Care Training Research Articles

Evaluation of the McGill-Tongji Blended Education Program for Teacher Leaders in General Practice: The importance of partnership and contextualization in International Primary Care Training Initiatives.

Strong primary health care (PHC) systems require well-established PHC education systems to enhance the skills of general practitioners (GPs). However, the literature on the experiences of international collaboration in primary care education in low- and middle-income countries remains limited. The purpose of this study was to evaluate the implementation and perceived impact of the McGill-Tongji Blended Education Program for Teacher Leaders in General Practice (referred to as the "Tongji Program"). In 2020-2021, the McGill Department of Family Medicine (Montreal, Canada) and Tongji University School of Medicine (TUSM,Shanghai, China) jointly implemented the Tongji Program in Shanghai, China to improve the teaching capacity of PHC teachers. We conducted an exploratory longitudinal case study with a mixed methods design for the evaluation. Quantitative (QUAN) data was collected through questionnaire surveys and qualitative (QUAL) data was collected through focus group discussions. The evaluation showed that learners in Tongji Program were primarily female GPs (21/22，95%) with less than 4 years of experience in teaching (16/22，73%). This program was considered a successful learning experience by most participants (19/22, 86%) with higher order learning tasks such as critical thinking and problem-solving. They also agreed that this program helped them feel more prepared to teach (21/22，95%), and developed a positive attitude toward primary care (21/22，95%). The QUAL interview revealed that both the Tongji and McGill organizers noted that TUSM showed strong leadership in organization, education, and coordination. Both students and teachers agreed that by adapting training content into contextualized delivery formats and settings, the Tongji Program successfully overcame language and technology barriers. Committed partnerships and contextualization were key to the success of the Tongji Program. Future research should focus on how international primary care education programs affect learners' behavior in their practice settings, and explore barriers and facilitators to change.

Nurses` Practices concerning Care of Transition to Oral Feeding in Preterm Neonate

Background: Premature neonates often struggle with oral feeding due to physiological immaturity, necessitating skilled nursing support during the transition from tube to oral feeding. Knowledge Gap: Despite the critical role of nurses in this process, there is limited evidence on their practices and the factors influencing their effectiveness. Aims: This study aimed to evaluate nurses' practices in caring for neonates transitioning to oral feeding and to identify predictive factors, such as education and training, that influence these practices. Methods: A descriptive cross-sectional study was conducted at Al-Batoul Training Hospital in the Diyala Governorate from October 2023 to February 2024. A non-probability convenience sample of 60 nurses was assessed using a 35-item checklist, validated by experts and tested for reliability (Cronbach’s alpha = 0.81). Data analysis involved descriptive and inferential statistics, with simple linear regression employed to identify relationships between nurses’ practices and demographic variables. Results: The findings revealed that 86.7% of nurses exhibited inadequate practices, with the majority (65.0%) having less than 5 years of experience and 85.0% not attending training courses. Regression analysis indicated that education level (p = 0.007) and attendance of training courses (p = 0.001) were significant predictors of practice quality. Novelty: This study is among the first to quantify the inadequacy of nurses' practices in the transition to oral feeding in a developing country context, highlighting education and training as critical areas for intervention. Implications: The results underscore the urgent need for healthcare organizations to implement comprehensive training programs and educational initiatives aimed at improving neonatal care practices, particularly in NICUs, to ensure better health outcomes for preterm infants. Highlights: Significant nurse practice deficiencies in neonate oral feeding transition. Education and training crucial for improving nurse performance. Need for comprehensive neonatal care training programs. Keywords: Premature neonates, oral feeding, neonatal care, nurse practices, training programs

Analyzing prejudice against immigrants in sending countries: The Brazilian case

AbstractPrejudice against immigrants has been widely studied in the literature, but analyzing immigrant‐receiving countries is not the same as analyzing sending countries, where the number of immigrants is very low. To address this gap, we examine the case of Brazil, a country that has witnessed numerous anecdotal episodes of prejudice against immigrants despite having a very low flow of migrants and therefore minimal material effects on the local population. Our study focuses on the levels of discrimination against immigrants in Brazil, with a specific analysis of four groups—Haitians, Germans, Venezuelans, and internal migrants known as nordestinos. We consider three policy‐related scenarios—housing, health care, and job training. To mitigate social desirability bias, we employ a combination of list and endorsement survey experiments in a face‐to‐face national sample of 1850 respondents conducted in January 2019. The results reveal a widespread negative perception of all groups of foreigners across all scenarios except the local group of migrants. The findings suggest that the Brazilian public's discrimination against foreigners is linked to a pervasive misperception of the social and economic threat immigrants allegedly pose to the nation.

