Search results for: emergency medical team

Authors: Ayşen Bakioğlu, Gökçen Seyra Çakır

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This study aims to explore how research assistants who work in project teams experience team member autonomy and how they reconcile team member autonomy with team collaboration. The study utilizes snowball sampling. 20 research assistants who work the faculties of education in Marmara University and Yıldız Technical University have been interviewed. The analysis of data involves a content analysis MAXQDAPlus 11 which is a qualitative data analysis software is used as the data analysis tool. According to the findings of this study, emerging themes include team norm formation, team coordination management, the role of individual tasks in team collaboration, leadership distribution. According to the findings, interviewees experience team norm formation process in terms of processes, which pertain to task fulfillment, and processes, which pertain to the regulation of team dynamics. Team norm formation process instills a sense of responsibility amongst individual team members. Apart from that, the interviewees’ responses indicate that the realization of the obligation to work in a team contributes to the team norm formation process. The participants indicate that individual expectations are taken into consideration during the coordination of the team. The supervisor of the project team also has a crucial role in maintaining team collaboration. Coordination problems arise when an individual team member does not relate his/her academic field with the research topic of the project team. The findings indicate that the leadership distribution in the project teams involves two leadership processes: leadership distribution which is based on the processes that focus on individual team members and leadership distribution which is based on the processes that focus on team interaction. Apart from that, individual tasks serve as a facilitator of collaboration amongst team members. Interviewees also indicate that individual tasks also facilitate the expression of individuality.

Keywords: project teams in higher education, research assistant teams, team collaboration, team member autonomy

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Authors: Poonam Chouhan, Rama Thakur, R. J. Mahajan, Kushla Pathania, Mehnaz Kumar

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Background: Cesarean sections are associated with short- and long-term risks and affect the health of the woman, her child, and future pregnancies. We conducted a study to compare Maternal, fetal, and neonatal elective versus emergency cesarean deliveries in a tertiary care center. Material & Methods: This was a cross-sectional comparative hospital-based study conducted at Kamla Nehru State Hospital for the mother and Child, Department of Obstetrics and Gynecology, Indira Gandhi Medical College, Shimla, from June 1, 2020, to May 31ˢᵗ, 2021). A total of 200 consenting participants (100 participants undergoing elective cesarean section & 100 participants undergoing emergency cesarean section) were enrolled. The analysis was performed using the statistical package for social sciences (SPSS) version 21. Results: Antenatal complications were more in women who had an emergency cesarean section (95%) as compared to those who had an elective cesarean section (46%) (p=0.0076). 26.5% of women had fetal complications, and out of them, 92.4% (49/53) underwent emergency cesarean section. IUGR was diagnosed in 8% of women, out of them, 56.2% had elective cesarean section & 43.8% had an emergency cesarean section. Malpresentation other than breech presentation were present in 3.5% (7/200) of women. Six (3%) women had cesarean section for macrosomia. Of these, 66.7% (4/6) had elective cesarean section & 33.3% had emergency cesarean section. 23% (46/200) neonates required NICU admission, and 5% (10/200) had transient tachypnoea of new-born (TTNB). Conclusion: Our study concluded that maternal and fetal Complications of an emergency cesarean are more as compared to a planned elective cesarean. An elective cesarean conducted well in time will prevent an emergency cesarean delivery and its related complications.

Keywords: maternal, fetal, neonatal, complications, cesareans

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Authors: Chaiyaporn Yuksen, Tapanawat Chaiwan

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Introduction: Emergency medical service (EMS) care for trauma patients must be provided on-scene assessment and essential treatment and have appropriate transporting to the trauma center. The shock index (SI), reverse shock index Glasgow Coma Scale (rSIG), and National Early Warning Score (NEWS) triage tools are easy to use in a prehospital setting. There is no standardized on-scene triage protocol in prehospital care. The primary objective was to determine the accuracy of SI, rSIG, and NEWS to predict the severity of trauma patients in the emergency department (ED). Methods: This was a retrospective cross-sectional and diagnostic research conducted on trauma patients transported by EMS to the ED of Ramathibodi Hospital, a university-affiliated super tertiary care hospital in Bangkok, Thailand, from January 2015 to September 2022. We included the injured patients receiving prehospital care and transport to the ED of Ramathibodi Hospital by the EMS team from January 2015 to September 2022. We compared the on-scene parameter (SI, rSIG, and NEWS) and ED (Emergency Severity Index) with the area under ROC. Results: 218 patients were traumatic patients transported by EMS to the ED. 161 was ESI level 1-2, and 57 was level 3-5. NEWS was a more accurate triage tool to discriminate the severity of trauma patients than rSIG and SI. The area under the ROC was 0.743 (95%CI 0.70-0.79), 0.649 (95%CI 0.59-0.70), and 0.582 (95%CI 0.52-0.65), respectively (P-value <0.001). The cut point of NEWS to discriminate was 6 points. Conclusions: The NEWs was the most accurate triage tool in prehospital seeing in trauma patients.

Keywords: on-scene triage, trauma patient, ED triage, accuracy, NEWS

Procedia PDF Downloads 127

Authors: Mete Ulaş Aksoy

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In contemporary politics, the state of emergency has become a permanent and salient feature of politics. This study aims to clarify the anthropological and ontological dimensions of the permanent state of emergency. It pays special attention to the structural relation between the exception and play. Focusing on the play in the context of emergency and exception enables the recognition of the difference and sometimes the discrepancy between the exception and emergency, which has passed into oblivion because of the frequency and normalization of emergency situations. This study coins the term “ludic exception” in order to highlight the difference between the exceptions in which exuberance and paroxysm rule over the socio-political life and the permanent emergency that protects the authority with a sort of extra-legality. The main thesis of the study is that the ludic elements such as risk, conspicuous consumption, sacrificial gestures, agonism, etc. circumscribe the exceptional moments temporarily, preventing them from being routine and normal. The study also emphasizes the decline of ludic elements in modernity as the main factor in the transformation of the exceptions into permanent emergency situations. In the introduction, the relationship between play and exception is taken into consideration. In the second part, the study elucidates the concept of ludic exceptions and dwells on the anthropological examples of the ludic exceptions. In the last part, the decline of ludic elements in modernity is addressed as the main factor for the permanent emergency.

Keywords: emergency, exception, ludic exception, play, sovereignty

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Authors: Yusuke Katayama, Tetsuhisa Kitamura, Kosuke Kiyohara, Sumito Hayashida, Taku Iwami, Takashi Kawamura, Takeshi Shimazu

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Background: Recently, the number of ambulance dispatches has been increasing in Japan and it is, therefore, difficult to accept emergency patients to hospitals smoothly and appropriately because of the limited hospital capacity. To facilitate the request for patient transport by ambulances and hospital acceptance, the emergency information system using information technology has been built up and introduced in various communities. However, its effectiveness has not been insufficiently revealed in Japan. In 2013, we developed a smartphone application system that enables the emergency-medical-service (EMS) personnel to share information about on-scene ambulance and hospital situation. The aim of this study was to assess the introduction effect of this application for EMS system in Osaka City, Japan. Methods: This study was a retrospective study with population-based ambulance records of Osaka Municipal Fire Department. This study period was six years from January 1, 2010 to December 31, 2015. In this study, we enrolled emergency patients that on-scene EMS personnel conducted the hospital selection for them. The main endpoint was difficulty in hospital acceptance at the scene. The definition of difficulty in hospital acceptance at the scene was to make >=5 phone calls by EMS personnel at the scene to each hospital until a decision to transport was determined. The definition of the smartphone application group was emergency patients transported in the period of 2013-2015 after the introduction of this application, and we assessed the introduction effect of smartphone application with multivariable logistic regression model. Results: A total of 600,526 emergency patients for whom EMS personnel selected hospitals were eligible for our analysis. There were 300,131 smartphone application group (50.0%) in 2010-2012 and 300,395 non-smartphone application group (50.0%) in 2013-2015. The proportion of the difficulty in hospital acceptance was 14.2% (42,585/300,131) in the smartphone application group and 10.9% (32,819/300,395) in the non-smartphone application group, and the difficulty in hospital acceptance significantly decreased by the introduction of the smartphone application (adjusted odds ration; 0.730, 95% confidence interval; 0.718-0.741, P<0.001). Conclusions: Sharing information between ambulance and hospital by introducing smartphone application at the scene was associated with decreasing the difficulty in hospital acceptance. Our findings may be considerable useful for developing emergency medical information system with using IT in other areas of the world.

Keywords: difficulty in hospital acceptance, emergency medical service, infomation technology, smartphone application

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Authors: Tomáš Ludík, Jiří Barta, Sabina Chytilová, Josef Navrátil

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Emergency management is a discipline of dealing with and avoiding risks. Appropriate emergency management software allows better management of these risks and has a direct influence on reducing potential negative impacts. Although there are several emergency management software products in the Czech Republic, they cover user requirements from the emergency management field only partially. Therefore, the paper focuses on the issues of requirement analysis within development of emergency management software. Analysis of the current state describes the basic features and properties of user requirements for software development as well as basic methods and approaches for gathering these requirements. Then, the paper presents more specific mechanisms for requirement analysis based on chosen software development approach: structured, object-oriented or agile. Based on these experiences it is designed new methodology for requirement analysis. Methodology describes how to map user requirements comprehensively in the field of emergency management and thus reduce misunderstanding between software analyst and emergency manager. Proposed methodology was consulted with department of fire brigade and also has been applied in the requirements analysis for their current emergency management software. The proposed methodology has general character and can be used also in other specific areas during requirement analysis.

Keywords: emergency software, methodology, requirement analysis, stakeholders, use case diagram, user stories

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Authors: Y. R. Lai, J. C. Jehng, T. T. Chang

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Team is a popular job design in the management settings. Because people on a team need to work together to complete a lot of tasks, the interaction between team members strongly influences team effectiveness. The study examines the effect of social capital and empowering leadership on team cohesion. There are three facets of social capital: structural facet, relational facet, and cognitive facet. Empowering leadership includes enhancing the meaningfulness of work, fostering participation in decision making, expressing confidence in high performance, and providing autonomy from bureaucratic constraints. Data were collected from 181 team members of 47 teams in the real estate agency industry. The results show that the relational social capital, enhancing the meaningfulness of work, and providing autonomy from bureaucratic constraints are positively related to two dimensions of team cohesion: sense of belonging and feelings of moral. Additionally, expressing confidence in high performance is negatively related to sense of belonging.

Keywords: social capital, empowering leadership, team cohesion, team effectiveness

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Authors: Baluku Nathan

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Infection prevention and control (IPC) is a practical, evidence-based approach that prevents patients and emergency health workers from being harmed by avoidable infections as a result of antimicrobial resistance; all hospital infection control programs put together various practices which, when used appropriately, restrict the spread of infection. A breach in these control practices facilitates the transmission of infections from patients to health workers, other patients, and attendants. It is, therefore important for all emergency medical technicians (EMTs) and patients to strictly adhere to them. It is also imperative for administrators to ensure the implementation of the infection control programme for their facilities. Purpose: The purpose of this study was to investigate the influencing factors of prevention practices against infection exposure among emergency medical technicians (EMTs) in the emergency department at Mbarara hospital. Methodology: This was a descriptive cross-sectional study that employed a self-reported questionnaire that was filled out by 32 EMTs in the emergency department from 12th February to 3rd march 2022. The questionnaire consisted of items concerning the defensive environment and other factors influencing infection prevention and control practices in the accident and emergency department of Mbarara hospital. Results: From the findings, the majority 16 (50%) always used protective gear when doing clinical work, 14 (43.8%) didn’t use protective gear, citing they were only assisting those performing resuscitations, gumboots were the least used protective gear with only3(9.4%) usage. About disposal techniques of specific products like blood and sharps, results showed 10 (31.3%) said blood is disposed of in red buckets, 5 (15.6%) in yellow buckets, and only 5(15.6%) in black buckets, and 12(37.5%) didn’t respond, however, 28(87.5%) said sharps were disposed of in a sharps container. The majority, 17 (53.1%), were not aware of the infection control guidelines even though they were pinned on walls of the emergency rooms, 15(46.9%) said they have never had quality assurance monitoring events, 14(43.8%) said monitoring was continuous while 15(46.9 %) said it was discrete. Conclusions: The infection control practices at the emergency department were inadequate in view of less than 100% of the EMTs observing the five principles of infection prevention, such as the use of personal protective equipment and proper waste disposal in appropriate color-coded bins. Dysfunctional infection prevention and control committees accompanied by inadequate supervision to ensure infection control remained a big challenge.

