Web-based Data Collection Tool Research Articles

National Fatality Review Case Reporting System: Twenty Years of Data Collection.

The National Fatality Review Case Reporting System (NFR-CRS) is a web-based data collection tool for child death review and fetal and infant mortality review teams. The NFR-CRS captures information from the multidisciplinary review, including the social and community risk factors that may have impacted the death. The NFR-CRS is a nimble data system that has evolved throughout the past 20 years. The most recent enhancements include a life stressors section focused on collecting contextual information such as racism and poverty, revised cause of death sections to better align data collected with risk factors identified in the research, and enhanced data visualizations. The NFR-CRS has improved data quality since the launch of a data quality initiative in 2015. As a result of the data quality initiative, the completeness, consistency, accuracy, and timeliness of the NFR-CRS data have improved. Limitations for the NFR-CRS include the fact that data entered are not population-based, data fields have evolved over time, and there are high percentages of missing and unknown data. Despite its limitations, the NFR-CRS remains a valuable research tool, especially when paired with other data sources.

The Fight Tumour Blindness Registry: Efficient capture of high-quality real-world data in uveal melanoma

ObjectifDécrire la création d'un outil de cueillette de données accessible en ligne servant à suivre la prise en charge du mélanome de l'uvée et les résultats des traitements. NatureDescription d'un registre clinique. ParticipantsPatients présentant un mélanome de l'uvée. MéthodesUn groupe d'oncologues oculaires a fait équipe avec des médecins d'autres spécialités pertinentes et des experts dans l’élaboration de registres pour mettre au point un ensemble minimal de données à recueillir afin de suivre l'issue clinique réelle du mélanome de l'uvée. Cet ensemble de données a servi à créer le registre Fight Tumour Blindness! (FTB!) chapeauté par les registres australiens Save Sight Registries. RésultatsLes données à recueillir sont les suivantes : caractéristiques démographiques des patients, antécédents médicaux, visite initiale, visite de suivi, traitement de la tumeur, détermination du stade et surveillance de la tumeur, examens anatomopathologiques et auto-questionnaires des patients. On y décrit les mécanismes intégrés afin d'assurer une cueillette complète et efficiente des données. ConclusionsLe registre FTB! peut servir à surveiller les résultats des traitements chez les patients qui présentent un mélanome de l'uvée. Il permet d’étalonner les résultats et de les comparer d'une clinique à l'autre et d'un pays à l'autre.

A novel web-based tool for lung transplant patients undergoing extracorporeal photopheresis

IntroductionExtracorporeal photopheresis (ECP) is considered an emerging rescue therapy for patients with CLAD (chronic lung allograft dysfunction). The aim of the study was to set up a web-based data collection tool for lung transplant patients with CLAD undergoing ECP. MethodologyThe web-based tool was developed using Oracle MySQL and coded in HTML, JavaScript and CSS (Cascading Style Sheets) and was set up with pre and post transplant data of possible interest in CLAD. The functionality assessment of the software was carried out using data from a cohort of CLAD patients undergoing ECP treatment. ResultsThe software consists of seven major sections. The validation cohort consisted of 25 lung transplant patients (13 men and 12 women, median age at transplant 51 years). A significant improvement in the rate of decline of FEV1, FVC and FEV1/FVC after introduction of ECP was observed. Forty-four percent of patients showed a <10% decline in FEV1 at 6 months. Patients with recurrent respiratory infections showed less probability of responding to ECP. ConclusionsToday informatics is an integral part of medical science and an essential tool for clinical decision-making under many circumstances, reducing costs and improving patient outcomes. The “Siena ECP Database” allowed us to identify major functional trajectories after the introduction of ECP. It showed good data collection capacity, providing significant pre- and post-transplant information associated with ECP response. Although no clear clinical profile of responders has yet been defined, BOS phenotype and absence of recurrent respiratory infections before diagnosis of CLAD seem to be associated with a positive response to ECP therapy.

