Allied Health Care Professional Research Articles

Characteristics of Long-Stay Patients in a PICU and Healthcare Resource Utilization After Discharge.

To examine the characteristics of long-stay patients (LSPs) admitted to a PICU and to investigate discharge characteristics of medical complexity among discharged LSP. We performed a retrospective cohort study where clinical data were collected on all children admitted to our PICU between July 1, 2017, and January 1, 2020. A single-center study based at Erasmus MC Sophia Children's Hospital, a level III interdisciplinary PICU in The Netherlands, providing all pediatric and surgical subspecialties. LSP was defined as those admitted for at least 28 consecutive days. None. Length of PICU stay, diagnosis at admission, length of mechanical ventilation, need for extracorporeal membrane oxygenation, mortality, discharge location after PICU and hospital admission, medical technical support, medication use, and involvement of allied healthcare professionals after hospital discharge. LSP represented a small proportion of total PICU patients (108 patients; 3.2%) but consumed 33% of the total admission days, 47% of all days on extracorporeal membrane oxygenation, and 38% of all days on mechanical ventilation. After discharge, most LSP could be classified as children with medical complexity (CMC) (76%); all patients received discharge medications (median 5.5; range 2-19), most patients suffered from a chronic disease (89%), leaving the hospital with one or more technological devices (82%) and required allied healthcare professional involvement after discharge (93%). LSP consumes a considerable amount of resources in the PICU and its impact extends beyond the point of PICU discharge since the majority are CMC. This indicates complex care needs at home, high family needs, and a high burden on the healthcare system across hospital borders.

Improving cognitive function after cardiac surgery: home-based computerised cognitive training (FACCT study)

Abstract Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Barts Charity Nurse / Allied Healthcare Professional Clinical Research Fellowship (MRC0229, Improving cognitive health after cardiac surgery) Background Postoperative cognitive dysfunction (POCD) occurs in up to 50% of patients after cardiac surgery. Despite extensive research, the underlying causes and pathophysiology are poorly understood. Further, definitive treatments for POCD are lacking. The focus of this doctoral work was to identify predictors of POCD, examine the effectiveness of existing cognitive interventions on improving cognitive function, and use the findings of both of these systematic reviews to design and develop a cognitive training programme in postoperative cardiac surgery patients. Objectives The aim of this study was to evaluate the feasibility and acceptability of a home-based computerised cognitive training programme in postoperative cardiac surgery patients. Methods This is a single-arm, non-blinded, feasibility and acceptability study involving adult (>18 years of age) patients admitted for first time elective cardiac surgery. Participants were required to complete an 8-week cognitive training programme (40 sessions [20 minutes/day, 5 days/week]), commencing one week postoperatively, and administered using their own computers or tablets. The Montreal Cognitive Assessment (MoCA), a brief test of global cognition, was administered preoperatively and after the training programme. Feasibility outcomes included recruitment and retention rates and adherence to the programme. Acceptability was assessed by the Theoretical Framework of Acceptability Questionnaire (TFA-Q) which was administered post-programme. Results In total, 95 patients were screened, 51 (53.7%) were eligible and approached, and 31 (60.8%) consented to participate. Of these, 29 participants enrolled in the cognitive training programme, 7 (24.1%) were female, 20 (69.0%) were white British, and the mean baseline MoCA was 26.9 (out of 30). Data collection is complete, final analysis will be complete for presentation prior to ACNAP 2023. Interim results suggest that home-based computerised cognitive training (CCT) is feasible in terms of recruitment rate (60.8%, exceeding the target of 50%) and acceptable (with 94.1% of those who completed the TFA-Q identifying CCT as acceptable). Other feasibility indicators measured include retention (58.6%) and adherence (31.0%). Conclusions A trial examining home-based computerised cognitive training appears feasible and acceptable to patients, although strategies to improve retention and adherence will need to be strengthened. If found to be beneficial, such a programme could offer an inexpensive and safe method of improving postoperative cognitive function.

Staffing levels and hospital mortality in England: a national panel study using routinely collected data

ObjectivesExamine the association between multiple clinical staff levels and case-mix adjusted patient mortality in English hospitals. Most studies investigating the association between hospital staffing levels and mortality have focused on...

