Care Unit Patients Research Articles

Identification of The Relationship Between Behavioral Theory And Nurses' Intention in Documenting Nursing Care Using The Theory Of Planned Behavior in The Integrated Inpatient Care Unit Building A RSCM

Nursing documentation is an important aspect of health services. This study aims to analyze the perception of nurses in RSCM regarding the importance of documentation, attitudes towards documentation, and factors that affect documentation practices. This study used a quantitative descriptive design with a cross-sectional approach. The research sample is all nurses at RSCM. Data collection was carried out through questionnaires. The results of the study show that most of the nurses in Building A RSCM strongly agree with the importance of nursing documentation and realize that good documentation can improve the quality of patient service. This is indicated by the r-table ≥ calculation with 15 items that have been declared valid. With KMO values of 0.772, 0.696, and 0.624 above 0.5 with a significance value (Sig.) of 0.000. In addition, there is a positive correlation between subjective norms and attitudes. The relationship between attitudes and subjective norms is quite strong. The majority of nurses also have a positive attitude towards documentation, such as being confident, consistent, and having good intentions. Factors that influence documentation practices include: a supportive work environment, availability of assistive devices, sufficient time, and support from colleagues. Integrated inpatient nurses in Building A of RSCM have a high awareness of the importance of nursing documentation. Positive attitudes and support from the work environment are important factors in improving the quality of documentation. However, there are still several obstacles that need to be considered, such as limited time and lack of priority in documentation.

The Effectiveness of Pressure Injury Prevention Education for Patient Care Technicians in an Adult Acute Care Setting: A Quality Improvement Project.

The purpose of this quality improvement project was to determine whether hospital-acquired pressure injuries (HAPIs) could be prevented by implementing an educational tool kit for patient care technicians (PCTs). Data were collected from 24 PCTs and 43 patients in a 26-bed inpatient adult acute care unit at an academic medical center in the mid-Atlantic region of the United States. Outcome data were collected over an 8-week period from September to November 2021. Hospital-acquired pressure injury prevalence was collected using the National Database of Nursing Quality Indicators (NDNQI) survey process. Full- and part-time PCTs' knowledge and attitudes were assessed through modified Pressure Injury Prevention Knowledge and Attitudes towards Pressure Ulcer Prevention Instruments. The PCTs' compliance with prevention strategies was assessed among patients using the modified NDNQI audit scores. Descriptive statistics, Fisher's Exact test, and Mann-Whitney U test were used for analysis. Among the 24 PCTs, 66.7% (n=16) had received prior education on HAPI prevention strategies. Hospital-acquired or unit-acquired pressure injury prevalence rates did not change significantly following the educational intervention. Mean Pressure Injury Prevention Knowledge scores increased from pre- to post-intervention (92.86; SD 9.63 vs 94.05; SD 12.86). Average Attitude towards Pressure Ulcer Prevention scores decreased from pre- to post-intervention (27.79; SD 4.88 vs 21.0; SD 7.51), indicating poorer attitudes toward pressure injury prevention. The mean NDNQI audit scores significantly improved from pre-implementation (M 1.40; SD 0.82, n =20) to measurement following the intervention (M 2.35; SD 0.99, n =23; P=.014). An educational curriculum tailored for PCTs increased HAPI prevention strategies. The project site incorporated the HAPI prevention educational tool kit from this quality improvement project into their annual hospital-wide training for all PCTs to learn and implement HAPI prevention strategies in their work setting.

Early mobilization in the intensive care unit for patients with subarachnoid hemorrhage-areview

Early mobilization of critical ill patients in the intensive care unit (ICU) has apositive effect on outcome. Currently, due to concerns of cerebral vasospasm and rebleeding patients with subarachnoid hemorrhage (SAH) have aprolong bedrest for 12-14days. What effect does early mobilization have on vasospasm, clinical outcome, length of stay and ICU complication rate in patients with SAH compared to standard treatment? Asystematic literature search was conducted in MEDLINE via the PubMed® (U.S. National Library of Medicine®, Bethesda, MD, USA) and CINAHL® (EBSCO, Ipswich, MA, USA) databases. A total of 14studies were identified. Overall, the studies showed an improved functional outcome and areduction in the length of hospitalization and ventilation time. Only in one study did vasospasms occur more frequently and the outcome of patients with early mobilization was worse. Further research is needed to identify possible positive effects of early mobilization in patients with SAH and to be able to describe the risk-benefit ratio more precisely.

Transformer-based model for predicting length of stay in intensive care unit in sepsis patients.

Sepsis, a life-threatening condition with a high mortality rate, requires intensive care unit (ICU) admission. The increasing hospitalization rate for patients with sepsis has escalated medical costs due to the strain on ICU resources. Efficient management of ICU resources is critical to addressing this challenge. This study utilized the dataset collected from 521 patients with sepsis at Chungbuk National University Hospital between July 2020 and August 2023. A transformer-based deep learning model was developed to predict ICU length of stay (LOS). The model incorporated global and local input data analysis through classification and feature-wise tokens, based on sequential organ failure assessment (SOFA) criteria. Model performance was evaluated using four-fold cross-validation. The proposed model achieved a mean absolute error (MAE) of 2.05 days for predicting ICU LOS. The result demonstrates the ability of the proposed model to provide accurate and reliable predictions. The proposed model offers valuable insights for healthcare resource management by optimizing ICU resource allocation and potentially reducing medical expenses. These findings highlight the applicability of the proposed model to efficient healthcare cost management.

Tracheostomy Practice in the Italian Intensive Care Units: A Point-Prevalence Survey.

Background and Objectives: A tracheostomy is a frequently performed surgical intervention in intensive care units (ICUs) for patients requiring prolonged mechanical ventilation. This procedure can offer significant benefits, including reduced sedation requirements, improved patient comfort, and enhanced airway management. However, it is also associated with various risks, and the absence of standardized clinical guidelines complicates its implementation. This study aimed to determine the prevalence of tracheostomy among ICU patients, while also evaluating patient characteristics, complication rates, and overall outcomes related to the procedure. Materials and Methods: We conducted an observational, cross-sectional, point-prevalence survey across eight ICUs in Italy. Data were collected over two 24 h periods in March and April 2024, with a focus on ICU characteristics, patient demographics, the details of tracheostomy procedures, and associated complications. Results: Among the 92 patients surveyed in the ICUs, 31 (33.7%) had undergone tracheostomy. The overall prevalence of tracheostomy was found to be 9.1%, translating to a rate of 1.8 per 1000 admission days. The mean age of patients with a tracheostomy was 59.5 years (SD = 13.8), with a notable predominance of male patients (67.7%). Neurological conditions were identified as the most common reason for ICU admission, accounting for 48.4% of cases. Tracheostomy procedures were typically performed after a mean duration of 12.9 days of mechanical ventilation, primarily due to difficulties related to prolonged weaning (64.5%). Both early and late complications were observed, and 19.35% of tracheostomized patients did not survive beyond one month following the procedure. The average length of stay in the ICU for these patients was significantly extended, averaging 43.0 days (SD = 34.3). Conclusions: These findings highlight the critical role of tracheostomy in the management of critically ill patients within Italian ICUs. The high prevalence and notable complication rates emphasize the urgent need for standardized clinical protocols aimed at optimizing patient outcomes and minimizing adverse events. Further research is essential to refine current practices and develop comprehensive guidelines for the management of tracheostomy in critically ill patients.

Percepções de enfermeiros hondurenhos sobre a qualidade do atendimento a pacientes com AVC: um estudo qualitativo

Objective: to explore the nurses’ perceptions among the quality of care to stroke patients in a public hospital in Northern Honduras. Method: a descriptive phenomenological study was carried out. The data collection was conducted by means of depth- interviews to 20 general nurses from the emergency and clinical medicine departments from the Atlántida General Hospital. Data analysis was by thematic technique. Results: the research found three key themes, and 10 subthemes, which illustrated the quality of stroke patients care in a general hospital from Honduras. The finding points up the theme “negative outcomes regarding the structure dimension of the patient care units”, which means the failure to improve or maintain the quality of healthcare. Likewise, “positive outcomes regarding the nursing process”, defined as pleasant and helpful among the care of stroke patients, such as ethical and humanized caring, and activities on promoting patient self-care with involvement of the relatives. Conclusion: the results indicate that Honduran nurses do not have qualified graduate training in critical care, which is a limitation that compromises the quality of care. Therefore, it is recommended to have clear organization structures and better resources managing, consequently, it may increase user satisfaction, as well as reducing hospital stays.

