Healthcare Staff Research Articles

How should medical society face patient feedback in online review platforms?

In the medical field, the importance of online reviews is escalating. However, the complexity of responding to these reviews is profound, as such anonymous critiques may encompass not only emotionally distressing content but also potentially malicious criticisms directed at healthcare professionals. While recognizing the vital role of patient feedback, there exists a necessity for a collective approach to managing online commentary. This effort seeks to strike a balance between patient satisfaction and the safeguarding of healthcare practitioners and administrative staff. We believe the global medical community must establish guidelines to effectively handle such scenarios, thereby contributing to the sustainability of patient-centered services.

Management of COVID-19 in Universitas Gadjah Mada (UGM) Academic Hospital: Balancing to save the patients and protect the staffs

The Coronavirus Disease 2019 (COVID-19) is a worldwide outbreak disease caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Indonesia is the fourth most populous country in the world and is predicted to be affected significantly over a more extended period. Universitas Gadjah Mada (UGM) Academic Hospital is one of the COVID-19 referral hospitals located in the Yogyakarta Special Region, Indonesia. Since the early months of the pandemic, the hospital has prepared strategies to provide effective and efficient patient care. The focus has been safety for both patients and healthcare staff. Here, we will share our experiences activating a Hospital Incident Command System (HICS) as a hallmark for preparedness and response to the COVID-19 pandemic disaster so it can be adopted in other hospitals nationwide or worldwide. The HICS in the UGM Academic Hospital includes 1) surge capacity for isolation rooms, 2) infection prevention and control, 3) human resources, 4) continuity of essential health services and patient care, 5) communication, 6) logistics and management of supplies including pharmaceuticals, 7) essential support services, 8) case management system, 9) surveillance early warning and monitoring, 10) laboratory services, and 11) additional programs including community service programs. Based on our experiences, early preparedness with a proactive response, and adapting plans to local needs, the national and global current situation are the keys to managing patient care. Implementing all levels of the hierarchy of control infection and keeping the human resources adequate also could protect staff

Modeling Nursing Home Harms From COVID-19 Staff Furlough Policies

Current guidance to furlough health care staff with mild COVID-19 illness may prevent the spread of COVID-19 but may worsen nursing home staffing shortages as well as health outcomes that are unrelated to COVID-19. To compare COVID-19-related with non-COVID-19-related harms associated with allowing staff who are mildly ill with COVID-19 to work while masked. This modeling study, conducted from November 2023 to June 2024, used an agent-based model representing a 100-bed nursing home and its residents, staff, and their interactions; care tasks; and resident and staff health outcomes to simulate the impact of different COVID-19 furlough policies over 1 postpandemic year. Simulating increasing proportions of staff who are mildly ill and are allowed to work while wearing N95 respirators under various vaccination coverage, SARS-CoV-2 transmissibility and severity, and masking adherence. The main outcomes were staff and resident COVID-19 cases, staff furlough days, missed care tasks, nursing home resident hospitalizations (related and unrelated to COVID-19), deaths, and costs. In the absence of SARS-CoV-2 infection in the study's 100-bed agent-based model, nursing home understaffing resulted in an annual mean (SD) 93.7 (0.7) missed care tasks daily (22.1%), 38.0 (7.6) resident hospitalizations (5.2%), 4.6 (2.2) deaths (0.6%), and 39.7 (19.8) quality-adjusted life years lost from non-COVID-19-related harms, costing $1 071 950 ($217 200) from the Centers for Medicare & Medicaid Services (CMS) perspective and $1 112 800 ($225 450) from the societal perspective. Under the SARS-CoV-2 Omicron variant conditions from 2023 to 2024, furloughing all staff who tested positive for SARS-CoV-2 was associated with a mean (SD) 326.5 (69.1) annual furlough days and 649.5 (95% CI, 593.4-705.6) additional missed care tasks, resulting in 4.3 (95% CI, 2.9-5.9) non-COVID-19-related resident hospitalizations and 0.7 (95% CI, 0.2-1.1) deaths, costing an additional $247 090 (95% CI, $203 160-$291 020) from the CMS perspective and $405 250 (95% CI, $358 550-$451 950) from the societal perspective. Allowing 75% of staff who were mildly ill to work while masked was associated with 5 additional staff and 5 additional resident COVID-19 cases without added COVID-19-related hospitalizations but mitigated staffing shortages, with 475.9 additional care tasks being performed annually, 3.5 fewer non-COVID-19-related hospitalizations, and 0.4 fewer non-COVID-19-related deaths. Allowing staff who were mildly ill to work ultimately saved an annual mean $85 470 (95% CI, $41 210-$129 730) from the CMS perspective and $134 450 (95% CI, $86 370-$182 540) from the societal perspective. These results were robust to increased vaccination coverage, increased nursing home transmission, increased importation of COVID-19 from the community, and failure to mask while working ill. In this modeling study of staff COVID-19 furlough policies, allowing nursing home staff to work with mild COVID-19 illness was associated with fewer resident harms from staffing shortages and missed care tasks than harms from increased COVID-19 transmission, ultimately saving substantial direct medical and societal costs.