Web-based Survey on the Knowledge, Attitude and Practice of COVID-19 Appropriate Behaviour among Vaccinated and Unvaccinated College Students in Puducherry, India: A Cross-sectional Study

Introduction: Coronaviruses (CoVs) encompass a large group of viruses known to infect the upper respiratory tract in humans. The devastating impact of the virus has led to widespread infections among millions of individuals. Widespread disregard for ‘Coronavirus Disease-2019 (COVID-19) Appropriate Behaviour’ (CAB) by the public has significantly strained the Indian healthcare system. Despite efforts to educate the public on CAB through social media since 2020, only a minority have incorporated these practices into their daily lives. Notably, some vaccinated individuals have been hesitant to adhere to CAB despite repeated awareness efforts. This study aims to understand adherence to CAB among vaccinated and unvaccinated students not associated with the healthcare system. Aim: To evaluate the Knowledge, Attitude and Practice (KAP) of CAB among vaccinated and unvaccinated college students. Materials and Methods: This descriptive cross-sectional study was conducted at Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry, India among various engineering and arts college students of Puducherry, India from December 2021 to February 2022. A web-based data collection tool was designed using Google Forms. Data was collected through invitation letters and questionnaires distributed via WhatsApp groups and Instagram. The study included a total of 360 responses, with the questionnaire comprising 40 questions related to KAP, consisting of 17, 7, and 16 questions, respectively. The results were expressed in percentages. Results: Among the vaccinated participants, 263 (89.7%) identified social media as the primary source of COVID-19 related information. Knowledge and attitude towards COVID19 vaccination revealed that over 50% were aware of the safety and efficacy of vaccines and the necessity of receiving two doses as advised by the government. While knowledge and attitude were similar across vaccinated and unvaccinated college students, there was a slightly higher percentage among the vaccinated group. However, there was an increased percentage of practice among unvaccinated students, indicating greater awareness of infection prevention. Conclusion: The study found that the knowledge, attitude, and behaviour of college students, particularly those not in medical fields, were satisfactory, likely due to the widespread availability of information on social media. These findings can be valuable for public health departments to adopt a peoplecentered approach to raise awareness among the public and reduce vaccine hesitancy.

STUDENTS' PERCEPTION OF THE USE OF GOOGLE FORMS IN ENGLISH SUBJECT

Information Communication Technology (ICT) has become the centre of the teaching and learning process in the 21stcentury. The Covid-19 pandemic made teaching and learning shift to online and partially abandoned the conventional method. Google Forms is one of the applications commonly used by teachers to give students exercises and administer tests. Google Forms is a web-based data collection tool offered for free as part of the Google Suite application suite provided by Google Cloud. Hence, this study investigates the students' perception of using Google Forms in an English subject. This study was conducted through a qualitative descriptive method, and purposive sampling was employed to collect the data. The participants in this research were 15 students in grade 10 from one of the senior high schools in Magelang. This study gathered the data through a questionnaire and an interview. The closed-ended questionnaire data were analyzed by the frequency of students' responses and were stated in percentages. Then, the interview was taped, transcribed, and analyzed. The study concludes that Google Forms helps students do their homework more effectively and efficiently. The students believe that Google Forms is more practical in helping them do exercises than paper as they need to erase and type if they want to change the answer. Although most students claim that Google Forms is effective and efficient as a method of doing exercises, they also feel that there need to be more features that can motivate students to participate in the class. As a result, students' motivation does not improve using Google Forms.

Implementation of a centralized, web-based surveillance for healthcare associated infections among residents of long-term care facilities in Italy

