Impact of Immersive Training on Senior Chemical Engineering Students\u27 Prioritization of Process Safety Decision Criteria

Every year new safety features and regulations are employed within the process industry to reduce risks associated with operations. Despite these advancements chemical plants remain hazardous places, and the role of the engineer will always involve risk mitigation through real time decision making. Results from a previous study by Kongsvik et al., 2015 indicated that there were three types of decisions in major chemical plants: strategic decisions, operational decisions, and instantaneous decisions. The study showed the importance for improving upon engineers’ operational and instantaneous choices when tasked with quick solutions in the workforce. In this research study, we dive deeper to understand how senior chemical engineering students’ prioritize components of decision making such as budget, productivity, relationships, safety, and time, and how this prioritization may change as a result of participation in a digital immersive training environment called Contents Under Pressure. More specifically, we seek to address the following two research questions: (1) How do senior chemical engineering students prioritize safety in comparison to criteria such as budget, personal relationships, plant productivity, and time in a process safety context, and (2) How does senior chemical engineering students’ prioritization of decision making criteria (budget, personal relationships, plant productivity, safety, and time) change after exposure to a virtual process safety decision making environment? As part of this study, 187 senior chemical engineering students from three separate institutions completed a pre- and post-reflection survey around their engagement with Contents Under Pressure and asked them to rank their prioritizations of budget, productivity, relationships, safety, and time. Data was analyzed using descriptive statistics, and Friedman and Wilcoxon-sign-rank post hoc analyses were completed to determine any statistical differences between the rankings of decision making factors before and after engagement with Contents Under Pressure. Simulating process safety decision making with interactive educational supports may increase students’ understanding of genuine workplace environments and factors that contribute to process safety, without the real world hazards that result from poor decision making. By understanding how students prioritize these factors, chemical engineering curricula can be adapted to focus on the areas of process safety decision making where students need the largest improvement, thereby better preparing them to enter the engineering workforce

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes