Involved Staff Members Research Articles

Barriers and Facilitators to Implementing a Community-Based Psychosocial Support Intervention Conducted In-Person and Remotely: A Qualitative Study in Quibdó, Colombia.

Community-based psychosocial support group (CB-PSS) interventions using task-shifting approaches are well suited to provide culturally appropriate services in low- and middle-income countries. However, contextual barriers and facilitators must be considered to tailor interventions effectively, particularly considering the challenges introduced by the COVID-19 pandemic. We explore the barriers, facilitators, and psychosocial changes associated with implementing a CB-PSS group intervention delivered by local lay providers to conflict-affected adults in Quibdó, Colombia, using both in-person and remote modalities. Data were analyzed from 25 individual interviews with participants and a focus group discussion involving staff members, including 7 community psychosocial agent facilitators and 2 mental health professional supervisors. The analysis used a thematic approach grounded in a descriptive phenomenology to explore the lived experiences of participants and staff members during implementation. Participant attendance in the in-person modality was compromised by factors such as competing work and family responsibilities and disruption caused by the COVID-19 pandemic. Participants in the remote modality faced challenges concerning unstable Internet connectivity, recurrent power outages caused by heavy rain, distractions, interruptions, and threats to confidentiality by family and coworkers. Despite these challenges, data revealed key contextual facilitators, including the community-based knowledge of facilitators and integration of traditional practices, such as the comadreo (informal talks and gatherings). Respondents shared that the CB-PSS groups promoted stronger community relationships and created opportunities for participants to exchange peer support, practice leadership skills, develop problem-solving skills based on peers' experiences, and enhance emotional regulation skills. Differences and similarities across in-person and remote modalities are discussed, as are key considerations for practitioners and policymakers.

Impact of Implementing New ICF-Based Practices on Staff Valence of Disability Practitioners: An Experience in Hong Kong.

The International Classification of Functioning, Disability, and Health (ICF) was endorsed by The World Health Organization (WHO) in 2001. However, Hong Kong is at the beginning stage of implementing and testing ICF-based practices. This study examines any changes in the valences of disability practitioners in an organization under the newly introduced ICF-based practices. It was hypothesized that the involved staff members' self-perceived valences in relation to the ICF would be enhanced. A pretest-posttest design was adopted. The 27-item Scale on Staff Valence under ICF-based practice (SSV-ICF) was used to measure the impact on staff valence of a pilot scheme in which ICF-based practice was implemented. Self-report questionnaires were completed by the involved staff members at the beginning of the pilot scheme and 12 months later. Analyses used paired samples t-tests and one-way repeated measures ANOVAs, performed by SPSS software, version 25. In total, 91 participants took part in the study. Results showed that participants achieved positive changes in all domains of valences, while participants' level of involvement in the new ICF-based intervention had significant effects on their score differences in the "Competence" domain (r = 0.262, p < 0.05), "Intrapersonal" domain (r = 0.242, p < 0.05), and "Total Score" of SSV-ICF (r = 0.210, p < 0.05). The study demonstrated that disability practitioners who implemented ICF-based practices developed higher staff valences, which, in turn, benefited service users. Implementation of ICF-based practices also contributed to a more positive organizational culture.

Roles reversed: The patient experience for staff on a mental health ward

Reflections following an experiential study involving staff members being admitted to an inpatient mental health ward. The reflections offer the perspectives of the researchers, the participants and some of the patients on the ward.

Direct Benefit Transfer Scheme for Tuberculosis Patients – Performance Challenges observed by the Providers and Patients

