Effective Health Care Delivery Research Articles

The Effectiveness of Telemedicine Technology in Supporting Health Access in Remote Areas Post-Pandemic

The COVID-19 pandemic highlighted the critical need for effective healthcare delivery systems, especially in remote areas with limited access to medical services. Telemedicine technology emerged as a transformative tool during this period, enabling healthcare providers to continue offering essential services despite physical distancing measures. This paper investigates the effectiveness of telemedicine in supporting healthcare access in remote areas post-pandemic. Using a qualitative approach, the study conducts a comprehensive literature review, analyzing academic articles, reports, and case studies from the last five years to evaluate the impact of telemedicine on healthcare delivery in underserved regions. The research identifies key benefits such as increased accessibility to healthcare services, reduced healthcare costs, and the ability to offer specialized care remotely. However, it also highlights challenges such as technological barriers, digital literacy, and concerns related to patient privacy and data security. The findings suggest that while telemedicine has proven to be effective in improving healthcare access, its success is contingent on addressing these challenges through adequate infrastructure, digital literacy programs, and regulatory frameworks. This study concludes by offering recommendations for policymakers and healthcare providers to enhance telemedicine adoption, ensuring that its potential to support health access in remote areas is fully realized. The paper emphasizes the importance of integrating telemedicine into broader healthcare systems to foster long-term sustainability and inclusivity in healthcare delivery.

Assessing the factors militating against the effective implementation of electronic health records (EHR) in Nigeria

This study assessed the factors militating against the effective implementation of electronic health records (EHR) in Nigeria, the computerization of patients’ health records with a lot of benefits including improved patients’ satisfaction, improved care processes, reduction of patients’ waiting time, and medication errors. Despite these benefits, healthcare organizations are slow to adopt the EHR system. Therefore, the study assessed the factors militating against the effective implementation of the EHR system, the level of awareness of EHR, and the utilization of electronic health records; it also investigated the factors militating against the effective implementation of EHR. This is a descriptive cross-sectional study conducted among members of staff of the University of Medical Sciences Teaching Hospital (UNIMEDTH). Purposive sampling was adopted to select the study participants, and a structured questionnaire was used for data collection. Statistical Product and Service Solutions (SPSS) version 27 was used for data analysis, R and Microsoft Excel were used for data visualization. Findings revealed that the respondents had a high level of awareness of EHR with an average mean of 1.29. The study revealed a low utilization rate for EHR (mean 3.01, SD 0.115) and data storage (mean 3.00, SD 0.231), indicating major problems with EHR implementation. Financial limitations (mean 2.63, SD 0.486) and insufficient ICT resources (mean 2.62, SD 0.516) are the main challenges. The regression analysis revealed that EHR utilization is highly impacted by awareness (F = 4.26, p < 0.008), accounting for 15.1% of the variance. Governmental assistance and financial constraints showed a statistically significant negative correlation (r=−0.04, p < 0.05), while inadequate internet connectivity and epileptic power supply showed a statistically significant positive association (r = 0.1, p < 0.05). The results show that, more government support is needed to alleviate financial constraints, and a stable power supply may enhance internet accessibility. The study concluded that epileptic power supply, poor internet connectivity, financial constraints, and other factors mentioned in the study militate against the effective implementation of electronic health records. It was recommended that the management should implement electronic health records effectively for efficient and effective health care delivery.

Optimizing the Fulfillment of Prisoners' Health Rights: A Case Study at Class IIA Correctional Facility

This study explores the fulfillment of health rights for inmates at the Class IIA Watampone Correctional Facility, focusing on the provision of adequate healthcare services and the challenges faced in ensuring prisoners' health rights. Despite the legal frameworks guaranteeing the right to health for all citizens, including inmates, significant discrepancies remain in the quality of healthcare provided in correctional facilities. Using an empirical approach, this research examines the existing healthcare systems, resources, and challenges in the prison environment, relying on observations and interviews with correctional officers and healthcare personnel. The study highlights the impact of overcrowding, insufficient healthcare staff, and lack of specialized services as key barriers to effective healthcare delivery. It also emphasizes the need for increased investment in medical infrastructure, staff training, and collaboration with national health systems to address these challenges. The findings underscore the importance of meeting the healthcare needs of inmates to fulfill legal obligations, improve rehabilitation outcomes, and promote public health. The study concludes with recommendations for improving healthcare conditions in prisons to ensure that inmates receive the care they are entitled to, which is crucial for their reintegration into society and the reduction of recidivism.

