Administrative Documents Research Articles

Ether Day Revisited: The Surgical Records of Edward Gilbert Abbott.

The details of the public demonstration of the effects of ether that initiated the modern era of surgery and anesthesia are often misreported. Existing published transcripts of the clinical records are incomplete or inaccurate. The patient notes of Gilbert Abbott were photographed, transcribed, and reviewed. The records are handwritten in "Surgical Records for 1846; Volume 30," of the Massachusetts General Hospital. The patient was admitted on September 25. The presenting condition was a congenital, mobile, compressible, multilobed, small lesion at the angle of the left mandible, and base of tongue. The operation on October 16 was an attempted ligation of the blood supply to the lesion. The postoperative diagnosis was a vascular lesion ("erectile tumor"). Postoperative management included application of sclerosants. The mass was unchanged in size on discharge on December 7. There is no documentation of the anesthetic administration in the progress note but a retrospective report of the anesthetic is pasted into the Records book. This account reported that the patient did not respond to the initial incision. He moved and cried out during the latter part of the procedure. Although he was aware of the operation taking place, he later said he had not experienced pain. The commentary concluded that the demonstration of the analgesic effectiveness of ether was inconclusive but that subsequently ether was shown to be effective. The surgery on October 16, an unsuccessful ligation of a congenital lymphovascular malformation, was performed under incomplete general anesthesia. Examination of the primary documents may allow for more accurate accounts of circumstances surrounding the discovery of anesthesia.

Methods of Detecting Medication Administration Point-of-Care Errors in Acute Adult Inpatient Settings: A Scoping Review Protocol.

Medication administration is recognized as a risk-prone activity where errors and near misses have multiple opportunities to occur along the route from manufacturing, through transportation, storage, prescription, dispensing, point-of-care administration, and post-administration documentation. While substantial research, education, and tools have been invested in the detection of medication errors on either side of point-of-care administration, less attention has been placed on this finite phase, leaving a gap in the error detection process. This protocol proposes to undertake a scoping review of the literature related to the detection of medication errors at the point-of-care to understand the potential size, nature, and extent of available literature. The aim is to identify research evidence to guide clinical practice and future research at the medication and patient point-of-care intersection. The search strategy will review literature from PubMed, CINAHL, Cochrane Collaboration, Embase, Scopus, PsychInfo, Web of Science, TRIP, TROVE, JBI Systematic Reviews, Health Collection (Informit), Health Source Nursing Academic, Prospero, Google Scholar, and graylit.org dated 1 January 2000–31 December 2021. Two independent reviewers will screen the literature for relevancy to the review objective, and critically appraise the citations for quality, validity, and reliability using the Joanna Briggs scoping review methodology and System for Unified Management, Assessment and Review of Information (SUMARI) tool. The data will be systematically synthesized to identify and compare the medication error administration detection method findings. A descriptive narrative discussion will accompany the findings.

Consistency of self-reported and documented historical influenza vaccination status of US healthcare workers.

BackgroundHealthcare personnel (HCP) are a priority group for annual influenza vaccination. Few studies have assessed the validity of recall of prior influenza vaccination status among HCP, especially for more than one preceding season.MethodsUsing data from a randomized controlled trial of influenza vaccination among 947 HCP from two US healthcare systems, we assessed agreement between participant self‐report and administrative record documentation of influenza vaccination status during the preceding five influenza seasons; kappa coefficients and sensitivity values were calculated. Administrative record documentation was considered the gold standard. Documented vaccination sources included electronic medical records, employee health records, outside immunization providers, and the state immunization information system.ResultsAmong 683 HCP with prior influenza immunization information, 89.7% (95% CI: 87.2%, 91.9%) of HCP were able to self‐report their vaccination status for the season preceding the survey. By the fifth preceding season, 82.6% (95% CI: 79.5%, 85.3%) of HCP were able to self‐report. Among HCP who self‐reported their vaccination status, agreement between self‐report and documented vaccination status ranged from 81.9% (95% CI: 77.2%, 86.7%) for the fifth season to 90.5% (95% CI: 87.2%, 93.9%) for the season preceding interview. HCP who received vaccine for only some of the preceding five seasons (18.3%) more commonly had ≥2 errors in their recall compared with those vaccinated all five preceding seasons (55.7% vs. 4.3%).ConclusionsSelf‐reported vaccination status is a reliable source for historical influenza vaccination information among HCP who are consistently vaccinated but less reliable for those with a history of inconsistent vaccination.

