- The COVID-19 impact and characterization on substance use-related emergency department visit for adolescents and young adults in Canada: Practical implications. [Journal Article]J Eval Clin Pract. 2023 Feb 08 [Online ahead of print]JE
- CONCLUSIONS: Our findings indicate unmet substance use treatment needs due to the limited accessibility and heightened threshold for ED visits during the pandemic. Providing access to substance treatment/programs outside ED is critical to reducing substance use-related complications presenting in the ED. Also, policies addressing the pandemic-related complexities in the ED and Health Human Resource challenges are warranted.
- Bypassing of nearest labor & delivery unit is contingent on rurality, wealth, and race. [Journal Article]Birth. 2023 Feb 08 [Online ahead of print]B
- Patient decisions to bypass the closest labor & delivery (L&D) facility in favor of other birthing locations can have consequences for the provision of health care in rural and micropolitan areas as patient volumes decline and payer mixes change. Among 220 589 uncomplicated births in Iowa, we document characteristics of birth parents who bypass their closest birthing facility, show how this bypas…
Patient decisions to bypass the closest labor & delivery (L&D) facility in favor of other birthing locations can have consequences for the provision of health care in rural and micropolitan areas as patient volumes decline and payer mixes change. Among 220 589 uncomplicated births in Iowa, we document characteristics of birth parents who bypass their closest birthing facility, show how this bypassing behavior results in changed travel times to delivery facilities across the rural/urban divide, and indicate the parts of the state where bypassing behavior is most prevalent. From 2013 to 2019, 55.2% of deliveries occurred in facilities that were further from birthing parents' residences than the closest L&D facility. Bypassing is associated with White, non-Hispanic race/ethnicity, and private insurance status. Although bypassing is least common among micropolitan birth parents, this group has the greatest travel burden to birthing facilities and exhibits increasing rates of bypassing over time. Perinatal quality improvement programs can target locations and populations where low-risk birthing parents can be encouraged to deliver close to home if medically appropriate, particularly in small towns and rural areas. This can potentially alleviate the risk of obstetric deserts by ensuring L&D units maintain patient volumes necessary to continue operations.
- The challenges facing residential aged care homes to participate in quality food and nutrition research. [Journal Article]J Hum Nutr Diet. 2023 Feb 08 [Online ahead of print]JH
- CONCLUSIONS: Several challenges to undertaking quality empirical research in residential aged care in Australia were identified. Research needs to be part of usual business, like hospitals and operate independently of staffing and funding issues. Issues within foodservices are system issues and there is a need for quality empirical research to determine solutions. This article is protected by copyright. All rights reserved.
- A health systems intervention to strengthen the integration of tuberculosis and COVID-19 detection: Outcomes of a quasi-experimental study in a high burden tuberculosis district in KwaZulu Natal, South Africa. [Journal Article]Trop Med Int Health. 2023 Feb 08 [Online ahead of print]TM
- CONCLUSIONS: These results add to the knowledge base regarding the effectiveness of interventions to strengthen TB case detection during the COVID-19 pandemic. The findings support the feasibility of a shift to online learning approaches in low-resource settings with appropriate support and suggest that even low-intensity interventions are capable of activating nurses to integrate existing disease control priorities during pandemic conditions.
- Increased mortality in ICU patients ≥70 years old with COVID-19 compared to patients with other pneumonias. [Journal Article]J Am Geriatr Soc. 2023 Feb 08 [Online ahead of print]JA
- CONCLUSIONS: In ICU-patients ≥70 years old, COVID-19 is more severe compared to bacterial or viral pneumonia.
- Evidence-based practice improves patient outcomes and healthcare system return on investment: Findings from a scoping review. [Review]Worldviews Evid Based Nurs. 2023 Feb 08 [Online ahead of print]WE
- CONCLUSIONS: Findings indicate that EBPs improve patient outcomes and ROI for healthcare systems. Coordinated and consistent use of established nomenclature and methods to evaluate EBP and patient outcomes are needed to effectively increase the growth and impact of EBP across care settings. Leaders, clinicians, publishers, and educators all have a professional responsibility related to improving the current state of EBP. Several key actions are needed to mitigate confusion around EBP and to help clinicians understand the differences between quality improvement, implementation science, EBP, and research.
