Biomedical subjects

Jessica Gacki-Smith

Publications and source records attributed to Jessica Gacki-Smith.

5 recordsLinked to original sources

PubMed2006

Designing ergonomic interventions for emergency medical services workers--part III: Bed to stairchair transfers.

The objective of the current work was to test interventions aimed at reducing the low-back musculoskeletal loads experienced by firefighters/paramedics (FFPs) providing emergency medical services (EMS) that involve transferring a patient between a bed and a stairchair. The interventions, developed or selected using focus groups, were a prototype Drew People Movertrade mark, and a Transfer Sling. These interventions changed the coupling between the EMS worker and the patient. They were compared with an under-axilla lift. Eleven FFP teams transferred a 75kg dummy between a bed and a stairchair. Both interventions were tested using two-person transfers. In addition, the Transfer Sling was tested using a one-person transfer. Surface electromyographic (EMG) data were collected from 8 trunk muscles from each participant along with spine kinematic data. Additionally, ground reaction force data obtained from two forceplates were acquired for one member of each FFP team that was used to estimate directional spine moments using a 3D linked-segment model. In the two-person transfers, there was 19 degrees less trunk flexion (p=0.002) for the FFP on the patient's left side and a trend towards less motion for the FFP on the patient's right side (p=0.079) when using the interventions. Both FFPs showed reductions in the ipsilateral Erector Spinae activity using the Drew People Mover and the Transfer Sling that averaged approximately 9% MVC, which corresponds to a 21% decrease in the muscle activation levels. While the overall EMG was greater when performing a single-FFP transfer, the Transfer Sling reduced the bilateral Erector Spinae activity by approximately 20%. During the two-person transfers, the FFP on the forceplate to the right side of the patient showed a reduction in the forward bending moment using the Drew People Mover relative to the Sling and under-axilla conditions. During the single-person transfers, only the twisting moment was significantly reduced through use of the Transfer Sling. These objective measures, when combined with the subjective ratings of perceived exertion and the verbal feedback lead us to recommend the use of these interventions for bed to stairchair transfers.

Adult↗

PubMed2006

Designing ergonomic interventions for EMS workers - part II: lateral transfers.

The objective of the current work was to test ergonomic interventions aimed at reducing the low back musculoskeletal loads experienced by firefighters/paramedics (FFPs) providing emergency medical services (EMS) when performing lateral transfers between a bed and a stretcher or between a stretcher and a hospital gurney. The interventions, developed using focus groups, were a bridgeboard to reduce the frictional force resisting the lateral sliding of the patient, the use of rods along each side of the patient to facilitate the grasping and handling of the bedsheet on which the patient is typically transferred, and a single rod that, when rolled in the bedsheet, resulted in the task being changed from a lifting task to a pulling task. Eleven two-person teams laterally transferred a 75 kg dummy with each intervention between a bed and simulated stretcher. Two roles were defined. For the two-sided transfers, the FFP roles were termed "stretcher-side" and "bed-side." Surface electromyographic (EMG) data were collected from 8 trunk muscles from each participant along with spine kinematic data. Additionally, kinetic data were obtained for the FFP in the stretcher-side role. Trunk flexion moments and Erector Spinae activity were reduced for the FFP in the stretcher-side role when using the bridgeboard and the single rod both individually and in combination. The single rod reduced the Erector Spinae activity in the FFP who typically would have been on the bed. For FFPs in both roles the single rod increased Latissimus Dorsi activation relative to the standard bedsheet transfer condition, although, this effect was moderated when the single rod was used in combination with the bridgeboard. Ratings of perceived exertion also supported the use of the single rod relative to the corresponding control condition.

Abdominal Muscles↗

PubMed2006

Designing ergonomic interventions for EMS workers, Part I: transporting patients down the stairs.

