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At least 523 records · Page 29Linked to original sources

PubMed2000

Mobile computerized tomography scanning in the neurosurgery intensive care unit: increase in patient safety and reduction of staff workload.

OBJECT: Transportation of unstable neurosurgical patients involves risks that may lead to further deterioration and secondary brain injury from perturbations in physiological parameters. Mobile computerized tomography (CT) head scanning in the neurosurgery intensive care (NICU) is a new technique that minimizes the need to transport unstable patients. The authors have been using this device since June 1997 and have developed their own method of scanning such patients. METHODS: The scanning procedure and radiation safety measures are described. The complications that occurred in 89 patients during transportation and conventional head CT scanning at the Department of Radiology were studied prospectively. These complications were compared with the ones that occurred during mobile CT scanning in 50 patients in the NICU. The duration of the procedures was recorded, and an estimation of the staff workload was made. Two patient groups, defined as high- and medium-risk cases, were studied. Medical and/or technical complications occurred during conventional CT scanning in 25% and 20% of the patients in the high- and medium-risk groups, respectively. During mobile CT scanning complications occurred in 4.3% of the high-risk group and 0% of the medium-risk group. Mobile CT scanning also took significantly less time, and the estimated personnel cost was reduced. CONCLUSIONS: Mobile CT scanning in the NICU is safe. It minimizes the risk of physiological deterioration and technical mishaps linked to intrahospital transport, which may aggravate secondary brain injury. The time that patients have to remain outside the controlled environment of the NICU is minimized, and the staff's workload is decreased.

Ambulances↗

PubMed2006

Changes in neuromuscular function due to intermittently increased workload during repetitive work in cold conditions.

OBJECTIVES: This study attempted to determine whether repetitive work in the cold affects the number of electromyographic (EMG) gaps and whether cold-induced deterioration in neuromuscular function can be restored by altering work intensity. METHODS: During 2 hours of simulated sausage packing, the occurrence of EMG gaps was studied in eight upper-extremity muscles at 19 degrees C and 4 degrees C. The additional effect of continuous, light repetitive work [wrist flexion-extension 10% of the maximal voluntary contraction (MVC), Cwork] and intermittently increased workload (10% or 30% MVC) (Iwork) on forearm muscle EMG gaps, the median frequency of the EMG spectrum, EMG activity, and muscle fatigue (as indicated by changes in the MVC of wrist flexion) at 4 degrees C was studied. RESULTS: During work simulation, the mean skin temperature decreased from 33.3 (SD 0.1) degrees C to 30.6 (SD 0.2) degrees C (P<0.05), and the number of EMG gaps diminished in seven muscles by 1.4-68.2% (P<0.05). During Iwork there were 44% and 37% more EMG gaps in the forearm flexors and extensors, respectively, and the median frequency shifted to higher frequencies (P<0.05) as compared with the situation in Cwork. The average EMG activity of the forearm flexors was 13% lower (P<0.05) during Iwork than during Cwork. Wrist flexion MVC decreased 18% and 15% in Cwork and Iwork, respectively. CONCLUSIONS: The cold-induced decrease in the number of EMG gaps and increased muscle strain and fatigue can be, at least partially, restored by intermittently increasing the workload (ie, breaking the monotonous work cycle).

Adult↗

PubMed1996

Evaluating the workload of practice nurses: a study.

In 1990 and 1991, 67 practice nurses with a total of 12,725 consultations took part in a before and after study of health board attached and practice-employed nurse workload. The intervention of the New General Practitioner Contract (DoH 1989) and other primary care changes in April 1990 provided an opportunity to examine the process of care, and identify and changes in workload or differences in working patterns of attached and practice-employed nurses, as a result of these modifications. Practice-employed nurses initiated more of their own appointments following implementation of the New Contract and saw fewer GP referrals. Routing treatment room work had decreased for both groups of nurses in the second year. Both groups of nurses had also increased their level of therapeutic listening in the second year, but practice-employed nurses reported higher levels of therapeutic listening than their attached colleagues during both recording periods.

