Citations

AbstractWith increasing numbers of people with Alzheimer's and other dementias across the globe, many countries have developed national plans to deal with the resulting challenges. In the United States, the National Alzheimer's Project Act, signed into law in 2011, required the creation of such a plan with annual updates thereafter. Pursuant to this, the US Department of Health and Human Services (HHS) released the National Plan to Address Alzheimer's Disease in 2012, including an ambitious research goal of preventing and effectively treating Alzheimer's disease by 2025. To guide investments, activities, and the measurement of progress toward achieving this 2025 goal, in its first annual plan update (2013) HHS also incorporated into the plan a set of short, medium and long‐term milestones. HHS further committed to updating these milestones on an ongoing basis to account for progress and setbacks, and emerging opportunities and obstacles. To assist HHS as it updates these milestones, the Alzheimer's Association convened a National Plan Milestone Workgroup consisting of scientific experts representing all areas of Alzheimer's and dementia research. The workgroup evaluated each milestone and made recommendations to ensure that they collectively constitute an adequate work plan for reaching the goal of preventing and effectively treating Alzheimer's by 2025. This report presents these Workgroup recommendations.

This study shows what employees in the Environment, Health and Safety (EHS) area within private Brazilian companies think about the relationship between ergonomic risks and Homogeneous Exposure Groups (HEG). Thirty-seven professionals from different market segments answered a questionnaire via Google Docs. The results show that 75.6% of the companies sampled use HEG in order to map occupational risks. Within those companies, 54% include ergonomic risks in their HEG, which has negative consequences to both employees and employers in these companies.

With various minimally invasive approaches in the field of surgery and new techniques entering rapidly, it is important to evaluate the effectiveness of these different practices. Information about the impact on both patient and provider can be gained through research investigations. Since the workload placed on the surgeon may influence patient outcomes, this study measured levels of stress and fatigue for the surgeon participating in an NIH randomized control trial of single incision versus 4-port laparoscopic cholecystectomy. Through the administration of the SURG-TLX for 22 Single-Incision Laparoscopic Cholecystectomies and 24 4-port cholecystectomies, physical workload was the only measure statistically different between 4-port and SILC (P=0.028). There was a significant difference in the duration (P=0.029) based on the procedure that was completed. Mental stress was highly correlated to many of the variables in the Surg-TLX and duration, degree of difficulty, and complexity were all highly correlated. This research shows how the SILC procedure can cause more stress on the surgeon. When the situation is combined with longer surgeries, higher complexity, and a higher degree of difficulty, the patient outcomes may be at risk.

This discussion panel aims to identify ergonomic concerns, solutions and research needs, physical stresses, and outcomes related to clinical and surgical procedures. This session will begin with formal presentations to demonstrate current ergonomic concerns and research initiatives associated with clinical and surgical procedures to frame the panel discussion for the second part of the session. Discussion of different procedures will help to identify solutions and research needs that relate to a broad range of ergonomic problems. Questions will be collected from the attendees and speakers and organized so as to guide the panel discussion and to engage all of the speakers in the discussion to achieve the symposium aims.

The adoptions of briefing and debriefing protocols have evolved from the Joint Commission’s initiative to improve communication and safety in the operating room. Briefing normally occurs prior to incision and is used to discuss and confirm critical information, while debriefing occurs during or after surgery. Debriefing provides a unique opportunity for individuals and teams to immediately reflect on their performance, allowing them to more easily identify errors and develop plans to improve their next performance. Studies have shown that using briefings and debriefings improve communication and teamwork. However, there is still much to learn about the value of both for surgical teams. This paper presents a robust methodology for examining and measuring the impacts of surgical team briefings and debriefings on teamwork. The methodology includes (1) audio/video recording the surgical care process, (2) prospective observations using a validated electronic data collection tool, (3) pre- and post-surgery surveys, and (4) individual surgical team member interviews. The current paper describes the methodology to obtain a robust and comprehensive data set for analyzing the impacts of briefing and debriefing on teamwork; the results of the surgeries recorded using this methodology will be presented in subsequent papers.

Fatigue and recovery have been associated with health, safety, and performance outcomes in hospital nurses. There is a growing emphasis on fatigue risk management and health promotion programs to support nurses and promote quality in hospitals. However, little is known about the relationships between fatigue and wellness measures in nurses. This study used a tree-based classification method to identify associations between self-reported fatigue, recovery and wellness measures in a survey study of hospital nurses. Significant relationships between multiple wellness measures and acute fatigue, chronic fatigue, and intershift recovery levels were identified. Specifically, the findings include critical levels of wellness measures where fatigue and recovery change. These findings have implications for ongoing efforts to develop effective fatigue management programs in this population.

Briefings are suggested to be an important mechanism for establishing and maintaining cohesive teams. However, there is still much to learn about briefings and how best to design and implement them for surgical teams in the operating room. Currently, there are no formally recognized protocols or methodologies for conducting surgical team briefings. This research reports preliminary findings from an effort to develop a model of team briefings for gynecological surgical teams. Semi-structured interviews were conducted using techniques derived from Applied Cognitive Task Analysis (Millitello & Hutton, 1998) with thirteen surgical team members spanning six different roles including surgeon, surgical resident, registered nurse, certified surgical assistant, certified scrub technician, and anesthesia. Findings reveal that informational needs are consistent across the team but also vary by individual role, illustrating the importance of addressing all stakeholders in potential interventions. Implications for the development of a team briefing model are discussed.

Surgical team members are typically defined by professional roles. In many surgical teams, membership changes as staffing decisions are subject to considerations other than keeping surgical teams consistent. These considerations may include staffing patterns on the day of surgery and at the time of a surgical case. Teamwork skill training and safety culture have been emphasized, although much is known about the contribution to team performance from team consistency. We review the literature on cognitive and psychosocial benefits of consistent surgical teams. Although empirical evidence base for consistent surgical teams is lacking, we believe that the theoretical justifications may lay the groundwork for future research on the impact of deliberate staffing decisions by organizations, to complement the current emphasis on individual teamwork knowledge, skills and attitude. We also outline some of barriers based on our experience in our respective healthcare organizations.