Introduction: Government of India launched an Aadhar-linked Direct Benefit Transfer (DBT) scheme from 1st April, 2018. Under this scheme, all notified TB patients would receive Rs 500 per month (~US$7) throughout the course of their treatment for nutritional support. Aim and Objectives: To determine the challenges faced by the health providers and patients in the implementation of Direct Benefit Transfer scheme. Methods: This was a mixed method cross-sectional study conducted on all public and private TB patients notified during the year 2019 under RNTCP (now NTEP) in district Amritsar, Punjab. Quantitative data about the availability and validation of bank accounts was obtained from the Nikshay portal after having permission from the District TB Officer. Qualitative data was obtained from the focus group discussion and in-depth interviews with the involved staff members (17) and patients (20) registered in Tuberculin units of Amritsar. Results: From the Nikshay reports, it was observed that there was significant difference between the public and private sector and between rural and urban areas. Focus group discussion was done with the TB Health Visitor (TBHV) and Senior TB supervisors (STS) and asked about the hurdles they faced. Items were identified and tabulated. In-depth interviews were conducted on 20 patients, 10 each from public and private sector respectively. Data collected was transcribed and arranged as per the themes or questions and then the information was recorded under those sub-headings. Conclusion: The major challenges observed by the providers were lack of support from the private sector, lack of awareness among people, technical issues and more work burden. Patients mostly mentioned about confidentiality issues, lack of awareness, social stigma of the disease, less amount and long and complex process.

Prevalence of SARS-CoV-2 amongst ophthalmologists throughout the first and second waves of the pandemic.

The study aims to investigate the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among ophthalmology unit staff throughout the first and second waves of the outbreak, in order to verify the effectiveness of the measures adopted in containing the contagion.A retrospective observational study was conducted involving staff members, who received a naso/oropharyngeal swab when complaining of SARS-CoV-2 symptoms and once a month as a screening measure. They were tested for SARS-CoV-2 antibodies as a screening measure during the first and the second wave. Clinical activities performed during the outbreak were compared with those performed during the same period in 2019 and correlated with the number of coronavirus disease-2019 eye care workers.Analysis included 25 workers. Clinical infection was 0% and 12% whereas the prevalence of SARS-CoV-2 antibodies ranged from 4% to 8% in the first and second wave, respectively. The increase in the prevalence of SARS-CoV-2 infection between the first and the second wave was not significant (1/25 vs 3/25, P = .6092). Clinical activities significantly decreased during the first wave compared with the same period in 2019 (3256 vs 10,075, P < .0001, –68% to 2019), but increased during the second wave (8208 vs 3256, P < .0001, +152% to the first wave).Despite the increase in routine activities during the second wave, we did not observe a significant increase in SARS-CoV-2 prevalence. Strict protection measures seemed to contain the rate of contagion among the ophthalmology unit members even in a high-volume clinical setting in one of the most affected area by the coronavirus disease-2019 outbreak.

Address mental health issues involving staff members

Amid the ongoing changes and stressors related to COVID‐19, the mental health of staff members has become one of the top personnel concerns at colleges and universities throughout the country. To help you address these issues from both a legal and practical standpoint, a panel of experts shared strategies during a webinar hosted by the Employment Law Alliance, moderated by José A. Olivieri, Esq., Co‐Managing Partner at Michael Best &amp; Friedrich LLP in Wisconsin.

Attitudes towards People with Mental Illness among Professionals Working in a Psychiatric Hospital in Rwanda

Aims: This quantitative study investigated the attitudes toward people with mental illness among professionals working in Ndera neuropsychiatric hospital in Rwanda. The purpose of this study was to determine whether there are differences in attitudes between direct care providers and supportive professionals towards the people with mental illness. Methods: The Community Attitudes towards Mentally Ill (CAMI) scale (Dear & Taylor, 1982) was used. A total of 72 members of the staff, including 55 directly involved staff members and 17 support staff members, participated in the survey. Results: The mean score is 3.98 for authoritarianism, 3.75 for social restrictiveness, 3.88 for benevolence, and 3.87 for community mental health ideology attitudes subscales. There is no statistically significant difference between the two groups in their overall scale scores. However, directly involved staff members had a greater mean score on many individual items (P≥0.05). Demographic variables did not account for the variance within the two groups (P≥0.05). 87.27% of our respondents think that staff members, patients and family members can be involved in the decision making process and 70.59% appreciate that it is good to involve staff, patients and family relatives in this process. Negative attitudes towards people with mental illness admitted to Ndera neuropsychiatric hospital are also present, even though the majority of our respondents have favorable attitudes towards the people with mental illness. There is the need to explore the influence of staff attitudes on the delivery of high quality healthcare.

An exploration of clinical psychology's response to parental bereavement in adults with intellectual disability.

