Care Activities Research Articles

Including adults and peers through translanguaging in literacy activities

ABSTRACT Translanguaging in reading activities in Early Childhood Education and Care (ECEC) can result in child engagement, language learning and the development of multilingual identities. Few studies have explored the engagement of very young children and languaging when they participate in activities with both educators and parents. The present study therefore investigates the ways in which educators in two daycare centres and parents jointly supported children when the parents read in the home language as well as the children’s engagement and interactions. The observational and interview data were collected in Luxembourg where a multilingual education policy is in place in ECEC. The findings show that the parents used the home language on its own or together with the instructional language which, in turn, resulted in different emotional and instructional support and impacted children’s engagement and interactions differently. While the opportunities to hear and speak a home language other than the institutional one resulted in most children performing their multilingual identities, children only engaged with content, interacted with the parent, educator and peers, and included them when the adults translanguaged. The findings suggest that children and parents can benefit from collaborative reading events when the adults draw on children’s multilingual repertoires.

Mycobacteroides abscessus outbreak and mitigation in a cardiothoracic transplant population: the problem with tap water

Hospital outbreaks caused by Mycobacteroides abscessus complex are a major cause for concern in vulnerable patients such as the cardiothoracic transplant population. To describe the outbreak investigation and mitigation steps undertaken to address an increase in healthcare-associated M. abscessus complex cases in an inpatient cardiothoracic transplant population. We extracted clinical characteristics from patients with M.abscessus pre-outbreak (March 2018 to December 2020) and during the outbreak (January 2021 to June 2022) from the electronic medical record. A multi-disciplinary team conducted the outbreak investigation and devised a mitigation strategy to implement at our institution. The baseline incidence of healthcare-associated M.abscessus was 0.11 cases per 10,000 patient-days; this increased to 0.24 cases per 10,000 patient-days during the outbreak. There were 1/9 (11%) cardiothoracic transplant patients in the pre-outbreak group compared with 7/12 (58%) during the outbreak, and respiratory specimen types compromised 6/9 (67%) of M.abscessus results in the pre-outbreak group compared with 10/12 (83%) during the outbreak. Among the clinical care activities involving water, a variety of water sources were utilized, including filtered and tap water. The incidence of healthcare-associated M.abscessus subsequently decreased to 0.06 cases per 10,000 patient-days after implementing an outbreak-mitigation strategy of sterile water precautions. Robust educational efforts from a multi-disciplinary team on eliminating exposure to tap water were effective measures to reduce healthcare-associated M.abscessus incidence at our institution. Non-tuberculous mycobacteria infection surveillance, targeted education, and water mitigation strategies may be beneficial preventative strategies for other lung transplant centres facing similar issues.

Sociodemographic and health disparities in self-care difficulties among older individuals: Evidence from South Africa

BackgroundAs South Africa’s population rapidly ages, the burden of non-communicable diseases and the challenges of performing daily care activities among older individuals are increasing. This study investigates trends in self-reported difficulties with daily care activities among older adults in South Africa and examines the association between these difficulties, sociodemographic factors, and chronic conditions.MethodsThe study used cross-sectional data from ten rounds of South Africa General Household Survey (2012–2021). Sample population included 26,362 men and 42,400 women aged 60 years and above. The outcome measure was assessed by self-reported difficulty in performing basic care activities such as washing or dressing.ResultsBetween 2012 and 2021, the percentage of participants reporting “A lot of difficulty” increased by 79.75%, “Some difficulty” increased by 112.11%, while “Unable to do” decreased by 8.97%. The risk of self-care difficulties was higher for men (RR = 1.11, 95% CI = 1.02, 1.20) and increased with age: RR = 1.24 (95% CI = 1.08, 1.42) for ages 65–69; RR = 2.27 (95% CI = 2.00, 2.58) for ages 70–74; and RR = 5.65 (95% CI = 5.08, 6.28) for ages 75+. Not being currently married (RR = 1.65, 95% CI = 1.51, 1.79), being of African/Black (RR = 1.21, 95% CI = 1.06, 1.38) or Coloured race (RR = 1.41, 95% CI = 1.21, 1.65), and having diabetes (RR = 1.44, 95% CI = 1.34, 1.55), hypertension (RR = 1.35, 95% CI = 1.26, 1.45), or asthma (RR = 1.30, 95% CI = 1.14, 1.48) were also associated with a higher risk of self-care difficulties.ConclusionThere was a notable increase in the proportion of participants reporting significant difficulty and some difficulty in performing self-care tasks, while a decrease was observed in the category of participants unable to do such tasks. Health policies should prioritize the specific needs of vulnerable sociodemographic and health groups, considering their increased risk of self-care difficulties.

Exploring the suitability of a ward-based clinical pharmacy activity collection tool for ambulatory care practice: a mixed-methods study.

At a London-based hospital, a validated ward-based clinical pharmacy activity collection tool has been used to monitor activities of clinical pharmacy teams across all settings, including ambulatory care services. No data confirm its representativeness for the full range of ambulatory clinical pharmacy services, and pharmacists share this concern. This study aimed to identify the range of clinical pharmacy activities in ambulatory care, assess the suitability of the existing ward-based tool for capturing these activities, and recommend modifications. Non-participant direct observations were conducted to record pharmacists' clinical activities in ambulatory clinics and multidisciplinary meetings. These observations were compared to the existing ward-based tool to identify discrepancies. Semi-structured interviews with eight ambulatory pharmacists were transcribed verbatim and thematically analysed inductively to explore the tool's representativeness of their routine clinical activities. Twenty-nine clinical pharmacy activities were observed in ambulatory services. Only fifteen were captured by the existing tool, with therapy monitoring and recommending therapeutic changes not accurately captured. Pharmacists agreed that the tool was not fully representative and included irrelevant activities. Four common uncaptured activities were multidisciplinary meeting-specific activities, arranging laboratory tests, monitoring patient outcomes, and liaising with community healthcare professionals. This study identified 33 candidate ambulatory clinical pharmacy activities. The existing ward-based tool does not fully capture the full range of ambulatory care clinical pharmacy activities, highlighting the need for an improved tool. Pharmacists recommended including the uncaptured activities. The candidate activities provide a foundation for standardised measurement of relevant ambulatory care activities to enable effective workforce deployment and improve patient outcomes.

Imagining the future household refrigerator: A study investigating the dimension of user needs

Household refrigerator concepts have evolved with changing applicational scenarios and requirements, providing users with support for healthy eating, personal care, and other activities in the kitchen and other areas of the home. However, current research on exploring user expectations and requirements for household refrigerators lacks considering the perspective of applicational scenarios and activity support. For this study, we invited 45 participants to explore immersive experience methods and conducted semi-structured interviews to investigate user requirements for future household refrigerators in different home areas and obtain dimensional details related to user needs, ultimately generating new insights into the demand for connected, intelligent, emotional, easy to use. Our findings are instructive for the design of future refrigerators in household scenarios and provide guidance and references for the design of other smart home appliances.

Veteran Patient Perceptions of a Universal Gloving Intervention for Healthcare-Associated Infection Prevention: A Qualitative Study

BackgroundUniversal gloving by healthcare workers (HCW) for all patient care activities (beyond isolation and standard precautions) has been proposed to reduce healthcare-associated infection transmission, but patient perceptions of this approach are unclear. We interviewed patients who experienced a universal gloving intervention by HCW within Veterans Affairs inpatient acute care units to understand their perceptions of universal gloving. MethodsWe conducted interviews with 15 across five Veterans Affairs (VA) hospitals. We used a rapid qualitative inquiry approach to analyze interview transcripts and identified patient perceptions of universal gloving regarding patient knowledge, patient experience, and HCW practice. ResultsPatients were highly supportive of healthcare workers’ use of universal gloving, noting potential benefits for infection prevention, patient and healthcare worker safety, and patient feelings of well-being and care. Patients also communicated support of universal gloving in the context of the COVID-19 pandemic. DiscussionUniversal gloving by healthcare workers may support patients’ feelings of safe and positive healthcare delivery. ConclusionsPatients’ positive perception of gloving may facilitate universal gloving as an infection prevention and control strategy.

