Search results for: care skills
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6517

Search results for: care skills

5197 Enhancing Students’ Language Competencies through Cooperative Learning

Authors: Raziel Felix-Aguelo

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Language competencies refer to the knowledge and abilities to use English in four inter-related skills: Speaking, listening, reading, and writing. Cooperative learning is a type of instruction where learners are grouped together to work on an assignment, project, or task. To become competent in second language, one needs to actively use English in each of four modalities. Learning English is challenging to second language learners. Sometimes, some students feel demotivated and scared to use English during class discussions and recitations. This paper explores the students’ attitude and perception towards cooperative learning in enhancing their language competencies. The primary method for this research is case study. Thirty-two grade 9 students within a single selected class are used as sample. The instruments used in data collection were questionnaire and semi-structured interviews. The finding shows that collaborative learning activities enhance the four skills of the students. The participants consider this approach motivational as they engage and interact with others. This indicates that students develop their language competencies as they rely to one another in doing meaningful language activities.

Keywords: language competencies, collaborative learning, motivation, language activities

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5196 The Effect of Vertical Integration on Operational Performance: Evaluating Physician Employment in Hospitals

Authors: Gary Young, David Zepeda, Gilbert Nyaga

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This study investigated whether vertical integration of hospitals and physicians is associated with better care for patients with cardiac conditions. A dramatic change in the U.S. hospital industry is the integration of hospital and physicians through hospital acquisition of physician practices. Yet, there is little evidence regarding whether this form of vertical integration leads to better operational performance of hospitals. The study was conducted as an observational investigation based on a pooled, cross-sectional database. The study sample comprised over hospitals in the State of California. The time frame for the study was 2010 to 2012. The key performance measure was hospitals’ degree of compliance with performance criteria set out by the federal government for managing patients with cardiac conditions. These criteria relate to the types of clinical tests and medications that hospitals should follow for cardiac patients but hospital compliance requires the cooperation of a hospital’s physicians. Data for this measure was obtained from a federal website that presents performance scores for U.S. hospitals. The key independent variable was the percentage of cardiologists that a hospital employs (versus cardiologists who are affiliated but not employed by the hospital). Data for this measure was obtained from the State of California which requires hospitals to report financial and operation data each year including numbers of employed physicians. Other characteristics of hospitals (e.g., information technology for cardiac care, volume of cardiac patients) were also evaluated as possible complements or substitutes for physician employment by hospitals. Additional sources of data included the American Hospital Association and the U.S. Census. Empirical models were estimated with generalized estimating equations (GEE). Findings suggest that physician employment is positively associated with better hospital performance for cardiac care. However, findings also suggest that information technology is a substitute for physician employment.

Keywords: physician employment, hospitals, verical integration, cardiac care

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5195 Violence Against Nurses – Healthcare Workers with Great Sacrifice - During The COVID-19 Pandemic: A Discussion Article

Authors: Sarieh Poortaghi, Zakiyeh Jafaryparvar, Marzieh Hasanpour, Reza Negarandeh

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Aim: This article aims to discuss how violence against health care workers especially nurses affects health care systems and the quality of care of the patients. In this paper causes of violence and strategies to reduce it have been discussed. Methods: Discourse of the literature considering the violence against nurses during the COVID-19 pandemic and its reasons and outcomes. Results: The COVID-19 pandemic has led to a significant increase in violence against healthcare providers. The attacker against nurses may be among patients, companions, visitors, colleagues such as doctors and other nurses, supervisors, and managers. Many individuals who experience violence in healthcare environments refrain from reporting it. The causes of violence against nurses include spending long periods with patients, perceiving nursing as a low-status profession, gender of nurses, direct and frequent contact with patients and their companions, inadequate facilities and high workload, weak healthcare delivery systems in public hospitals and inequality in health, nature of the department and shift type of personnel, work shifts and staff shortages, forcing nurses to work in non-standard conditions during the COVID-19 pandemic, prohibition of patient visits during the pandemic, patient death and nurses' sense of incompetence, and expressing stress through aggression. Workplace violence leads to a decrease in job satisfaction and an increase in continuous psychological stress, which has a negative impact on the personal and professional lives of nurses. Potential strategies for reducing workplace violence include protecting healthcare workers through laws, improving communication with patients and their families, critically analyzing information in social media, facilitating patient access through remote medical strategies, and improving access to primary healthcare services.

Keywords: nurses, health care workers, Covid-19, nursing

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5194 The Happy Workplace Program Promoting Health Literate Workplace in Thai Garment Industry

Authors: Kwanmuang Kaeodumkoeng, Jumnian Junhasobhaga

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This action research on the happy workplace program (HWP) promoting health literate workplace (HLW) in Thai Garment Industry Companies aimed to categorize activities promoting HLW and results of HWP in the Thai garment industry. Thirteen program reports purposely selected from sampled companies. Data were analyzed using descriptive statistics, paired t-test and content analysis. The results showed that the end of the program, the significant higher levels of work skills, life skills, and factors promoting happy workplace were found compared to before the program in all 13 companies. The activities and results of the HWP could be categorized in five steps of implementing an HWP, compared with the attributes of HLW were composed of 1) Leadership promotion; 2) Preparing workforce; 3) Planning, evaluating, and improving; 4) Communicating effectively; and 5) Designing easy to use materials and ensuring easy access.

Keywords: happy workplace program, health literate workplace, garment industry, indicators

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5193 Hypotonia - A Concerning Issue in Neonatal Care

Authors: Eda Jazexhiu-Postoli, Gladiola Hoxha, Ada Simeoni, Sonila Biba

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Background Neonatal hypotonia represents a commonly encountered issue in the Neonatal Intensive Care Unit and newborn nursery. The differential diagnosis is broad, encompassing chromosome abnormalities, primary muscular dystrophies, neuropathies and inborn errors of metabolism. Aim of study Our study describes some of the main clinical features of hypotonia in newborns and presents clinical cases of neonatal hypotonia we treated in our Neonatal unit in the last 3 years. Case reports Four neonates born in our hospital presented with hypotonia after birth, one preterm newborn 35-36 weeks of gestational age and three other term newborns (38-39 weeks of gestational age). Prenatal data revealed a decrease in fetal movements in both cases. Intrapartum meconium-stained amniotic fluid was found in 75% of our hypotonic newborns. Clinical features included inability to establish effective respiratory movements and need for resuscitation in the delivery room, respiratory distress syndrome, feeding difficulties and need for oro-gastric tube feeding, dysmorphic features, hoarse voice and moderate to severe muscular hypotonia. The genetic workup revealed the diagnosis of Autosomal Recessive Congenital Myasthenic Syndrome 1-B, Sotos Syndrome, Spinal Muscular Atrophy Type 1 and Transient Hypotonia of the Newborn. Two out of four hypotonic neonates were transferred to the Pediatric Intensive Care Unit and died at the age of three to five months old. Conclusion Hypotonia is a concerning finding in neonatal care and it is suggested by decreased intrauterine fetal movements, failure to establish first breaths, respiratory distress and feeding difficulties in the neonate. Prognosis is determined by its etiology and time of diagnosis and intervention.