Oral and Systemic Health in Older Adults: The Imperative Role of Nurses and Dentists in Integrated Smoking Cessation Programs

Background: Oral health is a critical component of overall health, particularly in older adults who face increased risks of oral and systemic diseases. Despite the preventability of many oral disorders, significant disparities exist, exacerbated by factors such as age, socioeconomic status, and access to care. Smoking and other lifestyle choices further complicate these health challenges. Methods: This review synthesizes current literature on the integration of oral health into general healthcare systems for elderly populations. A comprehensive analysis of studies from databases such as PubMed and Google Scholar was conducted, focusing on the roles of dental and nursing professionals in smoking cessation programs and their impact on oral and systemic health. Results: Findings indicate that incorporating oral health into general healthcare services significantly improves health outcomes for older adults. Dental practitioners are essential in advocating for smoking cessation, which can mitigate risks of periodontal disease and other systemic conditions. The review highlights various strategies for integration, including multidisciplinary cooperation, patient education, and addressing common risk factors. Conclusion: The integration of oral health into overall healthcare is vital for enhancing the health of older individuals. By addressing shared risk factors and fostering collaboration among healthcare providers, it is possible to reduce the prevalence of oral disorders and improve quality of life. Policymakers and health organizations must prioritize these strategies to ensure effective healthcare delivery for aging populations

Unlocking Success: Determining Predictors of High-Performance among COMBI Community Health Volunteers in Kuala Lumpur and Putrajaya

Background: Community Health Volunteers (CHVs) are crucial in achieving universal health coverage and vital in public health activities, including the COMBI (Communication for Behavioral Impact) approach for dengue prevention and control and assessing the performance of COMBI CHVs are essential in evaluating the program effectiveness. We aimed to measure the level of performance and determine predictors of high-performance among COMBI CHVs in Kuala Lumpur and Putrajaya. Methods: A cross-sectional study was conducted in 2023 among 285 COMBI CHVs from 5 health operational zones in Kuala Lumpur and Putrajaya. The CHVs were stratified proportionately, with 45.5% of respondents randomly selected from each stratum based on their zones. Self-administered questionnaires assessed their performance level and associated factors, including training, supervision, knowledge, motivation, and job satisfaction. Chi-square and Multiple Logistic Regression tests were used to determine the factors and predictors of high-performance COMBI CHVs. Results: The prevalence of high-performance COMBI CHVs was 59.3%, significantly associated with training factors (experience, duration, and adequacy of training), supervision factors (being supervised, supervision frequency, and encouragement from supervision), motivation and job satisfaction level. As for significant predictors, having at least one day of training (AOR=14.557), being supervised by medical personnel (AOR=4.997), having a high motivation level (AOR=5.538) and having a high job satisfaction level (AOR=4.562) were more likely to have a high-performance level. Conclusion: Training duration, supervisor background, motivation and job satisfaction can contribute to high-performance levels among COMBI CHVs, which can applied in evidence-based policies and strategies for performance improvement and more effective community healthcare delivery.