- Evidence Translating Ability: A Walker and Avant Concept Analysis. [Journal Article]Florence Nightingale J Nurs. 2023 Feb; 31(1):62-68.FN
- CONCLUSIONS: Evidence translating ability requires a set of skills that nurses have to do such as identifying the challenges and analyzing the setting for searching the evidence; the best evidence is not the highest evidence hierarchy, the best evidence is the evidence that suits patient, organization, and practitioner abilities.
- Occupational Satisfaction of Public Hospital Nurses in India: A Qualitative Explorative Study. [Journal Article]Florence Nightingale J Nurs. 2023 Feb; 31(1):42-47.FN
- CONCLUSIONS: The findings help us understand the various facilitating and hindering challenges nurses face in occupational satisfaction. It also emphasizes the organization's focus on modifiable factors in the working environment, enhancing satisfaction, and helping the nurses work more effectively and efficiently to deliver quality nursing care. Nursing administration in every healthcare setting should focus on strategies to improve nurses' professional development.
- SHEA/IDSA/APIC Practice Recommendation: Strategies to prevent healthcare-associated infections through hand hygiene: 2022 Update. [Journal Article]Infect Control Hosp Epidemiol. 2023 Feb 08 [Online ahead of print]IC
- The purpose of this document is to highlight practical recommendations to assist acute-care hospitals in prioritization and implementation of strategies to prevent healthcare-associated infections through hand hygiene. This document updates the Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals through Hand Hygiene, published in 2014. This expert guidance document is s…
The purpose of this document is to highlight practical recommendations to assist acute-care hospitals in prioritization and implementation of strategies to prevent healthcare-associated infections through hand hygiene. This document updates the Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals through Hand Hygiene, published in 2014. This expert guidance document is sponsored by the Society for Healthcare Epidemiology (SHEA). It is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America, the Association for Professionals in Infection Control and Epidemiology, the American Hospital Association, and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise.
- Lived Experiences of Adults with Sickle Cell Disease: A Qualitative Study, Dar es Salaam, Tanzania. [Journal Article]East Afr Health Res J. 2022; 6(2):189-195.EA
- CONCLUSIONS: Individuals with SCD experiences several episodes of pain that affect their quality of life. Pain episode can be triggered or aggravated by various factors. Several approaches are used by individuals with SCD to self-manage the pain including taking rest, drinking plenty of water or using pain relieving medication. Care for individuals with SCD should be comprehensive and include proper management of pain, health education on home-based intervention for sickle cell pain, supportive services to deal with psychosocial implications of SCD and improving coping strategies to live with the illness.
- Validity of Coronavirus Disease 2019 International Classification of Diseases, Tenth Revision in the Urgent Care Setting and Impact on Antibiotic Prescribing Rates. [Journal Article]Open Forum Infect Dis. 2023 Feb; 10(2):ofad010.OF
- We validated different coronavirus disease 2019 (COVID-19) International Classification of Diseases, Tenth Edition (ICD-10) encounter definitions across 2 urgent care clinics. Sensitivity of definitions varied throughout the pandemic. Inclusion of COVID-19 and COVID-19-like illness (CLI) ICD-10s rendered highest sensitivity but lowest specificity. Antibiotic prescribing rates were low for COVID-…
We validated different coronavirus disease 2019 (COVID-19) International Classification of Diseases, Tenth Edition (ICD-10) encounter definitions across 2 urgent care clinics. Sensitivity of definitions varied throughout the pandemic. Inclusion of COVID-19 and COVID-19-like illness (CLI) ICD-10s rendered highest sensitivity but lowest specificity. Antibiotic prescribing rates were low for COVID-19 ICD-10 encounters, increasing with CLI ICD-10 encounters.
