Disaster Medicine and Public Health Preparedness, Apr 1, 2014
ObjectivesHealthcare workers (HCW) are at increased risk of infection during pandemics. HCW perso... more ObjectivesHealthcare workers (HCW) are at increased risk of infection during pandemics. HCW personal protective equipment (PPE) use has been shown to lower infection rates among HCW and patients. However, low compliance and misuse are frequent. Since future outbreaks are unavoidable, this issue needs to be addressed.MethodsA validated questionnaire was distributed to 617 HCWs (nurses and physicians) in 21 hospitals and 40 primary care clinics in Israel at the peak of the A/H1N1 pandemic.ResultsPPE confidence was higher among HCWs with higher tested and self-perceived knowledge. Confidence was also higher among nurses compared with physicians and among employees in hospitals compared with those in primary care clinics. Experience treating A/H1N1 patients was related to higher self-perceived knowledge and PPE confidence.ConclusionsHigh levels of PPE knowledge were significantly correlated to HCWs’ confidence in PPE and may help increase PPE usage and reduce absenteeism. (Diaster Med Public Health Preparedness. 2014;0:1-8)
Background: Many emergency departments use coagulation studies in the evaluation of patients with... more Background: Many emergency departments use coagulation studies in the evaluation of patients with suspected acute coronary syndromes. Objectives: To determine the prevalence of abnormal coagulation studies in ED patients evaluated for suspected ACS, and to investigate whether abnormal international normalized ratio/partial thromboplastin time testing resulted in changes in patient management and whether abnormal results could be predicted by history and physical examination. Methods: In this retrospective observational study, hospital and ED records were obtained for all patients with a diagnosis of ACS seen in the ED during a 3 month period. ED records were reviewed to identify patients in whom the cardiac laboratory panel was performed. Other data included demographics, diagnosis and disposition, historical risk factors for abnormalities of coagulation, ED and inpatient management, INR/PTT, platelet count and cardiac enzymes. Descriptive statistical analyses were performed. Results: Complete data were available for 223 of the 227 patients (98.7%). Of these, 175 (78.5%) were admitted. The mean age was 64.2 years. Thirteen patients (5.8%) were diagnosed with acute myocardial infarction. Of the 223 patients, 29 (13%) and 23 (10%) had INR and PTT results respectively beyond the reference range. Seventy percent of patients with abnormal coagulation test results had risk factors for coagulation disorders. The abnormal results of the remaining patients included only a mild elevation and therefore no change in management was initiated. Conclusions: Abnormal coagulation test results in patients presenting with suspected ACS are rare, they can usually be predicted by history, and they rarely affect management. Routine coagulation studies are not indicated in these patients.
The paramedic profession in Israel was established in 1979 by Dr Nancy Caroline, medical director... more The paramedic profession in Israel was established in 1979 by Dr Nancy Caroline, medical director of the national emergency medical services (EMS) system, Magen David Adom. Since its establishment the profession has developed considerably and paramedics are currently at the frontier of pre-hospital emergency care in Israel. This article looks at the evolution of the paramedic profession in Israel, considering the introduction of mobile intensive care units and the paramedic's ever changing role in the provision of pre-hospital care.
AIMS To reveal factors associated with nurses' professional commitment during the COVID-19 pa... more AIMS To reveal factors associated with nurses' professional commitment during the COVID-19 pandemic. BACKGROUND During the first wave of the COVID-19 pandemic, the Nursing-Division at the Israeli Ministry of Health and partners conducted a study to examine nurses' perceptions towards a set of personal and professional circumstances that may affect their performance. METHOD A cross-sectional, web-based study, conducted in Israel. Study' participants included 817 community and hospital nurses. The Occupational Commitment Scale for Health Professionals during pandemic (PanHP-OCS) was used to gather data. Univariate and multivariant analyses explored associations between the PanHP-OCS score and demographic and professional variables. RESULTS About 40% of 817 respondents reported having managerial roles (n = 320). Those who received specific pandemic-focused training had significantly better PanHP-OCS scores (p <.001). Most respondents expected their organization to provide them emotional support. Linear regression explored the organizational commitment factor as the greatest contributor to nurses' professional commitment (Beta = .284, p <.001). CONCLUSION To enhance the nurses' professional commitment during the COVID-19 pandemic, training and emotional support must be emphasized in all types of nurses' workplaces, IMPLICATIONS FOR NURSING MANAGEMENT: In a pandemic, health organizations must provide dedicated pandemic training, including proactive emotional support for nurses. Special attention should be given to community care.
