Journal of evaluation in clinical practice最新文献

Introduction

Few data on the impact of specific interventions against Emergency Rooms ‘or Hospitals overcrowding are available in France.

Methods

In the present report, we retrospectively investigated the impact of the implementation of a short-stay observation unit associated with the admitter-rounder model, especially onto the other in-patient internal medicine units in a French University Hospital.

Results

During the first 100 days, 242 patients were admitted into the short-stay observation unit. The median length of stay (LOS) was 5 days, but it was lower during the first and third parts with the admitter-rounder model than during the second part without: 4 versus 6 days (p = 0.007).

Internal medicine bed-spaced patients accounted for 19.5% of the bed-spaced patients during the study period versus 28.1% during the same period the previous year (p = 0.04). The median LOS increased significantly in two units of internal medicine: 10 versus 8 days (p = 0.005) and 10 versus 8 days (p = 0.01) during the study period versus the same period the previous year, respectively.

Discussion

The reduced number of Internal Medicine bed-spaced patients, the reduced LOS of patients in short-stay observation unit when associated with the admitter-rounder model and the increase of LOS among some of the in-patient internal medicine units observed in this study should be evaluated elsewhere.

Background

Medication adherence is a crucial factor in managing and treating chronic diseases in older adults. Health literacy (HL) skills and rational drug use (RDU) knowledge are important for individuals to make informed decisions about medication adherence behaviours.

Aim

This study was conducted to determine the association between medication adherence and rational drug use knowledge and health literacy in older adults residing in nursing homes.

Methods

The cross-sectional study was conducted with 121 older adults residing in a nursing home in Turkey. The data were collected using the Participant Information Form, the Medication Adherence Report Scale (MARS-5), the Rational Drug Use Scale (RDUS), and The Turkish version of the European Health Literacy Survey Questionnaire (HLS EUEU-Q-TR).

Results

The mean age of the older adults was 69.92 ± 6.45 years and 76.9% were male. The mean score of MARS-5 was 21.80 ± 3.55. Among older adults, 43.8% were found to have inadequate RDU knowledge, 28.9% had inadequate HL, and 46.3% had problematic-limited HL. The RDU knowledge was a statistically significant strong predictor of medication adherence (R² = 0.495, p < 0.001). The HL was a statistically significant predictor of medication adherence (R² = 0.037, p < 0.05).

Conclusion

The study found that medication adherence among older adults residing in nursing homes was moderate, RDU knowledge and HL levels were low, and medication adherence increased as RDU knowledge and HL levels increased.

Aims

This study aims of determine the mediating role of individual innovativeness in the effect of nursing students' artificial intelligence anxiety on their robotic surgery knowledge level.

Design

This study was cross-sectional type.

Methods

It was conducted with 391 students. Artificial Intelligence Anxiety Scale, Robotic Surgery and Robotic Surgery Nursing Knowledge Level Survey and Individual Innovativeness Scale were used to collect data. PROCESS Macro methods were used.

Results

There was a negative, very weak and significant relationship among artificial intelligence anxiety and individual innovativeness and level of robotic surgery nursing knowledge. There was a positive, very weak and significant relationship among students' individual innovativeness and level of robotic surgery nursing knowledge. Individual innovativeness mediated the relationship among artificial intelligence anxiety and level of robotic surgery nursing knowledge.

Conclusions

Individual innovativeness contributes to reducing the artificial intelligence anxiety to increase the robotic surgery knowledge levels of students.

Background

Chronic respiratory disorders such as asthma and chronic obstructive pulmonary disease (COPD) may deteriorate into acute exacerbations requiring hospitalization. Assessing the predictors of prolonged hospital stays could help identify potential interventions to reduce the burden on patients and healthcare systems.

Aim

This study aimed to identify the risk factors attributed to prolonged hospital stays among patients admitted with acute exacerbations of chronic respiratory disorders in Jordan.

