scholarly journals Shift Work Disorder - Prevalence & Burden of Illness in Healthcare Providers of India

2019 ◽  
Vol 4 (6) ◽  
Keyword(s):  
Job Satisfaction ◽  
Emergency Medicine ◽  
Random Sample ◽  
Shift Work ◽  
Emergency Departments ◽  
Burden Of Illness ◽  
Sleep Hygiene ◽  
Emergency Physicians ◽  
Convenience Sample ◽  
Shift Work Disorder

Background: The proportion of shift workers in the society has taken a big leap in the last 2 decades or so. Thus, the epidemiological significance of shift work disorder (SWD) can no longer be ignored. Emergency Physicians & nurses almost always work in shifts and are an important subset of the population whose health and wellbeing directly and indirectly impacts the morbidity and mortality of the rest of the population. It is thus important to understand the magnitude of the problem in this population. Several studies describe a high incidence of SWD and psychosomatic complaints in EP. The main objective of this study is to examine the prevalence of symptoms of SWD; contribution of demographics, working hours, shift work, morningness/eveningness & sleep hygiene practices to occurrence of SWD, related health & occupational hazards and job satisfaction in a random sample of Emergency Physicians & nurses of India. Methods: A cross sectional survey of nurses and doctors working in emergency departments of at least 12 major urban hospitals across India was conducted during October 2016 – March 2017. Peer validated questionnaire with standard scales, descriptive & objective questions was emailed only to individuals who were known to be working in Emergency departments as nurses and doctors. This convenience-sample of email addresses was obtained through personal and professional contacts of the researcher. Those who volunteered responses were included in the study. No identifying information was collected. Those who reported diagnosed sleeping disorders were excluded from the analysis. For analysis, responses were divided into 2 groups – those who reported symptoms of SWD and those who did not. With aid of a professional biostatistician, these 2 groups were then compared for unique characteristics and statistically significant variables using t test, chi square test, odds ratio and logistic regression Results: Prevalence of symptoms indicative of SWD in a random sample of emergency medicine physicians and nurses in India ranges from 13-27% and was significantly (p=0.048) higher in those who did shift work and night shift work depending on the method of assessment. Women have 3 times higher risk than men. More than half (51%) the number of Emergency medicine physicians and nurses in the study suffer sleep disturbances due to work timings. This group may develop SWD in the future, pending due intervention. SWD is strongly (p<0.02) associated with bad sleep hygiene and excessive daytime sleepiness. The presence of symptoms of SWD also leads to poor job satisfaction. (p<0.05). Majority (60%) report preference for shifts that start later in the day

A Survey of National Physicians Working in an Active Conflict Zone: The Challenges of Emergency Medical Care in Iraq

2012 ◽  
Vol 27 (2) ◽  
pp. 153-161 ◽  
Author(s):  
Ross I. Donaldson ◽  
Patrick Shanovich ◽  
Pranav Shetty ◽  
Emma Clark ◽  
Sharaf Aziz ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Medical Care ◽  
Emergency Departments ◽  
Large Scale ◽  
Road Traffic ◽  
Health Workers ◽  
Emergency Medical Care ◽  
Convenience Sample ◽  
Emergency Medical ◽  
Conflict Zone

AbstractIntroductionThere has been limited research on the perspectives and needs of national caregivers when confronted with large-scale societal violence. In Iraq, although the security situation has improved from its nadir in 2006-2007, intermittent bombings, and other hostilities continue. National workers remain the primary health resource for the affected populace.ProblemTo assess the status and challenges of national physicians working in the Emergency Departments of an active conflict area.MethodsThis study was a survey of civilian Iraqi doctors working in Emergency Departments (EDs) across Iraq, via a convenience sample of physicians taking the International Medical Corps (IMC) Doctor Course in Emergency Medicine, given in Baghdad from December 2008 through August 2009.ResultsThe 148 physician respondents came from 11 provinces and over 50 hospitals in Iraq. They described cardiovascular disease, road traffic injuries, and blast and bullet injuries as the main causes of death and reasons for ED utilization. Eighty percent reported having been assaulted by a patient or their family member at least once within the last year; 38% reported they were threatened with a gun. Doctors reported seeing a median of 7.5 patients per hour, with only 19% indicating that their EDs had adequate physician staffing. Only 19% of respondents were aware of an established triage system for their hospital, and only a minority had taken courses covering ACLS- (16%) or ATLS-related (24%) material. Respondents reported a wide diversity of prior training, with only 3% having some type of specialized emergency medicine degree.ConclusionsThe results of this study describe some of the challenges faced by national health workers providing emergency care to a violence-stricken populace. Study findings demonstrate high levels of violent behavior directed toward doctors in Iraqi Emergency Departments, as well as staffing shortages and a lack of formal training in emergency medical care.Donaldson RI, Shanovich P, Shetty P, Clark E, Aziz S, Morton M, Hasoon T, Evans G. A survey of national physicians working in an active conflict zone: the challenges of emergency medical care in Iraq. Prehosp Disaster Med. 2012;27(2):1-9.

