Frontline Healthcare Providers Research Articles

Future Nurses in a Changing Climate: Exploring the Relationship Between Environmental Literacy and Climate Anxiety.

Climate change significantly impacts public health, increasing the prevalence of respiratory, cardiovascular and mental health issues. Nurses, as frontline healthcare providers, need strong environmental literacy to manage these health challenges. This study explores how environmental literacy among nursing students relates to climate anxiety, aiming to improve educational strategies and mental health support for future nurses. Is to investigate how environmental literacy among nursing students affects their levels of climate anxiety. A cross-sectional survey was utilised on a representative sample of 620 nursing students from each academic year. Climate anxiety scale and the environmental literacy scale for adults were used to collect data. Environmental literacy and its components were positively linked to cognitive-emotional and functional impairments and climate anxiety. Gender differences were observed, with females experiencing higher climate anxiety. Increased environmental literacy generally reduced climate anxiety, particularly in females, emphasising gender differences in environmental literacy's impact on climate anxiety. Despite the model's low explanatory power (R2 = 0.026), the findings highlight the importance of gender differences in the relationship between environmental literacy and climate anxiety. Nursing students show promise in their environmental knowledge but face significant climate anxiety. Gender differences in anxiety levels warrant attention. Addressing these concerns is crucial for preparing nurses to effectively address climate change's health effects and ensuring a resilient healthcare system. The study underscores the importance of integrating environmental literacy into nursing education and promoting pro-environmental behaviours among nursing students and professionals. It highlights the crucial role of mental health support services, policy advocacy and ongoing research in addressing climate anxiety and preparing nurses to tackle the health impacts of climate change. No patient or public involvement.

Knowledge and Attitude regarding Cardio Pulmonary Resuscitation (CPR) among Nurses in Bangladesh

Cardiac arrest remains a leading cause of mortality worldwide. The effective management of cardiac arrest requires a thorough understanding of cardiopulmonary resuscitation (CPR) techniques. As frontline healthcare providers, nurses are pivotal in identifying cardiac arrest and initiating CPR. This study aimed to evaluate the level of knowledge and attitude regarding CPR among nurses at Chittagong Medical College Hospital (CMCH), Bangladesh. A descriptive cross-sectional study was conducted involving government-registered nurses employed at CMCH. A convenience sampling method was employed to select participants. Data were collected using self-administered semi-structured questionnaires. The study found that 68.1% of the nurses had a diploma in nursing and limited experience in CCU/ICU and emergency departments. Furthermore, 76% of the nurses had not received CPR training. Only 1.4% of the participants exhibited good knowledge of CPR, 37.2% had an average level of knowledge, and 61.5% demonstrated poor knowledge. Regarding attitudes towards CPR, 24% of the nurses had a good attitude, while 76% had an average attitude. The findings indicate that nurses at CMCH possess inadequate knowledge of CPR despite a moderate attitude towards its practice. This study provides foundational data that could guide efforts to enhance CPR training and knowledge among nurses in Bangladesh.

Infertility Prevention and Health Promotion: The Role of Nurses in Public Health Initiatives.

Infertility is a growing public health concern, affecting millions of individuals and couples worldwide. Despite advancements in medical treatments, prevention remains a critical strategy for reducing the burden of infertility. Nurses, as frontline healthcare providers, play a pivotal role in infertility prevention and health promotion, particularly through public health initiatives. This review aims to explore the diverse roles of nurses in infertility prevention and their contributions to public health strategies. A review of existing literature was conducted to examine the epidemiology of infertility, key risk factors, and the preventive measures that can be employed by nursing professionals. Emphasis is placed on the role of nurses in health education, screening, early detection, and community-based interventions, which are essential in reducing infertility rates. In addition, this review identifies barriers that impede effective nurse-led infertility prevention, such as disparities in access to care, cultural sensitivity challenges, and policy constraints. Evidence suggests that nurses are well-positioned to lead public health campaigns, conduct reproductive health counseling, and advocate for policy reforms to improve infertility prevention. The review concludes with recommendations for future research, suggesting enhanced nursing education and training, as well as the need for stronger integration of nurses into public health policy-making. This study underscores the critical role of nurses in promoting reproductive health and preventing infertility, advocating for their inclusion in comprehensive public health strategies aimed at addressing infertility on a global scale.