ObjectiveThe Italian National Action Plan to contrast AMR identified among its objectives the development and implementation of a national Healthcare-Associated Infection (HAI) surveillance system based on European Centre for Disease Prevention and Control (ECDC) indications, through point prevalence surveys (PPS) of HAIs and antibiotic use in acute-care hospitals and long-term care facilities (LTCFs). We aimed to assess feasibility and appropriateness of proposed tools for a national surveillance system of HAIs and antibiotic use in LTCFs. Study designPoint prevalence survey. MethodsA pilot PPS was conducted between May–June 2022, among 15 LTCFs of 7 Italian regions. Data were collected in a single day in each LTCF, at the LTCF, ward, and resident levels, using a web-based data collection tool developed ad hoc. Data collector teams of each facility were invited to complete a questionnaire investigating opinions on the proposed tools. ResultsAmong 1025 included residents, the prevalence of residents with at least one HAI was 2.5% (95% CI 1.7%-3.7%) considering all HAIs and 2.2% (95% CI 1.3%–3%) without considering SARS-CoV-2 infections. The prevalence of antimicrobial use was 3% (95% CI 0.2%–4.3%). Overall, most respondents were satisfied with the web-based software, training and protocol, even though some difficulties were reported. ConclusionsA national surveillance network was established, which will facilitate future surveillance efforts. Further studies are necessary to evaluate the impact of the pandemic on HAI transmission and antibiotic use in LTCFs.

Surveillance of Mpox Cases Attending Sexual Health Services in England (SOMASS): design, implementation and initial findings from the SOMASS data collection tool, 2022

ObjectivesWe aimed to design and implement a data collection tool to support the 2022 mpox (monkeypox) outbreak, and to describe clinical and epidemiological data from individuals with mpox attending sexual...

A Point Prevalence Survey of Antimicrobial Usage in New Brunswick Hospitals.

Prevalence surveys are useful tools for assessing the appropriateness of antimicrobial therapy. The primary objective was to assess patterns of antimicrobial utilization and appropriateness in New Brunswick hospitals. The secondary objective was to assess the impact of hospital size and the presence of a penicillin allergy label on antimicrobial appropriateness. A point prevalence survey was conducted of inpatients taking 1 or more systemic antimicrobials during admission to hospitals in New Brunswick. A structured protocol and web-based data collection tool (National Antimicrobial Prescribing Survey) were used for this survey. Data regarding hospital size and presence of a penicillin allergy label were also collected. Antimicrobial utilization was assessed in terms of guideline compliance and appropriateness. Results were summarized descriptively. A χ2 analysis was performed to describe secondary outcomes. Ten hospitals participated, and a total of 2200 patients were admitted at the time of the survey. The overall prevalence of antimicrobial use was 22.7% (500/2200). A total of 648 antimicrobials were ordered. The most frequently prescribed antimicrobials by class were first-generation cephalosporins (14.0%, 91/648), third-generation cephalosporins (11.3%, 73/648), and piperacillin-tazobactam (10.2%, 66/648). The most common indications for antimicrobial therapy were respiratory tract infections (27.3%, 177/648), urinary tract infections (12.2%, 79/648), and intra-abdominal infections (11.4%, 74/648). Compliance with local or regional treatment guidelines, where applicable, was 66.2% (188/284). Provincially, 68.1% (441/648) of the antimicrobial orders were deemed appropriate. Larger centres had substantially higher rates of appropriateness (p < 0.001). The presence of a penicillin allergy label had no impact on appropriateness (p = 0.21). Several opportunities for targeted interventions were identified to improve antimicrobial prescribing, including decreasing the use of broad-spectrum antimicrobials, increasing guideline compliance, and ensuring documentation of antimicrobial duration by prescribers.

Evaluation of a remote hybrid staffing model for ambulatory clinical pharmacists in a pediatric health system during the COVID-19 pandemic.

