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The term "over-triage" certainly sounds ominous and wasteful, but as researchers at the University of California, San Diego (UCSD) School of Medicine note in their recent paper in The Journal of Trauma, Injury, Infection, and Critical Care, it is anything but simple.
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Is personal protective equipment (PPE) uncomfortable, too hot, poor-fitting or unattractive looking? The reality, very often, is that employees won't wear it.
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When an employee comes to you and tells you his shoulder is bothering him, you can do one of two things. You can either treat the problem and send him on his way, or you can dig deeper.
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When people in financial hardship are worried about being evicted from their homes or don't know where their next meal is coming from, they aren't likely to remember to take their blood pressure medication or check their blood sugar levels on a daily basis.
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Current ACGME standard (2003)
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The problem of fatigued medical residents has gotten the attention of the U.S. Occupational Safety and Health Administration.
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Training and education of health care workers is an important aspect of preventing transmission of flu. The Centers for Disease Control and Prevention offers this specific recommendation:
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With widespread adoption of safer sharps in hospitals, needlesticks declined by more than half for some of the most hazardous devices. Safety has become the norm in phlebotomy. Needle devices are placed in sharps containers instead of being left on bed linens or carts, where someone else may be stuck.
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Medical residents aren't the only hospital employees suffering from fatigue.
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During last year's H1N1 influenza pandemic, health care workers inadvertently transmitted flu to their co-workers, in some cases triggering a hospital-based outbreak. That and other information about H1N1 transmission helped shape new guidelines from the Centers for Disease Control and Prevention that rely on vaccination, respiratory hygiene, and monitoring of ill employees by employee health professionals.