The objective of the current work was to test ergonomic interventions aimed at reducing the magnitude of trunk muscle exertions in firefighters/paramedics (FFPs) providing emergency medical services (EMS) when transporting patients down the stairs. The interventions, developed using focus groups, were a footstrap to prevent the patient from sliding down on the backboard, a change in the handle configuration on the stairchair, and 2 devices, the "backboard wheeler" and a tank tread-like device (descent control system, DCS) for a stretcher, that change the backboard and stretcher carrying tasks into rolling and sliding tasks. Eleven two-person teams transported a 75 kg dummy with each intervention and its corresponding control condition down a flight of steps. Surface electromyographic (EMG) data were collected from 8 trunk muscles from each participant. Results showed that the backboard footstrap reduced the erector spinae (ERS) activity for the FFP in the "leader" role by 15 percent, on average. The change in handle configuration on the stairchair had no effect on the variables measured. The backboard wheeler reduced the ERS activity bilaterally in the FFP in the leader role and unilaterally for the FFP in the "follower" role, by 28 and 24 percent, respectively. The DCS reduced the 90th percentile ERS activity for both FFPs from 26 to 16 percent MVC, but increased the latissimus dorsi activity in the follower from 11 to 15 percent MVC. The DCS was the only intervention tested that resulted in a reduced rating of perceived exertion relative to the corresponding control condition. In summary, the hypotheses that the proposed interventions could reduce trunk muscle loading were supported for 3 of the 4 transport interventions tested.

Adult↗

PubMed2006

Research education needs of pediatric emergency nurses.

INTRODUCTION: Evidence-based practice in the emergency care of children is critical. The Pediatric Emergency Care Applied Research Network (PECARN) was developed to increase pediatric research; however, participation by emergency nurses has been limited. To identify research needs in order to increase research involvement, the Emergency Nurses Association (ENA) conducted a research needs assessment with nurses in PECARN emergency departments. METHODS: A self-administered needs assessment questionnaire was completed by 216 ED managers and nurses in 26 PECARN emergency departments between August and November of 2004. The questionnaires included items about research education, knowledge, and experience, as well as barriers to and resources for conducting research. Descriptive statistics were used to analyze the data. RESULTS: The primary barriers to nurses' research involvement included limited research knowledge and experience, limited awareness and availability of research resources, lack of dedicated time, and limited recognition for research contributions. However, the nurses reported moderate to extensive interest in research continuing education and desired moderate to extensive involvement in pediatric research. DISCUSSION: The nurses worked in research institutions with increased access to subjects and collaborative opportunities, indicating strong potential for nurses' research involvement. However, few institutions had practice models that included research recognition and dedicated research time. Furthermore, limited knowledge, experience, and awareness of research resources added to the barriers that reduced research involvement. To begin addressing the barriers, ENA developed a research curriculum based on the continuing education needs and interests identified by the nurses.

Attitude of Health Personnel↗

PubMed2005

Residents' access to ethics consultations: knowledge, use, and perceptions.

PURPOSE: To examine residents' levels of awareness, use, and perceptions of the ethics consultation service at Loyola University Medical Center, a large Midwestern academic teaching hospital. METHOD: In 2001-2002, the authors conducted a cross-sectional survey and semistructured interviews about knowledge and use of the ethics consultation service among all 229 internal medicine, surgery, anesthesiology, pediatrics, and medicine-pediatrics residents. Chi-square and t tests were used to compare categorical and continuous variables. RESULTS: In all, 135 (59%) of the residents responded, and of these 22 (16%) completed an interview. Most survey respondents (76%) reported awareness of the ethics consultation service, although only 28 (21%) indicated they knew how to request one. Most respondents (89%) had never personally requested an ethics consultation. Thirteen residents (10%) had wanted to call an ethics consultation, but decided not to request one. Residents reported barriers to requesting an ethics consultation were the attending physician's opposition (46%), lack of awareness of the ethics consultation service (15%), and negative perceptions of ethics consultations (15%). CONCLUSION: Several barriers hindered residents' use of ethics consultation services. Health care institutions should systematically educate employees about the availability and use of ethics consultation services. Institutions should establish mechanisms to give health care professionals in subordinate roles within the medical hierarchy a safe way to access and use the service.

Adult↗