Research supports expanding role of pharmacy techs in immunization delivery

Pharmacy technicians, despite being overlooked as members of the health care team, are uniquely positioned to make a positive impact on public health with immunizations. In a recent article published in JAPhA, authors sought to compile the research done to date that describes the role that technicians play in vaccine administration. The research team identified 14 studies that demonstrated the safety and efficacy of using pharmacy technicians as immunizers—a new role that is supported by technicians and pharmacists because of its benefits on pharmacy workflow and technician job satisfaction. Studies cited in the October 2021 JAPhA review article by DeMarco and colleagues found that pharmacy technicians, with adequate training, had increased knowledge related to all aspects of immunizations and were then able to talk to patients more effectively and confidently about their immunization-related needs. These technicians also displayed confidence in determining what supplies were needed, they identified appropriate injection sites, and they showed proper administration techniques and documentation of the patient’s vaccination. They also knew how to respond in the event of a vaccine emergency. Authors of the paper wrote that with these new opportunities “techs were empowered by the role” and experienced improved morale. Since time is the primary barrier for pharmacy staff in delivering immunization screenings, pharmacy technicians are in a perfect place to aid in the immunization process. Research found that technicians administering vaccines allowed pharmacists more time to focus on other clinical tasks, including talking with vaccine-hesitant patients about the benefits of immunizations. The JAPhA paper found that pharmacy teams were more successful in limiting disruptions to pharmacy operations when the addition of a pharmacy tech immunizer into the workflow was simple, with a defined list of procedures, and after success was shown during trial runs. DeMarco and colleagues wrote that patients supported technicians immunizing because of the “trusting relationship [they had] with the pharmacy team.” Using pharmacy technicians in screening and as immunizers benefited patients’ access and “decreased immunization wait times,” the researchers said. One study in the JAPhA review noted that 7 techs administered “4,400 immunizations over 6 months.” At least one patient outcome was measured in six of the included trials cited, ranging from higher vaccination rates, increased number of doses administered, and no adverse events following technician administration. The authors concluded that technicians are not only capable of providing vaccines, but that they do so safely. Historically, pharmacy technicians have been tasked with data entry and other administrative duties around immunizations, like insurance billing and point of sale. Prior to the COVID-19 pandemic, only a handful of states, including Washington, Rhode Island, and Idaho, allowed vaccines to be administered by pharmacy technicians. There has been increased momentum to expand the scope of practice of pharmacy technicians and several states have taken up this mantle by passing and enacting laws to increase opportunities for pharmacy technicians through expanded services. These expanded services have included verifying products, taking medication histories, and administering immunizations. As pharmacy technicians have transitioned to these new duties, there has been increasing evidence to support using technicians in advanced ways. With adequate, multimodal training, pharmacy technicians are prepared and willing to take on these new roles, a change that pharmacists enthusiastically support. Demarco and colleagues noted that expanded technician roles provided flexibility to the pharmacist’s time and allowed them to provide other clinical care.

Statin Administration for ST-Elevation Myocardial Infarction During Rotor Wing Transport

ObjectiveThe aim of this study was to evaluate the feasibility of statin administration by a critical care transport medicine (CCTM) team during rotor wing transport for ST-elevation myocardial infarction patients to a percutaneous intervention–capable center. MethodsWe conducted a retrospective study at a single CCTM program after an intervention focused on statin administration for ST-elevation myocardial infarction that included a formulary change and a single brief educational presentation to flight physicians. A comparison group of flight nurse practitioners underwent training after the study period and were used as a control. Two authors completed an independent chart review to collect data. Descriptive statistics and chi-square or Mann-Whitney U testing were used to compare groups. ResultsStatin administration (or documentation of statin administration before CCTM crew arrival or contraindication to statin administration) occurred during 15 of 19 (79%) transports staffed by trained providers and 3 of 18 (17%) transports staffed by untrained providers (P < .001 by chi-square test). Scene times were not significantly different between transports by trained and untrained providers. ConclusionIn summary, we demonstrate the feasibility and safety of a protocol for statin administration in the CCTM setting.