Mobile photon counting detector CT with multi material decomposition methods for neuroimaging of patients in intensive care unit

AbstractThe photon-counting detector computed tomography (PCD-CT) is a promising new technology that provides more spectral information in medical imaging. PCD-CT enables bedside imaging in the neuro intensive care unit (neuro ICU) for patients with life-threatening conditions such as brain hemorrhage and ischemic stroke. The primary purpose of this study is to evaluate a multi-material decomposition algorithm available on PCD-CT, dubbed MD Plus, to differentiate between contrast agent and hemorrhage in hyperdense lesions. A certified multi-energy phantom was used to validate its performance with various x-ray exposure conditions and locations of contrast agent. The results from the quantitative analysis of multi-energy phantoms and the clinical cases of patients in the ICU demonstrated that MD Plus can accurately differentiate between the contrast agent and the hemorrhage. The extended MD Plus algorithm, including virtual non-contrast (VNC) and bone removal, was also validated for various clinical applications.

Developing a Green Nursing Practice in a Profession That Contributes to Climate Change: One Nurse's Journey.

The health care industry accounts for 5% of global greenhouse gas emissions, with hospitals being the largest contributor. Critical care units create 3 times the greenhouse emissions of other hospital patient care units. Health care contributions to environmental harm include medical waste disposal, toxicant exposure, and pollutants. Integrating green practices into hospitals, especially in intensive care units, can seem overwhelming, with barriers including time constraints, lack of leadership and organizational support, and ignorance of green practices. Nursing is a socially responsible discipline committed to improving the health of individuals and communities; values of environmental stewardship and the desire to minimize poor health outcomes caused by climate change do not always align with hospital policies or clinician practices. This article addresses how nurses can confront the complex environmental problems in the workplace, apply sustainability principles to develop a green nursing practice, and collectively influence the future of national and global health.

Admixture of Liposomal Bupivacaine and Bupivacaine Hydrochloride for Peripheral Nerve Blocks in Adolescents Undergoing Orthopedic Surgery: An Observational Cohort Study.

Background/Objectives: In 2021, the Food and Drug Administration approved liposomal bupivacaine injectable suspension for single-dose infiltration in patients ≥ 6 years of age. Liposomal bupivacaine and bupivacaine hydrochloride admixtures may also be administered off-label for pediatric regional anesthesia including peripheral nerve blocks (PNBs). This single-injection, long-acting technique is not well described in pediatrics but may have benefits over traditional continuous catheter-based systems. The purpose of this investigation was to examine an adolescent cohort who received liposomal bupivacaine/bupivacaine hydrochloride PNBs for orthopedic surgery. Methods: Patient, surgical, anesthetic, block characteristics, and post-anesthesia care unit (PACU) outcomes were retrospectively reviewed from February 2020 to June 2024. From February to December 2022, a short follow-up survey was conducted to assess post-discharge patient-reported outcomes. Results: There were 524 liposomal bupivacaine/bupivacaine hydrochloride PNBs (106 upper-extremity and 418 lower-extremity) performed in 374 patients with a mean (standard deviation, range) age of 16 (1.2, 11-17) years. Two unilateral PNBs were performed in 150 (40%) patients to ensure an adequate sensory neural blockade. The interscalene (n = 81, 15%) and adductor canal (n = 140, 27%) blocks were the most common upper- and lower-extremity PNBs, respectively. Intraoperatively, the majority of the cohort (n = 258, 69%) underwent monitored anesthesia care (MAC). No patient required conversion from MAC to general anesthesia due to pain. In PACU, 288 (77%) patients reported no pain. Mild and moderate pain were reported by 56 (15%) and 30 (8%) patients, respectively. No patients developed local anesthetic toxicity. The survey results (n = 66) indicate that the majority of patients (96%) were satisfied with block analgesia postoperatively. Conclusion: Liposomal bupivacaine/bupivacaine hydrochloride PNBs were used successfully in adolescents undergoing a variety of orthopedic surgeries.

The Association Between Psychological Resilience and Spiritual Well-Being Among Family Caregivers of Terminally Ill Cancer Patients: A Multicenter Cross-Sectional Study.

