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Book part
Publication date: 15 August 2023

Richard Wiseman

Abstract

Details

Magic
Type: Book
ISBN: 978-1-80455-613-9

Article
Publication date: 28 April 2023

Yelda Durgun Şahin, Osman Metin Yavuz and Erol Kesiktaş

This study discusses that the necessary criteria and the solution approach taken to resolve the main spatial infection problems with a burn center design should be evaluated…

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Abstract

Purpose

This study discusses that the necessary criteria and the solution approach taken to resolve the main spatial infection problems with a burn center design should be evaluated holistically to achieve spatial infection control in a burn center. The burn center design plays an important role in protecting severely burned patients from infection because the microbial flora of the hospital can affect the infection risk. In hospitals, sterilization and disinfection are the basic components of infection prevention; however, the prevention and control of infection for burn patients also requires the design of burn centers that adhere to a specific set of criteria that considers spatial infection control in addition to appropriate burn treatment methods and treatments. In this study, a burn facility converted from a burn unit into a burn center is introduced and the necessary design inputs for the transformation are discussed because there is no holistic study in the literature that delas with all the spaces that should be in a burn center and relations between spaces. This study aims to define the functional relations between each of the units and the spaces that change according to different sterilization demands in the burn center for ensuring spatial infection control. Furthermore, it aims to propose a method for ensuring continuity in the control of spatial infections.

Design/methodology/approach

The burn care and health facilities guidelines are examined within the framework of spatial standards, together with a comprehensive literature review. The design method was based on the spread of microorganisms and the effect of human movement on space and spatial transitions in the burn center, according to all relevant literature reviews. To determine the extent to which the differences in treatment protocols of burn care guidelines were reflected in the space, interviews were conducted with burn facility officials. The plan–do–check–act (PDCA) method is also modeled to ensure the continuity of infection control in the burn center.

Findings

The burn center design findings are classified under three main headings, namely, location of the burn center in the hospital, spatial organization and physical features of the burn center and the air flowing system. The importance of the interactions among the criteria for spatial infection control has been revealed. Due to the physical space characteristics and air flow characteristics that change according to human movement and the way microorganisms spread, it has been seen that designing the air flow and architectural aspects together has an effective role in providing spatial infection control. Accordingly, a functional relation scheme for the center has been suggested. It is also proposed as a model to ensure the continuity of infection control in the burn center.

Practical implications

This research presents spatial measures for infection control in burn centers for practitioners in health-care settings such as designers, engineers, doctors and nurses. The PDCA method also leads to continuity of infection control for hospital management.

Originality/value

This is the first study, to the best of the authors’ knowledge, to focus on developing the criteria for spatial infection control in burn center. Moreover, the aim is to create a function chart that encompasses the relationships between the units within the burn center design so that infection control can be coordinated spatially.

Details

Facilities , vol. 41 no. 9/10
Type: Research Article
ISSN: 0263-2772

Keywords

Article
Publication date: 26 September 2023

Melanie Barlow, Bernadette Watson, Kate Morse, Elizabeth Jones and Fiona Maccallum

The response of the receiver to a voiced patient safety concern is frequently cited as a barrier to health professionals speaking up. The authors describe a novel Receiver Mindset…

Abstract

Purpose

The response of the receiver to a voiced patient safety concern is frequently cited as a barrier to health professionals speaking up. The authors describe a novel Receiver Mindset Framework (RMF) to help health professionals understand the importance of their response when spoken up to.

Design/methodology/approach

The framework draws on the broader receiver-focussed literature and integrates innovative findings from a series of empirical studies. These studies examined different receiver behaviour within vignettes, retrospective descriptions of real interactions and behaviour in a simulated interaction.

