Healthcare Institutions Research Articles

"Redefining Patient Experience: Strategies for Enhancing Patient-centered Care"

In recent years, the focus on patient-centered care has gained significant momentum, as healthcare organizations recognize the importance of delivering high-quality care that is responsive to individual patient preferences, needs, and values. This paper explores strategies for redefining the patient experience by emphasizing the integration of patient-centered care practices. Key strategies include enhancing communication between healthcare providers and patients, utilizing technology to support patient engagement, implementing shared decision-making models, and fostering a compassionate care environment. The study also examines the role of leadership in driving organizational culture changes that prioritize patient-centered care. By adopting these strategies, healthcare institutions can improve patient satisfaction, outcomes, and overall experience, leading to a more effective and empathetic healthcare system.

FEATURES OF THE MODERN HEALTHCARE MANAGEMENT SYSTEM

The article examines different approaches to the essence of the concepts of «management», «health care management», etc., based on which the interpretation of the concept of «health care management» is proposed. Conceptualization of the content of the terms «management» and «administration» is of great importance for the development of the conceptual and categorical apparatus not only of the theory of management and science in general, but also of modern branch theories. The variety of approaches is caused by the conditions of functioning of modern management systems in the field of health care, which is caused by the continuation of the reformation of the management system of the industry, the addition of the legal framework, the search for sources of financing, personnel support, and the development of infrastructure in most modern states. The article analyzes the object and subject of health care management as mandatory components of the structure of the health care system. The content of the main functions and methods of management in the field of health care is revealed. The interrelationship of functions and methods depending on the level of management and the applied model of organization of the health care system is analyzed. It is emphasized that the presence of different types of health care models depends not only on the method of financing and management, but also on the conformity of this model to the cultural, economic and social characteristics of the nation and the state. It is indicated that modern states, which continue the process of reforming the health care sector, can use the best practices of each of the presented models to create an effective and accessible system of medical care, capable of responding to modern challenges, with an effective management system. It has been established that the management system of the health care sector should be based on a number of scientific approaches that will allow taking into account all factors of the internal and external environment. It has been proven that the need to form an optimal management system is an important element of transformational processes in the field of health care. Today, the field of health care should be aimed at developing the capacity of health care institutions to meet the established quality standards, offer a favorable environment for the activities of medical workers, and meet the existing needs of citizens.

Use of Artificial Intelligence tools in supporting decision-making in hospital management

BackgroundThe use of Artificial Intelligence (AI) tools in hospital management holds potential for enhancing decision-making processes. This study investigates the current state of decision-making in hospital management, explores the potential benefits of AI integration, and examines hospital managers’ perceptions of AI as a decision-support tool.MethodsA descriptive and exploratory study was conducted using a qualitative approach. Data were collected through semi-structured interviews with 15 hospital managers from various departments and institutions. The interviews were transcribed, anonymized, and analyzed using thematic coding to identify key themes and patterns in the responses.ResultsHospital managers highlighted the current inefficiencies in decision-making processes, often characterized by poor communication, isolated decision-making, and limited data access. The use of traditional tools like spreadsheet applications and business intelligence systems remains prevalent, but there is a clear need for more advanced, integrated solutions. Managers expressed both optimism and skepticism about AI, acknowledging its potential to improve efficiency and decision-making while raising concerns about data privacy, ethical issues, and the loss of human empathy. The study identified key challenges, including the variability in technical skills, data fragmentation, and resistance to change. Managers emphasized the importance of robust data infrastructure and adequate training to ensure successful AI integration.ConclusionsThe study reveals a complex landscape where the potential benefits of AI in hospital management are balanced with significant challenges and concerns. Effective integration of AI requires addressing technical, ethical, and cultural issues, with a focus on maintaining human elements in decision-making. AI is seen as a powerful tool to support, not replace, human judgment in hospital management, promising improvements in efficiency, data accessibility, and analytical capacity. Preparing healthcare institutions with the necessary infrastructure and providing specialized training for managers are crucial for maximizing the benefits of AI while mitigating associated risks.

