scholarly journals Teleconsultation Using Mobile Phones for Diagnosis and Acute Care of Burn Injuries Among Emergency Physicians: Mixed-Methods Study (Preprint)

2018 ◽  
Author(s):  
Anders Klingberg ◽  
Lee Alan Wallis ◽  
Marie Hasselberg ◽  
Po-Yin Yen ◽  
Sara Caroline Fritzell
Keyword(s):  
Mixed Methods ◽  
Mobile Phone ◽  
Acute Care ◽  
Clinical Findings ◽  
Ease Of Use ◽  
Burn Injuries ◽  
Referral Process ◽  
Think Aloud ◽  
Burn Care ◽  
Medical Referrals

BACKGROUND The referral process in acute care remains challenging in many areas including burn care. Mobile phone apps designed explicitly for medical referrals and consultations could streamline the referral process by using structured templates and integrating features specific to different specialties. However, as these apps are competing with commercial chat services, usability becomes a crucial factor for successful uptake. OBJECTIVE The aim of this study was to assess the usability of a mobile phone app for remote consultations and referrals of burn injuries. METHODS A total of 24 emergency doctors and 4 burns consultants were recruited for the study. A mixed-methods approach was used including a usability questionnaire and a think-aloud interview. Think-aloud sessions were video-recorded, and content analysis was undertaken with predefined codes relating to the following 3 themes: ease of use, usefulness of content, and technology-induced errors. RESULTS The users perceived the app to be easy to use and useful, but some problems were identified. Issues relating to usability were associated with navigation, such as scrolling and zooming. Users also had problems in understanding the meaning of some icons and terminologies. Sometimes, some users felt limited by predefined options, and they wanted to be able to freely express their clinical findings. CONCLUSIONS We found that users faced problems mainly with navigation when the app did not work in the same way as the other apps that were frequently used. Our study also resonates with previous findings that when using standardized templates, the systems should also allow the user to express their clinical findings in their own words.

556 The Use of a Concentrated Surfactant Based Gel to Promote Burn Wound Healing

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S126-S127
Author(s):  
Rebecca Coffey ◽  
Rachel Penny
Keyword(s):  
Wound Healing ◽  
New Product ◽  
Ease Of Use ◽  
Burn Injuries ◽  
Full Thickness ◽  
Burn Wound ◽  
Burn Wounds ◽  
Burn Care ◽  
Product Trial ◽  
Burn Wound Healing

Abstract Introduction Strategies to remove necrotic tissue from burn wounds include excisional and non-excisional debridement. Alternative treatments could promote burn wound healing while minimizing patient discomfort and the need for surgery. We evaluated the usage of a concentrated surfactant gel (CSG) to promote burn wound healing in those with indeterminate depth and full thickness burn injuries. Methods An IRB approved retrospective study was conducted during a 10-patient new product trial period with enrollment between September and October 2019. Patients included in this study had indeterminate or full thickness burn wounds and were treated with a concentrated surfactant-based gel. Patients with non-burn diagnoses were excluded. Data collected included demographic information, injury descriptors, and additional burn wound characteristics. Results A total of 10 patients were included in this study as part of a new product trial. The subjects were 80% male with an average TBSA of 7.5%. 40% had indeterminate and 60% had full thickness burn wounds. Prior to initiation of the CSG, the burn wounds had been open for an average of 41 days. There were no infections or complications with usage of the CSG. 90% of patients reported less pain than the standard of care topical agents for burns. Average duration of treatment with the CSG until healing was 28 days. After usage of the CSG, no patients required surgery. Conclusions Our findings support the usage of a concentrated surfactant-based gel in patients with burn wounds. Patients reported decreased pain during dressing changes and ease of use compared to the standard topical agent in burn care. It also prevented surgical debridement in those with indeterminate and full thickness burn injuries.

scholarly journals Teleconsultation Using Mobile Phones for Diagnosis and Acute Care of Burn Injuries Among Emergency Physicians: Mixed-Methods Study