Purpose: This study was undertaken to determine the nature of the relationship between psychological resilience and spiritual well-being (SWB) among family caregivers (FCs) of patients with terminal cancer. Methods: This multicenter cross-sectional study included 173 FCs from nine inpatient hospice care units. SWB was assessed using the Functional Assessment of Chronic Illness Therapy-Spiritual well-being questionnaire, and various psychosocial variables, including psychological resilience, were also measured. Factors associated with SWB were identified by multivariate regression analysis adjusted for potential covariates. Results: Various factors were found to be associated with the SWB of FCs as determined by total FACIT-Sp-12 scores and the scores of its three domains. FC resilience was significantly associated with SWB as determined by total FACIT-Sp-12 scores and scores of the meaning and peace domains. Conclusion: Assessing FC psychological resilience would help palliative care providers improve their SWB.

Clinical characteristics and booster vaccine effectiveness of the Omicron variant

BackgroundAlthough many people received the COVID-19 vaccine, shortly after the Chinese government announced that the three-year COVID-19 restrictions were being eased, the first large number of Omicron infections appeared in Beijing. We describe epidemiological characteristics, clinical severity, and time-to-event distribution of patients infected with SARS-CoV-2 in Beijing Omicron outbreak, comparing those who received the booster vaccine with cases of full-course/partial-course vaccines.MethodsWe collected epidemiological, clinical, laboratory, and clinical management data from the hospital information system (HIS) for 1495 cases during Dec 2022-Jan 2023. We also collected illness onset time, diagnosis time, hospital admission time, and start and end times of each treatment. In addition, we collected the time of vaccination, inoculation times, and type of COVID-19 vaccination thorough the vaccination system. We described the epidemiological characteristics across vaccine inoculation doses, and estimated the risk of death, mechanical ventilation, and admission to the intensive care unit for patients admitted to hospital. We used the Kaplan–Meier method to estimate the survival rate and plot the survival curve, and the Cox proportional hazards model to assess the effect of covariates on survival time.ResultsOf the 1495 cases, 58.1% were male. The median ages in the non-vaccinated and vaccinated groups were 80 and 47 years. Elderly with underlying medical conditions and lower BMI less willing to vaccinate(p < 0.05). Both the inactivated vaccine and adenovirus vaccine could reduce clinical severity and prolong survival time, and the protective effect of booster vaccination was the best. The clinical severity increased linearly from the booster vaccinated group to the full-course vaccinated group and non-vaccinated groups, and the death risk of COVID-19 cases without vaccination was the highest.ConclusionBooster vaccines of COVID-19 can provide greater protection against severe illness and death, and continuous monitoring and regular assessment are needed to minimize the risk of a recurrence of the pandemic.

An earthquake reality: fasciotomy wounds and treatments

Earthquake-induced Crush Syndrome and subsequent acute kidney injury are important issues that affect morbidity and mortality. Fasciotomies prolong the length of stay in intensive care unit in patients with Compartment Syndrome due to the complications it causes. Infections and delayed wound healing are two common complications among these. Therefore, early closure of fasciotomy wounds is recommended. Although different treatments can be applied for treatment of wounds, data on this subject in pediatric patients are insufficient. We report the case of a 15-year-old girl who developed acute renal failure due to crush syndrome after being trapped in the wreckage for 9 hours and undergoing fasciotomy procedures for four locations, in the left extremity, two in the thigh and two in the cruris. Hemodialysis, antihypertensive, and antibiotic treatment were administered during the intensive care follow-up due to acute kidney injury, hypertension, and sepsis. With negative pressure therapy, silver alginate wound dressing, and hyperbaric oxygen therapy, all wounds epithelialized within two months. However, rehabilitation for drop foot syndrome caused by nerve cuts in the left extremity continues.

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.

Impact of care coordination on service utilisation for children with medically complex cerebral palsy.