End-of-Life Care during the COVID-19 Pandemic: Decreased Hospitalization of Nursing Home Residents at the End of Life.

(1) Background: Nursing homes (NHs) face unique challenges in end-of-life care for their residents. High rates of hospitalization at the end of life are frequent, often for preventable conditions. The increased clinical uncertainty during the pandemic, the high symptom burden of the COVID-19 disease, and the challenges in communication with families and between care teams might impact the option to hospitalize NH residents at the end of life. (2) Materials and methods: The study covered a 3-year period and compared the hospitalization rates of the NH residents of a sample of Portuguese NH during the last year of life before and during the pandemic. A total of 387 deceased residents were included in the study. (3) Results: There were fewer hospitalizations in the last year of life during the pandemic period, although the proportion of deaths at hospitals was the same. Hospitalizations occurred closer to death, and with more serious clinical states. The lower rate of hospitalization was due to lower hospitalization due to infection; (4) Conclusions: The data suggest an improvement in end-of-life care practices during the pandemic period, with the decrease in hospitalizations being due to potentially burdensome hospitalizations. The importance of the role of physicians, nurses, and caregivers in this setting may be relatively independent of each other, and each may be targeted in end-of-life care training. Further study is recommended to clarify the implications of the results and if the changes can be sustained in the long term.

2247 Clinical pharmacists working in primary care supporting people living with dementia: a UK survey

Abstract Background Clinical pharmacists are increasingly working as part of primary care teams in UK. Many people living with dementia live at home with the support of primary care. Given the complexity of their health problems and their use of several medications, clinical pharmacists may potentially play a crucial role in their support. Aims To explore clinical pharmacists’ experiences of working in primary care with people living with dementia and identify any specific training needs to provide effective support for this patient group. Methods An online survey sent via email in 2023 through professional organisations, social media, and utilising research team contacts. The survey covered topics including clinical pharmacists’ background, experience of working with people with dementia, and training needs. Results 57 clinical pharmacists responded to the survey; the mean time working as a clinical pharmacist was 9.6 years (standard deviation 8.6) and within a primary care setting was 6.1 years (standard deviation 6.1). Just over three-quarters of respondents (n = 31, 77%) work with people living with dementia. While almost two thirds (n = 35, 61%) had undertaken training for dementia care, such training often lasted a few hours (less than a day) (n = 17, 49%). Most respondents (n = 39, 89%) wanted further information or training; including non-pharmacological interventions to improve quality of life in dementia and how to support carers and relatives. Practice challenges reported included a lack of face-to-face consultations and getting assurance that the patient could safely take medications. Conclusions These findings indicate an interest in dementia care, a willingness to undertake further training but practice uncertainties that suggest a system approach might be beneficial.

Resident Aggression and Staff Burnout in Nursing Homes in Hong Kong.

This study examined the effects of exposure to resident aggression, self-efficacy, neuroticism, and attitudes toward dementia on burnout among direct care workers (DCWs) in nursing homes. A convenience sample of 800 DCWs from 70 randomly selected nursing homes in Hong Kong were recruited and individually interviewed. DCWs reported past-month experiences of resident aggression, levels of burnout, self-efficacy, neuroticism, attitudes toward dementia, and other personal and facility characteristics. Hierarchical multiple regression analysis revealed that, while physical environment of the facilities, and demographic background and self-efficacy of DCWs were not significant contributing factors, DCWs' exposure to resident aggression, insufficient experience and training in dementia care, negative attitudes toward dementia, and neurotic personality were associated with higher levels of staff burnout. Findings point to the importance of mitigating resident aggression and adequately screen and train staff to optimize their empathy and competence in minimizing the risk of burnout.

Comparing Learning Outcomes of Machine-Guided Virtual Reality-Based Training With Educator-Guided Training in a Metaverse Environment: Randomized Controlled Trial.

