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https://www.readbyqxmd.com/read/29346587/are-root-cause-analyses-recommendations-effective-and-sustainable-an-observational-study
#1
Peter D Hibbert, Matthew J W Thomas, Anita Deakin, William B Runciman, Jeffrey Braithwaite, Stephanie Lomax, Jonathan Prescott, Glenda Gorrie, Amy Szczygielski, Tanja Surwald, Catherine Fraser
Objective: To assess the strength of root cause analysis (RCA) recommendations and their perceived levels of effectiveness and sustainability. Design: All RCAs related to sentinel events (SEs) undertaken between the years 2010 and 2015 in the public health system in Victoria, Australia were analysed. The type and strength of each recommendation in the RCA reports were coded by an expert patient safety classifier using the US Department of Veteran Affairs type and strength criteria...
January 16, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29346222/-to-err-is-human-but-disclosure-must-be-taught-a-simulation-based-assessment-study
#2
Ashley C Crimmins, Ambrose H Wong, James W Bonz, Alina Tsyrulnik, Karen Jubanyik, James D Dziura, Kelly L Dodge, Leigh V Evans
INTRODUCTION: Although error disclosure is critical in promoting safety and patient-centered care, physicians are inconsistently trained in its practice, and few objective methods to assess competence exist. We used an immersive simulation scenario to determine whether providers with varying levels of clinical experience adhere to the disclosure safe practice guidelines when exposed to a serious adverse event simulation scenario. METHODS: This was a prospective cohort study with medical students, junior emergency medicine (EM) residents (PGY 1-2), senior EM residents (PGY 3-4), and attending EM physicians participating in a simulated case in which a scripted medication overdose resulted in an adverse event...
January 17, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29346221/a-validation-argument-for-a-simulation-based-training-course-centered-on-assessment-recognition-and-early-management-of-pediatric-sepsis
#3
Gary L Geis, Derek S Wheeler, Amy Bunger, Laura G Militello, Regina G Taylor, Jerome P Bauer, Terri L Byczkowski, Benjamin T Kerrey, Mary D Patterson
INTRODUCTION: Early recognition of sepsis remains one of the greatest challenges in medicine. Novice clinicians are often responsible for the recognition of sepsis and the initiation of urgent management. The aim of this study was to create a validity argument for the use of a simulation-based training course centered on assessment, recognition, and early management of sepsis in a laboratory-based setting. METHODS: Five unique simulation scenarios were developed integrating critical sepsis cues identified through qualitative interviewing...
January 17, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29346179/avstick-an-intravenous-catheter-insertion-simulator-for-use-with-standardized-patients
#4
Andrew Devenny, Danielle Lord, Joshua Matthews, Julia Tuhacek, Jennifer Vitlip, Mingxu Zhang, Amy C Bucha, Liyun Wang, Jenni M Buckley, Amy Cowperthwait
An overwhelming majority of hospitalized patients undergo intravenous (IV) catheter insertion in order to receive hydration and necessary medication. Current IV insertion training techniques include manikins that are unable to react or give feedback to the trainee. The Avstick® is a realistic training device that can be worn by an actor, allowing a nurse trainee to perform an IV catheter insertion on a live patient without causing the person harm. The purpose of this study is to demonstrate the effectiveness of the Avstick in nursing education to increase nurse-patient communication and trainee self-efficacy...
January 17, 2018: Nursing Education Perspectives
https://www.readbyqxmd.com/read/29345173/effects-of-3-day-serial-sodium-bicarbonate-loading-on-performance-and-physiological-parameters-during-a-simulated-basketball-test-in-female-university-players
#5
Anne Delextrat, Sinead MacKessy, Luis Arceo-Rendon, Aaron Scanlan, Roger Ramsbottom, Julio Calleja-González
The aim of this study was to investigate the effect of 3-day serial sodium bicarbonate ingestion on repeated sprint and jump performance. Fifteen female university basketball players (23.3±3.4 years; 173.1±5.8 cm; 65.8±6.3 kg; 23.6±4.9% body fat) ingested 0.4 g·kg-1 of body mass of sodium bicarbonate or placebo for 3 days (split in 3 equal daily doses), before completing a simulated basketball exercise. Sprint and circuit times, jump heights, performance decrements and gastrointestinal (GI) side effects were recorded during the test and blood lactate concentration was measured pre- and post-test...