Keywords: emergency medical technician, infection prevention, influencing factors, infection control

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Authors: Purnima K Bajre, Rujula Talloo

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A variety of vehicles are driven on roads such as private vehicles, commercial vehicles, public vehicles, and emergency service vehicles (EMV). Drivers driving different vehicles can have attitude differences towards emergency service vehicles which in turn affects their likelihood to give way to them. The present review aims to understand the factors that mediate this yielding behavior of drivers towards EMVs. Through extensive review of available literature, factors such as effects of lights and sirens, cognitive load, age of the driver, driving general experience, traffic load, drivers’ experience and training with EMVs and drivers’ attitude towards EMV drivers, have emerged as mediating factors. Whereas cognitive load is the most researched area and is observed to be associated negatively with on road drivers’ attitudes towards EMVs, there is a paucity of research to understand the relationships between empathy, pro-social skills, and on road drivers’ attitude towards EMVs.

Keywords: cognitive load, emergency service vehicle, empathy, traffic load

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Authors: Fang Tang, Jacob Longazo

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This paper describes a sliding autonomy approach for coordinating a team of robots to assist the human operator to accomplish tasks while adapting to new or unexpected situations by requesting help from the human operator. While sliding autonomy has been well studied in the context of controlling a single robot. Much work needs to be done to apply sliding autonomy to a multi-robot team, especially human-robot team. Our approach aims at a hierarchical sliding control structure, with components that support human-robot collaboration. We validated our approach in the USARSim simulation and demonstrated that the human-robot team's overall performance can be improved under the sliding autonomy control.

Keywords: sliding autonomy, multi-robot team, human-robot collaboration, USARSim

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Authors: Kari Bjorn

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Team learning has been studied and modeled as double loop model and its variations. Also, metacognition has been suggested as a concept to describe the nature of team learning to be more than a simple sum of individual learning of the team members. Team learning has a positive correlation with both individual motivation of its members, as well as the collective factors within the team. Team learning of previously very independent members of two teaching teams is analyzed. Applied Science Universities are training future professionals with ever more diversified and multidisciplinary skills. The size of the units of teaching and learning are increasingly larger for several reasons. First, multi-disciplinary skill development requires more active learning and richer learning environments and learning experiences. This occurs on students teams. Secondly, teaching of multidisciplinary skills requires a multidisciplinary and team-based teaching from the teachers as well. Team formation phases have been identifies and widely accepted. Team role stress has been analyzed in project teams. Projects typically have a well-defined goal and organization. This paper explores team stress of two teacher teams in a parallel running two course units in engineering education. The first is an Industrial Automation Technology and the second is Development of Medical Devices. The courses have a separate student group, and they are in different campuses. Both are run in parallel within 8 week time. Both of them are taught by a group of four teachers with several years of teaching experience, but individually. The team role stress scale items - the survey is done to both teaching groups at the beginning of the course and at the end of the course. The inventory of questions covers the factors of ambiguity, conflict, quantitative role overload and qualitative role overload. Some comparison to the study on project teams can be drawn. Team development stage of the two teaching groups is different. Relating the team role stress factors to the development stage of the group can reveal the potential of management actions to promote team building and to understand the maturity of functional and well-established teams. Mature teams indicate higher job satisfaction and deliver higher performance. Especially, teaching teams who deliver highly intangible results of learning outcome are sensitive to issues in the job satisfaction and team conflicts. Because team teaching is increasing, the paper provides a review of the relevant theories and initial comparative and longitudinal results of the team role stress factors applied to teaching teams.

Keywords: engineering education, stress, team role, team teaching

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Authors: Chin-Hsiang Lo, Wey Chia, Shih-Tien Hsu

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Introduction: Since 2016, the annual number of passengers on commercial flights at Taoyuan International Airport (TIA) has been ~40 million. Due to the outbreak and spread of COVID-19, the number of international flights sharply diminished in recent years. However, TIA is located at an East-Asian flight transportation junction; thus, many commercial and cargo flights continue service. When severe medical events happen on a commercial airliner, the decision to divert or not is based on consideration of both medical and operational issues. This study discusses the events related to the diversion of airplanes or reentry after taxiing for medical emergencies at Taoyuan International Airport. Background: We analyzed emergency medical records from the medical clinic of TIA from January 1, 2017, to December 31, 2022, for patients who needed emergency medical services but were unable to reach the airport clinic by themselves. We also collected data for patients treated after diversion from other airports or reentry after taxiing due to medical emergencies. Information such as when and where the event occurred, chief signs and symptoms, the tentative diagnosis (using the ICD-9-CM), management, and the sociodemographic features of the passengers were extracted from the medical records. Summary of Cases: TIA handled approximately 152 million passengers and 1,093,762 flights during the study period; a total of 2,804 emergencies occurred during this time period. Thirty-three medical emergencies warranted diversion (21 cases) or reentry (12 cases); 13 cases were diverted from Asia-Pacific flights and five from Asia-North America flights. The age of the passengers with diversion emergencies ranged from 2–85 years (mean, 46±20-years-old). Twenty-seven patients were transported to an emergency department, and four patients died. For all cases of diversion or reentry, the most common diagnoses were neurogenic problems (42.4%), Out-of-hospital cardiac arrest (OHCA) (15.2%), and cardiovascular problems (12.1%). Discussion: Most aircraft diversions were related to syncope, seizure, and OHCA. The decision to divert depends on medical and operational considerations. Emergency conditions are often serious; thus, improvement of the effectiveness of cooperation between airlines and medical teams remains a challenge.

