To see the other types of publications on this topic, follow the link: Emergency intervention.
Dissertations / Theses on the topic 'Emergency intervention'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 dissertations / theses for your research on the topic 'Emergency intervention.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
1
Rouse, Eno J. "Care Intervention in Reducing Emergency Department Utilization in Medicaid Populations." Thesis, Walden University, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13425519.
Full textAbstract:
Expansion of Medicaid and private health insurance coverage through passage of the Affordable Care Act of 2010 was expected to increase primary care access and reduce emergency department (ED) use by reducing financial burden and improving affordability of care. The aim of this study was to examine the differences in utilization patterns that exist among the Medicaid population that participated in an optimal level of care (OLC) intervention inclusive of appointments scheduled to primary care providers. Using the integrated behavior model as a theoretical framework, the key research question focused on determining if there was a difference in ED use among Medicaid individuals who scheduled follow-up appointments compared to those that did not schedule follow-up appointments. The sample population consisted of 176 Medicaid enrollees who presented to the ED for treatment of nonurgent conditions and participated in an OLC intervention from June 2016 to July 2017. The results showed that there were no differences in ED utilization between the population that had scheduled appointments compared to the population that did not have scheduled appointments. A bivariate analysis on demographic variables also showed no differences in ED utilization among the variables. The social change implications of this study are that the practice of scheduling appointments with primary care providers does not reduce or affect ED utilization in the Medicaid population. This study contributes to positive social change through the findings that reducing ED utilization requires more than follow-up appointment scheduling with primary care providers. Further studies are warranted to understand the potential barriers and factors that affect ED utilization.
2
Marietta, Matt L. PhD. "The Lessons of Comprehensive Emergency Management Theory for International Humanitarian Intervention." Digital Archive @ GSU, 2012. http://digitalarchive.gsu.edu/political_science_diss/24.
Full textAbstract:
This project seeks to expand the dialogue about international humanitarian intervention in a complex emergency or mass atrocity situation by asserting that post-intervention political reconstruction is as essential to the intervention as is the provision of material humanitarian aid and even the ostensive goal of protecting the aid regimes. As a result of this assertion, consideration of humanitarian intervention has, to this point, been too focused on the legal, ethical, and theoretical implications of war and hegemony. The current dialogue centers on its security studies aspects, owing largely to its Cold War precedent. However, a full consideration of the subject of humanitarian intervention must also consider the broader implications of the intervention, including recovery and mitigation of future events. When this is considered at all, the literature to this point largely treats post-intervention establishment of political and social infrastructure as a secondary consideration to the military intervention.
The primary approach to address this needed expansion includes drawing a comparison between humanitarian intervention and a similar domestic concept: comprehensive emergency management theory. While there are several dissimilarities between emergency management and its putative international correlate, the theoretical framework it establishes—including not only the response found in the usual literature, but also the well-defined concepts of recovery, mitigation, and preparedness—can expand our understanding of the implications and requirements of humanitarian intervention. It also provides an important lesson in its mirror example for the prescribed evolution of humanitarian intervention scholarship away from its Cold War genesis. This is because domestic emergency management also has a foundation in security studies concerns, but has since evolved into an all-hazards philosophy that embraces prevention and recovery as much as simple response to a human crisis. This parallel will provide a framework for approaching humanitarian intervention that goes significantly beyond the literature to this point and provides a much more encompassing approach to the subject than there has been to this point.
3
Rouse, Eno J. "Care Intervention and Reduction of Emergency Department Utilization in Medicaid Populations." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6275.
Full textAbstract:
Expansion of Medicaid and private health insurance coverage through passage of the Affordable Care Act of 2010 was expected to increase primary care access and reduce emergency department (ED) use by reducing financial burden and improving affordability of care. The aim of this study was to examine the differences in utilization patterns that exist among the Medicaid population that participated in an optimal level of care (OLC) intervention inclusive of appointments scheduled to primary care providers. Using the integrated behavior model as a theoretical framework, the key research question focused on determining if there was a difference in ED use among Medicaid individuals who scheduled follow-up appointments compared to those that did not schedule follow-up appointments. The sample population consisted of 176 Medicaid enrollees who presented to the ED for treatment of nonurgent conditions and participated in an OLC intervention from June 2016 to July 2017. The results showed that there were no differences in ED utilization between the population that had scheduled appointments compared to the population that did not have scheduled appointments. A bivariate analysis on demographic variables also showed no differences in ED utilization among the variables. The social change implications of this study are that the practice of scheduling appointments with primary care providers does not reduce or affect ED utilization in the Medicaid population. This study contributes to positive social change through the findings that reducing ED utilization requires more than follow-up appointment scheduling with primary care providers. Further studies are warranted to understand the potential barriers and factors that affect ED utilization.
4
Wilson, Neil Anthony. "Social identity, violence and emotions : bystander-perpetrator relationships in emergency intervention." Thesis, Lancaster University, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.635440.
Full text
5
陳敏恩 and Man-yan Esther Chan. "A comprehensive intervention for mild head injury patients in accidentand emergency department." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B43251018.
Full text
6
Schenk, Claudia F. "Addressing Needs of Intimate Partner Violence Survivors in the Emergency Department." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3919.
Full textAbstract:
Intimate partner violence is a global epidemic and public health concern, including in the United States. The purpose of this descriptive, exploratory, nonexperimental, quantitative study was to determine to what extent intimate partner violence survivors avail themselves of offered resources and interventions in health care settings. The general systems foundation was used for the study's theoretical foundation. The research questions ascertained the proportion of intimate partner violence survivors who accepted mental health, law enforcement, and community outreach resources; the level of comprehensive intervention they received; and the associations, if any, between types of services. Retrospective data were collected from121 medical records from an emergency department in the Midwest United States. Descriptive statistics were performed on collected medical record data and chi-square analyses were performed in an exploratory manner to determine associations between types and numbers of other services accepted. The outcomes indicated that the majority of participants accepted comprehensive intervention, social work or mental health intervention was the most frequently accepted service, and the majority of patients who accepted social work accepted other services. Anticipated social implications may include survivors receiving multi-disciplinary interventions sooner, increased efforts by health care providers to work collaboratively with community agencies, continued development of hospital policy and protocols, and opportunities for further research. Society may ultimately benefit from a decreased economic cost to society and a positive impact in growth and development of witnessing children.
7
Trinks, Anna. "Alcohol prevention in emergency care : Drinking patterns among patients and the impact of a computerized intervention in a Swedish Emergency department." Doctoral thesis, Linköpings universitet, Socialmedicin och folkhälsovetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-72333.
Full textAbstract:
The aim of this thesis was to generate knowledge about alcohol consumption among patients in a Swedish ED, the reach and effectiveness of a computerized brief intervention delivered in the ED, and factors that are associated with reduced alcohol consumption 6 months after the ED visit. The results from the studies show that alcohol consumption was higher among patients who were injured than patients who were not injured. Injury patients had a higher weekly consumption, drank more frequently and drank higher typical quantities than non-injury patients. Patients who were categorized as acute drinkers had higher weekly alcohol consumption and were more frequently engaged in heavy episodic drinking (HED) than non-acute drinkers. Among the patients who took part in the computerized test, more than 15% stated that they were at the preparation stage or actively motivated to change their alcohol consumption. Of the patients who were categorized as acute drinkers, 34% were at the action or preparation stage. Among patients who were categorized as risky drinkers, 48% became non-risky drinkers at follow-up. The relative change in average weekly consumption among risky drinkers was 30% and the relative change in HED occasions per month was 37% from baseline to follow-up. Motivated to reduce alcohol consumption at baseline, influenced by just visiting the ED, considering the alcohol-related feedback information and impact from a health care provider are independent predictors for reduced alcohol consumption.
8
Chan, Man-yan Esther. "A comprehensive intervention for mild head injury patients in accident and emergency department." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B43251018.
Full text
9
Burger, Julia. "Health Literacy, its Effect on Emergency Department Utilization, and a Smartphone-based Intervention." Master's thesis, Temple University Libraries, 2018. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/531766.
Full textAbstract:
Urban BioethicsM.A.