Findings

The authors' findings indicated that speaking up is an intergroup interaction where social identities, context and speaker stance intersect, directly influencing both perceptions of and responses to the message. The authors' studies demonstrated that when spoken up to, health professionals poorly manage their emotions and ineffectively clarify the speaker's concerns. Currently, targeted training for receivers is overwhelmingly absent from speaking-up programmes. The receiver mindset framework provides an evidence-based, healthcare specific, receiver-focussed framework to inform programmes.

Originality/value

Grounded in communication accommodation theory (CAT), the resulting framework shifts speaking up training from being only speaker skill focussed, to training that recognises speaking up as a mutual negotiation between the healthcare speaker and receiver. This framework provides healthcare professionals with a novel approach to use in response to speaking up that enhances their ability to listen, understand and engage in point-of-care negotiations to ensure the physical and psychological safety of patients and staff.

Details

Journal of Health Organization and Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 7 November 2023

Chih-Hsuan Huang, Yii-Ching Lee and Hsin-Hung Wu

Medical staff's emotional exhaustion increases cynical attitudes and behaviors about work and patients and leads medical staff to become detached from work. This may decrease…

Abstract

Purpose

Medical staff's emotional exhaustion increases cynical attitudes and behaviors about work and patients and leads medical staff to become detached from work. This may decrease patients' trust and satisfaction and even endanger patients' lives. There is a need to examine the critical factors affecting the medical staff's emotional exhaustion by investigating its relationship with the patient-safety dimensions based on the safety attitudes questionnaire (SAQ).

Design/methodology/approach

A case study is conducted from the viewpoints of physicians and nurses to examine the relationship between emotional exhaustion and six dimensions of the SAQ from 2016 to 2020 from a regional teaching hospital in Taiwan. Linear regression with forward selection is employed. Six dimensions of the SAQ are the independent variables, whereas emotional exhaustion is the dependent variable for each year.

Findings

Stress recognition is the most important variable to influence emotional exhaustion negatively, while job satisfaction is the second important variable to affect emotional exhaustion positively from 2016 to 2020. On the contrary, working conditions do not influence emotional exhaustion in this hospital from medical staff's viewpoints.

Originality/value

This study uses longitudinal data to find that both stress recognition and job satisfaction consistently influence emotional exhaustion negatively and positively, respectively, in this five-year period. The third dimension to impact emotional exhaustion varies from time to time. Thus, the findings from a cross-sectional study might be limited. The authors' findings show that reducing stress recognition and enhancing job satisfaction can lead to the improvement of emotional exhaustion from medical staff's viewpoints, which should be monitored by hospital management.

Details

Journal of Health Organization and Management, vol. 38 no. 1
Type: Research Article
ISSN: 1477-7266

Keywords

Book part
Publication date: 28 August 2023

Kathryn Burrows

To understand how parents make the decision to implant their deaf young children with cochlear implants, focusing specifically on the concepts of normality, medicalization, and…

Abstract

Purpose

To understand how parents make the decision to implant their deaf young children with cochlear implants, focusing specifically on the concepts of normality, medicalization, and stigma.

Methodology/Approach

I conducted 33 semi-structured interviews with the hearing parents or parent of children with cochlear implants. In all but two families I interviewed the primary caretaker which in all cases was a mother. In the remaining two interviews, I interviewed both parents together. Because of the relative scarcity of families with children with cochlear implants, and the difficulty in connecting with these families, I used a convenience sample, and I did not stratify it in any way. The only requirement for parents to be interviewed is that they had at least one deaf child who had been implanted with at least one cochlear implant. Although this is a small sample, the findings are transferable to other families with the same sociodemographic characteristics as those in my study.

Findings

Parents in the study focused on three key concepts: normality, risk analysis, and being a good parent. Dispositional factors such as the need to be “normal” and the desire for material success for one's children appeared to moderate the cost-benefit calculus.