scholarly journals Building and strengthening relationships between academic departments/divisions of emergency medicine and rural and regional emergency departments

CJEM ◽  
2019 ◽  
Vol 21 (5) ◽  
pp. 595-599 ◽  
Author(s):  
Aaron Johnston ◽  
Kylie Booth ◽  
Jim Christenson ◽  
David Fu ◽  
Shirley Lee ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Emergency Departments ◽  
Academic Departments ◽  
List Type ◽  
Emergency Physicians ◽  
Common Value ◽  
Rural And Urban ◽  
Canadian Association ◽  
Rural Physicians ◽  
Training Opportunities

ABSTRACTObjectivesMake recommendations on approaches to building and strengthening relationships between academic departments or divisions of Emergency Medicine and rural and regional emergency departments.MethodsA panel of leaders from both rural and urban/academic practice environments met over 8 months. Draft recommendations were developed from panel expertise as well as survey data and presented at the 2018 Canadian Association of Emergency Physicians (CAEP) Academic Symposium. Symposium feedback was incorporated into final recommendations.ResultsSeven recommendations emerged and are summarized below: 1)CAEP should ensure engagement with other rural stakeholder organizations such as the College of Family Physicians of Canada and the Society of Rural Physicians of Canada.2)Engagement efforts require adequate financial and manpower resources.3)Training opportunities should be promoted.4)The current operational interface between the academic department of Emergency Medicine and the emergency departments in the catchment area must be examined and gaps addressed as part of building and strengthening relationships.5)Initial engagement efforts should be around projects with common value.6)Academic Departments should partner with and support rural scholars.7)Academic departments seeking to build or strengthen relationships should consider successful examples from elsewhere in the country as well as considering local culture and challenges.ConclusionThese recommendations serve as guidance for building and strengthening mutually beneficial relationships between academic departments or divisions of Emergency Medicine and rural and regional emergency departments.

Variability of Contact Precaution Policies in US Emergency Departments

2014 ◽  
Vol 35 (3) ◽  
pp. 310-312 ◽  
Author(s):  
Daniel J. Pallin ◽  
Carlos A. Camargo ◽  
Deborah S. Yokoe ◽  
Janice A. Espinola ◽  
Jeremiah D. Schuur
Keyword(s):  
Emergency Medicine ◽  
Staphylococcus Aureus ◽  
Clostridium Difficile ◽  
Random Sample ◽  
Emergency Departments ◽  
Contact Precaution ◽  
Methicillin Resistant ◽  
Contact Precautions ◽  
Stool Incontinence

Contact precautions policies in US emergency departments have not been studied. We surveyed a structured random sample and found wide variation; for example, 45% required contact precautions for stool incontinence or diarrhea, 84% for suspected Clostridium difficile, and 79% for suspected methicillin-resistant Staphylococcus aureus infection. Emergency medicine departments and organizations should enact policies.

scholarly journals P075: Emergency physicians’ self-reported management of benign headache in Alberta emergency departments

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S90
Author(s):  
L. Krebs ◽  
C. Villa-Roel ◽  
S. Couperthwaite ◽  
M. Ospina ◽  
B. Holroyd ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Online Survey ◽  
Management Practices ◽  
Treatment Preferences ◽  
Emergency Physicians ◽  
Severe Condition ◽  
Convenience Sample ◽  
Patient Expectation ◽  
Traditional Therapy ◽  
Clinical Scenarios

