scholarly journals Application of an objective structured clinical examination to evaluate and monitor interns’ proficiency in hand hygiene and personal protective equipment use in the United States

2019 ◽  
Vol 16 ◽  
pp. 31 ◽  
Author(s):  
Ying Nagoshi ◽  
Lou Ann Cooper ◽  
Lynne Meyer ◽  
Kartik Cherabuddi ◽  
Julia Close ◽  
...  
Keyword(s):  
United States ◽  
Hand Hygiene ◽  
Clinical Examination ◽  
Personal Protective Equipment ◽  
The United States ◽  
Objective Structured Clinical Examination ◽  
Protective Equipment ◽  
Contact Precaution ◽  
Percent Correct ◽  
The Mean

Purpose: This study was conducted to determine whether an objective structured clinical examination (OSCE) could be used to evaluate and monitor hand hygiene and personal protective equipment (PPE) proficiency among medical interns in the United States.Methods: Interns in July 2015 (N=123, cohort 1) with no experience of OSCE-based contact precaution evaluation and teaching were evaluated in early 2016 using an OSCE for hand hygiene and PPE proficiency. They performed poorly. Therefore, the new interns entering in July 2016 (N=151, cohort 2) were immediately tested at the same OSCE stations as cohort 1, and were provided with feedback and teaching. Cohort 2 was then retested at the OSCE station in early 2017. The Mann-Whitney U-test was used to compare the performance of cohort 1 and cohort 2 on checklist items. In cohort 2, performance differences between the beginning and end of the intern year were compared using the McNemar chi-square test for paired nominal data.Results: Checklist items were scored, summed, and reported as percent correct. In cohort 2, the mean percent correct was higher on the posttest than on the pretest (92% vs. 77%, P<0.0001), and the passing rate (100% correct) was also significantly higher on the posttest (55% vs. 16%). At the end of intern year, the mean percent correct was higher in cohort 2 than in cohort 1 (95% vs. 90%, P<0.0001), and 55% of cohort 2 passed (a perfect score) compared to 24% in cohort 1 (P<0.0001).Conclusion: An OSCE can be utilized to evaluate and monitor hand hygiene and PPE proficiency among interns in the United States.

scholarly journals Issue of Compliance with Use of Personal Protective Equipment among Wastewater Workers across the Southeast Region of the United States

2019 ◽  
Vol 16 (11) ◽  
pp. 2009 ◽  
Author(s):  
Tamara Wright ◽  
Atin Adhikari ◽  
Jingjing Yin ◽  
Robert Vogel ◽  
Stacy Smallwood ◽  
...  
Keyword(s):  
United States ◽  
Personal Protective Equipment ◽  
Occupational Exposures ◽  
The United States ◽  
Protective Equipment ◽  
Linear Regression Models ◽  
Perceived Susceptibility ◽  
Occupational Illness ◽  
Southeast Region ◽  
The Impact

Wastewater workers are exposed to different occupational hazards such as chemicals, gases, viruses, and bacteria. Personal protective equipment (PPE) is a significant factor that can reduce or decrease the probability of an accident from hazardous exposures to chemicals and microbial contaminants. The purpose of this study was to examine wastewater worker’s beliefs and practices on wearing PPE through the integration of the Health Belief Model (HBM), identify the impact that management has on wastewater workers wearing PPE, and determine the predictors of PPE compliance among workers in the wastewater industry. Data was collected from 272 wastewater workers located at 33 wastewater facilities across the southeast region of the United States. Descriptive statistical analysis was conducted to present frequency distributions of participants’ knowledge and compliance with wearing PPE. Univariate and multiple linear regression models were applied to determine the association of predictors of interest with PPE compliance. Wastewater workers were knowledgeable of occupational exposures and PPE requirements at their facility. Positive predictors of PPE compliance were perceived susceptibility and perceived severity of contracting an occupational illness (p < 0.05). A negative association was identified between managers setting the example of wearing PPE sometimes and PPE compliance (p < 0.05). Utilizing perceived susceptibility and severity for safety programs and interventions may improve PPE compliance among wastewater workers.

