Examining clinicians' fatigue in a pediatric emergency department.

We examined fatigue among emergency department (ED) clinicians. ED clinicians are susceptible to burnout, because of fatigue. Fatigue represents a latent hazard in ED care, being associated with impaired clinician performance, poor patient outcomes, and a negative impact on patient safety.

A Smart Glass Telemedicine Application for Prehospital Communication: User-Centered Design Study.

Background: Smart glasses have emerged as a promising solution for enhancing communication and care coordination among distributed medical teams. While prior research has explored the feasibility of using smart glasses to improve prehospital communication between emergency medical service (EMS) providers and remote physicians, a research gap remains in understanding the specific requirements and needs of EMS providers for smart glass implementation.

Objective: This study aims to iteratively design and evaluate a smart glass application tailored for prehospital communication by actively involving prospective users in the system design process.

A Pilot Randomized Controlled Study to Determine the Effect of Real-Time Videos With Smart Glass on the Performance of the Cardiopulmonary Resuscitation.

The aim of this study was to determine the effect of real-time videos with smart glasses on the performance of cardiopulmonary resuscitation performed by nursing students. In this randomized controlled pilot study, the students were randomly assigned to the smart glass group (n = 12) or control group (n = 8). Each student's cardiopulmonary resuscitation performance was evaluated by determining sequential steps in the American Heart Association algorithm they applied and the accuracy and time of each step.

Information exchange, responsibilities and expectation management in interhospital transfers: a qualitative study of hospital medicine physicians and advanced practice providers.

Introduction: The transfer of patients between hospitals, known as interhospital transfer (IHT), is associated with higher rates of mortality, longer lengths of stay and greater resource utilisation compared with admissions from the emergency department. To characterise the IHT process and identify key barriers and facilitators to IHT care, we examined the experiences of physician and advanced practice provider (APP) hospital medicine clinicians who care for IHT patients transferred to their facility.

Methods: Qualitative descriptive study using semistructured interviews with adult medicine hospitalists from an academic acute care hospital that accepts approximately 4000 IHT patients annually.

Interventions to Improve Health Among Refugees in the United States: A Systematic Review.

Refugees arriving to the U.S. experience a high burden of both communicable and non-communicable diseases.

Evaluating Smart Glasses for Cardiopulmonary Resuscitation.

Smart glasses allow care providers to connect to remote experts for consultation and have the potential to improve care. The purpose of this study was to evaluate the user experience with smart glasses in a simulated nursing care environment. We collected data via post-simulation semi-structured interviews and System Usability Scale (SUS) surveys.

Information Seeking and Sensemaking in Emergency Medical Service through Simulation Video Review.

Emergency medical services (EMS) providers often face significant challenges in their work, including collecting, integrating, and making sense of a variety of information. Despite their criticality, EMS work is one of the very few medical domains with limited technical support. To design and implement effective decision support, it is essential to examine and gain a holistic understanding of the fine-grained process of sensemaking in the field.

Access to Healthcare Among US Adult Refugees: A Systematic Qualitative Review.

Refugees encounter numerous healthcare access barriers in host countries, leading to lower utilization rates and poorer health outcomes. In the US, social inequities and fragmented health systems may exacerbate these disparities. Understanding these factors is necessary to ensure equitable care of refugee populations.

Smart Glasses for Supporting Distributed Care Work: Systematic Review.

Background: Over the past 2 decades, various desktop and mobile telemedicine systems have been developed to support communication and care coordination among distributed medical teams. However, in the hands-busy care environment, such technologies could become cumbersome because they require medical professionals to manually operate them. Smart glasses have been gaining momentum because of their advantages in enabling hands-free operation and see-what-I-see video-based consultation.

Designing and implementing smart glass technology for emergency medical services: a sociotechnical perspective.

Objective: This study aims to investigate key considerations and critical factors that influence the implementation and adoption of smart glasses in fast-paced medical settings such as emergency medical services (EMS).

Materials And Methods: We employed a sociotechnical theoretical framework and conducted a set of participatory design workshops with 15 EMS providers to elicit their opinions and concerns about using smart glasses in real practice.

Results: Smart glasses were recognized as a useful tool to improve EMS workflow given their hands-free nature and capability of processing and capturing various patient data.

Effects of a QI intervention on pediatric asthma treatment using patient outcomes and workflow in an emergency department.

Objective: Evaluate a nurse-initiated quality improvement (QI) intervention aimed at enhancing asthma treatment in a pediatric emergency department (ED), utilizing outcomes and workflow.

