Hospital Medical Staff Research Articles

Research on Occupational Health and Safety of Medical Staff Based on ISO 45001

This paper aims to discussion on the application of International Organization for Standardization (ISO) 45001 in hospitals. With the spread of COVID-19 globalization, the occupational health and safety problems of many medical staff have become international commonalities. There are a lot of articles talking about how to protect medical staff, including World Health Organization (WHO), however most of them are focus on the details, which lack of system methodology and standardized model. By analyzing the Occupational Health and Safety (OH&S) risks faced by medical staff during the COVID-19, the importance of International Organization for Standardization (ISO) 45001 application in hospital industry is put forward. Firstly, the paper adopt a theoretical foundation by which or through which hospital can better manage medical staff’s occupational health and safety risks and improve their overall performance. Secondly, this paper uses Plan-Do-Check-Act (PDCA) model to hospitals, which provides a framework for hospital to plan what they need to do. Thirdly, from the ISO 45001 perspectives to explore how to solve the current occupational health problems faced by medical staff and adopt relevant programs to protect occupational health and safety of medical staff, thus promoting the healthy and sustainable development of individuals and hospitals. Findings-ISO 45001 can plays an important role in the occupational health and safety of medical staff. It is of great and urgent to instruct hospitals how to scientifically and effectively identify hazards (COVID-19), evaluate their risks and take corresponding prevention and control measures. Therefore it can promote the health and well-being of medical staff. The occupational health and safety management of medical staff in hospitals is also a concrete manifestation of their active fulfillment of social responsibilities. Originality/value: This paper offers an standardized angle to address the risks of occupational health and safety of medical staff during the spread of COVID-19. As for the application of ISO 45001, this paper provides some suggestions based on china’s practice and experience, which through the angles of theoretical research methods include high level structure, Plan-Do-Check-Act (PDCA) model and man, machine, material, Method, Environment (4M1E) model.

Exploration of nursing human resource rapid allocation mechanism in non-COVID-19 designated hospitals

Objective To explore how to rapidly allocate human resource in non-designated hospital under the situation of COVID-19 so as to satisfy the demand of epidemic situation control in-and-out hospital for nursing human resource. Methods According to the need assessments of normal workload, expected workload in epidemic situation control in hospital and workload for building the rescue team, the epidemic situation control human resource reserve was rapidly formed based on the research of original disaster nursing reserve force by three ways, allocating the disaster rescue motorized nurse reserve force, orienting allocation by Nursing Department, volunteering. The layered and progressive human resource was allocated to meet the demand of COVID-19 control for human resource at different stages. Results The reserve made up of 271 motorized nurses was built by Nursing Department within 24 hours; 71 nurses were urgently allocated to the Outpatient and Emergency Department, Fever Outpatient, Department of Infectious Disease, medical team supporting Wuhan, Intensive Care Unit by 5 batches which satisfied the demand of epidemic situation control in non-COVID-19 designated hospital and building medical staff supporting Wuhan for nursing human resource. Conclusions Layered and progressive human resource emergency allocation can effectively shorten the time of human resource emergency reaction in emergency public health event and improve the working efficiency. Key words: Nursing administration research; COVID-19; Workforce; Emergent allocation

Novel coronavirus pneumonia in the primary general hospital of treatment based on traditional Chinese medicine syndrome differentiation and prevention

Objective To observe the curative effect of TCM syndrome differentiation and treatment for novel coronavirus pneumonia (novel coronavirus pneumonia, NCP) patients and the preventive effect for Chinese medical staff. Methods A total of 62 NCP suspected patients admitted in 2020 were treated with TCM syndrome differentiation and treatment, as well as our hospital medical staff with No.1-4 hospital prescription. Results After taking traditional Chinese medicine, 16 out of 25 NCP suspected patients with phlegm heat stagnating lung syndrome were discharged to home for isolation observation, 4 patients hospitalized for observation, and 5 patients confirmed with NCP. For 15 patients with phlegm dampness accumulating lung syndrome, 7 patients were discharged to home for isolation observation, 3 patients were hospitalized for observation and 5 patients have been confirmed. For 18 patients with spleen stomach disharmony syndrome, 15 patients were discharged to home for isolation observation, 1 patient was hospitalized for observation and 2 patients have been confirmed. For 4 patients with Qi deficiency and dampness stagnation syndrome were discharged to home for isolation observation, 1 patient was hospitalized for observation, and two have been confirmed. The duration of taking traditional Chinese medicine was 1 to 20 days from admission to be discharged. The doctors and nurses who took the prescription of TCM for 12 to 15 days have been prevented from NCP infection. Conclusions The clinical effect and the preventive effect of TCM syndrome differentiation and treatment for NCP have been proved to be satisfactory. TCM can go into the primary hospital for treatment and prevention on NCP. Key words: Novel coronavirus pneumonia; Communicable diseases; Treatment based on syndrome differentiation; Primary general hospital; Protective effect