PurposeTo describe and quantify patient care activities performed by ambulatory clinical pharmacists supporting medical specialty clinics in a pediatric health system utilizing a hybrid staffing model during the coronavirus disease 2019 (COVID-19) pandemic.MethodsFive ambulatory clinical pharmacists, integrated within a health-system specialty pharmacy (HSSP), utilized a web-based data collection tool to record time spent performing patient care activities over a 2-week period. Work location (onsite or offsite) of the pharmacist was reported for each activity. Activities were classified as direct or indirect patient care. Direct patient care activities were subcategorized as telemedicine appointments, in-person clinic appointments, HSSP call center work, medication access support, electronic medical record consults, and previsit planning/postvisit documentation. Administrative tasks and precepting were considered indirect patient care activities.ResultsA total of 1,190 activities were completed, with 77% of all activities performed offsite. Direct and indirect patient care activities accounted for 871 (73.2%) and 319 (26.8%) of total activities, respectively. No activity took longer for the pharmacists to complete offsite versus onsite.ConclusionUsing a hybrid staffing model employed by a pediatric health system, ambulatory clinical pharmacists were able to efficiently provide a high volume of direct patient care activities even when working offsite. Rapid adaptation and implementation of telemedicine services was critical for pharmacists to continue to provide essential services within pediatric medical specialty clinics.

Integrating a web-based survey application into Qualtrics to collect risk location data for HIV prevention research

ABSTRACT Aspects of the physical and social environment play an important role in shaping HIV-related risk/prevention behaviors and access to prevention and treatment services. Here, we describe the feasibility of integrating a web-based survey application to collect risk locations into Qualtrics and compare this approach with a JavaScript-based alternative. Between 2017 and 2018, we enrolled 29 persons living with HIV in Boston Massachusetts to complete an interviewer-administered questionnaire using Qualtrics. Surveys collected demographics; sex/drug use risk behaviors; locations where participants met sex partners, had condomless sex, attended group sex events, and shared a syringe or injection equipment with someone else (up to 10 locations each); and the locations where participants (a) had sex with each sex partner (past 6 months) and (b) used drugs with each drug use partner (past 6 months). Location data were collected using embedded links to an encrypted web-based survey application. Overall, participants provided valid coordinates 93% of the time; when an exact location was not provided, a neighborhood was provided instead, resulting in little missing data. Our findings suggest that this web-based data collection tool (alone or with embedded links in Qualtrics) is a feasible and secure option for collecting risk location data.

Efficient capture of high-quality real-world data on treatments for glaucoma: the Fight Glaucoma Blindness! Registry

ObjectiveTo describe the development and implementation of a web-based high-quality data collection tool to track the outcomes of glaucoma treatments in routine practice.Methods and analysisThis is a prospective observational registry...

Development of a pharmacoeconomic registry: an example using hormonal contraceptives

BackgroundDisease-specific registries, documenting costs and probabilities from pharmacoeconomic studies along with health state utility values from quality-of-life studies could serve as a resource to guide researchers in evaluating the published literature and in the conduct of future economic evaluations for their own research. Registries cataloging economic evaluations currently exist, however they are restricted by the type of economic evaluations they include. There is a need for intervention-specific registries, that document all types of complete and partial economic evaluations and auxiliary information such as quality of life studies. The objective of this study is to describe the development of a pharmacoeconomic registry and provide best practices using an example of hormonal contraceptives.MethodsAn expert panel consisting of researchers with expertise in pharmacoeconomics and outcomes research was convened and the clinical focus of the registry was finalized after extensive discussion. A list of key continuous, categorical and descriptive variables was developed to capture all relevant data with each variable defined in a data dictionary. A web-based data collection tool was designed to capture and store the resulting metadata. A keyword based search strategy was developed to retrieve the published sources of literature. Finally, articles were screened for relevancy and data was extracted to populate the registry. Expert opinions were taken from the panel at each stage to arrive at consensus and ensure validity of the registry.ResultsThe registry focused on economic evaluation literature of hormonal contraceptives used for contraception. The registry consisted of 65 articles comprising of 22 cost-effectiveness analyses, 9 cost-utility analyses, 7 cost-benefit analyses, 1 cost-minimization, 14 cost analyses, 10 cost of illness studies and 2 quality of life studies. The best practices followed in the development of the registry were summarized as recommendations. The completed registry, data dictionary and associated data files can be accessed in the supplementary information files.ConclusionThis registry is a comprehensive database of economic evaluations, including costs, clinical probabilities and health-state utility estimates. The collated data captured from published information in this registry can be used to identify trends in the literature, conduct systematic reviews and meta-analysis and develop novel pharmacoeconomic models.