Health literacy is not only the ability to read, but also the ability of an individual to obtain, process, and understand the basic health information needed to make appropriate health decisions. Over time the concept of health literacy has evolved from considering it a risk factor to be managed to considering it an asset which can be continually built upon. With this in mind health professionals should continue to communicate in simple language, but should also provide their patients with high-quality educational materials and aid them in making the best choices about their health. One way to do this could be with the use of symptom-checking and decision-aiding smartphone apps. In this study, the primary caretakers of children aged 30 months and younger with publicly funded health insurance will be randomized to receive a pediatric symptom-checking smartphone app or a developmental milestone smartphone app. Caretaker health literacy will be measured, and data will be collected on emergency department and primary care office sick visits. It is hypothesized that the use of the pediatric symptom-checking smartphone app will decrease non-urgent visits to the pediatric emergency department.
Temple University--Theses
10
Vuong, Ashley. "Intimate Partner Violence in the Emergency Department: The Necessity of Screening and Intervention." Master's thesis, Temple University Libraries, 2018. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/507380.
Full textAbstract:
Urban BioethicsM.A.
Intimate partner violence (IPV) is a public health emergency and due to the often-hidden nature of IPV, it is not readily apparent who is a victim. However, a large proportion of victims are economically disadvantaged, and the emergency department is the first place where many patients present, whether it be for related or unrelated concerns. IPV is difficult to detect, and unfortunately, physicians are also notoriously poor at predicting who is a victim, especially in the emergency department. Because IPV is lethal, it is imperative to improve detection of victims and to intervene when they come forward. This paper seeks to elucidate future sustainable improvements in IPV detection and intervention in the emergency department. Findings indicate that universal computer screening in the emergency department followed by immediate intervention and contact with an IPV-specific advocate is a necessary step to start combating IPV.
Temple University--Theses
11
Nadjarian, Albert H. "An evaluation of screening, brief intervention, and referral to treatment in emergency departments." Thesis, Boston University, 2013. https://hdl.handle.net/2144/12169.
Full textAbstract:
Thesis (M.A.)--Boston UniversityAlcohol use disorders are major national public health problems that are responsible for impaired health. The emergence of SBIRT (Screening, Brief Intervention, and Referral to Treatment) has potentially revolutionized the strategies used to reach the at-risk population of drinkers, specifically within emergency departments (EDs). Several studies have confirmed the efficacy of SBIRT as a viable ED intervention method. Improved study measures have included keeping appointments for treatment, decreased average alcohol consumption and heavy episodic drinking, reduction in health care costs, and reduction in subsequent DUIs (Driving Under the Influence) and alcohol-related re-injury requiring emergency treatment. However, some studies reveal more mixed and sometimes complete lack of support. This manuscript brings this body of evidence together and introduces potential moderators to study results. These moderators include ethnicity, alcohol severity, type of injury, setting disparities, adherence to clinical trial guidelines, and emphasis on referral to treatment. This paper also analyzes patient motivations and behavior change patterns, their potential effect on study outcomes, and suggestions to improve study designs. SBIRT in EDs has provided a significant yet cost and resource-effective method of curbing alcohol misuse. Results from efficacy studies will hopefully mirror the SBIRT's evolution and resulting improvements to our nation's health.
12
Govender, Pregalathan. "The development and testing of a training intervention designed to improve the acquisition and retention of CPR knowledge and skills in ambulance paramedics." Doctoral thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/20835.
Full textAbstract:
Despite several therapeutic advances in cardio-pulmonary resuscitation (CPR), there has been little overall improvement in the out-of-hospital, cardiac arrest (OHCA) survival rates. Reports indicate that, although the incidence and outcome of OHCA vary across the globe, the median reported rates of survival at hospital discharge have remained below 10% for the 30 years preceding this study. One of the factors associated with this low survival rate is the deficient quality of the CPR provided during an OHCA by paramedics. Despite revised training standards, structured CPR training programmes and industry-regulated CPR refresher training schedules, paramedic-delivered CPR (pdCPR) during OHCAs is reported to be both inadequate and rarely in line with established resuscitation guidelines. International resuscitation bodies such as the International Liaison Committee on Resuscitation (ILCOR) postulate the need for tailored CPR training interventions in order to improve CPR performance. The aim of this study was to investigate the impact of a tailored pdCPR training intervention on pdCPR performance. The study was conducted in four phases and, using a mixed-method, multiphase design the study developed, implemented and evaluated the impact of a pdCPR training intervention which had been designed and tailored to improve the acquisition and retention of knowledge and skills by ambulance paramedics (AP). The primary outcome measure used in the study was the achievement of a competent rating which reflected the ability of the AP in question to perform high-quality, effective CPR as determined and evaluated by a 26 measure CPR Rapid Evaluation Tool predicated on variables derived from the globally accepted Cardiff list. Each of the 26 measures represented a treatment element within a pdCPR care bundle and which had been shown to contribute to successful resuscitation.
13
Forsberg, Lars. "Hazardous or harmful alcohol use in emergency care : early detection, motivation to change and brief intervention /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-547-6.
Full text
14
Harrison, Pearl Alethea. "Knowledge and Attitudes of Emergency Room Nurses Regarding Palliative Care Patients." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5716.
Full textAbstract:
Palliative care (PC) is the comprehensive management of patients diagnosed with terminal illness. Care for PC patients focuses on relieving symptoms. The purpose of this study was to determine the difference between pretest and posttest scores on the Frommelt Attitude towards the Care of the Dying (FATCOD) and the Palliative Care Quiz for Nurses (PCQN) after an educational intervention to emergency department (ED) nurses. The framework for this project was Bandura's social cognitive theory. The FATCOD was used to assess ED nurses' attitudes toward PC, and the PCQN was used to assess ED nurses' knowledge about PC prior to the educational program. The educational intervention was developed using evidence obtained from the literature review and guided by the PCQN. The program presented to the ED nurses covered the essentials of palliative care and the information and skills needed by the ED nurse caring for the PC patient. The FATCOD and the PCQN were then administered as a posttest. A total of 70 nurses from two ED units volunteered to take part in the project. Results of the PCQN pre- and posttest showed a significant difference (p < .05), and the FATCOD pre- and posttest showed no significant difference (p = .849). The results revealed that education significantly improved knowledge of PC for the ED nurses participating in the project. Attitudes about PC were not significantly changed after the education program. The project promotes positive social change by raising awareness of the need for PC educational opportunities for ED nurses. By improving PC in the ED, patients and their families may experience increased satisfaction with end-of-life care and improved quality of life.
15
Tokode, Olufolakemi. "The front line of care : a qualitative study of domestic violence intervention in the emergency department." Thesis, University of Manchester, 2012. https://www.research.manchester.ac.uk/portal/en/theses/the-front-line-of-care-a-qualitative-study-of-domestic-violence-intervention-in-the-emergency-department(797ad67b-48dd-4279-af57-324caac4cb6f).html.
Full textAbstract:
This study qualitatively explored the practice of domestic violence (DV) intervention in the emergency department (ED) from the distinct perspectives of service users, service providers and co-ordinators of DV voluntary organisations. The research participant group was made up of eight survivors of domestic abuse, fourteen staff members from an ED (including their manager) and eight co-ordinators from a voluntary organisation offering services for DV issues. The study was informed by the dearth of evidence regarding pragmatic intervention for the specific context of emergency departments (EDs), a need to develop system level interventions and a solid theoretical base to inform implementation of a more effective interventional strategy (Feder et al., 2009; Thurston and Eisener, 2006; Ramsay et al., 2002).The study utilised constructivist grounded theory and feminist perspectives to elicit unique viewpoints from interviews with the three separate groups. A range of meanings and conceptualisations were found which contribute to a more complex understanding of the issues involved and the responses to them. These included how women experience DV, the way DV is rendered invisible by ED culture and, perhaps most importantly, how a lack of policy implementation has influenced the practice of ED staff with regard to DV. Adopting a perspective that takes into account the sensitivity and gendered nature of DV made visible the socio-political and personal influences that affect both health providers' and health users' attitudes to seeking help. System-wide barriers to intervention ranged from personal to situational levels within the context of EDs. They included deep-seated ambivalence, fear and trust issues located within the constructs of both service users and providers regarding identifying and assessing the problem, seeking help, and providing support. Three overarching concepts were identified: 1) meanings and complex realities relating to DV and its intervention 2) barriers to seeking and providing help and 3) strategies for overcoming barriers and developing DV intervention within ED. Using rigorous, inductive, comparative and interpretive attributes of grounded theory procedures, conclusions were reached about the development of DV interventions in the department. These informed the propositions made for a comprehensive and integrated DV intervention including universal interventions which can be helpful irrespective of service user's disclosure and stage of abuse, providing resources within the ED to enhance DV intervention; improving the ED environment so that it is more favourable for DV intervention; implementing policies that make the experience of psychological abuse visible; and promoting DV awareness. Areas of concern were highlighted for practice, policy, and research relevant to DV intervention in EDs.