P37 Variable adherence to and effectiveness of a vancomycin continuous infusion protocol within ICUs at a London tertiary-care hospital: a single-centre retrospective service evaluation

BackgroundAppropriate vancomycin dosing and therapeutic monitoring is important to optimize treatment for serious Gram-positive infections. In St George's Hospital ICUs, the treatment protocol is a loading dose (<65 kg, 1000 mg; ≥65 kg, 1500 mg), followed by a continuous infusion based on creatinine clearance (CLCR). Vancomycin serum concentrations are taken daily at 0600 hours (target therapeutic range 20–25 mg/L). Non-therapeutic concentrations may negatively affect clinical outcomes and prolong length of stay.1MethodsElectronic prescribing and medicine administration data (vancomycin dose, dose timings, indication, patient biochemistry and demographics) within a 66-bed ICU service were reviewed retrospectively (July 2020–July 2021). Cockcroft-Gault CLCR was calculated using total body weight (TBW), or adjusted body weight in obese1 patients.Standards(i) Proportion of patients with a therapeutic concentration within two serum samples; and (ii) time taken to achieve therapeutic concentration.ResultsNinety-four percent (51/54) of patients received a correct protocol instructed loading dose, 31% (17/54) received a correct loading and maintenance dose, and 70% (38/54) had a vancomycin serum concentration taken. Forty-one percent (7/17) of correctly protocol dosed and monitored patients were therapeutic at their first day serum concentration, which decreased to 20% (3/15) by their second day serum concentration. Consistently therapeutically dosed patient groups included obese and normal weight patients with CLCR 10–20 mL/min and 21–50 mL/min. Whereas underweight and obese patients with CLCR >50 mL/min and 21–50 mL/min became supratherapeutic by their second day serum concentration. Obese and normal weight patients with CLCR >50 mL/min were consistently subtherapeutic. The mean time taken for non-therapeutic patients who continued treatment (n = 7) to become therapeutic after dose adjustments was 4 days. Patients (n = 17) were 82% male and of a mean age of 62 ± 17 years. Mean TBW was 79 ± 23 kg and mean CLCR 65 ± 48 mL/min. Sepsis was the most common vancomycin indication (65%).ConclusionsMultiple drug recording formats, plus adherence to and dosing of different aspects of the vancomycin protocol, requires review. This is to ensure accurate vancomycin administration documentation and that therapeutic concentrations are achieved more rapidly and consistently, whilst minimizing toxicity. A quality improvement project has been instigated to focus on protocol education, accessibility and improving IT infrastructure. Increased patient volume of distribution and renal function variability within the ICU population adds complexity to vancomycin pharmacokinetics. Research into pharmacokinetic models better representing the local ICU population and AUC24 drug monitoring is being explored based on recent international guidance.1

Barcode Medication Administration Software Technology Use in the Emergency Department and Medication Error Rates.

High-quality care during and after a medication process requires complete and accurate medication administration documentation. Veterans Affairs Medical Centers use barcode medication administration technology to document medication administered to Veterans throughout the inpatient and long-term care areas of the hospital. Barcode medication administration has demonstrated a reduction in medication administration errors; however, it is not commonly used in Veterans Affairs Medical Center clinical areas or emergency departments. During this study, only 39% of the recorded 165 Veterans Affairs Medical Centers that use barcode medication administration technology in their inpatient areas stated that barcode medication administration was also used in clinical areas of the hospital. Of these facilities, only 14% had implemented barcode medication administration in their emergency department. This study evaluated medication error rates before and after barcode medication administration technology was implemented in the emergency department of a Veterans Affairs Medical Center located in the Southeastern region of the United States. A total of 258 charts, 129 before and 129 after barcode medication administration technology implementation in the emergency department, were reviewed for Veterans who were evaluated and ordered to receive medication in the emergency department before transferring to an inpatient unit at the Veterans Affairs Medical Center where this study was conducted. A quantitative nonexperimental descriptive comparison demonstrated a 10.8% reduction in medication error rates and 21% reduction in the average number of medications given in error per chart after barcode medication administration technology was implemented in the emergency department. In addition to the study outcome, a potentially unsafe workaround was identified. Stakeholders that use barcode medication administration technology in their emergency departments would benefit from assessing the association between barcode medication administration use and medication administration error rates. However, assessing whether barcode medication administration technology remains useful and continues to provide safe medication administration practices for our Veterans is also recommended.

