scholarly journals The Effect of Simulation-Based Neonatal Emergency Team Training on Clinical Performance and Patient Outcome: A Systematic Review

2020 ◽  
Author(s):  
Morten S. Lindhard ◽  
Signe Thim ◽  
Henrik Sehested Laursen ◽  
Anders Wester Schram ◽  
Charlotte Paltved ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Systematic Review ◽  
Neonatal Mortality ◽  
Team Performance ◽  
Simulation Training ◽  
Clinical Performance ◽  
Team Training ◽  
Developed Countries ◽  
Risk Of Bias ◽  
Simulation Based

Abstract BackgroundA number of neonatal simulation-training programmes have been deployed during the last decade, and a growing number of studies have investigated effects of simulation-based team training. However, the body of evidence remains to be compiled. Therefore, we performed a systematic review on the effects of simulation-based team training on clinical performance and patient outcome.MethodsThe review was conducted according to the preferred reporting items for systematic review and meta-analysis (PRISMA). We included studies on team training in emergency neonatal settings with reported outcome on clinical performance and patient outcome. Two reviewers independently selected articles and assessed risk-of-bias using the Cochrane risk-of-bias tool 2.0 and the Newcastle-Ottawa quality assessment scale. Kirkpatricks’ model for evaluation of training programs provided the framework for a narrative synthesis.ResultsWe screened 1,434 titles and abstracts, evaluated 173 full-texts for eligibility, and included 24 studies. We identified only two studies with neonatal mortality outcome, and they had significant methodological limitations, and no conclusion could be reached regarding effects of simulation training in developed countries. Considering clinical performance, randomized studies showed improved team performance in simulated re-evaluations 3 and 6 months after the intervention.ConclusionsSimulation-based team training in neonatal resuscitation improves team performance and technical performance in simulation-based evaluations 3 to 6 months later. The current evidence was insufficient to conclude on neonatal mortality after simulation-based team training, since no studies were available from developed countries. Future research should include patient outcomes or clinical proxies of treatment quality whenever possible.

scholarly journals Mycoplasma genitalium incidence, persistence, concordance between partners and progression: systematic review and meta-analysis

2019 ◽  
Vol 95 (5) ◽  
pp. 328-335 ◽  
Author(s):  
Manuel Cina ◽  
Lukas Baumann ◽  
Dianne Egli-Gany ◽  
Florian S Halbeisen ◽  
Hammad Ali ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antimicrobial Resistance ◽  
Meta Analysis ◽  
Age Distribution ◽  
Mycoplasma Genitalium ◽  
Developed Countries ◽  
Sexual Partners ◽  
Risk Of Bias ◽  
Infection Status ◽  
Sexually Transmitted

BackgroundMycoplasma genitalium is increasingly seen as an emerging sexually transmitted pathogen, and has been likened to Chlamydia trachomatis, but its natural history is poorly understood. The objectives of this systematic review were to determine M. genitalium incidence, persistence, concordance between sexual partners and the risk of pelvic inflammatory disease (PID).MethodsWe searched Medline, EMBASE, LILACS, IndMed and African Index Medicus from 1 January 1981 until 17 March 2018. Two independent researchers screened studies for inclusion and extracted data. We examined results in forest plots, assessed heterogeneity and conducted meta-analysis where appropriate. Risk of bias was assessed for all studies.ResultsWe screened 4634 records and included 18 studies; six (4201 women) reported on incidence, five (636 women) on persistence, 10 (1346 women and men) on concordance and three (5139 women) on PID. Incidence in women in two very highly developed countries was 1.07 per 100 person-years (95% CI 0.61 to 1.53, I2 0%). Median persistence of M. genitalium was estimated from one to three months in four studies but 15 months in one study. In 10 studies measuring M. genitalium infection status in couples, 39%–50% of male or female sexual partners of infected participants also had M. genitalium detected. In prospective studies, PID incidence was higher in women with M. genitalium than those without (risk ratio 1.73, 95% CI 0.92 to 3.28, I2 0%, two studies).DiscussionIncidence of M. genitalium in very highly developed countries is similar to that for C. trachomatis, but concordance might be lower. Taken together with other evidence about age distribution and antimicrobial resistance in the two infections, M. genitalium is not the new chlamydia. Synthesised data about prevalence, incidence and persistence of M. genitalium infection are inconsistent. These findings can be used for mathematical modelling to investigate the dynamics of M. genitalium.Registration numbersCRD42015020420, CRD42015020405

Abstract 15595: Improved Clinical Performance and Teamwork of Pediatric Interprofessional Resuscitation Teams With a Simulation-Based Educational Intervention