Research report: Management of dysphagia using pharyngeal electrical stimulation in the general intensive care population - A service development.

Dysphagia places a substantial burden on the critically ill, affecting 12%-84% of this cohort, and is independently associated with worse outcomes. Pharyngeal electrical stimulation (PES-treatment) is a novel dysphagia therapy with an emerging evidence base. This retrospective observational study describes our dysphagia service and reports the use of PES-treatment as a standard of care in recovering critically ill patients at a single-site tertiary UK hospital. Patients admitted to Acute or Cardio-Thoracic adult intensive care units between 1st July 2017 and 30th June 2022 were routinely referred to Speech and Language Therapy (SLT) following tracheostomy, or suspected dysphonia/dysphagia. Clinical assessments and direct laryngeal visualisation using Fibreoptic Evaluation of Swallowing (FEES) were performed. Severe dysphagia was defined as Penetration-Aspiration Score of ⩾6 and patients were offered PES-treatment when staffing allowed. Of 289 patients with severe dysphagia, 19 underwent a course of PES-treatment with the remaining patients receiving standard care. PES-treatment patients were significantly less likely to remain nil-by-mouth (11.1% vs 62.5%, Chi2 p < 0.001) or to have an enteral feeding tube in situ at discharge from critical care (27.8% vs 62.5%, p = 0.006) than those receiving standard dysphagia care. Both groups demonstrated an improvement in Penetration-Aspiration Score at repeat FEES: PES-treatment mean difference -2.0 (p = 0.003); non-PES-treatment -1.68 (p < 0.001); (61% PES-treatment improved vs 40% non-PES-treatment, p = 0.09). Our observations suggest that PES may be effective in the general critical care population. PES may offer new treatment options for patients and healthcare staff managing severe dysphagia and its significant consequences.

Infection prevention and control: understanding the fundamentals.

Infection prevention and control is crucial to prevent patients and healthcare staff from being harmed by avoidable infections, including healthcare-associated infections. This article outlines the main elements of standard precautions for infection prevention and control, as set out by the World Health Organization. Nurses and other healthcare professionals can use this information to refresh their knowledge of infection prevention and control, understand the appropriate practices that should be adopted to reduce the risk of infection transmission, and increase their awareness of the importance of sustainability and education.

Innovations in nurse education: creating the multisensory learning approach of The WISE Room.

Nursing students often face anxiety and cognitive overload, leading to high attrition rates; meanwhile, traditional pastoral interventions have proved insufficient. A novel, digitally enhanced learning environment named The Wellbeing in Student Education (WISE) Room, was introduced as an alternative at a UK university. This study investigated the impact of The WISE Room, a 4m × 4m digital platform containing touch-interactive walls, co-created with students and academic staff, designed to promote insight through immersive experiences beyond traditional learning settings. A mixed-methods approach was adopted, collecting data from nursing students, healthcare staff and academic faculty. Data were collected at three stages, each corresponding with the iterative development of The WISE Room, including an evaluation of the intervention. Feedback from 240 participants was positive. In Phase 2 of the study, 93% of the 79 students and 21 staff who visited the room and completed a survey were satisfied with the room's suitability in three key areas: emotional wellbeing, academic readiness, and placement preparedness. The WISE Room has proved effective in supporting nursing students' wellbeing, and educational and placement preparation requirements. Its multisensory, digital and experiential nature is beneficial for students throughout their learner journey. Additional trials and content development will be required to enhance the learning and teaching experience further.

A scoping review exploring people's perceptions of healthcare uniforms.