Anxiety and demand for living conditions in the aftermath of disaster

In the aftermath of a disaster, due to disrupted traffic and communication systems, survivors have to endure severe conditions for a certain period, address multiple issues in affected areas, and overcome the situations by themselves. This study aims to depict the relationship between residents' anxiety about post-disaster living conditions and demand for measures to improve living conditions. In this study, the anxiety about post-disaster living conditions is treated as the concern and fear of the difficult situations until external resources are adequately provided and temporal living conditions are sufficiently improved. Then, this study deals with the demand for measures as the intention and attitude of responding to these problems and taking measures in isolated and difficult situations. The target area in this study is the districts of Kirime area in Inami Town, Wakayama, Japan, including the tsunami inundation area estimated by the Nankai Trough Megathrust Earthquake assessment. To illustrate the relationship between residents’ anxiety and demand, a questionnaire survey was conducted with residents in the research area between September 12 and October 17, 2022. The number of valid responses in this study was 724. In the analyses, after individual perceptions of the anxiety and demands were measured, we identify factors of the anxiety and demand and their relationships. Results indicated seven factors of living space problems, physical health, mental stress, changes of daily life, living problems caused by facility damage, maintaining privacy, and cooperation within the area in the anxiety, and five factors of support for medical and health care activities, consideration for women, common space management, responding to individual needs, and community disaster response activities in the demand. The main factors for the perception of post-disaster living conditions were mental stress, changes of daily life, living problems caused by facility damage, and cooperation within the area in the anxiety.

Achieving and sustaining reduction in hospital-acquired complications in an Australian local health service

BackgroundReducing the prevalence of hospital-acquired complications (HACs) is paramount for both patient safety and hospital financial performance because of its impact on patient’s recovery and health service delivery by diverting...

Interventional Strategies to Mitigate Maternal Stress and Enhance Coping Skills During Neonatal Admission Into Intensive Care Units in Low- and Middle-Income Countries: A Scoping Review.

Mothers of high-risk neonates experience tremendous stress during neonatal intensive care unit (NICU) admission. This stress has a negative impact on mothers' participation in neonatal care activities, psychological health and coping skills in the NICU. To determine the impact of interventional strategies to reduce maternal stress and enhance coping skills during neonatal admission to the NICU. A scoping review was carried out following the methodological framework outlined by Arksey and O'Malley. This scoping review was conducted as per the Joanna Briggs Institute guidelines, including a quality appraisal checklist for randomised and nonrandomised controlled trials. Patterns, advances, gaps, evidence for practice and research recommendations from the review (PAGER framework) were used to report the results. The following international databases were used to search for primary articles: Medline via PubMed, EBSCOhost via CINAHL, Scopus, Web of Science and the ProQuest Medical Library. Original studies published in English between January 2011 and January 2023 from low- and middle-income countries (LMICs) that assessed maternal stress and coping skills during neonatal NICU admission were included in the review. The review included 15 articles from LMICs, of which 60% were from middle-income, 25% were from lower-middle-income and 15% were from low-income countries. Interventional strategies were described under five categories. Maternal stress decreased significantly across all three subscales of the PSPS: 'sight and sound', 'baby looks and behavior' and 'parental relationship with baby and role alteration' during neonatal NICU admission. Interventional strategies involving family-centred care and emotional and psychological supportive care have been reported to have a consistently positive impact on alleviating maternal stress and enhancing coping skills in the NICU. Healthcare professionals, especially nurses, are pivotal in promptly recognising maternal stress and NICU stressors. The participation of mothers in neonatal care, such as through family-centred care and emotional support interventions, significantly reduces maternal stress and enhances coping skills.

National Academies of Sciences, Engineering, and Medicine Standing Committee on Primary Care: An Objective Venue to Inform Policy.

The 2021 National Academies of Sciences, Engineering, and Medicine (NASEM) report Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care outlined an implementation framework with recommendations for federal, state, and local policy makers, health systems, educational institutions, the interprofessional workforce, and others across the health care ecosystem to ensure that high-quality primary care is available for everyone in the United States. Based on 1 of the report's recommendations, the Department of Health and Human Services, in collaboration with the Department of Veterans Affairs and the Department of Agriculture, launched the Initiative to Strengthen Primary Health Care in 2021 to coordinate and prioritize primary care activities across the federal government. Formation of this federal coordinating body is a critical step for improving primary care in the US, but it is equally important to enable external primary care policy experts, researchers, and working clinicians to provide input on urgent primary care needs and priorities as primary care policy evolves. The newly launched NASEM Standing Committee on Primary Care will provide a venue for input that is independent, objective, and evidence-based to inform policy, spark progress and innovation, and confront challenging issues facing primary care today and in the future.

