scholarly journals MP31: Debriefing critical incidents in health care: a review of the evidence

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S51-S52 ◽  
Author(s):  
E. Katherine Conrad ◽  
R. DB. Morrison
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Patient Outcomes ◽  
Health Care Providers ◽  
Critical Incident ◽  
Critical Incidents ◽  
Well Being ◽  
Stressful Events ◽  
Care Providers ◽  
Inclusion Criteria

Introduction: Emergency health care providers (HCPs) regularly perform difficult medical resuscitations that require complex decision making and action. Critical incident debriefing has been proposed as a mechanism to mitigate the psychological effect of these stressful events and improve both provider and patient outcomes. The purpose of this updated systematic review is to determine if HCPs performing debriefing after critical incidents, compared to no debriefing, improves the outcomes of the HCPs or patients. Methods: We performed a librarian assisted systematic review of OVID Medline, CINAHL, OVID Embase and Google Scholar (January 2006 to February 2017) No restrictions for language were imposed. Two investigators evaluated articles independently for inclusion criteria, quality and data collection. Agreement was measured using the Kappa statistic and quality of the articles were assessed using the Downs and Black evaluation tool. Results: Among the 658 publications identified 16 met inclusion criteria. Participants included physicians, nurses, allied health and learners involved in both adult and pediatric resuscitations. Findings suggest that HCPs view debriefing positively (n=7). One moderate quality study showed that debriefing can enhance medical student and resident knowledge. Several studies (n=8) demonstrated at least some improvement in CPR and intubation related technical skills. Debriefing is also associated with improved short term patient survival but not survival to discharge (n=5). Two studies reported benefits to HCPs mental health as evidenced by improved ability to manage grief and decreased reported symptoms of Post-Traumatic Stress Disorder (PTSD). Conclusion: We found HCPs value debriefing after critical incidents and that debriefing is associated with improved HCP knowledge, skill and well-being. Despite these positive findings, there continues to be limited evidence that debriefing significantly impacts long term patient outcomes. Larger scale higher quality studies are required to further delineate the effect of structured debriefing on patient and provider outcomes.

Systematic Review of Human Trafficking Educational Interventions for Health Care Providers

2019 ◽  
Vol 42 (2) ◽  
pp. 131-142 ◽  
Author(s):  
Hannah E. Fraley ◽  
Teri Aronowitz ◽  
Hanni M. Stoklosa
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Human Trafficking ◽  
Health Care Providers ◽  
Current Knowledge ◽  
Well Being ◽  
Educational Interventions ◽  
Care Providers ◽  
Negative Attitudes ◽  
Global Population

Human trafficking is a global population health threat. Trafficking minors threatens the safety and well-being of youth. Limited studies measure health care providers’ awareness and attitudes toward trafficking. This systematic review synthesized retrospective and current knowledge and identified gaps in educational interventions aimed at increasing providers’ awareness and attitudes toward trafficking. A systematic search of four databases identified peer-reviewed published papers between January 1, 2000 and September 1, 2018. The Cochrane Collaboration’s Preferred Reporting Items for Systematic Reviews was followed. Study quality was assessed using the Downs and Black checklist. The Psychometric Grading Framework was used to assess the validity of instruments. Findings across studies ( N = 7) reveal providers (mostly social workers and physicians) have low awareness of trafficking and can have negative attitudes toward victims. Multiphase educational approaches and use of content experts, including survivors, in developing interventions enhanced sustainability of outcomes. Targeting multidisciplinary health care teams, including nurses, enhanced interventions.

Systematic Review and Meta-analysis of Seizure Recurrence After a First Unprovoked Seizure in 815 Neurologically and Developmentally Normal Children

2017 ◽  
Vol 32 (13) ◽  
pp. 1035-1039 ◽  
Author(s):  
Joanna Garcia Pierce ◽  
Stephen Aronoff ◽  
Michael Del Vecchio
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Providers ◽  
Meta Analysis ◽  
Care Providers ◽  
Limited Data ◽  
Inclusion Criteria ◽  
Seizure Recurrence ◽  
Normal Children ◽  
Unprovoked Seizure

Limited data exist for health care providers regarding seizure recurrence after a first unprovoked seizure in previously neurologically and developmentally normal children. A systematic review and meta-analysis was conducted to assess seizure recurrence after a first unprovoked seizure by performing an electronic search in PubMed, Embase, and Scopus. Six studies from 2817 met the inclusion criteria. The sample size consisted of 815 neurologically and developmentally normal children (1 month–17.5 years) on no antiepileptic drugs. This systematic review and meta-analysis estimated a recurrence rate within 3 years of 45% (95% CI: 37%, 60%). This estimate provides a touchstone for health care providers who are managing this particular population of children.

scholarly journals Depression and Suicidality in Gay Men: Implications for Health Care Providers