Methods: We evaluated the impact of QI interventions for pediatric patients presenting to the ED with asthma with pre-post analysis. A pediatric asthma score (PAS) of >8 indicated moderate to severe asthma.

Systems of communication in school-nurse led care coordination: A concept analysis.

Aim: To analyze the concept of systems of communication in school nurse-led care coordination to develop an operational definition that will inform intervention development.

Background: Communication has been identified as an essential attribute in care coordination. However, previous concept analyses of care coordination did not clearly define systems of communication or consider the context of school-based care coordination.

User Needs and Challenges in Information Sharing between Pre-Hospital and Hospital Emergency Care Providers.

Effective communication between pre-hospital and hospital providers is a critical first step towards ensuring efficient patient care. Despite many efforts in improving the communication process, inefficiencies persist. It is critical to understand user needs, work practices, and existing barriers to inform technology design for supporting pre-hospital communication.

Applications and User Perceptions of Smart Glasses in Emergency Medical Services: Semistructured Interview Study.

Background: Smart glasses have been gaining momentum as a novel technology because of their advantages in enabling hands-free operation and see-what-I-see remote consultation. Researchers have primarily evaluated this technology in hospital settings; however, limited research has investigated its application in prehospital operations.

Objective: The aim of this study is to understand the potential of smart glasses to support the work practices of prehospital providers, such as emergency medical services (EMS) personnel.

Opportunities and Challenges of Integrating Food Practice into Clinical Decision-Making.

Background: Food practice plays an important role in health. Food practice data collected in daily living settings can inform clinical decisions. However, integrating such data into clinical decision-making is burdensome for both clinicians and patients, resulting in poor adherence and limited utilization.

Endotracheal Tube Cuff Pressure Management: An Observational Study Guided by the SEIPS Model.

Introduction: The aim of the rigorous endotracheal tube cuff pressure (ETTCP) management is to maintain cuff pressures within the recommended values during the mechanical ventilation period. However, hyperinflation or hypoinflation of cuff has been reported because of inconsistent clinical practices in intensive care unit (ICU) settings. Furthermore, there is no available best evidence for clinical decision-making regarding the ETTCP management provided by international institutes.

Predicting hospitalization of pediatric asthma patients in emergency departments using machine learning.

Motivation: The timely identification of patients for hospitalization in emergency departments (EDs) can facilitate efficient use of hospital resources. Machine learning can help the early prediction of ED disposition; however, application of machine learning models requires both computer science skills and domain knowledge. This presents a barrier for those who want to apply machine learning to real-world settings.

Simulating Teamwork for Better Decision Making in Pediatric Emergency Medical Services.

Emergency Medical Services (EMS) are an essential component of health systems and are critical to the provision of pediatric emergency care. Challenges in this setting include fast pace, need for advanced teamwork, situational awareness and limited resources. The purpose of this study was to identify human factors-related obstacles during care delivery by EMS teams that could lead to inefficiencies and patient safety issues.

Information Needs of Skilled Nursing Facility Staff to Support Heart Failure Disease Management.

Objectives: Characterize key tasks and information needs for heart failure disease management (HF-DM) in the distinct care setting of skilled nursing facility (SNF) staff in partnership with community-based clinical stakeholders. Develop design recommendations contextualized to the SNF setting for informatics interventions for improved HF-DM in the SNF setting.

Methods: Semi-structured interviews with fifteen participants (registered nurses, licensed practical nurses, certified nursing aides and physicians) from 8 Denver-metro SNFs.

Considerations for Designing EHR-Embedded Clinical Decision Support Systems for Antimicrobial Stewardship in Pediatric Emergency Departments.

Objective: This study was aimed to explore the intersection between organizational environment, workflow, and technology in pediatric emergency departments (EDs) and how these factors impact antibiotic prescribing decisions.

Methods: Semistructured interviews with 17 providers (1 fellow and 16 attending faculty), and observations of 21 providers (1 physician assistant, 5 residents, 3 fellows, and 12 attendings) were conducted at three EDs in the United States. We analyzed interview transcripts and observation notes using thematic analysis.

Multidisciplinary Teams are Essential for Developing Clinical Decision Support to Improve Pediatric Health Outcomes: An Exemplar.

Clinical decision support with individualized patient education information can facilitate the translation of evidence-based guidelines into practice to improve pediatric patient outcomes. Interdisciplinary teams are required to develop and implement this technology support into practice. Engineering expertise with attention to three components is required: backend (e.