The New National Standard of Ukraine for the Formation of Organizational and Administrative Documentation: History of Development, Analysis of Main Changes and Issues of Implementation of the Standard

The New National Standard of Ukraine for the Formation of Organizational and Administrative Documentation: History of Development, Analysis of Main Changes and Issues of Implementation of the Standard

From mine industries to a place of culture, tourism, research and higher education: case study of the great mine Serbariu

PurposeThis study aims to explore how closed factories could be transformed and provide a path for sustainable development for a territory. The authors focus on the case of the Great Mine Serbariu, located in Carbonia (Sardinia), which used to be the largest coal mine in Italy between 1939 and 1964.Design/methodology/approachThe authors adopt a qualitative research design based on an exploratory single-case study, drawing on interviews with the main stakeholders, on a survey conducted among 5,158 visitors, and on administrative documentation of the City Council.FindingsThe analysis of the Great Mine Serbariu case showed that the regeneration of an exhausted mine serves a model of sustainable development, especially for the redevelopment of other urban and industrial degraded areas. The Great mine Serbariu was restored and turned into a place of culture, tourism, research and higher education, with the Italian Cultural Centre of Coal Mining (ICCCM) establishing its headquarters in the heart of the former mine. It attracted almost 220,000 visitors, generating both domestic and international tourist flows and making an industrial heritage a real resource for the area.Originality/valueThis article advances the authors’ understanding of how closed industries could become an instrument for sustainable development on the social, economic, touristic and cultural levels. This study would help local governments with examples to enhance the historical resources to create a new identity that led to a sustainable development of an urban landscape, and to create networks with other comparable museums all over Europe to better exploit the touristic and cultural potential.

“To Say the Sovereign’s Awarding…”: Practices of the Monarch’s Appeal to the Siberian Population at the End of the 16&lt;sup&gt;th&lt;/sup&gt; – 17&lt;sup&gt;th&lt;/sup&gt; Centuries

The article analyzes the problem of the origin of specific communicative practices that existed on the territory of Siberia in the late 16th – 17th centuries and the so-called “granted word”. This practice was as follows: on behalf of the tsar the authorized person (voivode) communicated with a “direct proclamation” to his subjects. The paper concludes by arguing that the “granted word” goes back to the earlier forms of sovereign “awards”, which included measures of encouragement and benefits. Moreover, the set of addressees of the tsarist “granted word” changed from the end of the 16th century and depended on the goals of the award, which were set by the central government. Based on the analysis of the Siberian administrative documentation of the 17th century, the authors identified the categories of addressees of the proclamation on behalf of the monarch. It has been established that by the 1650s in Siberia there was a practice of the proclamation of three versions of the “granted word”. They were supposed to be proclaimed one by one. The first version was addressed to service people (Boyar sons, Cossacks and Soldiers). The second one was addressed to peasants, traders and craftspeople. The third version was for Siberian natives – yasak-payers. During the 1st third of the 17th century, this particular form of direct address of the tsar to the population of Siberia acquired a new function. The “granted word” concretized, confirmed and consolidated the rights and obligations for each category of the Siberian population as subjects of the Russian monarch. According to the authors, the reasons for existing such practice on the territory of Siberia are concluded in the specifics of borderability. The monarch sought to additionally legitimate his right to manage this territory and wanted to remind his political influence.