Research Limitations/Implications

Limitations

This interview project concentrated on hearing families who had implanted their deaf children with cochlear implants; it does not include culturally Deaf parents who choose to use American Sign Language (ASL) with their Deaf children. Understanding how Deaf families understand the concepts of normality, medicalization, and stigma would shed light on how a distinctly “abnormal” group (by a statistical conception of normal) – ASL-using Deaf people-explain normality in the face of using a non-typical communication method. One can learn a lot by studying the absence of a phenomena, in this case, not implanting children with cochlear implants. It is possible that the existential threat felt by some Deaf people, specifically the demographic problem presented by cochlear implants, led Deaf educators or parents to resist being the subject of research.

Overwhelmingly the sample was female, and white. Only two participants were male, and none of the participants were non-white. The lack of diversity in the sample does not necessarily reflect a lack of diversity of children receiving cochlear implants. Medicaid, which disproportionately covers families of color, covers cochlear implants in most cases, so low SES/racial intersectionality should not have affected the lack of diversity in the sample. However, the oral schools are all private pay, with few scholarships available, so low SES/racial intersectionality in the sampling universe (all children who attend oral schools), may have played a part in the lack of racial diversity within the sample.

Implications

Parents in this study were very specific about the fact that they believed cochlear implants would lead to academic, professional, and personal success. They weaved narratives of normality, medicalization, and stigma through their stories. Normality is an important lens from which to see stories about disability and ability, as well as medical correction. As medical science continues to advance, more and more conditions will become medicalized, leading to more and more people taking advanced medical treatments to address problems that were previously considered “problems with living” that are now considered “medical problems” that can be treated with advanced science.

Originality/Value of Paper

This chapter's contribution to the sociological cochlear implant literature is it's weaving of narratives about normality, stigma, and medicalization into parental stories about the cochlear implant decision-making process. Most literature about the cochlear implant decision-making process focus on cost-benefit analysis, and logical decision-making processes, whereas this paper focuses on decision-making factors stemming from bias, emotions, and values.

Details

Social Factors, Health Care Inequities and Vaccination
Type: Book
ISBN: 978-1-83753-795-2

Keywords

Article
Publication date: 13 February 2024

Aleena Swetapadma, Tishya Manna and Maryam Samami

A novel method has been proposed to reduce the false alarm rate of arrhythmia patients regarding life-threatening conditions in the intensive care unit. In this purpose, the…

Abstract

Purpose

A novel method has been proposed to reduce the false alarm rate of arrhythmia patients regarding life-threatening conditions in the intensive care unit. In this purpose, the atrial blood pressure, photoplethysmogram (PLETH), electrocardiogram (ECG) and respiratory (RESP) signals are considered as input signals.

Design/methodology/approach

Three machine learning approaches feed-forward artificial neural network (ANN), ensemble learning method and k-nearest neighbors searching methods are used to detect the false alarm. The proposed method has been implemented using Arduino and MATLAB/SIMULINK for real-time ICU-arrhythmia patients' monitoring data.

Findings

The proposed method detects the false alarm with an accuracy of 99.4 per cent during asystole, 100 per cent during ventricular flutter, 98.5 per cent during ventricular tachycardia, 99.6 per cent during bradycardia and 100 per cent during tachycardia. The proposed framework is adaptive in many scenarios, easy to implement, computationally friendly and highly accurate and robust with overfitting issue.

Originality/value

As ECG signals consisting with PQRST wave, any deviation from the normal pattern may signify some alarming conditions. These deviations can be utilized as input to classifiers for the detection of false alarms; hence, there is no need for other feature extraction techniques. Feed-forward ANN with the Lavenberg–Marquardt algorithm has shown higher rate of convergence than other neural network algorithms which helps provide better accuracy with no overfitting.

Details

Data Technologies and Applications, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2514-9288

Keywords

Open Access
Article
Publication date: 20 November 2023

Concetta Russo, Alessandra Decataldo and Brunella Fiore

Introduction: The birth of a preterm child requires hospitalization in a neonatal intensive care unit (NICU), which is a very stressful experience for parents. Aim: To determine…

Abstract

Purpose

Introduction: The birth of a preterm child requires hospitalization in a neonatal intensive care unit (NICU), which is a very stressful experience for parents. Aim: To determine the stress level of parents of preterm babies admitted to intensive and sub-intensive units in two hospitals in Northern Italy and its association with their sociodemographic variables and the clinical conditions of their newborns.