Adult↗

PubMed1996

Validating a clinical workload measurement instrument for documenting pharmaceutical care.

The purpose of this study was to develop and validate a workload documentation instrument to manually record clinically oriented pharmaceutical care activities. Previous research documents clinical workload by pharmacists; however, the tools employed have not been tested for validity. Reported information is difficult to interpret since individuals are unlikely to categorize activities in a consistent manner. PharmaTrend was used as a template for defining activity and problem categories that corresponded to various clinical activities performed by our clinical, faculty, and staff pharmacists. Because the institution was not completely computerized, the actual documentation tool was portable and manual. Testing of the original instrument was accomplished using a survey consisting of written scenarios. Two phases of testing were required to achieve an overall 80 percent accuracy rate. At least 60 percent of available pharmacists participated in both phases and completed 90 percent or more of the surveys. The investigators concluded that an instrument to record clinically oriented pharmaceutical care activities had been developed, tested, and validated.

Documentation↗

PubMed1998

Workload measurement for resource nurses in the critical care unit: a pilot study.

Faced with financial and staffing pressures, the resource nurses in a large pediatric critical care unit asked, "How do we spend our time at work?" When a literature review showed no evidence of an applicable type of survey, a workload measurement tool was developed and the workload measured over a six-week period. Large amounts of time were shown to be spent on tasks or jobs that could be delegated to someone who was not a nurse. This study provided documentation to support the hiring of a staffing secretary and a pharmacy technician. An increased need to be available to offer educational and professional growth and developmental support to colleagues was also identified.

Data Collection↗

PubMed1999

Neuroendocrine responses to psychological workload of instrument flying in student pilots.

BACKGROUND: Information processing and stress tolerance are necessary features for instrument flying (IFR), especially among student pilots. Psychological workload of IFR flight may lead to stress reactions such as neuroendocrine activity. METHODS: Neuroendocrine responses to an IFR flight with Vinka piston-engined primary trainer were studied in 35 male volunteers who participated in the basic military flying course of the Finnish Air Force (FAF). The student pilots performed a 40-min IFR flight mission and a control session on land in randomized order between 11.00 h and 15.00 h. The IFR flight included 3 NDB approaches and was evaluated by flight instructors. Blood samples were collected 15 min before, 5 min and 60 min after the flight as well as control session, and. Plasma ACTH, beta3-endorphin (BE), cortisol, prolactin, adrenaline (A) and noradrenaline (NA) were measured. Psychological evaluations included psychomotor test (Wiener), Multi Coordination and Attention Test, ability tests and personality tests (CMPS and 16 PF). The overall psychological evaluation was made by an aviation psychologist. RESULTS: Plasma ACTH was significantly higher before and 5 min after the flight compared with control levels, but plasma BE increased significantly only before the flight. Plasma cortisol was significantly elevated before and 5 min after the flight. Plasma prolactin, NA and A increases were significant 5 min after the flight. High A levels after the flight correlated significantly with poor IFR flight performance as well as with poor psychomotor test results. CONCLUSIONS: The plasma prolactin and NA increases after the flight represented a direct type of stress reaction to the flight situation. The plasma BE response to IFR flight was an anticipatory stress reaction, but plasma ACTH, cortisol and A responses included both anticipatory and direct types of stress reactions. Psychological factors, flight performance and neuroendocrine responses to IFR flight appear to be associated with each other. Therefore, neuroendocrine reactions as a response to the psychological workload of military flying could be used for identifying stress tolerance in military pilots.

Adrenocorticotropic Hormone↗

PubMedDate not supplied

[Work and vocational integration of psychosomatic patients--utilization and indications for a workload tryout program].