A Review on Patient Counselling

Patient counseling is a fundamental component of modern healthcare that aims to improve patient understanding, adherence, and satisfaction with treatment plans. This review explores the various facets of patient counseling, including its definition, significance, methods, challenges, and potential advancements. Effective counseling involves a structured approach encompassing initial interactions, information dissemination, and follow-up sessions, all aimed at addressing the unique needs of each patient. The importance of patient counseling cannot be overstated, as it directly impacts health outcomes, reduces the risk of complications, and enhances the quality of life. By fostering open communication and trust, healthcare professionals can empower patients to take an active role in managing their health. However, barriers such as language differences, limited time, low health literacy, and psychological factors often hinder effective counseling. To overcome these challenges, strategies like cultural sensitivity, the use of technology, and improving communication skills are vital. Integrating digital tools such as telemedicine, mobile apps, and educational videos has significantly enhanced the counseling process, making it more interactive and accessible. Furthermore, continuous professional development programs for healthcare providers are essential to equip them with advanced skills and updated knowledge for better patient interaction. This review highlights the evolving role of patient counseling in a rapidly changing healthcare landscape. It underscores the need for personalized and culturally appropriate approaches to ensure optimal patient engagement and outcomes. By addressing existing challenges and adopting innovative methods, patient counseling can continue to be a cornerstone of effective healthcare delivery, fostering a collaborative and patient-centered approach.

Using Natural Language Processing and Social Media Data to Understand the Lived Experience of People with Fibromyalgia.

Fibromyalgia has many unmet needs relating to treatment, and the delivery of effective and evidence-based healthcare is lacking. We analyzed social media conversations to understand the patients' perspectives on the lived experience of fibromyalgia, factors reported to trigger flares of pain, and the treatments being discussed, identifying barriers and opportunities to improve healthcare delivery. A non-interventional retrospective analysis accessed detail-rich conversations about fibromyalgia patients' experiences with 714,000 documents, including a fibromyalgia language tag, which were curated between May 2019 and April 2021. Data were analyzed via qualitative and quantitative analyses. Fibromyalgia conversations were found the most on Twitter and Reddit, and conversation trends remained stable over time. There were numerous environmental and modifiable triggers, ranging from the most frequent trigger of stress and anxiety to various foods. Arthritis and irritable bowel syndrome (IBS) were the most frequently associated comorbidities. Patients with fibromyalgia reported a wide range of symptoms, with pain being a cardinal feature. The massage, meditation and acupuncture domains were the most reported treatment modalities. Opportunities to improve healthcare delivered by medical providers were identified with current frustration relating to a lack of acknowledgement of their disease, minimization of symptoms and inadequately meeting their care needs. We developed a comprehensive, large-scale study which emphasizes advanced natural language processing algorithm application in real-world research design. Through the extensive encapsulation of patient perspectives, we outlined the habitual symptoms, triggers and treatment modalities which provide a durable foundation for addressing gaps in healthcare provision.

Hospital-based health technology assessment of a screening rapid test MTBI (GFAP and UCH-L1 blood biomarkers) for mild traumatic brain injury.

The assessment of technology in hospital settings is a crucial step towards ensuring the delivery of efficient, effective, and safe healthcare. This study conducts a Hospital-Based Health Technology Assessment to evaluate the efficacy of a screening rapid test for mild Traumatic Brain Injury (mild TBI) utilizing blood biomarkers, specifically Glial Fibrillary Acidic Protein (GFAP) and Ubiquitin C-terminal Hydrolase L1 (UCH-L1). The assessment focuses on the clinical utility and performance characteristics of the proposed rapid test within a hospital setting. The screening model was meticulously examined for its ability to accurately detect mild TBI, considering the sensitivity and specificity of GFAP and UCH-L1 as blood biomarkers. The study involved a thorough evaluation of the test's diagnostic accuracy, comparing its outcomes with established standards for mild TBI diagnosis.Results from the Hospital-Based Health Technology Assessment highlight the potential of the GFAP and UCH-L1 blood biomarker-based rapid test as an efficient screening tool for mild TBI within a hospital environment. The evidence results show that the test is highly sensitive (91 percent to 100 percent) for the prediction of acute traumatic intracranial lesions, which helps rule out injury when the result is negative. When used within 12hours of injury in adult patients with mild TBI, this test holds promise in reducing the utilization of CT. The findings contribute valuable insights into the feasibility and reliability of implementing this technology for timely and accurate identification of mild TBI, enhancing clinical decision making and patient care in hospital settings.

