Mandatory Training Course Research Articles

The implementation of a protocol promoting the safe practice of brain death determination

PurposeThe purpose of the study is to describe the implementation of measures introduced in Israel in 2009 to promote the safe practice of brain death determination (BDD). Materials and methodsThe measures require (1) physicians to undergo a mandatory training course, (2) the mandatory performance of an ancillary test, and (3) retrospective examination of all BDD forms by an independent committee. Any deviations from practice parameters were noted. Surveys were also undertaken to assess (i) the attitude of local physicians to the measures and (ii) whether similar measures are in place in Europe and whether they were considered necessary. ResultsAfter implementation, the measures resulted in the absence of deviations from practice parameters over time. A majority of local physician (n = 64) felt the measures added a sense of security to BDD (73%) and ensured its proper performance (85%). The European survey (n = 20 countries) revealed (1) specialized BDD training is required in 60%, provided in 50%, while felt necessary by 80%; (2) independent supervision of BDD is performed in only one other country; and (3) BDD is performed country-wide using the same criteria in 80% while felt necessary by 95%. ConclusionThe measures were successfully implemented, reduced diversity in patient testing, and positively accepted by local physicians. Wider application of the measures may be appropriate as suggested by the results of a European survey and the variability of BDD reported in the literature.

Rate of Complications Among the Recipients of Intrathecal Baclofen Pump in Japan: A Multicenter Study

To evaluate the incidence of complications of intrathecal baclofen (ITB) therapy for spasticity in Japan, where a unique training course and nationwide registration are required. An analysis of complications was performed in all patients who underwent ITB in Japan from 2005 to 2011. Prior to surgery, all the doctors involved took a one-day training course, which included hands-on training. Surgical techniques that avoided complications were emphasized. A total of 406 pumps were implanted in 400 patients (277 men, 123 women) having severe spasticity. Because this study is currently in progress, among the 400 patients, 78.3% (313/400) had finished a one-year observation follow-up. There were 369 adult and 31 juvenile (under 17 years old) patients, including 12 patients under nine years old. All-cause adverse events were seen in 148 patients (37%), and 93 (23.3%) of these were regarded as severe. Catheter problems were observed in 34 (8.5%) patients: catheter migration in 25 (6.3%), breakage in 6 (1.5%), obstruction in 2 (0.5%), kinking in 1 (0.3%), and dislodgement in 1 (0.3%). Pump trouble was observed in seven (1.8%) patients: alarm abnormality in one (0.3%), memory error in one (0.3%), delayed recovery in one (0.3%), rotation in one (0.3%), malfunction in one (0.3%), and abnormal infusion rate in two (0.6%). Device-related and surgical wound infection occurred in 12 patients (3%), and nine were regarded as severe. Leakage or subcutaneous accumulation of the cerebrospinal fluid was seen in 13 patients (3.3%). The requirement of taking of a training course before starting ITB seemed to reduce complications. Although there were surgery-related complications, the rate of complications in Japan appeared to be lower than those reported in larger series of ITB. However, whether the reported rates can be primarily ascribed to a mandatory training course requires further investigations.

Frequency of Excisions and Yields of Malignant Skin Tumors in a Population-Based Screening Intervention of 360 288 Whole-Body Examinations

To explore the frequency of excisions and yields of histopathologically confirmed skin cancer. A population-based skin cancer screening intervention (the SCREEN project) in the German state of Schleswig-Holstein (July 1, 2003, to June 30, 2004). Physician offices. Participants could choose between nondermatologist physicians and dermatologists for their initial whole-body skin examination. All screening physicians received a mandatory 8-hour training course. PARTICIPANTS Inhabitants of Schleswig-Holstein 20 years or older with statutory health insurance (N = 360,288). Frequency of excisions and yields of malignant skin tumors (malignant melanomas [MMs], basal cell carcinomas [BCCs], and squamous cell carcinomas [SCCs]), stratified by sex and age. Overall, 15,983 excisions were performed (1 of 23 screenees). A total of 3103 malignant skin tumors were diagnosed in 2911 persons: 585 MMs, 1961 BCCs, 392 SCCs, and 165 other malignant skin tumors. Overall, 116 persons (3103 of 360,288) had to be screened to find 1 malignant tumor, with 1 of 620 for MM, 1 of 184 for BCC, and 1 of 920 for SCC. Twenty excisions were performed to find 1 melanoma in men 65 years and older, but more than 50 excisions were required to find 1 melanoma in men aged between 20 and 49 years. The results of SCREEN suggest a high yield of malignant skin tumors in a large-scale population-based screening project. We found that a high number of excisions was performed in the youngest screenees with an associated low yield, suggesting a need in screener training to emphasize a more conservative attitude toward excisions in young screenees.