- The impact of the COVID-19 pandemic and stringent social distancing measures on health-related quality of life and COVID-19 infection rates in patients with rheumatic disease: a longitudinal analysis through the pandemic. [Journal Article]Rheumatol Adv Pract. 2023; 7(1):rkad009.RA
- CONCLUSIONS: Mental and physical health in RD patients has changed throughout the pandemic; outcomes for both metrics of health were worse in CEV patients, although there were no differences in infection rates between the groups. These data might assist the understanding and planning of future health-care policy and social restrictions in RD patients.
- Oral health in patients with severe inflammatory dermatologic and rheumatologic disease. [Journal Article]Skin Health Dis. 2023 Feb; 3(1):e156.SH
- CONCLUSIONS: Patients with severe inflammatory dermatologic/rheumatologic conditions have poorer OH and OH-related QoL. Clinicians should appreciate the risk of poor OH in this cohort and have a low threshold for involving OH professionals in care pathways for severe inflammatory disease.
- Are virtual consultations suitable for patients with vulval disease? A multicentre audit of outcomes in the COVID-19 pandemic. [Journal Article]Skin Health Dis. 2023 Feb; 3(1):e178.SH
- CONCLUSIONS: Although in-person consultation remains the gold standard of care, VC may have a role in the management of selected patients with vulval disease. It is possible to provide good-quality photographs for clinical assessment, particularly with the help of a third party and follow-up patients with an established, cancer-unrelated diagnosis may be best suited for this consultation modality.
- Methods used for indirect comparisons of systemic treatments for psoriasis. A systematic review. [Review]Skin Health Dis. 2023 Feb; 3(1):e112.SH
- CONCLUSIONS: Understanding that there are different methodologies employed to answer differing research questions is key to helping clinicians to interpret the indirect evidence currently available in psoriasis.
- Functional Ability and Health Problems of Stroke Survivors: An Explorative Study. [Journal Article]Cureus. 2023 Jan; 15(1):e33375.C
- Background A stroke is an emergency medical condition that needs to be treated promptly. Patients who suffer from stroke frequently experience varying degrees of impairment, necessitating emergency hospital treatment and prolonged home care. It can lower the quality of life which leads to social isolation and makes it harder to function independently. The purpose of this research was to assess th…
Background A stroke is an emergency medical condition that needs to be treated promptly. Patients who suffer from stroke frequently experience varying degrees of impairment, necessitating emergency hospital treatment and prolonged home care. It can lower the quality of life which leads to social isolation and makes it harder to function independently. The purpose of this research was to assess the health issues and functional capacity of individuals living with stroke. Methodology An exploratory study was conducted in the neurological outpatient department of tertiary care hospitals in Chennai. A total of 30 post-stroke participants were selected using a convenient sampling technique. Data were collected by structured interviews using the Post-Stroke Checklist and Barthel Index. The data were analyzed through descriptive and inferential statistics. Results The majority of the patients were (86.7%) men in the age group of 55-65 years. Regarding the health problems identified with the Post-Stroke Checklist, the activities of daily living (80%) were the most common, and spasticity (48%) and pain (34%) were the least common. However, 60% of the participants had new problems related to vision, 66% had problems with hearing, 76% had problems with getting around inside or outside, and 60% had a history of a recent fall. Further, 52% had problems with remembering and concentrating on things, 72% had problems sleeping, and 45% were worried about their relationship with their spouse after the stroke. The median Barthel Index score was 43.5. Conclusions More than half of all stroke survivors were dependent on others for everyday activities. We recommend that a well-designed and focused assessment is needed to identify the functional ability and stroke-related health problems among individuals by all healthcare professionals for the successful rehabilitation of stroke survivors.