Virtual reality (VR) modules are commonly used for health care training, such as adult advanced cardiac life support (ACLS), due to immersion and engagement. The metaverse differs from current VR serious gaming by enabling shared social connections, while current VR modules focus on computer-based content without social interaction. Educators in the metaverse can foster communication and collaboration during training sessions. This study aimed to compare learning outcomes of VR-based, machine-guided training with educator-guided, VR-based training in the metaverse environment. A total of 62 volunteered students from Acibadem Mehmet Ali Aydinlar University Vocational School for Anesthesiology were randomly divided into 2 groups of 31 participants each: one group received VR-based training with machine guidance (MG), and the other received VR-based training with educator guidance (EG) in the metaverse. The members of both groups undertook VR-based basic training for ACLS. Afterward, the MG group was trained with a VR-based advanced training module, which provides training with full MG, whereas the EG group attended the VR-based, educator-guided training in the metaverse. The primary outcome of the study was determined by the exam score of the VR-based training module. Descriptive statistics defined continuous variables such as VR exam scores and time spent on machine- or educator-guided training. The correlation between training time and VR exam scores was assessed with the Spearman rank correlation, and nonnormally distributed variables were compared using the Mann-Whitney U test. Statistical significance was set at P<.05, with analyses executed by MedCalc Statistical Software (version 12.7.7). Comparing the VR test scores between the MG and EG groups revealed no statistically significant difference. The VR test scores for the EG group had a median of 86 (range 11-100). In contrast, the MG group scores had a median of 66 (range 13-100; P=.08). Regarding the correlation between the duration of machine-guided or educator-guided training and VR-based exam scores, for the MG group, =0.569 and P=.005 were obtained. For the EG group, this correlation was found to be =0.298 and P=.10. While this correlation is statistically significant for the MG group, it is not significant for the EG group. The post hoc power analysis (80%), considering the correlation between the time spent on training and exam scores, supported this finding. The results of this study suggest that a well-designed, VR-based serious gaming module with MG could provide comparable learning outcomes to VR training in the metaverse with EG for adult ACLS training. Future research with a larger sample size could explore whether social interaction with educators in a metaverse environment offers added benefits for learners. ClinicalTrials.gov NCT06288087; https://clinicaltrials.gov/study/NCT06288087.

Comparing the Surgical Outcomes of Carotid Endarterectomy: Assessing the Impact of Consultant versus Trainee Cases on Patient Care and Surgical Training

ObjectiveThis study assesses the impact of having a surgical trainee performing a carotid endarterectomy procedure on the post-operative rates of stroke and death. DesignObservational Retrospective study MethodsConsecutive patients, who underwent carotid endarterectomy between 01/05/2016 and 31/7/2022, were entered into a retrospectively collected database. Patients were stratified into two categories – consultant-led cases and trainees-led cases. Primary outcomes were 30- day stroke rate, and 30-day morbimortality. A sub analysis was performed after grouping the patients in whether there was a neurological event in the previous six months – symptomatic or asymptomatic. Results/ConclusionsTrainees-led cases had significantly longer clamping times and higher rates of stroke in asymptomatic patients compared with consultant-led cases. Patient’s safety should be our top priority. Any practice leading to a significantly increased rate of post-operative stroke must be discontinued. Training protocols and adequate supervision must ensure that trainees possess the necessary skills and knowledge to safely and effectively perform carotid endarterectomy (CEA) procedures, thereby prioritizing patient safety.

Improving the integration of care for trans adults: ICTA a mixed-methods study.

