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Duty hours

Gordon G Wisbach, Joshua Peters, Jenise Leon Guerrero, Nelson Mozzini, Helen Metzger
Introduction: The obesity epidemic in the USA includes active duty service members in the military and effects physical readiness. At the Naval Medical Center San Diego command, the Health & Wellness Department is charged with administering the Weight Management Programs (WMP) for sailors in the San Diego area to ensure military physical readiness requirements. The optimal allocation of personnel and resources to manage these programs is paramount for mission success. We analyzed the cost and effectiveness of the WMPs for the active duty population stationed at Naval Medical Center San Diego (NMCSD) with the intent of offering potential recommendations for program optimization...
March 14, 2018: Military Medicine
Karina Araujo Pinto, Rosane Harter Griep, Lucia Rotenberg, Maria da Conceição Chagas Almeida, Rosane Sousa Barreto, Estela M L Aquino
Perceived time constraints have been highlighted in sociological studies as representing a core issue in determining quality of life. The objective of this study was to test the hypothesis that gender inequalities regarding insufficiency of time play a role in the development of overweight and obesity in adults. The study used baseline data (2008-2010) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), which monitors a cohort of 15,105 civil servants of 35 to 74 years of age. Insufficient time for personal care and leisure due to professional and domestic duties, as detailed in a structured questionnaire, comprised the main exposure variable...
2018: PloS One
Katherine E Gallagher, Tusajigwe Erio, Kathy Baisley, Shelley Lees, Deborah Watson-Jones
BACKGROUND: The burden of cervical cancer and shortage of screening services in Tanzania confers an urgent need for human papillomavirus (HPV) vaccination. However, the sustainability and impact of another new vaccine campaign in an under-resourced health system requires consideration. We aimed to determine the impact of the government's school-based HPV vaccine campaign in Kilimanjaro region on the provision of routine primary health services and staff workload. METHODS: Data on daily numbers of consultations were collected from health facility register books in 63 dispensaries and health centres in North-West Tanzania for 20 weeks in 2014...
March 12, 2018: BMC Health Services Research
Marc Beltempo, Karin Clement, Guy Lacroix, Sylvie Bélanger, Anne-Sophie Julien, Bruno Piedboeuf
OBJECTIVE:  This article assesses the effect of reducing consecutive hours worked by residents from 24 to 16 hours on yearly total hours worked per resident in the neonatal intensive care unit (NICU) and evaluates the association of resident duty hour reform, level of trainee, and the number of residents present at admission with mortality in the NICU. STUDY DESIGN:  This is a 6-year retrospective cohort study including all pediatric residents working in a Level 3 NICU ( N  = 185) and infants admitted to the NICU ( N  = 8,159)...
February 8, 2018: American Journal of Perinatology
Holly E Reid, Anja Wittkowski, Sarah Vause, Alexander E P Heazell
OBJECTIVES: To explore the views of maternity service users and professionals towards obstetric consultant presence 24 hours a day, 7 days a week. DESIGN: Semistructured interviews conducted face to face with maternity service users and professionals in March and April 2016. All responses were analysed together (ie, both service users' and professionals' responses) using an inductive thematic analysis. SETTING: A large tertiary maternity unit in the North West of England that has implemented 24/7 obstetric consultant presence...
March 6, 2018: BMJ Open
Christopher Watura, Dominic Blunt, Dimitri Amiras
BACKGROUND: Telephone calls remain one of the most frequent interruptions in radiology reporting rooms, despite modern electronic order communication systems. A call received by a radiology trainee during the hour before completing a report may increase the chance of a discrepancy by 12%. AIM: To characterise telephone calls to radiology reporting rooms and identify ways to reduce these interruptions. METHODS AND MATERIALS: An observational study over five working days (10 programmed activity reporting sessions equivalent) was conducted across 2 large teaching hospital reporting rooms...
January 11, 2018: Current Problems in Diagnostic Radiology
Joshua Smith, W Graham Carlos, Cynthia S Johnson, Blaine Takesue, Debra Litzelman
OBJECTIVE: We tested a novel, web-based teaching electronic medical record to teach and assess residents' ability to enter appropriate admission orders for patients admitted to the intensive care unit. The primary objective was to determine if this tool could improve the learners' ability to enter an evidence-based, comprehensive initial care plan for critically ill patients. METHODS: The authors created three modules using de-identifed real patient data from selected patients that were admitted to the intensive care unit...