Analysis of Environmental Footprints of Health Centers in Kangra District, Himachal Pradesh, India

The experiment was conducted during December, 2020 to June, 2021 at Kangra district of Himachal Pradesh, India to evaluate the ecological footprint of 15 hospitals that were chosen at random. The purpose of this study was to assess the ecological impact of these medical facilities-which included both government and private hospitals—across five blocks of district. The ecological footprint framework was utilized to analyze factors such as food waste, solid waste, water consumption and energy consumption and material use, determining their impact on biocapacity. The average ecological footprints of the hospitals ranged from 116.5 to 271.4 global hectares (g ha). The ecological footprints varied across different blocks as follows Jawalamukhi (349.7 g ha), Dharamshala (535.6 g ha), Nurpur (698.3 g ha), Palampur (722.3 g ha), and Kangra (814.0 g ha). Notably, the hospitals in the Jawalamukhi block were the most sustainable, exhibiting the lowest ecological footprint. These results underscore the significant environmental impact of hospitals and the urgent need for initiatives to reduce their ecological footprint, particularly in the Kangra block. The results emphasize the importance of sustainable resource utilization in healthcare institutions to minimize their ecological footprint and promote environmental sustainability. To achieve a balance between providing healthcare services and protecting the environment, the research recommends extensive actions to enhance the effectiveness of resource utilization, waste management, and energy consumption in hospitals.

Protecting oneself while supporting the organisation: A longitudinal exploratory study of healthcare workers’ coping strategies and organisational resilience processes in the first year of the COVID-19 pandemic

The COVID-19 pandemic has been a major source of stress for health professionals and health institutions. In response, healthcare workers adapted their behaviours to protect their health and the organisational resilience of their institutions. The study aimed to explore these individual coping and organisational resilience strategies and their evolution during the first year of the pandemic. Based on a mixed and longitudinal protocol, the study included staff from several French-speaking Swiss healthcare institutions. Participants completed an online questionnaire three times during the first year of the pandemic. They described daily problematic work situations, coping styles, and organisational resilience strategies. ‘Problem solving’ was the most frequently reported coping style, followed by ‘positive thinking’, and in a lesser extent ‘seeking social support’ and ‘avoidance’. A high level of ‘problem solving’ and ‘positive thinking’ was associated with well-managed situations, learning and development of new work practices and higher team performance. A higher level of ‘seeking social support’ and ‘avoidance’ tended to be associated with high-risk problematic situations that hindered organisation resilience. Coping strategies differed depending on profession, job tenure and hierarchical status. The article concludes with recommendations for improving both organisational resilience and individual workers’ well-being in healthcare institutions.

Genome sequencing in the management of myelodysplastic syndromes and related disorders.

Myeloid neoplasms originate from the clonal proliferation of hematopoietic stem cells, which is driven by the acquisition of somatic genetic mutations. Within these disorders, myelodysplastic syndromes (MDS) are specifically characterized by morphologic abnormalities (dysplasia) and impaired maturation of myeloid precursors (ineffective hematopoiesis), resulting in peripheral blood cytopenia. Several studies have advanced the field of MDS, with a few landmark papers leading to a paradigm shift, opening new avenues of research and enabling a molecular revolution. These seminal papers include the first description of the 5q- syndrome, the identification of somatic mutations of TET2 in myeloid neoplasms, the detection of common pathway mutations in the splicing machinery, and the discovery of clonal hematopoiesis. The somatic genomic landscape of MDS is now well-defined. Genes that are recurrently mutated include epigenetic regulators, as well as genes of RNA splicing machinery, transcription regulation, DNA repair control, cohesin complex, and signal transduction. Furthermore, several disorders with a germline genetic predisposition to MDS have been identified, collectively accounting for up to 15% of all MDS cases. Genomic profiling can significantly improve the diagnostic approach to MDS, allowing the identification of distinct nosologic entities such as SF3B1-mutant or TP53-mutant MDS. The Molecular International Prognostic Scoring System for MDS (IPSS-M) has already proven to be a valuable tool for individualized risk assessment and treatment decisions. In addition, the recently developed molecular taxonomy of MDS will likely facilitate the implementation of precision medicine approaches for these disorders. This will necessitate the establishment of specialized infrastructures within public health systems, involving close collaboration between healthcare institutions, academia, and the life sciences industry.

Assessing institutional pediatric airway emergency readiness: key components and practices.

