PURPOSE: During the initial phase of the pandemic, healthcare professionals faced difficulties due to the limited availability of comprehensive learning resources on managing patients affected with coronavirus disease 2019 (COVID-19). The COVID-19 Skills Preparation Course (C19_SPACE) was tailored to meet the overwhelming demand for specialized training. The primary objective of this study was to assess the efficacy and impact of this program on enhancing clinical knowledge and to identify factors affecting this improvement. METHODS: As part of the project, data were collected prospectively to measure the baseline knowledge. After the descriptive statistics, multiple and multivariate logistic regression models were executed to identify the factors associated with knowledge increase. RESULTS: The final sample included 3140 medical doctors (MDs) and 3090 nurses (RNs). For the primary analysis, the mean value of the baseline knowledge test score of MDs was 62.41 (standard deviation, SD = 13.48), and it significantly (p < 0.001) increased to 84.65 (SD = 11.95). Factors influencing overall knowledge scores were female sex (AOR = 1.34 [1.04-1.73]), being a specialist qualified for intensive care medicine (adjusted odds ratio, AOR = 0.56, [0.33-0.96]), and performance on the pre-test (AOR = 0.91, [0.90-0.92]). As for the RNs, the mean value of the total knowledge score was 63.25 (SD = 13.53), which significantly (p < 0.001) increased to 81.51 (SD = 14.21). Factor associated with knowledge was performance on the pre-test (AOR = 0.92 [0.92-0.93]). CONCLUSIONS: C19_SPACE effectively increased the clinical knowledge of doctors and nurses. The effect was more pronounced in the program's target group of healthcare workers with less experience in the intensive care unit (ICU). Other factors associated with knowledge enhancement were sex and being a specialist in intensive care.
- MeSH
- COVID-19 * epidemiologie MeSH
- distanční studium metody MeSH
- dospělí MeSH
- klinické kompetence * normy statistika a číselné údaje MeSH
- lékaři MeSH
- lidé středního věku MeSH
- lidé MeSH
- pandemie MeSH
- prospektivní studie MeSH
- SARS-CoV-2 MeSH
- zdravotní sestry statistika a číselné údaje MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Aim: The present research aimed to provide a systematic analysis of the work ability (WA) of nurses assessed through the Work Ability Index (WAI) with a focus on factors influencing WA in the studied population. Design: A systematic literature review. Methods: In January 2024, a literature search was performed using Medline / PubMed and ScienceDirect databases, in order to identify studies focused on assessment of WA with the WAI among nurses. Databases were searched using 'work ability index' and 'nurse' as key terms. Articles were selected according to PRISMA guidelines. Results: Three hundred twenty-two studies were identified in the initial search (230 studies indexed by Medline / PubMed and 92 by ScienceDirect). After applying inclusion and exclusion criteria, a total of 16 studies were included in the systematic review. The results revealed common factors that affect WA among nurses. These factors are grouped as follows: age, gender, marital status, education, years of work, shift work, and diagnosed diseases. Conclusion: Assessing the WA of nurses with the WAI provides a comprehensive and structured approach to understanding their capacity to meet the demands of their profession while considering various dimensions of health and work-related factors.
- Klíčová slova
- Work Ability Index, WAI,
- MeSH
- klinické kompetence * statistika a číselné údaje MeSH
- průzkumy a dotazníky statistika a číselné údaje MeSH
- sběr dat MeSH
- zdravotní sestry * MeSH
- Publikační typ
- systematický přehled MeSH
OBJECTIVE: To evaluate interobserver agreement for the assessment of local tumor extension in women with cervical cancer, among experienced and less experienced observers, using transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI). METHODS: The TVS observers were all gynecologists and consultant ultrasound specialists, six with and seven without previous experience in cervical cancer imaging. The MRI observers were five radiologists experienced in pelvic MRI and four less experienced radiology residents without previous experience in MRI of the pelvis. The less experienced TVS observers and all MRI observers underwent a short basic training session in the assessment of cervical tumor extension, while the experienced TVS observers received only a written directive. All