Browsing by Autor "Kevin J. Blair"

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Implementation of a Hospital-based Trauma Registry in Santa Cruz de la Sierra, Bolivia: Methodology, Preliminary Results, and Lessons learned
(2016) Lina V. Mata; Marissa A. Boeck; Kevin J. Blair; Esteban Foíanini; Henry B. Perry; Adil H. Haider
ABSTRACT Aim Five million annual global deaths are attributable to injuries. Yet, a lack of reliable data leaves the true magnitude of injuries unknown in many low- and middle-income countries (LMICs), like Bolivia. Trauma registries provide a means of acquiring these data. We sought to evaluate methodology, preliminary results, and lessons learned during the implementation of a pilot, hospital-based trauma registry at one facility in Santa Cruz de la Sierra, Bolivia. Materials and methods Data collection occurred from January to September 2015 at Clínica Foianini, a private, 50-bed, third-level facility in Santa Cruz. A paper trauma registry form based on the Panamerican Trauma Society's (ATS's) essential elements model was utilized. Trained nurses completed forms at a trauma patient's initial hospital presentation. Results were analyzed via descriptive statistics. Results The registry produced 91 forms over 8 months. An ICD-10 diagnosis code search of hospital visits showed 2,816 eligible patients, with a registry capture rate of 3.2%. Most were males (59.3%) in their mid-20s with head contusions (19.8%), penetrating/lacerating upper extremity (11.0%) or head (7.7%) wounds, or upper extremity fractures (6.6%). Many forms were missing critical data, with average omissions of 12.5 per form (26.0% of questions) and 23.7 per question (26.0% of subjects). Errors averaged 1.0 per form (2.1% of questions) and 2.0 per question (2.2% of subjects). Conclusion Early efforts to implement a paper-based trauma registry at one Bolivian hospital highlight areas for improvement, mainly within education, training, and oversight. Lessons learned will inform long-term objectives to make the registry a standard hospital program across the city, and eventually throughout Bolivia, arming decision-makers with data for targeted trauma initiatives that save lives. Clinical significance These results provide insight into trauma registry implementation in LMICs, which serves to further inform the Bolivian program and can be applied to comparable initiatives in similar settings. How to cite this article Boeck MA, Blair KJ, Foianini JE, Perry HB, Mata LV, Aboutanos MB, Haider AH, Swaroop M. Implementation of a Hospital-based Trauma Registry in Santa Cruz de la Sierra, Bolivia: Methodology, Preliminary Results, and Lessons learned. Panam J Trauma Crit Care Emerg Surg 2016;5(2):101-112.
Protecting healthcare workers in the COVID-19 pandemic: respirator shortages and health policy responses in South America
(Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, 2020) Kevin J. Blair; Samuel Martínez-Vernaza; Eddy R. Segura; José Luis Gallardo Barrientos; Kent Garber; Sandra Gualtero-Trujillo; Catherine Juillard; Rodolfo Castro
A proteo dos profissionais de sade durante a pandemia da COVID-19: falta de respiradores e respostas a partir de polticas de sade na Amrica do Sul
The Bolivian trauma patient's experience: A qualitative needs assessment
(Elsevier BV, 2020) Jordan M. Rook; Ethan Wood; Marissa A. Boeck; Kevin J. Blair; Alexa Monroy; Erica Ludi; Eric J. Keller; David Victorson; Esteban Foíanini; Mamta Swaroop
What is trauma? Qualitatively assessing stakeholder perceptions in Santa Cruz de la Sierra, Bolivia
(Taylor & Francis, 2020) Kevin J. Blair; Alexa Monroy; Jordan M. Rook; Ethan Wood; Esteban Foíanini; Adil H. Haider; Mamta Swaroop; Marissa A. Boeck
Addressing the burden of injury in low-resource settings requires development of trauma systems. This study aimed to describe perceptions of trauma in Santa Cruz, Bolivia to better inform strategies for trauma system development. In 2015-2016, we conducted 16 individual and 11 group interviews with key stakeholders involved with or exposed to trauma. A pile sorting activity showed participants pictures of injury mechanisms to explore perceptions of trauma. Responses were analysed for themes using content and discourse analysis. Among 27 interviews, six were with physicians, seven with first responders, three with community members, and 11 with trauma patients. Pictures commonly categorised as trauma depicted a road traffic incident (92.6%), fall (88.9%), gunshot wound (88.9%), and burn (85.2%). Fewer respondents stated intoxication (51.9%) or drowning (40.7%) were trauma. Coding of responses revealed five themes: trauma definition, mechanism, physical injury, management, and psychological trauma. Medical personnel focused more on trauma as mechanism, physical injury, and management, whereas laypersons commonly described trauma as psychological. Varied understanding of what represents trauma could influence trauma registry data collection. Laypersons' focus on psychological trauma may affect use of designated trauma care hospitals. These viewpoints must be considered when designing policies and interventions for trauma system strengthening.