Rapid bedside inactivation of Ebola virus for safe nucleic acid tests

Rapid bedside inactivation of Ebola virus would be a solution for the safety of medical and technical staff, risk containment, sample transport and high-throughput or rapid diagnostic testing during an outbreak. We show that the commercially available MagNA Pure lysis/binding buffer used for nucleic acid extraction inactivates Ebola virus. A rapid bedside inactivation method for nucleic acid tests is obtained by simply adding MagNA Pure lysis/binding buffer directly into vacuum blood collection EDTA-tubes using a thin needle and syringe prior to sampling. The ready-to-use inactivation vacuum tubes are stable for more than 4 months and Ebola virus RNA is preserved in the MagNA Pure lysis/binding buffer for at least 5 weeks independent of the storage temperature. We also show that Ebola virus RNA can be manually extracted from MagNA Pure lysis/binding buffer-inactivated samples using the QIAamp Viral RNA mini kit. We present an easy and convenient method for bedside inactivation using available blood collection vacuum tubes and reagents. We propose to use this simple method for fast, safe and easy bedside inactivation of Ebola virus for safe transport and routine nucleic acid detection

Patient and nurse preferences for nurse handover - using preferences to inform policy: a discrete choice experiment protocol

Introduction Nursing bedside handover in hospital has been identified as an opportunity to involve patients and promote patient-centred care. It is important to consider the preferences of both patients and nurses when implementing bedside handover to maximise the successful uptake of this policy. We outline a study which aims to (1) identify, compare and contrast the preferences for various aspects of handover common to nurses and patients while accounting for other factors, such as the time constraints of nurses that may influence these preferences.; (2) identify opportunities for nurses to better involve patients in bedside handover and (3) identify patient and nurse preferences that may challenge the full implementation of bedside handover in the acute medical setting. Methods and analysis We outline the protocol for a discrete choice experiment (DCE) which uses a survey design common to both patients and nurses. We describe the qualitative and pilot work undertaken to design the DCE. We use a D-efficient design which is informed by prior coefficients collected during the pilot phase. We also discuss the face-to-face administration of this survey in a population of acutely unwell, hospitalised patients and describe how data collection challenges have been informed by our pilot phase. Mixed multinomial logit regression analysis will be used to estimate the final results. Ethics and dissemination This study has been approved by a university ethics committee as well as two participating hospital ethics committees. Results will be used within a knowledge translation framework to inform any strategies that can be used by nursing staff to improve the uptake of bedside handover. Results will also be disseminated via peer-reviewed journal articles and will be presented at national and international conferences

Reasons for leaving bedside nursing

Thesis (M.S.)--Boston University, 1963

Bedside Manners: Play and Workbook

[Excerpt] Our goal in the play was to create a balanced work. In Bedside Manners, the reader will find people who communicate poorly and those who communicate well. Although the play focuses primarily on physicians and nurses and the acute-care hospital setting, we have tried to expand the cast of characters to include others on the health care team and to include other settings. As the safety literature documents, poor communication between members of the health care team is not simply an individual problem—a question of a few bad apples spoiling the barrel—but is rather a system problem that stems from how health care has historically developed. Although it is beyond the scope of this commentary to describe that historical development, suffice it to say that the problems of contemporary health care team relationships have a long history and are shaped not only by economics but also by gender, culture, religion, ethnicity, and many other factors. Although our play is meant to stimulate discussion about health care teamwork and suggest ways that doctors, nurses, and others in health care can develop the skills necessary to create and sustain genuine interprofessional teams, it is primarily a work of theater. Its goal is to help those who work in health care approach a very hot topic in a way that is both interesting and even, dare I say it, fun. To accompany the play and make it more user-friendly, Scott Reeves, Lisa Hayes, and I have also written a workbook, which explains the various ways it can be performed, how to mount a performance, and how to lead a discussion or workshop after the play is over. We also explain how to use the play as part of an interprofessional curriculum. Although some in our audiences have scoffed at such a touchy feely or unconventional way to present a serious issue, our experience has convinced us that theater is a useful tool to enhance teamwork, patient safety, and also to create more satisfying workplace relationships. Theater has been with humankind since almost the beginning of our history precisely because it is such a powerful tool. It can be used by those in health care who spend their days working with sick, frightened, anxious people, people who are, by definition, not at their best. Under the best of circumstances, their work is beyond difficult. Good communication and teamwork not only produces good patient outcomes; it helps health care professionals care for one another

Persepsi Mahasiswa Terhadap Tahap Persiapan Bedside Teaching Pada Pembelajaran Rotasi Klinik

Background: Bedside teaching is an integral process of medical education. It will run effectively if only the preparation process prepared well. Preseptor need to comprehend curriculum in order to formulate purpose and theme in learning activity. Patient and setting for bedside teaching also need to be arranged carefully. As for student, preceptor needs to motivate them to occupy themselves with knowledge and clinical skills related to the bedside theme. Objectives: This research aim to evaluate bedside teaching preparation based on student perception. Methods: This descriptive study purposively involved 81 interns who were conducting learning at internal medicine, obstetric-gynecology, pediatric, and surgery department by the time of data collection performed. Questioner consists of 6 items to describe bedside teaching preparation phase (Corrected Item Total correlation > 0,3; Alpha Cronbach's 0,826) was delivered among all respondents. Results: 66.7% respondents perceived that bedside teaching was not well prepared. Some students admit that preseptor do not always inform them about the theme, learning objective, and which patient that will involve in bedside teaching. Some of them also answer that they were not instructed to prepare themselves with knowledge and skills needed for bedside teaching. Conclusion: Institution needs to facilitate training to maximize preceptor comprehension to conduct well prepared bedside teaching

Nurses\u27 Perception of Family Presence During Resuscitation

Background Family witnessed resuscitation (FWR) is the concept of allowing family members at bedside during cardiopulmonary resuscitation. Studies have shown that the lack of standard policies by hospitals regarding FWR forces nurses to make different decisions regarding family presence at bedside during resuscitation. The framework for this study is Sandman\u27s teleological model. Objectives To examine nurses\u27 perceptions of having family members present during adult cardiac resuscitation. Methods A descriptive study of 57 registered nurses (n = 57) from northern California was conducted. Participants completed a mailed survey consisting of a 22-item Likert scale questionnaire titled Family Presence Risk-Benefit Scale. Results Analysis from the questionnaire showed that the majority of participants were between the ages of 40-63 and had more than 20 years of working experience. About 51.9% worked in units with no formal policy on FWR and 71.7% had participated in a cardiac resuscitation. Study results show that nurses had varied opinions, but there were no statistically significant results to indicate that the majority of nurses favor FWR. Conclusions The study found there was no statistically significant data to conclude there was any consensus among nurses about the risks or benefits of families at bedside. This study concludes that nurses want to be present in the room if their loved ones were being resuscitated. To help nurses with decision-making guidelines during resuscitation, it is recommended that health-care institutions establish standard policies regarding FWR. Further studies need to be conducted to investigate nurses\u27 perceptions regarding FWR

Addressing Traumatic Stress in the Acute Traumatically Injured Patient

Psychological injuries after an acute traumatic event are commonly overlooked. Currently within United States, there is no consistently utilized screening process that addresses traumatic stress within the acute trauma population. Roy\u27s Adaptation Model guided this project, focusing on the idea that bedside nurses are at the frontline of providing early identification through nursing assessment. The purpose of this pilot study was to evaluate whether the implementation of the Primary Care-Posttraumatic Stress Disorder (PC-PTSD) screening tool by bedside nurses would result in identifying more patients at risk for traumatic stress after an acute trauma as compared with the use of no screening method. This descriptive survey study took place over a 6-week period at a Midwest Level 1 trauma hospital. The results revealed that the tool did not increase the number of health psychology consults when compared with the same 6-week period a year prior when no tool was used. Nonetheless, use of the PC-PTSD tool did trigger 28% of the patients to receive a health psychology consult. Forty-five percent of patients who received a health psychology consult were recommended outpatient therapy. Utilization of this tool by bedside nurses did not adversely increase a number of inappropriate health psychology consults. These results agree with the literature and further suggest that there are a clinically significant number of acute trauma patients who are at risk for traumatic stress. With this screening tool, nurses accurately assessed patients and connected them with timely psychological treatment

Experience of a tutor centric model for sonography training of emergency department registrars in an Australian urban emergency department 2009–2012

Purpose: To assess the impact of a regular sonographer proctored training program for emergency medicine trainees in the use of Emergency Department bedside ultrasound Methods: Emergency Department (ED) Registrars in the Swan District Hospital ED were provided with proctored instruction in bedside ultrasound in performance of extended focused assessment sonography in trauma (eFAST) and abdominal aortic aneurysm (AAA) detection. Training was conducted by credentialed sonographers for individual trainees in a 1:1 or 1:2 setting for 1 hour on a weekly basis. Registrars who trained in the Department between Jan 2009 to Dec 2012 were invited to participate in a survey conducted between June-August 2013 designed to assess the impact of training on their confidence and use of bedside sonography. Results: Registrars reported increased perception of their skill level in AAA and eFAST post-training. High levels of confidence in their ability to adjust machine settings for image optimization, recognition of free fluid in the abdomen and ability to recognise an AAA were also reported. The participants that completed at least 10 hours of training and at least 20 scans showed significantly greater improvement in their perception of skill and confidence levels than those with less time. Registrars reported training was of significant benefit, improving their confidence in obtaining good quality images and their understanding of the equipment, which contributed to them obtaining accreditation. Benefits were ongoing and 50% of participants reported using ultrasound in clinical practice at least 3 times per week and a further 30% at least weekly after leaving ED. Conclusion: Proctored training in the clinical context for ED registrars resulted in improvement in skills, confidence and willingness to maintain skills through practice in the clinical context over the long-term

Immersion in Physiology Bolsters Bedside Mechanistic Thinking

Purpose and Background: Compression of education and training with other responsibilities into more limited work hours Shift towards algorithm-based teaching/practice Less time spent in practice of basic science Intellectual Curiosity/Mechanistic Thinking less emphasized Self-directed learning and intellectual curiosity a primary focus for improvement in 2017 Mission Statement: Through science experimentation in applied physiology, housestaff will reconnect with basic physiology and apply learned principles to commonly encouraged clinical scenarios. Housestaff will participate in experiments to stimulate intellectual curiosity among participants and encourage appreciate and incorporation of physiology into their clinical and teaching roles