16
Real, Svensson Patricia, and Mendoza Daniela Tapia. "Sjuksköterskeinitierad intervention för sköra äldre på akutmottagning." Thesis, Sophiahemmet Högskola, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-3995.
Full textAbstract:
På Sveriges akutmottagningar ses att vistelsetiden ökar och att äldre över 65 år är de som står för nära hälften av alla akutbesök och mer än hälften av all sammanlagd vårdtid. Vistelsetiden inom sjukvården beskrivs med två begrepp, LOS som står för den totala vistelsetiden inom sjukhuset och ED LOS som beskriver vistelsetiden på akutmottagningen. Förlängd ED LOS och LOS drabbar äldre genom ökad förekomst av vårdskador och dödlighet. Skörhet är ett begrepp som används för att beskriva äldre som bedöms ha ökad risk att drabbas av sådana negativa konsekvenser. Sjuksköterskan på akutmottagningen har en nyckelfunktion inom patientsäkerhetsarbete och en viktig roll i att effektivisera patientflödet. Syftet var att beskriva sjuksköterskeinitierade interventioner för sköra äldre på akutmottagning genom att undersöka vad som var gemensamt i interventionerna samt deras effekt på ED LOS och LOS. En litteraturöversikt användes som metod. Datainsamlingen genomfördes via databassökningarna i PubMed och CINAHL. Femton vetenskapliga artiklar som beskrev sjuksköterskeinitierade interventioner som utfördes på akutmottagningar och som mätte ED LOS och LOS inkluderades i resultatet. Artiklarna kvalitetsgranskades och analyserades genom en integrerad analys. I resultatet framkom tre huvudkategorier med sju tillhörande underkategorier som beskrev gemensamma fynd i interventionerna. Huvudkategorierna var kunskapens betydelse för interventionen, samverkan för den sköra äldre och identifiering, bedömning och behandling av sköra äldre. ED LOS och LOS presenterades i relation till huvudkategorier och underkategorier. ED LOS minskade i nio interventioner, ökade i två och hade ingen signifikant skillnad i två. LOS hade ingen signifikant skillnad i fem interventioner och minskade i tre. Slutsatsen var att specialistsjuksköterskor har en viktig roll i att utveckla, implementera och leda interventioner för sköra äldre samt att samarbete mellan professioner och över organisationsgränser och införande av snabbspår var viktiga gemensamma faktorer i interventioner som minskade ED LOS och i viss mån LOS.
17
Holland, John Jeremiah. "Assessing the effectiveness of social work emergency certificates on linkage to services." Thesis, Boston College, 2009. http://hdl.handle.net/2345/981.
Full textAbstract:
Thesis advisor: Thanh V. TranABSTRACT This dissertation has the following specific aim: to measure outcomes of social work emergency certificates produced by a Mobile Crisis Team to determine the effectiveness of these certificates at linking clients to services. Linkage to services is a programmatic goal and is achieved by ensuring clients receive adequate crisis and follow up services as a result of Emergency Certificates. In doing so, risks of homicide, suicide and grave disability are mitigated. Under its administrative umbrella, Mobile Crisis Team operates a police-social work collaboration known as Crisis Intervention Team, and both are administered by the State of Connecticut Department of Mental Health and Addiction Services in southeastern Connecticut. The data comes from 233 consecutive cases that involved Emergency Certificate's to transport clients to the local emergency department for psychiatric evaluation and treatment. Data was gathered post-hoc by reviewing copies of each specific certificate and cross-referencing those certificates with an agency risk management report and an electronic data base that stores demographic data on all clients. Descriptive, bivariate and multivariable analysis, such as cross tabulations and binary logistic regression, were used to analyze the data in this study. Additionally, the chi-square automatic interaction detector (CHAID) was used to construct outcome trees to describe subgroups of interest. This research is a continuation of previously published research on the various permutations and outcomes of mobile crisis programs, and contributes two unique programmatic features: the use by social workers of a legally proscribed coercive tool to send people to the emergency department for assessment, and the effectiveness of police-social work collaborations compared to social work only referrals. Overall, linkage occurs in over 80% of cases, with significant predictors of linkage identified as substance abuse, Hispanic ethnicity, criminal justice involvement, suicide, affective disorders, and insurance status. Implications for program evaluation, future research and limitations of the study are also discussed
Thesis (PhD) — Boston College, 2009
Submitted to: Boston College. Graduate School of Social Work
Discipline: Social Work
18
Black, Kirsten. "Emergency contraception as a sexual health intervention : access and clinical outcomes through pharmacy and community provision." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.497774.
Full text
19
Haug, Marit. "The intervention strategies of humanitarian agencies in a complex political emergency : the case of Sri Lanka." Thesis, London School of Economics and Political Science (University of London), 2001. http://etheses.lse.ac.uk/1639/.
Full textAbstract:
This research attempts to answer the question of how humanitarian agencies engage with the combatants in a complex political emergency. The thesis has been designed as a case study of four non-governmental organisations, two Norwegian and two British, which have been working in Sri Lanka in the ongoing war. I focus on the period from 1995-1998 and build mainly of interview data with agency staff. Drawing on research literature on non-governmental organisations, I identify three roles which agencies can play in a complex political emergency: service delivery, advocacy and institution building. Ways in which agencies combine these roles are analysed, both in terms of their strategies in relation to actors in their environments, particularly the government and the LTTE, and in terms of the organisational challenges involved. When agencies move beyond a service delivery role issues relating to neutrality and impartiality often arise. Research literature on humanitarian assistance is applied to analyse how humanitarian agencies operationalise neutrality and impartiality and ways in which the agencies may be drawn into the conflict dynamic. My theoretical framework is organisational theory and, more specifically, research literature on organisations and their environments, and organisational strategy. In particular, I explore aspects of this literature which deal with situations in which organisations are subjected to pressure from their environments. This framework is then applied to identify the sources and types of constraints which agencies operate under and agency responses to these constraints, as well as the ways in which organisations develop strategies for managing their environments. I conclude that it is possible for agencies to combine different roles, but that in doing so, foreign humanitarian agencies have to actively manage their environments in order to ensure that their actions are perceived as legitimate by actors in the country in which they work.
20
Davison, John. "Multifactorial assessment and intervention in cognitively intact older recurrent fallers attending an accident & emergency department." Thesis, University of Newcastle Upon Tyne, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.424016.
Full text
21
Hategekimana, Celestin. "Evaluating the implementation of the emergency, triage, assessment and treatment plus admission care intervention in Rwanda." Thesis, University of British Columbia, 2015. http://hdl.handle.net/2429/55056.
Full textAbstract:
Background: Emergency, Triage, Assessment and Treatment plus Admission care (ETAT+) intervention – a locally adapted pediatric advanced life support program – introduced in Rwanda in 2010 to facilitate the achievement of the fourth Millennium Development Goal. The current thesis was undertaken as part of a larger program of research that aims to evaluate the ETAT+ implementation in Rwanda.
Methods: Data were gathered during a cross-sectional study in 8 district hospitals across Rwanda; an audit in these hospitals was undertaken to establish a baseline description of the availability of essential resources and process of care related to the leading causes of under-five mortality in Rwanda. To determine changes in participating healthcare providers’ knowledge and practical skills (n=374) between pre- and post ETAT+ implementation, a one group pre-posttest design was used. Paired t-test was used to assess the effect of ETAT+ training on knowledge improvement; and, linear and logistic regression models were fitted to examine factors associated with healthcare providers’ performance on ETAT+ knowledge and skills assessments in Rwanda.
