enriched by the development of several psychopathological scales, schedule and structured or semi-structured interviews the assessment of non verbal parameters remains uncovered. Our aims was to analyses the non verbal parameters, by an automatic system conceived by Dr. Enatescu et colab., in patients with mood disorders.MethodsThe instrument we used are: original traductors, systems of calculation and programming belonging to the artificial intelligence which create new pattern of representation of the gait, gesture, sonorous background of the speech, the dynamic of the writing which can be represented or through a matrix or in a n-dimensional space on specific clusters or to some human typology or to some psychical disorders.ResultsThe non verbal parameters processed by computer were sensible altered along with switching in the depressive states of subjects. The informatics data has had both diagnostic value and screening value for the course of unipolar depression.ConclusionsWe demonstrate that there is the chances for a new semiology which have objective paraclinic value for psychiatry field of automate analyses, nonverbal behavior parameters having the name “Extraverbale Analysis”.

Respiratory Failure and Hypoxemia (DRAFT)

2018 ◽  
Author(s):  
Jeffrey K. Javed ◽  
Jason E. Moore
Keyword(s):  
Respiratory Failure ◽  
Work Of Breathing ◽  
Rapid Response Team ◽  
Clinical Approach ◽  
Airway Patency ◽  
Therapeutic Modalities ◽  
Patient Deterioration ◽  
Effective Care ◽  
Response Team ◽  
Treatment Priorities

Respiratory failure and hypoxemia are among the most common problems encountered by the rapid response team (RRT) and can lead to rapid patient deterioration and arrest. A brief, systematic approach focusing on treatment priorities such as airway patency, correcting hypoxemia, and supporting work of breathing, allows RRT responders to quickly provide the appropriate level of supportive care and narrow the complex differential diagnosis of acute respiratory failure. This chapter reviews a logical and efficient clinical diagnostic evaluation, therapeutic modalities including rescue treatments and mechanical ventilation, and transport considerations for this patient group. The pragmatic, problem-based clinical approach discussed in this chapter will help RRTs provide effective care for this group of patients.

scholarly journals Compatibility of objective functions with simplex algorithm for controller tuning of HVDC system

2020 ◽  
Vol 39 (3) ◽  
pp. 34-43
Author(s):  
Haaris Rasool ◽  
Aazim Rasool ◽  
Ataul Aziz Ikram ◽  
Urfa Rasool ◽  
Mohsin Jamil ◽  
...  
Keyword(s):  
Optimization Technique ◽  
Absolute Error ◽  
Simplex Algorithm ◽  
Control Parameters ◽  
Objective Functions ◽  
Simulation Design ◽  
Hvdc System ◽  
Integral Time ◽  
Time Simulation ◽  
Simulation Based

This work aims to tune multiple controllers at the same time for a HVDC system by using a self-generated (SG) simulation-based optimization technique. Online optimization is a powerful tool to improve performance of the system. Proportion integral (PI) controllers of Multi-infeed HVDC systems are optimized by the evaluation of objective functions in time simulation design (TSD). Model based simulation setup is applied for rapid selection of optimal PI control parameters, designed in PSCAD software. A multiple objective function (OF), i.e. Integral absolute error (IAE), integral square error (ISE), integral time absolute error (ITAE), integral time square error (ITSE), and integral square time error (ISTE), is assembled for testing the compatibility of OFs with nonlinear self-generated simplex algorithm (SS-SA). Improved control parameters are achieved after multiple iterations. All OFs generate optimum responses and their results are compared with each other by their minimized numerical values. Disturbance rejection criteria are also proposed to assess the designed controller performance along with robustness of system. Results are displayed in form of graphs and tables in this paper.

