Workload Burden Research Articles

A Qualitative Exploration of the Impact of Increasing Criminalization on Domestic Violence Support Workers: Nonfatal Strangulation as a Case Study.

Specialized nongovernmental domestic violence (DV) services provide critical support to victim/survivors. This research draws on 14 semistructured focus groups with 27 DV support workers to examine how expanded criminalization impacts support workers' roles using a case study of a 2016 nonfatal strangulation offense legislated in Queensland, Australia. Our results describe a lack of governmental support intersecting with increased complexity and higher workload burden resulting from expanded criminalization. Expansions to criminal law need to account for and critically assess the full system impact of new DV legislation and the added burdens placed on the pivotal third sector of DV services.

Road to automated urinalysis analyzer: Validation of Sysmex UN-3000 to supplant manual urinalysis

Abstract Introduction/Objective Traditionally, urinalysis encompasses the chemical analysis of urine by dipstick and manual microscopy for formed elements. High specimen volume and varying subjectivity among individuals performing microscopic analysis make the practice both imprecise and inefficient. Implementation of Sysmex UN- Series™Automated Urinalysis (Sysmex Corporation, Kobe, Japan) fulfilled our need for automation, addressing both issues at hand. Automated urinalysis offers a solution for laboratories to meet the growing demand for faster result turn around times(TAT) with ever increasing specimen volumes. We expect greater sensitivity and reproducibility in terms of comparison to manual microscopy, as well as quicker TAT with the change in methodology. Methods/Case Report Using both unpreserved and preserved urine tubes, a macroscopic comparative study between Clinitek Advantus(manual) and Clinitek Novus (automated) methods was carried out on 141 urines with greater than 60 abnormal patients. Similarly, a microscopic study between the laboratory’s manual microscopy procedure and the Sysmex UF-5000 was carried out on 112 urines with greater than 60 abnormal patients. RBCs, WBCs, Epithelial cells were evaluated under high power field(40X); casts and crystals were evaluated under lower power field(10X). The Reference Range Interval for both chemical and microscopic was verified using 44 normal patient specimens. The quantified values are converted to high and low power field (hpf/lpf), analogous to the current system in the laboratory. Results (if a Case Study enter NA) Most parameters had >90% agreement between manual and automated method. Parameters falling below 90% were checked to see if discrepancies fell within 1 degree. Automated system is more sensitive than manual and our average TAT for urinalysis dropped 50%. Conclusion The automated urinalysis technology enabled us to focus only on samples requiring intervention based on pathological criteria, resulting in reduced overall TAT and workload burden, and improved consistency in reporting across specimens.

Navigating techno-stress: A qualitative exploration of university faculty's experiences and perspectives in the Peruvian context amidst the return to classes and the post-COVID-19 era

Background: Technology serves as a potent tool that enhances the quality of teaching and learning experiences. However, when educators lack proficiency in utilizing technology, it leads to obstacles in providing effective education, resulting in emotions of frustration, diminished self-assurance, and uncertainty regarding their teaching abilities. This study aims to investigate the experiences of university faculty members in relation to the impact of technology on their mental well-being. Methods: For this qualitative study, ten professionals engaged in university-level teaching, encompassing research domains, were selected for interviews. Inclusion criteria were based on teaching experience, tenure, specific courses or subjects taught, and active involvement during the research phase. The guiding question for the study was framed as follows: "What are the experiences and perceptions of university faculty members concerning techno-stress?" Additionally, the study identified four subcategories: work overload, social and emotional interaction, adaption to new technologies, and expectations and teaching quality. Results: Techno-stress is a composite of emotional and physical reactions triggered by the improper use of technology. Faculty members’ encounters with techno-stress have substantial implications for their quality of life. The subcategories shed light on different aspects of the faculty’s experiences, including the burden of excessive workload, the influence of social and emotional interactions, the process of adapting to evolving technologies, and the connection between expectations and the quality of their teaching. Conclusions: This research underscores the significance of technology in higher education, highlighting its potential to positively impact teaching and learning. Nevertheless, faculty members’ struggles with techno-stress indicate a pressing need for effective training and support. Establishing limits on connectivity with technology and others emerges as a crucial step in maintaining a healthy work-life balance. Ultimately, addressing techno-stress and providing appropriate guidance are essential for safeguarding the well-being of university faculty members and, consequently, enhancing the overall educational experience.