Unplanned Extubation in Extremely Preterm Neonates: Incidence, Risk Factors, and Impact on Clinical Outcomes.

Background Unplanned extubation (UE) poses a significant safety risk to mechanically ventilated, preterm, and critically ill neonates in the neonatal intensive care unit (NICU). Objective The aim of this study was to evaluate the incidence of UE from January 2018 to December 2021, identify contributing risk factors, and compare the outcomes with a cohort of extremely preterm (EP) infants. Methods A retrospective study was conducted in the NICU at the Women's Wellness and Research Center, Hamad Medical Corporation in Qatar. The study included 25 EP neonates who experienced UE events. The characteristics and outcomes of these infants were compared with a matched cohort of 75 EP infants without UE, selected using propensity score matching at a ratio of 1:3 to balance key baseline characteristics. This study was initiated in early 2018 following the introduction of a care improvement bundle that integrated various care practices and involved multiple healthcare staff. Results We recorded 25 UE events in our cohort of 507 EP neonates, totaling 5,668 invasive ventilation days. The incidence of UE events was 0.44 per 100 ventilation days over the four-year period, ranging from 0.60 in 2018 to 0.27 in 2020. UE occurred mainly during routine care activities (24%), due to agitation (20%), or during endotracheal tube manipulation (20%). Following a UE event, 64% of the neonates required positive pressure ventilation, and 88% were reintubated. Comparisons between the UE and non-UE groups revealed that UE was associated with significantly higher rates of bronchopulmonary dysplasia (BPD) (91.3% vs. 59.6%, p = 0.006), severe BPD (34.8% vs. 8.8%, p = 0.008), and increased postnatal steroid use (72.0% vs. 18.7%, p < 0.001). Neonates in the UE group had significantly longer hospital stays (127.0 days (IQR: 112.0-183.2) vs. 101.0 days (IQR: 90.0-139.5), p = 0.010), a higher median discharge postmenstrual age (42.8 weeks (IQR: 41.1-50.4) vs. 40.1 weeks (IQR: 37.3-46.6), p = 0.006), and a higher rate of receptive neurodevelopmental delays (50.0% vs. 19.5%, p = 0.009). Conclusion Neonates who experienced UE faced an increased risk of adverse respiratory and neurodevelopmental outcomes, including higher rates of BPD, increased postnatal steroid use, and longer NICU stays. This highlights the critical role of nursing care and continuous quality improvement efforts in the NICU to prevent UE.

Young Carers' Identification: Comparing Adolescents' and Parents' Perspectives.

Young carers are children or adolescents who provide significant care to another family member who has an illness or disability. This situation impacts their physical and mental health, and their social and school life. Nonetheless, this vulnerable population is often covert, which makes YCs' identification a major challenge. One of the methods in the literature to identify them consists of obtaining the adolescent's report of a relative's illness or disability, coupled with the standardized psychometric evaluation of their level of care. To date, no research had compared adolescents' and parents' perspectives using this method, while this would enable to gain insights on YCs' identification. The objective of this study was to compare parents' and adolescents' reports on the identification of an ill or disabled relative within the household, and adolescents' levels of caring activities. Survey data were collected from 776 adolescents (mean age = 12.76 years; 55.50% of females) and one of their parents (mean age = 44.31 years; 83.76% of females). They completed questionnaires evaluating their sociodemographic characteristics, illnesses or disabilities within their household, and adolescents' levelsof caring activities (MACA-YC 18). Cohen's κ for interrater agreement, Student's t-tests and chi-square tests of independence were performed for child-parent responses comparisons. Fewer adolescents reported that there was an ill or disabled relative within the household compared with their parents. Only 27.56% of the dyads agreed both on the person who was ill or disabled and the illness or disability. The dyads were more often in agreement when the ill or disabled relative had a serious somatic illness and was the mother. On the other hand, adolescents reported engaging in higher levels of caregiving activities than indicated by their parents' assessments. This study highlights the difference of perception between parents and adolescents both on illness and disability reports, and on adolescents' levels of caring activities. These two points of view seem complementary, suggesting that combining adolescents' and parents' perspectives can aid in better identifying young carers.