10.2196/11076 ◽  
2018 ◽  
Vol 6 (10) ◽  
pp. e11076 ◽  
Author(s):  
Anders Klingberg ◽  
Lee Alan Wallis ◽  
Marie Hasselberg ◽  
Po-Yin Yen ◽  
Sara Caroline Fritzell
Keyword(s):  
Mixed Methods ◽  
Acute Care ◽  
Mobile Phones ◽  
Mixed Methods Study ◽  
Burn Injuries ◽  
Emergency Physicians

scholarly journals Patient Adherence to a Mobile Phone–Based Heart Failure Telemonitoring Program: A Longitudinal Mixed-Methods Study (Preprint)

2018 ◽  
Author(s):  
Patrick Ware ◽  
Mala Dorai ◽  
Heather J Ross ◽  
Joseph A Cafazzo ◽  
Audrey Laporte ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mixed Methods ◽  
Mobile Phone ◽  
Disease Severity ◽  
Patient Adherence ◽  
Age Groups ◽  
Ease Of Use ◽  
Peace Of Mind ◽  
Program Enrollment ◽  
Over Time

BACKGROUND Telemonitoring (TM) can improve heart failure (HF) outcomes by facilitating patient self-care and clinical decision support. However, these outcomes are only possible if patients consistently adhere to taking prescribed home readings. OBJECTIVE The objectives of this study were to (1) quantify the degree to which patients adhered to taking prescribed home readings in the context of a mobile phone–based TM program and (2) explain longitudinal adherence rates based on the duration of program enrollment, patient characteristics, and patient perceptions of the TM program. METHODS A mixed-methods explanatory sequential design was used to meet the 2 research objectives, and all explanatory methods were guided by the unified theory of acceptance and use of technology 2 (UTAUT2). Overall adherence rates were calculated as the proportion of days patients took weight, blood pressure, heart rate, and symptom readings over the total number of days they were enrolled in the program up to 1 year. Monthly adherence rates were also calculated as the proportion of days patients took the same 4 readings over each 30-day period following program enrollment. Next, simple and multivariate regressions were performed to determine the influence of time, age, sex, and disease severity on adherence rates. Additional explanatory methods included questionnaires at 6 and 12 months probing patients on the perceived benefits and ease of use of the TM program, an analysis of reasons for patients leaving the program, and semistructured interviews conducted with a purposeful sampling of patients (n=24) with a range of adherence rates and demographics. RESULTS Overall average adherence was 73.6% (SD 25.0) with average adherence rates declining over time at a rate of 1.4% per month (P<.001). The multivariate regressions found no significant effect of sex and disease severity on adherence rates. When grouping patients’ ages by decade, age was a significant predictor (P=.04) whereby older patients had higher adherence rates over time. Adherence rates were further explained by patients’ perceptions with regard to the themes of (1) performance expectancy (improvements in HF management and peace of mind), (2) effort expectancy (ease of use and technical issues), (3) facilitating conditions (availability of technical support and automated adherence calls), (4) social influence (support from family, friends, and trusted clinicians), and (5) habit (degree to which taking readings became automatic). CONCLUSIONS The decline in adherence rates over time is consistent with findings from other studies. However, this study also found adherence to be the highest and most consistent over time in older age groups and progressively lower over time for younger age groups. These findings can inform the design and implementation of TM interventions that maximize patient adherence, which will enable a more accurate evaluation of impact and optimization of resources.

scholarly journals Dementia Caregiver Satisfaction and Utilization of a Telehealth App: Results From the FamTechCare Trial

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 149-149
Author(s):  
Kristine Williams ◽  
Clarissa Shaw ◽  
Yelena Perkhounkova ◽  
Maria Hein ◽  
Carissa Coleman
Keyword(s):  
Mixed Methods ◽  
Support Groups ◽  
Expert Panel ◽  
Video Recording ◽  
Ease Of Use ◽  
Attention Control ◽  
Caregiver Satisfaction ◽  
Dementia Caregiver ◽  
Severity Of Dementia ◽  
Person With Dementia