Complex care programmes for children with medically complex cerebral palsy (CP) exist; however, evidence for their impact is limited. This study (i) explored the impact of The Royal Children's Hospital Complex Care Hub (CCH) on hospital service utilisation rates over a 3-year period for children with medically complex CP compared with those eligible but received routine care, and (ii) compared health, disability and socio-demographic characteristics of children and their families in both groups. Electronic medical record data from 78 children (mean age 9.43 years, females n = 37) with medically complex CP who accessed CCH services, and 92 (mean age 10.86 years, females, n = 39) who received routine care were included. Multivariable regression was used to analyse service utilisation: number of emergency department (ED) presentations, length/number of inpatient and intensive care unit admissions and number/type of hospital appointments. Critical health-care needs, functioning/disability profile and child/family demographics for each group were compared. More children in the CCH group had a mixed motor type (73.1% vs. 15.2%), were classified within Gross Motor Function Classification System level V (76.9% vs. 34.8%), had respiratory, nutrition and social support needs and epilepsy. Children receiving CCH services had higher service utilisation rates; ED presentations (rate ratio (RR) = 1.81, 95% confidence interval (CI): 1.09-3.01), inpatient admissions (RR = 2.77, 95% CI: 2.01-3.83), outpatient encounters (RR = 1.69, 95% CI: 1.31-2.18) and telephone encounters (RR = 6.05, 95% CI: 4.56-8.02). Children with medically complex CP accessing a complex care service have higher service utilisation rates yet have more complex clinical presentations and higher support needs.

Healthcare Resource Utilization and Associated Costs in Patients With Chronic Graft-Versus-Host Disease Post-Allogeneic Hematopoietic Stem Cell Transplantation in England

Limited evidence suggests chronic graft-versus-host disease (cGvHD) following allogeneic hematopoietic stem cell transplantation (allo-HSCT) increases healthcare resource utilization (HCRU) and costs. However, this burden has not been well characterized in England. This study assesses secondary care HCRU and costs for patients following allo HSCT in England with cGvHD and patients who did not develop graft-versus-host disease (GvHD). Further stratification was performed among patients who did or did not subsequently receive high-cost therapies for the treatment of cGvHD. This descriptive, retrospective cohort study used Hospital Episode Statistics (HES) data from April 2017 to March 2022. HES data captures information on reimbursed diagnoses and procedures from all National Health Service (NHS) secondary care admissions and attendances in England. High-cost drugs as defined by NHS England are recorded in HES, these drugs and other procedures including plasma exchange, were used to identify patients with cGvHD who were in receipt of high-cost therapies. HCRU and costs were described for patients with cGvHD following allo-HSCT (n = 721) and were matched with patients with no evidence of GvHD following allo-HSCT (n = 718). HCRU and costs were also described for the subset of patients with cGvHD (n = 198) following receipt of high-cost therapies and patients with cGvHD prior to or without such therapies (n = 523). A higher proportion of patients with cGvHD had at least one inpatient or intensive care unit (ICU) admission or emergency care attendance than patients without GvHD (inpatient: 74.6% versus 66.6%; emergency care: 39.3% versus 30.5%; ICU: 7.4% versus 4.7%; respectively); whilst the proportion of patients with an outpatient attendance were similar for both groups (outpatient: 80.3% versus 84.1%; respectively). The cost across all secondary care settings was higher for patients with cGvHD than patients without GvHD, with a mean cost of inpatient admissions of £17,339 per patient-year for those with cGvHD versus £8548 per patient-year in patients without GvHD. A higher proportion of patients who received high-cost therapies for the treatment of cGvHD had at least one secondary care admission or attendance, than patients who did not (inpatient: 85.4% versus 66.4%; ICU: 7.1% versus 5.4%; outpatient: 87.9% versus 76.7%; emergency care: 44.4% versus 36.5%; respectively). Patients who were treated with high-cost therapies for the treatment of cGvHD had a greater mean number (14.6 versus 8.2 per patient-year, respectively) for all-cause inpatient admissions after treatment than patients who did not. In all secondary care settings, the total cost per patient-year was higher for patients who received high-cost therapies for the treatment of cGvHD, than for those who did not. Patients who were treated with high-cost therapies for the treatment of cGvHD had a greater mean cost (£21,137 versus £15,956 per patient-year, respectively) for all-cause inpatient admissions than patients who did not. This study demonstrates that cGvHD and the use of associated high-cost therapies impacts healthcare activity and costs across various secondary care settings in England more than patients without GvHD and patients with cGvHD who received no high-cost therapies.

