Staff acceptance of tele-ICU coverage: a systematic review.
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ABSTRACT:
SUBMITTER: Young LB
PROVIDER: S-EPMC3032369 | biostudies-other | 2011 Feb
REPOSITORIES: biostudies-other
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Project description:ObjectiveSummarize performance and development of ICU delirium-prediction models published within the past 5 years.Data sourcesSystematic electronic searches were conducted in April 2019 using PubMed, Embase, Cochrane Central, Web of Science, and Cumulative Index to Nursing and Allied Health Literature to identify peer-reviewed studies.Study selectionEligible studies were published in English during the past 5 years that specifically addressed the development, validation, or recalibration of delirium-prediction models in adult ICU populations.Data extractionScreened citations were extracted independently by three investigators with a 42% overlap to verify consistency using the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies.Data synthesisEighteen studies featuring 23 distinct prediction models were included. Model performance varied greatly, as assessed by area under the receiver operating characteristic curve (0.62-0.94), specificity (0.50-0.97), and sensitivity (0.45-0.96). Most models used data collected from a single time point or window to predict the occurrence of delirium at any point during hospital or ICU admission, and lacked mechanisms for providing pragmatic, actionable predictions to clinicians.ConclusionsAlthough most ICU delirium-prediction models have relatively good performance, they have limited applicability to clinical practice. Most models were static, making predictions based on data collected at a single time-point, failing to account for fluctuating conditions during ICU admission. Further research is needed to create clinically relevant dynamic delirium-prediction models that can adapt to changes in individual patient physiology over time and deliver actionable predictions to clinicians.
| S-EPMC7746201 | biostudies-literature
Project description:Cancer is considered one of the dominant life-threatening diseases in children. Working in the field of pediatric oncology, although rewarding, can be a source of stress and emotional burden for health care providers. The aim of this systematic review was to summarise the evidence regarding the occupational stress of health care providers working with pediatric cancer patients. Extensive search of the Pubmed and Scopus databases was performed to identify studies relevant to the topic. Initial search retrieved 657 studies. The reviewing investigators, after applying the inclusion/exclusion criteria, extracted data to critically appraise the quality of evidence. The final step of search concluded in 23 studies of heterogeneous design. Results revealed two main domains of which occupational stress derived from i) the interaction of the health care provider with the patient and the family, and ii) several organisational factors, such as hierarchical structures, experience, workload, and low organisational support. Literature on the stress of pediatric oncology staff is limited. The rather small sample sizes of the studies, the heterogeneity of methodological design, the lack of assessment from a sociological point of view, as well as the limited psychometric instruments adapted to pediatric oncology staff, make the validity of the results questionable. Further research is warranted to obtain a more accurate view of the field, to identify a cause-effect relation between work-related stress and pediatric oncology staff, and, more importantly, to guide future recommendations on support systems and stress management training within pediatric oncology settings.
| S-EPMC8623911 | biostudies-literature
Project description:Objective:We present qualitative findings from interviews with frontline clinicians and service users of a fetal telemedicine service. Methods:Semi-structured interviews with clinical stakeholders and service users were conducted, undertaken as part of a service evaluation. Data collection was undertaken by different teams, using interview schedules aligned to independent evaluation aims. Data were subjected to thematic analysis. Results:Sonographers reported four main challenges: delivering a shared consultation; the requirement to resist scanning intuitively; communications during the scan; and restricted room space. Notwithstanding, all clinicians reported that participating women were accepting of the technology. Service users reported few concerns. The main benefits of fetal telemedicine were identified as upskilled staff, increased access to specialist support and improved management of complex pregnancies. Convenience was identified as the main benefit by service users, including savings in time and money from not having to travel, take time off work, and arrange childcare. Conclusions:Service users and clinical stakeholders were accepting of the service. Service users reported satisfaction with communications during the consultation and awareness that telemedicine had facilitated local access to clinical expertise. Whilst clinical stakeholders reported challenges, the iterative nature of the evaluation meant that concerns were discussed, responded to, and overcome as the pilot developed. Clinical stakeholders' perception of benefits for service users encouraged their acceptance. Moreover, the evaluation established that fetal ultrasound telemedicine is a viable method to access expertise safely and remotely. It provided demonstrable evidence of a potential solution to some of the healthcare challenges facing rural hospitals.