Critical Analysis of Foundational Challenges in Modern Healthcare Systems

The various components of the present-day healthcare delivery system are multidimensional and require a vigorous response to the request for effective healthcare delivery, management and direction of healthcare workers, and formulation of policies and strategies on the use of technology, among others. This paper examines a few of the foundational issues all healthcare systems experience, which stifle their efficiency as healthcare advances. This paper critically evaluates the following significant challenges facing twenty-first-century healthcare: Workforce Challenges, Service Delivery, Financial Viability and Technological Incorporation. Based on the effects of these challenges on the quality and availability of health services, this paper provides solutions to these challenges to enhance the quality of health care around the globe. Recent and case studies are explored, and their findings are described to provide an overall view of these problems and their possible solutions.

AI-driven optimisation of EHR systems implementation in Tanzania’s primary health care

Purpose This study aims to explore how artificial intelligence (AI) can be used to overcome the challenges associated with implementing electronic health record (EHR) systems in primary health-care facilities in Tanzania. It aims to assess the technological, organisational and environmental barriers to EHR system implementation and investigate the role of AI in optimising these systems for more effective health-care delivery. Design/methodology/approach The study adopts a qualitative approach, using case studies from five regions in Tanzania: Dar es Salaam, Mwanza, Morogoro, Singida and Pwani. Data were collected through 26 semi-structured interviews with health-care providers, including medical doctors, nurses, pharmacists and IT personnel. The study applied the diffusion of innovation (DOI) theory and the technology-organisation-environment framework to assess the factors affecting EHR implementation and the potential integration of AI to enhance these systems. Findings Key challenges include unreliable network connectivity, frequent power outages, insufficient training and complex system usability issues. Despite these challenges, EHR systems have improved patient data accessibility and workflow efficiency. AI presents opportunities to address these challenges, mainly through predictive analytics, AI-driven encryption for data security and personalised training modules. AI integration can enhance system reliability, usability and security, ultimately improving health-care outcomes. Originality/value This study provides valuable insights into integrating AI to optimise EHR systems in resource-constrained environments like Tanzania. It addresses a gap in the literature by focusing on how AI can be adapted to low-resource settings and provides a framework for future EHR system implementations in similar contexts. The findings contribute to the global discourse on health-care informatics and the role of AI in improving health-care systems in developing countries.

Exploring telemedicine and organizational challenges in the healthcare system: a qualitative analysis using Grounded Theory.

Telemedicine is a context-specific intervention that implies significant procedural changes in a health organization. The objective of the study is to explore healthcare professionals' usage of and perceptions towards telemedicine technology and identify the perceived factors and related process change, influencing the effective adoption of telemedicine from an organizational perspective. The study includes multi-disciplinary commentaries of a purposive sample of 31 healthcare professionals, conducted through semi-structured qualitative interviews and employs Grounded Theory and Thematic Analysis techniques to analyze the data. Telemedicine is perceived as a highly beneficial digital intervention in healthcare, focusing on the delivery of effective healthcare, and promoting healthcare equity. Healthcare professionals showed their willingness to assimilate technology into clinical decision-making, resulting in better treatment outcomes, and recommended its' adoption into mainstream healthcare as a viable approach to providing remote healthcare. The key organizational issues with telemedicine adoption were system requirements, network connectivity, non-standardized medical records, and legal bottlenecks, that can be addressed by improving infrastructural convenience, optimizing service processes, imparting training, and adopting better technical measures. The focus is on exploring factors significant for the adoption of telemedicine technology from the perspective of multi-specialties in a health organization, rather than a specific specialty, as studied in previous scholarly work. This study contributes to the theory by proposing a conceptual framework on critical factors for telemedicine adoption, integrating the theory of planned behavior (TPB) and diffusion of innovation (DOI).

