Search results for: emergency staff department

Authors: Maeng-Hwan Hyun, Dae-Man Do, Young-Bok Choi

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Around the world, there are frequent incidents of natural disasters, such as earthquakes, tsunamis, floods, and snowstorms, as well as man made disasters such as fires, arsons, and acts of terror. These diverse and unpredictable adversities have resulted in a number of fatalities and injuries. If disaster occurrence can be assessed quickly and information such as the exact location of the disaster and evacuation routes can be provided, victims can promptly move to safe locations, minimizing losses. This paper proposes a behavior analysis method based on a nine degrees-of-freedom (9-DOF) sensor that is effective for the emergency rescue evacuation support system (ERESS), which is being researched with an objective of providing evacuation support during disasters. Based on experiments performed using the acceleration sensor and the gyroscope sensor in the 9-DOF sensor, data are analyzed for human behavior regarding stationary position, walking, running, and during emergency situation to suggest guidelines for system judgment. Using the results of the experiments performed to determine disaster occurrence, it was confirmed that the proposed method quickly determines whether a disaster has occurred.

Keywords: behavior analysis, nine degrees of freedom sensor, emergency rescue, disaster

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Authors: Carrollyne Aasen, Laverne Seales

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With increased Latinx communities within the United States, specifically in California, and more universities receiving designations of Hispanic-Serving institutions, Spanish programs have evolved to include more targeted and applicable practical skills. The Spanish program in the Languages and Cultures Department at California Lutheran University incorporated an interdisciplinary project with the Communication Department to create student-generated Spanish-language news inserts, which serve as a sister publication to the English-language student newspaper, The Echo. California Lutheran University is a Hispanic-Serving Institution, meaning it is an accredited undergraduate institution with full-time Hispanic/Latinx students equivalent to at least 25 percent of the total students enrolled. As a Hispanic Serving Institution with growing numbers of bilingual students, faculty, staff, and community members, the need for more information aimed at Hispanic/Latinx communities increased, resulting in the opportunity to reflect topics of interest by community members. This project was developed to fulfill the Spanish program's goals for proficiency by using the American Council on the Teaching of Foreign Languages guidelines and the university's need to support students and the community's voices. This article describes the stages from inception to production and the incorporation of journalism principles into the Spanish curriculum.

Keywords: interdisciplinary, media, foreign languages, HSI

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Authors: Emily Toon

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Nurses play a critical role in the prevention of ventilator-associated pneumonia through the maintenance of endotracheal tubes and use of subglottic secretion drainage via subglottic suctioning endotracheal tubes. The purpose of this evidence based practice project is to develop a staff education program on subglottic suctioning endotracheal tubes for critical care nurses at Middlesex Health with the aim of determining and documenting increased knowledge and/or practice change. The setting included registered nurses within Middlesex Health’s critical care unit who were recruited to complete a pre-test (n=14), view a presentation, and complete a post-test (n=10). Average pre-test scores were compared to average post-test scores to determine an increase in knowledge and/or practice change. The overall mean pre-test score was 59.7 percent, compared with the mean post-test score of 88.1 percent. Pre- and post-test scores were unmatched, so statistical significance could not be determined. The hypothesis that a staff education program on subglottic suctioning endotracheal tubes would demonstrate an increase in knowledge was supported, but not statistically. By integrating a pre-test/post-test design into educational presentations to evaluate increased knowledge, data generated may be used to improve methods and practices of delivering education and enhance staff learning.

Keywords: endotracheal tubes, staff education, subglottic secretion drainage, ventilator-associated pneumonia

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Authors: William Elnemer, Nauman Hussain, Samir Al-Ali, Henry Shu, Diane Ghanem, Babar Shafiq

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Introduction: The incidence of infection in open tibial shaft injuries varies depending on the severity of the injury, with rates ranging from 1.8% for Gustilo-Anderson type I to 42.9% for type IIIB fractures. The timely administration of antibiotics upon presentation to the emergency department (ED) is an essential component of fracture management, and evidence indicates that prompt delivery of antibiotics is associated with improved outcomes. The objective of this study is to identify factors that contribute to the expedient administration of antibiotics. Methods: This is a retrospective study of open tibial shaft fractures at an academic Level I trauma center. Current Procedural Terminology (CPT) codes identified all patients treated for open tibial shaft fractures between 2015 and 2021. Open fractures were identified by reviewing ED and provider notes, and with ballistic fractures were considered open. Chart reviews were performed to extract demographics, fracture characteristics, postoperative outcomes, time to operative room, time to antibiotic order, and delivery. Univariate statistical analysis compared patients who received early antibiotics (EA), which were delivered within one hour of ED presentation, and those who received late antibiotics (LA), which were delivered outside of one hour of ED presentation. A multivariate analysis was performed to investigate patient, fracture, and transport/ED characteristics contributing to faster delivery of antibiotics. The multivariate analysis included the dependent variables: ballistic fracture, activation of Delta Trauma, Gustilo-Andersen (Type III vs. Type I and II), AO-OTA Classification (Type C vs. Type A and B), arrival between 7 am and 11 pm, and arrival via Emergency Medical Services (EMS) or walk-in. Results: Seventy ED patients with open tibial shaft fractures were identified. Of these, 39 patients (55.7%) received EA, while 31 patients (44.3%) received LA. Univariate analysis shows that the arrival via EMS as opposed to walk-in (97.4% vs. 74.2%, respectively, p = 0.01) and activation of Delta Trauma (89.7% vs. 51.6%, respectively, p < 0.001) was significantly higher in the EA group vs. the LA group. Additionally, EA cases had significantly shorter intervals between the antibiotic order and delivery when compared to LA cases (0.02 hours vs. 0.35 hours, p = 0.007). No other significant differences were found in terms of postoperative outcomes or fracture characteristics. Multivariate analysis shows that a Delta Trauma Response, arrival via EMS, and presentation between 7 am and 11 pm were independent predictors of a shorter time to antibiotic administration (Odds Ratio = 11.9, 30.7, and 5.4, p = 0.001, 0.016, and 0.013, respectively). Discussion: Earlier antibiotic delivery is associated with arrival to the ED between 7 am and 11 pm, arrival via EMS, and a coordinated Delta Trauma activation. Our findings indicate that in cases where administering antibiotics is critical to achieving positive outcomes, it is advisable to employ a coordinated Delta Trauma response. Hospital personnel should be attentive to the rapid administration of antibiotics to patients with open fractures who arrive via walk-in or during late-night hours.

