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https://www.readbyqxmd.com/read/29049076/fatigue-risk-management-the-impact-of-anesthesiology-residents-work-schedules-on-job-performance-and-a-review-of-potential-countermeasures
#1
Lily R Wong, Erin Flynn-Evans, Keith J Ruskin
Long duty periods and overnight call shifts impair physicians' performance on measures of vigilance, psychomotor functioning, alertness, and mood. Anesthesiology residents typically work between 64 and 70 hours per week and are often required to work 24 hours or overnight shifts, sometimes taking call every third night. Mitigating the effects of sleep loss, circadian misalignment, and sleep inertia requires an understanding of the relationship among work schedules, fatigue, and job performance. This article reviews the current Accreditation Council for Graduate Medical Education guidelines for resident duty hours, examines how anesthesiologists' work schedules can affect job performance, and discusses the ramifications of overnight and prolonged duty hours on patient safety and resident well-being...
October 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29031926/monitoring-driver-fatigue-using-a-single-channel-electroencephalographic-device-a-validation-study-by-gaze-based-driving-performance-and-subjective-data
#2
José M Morales, Carolina Díaz-Piedra, Héctor Rieiro, Joaquín Roca-González, Samuel Romero, Andrés Catena, Luis J Fuentes, Leandro L Di Stasi
Driver fatigue can impair performance as much as alcohol does. It is the most important road safety concern, causing thousands of accidents and fatalities every year. Thanks to technological developments, wearable, single-channel EEG devices are now getting considerable attention as fatigue monitors, as they could help drivers to assess their own levels of fatigue and, therefore, prevent the deterioration of performance. However, the few studies that have used single-channel EEG devices to investigate the physiological effects of driver fatigue have had inconsistent results, and the question of whether we can monitor driver fatigue reliably with these EEG devices remains open...
October 12, 2017: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/29029694/prescriber-response-to-computerized-drug-alerts-for-electronic-prescriptions-among-hospitalized-patients
#3
Yael Zenziper Straichman, Daniel Kurnik, Ilan Matok, Hillel Halkin, Noa Markovits, Amitai Ziv, Ari Shamiss, Ronen Loebstein
BACKGROUND: Clinical decision support systems (CDSS) reduce prescription errors, but their effectiveness is reduced by high alert rates, "alert fatigue", and indiscriminate rejection. OBJECTIVES: To compare acceptance rates of alerts generated by the SafeRx(®) prescription CDSS among different alert types and departments in a tertiary care hospital, identify factors associated with alert acceptance, and determine whether alert overrides were justified. METHODS: In a retrospective study, we compared acceptance rates of all prescription alerts generated in 2013 in 18 departments of Israel's largest tertiary care center...
November 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29025165/impact-of-an-emergency-department-electronic-sepsis-surveillance-system-on-patient-mortality-and-length-of-stay
#4
Jonathan S Austrian, Catherine T Jamin, Glenn R Doty, Saul Blecker
Objective: The purpose of this study was to determine whether an electronic health record-based sepsis alert system could improve quality of care and clinical outcomes for patients with sepsis. Materials and Methods: We performed a patient-level interrupted time series study of emergency department patients with severe sepsis or septic shock between January 2013 and April 2015. The intervention, introduced in February 2014, was a system of interruptive sepsis alerts triggered by abnormal vital signs or laboratory results...
August 28, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28866704/unexpected-infant-death-secondary-to-a-pulmonary-infiltration-due-to-acute-myelocytic-leukaemia
#5
M Ben Khelil, Y Chkirbene, M Mlika, S Haouet, M Hamdoun
Acute myeloid leukaemia (AML) often presents with non-specific symptoms such as fatigue, anaemia or infection. Pulmonary involvement is uncommon in AML during the course of the disease and is usually caused by infection, haemorrhage, leukaemic pulmonary infiltrates and leukostasis. Lung localization of AML is very uncommon and potentially life threatening if not diagnosed and treated rapidly. The authors describe the sudden death of an asymptomatic five-month-infant because of a misdiagnosed lung localization of AML...
August 2017: Malaysian Journal of Pathology
https://www.readbyqxmd.com/read/28857664/the-role-of-pupil-size-in-communication-is-there-room-for-learning
#6
Mariska E Kret
The eyes are extremely important for communication. The muscles around the eyes express emotional states and the size of the pupil signals whether a person is aroused and alert or bored and fatigued. Pupil size is an overlooked social signal, yet is readily picked up by observers. Observers mirror their own pupil sizes in response, which can influence social impressions. In a landmark study by Hess [1975. The role of pupil size in communication. Scientific American, 233(5), 110-119] it was shown that individuals with large pupils are perceived more positively than individuals with small pupils...
August 31, 2017: Cognition & Emotion
https://www.readbyqxmd.com/read/28777245/effects-of-energy-beverage-consumption-on-pistol-aiming-steadiness-in-law-enforcement-officers
#7
Taylor P Monaghan, Bert H Jacobson, John H Sellers, Carlos A Estrada
Monaghan, TP, Jacobson, BH, Sellers, JH, and Estrada, CA. Effects of energy beverage consumption on pistol aiming steadiness in law enforcement officers. J Strength Cond Res 31(9): 2557-2561, 2017-The popularity of energy drinks (EDs)/shots (ESs) has grown steadily over the years resulting in billions of dollars of sales annually. Energy drink marketing focuses on the improved performance and alertness and a reduction in fatigue. Although caffeine comprises one of the ingredients, it is not fully known how the combination of the many remaining active ingredients affects physical performance...
September 2017: Journal of Strength and Conditioning Research
https://www.readbyqxmd.com/read/28770543/feasibility-and-safety-of-virtual-reality-based-early-neurocognitive-stimulation-in-critically-ill-patients
#8
Marc Turon, Sol Fernandez-Gonzalo, Mercè Jodar, Gemma Gomà, Jaume Montanya, David Hernando, Raquel Bailón, Candelaria de Haro, Victor Gomez-Simon, Josefina Lopez-Aguilar, Rudys Magrans, Melcior Martinez-Perez, Joan Carles Oliva, Lluís Blanch
BACKGROUND: Growing evidence suggests that critical illness often results in significant long-term neurocognitive impairments in one-third of survivors. Although these neurocognitive impairments are long-lasting and devastating for survivors, rehabilitation rarely occurs during or after critical illness. Our aim is to describe an early neurocognitive stimulation intervention based on virtual reality for patients who are critically ill and to present the results of a proof-of-concept study testing the feasibility, safety, and suitability of this intervention...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28756438/feedback-and-training-to-improve-use-of-an-electronic-prescribing-system-a-randomised-controlled-trial
#9
Scott Leung, Wu Yi Zheng, Anmol Sandhu, Richard Day, Ling Li, Melissa Baysari
Excessive presentation of alerts in electronic prescribing systems (ePS) results in 'alert fatigue' which reduces alert effectiveness and frustrates users. Previous research at our study site showed high rates of duplication alerts, some of which were the result of doctors not using available short-cut functions in the ePS. This study aimed to improve uptake of short-cut functions and so reduce alert fatigue by trialing two interventions: feedback and training. Fifty doctors were randomised to one of three groups: Control, Feedback or Training...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28750908/a-systematic-review-of-the-effectiveness-of-interruptive-medication-prescribing-alerts-in-hospital-cpoe-systems-to-change-prescriber-behavior-and-improve-patient-safety
#10
REVIEW
N Page, M T Baysari, J I Westbrook
OBJECTIVES: To assess the evidence of the effectiveness of different categories of interruptive medication prescribing alerts to change prescriber behavior and/or improve patient outcomes in hospital computerized provider order entry (CPOE) systems. METHODS: PubMed, Embase, CINAHL and the Cochrane Library were searched for relevant articles published between January 2000 and February 2016. Studies were included if they compared the outcomes of automatic, interruptive medication prescribing alert/s to a control/comparison group to determine alert effectiveness...
