Interventions to change clinician behaviour in relation to suicide prevention care in the emergency department: A scoping review protocol

2020 ◽  
Author(s):  
Hwayeon Danielle Shin ◽  
Christine Cassidy ◽  
Janet Curran ◽  
Lori Weeks ◽  
Leslie Anne Campbell ◽  
...  
Keyword(s):  
Emergency Department ◽  
Suicide Prevention ◽  
Behaviour Change ◽  
Clinical Care ◽  
Grey Literature ◽  
Allied Health Professionals ◽  
Wide Range ◽  
Knowledge And Attitude ◽  
Clinician Behaviour ◽  
Google Search

Objective: This review aims to explore, characterize, and map the literature on interventions implemented to change emergency department (ED) clinicians’ behaviour related to suicide prevention using the Behaviour Change Wheel (BCW) as a guiding theoretical framework. Introduction: An ED is a critical place for suicide prevention. Yet, many patients who present with suicide-related thoughts and behaviours are discharged without proper assessment or appropriate treatment. Supporting clinicians (who provide direct clinical care, including nurses, physicians, allied health professionals) to make the desired behaviour change following evidence-based suicide prevention care is an essential step toward improving patient outcomes. However, reviews to date have yet to take a theoretical approach to investigate interventions implemented to change clinicians’ behaviour. Inclusion criteria: This review will consider literature that includes interventions that target ED clinicians’ behaviour change related to suicide prevention. Behaviour change refers to observable practice changes as well as proxy measures of behaviour change including knowledge and attitude. There are many ways in which an intervention can change clinicians’ behaviour (e.g., education, altering service delivery). This review will include a wide range of interventions that target behaviour change regardless of the type but exclude interventions that exclusively target patients.Methods: Multiple databases will be searched: PubMed, PsycInfo, CINAHL and Embase. We will also include grey literature, including Google search, ProQuest Dissertations and Theses Global, and Scopus conference papers. Full text of included studies will be reviewed, critically appraised and extracted. Extracted data will be coded to identify intervention functions using the BCW. Findings will be summarized in tables accompanied by narrative reports.

scholarly journals Health assets in a global context: a systematic review of the literature

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e023810 ◽  
Author(s):  
Tine Van Bortel ◽  
Nuwan Darshana Wickramasinghe ◽  
Antony Morgan ◽  
Steven Martin
Keyword(s):  
Systematic Review ◽  
Clinical Care ◽  
Grey Literature ◽  
Theoretical Perspective ◽  
Added Value ◽  
Bibliographic Databases ◽  
Future Research ◽  
Global Context ◽  
Wide Range ◽  
Health Assets

ObjectiveTo provide an up-to-date overview of health assets in a global context both from a theoretical perspective and its practical applications to address health inequalities and achieve sustainable health.DesignA systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesA comprehensive search, including 10 electronic bibliographic databases and hand searches, was undertaken to capture the wide range of terms associated with ‘health assets’ and ‘asset-based approaches to health’.Eligibility criteriaAny peer-reviewed published and grey literature in English related to ‘health assets’ or ‘assets’ in a ‘health’ context was included without any date, country or study design restrictions and the quality of evidence was appraised according to the Oxford Level of Evidence.OutcomesA broad consideration of all outcome measures including clinical outcomes, patient-level, community-level and population-level impacts and costs, was adopted.Results478 publications were included. Health assets were researched in 40 countries, predominantly in the West such as the USA and the UK. A number of broad health assets were identified including community and individual assets. Even though research was conducted in a number of different settings, most occurred in the community, clinical, care or educational settings. A wide variety of interventions and approaches were implemented, most commonly related to education and/or training, asset mapping or asset approaches.ConclusionsGlobally, authors most often referred to general ‘health assets’, ‘assets’ or some form of ‘community asset’ in relation to health. Overall, the idea of health assets is framed within a positive paradigm focusing on health creation rather than curative approaches. The sustained credibility of the global ‘health assets’ literature depends on future research on definitional, theoretical and evaluative issues in order to convince policy-makers and service commissioners of its necessity and added value to the traditional deficit approach.