Keywords: hypotonic neonate, respiratory distress, feeding difficulties, fetal movements

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5192 Estimation of Biomedical Waste Generated in a Tertiary Care Hospital in New Delhi

Authors: Priyanka Sharma, Manoj Jais, Poonam Gupta, Suraiya K. Ansari, Ravinder Kaur

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Introduction: As much as the Health Care is necessary for the population, so is the management of the Biomedical waste produced. Biomedical waste is a wide terminology used for the waste material produced during the diagnosis, treatment or immunization of human beings and animals, in research or in the production or testing of biological products. Biomedical waste management is a chain of processes from the point of generation of Biomedical waste to its final disposal in the correct and proper way, assigned for that particular type of waste. Any deviation from the said processes leads to improper disposal of Biomedical waste which itself is a major health hazard. Proper segregation of Biomedical waste is the key for Biomedical Waste management. Improper disposal of BMW can cause sharp injuries which may lead to HIV, Hepatitis-B virus, Hepatitis-C virus infections. Therefore, proper disposal of BMW is of upmost importance. Health care establishments segregate the Biomedical waste and dispose it as per the Biomedical waste management rules in India. Objectives: This study was done to observe the current trends of Biomedical waste generated in a tertiary care Hospital in Delhi. Methodology: Biomedical waste management rounds were conducted in the hospital wards. Relevant details were collected and analysed and sites with maximum Biomedical waste generation were identified. All the data was cross checked with the commons collection site. Results: The total amount of waste generated in the hospital during January 2014 till December 2014 was 6,39,547 kg, of which 70.5% was General (non-hazardous) waste and the rest 29.5% was BMW which consisted highly infectious waste (12.2%), disposable plastic waste (16.3%) and sharps (1%). The maximum quantity of Biomedical waste producing sites were Obstetrics and Gynaecology wards with a total Biomedical waste production of 45.8%, followed by Paediatrics, Surgery and Medicine wards with 21.2 %, 4.6% and 4.3% respectively. The maximum average Biomedical waste generated was by Obstetrics and Gynaecology ward with 0.7 kg/bed/day, followed by Paediatrics, Surgery and Medicine wards with 0.29, 0.28 and 0.18 kg/bed/day respectively. Conclusions: Hospitals should pay attention to the sites which produce a large amount of BMW to avoid improper segregation of Biomedical waste. Also, induction and refresher training Program of Biomedical waste management should be conducted to avoid improper management of Biomedical waste. Healthcare workers should be made aware of risks of poor Biomedical waste management.

Keywords: biomedical waste, biomedical waste management, hospital-tertiary care, New Delhi

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5191 The Effectiveness of Warm-Water Footbath on Fatigue in Cancer Patient Undergoing Chemotherapy

Authors: Yu-Wen Lin, Li-Ni Liu

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Introduction: Fatigue is the most common symptoms experienced by cancer patients undergoing chemotherapy. Patients receiving anticancer therapies develop a higher proportion of fatigue compared with patients who do not receive anticancer therapies. Fatigue has significant impacts on quality of life, daily activities, mood status, and social behaviors. A warm-water footbath (WWF) at 41℃ promotes circulation and removes metabolites resulting in improving sleep and relieving fatigue. The aim of this study is to determine the effectiveness of WWF for relieving fatigue with cancer patients undergoing chemotherapy. Materials and Methods: This is a single-center, prospective, quasi-experimental design study in the oncology ward in Taiwan. Participants in this study were assigned to WWF group as experimental group and standard care group as a control group by purposive sampling. In the WWF group, the participants were asked to soak their feet in 42-43℃ water 15 minutes for consecutive 6 days at one day before chemotherapy. Each participant was evaluated for fatigue level by the Taiwanese version of the Brief Fatigue Inventory (BFI-T). BFI-T was completed for consecutive 8 days of the study. The primary outcome was compared the BFI-T score of WWF group to the standard care group. Results: There were 60 participants enrolled in this study. Thirty participants were assigned to WWF group and 30 participants were assigned to standard care group. Both groups have comparable characteristic. The BFI-T scores of both groups were increased associated with the days of chemotherapy. The highest BFI-T scores of both groups were on the day 4 of chemotherapy. The BFI-T scores of both groups were decreased since day 5 and significantly decreased in WWF group on day 5 compared to standard care group (4.17 vs. 5.7, P < .05). At the end of the study the fatigue at its worse were significantly decreased in WWF group (2.33 vs. 4.37, P < .001). There was no adverse event reported in this study. Conclusion: WWF is an easy, safe, non-invasive, and relatively inexpensive nursing intervention for improving fatigue of cancer patients undergoing chemotherapy. In summary, this study shows the WWF is a simple complementary care method, and it is effective for improving and relieving fatigue in a short time. Through improving fatigue is a way to enhance the quality of life which is important for cancer patients undergoing chemotherapy. Larger prospective randomized controlled trial and long-term effectiveness and outcomes of WWF should be performed to confirm this study.

Keywords: chemotherapy, warm-water footbath, fatigue, Taiwanese version of the brief fatigue inventory

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5190 Role of Physiotherapist: How Their Job and Working Area Could Be Known

Authors: Juan Pablo Hervas-Perez, Jesus Guodemar-Perez, Montserrat Ruiz-Lopez, Elena Sonsoles Rodriguez-Lopez, Noemi Mayoral-Gonzalo, Eduardo Cimadevilla Fernandez-Pola, Mario Caballero-Corella

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Physiotherapy is a healthcare discipline that covers many fields of action within the recovery and prevention of health. Some are well known, but others, such as working with newborns and premature children are not so. Physical therapist functions are well defined, but the impression of the population is that there are other professionals who can develop them, and a large part are unknown. Objective: To evaluate the level of knowledge of the sample on the role of the physiotherapist in general, and more specifically in the neonatal intensive care (NICU) units, and estimate your level of notions on the development centered care (DCC). Method: A descriptive, transversal, observational and prospective study developed on a 125 participants' sample. Results: From the sample studied, 87.2% had already had contact with physiotherapy previously. An 80.9% believed that the physiotherapist intervention was decisive for the cure, and 84.0% would recommend physiotherapy treatment to others. Of the total surveyed, 98.0% felt that the physiotherapist is who should run the physiotherapeutic treatments, but shares with other professions 71.0% of votes. The field's best-known work is rehabilitation (94.0%); Neonatology is on the 4th place (66.0% of votes). Conclusions: Many areas of work of physical therapy are unknown to a big part of the population, including the own health workers. Less than half of the sample meets the DCC, and only 58% of the interviewed physiotherapists know them.