Noninvasive ventilation outside the intensive care unit for respiratory rehabilitation after on-pump cardiac surgery: a prospective randomized controlled trial

BACKGROUND: Сardiac surgery with cardiopulmonary bypass is associated with a high risk of postoperative respiratory complications. Perioperative damage to the lungs caused by ischemia and reperfusion, mechanical ventilation, trauma, etc., is a trigger for aseptic inflammation in the lungs, and it makes compromised lungs an easy target for infection. Actively developed methods of protecting the lungs, such as lung-protective ventilation, are limited to the perioperative and resuscitation stages and do not exhaust the entire range of respiratory support required in the later stages of postoperative hospitalization. This indicates the need for methods of respiratory rehabilitation following transfer from the intensive care unit. AIM: To evaluate the effectiveness of respiratory rehabilitation using noninvasive mask lung ventilation performed outside the intensive care unit in cardiosurgical patients compared to standard breathing exercises. MATERIALS AND METHODS: This prospective, randomized, single-center study included 60 patients aged 62±12 years who underwent cardiac surgery with cardiopulmonary bypass (86±17 min) with bypass grafting of 2±1 coronary arteries and required mechanical lung ventilation for more than 6 hours following surgery. After transfer from the intensive care unit, patients in the control group (n=30) underwent standard respiratory rehabilitation, and those in the main group (n=30) additionally received four sessions of noninvasive mask lung ventilation. RESULTS: The patients in the main group had a more rapid respiratory function recovery and, thus, reduced postoperative hospitalization time (10 [8; 15]) compared to those in the standard group (14 [13; 20]). CONCLUSION: The use of noninvasive mask lung ventilation outside the intensive care unit along with the standard respiratory activation protocol is safe and speeds up respiratory rehabilitation and reduces postoperative hospitalization of patients after coronary bypass surgery.

Staff Safety Alert Banner Program Against Workplace Violence at an Urban American Hospital.

Workplace violence (WPV) in healthcare has become an issue worldwide, with increasing prevalence after the COVID-19 pandemic. Notably, WPV in any setting has individual and systemic repercussions. However, despite extensive literature reporting the prevalence of WPV in healthcare worldwide, effective, standardized prevention policies have not been established. We developed and piloted a WPV initiative at an urban hospital in the state of Maryland. Here, we aim to describe our program development methods and implementation. The 6-month program utilized a reporting tool developed within patients' electronic medical records (EMRs) to request the display of a Staff Safety Alert (SSA) banner to alert healthcare professionals of patients who engaged in violent behavior and are at increased risk of subsequent behavior. This tool was piloted on 21 patient care units. A review committee either approved or denied case requests filed by frontline workers, with holistic consideration involving patient status, potential biases, and communication flaws. Twenty-one banner requests were filed during the course of the pilot. Of which, eight were approved, and 13 were denied. The multi-trauma intermediate care floor filed the most case requests for a safety banner. Our pilot program offers a patient-centered intervention program where extensive personnel training and patient-focused considerations were applied prior to the approval or denial of a banner display. The SSA program was the initial step in institutionally combatting WPV in healthcare as staff are encouraged to officially document unsafe events followed by careful action in response.

Effectiveness of Communication Board on Level of Satisfaction among Mechanically Ventilated Patients at Intensive Care Unit in a Tertiary Hospital

Introduction: Critical care nurses are crucial in managing critical patients, facing challenges with advanced technology, alarms, ventilators, and multiple laboratory investigations. They must effectively communicate and manage patients on mechanical ventilation (MV), a lifesaving intervention for those needing oxygenation and ventilation support to ensure patient satisfaction. Materials and Methods: The study employed a quasi-experimental design with 80 mechanically ventilated patients selected through purposive sampling. Data were collected using demographic and clinical pro forma and a predesigned four-point Likert satisfaction scale comprised 14 items. The intervention group utilized a communication board, while the conventional group received routine care. The aim was to evaluate satisfaction levels in both groups, followed by a posttest on the 5th day using the same instrument. Results: The pretest revealed mean satisfaction scores of 32.47 ± 6.48 and 33.95 ± 6.41 for the intervention and conventional groups, respectively, with a mean difference of 1.47, considered statistically nonsignificant (t 78 = 1.023, P = 0.310). Conversely, posttest scores showed 37.85 ± 8.23 and 34.32 ± 6.18 for the intervention and conventional groups, respectively, with a mean difference of 3.53, indicating statistical significance (t 78 = 2.164, P = 0.034). Hence, the communication board intervention significantly enhanced satisfaction scores among mechanically ventilated patients, underscoring its positive impact on nursing care in terms of patients’ satisfaction. Conclusion: Effective communication is crucial in intensive care unit patient care, especially for those unable to speak due to MV. Utilizing communication boards significantly enhances patient satisfaction, highlighting the need for ongoing innovation in critical care nursing.