Behavior, Attitude, and Perception toward Safety Culture from Mandatory Safety Training Course

The construction industry is one of the most hazardous trades as far as work safety is concerned. Efforts have been made to improve safety in workplace. These efforts have focused on legislation, engineering failure, safety awareness campaigns, safety training, and unsafe behavior. After years of developing safety technologies and safety management systems in the industry, many organizations recognize that the safety culture within the industry has to be addressed if high standards of health and safety are to be maintained. Therefore, this paper investigated the relationship among people’s behavior, attitude, and perception toward the safety culture and evaluated the effectiveness of a mandatory safety training course in Hong Kong’s construction industry. A questionnaire survey and structured interviews were conducted. It was found that a good personal safety attitude, personal roles and commitment among workers, and low obstacles to safe behavior resulted in good perception of accidents. In addition, most of the participants in the mandatory safety training course understood the contents taught in the course and considered the course practical and useful. The results showed that workers paid more attention after completing the course; this indicated that a positive personal attitude toward the safety training course resulted in a positive personal safety attitude. Recommendations to improve the safety culture, effective mandatory safety training, and the implementation of safety regulations were also explored.

Seven year experience with a mandatory training course within the Vigigerme® infection control program

VigiGerme® is an infection control program built on social marketing principles at the University of Geneva Hospital (HUG). The 2-hour training course was introduced in 2003 and has been mandatory for all healthcare workers (HCWs) since.

Experiences of the ‘1st Newcastle ERCP and EUS Course for Nurses’

Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) are complex endoscopic procedures requiring highly skilled nursing assistants. For these procedures to be performed safely and efficiently, regular training and teaching for all staff involved is essential. Currently there are no mandatory training courses in the region for these procedures despite the recognized need. The aim of the first Newcastle ERCP and EUS course was to address the basic principles of these complex endoscopic procedures and highlight recent developments in the field. In this article, Manu Nayar, Gillian Nicholson, Heather Gray and Linda Hodgson outline the experiences of fifty nurses who attended the course.

Budget cuts threaten nurses' mandatory training courses.

WHEN NHS budgets begin to tighten, it becomes easy to predict where the first cuts will be made: training courses and conferences for staff.

PWE-015 Experience from the first Newcastle endoscopic retrograde cholangiopancreatography and endoscopic ultrasound course for nurses

<h3>Introduction</h3> Endoscopic retrograde cholangiopancreatography and endoscopic ultrasound (ERCP and EUS, respectively) are complex endoscopic procedures requiring highly skilled nursing assistants. For these procedures to be performed safely and efficiently; regular training and teaching is essential. Currently there are no mandatory training courses in the region for these procedures despite the recognised need. The aim of the course was to address the basic principles of these complex endoscopic procedures and highlight recent developments in the field. <h3>Methods</h3> Fifty nurses working in endoscopy units around the country attended the first Newcastle ERCP and Endoscopic Ultrasound course for nurses (The Newcastle Upon Tyne Hospitals NHS Foundation Trust). They were surveyed at the end of the course using a detailed questionnaire. <h3>Results</h3> 50 delegates attended from eight institutions around the UK. 49 (98%) delegates completed the questionnaire. The average experience of the staff working in endoscopy was 5.5 years (range 0–20 years). 13/49 (26.5%) had previously attended some form of ERCP±EUS training. 42 (85.7%) delegates thought all nurses should attend similar course. 38 (77.5%) thought their knowledge was either basic or moderate prior to attending the course. 47 (95.9%) said that their knowledge had improved after the course. 31 (63.2%) thought their ability to assist during an ERCP/EUS either basic or moderate before the course 45 (91.8%) thought their ability to assist during ERCP/EUS had improved after the course. Confidence in assisting the Endoscopist with therapeutic procedures increased from 28 (57.1%) to 41 (83.6%) of attendees after the course. 42 (85.7%) of attendees agree all nurses should undergo a training course within the first year in post in the Endoscopy unit. <h3>Conclusion</h3> 1. Less than a third of the endoscopy nurses attending the course had attended some form of formal training course for either ERCP or EUS, despite a medium time working in Endoscopy of 5.5 years. 2. This course not only improved the knowledge and ability to assist during a therapeutic ERCP/EUS list but also improved the nurse9s confidence about these complex procedures. 3. More prospective surveys are required to address training issues for nurse assistants involved in ERCP and EUS.