Evaluating the usability of Iran’s national comprehensive health information system: a think-aloud study to uncover usability problems in the recording of childcare data

IntroductionHealth information systems play a crucial role in the delivery of efficient and effective healthcare. Poor usability is one of the reasons for their lack of acceptance and low usage by users. The aim of this study was to identify the usability problems of a national comprehensive health information system using the concurrent think-aloud method in the recording of childcare data.MethodsA descriptive cross-sectional study was conducted in the health centers of Kashan University of Medical Sciences, Iran, in 2020. Ten healthcare providers as system's users were purposively selected to evaluate the system. To identify problems, a concurrent think-aloud evaluation was conducted. Two administrators of the system designed scenarios for ten childcare data recording tasks. By analysing the recorded files, usability problems were identified. The severity of the problems was then determined with the help of the users and problems were assigned to usability attributes based on their impact on the user.ResultsA total of 68 unique problems were identified in the system, of which 47.1% were rated as catastrophic problems. The participants assigned 47 problems (69%) to the user satisfaction attribute and 45 problems (66%) to the efficiency attribute; they also did not assign any problems to the effectiveness attribute.ConclusionThe problems identified in the national comprehensive health information system using the think-aloud method were rated as major and catastrophic, which indicates poor usability of this system. Therefore, resolving the system problems will help increase user satisfaction and system efficiency, allowing more time to be spent on patient care and parent's education as well as improving overall quality of care.

Considering patient-centred care and patient empowerment as essential to quality health care delivery in Ghana.

Rising cases of non-communicable diseases (NCDs), poor health choices, mistrust of the health system, self-medication, resistance of diseases to medication and dissatisfaction with the service experience serve as red flags on the path to Universal Health Coverage (UHC). This study explored the importance of patient-centred care (PCC) and patient empowerment (PE) within the context of healthcare service delivery in Ghana. The study considered PCC and PE from the perspective of three public healthcare facilities within the Greater Accra region. The researcher adopted a qualitative exploratory research approach. The study employed purposive sampling for the selection of healthcare facilities and healthcare providers. Convenience sampling was applied to select patient participants. A total of 33 in-depth interviews and 4 focus group discussions (FGDs) were conducted across the three sampled facilities as part of the data collection process. Healthcare providers and patients unanimously view quality as essential for effective healthcare delivery. The application of the capacitating role of PE and PCC is inexact and largely left to subjective interpretation. The Ministry of Health (MOH) has recognised that patient experiences, a key indicator of care quality, have often been suboptimal and is actively working to address these weaknesses. This study supports the call for health systems to remain committed to efforts to achieve UHC, with a focus on PCC and PE.

Exploring patient loyalty in telemedicine through bibliometric analysis and future horizons

Purpose In an era of rapid telemedicine expansion, patient loyalty is paramount for effective health-care delivery. This study aims to understand loyalty behaviours in telemedicine to refine services. The primary objectives are to elucidate the current state of scholarly inquiry concerning loyalty within the telemedicine sphere and to address existing research deficiencies within this domain. This exploration seeks to provide valuable insights and contribute to the advancement of knowledge in this critical area of inquiry. Design/methodology/approach This study uses a bibliometric analysis to investigate patient loyalty in telemedicine. By reviewing existing literature and analysing bibliometric data, the research identifies key deficiencies and addresses pertinent research questions within the telemedicine loyalty domain. This methodological approach aims to offer a comprehensive understanding of the current state of research and highlight areas requiring further investigation. Findings This study reveals significant gaps in existing research on telemedicine loyalty, identifying a need for more focused studies on patient loyalty behaviours. Through a bibliometric analysis, the findings highlight critical areas for improvement and potential strategies for enhancing patient loyalty in telemedicine. These insights are crucial for refining telemedicine services and ensuring effective health-care delivery. Research limitations/implications The findings may not capture all dimensions of patient loyalty in telemedicine, requiring further empirical studies. Future research should expand on these limitations by incorporating diverse methodologies and broader data sets to validate and extend the study’s insights. Practical implications The insights from this study can help health-care providers refine their telemedicine services to enhance patient loyalty. By understanding loyalty behaviours, providers can develop targeted strategies to improve patient satisfaction and retention. These practical implications are essential for the continuous improvement of telemedicine services, ensuring they meet patient needs and expectations effectively. Social implications Enhancing patient loyalty in telemedicine leads to significant societal benefits, particularly by improving health-care access for underserved populations in rural or economically disadvantaged areas. Continuous and trusted care helps reduce health-care disparities and fosters health equity, positively impacting quality of life through timely medical consultations. In the context of medical tourism, telemedicine facilitates reliable remote consultations, boosting confidence in health-care systems abroad and benefiting local economies. In addition, tourists can access health-care services while travelling, enhancing their sense of safety and well-being. Overall, these advancements highlight telemedicine’s potential to create a more equitable and accessible health-care landscape. Originality/value This study fills a critical gap in telemedicine research by focusing on patient loyalty, an area often overlooked in existing literature. The bibliometric analysis offers a novel approach to understanding and addressing loyalty behaviours. The findings contribute valuable knowledge, advancing the discourse on telemedicine loyalty and providing a foundation for future research and service improvements.

