The Experts below are selected from a list of 615 Experts worldwide ranked by ideXlab platform
Elizabeth A. Hunt - One of the best experts on this subject based on the ideXlab platform.
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Abstract P212: Simulated Pediatric Resuscitation During Novel H1N1 Influenza Outbreak
Circulation, 2009Co-Authors: Christopher M. Watson, Jordan Duval-arnould, Michael C. Mccrory, Elizabeth A. HuntAbstract:Background: Most hospital preparedness plans for highly infectious outbreaks rely on the implementation of strict isolation and personal protection equipment (PPE) measures. The impact of these interventions on the quality and efficiency of the first 5 minutes of pediatric resuscitation has not been studied. Methods: At the onset of the 2009 H1N1 outbreak, medium-fidelity simulation was conducted in situ on a pediatric ward Designated as the receiving ward for suspected cases. The simulated patient was an 8 year-old male with asthma admitted with suspected H1N1 influenza on enhanced airborne precautions. The patient then developed progressive respiratory failure and altered mental status prompting the “code” initiation. Observers assessed use of PPE, deviation from American Heart Association guidelines, and elapsed time: to staff arrival, room-entry, and specific resuscitation maneuvers. Results: Simulation revealed that the donning of full PPE including powered air-purifying respirators (PAPR) delayed the room entry of the first responder by 2.0 minutes. The first responder initially found no bedside oxygen therapy equipment. A bag-valve-mask was not located until 3.7 minutes. First pulse check occurred at 5.5 minutes. Basic airway maneuvers were performed and oxygen applied at 7.2 minutes. The first physician did not enter until 8.0 minutes due to delay in PPE acquisition. No Designated Team Member controlled room access or assisted with PPE. Discrepant use of PAPR and N95 respirators by Team Members was observed. Communication quality was also reduced with PAPR use. Conclusions: Simulation using a pediatric patient with a highly infectious disease suggests greater risk of adverse outcome due to delayed delivery of care during the first 5 minutes of resuscitation. Additionally, staff are at greater risk of infectious exposure due to inconsistent and improper use of PPE. To improve pediatric resuscitation, hospitals should expand the availability of bedside oxygen therapy equipment for children on enhanced airborne precautions. An explicit algorithm for the application of oxygen therapy by the first responder also is needed. A critical component of this algorithm must be a “gatekeeper” tasked with controlling room entry and use of PPE.
Christopher M. Watson - One of the best experts on this subject based on the ideXlab platform.
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Abstract P212: Simulated Pediatric Resuscitation During Novel H1N1 Influenza Outbreak
Circulation, 2009Co-Authors: Christopher M. Watson, Jordan Duval-arnould, Michael C. Mccrory, Elizabeth A. HuntAbstract:Background: Most hospital preparedness plans for highly infectious outbreaks rely on the implementation of strict isolation and personal protection equipment (PPE) measures. The impact of these interventions on the quality and efficiency of the first 5 minutes of pediatric resuscitation has not been studied. Methods: At the onset of the 2009 H1N1 outbreak, medium-fidelity simulation was conducted in situ on a pediatric ward Designated as the receiving ward for suspected cases. The simulated patient was an 8 year-old male with asthma admitted with suspected H1N1 influenza on enhanced airborne precautions. The patient then developed progressive respiratory failure and altered mental status prompting the “code” initiation. Observers assessed use of PPE, deviation from American Heart Association guidelines, and elapsed time: to staff arrival, room-entry, and specific resuscitation maneuvers. Results: Simulation revealed that the donning of full PPE including powered air-purifying respirators (PAPR) delayed the room entry of the first responder by 2.0 minutes. The first responder initially found no bedside oxygen therapy equipment. A bag-valve-mask was not located until 3.7 minutes. First pulse check occurred at 5.5 minutes. Basic airway maneuvers were performed and oxygen applied at 7.2 minutes. The first physician did not enter until 8.0 minutes due to delay in PPE acquisition. No Designated Team Member controlled room access or assisted with PPE. Discrepant use of PAPR and N95 respirators by Team Members was observed. Communication quality was also reduced with PAPR use. Conclusions: Simulation using a pediatric patient with a highly infectious disease suggests greater risk of adverse outcome due to delayed delivery of care during the first 5 minutes of resuscitation. Additionally, staff are at greater risk of infectious exposure due to inconsistent and improper use of PPE. To improve pediatric resuscitation, hospitals should expand the availability of bedside oxygen therapy equipment for children on enhanced airborne precautions. An explicit algorithm for the application of oxygen therapy by the first responder also is needed. A critical component of this algorithm must be a “gatekeeper” tasked with controlling room entry and use of PPE.
Divyesh V. Sejpal - One of the best experts on this subject based on the ideXlab platform.