December 2018: Medical Education Online
Ibrahim Raza, Awais Raza, Syed Ahmad Razaa, Ahmad Bani Sadar, Ahmad Uzair Qureshi, Usama Talib, Gerald Chi
BACKGROUND: The use of smartphones with touch screens has become a norm for healthcare professionals (HCP). The risk of smart screen contamination has been proven, and guidelines are available to deal with possible contamination. A large number of smartphone users apply plastic or glass screen protectors onto their mobile phone screens to prevent scratches. However, these materials are not scratch proof, and their antipathogenic properties have not been studied. METHODS: We have conducted a study to determine the frequency of smartphone screen protector contamination and compared the data with contamination on the bare area on the same mobile screens...
December 26, 2017: Curēus
Tony Rosen, Nisha Mehta-Naik, Alyssa Elman, Mary R Mulcare, Michael E Stern, Sunday Clark, Rahul Sharma, Veronica M LoFaso, Risa Breckman, Mark Lachs, Nancy Needell
PROBLEM DEFINITION: Hospitals have an opportunity to improve the quality of care provided to a particularly vulnerable population: victims of elder mistreatment. Despite this, no programs to prevent or stop elder abuse in the acute care hospital have been reported. An innovative, multidisciplinary emergency department (ED)-based intervention for elder abuse victims, the Vulnerable Elder Protection Team (VEPT), was developed at NewYork-Presbyterian / Weill Cornell Medical Center (New York City)...
March 2018: Joint Commission Journal on Quality and Patient Safety
Antoine Eskander, Stephen Y Kang, Enver Ozer, Amit Agrawal, Ricardo Carrau, James W Rocco, Theodoros N Teknos, Matthew O Old
BACKGROUND: This pictorial essay demonstrates a modification to the positioning, prepping, and draping technique for the subscapular system of flaps allowing the patient to be placed supine and without the need for a second assistant during the harvest or closure. METHODS AND RESULTS: We performed a literature review focusing on the positioning of the patient during the harvest of the subscapular system of flaps. A supine modification harvest prepping, draping, and position is then described in pictorial essay format...
February 27, 2018: Head & Neck
Martina Buljac-Samardžić, Connie Dekker-van Doorn, Jeroen Van Wijngaarden
OBJECTIVES: Delivering health care is emotionally demanding. Emotional competencies that enable caregivers to identify and handle emotions may be important to deliver safe care, as it improves resilience and enables caregivers to make better decisions. A relevant emotional competence could be psychological detachment, which refers to the ability to psychologically detach from work and patients in off-duty hours. The objective of this study was to examine the relationship between psychological detachment and patient safety...
February 26, 2018: Journal of Patient Safety
Riann Robbins, Sarah Sullivan, Brigitte Smith
BACKGROUND: The Accreditation Council for Graduate Medical Education mandates scheduled didactics for residency programs but allows flexibility in implementation. Work-hour restrictions, patient care duties, and operative schedules create barriers to attendance for surgical trainees. We explored vascular surgery trainees and faculty perceptions on trainees operative preparation and participation, and overall fund of knowledge after implementing an academic half day conference (AHD) schedule...
February 23, 2018: Surgery
Lauren N Ko, Daniela Kroshinsky
BACKGROUND: Although considered an outpatient specialty, dermatology plays an important role in inpatient medicine. We characterized the activity and structure of dermatology consultation services in select U.S. hospitals. METHODS: In this cross sectional study, a 31-question survey was distributed in person to 32 board-certified dermatologists at the 2017 Society of Dermatology Hospitalists meeting. RESULTS: Thirty participants completed the survey (yield 93...
February 22, 2018: International Journal of Dermatology
Huong Thi Thu Nguyen, Kazuyo Kitaoka, Masune Sukigara, Anh Lan Thai
PURPOSE: This study aimed to create a Vietnamese version of both the Maslach Burnout Inventory-General Survey (MBI-GS) and Areas of Worklife Scale (AWS) to assess the burnout state of Vietnamese clinical nurses and to develop a causal model of burnout of clinical nurses. METHODS: We conducted a descriptive design using a cross-sectional survey. The questionnaire was hand-divided directly by nursing departments to 500 clinical nurses in three hospitals. Vietnamese MBI-GS and AWS were then examined for reliability and validity...