| S-EPMC7232054 | biostudies-literature
Project description:BackgroundDespite being considered as a low prevalence country for hepatitis B (HBV), some populations in Germany are at higher risk of infection. In the context of the World Health Organization's (WHO) viral hepatitis elimination goals, a valid epidemiological data base is needed to plan and monitor the national response. Prevention strategies include general and targeted HBV vaccination programmes.ObjectiveThe aim of this work was to estimate the HBV vaccination coverage (VC) in the general population (GP) and different population groups in Germany from available evidence and to identify current evidence gaps for future research.MethodsWe conducted a systematic review on HBV VC in the general population and populations at high risk of HBV exposure or severe infection in Germany. We included eligible publications (01/01/2017 to 06/06/2020) from databases Embase, Pubmed and Livivo, from a previous scoping review (including data published 01/01/2005-17/03/2017), from the national surveillance system and screened the reference lists of all publications at full text level. Risk of bias was assessed using the Hoy et al. tool.ResultsWe included 68 publications of 67 studies and assigned them to one or more suitable population groups. Twenty-one studies contained data among children/adolescents and three among adults from the GP (VC 65.8-90.5% and 22.9-52.1%, respectively), one among travelers (VC 89.0%), 13 among immunocompromised populations (VC 7.8-89.0%), 16 among populations with occupational risk and 16 with non-occupational risk of HBV exposure (VC 63.6-96.5% and 4.4-84.5%, respectively).ConclusionComprehensive evidence at low risk of bias was identified for children/adolescents. However, 25 years after including HBV in the national immunisation schedule, VC in Germany is still below the 95%-goal defined by WHO. For people at occupational risk of HBV exposure, VC was mostly reported to be over the WHO goal of 80%, but quality of evidence was heterogenous and should be improved. For people at non-occupational risk of HBV exposure, evidence was sparse and of low quality. The low VC highlights the need for future research to plan vaccination programmes targeting these populations.
| S-EPMC8364709 | biostudies-literature
Project description:ObjectivesTo understand how patients and family members experience dehumanizing or humanizing treatment when in the ICU.DesignQualitative study included web-based focus groups and open-ended surveys posted to ICU patient/family social media boards. Focus groups were audio recorded and transcribed. Social media responses were collected and organized by stakeholder group. Data underwent qualitative analysis.SettingRemote focus groups and online surveys.PatientsICU patient survivors, family members, and ICU teams.InterventionsNot available.Measurements and main resultsSemi-structured questions and open-ended survey responses. We enrolled 40 patients/family members and 31 ICU team members. Focus groups and surveys revealed three primary themes orienting humanizing/dehumanizing ICU experiences: 1) communication, 2) outcomes, and 3) causes of dehumanization. Dehumanization occurred during "communication" exchanges when ICU team members talked "over" patients, made distressing remarks when patients were present, or failed to inform patients about ICU-related care. "Outcomes" of dehumanization were associated with patient loss of trust in the medical team, loss of motivation to participate in ICU recovery, feeling of distress, guilt, depression, and anxiety. Humanizing behaviors were associated with improved recovery, well-being, and trust. "Perceived causes" of dehumanizing behaviors were linked to patient, ICU team, and healthcare system factors.ConclusionsBehaviors of ICU clinicians may cause patients and families to feel dehumanized when in the ICU. Negative behaviors are noticed by patients and families, possibly contributing to poor outcomes including mental health, recovery, and lack of trust in ICU teams. Supporting ICU clinicians may enable a more empathic environment and in turn more humanizing clinician-patient encounters.
| S-EPMC8208441 | biostudies-literature
Project description:Background: Patient safety is a priority of any healthcare system, and one of the most effective measures is hand hygiene. For this, it is important that health staff have correct adherence and perform the technique properly. Otherwise, the incidence of nosocomial infections can increase, with consequent complications. The aim here was to analyze hand hygiene training and the effectiveness of different methods and educational strategies among nurses and whether they maintained correct adherence over time. Methods: A systematic review was conducted in the sources CINAHL (Cumulative Index to Nursing and Allied Health Literature), Dialnet, Lilacs (Latin American and Caribbean Health Sciences Literature), ProQuest (Proquest Health and Medical Complete), Medline, SciELO (Scientific Electronic Library Online), and Scopus. The search equation with Medical Subject Headings (MeSH) descriptors was "Nurs* AND (handwashing OR hand hygiene) AND clinical trial". The review was performed following the recommendations of the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: n = 17 clinical trials were included, with a total of 5747 nurses and nursing students. Strategies such as reminder sounds, practical simulations, videos, and audiovisual media improved handwashing compliance. Adherence overtime increased by up to 60%. The greatest effectiveness was related to the use of povidone-iodine, which reduced colony formation compared Hand hygiene teaching strategies among nursing staff: a systematic review to soap. Conclusions: The strategies that go beyond teaching techniques such as lectures may be more effective at increasing hand hygiene compliance. Combined approaches to learning/instruction improve user satisfaction by enabling self-management, flexibility, and repetition.
| S-EPMC6747325 | biostudies-literature
Project description:ObjectiveTo determine whether there is an association between healthcare professionals' wellbeing and burnout, with patient safety.DesignSystematic research review.Data sourcesPsychInfo (1806 to July 2015), Medline (1946 to July 2015), Embase (1947 to July 2015) and Scopus (1823 to July 2015) were searched, along with reference lists of eligible articles.Eligibility criteria for selecting studiesQuantitative, empirical studies that included i) either a measure of wellbeing or burnout, and ii) patient safety, in healthcare staff populations.ResultsForty-six studies were identified. Sixteen out of the 27 studies that measured wellbeing found a significant correlation between poor wellbeing and worse patient safety, with six additional studies finding an association with some but not all scales used, and one study finding a significant association but in the opposite direction to the majority of studies. Twenty-one out of the 30 studies that measured burnout found a significant association between burnout and patient safety, whilst a further four studies found an association between one or more (but not all) subscales of the burnout measures employed, and patient safety.ConclusionsPoor wellbeing and moderate to high levels of burnout are associated, in the majority of studies reviewed, with poor patient safety outcomes such as medical errors, however the lack of prospective studies reduces the ability to determine causality. Further prospective studies, research in primary care, conducted within the UK, and a clearer definition of healthcare staff wellbeing are needed.ImplicationsThis review illustrates the need for healthcare organisations to consider improving employees' mental health as well as creating safer work environments when planning interventions to improve patient safety.Systematic review registrationPROSPERO registration number: CRD42015023340.