Shifting Landscapes of Belonging: Birth Doulas and COVID-19

2020 ◽  
Vol 42 (4) ◽  
pp. 5-10
Author(s):  
Angela N. Castañeda ◽  
Julie Johnson Searcy
Keyword(s):  
United States ◽  
Personal Protective Equipment ◽  
The United States ◽  
Protective Equipment ◽  
Informational Support ◽  
Labor Support ◽  
Support Person ◽  
Hospital Policies

Abstract The rise of COVID-19 cases at hospitals translates to shifting policies about who can be present at births. Our research looks at data from nearly 400 qualitative surveys on how doulas—women who provide continuous emotional, physical, and informational support to pregnant and laboring people—navigate new restrictions redefining who belongs and is considered an “essential” birth worker in hospitals in the United States. The spectrum of new hospital guidelines spans from allowing only certified doulas, oftentimes with their own personal protective equipment (PPE) and on pre-approved hospital lists, to forcing pregnant people to choose only one support person, and in extreme cases, to banning any labor support—doula or partner. We examine what doulas reported about the changing hospital policies and shifting landscapes of belonging, thinking through what these contestations mean for birth.

scholarly journals Personal Protective Equipment for Common Urologic Procedures Before and During the United States COVID-19 Pandemic: A Single Institution Study

Urology ◽  
2020 ◽  
Vol 141 ◽  
pp. 1-6 ◽  
Author(s):  
David Sobel ◽  
Martus Gn ◽  
Timothy K. O'Rourke ◽  
Chris Tucci ◽  
Gyan Pareek ◽  
...  
Keyword(s):  
United States ◽  
Personal Protective Equipment ◽  
The United States ◽  
Protective Equipment ◽  
Single Institution

scholarly journals Adherence to Personal Protective Equipment Guidelines During the COVID-19 Pandemic Among Healthcare Personnel in the United States

2021 ◽  
pp. 1-8
Author(s):  
Oliver A. Darwish ◽  
Ayushi Aggarwal ◽  
Mehran Karvar ◽  
Chenhao Ma ◽  
Valentin Haug ◽  
...  
Keyword(s):  
United States ◽  
South Carolina ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Online Survey ◽  
The United States ◽  
Healthcare Personnel ◽  
Protective Equipment ◽  
Cdc Guidelines ◽  
Frontline Healthcare Workers

Abstract Objectives: Protecting frontline healthcare workers with personal protective equipment (PPE) is critical during the COVID pandemic. Through an online survey, we demonstrated variable adherence to the Center for Disease Control and Prevention’s (CDC) PPE guidelines among health care personnel (HCP). Methods: CDC guidelines for optimal and acceptable PPE usage in common situations faced by frontline healthcare workers were referenced to create a short online survey. The survey was distributed to national, statewide, and local professional organizations across the United States and to HCP using a snowball sampling technique. Responses were collected between June 15 and July 17, 2020. Results: 2245 responses were received from doctors, nurses, midwives, paramedics, and medical technicians in 44 states. Eight states with n>20 (Arizona, California, Colorado, Louisiana, Oregon, South Carolina, Texas, and Washington) and a total of 436 responses are included in the quantitative analysis. Adherence to CDC guidelines was observed to be highest in the scenario of patient contact when COVID was not suspected (86.47%) and lowest when carrying out aerosol generating procedures (AGPs) (42.47%). Conclusions: Further research is urgently needed to identify the reasons underlying variability between professions and regions to pinpoint strategies for maximizing adherence and improving the safety of HCPs.