February 8, 2018: Asian Nursing Research
Allison R Dahlke, Julie K Johnson, Caprice C Greenberg, Remi Love, Lindsey Kreutzer, Daniel B Hewitt, Christopher M Quinn, Kathryn E Engelhardt, Karl Y Bilimoria
OBJECTIVE: The aim of the study was to (1) assess differences in how male and female general surgery residents utilize duty-hour regulations and experience aspects of burnout and psychological well-being, and (2) to explore reasons why these differing experiences exist. BACKGROUND: There may be differences in how women and men enter, experience, and leave residency programs. METHODS: A total of 7395 residents completed a survey (response rate = 99%)...
February 16, 2018: Annals of Surgery
Christopher A Adin, Callie A Fogle, Steven L Marks
To ensure patient safety and protect the well-being of interns and residents, the Accreditation Council for Graduate Medical Education (ACGME) issued guidelines in 2003 limiting the working hours of physician trainees. Although many supported the goals of the ACGME, institutions struggled to restructure their programs and hire staff required by this unfunded mandate. Numerous studies have analyzed the effects of duty hours restrictions on patient outcomes and physician training over the past 15 years. Most agree that duty hours restrictions improved well-being of house officers, but these improvements came at the expense of continuity, and patient hand-offs led to medical errors...
February 19, 2018: Veterinary Surgery: VS
M Monica Gavris, Ioana Olteanu, Erzsebet Kantor, Radu Mateescu, Roxana Belicioiu
Purpose: To present the new IRIDEX MicroPulse P3 (MP3) technology in patients with refractory glaucoma and our preliminary results at 1 week and 1 month postoperatively. Methods: IRIDEX MP3 laser cyclophotocoagulation was performed in 7 eyes of 7 patients under retrobulbar anaesthesia with lidocaine 2% in the operating room. Each eye received two treatments of 80-90s over the superior and inferior hemisphere, avoiding the temporal- and nasal-most clock hours. 810nm IRIDEX MP3 was set to 31,3% duty cycle (0,5ms treatment pulse followed by 1,1 ms of rest)...
April 2017: Romanian Journal of Ophthalmology
Amanda Staudt, Jennifer Gurney, Krystal Valdez-Delgado, Mithun Suresh, Jennifer Trevino, Tuan Le, Jason Seery, Stacy Shackelford, Shawn Nessen, Elizabeth Mann-Salinas
BACKGROUND: Understanding patients' length of stay at far-forward Role 2 surgical units may help to determine support needs, stabilization requirements, pre-deployment training, and necessity of increased care capability prior to or during transport to a higher level of care. The objectives of this study were to 1) evaluate the amount of time patients spent at Role 2 and 2) determine factors associated with trauma patients' length of stay at Role 2. METHODS: We conducted a secondary data analysis of the Joint Trauma System Role 2 Database...
February 13, 2018: Journal of Trauma and Acute Care Surgery
Monique A M Gignac, Selahadin Ibrahim, Peter M Smith, Vicki Kristman, Dorcas E Beaton, Cameron A Mustard
Background: With the aging of populations in many countries, workers are expected to remain employed longer but may struggle with the onset of common, chronic conditions like arthritis. To date, few studies have examined workplace policies and practices that could help accommodate individuals with arthritis, and fewer still have used a sex and gender-based approach to explore similarities and differences between women and men. Objectives: This study compared the health and work contexts of workers aged ≥50 years to better understand similarities and differences between women and men in accommodation availability, need, use, and unmet needs...
February 6, 2018: Annals of Work Exposures and Health
Foteini Tseliou, Michael Rosato, Aideen Maguire, David Wright, Dermot O'Reilly
Due to the focus of studies about caregiving responsibilities on older caregivers, there has been a deficit of research on young caregivers. We aimed to investigate the association between caregiving and health/mortality risk in young caregivers when compared with their non-caregiving peers and older caregivers. A census-based record linkage was implemented linking all residents enumerated in the 2011 Northern Ireland Census with subsequently registered deaths data, until the end of 2015. Among those aged 5-24 years at the 2011 Census, approximately 4...
January 31, 2018: American Journal of Epidemiology
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