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Improving patient safety in the endoscopy unit: utilization of remote video auditing to improve time-out compliance
Gastrointestinal endoscopy, 2019Co-Authors: Kara L. Raphael, Sara Cerrone, Edward Sceppa, Patricia Schneider, Tara Laumenede, Ann Lynch, Divyesh V. SejpalAbstract:Background and Aims Patient and procedure verification, or the time-out process (TOP), is considered one of the most vital components of patient safety. It has long been a focus of intervention in the surgical community and recently was incorporated into the American Society for Gastrointestinal Endoscopy guidelines for safety in the GI endoscopy unit. The TOP has had limited attention in the endoscopy literature but remains an area for improvement in clinical endoscopy practice. The aim of this study was to identify barriers and improve TOP compliance rates in our endoscopy unit using remote video auditing (RVA). Methods This was a single-center, prospective, pilot initiative in an endoscopy unit at a tertiary care academic medical center. Video cameras with offsite monitoring were installed in each procedure room in our endoscopy suite in November 2016. Baseline TOP compliance rates were audited with RVA over a 2-month period. A multidisciplinary quality improvement Team reviewed the data, identified barriers to the TOP, and implemented actionable items in January 2017. TOP compliance rates were again monitored via RVA, and data were collected through October 2018. Pre- and postintervention TOP compliance rates were compared. Results Over the baseline period, 692 procedures were audited and TOP compliance documented. Baseline TOP compliance rate was 69.6%. Identifiable barriers to TOP compliance included a lack of Designated Team Member to lead TOP, inconsistent documentation of TOP, irrelevant safety checklist items not applicable to endoscopic procedures, and lack of patient safety culture. Actionable items implemented in response to these barriers included designation of a TOP leader, visual indication of initiation of TOP, creation of a concise endoscopy-specific safety checklist, and formal notification/education of the entire endoscopy Team. Postintervention TOP compliance rates were then audited from January 2017 to October 2018 and included 12,008 procedures. The mean TOP compliance rate significantly improved from baseline (95.3% vs 69.6%; 95% confidence interval, 22.4-29.3; P Conclusions TOP compliance rates significantly improved in our endoscopy unit through the use of RVA and implementation of 4 actionable items. Future studies should evaluate the reproducibility of this method in other endoscopy units.
Minden Kirsten - One of the best experts on this subject based on the ideXlab platform.
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Transitional care for rheumatic conditions in Europe: current clinical practice and available resources
'Springer Science and Business Media LLC', 2017Co-Authors: Clemente Daniel, Leon Leticia, Foster Helen, Carmona Loreto, Minden KirstenAbstract:OBJECTIVE: To assess European pediatric rheumatology providers’ current clinical practices and resources used in the transition from child-centered to adult-oriented care. METHODS: European pediatric rheumatologists were invited to complete a 17-item anonymized e-survey assessing current transition practices, transition policy awareness, and needs in advance of the publication of EULAR/PReS recommendations on transition. RESULTS: The response rate was 121/276 (44%), including responses from 115 centers in 22 European Union countries. Although 32/121 (26%) responded that their centers did not offer transition services, the majority (99%) agreed that a formalized process in transitioning patients to adult care is necessary. A minority (<30%) of respondents stated that they have a written transition policy although 46% have an informal transition process. Designated staff to support transitional care were available in a minority of centers: nurse (35%), physiotherapist (15%), psychologist (15%), social worker (8%), and occupational therapist (2%). The existence of a Designated Team Member to coordinate transition was acknowledged in many centers (64% of respondents) although just 36% use a checklist for young people as part of individualized transitional care. CONCLUSION: This survey of European pediatric rheumatology providers regarding transitional care practices demonstrates agreement that transitional care is important, and wide variation in current provision of transition services exists
Jordan Duval-arnould - One of the best experts on this subject based on the ideXlab platform.
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Abstract P212: Simulated Pediatric Resuscitation During Novel H1N1 Influenza Outbreak
Circulation, 2009Co-Authors: Christopher M. Watson, Jordan Duval-arnould, Michael C. Mccrory, Elizabeth A. HuntAbstract:Background: Most hospital preparedness plans for highly infectious outbreaks rely on the implementation of strict isolation and personal protection equipment (PPE) measures. The impact of these interventions on the quality and efficiency of the first 5 minutes of pediatric resuscitation has not been studied. Methods: At the onset of the 2009 H1N1 outbreak, medium-fidelity simulation was conducted in situ on a pediatric ward Designated as the receiving ward for suspected cases. The simulated patient was an 8 year-old male with asthma admitted with suspected H1N1 influenza on enhanced airborne precautions. The patient then developed progressive respiratory failure and altered mental status prompting the “code” initiation. Observers assessed use of PPE, deviation from American Heart Association guidelines, and elapsed time: to staff arrival, room-entry, and specific resuscitation maneuvers. Results: Simulation revealed that the donning of full PPE including powered air-purifying respirators (PAPR) delayed the room entry of the first responder by 2.0 minutes. The first responder initially found no bedside oxygen therapy equipment. A bag-valve-mask was not located until 3.7 minutes. First pulse check occurred at 5.5 minutes. Basic airway maneuvers were performed and oxygen applied at 7.2 minutes. The first physician did not enter until 8.0 minutes due to delay in PPE acquisition. No Designated Team Member controlled room access or assisted with PPE. Discrepant use of PAPR and N95 respirators by Team Members was observed. Communication quality was also reduced with PAPR use. Conclusions: Simulation using a pediatric patient with a highly infectious disease suggests greater risk of adverse outcome due to delayed delivery of care during the first 5 minutes of resuscitation. Additionally, staff are at greater risk of infectious exposure due to inconsistent and improper use of PPE. To improve pediatric resuscitation, hospitals should expand the availability of bedside oxygen therapy equipment for children on enhanced airborne precautions. An explicit algorithm for the application of oxygen therapy by the first responder also is needed. A critical component of this algorithm must be a “gatekeeper” tasked with controlling room entry and use of PPE.