Keywords: antibiotics, emergency department, fracture management, open tibial shaft fractures, orthopaedic surgery, time to or, trauma fractures

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Authors: Andrew White, Abigail Lowe, Kory Watkins, Hamed Akhlaghi, Nicole Winter

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The timing and appropriateness of diagnostic imaging are critical to the evaluation and management of traumatic injuries. Within the subclass of trauma patients, the prevalence of c-spine injury is less than 4%. However, the incidence of delayed diagnosis within this cohort has been documented as up to 20%, with inadequate radiological examination most cited issue. In order to assess those in which c-spine injury cannot be fully excluded based on clinical examination alone and, therefore, should undergo diagnostic imaging, a set of criteria is used to provide clinical guidance. The NEXUS (National Emergency X-Radiography Utilisation Study) criteria is a validated clinical decision-making tool used to facilitate selective c-spine radiography. The criteria allow clinicians to determine whether cervical spine imaging can be safely avoided in appropriate patients. The NEXUS criteria are widely used within the Emergency Department setting given their ease of use and relatively straightforward application and are used in the Victorian State Trauma System’s guidelines. This audit utilized retrospective data collection to examine the concordance of c-spine imaging in trauma patients to that of the NEXUS criteria and assess compliance with state guidance on diagnostic imaging in trauma. Of the 183 patients that presented with trauma to the head, neck, or face (244 excluded due to incorrect triage), 98 did not undergo imaging of the c-spine. Out of those 98, 44% fulfilled at least one of the NEXUS criteria, meaning the c-spine could not be clinically cleared as per the current guidelines. The criterion most met was intoxication, comprising 42% (18 of 43), with midline spinal tenderness (or absence of documentation of this) the second most common with 23% (10 of 43). Intoxication being the most met criteria is significant but not unexpected given the cohort of patients seen at St Vincent’s and within many emergency departments in general. Given these patients will always meet NEXUS criteria, an element of clinical judgment is likely needed, or concurrent use of the Canadian C-Spine Rules to exclude the need for imaging. Midline tenderness as a met criterion was often in the context of poor or absent documentation relating to this, emphasizing the importance of clear and accurate assessments. The distracting injury was identified in 7 out of the 43 patients; however, only one of these patients exhibited a thoracic injury (T11 compression fracture), with the remainder comprising injuries to the extremities – some studies suggest that C-spine imaging may not be required in the evaluable blunt trauma patient despite distracting injuries in any body regions that do not involve the upper chest. This emphasises the need for standardised definitions for distracting injury, at least at a departmental/regional level. The data highlights the currently poor application of the NEXUS guidelines, with likely common themes throughout emergency departments, highlighting the need for further education regarding implementation and potential refinement/clarification of criteria. Of note, there appeared to be no significant differences between levels of experience with respect to inappropriately clearing the c-spine clinically with respect to the guidelines.

Keywords: imaging, guidelines, emergency medicine, audit

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Authors: Abbas Ghahremani

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One of the most fundamental management issues in organizations and companies is the recruiting of efficient staff and compiling exact and perfect criteria for testing the applicants,which is guided and practiced by the manager of human resources of the organization. Obviously, each part of the organization seeks special features and abilities in the people apart from common features among all the staff in all units,which are called principal duties and abilities,and we will study them more. This article is trying to find out how we can identify the most efficient people among the applicants of employment by using proper methods of testing appropriate for the needs of different of employment by using proper methods of testing appropriate for the needs of different units of the organization and recruit efficient staff. Acceptable method for recruiting is to closely identify their characters from various aspects such as ability to communicate, flexibility, stress management, risk acceptance, tolerance, vision to future, familiarity with the art, amount of creativity and different thinking and by raising proper questions related with the above named features and presenting a questionnaire, evaluate them from various aspect in order to gain the proper result. According to the above explanations, it can be concluded which aspects of abilities and characteristics of a person must be evaluated in order to reduce any mistake in recruitment and approach an ideal result and ultimately gain an organized system according to the standards and avoid waste of energy for unprofessional personnel which is a marginal issue in the organizations.

Keywords: human resources management, staff recuiting, employment factors, efficient staff

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Authors: V. Miller, T. Jariel, C. Cooper-Chadwick

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Early treatment of stroke leads to higher survival and lower disability rates. Increasing knowledge to activate the emergency medical system for signs of stroke can improve outcomes for patients with stroke and decrease morbidity and mortality. Even though patients who get discharged from the hospital receive standard verbal and printed education, nearly 20% of them answer the question incorrectly when asked, “What will you do if you or someone you know have signs of stroke?” The main goal of this evidence-based project was to improve patients’ knowledge of what to do if they have signs of stroke. Evidence suggests that using video education in conjunction with verbal and printed education improves patient comprehension and retention. The percentage of patients who noted that they needed to call 911 for stroke symptoms increased from 80% to 87% in six months after project implementation. The results of this project demonstrate significant improvement in patients’ knowledge about the necessity of activation of emergency medical systems for stroke symptoms.