Design/methodology/approach

The sampling was non-probabilistic and included parents of preterm babies admitted to intensive and/or sub-intensive care for at least 10 days. Instruments: (1) information deduced from the clinical record of preterm newborns; (2) sociodemographic determinants of parents' well-being deduced from a questionnaire; (3) parental stress scale: neonatal intensive care unit (PSS:NICU), which measures the perception of parents about stressors from the physical and psychological environment of the NICU.

Findings

Results: A total of 104 parents of 59 hospitalized preterm babies participated in the study. The average parental stress level was 1.87 ± 0.837. The subscale score that got higher was parent-infant relationship subscale. Concerning the infant characteristics, the birth weight of the babies and the length of their hospitalization affected the parents' stress level. Looking at parents' sociodemographic characteristics instead, the greater predictors were gender, age and occupational social class.

Originality/value

The parental role alteration caused by infant premature birth and consequent hospitalization is a major stressor for parents and in particular for mothers. The variables that resulted positively associated with higher stress in parents of preterm infants hospitalized are specific parental characteristics, including not adequately or previously studied ones, and infant characteristics.

Details

International Journal of Sociology and Social Policy, vol. 43 no. 13/14
Type: Research Article
ISSN: 0144-333X

Keywords

Article
Publication date: 16 August 2022

Cong Toai Truong, Kim Hieu Huynh, Van Tu Duong, Huy Hung Nguyen, Le An Pham and Tan Tien Nguyen

In the COVID-19 outbreak periods, people's life has been deranged, leading to disrupt the world. Firstly, the number of deaths is growing and has the potential to surpass the…

Abstract

Purpose

In the COVID-19 outbreak periods, people's life has been deranged, leading to disrupt the world. Firstly, the number of deaths is growing and has the potential to surpass the highest level at any time. Secondly, the pandemic broke many countries' fortified lines of epidemic prevention and gave people a more honest view of its seriousness. Finally, the pandemic has an impact on life, and the economy led to a shortage in medical, including a lack of clinicians, facilities and medical equipment. One of those, a simple ventilator is a necessary piece of medical equipment since it might be useful for a COVID-19 patient's treatment. In some cases, the COVID-19 patients require to be treated by modern ventilators to reduce lung damage. Therefore, the addition of simple ventilators is a necessity to relieve high work pressure on medical bureaucracies. Some low-income countries aim to build a simple ventilator for primary care and palliative care using locally accessible and low-cost components. One of the simple principles for producing airflow is to squeeze an artificial manual breathing unit (AMBU) iterative with grippers, which imitates the motion of human fingers. Unfortunately, the squeezing angle of grippers is not proportional to the exhaust air volume from the AMBU bag. This paper aims to model the AMBU bag by a mathematical equation that enables to implement on a simple controller to operate a bag-valve-mask (BVM) ventilator with high accuracy performance.

Design/methodology/approach

This paper provides a curvature function to estimate the air volume exhausting from the AMBU bag. Since the determination of the curvature function is sophisticated, the coefficients of the curvature function are approximated by a quadratic function through the experimental identification method. To obtain the high accuracy performance, a linear regression model and a least square method are employed to investigate the characteristic of the BVM ventilator's grippers angle with respect to the airflow volume produced by the AMBU bag.

Findings

This paper investigates the correlation between the exhausting airflow of the AMBU bag and the grippers angle of the BVM ventilator.

Originality/value

The experimental results validated that the regression model of the characteristic of the exhausting airflow of the AMBU bag with respect to the grippers' angle has been fitted with a coefficient over 98% within the range of 350–750 ml.