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Elaine Gilfoyle ◽  
Deanna Koot ◽  
John Annear ◽  
Farhan Bhanji ◽  
Adam Cheng ◽  
...  
Keyword(s):  
Educational Intervention ◽  
Strong Correlation ◽  
Clinical Performance ◽  
Team Training ◽  
Chest Compressions ◽  
Team Members ◽  
Pediatric Resuscitation ◽  
Time To Initiation ◽  
Simulation Based ◽  
Resuscitation Team

Introduction: Human errors occur during resuscitation despite individual knowledge of resuscitation guidelines. Poor teamwork has been implicated as a major source of such error; therefore interprofessional resuscitation teamwork training is essential. Hypothesis: A one-day team training course for pediatric interprofessional resuscitation team members improves adherence to PALS guidelines, team efficiency and teamwork in a simulated clinical environment. Methods: A prospective interventional study was conducted at 4 children’s hospitals in Canada with pediatric resuscitation team members (n=300, 51 teams). Educational intervention was a one-day simulation-based team training course involving interactive lecture, group discussions and 4 simulated resuscitation scenarios followed by debriefing. First scenario of the day was conducted prior to any training. Final scenario of the day was the same scenario, with modified patient history. Scenarios included standardized distractors designed to elicit and challenge specific teamwork behaviors. Primary outcome measure was change (before and after training) in adherence to PALS guidelines, as measured by the Clinical Performance Tool (CPT). Secondary outcome measures: change in times to initiation of chest compressions and defibrillation; and teamwork performance, as measured by the Clinical Teamwork Scale (CTS). Correlation between CPT and CTS scores was analyzed. Results: Teams significantly improved CPT scores (67.3% to 79.6%, P< 0.0001), time to initiation of chest compressions (60.8 sec to 27.1 sec, P<0.0001), time to defibrillation (164.8 sec to 122.0 sec, P<0.0001) and CTS scores (56.0% to 71.8%, P<0.0001). Significantly more teams defibrillated under AHA target of 2 minutes (10 vs. 27, P<0.01). A strong correlation was found between CPT and CTS (r=0.530, P<0.0001). Conclusions: Participation in a simulation-based team training educational intervention significantly improved surrogate measures of clinical performance, time to initiation of key clinical tasks, and teamwork during simulated pediatric resuscitation. A strong correlation between clinical and teamwork performance suggests that effective teamwork optimizes clinical performance of resuscitation teams.

PP39 What is the risk of major trauma following a fall down stairs? – A systematic review

2021 ◽  
Vol 38 (9) ◽  
pp. A16.2-A16
Author(s):  
Christopher Holt ◽  
Samuel Keating ◽  
Michael Tonkins ◽  
Daniel Bradbury ◽  
Gordon Fuller
Keyword(s):  
Systematic Review ◽  
Major Trauma ◽  
Alcohol Intoxication ◽  
Grey Literature ◽  
Developed Countries ◽  
Risk Of Bias ◽  
Qualitative Synthesis ◽  
Increased Risk ◽  
Study Heterogeneity ◽  
Serious Injury

BackgroundSpecific mechanisms of injury are stated in pre-hospital triage tools to identify suspected cases of major trauma. Falls down stairs are common presentations in UK emergency departments, yet are frequently overlooked as a causative mechanism of major trauma. No prior systematic review has examined this association.MethodsSeven internationally recognised literature databases and seven grey literature databases were screened utilising a common search strategy from inception until 31 December 2019. Abstracts were screened for relevance by a single reviewer. Full texts were screened and subsequently extracted by 3 separate reviewers against strict inclusion/exclusion criteria. A risk of bias assessment based on GRADE recommendations was performed. In the absence of study heterogeneity, a narrative synthesis was planned. The reporting of this systematic review followed PRISMA 2009 statement guidelines.Results5240 articles were identified from database searching, 89 articles had their full texts assessed for eligibility and 6 articles were included for qualitative synthesis. All studies were retrospective in nature and originated from more economically developed countries. 7431 patients who fell down stairs were analysed, of which, 707 (9.5%) met major trauma definitions. Falls down stairs resulted in a significantly increased risk of serious injury compared to other fall mechanisms (OR: 1.621, 95% CI: 1.381 – 1.902, p<0.0005). Analysis of confounding factors demonstrated age (OR: 2.59, 95% CI: 1.57 – 4.28, p<0.001) and alcohol intoxication (OR: 2.6, 95% CI: 1.4 – 4.7, p=0.001) to be significantly associated with major trauma. Risk of bias was moderate to high across all 6 studies.ConclusionThis systematic review highlighted the paucity of literature surrounding the incidence of major trauma following falls down stairs.A retrospective cohort study is currently being undertaken to analyse the risk of major trauma following falls down stairs. On completion, the results will be incorporated with the results of this systematic review.

scholarly journals Can simulators be applied to improve cataract surgery training: a systematic review