September 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28744881/new-common-program-requirements-for-the-resident-physician-workforce-and-the-omission-of-strategic-napping-a-missed-opportunity
#11
Michelle M Shnayder, Joan E St Onge, Alberto J Caban-Martinez
OBJECTIVES: Napping has known benefits for fatigue mitigation and improved alertness. However the Accreditation Council for Graduate Medical Education (ACGME) New Common Program Requirements recently removed the 16 h work limit for PGY1 residents and removed any suggestions of napping. METHODS: We utilized a cross-sectional study design to administer a 44-item questionnaire in June 2016 to 858 residents and fellows at one large urban academic medical center. We assessed: 1) resident physician sentiment of work environment supportiveness for napping at work; and 2) agreement with 2011 ACGME guidelines on workweek hour limitations and strategic napping recommendations...
July 26, 2017: American Journal of Industrial Medicine
https://www.readbyqxmd.com/read/28728618/binge-viewing-sleep-and-the-role-of-pre-sleep-arousal
#12
Liese Exelmans, Jan Van den Bulck
STUDY OBJECTIVES: To investigate the prevalence of binge viewing, its association with sleep and examine arousal as an underlying mechanism of this association. METHODS: Four hundred twenty-three adults (aged 18-25 years old, 61.9% female) completed an online survey assessing regular television viewing, binge viewing, sleep quality (Pittsburgh Sleep Quality Index), fatigue (Fatigue Assessment Scale), insomnia (Bergen Insomnia Scale), and pre-sleep arousal (Pre-Sleep Arousal Scale)...
August 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28682835/technologic-distractions-part-1-summary-of-approaches-to-manage-alert-quantity-with-intent-to-reduce-alert-fatigue-and-suggestions-for-alert-fatigue-metrics
#13
REVIEW
Sandra L Kane-Gill, Michael F O'Connor, Jeffrey M Rothschild, Nicholas M Selby, Barbara McLean, Christopher P Bonafide, Maria M Cvach, Xiao Hu, Avinash Konkani, Michele M Pelter, Bradford D Winters
OBJECTIVE: To provide ICU clinicians with evidence-based guidance on tested interventions that reduce or prevent alert fatigue within clinical decision support systems. DESIGN: Systematic review of PubMed, Embase, SCOPUS, and CINAHL for relevant literature from 1966 to February 2017. PATIENTS: Focus on critically ill patients and included evaluations in other patient care settings, as well. INTERVENTIONS: Identified interventions designed to reduce or prevent alert fatigue within clinical decision support systems...
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28678892/electronic-health-record-alert-related-workload-as-a-predictor-of-burnout-in-primary-care-providers
#14
Megan E Gregory, Elise Russo, Hardeep Singh
BACKGROUND: Electronic health records (EHRs) have been shown to increase physician workload. One EHR feature that contributes to increased workload is asynchronous alerts (also known as inbox notifications) related to test results, referral responses, medication refill requests, and messages from physicians and other health care professionals. This alert-related workload results in negative cognitive outcomes, but its effect on affective outcomes, such as burnout, has been understudied...
July 5, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28633175/the-marshall-family-medicine-residency-twintern-schedule-the-impact-of-an-innovative-hospital-coverage-scheme-on-resident-fatigue
#15
Adam Franks, Stephen M Petrany, Sydnee McElroy, Adam Alley
BACKGROUND AND OBJECTIVES: Work hour restriction has strained the balance between resident service and education. Night Float (NF) rotations are a popular answer to managing this balance but weakens continuity, an essential tenant of family medicine. An innovative short call system for Marshall University's Family Medicine Hospital Service (FMHS), the twINTERN call model, was created in response. We studied the impact of this approach on resident fatigue. METHODS: Anonymous surveys assessed fatigue of the Marshall University's 2013-2014 Family Medicine intern resident class while on NF rotations (ICU, Pediatrics and Surgery) and the twINTERN call...
