Hospital Topics最新文献

The study was carried out to explore the attitude and perception of observers involved in monitoring of doffing through Real Time Remote Audio-Visual aided (RT-RAVA), the first well-sophisticated surveillance system. A 21-item online-survey proforma was used to collect the data amongst 150 nursing personnel. 3/4^th of the participants strongly agreed that they helped in reducing the doffing errors through RT-RAVA doffing. 97.3% perceived that the system is highly effective in reducing the infection during doffing. There was significant correlation between attitude and perception of the observers. The system was perceived as highly effective and was recommended for doffing.

The present study assessed whether applying enhanced recovery after surgery (ERAS) guidelines for cesarean delivery is feasible in the tertiary care setting with an add-on objective to identify barriers to successful implementation. The cross-sectional study included women undergoing elective CS and willing to participate. The study attempted to understand barriers to ERAS implementation through timely interviewing study participants. Sixty-two patients participated in the study. Antenatal and fetal complications were observed in 39(63%) and 32(51%) participants. The study observed that at least 80% of the proposed components could be applied to 71% of the study population. All 15 components could be applied to 7(11.2%) patients, and at least 50% could be applied to 58(94%) patients. The least applied component was minimizing starvation by taking clear liquids until 2 hrs before surgery in 26(42%) patients due to waiting hours outside the operation-theater (OT). When fitness-for-discharge was assessed against the percent components of ERAS implemented, the area under the curve (AUC) value was 0.75, with a specificity value of 95.65% and a positive predictive value of 94.12%. In the postoperative ERAS bundle, fitness-for-discharge on day-two was statistically associated with early and frequent breastfeeding (p = 0.000) and prevention of intra-op hypotension (p = 0.03). In conclusion, the primary barriers to implementing ERAS were resource limitations in the form of single functional OT and limited doctors.

This study examined the relationship between patient loyalty and adherence to treatment and evaluated the mediating role of patient satisfaction in this relationship. This study consisted of 386 participants. Correlation and regression analyses were used. A low level of positive correlation was found between loyalty and compliance scores. It was determined that satisfaction did not mediate the relationship between loyalty and compliance. In addition, a moderately positive relationship was found between loyalty and satisfaction. It has been observed that patient loyalty can play a critical role in important health outcomes such as adherence to treatment and increasing satisfaction.

As the United States (U.S.) moves toward the post-pandemic landscape, there remains a heightened need to increase the nursing workforce. The population continues to age, chronic illnesses are further exacerbated, and the highlight of the shortage of nurses weighed heavier while navigating care during Covid-19. This article examines nursing workforce improvement policies in a policy system where outcomes are either predicated by incremental decision-making or by punctuated changes. Punctuated Equilibrium Theory (PET) is posited to explain nursing policy trends and outcomes. Covid-19 created a punctuation in the healthcare system, leading to the "great resignation," the increase of travel nurses, and nurses working remotely via tele-health tools. What remains is the impact on nurse staffing policy and what will be done to provide nursing services moving into the future.

This cross-sectional study aimed to explore the perceptions and performances of hospital pharmacists in providing services for people with visual impairment. This study surveyed 150 hospital pharmacists at all levels in public hospitals in Bangkok, Thailand. The results demonstrate that hospitals faced challenges in translating the principles of the Convention Rights of People with Disabilities into hospital policy guidelines and service plans. Due to lack of policy endorsement, pharmacists were left unsupported for critical resources, such as facilities, budgets, staff, and materials to provide services quality. The hospital management and disability cultural competency were facilitating factors that promoted equitable care for vulnerable groups.

This study purposed to determine the levels of nursing informatics competency and self-efficacy in clinical practice and influencing factors on self-efficacy among Palestinian nurses in hospitals. A descriptive-correlational design was adopted. The nurses who worked in the North West Bank of Palestine (N = 331) were recruited. The data were collected using the Self-Assessment of Nursing Informatics Competencies Scale (SANICS) which consists of 30 items rated on a 5-point Likert scale, ranging from 1(not competent) to 5 (expert), and scored by calculating the mean as follows: novice/low (1.00-2.59), beginner/moderate (2.60-3.39), and competent/high (3.40-5.00); and the New General Self-Efficacy Scale (NGSE) that consists of eight items rated on a 5-point Likert scale, ranging from 1(strongly disagree) to 5(strongly agree) and scored according to the average of the scale, whereas the average of > 3 indicated high self-efficacy, and ≤ 3 reflected low self-efficacy. The data were collected during the period from September to November 2020. Findings showed that the total mean score for the nursing informatics competency scale was 2.9 (SD = 0.7), which indicated that the nurses had a moderate level of nursing informatics competency. The average score for the self-efficacy scale was 3.5 (SD = 0.8), which reflected that nurses had high self-efficacy. Self-efficacy in clinical practice increased with age and with nursing informatics competency. Thus, it is necessary to enhance nurses' informatics competency by developing continuous educational programs about this technology for nurses and engaging nurses in such programs to enhance their competencies in this system.