Abstract WP373: Saving Time for Initial Management of Stroke by Reorganization of In-Hospital Stroke Code Protocol

Introduction: Stroke is a relatively common in hospitalized patients. However, previous studies have shown delays in recognition and initial assessment of in-hospital stroke. We aimed to elucidate that reorganization of in-hospital stroke code protocol can improve process of acute stroke care and save the treatment time. Methods: Our reorganization of in-hospital stroke code comprises the development of in-hospital stroke code protocol and workshop for hospital medical staff. Before the intervention, if the medical staff identified patients with suspected stroke, they first contacted the attending physician, then the physician consulted the stroke neurologists immediately or after imaging. After the intervention, to quickly identify stroke patients, the medical staff can directly consult stroke neurologists when they identified patients with at least one of acute-onset symptoms, including face droop, arm drift, speech disturbance, eye deviation, aphasia, or neglect, within 6-hour from last seen well or stroke recognition. As an educational intervention, we held workshop for nurses and residents with an understanding of how to evaluate stroke symptoms, use the protocol, and manage stroke. Data were compared between 24-month period before and 12-month period after the intervention. Outcome measure included the time from stroke recognition to initial imaging, and evaluation by stroke neurologist, and from initial imaging to groin puncture. Results: One hundred four patients were included (before, 42; after, 62). Significant time savings were seen in the median time from stroke recognition to evaluation by stroke neurologist (91 vs. 56 minutes, p=0.015), and time from initial imaging to groin puncture (113 vs. 68, p=0.040). The rate of consultation to stroke neurologists before initial imaging was significantly increased (21% vs. 47%, p=0.012). The time from stroke recognition (234 vs. 103, p=0.126), and evaluation by stroke neurologist (135 vs. 81, p=0.056) to groin puncture tended to decrease. Conclusion: Reorganization of in-hospital stroke code protocol can improve the time for initial management of in-hospital stroke.

Knowledge Does Not Correlate with Behavior toward Deceased Organ Donation: A Cross-Sectional Study in Japan.

BackgroundAlthough knowledge is an important factor that influences decisions regarding deceased organ donation, the associations of knowledge with attitude and behavior regarding organ donation remain uncertain in countries with low organ donation rates like Japan.Material/MethodsWe conducted a cross-sectional survey of hospital medical and non-medical staff in 15 Japanese medical facilities. The questionnaire included items on knowledge, attitude, and behavior toward deceased organ donation and transplantation. Participants were divided into 3 groups according to the tertile of knowledge score. Modified Poisson regression models were used for associations of knowledge score with organ donor registration and willingness to become an organ donor after death.ResultsOf the 1967 staff, 1275 returned the questionnaires (response rate, 64.8%). There were 1190 study subjects with complete data for analysis. For the lowest (n=512), middle (n=428), and highest (n=250) tertile knowledge groups, the proportions of participants who registered and expressed willingness to donate organs were 20.1%, 23.4%, and 28.4% and 31.1%, 38.3%, and 44.0%, respectively. The adjusted proportion ratios for organ donor registration were 0.90 (95% CI, 0.73–1.10) for the middle and 1.00 (0.80–1.26) for the highest tertile of knowledge, compared with the lowest tertile. However, participants with the highest tertile of knowledge score expressed higher willingness for organ donation than the lowest tertile (adjusted proportion ratio, 1.37; 95% CI, 1.13–1.66).ConclusionsFor hospital staff in Japanese medical facilities, high knowledge about organ donation and transplantation was not associated with donor registration, but was associated with willingness to become an organ donor.