Healthcare staff uniforms are a subject of debate in the UK, and this is particularly true in the case of less understood roles such as advanced nurse practitioners. Aim: This review explores what is known about people's perceptions of health professionals' uniforms. A mixed methods scoping review following the Joanna Briggs Institute (JBI) methodology. Five databases (CINAHL, ASSIA, PsycINFO, and EMBASE) and several search engines were searched. Eligible reports were peer-reviewed English-language studies using any methodology to explore people's perceptions of different uniforms for health professionals. Forty-six studies (mainly from North America) were included, presenting a variety of perspectives on the uniforms worn by doctors, nurses and other health professionals. Culture and context likely influence how uniforms are understood. Practitioners should consider how this may affect communication with both patients and colleagues. What health professionals wear matters, particularly in relation to less well understood roles.

Impact of a health system vertical integration program on patient expenditures and healthcare utilization: Evidence from county hospitals in East China

In 2009, China launched a vertical integration pilot program to promote collaboration between tertiary and county hospitals to reduce rural-urban disparities and strengthen capacity building in healthcare services delivery in county healthcare facilities. Through the program, tertiary hospitals implemented a workforce mobility program to temporarily assign selected physicians and healthcare staff to paired county hospitals. This study uses hospital-level data from 2009 to 2015 to investigate the program's impact on medical expenditures and healthcare utilization among patients visiting the paired county hospitals. A difference-in-differences method with hospital and year-fixed effects is used to address the unobservable heterogeneity of hospitals and the potential impact of national healthcare reform. We find that the average outpatient expenditure experienced a 4.0% decline after the county hospitals received paired assistance from tertiary hospitals. The decline is mainly driven by a reduced proportion of diagnostic testing expenditures. However, there is no evidence that the program affected inpatient expenditures. In addition, county hospitals had 5.1% more outpatient visits after receiving paired assistance, while the average length of stay remains stable. These results are robust when we control the effect of the Zero-Markup drug policy and conduct permutation tests of sample assignment. We conclude that the paired assistance program has successfully improved hospital healthcare services delivery and controlled patient expenditures. Vertical integration has improved healthcare system performance in East China from 2009 to 2015.

Healthcare staff experiences on the impact of COVID-19 on emergency departments: a qualitative study

BackgroundThe COVID-19 pandemic has had a major impact on the access and delivery of healthcare services, posing unprecedented challenges to healthcare staff worldwide. Frontline healthcare staff faced unique stressors and challenges that impact their well-being and patient care. This qualitative study aimed to explore the experiences and perspectives of frontline ED healthcare staff on emergency care services during the COVID-19 pandemic, providing valuable insights into the challenges, adaptations, and lessons learned in delivering emergency care.MethodsThis study utilized a qualitative approach. In-depth semi-structured interviews were conducted with 30 ED healthcare staff from three different hospitals located in Turkey between 15/03/2022 and 30/04/2022. Convenience sampling was used to recruit participants. The duration of the interviews ranged from 28 to 37 min. Data saturation was reached as no new information was gathered. The data were analyzed using the thematic analysis method. NVivo software was used to manage the data analysis process. Member check was carried out to ensure that the generated themes conformed to the participants’ views.Results15 sub-themes under three themes emerged: (1) the impact of COVID-19 on emergency care services, including sub-themes of “introducing a COVID-19 unit in the ED”, “changes in the routine functioning of EDs”, “changes in the number of ED visits”, “quality of care”, “resources”, and “increased workload”; (2) the psychological effects of COVID-19 on ED healthcare staff, including sub-themes of “staying away from family”, “fear”, “society’s perspective on healthcare professionals”, “morale-staff burnout”, “psychological and emotional effects”, and “unable to receive sufficient support”; and (3) the difficulties faced by ED healthcare staff, including sub-themes of “difficult working conditions”, “community-based effects difficulties”, and “COVID-19 is an unknown situation”.ConclusionStaff burnout threatens the quality of patient care and staff retention, and therefore this should be addressed by ED directors and leaders. This study could inform appropriate stakeholders regarding lessons learned from COVID-19 to better manage future pandemics. Learning from such lived experiences and developing appropriate interventions to minimize the difficulties faced during COVID-19 would allow better management of future pandemics. This study calls for a reform to address the challenges faced by healthcare staff, improve the overall response to public health crises, and enhance the resilience of healthcare systems for future crises.