Pharmacists' Knowledge, Perception, and Prescribing Practice of Probiotics in the UAE: A Cross-Sectional Study.

The human body is a complex and interconnected system where trillions of microorganisms, collectively known as the gut microbiota, coexist with these cells. Besides maintaining digestive health, this relationship also impacts well-being, including immune function, metabolism, and mental health. As frontline healthcare providers, pharmacists are pivotal in promoting the benefits of probiotics for immune support. This study explored pharmacists' knowledge, perception, and practice behavior in the UAE towards the implication of probiotic application beyond digestive health, such as cardiovascular and mental health impacts and their diverse dosage forms. An online self-administered survey was distributed among pharmacists in the UAE. Data were collected through personal visits to pharmacies, where pharmacists were approached and asked to complete the questionnaire. The sample size included 407 pharmacists, determined using the formula for proportions with a 95% confidence level and a 5% margin of error. Statistical analysis was performed using SPSS version 29. Descriptive statistics were used to summarize demographic characteristics and survey responses. The knowledge levels were categorized into poor, moderate, and good. Chi-square analysis was employed to investigate associations between demographic factors and knowledge levels, with a significance level set at p < 0.05, enhancing the robustness of the study's findings. This study included 407 completed eligible responses. About 63.56% of participants were female, with 52.1% employed in pharmacy chains. While 91.2% of pharmacists recognized probiotics' role in immune support, only 30% were aware of their cardiovascular benefits. Moreover, chewing gum was the least known dosage form of probiotics, recognized by only 16.7% of respondents. Additionally, only 57% of the participants recognized liposomes as a dosage form. In practice, most pharmacists recommended storing probiotics at room temperature, accounting for 66.6%. The most prevalent misconception encountered in the pharmacy setting was the belief that probiotics are primarily intended for gastrointestinal tract problems, at 79.1% of the respondents. Regarding perception, the agreement was observed regarding the safety of probiotics for all ages. Perceived barriers included the high cost of probiotics, with the majority (86.5%) indicating this as a significant obstacle, while lack of demand was identified as the minor barrier by 64.6%. Additionally, an association was found at a significance level of p < 0.05 with knowledge, gender, educational level, type and location of pharmacy, and source of information. The study highlights knowledge gaps in pharmacists' understanding of probiotic applications beyond digestive health, particularly cardiovascular health and depression. Targeted educational interventions are necessary to address these gaps. The findings underscore the importance of ongoing professional development for pharmacists, enhancing their role in patient education and the promotion of probiotics for overall health.

Empowering nurses to support Greener NHS policy

Climate change is a significant global health threat, projected to cause over 250000 deaths annually by 2050, as a result of factors such as extreme heat, flooding and poor air quality caused by pollution. The NHS, as a major healthcare provider, contributes around 4% of the UK's total emissions and in October 2020, became the world's first health service to commit to reaching net zero carbon, in response to the profound and growing threat to health posed by climate change. Nurses, as frontline healthcare providers, are uniquely positioned to drive sustainability initiatives within healthcare settings, reducing environmental impact while improving patient outcomes. Sue Thomas explores how nurses can make a difference in line with the Greener NHS policy.

Mental Health Effects of COVID-19 Among Health Care Providers: A Case Study of Kalulushi General Hospital in Kalulushi District, Zambia