Multi-Centre Audit Of Myotonic Dystrophy In the UK: How Can We Improve Access to Care? (S11.001)

<h3>Objective:</h3> To conduct a multi-centre audit on patient care in a cohort of DM1 patients attending tertiary neuromuscular centres in the UK, based on 2018 consensus-based care recommendations. To assess the impact of an implementation of a change in practice to improve the access to care. <h3>Background:</h3> Myotonic Dystrophy Type 1 (DM1) is the most common muscular dystrophy in adults. Structured multi-disciplinary care is essential for managing the multi-system involvement in DM1 to improve patient safety and to reduce mortality and morbidity. Access to care can be variable dependent on geographical area and proximity to specialised services and time available to the neurologist. <h3>Design/Methods:</h3> Standardised audit tool was developed by consensus to enhance collection of practically important aspects of DM1 care retrospectively. Four tertiary neuroscience centres geographically distant, in the UK, were selected. <h3>Results:</h3> Total of 375 patients (197 (53%) female, mean age 47 years (range 1–84)) with DM1 were analysed. 62% had adult-onset disease. Neurology teams reviewed 64% of patients at least once a year. Cardiology review was performed annually for 30% of DM1 patients; of patients with respiratory needs, only 12% were reviewed as per recommendations; Swallowing function was assessed in only 44% of those required; assessment of cognitive-impairment was conducted only in 12%. Next we implemented an allied health care professional (AHP) led DM1-clinic in one centre and we analysed the data from 35 DM1 patients over three months: Total of 35 patients were reviewed. Cardiology review rates increased to 68%(22/35) where 100% of DM1 patients had respiratory and swallowing assessments. <h3>Conclusions:</h3> This multi-centre UK audit identifies several significant areas of care that need optimising in DM1, even within dedicated neuromuscular clinics. This highlights an opportunity for a national initiative to establish minimum care standards. However innovative utilisation of available resources can at least improve some aspects of, timely access to care. <b>Disclosure:</b> Dr. Hewamadduma has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB. Dr. Hewamadduma has received personal compensation in the range of $500-$4,999 for serving as a Consultant for ARENX. Dr. Hewamadduma has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BIOGEN. Dr. Hewamadduma has received personal compensation in the range of $500-$4,999 for serving as a Consultant for ROCHE. The institution of Dr. Hewamadduma has received research support from Neurocare . The institution of Dr. Hewamadduma has received research support from Sheffield Charitable Trust. Dr. Hewamadduma has received personal compensation in the range of $5,000-$9,999 for serving as a Adult Expert with National Health Service England (NHSE). Mr. Lilleker has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Mr. Lilleker has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Mr. Kelly has nothing to disclose. Miss White has nothing to disclose. Mr. Whiter has nothing to disclose. Dr. Islam has nothing to disclose. Dr. Campbell has nothing to disclose. Dr. Mehboob has nothing to disclose. Dr. Vonberg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Prova Health. Dr. Shanmugarajah has nothing to disclose. Dr. Grote has nothing to disclose. Dr. Viegas has nothing to disclose. Dr. Turner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Dyne Therapeutics. Dr. Turner has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Turner Partnership. The institution of Dr. Turner has received research support from MDUK.

Research priority setting for paediatric rheumatology in the UK.

The evidence base that underlies the management of children and young people with paediatric rheumatic diseases is deficient. In this field, there are many crucial unanswered questions. The UK Paediatric Rheumatology Clinical Studies Group, supported by UK National Institute for Health Research Clinical Research Network: children and Versus Arthritis, elicited ideas for research priorities from paediatric rheumatologists, trainees, allied health-care professionals, nurse specialists, patients, parents of patients, carers, and charities. These ideas were collected through online surveys and face-to-face meetings. A modified Delphi process was used, which included online research priority ranking surveys and a consensus workshop. A longlist of 55 disease-specific research priorities and 37 general research priorities were voted on in the first survey. A list of 11 top general research priorities was produced. The top ten disease-specific research priorities were discussed in depth at a Delphi workshop to determine their final ranking. This Health Policy paper will help to guide clinicians, academics, and funding bodies to prioritise research in paediatric rheumatic diseases, specifically in areas of unmet patient needs.