The effect of a professional workload test was assessed in a longitudinal study with 80 patients psychosomatic rehabilitation during and following their. In a second study indication criteria were tested with 358 consecutive patients. Participants in the workload program show an improvement of their work ability and job performance according to self-appraisal, superior appraisal and medical assessment. Work ability was still maintained 7 months after treatment. Patients with lasting work disability and unemployment not only show negative work-related attitudes, but also elevated psychological symptoms and a reduced quality of life. The program participants show high levels of psychological strain but also a stronger disposition to change the professional situation. Negative work-related and psychological consequences of lasting disability and unemployment deserve more attention in inpatient psychosomatic treatment.

Adult↗

PubMed2000

Sociodemographic and workload characteristics of dentists who participated in national survey, 1995.

Comprehensive, standardized data on the sociodemographic characteristics and workload of dentists in different provinces and territories in Canada are not available. The authors mailed a survey to a stratified random sample of dentists (n = 6,444) with three follow-up attempts. The response rate was 66.4%. Significant provincial and territorial differences in sociodemographic characteristics included gender, age, years since graduation, marital status, population size of town or city where primary practice is located and patient load. There was considerable variation in dentists' workload: more than 10% of dentists from New Brunswick and Prince Edward Island reported seeing > or = 30 patients per day. The majority of respondents reported seeing patients for 25 to 40 hours per week. British Columbia, Ontario, Saskatchewan and Newfoundland had a greater proportion of respondents > or = 60 years of age compared with other provinces/territories, indicating that there may be more opportunities in these provinces for younger dentists as a result of retirements.

Adult↗

PubMed2000

[Client categorization: a tool to assess nursing workload].

BACKGROUND: Client categorization is a management tool that allows an objective and structured assessment of the care demands imposed by patients and nursing workloads. AIM: To characterize the need for direct nursing care of patients admitted to a university hospital. PATIENTS AND METHODS: During two months, all patients admitted to intensive, intermediate care units and general services were categorized, their need for nursing care and the time invested by nurses in their care was registered. All patients were classified as maximal, high, median or low risk and as independent, totally or partially dependent on nursing care. Considering four degrees of risk and three degrees of dependency, 12 categories of patients were defined. RESULTS: Patients admitted to intensive care units were of maximal risk and totally dependent and required 1 nurse per 2.2 patients. Those admitted in intermediate care units required 1 nurse per 3.8 patients and those in general services, 1 nurse per 11.5 patients. CONCLUSIONS: Client categorization is a reproducible method that determines a standard measuring unit to define nursing needs. This allows the comparison of workloads between different services within a hospital or between hospitals.

Humans↗

PubMedDate not supplied

Driving performance and workload assessment of drivers with tetraplegia: an adaptation evaluation framework.

The purpose of this study was to establish a baseline for further research on adaptation evaluation for drivers with disabilities. Driving performance and workload for 26 drivers with spinal cord injuries (tetraplegia) was studied and compared to a matched group of able-bodied drivers in a driving simulator. Drivers with tetraplegia used two types of hand-operated controls for accelerating and braking. Able- bodied drivers drove with standard pedals. The drivers with tetraplegia performed the driving task equally as well as the control group but had a slightly longer reaction time (10%). Workload assessment revealed that drivers with tetraplegia experienced a significantly greater time pressure and spent more effort than did the able-bodied drivers. They were also more tired from braking and accelerating. The drivers with tetraplegia using separate levers had greater standard deviation in lateral lane position (7 cm), while those using a combined lever were more tired from braking and accelerating. Observed differences could be interpreted as indicators of insufficient adaptation.

Automobile Driving↗

PubMed1998

[Application of multistage evaluation scale in subjective assessment of mental workload].

The efficiency of multistage evaluation scale (MES) based on the fuzzy set theory as used in subjective assessment of mental workload was studied, and the results were compared with those of tracking performance and category scale (CS). It was found that error (ER) significantly increased when task became more difficult (P < 0.01) and the scalings of MES and CS also increased, but that of MES was significantly different in tasks of all the three difficulties (P<0.01) while those of CS was significant only between tasks 1 and 3 as well as tasks 2 and 3 (P <0.01), but not between tasks 1 and 2. These show that the result of MES is more agreeable with that of ER. So it might be a better subjective assessment measure of mental workload.