Disaster Medicine and Public Health Preparedness, Apr 1, 2014
ObjectivesHealthcare workers (HCW) are at increased risk of infection during pandemics. HCW perso... more ObjectivesHealthcare workers (HCW) are at increased risk of infection during pandemics. HCW personal protective equipment (PPE) use has been shown to lower infection rates among HCW and patients. However, low compliance and misuse are frequent. Since future outbreaks are unavoidable, this issue needs to be addressed.MethodsA validated questionnaire was distributed to 617 HCWs (nurses and physicians) in 21 hospitals and 40 primary care clinics in Israel at the peak of the A/H1N1 pandemic.ResultsPPE confidence was higher among HCWs with higher tested and self-perceived knowledge. Confidence was also higher among nurses compared with physicians and among employees in hospitals compared with those in primary care clinics. Experience treating A/H1N1 patients was related to higher self-perceived knowledge and PPE confidence.ConclusionsHigh levels of PPE knowledge were significantly correlated to HCWs’ confidence in PPE and may help increase PPE usage and reduce absenteeism. (Diaster Med Public Health Preparedness. 2014;0:1-8)
Background: Many emergency departments use coagulation studies in the evaluation of patients with... more Background: Many emergency departments use coagulation studies in the evaluation of patients with suspected acute coronary syndromes. Objectives: To determine the prevalence of abnormal coagulation studies in ED patients evaluated for suspected ACS, and to investigate whether abnormal international normalized ratio/partial thromboplastin time testing resulted in changes in patient management and whether abnormal results could be predicted by history and physical examination. Methods: In this retrospective observational study, hospital and ED records were obtained for all patients with a diagnosis of ACS seen in the ED during a 3 month period. ED records were reviewed to identify patients in whom the cardiac laboratory panel was performed. Other data included demographics, diagnosis and disposition, historical risk factors for abnormalities of coagulation, ED and inpatient management, INR/PTT, platelet count and cardiac enzymes. Descriptive statistical analyses were performed. Results: Complete data were available for 223 of the 227 patients (98.7%). Of these, 175 (78.5%) were admitted. The mean age was 64.2 years. Thirteen patients (5.8%) were diagnosed with acute myocardial infarction. Of the 223 patients, 29 (13%) and 23 (10%) had INR and PTT results respectively beyond the reference range. Seventy percent of patients with abnormal coagulation test results had risk factors for coagulation disorders. The abnormal results of the remaining patients included only a mild elevation and therefore no change in management was initiated. Conclusions: Abnormal coagulation test results in patients presenting with suspected ACS are rare, they can usually be predicted by history, and they rarely affect management. Routine coagulation studies are not indicated in these patients.
The paramedic profession in Israel was established in 1979 by Dr Nancy Caroline, medical director... more The paramedic profession in Israel was established in 1979 by Dr Nancy Caroline, medical director of the national emergency medical services (EMS) system, Magen David Adom. Since its establishment the profession has developed considerably and paramedics are currently at the frontier of pre-hospital emergency care in Israel. This article looks at the evolution of the paramedic profession in Israel, considering the introduction of mobile intensive care units and the paramedic's ever changing role in the provision of pre-hospital care.
AIMS To reveal factors associated with nurses' professional commitment during the COVID-19 pa... more AIMS To reveal factors associated with nurses' professional commitment during the COVID-19 pandemic. BACKGROUND During the first wave of the COVID-19 pandemic, the Nursing-Division at the Israeli Ministry of Health and partners conducted a study to examine nurses' perceptions towards a set of personal and professional circumstances that may affect their performance. METHOD A cross-sectional, web-based study, conducted in Israel. Study' participants included 817 community and hospital nurses. The Occupational Commitment Scale for Health Professionals during pandemic (PanHP-OCS) was used to gather data. Univariate and multivariant analyses explored associations between the PanHP-OCS score and demographic and professional variables. RESULTS About 40% of 817 respondents reported having managerial roles (n = 320). Those who received specific pandemic-focused training had significantly better PanHP-OCS scores (p <.001). Most respondents expected their organization to provide them emotional support. Linear regression explored the organizational commitment factor as the greatest contributor to nurses' professional commitment (Beta = .284, p <.001). CONCLUSION To enhance the nurses' professional commitment during the COVID-19 pandemic, training and emotional support must be emphasized in all types of nurses' workplaces, IMPLICATIONS FOR NURSING MANAGEMENT: In a pandemic, health organizations must provide dedicated pandemic training, including proactive emotional support for nurses. Special attention should be given to community care.
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