Details

International Journal of Intelligent Unmanned Systems, vol. 11 no. 3
Type: Research Article
ISSN: 2049-6427

Keywords

Article
Publication date: 3 August 2022

Li Li, Hsin-Hung Wu, Chih-Hsuan Huang, Yuanyang Zou and Xiao Ya Li

Understanding the antecedents of patient safety culture among medical staff is essential if hospital managers are to promote explicit patient safety policies and strategies. The…

Abstract

Purpose

Understanding the antecedents of patient safety culture among medical staff is essential if hospital managers are to promote explicit patient safety policies and strategies. The factors that influence patient safety culture have received little attention. The authors aim to investigate the antecedents of patient safety culture (safety climate) in relation to medical staff to develop a comprehensive approach to improve patient safety and the quality of medical care in China.

Design/methodology/approach

The Chinese version of the Safety Attitudes Questionnaire (CSAQ) was used to examine the attitudes toward patient safety among physicians and nurses. This medical staff was asked to submit the intra-organizational online survey via email. A total of 1780 questionnaires were issued. The final useable questionnaires were 256, yielding a response rate of 14.38%. One-way analysis of variance (ANOVA) was employed to test if different sex, supervisor/manager, age, working experience, and education result in different perceptions. Confirmatory factor analysis (CFA) was used to verify the structure of the data. Then linear regression with forward selection was performed to obtain the essential dimension(s) that affect the safety culture (safety climate).

Findings

The CFA results showed that 26 CSAQ items measured 6 safety-related dimensions. The linear regression results indicated that working conditions, teamwork climate, and job satisfaction had significant positive effects on safety culture (safety climate).

Practical implications

Hospital managers should put increased effort into essential elements of patient-oriented safety culture, such as working conditions, teamwork climate, and job satisfaction to develop appropriate avenues to improve the quality of delivered medical services as well as the safety of patients.

Originality/value

This study focused on the contribution that the antecedents of patient safety culture (safety climate) make with reference to the perspective of medical staff in a tertiary hospital in China.

Details

The TQM Journal, vol. 35 no. 6
Type: Research Article
ISSN: 1754-2731

Keywords

Article
Publication date: 31 July 2023

Mélanie Lefèvre, Jens Detollenaere, Renate Zeevaert and Carine Van de Voorde

Many countries have developed hospital-at-home (HAH) models to bring hospital services closer to home. Although some countries already have a long tradition of HAH for adults…

Abstract

Purpose

Many countries have developed hospital-at-home (HAH) models to bring hospital services closer to home. Although some countries already have a long tradition of HAH for adults, paediatric HAH has been developed more recently. Specificities of paediatric care make it difficult to directly extend an adult HAH model to the paediatric population. The objective of this study is to compare the organisation of paediatric HAH in four countries: France, Australia (states of Victoria and New South Wales), the Netherlands and Belgium. Ultimately, lessons can be drawn for further development in the countries analysed and/or for implementation in other countries.

Design/methodology/approach

Legal documents and other grey literature were analysed to describe the legal context for the provision of paediatric HAH in the selected countries. In addition, semi-structured in-depth interviews were conducted with key informants from paediatric HAH organisations in these countries, addressing the following topics: historical background, legal framework, functioning of HAH models, workforce, number of services, profile of children, type of care activities, funding, coordination with other providers and quality of care. Results were reviewed by a content expert from the respective country.

Findings

Organisational differences were highlighted in terms of coordinating actor (hospital or home nursing care services), decision-making process, range of clinical conditions treated, territorial organisation, qualifications and expertise of the team members, medical expertise, financing, responsibilities, etc.

Originality/value

There is no single preferred model for the provision of HAH care for children. There is a large variety in almost all aspects of organisation. There are, however, also some common characteristics across the different models. Notably, paediatric expertise of nurses within the HAH team was considered indispensable in all programmes.

Details

Journal of Integrated Care, vol. 31 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

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