Introduction: Telemedicine has been a growing trend. Its use in the field of orthopedic surgery has its own unique facets. To determine the perception and assess the utilization of telemedicine the current study was conducted.

Materials and methods: This is a cross-sectional exploratory study conducted from January to April 2022 among 142 orthopedic surgeons across India who had previous experience of using telemedicine and were willing to participate in this study. The data was collected using a validated semi-structured questionnaire consisting of 44 multiple Choice questions, divided into 7 sections: experience in using telemedicine, technical aspects, patient selection, problems faced, benefits, current use, and opinions designed in English language. The data obtained from the responses were tabulated, analyzed and expressed in proportions.

Results: We found that nearly 80% of orthopedic surgeons believed that teleconsultation was most appropriate for follow up visits. The two most common issues faced were technical issues relating to poor video/audio/connectivity, and difficulty with regard to viewing of radiographs, MRI films etc. The major advantage was perceived to be easier access for patients, especially bed ridden/old patients.

Conclusion: Our survey showed a significantly positive response toward telemedicine. Technical issues and lack of clinical examination were cited as the most common hindrances faced. Saving the time of the patient, and easier access to healthcare for old aged individuals, bed ridden patients and individuals in remote areas were the major perceived benefits.

Patient safety (PS) is of special importance in Inpatient Rehabilitation Hospital (IRH). Few studies have assessed the factors affecting PS in IRH. Therefore, this study aimed to explore the factors affecting PS based on the experiences of the rehabilitation team in an IRH. This qualitative study was conducted using the conventional content analysis approach in 2020-2021. The participants were 16 members of the rehabilitation team. They were purposively selected from Rofaydeh rehabilitation hospital, Tehran, Iran. Data collection was performed through semi-structured interviews and was continued up to data saturation. The mean age of the participants was 37.31 ± 8.68 years and their mean work experience was 8.75 years. The factors affecting PS in IRH were classified into five main categories, namely shortage of organizational resources, inappropriate physical environment of the IRH, inappropriate PS culture, patients' and their caregivers' limited participation in safety programs, and poor fall prevention programs. The results of this study revealed the factors affecting PS in IRH. Accurate identification of the influential factors on PS can help healthcare providers, managers, and policymakers use multi-component interventions to improve PS culture and increase PS in IRHs. Action research studies are also recommended to determine the main components of such interventions.

The increase in the number of people developing dementia, the growing number of geriatric patients suffering and dying from serious chronic diseases, and the rising costs of health care as a result of an aging population have centered attention on advance care planning. Advance care planning is the recurrent conversation between competent patients, their families, and the health care provider about end of life care. Although vital, advance care planning discussions between providers and patients are not occurring regularly, and completion rates of advance directives are low. Barriers to health care providers discussing advance directives include lack of time, knowledge, and confidence. The purpose of this project was to evaluate the effectiveness of an educational program regarding advance directives on nurse practitioner's competency and confidence to start advance care planning discussions. Wilcoxon signed rank test indicated that post-education, confidence improved significantly for all items (average rank of 4.5 vs average rank of 10.65). The study showed that most of the nurse practitioners were knowledgeable about advance directives and the educational program increased their level of confidence about initiating advance directive discussions.

Few countries have legally set a maximum age for practicing surgery. This is difficult to sustain as surgeon shortages in many localities require hospitals to grant surgical privileges based on internal peer review systems. This approach is not without problems. Some hospitals and medical societies have developed competency assessment programs. Based on the literature and the experience of various jurisdictions, the authors recommend a policy approach that does not mandate a retirement age for surgeons, but rather a mandatory age of 65 at which surgeons shall be legally subject to periodic assessment of physical dexterity, eye/hand coordination, and cognitive skills.