Keywords: emergency medical systems activation, evidence-based practice nursing, stroke education, video education

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Authors: Ali Vaezi, Jyotirmoy Dalal, Manish Verma

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The railroad is one of the primary transportation modes for hazardous materials (hazmat) shipments in North America. Installing an emergency response network capable of providing a commensurate response is one of the primary levers to contain (or mitigate) the adverse consequences from rail hazmat incidents. To this end, we propose a two-stage stochastic program to determine the location of and equipment packages to be stockpiled at each response facility. The raw input data collected from publicly available reports were processed, fed into the proposed optimization program, and then tested on a realistic railroad network in Ontario (Canada). From the resulting analyses, we conclude that the decisions based only on empirical datasets would undermine the effectiveness of the resulting network; coverage can be improved by redistributing equipment in the network, purchasing equipment with higher containment capacity, and making use of a disutility multiplier factor.

Keywords: hazmat, rail network, stochastic programming, emergency response

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Authors: Ashana Gupta

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Aim: In the UK, Botulinum Toxin (botox) is authorised for treating chronic myofascial pain secondary to masseter muscle hypertrophy (Fedorowicz et al. 2013). This audit aimed to ensure the Maxillofacial Unit is meeting the trust guidelines for the safe storage and disposal of botox. Method: The trust upholds a strict policy for botox handling. The audit was designed to optimise several elements including Staff awareness of regulations around botox handling A questionnaire was designed to test knowledge of advised storage temperatures, reporting of adverse events, disposal procedures and regulatory authorities. Steps taken to safely delivertoxin and eliminate unused toxin. A checklist was completed. These include marks for storagetemperature, identification checks, disposal of sharps, deactivation of toxin, and disposal. Results: All staff correctly stated storage requirements for toxin. 75% staff (n=8) were unsure about reporting and regulations. Whilst all staff knew how to dispose of vials, 0% staff showed awareness for the crucial step of deactivating toxin. All checklists (n=20) scored 100% for adequate storage, ID checks, and toxin disposal. However, there were no steps taken to deactivate toxin in any cases. Staff training took place with revision to clinical protocols. In line with Trust guidelines, an additional clinical step has been introduced including use of 0.5% sodium hypochlorite to deactivate botox. Conclusion: Deactivation is crucial to ensure residual toxin is not misused. There are cases of stolen botox within South-Tees Hospital (Woodcock, 2014). This audit was successful in increasing compliance to safe handling and disposal of botox by 100% and ensured our hospitalmeets Trust guidance.

Keywords: botulinum toxin, aesthetics, handling, disposal

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Authors: Bavornluck Kuosuwan

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The purpose of this research was to study the level of readiness of English communication skills for travel agents in the Silom road area of Bangkok in order to enter the ASEAN economic community in the year 2015. The multi-stage sampling method was utilized with 474 respondents from 79 travel agencies. An English Questionnaire was used to collect the data. Descriptive statistics included percentage, average, standard deviation and Pearson’s r coefficient. The findings revealed that the majority of respondents were not well prepared in terms of ASEAN knowledge including laws and regulations. The majority of respondents had not been well informed about the changes that will come with the coming of ASEAN economic community. Moreover, the level of English communication for most travel agents was between the poor and intermediate level and therefore improvement is needed, especially the speaking and listening skill. In other words, the majority of respondents needed more training in terms of communications skills. The correlation between the working environment and attitude of the staff was very positive. Moreover, the correlation between the background of staff and attitude of staff was also very positive and most of demographic factors had a positive correlation with attitude of staff, except gender.

Keywords: ASEAN, communication skills, travel agents, media engineering

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Authors: Jihene Jlassi, Ahmed Frikha, Wazna Kortli

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The objectives of Nurse-Patient Assignment are the minimization of the overall hospital cost and the maximization of nurses ‘preferences. This paper aims to assess nurses' satisfaction related to the implementation of patient acuity tool-based assignments. So, we used an integer linear program that assigns patients to nurses while balancing nurse workloads. Then, the proposed model is applied to the Paediatrics Department at Kasserine Hospital Tunisia. Where patients need special acuities and high-level nursing skills and care. Hence, numerical results suggested that proposed nurse-patient assignment models can achieve a balanced assignment

Keywords: nurse-patient assignment, mathematical model, logistics, pediatrics department, balanced assignment

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Authors: Novawiguna Kemalasari, Ahmad Badawi Saluy

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This research is a planned activity to find an objective answer to PT XYZ problem through scientific procedure. In this study, It was used quantitative research methods by using samples taken from a department selected by researchers. This study aims to analyze the influence of organizational culture, work discipline and work motivation on employee performance of Personal Care & Cosmetic Department (PCC) Flammable PT XYZ. This research was conducted at PT XYZ Personal Care & Cosmetic Department (PCC) Flammable involving 82 employees as respondents, the data were obtained by using questionnaires filled in self-rating by respondents. The data were analyzed by multiple linear regression model processed by using SPSS version 22. The result of research showed that organizational culture variable, work discipline and work motivation had significant effect to employee performance.

Keywords: organizational culture, work discipline, employee motivation, employees performance

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Authors: Mohammed Abdurabu, Akram Al-Warqi, Ebrahim M. A. Ebrahim, Jouhar Kollari, Salman Mirza

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The novel coronavirus (COVID-19) is one of the most recent pandemics that invaded earth that left and still leaving hundreds of thousands of patients and ended with high morbidity and mortality rates with no clear cure till this moment. COVID-19 has been proven to be associated with pathologic changes in coagulation, characterized by either thromboembolic or bleeding events. We present this case of a 44-year-old male patient that presented to our Emergency Department with flank pain that later was found to have renal angiomyolipoma (AML) rupture during his COVID-19 infection, ultimately requiring admission for hemorrhage control via Interventional Radiology (IR) drainage. Here, we discuss the role of the front-line physicians and how they should keep a low threshold for the different presentations that could be associated with COVID-19 infection.