From Headache to Handled: Advanced In-Basket Management System in Primary Care Clinics Reduces Provider Workload Burden and Self-Reported Burnout.

The electronic health record (EHR) has been associated with provider burnout, exacerbated by increasing In-Basket burden. We sought to study the impact of implementing a team-based approach to In-Basket management on a series of primary care ambulatory sites. We performed a workflow analysis of the transition to the Advanced In-Basket Management (AIM) nurse team triage for six family medicine clinic locations in a large health system. We abstracted and analyzed associated provider workflow metrics from our EHR. We conducted a postintervention provider survey on satisfaction with the AIM project and provider burnout. The AIM project was implemented in six family medicine clinics after provider townhalls and workgroup development. A nurse team curriculum was created using the principles of "maturing the message" before sending it to a provider and "only handle it once" to improve response efficiency. Provider workload metrics abstracted from the EHR demonstrated 12.2 fewer In-Basket messages per provider per day (p < 0.05), 6.3 fewer minutes per provider per day worked outside scheduled hours (p < 0.05), 3.5 fewer minutes spent in the In-Basket per provider per day (p < 0.05), but 13.7 more seconds spent per completed message per provider (p = 0.017), likely attributable to increased message complexity. Sixty-four percent of providers reported no burnout symptoms in a postintervention survey, 56% agreed that the AIM project reduced their burnout, and approximately 70% of providers agreed that the AIM project was acceptable and appropriate for their clinic. The AIM project demonstrates team-based nurse In-Basket triage is possible to implement across multiple primary care sites, is an acceptable intervention for providers, can reduce provider workload burden and self-reported provider burnout.

PLANNING FOR INCREASING LECTURER RESEARCH PRODUCTIVITY

The World Class University trend in higher education has an impact on the need for planning in the research aspect because the quantity and quality of research are very influential in global university rankings. This research explores planning strategies as well as challenges and obstacles in efforts to increase the research productivity of lecturers in the Building Engineering Education Study Program, Universitas Negeri Jakarta based on the perspective of the study program coordinator. This research uses a qualitative descriptive approach using data collection techniques in the form of documentation complete with interviews with the study program coordinator. The research productivity increases in some years, such 2021 and 2023, but there are inconsistent research trends from 2017 to 2024. Some of the plans carried out by the study program to increase lecturer research productivity include the 1 lecturer 1 publication per year program, expanding cooperation and collaboration with national and international universities in research and scientific publications, holding international scientific article publication workshops, initiating collaboration with industry in the field of research and forming a research team of lecturers. The obstacles and challenges faced by the study program include lecturer workload, resources, funding, and research administration burden

A quality assessment tool for focused abdominal sonography for trauma examinations using artificial intelligence.

Current tools to review focused abdominal sonography for trauma (FAST) images for quality have poorly defined grading criteria or are developed to grade the skills of the sonographer and not the examination. The purpose of this study is to establish a grading system with substantial agreement among coders, thereby enabling the development of an automated assessment tool for FAST examinations using artificial intelligence (AI). Five coders labeled a set of FAST clips. Each coder was responsible for a different subset of clips (10% of the clips were labeled in triplicate to evaluate intercoder reliability). The clips were labeled with a quality score from 1 (lowest quality) to 5 (highest quality). Clips of 3 or greater were considered passing. An AI training model was developed to score the quality of the FAST examination. The clips were split into a training set, a validation set, and a test set. The predicted scores were rounded to the nearest quality level to distinguish passing from failing clips. A total of 1,514 qualified clips (1,399 passing and 115 failing clips) were evaluated in the final data set. This final data set had a 94% agreement between pairs of coders on the pass/fail prediction, and the set had a Krippendorff α of 66%. The decision threshold can be tuned to achieve the desired tradeoff between precision and sensitivity. Without using the AI model, a reviewer would, on average, examine roughly 25 clips for every 1 failing clip identified. In contrast, using our model with a decision threshold of 0.015, a reviewer would examine roughly five clips for every one failing clip - a fivefold reduction in clips reviewed while still correctly identifying 85% of passing clips. Integration of AI holds significant promise in improving the accurate evaluation of FAST images while simultaneously alleviating the workload burden on expert physicians. Diagnostic Test/Criteria; Level II.