To assess the attitudes of Irish patients attending a pigmented lesion clinic and healthcare staff employed in an academic hospital to biobanking, a quantitative study

AbstractBackgroundA Biobank is a collection of biospecimens or biological samples and corresponding patient data points which are used for the purposes of medical research. Patient participation and support is imperative to biobank research.ObjectivesWe aim to quantitatively assess the attitudes of Irish patients attending a pigmented lesion clinic (PLC) in an Irish dermatology centre and staff working at an academic teaching hospital, to biobanking.MethodsA questionnaire was distributed to Healthcare staff working in an Academic Hospital and members of the Irish Association of Dermatology via their hospital email address. Patients who attended PLC January–April 2023, and patients previously diagnosed with melanoma January 2019–January 2021 were asked to complete the questionnaire. Respondents from a market research company, Bounce insights, was sent a modified questionnaire via a survey.ResultsIn total there were 426 respondents of ages; 16–&lt;18 years = 31 (7%), 18–35 years = 105 (25%), 36–65 years = 191 (45%) and &gt;65 years = 99 (23%). There were 166 (39%) males and 260 (61%) females. Of the 426 total respondents there were 180 (42%) previous healthcare workers. The number of total participants who were aware of biobanks was 130 (31%), no = 283 (66%), not sure = 13 (3%). Over 20% (84) of participants had donated a biospecimen previously. Healthcare workers reported a positive response in 84% (102) but only 46% (72) of the Bounce marketing respondents felt similarly (p = &lt;0.001). Over 60% of healthcare staff, 16% of all patients and 21% of the Bounce marketing group were aware of Biobanks. In total 83% (352) of all respondents were willing to donate a biospecimen following a medical procedure but 78% (331) were willing to donate an additional blood sample and that number fell to 57% (242) when asked if they would donate an additional tissue sample purely for the purposes of research. The number who would encourage a family member to donate a biospecimen was; yes = 241 (56.5%), no = 41 (9.6%) and not sure = 144 (34%). Interestingly age was related to individuals' initial impression of biobanks (X2 (6, N = 426) = 32, p = &lt;0.001), to a willingness to donate a biospecimen (p = &lt;0.039) and to a desire to be informed if their specimen was disposed of (p = &lt;0.001).ConclusionsIn Ireland, the majority of patients, healthcare workers and other members of the public are willing to donate biospecimens for the purposes of research.

Exploring the correlates of head-banging behaviour in a female forensic mental health unit: a mixed-methods study

ABSTRACT Despite the documented high prevalence of head-banging being used as a form of self-harm in forensic settings, little research has investigated its correlation with demographic and clinical factors. This mixed-methods study explores head-banging episodes (n = 145) within a female forensic mental health unit in England between 2019 and 2021. Using between-groups analyses, the study identifies clinical and demographic risk factors associated with head-banging behaviour in the sample. Results showed that White ethnicity, younger age, and a diagnosis of personality disorder were associated with an increased likelihood of head-banging. A subsequent regression analysis underscored the statistical significance of White ethnicity and younger age as predictors of head-banging behaviour in the sample. A thematic analysis of descriptive incident reports provided insights into the underlying psychological factors driving head-banging behaviour, which often emerged as a response to interpersonal factors or psychotic symptomatology. It is hypothesised that head-banging may vary in function across diagnoses. Further research should focus on using in-depth qualitative methods to better understand the functions of head-banging, developing effective management strategies for head-banging, as well as assessing its impact on healthcare staff.

The interdependence of caring, safety, and health in correctional settings: Analysis of a survey of security staff in a large county jail system

The health of incarcerated populations is intertwined with the health of security staff, but the social mechanisms, and especially the specific interventions, that might mitigate these health harms are underexplored. We examine one possible mechanism of interrelated health harms: whether and how jail security staff are willing and able to care for mentally ill detainees. We hypothesize that the attitudes of security staff towards care affect the well-being of everyone in a jail setting—staff, as well as detainees. Analyzing 539 anonymous respondent surveys administered to a stratified cluster sample of security staff working in a large U.S. county jail system, we (1) describe the prevalence of a perceived duty to care and availability of caring resources among security staff and (2) analyze whether variations in a duty to care and caring resources predict outcomes associated with staff and detainee well-being. Across five maximum likelihood models estimated, both perceived duty to care and availability of caring resources are significantly associated with collaborative relationships with medical staff, increased perceptions of personal safety, decreased frequency of hostile encounters, and better self-reported health outcomes. Our models explain 20 percent of the variation in self-reported health outcomes (R2 = .20), a meaningful effect of care on security personnel's well-being. Our findings suggest security staff have an often-overlooked duty to care akin to that experienced by healthcare staff. Among healthcare staff, dual loyalty trainings have successfully amplified caring duties relative to security duties; similar trainings for security staff might better leverage their caring duties to improve both staff and detainee well-being.