Introduction: Benign headache (BHA) management varies across emergency departments (EDs). This study documented current BHA management by Alberta emergency physicians (EP) in order to develop a provincial intervention to improve standardized practice. Methods: A convenience sample of Alberta EPs completed an online survey exploring their ED BHA management practices. Results are expressed as proportions. Results: A total of 73 EPs (73/192; 38%) who were mostly male (63%) and practiced emergency medicine for at least 15 years (51%) responded. EPs reported routine ED orders for metoclopramide (97%), ketorolac (90%) and IV fluids (85%) for patients with BHA showing no signs of pathological headache. For moderate-severe BHA's that did not improve with routine treatment, preferences were: IV narcotic (58%), IV dexamethasone (44%), and IV/IM dihydroergotamine (27%). Typically, EPs reported not ordering investigations for moderate-severe BHA presentations (88%); however, for those not improving the most common investigation was computed tomography (CT; 47%). CT ordering was associated with the following clinical scenarios: 1) not responding to traditional therapy and consulted to specialist (64%); 2) not responding to traditional therapy and being admitted (64%); 3) first presentation and afebrile (19%); 4) severe pain (11%); and 5) responding to traditional therapy and febrile (11%). One-quarter of EPs (27%) believed their patients usually or frequently expected a CT. Most EPs (60%) reported being completely or mostly comfortable discussing CT risks. Only 44% reported always or usually discussing risks prior to ordering. EPs reported that they were most frequently prevented from discussing risks because the patient was critically ill (42%) or because they believed explaining risks would not alter patient expectations (21%). These concerns were mirrored in the barriers EPs anticipated to limiting imaging, specifically the fear of missing a severe condition (62%), and patient expectation/request for imaging (48%). Conclusion: Self-reported treatment preferences for uncomplicated BHAs appear to be relatively consistent. Chart reviews could help assessing the reliability of self-reported BHA management practices. Perceived patient expectation appears to be an important influence on EP imaging ordering. Studies examining the communication between EPs and their patients are needed to explore how these expectations and perceived expectations are negotiated in the ED.

scholarly journals The role of sleep hygiene in the risk of Shift Work Disorder in nurses

SLEEP ◽  
2019 ◽  
Author(s):  
Lauren A Booker ◽  
Maree Barnes ◽  
Pasquale Alvaro ◽  
Allison Collins ◽  
Ching Li Chai-Coetzer ◽  
...  
Keyword(s):  
High Risk ◽  
Shift Work ◽  
Psychological Health ◽  
Odds Ratio ◽  
Sleep Hygiene ◽  
Low Risk ◽  
Shift Workers ◽  
Hygiene Practices ◽  
Shift Work Disorder ◽  
Unit Increase

Abstract A high proportion (20%–30%) of shift workers experience Shift Work Disorder (SWD), characterized by chronic sleepiness and/or insomnia associated with work schedules. The reasons for individual variation in shift work tolerance are not well understood, however. The aim of this study was to identify individual factors that contribute to the risk of SWD. Nurses (n = 202) were categorized as low or high risk of SWD based on the Shift Work Disorder Questionnaire. Participants provided demographic and lifestyle information and completed the Sleep Hygiene Index (SHI) and Morningness–Eveningness Questionnaire (MEQ). High risk of SWD was associated with poorer sleep hygiene (SHI, 35.41 ± 6.19 vs. 31.49 ± 7.08, p < .0001) and greater eveningness (MEQ, 34.73 ± 6.13 vs. 37.49 ± 6.45, p = .005) compared to low risk. No other factors, including body mass index, marital status, having children, or caffeine or alcohol intake were significant. Logistic regression showed that SHI was the most significant contributing factor to SWD risk (odds ratio [OR] = 1.09, 95% confidence interval [CI] = 1.04 to 1.14). Standardized odds ratio further revealed that with every unit increase on the SHI score, the odds of being at high risk of SWD increased by 80% (OR = 1.84). Most individuals at high risk of SWD reported “always” or “frequently” going to bed at different times (79%) and waking at different times (83%; compared to 58%, p = .017, and 61%, p = .002, respectively for the low-risk group), as well as going to bed stressed/angry (67% vs. 41%, p < .0001) and/or planning/worrying in bed (54% vs. 22%, p < .0001). Interventions aimed at improving sleep hygiene practices and psychological health of shift workers may help reduce the risk of SWD.

31. The birth of a new specialty: The history of emergency medicine in Canada

2007 ◽  
Vol 30 (4) ◽  
pp. 44 ◽  
Author(s):  
R. Elyas
Keyword(s):  
Emergency Medicine ◽  
Royal College ◽  
Emergency Departments ◽  
Clinical Medicine ◽  
Task Force ◽  
Family Physicians ◽  
Care Providers ◽  
Emergency Physicians ◽  
Canadian Association ◽  
History Of

