ORCID Profile
0000-0002-5343-6284
Current Organisations
UNISA
,
University of Cape Town
,
University of South Africa
,
Cape Peninsula University of Technology - Bellville Campus
,
Durban University of Technology
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Related Links
Publications
Changing culture through conversation: An action research inquiry on the adverse incident review process
Publisher: Hamad bin Khalifa University Press (HBKU Press)
Date: 09-10-2016
DOI: 10.5339/JEMTAC.2016.ICEPQ.122
Abstract: Background: Clinical governance requires having a process for adverse incident review and management to ensure the organisation ‘learns from its mistakes’ to prevent repetition. How leadership implements this system may enhance learning and patient safety, or have the unintended consequence of raising alarm, possible demotivation, and staff becoming risk-averse. The impact of the existing Ambulance Service incident management process was assessed from an organizational culture aspect. Methods: Action research uses iterative and collaborative cycles of study, action, and reflection to not only understand a complex situation by holding an attitude of inquiry but also to bring about positive change. Dialogue and narrative enquiry were used to collect data using a grounded theory approach for data interpretation. Dialogue was used both for reflection and for initiating change at various levels within the Service. Results: Initial data indicated a moderate fear culture in the Service, with staff becoming risk averse in the clinical environment due to concerns of being called for investigation. Dialogue sessions were held with key role players highlighting the experiences of staff. The impact of these conversations were reflected on and the outcomes of this reflection was used to frame further dialogue. Narrative (stories) of staff experiences were collected and used in the dialogue to highlight the impact of the adverse incident review system on staff morale. Based on these conversations, leadership made changes, including developing new incident review process with peer involvement, changing leaders of the process and an increased focus on communicating feedback to staff. As one staff member noted the mood in the corridors is much lighter. Conclusion: Action research provides an effective method for leaders, working in the real world environment, in dealing with the complex issues to bring about positive change, both in quality and patient safety, and staff satisfaction point of view.
Delivering of safe and effective CPR by means of an external chest compression device at Hamad Medical Corporation
Publisher: Hamad bin Khalifa University Press (HBKU Press)
Date: 09-10-2016
DOI: 10.5339/JEMTAC.2016.ICEPQ.82
Abstract: Objective: The objective of this study was to collect feedback from Ambulance Paramedics (AP) with respect of their experience of using an External Chest Compression Device (ECCD) on cardiac arrest patients. Aspects of particular interest were ease of use and their perceived effectiveness of delivered CPR. Background: HMCAS crews attend to several hundreds of cardiac arrests a year. To achieve Return of Spontaneous Circulation (ROSC), the key requirements are the provision of effective chest compressions delivering oxygen to the brain, maintaining coronary perfusion pressure, and priming the heart for successful defibrillation. Providing effective manual chest compressions in the austere Qatar pre-hospital setting with high temperatures is challenging, hence all HMCAS emergency vehicles have been equipped with ECCD. Methods: HMCAS receives daily reports compiled by its Documentation Officers. These reports highlight specific cases in which use of the ECCD was indicated but not implemented. These cases are followed up and audited to assess if non-provision of automated chest compressions was clinically acceptable. HMCAS monitors specific key performance indicators, i.e. ’Use of the LUCAS™2 in Adult Medical CPR Cases’ as well as ’ROSC in Medical CPR’. Feedback was collected over a 3-month period using a 10-point Likert scale type questionnaire distributed to ambulance paramedic teams who had used the ECCD during a real medical cardiac arrest case. Results: The results are based on 54 returned feedback questionnaires. Using a scale with 1 being very difficult and 10 being very easy, ambulance paramedics’ mean rating of the device's ease of use was of 8.8/10. Similarly, on a scale indicating perceived effectiveness, staff indicated that they found the chest compressions provided by ECCD to be highly effective (mean = 9.41/10). Conclusion: HMCAS staffs are highly satisfied with making use of the device since it provides them with a safer work environment and they are less fatigued after finishing a CPR case, especially during the summer months.