Coronavirus disease 2019 is an infectious disease which was first identified in Wuhan a City in the Peoples Republic of China in December 2019. The aim of this study was to establish the mental health effects of COVID 19 on the frontline health care providers at Kalulushi General Hospital in Kalulushi district of Zambia. A descriptive cross-sectional study was employed to assess the mental health effects of COVID 19 on the frontline health care providers at Kalulushi General Hospital in Zambia. The study used simple random sampling technique to select 122 respondents to participate in the study. Data was collected from study participants using structured questionnaire. The collected data was analyzed using SPSS version 25 and MS excel and was presented using tables, bar charts and pie charts. Multivariate logistic regression analysis was used to examine the relationships between socio-demographic characteristics and mental health effects of COVID-19 parameters. The ethical approval was gotten from Lusaka Apex Medical University Biomedical Research Ethics Committee, Kalulushi General Hospital and Kalulushi District Health Office respectively. The study revealed that, most of the respondents (31%) were afraid of contracting COVID-19, while 27% of study participants claimed that COVID 19 was a propaganda and that no one knew when it would end. The study also found that, a small proportion of study participants reported a decline in work morale (17%), likely associated with witnessing numerous deaths (19%) and the added stress of inadequate personal protective equipment (PPE) experienced by 15%. The study further demonstrated that 58% of the respondents accepted that working in a COVID-19 environment affected their mental health while 42% of the respondents did not accept that working in the COVID-19 environment did affect mental health of frontline healthcare providers. The study further revealed that, most of the respondents were using handwashing or sanitizers, facemasks and protective clothing (27%) to cope with COVID-19 pandemic. The study also showed that, a few respondents were practicing social distancing (22%), and having healthy diet (19%) in order to cope with COVID-19. Marital status and religion were found to have significant association with copying strategies of frontline healthcare providers against COVID-19 pandemic at Kalulushi General Hospital in Kalulushi District of Zambia (P &amp;lt; 0.05). WHO, CDC, and Zambian Ministry of Health should prioritize implementing Critical Incident Stress Management protocols, develop culturally sensitive mobile applications to offer self-guided interventions, and promote healthy coping mechanisms among frontline healthcare providers.

Factors Affecting Standing and Walking Outcomes for Individuals with Spinal Cord Injury during In-patient Rehabilitation: a Qualitative Study on the Perspectives of Physiotherapists

Purpose: Standing and walking outcomes following spinal cord injury (SCI) vary across rehabilitation centres and therapists. Much of this variation has been attributed to individual patient characteristics. However, insight from frontline health care providers, as well as exploration of comprehensive contributing factors, have been under investigated. This study aimed to explore the perspectives of physiotherapists on factors affecting standing and walking recovery and outcomes during in-patient SCI rehabilitation. Methods: An exploratory qualitative study was conducted using semi-structured focus group interviews. Our qualitative approach was grounded in interpretive description and used reflexive thematic analysis. Results: Ten physiotherapy representatives of seven different in-patient SCI rehabilitation sites across Canada participated. Dosage, organizational culture, length of stay, staffing, equipment, relationships, atmosphere, and mindset were the key factors identified. Our findings also highlight that how factors impact a site may differ, but perspectives on which factors influence standing and walking outcomes were similar. Factors beyond the individual and the relationship of these factors on training dosage were emphasized. Conclusion: Future work is needed to better understand the role of institutional culture, to design and implement potential ways to address key contributing factors, and to evaluate if such initiatives lead to improvements in standing and walking outcomes.

A low-cost approach to upskilling tutors in frontline health care worker production value chain.

Nigeria, like many countries, struggles with a shortage of healthcare professionals including frontline healthcare providers at the primary healthcare (PHC) level. While the country is pitched towards producing more healthcare professionals, the existing infrastructure to produce them is inadequate. Producing healthcare professional with the required skills to deliver quality services is impeded by several factors including the use of outdated curricula for their training, low application of technology in teaching, and weak tutor capacity that is worsened by the paucity and high cost of opportunities for tutor continuing professional development. To address these issues, the Health Workforce Management Activity (HWM), an initiative of the United States Agency for International Development (USAID), in 2023 designed and implemented a low-cost programme called TutorConnect that offered low-cost continuing professional development to tutors. TutorConnect is a Zoom-based monthly training programme that is facilitated by subject matter experts. The programme offered topics spanning effective learning, enhanced instructional design, and improved student engagement in the 14 months of its operation with over 700 tutors from more than 10 states in Nigeria that benefited from it. Utilising WhatsApp for additional support and peer-to-peer learning was crucial to providing more hands-on support, and institution-specific solutions. This low-cost approach to build competencies enabled access to continuing professional development by tutors, limiting effects of location and finances as barriers to continuing professional development. Developing the teaching capacity of tutors is pivotal to enhancing the quality of frontline healthcare worker training.

