Assessing the knowledge and skill of vaccination staff at Adult Vaccination Counters for COVID-19 vaccines: Simulated client method

The Government of Pakistan has established Adult Vaccination Counters (AVCs) to immunize general population with COVID-19 vaccine. Different brands of COVID-19 vaccines have different protocols. It is important that the knowledge and skills of the vaccination staff at AVCs should be accurate. To assess this, a cross-sectional study was conducted in all 15 AVCs at Khyber Pakhtunkhwa’s provincial capital in May 2021, using the simulated client approach. Structured open-ended and simulated scenario-based questions were used to collect data from the vaccination staff of AVCs. This study showed that 53.3% of the AVCs had at most three out of four brands of COVID-19 vaccines. 60% of the AVCs did not have the mechanism to track client’s vaccine first dose, date, and brand. Only 66.7% of the AVCs had a complete knowledge of all the available vaccines. 86.7% and 80% of the AVCs knew the correct duration and administration of the same brand of COVID-19 vaccine’s second dose respectively. At the client’s end, 6.7% were aware about the brand of administered COVID-19 vaccine. 46.7% were advised about the date of the second shot of vaccination. Only 13.3% of the clients were informed about the procedure of getting an official vaccination certificate. It was concluded that the knowledge and skill of the vaccination staff at AVCs is inadequate. Every vaccine has a different protocol in terms of number of doses and duration. AVCs must have a tracking system to inoculate the second dose with the same brand as the first dose. There is a need for rigorous monitoring and training of the COVID-19 vaccination staff on various protocols of vaccine to prevent losing public’s trust.

Simulated-Scenario and Peer-Mentorship Curriculum to Train Prehospital Providers in the Practice of Mass Gathering Medicine

Objective: A mass gathering medicine training program was established for a 7,200-seat arena. The objectives of this study were to describe the program schema and determine its impact in preparing novice emergency medical technicians (EMTs) to manage the difficulties of large-venue emergency medical services (EMS). Methods: Optional, anonymous surveys were administered to EMTs. Novice EMTs were assessed pre-/post-program implementation, and both novice and experienced EMTs completed self-reported Likert scales. Data were analyzed with nonparametric methods. Results: A total of 43/56 responses (response rate = 76.8%) were received. Only 37.2% of providers felt prepared to work mass gatherings before the training, and 60.5% stated that their previous education did not prepare them for large-venue challenges. After the training program, novice EMTs were significantly associated with increased knowledge of large-venue EMS procedures (P = 0.0170), higher proficiency using extrication equipment (P = 0.0248), increased patient care skills (P = 0.0438), and both increased confidence working events (P = 0.0002) and better teamwork during patient encounters (P = 0.0001). The majority of EMTs reported the program as beneficial. Conclusion: Upon hire, EMS providers felt unprepared to work large-venue EMS. The analyses demonstrated that this training program improved select large-venue emergency skills for prehospital providers and may fill a gap in the education system regarding mass gathering medicine.

Hydraulic transients for a pipe line network of treated effluent rising main using SAP 2R

Hydraulic transients occur as a direct result of rapid variations of flow field in pressurized systems. The change in velocity from valve closures or pump operations causes pressure surges that are propagated away from the source throughout the pipeline. The associated pressure changes during a transient period are quite large and occur quickly (within a few seconds). It should also be noted that when the maximum pressures exceed the bar ratings (mechanical strength) of the piping material, failure can occur. Similarly, if the minimum pressure drops below the vapour pressure of the fluid, cavitation can occur. The purpose of the present study is to model and simulate the hydraulic transients in a pipeline network system of treated effluent rising main of Mpophomeni sanitation scheme using SAP 2R. A total of five scenarios were simulated using different combinations. The simulation results show that the transient pressures in the pipeline exceeded the bar rating of the pipe where the bursts or cavitation may occur for the simulated scenario, but transient pressures were reduced to a safe limit after providing water hammer protection devices.