Modern day emergency rooms across Canada have almost completely transformed over the past 30 years; perhaps more so than any other specialty. Before the 1970’s, it was primarily general practitioners working on a part-time basis who ran our emergency departments. Some hospitals used interns and residents as first-line emergency care providers, often under the direction of a surgeon or internist. Emergency Medicine has evolved into a highly sophisticated and respected medical specialty that extends beyond clinical medicine, into both research and academia. The appeal of Emergency Medicine is so great that it is now one of the most sought after specialties in the annual CaRMS match. The success story of Emergency Medicine is characterized by the tireless efforts and determination of its founders across the country. They fought for adequate and supervised care of the acutely ill or traumatized patient, believing in a special body of knowledge that should be available to physicians who spend most, if not all, their time in Emergency Departments. In 1977, these founders formally united and The Canadian Association of Emergency Physicians was born. A few years later, in 1980, Emergency Medicine was finally designated as a free-standing specialty by the Royal College of Physicians and Surgeons of Canada. Meanwhile, the College of Family Physicians of Canada also sought to establish a parallel route for Emergency Training of Family Physicians, feeling that Emergency Medicine lay within the realm of Family Medicine. The result was that both colleges established Emergency Medicine training programs that exist until this day. Using journals, archives, a survey, and interviews, the paper will trace the history of the professionalization of Emergency Medicine in Canada. Johnson R. The Canadian Association of Emergency Physicians. The Journal of Emergency Medicine 1993; 11:362-364. Reudy J, Seaton T, Walker D, Rowat B, Cassie J. Report of the Task Force on Emergency Medicine: RCPSC Accreditation Section, 1988. Walker DMC. History and Development of the Royal College Specialty of Emergency Medicine. Annals Royal College of Physicians and Surgeons of Canada 1987; 20:349-352.

scholarly journals Knowledge and Confidence of a Convenience Sample of Australasian Emergency Doctors in Managing Dental Emergencies: Results of a Survey

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
Hossein Samaei ◽  
Tracey Joy Weiland ◽  
Stuart Dilley ◽  
George Alexander Jelinek
Keyword(s):  
Emergency Medicine ◽  
Periodontal Disease ◽  
Response Rate ◽  
Emergency Physicians ◽  
Knowledge Test ◽  
Convenience Sample ◽  
Pharmacological Management ◽  
Interactive Training ◽  
Level Of Knowledge ◽  
Emergency Doctors

Background. We aimed to determine Australasian Specialist Emergency Physicians’ and Emergency Physicians in Training (Trainees’) level of knowledge of common dental emergencies. We also explored confidence in managing dental emergencies; predictors of confidence and knowledge; and preferences for further dental education.Methods. A questionnaire was distributed electronically (September 2011) and directly (November 2011) to Fellows and Trainees of the Australasian College for Emergency Medicine. It explored demographics, confidence, knowledge of dental emergencies, and educational preferences.Results. Response rate was 13.6% (464/3405) and college members were proportionally represented by region. Fewer than half (186/446; 42%) had received dental training. Sixty-two percent (244/391, 95% CI 57.5–67.1) passed (>50%) a knowledge test. More than 60% incorrectly answered questions on dental fracture, periodontal abscess, tooth eruption dates, and ulcerative gingivitis. Forty percent (166/416) incorrectly answered a question about Ludwig’s Angina. Eighty-three percent (360/433) were confident in the pharmacological management of toothache but only 26% (112/434) confident in recognizing periodontal disease. Knowledge was correlated with confidence (r=0.488). Interactive workshops were preferred by most (386/415, 93%).Conclusions. The knowledge and confidence of Australasian Emergency Physicians and Trainees in managing dental emergencies are varied, yet correlated. Interactive training sessions in dental emergencies are warranted.

scholarly journals Assessment of the Preparedness and Planning of Academic Emergency Departments in India during the COVID-19 Pandemic – A Multicentric Survey

2021 ◽  
pp. 1-13
Author(s):  
Vivek Gopinathan ◽  
Sanjan Asanar ◽  
Vimal Krishnan S ◽  
Freston Marc Sirur ◽  
Jayaraj Mymbilly Balakrishnan
Keyword(s):  
Emergency Medicine ◽  
Emergency Departments ◽  
Disaster Preparedness ◽  
Treatment Protocol ◽  
Descriptive Statistics ◽  
Emergency Physicians ◽  
Pandemic Preparedness ◽  
Cross Sectional ◽  
Planning Strategies ◽  
Training Exercises

ABSTRACT Objective: Emergency Medicine being a young specialty in India, we aimed to assess the level of disaster preparedness and planning strategies among various academic Emergency Departments (EDs) across India during the COVID-19 pandemic. Methods: A cross-sectional multicentric survey was developed and disseminated online to various academic EDs in India and followed up over a period of 8 weeks. All results were analysed using descriptive statistics. Results: 28 Academic Emergency Medicine Departments responded to the study. Compared to Pre-COVID period, COVID-19 pandemic has led to 90% of centres developing separate triage system with dedicated care areas for COVID suspect/infected in 78.6% centres with nearly 70% utilizing separate transportation pathways. Strategizing and executing the Institutional COVID-19 treatment protocol in 80% institutes were done by Emergency Physicians. Training exercises for airway management and PPE usage were seen in 93% and 80% centres respectively. Marked variation in recommended PPE usage were observed across EDs in India. Conclusions: Our study highlights the high variance in the level of preparedness response among various EDs across India during the pandemic. Preparedness for different EDs across India needs to be individually assessed and planned according to the needs and resources available.

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