Hand Hygiene and Personal Protective Equipment in Healthcare Settings During COVID-19 Pandemic in Bangladesh

2020 ◽  
Author(s):  
Md Rezaul Karim ◽  
Sushil Kumar Sah ◽  
Afsarunnesa Syeda ◽  
Muhammad Tanvir Faysol ◽  
Aminur Rahman ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Healthcare Settings

scholarly journals Longer Residence in the United States is Associated With More Physical Function Limitations in African Immigrant Older Adults

2020 ◽  
pp. 073346482097760
Author(s):  
Manka Nkimbeng ◽  
Yvonne Commodore-Mensah ◽  
Jacqueline L. Angel ◽  
Karen Bandeen-Roche ◽  
Roland J. Thorpe ◽  
...  
Keyword(s):  
United States ◽  
Older Adults ◽  
Confidence Interval ◽  
Physical Function ◽  
Racial Discrimination ◽  
African Immigrants ◽  
The United States ◽  
African Immigrant ◽  
High Discrimination ◽  
The Mean

Acculturation and racial discrimination have been independently associated with physical function limitations in immigrant and United States (U.S.)-born populations. This study examined the relationships among acculturation, racial discrimination, and physical function limitations in N = 165 African immigrant older adults using multiple linear regression. The mean age was 62 years ( SD = 8 years), and 61% were female. Older adults who resided in the United States for 10 years or more had more physical function limitations compared with those who resided here for less than 10 years ( b = −2.62, 95% confidence interval [CI] = [–5.01, –0.23]). Compared to lower discrimination, those with high discrimination had more physical function limitations ( b = −2.51, 95% CI = [–4.91, –0.17]), but this was no longer significant after controlling for length of residence and acculturation strategy. Residing in the United States for more than 10 years is associated with poorer physical function. Longitudinal studies with large, diverse samples of African immigrants are needed to confirm these associations.

scholarly journals A Retrospective Analysis of Softball-Related Head and Facial Injuries Treated in United States Emergency Departments, 2013-2017

2019 ◽  
Vol 7 (2) ◽  
pp. 232596711982566 ◽  
Author(s):  
John S. Strickland ◽  
Marie Crandall ◽  
Grant R. Bevill
Keyword(s):  
United States ◽  
Head Injuries ◽  
The United States ◽  
Weighted Estimate ◽  
Body Parts ◽  
Facial Injuries ◽  
Closed Head Injuries ◽  
Closed Head ◽  
The Mean ◽  
Race Ethnicity

Background: Softball is a popular sport played through both competitive and recreational leagues. While head and facial injuries are a known problem occurring from games, little is known about the frequency or mechanisms by which they occur. Purpose: To analyze head/face injury diagnoses and to identify the mechanisms associated with such injuries. Study Design: Descriptive epidemiological study. Methods: A public database was used to query data related to head/facial injuries sustained in softball. Data including age, sex, race/ethnicity, injury diagnosis, affected body parts, disposition, incident location, and narrative descriptions were collected and analyzed. Results: A total of 3324 head and face injuries were documented in the database over the time span of 2013 to 2017, resulting in a nationwide weighted estimate of 121,802 head/face injuries occurring annually. The mean age of the players was 21.5 ± 14.4 years; 72.1% of injured players were female, while 27.9% were male. The most common injury diagnoses were closed head injuries (22.0%), contusions (18.7%), concussions (17.7%), lacerations (17.1%), and fractures (15.1%). The overwhelming majority of injuries involved being struck by a ball (74.3%), followed by colliding with another player (8.3%), colliding with the ground or a fixed object (5.0%), or being struck by a bat (2.8%). For those injuries caused by a struck-by-ball incident, most occurred from defensive play (83.7% were fielders struck by a hit or thrown ball) as opposed to offensive play (12.3% were players hit by a pitch or runners struck by a ball). Although helmet usage was poorly tracked in the database, female players (1.3%) were significantly more likely to have been wearing a helmet at the time of injury than were male players (0.2%) ( P = .002). Conclusion: The present study demonstrates that a large number of head and face injuries occur annually within the United States as a result of softball play. A variety of injuries were observed, with the majority involving defensive players being struck by the ball, which highlights the need for more focus on player safety by stronger adherence to protective headgear usage and player health monitoring.