2017 ◽  
Vol 11 (4) ◽  
pp. 910-919 ◽  
Author(s):  
Carrie Lee ◽  
John L. Oliffe ◽  
Mary T. Kelly ◽  
Olivier Ferlatte
Keyword(s):  
Health Care ◽  
Gay Men ◽  
Health Care Providers ◽  
Help Seeking ◽  
Adult Population ◽  
Well Being ◽  
Sexual Practices ◽  
Care Providers ◽  
Physical And Mental Health ◽  
Prevalence Of Depression

Gay men are a subgroup vulnerable to depression and suicidality. The prevalence of depression among gay men is three times higher than the general adult population. Because depression is a known risk factor for suicide, gay men are also at high risk for suicidality. Despite the high prevalence of depression and suicidality, health researchers and health care providers have tended to focus on sexual health issues, most often human immunodeficiency virus in gay men. Related to this, gay men’s health has often been defined by sexual practices, and poorly understood are the intersections of gay men’s physical and mental health with social determinants of health including ethnicity, locale, education level, and socioeconomic status. In the current article summated is literature addressing risk factors for depression and suicidality among gay men including family acceptance of their sexual identities, social cohesion and belonging, internalized stigma, and victimization. Barriers to gay men’s help seeking are also discussed in detailing how health care providers might advance the well-being of this underserved subgroup by effectively addressing depression and suicidality.

Creating Comics to Address Well-Being and Resilience During the COVID-19 Pandemic

2021 ◽  
pp. 152483992110654
Author(s):  
Kathryn West ◽  
Karen R. Jackson ◽  
Tobias L. Spears ◽  
Brian Callender
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Case Series ◽  
Narrative Medicine ◽  
Well Being ◽  
Small Scale ◽  
Care Providers ◽  
Graphic Medicine ◽  
Racial Injustice ◽  
Pilot Implementation

In this descriptive case series, we detail the theoretical basis, methodology, and impact of a small-scale pilot implementation of graphic medicine workshops as an innovative approach to well-being and resilience in the age of COVID-19 and increasing awareness of racial injustice. The data provided in this article are anecdotal and based on participation in the workshops. Images created during the workshops are also shared as examples of the types of reflection that graphic medicine can enable. The workshops themselves were designed collaboratively and are based on the theoretical principles of graphic medicine, narrative medicine, and racial and social justice. They were conducted as part of a larger wellness initiative and were offered to health care-focused faculty at our academic medical institution. Our findings suggest that this was a beneficial activity which helped participants to reflect and reconsider their experiences with the COVID-19 pandemic and surging awareness of racial injustice. Reflections also showed that drawings were correlated with ProQOL scores and may, in larger numbers, also help to mitigate or bring attention to issues of burnout in frontline providers. Drawings shared show the tremendous impact of COVID-19 and the simultaneous chaos and emptiness of practicing during dual pandemics. Our workshops engaged about 20 frontline health care providers and other health care faculty and highlight the utility of graphic medicine as a tool for building resilience and encouraging self-reflection. Further study is necessary, as is more rigorous analysis of the relationship between the graphics created and the ability to recognize and mitigate burnout.

Cultural Considerations in the Management of Chronic Pain

CAND Journal ◽  
2021 ◽  
Vol 28 (4) ◽  
pp. 11-13
Author(s):  
Shakila Mohmand ◽  
Sumar Chams
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Cultural Competency ◽  
Patient Outcomes ◽  
Health Care Providers ◽  
Cultural Beliefs ◽  
Coping Mechanisms ◽  
Care Providers ◽  
Pain Experience ◽  
Cultural Considerations

Cultural competency within health care helps eliminate racial and ethnic health disparities. When assessing and treating patients with chronic pain, practitioners should feel confident in using information regarding a patient’s individual cultural beliefs due to their significant impact on the pain experience. Culture impacts perception, outlook, and communication of pain, as well as coping mechanisms. These are aspects of subjective history that influence important decisions regarding the management of chronic pain. Becoming more aware of what to look for and which questions to ask can allow naturopathic doctors and other health-care providers to continue improving therapeutic relationships and patient outcomes.

Challenges of Providing Health Care in Complex Emergencies: A Systematic Review

2021 ◽  
pp. 1-5
Author(s):  
Hesam Seyedin ◽  
Morteza Rostamian ◽  
Fahimeh Barghi Shirazi ◽  
Haleh Adibi Larijani
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Services ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Qualitative Content Analysis ◽  
Care Delivery ◽  
Information Access ◽  
Care Providers ◽  
Complex Emergencies

Abstract Providing health care in times of complex emergencies (CEs) is one of the most vital needs of people. CEs are situations in which a large part of the population is affected by social unrest, wars, and food shortages. This systematic review study was conducted to identify the challenges of health-care delivery in CEs. We searched terms related to health-care delivery and CEs in PubMed, Web of Sciences, Science Direct, and Google scholar databases, as well as Persian databases SID and Magiran. The searching keywords included: “Health Care, Complex Crises, War, Humanitarian, Refugees, Displaced Persons, Health Services, and Challenges.” Of 409 records, we selected 6 articles based on the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist. Studies were analyzed through qualitative content analysis. The results show that CEs affect health-care delivery in 4 primary areas: the workforce, infrastructure, information access, and organization of health services. These areas can pose potential threats for health-care providers and planners at times of emergencies. Thus, they should be informed about these challenges to strengthen the health-care system.