Keywords: angiomyolipoma, COVID-19, renal, rupture

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Authors: Orathai Srithongtham, Ploypailin Mekathepakorn, Tossaphong Buraman, Pontida Moonpradap, Rungrueng Kitpati, Chulapon Kratet, Worayuth Nak-ai, Suwaree Charoenmukkayanan, Peeranuch Keawkanya

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The COVID-19 pandemic was effect to the health security of the Thai people. The PHEM principle was essential to the surveillance, prevention, and control of COVID-19. This study aimed to present the process of prevention and control of COVID-19 from February 29, 2021- April 30, 2022, and the factors and conditions influent the successful outcome. The study areas were three provinces. The target group was 37 people, composed of public health personnel. The data was collected in-depth, and group interviews followed the non-structure interview guide and were analyzed by content analysis. The components of COVID-19 prevention and control were found in the process of PHEM as follows; 1) Emergency Operation Center (EOC) with an incidence command system (ICS) from the district to provincial level and to propose the provincial measure, 2) Provincial Communicable Disease Committee (PCDC) to decide the provincial measure 3) The measure for surveillance, prevention, control, and treatment of COVID-19, and 4) outcomes and best practices for surveillance and control of COVID-19. The success factors of 4S and EC were as follows; Space: prepare the quarantine (HQ, LQ), Cohort Ward (CW), field hospital, and community isolation and home isolation to face with the patient and risky group, Staff network from various organization and group cover the community leader and Health Volunteer (HV), Stuff the management and sharing of the medical and non-medical equipment, System of Covid-19 respond were EOC, ICS, Joint Investigation Team (JIT) and Communicable Disease Control Unit (CDCU) for monitoring the real-time of surveillance and control of COVID-19 output, Environment management in hospital and the community with Infections Control (IC) principle, and Culture in term of social capital on “the relationship of Isan people” supported the patient provide the good care and support. The structure of PHEM, Isan’s Culture, and good preparation was a significant factor in the three provinces.

Keywords: public health, emergency management, covid-19, pandemic

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Authors: Mekroud Amel

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Emergency departments are known for the workload, the variety of pathologies and the difficulties in their management with the continuous influx of patients The role of our service in the management of patients with two or three mild to moderate organ failures, involving several disciplines at the same time, as well as the effect of this management on the skills and efficiency of our team has been demonstrated Borderline cases between two or three or even more disciplines, with instability of a vital function, which have been successfully managed in the emergency room, the therapeutic procedures adopted, the consequences on the quality and level of care delivered by our team, as well as that the logistical consequences, and the pedagogical consequences are demonstrated. The consequences found are Positive on the emergency teams, in rare situations are negative Regarding clinical situations, it is the entanglement of hemodynamic distress with right, left or global participation, tamponade, low flow with acute pulmonary edema, and/or state of shock With respiratory distress with more or less profound hypoxemia, with haematosis disorder related to a bacterial or viral lung infection, pleurisy, pneumothorax, bronchoconstrictive crisis. With neurological disorders such as recent stroke, comatose state, or others With metabolic disorders such as hyperkalaemia renal insufficiency severe ionic disorders with accidents with anti vitamin K With or without septate effusion of one or more serous membranes with or without tamponade It’s a Retrospective, monocentric, descriptive study Period 05.01.2022 to 10.31.2022 the purpose of our work: Search for a statistically significant link between the type of moderate to severe pathology managed in the emergency room whose problems are multivisceral on the efficiency of the healthcare team and its level of care and optional care offered for patients Statistical Test used: Chi2 test to prove the significant link between the resolution of serious multidisciplinary cases in the emergency room and the effectiveness of the team in the management of complicated cases Search for a statistically significant link : The management of the most difficult clinical cases for organ specialties has given general practitioner emergency teams a great perspective and has been able to improve their efficiency in the face of emergencies received

Keywords: emergency care teams, management of patients with dysfunction of more than one organ, learning curve, quality of care

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Authors: Sengul Celik, Alper Ketenci

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In Turkish Constitution about health care in Article 56, it is said that: everyone has the right to live in a healthy and balanced environment. It is the duty of the state and citizens to improve the environment, protect environmental health, and prevent environmental pollution. The state ensures that everyone lives their lives in physical and mental health; it organizes the planning and service of health institutions from a single source in order to realize cooperation by increasing savings and efficiency in human and substance power. The state fulfills this task by utilizing and supervising health and social institutions in the public and private sectors. General health insurance can be established by law for the widespread delivery of health services. To have health care is one of the basic rights of patients. After the coupe attempt in July 2016, the Government of Turkey has announced a state of emergency and issued lots of emergency decrees. By these emergency decrees, lots of people were dismissed from their jobs and lost their some basic social rights. The violations occur in social life. One of the most common observations is the discrimination by government in health care system. This study aims to put forward the violation of human rights in health care system in Turkey due to their discriminated position by an emergency decree. The study is a case study that is based on nine interviews with the people or relatives of people who lost their jobs by an emergency decree in Turkey. In this study, no personally identifiable information was obtained for the safety of individuals. Also no distinctive questions regarding the identity of individuals were asked. The interviews are obtained through internet call applications. The data were analyzed through the requirements of regular health care system in Turkey. The interviews expose that the people or the relatives of people lost their right to have regular health care. They have to pay extra amount both in clinical services and in medication treatment. The patient right to quality medical care without prejudice is violated. It was assessed that the people who are involved in emergency decree and their relatives are discriminated by government and deprived of regular medical care and supervision. Although international legal arrangements and legal responsibilities of the state have been put forward by Article 56, they are violated in practice. To prevent these kinds of violations, some measures should be taken against the deprivation in health care system especially towards the discriminated people by an emergency decree.