scholarly journals Comparison of qSOFA and Hospital Early Warning Scores for prognosis in suspected sepsis in emergency department patients: a systematic review

2021 ◽  
pp. emermed-2020-210416
Author(s):  
Lisa Sabir ◽  
Shammi Ramlakhan ◽  
Steve Goodacre
Keyword(s):  
Emergency Department ◽  
Early Warning ◽  
Literature Search ◽  
Grey Literature ◽  
Cochrane Library ◽  
Good Prediction ◽  
Icu Admission ◽  
Prediction Of Mortality ◽  
Wide Range ◽  
Early Warning Scores

BackgroundSepsis is a major cause of morbidity and mortality and many tools exist to facilitate early recognition. This review compares two tools: the quick Sequential Organ Failure Assessment (qSOFA) and Early Warning Scores (National/Modified Early Warning Scores (NEWS/MEWS)) for predicting intensive care unit (ICU) admission and mortality when applied in the emergency department.MethodsA literature search was conducted using Medline, CINAHL, Embase and Cochrane Library, handsearching of references and a grey literature search with no language or date restrictions. Two authors selected studies and quality assessment completed using QUADAS-2. Area under the receiver operating characteristic curve (AUROC), sensitivities and specificities were compared.Results13 studies were included, totalling 403 865 patients. All reported mortality and six reported ICU admission.The ranges for AUROC estimates varied from little better than chance to good prediction of mortality (NEWS: 0.59–0.88; qSOFA: 0.57–0.79; MEWS 0.56–0.75), however, individual papers generally reported higher AUROC values for NEWS than qSOFA. NEWS values demonstrated a tendency towards better sensitivity for ICU admission (NEWS ≥5, 46%-91%; qSOFA ≥2, 12%–53%) and mortality (NEWS ≥5, 51%–97%; qSOFA ≥2, 14%–71%) but lower specificity (ICU: NEWS ≥5, 25%–91%; qSOFA ≥2, 67%–99%; mortality: NEWS ≥5, 22%–91%; qSOFA ≥2, 58%–99%).ConclusionThe wide range of AUROC estimates and high heterogeneity limit our conclusions. Allowing for this, the NEWS AUROC was consistently higher than qSOFA within individual papers. Both scores allow threshold setting, determined by the preferred compromise between sensitivity and specificity. At established thresholds NEWS tended to higher sensitivity while qSOFA tended to a higher specificity.PROSPERO registration numberCRD42019131414.

scholarly journals 356 Comparison of qSOFA, and hospital early warning scores for prognosis in suspected sepsis in emergency department patients: a systematic review

2020 ◽  
Vol 37 (12) ◽  
pp. 843.1-843
Author(s):  
Lisa Sabir ◽  
Shammi Ramlakhan ◽  
Steve Goodacre
Keyword(s):  
Emergency Department ◽  
Early Warning ◽  
Literature Search ◽  
Grey Literature ◽  
Cochrane Library ◽  
Good Prediction ◽  
Suspected Sepsis ◽  
Icu Admission ◽  
Wide Range ◽  
Early Warning Scores

Aims/Objectives/BackgroundSepsis is a major cause of morbidity and mortality and many tools exist to facilitate early recognition. The current international consensus definition of sepsis recommends the use of the quick Sequential Organ Failure Assessment (qSOFA) score in the emergency department (ED) to rapidly identify those who are likely to have poor outcomes. Early Warning Scores (EWS) are used more routinely; if these could provide the same information, they could allow standardisation and streamlining of effort.This review compares two toolsqSOFA and EWS (National/Modified Early Warning Scores (NEWS/MEWS)) for predicting intensive care (ICU) admission and mortality when applied to suspected sepsis patients in the ED.Methods/DesignA literature search was conducted using Medline, CINAHL, Embase, and Cochrane Library, hand searching of references and a grey literature search with no language or date restrictions. Two authors selected studies and quality assessment completed using QUADAS-2. Area under the Receiver Operating Characteristic Curve (AUROC), sensitivities, and specificities were compared.Results/ConclusionsResults12 studies were included, totalling 395,661 patients. All reported mortality and six reported ICU admission.AUROC estimates were variable ranging from little better than chance to good prediction. The ranges demonstrated overlap between scores suggesting little difference for predicting mortality (NEWS: 0.59–0.88; qSOFA: 0.57–0.79; MEWS 0.56–0.75). However, individual papers mostly reported higher AUROC values for NEWS than qSOFA. NEWS demonstrated a trend to better sensitivity for ICU admission (NEWS≥5 0.46–0.91; qSOFA≥2 0.12–0.53) and mortality (NEWS≥5 0.51–0.97; qSOFA≥2 0.14–0.7) but lower specificity (ICU: NEWS≥5 0.25–0.91; qSOFA≥2 0.67–0.99. Mortality: NEWS≥5 0.22–0.91; qSOFA≥2 0.58–0.99).ConclusionThe wide range of AUROC estimates and high heterogeneity limit our conclusions. Allowing for this, the NEWS AUROC was consistently higher than qSOFA within individual papers. Both scores allow threshold setting, determined by the preferred compromise between sensitivity and specificity. At established thresholds NEWS trended to higher sensitivity whilst qSOFA favoured specificity.