Raising awareness about driving safety in an ambulance service
Publisher: Hamad bin Khalifa University Press (HBKU Press)
Date: 09-10-2016
DOI: 10.5339/JEMTAC.2016.ICEPQ.21
Abstract: Background: Worldwide ambulances are regularly involved in accidents as staff may not anticipate other drivers' actions, suffer from fatigue, or overestimate their driving privileges. An ambulance driving safety c aign started in June 2015 targeting some 935 registered HMCAS drivers. We aim to determine if our approach is effective in changing behaviours and believes, and reducing the number of accidents involving HMCAS vehicles. Methods: This study was ethically approved as a quality improvement project and is still ongoing. The c aign made use of ambulance dashboard stickers and posters at ambulance stations' exits with respectively 4 and 6 key messages covering frequent issues resulting in collisions. An official circular also informed staff of the c aign. A month later a survey started to be distributed to staff. Results: In two month, 189 anonymous online or paper questionnaires were fully completed. 69.2% of respondents had an HMCAS driving qualification (13.7% of qualified HMCAS drivers). On average, they reported having been involved in 0.90 accident requiring vehicle repair. Using a 5-point Likert scale (1 = very unsafe, 5 = very safe) respondents rated themselves as being safe drivers (4.24/5) and underestimated the monthly number of accidents with HMCAS vehicles to be 15.3 (Actual 21.2/month registered in 2014). Other data about self-reported driving behaviour and comparison between their perception about accidents and real data was analysed along with visibility and memorisation of the key messages. Conclusions: Staff underestimated the number of accidents. C aign material has been noticed by most staff except for the stickers inside the ambulances driving compartment which is not accessed by 23.2% of the respondents. Staff who saw the posters and stickers remembered nearly half of the information it contained. Although a significant decline accidents occurrences was noticed in September, the impact of the c aign cannot yet be reliably assessed over this relatively short period of time.
Initial results from a driving safety survey distributed to ambulance paramedics in Qatar
Publisher: Hamad bin Khalifa University Press (HBKU Press)
Date: 12-11-2015
DOI: 10.5339/JLGHS.2015.ITMA.59
Abstract: Fatal vehicle crashes are not uncommon for ambulance paramedics (1-3). Emergency services staff may be overconfident and overestimate the privileges they have on the road and overlook basic driving safety principles (4). In line with the WHO (5) a driving safety c aign targeting some 935 registered HMCAS drivers and other staff was initiated in June 2015. We aim to determine if our approach is effective in changing behaviour and believes, and reducing the number of accidents in which our vehicles are involved, and surveyed the staff. Posters and stickers were designed with respectively 6 and 4 key messages covering the most frequent issues resulting in collisions (with objects/other vehicles) or potentially putting lives at risk. These are visibly displayed at all ambulance stations and in the vehicle driving compartments. An official staff circular was then sent to inform them of the c aign. A month later a survey accessible online and on paper started to be distributed to staff. In one month 141 anonymous questionnaires were returned fully completed. On average using a 5-point Likert scale respondents rated themselves as being safe drivers (4.2/5) and estimated the monthly number of accident with HMCAS vehicles to be 15.3 (22.1/month registered in 2014) and to mainly occur at traffic light (75.2%). 75% had noticed the posters and 60% the stickers. Those who noticed could respectively cite 53.3% (3.2) and 54.6% (2.2) of the key messages. 72% of respondents (n=102) had an HMCAS driving qualification (10.9% of qualified HMCAS drivers). On average they had been involved in 0.95 accident requiring vehicle repair. As expected, staff underestimate the number of accidents. References: 1- Maguire, B. J., Hunting, K. L., Smith, G. S., & Levick, N. R. (2002). Occupational fatalities in emergency medical services: a hidden crisis. Annals of emergency medicine, 40(6), 625-632. 2- Maguire, B. J., & Smith, S. (2013). Injuries and fatalities among emergency medical technicians and paramedics in the United States. Prehospital and disaster medicine, 28(04), 376-382. 3- Becker, L. R., Zaloshnja, E., Levick, N., Li, G., & Miller, T. R. (2003). Relative risk of injury and death in ambulances and other emergency vehicles. Accident Analysis & Prevention, 35(6), 941-948. 4- Blau, G., Gibson, G., Hochner, A., & Portwood, J. (2012). Antecedents of Emergency Medical Service high-risk behaviors: Drinking and not wearing a seat belt. Journal of Workplace Behavioral Health, 27(1), 47-61. 5- World Health Organization. (2013). WHO global status report on road safety 2013: supporting a decade of action. World Health Organization. 6- Abu-Zidan, F. M., Abbas, A. K., Hefny, A. F., Eid, H. O., & Grivna, M. (2012). Effects of seat belt usage on injury pattern and outcome of vehicle occupants after road traffic collisions: prospective study. World journal of surgery, 36(2), 255-259. 7- Shepherd, J. L., Lane, D. J., Tapscott, R. L., & Gentile, D. A. (2011). Susceptible to Social Influence: Risky “Driving” in Response to Peer Pressure. Journal of Applied Social Psychology, 41(4), 773-797.