OA32 UK Paediatric Rheumatology Clinical Studies Group research priorities - results of a multidisciplinary consultation and consensus exercise

Abstract Background/Aims The evidence base underlying the management of children and young people (CYP) with paediatric rheumatic diseases (PRDs) is inadequate, with many critical outstanding questions warranting investigation. The aim of this study was to elicit multidisciplinary PRDs research priorities, through consultation with patients, carers and healthcare professionals. Methods This study was led by the UK NIHR CRN Children/Versus Arthritis Paediatric Rheumatology CSG (referred to as ‘the CSG’) and its Topic Specific Groups (TSGs). The CSG is a multidisciplinary group with strong patient/parent representation, supporting the development of clinical studies in the UK. Research priority ideas were sought from paediatric rheumatologists, trainees, allied healthcare professional (AHP), nurses, patients, parents and charities, through online surveys and face-to-face meetings. Research ideas were categorised as disease-specific or broad/general. They were grouped into sub-themes, duplicates/questions that had already been answered were removed, and similar submissions combined. A modified Delphi process was undertaken, including online research priority ranking, and an online consensus workshop to derive top PRD research priorities. Results The initial consultation yielded 304 research priority ideas; 25% from patients/parents, 22% from the CSG, 18% from TSGs, 13% from AHPs, 11% from trainees, 11% from Nurses. 55 disease-specific and 37 broad/general research priorities were voted upon in the first online survey, yielding a top 11 general broad research priorities. The top 10 disease specific priorities were discussed at the online Delphi priority setting workshop, and two online surveys were held during the workshop to determine their final ranking. Two of the disease-specific priorities were combined, leading to a top 9 (see Table). Disease specific proprieties related to clinical trials in JIA (n = 3) / Juvenile Dermatomyositis (n = 1) / Chronic Recurrent Multifocal Osteomyelitis (n = 1) / Juvenile Systemic Lupus Erythematosus (n = 1) Scleroderma (n = 1), management of JIA in adulthood (n = 1) and chronic pain (n = 1). Conclusion UK consensus-based PRD research priorities have been derived, underpinned by collaboration with patients/carers and healthcare professionals, helping to guide funding bodies to improve the evidence base in PRD’s. Disclosure E.M.D. Smith: None. N. Egbivwie: None. K. Cowan: None. A.V. Ramanan: None. C.E. Pain: None.

P286 Allied healthcare professional interventions for complex regional pain syndrome - which work? A systematic review of the literature

Abstract Background/Aims Complex regional pain syndrome (CRPS) is a severe chronic pain condition which usually occurs following limb trauma. Also associated with a range of signs and symptoms, including limb oedema, sensitivity to touch, skin colour and temperature changes, CRPS causes significant burden to individuals and society. UK 2018 guidelines for CRPS recommend early referral for therapies that encourage limb movement and use. Allied healthcare professionals (AHPs) are instrumental in delivering this early rehabilitation. The aim of this review was to explore current literature to identify non-surgical and non-pharmaceutical interventions for CRPS that are likely to be, or could be, delivered by AHPs, and to consider their therapeutic efficacy. Methods A systematic review of the literature was conducted between June and August 2021 using MEDLINE, Embase, Cochrane and CINAHL databases. Search terms were designed to identify studies of interventions for CRPS normally delivered by AHPs from 2010 onwards. Studies of surgical, pharmacological and psychotherapy/counselling interventions were excluded, as were those of post-stroke CRPS populations. Data were extracted for outcomes relating to pain, function, and quality of life. Results Following initial screening of 1,499 records, 40 articles were retained for further consideration. Of these, 14 met the inclusion criteria and were included in the review. From the data extracted, multidisciplinary rehabilitation was reported as effective in reducing pain, as was specific sensory-motor re-education using desensitisation; however, results for the efficacy of graded motor imagery on pain and function were contradictory. Neither ultrasound therapy or prism adaptation treatment were found to lead to improvements in either pain or function. Reduction in pain was a positive outcome of transcutaneous electrical stimulation (TENS) and of the use of visual illusions for people with body perception disturbance associated with CRPS. Whilst pain exposure physical therapy was associated with increased range of motion, there was no reported improvement in pain or quality of life. Low level laser therapy was found to be superior to inferential current therapy in pain reduction and range of motion. A methodological quality assessment of the studies in this review has yet to be conducted, however, it was noted that many of the studies acknowledged several limitations, not least the difficulty in recruiting a sample sufficient to demonstrate the statistical significance of indicative results. Conclusion Whilst there is some evidence for the efficacy of interventions for CRPS that are, or could be, delivered by AHPs, this review suggests only a small number of approaches have proved beneficial to date. A need remains for further research in order to provide guidance to support AHPs in treating this distressing condition. Disclosure G. Friend: None. N. Walsh: Grants/research support; NW has received funding for research from the NIHR. A. Llewellyn: Grants/research support; AL has received funding for research from the NIHR.