A Collaborative Application for Assisting the Management of Household Plastic Waste through Smart Bins: A Case of Study in the Philippines

The management and collection of household waste often represents a demanding task for elderly or impaired people. In particular, the increasing generation of plastic waste at home may pose a problem for these groups, as this type of waste accumulates very rapidly and occupies a considerable amount of space. This paper proposes a collaborative infrastructure to monitor household plastic waste. It consists of simple smart bins using a weight scale and a smart application that forecasts the amount of plastic generated for each bin at different time horizons out of the data provided by the smart bins. The application generates optimal routes for the waste-pickers collaborating in the system through a route-planning algorithm. This algorithm takes into account the predicted amount of plastic of each bin and the waste-picker’s location and means of transport. This proposal has been evaluated by means of a simulated scenario in Quezon City, Philippines, where severe problems with plastic waste have been identified. A set of 176 experiments have been performed to collect data that allow representing different user behaviors when generating plastic waste. The results show that our proposal enables waste-pickers to collect more than the 80% of the household plastic-waste bins before they are completely full.

Consequences of violating assumptions of integrated population models on parameter estimates

While ecologists know that models require assumptions, the consequences of their violation become vague as model complexity increases. Integrated population models (IPMs) combine several datasets to inform a population model and to estimate survival and reproduction parameters jointly with higher precision than is possible using independent models. However, accuracy actually depends on an adequate fit of the model to datasets. We first investigated bias of parameters obtained from integrated population models when specific assumptions are violated. For instance, a model may assume that all females reproduce although there are non-breeding females in the population. Our second goal was to identify which diagnostic tests are sensitive to detect violations of the assumptions of IPMs. We simulated data mimicking a short- and a long-lived species under five scenarios in which a specific assumption is violated. For each simulated scenario, we fitted an IPM that violates the assumption (simple IPM) and an IPM that does not violate each specific assumption. We estimated bias and uncertainty of parameters and performed seven diagnostic tests to assess the fit of the models to the data. Our results show that the simple IPM was quite robust to violation of many assumptions and only resulted in small bias of the parameter estimates. Yet, the applied diagnostic tests were not sensitive to detect such small bias. The violation of some assumptions such as the absence of immigrants resulted in larger bias to which diagnostic tests were more sensitive. The parameters informed by the least amount of data were the most biased in all scenarios. We provide guidelines to identify misspecified models and to diagnose the assumption being violated. Simple models should often be sufficient to describe simple population dynamics, and when data are abundant, complex models accounting for specific processes will be able to shed light on specific biological questions.

467 FRAILTY IN SITU SIMULATION

Introduction The ability to recognise and manage frailty and its associated presentations is variable among acute hospital staff. Patients living with frailty who are admitted to hospital are more likely to suffer adverse effects than those without. We created an inter-professional in-situ simulation programme designed to improve recognition and management of frailty and its common adverse events. The programme objectives align with recommendations from the British Geriatric Society’s ‘Frailty Hub’ and Royal College of Physicians’ ‘Acute Care Toolkit’ for frailty. Method Over a two month period, seven sessions were completed on the Older Persons Unit (OPU) at St Thomas’ Hospital. These comprised a simulated scenario followed by facilitated debrief—including technical skills and human factors highlighted by the scenario. Quantitative data was collected through pre and post session questionnaires using the Human Factors Skills for Healthcare Instrument (HuFSHI) and frailty based questions. Post session qualitative data was also collected. Results 30 participants attended the sessions (nursing, medical and allied health professional). All participants completing the post course questionnaire found the sessions useful. When comparing pre and post session data, participant confidence in 10/12 sections of the HuFSHI and 8/9 frailty based questions demonstrated improvement. The qualitative data showed common learning themes around improved communication, teamwork and escalation. Participants found that the sessions were a valuable ‘opportunity to reflect’ and ‘debrief’, and learn together as a multidisciplinary team. Conclusion In-situ simulation is an effective tool for improving knowledge and confidence in managing frail patients. It increases awareness and understanding of human factors, which are key to the multidisciplinary approach frail patients require. The course is being expanded across the OPU and now has funding for a departmental manikin. The programme can be disseminated to other units to help improve the care and safety of those with frailty in hospital.