Michael Sinnott

The need to address poor numeracy skills in the emergency department environment

Publisher: Wiley

Date: 08-04-2014

DOI: 10.1111/1742-6723.12207

Abstract: Substantial evidence exists for lack of numerical skills among many health professionals. Although poor numeracy has long been recognised as a contributor to medication error, other activities for which numerical literacy are required, such as interpretation of diagnostic results, have been largely ignored. Poor self-awareness of lack of numerical literacy increases the risk, especially in the busy and hurried emergency environment. System changes, such as standardising units and improving number presentation, reduce the potential for misinterpretation however system changes do not address the underlying deficiencies in mathematical skills. The training of doctors in numeracy has been largely ignored. In contrast, education for nurses frequently occurs during both pre- and post-registration programmes. Interventions have had mixed success, although additional emphasis in increasing conceptual understanding of numbers is encouraging. The consequences of poor numerical literacy should be addressed in all clinical staff, not only by practice change to remove the potential for errors to be made, but also complemented by self-awareness and education.

Hesitation and error: Does product placement in an emergency department influence hand hygiene performance?

Publisher: Elsevier BV

Date: 09-2015

DOI: 10.1016/J.AJIC.2015.04.199

Abstract: Existing research has consistently demonstrated poor compliance by health care workers with hand hygiene standards. This study examined the extent to which incorrect hand hygiene occurred as a result of the inability to easily distinguish between different hand hygiene solutions placed at washbasins. A direct observational method was used using ceiling-mounted, motion-activated video camera surveillance in a tertiary referral emergency department in Australia. Data from a 24-hour period on day 10 of the recordings were collected into the Hand Hygiene-Technique Observation Tool based on Feldman's criteria as modified by Larson and Lusk. A total of 459 episodes of hand hygiene were recorded by 6 video cameras in the 24-hour period. The observed overall rate of error in this study was 6.2% (27 episodes). In addition an overall rate of hesitation was 5.8% (26 episodes). There was no statistically significant difference in error rates with the 2 hand washbasin configurations. The amelioration of causes of error and hesitation by standardization of the appearance and relative positioning of hand hygiene solutions at washbasins may translate in to improved hand hygiene behaviors. Placement of moisturizer at the washbasin may not be essential.

Princess Alexandra Hospital

Location: Australia

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University Of Queensland

Location: Australia

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Australasian College For Emergency Medicine

Location: Australia

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Royal Australasian College Of Physicians

Location: Australia

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Linkage Projects - Grant ID: LP0669156

Start Date: 07-2006

End Date: 12-2009

Amount: $290,000.00

Funder: Australian Research Council

Linkage Projects - Grant ID: LP140100394

Start Date: 09-2014

End Date: 12-2018

Amount: $320,000.00

Funder: Australian Research Council