A national survey of pandemic fear and cyberchondria after ending zero-COVID policy: The chain mediating role of alexithymia and psychological distress

BackgroundMore than half the domestic population in China were infected with COVID-19 in two months after ending “zero-infection policy”, which severely overwhelmed frontline healthcare providers with stress and fear. However, there is no study to date investigating the associations between nurses' fear of pandemic and cyberchondria. This study aimed to 1) investigate the correlations between fear pandemic and cyberchondria among frontline nurses, and 2) discover its potential mechanism. MethodsA cross-sectional sample of frontline nurses (N = 8161) was recruited from 98 hospitals across China in February 2023. Participants were invited to complete an online, self-rated standardized questionnaire focused on pandemic fear, alexithymia, psychological distress, and cyberchondria. Environmental, clinical and socioeconomic information were collected for adjustment while conducting chain mediation analysis. ResultsWhen other covariates were controlled, it was found that fear of the pandemic significantly contributed to cyberchondria (b = 0.58, 95%CI [0.56, 0.60], p < .001). The chain mediation model suggested that both alexithymia and psychological distress were mediating factors between pandemic fear and cyberchondria. ConclusionsThe higher the perceived fear, the greater the cyberchondria, which suggests that reducing fear about the pandemic and providing adequate support could reduce the incidence of cyberchondria. As alexithymia and psychological distress may be transdiagnostic mechanisms between fear and cyberchondria, targeted interventions focused on expression dysregulation and emotional identification could be useful.

Management of iron deficiency anemia during pregnancy: a midwife-led continuity of care model

BackgroundGlobally, 36.5% of pregnancies are affected by anemia, particularly in low-and middle-income countries, posing significant risks to maternal and perinatal health. In rural Pakistan, 44.3% of pregnant women suffer from iron deficiency, contributing to the high prevalence of anemia. Limited accessibility to antenatal care exacerbates the challenge, necessitating innovative solutions. This study assessed a midwife-led continuity of care model, utilizing intravenous (IV) iron therapy for the management of anemia in Karachi, Pakistan.MethodsWe performed a retrospective analysis of data from a prospective cohort study conducted in two primary healthcare facilities, which employed a community midwife (CMW)-led continuity of care model for antenatal care, including IV iron therapy. We extracted data from February 2021 to March 2022 for women who were diagnosed with anemia based on hemoglobin (Hb) levels, categorized as mild (10.0 to 10.9 g/dL), moderate (7.0 to 9.9 g/dL), or severe (less than 7.0 g/dL). Assessment occurred at the initial antenatal care (ANC) visit to establish baseline anemia severity, and approximately 2 weeks after intravenous (IV) iron therapy administration to evaluate post-treatment changes were considered.ResultsWe enrolled 114 pregnant women, where the majority presented with moderate (88.6%) anemia. After IV iron treatment, 48.5% improved to normal-mild levels, while 50% remained unchanged. Severe anemia affected 10.5% at baseline; 42% shifted to moderate and 50% to normal-mild post-treatment, with one remaining unchanged (p &amp;lt; 0.001). Among women enrolled in the first and second trimesters, severe anemia improved to normal-mild (50%) and moderate levels (50%) (pre-treatment: n = 10, post-treatment: n = 0), and moderate anemia decreased by 48% (pre-treatment: n = 92, post-treatment: n = 47).ConclusionOur midwife-led model of care demonstrated an improvement in iron levels among pregnant women. The model addressed the challenges of anemia prevalence in Pakistan and underscored the significance of empowering front-line healthcare providers, such as community midwives (CMWs) for managing these common conditions.

Sociodemographic Disparity Patterns of Perceived Stress and Resilience Among Advanced Registered Nurse Practitioners During the Prolonged COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic, 1 of the most prolonged and extensive global pandemics in history, ravaged the world. Advanced practice registered nurses (APRNs) played crucial roles as frontline health care providers in detecting and treating COVID-19–infected patients. The purpose of this study was to provide updated knowledge and sociodemographic disparity patterns in APRNs’ perceived stress and resilience during the prolonged pandemic period. A total of 2,412 APRNs completed the surveys. The results of this research showed that APRNs’ stress and resilience were significantly impacted by the prolonged pandemic. Significant sociodemographic disparity patterns of perceived stress and resilience among APRNs were also clearly identified.

Perinatal loss in Tanzania: Perspectives of maternal-child healthcare providers.