This contemporary review aims to outline the key components and protocols for assessing emergency readiness in institutional pediatric airway management. Emphasis is placed on identifying essential elements that ensure preparedness and effective response in pediatric airway emergencies within healthcare institutions. Recent studies highlight several critical components of pediatric airway emergency readiness: dedicated pediatric airway teams, availability of specialized pediatric airway equipment, and simulation-based training to enhance the skills of healthcare providers. Additionally, interdisciplinary team coordination and regular drills have been shown to improve readiness and outcomes in pediatric airway emergencies. Effective emergency readiness in pediatric airway management requires a multifaceted approach. Key components include availability of appropriate and accessible equipment, adherence to standardized protocols, and ongoing education and training. Regular simulation exercises and interprofessional collaboration are essential for maintaining high levels of preparedness. Implementing these strategies can significantly improve the quality of care and patient outcomes in pediatric airway emergencies. Level 3.

Effects of a mindfulness-based health promotion program on mindfulness, psychological capital, compassion fatigue, and affect in healthcare workers.

This study aimed to examine the effects of the Mindfulness-Based Health Promotion program on mindfulness, psychological capital, compassion fatigue, and affect in a sample of healthcare workers at a hospital in Colombia. Randomized controlled study with pre-test and post-test measures, in which 33 workers participated (Mage = 35.01, SD = 10.0), assigned to the experimental group (EG, n = 16, Mage = 34.00, SD = 9.59) and the wait-list control group (CG, n = 17, Mage = 36.03, SD = 10.56). The contrast of the program effects was carried out through a mixed factorial ANOVA. We found significant effects on observing, non-reacting and mindfulness as a function of the group factor. We concluded the Mindfulness-Based Health Promotion program showed positive effects on mindfulness, this was tested with a novel program designed for the Latin population. This study is pioneering in using this mindfulness program in Colombia. These findings offer valuable insights for leaders of healthcare institutions when developing intervention programs that promote the mental health in the workplace. Future studies with larger samples and mixed-methods are necessary to confirm our results and to identify factors that can predict these findings.

The effect of patients' socioeconomic status in rehabilitation centers on the efficiency and performance.

Patients' socioeconomic status on hospitals' efficiency in controlling for clinical component characteristics may have a role that has few been studied in rehabilitation centers. Because of the national health insurance system, rehabilitation centers are free of charge. To answer whether a patient's socioeconomic status (SES) is associated with efficiency and performance, we use a counterfactual analysis to get the patient's SES effect "as if" the patient's case was identical to whatever hospital. We restrained the data to patients from public acute care units where the decision on rehabilitation sector admission is based on availability, limiting bias by confounding factors. Besides, an analysis of six pathologies led to the same results. An exhaustive, detailed administrative database on rehabilitation center stays in France. To define the patients' socioeconomic status, we use two sources of data: the information collected at the time of the patient's entry into rehabilitation care and the information collected during the patient's stay in acute care. This double information avoids possible loss of socio-economic details between the two admissions. Patients recruited were exhaustively admitted over the year 2018 for stroke, chronic obstructive pulmonary disease, heart failure, or total hip replacement in France in the acute care unit and then in a rehab center. Mainly the elderly population. Information on patients' demography, comorbidities, and SES are coded due to the reimbursement system. Different dimensions controlling for factors (hospital ownership, patient clinical characteristics, rehabilitation care specificities, medical staff detailed information, and patients' socioeconomic status), were progressively added to control for any differences in baseline data between the two groups. We assess rehabilitation centers' efficiency by combining selected outcome quality indicators (Physical score improvement, Cognitive score improvement, Mortality, Return-to-home). The specific Providers' Activity Index is used to get the performance index. The performance of healthcare institutions is correlated not only to the case mix of their patients but also to the socioeconomic status of the patients admitted. The performance needs to be seen in light of patients' socioeconomic status. The data reveals that patients' socioeconomic status affects rehabilitation care efficiency and performance. In controlling patients' socioeconomic status, for-profit rehabilitation hospitals seemed more efficient than public ones.