Methods

A retrospective cohort study was conducted by reviewing the demographic and clinical characteristics of hospitalized patients with asthma and COPD exacerbations between January 2017 and July 2021. The recorded variables were checked for their independence. Simple and stepwise multivariate linear regressions were then performed to identify variables associated significantly with a longer hospital length of stay (LOS).

Results

A total of 896 cases were evaluated. The mean ± SD stay was 5.66 ± 3.40 days, whereas the median (IQR) was 5.00 (4.00) days. Variables associated significantly with prolonged LOS in the multivariate analysis were female gender (β = 0.089, p = 0.011), pulmonary hypertension (β = 0.093, p = 0.004), allergic rhinitis (β = 0.086, p = 0.007), ICU admission (β = 0.096, p = 0.003), requirement for mechanical ventilation (β = 0.102, p = 0.002), higher total number of medications (β = 0.281, p < 0.001) and the number of exacerbation-related medications (β = 0.200, p < 0.001). However, smoking (β = −0.091, p = 0.008) was significantly associated with a shorter LOS.

Conclusions

Gender, pulmonary hypertension, allergic rhinitis, ICU admission, mechanical ventilation, the number of medications and smoking were significantly related to LOS. These findings emphasize the importance of patients' demographics and their clinical status in determining LOS, hence providing protective interventions to shorten it.

Aims and Objectives

In this study, it was aimed to determine nursing students' attitudes towards clinical practice and their perceptions of occupational risk.

Method

The research is descriptive and cross-sectional. The population of this study consisted of second-, third- and fourth-year students studying in the Department of Nursing affiliated to the Faculty of Health Sciences of a university located in Turkey. The analysis was conducted using JASP 0.19.1.0 and SPSS 25 software. Mann–Whitney U and Kruskal–Wallis tests were applied. The Bonferroni test was performed to identify the group causing the difference.

Results

A significant positive correlation was found between nursing students' perception of occupational risk and nursing students' attitude toward clinical practice (r = 0.434, p = 0.000). The mean score of the nursing students' perception of occupational risk in nursing students was 68.74 ± 15.04. The mean score of attitude towards clinical practice in nursing students was 100.04 ± 24.83. A statistically significant difference was found between the presence of attitude towards clinical practice in nursing students and perception of occupational risk in nursing students in the gender variable (p < 0.05), whereas a statistically significant difference was found between adequate information about the nursing profession and attitude towards clinical practice in nursing students (p < 0.05).

Conclusion

In the findings of the study, nursing students' perception of occupational risk and attitudes towards clinical practice were found at a high level. A statistically significant difference was found between the presence of perception of occupational risk in nursing students and attitude towards clinical practice in nursing students in the gender variable. In addition, a statistically significant difference was found between adequate knowledge and nursing profession about the nursing profession and attitude towards clinical practice in nursing students.

Background

To assess the Knowledge, Attitude, and Practice (KAP) of medical students at Hunan Medicine College towards insomnia and TCM treatment.

Methods

The study included 676 medical students. More than half were female (64.20%), and 33.8% reported experiencing insomnia for over a week. Participants' KAP scores were evaluated on insomnia and TCM treatment using a scale.

Results

The mean KAP scores for insomnia were 58.93%, 73.75%, and 64.94%, respectively, indicating insufficient knowledge but positive attitudes and moderate practices. TCM treatment scores were 78.18%, suggesting better awareness. Overall, 67.60% of medical students would choose TCM for insomnia treatment. Multivariable analysis revealed associations between choosing TCM and higher knowledge (OR = 1.30), positive attitude (OR = 1.46), better practice (OR = 3.44), and being in a later academic year (OR = 2.397).

Conclusion

The study underscores the need for targeted educational interventions to enhance understanding and promote effective practices among medical students, potentially improving their well-being and addressing insomnia more comprehensively.

Aim(s)

This study aims to evaluate the workload of clinical nurses by measuring the work relative value (work RVU) of common nursing items based on the resource-based relative value scale in China.

Background

Various single measurements have been employed to measure the nursing workload, but no comprehensive method has yet to be developed in China.