January 18, 2018: International Journal of Sport Nutrition and Exercise Metabolism
https://www.readbyqxmd.com/read/29343190/factors-affecting-effective-ventilation-during-newborn-resuscitation-a-qualitative-study-among-midwives-in-rural-tanzania
#6
R Moshiro, H L Ersdal, P Mdoe, H L Kidanto, C Mbekenga
BACKGROUND: Intrapartum-related hypoxia accounts for 30% of neonatal deaths in Tanzania. This has led to the introduction and scaling-up of the Helping Babies Breathe (HBB) programme, which is a simulation-based learning programme in newborn resuscitation skills. Studies have documented ineffective ventilation of non-breathing newborns and the inability to follow the HBB algorithm among providers. OBJECTIVE: This study aimed at exploring barriers and facilitators to effective bag mask ventilation, an essential component of the HBB algorithm, during actual newborn resuscitation in rural Tanzania...
2018: Global Health Action
https://www.readbyqxmd.com/read/29342964/data-driven-modeling-and-rendering-of-force-responses-from-elastic-tool-deformation
#7
Arsen Abdulali, Ruslan Rakhmatov, Tatyana Ogay, Seokhee Jeon
This article presents a new data-driven model design for rendering force responses from elastic tool deformation. The new design incorporates a six-dimensional input describing the initial position of the contact, as well as the state of the tool deformation. The input-output relationship of the model was represented by a radial basis functions network, which was optimized based on training data collected from real tool-surface contact. Since the input space of the model is represented in the local coordinate system of a tool, the model is independent of recording and rendering devices and can be easily deployed to an existing simulator...
January 15, 2018: Sensors
https://www.readbyqxmd.com/read/29342495/improving-perinatology-residents-skills-in-breaking-bad-news-a-randomized-intervention-study
#8
Maria Silvia Vellutini Setubal, Maria Ângela Reis Goes Monteiro Antonio, Eliana Martorano Amaral, John Boulet
OBJECTIVE:  Breaking bad news (BBN) is particularly difficult in perinatology. Previous research has shown that BBN skills can be learned and improved when taught and practiced. This project evaluated whether a structured training session would enhance perinatology residents' skills in BBN. METHODS:  This was a randomized controlled intervention study with year 1 to 4 Perinatology residents from a medical school in Brazil, during the 2014/15 school year. A total of 61 out of 100 (61%) eligible residents volunteered to a structured training program involving communicating a perinatal loss to a simulated patient (SP) portraying the mother followed by the SP's immediate feedback, both video recorded...
January 17, 2018: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/29342394/identification-of-linear-and-nonlinear-sensory-processing-circuits-from-spiking-neuron-data
#9
Dorian Florescu, Daniel Coca
Inferring mathematical models of sensory processing systems directly from input-output observations, while making the fewest assumptions about the model equations and the types of measurements available, is still a major issue in computational neuroscience. This letter introduces two new approaches for identifying sensory circuit models consisting of linear and nonlinear filters in series with spiking neuron models, based only on the sampled analog input to the filter and the recorded spike train output of the spiking neuron...
January 17, 2018: Neural Computation
https://www.readbyqxmd.com/read/29341795/the-ability-to-provide-quality-chest-compressions-over-lacrosse-shoulder-pads
#10
Richard J Boergers, Thomas G Bowman, Monica Lininger
CONTEXT:   Performance of quality cardiopulmonary resuscitation is essential for improving patient outcomes. Performing compressions over football equipment inhibits compression depth and rate, but lacrosse equipment has not yet been studied. OBJECTIVE:   To assess the effect of lacrosse shoulder pads on the ability to provide quality chest compressions on simulation manikins. DESIGN:   Crossover study. SETTING:   Simulation laboratory...
January 17, 2018: Journal of Athletic Training
https://www.readbyqxmd.com/read/29341749/towards-attosecond-high-energy-electron-bunches-controlling-self-injection-in-laser-wakefield-accelerators-through-plasma-density-modulation
#11
M P Tooley, B Ersfeld, S R Yoffe, A Noble, E Brunetti, Z M Sheng, M R Islam, D A Jaroszynski
Self-injection in a laser-plasma wakefield accelerator is usually achieved by increasing the laser intensity until the threshold for injection is exceeded. Alternatively, the velocity of the bubble accelerating structure can be controlled using plasma density ramps, reducing the electron velocity required for injection. We present a model describing self-injection in the short-bunch regime for arbitrary changes in the plasma density. We derive the threshold condition for injection due to a plasma density gradient, which is confirmed using particle-in-cell simulations that demonstrate injection of subfemtosecond bunches...
July 28, 2017: Physical Review Letters
https://www.readbyqxmd.com/read/29341640/role-of-intrapulse-coherence-in-carrier-envelope-phase-stabilization
#12
Nils Raabe, Tianli Feng, Tobias Witting, Ayhan Demircan, Carsten Brée, Günter Steinmeyer
The concept of coherence is of fundamental importance for describing the physical characteristics of light and for evaluating the suitability for experimental application. In the case of pulsed laser sources, the pulse-to-pulse coherence is usually considered for a judgment of the compressibility of the pulse train. This type of coherence is often lost during propagation through a highly nonlinear medium, and pulses prove incompressible despite multioctave spectral coverage. Notwithstanding the apparent loss of interpulse coherence, however, supercontinua enable applications in precision frequency metrology that rely on coherence between different spectral components within a laser pulse...
September 22, 2017: Physical Review Letters
https://www.readbyqxmd.com/read/29340856/core-point-of-care-ultrasound-curriculum-what-does-every-anesthesiologist-need-to-know
#13
REVIEW
Massimiliano Meineri, Gregory L Bryson, Ramiro Arellano, Nikolaos Skubas
Point-of-care ultrasound (POCUS) is becoming an integral part of anesthesia practice throughout the world. Despite the growing interest in POCUS among trainees and faculty, POCUS training is variable among universities across Canada. This suggests a need for curriculum development and standardization. International guidelines for Emergency Medicine and Critical Care have common frameworks and may be used as a reference to model anesthesia-specific curricula. The Royal College of Anaesthetists of the United Kingdom currently offers the only nationally approved POCUS curriculum for anesthesia and critical care trainees...
January 16, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29340549/teaching-model-for-evaluation-of-the-ability-and-competence-progress-in-endosuture-in-surgical-skill-laboratory
#14
Luiz Gonzaga de Moura-Júnior, Almino Ramos, Josemberg Marins Campos, Álvaro Antônio Ferraz, Hermano Ângelo Lima Rocha, Grijalva Otávio Costa
BACKGROUND: Laparoscopic manual suturing is probably the most difficult skill to be acquired in minimally invasive surgery. However, laparoscopic exercise endo-sutures can be learned with a simulator and are of great practical importance and clinical applicability, absorbing concepts that are immediately transferred to the operating room. AIM: To assess the progression of skills competence in endo-sutures through realistic simulation model of systematized education...
October 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/29338852/simulation-based-multidisciplinary-team-training-decreases-time-to-critical-operations-for-trauma-patients
#15
Margaret Murphy, Kate Curtis, Mary K Lam, Cameron S Palmer, Jeremy Hsu, Andrea McCloughen
BACKGROUND: Simulation has been promoted as a platform for training trauma teams. However, it is not clear if this training has an impact on health service delivery and patient outcomes. This study evaluates the association between implementation of a simulation based multidisciplinary trauma team training program at a metropolitan trauma centre and subsequent patient outcomes. METHOD: This was a retrospective review of trauma registry data collected at an 850-bed Level 1 Adult Trauma Centre in Sydney, Australia...