scholarly journals Community engagement approaches for malaria prevention, control and elimination: a scoping review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e049812
Author(s):  
Kiran Raj Awasthi ◽  
Jonine Jancey ◽  
Archie C A Clements ◽  
Justine E Leavy
Keyword(s):  
Community Engagement ◽  
Scoping Review ◽  
Grey Literature ◽  
Public Health Intervention ◽  
Malaria Prevention ◽  
Free Text ◽  
Sources Of Information ◽  
Wide Range ◽  
Scoping Reviews ◽  
Google Search

Community engagement (CE) is important for malaria prevention, control and ultimately elimination. As the decline of malaria has plateaued over the last 5 years, strengthening CE approaches will be necessary to enhance health promotion practice and policy to drive malaria transmission down further. Countries have adopted a wide range of public health intervention approaches for malaria prevention and control that best suit their context. This review will examine the existing evidence on the various CE approaches adopted by malaria programmes across the world and their outcomes.Methodology and analysisThe review methodology will follow the updated Joanna Briggs Institute guide for scoping review, 2017, which is based on the framework developed by Arksey and O’Malley and further developed by Levac Colquhoun and O’Brien. Proquest, Web of Knowledge and Medline will be searched for publications from January 2000 to 31 March 2021 while Google search engine will be used to find any grey literature. The eligibility criteria will be as follows: review will include primary studies written in the English language using appropriate study designs and methods, including quantitative, qualitative and mixed methods designs; and case, programme or project reports. Information on CE approaches designed specifically for malaria prevention, control, elimination and their outcomes will be explored. Subheadings and free text terms for ‘community engagement’ and ‘malaria’ will be used for the search. The article screening and data extraction will be examined by two reviewers after the initial search, and any disputes will be resolved by a third reviewer through discussion. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guide will be used to present the review methods and the results from the search. The scoping review results will identify and map the available evidences, sources of information and research gaps in the area of CE as one approach for malaria prevention, control and/or elimination.Ethics and disseminationThis study only aims to review secondary sources and does not require human research ethics committee approval. The findings of the scoping review will be submitted to a peer-reviewed journal for wider dissemination.

Point-of-care troponin testing and management of patients with acute coronary syndrome: a systematic review

2020 ◽  
Vol 15 (2) ◽  
pp. 1-16
Author(s):  
Huiyun Du ◽  
So Ting Chan ◽  
Parichat Wonggom ◽  
Peter Newman ◽  
Rosy Tirimacco ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Acute Coronary Syndrome ◽  
Cardiac Troponin ◽  
Point Of Care ◽  
Clinical Care ◽  
Grey Literature ◽  
Rapid Test ◽  
Point Of Care Testing ◽  
Coronary Syndrome