Keywords: diversion, syncope, seizure, OHCA

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Authors: Jakub Kraus, Vladimír Plos, Peter Vittek

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This article deals with a new approach to the airport emergency plans, which are the basic documents and manuals for dealing with events with impact on safety or security. The article describes the identified parts in which the current airport emergency plans do not fulfill their role and which should therefore be considered in the creation of corrective measures. All these issues have been identified at airports in the Czech Republic and confirmed at airports in neighboring countries.

Keywords: airport emergency plan, aviation safety, aviation security, comprehensive management system

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Authors: E. Tugba Topcu

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The emergency services are usually the first places to encounter forensic cases. Hence, it is important to consider forensics from the perspective of the emergency services staff and the physiological and psychological consequences that may arise as a result of behaviour by itself or another person. Accurate and detailed documentation of the situation in which the patient first arrives at the emergency service and preservation of the forensic findings is pivotal for the subsequent forensic investigation. The first step in determining whether or not a forensic case exists is to perform a medical examination of the patient. For each individual suspected to be part of a forensic case, police officers should be informed at the same time as the medical examination is being conducted. Violent events are increasing every year and with an increase in the number of forensic cases, emergency service workers have increasing responsibility and consequently play a key role in protecting, collecting and arranging the forensic evidence. In addition, because the emergency service workers involved in forensic events typically have information about the accused and/or victim, as well as evidence related to the events and the cause of injuries, police officers often require their testimony. However, both nurses and other health care personnel do not typically have adequate expertise in forensic medicine. Emergency nurses should take an active role for determining that whether any patient admitted to the emergency services is a clinical forensic patient the emergency service with injury and requiring possible punishment and knowing of their roles and responsibilities in this area provides legal protection as well as the protection of the judicial affair. Particularly, in emergency services, where rapid patient turnover and high workload exists, patient registration and case reporting may not exist. In such instances, the witnesses, typically the nurses, are often consulted for information. Knowledge of forensic medical matters plays a vital role in achieving justice. According to the Criminal Procedure Law, Article 75, Paragraph 3, ‘an internal body examination or the taking of blood or other biological samples from the body can be performed only by a doctor or other health professional member’. In favour of this item, the clinic nurse and doctor are mainly responsible for evaluating forensic cases in emergency departments, performing the examination, collecting evidence, and storing and reporting data. The courts place considerable importance on determining whether a suspect is the victim or accused and, thus, in terms of illuminating events, it is crucial that any evidence is gathered carefully and appropriately. All the evidence related to the forensic case including the forensic report should be handed over to the police officers. In instances where forensic evidence cannot be collected and the only way to obtain the evidence is the hospital environment, health care personnel in emergency services need to have knowledge about the diagnosis of forensic evidence, the collection of evidence, hiding evidence and provision of the evidence delivery chain.

Keywords: emergency department, emergency nursing, forensic cases, forensic nursing

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Authors: Mannan Mridha, Mohammad S. Islam

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Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: intensive care units, medical errors, medical devices, patient care and safety

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Authors: Victor Au, Khin Maung Than, Zaw Win Aung, Linawati Jumat

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Background & Objectives: Cardiac arrests can occur anywhere or anytime, and most of the cases will be brought to the emergency department except the cases that happened in at in-patient setting. Raja IsteriPangiran Anak Saleha (RIPAS) Hospital is the only tertiary government hospital which located in Brunei Muara district and received all referral from other Brunei districts. Data of cardiac arrests in Brunei Darussalam scattered between Emergency Medical Ambulance Services (EMAS), Emergency Department (ED), general inpatient wards, and Intensive Care Unit (ICU). In this audit, we only focused on cardiac arrest cases which had happened or presented to the emergency department RIPAS Hospital. Theobjectives of this audit were to look at demographic of cardiac arrest cases and the survival to discharge rate of In-Hospital Cardiac Arrest (IHCA) and Out-Hospital Cardiac Arrest (OHCA). Methodology: This audit retrospective study was conducted on all cardiac arrest cases that underwent Cardiopulmonary Resuscitation (CPR) in ED RIPAS Hospital, Brunei Muara, in the year 2019-2020. All cardiac arrest cases that happened or were brought in to emergency department were included. All the relevant data were retrieved from ED visit registry book and electronic medical record “Bru-HIMS” with keyword diagnosis of “cardiac arrest”. Data were analyzed and tabulated using Excel software. Result: 313 cardiac arrests were recorded in the emergency department in year 2019-2020. 92% cases were categorized as OHCA, and the remaining 8% as IHCA. Majority of the cases were male with age between 50-60 years old. In OHCA subgroup, only 12.4% received bystander CPR, and 0.4% received Automatic External Defibrillator (AED) before emergency medical personnel arrived. Initial shockable rhythm in IHCA group accounted for 12% compare to 4.9% in OHCA group. Outcome of ED resuscitation, 32% of IHCA group achieved return of spontaneous circulation (ROSC) with a survival to discharge rate was 16%. For OHCA group, 12.35% achieved ROSC, but unfortunately, none of them survive till discharge. Conclusion: Standardized registry for cardiac arrest in the emergency department is required to provide valid baseline data to measure the quality and outcome of cardiac arrest. Zero survival rate for out hospital cardiac arrest is very concerning, and it might represent the significant breach in cardiac arrest chains of survival. Systematic prospective data collection is needed to identify contributing factors and to improve resuscitation outcome.