2020 ◽  
Vol 5 (1) ◽  
pp. e000488
Author(s):  
Taha Muneer Ahmed ◽  
Badrul Hussain ◽  
M A Rehman Siddiqui
Keyword(s):  
Systematic Review ◽  
Cataract Surgery ◽  
Simulation Training ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Training Tool ◽  
Surgery Training ◽  
Simulation Based ◽  
Effective Training

ObjectiveThe purpose of this paper was to conduct a systematic review of existing literature on simulation-based training of cataract surgery. Available literature was evaluated and projections on how current findings could be applied to cataract surgery training were summarised. The quality of included literature was also assessed.Methods and analysisThe PubMed, Embase and Cochrane Library databases were searched for articles pertaining to simulation training in cataract surgery on 18 November 2019. Selected articles were qualitatively analysed.ResultsA total of 165 articles were identified out of which 10 met inclusion criteria. Four studies reported construct validity of the EyeSi simulator. Six studies demonstrated improved surgical outcomes corresponding to training on the simulator. Quality assessment of included studies was satisfactory.ConclusionCurrent studies on simulation training in cataract surgery all point towards it being an effective training tool with low risk of study biases confounding this conclusion. As technology improves, surgical training must embrace and incorporate simulation technology in training.

Effect of simulation‐based team training in airway management: a systematic review

Anaesthesia ◽  
2021 ◽  
Author(s):  
R. P. Nielsen ◽  
L. Nikolajsen ◽  
C. Paltved ◽  
R. Aagaard
Keyword(s):  
Systematic Review ◽  
Airway Management ◽  
Team Training ◽  
Simulation Based

scholarly journals Clinical Performance of CAD/CAM All-Ceramic Tooth-Supported Fixed Dental Prostheses: A Systematic Review and Meta-Analysis

Materials ◽  
2021 ◽  
Vol 14 (10) ◽  
pp. 2672
Author(s):  
Babak Saravi ◽  
Andreas Vollmer ◽  
Maja Hartmann ◽  
Gernot Lang ◽  
Ralf-Joachim Kohal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Prospective Studies ◽  
Clinical Performance ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Success Rates ◽  
Dental Prostheses ◽  
Cad Cam ◽  
Fixed Dental Prostheses

Although CAD/CAM ceramics present a promising alternative to metal-ceramic fixed dental prostheses, little is known about their mid- and long-term clinical performance. This systematic review aims to estimate the survival and success rates and describes the underlying complication characteristics for CAD/CAM tooth-supported zirconia- and lithium disilicate-based fixed dental prostheses (FDPs). We systematically searched MEDLINE and Web of Science to find relevant prospective studies with a follow-up of at least one year. We estimated pooled 1-, 5-, and 10-year survival and success rates by combining the collected data in a Poisson regression model. Descriptive statistics were conducted to evaluate the distribution of failures and complications in the included studies. Risk of bias for the included studies was assessed with an adapted checklist for single-arm trials. Pooled estimated 1-, 5-, and 10-year survival rates ranged from 93.80% to 94.66%, 89.67% to 91.1%, and 79.33% to 82.20%, respectively. The corresponding success rates excluding failures, but including any other types of intervention were 94.53% to 96.77%, 90.89% to 94.62%, and 81.78% to 89.25%. Secondary caries was the most frequent cause of failure, followed by chipping of the veneering. The most common cause of complication excluding failures but requiring intervention was chipping of the veneering. Risk of bias was generally acceptable for the included studies, with seven studies associated with low risk of bias, eight studies with a moderate risk of bias, and three studies with serious risk of bias. The current meta-analysis on CAD/CAM-supported FDPs revealed satisfying survival and success rates for up to 10 years of exposure. More prospective studies focusing on long-term performance are needed to strengthen the evidence currently available in the literature.

Simulation-Based Neonatal Resuscitation Team Training: A Systematic Review

PEDIATRICS ◽  
2021 ◽  
pp. e2020042010
Author(s):  
Morten Søndergaard Lindhard ◽  
Signe Thim ◽  
Henrik Sehested Laursen ◽  
Anders Wester Schram ◽  
Charlotte Paltved ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neonatal Resuscitation ◽  
Team Training ◽  
Simulation Based ◽  
Resuscitation Team

Simulation-based Team Training for Multiprofessional Obstetric Care Teams to Improve Patient Outcome

2017 ◽  
Vol 37 (4) ◽  
pp. 199-200
Author(s):  
A.F. Fransen ◽  
J. van de Ven ◽  
E. Schuit ◽  
A.A.C. van Tetering ◽  
B.W. Mol ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Obstetric Care ◽  
Team Training ◽  
Improve Patient Outcome ◽  
Simulation Based ◽  
Improve Patient
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