This research concerns improving the National Health Service health services trans adults need. These include the national specialist Gender Identity Clinics that support people making a medical transition. Not all trans people need to make a medical transition, and transition can take many different paths. Waits to be seen by Gender Identity Clinics are, however, several years long, and there may be significant problems of co-ordination between different aspects of transition-related care, and between transition-related care and general health care. The main objectives were to understand: Which factors make services more or less accessible and acceptable to the variety of trans adults? How initiatives for providing more person-centred and integrated care can be successfully implemented and further improved? An online and paper screening survey was used to gather data on demographics and service use of trans people across the United Kingdom, with 2056 responses. Researchers used survey data to construct five purposive subsamples for individual qualitative interviews, identifying groups of people more likely to experience social exclusion or stigma. There were 65 online interviews. In addition, 23 trans Black people and people of colour attended focus groups. Six case studies were completed: four on initiatives to improve care and two on experiences of particular trans populations. Fifty-five service provider staff and 45 service users were interviewed. The following undermine person-centred co-ordinated care and can lead to experiences of harm: lack of respectful treatment of trans people by general practitioner practices; inadequate funding of services; lack of support during waiting; the extended and challenging nature of Gender Identity Clinic diagnostic assessments, sometimes experienced as adversarial; breakdowns in collaboration between Gender Identity Clinics and general practitioner practices over hormone therapy; lack of National Health Service psychological support for trans people. Case studies indicated ways to improve care, although each has significant unresolved issues: training in trans health care for general practitioners; third-sector peer-support workers for trans people who come to National Health Services; gender services taking a collaborative approach to assessing what people need, clarifying treatment options, benefits and risks; regional general practitioner-led hormone therapy clinics, bringing trans health care into the mainstream; psychology services that support trans people rather than assess them. Some contexts of care and experiences of particular groups of trans people were not addressed sufficiently within the scope of the project. While efforts were made to recruit people subject to multiple forms of stigma, there remained gaps in representation. The findings have significant implications for commissioners and providers of existing National Health Services gender services, including recently established pilot services in primary care. In particular they point to the need for assessments for access to transition care to be more collaborative and culturally aware, implying the value of exploring informed consent models for accessing transition-related care. Further research is needed to investigate how far the findings apply with particular subpopulations. This study is registered as Research Registry, no. 5235. This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 17/51/08) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 28. See the NIHR Funding and Awards website for further award information.

Knowledge and training among nursing students regarding the conspiracy of silence in palliative care: A participatory action research

AimTo develop and implement specific training based on the knowledge and management of conspiracy of silence among nursing students. BackgroundConspiracy of silence refers to the concealment of information from a patient on the family’s request, under the influence of a paternalistic culture that seeks to protect the patient. DesignParticipatory action research. MethodsWas conducted in the following stages: reconnaissance (focus groups); planning, action and observation (theoretical sessions); and reflection (analysis of care plans). The focus group consisted of six fourth year and eight second-year students. The intervention was conducted with 42 s-year students and a total of 93 s-year students participated in the resolution of the clinical case. The study was conducted between October 2022 and June 2023 at the Faculty of Nursing, University of Valencia. For data analysis, the process described by Carrillo et al. (2011) was followed, involving coding and the creation of categories and subcategories. ResultsThe focus group deficiencies were detected in the students' learning of palliative care competence, breaking bad news and the conspiracy of silence (reconnaissance stage). Therefore, an intervention was conducted to reinforce these knowledge areas, specifically addressing the conspiracy of silence (planning, action and observation stages). The resolution of the case showed how students with training approached the situation more comprehensively, including the family and proposed activities that were consistent with managing the situation (reflection stage). ConclusionsAn active feedback process was successfully established, where the students' feedback helped create specific training on oncological palliative care and provided the students with tools to manage the conspiracy of silence. The results underscore the importance of providing students with training in palliative care and managing conspiracy of silence, through therapeutic communication training, active training or enhancing emotional intelligence. This training is essential for cultivating the attitudes and skills required to deliver high-quality palliative care.

72307 - “Are you curious about studying further?” Undergraduate nurses' attitudes towards specialist training in surgical care

72307 - “Are you curious about studying further?” Undergraduate nurses' attitudes towards specialist training in surgical care

Improving training for carers who support individuals with Intellectual Disabilities and Dementia: A service evaluation

Background:Within the Intellectual Disability (ID) population, the prevalence rate of dementia is higher than the general population (Chapman et al., 2018). This signifies a heightened demand on carers to support the transition from routine ID-based care to expert dementia care (Ryan et al., 2014). In line with the National Health Service’s (NHS) long-term plan (2019), it is vital for carers to access regular training to meet individuals’ dementia-related needs.Rationale:The local NHS Community Learning Disability Health Team developed two dementia training packages for paid carers working in residential and supported living facilities. Training package two (TP2) was developed in response to carer feedback obtained from training package one (TP1). This service evaluation aims to investigate the impact of TP2 on participants’ knowledge of dementia and post-diagnostic interventions. Furthermore, this evaluation aims to explore whether the quality of training improved between TP1 and TP2.Methodology:Participants who attended TP2 completed a pre and post knowledge measure; data was analysed using a repeated measures t-test. Quality scores were also completed post TP1 and TP2; this data was analysed using an independent t-test.Results:Participants reported statistically significantly higher dementia knowledge and post-diagnostic support knowledge scores following TP2. Compared with TP1, TP2 had statistically higher post-training quality scores.Discussion:Results from TP2 suggest that this dementia training package is viable and useful. The implications of these findings and wider literature are discussed, in addition to a critical review of the evaluation’s limitations, strengths and recommendations.