- Improving the Hospital Transfer Process for Acute Type A Aortic Dissections. [Journal Article]Cureus. 2023 Jan; 15(1):e33451.C
- Patients with acute type A aortic dissection who arrive at hospitals that lack the facilities to treat them must be transferred to a tertiary care facility to receive treatment. The transfer process involves a checkpoint at which the transfer is accepted or denied. Delays in making this decision may lead to suboptimal health outcomes. In light of this, the goal of this project was to devise a way…
Patients with acute type A aortic dissection who arrive at hospitals that lack the facilities to treat them must be transferred to a tertiary care facility to receive treatment. The transfer process involves a checkpoint at which the transfer is accepted or denied. Delays in making this decision may lead to suboptimal health outcomes. In light of this, the goal of this project was to devise a way to reduce the time to decision of transfer requests for patients with an acute type A aortic dissection. The project followed the Define-Measure-Analyze-Improve-Control (DMAIC) approach. To better understand the process, data were obtained from the University of Texas Southwestern Medical Center regarding reasons for patient transfer cancellation and the average time until a transfer was denied or accepted. After data analysis, a fishbone diagram was used to display 23 root causes of the delays in time to decision of the transfer request. These were narrowed down to the following four significant causes using a nominal voting technique: (1) no standard on disease-specific information for the handoff, (2) lack of a real-time database, (3) incompatible electronic health record system between facilities, and (4) multiple communication handoffs causing confusion. Solutions to each root cause were evaluated using a solution selection matrix. The final two solutions proposed for implementation were as follows: (1) to establish checklists of required documents and patient transfer criteria and (2) to create a regional database to provide real-time information on hospital capacity.
- Colorectal Cancer: A Systematic Review of the Current Situation and Screening in North and Central Asian Countries. [Review]Cureus. 2023 Jan; 15(1):e33424.C
- The prevalence of colorectal cancer (CRC) is increasing in the past few decades. A significant proportion of this increase is from low to middle income countries (LMIC). CRC prevalence is also increasing in North and Central Asian Countries (NCAC). Screening for colorectal cancer has decreased CRC mortality but data regarding screening practices in NCAC is limited. A literature search was conduc…
The prevalence of colorectal cancer (CRC) is increasing in the past few decades. A significant proportion of this increase is from low to middle income countries (LMIC). CRC prevalence is also increasing in North and Central Asian Countries (NCAC). Screening for colorectal cancer has decreased CRC mortality but data regarding screening practices in NCAC is limited. A literature search was conducted in PubMed/Medline, Embase and Cochrane for current colorectal cancer screening practices in NCAC. Incidence and mortality rates were derived from public health agency websites to calculate age-standardized CRC mortality-to-incidence ratios. Web-based online break-point testing defined as statistical major changes in CRC mortality trends was completed. Among the 677 screened studies, 37 studies met the criteria for inclusion for review. CRC screening in NCAC is not organized, although most countries have cancer registries. The data availability is scarce, and most data is prior to 2017. Most studies are observational. There is minimal data about colonoscopy preparations, adenoma detection and complications rates. The polyp detection rates (PDRs) and adenoma detection rates (ADRs) seem low to optimal in this region. Commonly measured outcomes include participation rate, fecal immunochemical tests (FIT) positivity rate and cost-benefit measures. Lower mortality-to-incidence ratios is seen in countries with screening programs. Kazakhstan and Lithuania with screening programs have achieved breakpoint suggesting major changes in CRC mortality trends. Data about CRC screening varies widely within NCAC. High human developmental index (HDI) countries like Lithuania and Estonia have higher incidence of CRC and mortality. Seven NCAC have CRC screening programs with most utilizing non-invasive methods for screening. Data collection is regional and not organized. The ADR and PDR are low to optimal in this region and cancer detection rates are comparable to other high-income countries (HIC). CRC detection rate is 0.05% for screening in Kazakhstan and 0.2% for screening in Lithuania. Very limited information is available on the actual cost and logistics of implementing a CRC screening program. All NCAC have a cancer registry, with some having a high-quality registry showing national coverage with good validity and completeness. Establishing guideline-based registries and increasing screening efficacy could improve CRC outcomes in NCAC.