Keywords: cardiac arrest, OHCA, IHCA, resuscitation, emergency department

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Authors: Shan-Yu Hsu, Hsin-Shu Huang

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The main purpose of this teaching research is to design an interdisciplinary team-assisted teaching method for trainees and interns and review the effectiveness of this teaching method on trainees' understanding of peritoneal dialysis. The teaching research object is the fifth and sixth-grade trainees in a medical center's medical school. The teaching methods include media teaching, demonstration of technical operation, face-to-face communication with patients, special case discussions, and field visits to the peritoneal dialysis room. Evaluate learning effectiveness before, after, and verbally. Statistical analysis was performed using the SPSS paired-sample t-test to analyze whether there is a difference in peritoneal dialysis professional cognition before and after teaching intervention. Descriptive statistics show that the average score of the previous test is 74.44, the standard deviation is 9.34, the average score of the post-test is 95.56, and the standard deviation is 5.06. The results of the t-test of the paired samples are shown as p-value = 0.006, showing the peritoneal dialysis professional cognitive test. Significant differences were observed before and after. The interdisciplinary team-assisted teaching method helps trainees and interns to improve their professional awareness of peritoneal dialysis. At the same time, trainee physicians have positive feedback on the inter-professional team-assisted teaching method. This teaching research finds that the clinical ability development education of trainees and interns can provide cross-professional team-assisted teaching methods to assist clinical teaching guidance.

Keywords: monitor quality, patient safety, health promotion objective, cross-professional team-assisted teaching methods

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Authors: Akram Sadat Jafari Roodbandi, Alireza Choobineh, Nazanin Hosseini, Vafa Feyzi

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Introduction: Physical fitness and optimum functional movement are essential for efficiently performing job tasks without fatigue and injury. Functional Movement Screening (FMS) tests are used in screening of athletes and military forces. Nurses and emergency medical staff are obliged to perform many physical activities such as transporting patients, CPR operations, etc. due to the nature of their jobs. This study aimed to assess relationship between FMS test score and the prevalence of musculoskeletal disorders (MSDs) in emergency nurses and emergency medical services (EMS) staff. Methods: 134 male and female emergency nurses and EMS technicians participated in this cross-sectional, descriptive-analytical study. After video tutorial and practical training of how to do FMS test, the participants carried out the test while they were wearing comfortable clothes. The final score of the FMS test ranges from 0 to 21. The score of 14 is considered weak in the functional movement base on FMS test protocol. In addition to the demographic data questionnaire, the Nordic musculoskeletal questionnaire was also completed for each participant. SPSS software was used for statistical analysis with a significance level of 0.05. Results: Totally, 49.3% (n=66) of the subjects were female. The mean age and work experience of the subjects were 35.3 ± 8.7 and 11.4 ± 7.7, respectively. The highest prevalence of MSDs was observed at the knee and lower back with 32.8% (n=44) and 23.1% (n=31), respectively. 26 (19.4%) health worker had FMS test score of 14 and less. The results of the Spearman correlation test showed that the FMS test score was significantly associated with MSDs (r=-0.419, p < 0.0001). It meant that MSDs increased with the decrease of the FMS test score. Age, sex, and MSDs were the remaining significant factors in linear regression logistic model with dependent variable of FMS test score. Conclusion: FMS test seems to be a usable screening tool in pre-employment and periodic medical tests for occupations that require physical fitness and optimum functional movements.

Keywords: functional movement, musculoskeletal disorders, health care worker, screening test

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Authors: Yang Liu

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The work team has been being adopted by the CCP for special missions in a limited time. Since the 18th National Congress of CCP, the unprecedented practice of the work team has had impacts beyond the original goal of poverty alleviation, their functions in village governance have still not been well studied. As the state agents that come from the outside of the village community, this article argues that the work team is a group that represents the coexistence of political, economic, and cultural capital, which contributes to effectively empower the state, and the village cadres and the peasants. For the state, more accurate bottom-up information could be collected by the work team, and policies could be made scientifically and implemented without distortion. For the village cadres, they can learn leadership skills and share more resources owned or mobilized by the work team. For the peasants, they have more access to participate the public affairs of their village and express their claims. The multiple empowerments have greatly improved the relationship among the state, the peasants, and the village cadres since a series of reforms from 1980s to 2000s that alienated the relationship among them.

Keywords: state, village cadre, empowerment, work team, peasants

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Authors: R. J. Kuo, W. C. Cheng, W. C. Lien, T. J. Yang

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Taiwan is a hyper endemic area for the Hepatitis B virus (HBV). The estimated total number of HBsAg carriers in the general population who are more than 20 years old is more than 3 million. Therefore, a case record review is conducted from January 2003 to June 2007 for all patients with a diagnosis of acute hepatitis who were admitted to the Emergency Department (ED) of a well-known teaching hospital. The cost for the use of medical resources is defined as the total medical fee. In this study, principal component analysis (PCA) is firstly employed to reduce the number of dimensions. Support vector regression (SVR) and artificial neural network (ANN) are then used to develop the forecasting model. A total of 117 patients meet the inclusion criteria. 61% patients involved in this study are hepatitis B related. The computational result shows that the proposed PCA-SVR model has superior performance than other compared algorithms. In conclusion, the Child-Pugh score and echogram can both be used to predict the cost of medical resources for patients with acute hepatitis in the ED.