A model for sustainable, partnership-based telehealth services in rural India: An early process evaluation from Tuver village, Gujarat

BackgroundTelehealth can improve access to high-quality healthcare for rural populations in India. However, rural communities often have other needs, such as sanitation or employment, to benefit fully from telehealth offerings, highlighting a need for systems-level solutions. A Business of Humanity approach argues that innovative solutions to wicked problems like these require strategic decision-making that attends to a) humaneness, e.g., equity and safety and b) humankind, or the needs and potential of large and growing markets comprised of marginalized and low-income individuals. The approach is expected to improve economic performance and long-term value creation for partners, thus supporting sustainability.MethodsA demonstration project was conducted in Tuver, a rural and tribal village in Gujarat, India. The project included seven components: a partnership that emphasized power-sharing and complementary contributions; telehealth services; health promotion; digital services; power infrastructure; water and sanitation; and agribusiness. Core partners included the academic partner, local village leadership, a local development foundation, a telehealth provider, and a design-build contractor. This early process evaluation relies on administrative data, field notes, and project documentation and was analyzed using a case study approach.ResultsFindings highlight the importance of taking a systems perspective and engaging inter-sectoral partners through alignment of values and goals. Additionally, the creation of a synergistic, health-promoting ecosystem offers potential to support telehealth services in the long-term. At the same time, engaging rural, tribal communities in the use of technological advances posed a challenge, though local staff and intermediaries were effective in bridging disconnects.ConclusionOverall, this early process evaluation highlights the promise and challenges of using a Business of Humanity approach for coordinated, sustainable community-level action to improve the health and well-being of marginalized communities.

Кадровый состав экспертов и ювелиров советского Государственного хранилища ценностей (Гохрана) в 1920-е гг.

The article is devoted to the study of staff changes in the State Repository of Valuables (Gokhran) of the RSFSR in the 1920s. It reviews personal files of the employees who carried out examination, assessment, classification, and description of valuables, and also processes resulting in emergence of new activity areas of the Goskhran. The expansion of valuables composition coming to the Gokhran led to emergence of new positions. The article examines professional qualities and competence of the Gokhran employees working with valuables of national importance. It details the biography of the main Gokhran expert N. A. Dmitriev. The methodological basis of the work is comparative-historical, systematic, descriptive methods, as well as method of archival heuristics. Scientific research of the Gokhran history does not pay enough attention to its jewelers training level, which was of great importance as working with valuables involved sorting, evaluating, separating diamonds, precious metals, systematizing valuables by kind and quality; it was a responsible job requiring special knowledge and skills, especially in the 1920s, when the directions of the Gokhran's activities were changing and the requirements to its personnel were heightened. The author has studied documents from the Russian State Archive of Economics (fond 2324 “State Bank of the RSFSR,” fond 7632 “State Repository of Valuables of the People's Commissariat of Finance of the USSR,” fond 7733 “Ministry of Finance of the USSR”), the Central State Archive of the City of Moscow (fond R-1204 “Moscow Jewelry Partnership,” fond R-1906 “Moscow Loan Treasury”). The documents prove competence of employees and high level of professionals working in the Gokhran. A comprehensive study of archival documents on personnel and on organizational and administrative documentation has permitted to identify patterns in the Gokhran personnel formation, to study the employees’ biographies. Masters from large jewelry firms Lorie, Faberge, Khlebnikov worked in the Gokhran. They were knowledgeable in types of precious metals processing and familiar with the world market of precious metals and stones. Increased variety of valuables, acquisition of church and Romanov treasures led to appearance of narrow specialists in the Gokhran. The contribution of this research to historical science is determined by its novelty. Involvement of a wide range of archival documents that have not been previously used in scientific research allows readers to learn the names of people who worked with valuables of national importance.

Identification of Administrative Document Titles Using Cosine Similarity

Identification of Administrative Document Titles Using Cosine Similarity

Method for Analyzing the Structure of Noisy Images of Administrative Documents

Method for Analyzing the Structure of Noisy Images of Administrative Documents

Научное наследие П. Б. Балданжапова: документы и материалы по истории Музея восточных культур