Global Divergence of Antifungal Prescribing Patterns: Data From the Global Antimicrobial Resistance, Prescribing, and Efficacy in Neonates and Children Surveys.

Globally, invasive fungal diseases (IFDs) have a significant impact in human health. With an increasing pediatric population at risk of IFD, effective antifungal drugs access and affordability should be ensured universally. The aim of our study was to characterize the global antifungal drug use in neonates and children and its variability between countries in different income groups. Data were extracted from the Global Antimicrobial Resistance, Prescribing and Efficacy in Neonates and Children Point Prevalence Survey project, consisting in 1 pilot and four 1-day Point Prevalence Survey between 2015 and 2017. The data had been entered through a study-specific web-based data collection tool. From a total of 13,410 children included, 7.8% (1048/13,410) received at least 1 systemic antifungal drug: 9.5% (95% confidence interval: 8.9%-10.1%) in high income countries (HIC) versus 5.0% (95% confidence interval: 4.4%-5.6%) in low-middle income countries (LMIC) (P < 0.01). A significant proportion of patients on antifungals belonged to high-risk group for IFD (67.4%; 706/1048); most of these were managed in HIC (72.8%, P < 0.01). The likelihood of receiving antifungals being in high-risk group was higher in HIC compared with LMIC (ratio of 5.8 vs. 3.4, P < 0.01). Antifungal prophylaxis was more likely prescribed in HIC (67.2% vs. 30.4%, P < 0.01). Fluconazole was the most frequently prescribed drug. The proportional use of fluconazole was higher in LMIC compared with HIC. A significant variability of antifungal prescribing patterns was observed. The proportional use of systemic antifungals was twice as high in HIC compared with LMIC. More detailed data on access and antifungal use in limited-resource settings should be explored.

Effectiveness of a web-based electronic prospective data collection tool for surgical data in shoulder arthroplasty

BackgroundThe purpose of this study was to demonstrate the validity and efficiency of the Outcomes Management and Evaluation (OME) system, a prospectively designed electronic data collection tool, for collecting comprehensive and standardized surgical data in shoulder arthroplasty. MethodsSurgical data from the first 100 cases of shoulder arthroplasty that were collected into the OME database were analyzed. Surgeons completed a traditional narrative operative note and also an OME case report using an encrypted smartphone. A blinded reviewer extracted data from the operative notes and implant logs in the electronic medical records (EMR) by manual chart review. OME and EMR data were compared with regard to data counts and agreement between 39 variables related to preoperative pathology, including rotator cuff status and glenoid wear, and surgical procedures. Data counts were assessed using both raw percentages and with McNemar's test (with continuity correction). Agreement of nominal variables was analyzed using Cohen's unweighted kappa (κ) and of ordinal variables using the linearly weighted Cohen's test. Efficiency was assessed by calculating the median time needed to complete OME. ResultsCompared to the EMR, the OME database had significantly higher data counts for 56% (22 of 39) of the variables assessed. A high level of proportional and statistical agreement was demonstrated between the data in the 2 datasets. Ten of 39 variables had 100% agreement but could not be statistically compared because both datasets had the same single response under those variables. Among the 29 variables that were compared, 79% (23 of 29) of variables had >80% raw proportional agreement, and 69% (20 of 29) of variables showed at least substantial agreement (κ > 0.6). The median time for completing OME surgery data entry was 92 seconds (IQR 70-126). ConclusionThe prospectively designed, electronic data entry system (OME) is an efficient and valid tool for collecting comprehensive and standardized surgical data on shoulder arthroplasty. Level of evidenceLevel IV; Case series; Diagnostic study

Radiographers' assessment of referrals for CT and MR imaging using a web-based data collection tool