Keywords: emergency decree in Turkey, health care, discriminated people, patients rights

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Authors: Savaş Durduran, Ceren Yağci

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The nature of the events going on in the world, when people’s lives are considered significantly affects natural disasters. Considering thousands of years of earth history, it is seen that many natural disasters, particularly earthquakes located in our country. Behaving cautious, without occurring hazards, after being disaster is much easier and cost effective than returning to the normal life. The four phases of disaster management in the whole world has been described as; pre-disaster preparedness and mitigation, post-disaster response and rehabilitation studies. Pre-disaster and post-disaster phases has half the weight of disaster management. How much would be prepared for disaster, no matter how disaster damage reducing work gives important, we will be less harm from material and spiritual sense. To do this in a systematic way we use the Geographic Information Systems (GIS). The execution of the emergency services to be on time and emergency control mechanism against the development the most appropriate decision Geographic Information System GIS) can be useful. The execution of the emergency services to be on time and emergency control mechanism towards for developing to be the most appropriate decision Geographic Information System (GIS) can be useful. The results obtained by using products with GIS analysis of seismic data to the city, manager of the city required information and data that can be more healthy and satisfies the appropriate policy decisions can be produced. In this study, using ArcGIS software and benefiting reports of the earthquake that occurred in the Konya city, spatial and non-spatial data consisting databases created, by the help of this database a potential disaster management aimed in the city of Konya regard to urban earthquake, GIS-aided analyzes were performed.

Keywords: geographic information systems (GIS), disaster management, emergency control mechanism, Konya

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Authors: Xiyang Li, Qi Yu, Lun Zhang

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In the face of natural disasters and other emergency situations, determining the optimal location of rescue centers is crucial for improving rescue efficiency and minimizing impact on affected populations. This paper proposes a method that integrates genetic algorithms (GA) and backpropagation neural networks (BPNN) to address the site selection optimization problem for emergency rescue centers. We utilize BPNN to accurately estimate the cost of delivering supplies from rescue centers to each temporary camp. Moreover, a genetic algorithm with a special partially matched crossover (PMX) strategy is employed to ensure that the number of temporary camps assigned to each rescue center adheres to predetermined limits. Using the population distribution data during the 2022 epidemic in Jiading District, Shanghai, as an experimental case, this paper verifies the effectiveness of the proposed method. The experimental results demonstrate that the BPNN-GA method proposed in this study outperforms existing algorithms in terms of computational efficiency and optimization performance. Especially considering the requirements for computational resources and response time in emergency situations, the proposed method shows its ability to achieve rapid convergence and optimal performance in the early and mid-stages. Future research could explore incorporating more real-world conditions and variables into the model to further improve its accuracy and applicability.

Keywords: emergency rescue centers, genetic algorithms, back-propagation neural networks, site selection optimization

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Authors: Nathaniel Oladimeji Dixon, Adekemi Dorcas Fadun

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Educational managers have observed a downward trend in the administrative effectiveness of non-teaching staff in federal universities in South-west Nigeria. This is evident in the low-quality service delivery of administrators and unaccomplished institutional goals and missions of higher education. Scholars have thus indicated the need for the deployment and adoption of a practice that encourages information collection and sharing among stakeholders with a view to improving service delivery and outcomes. This study examined the extent to which knowledge management correlated with the administrative effectiveness of non-teaching staff in federal universities in South-west Nigeria. The study adopted the survey design. Three federal universities (the University of Ibadan, Federal University of Agriculture, Abeokuta, and Obafemi Awolowo University) were purposively selected because administrative ineffectiveness was more pronounced among non-teaching staff in government-owned universities, and these federal universities were long established. The proportional and stratified random sampling was adopted to select 1156 non-teaching staff across the three universities along the three existing layers of the non-teaching staff: secretarial (senior=311; junior=224), non-secretarial (senior=147; junior=241) and technicians (senior=130; junior=103). Knowledge Management Practices Questionnaire with four sub-scales: knowledge creation (α=0.72), knowledge utilization (α=0.76), knowledge sharing (α=0.79) and knowledge transfer (α=0.83); and Administrative Effectiveness Questionnaire with four sub-scales: communication (α=0.84), decision implementation (α=0.75), service delivery (α=0.81) and interpersonal relationship (α=0.78) were used for data collection. Data were analyzed using descriptive statistics, Pearson product-moment correlation and multiple regression at 0.05 level of significance, while qualitative data were content analyzed. About 59.8% of the non-teaching staff exhibited a low level of knowledge management. The indices of administrative effectiveness of non-teaching staff were rated as follows: service delivery (82.0%), communication (78.0%), decision implementation (71.0%) and interpersonal relationship (68.0%). Knowledge management had significant relationships with the indices of administrative effectiveness: service delivery (r=0.82), communication (r=0.81), decision implementation (r=0.80) and interpersonal relationship (r=0.47). Knowledge management had a significant joint prediction on administrative effectiveness (F (4;1151)= 0.79, R=0.86), accounting for 73.0% of its variance. Knowledge sharing (β=0.38), knowledge transfer (β=0.26), knowledge utilization (β=0.22), and knowledge creation (β=0.06) had relatively significant contributions to administrative effectiveness. Lack of team spirit and withdrawal syndrome is the major perceived constraints to knowledge management practices among the non-teaching staff. Knowledge management positively influenced the administrative effectiveness of the non-teaching staff in federal universities in South-west Nigeria. There is a need to ensure that the non-teaching staff imbibe team spirit and embrace teamwork with a view to eliminating their withdrawal syndromes. Besides, knowledge management practices should be deployed into the administrative procedures of the university system.

Keywords: knowledge management, administrative effectiveness of non-teaching staff, federal universities in the south-west of nigeria., knowledge creation, knowledge utilization, effective communication, decision implementation

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Authors: Scott Ashby, Emily Granger, Mark Connellan

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Objectives: 1) To identify if emergency coronary angiography improves outcomes in studies examining OHCA from assumed cardiac aetiology? 2) If so, is it indicated in all patients resuscitated following OHCA, and if not, who is it indicated for? 3) How effective are investigations for screening for the appropriate patients? Background: Out-of-hospital cardiac arrest is one of the leading mechanisms of death, and the most common causative pathology is coronary artery disease. In-hospital treatment following resuscitation greatly affects outcomes, yet there is debate over the most effective protocol. Methods: A literature search was conducted over multiple databases to identify all relevant articles published from 2005. An inclusion criterion was applied to all publications retrieved, which were then sorted by type. Results: A total of 3 existing reviews and 29 clinical studies were analysed in this review. There were conflicting conclusions, however increased use of angiography has shown to improve outcomes in the majority of studies, which cover a variety of settings and cohorts. Recommendations: Currently, emergency coronary angiography appears to improve outcomes in all/most cases of OHCA of assumed cardiac aetiology, regardless of ECG findings. Until a better tool for screening is available to reduce unnecessary procedures, the benefits appear to outweigh the costs/risks.