| S-EPMC4938539 | biostudies-literature
Project description:BACKGROUND:Only a few telemedicine applications have made their way into regular care. One reason is the lack of acceptance of telemedicine by potential end users. OBJECTIVE:The aim of this systematic review was to identify theoretical predictors that influence the acceptance of telemedicine. METHODS:An electronic search was conducted in PubMed and PsycINFO in June 2018 and supplemented by a hand search. Articles were identified using predefined inclusion and exclusion criteria. In total, two reviewers independently assessed the title, abstract, and full-text screening and then individually performed a quality assessment of all included studies. RESULTS:Out of 5917 potentially relevant titles (duplicates excluded), 24 studies were included. The Axis Tool for quality assessment of cross-sectional studies revealed a high risk of bias for all studies except for one study. The most commonly used models were the Technology Acceptance Model (n=11) and the Unified Theory of Acceptance and Use of Technology (n=9). The main significant predictors of acceptance were perceived usefulness (n=11), social influences (n=6), and attitude (n=6). The results show a superiority of technology acceptance versus original behavioral models. CONCLUSIONS:The main finding of this review is the applicability of technology acceptance models and theories on telemedicine adoption. Characteristics of the technology, such as its usefulness, as well as attributes of the individual, such as his or her need for social support, inform end-user acceptance. Therefore, in the future, requirements of the target group and the group's social environment should already be taken into account when planning telemedicine applications. The results support the importance of theory-guided user-centered design approaches to telemedicine development.
| S-EPMC6547771 | biostudies-literature
Project description:Background: Modern surgery demands high-quality and reproducibility. Due to new working directives, resident duty hours have been restricted and evidence exists that pure on-the-job training provides insufficient exposure. We hypothesize that supplemental simulations in animal models provide a realistic training to augment clinical experiences. This study reviews surgical training models, their costs and survey results illustrating academic acceptance. Methods: Animal models were identified by literature research. Costs were analyzed from multiple German and Austrian training programs. A survey on their acceptance was conducted among faculty and medical students. Results: 915 articles were analyzed, thereof 91 studies described in-vivo animal training models, predominantly for laparoscopy (30%) and microsurgery (24%). Cost-analysis revealed single-training costs between 307€ and 5,861€ depending on model and discipline. Survey results illustrated that 69% of the participants had no experience, but 66% would attend training under experienced supervision. Perceived public acceptance was rated intermediate by medical staff and students (4.26; 1-low, 10 high). Conclusion: Training in animals is well-established and was rated worth attending in a majority of a representative cohort to acquire key surgical skills, in light of reduced clinical exposure. Animal models may therefore supplement the training of tomorrow's surgeons to overcome limited hands-on experience until virtual simulations can provide such educational tools.
| S-EPMC7554573 | biostudies-literature
Project description:Vaccination it is considered a vital strategy in order to mitigate monkeypox by protecting from severe disease and helping in reduction of hospitalisations. In this sense, this study aims to estimate the global prevalence of vaccination acceptance against monkeypox. We conducted a systematic review with a comprehensive search strategy for the following databases: PubMed, Scopus and Web of Science. A random-effect model meta-analysis was carried out using observational studies assessing the intention of vaccines against monkeypox from multiple continents. The quality assessment was developed using the Newcastle-Ottawa Scale adapted for cross-sectional studies. In addition, a subgroup analysis by study location and population and a sensitivity analysis was developed.Eleven cross-sectional studies were included. A total of 8045 participants were included. The pooled prevalence of monkeypox vaccination acceptance in all participants was 56.0% (95%CI: 42.0-70.0%). In the subgroup analysis of monkeypox vaccine acceptance according to continents, the prevalence of vaccine acceptance was 50.0% (95%CI: 24.0-76.0%) in Asian countries and 70.0% (95%CI: 55.0-84.0%) in European countries. The prevalence of vaccine acceptance was 43.0% (95%CI: 35.0-50.0%) in the general population, 63.0% (95%CI: 42.0-70.0%) in healthcare workers, and 84.0% (95%CI: 83.0-86.0%) in the LGBTI community. Despite the high prevalence of monkeypox vaccination acceptance in the LGBTI community found in our study, vaccination acceptance from healthcare workers and the general population are lower. Governments could use these results for planning, developing or promoting vaccination strategies and public health policies focused on these populations.
| S-EPMC9697127 | biostudies-literature