Abstract Technology can enhance support for families caring for persons with dementia but must be acceptable to be adopted. In the FamTechCare trial, caregivers used an app to videorecord care encounters that were reviewed by an expert panel who provided tailored feedback. The intervention reduced caregiver depression and improved caregiver competence. This mixed methods study reports caregiver satisfaction and utilization of the intervention and evaluation of the intervention by the expert panel. A convergent parallel mixed methods design was used to evaluate the satisfaction, usability, and feasibility of the intervention. Caregiver-person with dementia dyads were randomized to the FamTechCare video support or telephone attention control support groups. Caregivers completed a satisfaction survey at the completion of the 3-month trial. The number and duration of videos submitted and calls received by caregivers were used to evaluate utilization. Relationships between participant characteristics and satisfaction and utilization were evaluated. Feasibility and future directions for the intervention were assessed through interviews with the expert panel. The majority of caregivers in both groups reported benefits from participation. More FamTechCare caregivers found the interventionist support to be helpful (p=.001) and effective (p=.020) compared to attention control caregivers. FamTechCare caregivers of persons with more severe dementia were more likely to report that video recording intruded on their privacy (p=.050). Age, gender, education, dyad relationship, rural status, and type and severity of dementia were not associated with ratings of acceptability, ease of use, or intervention utilization. The expert panel rated FamTechCare as useful and identified adaptations to enhance feasibility.

82 The Significant Burden of Burn Injuries in the Middle East: An Epidemiological Study of Nineteen Countries over 27 Years

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S56-S57
Author(s):  
Zachary J Collier ◽  
Yasmina Samaha ◽  
Priyanka Naidu ◽  
Katherine J Choi ◽  
Christopher H Pham ◽  
...  
Keyword(s):  
Middle East ◽  
Age Groups ◽  
Mortality Rates ◽  
Burn Injuries ◽  
Burn Care ◽  
Life Years ◽  
Significant Burden ◽  
Mortality Ratio ◽  
Incident Cases ◽  
Age And Sex

Abstract Introduction Despite ongoing improvements in burn care around the world, the burden of burn morbidity and mortality has remined a significant challenge in the Middle East due to ongoing conflicts, economic crises, social disparities, and dangerous living conditions. Here, we examine the epidemiology of burn injuries in the Middle East (ME) relative to socio-demographic index (SDI), age, and sex in order to better define regional hotspots that may benefit most from sustainability and capacity building initiatives. Methods Computational modeling from the 2017 Global Burden of Disease (GBD17) database was used to extrapolate burn data about the nineteen countries that define the ME. Using the GBD17, the yearly incidence, deaths, and Disability-Adjusted Life Years (DALYs) from 1990 to 2017 were defined with respect to age and sex as rates of cases, deaths, and years per 100,000 persons, respectively. Mortality ratio represents the percentage of deaths relative to incident cases. Data from 2017 was spatially mapped using heat-mapping for the region. Results Over 27 years in the ME, an estimated 18,289,496 burns and 308,361 deaths occurred causing 24.5 million DALYs. Burn incidence decreased by 5% globally but only 1% in the ME. Although global incidence continued to decline, most ME countries exhibit steady increases since 2004. Compared to global averages, higher mortality rates (2.8% vs 2.0%) and DALYs (205 vs 152 years) were observed in the Middle East during this time although the respective disparities narrowed by 95% and 42% by 2017. Yemen had the worst death and DALY rates all 27 years with 2 and 2.2 times the ME average, respectively. Sudan had the highest morality ratio (3.7%) for most of the study, twice the ME average (1.8%), followed by Yemen at 3.6%. Sex-specific incidence, deaths, and DALYs in the ME were higher compared to the global cohorts. ME women had the worst rates in all categories. With respect to age, all rates were worse in the ME age groups except in those under 5 years. Conclusions For almost three decades, ME burn incidence, deaths, DALYs, and mortality rates were consistently worse than global average. Despite the already significant differences for burn frequency and severity, especially in women and children, underreporting from countries who lack sufficient registry capabilities likely means that the rates are even worse than predicted.