Analisis Capaian Kompetensi Mahasiswa dalam Objective Structured Clinical Examination (OSCE) Semester Ganjil Tahun Ajaran 2017/2018 Fakultas Kedokteran Universitas HKBP Nommensen Medan

2020 ◽  
Vol 5 (2) ◽  
pp. 28-35
Author(s):  
Jenny Novina Sitepu
Keyword(s):  
Clinical Examination ◽  
Clinical Reasoning ◽  
Clinical Skills ◽  
Objective Structured Clinical Examination ◽  
Treatment Practice ◽  
Standard Patient ◽  
The Mean ◽  
Reasoning Skills ◽  
Clinical Reasoning Skills ◽  
Academic Year

Backgroud: Clinical skills is one of competency as a doctor. Objective Structured Clinical Examination (OSCE) is an ideal way to assess clinical skills for undergraduated, graduated, and postdraduated clinical students. The low score in some OSCE station can be an input for teaching and curriculum improvement. This study aim to analyzed student competency achievement in first term in 2017/2018 academic year in  Fakultas Kedokteran Universitas HKBP Nommensen. Methods: This study was qualitative study with descriptive design. The sample was OSCE score in first term in 2017/2018 academic year. Student achievement was the mean score of every student in all station in OSCE. Competency achievement was the mean of students score for every competency in OSCE. Next, the stations was categorized in practice/ procedure skills station and clinical reasoning skills station. Skills achievement was got form the mean of score (in percent) of procedure skills and clinical reasoning station. Indept interview with students and lectures was held to knowed their perception about OSCE. Results: Students’ achievement in OSCE of first term academic year 2017/2018 was 62.4% for 2015’s students, and 64.6% for 2016’ students. The lowest competency achievement of 2015’s students was diagnosis and differential diagnosis. For the 2016’s students, it was farmacology treatment. Practice/ procedure skills achievement in OSCE of first term academic year 2017/2018 was 61.34% (2015’s students) and 74.4% (2016’s students). The clinical reasoning skills achievement was 62.80% (2015’s students), and 58.77% (2016’s students). Based on indept interview, the things that make student’s achievement low were the clinical reasoning ability of students was still low, the standard patient that involved in OSCE didn’t acted properly, the students’ knowledge about medicine and prescription was poor, and there were lot of learning schedules and learning subjects that students must did and learned. Conclusions:  Students’ achievement in OSCE of first term academic year 2017/2018 is need to  be improved.

Management of personal protective equipment during the COVID-19 pandemic in England and the state of New York: A comparative case study

2020 ◽  
Vol 18 (7) ◽  
pp. 71-89
Author(s):  
Amy Barber, BSc ◽  
Annaëlle Vinzent, BS ◽  
Imani Williams, BA
Keyword(s):  
New York ◽  
Supply Chain ◽  
Health Systems ◽  
Personal Protective Equipment ◽  
New York State ◽  
The United States ◽  
Mitigation Strategies ◽  
Comparative Case Study ◽  
Protective Equipment

Background: The COVID-19 crisis placed extraordinary demands on the supply of personal protective equipment (PPE) at the beginning of 2020. These were coupled with shocks to the supply chain resulting from the disease. Many typically well-resourced health systems faced subsequent shortages of equipment and had to implement new strategies to manage their stocks. Stockpiles of protective equipment were held in both the United States and United Kingdom intended to prevent shortages. Method: Cross-comparative case study approach by applying Pettigrew and Whipp’s framework for change management. Setting: The health systems of England and New York state from January 2020 to the end of April 2020. Results: Both cases reacted slowly to their outbreaks and faced problems with supplying enough PPE to their health systems. Their stockpiles were not enough to prevent shortages, with many distribution problems resulting from inadequate governance mechanisms. No sustainable responses to supply disruptions were implemented during the study period in either case. Health systems planned interventions along each part of the supply chain from production and importing, to usage guidelines. Conclusion: Global supply chains are vulnerable to disruptions caused by international crises, and existing mitigation strategies have not been wholly successful. The existence of stockpiles is insufficient to preventing shortages of necessary equipment in clinical settings. Both the governance and quality of stockpiles, as well as distribution channels are important for preventing shortages. At the time of writing, it is not possible to judge the strength of strategies adopted in these cases.

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