The influence of organizational agility on nurses` career planning: nurses` grit as a mediating factor

BackgroundOrganizational agility is the cornerstone of the complex dynamics for the success of healthcare organizations and the sustenance of nurses’ career planning and professional development.AimAssess the organizational agility and the extent of nurses’ career planning. It also sought to investigate the association between the two and the intermediating function that nurses` grit plays in this association.DesignA cross-sectional descriptive design following STROBE guidelines was carried out.Methods and toolsData were collected from 300 nurses who made up the entire population sample that we used (a judgmental non-probability sampling technique) working across all in-patient care units at Itay El-Baroud General Hospital, in El Behaira governorate, using structured questionnaires as follows: the organizational agility questionnaire, the career planning scale, and the grit scale. The sociodemographic characteristics of the studied nurses were also collected. Statistical analyses were used to analyze the data, including ANOVA, Pearson correlation, and SEM, to determine whether career development may act as a mediator between organizational agility and the nurses’ career planning.ResultsRendering the findings of this study, more than half of nurses have a high perception regarding organizational agility and career planning. In contrast, the majority of them have a moderate perception regarding grit. In addition, there is a statistically high significant relationship between organizational agility and career planning. Also, there is a statistically high significant relationship between organizational agility and grit. There is a statistically high significant relationship between career planning and grit.ConclusionThe statistically substantial correlations among grit, career planning, and organizational agility demonstrate how interrelated they are. This implies that encouraging organizational flexibility and effective career planning techniques may have a good impact on nurses’ resilience, which would ultimately result in a workforce of nurses who are more resilient and engaged. Additional investigation into the precise mechanisms behind these associations may yield important information for improving nurse wellbeing and retention.Nursing implicationsAccording to this study, putting organizational agility and career planning first can have a good impact on nurses’ grit, which will make them more resilient and engaged workers. To encourage flexibility and growth among nurses, healthcare institutions should make training investments, provide clear career tracks, and support work-life balance. More investigation into the precise mechanisms underlying these connections may yield insightful information that improves nurse well-being and retention. The importance of organizational agility in creating a supportive work environment for nurses’ career growth should be acknowledged by healthcare companies. This can lead to increased job satisfaction and lower turnover.

Cooperation across healthcare service levels for medication reviews in older people with polypharmacy admitted to a municipal in-patient acute care unit (The COOP II Study): study protocol for a randomized controlled trial

BackgroundPolypharmacy and inappropriate drug use are associated with adverse health outcomes in older people. Collaborative interventions between geriatricians and general practitioners have demonstrated effectiveness in improving clinical outcomes for complex medication regimens in home-dwelling patients. Since 2012, Norwegian municipalities have established municipal in-patient acute care (MipAC) units, designed to contribute towards reducing the number of hospital admissions. These units predominantly serve older people who typically benefit from multidisciplinary approaches. The primary objective of this study is to evaluate the effect of cooperative medication reviews conducted by MipAC physicians, supervised by geriatricians, and in collaboration with general practitioners, on health-related quality of life and clinical outcomes in MipAC patients ≥ 70 years with polypharmacy. Additionally, the study aims to assess the carbon footprint of the intervention.MethodsThis is a randomized, single-blind, controlled superiority trial with 16 weeks follow-up. Participants will be randomly assigned to either the control group, receiving usual care at the MipAC unit, or to the intervention group which in addition receive clinical medication reviews that go beyond what is considered usual care. The medication reviews will evaluate medication appropriateness using a structured but individualized framework, and the physicians will receive supervision from geriatricians. Following the clinical medication reviews, the MipAC physicians will arrange telephone meetings with the participants’ general practitioners to combine their assessments in a joint medication review. The primary outcome is health-related quality of life as measured by the 15D instrument. Secondary outcomes include physical and cognitive functioning, oral health, falls, admissions to healthcare facilities, and mortality.DiscussionThis study aims to identify potential clinical benefits of collaborative, clinical medication reviews within community-level MipAC units for older patients with polypharmacy. The results may offer valuable insights into optimizing patient care in comparable municipal healthcare settings.Trial registrationThe study was registered prospectively on ClinicalTrials.gov 30.08.2023 with identifier NCT06020391.