Over 98% of stillbirths and neonatal deaths occur in Low- and Middle-Income Countries, such as Tanzania. Despite the profound burden of perinatal loss in these regions, access to facility or community-based palliative and psychosocial care is poor and understudied. In this study we explore perinatal loss through the lens of front-line healthcare providers, to better understand the knowledge and beliefs that guide their engagement with bereaved families. A Knowledge Attitudes and Practices survey addressing perinatal loss in Tanzania was developed, translated into Swahili, and administered over a 4-month period to healthcare professionals working at the Kilimanjaro Christian Medical Center (KCMC). Results were entered into REDCap and analyzed in R Studio. 74 providers completed the survey. Pediatric providers saw a yearly average of 5 stillbirths and 32.7 neonatal deaths. Obstetric providers saw an average of 11.5 stillbirths and 13.12 neonatal deaths. Most providers would provide resuscitation beginning at 28 weeks gestational age. Respondents estimated that a 50% chance of survival for a newborn occurred at 28 weeks both nationally and at KCMC. Most providers felt that stillbirth and neonatal mortality were not the mother's fault (78.4% and 81.1%). However, nearly half (44.6%) felt that stillbirth reflects negatively on the woman and 62.2% agreed that women are at higher risk of abuse or abandonment after stillbirth. A majority perceived that women wanted hold their child after stillbirth (63.0%) or neonatal death (70.3%). Overall, this study found that providers at KCMC perceived that women are at greater risk of psychosocial or physical harm following perinatal loss. How women can best be supported by both the health system and their community remains unclear. More research on perinatal loss and bereavement in LMICs is needed to inform patient-level and health-systems interventions addressing care gaps unique to resource-limited or non-western settings.

Exploring Holistic Cancer Care and Survivorship in India Through the Kerala Model of Palliative Care: Role of Community Nurse and Outpatient Meetings.

Support groups and meetings are self-help gatherings that provide a unique sense of community, unconditional acceptance, and information on cancer and its treatment. This cross-sectional study examined 12 outpatient meetings within the Kerala model of palliative care, a community-based service provided to patients irrespective of disease, stage, or prognosis starting from the time of diagnosis. The study focused on the pivotal role of community nurses in facilitating these meetings, with participants including cancer patients and survivors. Using in-depth interviews (n = 52) and participant observations, this research used a qualitative approach and explored the dynamics and outcomes of outpatient meetings. Findings highlight the indispensable contributions of these community nurses serving as linchpins in providing support, guiding discussions, and offering crucial education. Outpatient meetings effectively addressed psychosocial concerns, combatted stigmas associated with cancer, and promoted informed decision making in cancer care. The study emphasizes the need for recognizing the role played by community nurses in improving psychosocial support and diminishing stigma, and ultimately the quality of life of patients and survivors through the palliative cancer care within the Kerala model. We also underscore the need for policy initiatives, resource allocation, and training programs tailored to support these frontline health care providers effectively.

The influence of COVID-19 pandemic on the mental health of pharmacists as frontline health care providers in Nepal

BackgroundDue to COVID-19, pharmacists have been exposed to a variety of dangers that have an impact on their mental health. The study highlights that impact of COVID-19 and work led to burnout among them. Thus, it is necessary to offer mental health services. AimsTo assess the impact of COVID-19 on the work of pharmacy professionals and ascertain the extent of the influence of burnout on mental health among pharmacists working as frontline health providers in Nepal. MethodsPharmacists from Province 2, 3, and 5 in Nepal participated in a self-administered questionnaire that assessed mental health and wellbeing and burnout using 16-item OLBI. Data was collected from January 2023–March 2023. Independent sample t-test, one-way ANOVA, Pearson's correlation, and linear regression were employed to identify any significant connections between burnout and mental health and wellbeing. ResultsOut of 243 participants, COVID-19 pandemic and work was found to have a negative impact on the mental health and wellbeing of a 33.7% of pharmacists. Participants reported having financial issues in 41.6% of cases and 9.5% considered leaving the profession and were concerned about the provision of service quality and making mistakes at work. A strong and meaningful positive relationship and linear regression were observed between exhaustion, disengagement, burnout, mental health and wellbeing. Pharmacists working part-time (p < 0.050) in hospital settings experienced burnout as a result of insufficient training, extended working hours, and stress both on and off the job. ConclusionsPharmacists are to prioritize a healthy work-life balance, which includes avoiding prolonged shifts >8 h, regular physical exercise and promote open communication among colleagues to address workplace concerns.