- Patients' Opinions Toward Healthcare Quality and Improvement in Aseer Health: A Cross-Sectional Study. [Journal Article]Cureus. 2023 Jan; 15(1):e33432.C
- Introduction Population health is crucial to government planning. The 2030 national vision is transforming all Saudi sectors. The health sector revolution intends to boost life expectancy by reducing mortality due to road traffic accidents and morbidity due to chronic illness. Health services will change from treatment-based to person-centered and preventive care, empower the population, increase…
Introduction Population health is crucial to government planning. The 2030 national vision is transforming all Saudi sectors. The health sector revolution intends to boost life expectancy by reducing mortality due to road traffic accidents and morbidity due to chronic illness. Health services will change from treatment-based to person-centered and preventive care, empower the population, increase access to healthcare and improve service quality by offering high customer satisfaction. This study establishes a baseline assessment for public awareness, behavior, healthcare access, and quality. Method A cross-sectional study was conducted in the Aseer region in southwestern Saudi Arabia in 2022, September and October. Using the Aseer region's 2.1 million people to calculate the sample needed, the minimal sample size was 664. The study used cluster random sampling and a structured self-administered questionnaire to meet health transformation strategy requirements. All study variables underwent descriptive and bivariate analysis. Result The survey received 1,381 responses, with 97.2% of participants being Saudi and 84.4% being male. 312 (22.6%) of participants self-reported their health status as weak; 615 (44.5%) self-reported as having a good health status; and 667 (48.3%) reported having high knowledge. 740 people (53.6%) said that health was very important in their daily lives. The evaluation rate for Ministry of Health services in primary healthcare centers was 585 (42.4%) medium and 398 (28.8%) media for inpatient services. Evaluation for surgical procedure availability was 388 (28.1%) media. The results showed there is a statistically significant relationship (p-value < 0.05) between health status and age, gender, knowledge, and the importance of a healthy lifestyle. And there is a statistically significant relationship between the availability and quality of the health service profile, including inpatient, outpatient, and virtual care. Nationality appears to be statistically insignificant. Conclusion Health promotion is effective because people are health conscious. The importance of health and lifestyle presents a tremendous opportunity to incorporate health into all policies and improve the availability of healthy lifestyle options and surroundings to support healthy behaviors that will reduce preventable disease and risk mortality and morbidity. Health status was also linked to healthcare availability and quality.
- Quality of life and nurse-patient interaction among NH residents: Loneliness is detrimental, while nurse-patient interaction is fundamental. [Journal Article]J Clin Nurs. 2023 Feb 07 [Online ahead of print]JC
- CONCLUSIONS: This study suggests that loneliness is frequent as well as more detrimental to quality-of-life among nursing home residents compared to anxiety and depression. Furthermore, the present results show that the nurse-patient interaction represents an essential health-promoting resource for Quality-of-life in this population.
- The effectiveness of pay-for-performance contracts with non-governmental organizations in Afghanistan - results of a controlled interrupted time series analysis. [Journal Article]BMC Health Serv Res. 2023 Feb 07; 23(1):122.BH
- CONCLUSIONS: P4P contracts with NGOs led to a substantial improvement in service delivery at lower cost despite a very difficult security situation. The promising results from this large-scale experience warrant more extensive application of P4P contracts in other fragile settings or wherever coverage remains low.
- A multi-granular stacked regression for forecasting long-term demand in Emergency Departments. [Journal Article]BMC Med Inform Decis Mak. 2023 Feb 07; 23(1):29.BM
- CONCLUSIONS: Combining models of population health and wider urgent care service capacity for predicting monthly ED attendances leads to an improved performance compared to each model individually. Policies designed to improve population health will reduce ED attendances and enhance quality and safety in the long-term.
- Singapore KneE osTeoarthritis CoHort (SKETCH): protocol for a multi-centre prospective cohort study. [Journal Article]BMC Musculoskelet Disord. 2023 Feb 07; 24(1):104.BM
- CONCLUSIONS: Results will allow contextualization, identification, and phenotyping of the critical (and potentially modifiable) psychosocial parameters that predict positive clinical outcomes in the OA population to guide optimization and refinement of healthcare and community. This will facilitate: 1. identification of high-risk knee OA subpopulations that will likely experience poor outcomes and 2. formulation of targeted multidisciplinary comprehensive approaches to address these psychosocial factors to optimize non-surgical treatment care, maximize functional outcomes and create more value-based care model for knee OA.
