scholarly journals Likelihood of Infectious Outcomes Following Infectious Risk Moments During Patient Care—An International Expert Consensus Study and Quantitative Risk Index

2018 ◽  
Vol 39 (3) ◽  
pp. 280-289 ◽  
Author(s):  
Lauren Clack ◽  
Simone Passerini ◽  
Tanja Manser ◽  
Hugo Sax

OBJECTIVETo elicit expert consensus on the likelihood of infectious outcomes (patient colonization or infection) following a broad range of infectious risk moments (IRMs) from observations in acute care.DESIGNExpert consensus study using modified Delphi technique.PARTICIPANTSPanel of 40 international experts including nurses, physicians and microbiologists specialized in infectious diseases and infection prevention and control (IPC).METHODSThe modified Delphi process consisted of 3 online survey rounds, with feedback of mean ratings and expert comments between rounds. The Delphi survey comprised 52 care scenarios representing observed IRMs organized into 6 sections: hands, gloves, medical devices, mobile objects, invasive procedures, and additional moments. For each scenario, experts indicated the likelihood of both patient colonization and infection on a scale from 0 to 5 (high). Expert ratings were plotted against frequencies of IRMs observed during actual patient care resulting in a risk index.RESULTSFollowing 3 rounds, consensus was achieved for 92 of 104 items (88.5%). The mean ratings across all scenarios for likelihood of colonization and infection were 2.68 and 2.02, respectively. The likelihood of colonization was rated higher than infection for 48 of 52 scenarios. Ratings were significantly higher for colonization (P=.001) and infection (P<.0005) when the scenario involved transfer of pathogens to critical patient sites.CONCLUSIONSThe design of effective IPC strategies requires the selection of behaviors according to their impact on patient outcomes. The IRM index reported here provides a basis for standardizing and prioritizing targets for quality improvement initiatives, training, and future research in acute health care.Infect Control Hosp Epidemiol 2018;39:280–289

Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Arif Hussain ◽  
Gabriele Via ◽  
Lawrence Melniker ◽  
Alberto Goffi ◽  
Guido Tavazzi ◽  
...  

AbstractCOVID-19 has caused great devastation in the past year. Multi-organ point-of-care ultrasound (PoCUS) including lung ultrasound (LUS) and focused cardiac ultrasound (FoCUS) as a clinical adjunct has played a significant role in triaging, diagnosis and medical management of COVID-19 patients. The expert panel from 27 countries and 6 continents with considerable experience of direct application of PoCUS on COVID-19 patients presents evidence-based consensus using GRADE methodology for the quality of evidence and an expedited, modified-Delphi process for the strength of expert consensus. The use of ultrasound is suggested in many clinical situations related to respiratory, cardiovascular and thromboembolic aspects of COVID-19, comparing well with other imaging modalities. The limitations due to insufficient data are highlighted as opportunities for future research.


2016 ◽  
Vol 77 (1) ◽  
pp. 43-46 ◽  
Author(s):  
Frances Johnson ◽  
Agnes T. Black ◽  
Jiak Chin Koh

Barriers to dietitians' participation in research include lack of time, self-perceived competence, confidence, administrative support, and funding. Providence Health Care, a multi-site health care organization in Vancouver, British Columbia implemented the Practice-based Research Challenge (RC), a 1-year research program, to support interdisciplinary teams of nurses and allied health professionals to conduct practice-relevant research projects. Funding, mentoring, and research education were provided to research teams. From 2011 to 2015, 37% of all dietitians in the organization were involved in the RC in 4 cohorts of the 1-year program. An online survey was conducted to understand these dietitians' interest and experience in the RC. The survey results indicated that the major reasons for participating in the program were to increase knowledge, improve patient care, and to work on a project of interest. Respondents thought they gained knowledge, enhanced professional development, and improved patient care. A majority stated they would likely conduct future research. The RC enabled and supported dietitians' participation in research; infrastructure supports for research and enabling a culture of research participation are key contributors to promoting dietitians involvement in research.