January 8, 2018: Injury
https://www.readbyqxmd.com/read/29338143/anesthesiology-residents-induction-month-a-pilot-study-showing-an-effective-and-safe-way-to-train-novice-residents-through-simulation
#16
Federico L Barra, Luca Carenzo, Jeffrey Franc, Claudia Montagnini, Flavia Petrini, Francesco Della Corte, Pier L Ingrassia
BACKGROUND: The transition of new residents from medical school to the post-graduate clinical environment remains challenging. We hypothesized that an introductory simulation course could improve new residents' performance in anesthesiology. METHODS: "Anesthesiology Residents Induction Month" (ARIM) was designed as a non-clinical simulation training program aiming at providing the theoretical and practical skills to safely approach, as junior anesthesiologists, the operating rooms...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29337578/physiologically-based-pharmacokinetic-modeling-in-lead-optimization-i-evaluation-and-adaptation-of-gastroplus-to-predict-bioavailability-of-medchem-series
#17
Pankaj R Daga, Michael B Bolger, Ian S Haworth, Robert Daniel Clark, Eric J Martin
When medicinal chemists need to improve bioavailability (%F) within a chemical series during lead optimization, they synthesize new series members with systematically modified properties mainly by following experience and general rules of thumb. More quantitative models that predict %F of proposed compounds from chemical structure alone have proven elusive. Global empirical %F quantitative structure-property (QSPR) models perform poorly and projects have too little data to train local %F QSPR models. Mechanistic oral absorption and physiologically-based pharmacokinetic (PBPK) models simulate the dissolution, absorption, systemic distribution, and clearance of a drug in preclinical species and humans...
January 16, 2018: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/29337170/virtual-cerebral-aneurysm-clipping-with-real-time-haptic-force-feedback-in-neurosurgical-education
#18
Matthias Gmeiner, Johannes Dirnberger, Wolfgang Fenz, Maria Gollwitzer, Gabriele Wurm, Johannes Trenkler, Andreas Gruber
OBJECTIVE: Realistic, safe and efficient modalities for simulation-based training are highly warranted to enhance the quality of surgical education and should be incorporated in resident training. The aim of this study was to develop a patient-specific virtual cerebral aneurysm-clipping simulator with haptic force-feedback and real-time deformation of the aneurysm and vessels. METHODS: A prototype simulator was developed from 2012-2016. Evaluation of virtual clipping by blood flow simulation was integrated in this software and the prototype was evaluated by 18 neurosurgeons...
January 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29336833/education-for-ecmo-providers-using-education-science-to-bridge-the-gap-between-clinical-and-educational-expertise
#19
REVIEW
Lindsay Johnston, Susan B Williams, Anne Ades
A well-organized educational curriculum for the training of both novice and experienced ECMO providers is critical for the continued function of an institutional ECMO program. ELSO provides guidance for the education for ECMO specialists, physicians and staff, which incorporates "traditional" instructor-centered educational methods, such as didactic lectures and technical skill training. Novel research suggests utilization of strategies that align with principles of adult learning to promote active learner involvement and reflection on how the material can be applied to understand existing and new constructs may be more effective...
January 11, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29336338/training-in-urological-robotic-surgery-future-perspectives
#20
Ahmed El Sherbiny, Ahmed Eissa, Ahmed Ghaith, Elena Morini, Lucilla Marzotta, Maria Chiara Sighinolfi, Salvatore Micali, Giampaolo Bianchi, Bernardo Rocco
As robotics are becoming more integrated into the medical field, robotic training is becoming more crucial in order to overcome the lack of experienced robotic surgeons. However, there are several obstacles facing the development of robotic training programs like the high cost of training and the increased operative time during the initial period of the learning curve, which, in turn increase the operative cost. Robotic-assisted laparoscopic prostatectomy is the most commonly performed robotic surgery. Moreover, robotic surgery is becoming more popular among urologic oncologists and pediatric urologists...
January 2018: Archivos Españoles de Urología
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