Release and health outcomes of exposure to chalk particles in classrooms: a systematic literature review.

This systematic review explores the release and health outcomes of exposure to chalk particles in classrooms. A literature search was conducted on Scopus, Google Scholar, and the Web of Science. Chalk particles contribute significantly to poor indoor air quality in classrooms. Higher concentrations of PM2.5 chalk particles were found in the front row (14.25 µg/m3) and near the chalkboard (19.07 µg/m3). Inhalation and dermal are significant exposure routes; hence, teachers and learners are at risk of developing respiratory and skin disorders. Inhalation of chalk particles correlates with reduced lung function in teachers and learners. The release and size of chalk particles depend on the activities, type of chalk sticks, and texture of the chalkboards. Wiping the chalkboard releases more chalk particles of smaller size (3.85-9.3 µm) than writing (10.57-92.91 µm). A shift from chalk sticks and chalkboards in classrooms is necessary to mitigate the associated health risks.

Discovering "What Matters" to patients: A quality improvement project.

PURPOSE: Age-Friendly Health Systems were developed to provide an evidenced based framework to provide high-quality care to older adults. The purpose of this quality improvement initiative was to increase the completion of the "What Matters" section of the "Get to Know Me" boards. METHODS: Face-to-face training was provided to staff via individual sessions on "What Matters" to patients and how to complete the boards. Re-education continued weekly over a 15 week period. Board Completion rates were collected weekly. RESULTS: 60 nurses participated in this project. The "What Matters" completion rates increased from 27 % to 59 % over the intervention period on the SACU and 16 % to 32 % on the SIMC . CONCLUSIONS: The "Get to Know Me Boards" are a visible way to describe "What Matters" to patients. Education helped to increase the completion rate of the boards allowing for "What Matters" to be accessible to members of the healthcare team.

Engaging patients, families and professionals at the bedside using whiteboards.

Health-care systems around the world are striving to be patient-centered, and there is growing evidence that engaging patients and families in their care, as well as in efforts to redesign services, contributes to improved outcomes and experiences for patients and providers. This patient-oriented care movement includes efforts to improve the quality of information and communication between health-care professionals and patients as well as families and caregivers. Whiteboards have emerged as a best practice in hospitals to promote engagement and improve information and communication, yet with limited empirical evidence regarding their value to patients, families, or interprofessional teams. We introduced whiteboards on an acute medical unit at a community hospital and conducted an evaluation using a pre-post design collecting both qualitative and quantitative data. Baseline and post-implementation data were collected via qualitative interviews with patients/family and providers and using the Canadian Patient Experience Survey; focus groups were held with staff and members of the care team. Qualitative results highlighted improvements in communication between the care team and patients as well as family members. Implications for practice include attention to patient/family empowerment and safety, adherence to guidance for good communication, and support for regular training and education in the use of communication tools for members of the interprofessional team.

Where's the Marker? Perceptions of Whiteboards in the Emergency Department.

BACKGROUND: In the emergency department, bedside whiteboards are used to help improve communication, teamwork, and collaboration among health care providers. In addition, previous studies have shown that whiteboards aid the patient with the identification of their health care providers, plan of care, expected length of stay, and overall patient satisfaction. PURPOSE: This evidence-based evaluation project assessed the perceptions of emergency department health care providers on their awareness of the effectiveness of bedside whiteboards, whether there are challenges with using them, and whether they are being updated and used consistently. METHOD: A survey was utilized to evaluate emergency department health care providers (nurses, patient care technicians, and attending providers) on their perceptions of bedside whiteboards in the patient rooms using a 10-question survey. OUTCOMES: The survey was sent via email to 135 emergency department health care providers, with 64 respondents. The survey results showed that 41.3% of the respondents agreed that bedside whiteboards promote patient satisfaction, 36.5% agreed that they promote patient safety, 53.1% agreed they take minimal completion time, and 50% felt they help keep patients informed about care. However, 85.9% of participants felt bedside whiteboards are not updated consistently, and 81.2% felt they are not updated consistently among all 3 shifts. In addition, 73.4% reported that they lack access to materials to update the whiteboards and 38.1% were neutral regarding whiteboards promoting patient safety. IMPLICATIONS: Proper materials (markers and erasers) are integral to bedside whiteboard use. Continued staff education on the function of bedside whiteboards may improve proper whiteboard use.

Education and learning: what's on the horizon?

Numerous organizations have called for significant changes in education for health care professionals. The call has included the need to incorporate evidence-based as well as innovative strategies. Previous articles in this column have focused primarily on evidence-based teaching strategies, including concept mapping, brain-based learning strategies, methods of competency assessment, and so forth. This article shifts the focus to new ways of thinking about knowledge and education. The article will also introduce evolving, innovative, less commonly used learning strategies and provide a peek into the future of learning.

Digital video analysis of health professionals' interactions with an electronic whiteboard: a longitudinal, naturalistic study of changes to user interactions.