The dearth of literature regarding how or when to intervene when an adult with intellectual disability is bereaved may impede clinical practice; this study therefore aimed to explore the current clinical psychology response, so as to enhance understanding of the role of the profession in supporting grief within this population. A collective case study design was used. Data for six persons with intellectual disability, including interviews with parentally bereaved persons and involved staff members, were integrated into individual case stories for cross-case synthesis. Data were analysed using thematic analysis. Five overarching themes illustrated that the clinical psychology role is broadly distributed and identified potentially complicating factors such as "gatekeeping" and "staff uncertainty." A model of bereavement supports reflecting that by Read (Learning Disability Practice, 8, 2005, 31) is being approximated in clinical practice; further research is required to determine how best to implement this, and whether this meets the true needs of the population.

How to keep drug data up-to-date

Background The formulary of any Swiss hospital changes quite often, for example, either due to adaptions made by the drug and therapeutics committee, due to drug shortages, or due to market withdrawals of drugs. When changes of the formulary occur, all relating drug data have to be actualized. It is essential not only to integrate new drug data, but also to erase old data to keep all systems up to date. Drug data management is a challenging and ever-expanding task for hospital pharmacies. Aim of the project The aim of the project was to optimize drug data management in the Children's Hospital Zurich. Methods After interviewing all involved staff members, a flowchart was developed that describes the algorithms to keep all relevant drug data containing systems up to date: – clinical decision support systems; – the logistics and productions software; – pharmacy guidelines and drug information lists. The flowchart serves as working tool to define the adaptations to be made after each mutation of the formulary. Responsibilities for the different topics were defined. A pivot table serves to generate to-do lists and to document the completion of the tasks. This ensures an overview of the status and a controlling tool of all drug data mutations. Evaluation Since implementation of the flowchart four months ago, 45 mutations have been documented. The new process proves to be helpful for all involved staff members, improving drug data management und data quality. Conclusion As drug data management in the hospital pharmacy is getting more complex, it seems unavoidable to develop new standard procedures. Through the implementation of algorithms and responsibilities by a flowchart, drug data management is optimized.

MO‐DE‐BRA‐04: Hands‐On Fluoroscopy Safety Training with Real‐Time Patient and Staff Dosimetry

Purpose:Fluoroscopically guided interventions (FGI) are routinely performed across many different hospital departments. However, many involved staff members have minimal training regarding safe and optimal use of fluoroscopy systems. We developed and taught a hands‐on fluoroscopy safety class incorporating real‐time patient and staff dosimetry in order to promote safer and more optimal use of fluoroscopy during FGI.Methods:The hands‐on fluoroscopy safety class is taught in an FGI suite, unique to each department. A patient equivalent phantom is set on the patient table with an ion chamber positioned at the x‐ray beam entrance to the phantom. This provides a surrogate measure of patient entrance dose. Multiple solid state dosimeters (RaySafe i2 dosimetry systemTM) are deployed at different distances from the phantom (0.1, 1, 3 meters), which provide surrogate measures of staff dose. Instructors direct participating clinical staff to operate the fluoroscopy system as they view live fluoroscopic images, patient entrance dose, and staff doses in real‐time. During class, instructors work with clinical staff to investigate how patient entrance dose, staff doses, and image quality are affected by different parameters, including pulse rate, magnification, collimation, beam angulation, imaging mode, system geometry, distance, and shielding.Results:Real‐time dose visualization enables clinical staff to directly see and learn how to optimize their use of their own fluoroscopy system to minimize patient and staff dose, yet maintain sufficient image quality for FGI. As a direct result of the class, multiple hospital departments have implemented changes to their imaging protocols, including reduction of the default fluoroscopy pulse rate and increased use of collimation and lower dose fluoroscopy modes.Conclusion:Hands‐on fluoroscopy safety training substantially benefits from real‐time patient and staff dosimetry incorporated into the class. Real‐time dose display helps clinical staff visualize, internalize, and ultimately utilize the safety techniques learned during the training.RaySafe/Unfors/Fluke lent us a portable version of their RaySafe i2 Dosimetry System for 6 months.

