Healthcare Staff Research Articles

TB Care in Ukraine: Understanding Access Barriers at the Primary Healthcare Level

Abstract Background In the WHO European Region, Ukraine is a high-priority country for TB control, being one of nine globally with high rates of multidrug-resistant TB. The WHO emphasizes patient-centered TB care, prioritizing patients as key figures in the care continuum. Thus, our aim was to explore barriers impacting the accessibility of TB services for patients at the primary healthcare level (PHC) in Ukraine. Methods During December 2022-June 2023, a qualitative study was conducted across eight PHC facilities in the Kyiv, Odesa, Mykolayiv, and Volyn regions. The study comprised: 4 focus groups involving 27 family doctors, 16 in-depth interviews with managers and health authorities from regional and national levels, as well as 25 interviews with TB patients. All data was transcribed, manually coded and deductively analyzed. Results All participants highlighted the benefits for patients of providing TB care continuum at the PHC level, yet the program lacks clear requirements for training of family doctors and nurses. Overall family doctors perceived positively various TB training they received; but despite this, they expressed doubts and reported a lack of practical skills, affecting the quality of care provided. Patients highlighted several barriers in interacting with healthcare providers, including stigma and cases of dismissive behavior of healthcare workers, communication challenges, and breaches of patientś data confidentiality. Patients also mentioned self-stigma, and perceptions of family doctors as poorly trained in TB. Still, patients who received healthcare services from the same family doctor “during long time” positively described their experience with TB services too. Conclusions Establishing robust patient-provider interaction at the PHC level can help overcome persistent barriers to TB care continuum in Ukraine. To achieve this, a comprehensive TB training program tailored for PHC family doctors and nurses should be developed and implemented. Key messages • Expanding TB healthcare services to primary healthcare levels in Ukraine can be beneficial for patients. Training primary healthcare staff can enhance TB care quality. • Establishing robust patient-provider interaction at the PHC level can help overcome persistent barriers to TB care continuum in Ukraine.

Mental health benefit uptake of women before and during the perinatal period in Austria

Abstract One in five women may experience a perinatal mental illness (PMI) during pregnancy and up to one year after giving birth, during the so-called perinatal period. Although there is strong evidence that this can have a negative effect on the children’s future health, many mothers do not receive any treatment. To determine whether and what type of mental health services women in Austria claim during the perinatal period, the uptake of five key mental health insurance benefits was analysed using pseudonymised health insurance data from Austria’s largest insurance, ÖGK. In 2017 and 2018, 131,025 ÖGK insured women gave birth, representing 80% of all births in Austria in the two years. Of these women, almost 20% claimed at least one benefit during the perinatal period. Including the year before pregnancy this number increased to 25%. Most often, only one benefit was claimed in only one of the analysed periods (the year before pregnancy, pregnancy, and the year after birth). Psychotherapy was claimed most often, while hospital admissions occurred the least. Further, the youngest (≤ 20 years) and the oldest (≥ 41 years) women claimed benefits more frequently than at other ages. After adjustment for the shorter pregnancy period, benefit uptake was generally highest during pregnancy and lowest after giving birth. Considering the shortage of specialised perinatal mental health services in Austria, the uptake of the five analysed types of services was high and corresponds to international prevalence figures on PMI. The actual number may be even higher, considering the services and the women not covered in the available data. As there is a lack of a perinatal mental health infrastructure and specialised healthcare staff in Austria, this warrants further investigations into the quality of care provided to the women and more training and education concerning mental problems occurring during the perinatal period. Key messages • Around a quarter of women claim mental health benefits during the perinatal period, most often psychotherapy services. • Substantial demand for mental health services during the perinatal period calls for comprehensive infrastructure and quality assessments of available options.

What are the health system impacts of engaging with global health activity? A qualitative study

Abstract Background Global health partnerships between high-income health systems and low- and middle-income countries (LMICs) are becoming more common as there is an appreciation of the need for collaboration to solve global health issues through knowledge and skill exchange. However, partnership evaluations largely focus on the benefits to individual participants and recipient systems, with little evidence of the impacts on the high-income system. Therefore, the aim of this study was to explore the health system-wide impacts of engaging with global health activity and consider the arguments for and against adopting these partnerships. Methods We carried out semi-structured interviews with individuals from three UK health systems that engage with global health activity to explore their motivations to in doing so. Transcripts were thematically analysed. Results We found that engagement in global health activity can contribute to workforce recruitment, retention, development, and upskilling, benefiting the system. Examples were also given of system-wide clinical, reputational, and economic benefits. However, this activity impacts short term staffing and can cause personal emotional issues that systems need to support. We also explored facilitators of engaging in global health work which included operational support, supporting healthcare staff to engage, and system acceptance. Barriers included lack of senior buy-in, opportunity access inequities, operational challenges, and the current UK health system challenges. Conclusions This study demonstrated the potentially significant system-level benefits of engaging in global health activity. These focused on improved workforce, which is a major public health issue worldwide. We have also identified system characteristics, such as buy-in and operational support, which influence success. We hope this work provides a building block demonstrating there are benefits to be had for donor health systems, but barriers must be overcome. Key messages • The potential benefits and drawbacks that may arise from high-income health systems engaging in global health, as well as facilitators and barriers, are explored. • This study creates a foundation to understand donor-system benefits and encourages further research, particularly in systems who do not engage with global health activity to understand why this is.

Training for migrant live-in care workers in Austria: results from an online survey

Abstract Background In Austria, almost 60.000 migrant “24-hour” live-in caregivers work in two- or four-week shifts, travelling between Austria and their countries of origin (mostly Romania, Slovakia, Croatia, Hungary and more) to care for frail older people at home. As opposed to other social and healthcare professions, live-in care workers do not require any formal training at all to be able to work in Austria. Methods With the aim of gaining an in-depth insight into the working conditions of live-in caregivers and with the aim of recording their problems and needs, an online survey including 40 questions was conducted from 15 July to 15 September 2023 in four languages (Slovak, Romanian, Bulgarian and German). The study is part of the MigraCare project which focuses on improving working and living conditions for migrant live in care workers. Results Results show that many live-in caregivers are not fully aware of their job profile: what are nursing and medical tasks they are only allowed to do when delegated by professional healthcare staff? Most respondents have to take on tasks that are outside their job profile. Many state that it is difficult to care for people with dementia. In addition, some caregivers report physical and psychological violence and sexual harassment. Most wish for training possibilities regarding topics like dementia, communication with client and family, legal framework regarding their job in the long-term care sector and others. Conclusions Live-in care workers wish for continuous education activities and for a better relationship with the family relatives and the care recipient. Based on the results of the survey short multilingual training videos have been developed easily accessible on a video platform for live-in care workers. Also, a connection to community nurses has been established in order to improve communication between care recipient, family members and live-in care workers. Key messages • Results from an online survey show that live-in care workers face challenges at work which are partly due to an unclear job profile as well as communication problems with the care recipient. • Results of an online survey show that live-in care workers wish for education and training opportunities (mother tongues) in the field of dementia care, communication with family or legal framework.

Measures to increase the retention of migrant healthcare professionals in Germany

Abstract Background The shortage of skilled workers in the healthcare sector is a pressing issue in Germany that has been worsening in recent years. It is often compensated by the deployment of specialists from abroad. However, this is accompanied by various challenges. This article synthesizes challenges from nine years of research and proposes approaches to solutions that have proven successful in practice in Germany as well as in international settings. Methods The insights presented here condense the results from a total of six research projects (four on physicians and two on nursing). The research projects are based on exploratory qualitative interviews, quantitative questionnaires, mixed-methods designs, and the generation and testing of measures that can help with the integration of foreign skilled workers. Results The main challenges for migrated skilled workers are inadequate language and communication skills, lack of knowledge about the national healthcare system, disease and therapy concepts, unfamiliar forms of inter-hierarchical and inter-professional collaboration, a lack of understanding of administrative and bureaucratic processes and social integration. The following measures have proven successful in Germany and abroad: increasing social integration of physicians (e.g. through partner or peer programs), streamlining systems, establishing professional structures for the integration of foreign skilled workers, and creating a positive work environment. Conclusions Compared to findings from international studies, in Germany the hurdles of administrative processes, the peculiarities of the healthcare system (e.g. social medicine), and learning the language are considered to be the highest. It is important to counteract these challenges with appropriate measures in order to prevent a migration of healthcare professionals already in Germany to (mostly English-speaking) foreign countries. Key messages • In Germany the hurdles of administrative processes, the peculiarities of the German healthcare system (e.g. social medicine), and learning the German language are considered to be the highest. • It should be considered to no longer leave the migration of healthcare staff to individual integration efforts, but to create appropriate government structures that focus on their social integration.

Perspectives on intersectoral collaboration and citizen participation in community-based prevention

Abstract Background Challenges in healthcare, such as rising healthcare costs, shortages of healthcare staff, and health disparities, have made many countries focus on intersectoral collaboration (IC) and citizen participation (CP) in community-based prevention (CBP) and health promotion (HP). Previous research on IC and CP has addressed the importance of exchanging perspectives to arrive at a shared vision and ambition. Our study is part of a long-term action research project conducted in two neighborhoods in the Netherlands. It aims to provide insight into stakeholders’ perspectives on IC and CP in CBP and HP to facilitate building partnerships. Methods Data collection takes place from March to June 2024. As part of a Q-study, we perform post-sort interviews. The Q-methodology is based on sorting statements concerning various aspects of IC and CP in CBP and HP (e.g., roles and tasks, involvement of citizens, communication, perceived barriers, etc.). We aim to include 40-50 participants from the aforementioned neighborhoods with diverse backgrounds. Participants sort 40 statements (Q-set) into a fixed-scaled framework ranging from -4 (disagree) to + 4 (agree). The interview is about individual sorting and perspectives on their own role within the collaboration. Results So far, the results of 10 participants with backgrounds in health care, social work, sports, local authority, volunteer work, and public health have been analyzed.Preliminary data synthesis shows six themes concerning shared purpose, collaboration partners, social collaboration competencies, personal motivation, conditions, and collaboration organization. Conclusions The preliminary themes overlap with findings from previous research. We will adapt existing models to reflect on our findings and enrich the literature with new themes or insights in the specific context. The interviews will help interpret the Q-sorts and develop follow-up actions in the action research projects in the participating neighborhoods. Key messages • Insights in stakeholders’ perspectives are valuable for building local collaborative partnerships. • Shared purpose, collaboration partners, social collaboration competencies, personal motivation, conditions, and collaboration organization are themes of interest to intersectoral collaboration.

Exploring the role of AI-driven chatbots in patient care: a critical evaluation amidst healthcare staff shortages

Abstract Background Amidst the backdrop of staff shortages in healthcare systems, patients and their families are increasingly turning to chatbots, powered by Large Language Models (LLMs), for information about their medical conditions. These AI-driven chatbots, capable of generating human-like responses across a broad range of topics, have become a prevalent tool in the healthcare landscape. Given the proliferation of these chatbots, it is crucial to evaluate the quality and accuracy of the responses they provide. Methods We selected five freely accessible chatbots (Bard, Microsoft Copilot, PiAI, ChatGPT, and ChatSpot) for our study. These chatbots were posed questions spanning three medical fields: cardiology, cardio-oncology, and cardio-rheumatology. The responses generated by the chatbots were then compared against established guidelines from the European Society of Cardiology, American Academy of Dermatology, and American Society of Clinical Oncology. In addition to the content, the readability of the responses was evaluated using four different readability scales: the Flesch Reading Scale, Gunning Fog Scale Level, Flesch-Kincaid Grade Level, and Dale-Chall Score. To assess the accuracy of the responses in accordance with the medical guidelines, two independent medical professionals rated them on a 3-point Likert scale (0 - incorrect, 1 - partially correct or incomplete, 2 - correct). This allowed us to gauge the compliance of the chatbot responses with the medical guidelines. Results Results: In our study, we posed a total of 45 questions to each of the chatbots. Out of the five chatbots, Microsoft Copilot, PiAI, and ChatGPT were able to respond to all the questions. The length of the responses varied, with PiAI providing the shortest average response length of 7.26 words, and Bard providing the longest at 18.9 words. In terms of readability, the Flesch Reading Ease Scale scores ranged from 17.67 (ChatGPT) to 39.34 (Bard), indicating the relative complexity of the responses. The Flesch-Kincaid Grade Level, which reflects the academic grade level required to comprehend the text, ranged from 14.02 (PiAI) to 15.97 (ChatGPT). The Gunning Fog Scale Level, another measure of readability, varied from 15.77 (Bard) to 19.73 (ChatGPT). Lastly, the Dale-Chall Score, which assesses the understandability of the text, ranged from 10.24 (Bard) to 11.87 (ChatGPT). These results highlight the variability in the readability and complexity of responses generated by different chatbots. Readability analysis is presented in table 1. Conclusion This study indicates that chatbots vary in length, quality and readability. They answer each question in their way, based on data they have pulled from the network. Our data suggests that people who want information from a chatbot need to be careful and verify the answers they get.

Deafness and Inclusion: Perceived Communicative Barriers in the Area of Rehabilitation in Italy

Abstract Introduction Deafness can create a communication deficit/barrier between the Deaf or Hard of Hearing patient and the Healthcare Workers (HWs), with negative outcomes for diagnostic and therapeutic success. As underlined by the COVID-19 pandemic, there is a need to train HWs in effective communication strategies in order to avoid marginalising or excluding the Deaf Community by denying them access to healthcare services. This study highlights the urgent need and desire of Healthcare staff for training in effective communication strategies, such as sign language, to help the Deaf community gain equal access to Healthcare. Materials and methods A cross-sectional survey was carried out between May and July 2022 using the Google Forms platform. An anonymous questionnaire was given to Rehabilitation HWs (RHWs) at a national level to collect information from the HWs of the various areas of rehabilitation, identifying their knowledge, training, and experience with regard to deafness. Data analysis was then carried out using the Google Forms program, SPSS program Windows7 Excel Spreadsheet. Results 252 RHWs belonging to 8 different profiles answered this survey. 89% were women. 46% were younger than 30. 57% of these 252 had deaf patients, but 54.6% of these had no prior training. 33% of the RHWs had followed courses or seminars on deafness at least once. When asked, 94% were interested in courses or training in communication with deaf people. Conclusions HWs recognize the gap in communication and are willing to learn more in the matter for effective communication with their patients to gain a better therapeutic success. They also consider a program that imparts such knowledge and training to be highly important. Key messages • Therapeutic success is increased if there are effective communication strategies, such as sign language, between the Deaf and Healthcare provider. • This study shows the importance of training all health workers in effective communication strategies with deaf people to allow an all-inclusive healthcare.

Does staffing impact health and work conditions of staff in long-term care homes?: a scoping review

Abstract Background Long-Term Care (LTC) homes are highly regulated and task oriented, with demanding work and insufficient resources. Chronic underfunding of the sector, coupled with increased complexity of care, has deteriorated working conditions, resulting in precarious employment, intensified and stressful work, and decreased job satisfaction. These work conditions have contributed to severe staffing shortages of healthcare workers globally. To meet increased labour demands, OECD countries on average will need to increase the proportion of overall employment dedicated to LTC by 32% over the next decade. While reviews of literature have examined the association between staffing and care outcomes for residents in LTC, they have not examined how staffing structures affect the healthcare staff themselves. This scoping review asks: How does staffing impact the health of staff and working conditions in LTC? Methods A scoping review of empirical peer reviewed and grey literature was conducted to examine the association between LTC staffing practices and how they impact working conditions and the health and well-being of staff. PubMed, CINHAL, and Scopus databases were searched for relevant articles published within the past 10 years. Results Searches yielded 3994 unique articles, which were independently screened by pairs of reviewers. Preliminary results highlight that staffing levels are not optimized for healthy, sustainable work conditions. The level of staff, their skill mix, and ratios all impact the ability to provide care. In circumstances where there is inadequate staffing, care workers are more likely to experience stress, burnout, job dissatisfaction, and increased injury and illness. Conclusions Staffing practices shape working conditions which impact healthcare workers own health outcomes. To facilitate a strong LTC workforce, working conditions and occupational health need to be a priority in improvement initiatives. Key messages • With extreme staffing shortages challenging the healthcare sector, this review highlights the need for heightened attention to the impact of staffing practices on the healthcare workforce. • Improving working conditions and attuning to the needs of the workforce, ultimately improves quality of care.

Healthy lifestyle promotion project among healthcare workers

Abstract Background The psychosocial risks generated from difficult work conditions are damaging not only for the workers’ health and safety, but also have a huge impact on the organization and management efficiency. Description Some of the primary challenges that health workers face are demanding schedules and stressful shift patterns which lead to higher levels of worker burnout. Ensuring the well-being of healthcare staff is crucial not only for the individual workers, but it also brings important lessons to the community creating an environment built on a culture of health. Results In the past year, the Hospital of Cittadella (Province of Padua) has launched a set of programmes structured to help the staff make better lifestyle choices that affect not only their personal life but also create a more sustainable work environment. One of the projects involved various meetings with a Physical Medicine-Rehabilitation physician, a physical therapist, an Occupational Medicine physician and a medical yoga teacher. The encounters, attended by nearly 10% of the hospital staff, were aimed to help healthcare workers create a more balanced lifestyle and to implement physical activity and posture exercises in their daily routine. Four nutrition classes were also organized with the help of a nutritional biologist. The aim of this course was to show the basics of healthy diets supported by scientific data and guide the participants towards realistic and healthy meal plans. Lessons In conclusion, increasing the general wellbeing within the healthcare context is not an easy task, especially when organizational circumstances like staff reduction are being faced. These projects represent a small step towards facing these difficulties. It is important to note that the motivation, collaboration, inclusivity, flexibility and reliance are all elements that contribute to better mental and physical health of the healthcare staff which is crucial on an individual, organizational and societal level. Key messages • Increasing personal well being amongst healthcare workers can help create a more sustainable work environment. • A healthy work environment is crucial for a better functioning organization.

Factor Influencing Unmet Healthcare Needs among the disabled

Abstract Background The unmet Healthcare needs (UHNs) of the disabled are not only detrimental to their quality of life but also can lead to serious health outcome including death. A variety of factors including socioeconomic, personal, environmental factors affect UHNs for the disabled. Methods We analyzed the UHNs status and influencing factors among 4,326 adult the disabled using Korea disability Life Data. Chi-square analysis was conducted to identify differences in UHNs according to characteristics of general, disability, environmental of the disabled. Logistic regression analysis was conducted to determine factors affecting UHNs. Results Those with low educational level (aOR=1.23, 95% CI = 1.02-1.48), those enrolled in private insurance (aOR=1.23, 95% CI = 1.02-1.50), those need help with daily living (aOR=1.30, 95% CI = 1.06-1.59), those who rarely go out (aOR=1.57, 95% CI = 1.27-1.92), those who use taxis (aOR=1.41, 95% CI = 1.05-1.89) or call taxi for the disabled when going to the hospital (aOR=1.37, 95% CI = 1.01-1.88), the communication disabled (aOR=1.30, 95% CI = 1.03-1.65), those with poor subjective health status (aOR=1.25, 95% CI = 1.04-1.49), those felt the explanation of treatment results was insufficient (aOR=4.04, 95% CI = 1.37-11.93), and those dissatisfied with healthcare services (aOR=3.52, 95% CI = 2.74-4.51) were more likely to experience UHNs. Conclusions Effective healthcare service provision for the disabled requires not only financial assistance but also social support, along with education for healthcare staff, policies with the characteristics of disabilities. Funding: This research was supported by a grant of Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HC23C0165) and by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. RS-2024-00394642) Key messages • The disabled need not only financial support when using healthcare services, but also support from society, such as accompanying them to the hospital and providing transportation. • Education for healthcare staff who communicate with the disabled and provision policy to provide appropriate healthcare services according to the characteristics of disabilities are needed.

Wait, What? What's Going On?- Pregnancy Experiences of Deaf and Hard of Hearing Mothers Who Do Not Sign.

Deaf and hard of hearing (DHH) women experience higher rates of reproductive healthcare barriers and adverse birth outcomes compared to their hearing peers. This study explores the pregnancy experiences of DHH women who do not sign to better understand their barriers and facilitators to optimal perinatal health care. Qualitative study using thematic analysis. Semi-structured, individual remote, or in-person interviews in the United States. Twenty-two DHH English speakers (non-signers) who gave birth in the United States within the past 5 years. Semi-structured interviews explored how DHH women experienced pregnancy and birth, including access to perinatal information and resources, relationships with healthcare providers, communication access, and their involvement with the healthcare system throughout pregnancy. A thematic analysis was conducted. The barriers and facilitators related to a positive perinatal care experience among DHH women. Five key themes emerged. For barriers, healthcare communication breakdowns and loss of patient autonomy highlighted DHH women's struggle with perinatal health care. In contrast, DHH participants outlined the importance of accessible health communication practices and accommodations, use of patient advocacy or self-advocacy, and assistive technologies for DHH parents for more positive perinatal care experiences. Perinatal healthcare providers and staff should routinely inquire about ways to ensure an inclusive and accessible healthcare experience for their DHH patients and provide communication accommodations for optimal care. Additionally, healthcare providers should be more aware of the unique parenting needs and resources of their DHH patients.

Exploring the Impact of Managerial Coaching, Emotional Intelligence and Social Support on Employee Retention: The Mediating Role of Employee Resilience in Malaysian Public Healthcare

This paper explores the correlation between managerial coaching, emotional intelligence, social support, employee resilience, and retention among healthcare workers in Malaysia's public healthcare sector. Retaining healthcare staff has become a severe difficulty in the BANI (Brittle, Anxious, Non-linear, Incomprehensible) environment, worsened by the COVID-19 epidemic. The study suggests that managerial coaching, emotional intelligence, and social support are essential for developing resilience among healthcare workers. This resilience, in turn, impacts their ability to stay in their jobs. The study will employ a quantitative cross-sectional survey approach to examine the links inside specific public hospitals in Malaysia. The results are anticipated to offer a vital understanding of how public healthcare in Malaysia can strategically improve staff resilience and retention, guaranteeing the long-term viability of the healthcare workforce in a world after the pandemic. This study enhances our comprehension of the intricate processes that impact staff retention in the public healthcare industry, providing practical implications for policymakers and healthcare managers.

Exploring the experience of cardiothoracic ICU clinicians during the COVID-19 pandemic: A grounded theory study.

Prior to the COVID-19 pandemic a flexible approach to visiting was adopted by many Intensive Care Units in the United Kingdom. Due to the rapid spread globally of COVID-19, significant policy changes were put in place, including the restriction on visitors to patients in hospital. Evidence has emerged demonstrating the negative impact of these restrictions on patients with COVID-19, their families and the staff caring for them. However, there is limited data about the impact of these restrictions in the non-COVID ICU environment. This study aimed to explore the experiences of staff caring for non-COVID-19 patients in a cardiothoracic critical care unit during the COVID-19 pandemic. This qualitative research study adopted a grounded theory methodological approach. This methodology was used due to the unique situation, with no prior research available. We recruited healthcare staff that worked in a cardiothoracic critical care unit during the COVID-19 pandemic. Semi structured interviews were carried out, transcribed, and analysed. Using the data collected, a theory was constructed. Interviews were carried out with 20 healthcare staff from a range of professions including nurses, doctors, and allied health professionals. Following data analysis four main categories emerged from the data: impact and implementation of visiting restrictions; the dehumanisation of patients; end-of-life care and witnessing distress. From these four categories, a theory has emerged suggesting that healthcare staff in a non-covid ICU were regularly exposed to potentially moral injurious events, despite being shielded from caring for patients with COVID-19. This study provides a theory that healthcare staff caring for non-COVID-19 critical care patients during the period of visiting restrictions were exposed to potentially morally injurious events. Repeated exposure to potentially morally injurious events can lead to the development of moral injury and its adverse consequences. This study highlights the need to support all staff in the post COVID era, including those who worked in a non-COVID environment.

Improving Family-Centered Rounds With a Nursing Checklist in the Electronic Health Care Record.

Family-centered rounds (FCR) is the standard for pediatric communication, but community pediatric hospital medicine services may face barriers in implementation, including offering FCR to families with a language preference other than English (LOE) versus those with an English preference (EP). The goal of our quality improvement project was to increase FCR from 33% to 80% over 1 year. Interventions included an FCR checklist integrated into the electronic healthcare record (EHR-FCR checklist), staff education, visual prompts, and interpreters. Our primary outcome measure was weekly % FCR. Our main process measure was weekly % nursing documentation. To address language inclusion, we compared FCR encounters for families with LOE versus EP. The use of the checklist without interventions was assessed during the sustain period. Control charts were used to analyze measures. Fisher's exact test was used to compare FCR for families with LOE versus EP. FCR increased to 81% during the intervention period and then decreased to 73% during the sustain period. Nursing documentation increased to 93% with the EHR-FCR checklist implemented as a flowsheet. There was no statistical difference in the proportion of families with LOE versus EP who participated in FCR (84% versus 81%, P = .38) during the intervention period; a statistically higher proportion of families with LOE participated in FCR during the sustain period (87% vs 72%, P <.01). We increased documented FCR on our community pediatric hospital medicine service, including FCR for families with LOE, by implementing a nursing-completed EHR-FCR checklist supported by staff education, visual prompts, and interpreters.

Implementing Dynamic Systems Development Method for a Web-Based System to Evaluate Child Health and Growth

The Simpang Gambir UPTD Community Health Center has developed an innovative digital system to monitor the growth of toddlers. Previously, the recording of toddler growth data was done manually, often leading to data loss or damage. This new system is designed to address these issues and provide a more efficient and accurate solution. The system not only facilitates health center staff and posyandu cadres in monitoring toddler development but also assists them in creating digital growth reports. With this system, toddler growth data can be accessed quickly and easily, facilitating decision-making regarding child health management. One of the key features of this system is its ability to track toddler growth based on weight-for-age charts. This feature allows health workers to easily identify toddlers with nutritional problems and promptly provide necessary interventions. Additionally, the system is equipped with a fast data search feature, enabling staff to easily find specific toddler growth data. The development of this system utilizes the Dynamic System Development Method (DSDM), allowing for a structured and efficient development process. With this method, the system can be developed rapidly and in accordance with user needs.

Healthcare Internet of Things system implementations for COVID-19 prevention

BackgroundIn response to the widespread transmission of COVID-19 in Australia, healthcare facilities implemented stringent infection control measures, and mandatory and manual screening procedures were introduced to ensure the safety of patients and healthcare staff. However, these necessary measures resulted in imbalances within the healthcare system, a shortage of front-line workers and impacts on patient experience and wait times. The prioritization of infection control measures shifted resources away from routine care, causing delays in accessing necessary healthcare services.Methods and FindingsTo address these challenges, we developed and implemented an Internet of Things (IoT) Smart Screening eGate solution in partnership with a large metropolitan children’s hospital in Australia. This solution integrated a contactless health self-service web app, thermal camera, and physical barrier to automate the COVID-19 health screening and data recording process. During the 3-month pilot period, we deployed the eGate at multiple entrances to the hospital, and monitored the number of users of the system in different periods. We also used a framework of formative evaluation to classify user design challenges within limited resources and improved the design of the eGate to enhance its effectiveness. Our findings show that the IoT eGate solution improved the efficiency of the screening process and reduced the workload and exposure risks of front-line staff and anyone who required access to the hospital. By automating the screening process, we reduced the need for manual screening and minimized contact between individuals, thus reducing the risk of potentially infected.ConclusionIn conclusion, our pilot study demonstrated the potential of IoT technologies in improving the efficiency and safety of medical facilities during pandemics and provided a series of recommendations for the translation of IoT technologies for medical facilities, including the importance of co-design and collaboration with stakeholders, user-centered design, and ongoing monitoring and evaluation.

Implementing AI-Driven Bed Sensors: Perspectives from Interdisciplinary Teams in Geriatric Care.

Sleep is a crucial aspect of geriatric assessment for hospitalized older adults, and implementing AI-driven technology for sleep monitoring can significantly enhance the rehabilitation process. Sleepsense, an AI-driven sleep-tracking device, provides real-time data and insights, enabling healthcare professionals to tailor interventions and improve sleep quality. This study explores the perspectives of an interdisciplinary hospital team on implementing Sleepsense in geriatric hospital care. Using the interpretive description approach, we conducted focus groups with physicians, nurses, care aides, and an activity worker. The Consolidated Framework for Implementation Research (CFIR) informed our thematic analysis to identify barriers and facilitators to implementation. Among 27 healthcare staff, predominantly female (88.89%) and Asian (74.1%) and mostly aged 30-50 years, themes emerged that Sleepsense is perceived as a timesaving and data-driven tool that enhances patient monitoring and assessment. However, barriers such as resistance to change and concerns about trusting the device for patient comfort and safety were noted, while facilitators included training and staff engagement. The CFIR framework proved useful for analyzing implementation barriers and facilitators, suggesting future research should prioritize effective strategies for interdisciplinary team support to enhance innovation adoption and patient outcomes in rehabilitation settings.

Spiritual care competences of healthcare workers in emergency and intensive care-aprospective questionnaire study

In intensive and emergency care, patients and their relatives are confronted with potentially existential crises. Spiritual care can be an additional resource to address related psychosocial and physical symptoms and to support patients and their relatives. Accordingly, healthcare workers need spiritual skills to recognize and respond to these needs. What spiritual competencies do healthcare workers in intensive and emergency care have? Are there differences between professions and genders? What factors influence spiritual competencies? The prospective questionnaire study included physicians participating in intensive care and emergency medicine courses and nurses who were training or working in intensive and emergency care. Self-reported spiritual competencies were assessed using the Spiritual Care Competence Questionnaire (SCCQ), which captures the following areas: perceptual competence, team-spirit, documentation competence, self-awareness and proactive opening, knowledge about other religions, competence in conversation techniques and proactive empowerment-competence. We included 465 physicians (50% female, years in profession: mean = 4.0, standard deviation [SD] = 3.5) and 86nurses (80% female, years in profession: mean = 12.7, SD = 10.7). The average SCC was2.3 (SD 0.4) out of amaximum of 4points, with higher spiritual competences among spiritual and religious respondents. There were differences in specific competencies between the professions and genders. Women indicated ahigher level of competence in the area of perception and conversation skills, physicians in documentation skills. Overall, there is aclear need to train healthcare staff in the field of intensive care and emergency medicine.

The Privatization and Deregulation of Healthcare in India with an Emphasis on Oversight, COVID-19, and Liberal Policy

The quasi-notion of the centralized and privatized nature of healthcare anent the familiar juxtaposition of the latter in India upon the post-liberal and welfare-esque socio-economic context of the aforementioned institution in the West provides an inherently conclusive but convoluting interpretation and dissertation into the documented and instituted proto-struggles of those latterly employed. The menial and oppositionary treatment and subjugation of doctors and other healthcare staff is a reference id est apropos in the positional setting of the perspective of the neo-polity situated in the post-industrial Indian context. The government, both locally and federally, has an implicitly embedded responsibility toward the political essence of its representation in the view of its constituents and also the latterly employed. This paper creates an extraversion scale and similarly an extraversion test entitled, the ‘L/R Extraversion Scale’. The L/R Extraversion Scale judges the perspectives of its respondents in a defined pair of grading/scoring scales, id es namely, the ‘Left Extraversion Scale’ (LES), and the ‘Right Extraversion Scale’ (RES); scored out of 8 and represented on the X-Y axes alongside the accompanying intensity and frequency of the received variable responses on the test. When represented as the latter, and upon the presentation of the median at four, the delineation of the results in the second and fourth quadrants allows for an analysis of the scores on the LE and RE Scales.