Keywords: acute hepatitis, medical resource cost, artificial neural network, support vector regression

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Authors: G. Scremin, I. Y. Suh, S. Doukas

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Spectators follow their favorite sports teams for different reasons. While some attend a sporting event simply for its entertainment value, others do so because of the personal sense of achievement and accomplishment their connection with a sports team creates. Moreover, the level of identity spectators feel toward their favorite sports team falls in a broad continuum. Some are mere spectators. For those spectators, their association to a sports team has little impact on their self-image. Others are die-hard fans who are proud of their association with their team and whose connection with that team is an important reflection of who they are. Several motives for sports consumption can be used to explain the level of spectator support in a variety of sports. Those motives can also be used to explain the variance in the identification, attachment, and loyalty spectators feel toward their favorite sports team. Motives for sports consumption can be used to discriminate the degree of identification spectators have with their favorite sports team. In this study, motives for sports consumption was used to discriminate the level of identity spectators feel toward their sports team. It was hypothesized that spectators with a strong level of team identity would report higher rates of interest in player, interest in sports, and interest in team than spectators with a low level of team identity. And spectators with a low level of team identity would report higher rates for entertainment value, bonding with friends or family, and wholesome environment. Football spectators in the United States and England were surveyed about their motives for football consumption and their level of identification with their favorite football team. To assess if the motives of sports fans differed by level of team identity and allegiance to an American or English football team, a Multivariate Analysis of Variance (MANOVA) under the General Linear Model (GLM) procedure found in SPSS was performed. The independent variables were level of team identity and allegiance to an American or English football team, and the dependent variables were the sport fan motives. A tripartite split (low, moderate, high) was used on a composite measure for team identity. Preliminary results show that effect of team identity is statistically significant (p < .001) for at least nine of the 17 motives for sports consumption assessed in this investigation. These results indicate that the motives of spectators with a strong level of team identity differ significantly from spectators with a low level of team identity. Those differences can be used to discriminate the degree of identification spectators have with their favorite sports team. Sports marketers can use these methods and results to develop identity profiles of spectators and create marketing strategies specifically designed to attract those spectators based on their unique motives for consumption and their level of team identification.

Keywords: fan identification, market segmentation of sports fans, motives for sports consumption, team identity

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Authors: Yu-Chen Wei

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The relationship between organizational human capital and organizational effectiveness have been a common topic of interest to organization researchers. Much of this research has concluded that higher human capital can predict greater organizational outcomes. Whereas human capital research has traditionally focused on organizations, the current study turns to the team level human capital. In addition, there are no known empirical studies assessing the effect of human capital divergence on team performance. Team human capital refers to the sum of knowledge, ability, and experience embedded in team members. Team human capital divergence is defined as the variation of human capital within a team. This study is among the first to assess the role of human capital divergence as a moderator of the effect of team human capital on team performance. From the traditional perspective, team human capital represents the collective ability to solve problems and reducing operational risk of all team members. Hence, the higher team human capital, the higher the team performance. This study further employs social learning theory to explain the relationship between team human capital and team performance. According to this theory, the individuals will look for progress by way of learning from teammates in their teams. They expect to have upper human capital, in turn, to achieve high productivity, obtain great rewards and career success eventually. Therefore, the individual can have more chances to improve his or her capability by learning from peers of the team if the team members have higher average human capital. As a consequence, all team members can develop a quick and effective learning path in their work environment, and in turn enhance their knowledge, skill, and experience, leads to higher team performance. This is the first argument of this study. Furthermore, the current study argues that human capital divergence is negative to a team development. For the individuals with lower human capital in the team, they always feel the pressure from their outstanding colleagues. Under the pressure, they cannot give full play to their own jobs and lose more and more confidence. For the smart guys in the team, they are reluctant to be colleagues with the teammates who are not as intelligent as them. Besides, they may have lower motivation to move forward because they are prominent enough compared with their teammates. Therefore, human capital divergence will moderate the relationship between team human capital and team performance. These two arguments were tested in 510 team-seasons drawn from major league baseball (1998–2014). Results demonstrate that there is a positive relationship between team human capital and team performance which is consistent with previous research. In addition, the variation of human capital within a team weakens the above relationships. That is to say, an individual working with teammates who are comparable to them can produce better performance than working with people who are either too smart or too stupid to them.

Keywords: human capital divergence, team human capital, team performance, team level research

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Authors: Yoonhee Cho, Gye-Hoon Hong

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This study focuses on the roles of distributive and procedural justice on job engagement. Additionally, the study focuses on whether situational factors such as team efficacy and team leaders’ coaching moderate the relationship between distributive and procedural justice and job engagement. Ordinary linear regression was used to analyze data from seven South Korean Companies (total N=346). Results confirmed the hypothesized model indicating that both distributive and procedural justices were positively related to job engagement of employees. Team efficacy and team leaders’ coaching moderated the relationship between distributive justice and job engagement whereas it brought non-significant result found for procedural justice. The facts that two types of justice and the interactive effects of two situational variables were different implied that different managerial strategies should be used when job engagement was to be enhanced.

Keywords: coaching, distributive justice, job engagement, procedural justice, team efficacy

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Authors: Etta Conteh, Tracy Macintosh

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Introduction: Restraints are often used in the Emergency Department when it is necessary for a patient to be restrained in order to decrease their agitation and better treat them. Chemical and physical restraints may be used on these patients at the discretion of the medical provider. Racism and injustice are rampant within our country, and medicine and healthcare are not spared. While racism and racial bias in medicine and healthcare have been studied, information on the differences in the use of restraints by race are scarce. Objective: The objective of this study is to determine if African Americans and Hispanic-American patients are restrained at higher rates compared to their White counterparts. Methods: This study will be carried out through a retrospective analysis utilizing the Hospital Corporation of America (HCA) national Emergency Department (ED) and inpatient database with patient visits from 2016-2019. All patient visits, with patients aged 18 years or older, will be reviewed, looking specifically for the race and the use and type of restraints. Other factors, such a pre-existing psychiatric condition, will be used for sub-analysis. Rationale: The outcome of this project will demonstrate the absence or presence of a racial disparity in the use of restraints in the Emergency Department. These results can be used as a foundation for improving racial equity in healthcare treatment.