Health and social care staff's recognition of elder abuse perpetrated by family members of persons with dementia: a mixed-method study.

Health and social care staff play a significant role in detecting and reporting abuse among persons with dementia. However, they are often left to their own judgements which can lead to elder abuse not being detected or acted on. The aim was to explore what healthcare and social care staff consider elder abuse, and their experience of elder abuse perpetrated by family members of persons with dementia. This mixed-method vignette study was conducted in Sweden during the year 2021. In total 39 staff working in dementia care were included. They first answered the Caregiver Scenario Questionnaire and then participated in a group interview. An inconsistency was revealed regarding whether a management strategy for behavioural difficulties included in the Caregiver Scenario Questionnaire should be considered an abusive act or not. No participants were able to identify all five abusive behaviour management strategies. Participants described witnessing 101 abusive acts including different types of abuse of a person with dementia, with emotional/psychological abuse and neglect being most common. Health and social care staff who work close to older persons are able to detect abuse perpetrated by family members. However, inconsistency in defining abusive acts demonstrates the uncertainty in identifying abuse. This may lead to abuse not being identified, but it also creates feelings of inadequacy among staff.

Daily life without cranial bone protection while awaiting cranioplasty: a qualitative study

PurposeDecompressive craniectomy is occasionally performed as a life-saving neurosurgical intervention in patients with acute severe brain injury to reduce refractory intracranial hypertension. Subsequently, cranioplasty (CP) is performed to repair the skull defect. In the meantime, patients are living without cranial bone protection, and little is known about their daily life. This study accordingly explored daily life among patients living without cranial bone protection after decompressive craniectomy while awaiting CP.MethodsA multiple-case study examined six purposively sampled patients, patients’ family members, and healthcare staff. The participants were interviewed and the data were analyzed using qualitative content analysis.ResultsThe cross-case analysis identified five categories: “Adapting to new ways of living,” “Constant awareness of the absence of cranial bone protection,” “Managing daily life requires available staff with adequate qualifications,” “Impact of daily life depends on the degree of recovery,” and “Daily life stuck in limbo while awaiting cranioplasty.” The patients living without cranial bone protection coped with daily life by developing new habits and routines, but the absence of cranial bone protection also entailed inconveniences and limitations, particularly among the patients with greater independence in their everyday living. Time spent awaiting CP was experienced as being in limbo, and uncertainty regarding planning was perceived as frustrating.ConclusionThe results indicate a vulnerable group of patients with brain damage and communication impairments struggling to find new routines during a waiting period experienced as being in limbo. Making this period safe and reducing some problems in daily life for those living without cranial bone protection calls for a person-centered approach to care involving providing contact information for the correct healthcare institution and individually planned scheduling for CP.

2275 Enhancing delirium awareness among patients’ relatives: a quality improvement project in elderly care

Abstract Aim This Quality Improvement Project (QIP) addressed the pressing need for increased awareness of delirium among patients’ relatives. With a 26% rise in the elderly population in Cambridgeshire, surpassing the 18.6% national average, the project provides crucial information to enhance patients’ relatives access to information about delirium, a condition affecting up to 50% of older hospitalised patients. Method This prospective QIP was conducted across seven Cambridge University Hospital (CUH) geriatric wards. Qualitative surveys determined delirium awareness, understanding, interest and perception of information availability among patients’ relatives with delirium. Measurements included data on the views of online Trust delirium information. Interventions included designing a new eye-catching delirium information poster with a QR code linked to the Trust delirium information leaflet, strategically placing QR code-enabled posters in wards, awareness campaigns targeting healthcare professionals, liaison with the inpatient Dementia team, and targeted communication at Dementia and Delirium Champion training sessions for nursing and healthcare staff. Results Pre- and post-intervention questionnaires, involving 13 relatives visiting these wards, showed a 16%, 10% and 20% respective increase in respondents’ awareness, understanding, and interest in delirium. There was a 29% increase in awareness of location of delirium information post intervention. After the interventions, views of the Trust delirium website increased by 132%. Cycles of the QIP highlighted the importance of laminated posters to comply with infection control measures and the need liaison with ward teams about strategic poster placement. Conclusion this QIP successfully demonstrated the effectiveness of QR code enabled access to patient/relative information and that a multi-faceted approach is required to facilitate effective information provision. We also demonstrated these measures increased delirium awareness in relatives. Future recommendations include continuous monitoring of the availability of posters within clinical areas, content evaluation, and work with the Dementia team to roll this out to all wards with older people within Trust.