Evaluating the impact of a joint Clinical Nurse Specialist and Allied Health Care Professional clinic for neuro-oncology patients attending Velindre Cancer Centre, Cardiff

Abstract Aims Key governing guidelines recognise that the holistic and complex needs of neuro-oncology patients are best served by a cohesive multidisciplinary team (MDT). Achieving a joint Clinical Nurse Specialist (CNS) and Allied Healthcare Professional (AHP) clinic (including Speech and Language Therapy, Physiotherapy, Dietetics and Occupational Therapy) for neuro-oncology patients has been a longstanding vision at Velindre Cancer Centre (VCC) in Cardiff. A successful funding application to Welsh Government in July 2020 allowed the establishment of a virtual “one stop shop” clinic with CNS and AHPs available along the care trajectory to improve patient and carer quality of life. The project reports on whether this innovative clinic model successfully achieved the desired coordinated, anticipatory and holistic care. Method The project utilised service improvement methodology principles with aims inherent within quarterly timeframes. This included robust data collection on patient attendances and interventions, improving patient education and self-management and wide patient, care and staff engagement by means of questionnaires and semi-structured interviews. The mixed methods approach yielded rich quantitative and qualitative data. Results The data demonstrates an increasing demand for the joint neuro-oncology clinic indicating that additional resources may be required. From triangulation of patient, carer and wider team engagement the key benefits were perceived to be having accessibility to the team in a convenient way, the provision of support and timely information and the overall perception of enhanced holistic care. Conclusion The data demonstrates the huge successes of the joint neuro-oncology clinic so far, including improvements to patient and carer quality of life, wider VCC benefits and cost saves. The persuasive case was presented to Welsh Government, and ongoing endorsement has been achieved for the next financial year.

Can webinars support the implementation of video consultations at pace and scale within the allied health professions?

Background/aims In an attempt to reduce the impact of COVID-19 and support remote working, many allied healthcare professionals were equipped with video consultation technology. To support this new way of working, profession-specific webinars were delivered and attended by over 50% of the total allied healthcare professional workforce in Scotland. This study aimed to evaluate the impact of these webinars on the knowledge and confidence of allied health professionals in delivering services via video conferencing. Methods Attendees knowledge and current video conferencing use were ascertained immediately before and after webinars. Surveys were also completed at 4 and 8 weeks after the webinar to establish any impact on clinical practice. Results Levels of understanding, knowledge and confidence increased considerably (P&lt;0.001). Follow up at 8 weeks post webinar identified that 75.5% of attendees were using video conferencing, with allied healthcare professional video conferencing activity representing 17% of all national activity by June 2020. Conclusions Upskilling a diverse and dispersed workforce at pace and scale to enable safe remote working has been critical throughout the pandemic. Webinars have proven to be popular with staff to increase their knowledge of and ability to confidently use video conferencing to provide allied healthcare professional services across Scotland.