2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Luke McElroy ◽  
J McGillivray ◽  
Michael Wilson

Abstract Aims Delphi methodology can be used to develop consensus opinion amongst a group of stakeholders. This can be used to prioritise clinically relevant, patient centred research questions to guide future funding allocations. The aim of our study was to identify key future research priorities pertaining to the management of major trauma in the UK. Methods A three-phased modified Delphi process was undertaken. Phase 1 involved the submission of research questions by members of the trauma community using an online survey (Phase 1). Phases 2 and 3 involved two consecutive rounds of prioritisation after questions were subdivided into 6 subcategories: Brain Injury, Rehabilitation, Trauma in Older People, Prehospital, Interventional, and Miscellaneous (Phases 2 and 3). Cut-off points were agreed by consensus among the steering subcommittees. This established a final prioritised list of research questions. Results 201 questions across all were submitted by 65 stakeholders in phase 1. After analysis and with consensus achieved, 186 questions were taken forward for prioritisation in phase 2 with 114 included in phase 3. 56 prioritised major trauma research questions across the 6 categories were identified with a clear focus on long-term patient outcomes. Conclusions Consensus from within the major trauma community has identified 56 key research questions across 6 categories. Dissemination of these questions to funding bodies to allow for the development of high-quality research is now required. There is a clear indication for targeted multi-centric multi-disciplinary research in major trauma.


Author(s):  
Simon P. Mooijaart ◽  
Christian H. Nickel ◽  
Simon P. Conroy ◽  
Jacinta A. Lucke ◽  
Lisa S. van Tol ◽  
...  

Abstract Purpose Geriatric Emergency Medicine (GEM) focuses on delivering optimal care to (sub)acutely ill older people. This involves a multidisciplinary approach throughout the whole healthcare chain. However, the underpinning evidence base is weak and it is unclear which research questions have the highest priority. The aim of this study was to provide an inventory and prioritisation of research questions among GEM professionals throughout Europe. Methods A two-stage modified Delphi approach was used. In stage 1, an online survey was administered to various professionals working in GEM both in the Emergency Department (ED) and other healthcare settings throughout Europe to make an inventory of potential research questions. In the processing phase, research questions were screened, categorised, and validated by an expert panel. Subsequently, in stage 2, remaining research questions were ranked based on relevance using a second online survey administered to the same target population, to identify the top 10 prioritised research questions. Results In response to the first survey, 145 respondents submitted 233 potential research questions. A total of 61 research questions were included in the second stage, which was completed by 176 respondents. The question with the highest priority was: Is implementation of elements of CGA (comprehensive geriatric assessment), such as screening for frailty and geriatric interventions, effective in improving outcomes for older patients in the ED? Conclusion This study presents a top 10 of high-priority research questions for a European Research Agenda for Geriatric Emergency Medicine. The list of research questions may serve as guidance for researchers, policymakers and funding bodies in prioritising future research projects.


Crisis ◽  
2017 ◽  
Vol 38 (3) ◽  
pp. 202-206 ◽  
Author(s):  
Karl Andriessen ◽  
Dolores Angela Castelli Dransart ◽  
Julie Cerel ◽  
Myfanwy Maple

Abstract. Background: Suicide can have a lasting impact on the social life as well as the physical and mental health of the bereaved. Targeted research is needed to better understand the nature of suicide bereavement and the effectiveness of support. Aims: To take stock of ongoing studies, and to inquire about future research priorities regarding suicide bereavement and postvention. Method: In March 2015, an online survey was widely disseminated in the suicidology community. Results: The questionnaire was accessed 77 times, and 22 records were included in the analysis. The respondents provided valuable information regarding current research projects and recommendations for the future. Limitations: Bearing in mind the modest number of replies, all from respondents in Westernized countries, it is not known how representative the findings are. Conclusion: The survey generated three strategies for future postvention research: increase intercultural collaboration, increase theory-driven research, and build bonds between research and practice. Future surveys should include experiences with obtaining research grants and ethical approval for postvention studies.


2014 ◽  
Author(s):  
Eleanor R. Mackey ◽  
Abigail M. Romirowsky ◽  
Marissa Tolep ◽  
Anna Vannucci ◽  
Evan Nadler

2020 ◽  
Author(s):  
Michael Bollwerk ◽  
Bernd Schlipphak ◽  
Joscha Stecker ◽  
Jens Hellmann ◽  
Gerald Echterhoff ◽  
...  