Simulation-based ENT induction: validation of a novel mannequin training model

2019 ◽  
Vol 134 (1) ◽  
pp. 74-80
Author(s):  
S Bhalla ◽  
I Beegun ◽  
Z Awad ◽  
N Tolley
Keyword(s):  
Qualitative Data ◽  
Training Model ◽  
Knowledge Retention ◽  
Junior Doctors ◽  
Structured Interviews ◽  
Confidence Levels ◽  
Simulation Based ◽  
Written Assessment ◽  
Anxiety Levels ◽  
Induction Model

AbstractObjectiveTo ascertain whether simulation-based teaching is superior to lecture-based teaching for an induction programme using a home-made induction model.MethodsA simulation-based induction programme was designed and separate lecture-based teaching covering the same content was organised for junior doctors. The junior doctors were asked to complete pre- and post-induction surveys regarding confidence and anxiety levels. The skills taught included microsuction, flexible nasendoscopy, and anterior and posterior nasal packing. Structured interviews were conducted after the programme to gain qualitative data for analysis. The trainees’ knowledge retention was compared using a standardised written assessment one month after the session.ResultsSimulation-based teaching using the induction model was associated with a statistically significant increase in confidence levels and reduction in anxiety levels, and was associated with greater knowledge retention.ConclusionA regular simulation induction programme should be introduced using the induction model, as it leads to better knowledge retention and increased confidence levels.

A Pilot Study to Explore Novice Debriefers’ Post-Simulation Debriefing Experiences

2020 ◽  
pp. 104687812097099
Author(s):  
Grace Ng ◽  
Daniel M. Lugassy
Keyword(s):  
Faculty Development ◽  
Skill Acquisition ◽  
Health Professions ◽  
Structured Interviews ◽  
Roles And Responsibilities ◽  
Learner Participation ◽  
Simulation Based ◽  
Data Saturation ◽  
Study Participants ◽  
Shed Light

Introduction. Effective debriefing of simulation-based experiences is critical for learning. Approximately 33% of health professions instructors are debriefing novices. However, specific faculty development needs of novice debriefers has not been studied. This study examines how health professions instructors approach debriefing when they are new to debriefing simulation-based experiences. Methods. This pilot qualitative study used a thematic analysis approach to explore novice debriefers’ experiences in conducting post-simulation debriefings. Eligible participants engaged in one-hour semi-structured interviews. Recruitment continued until data saturation was reached. We reviewed verbatim interview transcripts, hand-coded the data, and formed codes into themes. Results. Nine novice debriefers participated. The overarching theme “I’m on my own…and they’re on their own,” reflects debriefers’ view that they are on their own, without resources. Debriefers also believe learners should identifying their own errors. Three main themes emerged: “Deep divide between me and the learners” portrays a separation between debriefers and learners in terms of expectations, roles, and responsibilities. “Winging it” depicts debriefers’ making-up their own debriefing approaches. “Debriefing quality: missing pieces of the puzzle” portrays novice debriefers unaware of criteria for effective debriefing. Conclusions. Novice debriefers in this study perceived that they were on their own, having little to no debriefing training and mentorship. Study participants expressed debriefing struggles in several areas including discussing errors, facilitating learner participation, and assessing debriefing quality. Our findings shed light on simulation as a growing specialty by health profession educators and it is critical that resources are devoted to faculty development for debriefing skill acquisition. These findings can serve as a basis for future studies on debriefer skill acquisition.

scholarly journals Cancer in children: the diagnostic itinerary

2007 ◽  
Vol 15 (5) ◽  
pp. 1025-1032 ◽  
Author(s):  
Aline Cristiane Cavicchioli ◽  
Maria José Menossi ◽  
Regina Aparecida Garcia de Lima
Keyword(s):  
Problem Solving ◽  
Health Service ◽  
Qualitative Analysis ◽  
Signs And Symptoms ◽  
Study Data ◽  
Structured Interviews ◽  
Care Services ◽  
Specialized Care ◽  
Cancer In Children ◽  
Chronological Time

This study aims to describe the trajectory children and adolescents experience from the beginning of cancer signs and symptoms until the confirmation of the diagnosis, based on their parents' report. A total of eight mothers and two fathers participated in the study. Data were collected through semi structured interviews, and data were subject to qualitative analysis. We found that this period is significant for parents, who are capable of recognizing that something wrong started to happen to their children, expressed through signs and symptoms. They precisely reported the chronological time of this trajectory. The challenges they mentioned refer to the different diagnostic hypotheses, the difficulty to performing specific diagnostic exams and to be referred to specialized care services. This search for health service care revealed to be a difficult journey, which permits to identify that the Brazilian Basic Health System's principles of accessibility and problem-solving capacity are jeopardized.

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