Évaluation de l’impact économique et du parcours patient lors du traitement de l’occlusion coronaire totale chronique

Chronic total occlusion (CTO) of coronary arteries is defined as complete absence of antegrade coronary flow without iodine passage, since more than 3 months. Coronary revascularization is a highly resource-intensive angioplasty procedure involving numerous medical devices (MDs). Its consumption and associated costs are not covered by either the medical act classification (CCAM) or the hospitalization fees and additional MD funding. The primary aim of this study is to analyze the financial sustainability of this activity for a public healthcare institution and to assess the budgetary impact of CTO treatment on the most expensive items of expenditure. The secondary aim is to describe the patient's intra-hospital pathway. CTO revascularization stays are categorized under the code 05K06 "Vascular Stents without Myocardial Infarction". Major cost items were identified using national coded expenditure data and compared with those from our cost study. Every CTO intervention from January to November 2021 were retrospectively retrieved. Establishment purchase prices in 2021 were used to determine MD costs. Clinical data were extracted from electronic patient records. Operative data (procedure duration, professionals involved, and MD used) were extracted. Human Resources (HR) costs were integrated into the calculations. A Sankey diagram was created. Data are expressed as mean ± standard deviation. In our study, 41 patients underwent 45 interventions. The median was 65 years. 78% of interventions were successful with a median duration of 113 minutes. 222 different MD references were used, with 27% reimbursed additionally and 73% funded within the homogeneous group of stays (HGS). The total cost of MD described in the coded expenditure data is 2142euro, of which 721euro is funded within the HGS. In our cohort, it represented averages of 2736euro ± 1393euro and 1710euro ± 926euro, respectively. Regarding HR, the total cost described in the coded expenditure data was 442euro compared to 410euro ± 169euro in our cohort. Finally, patient pathway analysis showed an average length of stay (LOS) of 1.8 days. Two pathways were identified depending on admission context: weekday hospitalization or cardiac intensive care. CTO revascularization is a planned intervention with a short LOS and a highly standardized patient pathway. Our study highlights a proliferation of MD references used during CTO revascularization due to innovative industrial developments. The cost differential with coded expenditure data confirms the need for a revision of the procedure and its categorization within an HGS, which is currently non-specific.

Case study: lessons learned from a community-based early frailty intervention programme in Singapore.

Frailty is a dynamic and evolving state of health which involves the gradual loss of physiological in-built reserves. In Singapore, there is growing interest in delivering frailty intervention programmes at scale in the community to meet the demands of an ageing population. New methods of programme delivery such as community-led models that do not rely on healthcare professional manpower are critical to address this unmet need. In this paper, we describe our experience and some lessons learned from the implementation of a community-based early frailty intervention programme for older adults, delivered for the first time by trained laypersons. From August to September 2022, "Steady Lah," a community-based early frailty intervention programme with physical activity and nutrition-based elements, was conducted at an Active Ageing Centre in Singapore. A total of 23 participants with mean age of 73.8 years were enrolled in the 12-session programme comprising of progressive strength and balance-based exercises and workshop-based learning focusing on nutrition. In the implementation of this run of "Steady Lah," modifications were made from a healthcare professional-led model to a trained layperson-led model with additional steps taken to ensure participant safety and assess overall effectiveness when delivered by trained laypersons. Good collaboration between stakeholders in healthcare institutions and the community is necessary to co-develop a model that prioritises the needs of the frail older adults.

Healthcare in the Age of Google

We were inspired to write this commentary because of an encounter at a conference where physicians told medical and undergraduate students that they laugh when patients Google search medical information. We recognized these actions to be rooted in oppression. Despite public commitments made by the medical community and other health professional groups to combat racism and other forms of oppression, some healthcare encounters continue to be rooted in racism and discrimination. We specifically address anti-Indigenous racism and its impacts on the health and well-being of Indigenous Peoples to Turtle Island. We recommend the implementation of anti-racist and anti-colonial pedagogies to ensure that medical schools, other health professional programs, and healthcare institutions are training anti-oppressive care providers.