Adult↗

PubMed2005

Changes in trauma service workload since the introduction of the penalty points system.

With the introduction of the penalty points system (PPS) has come many media reports indicating a reduction in road traffic accident (RTA) rates. We hypothesised that reduced RTAs would result in a reduction in hospital trauma workloads. To study this we examined the numbers of RTA related femoral shaft fracture presentations to the six Dublin teaching hospitals and Waterford regional hospital within the six months since the introduction of the PPS and the two previous corresponding six month periods. We also analysed all RTA related discharges from Beaumont hospital during these three time periods. Whilst a slight reduction in RTA related femoral shaft fracture numbers was observed a dramatic reduction in total RTA related discharges from Beaumont hospital was identified with 70 patients discharged in the first six months since the introduction of the PPS compared to 124 and 125 discharges in the same two preceding six month periods. This reduction was greatest for head and thoracic injuries which were halved, while total numbers of limb injuries were maintained, resulting in no reduction in orthopaedic RTA related discharges or workload.

Accidents, Traffic↗

PubMed1992

A comparison of workloads of physician-gastroenterologists and other consultant physicians. Prepared on behalf of the Clinical Services Committee, British Society of Gastroenterology.

In response to a workload questionnaire, carried out as part of an enquiry into manpower needs in gastroenterology, replies were received from 17 health regions, relating to 86 hospitals and 135 consultant gastroenterologists. The average yearly number of deaths and discharges of patients under the care of gastroenterologists was 992, while that of patients cared for by consultant physicians in other specialties was 679. When daycase admissions were also included, there were 1,553 annual discharges per gastroenterologist as compared with 871 for other physicians. These 682 extra cases per gastroenterologist largely represent the additional workload of gastrointestinal endoscopy.

Endoscopy↗

PubMed2005

[Differences in workload for male and female physicians].

BACKGROUND: In this article we describe differences in workload for male and female physicians according to the gender of their patients. MATERIAL AND METHODS: Data from the National Insurance Service for the autumn of 2001 (1637 general practitioners) and from a comprehensive questionnaire survey among general practitioners in the autumn of 2002 (2306). RESULTS: 62 % of the patients of female physicians are women, compared to 47 % of the patients of male physicians. Female physicians have a mean of 200 fewer patients on their lists than have their male colleagues. Female physicians also have a high proportion of women on their list irrespective of the length of their list. Of those with a long patient list (>1800 patients), almost 50 % of the female physicians wanted a shorter list, compared to only 26 % of their male colleagues. INTERPRETATION: The total workload in terms of length of patient list and gender distribution of patients on the list is not necessarily different for male and female physicians. Female physicians may have chosen to have a shorter patient list in order to compensate for the fact that their patients on average have more consultations and receive more services. On the other hand, male physicians may allow themselves to have a longer patient list because they have patients who on average require less treatment.

Family Practice↗

PubMed2006

Nursing and knowledge work: issues regarding workload measurement and the informatics nurse specialist.

The profession of nursing has been faced with questions concerning workload measurement for decades, and those concerns continue to be relevant today. Traditionally, nursing has turned to time-motion studies to study this, but there is a debate about how relevant time-motion studies are to the profession of nursing when it is viewed as knowledge work. Healthcare workers, including the nursing profession, may be the single biggest group of knowledge workers. Knowledge workers today represent a significantly different workforce than are the workers of the past. Informatics, as a specialty, is relatively new to the nursing profession and continually evolving. As more nurses enter informatics and function as informatics nurse specialists, they will continue to be in the group of knowledge workers whose observable input and output is difficult to measure. Today's healthcare leaders, managers, and administrators need to identify an appropriate method of workload measurement for knowledge workers.