Oncology Clinicians' Perspectives of a Remote Patient Monitoring Program: A Multi-Modal Case Study Approach.

Remote patient monitoring (RPM) aims to improve patient access to care and communication with clinical providers. Overall, understanding the usability of RPM applications and their influence on clinical care workflows is limited from the perspectives of clinician end users at a cancer center in the Northeast, United States. Explore the usability and functionality of RPM and elicit the perceptions and experiences of oncology clinicians using RPM for oncology patients after hospital discharge. The sample included 30 of 98 clinicians (31% response rate) managing at least five patients in the RPM program and responding to the m-Health Usability between March 2021- October 2021. Overall, clinicians responded positively to the survey. Item responses with the highest proportion of disagreement were explored further. A nested sample of five clinicians who responded to the study survey (30% response rate) participated in interview sessions conducted from November 2021 to February 2022, and averaged 60 minutes each. Survey responses highlighted that RPM was easy to use and learn and verified symptom alerts during follow-up phone calls. Areas to improve identified practice changes from reporting RPM alerts through digital portals and its influence on clinicians' workload burden. Interview sessions revealed three main themes: clinician understanding and usability constraints, patient constraints, and suggestions for improving the program. Subthemes for each theme were explored, characterizing technical and functional limitations that could be addressed to enhance efficiency, workflow, and user experience. Clinicians support the value of RPM for improving symptom management and engaging with providers. Functional changes to enhance the program's utility, such as input from patients about temporal changes in their symptoms and technical resources for home monitoring devices.

Primary care physicians and laypersons' perceptions of multicancer detection clinical trial designs.

The National Cancer Institute Cancer Screening Research Network is launching a pilot study (Vanguard) to determine feasibility of successful completion of a clinical trial of multicancer detection tests. This focus group study reports perceptions of primary care physicians and laypersons of different clinical trial designs and willingness to participate in a multicancer detection clinical trial. We undertook 14 focus groups with 88 laypersons and 6 focus groups with 45 primary care physicians. Participants were shown graphics of clinical trial designs and asked for their reactions. Focus group recordings were transcribed verbatim, and thematic analysis of the transcripts were conducted to identify emergent themes. Primary care physician and layperson participants recognized the importance of conducting clinical trials to determine the clinical utility of multicancer detection tests. Primary care physicians expressed reluctance to participate in trials because of workload burden, and laypersons expressed hesitancy about enrolling in the control group. Primary care physicians and laypersons expressed concern about a study design in which multicancer detection test results would not be returned to the control group (intended effect), but they respectively indicated a willingness to refer patients to, or participate in, a multicancer detection test clinical trial given transparent and clear communication on collection and use of biospecimens and data, particularly if a multicancer detection test would eventually be run and results eventually returned. This study yielded important insights to guide trial design in planning prospective evaluation of multicancer detection testing. Maintaining transparency and trust while possibly withholding multicancer detection test results to maximize trial feasibility and efficiency is of particular concern.

An interpretative phenomenological study on nurses’ perceived affective wellbeing at work

Nurses face increasingly complex and challenging workloads, exacerbated by high rates of absenteeism, mental health issues, and low morale, all of which significantly impact patient care. This study focuses on exploring nurses&amp;rsquo; perceived affective wellbeing, perceived workload burden, and the current working conditions they face. The objective was to understand nurses&amp;rsquo; perspectives on affective wellbeing, self-care, and work-life balance. We utilized an interpretative phenomenological approach to design the data collection and management for this study. Through open dialogue, we explored the notion of wellbeing at work with nurses of varying levels of work experience, from fairly novice to expert practitioners who have worked for decades in their fields. The broader responsibilities of nurses of nurses within the National Health Service (NHS) were also examined. Two experts in interpretative phenomenological analysis led the discussion in three different groups, which each consisted of nurses with similar years of work experience, averaging 13 years. Thirty-eight registered nurses volunteered to participate in these discussion groups, with participants recruited from postgraduate courses and representing both acute and community care settings in regional hospitals. Nurses shared insights into what makes nursing a rewarding job but also acknowledged the significant challenges they face. Discussions highlight the stressful and traumatic circumstances nurses often encounter, particularly noting a lack of collegiality among nurses at all levels, limited career aspirations, inadequate support with workloads, and the emotional distress experienced in daily work life. Nurses described their jobs as exhausting and draining, leading to physical and emotional fatigue, detachment, and isolation. These findings hold relevance within the current landscape of nurse and resource shortages in the NHS. Of note, this study identified deeper concerns within the nursing workforce, including emotional dissonance, role dissonance, and disengagement.