Keywords: functions of physiotherapist, neonatal intensive care, physiotherapy, prematurity

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5189 Experiential Language Learning as a Tool for Effective Global Leadership

Authors: Christiane Dumont

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This paper proposes to revisit foreign-language learning as a tool to increase motivation through advocacy and develop effective natural communication skills, which are critical leadership qualities. To this end, collaborative initiatives undertaken by advanced university students of French with local and international community partners will be reviewed. Close attention will be paid to the acquisition of intercultural skills, the reflective process, as well as the challenges and outcomes. Two international development projects conducted in Haiti will be highlighted, i.e., collaboration with a network of providers in the Haitian cultural heritage preservation and tourism sector (2014-15) and development of investigation and teacher training tools for a primary/secondary school in the Port-au-Prince area (current). The choice of community-service learning as a framework to teach French-as-a-second-language stemmed from the need to raise awareness against stereotypes and prejudice, which hinder the development of effective intercultural skills. This type of experiential education also proved very effective in identifying and preventing miscommunication caused by the lack of face-to-face interaction in our increasingly technology-mediated world. Learners experienced first-hand, the challenges and advantages of face-to-face communication, which, in turn, enhanced their motivation for developing effective intercultural skills. Vygotsky's and Kolb's theories, current research on service learning (Dwight, Eyler), action/project-based pedagogy (Beckett), and reflective learning (TSC Farrell), will provide useful background to analyze the benefits and challenges of community-service learning. The ultimate goal of this paper is to find out what makes experiential learning truly unique and transformative for both the learners and the community they wish to serve. It will demonstrate how enhanced motivation, community engagement, and clear, concise, and respectful communication impact and empower learners. The underlying hope is to help students in high-profile, and leading-edge industries become effective global leaders.

Keywords: experiential learning, intercultural communication, reflective learning, effective leadership, learner motivation

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5188 Perceived and Performed E-Health Literacy: Survey and Simulated Performance Test

Authors: Efrat Neter, Esther Brainin, Orna Baron-Epel

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Background: Connecting end-users to newly developed ICT technologies and channeling patients to new products requires an assessment of compatibility. End user’s assessment is conveyed in the concept of eHealth literacy. The study examined the association between perceived and performed eHealth literacy (EHL) in a heterogeneous age sample in Israel. Methods: Participants included 100 Israeli adults (mean age 43,SD 13.9) who were first phone interviewed and then tested on a computer simulation of health-related Internet tasks. Performed, perceived and evaluated EHL were assessed. Levels of successful completion of tasks represented EHL performance and evaluated EHL included observed motivation, confidence, and amount of help provided. Results: The skills of accessing, understanding, appraising, applying, and generating new information had a decreasing successful completion rate with increase in complexity of the task. Generating new information, though highly correlated with all other skills, was least correlated with the other skills. Perceived and performed EHL were correlated (r=.40, P=.001), while facets of performance (i.e, digital literacy and EHL) were highly correlated (r=.89, P<.001). Participants low and high in performed EHL were significantly different: low performers were older, had attained less education, used the Internet for less time and perceived themselves as less healthy. They also encountered more difficulties, required more assistance, were less confident in their conduct and exhibited less motivation than high performers. Conclusions: The association in this age-hetrogenous ample was larger than in previous age-homogenous samples. The moderate association between perceived and performed EHL indicates that the two are associated yet distinct, the latter requiring separate assessment. Features of future rapid performed EHL tools are discussed.

Keywords: eHealth, health literacy, performance, simulation

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5187 Status of Vocational Education and Training in India: Policies and Practices

Authors: Vineeta Sirohi

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The development of critical skills and competencies becomes imperative for young people to cope with the unpredicted challenges of the time and prepare for work and life. Recognizing that education has a critical role in reaching sustainability goals as emphasized by 2030 agenda for sustainability development, educating youth in global competence, meta-cognitive competencies, and skills from the initial stages of formal education are vital. Further, educating for global competence would help in developing work readiness and boost employability. Vocational education and training in India as envisaged in various policy documents remain marginalized in practice as compared to general education. The country is still far away from the national policy goal of tracking 25% of the secondary students at grade eleven and twelve under the vocational stream. In recent years, the importance of skill development has been recognized in the present context of globalization and change in the demographic structure of the Indian population. As a result, it has become a national policy priority and taken up with renewed focus by the government, which has set the target of skilling 500 million people by 2022. This paper provides an overview of the policies, practices, and current status of vocational education and training in India supported by statistics from the National Sample Survey, the official statistics of India. The national policy documents and annual reports of the organizations actively involved in vocational education and training have also been examined to capture relevant data and information. It has also highlighted major initiatives taken by the government to promote skill development. The data indicates that in the age group 15-59 years, only 2.2 percent reported having received formal vocational training, and 8.6 percent have received non-formal vocational training, whereas 88.3 percent did not receive any vocational training. At present, the coverage of vocational education is abysmal as less than 5 percent of the students are covered by the vocational education programme. Besides, launching various schemes to address the mismatch of skills supply and demand, the government through its National Policy on Skill Development and Entrepreneurship 2015 proposes to bring about inclusivity by bridging the gender, social and sectoral divide, ensuring that the skilling needs of socially disadvantaged and marginalized groups are appropriately addressed. It is fundamental that the curriculum is aligned with the demands of the labor market, incorporating more of the entrepreneur skills. Creating nonfarm employment opportunities for educated youth will be a challenge for the country in the near future. Hence, there is a need to formulate specific skill development programs for this sector and also programs for upgrading their skills to enhance their employability. There is a need to promote female participation in work and in non-traditional courses. Moreover, rigorous research and development of a robust information base for skills are required to inform policy decisions on vocational education and training.

