Home environmental hazard education for undergraduate and prelicensure nursing students.

This paper presents a Healthy Homes education module for undergraduate and prelicensure nursing students. The education module, which is based on the National Center for Healthy Housing's framework for Healthy Homes, was developed, implemented, and evaluated in three phases. Phase 1 included nine Web-based recorded lectures on the Healthy Homes principles and on home assessment and referral. In the next phase, a Healthy Homes clinical laboratory simulation (home visit scenario and four rooms of an apartment) was created. Phase 3 involved piloting home visits by students who, under the supervision of a clinical instructor, conducted Healthy Homes assessments of clients living in two low-income subsidized housing sites. Using a pretest-posttest format, students' knowledge of Healthy Homes concepts significantly increased after completing the Phase 1 Web-based lectures. Student evaluations, which were collected after each phase, were consistently positive.

Evaluation of occupational injuries in an urban emergency medical services system before and after implementation of electrically powered stretchers.

Musculoskeletal injuries are frequently reported among Emergency Medical Services (EMS) professionals. The objective of this study was to evaluate occupational injuries in an urban EMS system before and after implementation of hydraulic stretchers. Data for this analysis were obtained from Austin Travis County EMS (A/TCEMS). In December 2006, A/TCEMS placed into service electrically powered patient stretchers. The pre-intervention period was between 01/01/1999 and 12/31/2006, and the post-intervention period was between 01/01/2007 and 4/30/2008. Incidence rate calculations were performed for four injury sub-groups and rate ratios (RRs) and corresponding 95% confidence interval (CI) were presented. There were 2087 and 706 person-years of observation pre- and post-intervention, respectively. The incidence rates for overall injury pre-intervention and post-intervention were 61.1 and 28.8 per 100 FTE, with a corresponding RR of 0.47 (95% CI 0.41-0.55) indicating a significant decrease in the rate of injury. The subcategory of stretcher-related injuries had the lowest RR (0.30; 95% CI 0.17-0.52) when comparing pre- and post-intervention time periods.

Disaster preparedness of nationally certified emergency medical services professionals.

OBJECTIVES: During disasters, the public expects that emergency care will be available at a moment's notice. As such, an emergency medical services (EMS) workforce that is trained and prepared for disasters is imperative. The primary objectives of this study were to quantify the amount of individual-level training EMS professionals receive in terrorism and disaster-preparedness, as well as to assess EMS professionals' participation in multiagency disaster drills across the United States. Characteristics of those most likely to have received individual-level training or participated in multiagency disaster drills were explored. The secondary objectives were to assess EMS professional's perception of preparedness and to determine whether the amount of training individuals received was correlated with their perceptions of preparedness. METHODS: A structured survey was administered to nationally certified EMT-Basics and paramedics as part of their 2008 recertification paperwork. Outcome variables included individual-level preparedness training, participation in multiagency disaster drills, and perception of preparedness. Descriptive statistics and logistic regression modeling were used to quantify the amount of training received. Spearman rank correlation coefficients were used to analyze whether training was correlated with an individual's perception of preparedness. RESULTS: There were 46,127 EMS professionals who had the opportunity to complete the recertification questionnaire; 30,570 (66.3%) responded. A complete case analysis was performed on 21,438 respondents. Overall, 19,551 respondents (91.2%) reported receiving at least 1 hour of individual-level preparedness training, and 12,828 respondents (59.8%) reported participating in multiagency disaster drills, in the prior 24 months. Spearman rank correlation coefficients revealed that hours of individual-level preparedness training were significantly correlated with the perception of preparedness. CONCLUSIONS: While areas where EMS should focus attention for improvement were identified, a majority of nationally certified EMT-Basics and paramedics reported participating in both individual and multiagency disaster-preparedness training. A large majority of respondents reported feeling adequately prepared to respond to man-made and natural disasters and the perception of preparedness correlated with hours of training.

Studying critical values: adverse event identification following a critical laboratory values study at the ohio state university medical center.

No study to date has used laboratory critical values to evaluate variations in patient adverse events. We retrospectively analyzed a database of critical values to determine their distribution by hospital unit over time. The data were drawn from the Ohio State University Medical Center Information Warehouse (Columbus) for a 58-month period. Critical values were plotted over time on statistical control charts and analyzed for unusual peaks in monthly occurrence rates. Chart review of individual patient results yielded several predictor variables for the unusual peaks. Of these, occurrence of patient adverse events was the most relevant independent predictor variable for a month with an unusual number of critical values vs a normal month. This result epidemiologically confirms the basic premise of critical value reporting and suggests that the control-chart method of this type could be a new statistical tool to compare clinical activity of different hospital locations at different times.