Results: Baseline assessment reveals some deficiencies in processes of care (i.e. assessment, treatment and follow-up care), poor organization of some hospital services (e.g., triage), and poor uptake of current pediatric clinical practice guidelines (e.g., dehydration). Post ETAT+, participants’ knowledge scores improved on average by 22.8% (95% CI 20.5, 25.1). Compared to participants who identified as proficient in French, those who identified as proficient in both English and French had on average a higher improvement in knowledge (least square mean=6.64; 95% CI 3.79, 9.49) and were more likely to pass the practical skills assessment (adjusted odds ratio=2.58; 95% CI 1.28, 5.48).
Conclusions: The audit of medical records reveals gaps in the process of pediatric care; and these gaps were found to be consistent with knowledge gaps among healthcare providers, as assessed through the ETAT+ pre-assessment. Improvements in post-ETAT+ performance were significant and a number of factors (e.g., language barriers) were identified as important influences on ETAT+ training outcomes. These factors need to be taken in account when implementing ETAT+ and other continuing medical education interventions within the Rwandan context.Medicine, Faculty of
Population and Public Health (SPPH), School of
Graduate
22
Lisle, Janet. "Miscarriage misfortunes : towards evidence-based nursing for miscarrying women in the emergency department." Access the electronic text, 2008. http://www.biblio.uottawa.ca/biblio/documents/ID-en.pdf.
Full text
23
Macalintal, Jonjon. "Moving Evidence into Practice: Early Sepsis Identification and Timely Intervention in the Emergency Department (Project Code Sepsis)." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2322.
Full textAbstract:
Sepsis is the leading cause of death among hospitalized patients in the United States, is responsible for more than 200,000 deaths annually, and has as high as a 50% mortality rate. Sepsis requires prompt identification so that early goal-directed therapy can be instituted to lead to better outcomes. The purpose of this quality improvement project was to determine if implementing an evidence-based identification and intervention program, Project Code Sepsis, in the emergency department can increase the number of patients who receive antibiotics within the first hour of triage and decrease the length of hospital stay. Specifically, the primary project goals were: (a) to administer initial antibiotic treatments within 1 hour of triage to more than 75% of patients, and (b) to reduce length of hospital stay to an average of less than 7 days. The project was developed from the Donabedian Healthcare Quality Triad and guided by the Six Sigma DMAIC method. A total of 306 patients were included in this project conducted from May to October 2015. The sepsis-screening tool was fully implemented during August when more than 75% of patients received their initial antibiotic within one hour of triage time. However, this accomplishment was not sustained during the next two months. Interestingly, August was also the month with the highest length of hospital stay (7.49 days) among sepsis patients. This quality improvement project did not show that the provision of antibiotic therapy within the first hour of triage time decreases the length of hospital stay among sepsis patients. Multiple factors including administration of intravenous fluids and vasopressors for hypotension, nurse and physician experiences, patient acuity, and local sepsis bacteria profile should be considered together in future studies and quality improvement projects.
24
Mahabee-Gittens, E. Melinda, Robert T. Ammerman, Jane C. Khoury, Lara Stone, Gabe T. Meyers, John K. Witry, Ashley L. Merianos, et al. "Healthy families: study protocol for a randomized controlled trial of a screening, brief intervention, and referral to treatment intervention for caregivers to reduce secondhand smoke exposure among pediatric emergency patients." BIOMED CENTRAL LTD, 2017. http://hdl.handle.net/10150/624340.
Full textAbstract:
Background: Involuntary exposure to secondhand smoke (SHSe) is an important cause of morbidity in children who present to the pediatric emergency department (PED) and urgent care (UC). SHSe interventions delivered in the PED and UC would benefit both the smoker and child, but there have been no large trials testing the efficacy of such interventions. The Healthy Families program is the first randomized controlled trial to test whether a screening, brief intervention, and referral to treatment (SBIRT) intervention delivered in the PED and UC will be effective in decreasing SHSe in children and increasing cessation in smokers. Methods/design: This trial uses a randomized, two-group design in which caregiver-smokers of children 0-17 years old are recruited from the PED and UC. Eligible caregiver-smokers are randomized to either the: 1) SBIRT Condition with face-to-face, tailored counseling that focuses on the child's illness, the importance of reducing child SHSe, caregiver smoking cessation, and the option to receive nicotine replacement therapy; or 2) Healthy Habits Control Condition which includes face-to-face, tailored attention control "5-2-1-0" counseling that focuses on improving the child's health. Dyadic assessments are conducted in-person at baseline, and via email, phone, or in-person at 6-weeks and 6-months. The primary outcomes are biochemically-verified, 7-day point prevalence and prolonged smoking abstinence. Secondary outcomes are cigarettes smoked per week, 24 h quit attempts, and biochemically validated child SHSe at each time point. The costs of this intervention will also be analyzed. Discussion: This study will test an innovative, multilevel intervention designed to reduce child SHSe and increase smoking cessation in caregivers. If effective and routinely used, this SBIRT model could reach at least one million smokers a year in the U.S., resulting in significant reductions in caregivers' tobacco use, SHSe-related pediatric illness, and healthcare costs in this population of children.
25
Randall, Jeff. "Differences in age-related appraisals in children's and adolescents' coping processes in a fire emergency situation." Diss., This resource online, 1993. http://scholar.lib.vt.edu/theses/available/etd-06062008-170439/.
Full text
26
Au, Man-yee, and 區敏儀. "Appropriateness and feasibility of music intervention in reducing anxiety for patients undergoing minor operative procedures in Accidentand Emergency Department." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B44622740.
Full text
27
Zauhar, Sean Russel-Jacque. "Effects of Police-Mental Health Collaborative Services on Calls, Arrests, and Emergency Hospitalizations." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7265.
Full textAbstract:
With the increasing amount of police calls involving persons experiencing a mental health crisis (PICs), agencies are looking for ways to reduce the overuse of emergency services and criminal confinement. Police-mental health collaborative (PMHC) programs were developed to utilize the expertise of both mental health and law enforcement practitioners to provide immediate linkage to psychiatric services in an effort to prevent unnecessary involvement in the criminal justice system. The theoretical framework for this study was built on the sequential intercept model (SIM) along with the theories of social network and social support. The SIM identifies 5 key points where PICs can be diverted away from the criminal justice system. PMHC programs fall within the first intercept where persons with mental illness can be diverted at their first initial contact with law enforcement. Limited empirical research exists that show PMHC programs are reaching their intended objectives. The purpose of this quantitative study was to determine the effect of PMHC services on the likelihood that PICs will have future mental health calls (MHCs), arrests, and emergency hospitalizations (EHPs). Archival data from 1 midwestern police agency and online public court records was used in the analysis. The study employed OLS and logistic regression techniques, which revealed no statistically significant relationships between the PMHC interventions and the likelihood of future MHCs, arrests, and EHPs. However, significance was achieved for several covariates including transient status, prior history of MHCs, arrests, and EHPs. These findings will contribute to positive social change by informing policymakers and practitioners on best practices in community mental health crisis response.
28
Larsson, Margareta. "The Adoption of a New Contraceptive Method – Surveys and Interventions Regarding Emergency Contraception." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4237.
Full text
29
Freeman, Toby, and toby freeman@flinders edu au. "The Role of Health Professionals in the Prevention of Smoking- and Alcohol-Related Harms: Application of the Theory of Planned Behaviour to Work Behaviours." Flinders University. School of Psychology, 2007. http://catalogue.flinders.edu.au./local/adt/public/adt-SFU20070703.133715.
Full textAbstract:
Professional practice change and the transfer of research into practice are critical issues for the public health field. The program of research presented here investigated the potential for practice change in dental hygienists and Emergency Department nurses provision of brief interventions targeting smoking (of tobacco) and alcohol consumption respectively. Smoking and risky alcohol consumption are two high prevalence public health issues that have a substantial impact on the burden of death and illness in Australia.
Research on dental hygienists and nurses uptake of these interventions is limited and has largely focused on descriptions of perceived barriers. Little research has been conducted on the attitudes and motivations of health professionals to engage in these interventions. The present research was designed to address that gap. Specifically, two behaviours by dental hygienists and Emergency Department nurses were investigated: identification of patients at risk and provision of assistance to such patients.