Keywords: policy, skill, training, vocational education

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5186 Support Provided by Midwives to Women during Labour in a Public Hospital, Limpopo Province, South Africa: A Participant Observation Study

Authors: Sonto Maputle

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Background: Support during labour increase women's chances of having positive childbirth experiences as well as childbirth outcomes. The purpose of this study was to determine the support provided by midwives to women during labour at the public hospital in Limpopo Province. The study was conducted at the Tertiary hospital in Limpopo Province. Methods: A qualitative, participant observation approach was used. Population consisted of all women that were admitted to deliver their babies and the midwives who provided midwifery care in the obstetric unit of one tertiary public hospital in Limpopo Province. Non-probability, purposive and convenience sampling were used to sample 24 women and 12 midwives. Data were collected through participant observations which included unstructured conversations with the use of observational guide, field notes of events and conversations that occurred when women interact with midwives were recorded verbatim and a Visual Analog Scale to complement the observations. Data was analysed qualitatively but were presented in the tables and bar graphs. Results: Five themes emerged as support provided by midwives during labour, namely; communication between women and midwives, informational support, emotional support activities, interpretation of the experienced labour pain and supportive care activities during labour. Conclusion: The communication was occurring when the midwife was rendering midwifery care and very limited for empowering. The information sharing focused on the assistive actions rather than on the activities that would promote mothers’ participation. The emotional support activities indicated lack of respect and disregard cultural preferences and this contributed to inability to exercise choices in decision-making. The study recommended the implementation of Batho Pele principles in order to provide woman-centred care during labour.

Keywords: communication between women and midwives, labour pains, informational and emotional support, physical comforting measures

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5185 Investigation of the Functional Impact of Amblyopia on Visual Skills in Children

Authors: Chinmay V. Deshpande

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Purpose: To assess the efficiency of visual functions and visual skills in strabismic & anisometropic amblyopes and to assess visual acuity and contrast sensitivity in anisometropic amblyopes with spectacles & contact lenses. Method: In a prospective clinical study, 32 children ageing from 5 to 15 years presenting with amblyopia in a pediatric department of Shri Ganapati Netralaya Jalna, India, were assessed for a period of three & half months. Visual acuity was measured with Snellen’s and Bailey-Lovie log MAR charts whereas contrast sensitivity was measured with Pelli-Robson chart with spectacles and contact lenses. Saccadic movements were assessed with SCCO scoring criteria and accommodative facility was checked with ±1.50 DS flippers. Stereopsis was assessed with TNO test. Results: By using Wilcoxon sign rank test p-value < 0.05 (< 0.001), the mean linear visual acuity was 0.29 (≈ 6/21) and mean single optotype visual acuity found to be 0.36 (≈ 6/18). Mean visual acuity of 0.27(≈ 6/21) with spectacles improved to 0.33 (≈ 6/18) with contact lenses in amblyopic eyes. The mean Log MAR visual acuity with spectacles and contact lens were found to be 0.602( ≈6/24) and 0.531(≈ 6/21) respectively. The contrast threshold out of 20 amblyopic eyes shows that mean contrast threshold changed in 9 patients from spectacles 0.27 to contact lens 0.19 respectively. The mean accommodative facility assessed was 5.31(± 2.37). 24 subjects (75%) revealed marked saccadic defects on the test applied. 78% subjects didn’t show even gross stereoscopic ability on TNO test. Conclusion: This study supports the facts about amblyopia and associated deficits in visual skills which are claimed in previous studies. In addition, anisometropic amblyopia can be managed better with contact lenses.

Keywords: strabismus, anisometropia, amblyopia, contrast sensitivity, saccades, stereopsis

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5184 Blood Ketones as a Point of Care Testing in Paediatric Emergencies

Authors: Geetha Jayapathy, Lakshmi Muthukrishnan, Manoj Kumar Reddy Pulim , Radhika Raman

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Introduction: Ketones are the end products of fatty acid metabolism and a source of energy for vital organs such as the brain, heart and skeletal muscles. Ketones are produced in excess when glucose is not available as a source of energy or it cannot be utilized as in diabetic ketoacidosis. Children admitted in the emergency department often have starvation ketosis which is not clinically manifested. Decision on admission of children to the emergency room with subtle signs can be difficult at times. Point of care blood ketone testing can be done at the bedside even in a primary level care setting to supplement and guide us in our management decisions. Hence this study was done to explore the utility of this simple bedside parameter as a supplement in assessing pediatric patients presenting to the emergency department. Objectives: To estimate blood ketones of children admitted in the emergency department. To analyze the significance of blood ketones in various disease conditions. Methods: Blood ketones using point of care testing instrument (ABOTTprecision Xceed Pro meters) was done in patients getting admitted in emergency room and in out-patients (through sample collection centre). Study population: Children aged 1 month to 18 years were included in the study. 250 cases (In-patients) and 250 controls (out-patients) were collected. Study design: Prospective observational study. Data on details of illness and physiological status were documented. Blood ketones were compared between the two groups and all in patients were categorized into various system groups and analysed. Results: Mean blood ketones were high in in-patients ranging from 0 to 7.2, with a mean of 1.28 compared to out-patients ranging from 0 to 1.9 with a mean of 0.35. This difference was statistically significant with a p value < 0.001. In-patients with shock (mean of 4.15) and diarrheal dehydration (mean of 1.85) had a significantly higher blood ketone values compared to patients with other system involvement. Conclusion: Blood ketones were significantly high (above the normal range) in pediatric patients who are sick requiring admission. Patients with various forms of shock had very high blood ketone values as found in diabetic ketoacidosis. Ketone values in diarrheal dehydration were moderately high correlating to the degree of dehydration.

Keywords: admission, blood ketones, paediatric emergencies, point of care testing

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5183 Factors Contributing to Work Stress Among Nurses in Hadiya Zone’s Public Hospitals, Central Ethiopia, in 2023

Authors: Asnakech Zekiwos

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Background: Stress in nursing refers to the reactions nurses experience when faced with work demands that exceed their knowledge, skills, or ability to cope. Nursing, as a profession, is particularly susceptible to work-related stress. Methods: A cross-sectional study was conducted among 405 randomly selected nurses working in Hadiya Zone Public Hospitals from March 1 to 30, 2023. Data were collected using a pre-tested self-administered questionnaire. The data were entered using Epi-data version 3.1 and analyzed using SPSS version 20.0. Multivariable logistic regression analysis was performed to identify factors associated with the level of work stress. Variables with a p-value <0.05 were considered statistically significant. Results: In this study, 56% (95% CI 50.9-61.2) of the participants reported being stressed in their work. Several factors were found to be associated with work stress, including being female (AOR=1.94, 95% CI 1.19-3.16), rotating shifts (AOR=2.06, 95% CI 1.31-3.25), working in the intensive care unit (AOR=3.42, 95% CI 1.20-9.73), and having post-basic training (AOR=0.55, 95% CI 0.34-0.92). Conclusion: The study revealed a high level of work stress among nurses in the study area. The zonal health unit takes measures to address work stress by providing job orientation during the hiring process, rotation, and on-the-job training to help nurses cope with and manage stressful events. Stress in public hospitals and among nurses is an important issue that needs attention.