Using Near-Infrared Spectroscopy and Education to Support Older Adults with Diabetic Foot Ulcers to Age-in-Place: A Case Series.

The objective of this article is to demonstrate the added value of foot care provided by an RN with foot care training to older adults in their home by focusing on four older adults with diabetic foot ulcers. The RN used a mobile multispectral near-infrared spectroscopy device to enhance the assessment of the diabetic foot ulcers. The Mobile Seniors Wellness Network methodically engaged with English-speaking adults 55 years and older living within a 90-minute radius of the city's community health center. Older adults were referred to the research project through various sources. The participation group included 366 participants with varying holistic healthcare concerns and financial stressors that impacted their ability to age well in place. Over the course of visits by the RN and registered social worker, positive outcomes were facilitated through the collaboration of the participant and the multidisciplinary team, thus enhancing the individual's confidence to remain at home longer. In a time of ongoing provincial health crisis, it may be cost-effective to provide in-home support to those who want to age well in their communities by deploying a Mobile Seniors Wellness Network system throughout the province and enhancing the RN's assessment of feet with a portable and innovative technology tool.

Dementia Care Among United States Dialysis Providers: A Mixed Methods Study Evaluating Clinician Comfort and Knowledge

Rationale & ObjectiveGiven the high burden of dementia in dialysis patients, the dialysis workforce needs to be prepared to provide high-quality, person-centered dementia care. We explored comfort with and knowledge of dementia among U.S. dialysis care providers. Study DesignWeb-based survey Setting & ParticipantsEmails were sent to National Kidney Foundation and National Association of Nephrology Technicians/Technologists membership listservs (9/26/22-10/22/22). 1121 respondents had complete data for analysis (57% 35-49 years; 62% female; 62%/22% white/Black) [including 81 physicians, 61 advanced practice providers, 230 nurse managers, 260 nurses, 202 social workers, 195 dietitians, and 86 dialysis patient care technicians]. ExposuresProvider role, age, tenure, gender, previous dementia training, awareness of dementia guidance. OutcomesDementia Knowledge (assessed using Dementia Knowledge Assessment Scale (DKAS; score range, 0-25)]. Analytic ApproachCharacteristics of respondents, comfort with dementia care, and dementia knowledge were summarized and tabulated overall and by role. Robust regression was used to obtain coefficients confidence intervals for the associations between characteristics and DKAS scores, adjusting for role and tenure. Free-text responses to an open-ended question about treating patients with dementia or cognitive impairment were analyzed using thematic analysis. ResultsDementia knowledge among U.S. dialysis providers may be limited (overall DKAS score = 17; range, 13-21 across roles), despite most reporting knowing when patients had dementia (97%) and receiving training in dementia care (62%). Further, training may be inadequate: those who reported receiving dementia training had lower DKAS scores than those who reported not receiving training (β=-3.9, 95% CI: -4.4,-3.4). Thematic analysis of open-ended responses suggested that the impact of dementia on dialysis care and management and treatment beyond dialysis care are challenging for providers. LimitationsData were self-reported and limited information was gathered about quality, content, and timing of dementia training received. ConclusionMany U.S. dialysis care providers had suboptimal dementia knowledge, despite reporting being comfortable with providing dementia care and reporting they received prior training. Qualitative findings indicate complexity among providers regarding comfort with and knowledge of treating patients with cognitive impairment. Targeted training for the dialysis workforce in dementia knowledge and best practices for person-centered dementia care is warranted.