Self-Care for Nurse Leaders in Acute Care Environment Reduces Perceived Stress: A Mixed-Methods Pilot Study Merits Further Investigation

2017 ◽  
Vol 36 (1) ◽  
pp. 79-90 ◽  
Author(s):  
Susan Mac Leod Dyess ◽  
Angela S. Prestia ◽  
Doren-Elyse Marquit ◽  
David Newman
Keyword(s):  
Mixed Methods ◽  
Acute Care ◽  
Perceived Stress ◽  
Repeated Measures ◽  
Self Care ◽  
Nurse Leaders ◽  
Future Research ◽  
Care Practice ◽  
Meditation Practice ◽  
Significant Drop

Acute care practice settings are stressful. Nurse leaders face stressful demands of numerous competing priorities. Some nurse leaders experience unmanageable stress, but success requires self-care. This article presents a repeated measures intervention design study using mixed methods to investigate a self-care simple meditation practice for nurse leaders. Themes and subthemes emerged in association with the three data collection points: at baseline (pretest), after 6 weeks, and after 12 weeks (posttest) from introduction of the self-care simple meditation practice. An analysis of variance yielded a statistically significant drop in perceived stress at 6 weeks and again at 12 weeks. Conducting future research is merited.

scholarly journals Technology Acceptance of a Machine Learning Algorithm Predicting Delirium in a Clinical Setting: a Mixed-Methods Study

2021 ◽  
Vol 45 (4) ◽  
Author(s):  
Stefanie Jauk ◽  
Diether Kramer ◽  
Alexander Avian ◽  
Andrea Berghold ◽  
Werner Leodolter ◽  
...  
Keyword(s):  
Machine Learning ◽  
Mixed Methods ◽  
Technology Acceptance ◽  
Health Care Professionals ◽  
User Acceptance ◽  
Ease Of Use ◽  
Perceived Usefulness ◽  
Actual System ◽  
System Use ◽  
Delirium Management

AbstractEarly identification of patients with life-threatening risks such as delirium is crucial in order to initiate preventive actions as quickly as possible. Despite intense research on machine learning for the prediction of clinical outcomes, the acceptance of the integration of such complex models in clinical routine remains unclear. The aim of this study was to evaluate user acceptance of an already implemented machine learning-based application predicting the risk of delirium for in-patients. We applied a mixed methods design to collect opinions and concerns from health care professionals including physicians and nurses who regularly used the application. The evaluation was framed by the Technology Acceptance Model assessing perceived ease of use, perceived usefulness, actual system use and output quality of the application. Questionnaire results from 47 nurses and physicians as well as qualitative results of four expert group meetings rated the overall usefulness of the delirium prediction positively. For healthcare professionals, the visualization and presented information was understandable, the application was easy to use and the additional information for delirium management was appreciated. The application did not increase their workload, but the actual system use was still low during the pilot study. Our study provides insights into the user acceptance of a machine learning-based application supporting delirium management in hospitals. In order to improve quality and safety in healthcare, computerized decision support should predict actionable events and be highly accepted by users.

41 Enhancing Burn Medical Care During a Disaster Using a Novel Augmented-Reality Application

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S31-S31
Author(s):  
Sena Veazey ◽  
Maria SerioMelvin ◽  
David E Luellen ◽  
Angela Samosorn ◽  
Alexandria Helms ◽  
...  
Keyword(s):  
Decision Support ◽  
Augmented Reality ◽  
Clinical Decision Support ◽  
Decision Support Tool ◽  
Clinical Decision ◽  
Burn Injuries ◽  
Medical Decision ◽  
Support Tool ◽  
Burn Care ◽  
Clinical Decision Support Tool

