3 research outputs found
Core components for effective infection prevention and control programmes: new WHO evidence-based recommendations
Abstract
Health care-associated infections (HAI) are a major public health problem with a significant impact on morbidity, mortality and quality of life. They represent also an important economic burden to health systems worldwide. However, a large proportion of HAI are preventable through effective infection prevention and control (IPC) measures. Improvements in IPC at the national and facility level are critical for the successful containment of antimicrobial resistance and the prevention of HAI, including outbreaks of highly transmissible diseases through high quality care within the context of universal health coverage. Given the limited availability of IPC evidence-based guidance and standards, the World Health Organization (WHO) decided to prioritize the development of global recommendations on the core components of effective IPC programmes both at the national and acute health care facility level, based on systematic literature reviews and expert consensus. The aim of the guideline development process was to identify the evidence and evaluate its quality, consider patient values and preferences, resource implications, and the feasibility and acceptability of the recommendations. As a result, 11 recommendations and three good practice statements are presented here, including a summary of the supporting evidence, and form the substance of a new WHO IPC guideline
Using video-reflexive ethnography and simulation-based education to explore patient management and error recognition by pre-registration physiotherapists
Background: Upon graduation, physiotherapists are required to manage clinical caseloads involving deteriorating
patients with complex conditions. In particular, emergency on-call physiotherapists are required to provide respiratory/
cardio-respiratory/cardiothoracic physiotherapy, out of normal working hours, without senior physiotherapist support. To
optimise patient safety, physiotherapists are required to function within complex clinical environments, drawing on their
knowledge and skills (technical and non-technical), maintaining situational awareness and filtering unwanted stimuli
from the environment. Prior to this study, the extent to which final-year physiotherapy students were able to manage an
acutely deteriorating patient in a simulation context and recognise errors in their own practice was unknown.
Methods: A focused video-reflexive ethnography study was undertaken to explore behaviours, error recognition abilities
and personal experiences of 21 final-year (pre-registration) physiotherapy students from one higher education institution.
Social constructivism and complexity theoretical perspectives informed the methodological design of the study. Video
and thematic analysis of 12 simulation scenarios and video-reflexive interviews were undertaken.
Results: Participants worked within the professional standards of physiotherapy practice expected of entry-level
physiotherapists. Students reflected appropriate responses to their own and others’ actions in the midst of
uncertainty of the situation and physiological disturbances that unfolded during the scenario. However, they
demonstrated a limited independent ability to recognise errors. Latent errors, active failures, error-producing
factors and a series of effective defences to mitigate errors were identified through video analysis. Perceived
influential factors affecting student performance within the scenario were attributed to aspects of academic
and placement learning and the completion of a voluntary acute illness management course. The perceived
value of the simulation scenario was enhanced by the opportunity to review their own simulation video with
realism afforded by the scenario design.
Conclusions: This study presents a unique insight into the experiences, skills, attitudes, behaviours and error
recognition abilities of pre-registration physiotherapy students managing an acutely deteriorating patient in a
simulation context. Findings of this research provide valuable insights to inform future research regarding
physiotherapy practice, integration of educational methods to augment patient safety awareness and
participant-led innovations in safe healthcare practice.
Keywords: Error recognition, Deterioration, Physiotherapy, Simulation-based education, Video-reflexive
ethnograph
Physiognomy and Ekphrasis: The Mesopotamian Tradition and its Transformation in Graeco-Roman and Semitic Literatures
Physiognomy and ekphrasis are two of the most important modes of description in antiquity and represent necessary precursors of scientific description. The primary way of divining the characteristics and fate of an individual, whether inborn or acquired, was to observe the individual\u2019s external characteristics and behaviour. This volume focuses initially on two types of descriptive literature in Mesopotamia: physiognomic omens and what we might call ekphrastic description. These modalities are traced through ancient India, Ugarit and the Hebrew Bible, before arriving at the physiognomic treatises of the Greek world, where physiognomic discussions become intertwined with ekphrastic descriptions of otherwise non-visible human characteristics or personality traits. In the Graeco-Roman world, literary and visual iconic media often interact, as the representations of famous historical figures such as Pericles, Socrates or Augustus clearly show. The Arabic compendial culture absorbed and remade these different physiognomic and ekphrastic traditions, incorporating both Mesopotamian links between physiognomy and medicine and the interest in the ekphrasis of characterological types that had emerged in the Hellenistic period. This volume offers the first wide-ranging picture of these modalities of description in antiquity and the Arab Middle Ages