Experience of Healthy Adult Women with the Receptive Music Therapy Using Body-Monochords – Qualitative Phenomenological Study

Resonance chair/harmonisation recliner are prototypes of body-monochords that were developed in the Czech Republic. These instruments are therapeutically used in music therapy practice, healthcare institutions and by people with disabilities. The aim of this study was to understand how people experience this intervention in the context of private music therapy practice. The design of this qualitative study was based on phenomenology. Six healthy women on maternity leave reflected their experience through semistructured interviews before and after therapeutic session with resonance chair/harmonisation recliner. Interpretative phenomenological analysis was used to identify 12 themes describing the course of these sessions. The women experienced changes on physical, cognitive, and emotional levels related to relaxation and muscles relieve, calming of mind, different experience with feeling of vibrations, vivid imaginations, or changes in body perception. Intervention on resonance chair/harmonisation recliner offered positive experience to the participants and provided them with a space for self-care and rest. No serious adverse events were reported by the participants during or after the intervention. The intervention using resonance chair/harmonisation recliner was highly valued by our participants and has a meaningful usage in private music therapy practice. Future researchers may explore long-term experience of participants and identify other populations that may have specific benefit from this intervention.

Real world comparison of filgrastim to filgrastim-sndz in patients with chemotherapy-induced neutropenia.

There exists some apprehension by prescribers, healthcare providers, and other stakeholders regarding the real-world safety and effectiveness of biosimilars. While some of the apprehension is likely due to clinician knowledge gaps in the biosimilarity exercise, additional data (including those generated from the real-world) regarding safety and efficacy could reduce a clinician's perception of biosimilar uncertainty and can potentially increase biosimilar acceptance and uptake. The published literature is lacking regarding the real-world impact on healthcare costs and clinical outcomes when a single healthcare institution converts from filgrastim to filgrastim-sndz as its short-acting Granulocyte Colony Stimulating Factor (GCSF), especially within diverse populations and indications not explicitly studied through the registration trials. Specifically, both filgrastim and filgrastim-sndz possess FDA-approved indications within patients with hematologic malignancies receiving high-dose chemotherapy and in those undergoing bone marrow transplantation. As a biosimilar to filgrastim, the FDA did not require prospective, randomized controlled trials to obtain these indications for filgrastim-sndz. The purpose of this study is to describe real-world healthcare resource costs, utilization patterns, and clinical outcomes in patients with hematologic malignancies who received filgrastim-sndz or filgrastim to support neutrophil recovery following chemotherapy (i.e., induction or consolidation) or a bone marrow transplant (BMT) at Yale New Haven Hospital (YNHH). A total of 148 patients were identified and met the following criteria: at least 18 years old, Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2, absence of fever or infection, newly diagnosed acute myeloid leukemia or newly post-bone marrow transplant and received filgrastim-sndz (Zarxio®) or reference filgrastim (Neupogen®). Healthcare resource utilization outcomes were compared between biosimilar and reference filgrastim using descriptive statistics. There were no major differences between either cohort, including duration of hospitalization, the number of overall emergency room visits and additional hospital admissions with a primary diagnosis of febrile neutropenia or neutropenia within 30 days post-discharge from initial hospital admission, time to neutrophil recovery following GCSF support, and the incidence and duration of both fever and febrile neutropenia. The total cost based on treatment of all patients in each arm differed significantly with filgrastim-sndz being the most cost-effective choice. filgrastim-sndz significantly reduced healthcare utilization costs compared to reference filgrastim with similar effect on absolute neutrophil count, incidence of fever, and febrile neutropenia.

Achievements and Challenges in the Development of a Nurse-Led Respectful Delivery Care Model Provided by Partners in Health in Rural Mexico.

The model of obstetric care predominant in Mexico in most public and private healthcare institutions is particularly focused on a physiological perspective of the female body that does not respond to women's need for emotional comfort and satisfaction. In the last decade, however, various initiatives that provide obstetric care centered on women's rights have emerged. To analyze the implementation of a model of humanized/respectful delivery care supervised by nursing and midwifery undergraduate interns in a birthing center in the state of Chiapas, in order to identify achievements and future challenges. We used information from secondary sources and carried out a descriptive analysis. Births attended at the birthing center increased in relation to all the births registered in the Angel Albino Corzo municipality between 2017 and 2022. Positive indicators of respectful care increased with the implemented model, while negative indicators decreased. Between 2016 and 2022, obstetric nurses attended more than 1500 births without maternal deaths and managed some emergency cases referred to specialized care. This case illustrates the potential of alternative models of obstetric care. Evidence-based, midwife- and nurse-led models of clinical obstetric care should be expanded in the Mexican healthcare system.