Shared care for patients with a left ventricular assist device: a scoping review.

Left ventricular assist devices (LVADs) are increasingly implanted in patients with advanced heart failure. Currently, LVAD care is predominantly concentrated at specialized tertiary care hospitals. However, the increasing workload and logistical burden for implanting centres pose significant challenges to accessing care for individual patients in remote areas. An emerging approach to LVAD patient management is the use of a shared care model (SCM), which facilitates collaboration between implanting centres and local non-implanting hospitals. This scoping review explores and synthesizes the current scientific evidence on the use of SCMs in LVAD care management. Eligible studies were identified in EMBASE, PubMed MEDLINE, Web of Science, Cochrane and Google Scholar. Findings were synthesized in accordance with PRISMA-ScR guidelines. Of the 950 records screened, five articles met the inclusion criteria. Four review articles focused on the proposed benefits and challenges of using SCMs. Main benefits included improved patient satisfaction and continuity of care. Important challenges were initial education of non-implanting centre staff and maintaining competency. One prospective study showed that absence of LVAD-specific care was associated with impaired survival and higher rates of pump thrombosis and LVAD-related infections. The use of SCMs is a promising approach in the long-term management of LVAD patients. However, sufficient evidence about the impact of SCMs on patients and the healthcare system is not currently available. Standardized protocols based on prospective studies are needed to develop safe and effective shared care for LVAD patients.

Gendered Impact of Climate Change among Paddy Farmers of Kahama District, Shinyanga Region, Tanzania

The study presents the findings on the research which examined gendered impacts of climate change among the paddy farmers of Kahama District, Shinyanga Region. Specifically, the study assessed gendered desegregated effects of climate change among the paddy farmers and the implications on the effects of climate change among women farmers of Kahama District. The study adopted a cross sectional research design on which 312 randomly selected farm households were interviewed. The study employed a triangulation approach whereby primary data were collected through household surveys, field observation and key informants’ interviews. The findings revealed that women and men farmers disproportionally affected by climate change. These effects include the prevalence pests and diseases over a period of 30 years and the general decrease in crop yields to due to the changes in temperature and rainfall patterns. These effects pose negative implications in increasing women’s workload and time burden, health and safety risks, and livelihood and food security respectively. The study concluded that women bear a disproportionate burden of the challenges of climate change due to existing social and economic inequalities. This negatively subject women farmers into health, livelihoods and overall additional household burden of the households’ activities. The study recommends to the Government to enforce gender-sensitive policies and interventions. Furthermore, it is recommended to the Government to ensure that effective strategies prioritize gender equity and inclusivity so as to build a more adaptive farming community.

Breast Cancer Detection and Localizing the Mass Area Using Deep Learning

Breast cancer presents a substantial health obstacle since it is the most widespread invasive cancer and the second most common cause of death in women. Prompt identification is essential for effective intervention, rendering breast cancer screening a critical component of healthcare. Although mammography is frequently employed for screening purposes, the manual diagnosis performed by pathologists can be laborious and susceptible to mistakes. Regrettably, the majority of research prioritizes mass classification over mass localization, resulting in an uneven distribution of attention. In response to this problem, we suggest a groundbreaking approach that seeks to identify and pinpoint cancers in breast mammography pictures. This will allow medical experts to identify tumors more quickly and with greater precision. This paper presents a complex deep convolutional neural network design that incorporates advanced deep learning techniques such as U-Net and YOLO. The objective is to enable automatic detection and localization of breast lesions in mammography pictures. To assess the effectiveness of our model, we carried out a thorough review that included a range of performance criteria. We specifically evaluated the accuracy, precision, recall, F1-score, ROC curve, and R-squared error using the publicly available MIAS dataset. Our model performed exceptionally well, with an accuracy rate of 93.0% and an AUC (area under the curve) of 98.6% for the detection job. Moreover, for the localization task, our model achieved a remarkably high R-squared value of 97%. These findings highlight that deep learning can boost the efficiency and accuracy of diagnosing breast cancer. The automation of breast lesion detection and classification offered by our proposed method bears substantial benefits. By alleviating the workload burden on pathologists, it facilitates expedited and accurate breast cancer screening processes. As a result, the proposed approach holds promise for improving healthcare outcomes and bolstering the overall effectiveness of breast cancer detection and diagnosis.