Keywords: stress, nurses, public hospitals, expanded stress scale

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5182 Autism Awareness Among School Students and the Violent Reaction of the Autist Toward Society in Egypt

Authors: Naglaa Baskhroun Thabet Wasef

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Specific education services for students with Autism remains in its early developmental stages in Egypt. In spite of many more children with autism are attending schools since The Egyptian government introduced the Education Provision for Students with Disabilities Act in 2010, the services students with autism and their families receive are generally not enough. This pointed study used Attitude and Reaction to Teach Students with Autism Scale to investigate 50 primary school teachers’ attitude and reaction to teach students with autism in the general education classroom. Statistical analysis of the data found that student behavior was the most noticeable factor in building teachers’ wrong attitudes students with autism. The minority of teachers also indicated that their service education did not prepare them to meet the learning needs of children with autism in special, those who are non-vocal. The study is descriptive and provides direction for increasing teacher awareness for inclusivity in Egypt.

Keywords: attitude, autism, teachers, sports activates, movement skills, motor skills, autism attitude

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5181 Entrepreneur Universal Education System: Future Evolution

Authors: Khaled Elbehiery, Hussam Elbehiery

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The success of education is dependent on evolution and adaptation, while the traditional system has worked before, one type of education evolved with the digital age is virtual education that has influenced efficiency in today’s learning environments. Virtual learning has indeed proved its efficiency to overcome the drawbacks of the physical environment such as time, facilities, location, etc., but despite what it had accomplished, the educational system over all is not adequate for being a productive system yet. Earning a degree is not anymore enough to obtain a career job; it is simply missing the skills and creativity. There are always two sides of a coin; a college degree or a specialized certificate, each has its own merits, but having both can put you on a successful IT career path. For many of job-seeking individuals across world to have a clear meaningful goal for work and education and positively contribute the community, a productive correlation and cooperation among employers, universities alongside with the individual technical skills is a must for generations to come. Fortunately, the proposed research “Entrepreneur Universal Education System” is an evolution to meet the needs of both employers and students, in addition to gaining vital and real-world experience in the chosen fields is easier than ever. The new vision is to empower the education to improve organizations’ needs which means improving the world as its primary goal, adopting universal skills of effective thinking, effective action, effective relationships, preparing the students through real-world accomplishment and encouraging them to better serve their organization and their communities faster and more efficiently.

Keywords: virtual education, academic degree, certificates, internship, amazon web services, Microsoft Azure, Google Cloud Platform, hybrid models

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5180 Nurturing Resilient Families: Strategies for Positive Parenting and Emotional Well-Being

Authors: Xu Qian

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This abstract explores the importance of building resilience within families and offers evidence-based strategies for promoting positive parenting and enhancing emotional well-being. It emphasizes the role of effective communication, conflict resolution, and fostering a supportive environment to strengthen family bonds and promote healthy child development. Introduction: The well-being and resilience of families play a crucial role in fostering healthy child development and promoting overall emotional well-being. This abstract highlights the significance of nurturing resilient families and provides evidence-based strategies for positive parenting. By focusing on effective communication, conflict resolution, and creating a supportive environment, families can strengthen their bonds and enhance emotional well-being for both parents and children. Methods: This abstract draws upon a comprehensive review of existing research and literature on resilient families, positive parenting, and emotional well-being. The selected studies employ various methodologies, including surveys, interviews, and longitudinal observations, to investigate the factors contributing to family resilience and the strategies that promote positive parenting practices. The findings from these studies serve as the foundation for the strategies discussed in this abstract. Results: The results of the reviewed studies demonstrate that effective communication within families is a key factor in building resilience and promoting emotional well-being. Open and honest communication allows family members to express their thoughts, feelings, and concerns, fostering trust and understanding. Conflict resolution skills, such as active listening, compromise, and problem-solving, are vital in managing conflicts constructively and preventing negative consequences on family dynamics and children's well-being. Creating a supportive environment that nurtures emotional well-being is another critical aspect of promoting resilient families. This includes providing emotional support, setting clear boundaries, and promoting positive discipline strategies. Research indicates that consistent and responsive parenting approaches contribute to improved self-regulation skills, emotional intelligence, and overall mental health in children. Discussion: The discussion centers on the implications of these findings for promoting positive parenting and emotional well-being. It emphasizes the need for parents to prioritize self-care and seek support when facing challenges. Parental well-being directly influences the quality of parenting and the overall family environment. By attending to their own emotional needs, parents can better meet the needs of their children and create a nurturing atmosphere. Furthermore, the importance of fostering resilience in children is highlighted. Resilient children are better equipped to cope with adversity, adapt to change, and thrive in challenging circumstances. By cultivating resilience through supportive relationships, encouragement of independence, and providing opportunities for growth, parents can foster their children's ability to bounce back from setbacks and develop essential life skills. Conclusion: In conclusion, nurturing resilient families is crucial for positive parenting and enhancing emotional well-being. This abstract presents evidence-based strategies that emphasize effective communication, conflict resolution, and creating a supportive environment. By implementing these strategies, parents can strengthen family bonds, promote healthy child development, and enhance overall family resilience. Investing in resilient families not only benefits individual family members but also contributes to the well-being of the broader community.

Keywords: childrearing families, family education, children's mental health, positive parenting, emotional health

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5179 Gamification Teacher Professional Development: Engaging Language Learners in STEMS through Game-Based Learning

Authors: Karen Guerrero

Abstract:

Kindergarten-12th grade teachers engaged in teacher professional development (PD) on game-based learning techniques and strategies to support teaching STEMSS (STEM + Social Studies with an emphasis on geography across the curriculum) to language learners. Ten effective strategies have supported teaching content and language in tandem. To provide exiting teacher PD on summer and spring breaks, gamification has integrated these strategies to engage linguistically diverse student populations to provide informal language practice while students engage in the content. Teachers brought a STEMSS lesson to the PD, engaged in a wide variety of games (dice, cards, board, physical, digital, etc.), critiqued the games based on gaming elements, then developed, brainstormed, presented, piloted, and published their game-based STEMSS lessons to share with their colleagues. Pre and post-surveys and focus groups were conducted to demonstrate an increase in knowledge, skills, and self-efficacy in using gamification to teach content in the classroom. Provide an engaging strategy (gamification) to support teaching content and language to linguistically diverse students in the K-12 classroom. Game-based learning supports informal language practice while developing academic vocabulary utilized in the game elements/content focus, building both content knowledge through play and language development through practice. The study also investigated teacher's increase in knowledge, skills, and self-efficacy in using games to teach language learners. Mixed methods were used to investigate knowledge, skills, and self-efficacy prior to and after the gamification teacher training (pre/post) and to understand the content and application of developing and utilizing game-based learning to teach. This study will contribute to the body of knowledge in applying game-based learning theories to the K-12 classroom to support English learners in developing English skills and STEMSS content knowledge.