Keywords: out of hospital cardiac arrest, coronary angiography, resuscitation, emergency medicine

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Authors: Bindhiya Thomas, Rehana Hafeez

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Background: The Surgical Ambulatory Unit (SAU) also known as the Same Day Emergency Care (SDEC) is an established part of many hospitals providing same day emergency care service to surgical patients who would have otherwise required admission through the A&E. Prior to Covid, the SAU was functioning as a 12-hour service, but during the Covid crisis this service was transformed to a 24 hour functioning Surgical Ambulatory Assessment unit (SAAU). We studied the effects that this change brought about in-patient care in our hospital. Objective: The objective of the study was to assess the impact of a 24-hour Surgical Ambulatory Assessment unit on patient care during the time of Covid, in particular its role in freeing A&E capacity and delivering effective patient care. Methods: We collected two sets of data retrospectively. The first set was collected over a 6-week period when the SAU was functioning at the Princess Royal University Hospital. On March 23rd, 2020, the SAU was transformed into a 24-hour SAAU. Following this transformation, a second set of patient data was collected over a period of 6 weeks. A comparison was made between data collected from when the hospital had a 12-hour Surgical Ambulatory unit and later when it was transformed into a 24-hour facility. Its effects on the change in the number of patients breaching the four hour waiting period and the number of emergency surgical admissions. Results: The 24-hour Surgical Ambulatory Assessment unit brought significant reductions in the number of patients breaching the waiting period of 4 hours in A&E from 44% during the period of the 12-hour Surgical Ambulatory care facility to 0% from when the 24-hour Surgical Ambulatory Assessment Unit was established. A 28% reduction was also seen in the number of surgical patients' admissions from A&E. Conclusions: The 24-hour SAAU was found to have a profound positive impact on emergency care of surgical patients. Especially during the Covid crisis, it played a crucial role in providing not only effective and accessible patient care but also in reducing the A&E workload and admissions. It thus proved to be a strategic tool that helped to deal with the immense workload in emergency care during the Covid crisis and helped free much needed headspace at a time of uncertainty for the A&E to better configure their services. If sustained, the 24-hour SAAU could be relied on to augment the NHS emergency services in the future, especially in the event of another crisis.

Keywords: Princess Royal University Hospital, surgical ambulatory assessment unit, surgical ambulatory unit, same day emergency care

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Authors: Junaid C, Sabique MK

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Introduction: MES Mamapd College is an autonomous college established in 1964 affiliated with the University of Calicut run by the Muslim Educational Society Kerala. The department of Arabic of the college is having a pivotal role in promoting Arabic language learning, teaching, research, and other allied academic activities. State of Problem: Department of Arabic of the college introduced before the academic committee the culture of international seminars. The department connected the academic community with foreign scholars and introduced industry-academia collaboration programs which are beneficial to the job seekers. These practices and innovations should be documented. Objectives: Create awareness of innovative practices implemented for the promotion of the Arabic language. Infuse confidence in learners in learning of Arabic language. Showcase the distinctive academic programs initiated by the department Methodology: Data will be collected from archives, souvenirs, and reports. Survey methods and interviews with authorities and beneficiaries will be collected for the data analysis. Major results: MES Mampad College introduced before its stakeholders different unique academic practices related to the Arabic language and literature. When the unprecedented pandemic situation pulled back all of the academic community, the department come forward with numerous academic initiatives utilizing the virtual space. Both arenas will be documented. Conclusion: This study will help to make awareness on the promotion of the Arabic language studies and related practices initiated by the department of Arabic MES Mampad College. These practices and innovations can be modeled and replicated.

Keywords: teaching Arabic language, MES mampad college, Arabic webinars, pandemic impacts in literature

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Authors: Natalie Preville, Carlos Joel Mejia-Olivares

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In the UK, since the early 1950s when the NHS was founded, international staff in the NHS have played an important role. Currently, they represent 16% of the workforce within the NHS in the UK. Furthermore, to address the shortfalls in nursing staff, international recruitment programs have been essential to reduce the gaps in the UK nursing workforce over the last two decades. The NHS Long Term Plan (2019) aims to have a significant reduction of nursing vacancies to 5% by 2028. However, in 2021 and 2022, Workforce Race Equality Standards (WRES) reports stated that there is inequitable Career Progression (CP) among Internationally Recruited (IR) nurses as compared to British counterparts. In addition, there is sufficient literature exploring the motives and lived experiences of IR nurses, which underpins the findings. Therefore, the overall aim of this report is to conduct a scoping project to understand the experiences of the IR nurses who joined the NHS in the South East of England within the last 5 years. Methodology- This document is based on the data from a survey developed by Royal Berkshire NHS Foundation Trust using Microsoft forms and consisted of 23 questions divided into four themes, staff background, career experience, career progression and future career plans within Royal Berkshire NHS Foundation Trust. The descriptive analysis provided the initial analysis of the quantitative data. As a result, 44 responses were collected and evaluated by utilising Microsoft excel. Key findings: Career experiences; 72% of respondents felt that their current role was a good fit, and in a subsequent question, the main reason cited was having “relevant skills”. This indicates that, for the most part, the prior experience of IR nurses is a large factor in their placement, which is viewed positively; the next step is to effectively apply similar relevance in aligning prior experience with career progression opportunities. Moreover, 67% of respondents feel valued by the department/team, which is a great reflection of the values of the Trust being demonstrated towards IR Nurses. However, further studies may be necessary to explore the reasons why the remaining 33% may not feel valued; this can include having a better understanding of cultural perceptions of value. Perceived Barriers: Although 37% of respondents had been promoted since commencing employment with the Trust, the data indicates that there is still room for CP opportunities, as it is the leading barrier reported by the respondents. Secondly, the growing mix of cultures within the nursing workforce gives the appearance of inclusion. However, this is not the experience of some IR nurses. Conclusion statemen: Survey results indicate that this NHS Trust has an excellent foundation to integrate international nurses into their workforce with scope for career progression in a reasonable timeframe. However, it would be recommendable to include fast-tracking career promotions by recognizing previous studies and professional experience. Further exploration of staff career experiences and goals may provide additional useful data for future planning.