IntroductionThere is limited research related to the radiographers' role in assessing of radiology referrals to justify imaging. This study investigated radiographers' compliance with guidelines in the assessment of CT and MRI referrals and factors that influenced their performance. MethodsThis research was facilitated by the EFRS Research Hub at ECR 2019. Five radiology referral scenarios for CT and/or MRI were distributed to radiographers, as determined by their scope of practice, who volunteered at the Research Hub. A web-based data collection tool was used. The radiographers were required to determine the appropriateness of each referral, highlight any concerns and recommend suitable investigations if applicable. Linear regression analysis was used to determine whether postgraduate qualification, grade/role of the radiographer and use of guidelines influenced the radiographers' performance in assessing the referrals. ResultsParticipants originated from 24 countries (n = 51 CT, n = 40 MRI), the majority originating from the UK, Ireland, Italy, Spain, Norway and Austria. Responses consistent with guidelines were 58% and 57% for CT and MRI, respectively. Possession of an MSc qualification in CT was a significant factor of influence for a higher consistency with guidelines (p = 0.02) in CT. Employment as a radiographer in a lead professional role and/or educator was a significant factor of influence for a higher consistency with guidelines in MRI (p = 0.01). ConclusionA total of 58% for CT and 57% for MRI of the radiographers' responses complied with guidelines. Factors such as postgraduate education and leading professional roles are associated with better performance. Implications for practiceConsidering qualifications, experience and managerial role is vital before radiographers are delegated task of justifying CT and MR Imaging.

Does Metal Hypersensitivity Have Relevance in Patients Undergoing TMJ Prosthetic Replacement?

Although concerns regarding implant-related metal hypersensitivity exist, no guidelines have been accepted for screening or treatment of patients with metal sensitivity before temporomandibular joint replacement (TMJR). The present study aimed to determine the trends in TMJR metal sensitivity screening and the effect of positive test results on patient treatment. A questionnaire was distributed to members of the American Society of Temporomandibular Joint Surgeons and the European Society of Temporomandibular Joint Surgeons using a web-based data collection and analysis tool. The questions aimed to establish the screening methods used to establish a diagnosis of metal hypersensitivity and any changes in management when metal hypersensitivity had been documented. A total of 72 responses (32.43%) were collected through the survey, with respondents primarily practicing in the United States (47.22%). Of the participants, 75% believed that metal hypersensitivity occurs with TMJR and only 2.77% did not. Most agreed that patients should be questioned about any metal sensitivities before consideration for TMJR (91.66%), and 80.55% routinely asked their patients if they had a previous sensitivity to any metals. Nickel was the most commonly encountered metal allergen (64.28%). If a metal allergy were reported, 44.28% of surgeons would refer the patient to determine the specific metal allergen. The diagnosis for metal allergy was based primarily on patient signs and symptoms (52.85%) and an allergist or dermatologist consultation (44.28%). The lymphocyte transformation test was the test most used by respondents to confirm the diagnosis. Of the surgeons, 41.42% would choose to observe/monitor as their first choice for patients testing positive for metal hypersensitivity. In the case of a "mild" reaction to metal hypersensitivity testing, 54.28% would alter their implant choice to a nonreactive metal component. For "severe" reactions to preoperative metal hypersensitivity testing, 62.85% would alter their implant choice to a nonreactive metal component, and 22.85% would choose not to perform TMJR. The results from the present study have demonstrated that respondent TMJ surgeons agree that metal hypersensitivity occurs with TMJR. However, their approaches to screening and managing metal hypersensitivity vary. Further research of this topic is required to eventually develop specific management pre- and postoperative guidelines for the treatment of patients with metal sensitivities.

SAT-039 Socio-Demographic Characteristics, Out of Pocket Expenditure, Quality of Life and Six Months Treatment Outcomes of Haemodialysis Patients in India