The program of research applied the Theory of Planned Behaviour to these behaviours in order to:
1) examine the role of dental hygienists and Emergency Department nurses in the provision of brief interventions for smoking and alcohol consumption respectively,
2) assess the ability of the Theory of Planned Behaviour to understand and predict health professionals identifying and assisting behaviour,
3) assess the ability of the theory to account for the influence of organisational factors on workers behaviour, and
4) design and evaluate a Theory of Planned Behaviour-based professional practice change intervention.
This is the first research to apply the Theory of Planned Behaviour to these behaviours, to examine the potential of the theory to account for the influence of organisational factors on workers behaviour, and to trial an intervention targeting behaviour in an organisational setting.
The four studies undertaken provided a comprehensive application of the Theory of Planned Behaviour.
In the first study, a meta-analysis of published research examined the ability of the Theory of Planned Behaviour to predict behaviours in an organisational setting. This was the first meta-analysis of studies applying the Theory of Planned Behaviour applications to organisational settings. The findings were comparable to results of a meta-analysis of studies applying the theory to social and health behaviours, supporting the application of the theory to the organisational setting, and also highlighted the potential importance of perceived behavioural control for work behaviours. Studies 2 to 4 were designed to follow Ajzen and Fishbeins (1975) 3-step methodology for applying the theory.
In Study 2, the behavioural, normative, and control beliefs held by dental hygienists and Emergency Department nurses, and potentially relevant organisational factors, such as workload and available support, were identified through in-depth qualitative interviews.
Study 3 measured the ability of the Theory of Planned Behaviour to predict dental hygienists and Emergency Department nurses frequency of identifying and assisting. The theory was most successful in predicting dental hygienists frequency of assisting patients who smoke. The self-efficacy dimension of perceived behavioural control was the strongest predictor of this behaviour. The findings for Emergency Department nurses indicated that subjective norms were an important predictor of intentions to identify and assist patients. The Theory of Planned Behaviour accounted for the influence of organisational factors on behaviour for both dental hygienists and nurses.
Study 4 involved a randomised controlled trial which evaluated a professional intervention targeting dental hygienists assistance of patients who smoke. Trends indicated potential benefits of the intervention, but overall no significant changes in dental hygienists role adequacy, role legitimacy, and targeted control beliefs emerged. This outcome was attributed to ceiling effects and the influence of a media campaign that coincided with the intervention.
The research presented here provides partial support for the application of the Theory of Planned Behaviour to professional practice change efforts. Specifically, the ability of the theory to explain the impact of organisational factors and identify variables most predictive of behaviour may provide valuable insight for prioritising future professional practice change efforts.
30
Muntlin, Åsa. "Identifying and Improving Quality of Care at an Emergency Department : Patient and healthcare professional perspectives." Doctoral thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-110260.
Full textAbstract:
Background: Patients in the emergency department are not always satisfied with the care received and the nursing care in the emergency department is sometimes described as instrumental and non-holistic. Structured quality improvement work and evidence-based practice are needed. Aim: The overall aim was to emphasize general patients in the emergency department to enhance the knowledge on how they perceive the quality of care and how the care could be improved through collaboration with the healthcare professionals. Methods: Four studies, with quantitative and qualitative designs, were conducted in a Swedish emergency department. Two hundred patients answered a questionnaire, after which 22 healthcare professionals comprising five focus groups were interviewed, and finally 200 patients were included in an intervention study. Results: The following five areas for improvement were identified: “information, respect and empathy”, “pain relief”, “nutrition”, “waiting time” and “general atmosphere”. Of these areas, the healthcare professionals prioritized “information, respect and empathy”, “waiting time” and “pain relief” to be highlighted in the quality improvement work. Although goals and suggestions for changes were stated, barriers to quality improvement at different levels in the health care were detected. The results of the intervention study showed that structured nursing assessment of the patients’ abdominal status and nurse-initiated intravenous opioid analgesic could increase frequency of analgesic and reduce time to analgesic in the emergency department. Patients perceived lower pain intensity and improved quality of care in pain management. Conclusions: An uncomplicated nursing intervention, related to pain management, based on the results from a patient questionnaire and interviews with healthcare professionals, can improve the care process and pain management in the emergency department, as well as patients’ perceptions of the quality of care in pain management. To succeed with continuous quality improvement work, barriers to change should be addressed.
31
Tarantino, Nicholas. "Substance Use Severity Predicts Suicidal Ideation in Early Adult Emergency Department Patients: The Role of Family Support." Digital Archive @ GSU, 2012. http://digitalarchive.gsu.edu/psych_theses/95.
Full textAbstract:
Alcohol and drug abuse are strong predictors of suicide. While screening methods have proven effective at identifying and treating substance abuse in non-treatment-seeking users (e.g., screening and brief intervention [SBI]), less attention has been given to the co-occurrence of suicidality among this population, including its correlates and etiology. The current study addresses this gap by presenting data from early adult emergency department (ED) patients (mean age = 27; N = 505), screened for substance abuse and suicidal ideation. Prevalence of past year ideation was high (15%). Results demonstrated a significant and positive indirect effect of cocaine use severity on likelihood of suicidal ideation, mediated through family support. The implications for SBI practices in the ED and suicide etiology among non-treatment-seeking substance abusers are discussed.
32
Hoehn, Jonathan. "Regression/Decision Trees to Predict the Severity of Intervention Needed for COVID-19 Positive Patients Using Baseline Emergency Department Vitals at Presentation." University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1613745329872462.
Full text
33
Xu, Yilun. "The Efficacy of a Lifting Strap as an Ergonomic Intervention for EMS Providers: Does it make it easier to raise a Patient from Supine Lying Posture to Upright Sitting Posture?" The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1566175038221903.
Full text
34
Yost, David M. "Hardiness and Perceived Work Stress as Predictors of Professional Quality of Life Among Emergency Services and Assessment Clinicians." Ohio University / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1466085691.
Full text
35
Diestelkamp, Silke [Verfasser], and Martin [Akademischer Betreuer] Härter. "Differential Effectiveness of a Brief Motivational Intervention for Children and Adolescents Following Acute Alcohol Intoxication in the Emergency Department / Silke Diestelkamp ; Betreuer: Martin Härter." Hamburg : Staats- und Universitätsbibliothek Hamburg, 2017. http://d-nb.info/1139492853/34.
Full text
36
Omérov, Majda. "Violence in psychiatric inpatient care /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-850-5/.
Full text
37
Gibson, Samantha. "Investigating the impact of providing a cognitive behavioural therapy intervention for frequent attenders at the Emergency Department with medically unexplained symptoms : a mixed method study." Thesis, University of the West of England, Bristol, 2018. http://eprints.uwe.ac.uk/33901/.
Full textAbstract:
Background: There are a cohort of people who attend the Emergency Department (ED) extremely frequently. In many cases the symptoms driving their presentations are medically unexplained (MUS). Objectives: The aim of the research was to identify if providing a CBT intervention to frequently attending (high risk) patients with MUS in the healthcare setting they are comfortable with (ED) had impacted attendance patterns and if so how? Design: A mixed method approach was utilised to investigate the impact of providing CBT to ‘high risk’ group of frequent attenders with Medically Unexplained Symptoms at the Emergency Department. Quantitative participants were an opportunistic sample consisting of 50 of the most frequently attending (high risk) patients at the Emergency Department allocated to either control or intervention group. The qualitative research design employed semi-structured interviews. Ten participants were recruited from patients who had attended the CBT intervention. Interviews were transcribed verbatim and analysed using Thematic Analysis. Results: The patients who received the CBT intervention had significantly (p=0.001) reduced their ED attendances and inpatient bed days (p=0.001) following the intervention. In addition, the qualitative approach identified four meaningful themes through thematic analysis: The ED and Me; Psychological Impact; My Treatment and The Long-term Impact: What’s Changed? Conclusion: This study has given a detailed insight into the patients’ perspectives that supports the statistical data of their behaviour pre and post intervention. This study supported the declaration that providing a CBT intervention to high risk frequent attenders with MUS in the ED has a measurable impact on their health care utilisation, not only in the ED, but across the hospital.