Healthcare professionals’ perspective on the organization of COVID-19 post-hospital aftercare: perspective, barriers and facilitators

ABSTRACT Background After the outbreak of COVID-19, new post-hospital aftercare for patients with COVID-19 had to be established which healthcare professionals (HCPs) had to implement in their healthcare settings. Purpose This study aimed to evaluate HCPs’ perspective on the organization of COVID-19 post-hospital aftercare and identify barriers and facilitators regarding this aftercare in the Netherlands. Methods In this mixed-methods study we sent out a survey 1 and 2 years after the COVID-19 outbreak in the Netherlands to healthcare institutions (HCIs) and asked HCPs across multiple disciplines involved in the COVID-19 post-hospital aftercare to participate. The survey comprised three parts: (1) demographics; (2) the Care Process Self-Evaluation Tool as quantitative measure (CPSET; five domains; scoring range 0–100) to assess HCPs’ perspective on COVID-19 post-hospital aftercare; and (3) barriers and facilitators regarding this aftercare as a qualitative measure. Descriptive statistics and thematic analysis were performed. Results At 1 year, 82 HCPs from 48 HCIs, and at 2 years, 29 HCPs from 24 HCIs participated in the survey. Overall, HCPs had a favorable perspective on COVID-19 aftercare in both assessments. The CPSET domain ‘patient-focused organization’ scored highest (median 81.7 [interquartile range 75.0–90.0] and 85.0 [78.3–96.7]) and ‘monitoring of follow-up care’ lowest (67.1 [55.7–75.7] and 70.0 [52.0–86.7]) at 1 and 2 years, respectively. According to HCPs the COVID-19 post-hospital aftercare solutions to overcome the identified barriers include a clear follow-up and referral procedures with emphasis on multidisciplinary treatment, employment of more HCPs, and extension of treatment duration. Conclusion We concluded that HCPs generally held a positive perspective on COVID-19 aftercare, despite its rapid development and reliance on expert opinion. Key steps in improving COVID-19 aftercare include using quality indicators for monitoring of follow-up care, establishing a well-defined aftercare pathway, addressing resource constraints, and enhancing multidisciplinary collaboration and communication. These insights obtained from HCPs are crucial for policymakers and national healthcare authorities to further improve COVID-19 post-hospital aftercare and for pandemic preparedness.

Best Practices in Supporting Inpatient Communication With Technology During Visitor Restrictions: An Integrative Review.

Since the onset of the COVID-19 pandemic, healthcare workers around the world have experimented with technologies to facilitate communication and care for patients and their care partners. Our team reviewed the literature to examine best practices in utilizing technology to support communication between nurses, patients, and care partners while visitation is limited. We searched four major databases for recent articles on this topic, conducted a systematic screening and review of 1902 articles, and used the Johns Hopkins Nursing Evidence-Based Practice for Nurses and Healthcare Professionals Model & Guidelines to appraise and translate the results of 23 relevant articles. Our evaluation yielded three main findings from the current literature: (1) Virtual contact by any technological means, especially video visitation, improves satisfaction, reduces anxiety, and is well-received by the target populations. (2) Structured video rounding provides effective communication among healthcare workers, patients, and offsite care partners. (3) Institutional preparation, such as a standardized checklist and dedicating staff to roles focused on facilitating communication, can help healthcare workers create environments conducive to therapeutic virtual communication. In situations that require healthcare facilities to limit visitation between patients and their care partners, the benefits of virtual visitation are evident. There is variance in the types of technologies used to facilitate virtual visits, but across all of them, there are consistent themes demonstrating the benefits of virtual visits and virtual rounding. Healthcare institutions can prepare for future limited-visitation scenarios by reviewing the current evidence and integrating virtual visitation into modern healthcare delivery.