Abstract Introduction In disaster or mass casualty situations, access to remote burn care experts, communication, or resources may be limited. Furthermore, burn injuries are complex and require substantial training and knowledge beyond basic clinical care. Development and use of decision support (DS) technologies may provide a solution for addressing this need. Devices capable of delivering burn management recommendations can enhance the provider’s ability to make decisions and perform interventions in complex care settings. When coupled with merging augmented reality (AR) technologies these tools may provide additional capabilities to enhance medical decision-making, visualization, and workflow when managing burns. For this project, we developed a novel AR-based application with enhanced integrated clinical practice guidelines (CPGs) to manage large burn injuries for use in different environments, such as disasters. Methods We identified an AR system that met our requirements to include portability, infrared camera, gesture and voice control, hands-free control, head-mounted display, and customized application development abilities. Our goal was to adapt burn CPGs to make use of AR concepts as part of an AR-enabled burn clinical decision support system supporting four sub-applications to assist users with specific interventional tasks relevant to burn care. We integrated relevant CPGs and a media library with photos and videos as additional references. Results We successfully developed a clinical decision support tool that integrates burn CPGs with enhanced capabilities utilizing AR technology. The main interface allows input of patient demographics and injuries with step-by-step guidelines that follow typical burn management care and workflow. There are four sub-applications to assist with these tasks, which include: 1) semi-automated burn wound mapping to calculate total body surface area; 2) hourly burn fluid titration and recommendations for resuscitation; 3) medication calculator for accurate dosing in preparation for procedures and 4) escharotomy instructor with holographic overlays. Conclusions We developed a novel AR-based clinical decision support tool for management of burn injuries. Development included adaptation of CPGs into a format to guide the user through burn management using AR concepts. The application will be tested in a prospective research study to determine the effectiveness, timeliness, and performance of subjects using this AR-software compared to standard of care. We fully expect that the tool will reduce cognitive workload and errors, ensuring safety and proper adherence to guidelines.

scholarly journals Pilot Evaluations of Two Bluetooth Contact Tracing Approaches on a University Campus: Mixed Methods Study (Preprint)

2021 ◽  
Author(s):  
Tyler Shelby ◽  
Tyler Caruthers ◽  
Oren Y Kanner ◽  
Rebecca Schneider ◽  
Dana Lipnickas ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Mobile Phone ◽  
Sensitivity And Specificity ◽  
Mobile App ◽  
Mixed Methods Study ◽  
Self Report ◽  
Contact Tracing ◽  
Free Text ◽  
Contact Interactions ◽  
University Campus

BACKGROUND Many have proposed the use of Bluetooth technology to help scale up contact tracing for COVID-19. However, much remains unknown about the accuracy of this technology in real-world settings, the attitudes of potential users, and the differences between delivery formats (mobile app vs carriable or wearable devices). OBJECTIVE We pilot tested 2 separate Bluetooth contact tracing technologies on a university campus to evaluate their sensitivity and specificity, and to learn from the experiences of the participants. METHODS We used a convergent mixed methods study design, and participants included graduate students and researchers working on a university campus during June and July 2020. We conducted separate 2-week pilot studies for each Bluetooth technology. The first was for a mobile phone app (“app pilot”), and the second was for a small electronic “tag” (“tag pilot”). Participants validated a list of Bluetooth-identified contacts daily and reported additional close contacts not identified by Bluetooth. We used these data to estimate sensitivity and specificity. Participants completed a postparticipation survey regarding appropriateness, usability, acceptability, and adherence, and provided additional feedback via free text. We used tests of proportions to evaluate differences in survey responses between participants from each pilot, paired <i>t</i> tests to measure differences between compatible survey questions, and qualitative analysis to evaluate the survey’s free-text responses. RESULTS Among 25 participants in the app pilot, 53 contact interactions were identified by Bluetooth and an additional 61 by self-report. Among 17 participants in the tag pilot, 171 contact interactions were identified by Bluetooth and an additional 4 by self-report. The tag had significantly higher sensitivity compared with the app (46/49, 94% vs 35/61, 57%; <i>P</i>&lt;.001), as well as higher specificity (120/126, 95% vs 123/141, 87%; <i>P</i>=.02). Most participants felt that Bluetooth contact tracing was appropriate on campus (26/32, 81%), while significantly fewer participants felt that using other technologies, such as GPS or Wi-Fi, was appropriate (17/31, 55%; <i>P</i>=.02). Most participants preferred technology developed and managed by the university rather than a third party (27/32, 84%) and preferred not to have tracing apps on their personal phones (21/32, 66%), due to “concerns with privacy.” There were no significant differences in self-reported adherence rates across pilots. CONCLUSIONS Convenient and carriable Bluetooth technology may improve tracing efficiency while alleviating privacy concerns by shifting data collection away from personal devices. With accuracy comparable to, and in this case, superior to, mobile phone apps, such approaches may be suitable for workplace or school settings with the ability to purchase and maintain physical devices.

Sign in / Sign up

Export Citation Format

Share Document