Knowledge and Preventive Measures Adopted by Allied Health Care Professional Students to Control Transmission of COVID-19 Pandemic Infection During Lockdown

Introduction: After declaration of COVID-19 infection as pandemic by World Health Organisation (WHO),various preventive strategies have been intended to mitigate disease spread and control the infection ratesuch as isolation of patients, social distancing, hygienic practices; covering mouth and nose, restriction ofmass gathering in society. Hence we planned this survey to assess the knowledge and preventive measuresadopted by students to control COVID-19 infection during lockdown.Methods: This cross sectional study was conducted among students of School of Allied Health Sciences,DMIMS, Wardha during April-May 2020. First year was selected randomly and all 168 students wereapproached by internet for sharing questionnaire after IEC approval. Received responses is analysed in theform of descriptive statistics.Results: Total 139 students responded. 38.85% students understood the relationship between massgathering and transmission of COVID-19 infection at community level. Only 34(24.46%) students wereaware about safe social distance. Less than half of the students 66(47.48%) were aware about minimum 20seconds needed to hand-rub by the alcohol based sanitizer. About 108(77.7%) students maintained the socialdistancing sincerely, only 74(52.5%) students always used to wear the mask and; 100(71.94%) participantsalways used to wash their hands.Conclusions: Though some of the students adopted standards practices, others observed to be consideringit as less important. Such survey can be conducted among in various institutions to assess the awareness andshortfall in practices. Awareness level can be raised through dedicated online awareness program.

Assessment of Knowledge, Attitude and Practices of Allied Health Care Professional Students Towards Universal Precaution

A universal precaution is an approach to infection control to treat all human blood and certain human bodyfluids. History and examination cannot reliably identify all patients infected. Universal precautions areframed to prevent health care professionals who are exposed to various infections and by practicing variousbasic principles of infection control. A cross sectional survey was conducted to assess knowledge, attitudeamongst allied health care professional about universal precautions and to investigate their practicetowards universal precaution. First year Students of School allied health sciences, who were willing toparticipate included in the study. Study showed overall moderate knowledge among the students. Hencetraining sessions of universal precaution may need to be conducted regularly for these students. Awarenessamongst students can be achieved to maximum level by conducting awareness programs every year by theInfection control committee in the medical college.

Identity matters - perceptions of inter-professional feedback in the context of workplace-based assessment in Diabetology training: a qualitative study

BackgroundInter-professional collaboration is acknowledged as essential for quality patient-care. However, little is known about receptiveness to inter-professional feedback in the postgraduate training. This study explores, in light of social identity theory, the perceptions of residents, supervising physicians and allied health care professionals regarding inter-professional feedback in the context of workplace-based assessment.MethodsFor 6 months, residents in Diabetology at the University Hospital of Bern performed formative workplace-based assessments under direct observation of a supervising physician and an allied health care professional. Feedback from both observers was given to the resident after every assessment. Subsequently, focus group discussions were conducted to collect the participants’ perceptions of inter- and intra-professional feedback. Transcripts were analyzed qualitatively using a thematic analysis approach.ResultsWe identified four main themes: (1) Identity and hierarchy; (2) Interdependence of feedback source and feedback content; (3) Impact on collaboration and patient-care; (4) Logistical and organizational requirements. While different social identities are the source of inter-professional hierarchies, they did not impede the receptiveness to feedback. Perceived trustworthiness of the feedback was attributed with more importance than professional affiliations, whereas intra-professional hierarchies between physicians led to the perception of a more summative nature of the feedback and rather impeded receptiveness. According to the participants, inter-professional feedback raised awareness of the working reality of other team members and had a positive impact on communication between the different professional groups. Moreover, participants reported positive response from patients regarding the inter-professional collaboration they experienced. Considerable organizational effort is required to enable the parallel observation of a resident’s consultation by a supervising physician and an allied health care professional.ConclusionsFeedback from allied health care professionals can be a valuable learning resource for residents, given its role outside the sometimes conflicting area of intra-professional hierarchies. Inter-professional feedback in the context of workplace-based assessment carries the potential to strengthen collaboration between the different professional groups.

