Enhancing the detection of injuries and near-misses among patient care staff in a large pediatric hospital.

Objectives Compared to other industries, healthcare has one of the highest rates of non-fatal occupational injury/illness. Evidence indicates these rates are underestimated, highlighting the need for improved injury surveillance. This study aims to demonstrate the feasibility of integrating active data collection in a passive injury surveillance system to improve detection of injuries in a healthcare establishment. Methods Using digital voice recorders (DVR), pediatric healthcare providers prospectively recorded events throughout their shift for two weeks. This sample-based active injury surveillance was then integrated into an institutional surveillance system (ISS) centered on passive data collection initiated by employee reports. Results Injuries reported using DVR during two-week intervals from February 2014 to July 2015 were 40.7 times more frequent than what would be expected on the basis of the usual ISS reports. Psychological injuries (eg, stress, conflict) and near-misses were captured at a rate of 16.1 per 1000 days [95% confidence interval (CI) 14.1-18.3] and 35.6 per 1000 days (95% CI 32.7-38.8), respectively. Finally, 68% (95% CI 65-72%) of participants preferred using DVR either as an alternative or complement to the existing ISS. Conclusions This study showed that it is feasible to improve injury surveillance in a healthcare establishment by integrating active data collection based on voice recording within a passive injury surveillance system. Enhanced surveillance provides richer information that can guide the development of effective injury prevention strategies.

Selection of employee personal protective equipment based on aggressive behavior in pediatric neuropsychiatry.

PURPOSE: Hospitalized patients with a developmental or intellectual disability and a psychiatric disorder (dual-diagnosis) often pose a risk to themselves or others leading to high injury rates for their providers. Therefore, evidence-based strategies to reduce employee injuries resulting from interactions are necessary. METHODS: To reduce injuries resulting from interactions with dual-diagnosis patients, the Initial Behavioural Assessment (IBA) and Protective Equipment Decision Key (PEDK) were used in inpatient neuropsychiatry. The IBA-PEDK identify patients' aggressive behaviors to provide employees with personal protective equipment (PPE). Inter-rater reliability, validity, and adherence were examined. RESULTS: Injuries significantly decreased after implementing the IBA-PEDK. The average kappa coefficient was 0.64 with a 90.6% agreement. Ninety-three percent of respondents reported wearing PPE at the time of injury. CONCLUSIONS: A quick, user-friendly tool that provides a standardized method for determining PPE based on patient-specific behavior can significantly reduce aggression-related injuries.

Using the California Q-sort Measure of Life History Strategy to Predict Sexual Behavioral Outcomes.

The validity of the California Q-set measure of life history (LH) strategy was examined by conducting secondary analyses on longitudinal data that included the Q-sort measure of LH strategy at multiple ages (base year N = 106) and six measures of reproductive behavior. LH strategy Q-sort ratings showed stability from ages 14-23. Additionally, the ratings were found to be good prospective and age concurrent predictors of six reproductive behaviors. LH strategy as rated at age 14 was found to be a significant predictor of age of sexual debut, number of sexual partners, frequency of intercourse, number of abortions, age at birth of first child, and likelihood for having contracted venereal disease as measured up to age 32. Future research should test the further utility of the measure focusing on ways to reduce its cumbersomeness without reducing its ability to predict behavioral outcomes.