Methods

A descriptive study was conducted to construct a common item set for nursing work in general wards on the basis of the 2019 History Information System nursing database from Class A tertiary hospitals to identify the time associated with each service. Data cleaning methods, expert consensus meetings, observational methods, Delphi consensus methods and the analytic hierarchy processes were employed.

Results

A common item set for nursing work was established, which contained 2 first-level indexes, 8 secondary-level indexes and 79 third-level indexes. The average working hours of the common items ranged from 1.38 to 23.76 min. The top three nursing items identified were: extra large dressing change, cleaning enema, and nasal feeding catheterization.

Conclusions

The common nursing items used in general wards were universal. The work RVU of common items comprehensively evaluates clinical nurses' workload, which can better meet the needs of management.

Implications

The work RVU of common items will facilitate effective and comprehensive allocation of nursing human resources and performance assessment.

Reporting Method

We have adhered to relevant EQUATOR guidelines and named the reporting method.

Background

Problem-solving skills are some of the leading strategies for dynamism in the content and quality of nursing care.

Aim

The present study is aimed at determining nursing students' problem-solving, solution-focused thinking, and emotional intelligence levels and investigating the relationship between their problem-solving skills and these variables.

Methods

The study comprised 305 nursing students in Turkey. Data were collected between May and June 2021, using the personal information form, problem-solving inventory, solution-focused inventory and Schutte emotional intelligence scale. One-way ANOVA, t-test and multiple regression were used for data analysis.

Results

The mean age of the participants was 21.81 ± 5.93 years, 75.7% of them were women, 35.1% were senior students and 58.0% perceived their academic achievement as moderate. The mean scores from the overall problem-solving inventory, solution-focused inventory, and emotional intelligence scale were 92.93 ± 19.30, 50.26 ± 8.43 and 128.22 ± 14.11, respectively. Variables such as sex, perceived academic achievement, emotional intelligence and solution-focused thinking levels affected problem-solving skills (p < 0.01). The effective predictive factors accounted for 50.2% of the change in participants' problem-solving skill levels.

Conclusion

For this reason, revising the national nursing curriculum with programmes that develop emotional intelligence and solution-focused thinking skills will enable nursing students to better manage the nursing process in clinical and field practices.

Rationale

Established coronary artery disease (CAD) patients are at increased risk for recurrence of cardiovascular events and mortality due to non-attainment of recommended risk factor control targets.

Objective

We aimed to evaluate the attainment of treatment targets for risk factor control among CAD patients as recommended in the Indonesian CVD prevention guidelines.

Methods

Patients were consecutively recruited from the Makassar Cardiac Center at Wahidin Sudirohusodo Hospital, Indonesia. Targets for systolic blood pressure (SBP < 140 mmHg), low-density lipoprotein-cholesterol (LDL-C < 1.8 mmol/L), body mass index (BMI: 20–25 kg/m²), non-smoking status and antithrombotic use were assessed according to the national guideline. Attainment levels were evaluated in CAD population subgroups using logistic regression to identify patients who required more intensive monitoring.

Results

A total of 395 CAD patients (median age: 57 years (IQR: 49–65), 63.8% men) were recruited between February and June 2021. We observed that 1.8% of the CAD patients met all risk factor treatment targets. LDL-C had the lowest attainment level (5.1%), followed by BMI (59.7%), SBP (62.8%), antithrombotic usage (76.7%) and non-smoking status (94.4%). Apart from lower attainment of SBP control in the 50+ years age group (aOR: 0.57, 95% CI: 0.35–0.94) and women (aOR: 0.53, 95% CI: 0.34–0.83), the attainment levels of other risk factors were consistently low across age, sex, marital status and educational subgroups.

Conclusion

These findings emphasize the urgent need for effective management and heightened awareness, particularly for controlling LDL-C in the CAD population. Action to address this issue is crucial for mitigating the CVD burden, particularly in low- and middle-income countries such as Indonesia.