Keywords: gamification, teacher professional development, STEM, English learners, game-based learning

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5178 Role of mHealth in Effective Response to Disaster

Authors: Mohammad H. Yarmohamadian, Reza Safdari, Nahid Tavakoli

Abstract:

In recent years, many countries have suffered various natural disasters. Disaster response continues to face the challenges in health care sector in all countries. Information and communication management is a significant challenge in disaster scene. During the last decades, rapid advances in information technology have led to manage information effectively and improve communication in health care setting. Information technology is a vital solution for effective response to disasters and emergencies so that if an efficient ICT-based health information system is available, it will be highly valuable in such situation. Of that, mobile technology represents a nearly computing technology infrastructure that is accessible, convenient, inexpensive and easy to use. Most projects have not yet reached the deployment stage, but evaluation exercises show that mHealth should allow faster processing and transport of patients, improved accuracy of triage and better monitoring of unattended patients at a disaster scene. Since there is a high prevalence of cell phones among world population, it is expected the health care providers and managers to take measures for applying this technology for improvement patient safety and public health in disasters. At present there are challenges in the utilization of mhealth in disasters such as lack of structural and financial issues in our country. In this paper we will discuss about benefits and challenges of mhealth technology in disaster setting considering connectivity, usability, intelligibility, communication and teaching for implementing this technology for disaster response.

Keywords: information technology, mhealth, disaster, effective response

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5177 The Effectiveness of the Family-Centered Sensory and Motor Interactive Games Program on Strengthening the Developmental and Motor Skills of Children aged 12 to 24 Months Who Have a Prior History of Low Birth Weight

Authors: Seyede Soraya Alavinezhad, Gholam Ali Afrooz, Seyedsaeid Sajjadianari

Abstract:

The purpose of this study was to assess the efficacy of a family-centered sensory and motor interactive activities program in enhancing the motor and developmental abilities of infants between the ages of 12 and 24 months who have a medical history of low birth weight. The design of the study was a combined method (qualitative and quantitative). The statistical population comprised infants between the ages of 12 and 24 months who had a documented history of low birth weight in Tehran in 2022. The study sample comprised twenty-eight infants, ranging in age from twelve to twenty-four months, whose mothers were selected using a readily available sampling method. The participants were allocated into two groups—experimental and control—at random. The Children's Developmental Screening Scale, the third edition of Ages and Stages Questionnaires (ASQ3TM), was utilized in both cohorts. Two sessions of the family-centered program for mothers and sixteen sessions for children in the experimental group were taken into account. The statistical analysis software SPSS version 26 was utilized to analyze the data. Initially, the descriptive analysis of the variables, the normality of the assumptions, and the equality of the variance of the variables in the groups were examined. Subsequently, univariate analysis of covariance was employed to examine research hypotheses. The results of the covariance analysis demonstrated that the family-centered interactive activities program for sensory and motor development was effective. A significant difference has been observed between the experimental and control groups with regard to developmental skills between the pre-test and post-test (P<0.005). Motor and developmental skills among children aged 12 to 24 months with a history of low birth weight can be enhanced through entertainment programs that incorporate suitable structure, according to the findings of this study. It is recommended that future research investigate the efficacy of this program on children of average weight and conduct longitudinal studies.

Keywords: children, developmental skills, low birth weight, sensory and motor interactive games program

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5176 Strengthening Facility-Based Systems to Improve Access to In-Patient Care for Sick Newborns in Brong Ahafo Region, Ghana

Authors: Paulina Clara Appiah, Kofi Issah, Timothy Letsa, Kennedy Nartey, Amanua Chinbuah, Adoma Dwomo-Fokuo, Jacqeline G. Asibey

Abstract:

Background: The Every Newborn Action Plan provides evidence–based interventions to end preventable deaths in high burden countries. Brong Ahafo Region is one of ten regions in Ghana with less than half of its district hospitals having sick newborn units. Facility-based neonatal care is not prioritized and under-funded, and there is also inadequate knowledge and competence to manage the sick. The aim of this intervention was to make available in–patient care for sick newborns in all 19 district hospitals through the strengthening of facility-based systems. Methods: With the development and dissemination of the National Newborn Strategy and Action Plan 2014-2018, the country was able to attract PATH which provided the region with basic resuscitation equipment, supported hospital providers’ capacity building in Helping Babies Breathe, Essential Care of Every Baby, Infection Prevention and Management and held a symposia on managing the sick newborn. Newborn advocacy was promoted through newborn champions at the facility and community levels. Hospital management was then able to mobilize resources from communities, corporate organizations and from internally generated funds; created or expanded sick newborn care units and provided essential medicines and equipment. Kangaroo Mother Care was initiated in 6 hospitals. Pediatric specialist outreach services initiated comprised telephone consultations, teaching ward rounds and participating in perinatal death audits meetings. Newborn data capture and management was improved through the provision and training on the use of standard registers provided from the national level. Results: From February 2015 to November 2017, hospitals with sick newborn units increased from 7 to 19 (37%-100%). 180 pieces each of newborn ventilation bags and masks size 0, 1 and penguin suction bulbs were distributed to the hospitals, in addition to 20 newborn mannequin sets and 90 small clinical reminder posters. 802 providers (96.9%) were trained in resuscitation, of which 96% were successfully followed up in 6 weeks, 91% in 6 months and 80% in 12 months post-training. 53 clinicians (65%) were trained and mentored to manage sick newborns. 56 specialist teaching ward rounds were conducted. Data completeness improved from 92.6% - 99.9%. Availability of essential medicines improved from 11% to 100%. Number of hospital cots increased from 116 to 248 (214%). Cot occupancy rate increased from 57.4% to 92.5%. Hospitals with phototherapy equipment increased from 0 to 12 (63%). Hospitals with incubators increased from 1 to 12 (5%-63%). Newborn deaths among admissions reduced from 6.3% to 5.4%. Conclusion: Access to in-patient care increased significantly. Newborn advocacy successfully mobilized resources required for strengthening facility –based systems.