observers were assigned the same images from cervical cancer patients at all stages (n = 60) and performed offline evaluation to answer the following three questions: (1) Is there a visible primary tumor? (2) Does the tumor infiltrate > ⅓ of the cervical stroma? and (3) Is there parametrial invasion? Interobserver agreement within the four groups of observers was assessed using Fleiss kappa (κ) with 95% CI. RESULTS: Experienced and less experienced TVS observers, respectively, had moderate interobserver agreement with respect to tumor detection (κ (95% CI), 0.46 (0.40-0.53) and 0.46 (0.41-0.52)), stromal invasion > ⅓ (κ (95% CI), 0.45 (0.38-0.51) and 0.53 (0.40-0.58)) and parametrial invasion (κ (95% CI), 0.57 (0.51-0.64) and 0.44 (0.39-0.50)). Experienced MRI observers had good interobserver agreement with respect to tumor detection (κ (95% CI), 0.70 (0.62-0.78)), while less experienced MRI observers had moderate agreement (κ (95% CI), 0.51 (0.41-0.62)), and both experienced and less experienced MRI observers, respectively, had good interobserver agreement regarding stromal invasion (κ (95% CI), 0.80 (0.72-0.88) and 0.71 (0.61-0.81)) and parametrial invasion (κ (95% CI), 0.69 (0.61-0.77) and 0.71 (0.61-0.81)). CONCLUSIONS: We found interobserver agreement for the assessment of local tumor extension in patients with cervical cancer to be moderate for TVS and moderate-to-good for MRI. The level of interobserver agreement was associated with experience among TVS observers only for parametrial invasion. © 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
- MeSH
- cervix uteri diagnostické zobrazování MeSH
- dospělí MeSH
- gynekologie statistika a číselné údaje MeSH
- klinické kompetence statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody statistika a číselné údaje MeSH
- nádory děložního čípku diagnostické zobrazování patologie MeSH
- odchylka pozorovatele MeSH
- radiologie statistika a číselné údaje MeSH
- reprodukovatelnost výsledků MeSH
- staging nádorů metody statistika a číselné údaje MeSH
- ultrasonografie metody statistika a číselné údaje MeSH
- vagina diagnostické zobrazování MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
BACKGROUND: Antibiotic exposure in intensive care patients with sepsis is frequently inadequate and is associated with poorer outcomes. Antibiotic dosing is challenging in the intensive care, as critically ill patients have altered and fluctuating antibiotic pharmacokinetics that make current one-size-fits-all regimens unsatisfactory. Real-time bedside dosing software is not available yet, and therapeutic drug monitoring is typically used for few antibiotic classes and only allows for delayed dosing adaptation. Thus, adequate and timely antibiotic dosing continues to rely largely on the level of pharmacokinetic expertise in the ICU. Therefore, we set out to assess the level of knowledge on antibiotic pharmacokinetics among these intensive care professionals. METHODS: In May 2018, we carried out a cross-sectional study by sending out an online survey on antibiotic dosing to more than 20,000 intensive care professionals. Questions were designed to cover relevant topics in pharmacokinetics related to intensive care antibiotic dosing. The preliminary pass mark was set by members of the examination committee for the European Diploma of Intensive Care using a modified Angoff approach. The final pass mark was corrected for clinical relevance as assessed for each question by international experts on pharmacokinetics. RESULTS: A total of 1448 respondents completed the survey. Most of the respondents were intensivists (927 respondents, 64%) from 97 countries. Nearly all questions were considered clinically relevant by pharmacokinetic experts. The pass mark corrected for clinical relevance was 52.8 out of 93.7 points. Pass rates were 42.5% for intensivists, 36.1% for fellows, 24.8% for residents, and 5.8% for nurses. Scores without correction for clinical relevance were worse, indicating that respondents perform better on more relevant topics. Correct answers and concise clinical background are provided. CONCLUSIONS: Clinically relevant pharmacokinetic knowledge on antibiotic dosing among intensive care professionals is insufficient. This should be addressed given the importance of adequate antibiotic exposure in critically ill patients with sepsis. Solutions include improved education, intensified pharmacy support, therapeutic drug monitoring, or the use of real-time bedside dosing software. Questions may provide useful for teaching purposes.