The use of argon plasma coagulation in ruptured hemorrhagic syndrome (Mallory-Weiss syndrome) complicated by ongoing bleeding

Objective: to evaluate the efficacy and safety of argon plasma coagulation for endoscopic hemostasis in Mallory-Weiss syndrome. Materials and methods: on the basis of a clinical observation of a patient admitted to the emergency department of the State Budgetary Healthcare Institution of the Moscow Region of the Children’s Central City Hospital with complaints of vomiting of scarlet blood, dark stools, weakness, dizziness. The patient underwent emergency EGDS. Results: According to the EGDS data, a linear mucosal rupture was detected in the lower third of the esophagus along the posterior wall with a transition to the stomach cardia along the lesser curvature, about 8-9 cm long (5 cm in the esophagus, 3-4 cm in the stomach), up to 2 cm deep. -3 mm, from the rupture there is a flow of scarlet blood of medium intensity, in the bottom of the defect, fibers of the submucosal and muscular layers were determined. Endoscopic hemostasis was performed: argon plasma coagulation of the rupture of the mucous membrane of the esophagus and stomach. Against the background of endoscopic treatment by argon plasma coagulation in a patient with a long rupture, hemostasis was achieved and surgical treatment was avoided, which could aggravate the condition and lengthen the treatment time. Conclusions: Argon plasma coagulation as a non-contact method of hemostasis has a limited penetration depth and is safer and more effective than other (contact) electrocoagulation methods, where, as a rule, it is difficult to control the depth of exposure. The use of this method improves the efficiency of endoscopic hemostasis, reduces economic costs, and reduces the patient’s stay in bed.

Leaders development program by 360 degree feedback: reflection on head nurses' leadership practices.

Leadership in nursing is crucial for delivering high-quality healthcare and ensuring positive outcomes for patients, staff, and institutions. Many nurses in leadership positions lack formal training, which can compromise their effectiveness. This study aims to evaluate the effect of a leadership development program utilizing 360-degree feedback on head nurses' leadership practices. A true-experimental design was employed in three healthcare institutions. The study involved 80 head nurses (40 intervention, 40 control), 240 staff nurses, and 29 supervisors. The intervention group participated in a six-week leadership development program using 360-degree feedback. Data were collected pre- and post-intervention using the Leadership Development and 360-Degree Feedback Knowledge Questionnaire and the Leadership Practices Inventory (LPI). The intervention group showed significant improvements in leadership knowledge and practices across all dimensions. Knowledge scores increased from 25.1 ± 8.8 to 93.0 ± 5.1 post-intervention, maintaining at 83.2 ± 7.1 at follow-up. Self-assessed leadership scores improved from 88.1 ± 6.0 to 97.5 ± 2.7, and 98.5 ± 2.0 at follow-up. Supervisor and staff assessments also showed substantial increases. Multiple linear regression analyses confirmed the strong positive impact of the intervention on leadership outcomes. The leadership development program using 360-degree feedback significantly enhanced head nurses' leadership knowledge and practices. The results suggest that such programs can improve leadership capabilities in healthcare settings, leading to better patient care and organizational performance. Future research should address group homogeneity and explore long-term impacts on patient outcomes.

Assessment of nurses’ compliance with Patients’ Rights in South Africa: a scoping review

Abstract Background Compliance with Patients’ Rights by nurses is a crucial determinant of how well healthcare services are provided. Nurses are responsible for upholding Patients’ Rights because they spend so much time with patients. Therefore, it is essential to continuously assess nurses’ compliance with Patients’ Rights in healthcare institutions. Objectives To outline the breadth and type of existing research on nurses’ compliance with Patients’ Rights as well as to pinpoint any gaps in the body of existing knowledge. Methods A scoping review search was done in six electronic databases. For eligibility, articles written in English and focusing on nurses’ compliance with Patients’ Rights in South Africa (SA) were checked and evaluated. Data were taken from eligible study materials in order to compile, evaluate the quality, summarize, and create a narrative summary of the results. Results The literature collected was 1158 records from six data bases, after deleting 239 duplicates, 919 records remained. A total of 891 records were excluded using title and abstract of the studies. Fifteen articles were included in the final analysis. Four articles were quantitative studies, ten qualitative and one a mixed method. The included studies focused on six Patients’ Rights listed in the Patients’ Rights Charter, which consist of 12 Patients’ Rights. Conclusion Nurses’ compliance with Patients’ Rights is inconsistent and there are limited studies on nurses’ compliance with all Patients’ Rights in SA. More studies are required in future, as seen by the included studies’ inconsistent findings.