MODERNIZATION OF THE ORGANIZATIONAL CULTURE OF THE HEALTHCARE INSTITUTION IN THE CONDITIONS OF MEDICAL REFORM

Subject, aim of research. The subject of the study is the modernization of the organizational culture of health care facilities in the implementation of the second stage of medical reform in Ukraine. The aim is to identify the factors and problems of the organizational culture of medical institutions, as well as directions and tools for its modernization in the context of medical reform. Methods and methodology of work. The methodological basis is the scientific works of domestic and foreign scientists. The research is based on a systematic approach and methods of strategic analysis, in particular SWOT-analysis, comparative analysis, export valuation method, questionnaire method, etc. Research results. The article emphasizes that the main factor of health care facilities modernization in Ukraine is the medical reform. The main challenges facing secondary hospitals are highlighted: increased competition of healthcare market, expanding the range of funding sources, technological change, demand transformation and epidemiological threat. The main directions of modernization of health care institutions organizational culture are identified. Among them there are strengthening its functional component with separation of responsibilities and capabilities of hospital management and medical staff; innovative development; communication with colleagues from other institutions, including foreign ones, and patients respectively to the requirements of digitalization; staff training, the use of crisis management tools, etc. The project profile of the evaluation components of the effectiveness of the organizational culture of health care institutions modernization has been formed. The important role of PR-management and image-making in the formation of corporate culture of modern medical institutions is emphasized.

Implementation of an antibiotic stewardship quality improvement initiative in a community hospital for infants born at ≥35 weeks

We present our experience in the implementation of an antibiotic stewardship quality improvement initiative directed toward infants born at ≥35 weeks using as a primary tool the Kaiser Permanente early onset sepsis calculator (KP-EOS-C) at the Baylor Scott & White Medical Center – Frisco. After the approval and support of the medical staff and administration, we proceeded to launch an extensive educational program for all women’s services nursing staff on how to utilize this calculator to communicate results to the pediatricians on staff. After implementation, we saw a 54% reduction in the number of infants undergoing sepsis workup evaluations and a 51% reduction in the number of infants receiving antibiotics (P < 0.001). We conclude that the implementation of this type of initiative may be feasible and worthwhile in other similar community hospitals, provided there is buy-in by physicians and administration as well as an extensive educational program to the hospital medical and nursing staff.

Health Information Seeking Through Social Media and Search Engines by Parents of Children With Orofacial Cleft in Nigeria.

To ascertain the level of utilization of social media platforms and search engines by parents of children with orofacial cleft presenting to our clinic, with respect to information seeking about the condition and its treatment. All consenting parents of children attending the cleft outpatient clinic of the Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-Araba, Lagos, within the study period were included in the sample population. Data collection was done using a 17-item interviewer-administered questionnaire. A total of 50 parents participated in the study. Eighty-eight percent first sought information about their child's condition from hospital medical staff. Sixty-eight percent of the parents are active users of social media for general purposes, with Facebook being the most used platform (62%). Forty percent of the total respondents have used search engines/social media to seek information on their child's condition, with majority of those (80%) using Google to search for such information, 35% of the search was in relation to diagnosis, and 75% of the parents considered the information obtained very useful. Only 3 parents reported being part of a social media support group based on their child's condition. The use of Internet resources for information seeking among the population studied is low. There is need to leverage on social media to provide support groups for families with children who have cleft.

Clasificador de atención de la inmediatez en el área de servicios de urgencias Médicas

In Mexico and Latin America it has become necessary to train emergency personnel to carry out the first stage of triage in order to optimize the human resources available in hospitals. Therefore, this research develops a mobile application that allows the patient's symptoms to be recorded when they go to the emergency services area and can be classified by a Bayesian network in a supervised learning environment that allows the hospital's medical staff to determine the procedure which must apply to the patient. The data collected from the mobile application is stored in a web system, therefore the symptoms are used as attributes to be classified and to make a prognosis of the possible disease, which determines the priority of the medical care using the colors of the practical guides of the health clinics, therefore the message is displayed indicating the color, the response time and a possible diagnosis of the disease.

Investigation into the adaption of PMV to evaluation of the medical staff in hospitals in Guangzhou

In this investigation, the measurement thermal parameters and thermal comfort field survey were carried in six air conditioned hospitals in Guangzhou. A total of 114 valid questionnaires were collected. Based on the data, there were strong linear regression relationships between PMV and MTSV and operative temperature. The neutral PMV of medical staff was 0.004. The neutral operation temperature was 22.99 °C from the PMV model. The thermal comfort temperature which meets a satisfaction degree of 90% ranges from 21.29°C to 24.70°C. In addition, the neutral temperature was 24.36 °C from the linear regression of MTSV. The range of thermal comfort temperature was between 22.86°C and 25.85°C. Comparing the MTSV and PMV, the MTSV was lower than that of PMV.