Haemodialysis is the primary form of renal replacement modality in India. In the absence of a national registry, systematic evaluation of outcomes for those starting dialysis are not available. The socio-demographic predictors of poor clinical outcomes have received limited attention thus far. The Dialysis Outcomes in India study is following a cohort of incident dialysis patients to evaluate the impact of socio-demographic and economic factors on clinical outcomes among end-stage kidney disease (ESKD) patients initiated on haemodialysis in India. Here we present the results from the baseline socio-demographic, clinical characteristics, Quality of Life (QoL) and six months clinical outcomes. A total of 1000 participants were recruited between Nov 2016 and Mar 2018 in 16 facilities across nine states in India. A web-based secure data collection tool was developed using open source tools. We used routine medical records for the collection of demographic and clinical information. Structured interviews were conducted to collect socio-economic parameters, including out-of-pocket expenditure (OoPE), with QoL measured using Euroqol-5D-3L®. Median age (IQR) of enrolled participants was 58 (48-66) years, 29% were female. One-fifth of the participants were graduates (female 15 % and males 85%), and 80% of the participants had at 12 years of education or less (female 88% and males 75%). A history of hypertension was reported in 68% of participants [duration 5 (3-10) years], and diabetes in 50% [duration 10 (5-15) years]. Majority (80%) of the female participants worked within the home, and 44% of the males were either retired or not working. Nine percent of the participants reported that they had to change their occupation due to kidney disease and treatment schedules. Median monthly family income was reported as US$ 500 (586). Median distance traveled to the dialysis unit was 10 (5-20) kms. The median monthly OoP expenditure was US$ 360±220 for uninsured participants and US$ 180±140 for insured participants. A feeling of severe anxiety/depression was reported by 15% of the patients and 16% reported severe problems related to activities of daily living. At the six months interim analysis, 73% remain on haemodialysis, 10% of the participants have died, 6% have withdrawn from dialysis, 4% have received a transplant, and 1.5% have switched to peritoneal dialysis.Tabled 1Table 1: Six months treatment outcomesOutcomesTotal (n=1000)Female (n=294)Male (n=706)Continuing Dialysis727 (72.7%)218 (74.1%)509 (72.1%)Kidney Transplant43 (4.3%)5 (1.7%)38 (5.4%)Peritoneal Dialysis14 (1.4%)7 (2.4%)7 (1%)Conservative Therapy37 (3.7%)7 (2.4%)30 (4.3%)Withdrew Dialysis63 (6.3%)19 (6.4%)44 (6.2%)Death99 (9.9%)33 (11.2%)66 (9.4%)Lost to Follow-up17 (1.7%)5 (1.7%)12 (1.7%) Open table in a new tab Our study had 100% follow up compliance at six months and noted high dialysis-related OoP expenditure, particularly in those who were uninsured. Low levels of health insurance coverage represent a major challenge for policymakers in mitigating the economic burden of dialysis treatment. A high number of participants quitting their job or reducing working hours highlights the challenges related to maintaining employment for patients undergoing dialysis. The complete follow-up data will provide much-needed information for improvement of dialysis services in India.

Serious kidney disease in pregnancy: an Australian national cohort study protocol

BackgroundMaternal kidney disease (acute kidney injury (AKI), advanced chronic kidney disease (CKD), dependence on dialysis or a kidney transplant) has a substantial impact on pregnancy, with risks of significant perinatal morbidity. These pregnancies require integrated multidisciplinary care to manage a complex and often challenging clinical situation. The ability to deliver optimal care is currently hindered by a lack of understanding around prevalence, management and outcomes in Australia. This study aims to expand an evidence base to improve clinical care of women with serious kidney impairment in pregnancy.Methods/designThe “Kidney Disease in Pregnancy Study” is a national prospective cohort study of women with stage 3b-5 CKD (including dialysis and transplant) and severe AKI in pregnancy, using the Australasian Maternity Outcomes Surveillance System (AMOSS). AMOSS incorporates Australian maternity units with > 50 births/year (n = 260), capturing approximately 96% of Australian births. We will identify women meeting the inclusion criteria who give birth in Australia between 1st August 2017 and 31st July 2018. Case identification will occur via monthly review of all births in Australian AMOSS sites and prospective notification to AMOSS via renal or obstetric clinics. AMOSS data collectors will capture key clinical data via a web-based data collection tool. The data collected will focus on the prevalence, medical and obstetric clinical care, and maternal and fetal outcomes of these high-risk pregnancies.DiscussionThis study will increase awareness of the issue of serious renal impairment in pregnancy through engagement of 260 maternity units and obstetric and renal healthcare providers across the country. The study results will provide an evidence base for pre-pregnancy counselling and development of models of optimal clinical care, clinical guideline and policy development in Australia. Understanding current practices, gaps in care and areas for intervention will improve the care of women with serious renal impairment, women with high-risk pregnancies, their babies and their families.