Psychological wellbeing, burnout and substance use amongst medical students in New Zealand

Medical students are thought to have increased pressures in study life beyond that of their peers. This could impact their psychological wellbeing, burnout and substance use, impeding a smooth transition into the health workforce. A cross-sectional electronic survey of one of New Zealand’s two medical schools was undertaken, and students in all years were invited to participate through email. Two hundred and twenty students completed the survey. Forty-six students (21%) reported that they were currently seeing a GP or Allied Healthcare Professional (AHP) for their mental ill-health. Seventy-seven students (35%) reported having taken cannabis during medical school. The number of respondents reaching the threshold for CAGE, and thus demonstrating problem drinking, was 40 (18%). Additionally, burnout levels were scored, with 150 students (68%) classifying as disengaged and 169 (77%) as suffering from exhaustion on the Oldenburg burnout measure. Going forwards, organizational bodies including governments and medical schools should place emphasis on the importance of optimizing medical student wellbeing, including resilience training and improved workforce wellbeing planning, to positively impact not just medical students as they progress to doctors, but for patients, and the healthcare system as a whole.

What constitutes an excellent allied health care professional? A multidisciplinary focus group study

BackgroundDetermining what constitutes an excellent allied health care professional (AHCP) is important, since this is what will guide the development of curricula for training future physical therapists, oral hygienists, speech therapists, diagnostic radiographers, and dietitians. This also determines the quality of care.AimTo describe perspectives of AHCPs on which characteristics are commonly associated with an excellent AHCP.MethodsAHCPs’ perspectives were derived from three focus group discussions. Twenty-one health care professionals participated. The final analysis of the focus group discussions produced eight domains, in which content validity was obtained through a Delphi panel survey of 27 contributing experts.ResultsAccording to the survey, a combination of the following characteristics defines an excellent AHCP: (1) cognizance, to obtain and to apply knowledge in a broad multidisciplinary health care field; (2) cooperativity, to effectively work with others in a multidisciplinary context; (3) communicative, to communicate effectively at different levels in complex situations; (4) initiative, to initiate new ideas, to act proactively, and to follow them through; (5) innovative, to devise new ideas and to implement alternatives beyond current practices; (6) introspective, to self-examine and to reflect; (7) broad perspective, to capture the big picture; and (8) evidence-driven, to find and to use scientific evidence to guide one’s decisions.ConclusionThe AHCPs perspectives can be used as a reference for personal improvement for supervisors and professionals in clinical practice and for educational purposes. These perspectives may serve as a guide against which talented students can evaluate themselves.

The Allied Health Care Professional's Role in Assisting Medical Decision Making at the End of Life

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Kathleen Mears Memorial Lecture: Innovative Research for the END Allied Healthcare Professional

ABSTRACT.Electroneurodiagnostic technologists play a key role in health care. It is time for these allied health professionals to make a commitment and contribution, using scientific methodology, to the body of medical research and publication. Research methods, quantitative, qualitative, and mixed research design will be reviewed. Introduced is an innovative research approach that is applicable to END practice; it is called, action research.

2002 Review of Allied Health Care Professional Recruitment Incentives

2002 Review of Allied Health Care Professional Recruitment Incentives

2001 Review of Allied Health Care Professional Recruitment Incentives

2001 Review of Allied Health Care Professional Recruitment Incentives

2000 Review of Allied Health Care Professional Recruitment Incentives

2000 Review of Allied Health Care Professional Recruitment Incentives

Perspectives on Pediatric and Adolescent Gynecology from the Allied Health Care Professional: Teens, Periods, and Pregnancy

Jeanne is 16 and has been coming to you for care since she was a toddler. Her younger siblings see you also. Todays appointment she made herself because she is having trouble with her periods. Since menarche at age 12 she has had monthly periods but two months ago she had a one-day period and missed her period this past month. She had sex once at a party after having a few drinks. She is afraid she might be pregnant and remembers that you told her when she was about 12 that you would respect her confidentiality about sensitive issues. Irregular periods are common in adolescence; many teens do not ovulate monthly for a year or two after their menarche. However pregnancy is the most likely cause of periods in a teen. It is wise to suspect or at least rule out pregnancy when a teen has some irregular periods especially if: use of drugs/alcohol is suspected; there is some instability in the teens family life such as parents divorce or separation remarriage death or parent has a new partner; poor intrafamily communication; family abuse of drugs/alcohol; family history of mental illness especially in a parent; domestic violence. (excerpt)