Effects of COVID-19 pandemic on psychiatric and psychological consultation-liaison contacts in a general hospital in North-East of Italy: a retrospective study.

The COVID-19 pandemic has prompted significant changes in healthcare, particularly affecting psychiatric and psychological Consultation-Liaison (CL) services in general hospital settings. To assess the effects of COVID-19-related restrictions on utilization of psychiatric and psychological CL services in Northeast Italy during 2020, and to compare it to the use of services in the previous year (2019). The study collected data on psychiatric and psychological consultations in 2019 and 2020 from a hospital database. It categorizes consultations by type of patient (inpatient or outpatient) and referral source (hospital wards, general practitioners, other specialists). Pandemic-related restrictions were classified as "lockdown," "intermediate restrictions," and "no or reduced restrictions" based on the Covid Stringency Index (CSI). Poisson regression models were employed to analyze the data. The findings reveal a significant 28% increase in the number of psychiatric and psychological consultations in 2020. Consultations for outpatients increased by 51%, while those for inpatients decreased by 11%. However, the lockdown and intermediate restriction phases were deemed responsible of a decrease of 42.9% and 19.5% in consultations respectively. This study highlights the persistent psychological burden during the COVID-19 pandemic, alongside reduced CL services due to lockdown measures. Integrating telemedicine into these types of services becomes imperative for meeting patient needs during restrictions. These findings can inform policies and practices to improve effective mental health care delivery during and beyond pandemics. Future research should explore the impact of pandemic-related restrictions on mental healthcare across settings and clinical factors affecting service accessibility.

Pandemic and brain-drain in Africa: assessing the impact of the COVID-19 outbreak on ‘capital flight’ of Nigeria’s health workers

ABSTRACT Human Capital flight has become notable in the healthcare workforce in the post-COVID-19 era with a significant impact on effective healthcare delivery in Nigeria. This article examines the push and pull factors responsible for the drastic increase of human capital flight in the health sector during/after the COVID-19 pandemic. Relying on both primary and secondary methods of data collection applying interpretive qualitative method for data analysis, the study argues that stopping brain-drain in Nigeria will be a mirage if Nigerian healthcare professionals are not motivated with sufficient retention mechanisms through a significant pay increase and an enabling working environment, among other social benefits.

Review of Manpower Management in Healthcare System: Strategies, Challenges, and Innovations.

Hospital manpower management (HRM) is vital for effective healthcare delivery. Unique challenges, such as managing diverse staff, ensuring clear communication, and optimizing resources, complicate HRM. Rising operational costs, workforce shortages, and employee burnout necessitate strategic approaches to manpower management. This review aims to provide a comprehensive understanding of manpower management in hospitals, focusing on identifying core components and discussing innovative strategies to address current challenges, particularly those related to workforce shortages. A literature review was conducted using databases such as PubMed, Scopus, and Google Scholar. Key terms included "hospital manpower management", "HRM challenges in healthcare", and "workforce shortages", selected for their relevance to the core focus of this review. Relevant articles published from 2019 to 2023 were selected for analysis. The review identified core components of manpower management: recruitment and staffing, workforce planning, training and development, performance management, and compensation and benefits. Strategies to address workforce shortages included strategic hiring and enhancing employee engagement. The integration of technology and ongoing training emerged as critical for maintaining high-quality patient care. Effective manpower management is essential for the sustainability of healthcare systems. This review highlighted the importance of innovative HRM strategies to tackle workforce shortages and improve employee satisfaction. By focusing on comprehensive HRM practices, healthcare organizations could enhance workforce efficiency and provide better patient care. Future research should explore the long-term impacts of these strategies on healthcare.