38
Almashali, Malak Ataaalah. "Expediting the confirmation of acute myocardial infarction with point of care troponin and heart fatty acid binding protein testing to facilitate early intervention in emergency department." Thesis, Manchester Metropolitan University, 2018. http://e-space.mmu.ac.uk/621967/.
Full textAbstract:
Cardiac troponin is the reference standard biomarker for the diagnosis of acute myocardial infarction (AMI). In the appropriate clinical context, the detection of a rise and/or fall of cardiac troponin is highly sensitive and specific for this diagnosis. However, troponin testing has two key limitations. First, as levels in serum or plasma can take several hours to rise, the diagnostic sensitivity of troponin testing is insufficient to allow acute coronary syndromes to be safely 'ruled out' and serial testing remains necessary. Second, because of the need to detect a rise and/or fall of troponin, serial testing is essential to differentiate chronic troponin elevations from those related to AMI. As a result, international guidance currently recommends serial testing over 6-12 hours. Recent evidence suggests that, with contemporary sensitive troponin assays, AMI can often be 'ruled out' and/or 'ruled in' with serial testing over as little as 1 to 3 hours However, as the turnaround time of laboratory-based testing is typically 1-2 hours, these results may still be unavailable at the time key decisions about initial treatment and patient disposition are made in the Emergency Department (ED). Point of care troponin (POCT) testing at the patient's bedside has a shorter turnaround time than laboratory-based assays and eliminates the need to transport the sample to a central laboratory. When patient pathways are appropriately designed to accommodate point of care testing, key management decisions may be expedited, potentially reducing ED length of stay. If the accuracy and safety of rapid diagnostic strategies using point of care troponin testing over 3 hours can be demonstrated, there are tremendous potential benefits for ED throughput, healthcare resource use and for patients (both in terms of receiving appropriate reassurance with avoidance of hospital admission and receiving appropriate early treatment for acute coronary syndromes). In this study, we will evaluate several promising strategies that may enable clinicians to make accurate diagnoses based on information available in the ED and a single blood test for cardiac markers at the POC. During the study period of February 2015 to March 2017 there were 1,613 patients enrolled. Of this cohort, some patients were excluded for missing i-Stat on arrival, and the patients who did not have an ECG recorded were excluded. This left 733 patients in the final group for analysis consisting of 457 men (62.3%) and 276 women (37.7%). The mean age was 58 years (standard deviation 16). In a pragmatic study we determined the interobserver reliability of Heart-type fatty acid-binding protein (h-FABP) the absolute agreement between investigators was 93.0% with a kappa of 0.81 (95% CI 0.6-1.0), indicating near perfect agreement. In total there were three (7.0%) disagreements. The diagnostic accuracy of POC h-FABP lateral flow immunoassay (True Rapid, FABPulous BV) device for diagnosing or excluding AMI using a single test at the time of patient presentation to the ED and three hours later has been evaluated, the sensitivity and NPV to rule out AMI were 48.24% (95%CI: 37.26% to 59.34%) and 92.48 % (95%CI: 90.91% to 93.80%) respectively. While Specificity and PPV were 89.27 % (95%CI: 86.53%to 91.62%) and 38.68% (95%CI: 31.45% to 46.44%) respectively. However, this strategy would allow 85 % of patients to be discharged (rule out percentage). The diagnostic accuracy of a contemporary POC cTn assay used on arrival and 3 hours later in patients with suspected ACS, at the conventional 99th percentile and novel LoD cut-offs was also evaluated. Finally, we were validated the T-MACS with a contemporary POC cTn assay (i-Stat, Abbott Point of Care, New Jersey) in order to investigate the clinical diagnostic accuracy of i-Stat device to rule out AMI in EDs. By setting the cut off levels of POC at 10ng/ml and functional sensitivity at 10% CV, the T-MACS rule has successfully 'ruled out' > 41.8% of patients with suspected cardiac chest pain following a single blood test, with a sensitivity of 97.4% (90.8 - 99.7%) and NPV of 99.3% (97.1 - 99.8%), in a very short turnaround time of 5-10 minutes. On the other hand T-MACS has risk stratified the patients who were at high risk to have AMI with a specificity of 93.56% (91.27% to 95.40%) and a PPV of 50.00% (42.08% to 57.92%). To our knowledge, this is the first successful validation of a single test 'rule out strategy' using a POC cTn assay. With a 5-10 minute turnaround time, this assay could help to unburden crowded EDs by enabling almost immediate reassurance and discharge for >40% of patients with suspected cardiac chest pain.
39
Aquin, Edward Herman. "Impact evaluation of a 'brief intervention program' for clients who deliberately self harm : a thesis submitted to the Victoria University of Wellington in fulfilment of the requirements for the degree of Master of Nursing (Clinical) /." ResearchArchive@Victoria e-thesis, 2009. http://hdl.handle.net/10063/1238.
Full text
40
Bernardo, Carla Maria Chaves da Silva. "O conceito de emergência social: estudo de caso - A Linha Nacional de Emergência Social (LNES-144) – do laboratório ao observatório social." Master's thesis, Instituto Superior de Ciências Sociais e Políticas, 2012. http://hdl.handle.net/10400.5/5102.
Full textAbstract:
Dissertação de Mestrado em Gestão e Políticas PúblicasO objectivo principal deste trabalho consiste em perceber o que é a Emergência Social. Este conceito terá surgido, na década de 80 do século XX, como um instrumento de luta contra a pobreza e a exclusão social, tendo vindo a suscitar um interesse crescente, no actual contexto social pautado por uma reestruturação profunda do Estado Social. Para levar a cabo o estudo, utilizar-se-á uma perspectiva mista: a) A nível diacrónico, tentar-se-á descrever como surgiu e evoluiu o conceito de Emergência Social no tempo; b) A nível sincrónico, tentar-se-á examinar como é actualmente operacionalizado esse conceito, em termos de políticas públicas e de serviços de proximidade. Para o efeito, faz-se uso de metodologia qualitativa, levando-se a cabo um estudo exploratório. A abordagem metodológica será o Estudo de Caso, sendo o objecto de estudo a Linha Nacional de Emergência Social (LNES-144), serviço público, de âmbito nacional, criado em 2001, na área da Emergência Social. Os resultados apontam para a LNES-144 como um serviço inovador, com um importante papel de laboratório social, tendo deixado uma marca significativa, que lhe permite ser encarado como uma referência na área da Emergência Social. Contudo, foram identificadas algumas limitações ao nível do seu papel enquanto observatório social.
This work main focus is to try to define and study Social Emergency. This concept first surfaced in the mid 80’s as a struggle against poverty and social exclusion and it caused an uprising interest, due to the profound on-going restructures within the concept of Wellfare State. For this topic development, we will use a mixed approach: a) From a diachronic level, we will try to describe both the source, and timeline for the Social Emergency concept b) From a synchronic level, we will try to analyse its actual applicability, regarding both public policies, and proximity services. To achieve this goal, we’ll use a qualitative methodology and an exploratory analysis. In what concerns the methodological approach, we`ll use Linha Nacional de Emergência Social (LNES-144) case study, a nationwide Portuguese public service created in 2001. The results show LNES-144 as an innovating service, of great relevance in the social laboratory plan, notwithstanding there’re still some limitations regarding the observatory focus.
41
Bartlett, Brendan C. "Norm emergence and humanitarian intervention." Thesis, Monterey, Calif. : Naval Postgraduate School, 2008. http://edocs.nps.edu/npspubs/scholarly/theses/2008/Dec/08Dec%5FBartlett.pdf.
Full textAbstract:
Thesis (M.A. in Security Studies (Defense Decision-Making))--Naval Postgraduate School, December 2008.Thesis Advisor(s): Clunan, Anne. "December 2008." Description based on title screen as viewed on January 29, 2009. Includes bibliographical references (p. 129-141). Also available in print.
42
Tolaj, Suana. "KRISREAKTIONER OCH KRISHANTERING BLAND VÅRDPERSONALEN." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-26757.