Psychoanalysis and Palestine-Israel: A personal angle

Identifications with or against Israel are widespread and powerful, and through them we are drawn into the conflict between Israel and the Palestinians. Psychoanalysts tend to see such identifications as involving a regressive pull, which fuels a view of the conflict as belonging exclusively in the external domain, placing the issues involved beyond the reach of psychoanalysis. This paper describes work done in the “Nazareth conferences”, involving staff members’ Jewish and Muslim identifications, which mobilised powerful feelings. It is suggested that containing these is a necessary prelude to acknowledging the experience of the other – an alternative to the on-going enactment of violent conflict.

Survey on critical incident reporting in a child and adolescent mental health service

To examine the prevalence and nature of critical incident reports at a generic child and adolescent mental health service. This is a retrospective survey of all critical incident reports completed at a community based child and adolescent mental health service between 2008 and 2011. Information was obtained about the nature of incidents and actions taken. In a three year period, only eighteen incident report forms were completed. Staff were most frequently the victims of the incidents (50%, n = 9), followed by clients (38.8%, n = 7) and parents of clients (11.1%, n = 2). Falls were the most common incident reports (44.4%, n = 8). Two incidences were related to physical aggression and threatening behaviour by clients. Critical incident reporting was found to be uncommon overall. Most of the recorded incidents involved staff members and were of minor significance. Specific training for staff regarding incident reporting should be provided to ensure an acceptable standard of investigation is consistently carried out for all significant incidents.

Group A Streptococcus Toxic Shock Syndrome: An outbreak report and review of the literature

Group A Streptococcal (GAS) Toxic Shock Syndrome (TSS) is an acute, rapidly progressive, and often fatal illness. Outbreaks can occur in hospitals. However, early infection control measures may interrupt transmissions and prevent morbidity and mortality. Two cases of invasive GAS TSS were diagnosed within 48h after two uncomplicated laparoscopic surgeries that were performed in the same operating room of a women's hospital. Investigations conducted by the infection prevention and control department of the hospital identified 46 obstetrical staff members who were involved in the surgeries and/or had contact with either of the patients. All of the staff members were interviewed regarding any recent history of upper respiratory tract infections, the presence of skin lesions and vaginal or rectal symptoms. Throat, rectal, and vaginal cultures were obtained two times from all of the involved staff members. Throat colonization with GAS was detected in the cultures from one obstetrical intern who attended the 1st surgery and from one nurse who had formerly worked in the postnatal ward. These two strains were epidemiologically different from each other and from the outbreak strain. Both carriers were suspended from direct patient care and were treated with a ten-day course of oral clindamycin. The success of their decolonization status was assessed at the end of therapy and at three, six, nine and twelve months thereafter before reassigning them to routine work. Unfortunately, in spite of the extensive investigation of all involved personnel and of the environment, the mode of transmission to the second patient could not be established. However, droplet or airborne transmission could not be ruled out. Early and meticulous implementation of infection control measures was crucial and instrumental in the successful management and control of this outbreak. Furthermore, there were no subsequent GAS cases detected during the 24 months following the outbreak.