Evaluation of Healthcare Operations Management using TOPSIS Method

The daily activities of the facility that have an effect on consumer satisfaction and organizational goals are referred to as healthcare operations management. The goal of healthcare program management is to raise money to keep service levels and standards at a reasonable level. Planning, coordinating, and controlling a healthcare system's activities are all parts of operations management in hospitals. It comprises both clinical and quasi-function management. Follow the operating budget, financial goals, and performance standards with economy and efficiency. Develop policies and processes that support high-quality healthcare by working together with hospital management, clinical teams, and the neighborhood. directing a group of medical specialists. financial responsibilities such as managing the revenue cycle, procuring medical supplies, and tracking patient billing, claims, and reimbursements. administer the policies and procedures of the medical facility, make sure that best practices are implemented, and deal with instances of facility non-compliance. Understanding and observing current healthcare rules and regulations requires analytical skills. Encourages employees to give their best effort to patient care. Employing, training, and delegating work to the proper employees while coming up with innovative solutions to staff members and patient issues are all examples of managerial skills. More and more complicated operations were carried out by licensed surgeons. The average functional workload rises sharply with age, peaks between the ages of 40 and 44, and then drops linearly after that. Following medical school graduation, it takes a surgeon 18 years to work as much as they can. a facility created, staffed, and outfitted for the diagnostic of illness, the medical and surgical care of the ill and injured, and their housing while undergoing these procedures. A contemporary hospital frequently doubles as a training and research facility. Outlining the steps necessary to accomplish specified objectives is the process of strategic planning in healthcare systems. All strategies have the same objective, which is to bring an organization's activities into line with its declared goal or values, despite the fact that there are several strategy kinds and degrees. Hospitals, medical equipment, diagnostic testing, telemedicine, medical tourism, outsourcing, and health insurance are all part of the healthcare industry. Due to its development, rising spending on services, and governmental and private organizations, the Indian healthcare industry is expanding quickly. assisting many departments in cooperating to accomplish the hospital's objectives. Control hiring, training, and quality control procedures for patient care. involvement in setting the budget and calculating the price of healthcare services. The first group consists of regular patients who see their doctor each month. People must continue using the healthcare system since they have a chronic sickness of some kind. "Healthy" patients fall into the second category. Providing products and services that are used to practice medicine through prophylactic, prophylaxis, rehabilitative, and palliative care is the function of the healthcare industry, commonly referred to as the healthcare industry or the health economy. The Indian government is very important in the health industry. India happens to be among the world's most populated nations, and its people need access to high-quality healthcare. The Indian government contributes significantly to funding healthcare projects and enhancing the availability and standard of services. Health care may operate in a systematic manner thanks to hospital administration, which makes it easier to supply diverse services quickly and easily. It enables better financial control for major hospitals that provide a wide variety of services by managing cash flow, making smarter investments, and regulating costs. Successful health service leaders never stop stressing how important it is to provide safe, excellent treatment that is compassionate. They make sure that customers' voices are regularly heard at all levels, and they continuously monitor patient experiences, worries, wants, and comments (both positive and negative). TOPSIS (Technique for Order of Preference by Similarity to Ideal Solution) analysis using Knowledge areas, Procedures, Medical conditions, Patient groups, Planning horizons, Levels of difficulty Alternative value, and New Karolinska, Sabbatsberg, Dander yd hospital Evaluation Parameters in value. Knowledge areas, Procedures, Medical conditions, Patient groups, Planning horizons, and Levels of difficulty. New Karolinska, Sabbatsberg, Dander yd hospital. Patient groups got the first rank whereas Medical conditions had the lowest rank.

Healthcare workers' knowledge of indicators for a palliative care approach.

Palliative care is an essential element of universal healthcare, yet not all people who need palliative care are able to receive it. One of the barriers to ensuring access for people who require palliative care is the identification of those eligible. This study evaluated healthcare workers' ability to identify patients who are eligible for palliative care based on their training or experience in palliative care. The setting for the study comprised the Heideveld Emergency Centre and Heideveld Community Day Centre in the Cape Metro, Cape Town, South Africa. This study made use of a cross-sectional survey of healthcare workers. Of the 55 participants in this study, most were able to correctly identify patients with cancer and chronic kidney disease as needing palliative care, but less accurate with other organ failure categories, trauma indications, or functional assessment of the patient. Participants who reported previous awareness training reported improved knowledge on the indications for a palliative care approach compared to no prior training. Our cohort was too small to analyse the results statistically. From what was analysed, the ability of healthcare workers to identify a person in need of palliative care could be better; more work is needed on our awareness training and basic training courses to improve this vital step.Contribution:This research highlights the fact that existing training for palliative care needs to be more applicable to the setting and that training of staff with existing courses does make a difference in knowledge.

Evaluation of Healthcare Operations Management using TOPSIS Method

The daily activities of the facility that have an effect on consumer satisfaction and organizational goals are referred to as healthcare operations management. The goal of healthcare program management is to raise money to keep service levels and standards at a reasonable level. Planning, coordinating, and controlling a healthcare system's activities are all parts of operations management in hospitals. It comprises both clinical and quasi-function management. Follow the operating budget, financial goals, and performance standards with economy and efficiency. Develop policies and processes that support high-quality healthcare by working together with hospital management, clinical teams, and the neighborhood. directing a group of medical specialists. financial responsibilities such as managing the revenue cycle, procuring medical supplies, and tracking patient billing, claims, and reimbursements. administer the policies and procedures of the medical facility, make sure that best practices are implemented, and deal with instances of facility non-compliance. Understanding and observing current healthcare rules and regulations requires analytical skills. Encourages employees to give their best effort to patient care. Employing, training, and delegating work to the proper employees while coming up with innovative solutions to staff members and patient issues are all examples of managerial skills. More and more complicated operations were carried out by licensed surgeons. The average functional workload rises sharply with age, peaks between the ages of 40 and 44, and then drops linearly after that. Following medical school graduation, it takes a surgeon 18 years to work as much as they can. a facility created, staffed, and outfitted for the diagnostic of illness, the medical and surgical care of the ill and injured, and their housing while undergoing these procedures. A contemporary hospital frequently doubles as a training and research facility. Outlining the steps necessary to accomplish specified objectives is the process of strategic planning in healthcare systems. All strategies have the same objective, which is to bring an organization's activities into line with its declared goal or values, despite the fact that there are several strategy kinds and degrees. Hospitals, medical equipment, diagnostic testing, telemedicine, medical tourism, outsourcing, and health insurance are all part of the healthcare industry. Due to its development, rising spending on services, and governmental and private organizations, the Indian healthcare industry is expanding quickly. assisting many departments in cooperating to accomplish the hospital's objectives. Control hiring, training, and quality control procedures for patient care. involvement in setting the budget and calculating the price of healthcare services. The first group consists of regular patients who see their doctor each month. People must continue using the healthcare system since they have a chronic sickness of some kind. "Healthy" patients fall into the second category. Providing products and services that are used to practice medicine through prophylactic, prophylaxis, rehabilitative, and palliative care is the function of the healthcare industry, commonly referred to as the healthcare industry or the health economy. The Indian government is very important in the health industry. India happens to be among the world's most populated nations, and its people need access to high-quality healthcare. The Indian government contributes significantly to funding healthcare projects and enhancing the availability and standard of services. Health care may operate in a systematic manner thanks to hospital administration, which makes it easier to supply diverse services quickly and easily. It enables better financial control for major hospitals that provide a wide variety of services by managing cash flow, making smarter investments, and regulating costs. Successful health service leaders never stop stressing how important it is to provide safe, excellent treatment that is compassionate. They make sure that customers' voices are regularly heard at all levels, and they continuously monitor patient experiences, worries, wants, and comments (both positive and negative). TOPSIS (Technique for Order of Preference by Similarity to Ideal Solution) analysis using Knowledge areas, Procedures, Medical conditions, Patient groups, Planning horizons, Levels of difficulty Alternative value, and New Karolinska, Sabbatsberg, Dander yd hospital Evaluation Parameters in value. Knowledge areas, Procedures, Medical conditions, Patient groups, Planning horizons, and Levels of difficulty. New Karolinska, Sabbatsberg, Dander yd hospital. Patient groups got the first rank whereas Medical conditions had the lowest rank.