- MeSH
- antibakteriální látky aplikace a dávkování farmakokinetika terapeutické užití MeSH
- dospělí MeSH
- jednotky intenzivní péče organizace a řízení statistika a číselné údaje MeSH
- klinické kompetence normy statistika a číselné údaje MeSH
- kritický stav terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- monitorování léčiv metody MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- sepse farmakoterapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: The European School of Urology (ESU) started the European Urology Residents Education Programme (EUREP) in 2003 for final year urology residents, with hands-on training (HOT) added later in 2007. OBJECTIVE: To assess the geographical reach of EUREP, trainee demographics, and individual quality feedback in relation to annual methodology improvements in HOT. DESIGN, SETTING, AND PARTICIPANTS: From September 2014 to October 2017 (four EUREP courses) several new features have been applied to the HOT format of the EUREP course: 1:1 training sessions (2015), fixed 60-min time slots (2016), and standardised teaching methodology (2017). The resulting EUREP HOT format was verified by collecting and prospectively analysing the following data: total number of participants attending different HOT courses; participants' age; country of origin; and feedback obtained annually. RESULTS AND LIMITATIONS: A total of 796 participants from 54 countries participated in 1450 HOT sessions over the last 4 yr. This included 294 (20%) ureteroscopy (URS) sessions, 237 (16.5%) transurethral resection (TUR) sessions, 840 (58%) basic laparoscopic sessions, and 79 (5.5%) intermediate laparoscopic sessions. While 712 residents (89%) were from Europe, 84 (11%) were from non-European nations. Of the European residents, most came from Italy (16%), Germany (15%), Spain (15%), and Romania (8%). Feedback for the basic laparoscopic session showed a constant improvement in scores over the last 4 yr, with the highest scores achieved last year. This included feedback on improvements in tutor rating (p=0.017), organisation (p<0.001), and personal experience with EUREP (p<0.001). Limitations lie in the difficulties associated with the use of an advanced training curriculum with wet laboratory or cadaveric courses in this format, although these could be performed in other training centres in conjunction with EUREP. CONCLUSIONS: The EUREP trainee demographics show that the purpose of the course is being achieved, with excellent feedback reported. While European trainees dominate the demographics, participation from a number of non-European countries suggests continued ESU collaboration with other national societies and wider dissemination of simulation training worldwide. PATIENT SUMMARY: In this paper we look at methodological improvements and feedback for the European Urology Residents Education Programme hands-on-training over the last 4 yr.
- MeSH
- dospělí MeSH
- klinické kompetence statistika a číselné údaje MeSH
- kurikulum statistika a číselné údaje MeSH
- kurzy a stáže v nemocnici normy MeSH
- laparoskopie výchova MeSH
- lidé středního věku MeSH
- lidé MeSH
- mrtvola MeSH
- transuretrální resekce prostaty výchova MeSH
- tréninková simulace metody MeSH
- ureteroskopie výchova MeSH
- urologické chirurgické výkony výchova MeSH
- urologie výchova MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Evropa MeSH
- Itálie MeSH
- Německo MeSH
- Rumunsko MeSH
- Španělsko MeSH
PURPOSE: Arthroscopy of the hip joint is considered a demanding procedure with long learning curve. There are only a few studies that concentrate on this topic. This prospective clinical study evaluates the learning curve of the hip arthroscopy based on clinical outcomes, surgical time, and complication rate. MATERIALS: In this study, we first evaluated 150 hip arthroscopy procedures performed by a single surgeon. The patient group consisted of 86 females and 64 males with mean age 37 years (range 16-69). Study cohorts were divided into groups of 50 patients. Surgical time, complication rate and clinical results based on NAHS score were recorded for each group. Statistical analysis of differences between groups was performed using the ANOVA method and paired t-test. RESULTS: We found a statistically significant decrease of complication rate with more procedures performed. There were significantly better clinical outcomes after at least 100 procedures. No difference in surgical time was found, but towards the end of the learning curve, more complex procedures were performed. The only statistical difference was the portal setup time. The learning curves were constructed based on these results. CONCLUSIONS: Hip arthroscopy provides very good clinical outcomes if precisely indicated and performed. It is, however, a demanding procedure with many possible pitfalls and complications. According to our study, at least 100 procedures are needed to gain basic technical and indication skills. The presence of a more skilled surgeon in the beginning of the learning curve is advised to reduce the complication rate.
- MeSH
- artroskopie škodlivé účinky výchova metody MeSH
- chirurgové výchova MeSH
- délka operace MeSH
- dospělí MeSH
- femoroacetabulární impingement chirurgie MeSH
- klinické kompetence statistika a číselné údaje MeSH
- křivka učení MeSH
- kyčelní kloub chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- pooperační komplikace epidemiologie etiologie MeSH
- prospektivní studie MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinická studie MeSH
- práce podpořená grantem MeSH
INTRODUCTION: Most contemporary 12-lead electrocardiogram (ECG) devices offer computerized diagnostic proposals. The reliability of these automated diagnoses is limited. It has been suggested that incorrect computer advice can influence physician decision-making. This study analyzed the role of diagnostic proposals in the decision process by a group of fellows of cardiology and other internal medicine subspecialties. MATERIALS AND METHODS: A set of 100 clinical 12-lead ECG tracings was selected covering both normal cases and common abnormalities. A team of 15 junior Cardiology Fellows and 15 Non-Cardiology Fellows interpreted the ECGs in 3 phases: without any diagnostic proposal, with a single diagnostic proposal (half of them intentionally incorrect), and with four diagnostic proposals (only one of them being correct) for each ECG. Self-rated confidence of each interpretation was collected. RESULTS: Availability of diagnostic proposals significantly increased the diagnostic accuracy (p<0.001). Nevertheless, in case of a single proposal (either correct or incorrect) the increase of accuracy was present in interpretations with correct diagnostic proposals, while the accuracy was substantially reduced with incorrect proposals. Confidence levels poorly correlated with interpretation scores (rho≈2, p<0.001). Logistic regression showed that an interpreter is most likely to be correct when the ECG offers a correct diagnostic proposal (OR=10.87) or multiple proposals (OR=4.43). CONCLUSION: Diagnostic proposals affect the diagnostic accuracy of ECG interpretations. The accuracy is significantly influenced especially when a single diagnostic proposal (either correct or incorrect) is provided. The study suggests that the presentation of multiple computerized diagnoses is likely to improve the diagnostic accuracy of interpreters.