Continuous training program for technicians handling antineoplastic drugs and occupational exposure risk

Training and regular evaluation of technicians involved in the preparation of antineoplastic agents seems essential to reduce occupational exposure. In this way, a continuous training program was established. Technicians were asked to prepare a safe simulated liquid cytotoxic drug with a fluorescein solution (10 mg/L). After, occupational exposure with this solution was simulated. Ultra-violet light (365 nm) was employed to determine surface contamination. This continuous training program is tested and validated with pharmacy technicians. All people handling these drugs (physicians, nurses, pharmacy staff) can use this program. Short mandatory training courses are stimulating and well appreciated.

Assessment of quality assurance in HIV testing in health facilities in Lake Victoria zone, Tanzania

Tanzania is currently implementing the antiretroviral treatment programme, and has a target of putting about 400,000 eligible HIV infected individuals on treatment by 2008. This will involve screening a large number of people, which will require non-laboratory personnel to be involved in doing HIV testing. In order to guarantee reliable and quality HIV test results, there is a need to ensure that quality assurance (QA) procedures are followed from specimen collection, testing and reporting of results. In light of the above a survey was conducted to assess QA in HIV testing in health facilities in Lake Victoria zone, Tanzania. A total of 89 health facilities (29 hospitals, 34 health centres, 9 dispensaries and 17 voluntary and counselling testing centres) were surveyed. Only three (10.3%) health facilities reported performing Uniform II ELISA for HIV diagnosis. All other health facilities reported to be using HIV rapid tests Capillus and Determine. Five (5.6%) of health facility laboratories performed CD4 counts. Internal quality control (IQC) were performed in 21 (63.6%) of the hospitals. Kits for HIV testing were reported to be readily available by 54 (60.7%) of the facilities. Only 16 (18%) of the health facilities had standard operating procedures in place. Systems of equipment calibration were reported by 13 (14.6%) of the health facilities. Counselling services were available in all health facilities and all counsellors had received the 6-week mandatory training course. These findings show that most of health facilities in the Lake Victoria zone do not adhere to QA procedures in HIV testing. There is therefore, a need to establish a monitoring system to laboratories performing HIV testing for the purpose of ensuring QA procedures are done. Personnel doing HIV testing should be re-trained at a regular basis to cope with new techniques and ensure QA procedures are followed.

BBC’S Casualty is not doing the profession any favours

Am I the only person who is worried about the portrayal of nursing in the BBC television series Casualty? The behaviour of Bruno, a senior staff nurse, could be viewed as detrimental to the profession. In recent episodes he was selling prescription pads and advocating non-attendance at a mandatory training course. I know the programme is fictional and if hospital life was portrayed accurately then the programme would be boring, but do we want nurses to be shown like this?

Évaluation de la mise en place d'une formation continue du personnel de l'hôpital Bichat à la prise en charge des arrêts cardiocirculatoires intrahospitaliers

Management of in-hospital cardiac arrest is now considered as a hospital quality indicator. Such management actually requires training health care workers (HCWs) for basic life support (BLS). Objective. – To assess the usefulness and efficacy of a short mandatory BLS training course amongst general ward HCWs in a 1,200 bed teaching hospital. Study design. – The in-hospital medical emergency team (MET) established a 45-min BLS training course comprising 10 goals for basic CPR and preparing for the arrival of the MET. Assessment was based on satisfaction questionnaires, cross-sectional evaluation of knowledge and skills of HCWs before and 1 year after the start of the training course. Efficacy of BLS performed on ward was assessed by the MET on scene. Results. – One year after, 68 training sessions had been fulfilled and 522 HCWs had been trained (46.27% of total HCWs). HCWs were satisfied with the teaching course. Instant retention of objectives was over 90%. Cross-sectional surveys showed an improvement of BLS knowledge and skills. The knowledge of initial clinical assessment remained low. Knowledge and skills were significantly higher amongst HCWs who had been trained than amongst those who had not. Unfortunately, general ward BLS performance showed no improvement. Conclusion. – Short mandatory training courses are stimulating and well appreciated amongst HCWs. Although basic knowledge and skills improve dramatically, no improvement of on-scene BLS performance occurs.

Air Force Academy Ends Mandatory Boxing Activity

ABSTRACT IN RESPONSE to mounting pressure from the medical community, the US Air Force Academy has eliminated boxing as a mandatory activity.Until now, boxing was offered at the Army, Navy, and Air Force academies as an intramural sport and a mandatory combative training course. But now Air Force cadets will not be required to box as freshmen; they will have the option of taking the course as sophomores and may still participate intramurally. If any cadet boxes at the [Air Force] academy, it will be because he wants to, says Capt Will Lane, executive officer of the athletic department.Events leading to this decision stem in part from an editorial by George D. Lundberg, MD, editor-in-chief of the Journal of the American Medical Association, published June 8,1994. A longtime opponent of boxing, Lundberg called on the surgeons general of the US Army, Navy, and Air Force to influence the elimination