Keywords: facility-based systems, Ghana, in-patient care, newborn advocacy

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5175 A Bicycle Based Model of Prehospital Care Implanted in Northeast of the Brazil: Initial Experience

Authors: Odaleia de O. Farias, Suzelene C. Marinho, Ecleidson B. Fragoso, Daniel S. Lima, Francisco R. S. Lira, Lara S. Araújo, Gabriel dos S. D. Soares

Abstract:

In populous cities, prehospital care services that use vehicles alternative to ambulances are needed in order to reduce costs and improve response time to occurrences in areas with large concentration of people, such as leisure and tourism spaces. In this context, it was implanted a program called BIKE VIDA, that is innovative quick access and assistance program. The aim of this study is to describe the implantation and initial profile of occurrences performed by an urgency/emergency pre-hospital care service through paramedics on bicycles. It is a cross-sectional, descriptive study carried out in the city of Fortaleza, Ceara, Brazil. The data included service records from July to August 2017. Ethical aspects were respected. The service covers a perimeter of 4.5 km, divided into three areas with perimeter of 1.5 km for each paramedic, attending from 5 am to 9 pm. Materials transported by bicycles include External Automated Defibrillator - DEA, portable oxygen, oximeter, cervical collar, stethoscope, sphygmomanometer, dressing and immobilization materials and personal protective equipment. Occurrences are requested directly by calling the emergency number 192 or through direct approach to the professional. In the first month of the program, there were 93 emergencies/urgencies, mainly in the daytime period (71,0%), in males (59,7%), in the age range of 26 to 45 years (46,2%). The main nature was traumatic incidents (53.3%). Most of the cases (88,2%) did not require ambulance transport to the hospital, and there were two deaths. Pre-hospital service through bicycles is an innovative strategy in Brazil and has shown to be promising in terms of reducing costs and improving the quality of the services offered.

Keywords: emergency, response time, prehospital care, urgency

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5174 Students' Perceptions of Assessment and Feedback in Higher Education

Authors: Jonathan Glazzard

Abstract:

National student satisfaction data in England demonstrate that undergraduate students are less satisfied overall with assessment and feedback than other aspects of their higher education courses. Given that research findings suggest that high-quality feedback is a critical factor associated with academic achievement, it is important that feedback enables students to demonstrate improved academic achievement in their subsequent assessments. Given the growing importance of staff-student partnerships in higher education, this research examined students’ perceptions of assessment and feedback in one UK university. Students’ perceptions were elicited through the use of a university-wide survey which was completed by undergraduate students. In addition, three focus groups were used to provide qualitative student perception data across the three university Facilities. The data indicate that whilst students valued detailed feedback on their work, less detailed feedback could be compensated for by the development of pre-assessment literacy skills which are front-loaded into courses. Assessment literacy skills valued by students included the use of clear assessment criteria and assignment briefings which enabled students to fully understand the assessment task. Additionally, students valued assessment literacy pre-assessment tasks which enabled them to understand the standards which they were expected to achieve. Students valued opportunities for self and peer assessment prior to the final assessment and formative assessment feedback which matched the summative assessment feedback. Students also valued dialogic face-to-face feedback after receiving written feedback Above all, students valued feedback which was particular to their work and which gave recognition for the effort they had put into completing specific assessments. The data indicate that there is a need for higher education lecturers to receive systematic training in assessment and feedback which provides a comprehensive grounding in pre-assessment literacy skills.

Keywords: formative assessment, summative assessment, feedback, marking

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5173 The Organization of Multi-Field Hospital’s Work Environment in the Republic of Sakha, Yakutia

Authors: Inna Vinokurova, N. Savvina

Abstract:

The goal of research: to study the organization of multi-field hospital’s work environment in the Republic of Sakha (Yakutia), Autonomous public health care institution of Republic of Sakha (Yakutia) - Republican Hospital No. 1 - National Center of Medicine. Results: Autonomous public health care institution of Republic of Sakha (Yakutia) - Republican Hospital No. 1 - National Center of Medicine is a multidisciplinary, specialized hospital complex that provides specialized and high-tech medical care to children and adults in the Republic of Sakha (Yakutia) of the Russian Federation. There are 5 diagnostic and treatment centers (advisory and diagnostic, clinical, pediatric, perinatal, Republican cardiologic dispensary) with 45 clinical specialized departments with 727 cots, 5 resuscitation departments, 20 operating rooms and out-patient department with 905 visits in alternation in the National Center of Medicine. Annually more than 20,000 patients receive treatment in the hospital of the Republican Hospital of the Republic of Sakha (Yakutia), more than 70,000 patients visit out-patient sections, more than 2 million researches are done, more than 12,000 surgeries are performed, more than 2 thousand babies are delivered. National Center of Medicine has a great influence with such population’s health indicators as total mortality, birth rate, maternal, infant and perinatal mortality, circulatory system incidence. The work environment of the Republican Hospital of the Republic of Sakha (Yakutia) is represented by the following structural departments: pharmacy, blood transfusion department, sterilization department, laundry, dietetic department, infant-feeding centre, material and technical supply. More than 200 employees work in this service. The main function of these services is to provide on-time and fail-safe supply with all necessary: wear parts, medical supplies, donated blood and its components, foodstuffs, hospital linen , sterile instruments, etc. Thus, the activity of medical organization depends on the work environment, including quality health care, so it is a main part of multi-field hospital activity.

Keywords: organization of multi-field hospital’s, work environment, quality health care, pharmacy, blood transfusion department, sterilization department

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5172 The Effect of Age on the Outcome of Teenage Pregnancy in Nigeria: A Demographic Study

Authors: Chinelo Igwenagu

Abstract:

Teenage childbearing in developing countries has been a thing of great concern as it has often led to a number of socioeconomic problems both to the society and to the families affected. The outcome of teenage pregnancy has been generally associated with higher rates of maternal morbidity and mortality, greater risks for delivery complications, low-birth weight infants and child mortality. As a result of teenagers’ physiological and social immaturity and their lack of adequate prenatal care, health risks associated with their pregnancies and childbearing are more pronounced than those of older women. Therefore this study has examined the relationship between the age of teenagers and the outcome of teenage pregnancy. Based on this study, the result of the analysis shows that both teenagers and older mothers suffer similarly during child bearing. Hence improve medical care is paramount in all the situations.