Impact of the Reference Multiple-Time-Point Dosimetry Protocol on the Validity of Single-Time-Point Dosimetry for [177Lu]Lu-PSMA-I&T Therapy.

Internal dosimetry supports safe and effective patient management during radionuclide therapy. Yet, it is associated with high clinical workload, costs, and patient burden, as patient scans at multiple time points (MTPs) must be acquired. Dosimetry based on imaging at a single time point (STP) has continuously gained popularity. However, MTP protocols, used as a reference to judge the validity of STP dosimetry, differ depending on local requirements and deviate from the unknown patient-specific ground truth pharmacokinetics. The aim of this study was to compare the error and optimum time point for different STP approaches using different reference MTP protocols. Methods: Whole-body SPECT/CT scans of 7 patients (7.4-8.9 GBq of [177Lu]Lu-PSMA-I&T) were scheduled at 24, 48, 72, and 168 h after injection. Sixty lesions, 14 kidneys, and 10 submandibular glands were delineated in the SPECT/CT data. Two curve models, that is, a mono- and a biexponential model, were fitted to the MTP data, in accordance with goodness-of-fit analysis (coefficients of variation, sum of squared errors). Three population-based STP approaches were compared: one method published by Hänscheid etal., one by Jackson etal., and one using population-based effective half-lives in the mono- or biexponential curve models. Percentage differences between STP and MTP dosimetry were evaluated. Results: Goodness-of-fit parameters show that a monoexponential function and a biexponential function with shared population-based parameters and physical tail are reasonable reference models. When comparing both reference models, we observed maximum differences of -44%, -19%, and -28% in the estimated absorbed doses for lesions, kidneys, and salivary glands, respectively. STP dosimetry with an average deviation of less than 10% from MTP dosimetry may be feasible; however, this deviation and the optimum imaging time point showed a dependence on the chosen reference protocol. Conclusion: STP dosimetry for [177Lu]Lu-PSMA therapy is promising to boost the integration of dosimetry into clinical routine. According to our patient cohort, 48 h after injection may be regarded as a compromise for STP dosimetry for lesions and at-risk organs. The results from this analysis show that a common gold standard for dosimetry is desirable to allow for reliable and comparable STP dosimetry.

Association of a device-based remote management heart failure pathway with outcomes: TriageHF Plus real-world evaluation.

Clinical pathways have been shown to improve outcomes in patients with heart failure (HF). Although patients with HF often have a cardiac implantable electronic device, few studies have reported the utility of device-derived risk scores to augment and organize care. TriageHF Plus is a device-based HF clinical pathway (DHFP) that uses remote monitoring alerts to trigger structured telephone assessment for HF stability and optimization. We aimed to evaluate the impact of TriageHF Plus on hospitalizations and describe the associated workforce burden. TriageHF Plus was a multi-site, prospective study that compared outcomes for patients recruited between April 2019 and February 2021. All alert-triggered assessments were analysed to determine the appropriateness of the alert and the workload burden. A negative-binomial regression with inverse probability treatment weighting using a time-matched usual care cohort was applied to estimate the effect of TriageHF Plus on non-elective hospitalizations. A post hoc pre-COVID-19 sensitivity analysis was also performed. The TriageHF Plus cohort (n=443) had a mean age of 68.8±11.2years, 77% male (usual care cohort: n=315, mean age of 66.2±14.5years, 65% male). In the TriageHF Plus cohort, an acute medical issue was identified following an alert in 79/182 (43%) cases. Fifty assessments indicated acute HF, requiring clinical action in 44 cases. At 30day follow-up, 39/66 (59%) of initially symptomatic patients reported improvement, and 20 (19%) initially asymptomatic patients had developed new symptoms. On average, each assessment took 10min. The TriageHF Plus group had a 58% lower rate of hospitalizations across full follow-up [incidence relative ratio: 0.42, 95% confidence interval (CI): 0.23-0.76, P=0.004]. Across the pre-COVID-19 window, hospitalizations were 31% lower (0.69, 95% CI: 0.46-1.04, P=0.077). These data represent the largest real-world evaluation of a DHFP based on multi-parametric risk stratification. The TriageHF Plus clinical pathway was associated with an improvement in HF symptoms and reduced all-cause hospitalizations.