Modeli organizacije paliativne oskrbe odraslih

Palliative care is a young medical profession in Slovenia. It ensures the best possible quality of life for patients with chronic incurable diseases, regardless of their age, and offers support to their loved ones during the patient’s illness and after death during the mourning period. In the early period, palliative care is integrated with specific treatment. However, later, it continues with the period of late palliative care and throughout the last days of life. Its central purpose is to preserve the dignity of life and the values of the individual. Contemporary guidelines envision the implementation of palliative care tailored to individual needs throughout the entire course of life with an incurable disease. It should be holistic, continuous, and integrated into core medical disciplines. The appropriate coordination of palliative care activities, which directs the patient to the most suitable provider based on their current needs is of key importance. In this paper, based on a review of international recommendations, local characteristics and experiences, we will present the most common palliative care activities, their interrelationship and interdependence in the provision of palliative care, and thus define a model of palliative care that can, in our environment, provide appropriate support to as many patients as possible.

Frailty and related factors among community-dwelling older adults in Türkiye

Abstract Background Frailty in elderly can lead to complex challenges in the follow-up and management of health services. Ensuring comprehensive primary care services and social support can avert, reverse, or mitigate frailty in old age. We aimed to evaluate frailty and its associated factors in individuals aged ≥65 years. Methods We conducted a cross-sectional study in patients applying to primary care centres in 2024, in a city where 10% of the population is elderly. The centres were divided into clusters based on the socioeconomic status of the regions they serve, and nine were randomly selected by weight. A total of 1154 elderly who consecutively presented were included. A questionnaire including sociodemographic characteristics, Edmonton Frailty Scale, Loneliness Scale for the Elderly (LSE), Charlson Comorbidity Index (CCI), International Falls Effectiveness Scale (FES-I) was applied to the elderly. Results The mean age was 71.3±5.3 years, and 50.8% were male. In the study, 20.1% were frail, and 19.6% were apparently vulnerable. It was found that those aged 70-79 and ≥80 years, women, deceased/separated from their spouses, those with low education, those whose occupation was housewife, those earning below minimum wage, those who lived alone, non-exercisers, those taking &amp;gt;8 medications/day, and those who had ≥2 falls/last year were more frail. In multivariate logistic regression analysis, illiteracy (Odds ratio-OR:15.2, 95%CI:1.7-135.5), taking &amp;gt;8 medications/day (OR:4.1, 1.7-9.9), falling ≥2 times/last year (OR:3.4, 1.8-6.4) and ≥4 points on the CCI (OR:1.9, 1.0-3.4) were found to be predictors of frailty. Each score on the FES-I and LSE increased the risk of frailty by 1.08 (1.05-1.11) and 1.13 (1.08-1.17) times, respectively. Conclusions One in five people was found to be frail. Low education level, &amp;gt;8 medications/day, ≥2 falls in the last year, severity of comorbidity, fear of falling, and high levels of loneliness were found to be predictive factors for frailty. Key messages • Encouraging a healthy lifestyle to prevent comorbid diseases and early interventions to avoid falls can reduce frailty. • Providing social activities in primary care and promoting the elderly to participate in these activities can help prevent loneliness, which is a risk factor of frailty.

Practicing what you preach. Do cardiology trainees in the United Kingdom follow the lifestyle advice that they would give to patients?

Abstract Background The role of lifestyle factors in determining the risk of cardiovascular disease is well established. As a result, lifestyle modification is recommended as part of numerous European Society of Cardiology guidelines. However, it remains uncertain how closely cardiologists adhere to guidelines in their personal life. Poor lifestyle among clinicians can contribute to poor health and may increase absenteeism and potentially reduce the quality of patient care. Purpose To establish whether cardiology trainees in the UK follow appropriate guideline-directed lifestyle advice in their personal life. Methods All cardiology trainees within the UK were eligible to participate in the 2023 British Junior Cardiologists' Association (BJCA) training survey and the survey was advertised through national and local campaigns. The survey contained questions on smoking status, alcohol intake, healthy diet, partaking in regular exercise, frequency of adequate quality of sleep, and demographic questions. Responders were eligible for inclusion if they consented to participate in health and wellbeing survey questions, and if they had completed four demographic questions. Results Of the 398 responders to the 2023 BJCA survey, 212 consented to answer health and wellbeing questions (66% male, age 34±4 years, 42% had dependents) and were included. Responders included trainees representing all four UK nations. Very few cardiology trainees were current smokers either of cigarettes/cigars (n=2, 1%), or e-cigarettes (n=2, 1%), with 12 (6%) being ex-smokers. Few trainees (n=13, 6%) consumed alcohol above the UK recommended maximum of 14 units per week (Fig 1A). However, only 14% (n=29) regularly achieved 30 minutes of moderate or 15 minutes of intense exercise on at least 5 days each week (Fig 1B). Most trainees (n=167, 80%) only obtained adequate sleep on four or fewer nights each week (Fig 1C). Only 37% (n=78) of trainees agreed or strongly agreed that they were able to maintain a healthy diet most days (Fig 1D). Conclusions Most UK cardiology trainees followed guidance related to smoking and alcohol intake. However, far fewer trainees followed healthy lifestyle guidance relating to exercise, sleep, and diet. Whether these findings are similar across other ESC nations should be investigated. Further work is required to establish the impact of healthy living on clinician working activity and subsequent quality of patient care. Training bodies should consider how occupational factors may contribute to a trainee’s adverse healthy living.

Economic burden of suicide in Sweden in 2022

Abstract Background Suicide and suicidal behaviors bring massive human, social and economic impacts. Estimates of the cost of suicide can give some guidance as to where research on developing new interventions might be focused to give the greatest potential gain. The aim of the study is to quantify the economic cost of suicide in Sweden in 2022. Methods Incidence of suicide attempts and mortality due to suicide, intentional and undetermined (ICD10 X60-X84 and Y10-Y34) were sourced from the Swedish National Board of Health and Welfare databases for 2022. Cost were estimated from a societal perspective, including costs for inpatient and outpatient care, medication, police and justice activities as well as productivity losses due to early mortality. Results In 2022, a total of 1,569 suicide death were registered in Sweden (1,102 men and 467 women). The incidence rate remains stable during the last ten years, 17 death per 100 000. In total, 18,854 patients (10, 359 women and 8,459 men) were treated in inpatient and outpatient hospital care with suicide-related diagnoses, generated 32,843 days in inpatient care and 11,471 outpatient care visits. Direct costs for suicide death including forensic examination, emergency services, police investigation and property damage were estimated as €6,02 million, while indirect costs for productivity losses totaled €690 million. Direct healthcare costs for suicide related treatment were estimated at €54.3 million. Overall, suicide and suicide attempts cost around €750 million per year to society. Conclusions Estimates of the economic burden of suicide are needed for the Swedish setting, and these amounted to €60.3 million in direct costs and €690 million in indirect costs in 2022. The cost might be underestimated because the societal cost of suicide bereaved persons was not considered. These cost estimates can provide useful inputs to a cost-effectiveness analysis of a specific preventive intervention, and to its subsequent evaluation. Key messages • Economic burden of suicide is substantial for society. • Public health policies aimed at the prevention of suicide should be increased.

Risk perception survey for healthcare-associated infections in a large teaching hospital in Rome