Evidence-based nutrition for the malnourished, hospitalised patient: one bite at a time.

Although malnutrition is a highly prevalent condition in the inpatient setting, particularly in older patients with multiple morbidities, the medical community has struggled to find efficient, evidence-based approaches for its prevention and treatment. From an evolutionary perspective, illness-related low appetite may be seen as a protective response with the goals to accelerate recovery from disease by improving autophagy. In line with this, earlier trials in the intensive care setting including severely ill patients have demonstrated unwarranted effects of overnutrition on patient outcomes. Uncertainties regarding the best approach to the malnourished inpatient in conjunction with a lack of strong trial data may, in part, explain the low level of attention that hospital medical staff have paid to the issue of malnutrition in the non-critical care inpatient setting. The recent Effect of early nutritional support on Frailty, Functional Outcomes and Recovery of malnourished medical inpatients Trial (EFFORT) study, however, has shown that individualized nutritional support reduces severe complications and improves mortality in medical inpatients, with positive effects on functional outcomes and quality of life. These results from a high quality effectiveness trial in conjunction with other studies, such as the NOURISH trial, should prompt us to improve our management of malnutrition in the inhospital setting. This procedure should start with a systematic screening for risk of malnutrition of admitted patients, effective assessment of nutritional status in multidisciplinary teams including dieticians, nurses and physicians, and early start of individualized adequate nutritional support of at risk patients to reach nutritional goals. Understanding the optimal use of nutritional support in patients with acute illness is complex because timing, route of delivery, and the amount and type of nutrients may all affect patient outcomes. Also, particularly for patients on the medical ward, factors like the logistics of catering, staffing to provide food and support the patient (i.e., number of nurses and dieticians), motivation/understanding of the patient to eat in defiance of appetite, the empathic human factor of nutritional care, the quality of meals, the taste of supplements, and unnecessary fasting for diagnostic or therapeutic procedures have a strong influence on nutritional care of patients. Further research and clinical trials are required to better understand, step by step, how we can use clinical nutrition best to maximize recovery of our patient and improve their functional status and their quality of life. Such evidence regarding nutritional therapy may allow us to implement personalized nutrition-driven interventions in the future.

Medical training in private and public.

Globally, the need for medical student training to be undertaken in the private sector is likely to increase. In Australia, it has increased by 250 per cent in the last decade. Effective clinical education is highly dependent on the attitudes and willingness to participate of both patients and medical staff. We aimed to examine these attitudes in both private and public hospitals. Patients and medical staff at a private and a public hospital in Sydney were surveyed during December 2016 and January 2017 to investigate attitudes to medical student training. Attitudes were compared between hospitals. We also compared recent attitudes in the private hospital with those obtained in 2012. Patients at the public hospital were significantly more likely to want a student present at a consultation than those at a private hospital. Public hospital doctors had more positive attitudes towards medical students than their private colleagues. The negative financial impact of teaching was more significant for those in private practice. Since 2012, attitudes of private hospital patients towards medical students became significantly more positive whereas doctors' attitudes became less positive. The expansion of clinical education into the private sector is likely to increase globally DISCUSSION: The willingness of patients to participate in medical student training in both public and private hospitals is encouraging for future expansion into the private sector. The reduced willingness amongst private hospital medical staff over time and, in comparison to public hospital staff, suggests a need to address barriers for staff in the private sector.