Comparison of Alabama Nurse Experiences Between Practice Areas During the Early COVID-19 Pandemic.

According to the Total Worker Health® framework, safety culture including a reasonable workload among healthcare workers is essential to the security and well-being of patients, staff, and healthcare organizations. Evaluating the impact of the pandemic on the nursing workforce in different practice areas is critical for addressing workforce health and sustainability. The purpose of this study was to compare work and selfcare experiences among Alabama nurses between practice areas and the early pandemic years (2020 vs. 2021). A secondary analysis of cross-sectional Alabama State Nurses Association (ASNA) survey data was conducted. Kruskal-Wallis analysis of variance, Wilcoxon rank, and false discovery rates were examined. There were 1,369 and 2,458 nurse survey responses in 2020 and 2021, respectively. By 2021, nurses reported worsening staff shortages, a greater need for retired and new graduate nurses to help with the workload burden, and perceptions of heavier emergency department workloads. Lower proportions of nurses reported the ability to engage in self-care activities and satisfaction with state and federal crisis management. Intensive care nurses were more likely to report staffing shortages while also reporting the lowest ability to engage in self-care. Overall, the Alabama nursing workforce perceived worsening work conditions in 2021 compared to when the pandemic began. Practice areas varied greatly in their responses, with acute and intensive care areas perceiving more difficult work conditions. Total Worker Health® programs should be designed to promote and support nurses' well-being based on their experience and the needs of specific practice areas.

Evidence-Based Guidelines for Low-Risk Ethics Applicants: A Qualitative Analysis of the Most Frequent Feedback Made by Human Research Ethics Proposal Reviewers

AbstractHuman Research Ethics Committee (HREC) reviewers often provide similar feedback across applications, which suggests that the problem lies in researcher awareness of key issues rather than novel, unsolvable challenges. If common problems can be addressed before lodgement by applicants referencing clear evidence-based supports (e.g., FAQs on common application shortcomings), it would improve efficiency for HREC members and expedite approvals. We aim to inform such supports by analysing the patterns in the most frequent feedback made by HREC members during review processes. We collected every instance (N = 4,195) of feedback made on N = 197 ‘low-risk’ protocols by all HREC staff (N = 16) at one institution over the course of a full year (2019). Reflexive thematic analysis to identify themes (and content analysis to determine relative frequency) revealed that the top three themes are consistent with existing literature: Consent, Administrative, and Methodological concerns. However, we identified important new themes that are not captured in previous research, including ‘Risk to Researchers’, ‘Commercial benefit, scope and scale’, ‘Diversity’ (covering issues of cultural sensitivity, language and accessibility), as well as fair right to a complaints process. Our thorough exploration of information-rich primary data marks an important methodological improvement over previous studies and offers a theoretical contribution to understanding themes that have heretofore been overlooked in the ethics review process. By identifying the common challenges experienced in HREC review we can better inform tailored supports to applicants (by extension reducing workload burdens on HREC systems) and reduce their perceived barriers to engaging in challenging but meaningful research.