Mental Health Burden and Facilitators Among Frontline Healthcare Professionals in Nigeria Amid COVID-19 Pandemic: A Cross-sectional Study.

During the COVID-19 pandemic, the frontline healthcare providers faced significant mental health stressors. Previous pandemics have revealed the need for psychosocial support and healthy coping mechanisms to mitigate mental health risks. The study aimed to assess psychological impact and supportive mechanisms experienced by frontline healthcare workers treating COVID-19 patients in Kaduna State. This study involved 38 frontline healthcare providers mainly from Kaduna State Infectious Disease Treatment Center. Participants' mental health burden was captured through Hospital Anxiety and Depression Scale. Mental health facilitators were assessed through six tools: Ten-Item Values Inventory, healthy defense section of the Defense Style Questionnaire, Existential Anxiety Questionnaire, Brief Resilience Scale, Oslo Social Support Scale, and the Insomnia Severity Index. The mean age of the study participants was 35.5 ± 6.6 years, with the majority being males (68.4%) and doctors (39.5%). More than a quarter of the participants showed appreciable symptoms of depression and anxiety. Psychosocial facilitators such as moral values, openness to change, self-transcendence, sublimation, anticipation, and humor scored above average for more than half of the participants. Most participants demonstrated moderate resilience and social support, with few experiencing sleep challenges. Comparisons of variables indicated "openness to change" was significantly higher among males, whereas symptoms of depression and anxiety were associated with higher levels of existential concerns and sleep challenges. Our study finds that Nigerian frontline health workers experienced significant mental health challenges during the COVID-19 pandemic. It identified specific facilitators linked to gender and psychological burdens, informing the need for tailored support interventions.

Adaptive Stacking Ensemble Techniques for Early Severity Classification of COVID-19 Patients

During outbreaks of infectious diseases, such as COVID-19, it is critical to rapidly determine treatment priorities and identify patients requiring hospitalization based on clinical severity. Although various machine learning models have been developed to predict COVID-19 severity, most have limitations, such as small dataset sizes, the limited availability of clinical variables, or a constrained classification of severity levels by a single classifier. In this paper, we propose an adaptive stacking ensemble technique that identifies various COVID-19 patient severity levels and separates them into three formats: Type 1 (low or high severity), Type 2 (mild, severe, critical), and Type 3 (asymptomatic, mild, moderate, severe, fatal). To enhance the model’s generalizability, we utilized a nationwide dataset from the South Korean government, comprising data from 5644 patients across over 100 hospitals. To address the limited availability of clinical variables, our technique employs data-driven strategies and a proposed feature selection method. This ensures the availability of clinical variables across diverse hospital environments. To construct optimal stacking ensemble models, our technique adaptively selects candidate base classifiers by analyzing the correlation between their predicted outcomes and performance. It then automatically determines the optimal multi-layer combination of base and meta-classifiers using a greedy search algorithm. To further improve the performance, we applied various techniques, including imputation of missing values and oversampling. The experimental results demonstrate that our stacking ensemble models significantly outperform existing single classifiers and AutoML approaches, with improvements of 6.42% and 8.86% in F1 and AUC scores for Type 1, 9.59% and 6.68% for Type 2, and 11.94% and 9.24% for Type 3, respectively. Consequently, our approach improves the prediction of COVID-19 severity levels and potentially assists frontline healthcare providers in making informed decisions.