Seguimiento del paciente anciano polimedicado en un área de salud

Implantar una estrategia coordinada entre la unidad de atención familiar y el servicio de farmacia que posibilite la revisión del tratamiento en pacientes polimedicados. Para ello se ha desarrollado una herramienta informática que permite al médico responsable del paciente visualizar de forma rápida y resumida la descripción del tratamiento farmacológico actualizado, así como la detección de riesgos de iatrogenias y/o ajuste de dosis y consejo farmacoterapéutico. Para el estudio se ha considerado paciente polimedicado aquel que toma 10 o más medicamentos durante, al menos, un mes. Fases de desarrollo: Diseño de un formulario guía para revisión de tratamientos por el médico de familia. Desarrollo de un informe farmacoterapéutico (IFT) como documento de apoyo al médico para la revisión del tratamiento. Puesta en marcha del circuito coordinado médico de familia-farmacéutico: redacción de instrucciones de trabajo y difusión entre los profesionales implicados. La población diana del estudio corresponde a 1.897 pacientes polimedicados. Se han emitido 1.897 informes, en los que se recogen: 8.530 recomendaciones (10% alertas de agencias reguladoras, 31% recomendaciones sobre medicación de alto riesgo en paciente anciano, 7% información sobre novedades terapéuticas y 52% recomendaciones sobre uso adecuado del medicamento); 399 interacciones de alta relevancia clínica y 5.036 recomendaciones de ajuste posológico. Estos informes farmacoterapéuticos están permitiendo la revisión del tratamiento de prácticamente el 100% de la población seleccionada. El desarrollo e implantación de herramientas informáticas en el seguimiento de pacientes polimedicados permite la elaboración de IFT que facilitan la revisión médica rutinaria del tratamiento farmacológico en un censo de pacientes relativamente amplio. Implement a coordinated strategy for the family care unit and the pharmacy division in order to enable revising treatment in polymedicated patients. To this end, we have developed a software tool permitting the patient's primary doctor to have a quick, summarised description of the patient's updated pharmacological treatments, and detect iatrogenic risks and/or dosage adjustments and pharmacotherapy advice. In this study, polymedicated patients are defined as those taking 10 or more medications during at least one month. Development phases: Design of a guide form to assist the family doctor in reviewing treatments. Development of a pharmacotherapy report (FTR) as a complementary document to assist the doctor in reviewing treatments. Implementation of a coordinated loop between the family doctor and the pharmacist. Review of work instructions and distribution to involved staff members. The target population of the study consists of 1897 polymedicated patients. We issued 1897 reports, containing the following: 8530 recommendations (10% alerts from regulatory authorities, 31% recommendations regarding high-risk drugs in elderly patients, 7% information on new treatments and 52% recommendations on proper drug use); 399 highly relevant drug interactions; and 5036 recommendations for dose adjustment. These pharmacotherapy reports permit treatment to be revised for nearly 100% of the selected population. The development and implementation of software tools for monitoring polymedicated patients enables us to create FTRs that facilitate routine medical reviews of pharmacological treatment in a fairly wide range of patients.

Endovascular stenting of abdominal aortic aneurysms

Business logistics is defined as the science of planning, design, and support of business operations of procurement, purchasing, inventory, warehousing, distribution, transportation, customer support, financial and human resources.1 Devolved to the medical field, it might be defined as the planning framework for the management of patients (e.g. with ruptured abdominal aortic aneurysms), healthcare institutions (e.g. hospitals), material (e.g. stock of endografts), human resources (e.g. involved staff members), information (e.g. education) and other aspects (e.g. transportation of patients with ruptured abdominal aortic aneurysm, finances). This chapter deals with the aforementioned issues of logistics in patients with ruptured abdominal aortic aneurysm and provides an insight into already published literature as well as the personal experience of the authors.

Strengthening the International Curriculum: the Principal's Role

As instructional leaders, principals can ensure that international education is a strong component of the curriculum. They can do this by being current on world affairs, involving staff members in curriculum development, and uti lizing the myriad of school and community resources.

Allocating Money for Priority Items—Easier with Participative Budgeting

Who receives money for what school programs? When money is tight, principals may find that involving staff members in budgeting makes allocating money easier and more effective.

Administrative considerations in developing a volunteer program.

A volunteer program can become a solid, smooth-functioning part of a community mental health center or other agency if it is built around the needs of both the agency and the volunteers. The author discusses the need to develop realistic job descriptions, to screen the applicants carefully, and to provide continued training and supervision both individually and in groups. She emphasizes that staff resistance to a volunteer program can be overcome by involving staff members in the program and by making them aware of the high quality of work the volunteers do.

Stanford Radar Astronomy Center

Stanford University and the Stanford Research Institute have established a new Center for Radar Astronomy, which will carry out a combined research program involving staff members of the two institutions and will also be intended for the training of graduate students. The center will employ various antennas and transmitters belonging to the University's “antenna farm”, including Stanford's 150‐ft parabolic reflector, which is one of three largest fully steerable paraboloids in the United States. The instrument was designed to serve both as a transmitting and a receiving antenna. Coupled to it is a transmitter capable of producing a 400 000‐watt radar probe for the exploration of the solar system.