As hospital departments continue to introduce electronic whiteboards in real clinical settings a range of human factor issues have emerged and it has become clear that there is a need for improved methods for designing and testing these systems. In this study, we employed a longitudinal and naturalistic method in the usability evaluation of an electronic whiteboard system. The goal of the evaluation was to explore the extent to which usability issues experienced by users change as they gain more experience with the system. In addition, the paper explores the use of a new approach to collection and analysis of continuous digital video recordings of naturalistic "live" user interactions. The method developed and employed in the study included recording the users' interactions with system during actual use using screen-capturing software and analyzing these recordings for usability issues. In this paper we describe and discuss both the method and the results of the evaluation. We found that the electronic whiteboard system contains system-related usability issues that did not change over time as the clinicians collectively gained more experience with the system. Furthermore, we also found user-related issues that seemed to change as the users gained more experience and we discuss the underlying reasons for these changes. We also found that the method used in the study has certain advantages over traditional usability evaluation methods, including the ability to collect analyze live user data over time. However, challenges and drawbacks to using the method (including the time taken for analysis and logistical issues in doing live recordings) should be considered before utilizing a similar approach. In conclusion we summarize our findings and call for an increased focus on longitudinal and naturalistic evaluations of health information systems and encourage others to apply and refine the method utilized in this study.

Experiences and Expectations of Information and Communication Technologies in Flexible Assertive Community Treatment Teams: Qualitative Study.

BACKGROUND: Flexible Assertive Community Treatment (FACT) is a model of integrated care for patients with long-term serious mental illness. FACT teams deliver services using assertive outreach to treat patients who can be hard to reach by the health care service, and focus on both the patient's health and their social situation. However, in Norway, FACT team members have challenges with their information and communication (ICT) solutions. OBJECTIVE: The aim of this study was to explore Norwegian FACT teams' experiences and expectations of their ICT solutions, including electronic health records, electronic whiteboards, and calendars. METHODS: We gathered data in two phases. In the first phase, we conducted semistructured interviews with team leaders and team coordinators, and made observations in FACT teams targeting adults. In the second phase, we conducted semistructured group interviews in FACT teams targeting youth. We performed a thematic analysis of the data in a theoretical manner to address the specific objectives of the study. RESULTS: A total of 8 teams were included, with 5 targeting adults and 3 targeting youth. Due to the COVID-19 pandemic, we were not able to perform observations in 2 of the teams targeting adults. Team leaders and coordinators in all 5 teams targeting adults were interviewed, with a total of 7 team members participating in the teams targeting youth. We found various challenges with communication, documentation, and organization for FACT teams. The COVID-19 pandemic was challenging for the teams and changed the way they used ICT solutions. There were issues with some technical solutions used in the teams, including electronic health records, electronic whiteboards, and calendars. Lack of integration and access to data were some of the main issues identified. CONCLUSIONS: Despite the FACT model being successfully implemented in Norway, there are several issues regarding the ICT solutions they use, mainly related to access to data and integration. Further research is required to detail how improved ICT solutions should be designed. While FACT teams targeting adults and youth differ in some ways, their needs for ICT solutions are largely similar.

Use of e-Health in Norwegian FACT Teams: A User Perspective.

Flexible assertive community treatment (FACT) is a model for delivering long-term, integrated and comprehensive treatment and follow-up for patients with severe mental illness. The objective of this study was to examine ICT challenges of Norwegian FACT teams. Doing observations in 3 teams and interviews with 5 teams we examined use of ICT systems, identifying challenges with the use of the electronic whiteboards, electronic health records, and team calendars. Better ICT systems and infrastructure are needed to support Norwegian FACT teams.

Electronic Paper Displays in Hospital Operations: Proposal for Deployment and Implementation.

BACKGROUND: Display signage is ubiquitous and essential in hospitals to serve several clerical, operational, and clinical functions, including displaying notices, providing directions, and presenting clinical information. These functions improve efficiency and patient engagement, reduce errors, and enhance the continuity of care. Over time, signage has evolved from analog approaches such as whiteboards and handwritten notices to digital displays such as liquid crystal displays, light emitting diodes, and, now, electronic ink displays. Electronic ink displays are paper-like displays that are not backlit and show content by aligning microencapsulated color beads in response to an applied electric current. Power is only required to generate content and not to retain it. These displays are very readable, with low eye strain; minimize the emission of blue light; require minimal power; and can be driven by several data sources, ranging from virtual servers to electronic health record systems. These attributes make adapting electronic ink displays to hospitals an ideal use case. OBJECTIVE: In this paper, we aimed to outline the use of signage and displays in hospitals with a focus on electronic ink displays. We aimed to assess the advantages and limitations of using these displays in hospitals and outline the various public-facing and patient-facing applications of electronic ink displays. Finally, we aimed to discuss the technological considerations and an implementation framework that must be followed when adopting and deploying electronic ink displays. METHODS: The public-facing applications of electronic ink displays include signage and way-finders, timetables for shared workspaces, and noticeboards and bulletin boards. The clinical display applications may be smaller form factors such as door signs or bedside cards. The larger, ≥40-inch form factors may be used within patient rooms or at clinical command centers as a digital whiteboard to display general information, patient and clinician information, and care plans. In all these applications, such displays could replace analog whiteboards, noticeboards, and even other digital screens. RESULTS: We are conducting pilot research projects to delineate best use cases and practices in adopting electronic ink displays in clinical settings. This will entail liaising with key stakeholders, gathering objective logistical and feasibility data, and, ultimately, quantifying and describing the effect on clinical care and patient satisfaction. CONCLUSIONS: There are several use cases in a clinical setting that may lend themselves perfectly to electronic ink display use. The main considerations to be studied in this adoption are network connectivity, content management, privacy and security robustness, and detailed comparison with existing modalities. Electronic ink displays offer a superior opportunity to future-proof existing practices. There is a need for theoretical considerations and real-world testing to determine if the advantages outweigh the limitations of electronic ink displays.