Full textAbstract:
Att nästan varje dag konfronteras genom sitt yrke med t ex tragedier, allvarligt skadade eller dödfall upplevs olika av oss alla. Syftet med föreliggande studie var att beskriva krisreaktioner samt möjligheten till krishantering hos vårdpersonalen efter traumavård vid en akutmottagning. En enkät användes för datainsamling. Resultatet visar att personalen upplever krisreaktioner i samband med omhändertagandet av skadade barn samt yngre patienter och vid omhändertagandet av deras anhöriga. Möjlighet till krishantering finns på arbetsplatsen men alla är inte nöjda. Förslag på förbättring av krishanteringen handlar om bl a återkommande formell krishantering.To almost daily be confronted at work by tragedies, seriously hurt people or death is something that we all experience in different ways. The aim of this study was to describe crisis reactions and the possibility of crisis interventions after trauma care among the nursing staff at one emergency department. A questionnaire was used to collect data. The result shows that the nursing staff experience crisis reactions when taking care of hurt children and younger patients, and when taking care of there relatives. There is possibility to crisis interventions at the workplace but not everybody is satisfied with it. Among other things, the nursing staff proposed recurring formal crisis interventions as an improvement.
43
Lin, Junwei, and 林俊伟. "Overcrowding in emergency departments in Hong Kong and interventions to improve emergency care." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193798.
Full textAbstract:
Background Emergency department (ED) overcrowding has become a worldwide problem over the past few years, which has been reported in USA, Canada, New Zealand and Australia. For the past two decades, ED overcrowding has also become a controversial issue in Hong Kong, due to high demand for emergency service and misuse of emergency services. In 2002, although there was a charge for emergency department visit which led to a markedly decrease (19.1%) of total attendance, but now the rising trend of ED overcrowding seems to resurface during past few years. This paper aims to review and synthesis causes of ED overcrowding and possible interventions so as to provide possible recommendations for emergency care in Hong Kong.
Methods Literatures on ED overcrowding and potential interventions were searched from PubMed, Google Scholar and Google to locate all relevant articles in English up to May 2013. Through PubMed, ED was described using “Emergency Medicine [MeSH]” OR “emergency department” OR “emergency”, and overcrowding was described using “Crowding [MeSH]” OR “crowded” OR “overcrowding” OR “overcrowded” OR “congestion”, and interventions was described using “interventions” OR “solutions”. Besides, relevant emergency medicine literatures published from the Hong Kong Journal of Emergency Medicine were also reviewed.
Results
I identified and reviewed relevant articles and found that ED attendance has been steadily rising during the past decades in Hong Kong. Although the causes may be somewhat different between different countries, causes of ED overcrowding could be related to easy access to emergency services, barriers to primary care as well as specialist care, and the rising aging population which might be an important underlying cause. As the problem of ED overcrowding will have significant negative impact on patient outcomes, such as unnecessary death, two common interventions to the problem are increasing the resources and demand management. Apart from increasing resources within emergency departments to cater for the increasing demand, it is of highly significance to improve community and primary care for the needs of older people who will contribute a great proportion to ED overcrowding in the future.
Conclusion Semi-urgent and non-urgent visits do account for a great proportion among the total attendance, so it is important triage these patients to alleviate the overcrowding. What’s more, pressure on EDs can be related to a significant increase in the number of elderly patients who may require more investigation or admissions, and need much longer time to manage. As a result, future health policies should focus more on the aging population to improve emergency care.published_or_final_version
Public Health
Master
Master of Public Health
44
De, Man Martin. "Emergency medicine registrars' attitudes towards youth violence prevention interventions in Cape Town emergency centres." Master's thesis, University of Cape Town, 2017. http://hdl.handle.net/11427/25044.
Full textAbstract:
Background: The City of Cape Town, South Africa, has a large youth violence problem with the highest percentage of non-natural deaths per age group in Cape Town occurring between 15 and 24 years of age. Many authorities suggest that youth violence is preventable and there is a fast growing international knowledge base on how emergency centres (ECs) and EC personnel can contribute to youth violence prevention (YVP). In order to utilise this opportunity most effectively, it is important to understand the challenges faced by EC staff, their perceptions of youth violence, and their willingness to engage in YVP interventions in the EC. There is currently no known EC-based YVP intervention in South Africa. Objectives: This study explored the perceptions and attitudes of Cape Town emergency medicine doctors on youth violence, their role in YVP and how it applies to their practice in the EC. Methods: Semi-structured focus groups, each with 3-5 Cape Town emergency medicine (EM) registrars, were conducted, using five basis questions for discussion to elicit participants' perceptions of and attitudes towards YVP. Data saturation was reached after three focus groups. Thematic analysis as described by Braun and Clarke was carried out on the focus group data sets. Results: The three focus groups were all diverse in terms of race, gender, and level of training. In terms of the "Extent of the problem" themes around acceptability and increased burden were explored."Youth Violence Prevention in the EC" focused on the need for a champion, role of the emergency doctor vs. other stakeholders and sustainability issues. Conclusions: EM registrars in Cape Town have a very limited knowledge of YVP in general and specific to the EC. They are faced with immense challenges that relate to patient load, violence directed to EC personnel, and a sense of despair or despondence in terms of ability to effect change. Concerns about the possible implementation of YVP interventions were sustained funding and sustainability in general. These and other factors influenced attitudes towards EC initiated YVP. Notwithstanding challenges, this study has shown an overwhelmingly positive attitude of EM registrars towards the concept of YVP intervention in the EC, and them being the champion or co-champion of it. Recommendations: It is recommended that EM registrars in their training time should receive theoretical and practical training on YVP which can lead to increased awareness of YVP issue, the need to know resources in the community, and in the future will make it easier to implement a pilot intervention project in a selected EC. Further research is needed on a relevant screening tool to identify high risk patients in local ECs.
45
Ponte, Sandra. "Relatório de Projeto: implementação da via verde sépsis no serviço de urgência geral." Master's thesis, Instituto Politécnico de Setúbal. Escola Superior de Saúde, 2013. http://hdl.handle.net/10400.26/5476.
Full textAbstract:
Relatório de Trabalho de Projeto
Apresentação para obtenção do grau de Mestre em Enfermagem Médico-CirúrgicaSegundo estudos recentes na Europa, atualmente a sépsis representa um grave problema de saúde pública, tanto a incidência da inadequada resposta do organismo à infeção, como a mortalidade hospitalar por sépsis, têm vindo a aumentar (DGS, 2010). Neste sentido, a criação de Vias Verdes como estratégia organizada para a abordagem, encaminhamento e tratamento mais adequado, permitindo não só diminuir a morbilidade e mortalidade, mas também a rentabilização de recursos e a redução de custos para as organizações, é crucial para combater esta problemática. Baseada nas diretrizes da Surviving Sepsis Campaing (SSC, 2008) e da Direção Geral de Saúde (DGS, 2010) surgiu a oportunidade de implementação de uma Via Verde para a Sépsis (VVS) nos serviços de urgência. Utilizámos a metodologia de trabalho de projeto com o intuito de avaliar o projeto implementado e o cumprimento do protocolo VVS num Serviço de Urgência Geral (SUG) de um Centro Hospitalar de Lisboa, passado um ano do início do seu desenvolvimento. Assim, temos como objetivos específicos: analisar as etapas do projeto de intervenção em serviço, realizadas; apresentar os resultados obtidos no primeiro ano da implementação do protocolo VVS; evidenciar os resultados de aprendizagem e o desenvolvimento das competências de enfermeira especialista comuns e específicas em enfermagem em pessoa em situação crítica; e refletir sobre o perfil desenvolvido relativamente às competências de mestre em enfermagem médico-cirúrgica. Concluímos que foram concretizadas todas as etapas do projeto planeadas, tendo sido introduzidas medidas corretivas na sua consecução. O protocolo de ativação VVS foi aplicado a uma população de 165 clientes, na qual obtivemos uma amostra de 68 para estudo dos resultados. Na recolha de dados, recorreu-se aos indicadores de registos da aplicação informática existente, sendo que os resultados obtidos permitiram validar a possibilidade da sua aplicação e o cumprimento do protocolo na sua totalidade em 19 clientes. De forma geral pensamos que a realização deste trabalho de projeto contribuiu para a reflexão das aprendizagens e das competências especializadas desenvolvidas, assim como para o desenvolvimento do nosso perfil de mestre, no sentido em que podem ser aplicadas na promoção e garantia da melhoria da acessibilidade, qualidade e segurança dos cuidados de enfermagem especializados, prestados à pessoa em situação crítica, e particularmente ao cliente com suspeita de infeção candidato à inclusão no protocolo de atuação e tratamento em contexto de VVS.