Pharmacological labour pain interventions: South African midwives’ perspective

BackgroundWomen of childbearing age feel great about giving birth, but the pain could be excruciating depending on their pain tolerances. Midwives requires obstetrical knowledge and skills such as pain management during labour and safety. We explored midwives’ perspectives on the utilisation of pharmacological pain alleviation interventions during labour in selected hospitals in Matjhabeng Municipality, Free State province, South Africa. A qualitative study was undertaken, involving a sample of ten midwives, using a semi-structured interview guide. The interviews were audio-recorded and transcribed verbatim. Tesch’s open coding data analysis method was applied to analyse the data. The midwives were restricted to use Pethidine and Phenergan prescribed by doctors for labour pain relief, which disrupted labour pain management and obliged them either to wait for a physician or follow telephone instructions. According to the midwives, women taking Pethidine and Phenergan encountered adverse effects and discomfort. Midwives identified high workload, inadequate personnel, lack of skill and knowledge, lack of medication availability, and lack of infrastructure as the primary challenges of administering pharmacological methods to women in labour. The lack of standing orders, which delays the administration of medications pending a physician’s prescription, constituted an additional difficulty. In the instance that Pethidine and Phenergan were unavailable or ineffective for some women, the midwives recommended that women be administered alternative pharmacological pain relievers. They also advocated for institutionalization of pharmacological guidelines allowing them to use their discretion when treating labour pain. Midwives can only utilise a few standardised and regulated pharmacological medications for labour pain management. The midwives’ ability to administer pharmacological pain relief during labour was hampered by a high workload burden, insufficient staff, lack of skill and understanding, drug unavailability, and inadequate infrastructure. Midwives advocated for supported guidelines that would allow them to treat labour pain at their discretion. Intersectoral stakeholders are required to improve midwife skills and attitudes. Health facilities need to train and supply analgesics to midwives. Midwives ought to be familiar with pharmacological pain relievers.

Impact of unscheduled nurse-led virtual care for people with diabetes on nursing practices and patient satisfaction.

The COVID-19 pandemic and its social restrictions accelerated the expansion of virtual clinical care, and this has been reported to be safe, low cost and flexible. This study aimed to examine nursing practices and patient satisfaction with unscheduled nurse-led virtual care for people with diabetes. A cross-sectional descriptive survey of clinical nurse specialists and patients was carried out, using an activities log for nursing practices and a satisfaction and enablement survey for callers. Patients reported high satisfaction levels and greater self-confidence in keeping themselves healthy after receiving virtual care. Most calls (74.8%) from patients were for advice and education. Each call led to an average of 2.5 actions for the clinical nurse specialist. The service is highly valued and is effective, but adds to the nurse workload burden.

Utilizing Telenursing to Supplement Acute Care Nursing in an Era of Workforce Shortages: A Feasibility Pilot.

Hospitals are experiencing a nursing shortage crisis that is expected to worsen over the next decade. Acute care settings, which manage the care of very complex patients, need innovations that lessen nurses' workload burden while ensuring safe patient care and outcomes. Thus, a pilot study was conducted to evaluate the feasibility of implementing a large-scale acute care telenurse program, where a hospital-employed telenurse would complete admission and discharge processes for hospitalized patients virtually. In 3 months, almost 9000 (67%) of patient admissions and discharges were conducted by an acute care telenurse, saving the bedside nurse an average of 45 minutes for each admission and discharge. Preliminary benefits to the program included more uninterrupted time with patients, more complete hospital admission and discharge documentation, and positive patient and nurse feedback about the program.

Ketidakadilan Gender dalam Rumah Tangga pada Diskusi Susahnya Jadi Perempuan Part 2 Mata Najwa: Kajian Pragmatik

Married life being one of the new levels of a life that brings some differences to some people. The concept of division of roles in the household is often misunderstood by some groups in society. Therefore, it is necessary to carry out several studies in this regard. The study with the object of discussion “Susahnya Jadi Perempuan Part 2 Mata Najwa” aims to theoretically prove the phenomenon of gender inequality experienced in households. To achieve this goal, we use a descriptive qualitative method with a case study approach. The dialogues uttered by the speakers were also reviewed through pragmatic theory and resulted in the discovery of locutionary, illocutionary, and perlocutionary speech acts in the object. Through the application of gender inequality theory to objects, it was found that there are two forms of inequality that occur in households, namely workload or double burden, and stereotypes that include women”s beauty standards, men’s participation in family planning programs, and men’s obligations in the household .