[Time-allocation study of nurse and physician activities in the emergency department]

Effectiveness of a Mobile App in Reducing Therapeutic Turnaround Time and Facilitating Communication between Caregivers in a Pediatric Emergency Department: A Randomized Controlled Pilot Trial

For maintaining collaboration and coordination among emergency department (ED) caregivers, it is essential to effectively share patient-centered information. Indirect activities on patients, such as searching for laboratory results and sharing information with scattered colleagues, waste resources to the detriment of patients and staff. Therefore, we conducted a pilot study to evaluate the initial efficacy of a mobile app to facilitate rapid mobile access to central laboratory results and remote interprofessional communication. A total of 10 ED residents and registered nurses were randomized regarding the use of the app versus conventional methods during semi-simulated scenarios in a pediatric ED (PED). The primary outcome was the elapsed time in minutes in each group from the availability of laboratory results to their consideration by participants. The secondary outcome was the elapsed time to find a colleague upon request. Time to consider laboratory results was significantly reduced from 23 min (IQR 10.5–49.0) to 1 min (IQR 0–5.0) with the use of the app compared to conventional methods (92.2% reduction in mean times, p = 0.0079). Time to find a colleague was reduced from 24 min to 1 min (i.e., 93.0% reduction). Dedicated mobile apps have the potential to improve information sharing and remote communication in emergency care.

Knowledge and Self-Protective Practices Against COVID-19 Among Healthcare Workers in Vietnam

Background: In middle-income countries such as Vietnam, where healthcare resources are already constrained, protecting healthcare workers (HCWs) is essential for ensuring the sustainability of COVID-19 response in Vietnam. This study was conducted to assess the knowledge and practices regarding the prevention of the COVID-19 among the HCWs in Vietnam to identify the ways of disseminating information to maximize the safety of these essential workers.

Methods: An online cross-sectional study, using respondent-driven sampling, was conducted in Vietnam with 742 participants within 2 weeks. The validity of the questionnaire was examined by exploratory factor analysis. Descriptive statistics were used to identify the level of knowledge and practices among the HCWs to prevent the COVID-19. Inferential statistics and regression modeling were used to identify the associated factors with results.

Results: Vietnamese HCWs had a high level of knowledge with more than 75% of the participants demonstrating awareness of all the modes of transmission aside from air. The mean knowledge score was 3.7 ± 0.8 (range 1–5). Nearly all the participants relied on the Ministry of Health (98.3%) and the internet (95.5%) for information regarding the COVID-19. The participants endorsed a moderately high level of self-protective practices with mean scores of 4.2 and 3.6 (band score 1–5) for the precautionary and psychological measures, respectively. Nurses were more likely to practice the precautionary measures than doctors and the HCWs at the central level were more likely to practice the psychological measures than those at the district level.

Conclusion: Future education initiatives should consolidate the latest literature in an accessible format, focusing initially on the gaps of knowledge regarding aerosol transmission. These initiatives should primarily focus on the doctors, especially those in emergency and intensive care departments.

Multitasking behaviors and provider outcomes in emergency department physicians: two consecutive, observational and multi-source studies

Background

Multitasking is a key skill for emergency department (ED) providers. Yet, potentially beneficial or debilitating effects for provider functioning and cognition are underexplored. We therefore aimed to investigate the role of multitasking for ED physicians’ work stress and situation awareness (SA).

Methods

Two consecutive, multi-source studies utilizing standardized expert observations in combination with physicians’ self-reports on stress and SA were set out in an academic ED. To control for ED workload, measures of patient acuity, patient counts, and ED staff on duty were included. Regression analyses estimated associations between observed proportion of time spent in multitasking with matched ED physicians’ reports on stress (study 1) and SA (study 2).

Results

ED physicians engaged between 18.7% (study 1) and 13.0% (study 2) of their worktime in multitasking. Self-reported as well as expert-observed multitasking were significantly associated. This confirms the internal validity of our observational approach. After controlling for ED workload, we found that physicians who engaged more frequently in multitasking perceived higher work stress (Beta = .02, 95%CI .001–.03; p = .01). In study 2, ED physicians with more frequent multitasking behaviors reported higher SA (B = .08, 95%CI .02–.14; p = .009).

Conclusions

Multitasking is often unavoidable in ED care. Our findings suggest that ED physicians’ multitasking increases stress experiences, yet, may facilitate professional’s experiences of situation awareness. Our results warrant further investigation into potentially ambivalent effects of ED providers’ multitasking in effectively sharing time between competing demands while maintaining performance and safety.