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The Evidence Speaks

The Evidence Speaks (April 2020)

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The Evidence Speaks Series is a recurring feature highlighting the latest in CHÉOS research. This series features summaries of select publications as well as in-depth features on the latest work from our investigators. The Series is designed to keep media and the research community up-to-date with CHÉOS’ current research results in the health outcomes field.

Chiu JA, Shergill M, Dhingra V, Ronco JJ, LeBlanc A, Pamplin C, McKeown S, Dodek PM. Variation in the Management of Pain, Agitation, and Delirium in Intensive Care Units in British Columbia. Am J Crit Care. 2020 Mar 1;29(2):122–9.

In critically ill patients, pain, agitation, and delirium (PAD) are associated with negative outcomes such as increased mortality, length of stay, and long-term cognitive impairment. CHÉOS Scientist Dr. Peter Dodek and Project Manager Judy Chiu worked with a team from British Columbia to document current practice in managing PAD in intensive care units (ICUs) and identify opportunities for improvement. The team developed a 13-item online survey to gather insights into current PAD assessment and management practices in the ICU. A note was sent to 30 ICUs across the five geographic health authorities in British Columbia requesting that the person most informed about PAD practices at each site complete the survey. The results of the survey revealed that there is a wide variation in self-reported practices for PAD assessment and management in ICUs in British Columbia; for example, only half of the participating ICUs had a unit-specific pain algorithm. In conjunction with gaps between practice and evidence-based guidelines, this variation indicates that there is room for improvement in the processes of care.

Grunau B, Humphries K, Stenstrom R, Pennington S, Scheuermeyer F, Diepen S van, Awar E, Assil RA, Kawano T, Brooks S, Gu B, Christenson J. Public Access Defibrillators: Gender-Based Inequities in Access and Application. Resuscitation. 2020 Feb 29 epub ahead of print.

In cardiac arrest, defibrillation can improve patient outcomes. Some automated external defibrillators (AEDs) have been placed in public areas and, while they appear to improve the outcomes in out-of-hospital cardiac arrest (OHCA), it isn’t clear whether men and women benefit equally. CHÉOS Scientists Drs. Brian Grunau, Karin Humphries, Rob Stenstrom, Frank Scheuermeyer, Jim Christenson, and colleagues examined whether access to and use of public AEDs varied between men and women. The researchers analyzed data from the Resuscitation Outcomes Consortium Epistry 3 cardiac arrest registry, which prospectively collected data on non-traumatic OHCA treated by emergency medical services (defined as patients who received chest compressions from emergency medical services, or who received defibrillation via a professional or lay rescuer). Among the 61,473 patients’ data analyzed, it was determined that women had fewer OHCA in public places where a public access AED may exist. Furthermore, among OHCA in public locations where bystanders intervened, women were less likely to have public access AED applied. The researchers concluded that initiatives to optimize AED locations and educate the public on gender-specific resuscitation may improve outcomes in women with OHCA.

Hawke LD, Darnay K, Relihan J, Khaleghi-Moghaddam M, Barbic S, Lachance L, Ben-David S, Brown M, Iyer S, Chaim G, Soklaridis S, Kidd SA, Halsall T, Mathias S, Henderson J. Enhancing researcher capacity to engage youth in research: Researchers’ engagement experiences, barriers and capacity development priorities. Health Expectations. 2020 Mar 14;00:1–9.

Engaging youth in health services research is valuable to gathering insights into their needs, experiences, and preferences, and to ensure any collaborative research is aligned with young peoples’ needs and priorities. This can result in research that is more feasible and relevant, plus findings that are valid. CHÉOS Scientists Drs. Skye Barbic and Steve Mathias joined a pan-Canadian group to analyze the experiences, needs, and knowledge gaps of researchers interested in youth engagement training. The group recruited 84 participants who expressed interest in registering for a workshop that had learning goals concerning youth engagement in research, and completed a pre-workshop survey about their experience, attitudes, perceived barriers, and capacity development needs. The survey highlighted that, while the researchers had positive attitudes about the importance of youth engagement, they found it complex. This highlighted that skills needed for collaborating with young people in the design and conduct of research must be learned; this could be supported by training and networking opportunities. Furthermore, the findings demonstate that researchers require ways to formally acknowledge the value of youth engagement.[/vc_column_text][/vc_column][/vc_row]