Goals. The purpose of the publication is to introduce into scientific circulation previously unknown documentary sources connected with the organization of the Museum of Oriental Cultures at the Buryat Institute of Social Sciences of the Siberian Branch of the USSR Academy of Sciences. Materials and Methods. A frontal search was carried out in the personal archive fund of Purbo B. Baldanzhapov, kept at the Center of Oriental Manuscripts and Xylographs of the Institute for Mongolian, Buddhist and Tibetan Studies, SB RAS.The classification and systematization of the identified array of office-work materials was carried out, the types of documents have been identified, their thematic and chronological spectrum was determined. Results. It was determined that the F29 collection contained Purbo Baldanzhapov`s memoranda, reference materials, personal letters to the leaders of the Buryat ASSR about the urgent need to expand the USSR’s ties with the countries of the East, Buddhist organizations and individual figures, about the necessity of formation of a specialized department — the Museum of Oriental Cultures.The article also analyzes the block of administrative office documentation, containing orders of the Buryat Institute of Social Sciences on the formation of the Museum, the Regulations on the Museum, staffing, work reports. Conclusions. As a result of the study, a unique documentary array has been revealed showing, on the one hand the history of one of the stages of the formation of oriental studies in Transbaikalia, on the other — a little-known page in the history of museum affairs in the region.It is emphasized that these materials reflect the mechanisms, forms and methods of organizing scientific and museum activities in the second half of the 1960s. — the period of reforms and reorganizations in Soviet science. The identified sources will become the basis for further research by historians, orientalists, museologists, etc.

The Impact of Smart Pump Interoperability on Errors in Intravenous Infusion Administrations: A Multihospital Before and After Study.

ObjectiveThe objective of this study was to assess the frequency, type, and severity of errors associated with intravenous medication administration before and after smart pump interoperability.MethodsWe conducted an observational study at a community healthcare system before and after implementing smart pump interoperability. Point prevalence methodology was used to collect data on medication administration and errors in adult inpatient settings.ResultsObservations were completed for 350 infusions preintervention (178 patients) and 367 postintervention (200 patients). Total errors significantly decreased from 401 (114.6 per 100 infusions) to 354 (96.5 per 100 infusions, P = 0.02). Administration errors decreased from 144 (41.1 per 100 infusions) to 119 (32.4 per 100 infusions, P = 0.12). Expired medication errors significantly reduced from 11 (3.1 per 100 infusions) to 2 (0.5 per 100 infusions, P = 0.02). Errors involving high-risk medications significantly reduced from 45 (12.8 per 100 infusions) to 25 (6.8 per 100 infusions, P = 0.01). Errors involving continuous medications significantly reduced from 44 (12.6 per 100 infusions) to 22 (6.0 per 100 infusions, P = 0.005). When comparing programming type, manual programming resulted in 115 (77.2%) of administration and user documentation errors compared with 34 errors (22.8%) that occurred when autoprogramming was used. Of these, errors involving high-risk medications reduced from 21 (84.0%) to 4 (16.0%) after using autoprogramming.ConclusionsSmart pump interoperability resulted in a 16% reduction in medication administration errors. Despite using dose error reduction software and autoprogramming, some types of errors persisted. Further studies are needed to understand how technology use can be optimized.

Standardization of caregiver and nursing perioperative care on gynecologic oncology wards in a resource-limited setting

IntroductionIn Kampala, Uganda, there is a strong cultural practice for patients to have designated caregivers for the duration of hospitalization. At the same time, nursing support is limited. This quality improvement project aimed to standardize caregiver and nursing perioperative care on the gynecologic oncology wards at the Uganda Cancer Institute and Mulago Specialised Women and Neonatal Hospital. MethodsWe developed, implemented, and evaluated a multidisciplinary intervention involving standardization of nursing care, patient education, and family member integration from October 2019 – July 2020. Data were abstracted from medical records and patient interviews pertaining to the following outcomes: 1) pain control; 2) post-operative surgical site infections, urinary tract infections, and pneumonia; 3) nursing documentation of medication administration, pain quality, and vital sign assessments, and 4) patient and caregiver education. Descriptive statistics, Fisher’s exact test, and independent samples t-test were applied. ResultsData were collected from 25 patients undergoing major gynecologic procedures. Pre- (N = 14) and post- (N = 11) intervention comparison demonstrated significant increases in preoperative patient education (0% to 80%, p = 0.001) and utilization of a comprehensive postoperative order form (0% to 45.5%, p = 0.009). Increased frequency in nursing documentation of patient checks (3 to 8, p = 0.266) and intraoperative antibiotic administration (9 to 10, p = 0.180) in patient charts did not reach significance. There was no change in infection rate, pain score utilization, caregiver documentation, or preoperative medication acquisition. ConclusionOur findings suggest that patient- and family-centered perioperative care can be improved through standardization of nursing care, improved education, and integration of caregivers in a nursing-limited setting.