Keywords: emergency medicine, public health, racism, restraint use

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Authors: Ashley L. Freeman, Jessica D. Watkins

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TeleEmergency Medicine (TeleEM) is an innovative approach leveraging virtual technology to deliver specialized emergency medical care across diverse healthcare settings, including internal acute care and critical access hospitals, remote patient monitoring, and nurse triage escalation, in addition to external emergency departments, skilled nursing facilities, and community health centers. TeleEM represents a significant advancement in the delivery of emergency medical care, providing healthcare professionals the capability to deliver expertise that closely mirrors in-person emergency medicine, exceeding geographical boundaries. Through qualitative research, the extension of timely, high-quality care has proven to address the critical needs of patients in remote and underserved areas. TeleEM’s service design allows for the expansion of existing services and the establishment of new ones in diverse geographic locations. This ensures that healthcare institutions can readily scale and adapt services to evolving community requirements by leveraging on-demand (non-scheduled) telemedicine visits through the deployment of multiple video solutions. In terms of financial management, TeleEM currently employs billing suppression and subscription models to enhance accessibility for a wide range of healthcare facilities. Plans are in motion to transition to a billing system routing charges through a third-party vendor, further enhancing financial management flexibility. To address state licensure concerns, a patient location verification process has been integrated through legal counsel and compliance authorities' guidance. The TeleEM workflow is designed to terminate if the patient is not physically located within licensed regions at the time of the virtual connection, alleviating legal uncertainties. A distinctive and pivotal feature of TeleEM is the introduction of the TeleEmergency Medicine Care Team Assistant (TeleCTA) role. TeleCTAs collaborate closely with TeleEM Physicians, leading to enhanced service activation, streamlined coordination, and workflow and data efficiencies. In the last year, more than 800 TeleEM sessions have been conducted, of which 680 were initiated by internal acute care and critical access hospitals, as evidenced by quantitative research. Without this service, many of these cases would have necessitated patient transfers. Barriers to success were examined through thorough medical record review and data analysis, which identified inaccuracies in documentation leading to activation delays, limitations in billing capabilities, and data distortion, as well as the intricacies of managing varying workflows and device setups. TeleEM represents a transformative advancement in emergency medical care that nurtures collaboration and innovation. Not only has advanced the delivery of emergency medicine care virtual technology through focus group participation with key stakeholders, rigorous attention to legal and financial considerations, and the implementation of robust documentation tools and the TeleCTA role, but it’s also set the stage for overcoming geographic limitations. TeleEM assumes a notable position in the field of telemedicine by enhancing patient outcomes and expanding access to emergency medical care while mitigating licensure risks and ensuring compliant billing.

Keywords: emergency medicine, TeleEM, rural healthcare, telemedicine

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Authors: Baluku Nathan

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Infection prevention and control (IPC) is a practical, evidence-based approach that prevents patients and emergency health workers from being harmed by avoidable infections as a result of antimicrobial resistance; all hospital infection control programs put together various practices which, when used appropriately, restrict the spread of infection. A breach in these control practices facilitates the transmission of infections from patients to health workers, other patients and attendants. It is, therefore, important for all EMTs and patients to adhere to them strictly. It is also imperative for administrators to ensure the implementation of the infection control program for their facilities. Purpose: The purpose of this study was to investigate the influencing factors of prevention practices against Infection exposure among emergency medical technicians (EMTs) in the emergency department at Mbarara hospital. Methodology: This was a descriptive cross-sectional study that employed a self-reported questionnaire that was filled out by 32 EMTs in the emergency department from 12th February to 3rd march 2022. The questionnaire consisted of items concerning the defensive environment and other Factors influencing Infection prevention and control practices in the accident and emergency department of Mbarara hospital. Results: From the findings, majority16(50%) always used protective gear when doing clinical work,14 (43.8%) didn’t use protective gear, citing they were only assisting those performing resuscitations, gumboots were the least used protective gear with only3(9.4%) usage. Regarding disposal techniques of specific products like blood and sharps, results showed 10 (31.3%) said blood is disposed of in red buckets, 5(15.6%) in yellow buckets and only5(15.6%) in black buckets and 12(37.5%) didn’t respond. However, 28(87.5%) said sharps were disposed of in a sharps container. The majority, 17(53.1%), were not aware of the infection control guidelines even though they were pinned on walls of the emergency rooms,15(46.9%) said they had never had quality assurance monitoring events,14(43.8%) said monitoring was continuous while15(46.9 %) said it was discrete. Conclusions: The infection control practices at the emergency department were inadequate in view of less than 100% of the EMTs observing the five principles of infection prevention, such as the use of personal protective equipment and proper waste disposal in appropriate color-coded bins. Dysfunctional infection prevention and control committees accompanied by inadequate supervision to ensure infection control remained a big challenge.

Keywords: infection prevention, influencing factors, emergency medical technician (EMT), emergency unit

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Authors: S. MacDougall-Davis, S. Wysling, R. Willmore