Abstract: According to recent studies in Europe, currently sepsis is a serious public health problem. Both the incidence of inadequate body's response to infection and hospital mortality caused by sepsis has increased (DGS, 2010). Creation Greenways, as an organized strategy for addressing, routing and more appropriate treatment, allows a decrease of morbidity and mortality but also maximize resources and reduce costs for organizations. It is crucial to combat this problem. Based on the guidelines of Survivig Sepsis Campaing (SSC, 2008) and the General Directorate of Health (DGS, 2010) had the opportunity to implement a Green Way to Sepsis (VVS) in emergency department. We used the methodology of the project work in order to evaluate the project implemented in compliance with the protocol VVS in emergency department of a Lisbon Hospital Center, one year from beginning of its development. We have the following objectives: analyze the stages of the project intervention service performed; present the results obtained in the first year of implementation of the protocol VVS; highlight the learning outcomes and skills development of general and specific nurse specialist to a person in a critical condition, and finally a reflection regarding the profile developed in relation to capabilities in master medical-surgical nursing. We conclude that all steps were completed project planned coorective measures have been introduced in their accomplishment. The VVS activation protocol was applied to a population of clients 165 witch obtained a sample of 68 to analyze the results. In data collection, we used the indicators record the computer application and the results obtained allowed to validate the possibility of their implementation and compliance with the protocol in its entirety in 19 clients. Overall we think that this work project contributed to the reflection of lessons learned and expertise developed and weel as developing our profile master, in the sense that they can be used to promote and ensure the improvement of accessibility, quality and safety of skilled nursing care, provided to a peson in critical condition, and particularly to the client witch suspected infection candidate for inclusion in the protocol of operation and treatment in the context of VVS.
46
Franzén, Carin. "Trafikskadades erfarenheter av vård och kostnadseffektivt stöd." Doctoral thesis, Umeå universitet, Institutionen för omvårdnad, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1803.
Full textAbstract:
The overall aim of this thesis was to describe experiences of emergency treatment among people injured in traffic accidents, and to test and evaluate the effects of follow-up telephone calls from a nurse during the subsequent phase. The thesis is based on four sub-studies of motorists, bicyclists, and pedestrians who had fallen in traffic during the years 2002-2005. The participants were aged 18 to 70 years old and had minor (MAIS 1) or nonminor (MAIS 2+) injuries. Sub-study I was a qualitative study in which individual narrative interviews were conducted with nine persons who had sustained traffic injuries. The aim of this study was to describe the injured individuals’ experiences of pre-hospital and hospital care and subsequent rehabilitation. The interviews were analysed using content analysis, and the experiences of the interviewees were formulated into four themes: facing commotion, experiencing trust and security, lacking security and support, and struggling to return to everyday life. The results showed that a sensitive caregiver who provides comprehensible information facilitates both the emergency treatment and the subsequent period of care and rehabilitation. Sub-study II was a cross-sectional study in which the participants (n=565) estimated their perceptions of the quality of care in the accident and emergency department (A&E) after an injury event. The Mini-KUPP (“Quality from the Patient’s Perspective”) questionnaire was used to estimate quality of care at the A&E. The questionnaire was posted to the subjects’ home addresses three weeks after the visit to the A&E. The results showed that the quality of care was scored on the top half of the scale by all three road user categories. In a multiple logistic regression analysis, significant connections emerged between good quality of care and a short waiting time, non-minor injuries (MAIS2+), higher age, and higher levels of education. The factor most closely associated with the perception of good quality of care was a short waiting time. Sub-study III was a stratified and randomised intervention study including 568 injured persons. In addition to modern trauma care, the intervention group received follow-up via telephone, three weeks after the injury, by a nurse who provided advice and support during the rehabilitation period. The control group received modern trauma care but no follow-up. Both groups estimated their health-related quality of life two weeks (baseline) and six months after the injury. After six months, estimates of health-related quality of life were generally higher in the intervention group than in the control group. A sub-group analysis found that the differences were most pronounced for the group who had received adequate advice in connection with the telephone follow-up. Of the three road user categories, the motorists gained the greatest benefit from the telephone intervention, with milder problems with regard to pains/difficulties and essential activities. Sub study IV was a health economic study. The calculations were built on the results from study III (n=568). A cost utility analysis was performed, including the costs for the intervention and the QALYs gained. The results showed that the telephone intervention was cost-effective. The total gain in the intervention group was 2.60 QALYs, while the car occupants gained 1.54 QALYs. The cost per QALY gained was 16 000 SEK overall and 8 500 SEK for car occupants. Conclusion: A sensitive caregiver who also provides good information can instil security and trust in the patient. For the purposes of generally improving the quality of care in an A&E, the aim above all should be a short waiting time, but the treatment of minor injuries should also be improved. Access to a supportive nurse who is able to provide advice during the subsequent phase has the potential to improve health-related quality of life in a cost-effective way.
47
Britz, Etienne Francois. "Emergence in the self-organizing city : a mult-functional intervention." Pretoria : [s.n.], 2007. http://upetd.up.ac.za/thesis/available/etd-11162007-152819.
Full text
48
Knutson, Donna Beth. "Drills and Exercises as Interventions to Improve Public Health Emergency Response." Thesis, Walden University, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3563563.
Full textAbstract:
The 2001 destruction of the World Trade Center and the subsequent anthrax attacks highlighted the inability of an antiquated public health system in the United States to respond effectively to emergencies. Little documentation exists to define how public health agencies can improve performance. The overarching research question was the extent to which drills and exercises improve performance in public health emergencies. Adult learning theory and deliberate practice theory were explored in this context. The research data were from 50 state public health departments, which were required to report performance information to the U.S. Centers for Disease Control and Prevention. The data were examined using Poisson analysis and logistic regression. Results indicated that drills and exercises had no statistically significant impact on public health performance for the 3 performance measures examined; of all predictors, what explained the most variance in reaching performance targets was the number of real emergencies to which a health department had responded in the past. Performing drills and exercises did not predict the likelihood of reaching performance targets. These findings have implications for positive social change for Congressional leaders and other government representatives. Such public servants could use this information to guide their efforts to redirect public health emergency preparedness funds away from drills and exercises and toward other fundamental public health activities. These more focused efforts could facilitate the improvement of public health laboratory capacity, the training of field epidemiologists, and the advancements in technology for enhanced reporting and surveillance.
49
Patton, Robert. "Alcohol and the Emergency Department : screening and interventions to reduce harm." Thesis, King's College London (University of London), 2011. https://kclpure.kcl.ac.uk/portal/en/theses/alcohol-and-the-emergency-department-screening-and-interventions-to-reduce-harm(245ed8bd-b438-4bdf-8c59-b584e759bdef).html.
Full text
50
Knutson, Donna Beth. "Drills and Exercises as Interventions to Improve Public Health Emergency Response." ScholarWorks, 2011. https://scholarworks.waldenu.edu/dissertations/1063.
Full textAbstract:
The 2001 destruction of the World Trade Center and the subsequent anthrax attacks highlighted the inability of an antiquated public health system in the United States to respond effectively to emergencies. Little documentation exists to define how public health agencies can improve performance. The overarching research question was the extent to which drills and exercises improve performance in public health emergencies. Adult learning theory and deliberate practice theory were explored in this context. The research data were from 50 state public health departments, which were required to report performance information to the U.S. Centers for Disease Control and Prevention. The data were examined using Poisson analysis and logistic regression. Results indicated that drills and exercises had no statistically significant impact on public health performance for the 3 performance measures examined; of all predictors, what explained the most variance in reaching performance targets was the number of real emergencies to which a health department had responded in the past. Performing drills and exercises did not predict the likelihood of reaching performance targets. These findings have implications for positive social change for Congressional leaders and other government representatives. Such public servants could use this information to guide their efforts to redirect public health emergency preparedness funds away from drills and exercises and toward other fundamental public health activities. These more focused efforts could facilitate the improvement of public health laboratory capacity, the training of field epidemiologists, and the advancements in technology for enhanced reporting and surveillance.