Towards collaborative action: A project on interprofessional stroke care in the Covid-19 pandemic

Abstract Background Stroke is one of the leading causes of disability in adulthood. Cooperatively organised stroke care requires a high degree of interprofessional competence of junior professionals. Objectives The project aim was to develop interprofessional competences for stroke care, to identify gaps in care as well as approaches to innovation during the pandemic through joint research. The focus was on person-centred care, communication and collaboration, roles and responsibilities, including stroke-navigators. German Bachelor students of occupational therapy, physiotherapy and speech therapy of the 7th semester (n = 22) were accompanied online in 60 teaching units in 2020/2021. The seminars consisted of (a) theoretical introduction to interprofessional stroke care (b) case-based collaboration with problem-based learning (c) applied health services research. The evaluation was based on a central questionnaire and written reflections from all students. Results The following themes were identified and investigated in 5 interprofessional groups: (1) Impact of the Covid-19 pandemic on the acute care and rehabilitation of stroke patients, (2) International comparison of interprofessional stroke care based on guidelines to improve current practice, (3) Interprofessional diagnostics in stroke care, (4) Interprofessional patient-centered goal setting in outpatient stroke care, (5) Agreements of actors involved in stroke treatment to best serve the needs of the patient. The response rate to the centralised evaluation was low (14%). The project was rated good to very good in terms of planning and presentation, relevance, and interaction with students. Conclusions The students reported central aspects for interprofessional learning: The reflections predominantly described growth in professional competences, in skills for cooperation and problem solving, which can be transferred to professional life. The main point of criticism was the necessity of digital teaching in the pandemic. Key messages • Empowering interprofessional cooperation through a joint project of different Bachelor programmes helps to strengthen the students’ professional identity and shared responsibility for stroke care. • Online teaching can be a valuable facilitator of learning, but should not completely replace face-to-face teaching for stroke care.


Background:
Recent events in the world, wars, pandemics, have once again raised the issue of the need for competent human resources in global public health (GPH). In Georgia, there are master's degree programs in public health where global health is mostly offered as an elective or core course of the curriculum. University of Georgia (UG) is involved in the ERASMUS + project in GPH (BACE). UG initiated to create new GPH Master Program, which will be response towards local, regional and international challenges and demand. Objective: Main objective of developing GPH program was to address and meet national and international global health education needs and challenges. The aim of the study was to identify evidence-based prerequisites for the MPH in GPH (UG). We conducting document review based on the GPH competency model (GPHCM) and evaluated: 1) GPH & MPH programs of the top 20 world university ranking (THE/2022); 2) CUGH associated programs; 3) Georgian MPH programs; 4) Georgian education documents (such as Georgian National Qualifications Framework (GNQF)); 5) Main directions of career development in global health. In addition, interviews with national experts were conducted (in education, employment, program leaders) using the Delph method. Results: Study found that depending on the scope and content of the program, prerequisites for obtaining MPH in GPH varies. In addition to English competence and a high GPA, working or research experience or interviews or additional exams or other are required. In Georgia, there is no adopted GPHCM, but GNQF allows the establishment of MPH in GPH. UG new Master program (120 ECTS) will include 99 ECTS core (including research practicum & thesis) and 21 ECTS elective courses based on 6 domains of GPHCM. The program will mostly focus on population health management at a global level.

Background:
Stroke is one of the leading causes of disability in adulthood. Cooperatively organised stroke care requires a high degree of interprofessional competence of junior professionals.

Objectives:
The project aim was to develop interprofessional competences for stroke care, to identify gaps in care as well as approaches to innovation during the pandemic through joint research. The focus was on person-centred care, communication and collaboration, roles and responsibilities, including strokenavigators. German Bachelor students of occupational therapy, physiotherapy and speech therapy of the 7th semester (n = 22) were accompanied online in 60 teaching units in 2020/2021. The seminars consisted of (a) theoretical introduction to interprofessional stroke care (b) case-based collaboration with problem-based learning (c) applied health services research. The evaluation was based on a central questionnaire and written reflections from all students.

Results:
The following themes were identified and investigated in 5 interprofessional groups: (1) Impact of the Covid-19 pandemic on the acute care and rehabilitation of stroke patients, (2) International comparison of interprofessional stroke care based on guidelines to improve current practice, (3) Interprofessional diagnostics in stroke care, (4) Interprofessional patient-centered goal setting in outpatient stroke care, (5) Agreements of actors involved in stroke treatment to best serve the needs of the patient. The response rate to the centralised evaluation was low (14%). The project was rated good to very good in terms of planning and presentation, relevance, and interaction with students.

Conclusions:
The students reported central aspects for interprofessional learning: The reflections predominantly described growth in professional competences, in skills for cooperation and problem solving, which can be transferred to professional life. The main point of criticism was the necessity of digital teaching in the pandemic.

Key messages:
Empowering interprofessional cooperation through a joint project of different Bachelor programmes helps to strengthen the students' professional identity and shared responsibility for stroke care. Online teaching can be a valuable facilitator of learning, but should not completely replace face-to-face teaching for stroke care.

Background:
Surgical site infections (SSIs) are the most common hospitalacquired infections (HAIs) in low-and middle-income countries. Many reports have shown that surveillance and management of factors associated with SSI decreased rates and improved overall outcomes.This study aimed to appraise the prevalence trend and risk factirs of SSIs during 10-year period (2012 -2021) in a Tunisian university hospital.

Methods:
The SSI surveillance module is based on the National Healthcare Safety Network (NHSN), Centers for Disease Control and Prevention (CDC). For the current study, data collected over ten years through point prevalence surveys were analyzed. Univariate and multivariate logistic analysis were used to identify SSI risk factors.

Results:
Overall, 2957 patients were observed; the mean age was 48.4 AE 23.5 years and 57.2% were male. We identified 289 infected patients (9.8%) and 319 HAIs (10.8%). SSIs were found in 21.6% of cases.The prevalence of SSI decreased from 27.9% in 2012 to 21.6% in 2021. However, this decrease was not statistically significant. The majority of the positive cultures were Staphylococcus aureus (14.3%) followed by Escherichia Coli (11.1%) and Klebsiella pneumoniae (9.5%). Antimicrobial resistance was found in 17.5% of cases. Univariable analysis found that lenght of stay (p < 10-3), obesity (p = 0.047), the use of antibiotic treatment in 6 months (p = 0.002), and the use of central line (p < 10-3) were associated with SSI. Independent risk factors significantly associated with SSIs were length of stay (aOR = 8.6), the use of central line (aOR = 3), and the use of antibiotic treatment in 6 months (aOR = 2.2).

Conclusions:
With continuous surveillance, the prevalence of SSIs decreased. In Sahloul university hospital, there has been a strengthening of the application of hygiene standard precautions during the two last years, and more particularly the respect of hand hygiene, combined with continued inpatient antimicrobial stewardship programs. Key messages: Active surveillance and management of factors associated with surgical site infection (SSI) decreased the incidence and improved overall outcomes. With continuous surveillance, the prevalence of SSIs decreased over the 10-year study period.