Barriers in Case Managers’ Roles: A Qualitative Systematic Review

2017 ◽  
Vol 40 (10) ◽  
pp. 1522-1542 ◽  
Author(s):  
Jee Young Joo ◽  
Diane L. Huber
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Case Management ◽  
Health Care Providers ◽  
Management Practices ◽  
Case Managers ◽  
Qualitative Studies ◽  
Complex Case ◽  
Bibliographic Databases ◽  
Care Providers

The challenges faced by case managers when implementing case management have received little focus. Several qualitative studies have been published that may be able to shed light on those challenges. This study is a systematic review of qualitative literature to identify barriers case managers have when implementing case management. Five electronic bibliographic databases were systematically searched, and 10 qualitative studies were identified for inclusion in the review which were published from 2007 to 2016. Through thematic synthesis of findings, five themes were identified as barriers to case management implementation: unclear scope of practice, diverse and complex case management activities, insufficient training, poor collaboration with other health-care providers, and client relationship challenges. This review study suggested that standardized evidence-based practical protocols and certification programs may help overcome case managers’ barriers and improve case management practices. Health policymakers, case management associations, and health-care management researchers should develop educational and practical supports for case managers.

scholarly journals Mobile Apps for Drug–Drug Interaction Checks in Chinese App Stores: Systematic Review and Content Analysis (Preprint)

2020 ◽  
Author(s):  
Chunying Shen ◽  
Bin Jiang ◽  
Qilian Yang ◽  
Chengnan Wang ◽  
Kevin Z Lu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Providers ◽  
Arithmetic Mean ◽  
Mobile App ◽  
Average Score ◽  
Care Providers ◽  
Rating Score ◽  
Average Rating ◽  
Mhealth Apps

BACKGROUND As a computerized drug–drug interaction (DDI) alert system has not been widely implemented in China, health care providers are relying on mobile health (mHealth) apps as references for checking drug information, including DDIs. OBJECTIVE The main objective of this study was to evaluate the quality and content of mHealth apps supporting DDI checking in Chinese app stores. METHODS A systematic review was carried out in November 2020 to identify mHealth apps providing DDI checking in both Chinese iOS and Android platforms. We extracted the apps’ general information (including the developer, operating system, costs, release date, size, number of downloads, and average rating), scientific or clinical basis, and accountability, based on a multidimensional framework for evaluation of apps. The quality of mHealth apps was evaluated by using the Mobile App Rating Scale (MARS). Descriptive statistics, including numbers and percentages, were calculated to describe the characteristics of the apps. For each app selected for evaluation, the section-specific MARS scores were calculated by taking the arithmetic mean, while the overall MARS score was described as the arithmetic mean of the section scores. In addition, the Cohen kappa (κ) statistic was used to evaluate the interrater agreement. RESULTS A total of 7 apps met the selection criteria, and only 3 included citations. The average rating score for Android apps was 3.5, with a minimum of 1.0 and a maximum of 4.9, while the average rating score for iOS apps was 4.7, with a minimum of 4.2 and a maximum of 4.9. The mean MARS score was 3.69 out of 5 (95% CI 3.34-4.04), with the lowest score of 1.96 for Medication Guidelines and the highest score of 4.27 for MCDEX mobile. The greatest variation was observed in the information section, which ranged from 1.41 to 4.60. The functionality section showed the highest mean score of 4.05 (95% CI 3.71-4.40), whereas the engagement section resulted in the lowest average score of 3.16 (95% CI 2.81-3.51). For the information quality section, which was the focus of this analysis, the average score was 3.42, with the MCDEX mobile app having the highest score of 4.6 and the Medication Guidelines app having the lowest score of 1.9. For the overall MARS score, the Cohen interrater κ was 0.354 (95% CI 0.236-0.473), the Fleiss κ was 0.353 (95% CI, 0.234-0.472), and the Krippendorff α was 0.356 (95% CI 0.237-0.475). CONCLUSIONS This study systematically reviewed the mHealth apps in China with a DDI check feature. The majority of investigated apps demonstrated high quality with accurate and comprehensive information on DDIs. However, a few of the apps that had a massive number of downloads in the Chinese market provided incorrect information. Given these apps might be used by health care providers for checking potential DDIs, this creates a substantial threat to patient safety.

Sign in / Sign up

Export Citation Format

Share Document