El rol del personal de enfermería en los centros coordinadores de urgencias de España: un elemento a considerar / Nurses' roles in emergency response coordination centers in Spain: a resource to consider

OBJETIVO: Conocer la dotación de personal de enfermería de los centros de coordinación de urgencias (CCU) españoles, así como las funciones y actividades de los profesionales dentro de la estructura y organización de los CCU. MÉTODO: Estudio observacional transversal realizado entre enero y abril del 2019 mediante consulta de la información institucional en memorias y páginas web de los servicios de emergencia, así como entrevistas telefónicas y correos electrónicos a informantes clave (responsables de enfermería o profesionales implicados directamente en la gestión de llamadas) de las 17 comunidades autónomas (CCAA) y las ciudades autónomas de Ceuta y Melilla. RESULTADOS: Todas las CCAA, excepto Asturias, La Rioja y las dos ciudades autónomas, tienen personal de enfermería cuyas funciones más habituales son la prevención y promoción de la salud, atención a consultas sanitarias, apoyo a atención primaria, alertas epidemiológicas, gestión de incidentes de múltiples víctimas, transporte secundario, activación de códigos asistenciales, coordinación de trasplantes y preavisos hospitalarios. CONCLUSIONES: El personal de enfermería en los CCU de España tiene funciones similares, pero con distinto nivel de desarrollo en cada CCAA

OBJETIVES: To study nurse staffing at emergency response coordination centers (ERCCs) and determine nurses' functions and activities within the structure and organization of ERCCs. METHODS: Observational cross-sectional study in January and April 2019 in the 17 Spanish autonomous communities and the autonomous cities of Ceuta and Melilla. We consulted ERCC institutional reports and webpages, conducted telephone interviews, and maintained email correspondence with key informants (nurse supervisors and staff directly implicated in managing emergency calls). RESULTS: All the ERCCs except those in Asturias, Rioja, and the 2 autonomous cities have nurses on staff. Their usual functions are prevention and health promotion; supporting primary care physicians; managing health alerts, multiple victim incidents, and secondary patient transport; activating response codes; coordinating transport for transplants; and contacting hospitals so they expect arrivals. CONCLUSION: Nurses in Spanish ERCCs have similar functions, but they are developed at different levels in each center

Evaluating quality neonatal care, call Centre service, tele-health and community engagement in reducing newborn morbidity and mortality in Bungoma county, Kenya.

BACKGROUND: Neonatal mortality is a major health burden in Bungoma County with the rate estimated at 31 per 1000 live births and is above the national average of 22 per 1000. Nonetheless, out of the nine sub county hospitals, only two are fairly equipped with necessary infrastructure and skilled personnel to manage neonatal complications such as prematurity, neonatal sepsis, neonatal jaundice, birth asphyxia and respiratory distress syndrome. Additionally, with more than 50% of neonates delivered without skilled attendance, in below par hygiene environments such as home and on the roadsides, with non-existent community based referral system, the situation is made worse. The study aims to evaluate the progress made by an intervention "Collaborative Newborn Support Project" geared towards reducing neonatal mortality rate by 30% between October 2015 and December 2018 in Bungoma County, Kenya. METHODS/DESIGN: This intervention will take a quasi-experimental design approach with experimental and control sites. The project will involve pre- and post-intervention data collection with comparison group to assess intervention effects. The primary outcome will be the percentage reduction of neonatal mortality in Bungoma County. Secondary outcomes include; a) Percentage of mothers or care givers able to identify at least three danger signs in neonates in the project area, b) Proportion of neonates with complications referred to specialized neonatal centers, through the call center, c) Percentage of health providers in neonatal care units who adhere to expected neonatal standards of care (rapid and complete application of standard protocols), d) Percentage increase in neonates with severe complications in the specialized neonatal units and e) Percentage of neonates who stay in neonatal care units beyond 5 days. DISCUSSION: We outline implementation details of the ongoing 'Collaborative Newborn Support Project' in Bungoma County, Kenya. This includes strategies in the operations of the telehealth platform, call centre service, community engagement and measuring of the outputs and outcomes. The funding and ethical approvals have been obtained and the study commenced. TRIAL REGISTRATION: PACTR201712002802638 Retrospectively registered on 5th December 2017 at Pan African Clinical Trials Registry.

Implementation and quality assessment of a pharmacy services call center for outpatient pharmacies and specialty pharmacy services in an academic health system.

PURPOSE: The implementation and quality assessment of a pharmacy services call center (PSCC) for outpatient pharmacies and specialty pharmacy services within an academic health system are described. SUMMARY: Prolonged wait times in outpatient pharmacies or hold times on the phone affect the ability of pharmacies to capture and retain prescriptions. To support outpatient pharmacy operations and improve quality, a PSCC was developed to centralize handling of all outpatient and specialty pharmacy calls. The purpose of the PSCC was to improve the quality of pharmacy telephone services by (1) decreasing the call abandonment rate, (2) improving the speed of answer, (3) increasing first-call resolution, (4) centralizing all specialty pharmacy and prior authorization calls, (5) increasing labor efficiency and pharmacy capacities, (6) implementing a quality evaluation program, and (7) improving workplace satisfaction and retention of outpatient pharmacy staff. The PSCC centralized pharmacy calls from 9 pharmacy locations, 2 outpatient clinics, and a specialty pharmacy. Since implementation, the PSCC has achieved and maintained program goals, including improved abandonment rate, speed of answer, and first-call resolution. A centralized 24-7 support line for specialty pharmacy patients was also successfully established. A quality calibration program was implemented to ensure service quality and excellent patient experience. Additional ongoing evaluations measure the impact of the PSCC on improving workplace satisfaction and retention of outpatient pharmacy staff. CONCLUSION: The design and implementation of the PSCC have significantly improved the health system's patient experiences, efficiency, and quality.

After-hours/on-call experience during primary care nurse practitioner education utilizing standard scenarios and simulated patients.

BACKGROUND AND PURPOSE: Few nurse practitioner (NP) programs include an after-hours/on-call component in their clinical preparation of NP students. This role is expected in many primary and specialty care practices, and is one that students feel unprepared to competently navigate. METHODS: Utilizing simulated callers as patients or parents, NP students participated in a simulated after-hours/on-call experience that included receiving the call, managing the patient, and submitting documentation of the encounter. Students completed pre- and postparticipation evaluations, and were evaluated by the simulated patient callers and faculty using standardized evaluation tools. CONCLUSIONS: NP students rated the experience as an educationally valuable experience despite feeling anxious and nervous about the experience. Several essential skills were identified including critical thinking, clear communication, self-confidence, and access to resources. After participation NP students were more receptive to an NP position with an on-call component. IMPLICATIONS FOR PRACTICE: Inclusion of a simulated on-call experience is a feasible component of NP education and should be added to the NP curriculum.