June 2017: Family Medicine
https://www.readbyqxmd.com/read/28623183/phone-based-interventions-in-adolescent-psychiatry-a-perspective-and-proof-of-concept-pilot-study-with-a-focus-on-depression-and-autism
#16
Robert Yuzen Chen, Jordan Robert Feltes, William Shun Tzeng, Zoe Yunzhu Lu, Michael Pan, Nan Zhao, Rebecca Talkin, Kavon Javaherian, Anne Glowinski, Will Ross
BACKGROUND: Telemedicine has emerged as an innovative platform to diagnose and treat psychiatric disorders in a cost-effective fashion. Previous studies have laid the functional framework for monitoring and treating child psychiatric disorders electronically using videoconferencing, mobile phones (smartphones), and Web-based apps. However, phone call and text message (short message service, SMS) interventions in adolescent psychiatry are less studied than other electronic platforms. Further investigations on the development of these interventions are needed...
June 16, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28587608/integrating-clinical-decision-support-systems-for-pharmacogenomic-testing-into-clinical-routine-a-scoping-review-of-designs-of-user-system-interactions-in-recent-system-development
#17
Marc Hinderer, Martin Boeker, Sebastian A Wagner, Martin Lablans, Stephanie Newe, Jan L Hülsemann, Michael Neumaier, Harald Binder, Harald Renz, Till Acker, Hans-Ulrich Prokosch, Martin Sedlmayr
BACKGROUND: Pharmacogenomic clinical decision support systems (CDSS) have the potential to help overcome some of the barriers for translating pharmacogenomic knowledge into clinical routine. Before developing a prototype it is crucial for developers to know which pharmacogenomic CDSS features and user-system interactions have yet been developed, implemented and tested in previous pharmacogenomic CDSS efforts and if they have been successfully applied. We address this issue by providing an overview of the designs of user-system interactions of recently developed pharmacogenomic CDSS...
June 6, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28583143/fatigue-mitigation-with-sleeptracktxt2-in-air-medical-emergency-care-systems-study-protocol-for-a-randomized-controlled-trial
#18
P Daniel Patterson, Charity G Moore, Frank X Guyette, Jack M Doman, Denisse Sequeira, Howard A Werman, Doug Swanson, David Hostler, Joshua Lynch, Lindsey Russo, Linda Hines, Karen Swecker, Michael S Runyon, Daniel J Buysse
BACKGROUND: Most air medical Emergency Medical Services (EMS) clinicians work extended duration shifts, and more than 50% report inadequate sleep, poor sleep quality, and/or poor recovery between shifts. The SleepTrackTXT pilot trial (ClinicalTrials.gov, NCT02063737) showed that use of mobile phone text messages could impact EMS clinician self-reported fatigue and sleepiness during long duration shifts. The purpose of the SleepTrackTXT2 trial is to leverage lessons learned from the first SleepTrackTXT study and test an enhanced intervention targeting air medical EMS clinicians...
June 5, 2017: Trials
https://www.readbyqxmd.com/read/28579472/identifying-environmental-reservoirs-of-clostridium-difficile-with-a-scent-detection-dog-preliminary-evaluation
#19
E Bryce, T Zurberg, M Zurberg, S Shajari, D Roscoe
BACKGROUND AND AIM: Prompted by an article describing a dog trained to detect Clostridium difficile in patients, our institution evaluated a dog's ability to detect C. difficile scent from equipment and surfaces to assist in strategic deployment of adjunctive cleaning measures. METHODS: An expert in drug and explosives scent dog handling trained a canine to identify odours from pure cultures and/or faecal specimens positive for C. difficile. Methods used to assess explosive and drug detection dogs were adapted and included evaluation of (i) odour recognition, using containers positive and negative for the scent of C...
June 1, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28574535/telemetry-monitor-watchers-reduce-bedside-nurses-exposure-to-alarms-by-intercepting-a-high-number-of-nonactionable-alarms
#20
Sonali Palchaudhuri, Stephanie Chen, Elaine Clayton, Anthony Accurso, Sammy Zakaria
Cardiac telemetry, designed to monitor hospitalized patients with active cardiac conditions, is highly utilized outside the intensive care unit but is also resource-intensive and produces many nonactionable alarms. In a hospital setting in which dedicated monitor watchers are set up to be the first responders to system-generated alerts, we conducted a retrospective study of the alerts produced over a continuous 2-month period to evaluate how many were intercepted before nurse notification for being nonactionable, and how many resulted in code team activations...
June 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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