PHARMACY PRACTICE STANDARDS AND CHALLENGES IN NIGERIA: A COMPREHENSIVE ANALYSIS

Pharmacy practice standards and challenges in Nigeria constitute a critical area of concern due to their profound impact on healthcare delivery and patient outcomes. This comprehensive analysis delves into the multifaceted landscape of pharmacy practice in Nigeria, highlighting prevailing standards and the array of challenges faced by pharmacists in their professional endeavors. Nigeria, like many other developing countries, grapples with a complex healthcare system marked by resource constraints, regulatory ambiguities, and evolving patient needs. Within this context, pharmacists play a pivotal role as frontline healthcare providers, responsible for ensuring safe and effective medication use. However, the absence of robust regulatory frameworks and standardized practices poses significant hurdles to the delivery of quality pharmaceutical care. This analysis examines the existing pharmacy practice standards in Nigeria, emphasizing the role of regulatory bodies such as the Pharmacists Council of Nigeria (PCN) in setting guidelines and enforcing compliance. It also scrutinizes the challenges encountered by pharmacists, including inadequate infrastructure, limited access to essential medicines, counterfeit drugs, and insufficient professional development opportunities. Furthermore, the analysis explores the impact of socio-economic factors, cultural beliefs, and healthcare disparities on pharmacy practice in Nigeria. It underscores the need for collaborative efforts among stakeholders, including government agencies, healthcare institutions, pharmaceutical industry players, and professional associations, to address these challenges comprehensively. In conclusion, this study underscores the importance of enhancing pharmacy practice standards in Nigeria to promote patient safety, optimize medication therapy outcomes, and advance public health objectives. By addressing the identified challenges and fostering a supportive environment for pharmacists, Nigeria can harness the full potential of its pharmacy workforce to meet the healthcare needs of its population effectively.&#x0D; Keywords: Pharmacy, Standards, Nigeria, Practices, Review.

Knowledge regarding biomedical waste management among nursing staffs of Teaching Hospital at Birgunj, Parsa, Nepal.

Biomedical waste poses significant environmental and public health risks, necessitating proper handling and disposal. Nursing staff, as frontline healthcare providers, play a crucial role in ensuring safe biomedical waste management practices. The objective of this study is to identify the knowledge on biomedical waste management among nurses in a hospital at Birgunj. A descriptive cross-sectional study was conducted among nurses working in National Medical College and Teaching Hospital. The nonprobability purposive sampling technique was used to collect data from 169 nurses using a self-administered questionnaire. Statistical Package for Social Science (SPSS) version 23 facilitated data entry and analysis. Descriptive analysis, employing mean and standard deviation, was conducted, while inferential analysis utilized the chi-square test to explore associations between knowledge levels and selected demographic variables. Results indicated that among the 169 respondents, the majority (67.45%) possessed adequate level of knowledge. Notably, no significant associations were observed between the nurse's knowledge level on biomedical waste management and the selected demographic variables. To enhance knowledge among nurses regarding biomedical waste management, it is recommended that hospital authorities organize continuous education programs and periodic training sessions. These initiatives can contribute to an increased understanding of proper biomedical waste management practices among nursing staff.

Frontline Providers’ and Patients’ Perspectives on Improving Diagnostic Safety in the Emergency Department: A Qualitative Study

Few studies have described the insights of frontline health care providers and patients on how the diagnostic process can be improved in the emergency department (ED), a setting at high risk for diagnostic errors. The authors aimed to identify the perspectives of providers and patients on the diagnostic process and identify potential interventions to improve diagnostic safety. Semistructured interviews were conducted with 10 ED physicians, 15 ED nurses, and 9 patients/caregivers at two separate health systems. Interview questions were guided by the ED-Adapted National Academies of Sciences, Engineering, and Medicine Diagnostic Process Framework and explored participant perspectives on the ED diagnostic process, identified vulnerabilities, and solicited interventions to improve diagnostic safety. The authors performed qualitative thematic analysis on transcribed interviews. The research team categorized vulnerabilities in the diagnostic process and intervention opportunities based on the ED-Adapted Framework into five domains: (1) team dynamics and communication (for example, suboptimal communication between referring physicians and the ED team); (2) information gathering related to patient presentation (for example, obtaining the history from the patients or their caregivers; (3) ED organization, system, and processes (for example, staff schedules and handoffs); (4) patient education and self-management (for example, patient education at discharge from the ED); and (5) electronic health record and patient portal use (for example, automatic release of test results into the patient portal). The authors identified 33 potential interventions, of which 17 were provider focused and 16 were patient focused. Frontline providers and patients identified several vulnerabilities and potential interventions to improve ED diagnostic safety. Refining, implementing, and evaluating the efficacy of these interventions are required.

Healthcare simulation training for cutaneous anthrax presentation: improving readiness in frontline healthcare providers

Healthcare simulation training for cutaneous anthrax presentation: improving readiness in frontline healthcare providers