Keywords: childbearing, mortality, Nigeria, pregnancy, prematurity, teenagers

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5171 Examination of the Impact of Projects Based on Reggio Emilia Approach on the Creative Thinking Skills of Preschool Children: A Qualitative Study

Authors: Arzu Akar Gençer, Mübeccel Gönen

Abstract:

The objective of the study is to investigate the impact of the projects based on Reggio Emilia Approach, on the creative thinking skills of preschool children. The study is carried out with eighteen 6 years old children in a class of a preschool, and entailed the development of projects based on Reggio Emilia approach with the children, for a period of 3 months. The study employs qualitative model. The children were analyzed with reference to the creative thinking aspects (rationality, originality, flexibility, and applicability) of the projects applied. As the projects based on Reggio Emilia approach arose out of the interests and curiosity of the children, and had their roots in the existing class culture, it is possible to conclude that they have an impact on the creativity of the children with reference to the aspects of creative thinking.

Keywords: Reggio Emilia approach, project, creativity, preschool children

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5170 Digital Advance Care Planning and Directives: Early Observations of Adoption Statistics and Responses from an All-Digital Consumer-Driven Approach

Authors: Robert L. Fine, Zhiyong Yang, Christy Spivey, Bonnie Boardman, Maureen Courtney

Abstract:

Importance: Barriers to traditional advance care planning (ACP) and advance directive (AD) creation have limited the promise of ACP/AD for individuals and families, the healthcare team, and society. Reengineering ACP by using a web-based, consumer-driven process has recently been suggested. We report early experience with such a process. Objective: Begin to analyze the potential of the creation and use of ACP/ADs as generated by a consumer-friendly, digital process by 1) assessing the likelihood that consumers would create ACP/ADs without structured intervention by medical or legal professionals, and 2) analyzing the responses to determine if the plans can help doctors better understand a person’s goals, preferences, and priorities for their medical treatments and the naming of healthcare agents. Design: The authors chose 900 users of MyDirectives.com, a digital ACP/AD tool, solely based on their state of residence in order to achieve proportional representation of all 50 states by population size and then reviewed their responses, summarizing these through descriptive statistics including treatment preferences, demographics, and revision of preferences. Setting: General United States population. Participants: The 900 participants had an average age of 50.8 years (SD = 16.6); 84.3% of the men and 91% of the women were in self-reported good health when signing their ADs. Main measures: Preferences regarding the use of life-sustaining treatments, where to spend final days, consulting a supportive and palliative care team, attempted cardiopulmonary resuscitation (CPR), autopsy, and organ and tissue donation. Results: Nearly 85% of respondents prefer cessation of life-sustaining treatments during their final days whenever those may be, 76% prefer to spend their final days at home or in a hospice facility, and 94% wanted their future doctors to consult a supportive and palliative care team. 70% would accept attempted CPR in certain limited circumstances. Most respondents would want an autopsy under certain conditions, and 62% would like to donate their organs. Conclusions and relevance: Analysis of early experience with an all-digital web-based ACP/AD platform demonstrates that individuals from a wide range of ages and conditions can engage in an interrogatory process about values, goals, preferences, and priorities for their medical treatments by developing advance directives and easily make changes to the AD created. Online creation, storage, and retrieval of advance directives has the potential to remove barriers to ACP/AD and, thus, to further improve patient-centered end-of-life care.

Keywords: Advance Care Plan, Advance Decisions, Advance Directives, Consumer; Digital, End of Life Care, Goals, Living Wills, Prefences, Universal Advance Directive, Statements

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5169 Inquiry-based Science Education in Computer Science Learning in Primary School

Authors: Maslin Masrom, Nik Hasnaa Nik Mahmood, Wan Normeza Wan Zakaria, Azizul Azizan, Norshaliza Kamaruddin

Abstract:

Traditionally, in science education, the teacher provides facts and the students learn them. It is outmoded for today’s students to equip them with real-life situations, mainly because knowledge and life skills are acquired passively from the instructors. Inquiry-Based Science Education (IBSE) is an approach that allows students to experiment, ask questions, and develop responses based on reasoning. It has provided students and teachers with opportunities to actively engage in collaborative learning via inquiry. This approach inspires the students to become active thinkers, research for solutions, and gain life-long experience and self-confidence. Therefore, the research aims to investigate how the primary-school teacher supports students or pupils through an inquiry-based science education approach for computer science, specifically coding skills. The results are presented and described.

Keywords: inquiry-based science education, student-centered learning, computer science, primary school

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5168 A Perspective on Emergency Care of Gunshot Injuries in Northern Taiwan

Authors: Liong-Rung Liu, Yu-Hui Chiu, Wen-Han Chang

Abstract:

Firearm injuries are high-energy injuries. The ballistic pathways could cause severe burns or chemical damages to vessels, musculoskeletal or other major organs. The high mortality rate is accompanied by complications such as sepsis. As laws prohibit gun possession, civilian gunshot wounds (GSW) are relatively rare in Taiwan. Our hospital, Mackay Memorial Hospital, located at the center of Taipei city is surrounded by nightclubs and red-light districts. Due to this unique location, our hospital becomes the first-line trauma center managing gunshot victims in Taiwan. To author’s best knowledge, there are few published research articles regarding this unique situation. We hereby analyze the distinct characteristics and length of stay (LOS) of GSW patients in the emergency room (ER) at Mackay Memorial Hospital. A 6-year retrospective analysis of 27 patients treated for GSW injuries from January 2012 to December 2017 was performed. The patients’ records were reviewed for the following analyses, 1) wound position and the correlated clinical presentations; 2) the LOS in ED of patients receiving emergency surgery for major organ or vascular injuries. We found males (96.3%) were injured by guns more often than females (3.7%) in all age groups. The most common injured site was in the extremities. With regards to the ER LOS, the average time were 72.2 ± 34.5 minutes for patients with triage I and 207.4 ± 143.9 minutes for patients with triage II. The ED LOS of patients whose ISS score were more than 15 was 59.9 ± 25.6 minutes, and 179.4 ± 119.8 minutes for patients whose ISS score were between 9 to 15, respectively. Among these 27 patients, 10 patients had emergency surgery and their average ED stay time was 104.5 ± 33.3 minutes. Even more, the average ED stay time could be shortened to 88.8 ± 32.3 minutes in the 5 patients with trauma team activation. In conclusion, trauma team activation in severe GSW patients indeed shortens the ED LOS and might initially improve the quality of patient care. This is the result of better trauma systems, including advances in care from emergency medical services and acute care surgical management.

Keywords: gunshot, length of stay, trauma, mortality

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