Abstract Background Healthcare-associated infections (HAIs) are the main complications of hospitalization. The goal of the study was to enhance awareness, improve risk perception, and facilitate measures to reduce the outcomes of HAIs. A bottom-up approach, in which the healthcare workers involved play a key role, can be adopted to decrease the spread of HAIs. Therefore, a survey was conducted in a large teaching hospital in Rome from 2019 to 2023, excluding 2020 due to COVID-19. Methods A longitudinal study was conducted in all integrated care departments with beds. The data was collected using a standardized, anonymous, self-administered questionnaire for healthcare workers. The questionnaire consisted of 61 items assessing socio-professional features, knowledge of HAIs, attitudes and barriers to hygiene compliance, self-analysis of professional behavior and advice for new interventions. The study lasted 21 days between November and December, which is considered a period of normal care activity. A multivariable logistic regression model was built. Statistical analyses were performed with STATA 18.0. Results There were 384 health workers respondents: female (67.7%) and nurses (56.5%). The most represented areas were internal medicine (37.9%) and surgery (27.3%). The correct frequency of perception of HAIs increased from 33.3% in 2019 to 36.3% in 2023. From 2022 to 2023, the multivariable model showed that physicians (OR 0.48, CI 95% 0.24-0.93, p-value 0.03) and elder staff (OR 1.02, CI 95%, 1.0-1.1, p-value 0.04) seemed to be more aware of the prevalence of HAIs in their ward. Conclusions Targeted training days were organized after the study to discuss the data collected. Staff awareness of the prevalence of HAIs in their ward is improving, even if it is complicated to quantify it by attending HAIs training events. The survey has been included as a corporate goal for 2024 as a useful tool to improve awareness of HAIs and to evaluate the effectiveness of ongoing training. Key messages • A bottom-up approach, in which healthcare workers assume a pivotal role, can be employed to reduce the spread of HAIs as it serves as a valuable tool to evaluate the efficacy of targeted training. • The results indicate that the education of healthcare workers is a crucial factor in enhancing awareness of HAIs. Therefore, there is a need to improve the education of younger and non-medical staff.

Web-Based Nursing Care Documentation for Students to Support Online Learning

Nursing care is the most critical element in nursing services, which aims to improve the patient’s health status. Ineffective and inefficient care documentation can impact the quality of nursing services. However, the increasingly advanced development of technology provides freedom for the health world to improve the quality of patient-centered services. Educational institutions have also used information technology in learning process activities. As prospective health professionals, students must be equipped with competencies to support their performance. In this study, a web-based nursing care information system was developed to assist students in documenting care activities. The website application was designed to increase student competency in nursing documentation activities to provide high-quality nursing services even though learning is online. The waterfall model approach was used in application design. The design stage started with analyzing application requirements, followed by system design and coding. Next, using a Likert-scale questionnaire, a usability test was performed on 15 beta users to assess the functionality of the application. The results showed that the nursing care website application was easy to use and that students felt satisfied. It is hoped that the website application can be made more attractive by including a decisional support system to make it easier for students to enforce nursing diagnoses on patients.

Young carers in Ghana: caring activities, ways into care and the impacts of caregiving

ABSTRACT In Ghana, children often provide care and support to family members with disabilities, mental illnesses and other health conditions. Understanding the nature of their caring activities is essential for identifying stressors and promoting better health and wellbeing outcomes for this group of children, described in the wider literature as young carers. This qualitative study investigated the nature and impact of caring activities on young carers aged 11–17 years. The findings revealed that young carers provide domestic, financial, medical and personal care. Caring activities while beneficial, result in a double burden, as young carers often support both the care recipients and their dependents. Despite the challenges associated with caring activities, the study also reveals the myriad reasons young carers enter care work, suggesting that the work of young carers is not simply an obligation or a choice but a process and an integral part of Ghanian family structures. The study highlights the urgent need for formal mechanisms to identify and support young carers and their care recipients in Ghana.

Evaluation and redesign of an internal medicine pharmacy practice model at a tertiary care hospital.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Clinical pharmacists are embedded into the care for patients admitted to internal medicine floors at Cleveland Clinic. The existing practice model utilized by the internal medicine pharmacy team had an uneven distribution of clinical activities among the various pharmacist roles. A study was completed to evaluate a potential adjustment to the pharmacy practice model. The objective of this study was to assess the type and quantity of clinical activities performed by each pharmacist role. These data were then utilized to evaluate the need for redistribution of care activities among the pharmacist roles and to determine the need for additional pharmacist full-time equivalents. From January to February 2023, data pertaining to the amount and type of clinical activities completed by the 9 internal medicine pharmacist roles was either manually collected or extracted from the electronic medical record. The data were then utilized to calculate a responsibility score for each role. Descriptive statistics were also calculated to assess the results. Each pharmacist role cared for an average of 34.4 patients (minimum, 24.4; maximum, 57.7) during the study period. The average responsibility score for each pharmacist role was 309.8 (minimum, 237.5; maximum, 447.8). On the basis of the data collected during the 4-week study period, a new pharmacy practice model was developed that incorporated 2 additional full-time equivalents. This model balanced patient care responsibilities among the pharmacist roles and moved the practice model from a location-based to a team-based coverage model.