Status and perspectives of registry-based studies in German ophthalmology

Registry studies provide insights into real-life diagnostic and treatment data outside of clinical trials. Registry studies are interesting for quality management and explorative analyses can lead to the identification of possible risk or prognostically relevant factors and generate hypotheses. There are currently relatively few active registry studies in German ophthalmology. The aim of this survey was to collate the different infrastructure and in particular the potential hurdles in the establishment and performance of registry studies in German ophthalmology departments. An online questionnaire collected data on participation in registry studies in German ophthalmology departments between September and December 2018. The survey was addressed to all hospital management and medical staff involved in registry studies in German ophthalmology. Out of 45participants 18were head of the department, the remaining 27were consultants(15), medical specialists(2) and residents(10). According to the department head an average of2.5 (2.0-3.5) employees per clinic participate in2.0 (1.7-3.0) registry studies. The amount of reimbursement recommended by the hospital management differed significantly from the amount suggested by the staff (0.0 (0; 75) € (0-100) vs. 100.0 (50.0; 150.0) €; p = 0.0012). The most frequent hurdles to conducting aregistry study were bureaucracy and limited human resources. Half of the surveyed centers profited from aseparate study center and good clinical practice (GCP) courses for employees involved in studies were mandatory. Aquarter of these centers received support from an IT department and/or astatistician. Registry studies are an important instrument in ophthalmology research and their importance is increasing in Germany. An agreement on national standards would make the establishment of further registry studies easier.

A Causal Analysis of Life Expectancy at Birth. Evidence from Spain.

Background: From a causal point of view, there exists a set of socioeconomic indicators concerning life expectancy. The objective of this paper is to determine the indicators which exhibit a relation of causality with life expectancy at birth. Methods: Our analysis applies the Granger causality test, more specifically its version by Dumitrescu–Hurlin, starting from the information concerning life expectancy at birth and a set of socioeconomic variables corresponding to 17 Spanish regions, throughout the period 2006–2016. To do this, we used the panel data involving the information provided by the Spanish Ministry of Health, Consumer Affairs and Social Welfare (MHCSW) and the National Institute of Statistics (NIS). Results: Per capita income, and the rate of hospital beds, medical staff and nurses Granger-cause the variable “life expectancy at birth”, according to the Granger causality test applied to panel data (Dumitrescu–Hurlin’s version). Conclusions: Life expectancy at birth has become one of the main indicators able to measure the performance of a country’s health system. This analysis facilitates the identification of those factors which exhibit a unidirectional Granger-causality relationship with life expectancy at birth. Therefore, this paper provides useful information for the management of public health resources from the point of view of the maximization of social benefits.

Neonatal Incubator Embedded Temperature Observation and Monitoring Using GSM

In order to reduce the risks of death rates, neglecting by the observers, and sometimes the little number of the medical staff in hospital, A monitoring system based microcontroller in neonatal incubator was developed in this article. An interfacing process is made between the infant, infant incubator, and the computer, by taking the temperature readings and send the results to doctor's or the person who in- charge's phone through Short Messages Service, and to a personal computer PC, with sound alarm on the incubator, every given period of time; A temperature sensor is interfaced with a configured single inline module SIM of phone, the temperature reading that obtained from interfacing method is combined with the readings of the incubator sensor, then the final result will be taken from the microcontroller because it will be more accurate than the incubator’s thermometer.&#x0D; This system was designed only to check and give an alarm if there was any unaccepted change in temperature due to the normal temperature ranges.

Qualitative study on doctor-patient trust at public hospitals based on bureaucracy theory

Objective To analyze the impacts of bureaucracy management at tertiary public hospitals in Beijing on exchange modes and trust between doctors and patients, using both the bureaucracy theory and trust theory. To study the role of such management as an organizational structure for hospital operation and service, in the transition of doctor-patient trust from traditional special trust to a universal trust based on bureaucracy structure and specialized job division. Methods The purpose sampling method was used to select 94 hospital administrators, medical staff, and patients from six tertiary hospitals for a field survey. Results Bureaucracy at public tertiary hospitals keeps improving, and its systematic and refined organizational structure is changing the exchanges between doctors and patients, earmarking universal trust of the fundamental type of doctor-patient trust, aided by special trust. Rules and regulations of bureaucracy normalize medical services, and specialization enables medical workers in their clinical work against difficult and severe diseases, winning both reputation and patient trust as well. However, the specialized, professional and dehumanized characteristic of bureaucracy tend to encourage doctors to attend to diseases than patients, and separate links in medical services to decrease doctor-patient trust in the meantime. Conclusions Bureaucracy is a necessary organizational form of urban public hospitals, but it should strengthen their humanity feature and improve their communication with patients with rules and regulations. At the same time, with the use of integrated medical mode in clinical practice, bureaucracy could be improved to benefit patients and enhance trust of patients. Key words: Hospitals, public; Bureaucracy; Doctor-patient trust; Type of doctor-patient trust; Qualitative study