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Background: The application of good non-technical skills, also known as crew resource management (CRM), is central to the delivery of safe, effective healthcare. The authors have been running remote trauma courses for over 10 years, primarily focussing on developing participants’ CRM in time-critical, high-stress clinical situations. The course has undergone an iterative process over the past 10 years. We employ a number of experiential learning techniques for improving CRM, including small group workshops, military command tasks, high fidelity simulations with reflective debriefs, and a ‘flipped classroom’, where participants are asked to create their own simulations and assess and debrief their colleagues’ CRM. We created a randomised simulation study to assess the impact of our course on UK medical students’ CRM, both at an individual and a teams level. Methods: Sixteen students took part. Four clinical scenarios were devised, designed to be of similar urgency and complexity. Professional moulage effects and experienced clinical actors were used to increase fidelity and to further simulate high-stress environments. Participants were block randomised into teams of 4; each team was randomly assigned to one pre-course simulation. They then underwent our 5 day remote trauma CRM course. Post-course, students were re-randomised into four new teams; each was randomly assigned to a post-course simulation. All simulations were videoed. The footage was reviewed by two independent CRM-trained assessors, who were blinded to the before/after the status of the simulations. Assessors used the internationally validated team emergency assessment measure (TEAM) to evaluate key areas of team performance, as well as a global outcome rating. Prior to the study, assessors had scored two unrelated scenarios using the same assessment tool, demonstrating 89% concordance. Participants also completed pre- and post-course questionnaires. Likert scales were used to rate individuals’ perceived NTS ability and their confidence to work in a team in time-critical, high-stress situations. Results: Following participation in the course, a significant improvement in CRM was observed in all areas of team performance. Furthermore, the global outcome rating for team performance was markedly improved (40-70%; mean 55%), thus demonstrating an impact at Level 4 of Kirkpatrick’s hierarchy. At an individual level, participants’ self-perceived CRM improved markedly after the course (35-70% absolute improvement; mean 55%), as did their confidence to work in a team in high-stress situations. Conclusion: Our study demonstrates that with a short, cost-effective course, using easily reproducible teaching sessions, it is possible to significantly improve participants’ CRM skills, both at an individual and, perhaps more importantly, at a teams level. The successful functioning of multi-disciplinary teams is vital in a healthcare setting, particularly in high-stress, time-critical situations. Good CRM is of paramount importance in these scenarios. The authors believe that these concepts should be introduced from the earliest stages of medical education, thus promoting a culture of effective CRM and embedding an early appreciation of the importance of these skills in enabling safe and effective healthcare.

Keywords: crew resource management, non-technical skills, training, simulation

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Authors: Zarabizan Zakaria, Hayati Zainal

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The construction industry is one of the most important sectors that contribute to the nation’s economy and catalyze towards the growth of other industries. However, some construction projects have not been completed on its stipulated time and duration, scope and budget due to several factors. This problem arises due to the weaknesses of human factors, especially from ineffective leadership quality practiced by project managers and contractors in managing project teams. Therefore, a construction project should impose the element of Project Team. The project team is formed in the implementation of the project which includes the project brief, project scope, customer requirements and provided designs. Many organizations in the construction sector use teams to meet today's global competition and customer expectations, however, team effectiveness evaluation is required. In insuring the construction team is successful and effectiveness, the construction department must encourage, measure, set up, and evaluate or review the effectiveness of project team that was formed. In order to produce a better outcome for a high-end project, an effective and efficient project team is required which also help in increasing overall productivity. The purpose of this study is to determine the role of team effectiveness in the construction project team based on the overall construction project performance. It examines several different factors which related to team effectiveness. It also examines the relationship between team effectiveness factor and project performance aspect. Team Effect Review and Project Performance Review are developed to be used for data collection. Data collected were analyzed using several statistical tests. Results obtained from data analysis are validated using semi-structured interviews. Besides that, a comprehensive survey were developed to assess the way construction project teams in order to maintain its effectiveness throughout the project phase. In order to determine a project successful it has been found that Project Team Leadership is the most important factor. In addition, the definition of team effectiveness in the construction project team is developed based on the perspective of project clients and project team members. The results of this study are expected to provide an idea on the factors that are needed to be focused on improving the team's effectiveness towards project performance aspects. At the same time, the definition of team effectiveness from team members and owner views has been developed in order to provide a better understanding of the word team's effectiveness in construction projects.

Keywords: project team, leadership, construction project, project successful

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Authors: P. B. Thumar

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Today’s athletes face acute and unique challenges as the competition standards are higher and tougher. There are certain moments during a competition that appear to carry great psychological significance when the momentum starts to shift in one direction or another. These situations require athletes to remain completely focused and calm in facing the difficult circumstances. The purpose of the study was to compare the Mental Toughness level among the players of the team and individual sports. Purposive sampling was done in which subjects for the present study were the male students of The M. S. University of Baroda, Vadodara studying various courses in the academic year 2014-15. Thus, a total number of 120 boys were identified and included in the study from which 60 boys had participated in individual sports and 60 in team sports. ‘The Mental Toughness Questionnaire’ prepared by Dr. Alan Goldberg was used to determine mental toughness level of the players of the team and individual sports. The scores arrived from 60 individual players and 60 team players were compared by applying the t-test. Significant difference was found on overall Mental Toughness and in subcomponents there was significant difference in ability to handle pressure, concentration and confidence whereas there was no significant difference in reboundability and motivation among team and individual sports players. This could be largely due the nature of both sports. Team players of MSU found to be having more overall mental toughness, and team players are able to handle pressure more than individual players, can concentrate more and are also more confident while playing in the team. Team preparation and training prior to competition could have increased the level of ability to handle pressure, concentration and confidence of team players.

Keywords: mental toughness, reboundability, confidence, team sports, individual sports

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Authors: Siqi Fang, Jingxi Hou

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Positive psychology and coaching psychology share a number of fundamental assumptions and common themes. Blending positive psychology, mindfulness, and coaching psychology, our work in team coaching with leaders enhances both leadership and team effectiveness. Although individual coaching has proven to be effective, this article advocates the benefits of leadership coaching in team settings, because durable changes in leadership behaviors are more likely to occur. Does leadership team coaching really work? Does it help improve senior leadership team effectiveness and productivity? This action research study answers these questions by tracking the progress of three typical senior leadership teams consisting of 31 executives participating in a six-month team coaching program. Assessments (pre- and post), workshops, and feedback based on ego development theories and mindfulness were applied to upgrade the senior leadership teams’ transformational stages and reframe their organizational leadership cultures. Results suggest that the team effectiveness of the three leadership teams increased up to 43 percent according to post-survey feedback from superior, direct report, and peers. Discussion is offered to show that senior leadership team coaching help teams to achieve a consensus on common purposes, establish a foundation of trust, improve collective skills, and promote efficient operation. All factors translate into better team performance. Implications of the results for future executive development programs are discussed and specific recommendations are provided.

Keywords: action research, ego development, mindfulness, senior leadership team coaching, team effectiveness, transformational stages

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