Health Knowledge, Attitudes, Practice↗

PubMed1991

Secondary-task assessment of workload: neuropsychological considerations for applied psychology.

The secondary-task paradigm has enjoyed considerable success as an assessment technique for operators' workload. However, during the past several years experimental neuropsychologists have employed an almost identical paradigm in their research investigating cerebral lateralization of function. To date, these areas of literature have existed as relatively isolated bodies of work, largely due to the differences between the disciplines. In the present manuscript is a brief review of the results from neuropsychological secondary-task studies and a consideration of these results in terms of their implications for the measurement of operators' workload.

Attention↗

PubMed1990

The relationship between psychic workload and cardiovascular response in industrial men managers.

The aim of the present study was to estimate the relationship between high-strain work and heart rate. The study was carried out in 23 managers from a big industrial plant. Evaluation of work demands and the ability to cope with them as regards mental difficulty, monotony, risk, responsibility, interpersonal conflicts and time pressure was regarded as an indicator of psychic workload. Heart rate (HR) was recorded according to the Holter method. Mean HRs were calculated for periods of work (HR work), outside work (HR home) and sleep (HR sleep). HR during work suggested the occurrence of substantial psychic load. This was supported by subjective evaluation, especially as regards responsibility, interpersonal conflicts, time pressure and mental difficulty. Work demands and the ability to cope with them could be regarded as the predictors of HR in all three periods of time considered, but especially during sleep. The prolonged influence of psychic workload on cardiovascular system reflects its intensity and may be the cause of the common occurrence of cardiovascular diseases in managerial staff.

Adult↗

PubMed1995

Practice nurses' workload and consultation patterns.

BACKGROUND: There are calls for the role of the practice nurse to be developed and extended. Before areas for further training and education can be identified, baseline data are needed on practice nurses' current activity and workload. AIM: A study was undertaken to analyse the activity of practice nurses in two large inner city general practices and to assess the skills mix of the nursing staff required to meet the needs of the practices. METHOD: The study practices had a combined list of 26,000 patients, 80% of patients attracting a deprivation allowance. Each practice employed three practice nurses. A nurse activity index with 45 codes was constructed to describe patient-nurse consultations. Activity codes were categorized into traditional treatment tasks, extended role tasks or diagnosis and management tasks. For eight months, practice nurses in practices Y and Z recorded activity index codes for each patient consultation. Practice Y also recorded the source of referral and the age and sex of the patient. RESULTS: There were 13,898 practice nurse consultations during the study period, equivalent to an annual nurse consultation rate of 0.8 per patient. Compared with the practice population as a whole, the patients attending the practice nurses in practice Y were older (mean age 43 years versus 37 years, P < 0.001). Those attending the practice nurses in practice Y were also more likely to be female (61% of consultations were with female patients compared with 50% of the practice population as a whole, P < 0.001). In practice Y, patients referred themselves to the practice nurse in 42% of consultations, 32% were follow-up consultations and in 25% of cases the patient had been referred by a doctor. The most common reasons for nurse consultation were blood tests (15% of procedures in practice Y and 18% in practice Z) and dressings (13% in both practices). Most procedures in practices Y and Z were in the traditional treatment category (61%), 26% were in the extended role category and 9% in the diagnosis and management category (3% coded 'other', 1% uncoded). Between practices, the greatest difference in recorded procedures was for asthma check ups (7% of procedures in practice Y compared with 2% in practice Z). CONCLUSION: This study describes the workload of practice nurses in two inner city practices over eight months. Other practices could use the activity index to make comparisons over time and between practices. Up to 60% of nurses' work in the study practices could be done by a nurse without extended training and up to 30% could be done by a health care assistant, but with some loss of quality. It is suggested that half the nursing hours available to a practice should be offered by a nurse with extended training in order to undertake and develop extended role tasks and diagnosis and management tasks.

Adolescent↗