- MeSH
- chybná diagnóza statistika a číselné údaje MeSH
- elektrokardiografie statistika a číselné údaje MeSH
- kardiologie MeSH
- klinické kompetence statistika a číselné údaje MeSH
- lidé MeSH
- odchylka pozorovatele MeSH
- srdeční arytmie diagnóza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Aim: Dysphagia is a common and potentially serious problem in patients with neurological conditions. In many countries, dysphagia screening is used, which contributes to better patient outcomes. In Greece, the implementation of dysphagia screening has not yet been described. The aim was to examine the effectiveness of an educational session delivered to Greek masters-level nursing students and their faculty on the correct use of an 8-item nursing dysphagia screening instrument developed in the Czech Republic. Methods: Fifteen students and nursing faculty members of the Technological Educational Institute of Athens were enrolled in this descriptive pilot study. They were educated on dysphagia in a session consisting of a theoretical and practical part and a discussion. The participants were asked to indicate their clinical experience with dysphagia and their opinion on the importance of nurses’ involvement in dysphagia assessment. Their knowledge of the screening procedure and interpretation and documentation of the result was tested using a hypothetical patient case. Results: In this study, 4 (27%) participants had prior experience with patients with dysphagia. All of them thought that nurses’ involvement in dysphagia assessment was very important. Slightly more than half of the participants identified, interpreted, and documented all of the 8 item results correctly. Conclusion: The participants were motivated to learn, however, complete mastery of the assessment technique was not achieved. The learning experience was affected by several issues that were unique to Greece, and the participants’ efforts focused on understanding how the new knowledge and skills could affect their daily practice. Direct ongoing support in the clinical setting could be beneficial.
- MeSH
- klinické kompetence statistika a číselné údaje MeSH
- lidé MeSH
- ošetřovatelská diagnóza * MeSH
- ošetřovatelské zhodnocení statistika a číselné údaje MeSH
- pilotní projekty MeSH
- poruchy polykání * ošetřování MeSH
- studium ošetřovatelství MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- Geografické názvy
- Řecko MeSH
OBJECTIVES: Five different second-generation supraglottic airway devices, ProSeal LMA, Supreme LMA, i-gel, SLIPA, and Laryngeal Tube Suction-D, were studied. Operators were inexperienced users with a military background, combat lifesavers, nurses, and physicians. METHODS: This was a prospective, randomized, single-blinded study. Devices were inserted in the operating room in low light conditions after induction of general anesthesia. Primary outcome was successful insertion on the first attempt while secondary aims were insertion time, number of attempts, oropharyngeal seal pressure, ease of insertion, fibre optic position of device, efficacy of ventilation, and intraoperative trauma or regurgitation of gastric contents. RESULTS: In total, 505 patients were studied. First-attempt insertion success rate was higher in the Supreme LMA (96%), i-gel (87.9%), and ProSeal LMA (85.9%) groups than in the Laryngeal Tube Suction-D (80.6%) and SLIPA (69.4%) groups. Insertion time was shortest in the Supreme LMA (70.4 ± 32.5 s) and i-gel (74.4 ± 41.1 s) groups (p < 0.001). Oropharyngeal seal pressures were higher in the Laryngeal Tube Suction-D and ProSeal LMA groups than in other three devices. CONCLUSIONS: Most study parameters for the Supreme LMA and i-gel were found to be superior to the other three tested supraglottic airway devices when inserted by novice military operators.
- MeSH
- analýza selhání vybavení MeSH
- design vybavení MeSH
- dospělí MeSH
- dvojitá slepá metoda MeSH
- klinické kompetence statistika a číselné údaje MeSH
- laryngální masky * MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- ozbrojené síly výchova statistika a číselné údaje MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- vojenské lékařství výchova přístrojové vybavení MeSH
- výsledek terapie MeSH
- zajištění dýchacích cest přístrojové vybavení metody MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
- srovnávací studie MeSH
- Geografické názvy
- Česká republika MeSH