111 Learning and informing on paediatric emergency department intubations

Advanced airway interventions are high risks, high stakes, but low frequency events for children in paediatric emergency departments (PEDs), with serious consequences for morbidity and mortality. We aimed to describe the providers, techniques, success rates, and adverse event rates of intubation in one of Canada’s busiest PEDs and Level 1 pediatric trauma center. Information on team member perception of the quality of communication and effectiveness of leadership were also evaluated. A prospective cohort QI project was undertaken to investigate intubation events at one Canadian PED between 2013 and 2018. Providers who were involved in the airway management recorded intubation data via a web-based data collection tool. The aim of the project was to collect data about intubation events with relevant patient demographics, reason for intubation, personnel, number of attempts to intubate, techniques used, medications used, and adverse event rates. Providers were also asked to rate the effectiveness of team communication and intubation event congruity on a scale from 1 to 100. Descriptive statistics for each intubation attempt, as well as time-trended use by year are reported here. In total, 292 PED intubation reports were completed by respiratory therapists (26.0%), fellows (23.3%), staff physicians (23.3%), documenting nurses (16.4%), and charge nurses (10.6%). Intubation indications were airway protection (65.1%), respiratory failure (40.4%), or inadequate oxygenation (18.8%). Fellows managed the majority (60.3%) of initial intubation attempts followed by resident physicians (17.8%). Fentanyl (26.0%) and Ketamine (26.4%) were the induction agents most often used; Rocuronium was the most common paralytic agent used (49.7%). In terms of intubation equipment, laryngoscope was most commonly used (55.1%), followed by glidescope (26.4%). On first attempt intubation, the most common adverse events reported were hypoxemia (5.5%), hypotension (3.1%), and aspiration/airway compromise (3.1%). Personnel involved in the intubation event reported a high mean team communication effectiveness (81.58, SD 16.81) and a high mean intubation event congruity (82.99, SD 16.75). Throughout the duration of this project, iterative systemic interventions occurred in our PED which may have contributed to the changes observed (introduction of standardized RSI order sets, VL equipment, standardization of trauma leadership, and finally introduction of an airway checklist). The present study offers some insight into PED intubations, a relatively understudied area. Overall, there was a high first-attempt intubation success rate with few adverse events reported. In terms of team dynamics, personnel rated both team communication and congruity as high.

The experience of occupational psychosocial stress among librarians in three African countries

PurposeThe purpose of this paper is to focus on describing the experience of occupational psychosocial stress among librarians in Ghana, Nigeria and South Africa. It further seeks to identify the various psychosocial stress components and how they interact to determine the stress level of librarians.Design/methodology/approachUsing the Effort-Reward Imbalance scale, this descriptive study employed a web-based data collection tool (Google Form) to design and solicit data from respondents. Convenient sampling technique was used to employ 153 librarians from Ghana, Nigeria and South Africa with at least a diploma in any library-related programme, who work in either academic, public or special libraries.FindingsThis study established the prevalence of occupational psychosocial stress among librarians from Ghana, Nigeria and South Africa. It was realised that gender, country of residence of respondents, age, work experience, workers with children under 13 years of age and work roles were the main factors that influenced the occupational stress among the respondents.Research limitations/implicationsThe response rate for this study was low. As a result, undertaking any inferential statistics to explain relationships was not possible.Originality/valueThe value of this study lies in the depth of narrative data collected and the insight it affords with regards to contemporary work within libraries in Africa and beyond. The results presented may provide both a starting point for further discussion and may also promote an increased openness about issues of employee safety in the library environment.