Background Early identification of acute coronary syndrome is crucial for a patient's likelihood of survival. Point-of-care testing of cardiac troponin is a rapid test of cardiac troponin that can be conducted closer to where clinical care is delivered, with a significant shorter turnaround time. Point-of-care testing of troponin may improve timely diagnosis of acute coronary syndrome. Aim To examine existing evidence on the effectiveness of point-of-care testing of troponin for acute coronary syndrome management in the emergency department. Methods A systematic review of randomised controlled trials was conducted across databases, and grey literature. Results No study evaluated adherence to acute coronary syndrome management guidelines. One of the five studies that assessed length of stay showed a statistically significant reduction (P=0.035). Two of the three studies that measured time to disposition in emergency department demonstrated statistically significant effects (P=0.04 vs P=0.05) favouring point-of-care testing of troponin. One study demonstrated statistically significant effects on successful discharge to home from emergency department (P=0.001). No significant effects were reported for mortality or accuracy. Conclusion Point-of-care testing of troponin can significantly reduce time to disposition in emergency department and successful discharge home. Translation of this evidence into clinical practice is recommended.

scholarly journals Scoping review protocol: bladder cancer in Nigeria: what are the gaps in clinical care and research?

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041894
Author(s):  
Joyce Kibaru ◽  
Pinky Kotecha ◽  
Abdulkarim Muhammad Iya ◽  
Beth Russell ◽  
Muzzammil Abdullahi ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Scoping Review ◽  
Low Income ◽  
Clinical Care ◽  
Grey Literature ◽  
Case Series ◽  
Cochrane Library ◽  
Future Research ◽  
Scoping Reviews ◽  
Local Risk

IntroductionBladder cancer (BC) is the 10th common cancer worldwide and ranks seventh in Nigeria. This scoping review aims to identify the gaps in clinical care and research of BC in Nigeria as part of the development of a larger national research programme aiming to improve outcomes and care of BC.Methods and analysisThis review will be conducted according to Arksey and O’Malley scoping review methodology framework. The following electronic databases will be searched: Medline (using the PubMed interface), Ovid Gateway (Embase and Ovid), Cochrane library and Open Grey literature. Two independent reviewers will screen titles and abstracts and subsequently screen full-text studies for inclusion, any lack of consensus will be discussed with a third reviewer. Any study providing insight into the epidemiology or treatment pathway of BC (RCTs, observations, case series, policy paper) will be included. A data chart will be used to extract relevant data from the included studies. Results will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. A consultation process will be carried out with a multidisciplinary team of Nigerian healthcare professionals, patients and scientists.Ethics and disseminationThe results will be disseminated through peer-reviewed publications. By highlighting the key gaps in the literature, this review can provide direction for future research and clinical guidelines in Nigeria (and other low-income and middle-income countries), where BC is more prevalent due to local risk factors and healthcare settings.

scholarly journals 322. Evaluation of the BioFire® Bone and Joint Infection (BJI) Panel for the Detection of Microorganisms and Antimicrobial Resistance Genes in Synovial Fluid Specimens

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S233-S234
Author(s):  
Corrin Graue ◽  
Bryan H Schmitt ◽  
Amy Waggoner ◽  
Frederic Laurent ◽  
Lelia Abad ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Synovial Fluid ◽  
Resistance Genes ◽  
Clinical Care ◽  
Joint Infection ◽  
High Morbidity ◽  
Bone And Joint Infection ◽  
Microbiological Methods ◽  
Antimicrobial Resistance Genes ◽  
Wide Range