Threat perceptions towards immigrants continue to gain importance in the context of growing international migration. To reduce associated intergroup conflicts, it is crucial to understand the personal and contextual determinants of perceived threat. In a large online survey study (N = 1,184), we investigated the effects of ideology (i.e., Right-Wing Authoritarianism and Social Dominance Orientation), subjective societal status (SSS) and their interaction effects in predicting symbolic and realistic threat perceptions towards Middle Eastern immigrants. Results showed that ideology (higher RWA and SDO) and lower SSS significantly predicted both symbolic and realistic threat, even after controlling for income, education, age, and gender. Furthermore, ideology and SSS interacted significantly in predicting realistic threat, with higher levels of SDO and RWA enhancing the effect of SSS. In the discussion, we focus on the implications of our findings with respect to understanding societal conflicts, discuss methodological limitations, and provide directions for future research.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A150-A151
Author(s):  
Jamie Walker ◽  
Rebecca Campbell ◽  
Ivan Vargas

Abstract Introduction Insomnia and depression are highly comorbid and have been shown to be independently associated with lower levels of physical activity. It is not clear, however, if being less physically active is a risk factor for or consequence of depression and insomnia. The factors that explain the associations between insomnia, depression, and physical activity are likely complex and overlapping. For example, insomnia may predict inactivity by impacting one’s energy levels, leaving them too tired to exercise. Insomnia may also interfere with one’s motivation to exercise due to low mood, as insomnia is associated with the development of depressive symptoms. The purpose of the present study was to explore whether depression mediated the link between insomnia and low levels of physical activity. Methods A national online survey was conducted from April-June 2020. Participants completed surveys to assess demographics, mood, sleep, and physical activity. Depressive symptoms were estimated with the Center for Epidemiologic Studies Depression Scale (CES-D). Insomnia symptoms were estimated with the Insomnia Severity Index (ISI). Physical activity levels were estimated with the International Physical Activity Questionnaire (IPAQ). Analyses were conducted using multiple linear regression, with separate models for depression, insomnia, and the combination of the two, on levels of physical activity. Results 3,952 adults (Mage = 46.9 years) completed the survey. According to the unadjusted models, greater insomnia symptoms were associated with greater depressive symptoms (b = 0.4523, SE = 0.019593, p &lt; .001), and lower levels of physical activity (b = -38.741, SE = 18.236, p = 0.0337). The relationship between insomnia and physical activity was no longer significant, however, when controlling for depression (b = -6.140, SE = 19.274, p = 0.75). According to the mediation analyses, there was an indirect effect of insomnia on physical activity that was explained by differences in depressive symptoms (Sobel Test = -4.895, SE = 6.518, p &lt; .001). Conclusion Our findings support previous research indicating associations between symptoms of insomnia and depression and physical activity. Future research should examine if these same results hold using a longitudinal design. Support (if any) Vargas: K23HL141581


2021 ◽  
pp. 095646242110230
Author(s):  
Alexandria Lunt ◽  
Carrie Llewellyn ◽  
Jake Bayley ◽  
Tom Nadarzynski

Introduction: The COVID-19 pandemic and social distancing measures forced sexual health services to engage with patients remotely. We aimed to understand perceived barriers and facilitators to the provision of digital sexual health services during the first months of the pandemic. Methods: An online survey and qualitative interviews with UK sexual healthcare professionals recruited online and via snowball sampling were conducted in May–July 2020. Results: Amongst 177 respondents (72% female, 86% White, mean age = 46, SD = 9), most utilised telephone and email as their main communication channels; however, their perceived effectiveness varied (94% and 66%, respectively). Most agreed that staff needed additional training (89%), the available technology was not adequate (66%) and health professionals were hesitant to provide online consultations (46%). They had positive attitudes towards digitalisation, improving service quality and cost-effectiveness but were concerned about exacerbating health inequalities. Discussion: The study identifies a need for clear guidelines and training around the use of digital tools as well as a demand for investment in hardware and software required for the provision of remote services. Future research needs to explore the acceptability, safety and effectiveness of various digital tools to narrow health inequalities in sexual health service users.


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