Study of sleep quality among patients admitted to the respiratory intensive care unit

BackgroundSeveral factors may cause sleep disruption among critically ill patients. Determination of these factors that interfere with patients’ quality of sleep is very important in the treatment process to ensure normal sleep process.ObjectiveThe aim was to assess the quality of sleep among critically ill patients admitted to the respiratory intensive care unit (RICU) and identify the risk factors.Materials and methodsThis observational study was carried out on all patients who were admitted to the RICU. Patients’ age, gender, duration of ICU stay, cause of admission, and scores for the severity of illness on admission including Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment were done. A Freedman questionnaire was determined twice: at the RICU and at home to evaluate sleep quality and the contributing factors.ResultsOne hundred patients were enrolled in this study. The mean ICU stay was 5.41±2.03 days; 82% of them were admitted for the first time to the RICU. The mean score of sleep quality of patients at the RICU was 4.38±1.83, which was significantly reduced compared with the mean score at home post-admission 8.30±1.09 (P<0.001). Noise (7.60 ±1.40) was the main sleep disruptive factor in the RICU; hospital staff conversations (7.77±1.38) and medical staff pagers and phones (7.42±1.53) were the maximum noises. Frequent use of light is the second influential factor for sleep disruption (6.82±1.31), followed by nursing interventions and blood sampling.ConclusionDue to the poor sleep quality during hospitalization and due to the presence of a wide range of sleep disturbing factors such as noise, light, and nursing activities, nursing education, using eye shields, and ear plugs might reduce environmental noise and improve sleep quality.

The value of PAs in hospital medical staff governance.

Regulatory and accrediting standards require hospitals to have a medical staff responsible for quality of care, patient safety, and clinician self-governance. PAs are on about 20% of hospital medical staffs in the United States and the number is growing.

Функционирование больниц гражданского ведомства в городах Тобольской губернии в 1870—1917 годах

The main aspects of the functioning of civilian hospitals in the cities of the Tobolsk province (city, prison, foreign, hospitals of the Orders of public charity, as well as small hospitals at some educational institutions) is discussed in the article. Based on the information contained in the reports of the Tobolsk Medical Board, as well as in the annual reviews of the province, changes are observed in the number of hospitals and medical personnel, the number of inpatient beds for several time sections. Attention is paid to the characteristics of hospital infrastructure, the material and technical and sanitary conditions of medical institutions. The conditions of stay of patients in medical institutions, issues of their nutrition are described. The conclusion is drawn about the increase in the costs of the central and local authorities for the organization of inpatient treatment during this period, as well as about the positive dynamics in the number of hospital facilities and medical staff in the cities of the specified province, qualitative changes in the organization of medical care for inpatients, and the improvement of their conditions in hospitals. The problems that arise in the functioning of hospital facilities in the cities of the province during the First World War are indicated.

Stop the Bleed: A nurse-driven community outreach initiative

Introduction: As part of a national public health initiative, our Level I Trauma Center has committed to training the public in bleeding control (B-Con) as part of the Stop the Bleed (StB) campaign. Our primary objectives were for nurse-led teams to present course materials to people with no healthcare background and to evaluate the impact of this training by participants' perceived ability to respond to life-threatening bleeding. Methods: We initially launched trainings for hospital medical staff, followed by courses for community members, business entities, and academic institutions. Trainings consisted of a 30-minute lecture, followed by a skills session during which participants practiced wound compression, wound packing, and tourniquet application. Participants completed pre- and posttraining questionnaires to assess learning. Answers were scored on a five-point Likert scale. Results were entered into Qualtrics (Provo, UT). Results: A total of 345 laypersons attended 43 StB training sessions. Nurses participated as skills' instructors at 100% of the trainings. Sixty-one percent of participants had previous cardiopulmonary resuscitation (CPR) or first aid training, while 9% reported prior B-Con training. Seventy-three percent of participants reported increased confidence in responding to an emergency medical situation after training, and 86% reported increased confidence in their ability to stop someone from bleeding. Conclusion: Nurses are well equipped to teach healthcare topics in a community-based setting and represent an ideal instructor pool for the large-scale implementation of StB. Given the positive impact of this program, nurses should continue to play a crucial role in growing this nationwide hemorrhage control campaign. The following core competencies are addressed in this article: Practice-based learning and improvement, Communication skills, and Medical knowledge.