When Return Orders Are More than Just a Deportation Receipt: Transit Migration and Socio-legal Meanings of Administrative Documents

In this article we argue that, in this specific context, the fundamental element for defining a person as a “migrant in transit” has been an administrative document (the return order) that confirms an infraction (the irregular entry) and provides for the imposition of a coercive measure (returning the migrant to the country of origin or the country from which they came). The interesting thing about the return order is that social practice transcends its formal sanctioning implication, acquiring other meanings, connotations and utilities depending on the moment, becoming a key document in assistance centers.

The Pedagogical Boxes’ Educational Program at the Homem do Nordeste Museum

In the administrative archive of the Joaquim Nabuco Foundation, we find the administrative documentation of the Museu do Homem do Nordeste (Muhne) since its foundation in 1979. By exploring this documentation, it was possible to observe the set of education initiatives in museums developed by the Muhne team in the 1990s. We found copies of the plans and reports of the educational program called "Didactic Boxes" dating from 1996 and 1997. Consulting the project, the activity report, the printed material containing instructions for using the didactic boxes and the disclosure pamphlet and the photos of the activities we understand the characteristics of the activity. The analysis of this specific action allowed us to perceive the set of epistemological principles that guided the museum team in their educational actions in the 1990s. Keywords: Didactic Boxes. Educational Program. Museum of the Northeast. Joaquim Nabuco Foundation

National Disability Insurance Scheme and Lived Experience of People Presenting to the Emergency Department: Protocol for a Mixed Methods Study.

BackgroundCurrently, within Australia, 3.6% of all emergency department (ED) presentations are mental health–related. Information about the context of the person presenting to the ED (beyond immediate needs), including their psychosocial disability (PSD) National Disability Insurance Scheme (NDIS) plan, is reported as incomplete and fragmented. There are missed opportunities for early support and care continuity that could potentially inform ED practitioners to revise current practices.ObjectiveThe aims of this study are: (1) to obtain original data from the lived experience voice of those with the PSD NDIS plan and their experience when presenting to an ED, (2) to gather information from NDIS service providers to reveal communication pathways between the ED and NDIS services, and (3) to gain knowledge from ED clinicians around processes for improving continuity of care and consumer experience.MethodsThis inductive, mixed methods phenomenological study will involve data collection analyzed sequentially, with each stage informing future stages of the research. Interviews will focus on the lived experience voice exploring concerns that have led to an ED presentation, alongside an analysis of associated clinical and administrative documentation and communications. Focus groups with NDIS support workers and support coordinators will provide phenomenological data around the experience from their perspective. National quantitative surveys among those with a PSD NDIS plan and emergency services clinicians will provide insight into current practices within community care and ED presentations. The research project design includes a lived experience advisory group who are assisting with the design of the interview and focus group schedules and national surveys, as well as in shaping the interpretation of qualitative information. All transcripts will be subject to thematic analysis to understand individuals’ meaning-making of these complex and particular phenomena. The research team includes a lived experience researcher and a lived experience carer (PhD candidate).ResultsThis study is funded by MIND Australia as a PhD industry scholarship, which commenced in April 2020. A systematic review as a preresearch activity has been completed and is currently under review. The Human Research Ethics Committee of the University of South Australia has approved this project. An advisory group has been selected, and interview, focus group, and survey schedules are currently being codesigned. Recruitment will commence in November 2021. It is envisaged that data collection will be completed by June 2022.ConclusionsUnderstanding the lived experience of the precare, during care, and postcare stages of ED presentations from the perspective of those with a PSD NDIS plan will inform the research team around current practices and provide information about improvement for pathways of care for consumers and carers, while also informing health policy.International Registered Report Identifier (IRRID)PRR1-10.2196/33268