Managing an adolescent with Type 1 Diabetes and socioeconomic deprivation in a remote primary care setting — Ethical challenges

This case study discusses the ethical challenges encountered by a primary care team in managing a 17-year-old girl with Type 1 diabetes in a socio-economically deprived tribal area. The case highlights critical issues such as justice in access to essential medicines, ethical dilemmas arising from complex family dynamics, and systemic failures within the public health system. By examining these challenges, this case study underscores the importance of addressing broader social determinants of health to ensure just and effective healthcare delivery in rural and tribal settings.

4.C. Scientific session: Navigating through complex challenges of responding to outbreaks of multidrug-resistant organisms

Abstract Antimicrobial resistance is one of the top ten global public health threats according to the WHO, contributing to millions of deaths each year. While outbreaks of multidrug-resistant organisms (MDROs) are well studied in hospital and nursing home settings, knowledge gaps exist concerning the complex challenges of outbreaks of MDROs among vulnerable patient populations, such as patients with intellectual disabilities or elderly patients living longer at home with multiple comorbidities. The coordination of such outbreaks requires a multidisciplinary approach as these patients often receive care throughout different healthcare settings, including long-term care and home-based nursing care. We delve into the complexities of coordinating an MDRO outbreak response involving healthcare professionals from various healthcare settings. The challenges inherent to the coordination of multidisciplinary involvement and the use of innovative strategies for outbreak preparedness and surveillance, will be thoroughly examined based on scientific evidence and practice based experiences. Workshop objectives • To exchange experiences on managing cross-institutional outbreaks of MDROs • To foster deeper understanding of the complexities of multidisciplinary involvement during MDRO outbreaks among vulnerable patient populations The workshop structure: - A brief introduction will be provided on the generic challenges in providing long-term care to vulnerable patient populations carrying MDROs. We will subsequently illustrate potential challenges faced during a cross-institutional MDRO outbreak among these patients through a realistic scenario (5 min): A patient with severe intellectual and physical disabilities living in both a long-term care facility as well as with family at home, unexpectedly turns out to be carrying an MDRO after recent hospital admission. As the patient receives nursing care from both from family members and nursing staff in different healthcare settings, a cross-institutional MDRO outbreak has occurred requiring a coordinated response. - Hereafter, individual presenters will address evidence- and experience-based challenges faced in MDRO outbreak responses within the specific healthcare settings covered in the previously presented scenario. We will navigate through the scenario together with the participants, discussing practical and ethical dilemmas, and explore ways for containing the MDRO outbreak while maintaining effective and compassionate healthcare delivery. In addition, we will discuss the use of public health innovations, such as social network analysis as a basis for the development of a stress test exercise to improve preparedness for MDRO outbreaks, and the role of wastewater surveillance in MDRO outbreaks. Discussions will be facilitated by (online) voting tools to invite participants to exchange experiences (40 min). We conclude with an exciting quiz to summarize the key messages of this workshop (10 min). Key messages • Healthcare setting, knowledge, proportionality and well-being of vulnerable patients populations are important to acknowledge during cross-institutional MDRO outbreaks. • Novel stress test exercise and wastewater surveillance are potential methods to improve preparedness and surveillance, respectively, during cross-institutional MDRO outbreak responses.

Information Needs and Seeking Behavior of Nurses for Effective Health Care Delivery: A Case Study of Federal Medical Center, Owerri.

Information Needs and Seeking Behavior of Nurses for Effective Health Care Delivery: A Case Study of Federal Medical Center, Owerri.