Abstract Background Bone and Joint Infections (BJIs) present with non-specific symptoms that may include pain, swelling, and fever and are associated with high morbidity and significant risk of mortality. BJIs can be caused by a variety of bacteria and fungi, including anaerobes and microorganisms that can be challenging to culture or identify by traditional microbiological methods. Clinicians primarily rely on culture to identify the pathogen(s) responsible for infection. The BioFire® Bone and Joint Infection (BJI) Panel (BioFire Diagnostics, Salt Lake City, UT) is designed to detect 15 gram-positive bacteria (including seven anaerobes), 14 gram-negative bacteria (including one anaerobe), two yeast, and eight antimicrobial resistance (AMR) genes from synovial fluid specimens in about an hour. The objective of this study was to evaluate the performance of an Investigational Use Only (IUO) version of the BioFire BJI Panel compared to various reference methods. Methods Remnant synovial fluid specimens, which were collected for routine clinical care at 13 study sites in the US and Europe, underwent testing using an IUO version of the BioFire BJI Panel. Performance of this test was determined by comparison to Standard of Care (SoC) consisting of bacterial culture performed at each study site according to their routine procedures. Results A total of 1544 synovial fluid specimens were collected and tested with the BioFire BJI Panel. The majority of specimens were from knee joints (77.9%) and arthrocentesis (79.4%) was the most common collection method. Compared to SoC culture, overall sensitivity was 90.2% and specificity was 99.8%. The BioFire BJI Panel yielded a total of 268 Detected results, whereas SoC yielded a total of 215 positive results for on-panel analytes. Conclusion The BioFire BJI Panel is a sensitive, specific, and robust test for rapid detection of a wide range of analytes in synovial fluid specimens. The number of microorganisms and resistance genes included in the BioFire BJI Panel, together with a reduced time-to-result and increased diagnostic yield compared to culture, is expected to aid in the timely diagnosis and appropriate management of BJIs. Disclosures Benjamin von Bredow, PhD, BioFire (Grant/Research Support) Jennifer Dien Bard, PhD, BioFire Diagnostic (Consultant, Scientific Research Study Investigator) Bart Kensinger, PhD, BioFire Diagnostics (Employee) Benedicte Pons, PhD, bioMerieux SA (Employee) Corinne Jay, PhD, bioMerieux SA (Employee)

scholarly journals Changing behaviour, ‘more or less’: do implementation and de-implementation interventions include different behaviour change techniques?

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Andrea M. Patey ◽  
Jeremy M. Grimshaw ◽  
Jill J. Francis
Keyword(s):  
Behaviour Change ◽  
Implicit Theories ◽  
Cochrane Library ◽  
Behaviour Change Techniques ◽  
Behaviour Change Technique ◽  
Exact Test ◽  
Continuity Correction ◽  
Chi Squared ◽  
Clinician Behaviour ◽  
The Cochrane Library

Abstract Background Decreasing ineffective or harmful healthcare practices (de-implementation) may require different approaches than those used to promote uptake of effective practices (implementation). Few psychological theories differentiate between processes involved in decreasing, versus increasing, behaviour. However, it is unknown whether implementation and de-implementation interventions already use different approaches. We used the behaviour change technique (BCT) taxonomy (version 1) (which includes 93 BCTs organised into 12 groupings) to investigate whether implementation and de-implementation interventions for clinician behaviour change use different BCTs. Methods Intervention descriptions in 181 articles from three systematic reviews in the Cochrane Library were coded for (a) implementation versus de-implementation and (b) intervention content (BCTs) using the BCT taxonomy (v1). BCT frequencies were calculated and compared using Pearson’s chi-squared (χ2), Yates’ continuity correction and Fisher’s exact test, where appropriate. Identified BCTs were ranked according to frequency and rankings for de-implementation versus implementation interventions were compared and described. Results Twenty-nine and 25 BCTs were identified in implementation and de-implementation interventions respectively. Feedback on behaviour was identified more frequently in implementation than de-implementation (Χ2(2, n=178) = 15.693, p = .000057). Three BCTs were identified more frequently in de-implementation than implementation: Behaviour substitution (Χ2(2, n=178) = 14.561, p = .0001; Yates’ continuity correction); Monitoring of behaviour by others without feedback (Χ2(2, n=178) = 16.187, p = .000057; Yates’ continuity correction); and Restructuring social environment (p = .000273; Fisher’s 2-sided exact test). Conclusions There were some significant differences between BCTs reported in implementation and de-implementation interventions suggesting that researchers may have implicit theories about different BCTs required for de-implementation and implementation. These findings do not imply that the BCTs identified as targeting implementation or de-implementation are effective, rather simply that they were more frequently used. These findings require replication for a wider range of clinical behaviours. The continued accumulation of additional knowledge and evidence into whether implementation and de-implementation is different will serve to better inform researchers and, subsequently, improve methods for intervention design.

Adherence to guideline creation recommendations for suicide prevention in the emergency department: A systematic review

2021 ◽  
Author(s):  
Michael P. Wilson ◽  
Jaskiran Kaur ◽  
Lindsay Blake ◽  
Alison H. Oliveto ◽  
Ronald G. Thompson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Suicide Prevention
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