2304 Models of care and the role of clinical pharmacists in UK primary care for older people: findings from a scoping review

Abstract Introduction Pharmacists have traditionally worked in primary care, in the community, and with GPs. However, the role of the clinical pharmacist in primary care is evolving and there are plans to employ more clinical pharmacists in the NHS. With an ageing UK population, there is an increase in the number of people living with multiple long-term conditions, accompanied by polypharmacy, posing numerous challenges to healthcare systems. This review investigates the evidence about the varied roles and services delivered by clinical pharmacists in primary care, capturing the perspectives of health and care professionals, older adults, and their carers. Method Our scoping review followed the framework for scoping reviews in accordance with the Joanna Briggs Institute (JBI) methodology. A broad search was conducted in 2023 in CINAHL, Cochrane, Medline, SCOPUS, and Web of Science. We included articles that explored the landscape of clinical pharmacy services for older people in the UK, focusing on roles and services delivered, perceptions, and experiences. Results A total of 23 articles was included. These shed light on the multifaceted responsibilities of clinical pharmacists for older people. Stakeholder perspectives, including healthcare professionals and care home staff, emphasise the positive outcomes of clinical pharmacist involvement, from reducing other practitioners’ workloads to improving patient safety. However, communication gaps among the primary care team and those living with dementia, concerns about competence, and the need for clear role definitions of clinical pharmacists emerge as challenges. Conclusions and implications The review enhances our understanding of the clinical pharmacist service in the UK and identifies gaps in research evidence, emphasising the need for empirical studies on the experiences of older people with cognitive impairment and those from minority ethnic backgrounds. The findings can be used for policymaking, workforce planning, and healthcare provision to improve the services for older people in the UK.

Implementation of a digital distress detection system in palliative care: qualitative data on perspectives of a multiprofessional palliative care team

BackgroundDigital health technologies such as sensor systems are intended to support healthcare staff in providing adequate patient care. In the Department of Palliative Medicine (University Medical Center Freiburg), we developed and implemented a noninvasive, bed-based sensor system in a pilot study. The aim was to detect distress in patients who were no longer able to express themselves by monitoring heart and respiratory rates, vocalizations, and movement measurements. The sensor system was intended to supplement standard care, which generally cannot guarantee constant monitoring. As there is a lack of data on how healthcare professionals experience such a techno-digital innovation, the aim of this study was to explore how the multiprofessional palliative care team who piloted the sensor system perceived its potential benefits and limitations, and how they experienced the broader context of healthcare technology and research in palliative care.MethodsWe conducted a qualitative interview study with 20 members of the palliative care team and analyzed the recorded, verbatim transcribed interviews using qualitative content analysis.ResultsThe sensor system was described as easy to use and as helpful support for patients, care staff, and relatives, especially against the backdrop of demographic change. However, it could not replace human interpretation of stress and subsequent treatment decisions: this remained the expertise of the nursing staff. A potential reduction in personnel was expected to be a risk of a digital monitoring system. The special conditions of research and digital health technologies in an end-of-life context also became clear. Specifically, healthcare staff were open to health technologies if they benefited the patient and were compatible with professional nursing and/or palliative care attitudes. Additionally, a patient-protective attitude and possible interprofessional differences in priorities and the resulting challenges for the team became apparent.ConclusionsA potential digital solution for distress monitoring was considered useful by palliative care practitioners. However, interprofessional differences and compatibility with existing palliative care practices need to be considered before implementing such a system. To increase user acceptability, the perspectives of healthcare professionals should be included in the implementation of technological innovations in palliative care.

Perceptions Toward Telemedicine of Health Care Staff in Nursing Homes in Northern Germany: Cross-Sectional Study.