- Comparisons on factors affecting residents fulfilling self-determination in ethno-specific and mainstream nursing homes: a qualitative study. [Journal Article]BMC Geriatr. 2023 Feb 07; 23(1):81.BG
- CONCLUSIONS: Culturally competent care created by staff, nursing homes and the aged care system is a basic condition for residents from ethnic minority groups to fulfil self-determination. In addition, person-centred care approach enables residents to optimise self-determination.
- Informed or misinformed consent and use of modified texture diets in dysphagia. [Journal Article]BMC Med Ethics. 2023 Feb 07; 24(1):7.BM
- CONCLUSIONS: Research is required to examine the informed consent processes in different settings, but there is ample reason to suggest that current practice in this area is suboptimal. Staff need to reflect on their current practice regarding use of modified texture diets with an awareness of the current evidence and through the 'lens' of informed consent. Education is required for staff to clarify the importance of, and requirements for, valid informed consent and for decision making that reflects people's preferences and values.
- Lessons identified from initiating a thalassaemia programme in a conflict setting: a case study from northeast Syria. [Journal Article]Confl Health. 2023 Feb 07; 17(1):5.CH
- CONCLUSIONS: Although this type of programming was not "routine" for the organisation, MSF demonstrated that life-sustaining thalassaemia care can be provided in complex conflict settings. International non-governmental organisations can consider this care possible in similar contexts.
- The effects of Digital Buddy programme on older adults' mental well-being: study protocol for a multi-centre, cluster randomized controlled trial. [Journal Article]Trials. 2023 Feb 07; 24(1):95.T
- Mental well-being is associated with many mental health symptoms, including depression and health-related quality of life. Digital divide could impact mental health, particularly during the COVID-19 pandemic. Information and communication technology (ICT)-based tools and interventions could effectively provide social support. Intergenerational mentoring between college students and older adults c…
Mental well-being is associated with many mental health symptoms, including depression and health-related quality of life. Digital divide could impact mental health, particularly during the COVID-19 pandemic. Information and communication technology (ICT)-based tools and interventions could effectively provide social support. Intergenerational mentoring between college students and older adults could promote eHealth literacy and self-efficacy, and it is advocated to bridge the digital divide for older adults. However, the effectiveness of an intervention which employs ICT-based tools and intergenerational mentoring strategies (i.e. Digital Buddy) on mental well-being is unclear.
- Clinical research coordinators' role in knowledge translation activities in rehabilitation: a mixed methods study. [Journal Article]BMC Health Serv Res. 2023 Feb 07; 23(1):124.BH
- CONCLUSIONS: This study provides valuable insights into the scope of CRCs' role. The results shed light on the challenges that they face and potential solutions to overcome them. The knowledge generated in this study can be used to implement this role with similar duties in rehabilitation settings or other health care domains.
- A novel approach to frontline health worker support: a case study in increasing social power among private, fee-for-service birthing attendants in rural Bangladesh. [Journal Article]Hum Resour Health. 2023 Feb 07; 21(1):7.HR
- CONCLUSIONS: The SHE model successfully established a private SBA cadre that improved birth outcomes and enhanced their social power and technical skills in challenging settings through the mainstream health system. Strengthening the agency, voice, and well-being of the SHEs has transformative potential. Designing SBA interventions that increase their power in their social context could expand their economic independence and reinforce positive gender and power norms in the community, addressing long-standing issues of poor remuneration, overburdened workloads, and poor retention. Witnessing the introduction of peer or near-peer women with well-respected, well-compensated roles among their neighbors can significantly expand the effectiveness of frontline health workers and offer a model for other women in their own lives.
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- Student nurses' perceptions and experiences in caring for people living with HIV/AIDS: a qualitative study. [Journal Article]BMC Med Educ. 2023 Feb 07; 23(1):99.BM
- CONCLUSIONS: Findings shed light on the development and changes in student nurses' perspectives on PLWHAs throughout their clinical experiences. Student nurses' perceptions and attitudes toward PLWHAs progressed through three distinct stages, and positive changes were observed after care-giving. Participants' perceptions and practical experiences with patients with AIDS enable patients to receive fair and high-quality care and provide valuable insights for nursing educators better prepare HIV nurses.