23 research outputs found
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Abstract TP254: The Use of Prehospital Telemedicine to Aid in the Decision to Airlift Patients to a Comprehensive Stroke Center From a Rural Area
Introduction:
In patients with acute ischemic stroke, significant time can elapse from symptom onset until initiation of thrombolytic therapy. Prehospital diagnosis can reduce time delays, and remote evaluation using telemedicine may help; especially in the context of rural areas where a decision to airlift the patient to a stroke center must be made. The Florida Keys is a stretch of 126 miles with no stroke center. In order to combat delays to therapy, a system was implemented to airlift patients directly from the field to a comprehensive stroke center. Air transport costs can range 50,000 per patient, whereas the cost to place the telemedicine unit inside the ambulance was $2,250.
Hypothesis:
The purpose of the study was to determine the feasibility of using prehospital telemedicine as a triage tool to air transport stroke patients.
Methods:
Fire Rescue units in three departments were equipped with a smartphone programmed with encrypted software. Noise cancelling headsets were provided, together with a hard mount antenna. Stroke physicians were given a tablet with the same software. Prehospital providers conducted the CPSS initially, then the MEND exam, and if abnormal, contacted the stroke physician for a telemedicine consult. Crews were stationed on a designated landing zone, in an effort to reduce time to air transport after the exam was performed. Upon the patient’s arrival at the receiving facility, the physician performed the NIHSS again and recorded his/her findings.
Results:
From January 2013 to July 2015, physicians utilized telemedicine to evaluate 45 stroke patients. The initial pilot phase led to software and hardware upgrades to enhance patient examinations. The average NIHSS was 10. Initial analysis revealed a high correlation between the NIHSS done over telemedicine and the arrival NIHSS performed by the same physician. EMS providers and stroke physicians found the system easy to use and extremely valuable in making the triage determination.
Conclusion:
The use of prehospital telemedicine to conduct a neurological exam by a stroke physician has proven to be a valuable tool. Prehospital telemedicine for stroke air transport determination is feasible and cost-effective
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Preparing for the worst. A review of the ADDIE simulation model for disaster-response training.
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What participants learn, with, from and about each other during inter-professional education encounters: A qualitative analysis
Safe healthcare requires teamwork and collaboration. To meet the needs of healthcare organizations and professionals, inter-professional education, is no longer an optional educational trend but rather a mandate of accrediting health education agencies.
In an effort to better understand the impact of inter- professional educational activities, this study sought to explore via qualitative methods what nursing and medical students learn with, from, and about one another during a week - long simulation-based inter-profession education course.
A convenience sample of post-course survey responses from students participating in a week-long, inter-professional, simulation-based patient safety course was used to longitudinally explore what participants learn with, from, and about each other.
The setting for this study was a research university located in the southeast United States.
The participants included a total of 272 second semester accelerated option Bachelor of Nursing students and 599 medical students entering the 3rd year of their program that participated in an annual patient safety course. The study analyzed responses of students to questions in a post-course survey regarding educational outcomes while learning with students from a different profession.
In the responses from 871 students collected over four years, the following key themes emerged. Students: 1) articulated learning the importance of contributions of other professions to the healthcare team, 2) expressed an appreciation for areas where their colleagues' training was superior to their own; and 3) identified deficiencies in their own knowledge and skill sets.
The findings of this study provide a basis for developing more specific curricular content as part of inter-professional education endeavors to strengthen constructive views of healthcare professions, foster a more collaborative shared mental model, and to correct perceived misconceptions
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Abstract 126: The Impact of Rapid Response Team Training on Team Dynamics and Provider Self-Confidence
Introduction Rapid Response Team (RRT) training is essential to early recognition and management of the critically ill patient. Using the Rapid Response Team Training curriculum (SimMedical and Lae..
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Simulation in healthcare education: A best evidence practical guide. AMEE Guide No. 82
Over the past two decades, there has been an exponential and enthusiastic adoption of simulation in healthcare education internationally. Medicine has learned much from professions that have established programs in simulation for training, such as aviation, the military and space exploration. Increased demands on training hours, limited patient encounters, and a focus on patient safety have led to a new paradigm of education in healthcare that increasingly involves technology and innovative ways to provide a standardized curriculum. A robust body of literature is growing, seeking to answer the question of how best to use simulation in healthcare education. Building on the groundwork of the Best Evidence in Medical Education (BEME) Guide on the features of simulators that lead to effective learning, this current Guide provides practical guidance to aid educators in effectively using simulation for training. It is a selective review to describe best practices and illustrative case studies. This Guide is the second part of a two-part AMEE Guide on simulation in healthcare education. The first Guide focuses on building a simulation program, and discusses more operational topics such as types of simulators, simulation center structure and set-up, fidelity management, and scenario engineering, as well as faculty preparation. This Guide will focus on the educational principles that lead to effective learning, and include topics such as feedback and debriefing, deliberate practice, and curriculum integration - all central to simulation efficacy. The important subjects of mastery learning, range of difficulty, capturing clinical variation, and individualized learning are also examined. Finally, we discuss approaches to team training and suggest future directions. Each section follows a framework of background and definition, its importance to effective use of simulation, practical points with examples, and challenges generally encountered. Simulation-based healthcare education has great potential for use throughout the healthcare education continuum, from undergraduate to continuing education. It can also be used to train a variety of healthcare providers in different disciplines from novices to experts. This Guide aims to equip healthcare educators with the tools to use this learning modality to its full capability
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Abstract 3468: Correlation of the Miami Emergency Neurologic Deficit (MEND) Exam Performed in the Field by Paramedics with an Abnormal NIHSS and Final Diagnosis of Stroke for Patients Airlifted from the Scene.
Introduction Early recognition and rapid transport to a stroke center by prehospital providers is essential in the care of stroke patients. In this study, prehospital providers were trained to perf..