ASSESSMENT OF NEWBORN PAIN RELATED TO CARE

Pain in newborns is an issue we cannot ignore any longer. The health care providers should confirm that the baby is comfortable during any procedures as it is not only that it is ethically right for them to treat in pain the patients but can also have serious after-effects in newborns and can also lead to other diseases. This study aimed to evaluate pain induced by medical procedures, describe pain management practices, and improve pain management. Two surveys were conducted: the first one on the patients through the prospective descriptive observational study. This was carried out in the NICU in the department of neonatology in the CHU MOHAMED VI of Oujda over a period of 4 months, starting from February 26, 2024 until June 26, 2024. Pain was assessed by using the DAN scale in 98 newborns (female: 56%, sex ratio: 1.27, premature: 42%, and mean weight: 2538g). The median DAN score duringmedical procedures was 4.5, which dropped to 1 three minutes after the painful procedure. The second survey was conducted among a sample of 45 medical and paramedical workers of the neonatology department of the CHU MOHAMED VI Oujda. Eighteen percent of the medical and paramedical staff indicated that they had taken specific training in pain and palliative care. A specific training session was organized for enhancing pain management. Before the training, 44% of caregivers had never assessed the pain level of their patient whereas after the training 78% of them will always assess the pain, this improved significantly post training. Regarding pain management, before training, it was not done routinely, fifty-eight percent of caregivers reported that they rarely or never used any preventive strategies, whereas after training, 84% reported always or often using preventive measures. The majority of caregivers were against the presence of parents during invasive procedures.

Designing an implementation science clinical trial to integrate hypertension and cardiovascular diseases care into existing HIV services package in Botswana (InterCARE)

BackgroundDespite success in HIV treatment, diagnosis and management of hypertension (HTN) and cardiovascular disease (CVD) remains suboptimal among people living with HIV (PLWH) in Botswana, with an overall HTN control of only 19% compared to 98% HIV viral suppressed. These gaps persist despite CVD primary care national guidelines and availability of free healthcare including antihypertensive medications. Our study aims to develop and test strategies to close the HTN care gap in PLWH, through integration into HIV care, leveraging the successful national HIV care and treatment program and strategies.MethodsThe InterCARE trial is a cluster randomized controlled hybrid type 2 effectiveness-implementation trial at 14 sites designed to enroll 4652 adults living with HIV and HTN plus up to 2326 treatment partners. Primary outcomes included effectiveness (HTN control) and implementation outcomes using the Reach Effectiveness Adoption Implementation and Maintenance framework, with explanatory mixed methods used to understand variability in outcomes.InterCARE trial’s main strategies include healthcare worker HTN and CVD care training plus long-term practice facilitation, electronic health record (EHR) documentation of key indicators and use of reminders, and use of treatment partners to provide social support to people living with HIV and HTN. InterCARE started with formative research to identify contextual factors influencing care gaps using the Consolidated Framework for Implementation Research. Results were used to adapt initial and develop additional implementation strategies to address barriers and leverage facilitators. The package was pilot tested in two clinics, with findings used to further adapt or add strategies for the clinical trial.DiscussionIf successful, the InterCARE model can be scaled up to HIV clinics nationwide to improve diagnosis, management, and support in Botswana. The trial will provide insights for scale-up of HTN integration into HIV care in the region.Trial registrationClinicalTrials.gov reference NCT05414526. Registered 18 May 2022, https://clinicaltrials.gov/study/NCT05414526?term=NCT05414526.&rank=1.

Undergraduate midwifery students' experiential learning of perinatal bereavement care: A qualitative analysis

BackgroundIt is widely acknowledged that midwives are essential in providing care for mothers experiencing perinatal death. However, midwifery students lack the knowledge and skills needed to deal with perinatal death, and. There is limited research on perinatal bereavement care training for midwifery students. AimTo investigate undergraduate midwifery students' experiential learning of perinatal bereavement care and serve as a reference for future perinatal bereavement care teaching and training. DesignQualitative descriptive design. SettingUniversity in Guangzhou, China. ParticipantsUndergraduate midwifery students at a university in Guangzhou, China. MethodThis research was conducted at a university in Guangzhou, China. The participants were recruited using purposeful sampling. Semi-structured, in-depth interviews were conducted with 11 midwifery students who participated in perinatal bereavement care training from May to June 2023. The Colalizzi 7-step data analysis method was used for data analysis. ResultsFrom the data, five themes emerged: 1) immersive experience of perinatal bereavement care, 2) formation of perspectives on perinatal bereavement care, 3) clarification of the service boundaries and internalization of the professional service spirit, 4) emotional impact and coping strategies, and 5)) factors influencing practice optimization. ConclusionsExperiential learning is an effective teaching strategy. However, participants continued to feel unprepared to provide perinatal bereavement care. Implementing relevant training, disseminating perinatal bereavement care knowledge and skills, and enhancing the ability of midwifery students to manage and cope with the psychological impact of perinatal death are important.