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Enhancement of the capacity of a healthcare team through real-time information-sharing using a wireless intercom system: a prospective simulation study

Por: Sato · H. · Kuwabara · D. · Minoguchi · K. · Masubuchi · T. · Matsumoto · M. · Okuyama · Y. · Kawakami · H. · Abe · T. · Nakamura · K. · Goto · T. · Nakajima · K.
Objectives

Rising patient numbers and limited resources are creating a challenging environment for healthcare providers recently. Anaesthesiologists are also increasingly faced with complex situations, requiring high adaptability in the operating room. To enhance team adaptability during emergencies, effective communication methods are essential. This study aimed to compare the impact of mobile phones and intercoms on the response time and effectiveness of anaesthesiologist teams in emergency situations.

Design

Prospective, observational and simulation study.

Setting

Anaesthesiology and Critical Care, Yokohama City University Medical Center, Yokohama, Japan.

Participants and methods

This study, conducted at Yokohama City University Medical Center (Yokohama, Japan), evaluated how communication methods (intercoms vs mobile phones) impact the efficiency of anaesthesiologists in the simulation setting. Two scenarios were tested: (1) retrieving a video laryngoscope during a difficult intubation and (2) gathering support during cardiac arrest.

Primary and secondary outcome measures

Outcomes measured included time to secure equipment, time for assistance to arrive and staff numbers gathered. The Wilcoxon signed-rank test was used to compare the outcomes between the intercom and mobile phone groups.

Results

In scenario 1, the time to secure the video laryngoscope was significantly shorter with intercom use compared with mobile phones (intercom vs mobile phone, median (IQR): 29 (25–33) s vs 50 (39–62) s; p=0.013, effect size 20 (95% CI 7 to 31)). In scenario 2, the time from the request for assistance until the first supporting staff member reached the operating room was significantly shorter in using the intercoms (intercom vs mobile phone, median (IQR): 16 (14–18) s vs 35 (31–38) s; p=0.04, effect size 17 (95% CI 6 to 24)), and more personnel were available in the intercom group (intercom vs mobile phone, median (IQR): 3 (3–3.5) persons vs 2 (1–2) persons; p=0.04, effect size 1.5 (95% CI 1 to 3)).

Conclusion

Real-time information sharing through intercoms improved the ability of the anaesthesiologist team to respond more rapidly and effectively in emergency situations, enhancing overall team adaptability. This approach may improve patients’ outcomes by shortening response times and increasing team coordination.

Clinical characteristics, treatments and outcomes of hospitalised COVID-19 patients across pandemic waves at a tertiary acute care hospital in Narita, Japan: a single-centre retrospective observational study

Por: Hase · R. · Kurata · R. · Niiyama · Y. · Matsuda · N. · Ueda · H. · Kikuchi · K. · Ishida · K. · Kubota · Y. · Fujii · M. · Kurita · T. · Muranaka · E. · Sasazawa · H. · Mito · H. · Yano · Y. · Oku · R. · Tateishi · Y. · Toishi · S. · Obata · S. · Noguchi · Y. · Nakanishi · K. · Sunami · S.
Objective

This study aims to describe the characteristics of hospitalised COVID-19 patients in a tertiary care hospital close to an international airport in Japan and to compare these characteristics among different waves during the pandemic.

Design

Retrospective observational study.

Setting

Tertiary care centre in Japan.

Participants

All patients diagnosed with COVID-19 who were hospitalised between January 2020 and April 2022 were included.

Measurements

Clinical characteristics, characteristics of admission, treatments and outcomes were investigated and compared among six pandemic waves.

Results

A total of 827 patients were included. The median age was 58.0 years. More than half of the patients (58.3%) had at least one comorbidity. The majority of patients (89.0%) were domestically infected patients admitted under the Infectious Diseases Law, while the remaining patients (11.0%) were those diagnosed during airport quarantine and admitted under the Quarantine Act. Hospital-acquired COVID-19 infection occurred in 7.0% of cases, and mainly during the sixth wave. Overall, some form of oxygen therapy, high-flow oxygen devices, invasive mechanical ventilation (IMV) and extracorporeal membrane oxygenation was provided in 46.3%, 10.4%, 4.5% and 1.5% of cases, respectively. Only 1.8% of patients were treated in the intensive care unit (ICU), and 59.5% of patients on IMV were managed in the non-ICU ward. The in-hospital mortality rate was 5.8%. Median age, percentages of some comorbidities, vaccination coverage, medications for COVID-19, types of supportive care and ICU admissions differed significantly among waves.

Conclusions

This study suggests that patient characteristics, vaccination coverage, standard of treatment and severity of illness changed across waves during the COVID-19 pandemic. Intensive care delivery in non-ICU wards was unavoidable due to limited ICU capacity, which may be a key consideration when preparing for future pandemics.

Feasibility and acceptability of point-of-care ultrasound delivered by midwives during routine antenatal care in Malawi: a prospective implementation science study

Por: Payesa · C. · Seyama · L. · Chimwaza · Y. · Sindani · F. · Kanise · Y. · Bvutula · E. · Phiri · M. · Nyangulu · P. · Gadama · L. · Kachale · F. · Gadama · G. · Mwale · M. · Yenokyan · G. · Sripad · P. · Hyre · A. · Noguchi · L. M. · Dadabhai · S.
Objectives

To evaluate the feasibility and acceptability of integrating point-of-care ultrasound scan (POCUS) by midwives into routine antenatal care (ANC) services.

Design

Prospective, observational, multiphase, implementation science study.

Main outcome measures

Primary outcomes included the proportion of midwives who completed training and competency checks for basic obstetric scanning using a POCUS device; the feasibility and acceptability of midwife-delivered POCUS from the perspectives of midwives and pregnant women captured on structured questionnaires; and the proportion of scans meeting predefined quality standards. Secondary outcomes included responses to acceptability-related questionnaires administered to midwives and pregnant women.

Setting

Rural, periurban and urban health centres in Blantyre District, Malawi.

Participants

Pregnant women attending ANC and midwives providing care at participating health facilities.

Results

Obstetric registrars trained and mentored 45 midwives, and 42 (93%) completed the training. Most midwives (95%, n=40) found providing POCUS during ANC was feasible and acceptable. Overall, device durability was rated positively. Of the 1499 pregnant women who received a scan, 99% (n=1484) reported that receiving an ultrasound from a midwife during ANC was acceptable. Independent assessors determined that over 70% of the subsample of reviewed scans met minimum quality standards.

Conclusions

Midwife-delivered POCUS is feasible and highly acceptable in diverse antenatal settings in Malawi. These findings support task-sharing models as a means of expanding access to this essential ANC service, particularly in low-resource settings.

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