Keywords: career progression, International nurses, perceived barriers, staff survey

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Authors: Jennifer E. Lynette

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The purpose of this study is to develop a nation-wide assessment tool to gauge the quality and efficiency of response activities by emergency personnel to fires in Denmark. Current fire incident reports lack detailed information that can lead to breakthroughs in research and improve emergency response efforts. Information generated from the report database is analyzed and assessed for efficiency and quality. By utilizing information collection gaps in the incident reports, an improved, indepth, and streamlined quality gauging system is developed for use by fire brigades. This study pinpoints previously unrecorded factors involved in the response phases of a fire. Variables are recorded and ranked based on their influence to event outcome. By assessing and measuring these data points, quality standards are developed. These quality standards include details of the response phase previously overlooked which individually and cumulatively impact the overall success of a fire response effort. Through the application of this tool and implementation of associated quality standards at Denmark’s fire brigades, there is potential to increase efficiency and quality in the preparedness and response phases, thereby saving additional lives, property, and resources.

Keywords: emergency management, fire, preparedness, quality standards, response

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Authors: Jirapat Suriyachaisawat, Ekkit Surakarn

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Introduction: To improve early detection and mortality rate of in-hospital cardiac arrest, Emergency Response Team (ERT) system was planned and implemented since June 2009 to detect pre-arrest conditons and for any concerns. The ERT consisted of on duty physicians and nurses from emergency department. ERT calling criteria consisted of acute change of HR < 40 or > 130 beats per minute, systolic blood pressure < 90 mmHg, respiratory rate <8 or >28 breaths per minute, O2 saturation <90%, acute change in conscious state, acute chest pain or worry about the patients. From the data on ERT system implementation in our hospital in early phase (during June 2009-2011), there was no statistic significance in difference in in-hospital cardiac arrest incidence and overall hospital mortality rate. Since the introduction of the ERT service in our hospital, we have conducted continuous educational campaign to improve awareness in an attempt to increase use of the service. Methods: To investigate outcome of ERT system in in-hospital cardiac arrest and overall hospital mortality rate, we conducted a prospective, controlled before-and after examination of the long term effect of a ERT system on the incidence of cardiac arrest. We performed chi-square analysis to find statistic significance. Results: Of a total 623 ERT cases from June 2009 until December 2012, there were 72 calls in 2009, 196 calls in 2010, 139 calls in 2011 and 245 calls in 2012. The number of ERT calls per 1000 admissions in year 2009-10 was 7.69; 5.61 in 2011 and 9.38 in 2013. The number of code blue calls per 1000 admissions decreased significantly from 2.28 to 0.99 per 1000 admissions (P value < 0.001). The incidence of cardiac arrest decreased progressively from 1.19 to 0.34 per 1000 admissions and significant in difference in year 2012 (P value < 0.001 ). The overall hospital mortality rate decreased by 8 % from 15.43 to 14.43 per 1000 admissions (P value 0.095). Conclusions: ERT system implementation was associated with progressive reduction in cardiac arrests over three year period, especially statistic significant in difference in 4th year after implementation. We also found an inverse association between number of ERT use and the risk of occurrence of cardiac arrests, but we have not found difference in overall hospital mortality rate.

Keywords: cardiac arrest, outcome, in-hospital, ERT

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Authors: Ali Obaid Alyami

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In Saudi Arabia, the pandemic of Coronavirus (COVID-19) has been affecting administrative contracts in many different ways. Lots of planned projects were stopped temporarily or implemented partially. Many contractors have suffered financial struggles and the absence of manpower. These administrative contracts are governed by Government Tenders and Procurement Law (GTPL) which was issued by a royal decree in 2019. This law addresses some challenges that could be stumbling blocks in the way of implementing a contract. One significant challenge is emergency circumstances that occur during the implementation of an administrative contract. The law provides some solutions for this disruption, but these solutions may not compensate for the whole damages that contractors suffer. This study will use the doctrinal methodology to analyze the rules of law and their application to the research problem. Most importantly, the issue that arises in this research is the possibility of governmental entities’ consideration, in administrative contracts, of the pandemic Coronavirus (COVID-19) as an emergency circumstance. This study points out the conditions for applying the theory of emergency circumstances on administrative contracts in addition to the definition of the theory and analyzing its elements. The other significant question is the limits on governmental entities to make a change in an administrative contract to achieve contractual rebalancing. GPTL and its implementing regulation set the conditions and limits of contractual rebalancing. However, this study finds that although GTPL provides rules for contractual rebalancing, there are some other mechanisms that contractors may take to fully compensate for the damages. For instance, when the loss cannot be minimized by GTPL, contractors might file lawsuits before the administrative judiciary. The study concludes that GTPL is a very comprehensive law system that stipulates specific rules for contractual rebalance and treats the emergency circumstances that obstruct the performance of administrative contracts.