Digitalization in the German health care system is progressing slowly, even though it offers opportunities for improvement of care. In nursing homes, most of the staff's work is paper based. Following the pandemic, there has been a decrease in the use of telemedicine applications. To ensure long-term implementation, the views of users, in this case nurses, are of interest. This cross-sectional study was conducted to describe which digital applications are already being used at inpatient care facilities, the attitude of nurses toward telemedicine, and for which areas the use of telemedicine in the facilities is considered appropriate by the participants. All inpatient care facility staff in Schleswig-Holstein were invited to participate in the survey from August 1 to October 31, 2022. The questionnaire consists of 17 determinants that ask about the attitude, use, and possible applications of telemedicine. In addition to a descriptive analysis, the influence of the general attitude toward telemedicine on various determinants was examined using the Fisher exact test for nominal variables and Spearman correlation coefficient for metric variables. A total of 425 caregivers participated in the survey. Of these respondents, 10.7% (n=41) currently used video consultations, and 76.1% (n=321) of the respondents were in favor of video consultations being practiced in training. Furthermore, 74.8% (n=312) of the respondents would attend a training on telephone medical consultation. Respondents indicated that video consultations have a small added value compared to asynchronous telemedicine (eg, sending photos). However, video consultations were perceived as somewhat less time-consuming than other communication channels. Video consultations are perceived as most useful for clarifying urgent problems. The respondents estimated that one in five paramedic calls at their facilities could be reduced through telemedicine approaches. It was important to the participants that telemedicine is as simple as possible and that there is a high level of data security. Although many caregivers have a positive attitude toward telemedicine and perceive its advantages, communication channels such as video consultation are still used infrequently in care facilities. To promote the use of telemedicine applications, it is important to emphasize their benefits. The presumed saving of paramedic calls thus represents a benefit, and it is crucial to train caregivers in the use of telemedicine to avoid uncertainties in dealing with the newer technologies. It is important to give them enough time and repetitions of the training.

Patient safety culture in a tertiary care hospital in Makkah, Saudi Arabia, a cross-sectional study

BackgroundPatient safety remains an area of global concern, and patient safety culture among healthcare staff is one of its most important determinants. Saudi Arabia is investing much effort in enhancing patient safety. Assessment of patient safety culture is enlightening about the impact of such efforts and invaluable in informing policy makers about future directions. This study aimed to assess patient safety culture in King Abdullah Medical City (KAMC), a tertiary referral center in Makkah, Saudi Arabia.MethodsIn this cross-sectional study the Hospital Survey on Patient Safety Culture (HSOPSC) version 2.0 was distributed electronically to all staff of KAMC. The HSOPSC version 2.0 Data Entry and Analysis Tool was used to compare results obtained from KAMC to those obtained from global data. Additional analyses were performed on SPSS to explore the presence of associations between responses and participant characteristics.ResultsA total of 350 participants completed the questionnaire, 58.6% of whom were nurses. A comparison of the composite measure of all 10 domains of the HSOPSC showed 62% positive responses at KAMC versus 70% in the global database. This difference was statistically significant, with a chi-square of 10.64 and a p value of 0.001. The percentages of positive responses from the KAMC data exceeded those from the global data in the “Organizational learning and continuous improvement” and the “Communication about error” domains (p = 0.002 and 0.003, respectively).ConclusionAlthough safety culture seems to score lower at KAMC than globally, accelerated improvement in the future is expected based on improvement trends in the literature and the national efforts focused on patient safety.

Assessment of airborne infection control practices at health care facilities of Tumkur District, Karnataka: A descriptive study

IntroductionTuberculosis (TB) is a major health hazard in India and is one of the leading causes of death worldwide. Airborne transmission of infectious disease is a major public health concern. Adherence to the airborne infection control (AIC) is crucial to prevent spread of TB among patients who visit health care facilities and among the health care staff. ObjectivesTo assess the airborne infection control practices at health care facilities of Tumkur Methodology: This descriptive study was conducted in 85 public health institutes in 5 TB units of Tumkur. Data was collected using pre-tested; semi-structured questionnaire through personal interview, verification of records and inspection using WHO check-list. ResultsThe present study showed infection control committee and infection control plan were present in 97.65% and 90.59%, clinical staff underwent periodic TBIC training in 91.76% of PHIs. Waiting area and sputum sample collection area were well-ventilated in 97.65% & 97.65% of PHIs. Health workers practiced hand hygiene in 90.59%, PPEs were available in 85.06% PHIs. ConclusionThe study concludes that, airborne infection control measures which includes administrative, environmental, and use of personal protective equipment were satisfactory among the PHIs but still there is scope for improvement.