Qatar ambulance service and Hamad General Hospital Emergency Department staff's perception of current patient handover practice
Publisher: Hamad bin Khalifa University Press (HBKU Press)
Date: 09-10-2016
DOI: 10.5339/JEMTAC.2016.ICEPQ.105
Abstract: Background: The handover process is meant to ensure patient safety and maintain continuity of care through endorsement of critical patient information. This study evaluates staff's perceptions about the current patient handover process effectiveness between Ambulance Service (AS) and Emergency Department (ED) clinicians. It may help identify barriers and contributing factors to an effective patient handover. Methods: An electronic questionnaire was circulated to all ED doctors/nurses and AS staff (Estimated N = 1,000). 400 questionnaires were completed of which 92 did not meet the inclusion criteria. Respondents were 43% AS staff, 29% ED nurses, and 28% ED doctors. A 4-point Likert scale (1 = strongly disagree-4 = strongly agree) was used. The mean was calculated for every variable to determine each group perception. One-way ANOVA tested the relationship between demographics and perceptions’ variables. Results: Although 62% of respondents believe the current handover process is safe and 65% believe AS staff report all critical information, 70% of respondents think that it causes AS/ED staff conflicts, and 72% believe the current handover process needs changing. ANOVA test revealed significant differences in the mean between study groups’ handover safety perceptions. Interestingly, ED nurses expressed more safety concern (2.43) than ED doctors (2.58) and AS staff (2.82) with p-value 0.05. The main perceived barriers to effective handover were: Lack of handover protocol (89%) Lack of a standardized handover tool (89%) Fragmented communication (85%) and Frequent interruptions (82%). 93% of the respondents believe the use of a standardized handover tool will improve the patient handover process despite 67% of them not knowing any standardized handover tool. Conclusion: The lack of handover protocol and a standardized tool leads to significant variation and is a patient safety concern due to potential loss of critical information. We believe that a mutually agreed standardized handover tool such as ISBAR would reduce handover variation and ensure quality.
Simplifying simulated practice for healthcare professionals and educators
Publisher: Hamad bin Khalifa University Press (HBKU Press)
Date: 09-10-2016
DOI: 10.5339/JEMTAC.2016.ICEPQ.79
Abstract: Introduction: Simulation is almost synonymous with computerised mannequins although they are not always essential components of the learning experience as what often matters most is the facilitation process of the learning experience rather than the technology. Methods: We developed Visually Enhanced Mental Simulation (VEMS) for staff to demonstrate cognitive and decision making skills away from the practical context. Scenario participants are oriented by facilitators to the VEMS process which is a simulation approach that involves a whiteboard, laminated cards, and a poster to represent equipment and the patient. It requires participants to verbalise thoughts and actions including equipment settings, and actual communication with the patient and bystanders represented by the facilitators. Information like physiological parameters and interventions made by the participating crew are written on the whiteboard. Scenarios use the same scripts as what is prepared for full-scale simulation and are followed by a debriefing. It is complemented by parallel skills sessions, and ultimately both aspects are combined into full-scale scenario-based simulation. Results: VEMS has been facilitated with uni/multi-professional teams of healthcare professionals for pre-hospital, interfacility, and handover scenarios. Comparison between VEMS and mannequin-based scenarios is ongoing and currently shows just a slightly less positive rating for VEMS although they advocate for this modality prior to full-scale simulation. VEMS reduces pressure on equipment demand and the staff engagement is such that similar clinical practitioner's mistakes are “observed” in both types of simulation approaches. Conclusion: VEMS can be run almost anywhere as it requires a minimum of equipment but still requires time and experienced facilitators. Briefing about the process and expectations are as important as the preparation of the scenario script and clinical knowledge and facilitation style of the facilitators. VEMS can be very engaging for multiprofessional teams and address learning outcomes similar to what would be achieved in full-scale simulation.
Related Organisations
Cape Peninsula University Of Technology - Bellville Campus
Location: South Africa
Related Funding Activities
No related grants have been discovered for John Meyer.