Keywords: administrative contracts, emergency circumstances, balance of contract, administrative judiciary, government tenders, procurement law

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Authors: Jiří Barta

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The paper deals with simulation programs of spread of harmful substances. Air pollution has a direct impact on the quality of human life and environmental protection is currently a very hot topic. Therefore, the paper focuses on the simulation of release of harmful substances. The first part of article deals with perspectives and possibilities of implementation outputs of simulations programs into the system which is education and of practical training of the management staff during emergency events in the frame of critical infrastructure. The last part shows the practical testing and evaluation of simulation programs. Of the tested simulations software been selected Symos97. The tool offers advanced features for setting leakage. Gradually allows the user to model the terrain, location, and method of escape of harmful substances.

Keywords: Computer Simulation, Symos97, Spread, Simulation Software, Harmful Substances

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Authors: Mohamed Chabi

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The project of helping students at risk started at the Math department in the new foundation program at Qatar University in the fall 2012 semester. The purpose was to find ways to help students who were struggling with their math courses Elementary algebra or Precalculus course due to many factors. Department had formed the Committee “students at Risk” at the start of 12-13 to assist struggling students in our math courses to get their studies on track. A mechanism was developed to support students who are at risk using a developed E-Monitoring system. E-Monitoring system was developed to manage automatically all transactions relevant to the students’ attendance, Students ‘‘warning Students’’ grading, etc. E-Monitoring System produce various statistics such as, Overall course statistics, Performance, Students at Risk… to help department to develop a higher quality of education in the Foundation Program at Math department. The mechanism was studies and evaluated. Whatever the cause, the sooner we identify students who are not performing well academically, the sooner we can provide, or direct them to the resources that are available to them. In this paper, we outline the mechanism and its effect on students’ performance. The collected data from various exams shows that students had benefited from the mechanism.

Keywords: students at risk, e-monitoring system, warning students, performance

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Authors: Mary Bernardin, Margie Batek, Joseph Moen, David Schnadower

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Background: Exposure to violence not only has negative psychological impact on children but is a risk factor for children becoming recurrent victims of violence. However, little is known regarding the degree to which child victims of violence are exposed to trauma at home and in their community, or its association with specific psychological diagnoses. Objective: The aims of this study were to perform in-depth characterizations of family, community and psychological wellness amongst pediatric victims of interpersonal violence. Methods: As standard of care at the Saint Louis Children’s Hospital pediatric emergency department (ED), social workers perform in-depth interviews with all children presenting due to violent interpersonal encounters. In this retrospective cross-sectional study, we collected data from social work interviews on family structure, exposure to violence in the community and the home, as well as history of psychological diagnoses amongst children ages 8-19 years who presented to the ED for injuries related to interpersonal violence from 2014-2017. Results: A total of 407 patients presenting to the ED for an interpersonal violent encounter were analyzed. The average age of studied youths was 14.7 years (SD 2.5). Youths were 97.5% African American ethnicity and 66.6% male. 67.8% described their home having a nonnuclear family structure, 50% of which reported living with a single mother. Of the 21% who reported having incarcerated family members, 56.3% reported their father being incarcerated, 15% reported their mother being incarcerated, and 12.5% reported multiple family members being incarcerated. 11.3% reported witnessing domestic violence in their home. 12.8% of youths reported some form of child abuse. The type of child abuse was not specified in 29.3% of cases, but physical abuse (32.8%) followed by sexual abuse (22.4%) were the most commonly reported. 14.5% had history of placement in foster care and/or adoption. 64% reported having witnessed violence in their community. 30.2% reported having lost friends or family due to violence, and of those, 26.4% reported the loss of a cousin, 18.9% the loss of a friend, 16% the loss of their father, and 12.3% the loss of their brother due to violence. Of the 22.4% youths with psychiatric diagnose(s), 48.4% had multiple diagnoses, the most common of which were ADD/ADHD (62.6%), followed by depression (31.9%), bipolar disorder (27.5%) and anxiety (15.4%). Conclusions: A remarkable proportion of children presenting to EDs due to interpersonal violence have a history of exposure to instability and violence in their homes and communities. Additionally, psychological diagnoses are frequent among pediatric victims of violence. More research is needed to better understand the association between trauma exposure, psychological health and violent victimization amongst children.

Keywords: community violence, emergency department, pediatric interpersonal violence, pediatric trauma, psychological effects of trauma

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Authors: Emily Saurman, David Lyle

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In Australia, a well serviced rural town might have a psychiatrist visit once-a-month with more frequent visits from a psychiatric nurse, but many have no resident access to mental health specialists. Access to specialist care, would not only reduce patient distress and benefit outcomes, but facilitate the effective use of limited resources. The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) was developed to improve access to specialist emergency mental health care in rural and remote communities using telehealth technologies. However, there has been no current benchmark to gauge program efficiency or capacity; to determine whether the program activity is justifiably sufficient. The evaluation of MHEC-RAP used multiple methods and applied a modified theory of access to assess the program and its aim of improved access to emergency mental health care. This was the first evaluation of a telepsychiatry service to include a time and motion study design examining program time expenditure, efficiency, and capacity. The time and motion study analysis was combined with an observational study of the program structure and function to assess the balance between program responsiveness and efficiency. Previous program studies have demonstrated that MHEC-RAP has improved access and is used and effective. The findings from the time and motion study suggest that MHEC-RAP has the capacity to manage increased activity within the current model structure without loss to responsiveness or efficiency in the provision of care. Enhancing program responsiveness and efficiency will also support a claim of the program’s value for money. MHEC-RAP is a practical telehealth solution for improving access to specialist emergency mental health care. The findings from this evaluation have already attracted the attention of other regions in Australia interested in implementing emergency telepsychiatry programs and are now informing the progressive establishment of mental health resource centres in rural New South Wales. Like MHEC-RAP, these centres will provide rapid, safe, and contextually relevant assessments and advice to support local health professionals to manage mental health emergencies in the smaller rural emergency departments. Sharing the application of this methodology and research activity may help to improve access to and future evaluations of telehealth and telepsychiatry services for others around the globe.

Keywords: access, emergency, mental health, rural, time and motion

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