Getting Better Hospital Alarm Sounds Into a Global Standard

The reserved set of audible alarm signals embodied within the global medical device safety standard, IEC 60601-1-8, is known to be problematic and in need of updating. The current alarm signals are not only suboptimal, but there is also little evidence beyond learnability (which is known to be poor) that demonstrates their performance in realistic and representative clinical environments. In this article, we describe the process of first designing and then testing potential replacement audible alarm signals for IEC 60601-1-8, starting with the design of several sets of candidate sounds and initial tests on learnability and localizability, followed by testing in simulated clinical environments. We demonstrate that in all tests, the alarm signals selected for further development significantly outperform the current alarm signals. We describe the process of collecting considerably more data on the performance of the new sounds than exists for the current sounds, which ultimately will be of use to end users. We also reflect on the process and practice of working with the relevant committees and other practical issues beyond the science, which also need constant attention if the alarms we have developed are to be included successfully in an updated version of the standard

Investigación de la repercusión en el proceso de aprendizaje según la metodología docente en la infección urinaria

Introduction: The classical teaching methodology was based on passive transmission-based learning. The model has changed towards an orientation based on student-centred learning. Objective: The objective of the study has been to evaluate the students’ perception when learning about urinary tract infections, and their perspective about the teaching imparted on this pathology in the various subjects that include ITU in their syllabus. Methods: A cross-sectional analytical study of the responses to an anonymous survey entitled: “Methodology on urine infections. Teaching aspects “issued by 228 students at their fifth year of Medical School, from two promotions. They referred to the following subjects: Pharmacy, Pathophisiology, Gynecology and Obstetrics, Infectious diseases, Microbiology, Nephrology, Pediatrics and Urology. Results: The following variables have been analysed: teaching content, teaching basic aspects of the disease, consideration of teaching methodology and improvement suggestions. Descriptive and inferential statistics were used. Conclusion: The study has concluded that teaching urinary tract infection is perceived in specific subjects related to microorganism (Microbiology), the target organ (Infectious diseases, Urology), affected patients (Pediatrics, Gynecology and Obstetrics) rather than transversal subjects such as Pathophysiology or Pharmacy. The teaching methodology has been considered appropriate by more than 50% of the students in five from the 8 subjects that teach the concept of urinary tract infection. The students suggest convenient changes in current teaching methodology in several subjects that impart the urinary tract infection concept. © 2019 AE

Investigación de la repercusión en el proceso de aprendizaje según la metodología docente en la infección urinaria

Introduction: The classical teaching methodology was based on passive transmission-based learning. The model has changed towards an orientation based on student-centred learning. Objective: The objective of the study has been to evaluate the students’ perception when learning about urinary tract infections, and their perspective about the teaching imparted on this pathology in the various subjects that include ITU in their syllabus. Methods: A cross-sectional analytical study of the responses to an anonymous survey entitled: “Methodology on urine infections. Teaching aspects “issued by 228 students at their fifth year of Medical School, from two promotions. They referred to the following subjects: Pharmacy, Pathophisiology, Gynecology and Obstetrics, Infectious diseases, Microbiology, Nephrology, Pediatrics and Urology. Results: The following variables have been analysed: teaching content, teaching basic aspects of the disease, consideration of teaching methodology and improvement suggestions. Descriptive and inferential statistics were used. Conclusion: The study has concluded that teaching urinary tract infection is perceived in specific subjects related to microorganism (Microbiology), the target organ (Infectious diseases, Urology), affected patients (Pediatrics, Gynecology and Obstetrics) rather than transversal subjects such as Pathophysiology or Pharmacy. The teaching methodology has been considered appropriate by more than 50% of the students in five from the 8 subjects that teach the concept of urinary tract infection. The students suggest convenient changes in current teaching methodology in several subjects that impart the urinary tract infection concept. © 2019 AE

In COVID-19 health messaging, loss framing increases anxiety with Little-to-No concomitant benefits: Experimental evidence from 84 countries

The COVID-19 pandemic (and its aftermath) highlights a critical need to communicate health information effectively to the global public. Given that subtle differences in information framing can have meaningful effects on behavior, behavioral science research highlights a pressing question: Is it more effective to frame COVID-19 health messages in terms of potential losses (e.g., “If you do not practice these steps, you can endanger yourself and others”) or potential gains (e.g., “If you practice these steps, you can protect yourself and others”)? Collecting data in 48 languages from 15,929 participants in 84 countries, we experimentally tested the effects of message framing on COVID-19-related judgments, intentions, and feelings. Loss- (vs. gain-) framed messages increased self-reported anxiety among participants cross-nationally with little-to-no impact on policy attitudes, behavioral intentions, or information seeking relevant to pandemic risks. These results were consistent across 84 countries, three variations of the message framing wording, and 560 data processing and analytic choices. Thus, results provide an empirical answer to a global communication question and highlight the emotional toll of loss-framed messages. Critically, this work demonstrates the importance of considering unintended affective consequences when evaluating nudge-style interventions

International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module

•We report INICC device-associated module data of 50 countries from 2010-2015.•We collected prospective data from 861,284 patients in 703 ICUs for 3,506,562 days.•DA-HAI rates and bacterial resistance were higher in the INICC ICUs than in CDC-NHSN's.•Device utilization ratio in the INICC ICUs was similar to CDC-NHSN's. Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically

Impact of COVID-19 on Cardiovascular Testing in the United States Versus the Rest of the World

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-U.S. institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection