Hospital Administrators Research Articles

Best practices in telesurgery: framework and recommendations from the society of robotic surgery (SRS) for safe and effective implementation.

This framework from the Society of Robotic Surgery offers best practices for safe, effective, and ethical telesurgery. It is based on a comprehensive literature review, Delphi consensus process, and an international meeting in Orlando, Florida, in February 2024, involving experts from a variety of domains including surgery, engineering, telecommunications, hospital administration, law, and regulatory affairs. Key areas covered include the global landscape and new models of remote surgical care, technological needs like connectivity and cybersecurity, safety standards, training and credentialing for surgical teams, and scalable implementation models. It also addresses legal and ethical issues, clinical indications, and regional and international regulatory comparisons. This framework aims to be a key reference for institutions, surgical societies, policymakers, and technology developers to promote safe, equitable, and sustainable telesurgery worldwide.

Associations Between Workplace Violence and Work Performance Among Nurses: A Longitudinal Study Based on Affective Events Theory.

This study aims to examine the chain-mediating effects of affective reactions and burnout on the relationship between workplace violence and work performance among nurses while distinguishing between physical and psychological violence. A longitudinal study was conducted between October 2020 and October 2022. The study took place in four tertiary hospitals of Shandong Province, China. A total of 1086 nurses were recruited. Workplace psychological violence, workplace physical violence, work performance, affective reactions (including anxiety and depressive symptoms) and burnout were assessed using self-report questionnaires. Data were analysed using multiple linear regressions and structural equation modelling on SPSS and AMOS. The STROBE checklist was used for this study. Workplace psychological violence, but not physical violence, was associated with nurses' work performance. Burnout mediates the relationship between workplace psychological violence and work performance. Affective reactions and burnout play serial intermediary roles in the relationship between workplace psychological violence and work performance. Interventions aimed at reducing anxiety, depressive symptoms, and burnout among nurses who have experienced psychological violence may enhance their work performance. Hospital administrators should prioritise the development of strategies to prevent psychological violence (e.g., anti-bullying training and counselling support) and enhance nurse performance through burnout screening and targeted interventions. This study was conducted in Shandong Province, China, and relied on self-reported data, which may be subject to social desirability bias. No patient or public contribution.

Hospital governance accountability challenges in Iran: a qualitative study

IntroductionHospital governance is crucial for ensuring the quality of care and patient safety. Despite numerous reforms in hospital governance accountability structures in Iran, some challenges persist. This study identifies the challenges of governance accountability structures in Iranian hospitals from the perspectives of administrators and policymakers.MethodsThis qualitative study used semi-structured interviews with 23 hospital administrators and governance experts in Iran. Participants were selected through purposive sampling. Interviews were conducted face-to-face, online, or by phone, and data were analyzed using thematic analysis based on Braun and Clarke’s framework.ResultsThe study identified two main themes: governance structure challenges and accountability structure challenges. Governance structure challenges included internal issues such as the lack of a medical staff council, presidential governance, and the dominance of physicians, as well as external matters like centralization and rigid regulations. Accountability challenges encompassed administrative, financial, and socio-political dimensions, with issues such as the preference for personal relationships over accountability, centralized planning, and political pressures affecting hospital operations.ConclusionThe study highlights the need for reforms in Iranian hospital governance and accountability structures. Recommendations include forming boards of trustees and medical staff, decentralizing decision-making, and revising regulations to improve clinical, financial, and socio-political accountability. These changes could enhance the overall governance and accountability of Iranian hospitals.

Pengaruh Beban Kerja dan Keseimbangan Kehidupan Kerja terhadap Kinerja Karyawan melalui Kepuasan Kerja pada Perawat Instalasi Cendana RSUD Dr. Moewardi Surakarta

Nurses are healthcare professionals who play a crucial role in the establishment of a high-quality hospital. A nurse’s performance refers to the quality of work outcomes achieved by an employee in fulfilling their responsibilities. Therefore, a hospital's efforts to improve employee performance must be prioritized to ensure the presence of competent and high-performing staff. This study aims to analyze the direct relationship between workload, job satisfaction, and work-life balance on employee performance, as well as the indirect relationship between workload and work-life balance on nurses' performance mediated by job satisfaction at the Cenadan Unit of Moewardi Regional General Hospital, Surakarta. The research method used is a quantitative approach with a census technique involving 93 nurses as respondents. Data were collected using a questionnaire distributed via Google Forms. The data were processed using multivariate analysis with PLS-SEM method and SmartPLS software. The results indicate that workload has a negative effect on job satisfaction, while work-life balance has a positive effect. Job satisfaction positively influences employee performance and mediates the effect of workload and work-life balance on performance. This study provides theoretical contributions to the development of hospital administration science and practical recommendations for hospital management in optimizing human resource management.

Factors affecting nurses’ childbearing intentions of nurses working in teaching hospitals in Yazd, Iran: a study based on theory of planned behavior

BackgroundNowadays, declining fertility rates are a significant societal challenge that particularly affects working women. While research has examined a variety of contributing factors, there is a significant lack of studies specifically on nurses, whose demanding clinical schedules and work environments may significantly influence their childbearing intentions. This study, using the theory of planned behavior, examines these factors for nurses in Yazd teaching hospitals. The results provide valuable data for policymakers to design targeted strategies and support systems to encourage nursing professionals to pursue parenting responsibilities and ultimately reduce the negative effects of low fertility rates.MethodsThis cross-sectional study was conducted on female nurses working in teaching hospitals in Yazd, Iran (2024). To do so, 190 nurses were selected using stratified proportional random sampling and a 14-item questionnaire developed by Nakhaei et al. study was completed. Data were analyzed using descriptive statistics (mean and standard deviation) and inferential statistics including independent samples T-test, one-way ANOVA, Mann-Whitney test, Kruskal-Wallis, Pearson correlation coefficient, Spearman correlation coefficient, and logistic regression.ResultsBased on our findings, 35% of nurses intended to have children in the next three years. Based on the results of the Pearson correlation coefficient test, a significant inverse correlation was observed between the subjective norm towards having children and the number of children (P < 0.001, r=-0.450). A statistically significant difference was reported in the mean score of perceived control over childbearing in terms of childbearing intention (P = 0.019); besides, a statistically significant difference was observed regarding childbearing in terms of age group (P = 0.004). Multivariate regression analysis with the effect of background variables considered constant, only the number of children had a significant effect on subjective norm (P < 0.001), meaning that for each added child, the score of subjective norm towards childbearing decreased meanly by 1.657 points.ConclusionsGiven the negative impact of increasing age on perceived control and childbearing intention, health policymakers and hospital administrators can help ameliorate perceived control and foster the childbearing intention by creating more flexible working conditions and incentive policies, including financial support for female nurses. Moreover, programs that focus on encouraging childbearing in younger women can be more effective.Clinical trial numberNot applicable.

A qualitative exploration of STI partner notification services delivery models among key stakeholders in rural southwestern Uganda

BackgroundComprehensive STI care requires not only patient treatment but STI partner notification (PN) and evaluation to prevent ongoing STI transmission and reinfection. In rural, southwestern Uganda, we explored healthcare practitioners’ views on three STI PN models that focused on task-shifting to non-physician practitioners to inform the development of a novel STI PN services delivery system.MethodsFrom September to November 2023, we conducted individual in-depth interviews with 32 participants from 4 categories (8 participants from each category): patients with a self-reported history of having an STI in Uganda, healthcare workers (physicians, nurses, and community health workers), pharmacists, and healthcare administrators (Ministry of Health officials and regional referral hospital administrators). Interviews explored participants’ views on a nursing-based, pharmacy-based, and community-based STI PN models as well as healthcare system tools and needs to facilitate PN. We used inductive and deductive approaches to generate a codebook guided by the Consolidated Framework for Implementation Research in a thematic analysis.ResultsTen female and twenty-two male participants participated in individual in-depth interviews. The median age of the patient and healthcare practitioner participants was 32 and 34 years, respectively. We found that (1) the nursing model was overall supported as nurses (though with one participant noting dissatisfaction with nurses), (2) pharmacies are well-positioned to engage in STI PN as they are early points of contact for patients, incentivized monetarily by PN and patient-delivered partner medication, and have the potential to physically restructure to create private spaces and increase counseling training, (3) the community-based model should center on village health teams and focus on advocacy and education.ConclusionGiven the high STI incidence globally and in sub-Saharan Africa, exploring innovative STI care models that resonate with patients and healthcare practitioners will be important. Future work includes a Delphi method to refine these models for testing.

Financial Implications of Emergency Room Occupancy Management on Medication Errors: A Case Study of a Tertiary Care Hospital in Pakistan

Medication errors have emerged as the third leading cause of death globally, resulting in increased healthcare costs, patient dissatisfaction, and compromised treatment outcomes. In the context of emergency departments, overcrowding and inefficient occupancy management can significantly exacerbate these errors, placing both patients and healthcare institutions at financial and operational risk. This study investigates the financial and clinical consequences of poor emergency room (ER) occupancy management on medication errors within a public tertiary care hospital in Islamabad, Pakistan. By identifying systemic gaps, the study aims to propose strategies for improving patient safety and institutional performance. This study aims to explore the link between ER occupancy management and medication errors while assessing its financial implications for hospital operations. Specifically, the objectives include: Understanding how emergency room occupancy influences medication errors, Identifying the operational inefficiencies contributing to medication-related incidents, Providing insights into the root causes of such errors for better risk mitigation, Offering evidence-based recommendations to hospital administrators for optimal resource utilization and improved cost-effectiveness, Supporting policy decisions through data-driven findings, Facilitating future research in the domain of healthcare quality and financial sustainability, A descriptive research design utilizing a mixed-methods approach was adopted. The study was conducted in a public sector tertiary care hospital in Islamabad, focusing on medical personnel including doctors, nurses, pharmacists, and paramedics. Stratified random sampling was used to ensure representation across professional groups. Data collection tools included structured questionnaires, checklists, and focus group discussions, developed through expert consultation and a thorough literature review. Ethical approval was obtained from the hospital’s ethical committee. The analysis revealed several key factors contributing to medication errors, including overcrowded emergency departments, staff shortages, long working hours, inadequate feedback mechanisms, and limited training opportunities. These operational inefficiencies not only compromised patient safety but also led to avoidable costs associated with adverse drug events, prolonged hospital stays, and repeat treatments. The findings underscore the critical need for improved ER occupancy management to minimize medication errors and associated financial burdens. Recommendations include optimized staff-to-patient ratios, adherence to standard operating procedures (SOPs), regular training programs focused on patient safety, and the establishment of robust adverse event reporting systems. Effective management strategies can improve both clinical outcomes and cost-efficiency in public healthcare facilities.

Workaholism and work-family conflict among critical care nurses: a cross-sectional study

BackgroundCritical care nurses’ boundaries between personal and professional life are sometimes blurred by the high demands placed on nurses. The rise in workaholism in this high-stress setting puts nurses’ health at serious risk and can intensify work-family conflict, endangering both personal health and well-being and professional output.AimThis study examined the relationship between workaholism and work-family conflict among critical care nurses.DesignA descriptive cross-sectional design that adheres to STROBE criteria.Methods and toolsThe study participants consisted of 360 nurses from the critical care units at Alexandria University Hospital. This hospital is the highest-capacitated hospital in Alexandria governorate in terms of bed capacity (6760), number of nurses, and the diversity of services rendered in different qualifications. It provides therapeutic and educational services. Nurses completed two tools, the Dutch Work Addiction Scale (DUWAS) and the Work-Family Conflict Multidimensional Scale (WFC). Statistical tests comprised the Pearson coefficient, the Student t-test, and a one-way ANOVA. The 5% level was used to assess the results’ significance.ResultsOverall workaholism (DUWAS) is positively and significantly correlated with WFC (r = 0.415, p = < 0.001).ConclusionThe results of this cross-sectional study show that among critical care nurses, workaholism is a major factor in work-family conflict. The necessity of focused organizational initiatives in healthcare settings is highlighted by these findings. To lessen excessive job participation, hospital administrators should specifically develop structured work-life balance initiatives, such as flexible scheduling, workload management guidelines, and access to mental health services. Recognizing workaholism symptoms and promoting helpful supervisory techniques should also be emphasized in leadership training.Clinical trial numberNot applicable.

The effect of patıent advocacy on professıonal values in nurses: a correlatıonal study

BackgroundPatient advocacy, which is an integral part of patient care processes, envisages the defense of patients on issues such as patient rights and ethical values and is a concept directly related to the core values of the nursing profession. It is thought that nurses’ patient advocacy behaviors are linked to their perceptions of professional values. Therefore, this study aimed to determine the effect of nurses’ patient advocacy behaviors on professional values.MethodsThe study is descriptive, correlational, and cross-sectional. It was conducted with 527 nurses working in a city hospital in Istanbul between August and September 2023. Data were collected using the Information Form, Patient Advocacy Scale for Nurses, and Professional Values Scale. Descriptive tests, correlation analysis, and simple linear regression analysis were used to analyze the data. A STROBE checklist was used to report the study.ResultsNurses’ Patient Advocacy Behaviors score was 163.84 (SD = 22.88) and the Professional Values score was 110.26 (SD = 16.29). The study determined that there was a significant, positive, and moderate relationship between the total scores of patient advocacy behaviors and the perception of nurses’ professional values (r = 0.628). It was found that female nurses had more professional values than male nurses, nurse managers had more professional values than other nurses, and day shift nurses had more professional values than night shift nurses (p > 0.05). It was determined that the model created for the perception of professional values was significant and patient advocacy behaviors explained 51.4% of the variance of the perception of professional values.ConclusionIt was found that there was a moderate and positive relationship between patient advocacy behaviors and professional value perceptions of nurses. According to this result, it is recommended that more training on patient advocacy and professional values be included in the nursing education curriculum, the quality of the training should be improved, more studies should be conducted on these issues, and policymakers and hospital administrators should encourage nurses.

Child restraint legislation and injury rate NSW 2001-2019: analysing hospital administration data.

In March 2010, New South Wales (NSW), Australia, introduced legislation mandating age-appropriate restraints for child passengers up to 7 years. This study aims to evaluate its impact on child injury rates using linked hospital and death data. An interrupted time series using random effects quasi-Poisson regression analysed hospital-admitted injury rates in child passengers (0-14 years) in NSW, Australia, from July 2001 to March 2019. Hospital administration data were divided into prelegislation, legislation and postlegislation periods, with the legislative period spanning November 2007 to December 2011, accounting for a 6-month adaptation and enforcement grace period. Injury rates in children under 14 were reduced postlegislation compared with prelegislation. The average injury rate was 33% lower for children directly affected by the legislation (aged 1-6 years, incidence rate ratio (IRR)=0.67, 95% CI: 0.57 to 0.79), 25% lower for children aged 7-10 years (IRR=0.75, 95% CI: 0.65 to 0.85) and 20% lower for children aged 11-14 years (IRR=0.80, 95% CI: 0.68 to 0.94). Compared with children aged 11-14, the injury rate for other age groups decreased, though with large uncertainty in these estimates. The findings suggest a decrease in injuries among child passengers following legislation mandating age-appropriate restraints up to 7 years. However, similar reductions among older children and substantial uncertainty in estimates using the oldest children as controls limit attribution of the effect solely to the legislation. Combined with observational studies showing increased restraint use among children under 12 years old, the results indicate an overall postlegislation improvement in child passenger safety in NSW, Australia.

Intentions to leave the job and nursing profession among nurses in Kenya’s referral hospitals: exploring the effects of organizational culture, work-related stress and job satisfaction

Background Kenya’s healthcare system, like many in Low- and Middle-Income Countries, is grappling with a severe shortage of nurses, yet experiences continuous mass exodus and high turnover. While understanding, and early suppression of nurses’ job and professional turnover intentions is crucial for tackling this crisis, there are limited studies conducted in Kenya focusing on major predictors of nurse turnover intentions, including organizational culture, work-related stress and job satisfaction. This study therefore aimed to fill this gap.AimTo explore the effects of organizational culture, work-related stress and job satisfaction on nurses’ job and professional turnover intentions in Kenya. MethodsThis cross-sectional study surveyed 429 nurses in Kenya’s major referral hospitals. Validated tools were used to assess organizational culture (OC), Work-Related Stress (WRS), job satisfaction (JS), job Turnover Intention (TI) and Profession Turnover Intention (ProfTI). Data were analysed using SPSS v28 with Chi-square, correlation and logistic regression at a 95% confidence level(P < .005).Results Our analysis revealed that 81.4% and 31.4% of Kenyan nurses intend to leave their jobs and the nursing profession respectively. The overall organizational culture was largely neutral with a slight inclination to positive (M = 2.54, SD = 0.62), work-related stress was moderately high (M = 2.92, SD = 0.51), and job satisfaction was low, with only 56.6% of nurses reporting satisfaction. Predictors of TI were Age (OR = 0.45, 95% CI [0.26,0.078], P = .004), years of work experience (OR = 0.40, 95% CI [0.17, 0.93], P = .033) and job satisfaction (OR = 0.45,95% CI [0.26, 0.77], P = .004). Contrary to many existing literature, WRS inversely predicted TI (OR = 0.63, 95% CI [0.40, 0.99], P = .046). Predictors of ProfTI were: marital status(OR = 3.19, 95% CI [1.70,5.99], P = .001), working in surgical wards (OR = 12.70, 95% CL [1.48,108.85], P = .020) or in ICU/renal/theatre (OR = 10.79, 95% CI [1.27, 91.45] P = .029), salary(OR = 4.91,95% CI[1.21,19.92], P = .026),Job satisfaction (OR = 35, 95% CI [0.23, 0.54], P = < 0.001) and WRS (OR = 1.74, 95%, CI [1.15. 2.61], P = .008). Organizational culture did not significantly predict TI or ProfTI.Conclusion Kenya’s major referral hospitals are facing a crisis, marked by high rates of both TI and ProfTI. Urgent action is required from hospital managers and administrators, policymakers, the Kenyan government, and all other key stakeholders to enhance job satisfaction, reduce work-related stress, foster a strong positive organizational culture, and improve salaries.Clinical trial numberNot applicable.

The Impact of Academic Load, Time Management, and Work-Study-Life Balance on Graduate Students' Anxiety Levels

Postgraduate students often face complex academic and professional pressures that can trigger anxiety and affect their mental well-being. This research purpose is to analyze the impact of academic workload, time management, also work-study-life balance on the anxiety levels of postgraduate students at Universitas Pelita Harapan. In this research, Author use a quantitive method which use a descriptive correlational and cross sectional approach. In this research, the populations is allof students in the Master of Management (MM) and/or Master of Hospital Administration (MARS) programs at Universitas Pelita Harapan (UPH), with a sample of 35 students selected using purposive sampling techniques. The results showed that the influence of Academic Workload on Student Anxiety was significant with a p-value of 0.038 (p &lt; 0.05), the influence of Time Management on Student Anxiety was significant with a p-value of 0.041 (p &lt; 0.05), and the influence of Work-Study-Life Balance on Student Anxiety was highly significant with a p-value of 0.000 (p &lt; 0.05).

Patient satisfaction with services at dental out patient department- mulago hospital, Uganda

Patient satisfaction is crucial in the evaluation of the overall quality of dental healthcare. Patient satisfaction surveys are essential in obtaining a comprehensive understanding of the patient’s need and their opinion of the service received at the healthy facility. The purpose of the study was to determine the level of patient satisfaction with dental services and associated factors at Dental Outpatient department (OPD), Mulago hospital. A cross-sectional study using a quantitative approach was conducted using exit interviews from 206 patients aged 18–60 years. Patient satisfaction was measured as a composite categorical variable obtained by asking a number of questions using a 4 point Likert scale ranging from 1-strongly Disagree, 2- Disagree, 3- Agree, 4- Strongly Agree. It was presented as a Binary outcome as Satisfied and Not satisfied. Descriptive statistics, Chi-square tests, Modified Poisson regression and Principal Component Analysis (PCA) were used during data analysis. Overall, 60.2% of the respondents were satisfied with dental services. Females were 126 (61.17%) while males 80 (38.83%). Secondary level education was 89 (43.20%) while no level of education was 11 (5.34%). Self-employed respondents were 75 (36.41%) while peasant farmers were 14 (6.80%). Age, marital status and occupation were significantly associated with patient satisfaction. PCA results show that patients were highly satisfied with the health providers’ technical competence and least satisfied with physical environment. In conclusion, patient satisfaction was suboptimal at 60.2%. There is need for the hospital administration to improve the physical environment at the dental OPD.

Omalizumab home injection versus hospital administration in severe asthma: Impact on asthma control.

Background: Initial studies recommended that omalizumab be administered by health-care professionals. However, subsequent research revealed that the prevalence of anaphylaxis after subcutaneous omalizumab injections was only 0.09%. Objective: In this study, we aimed to evaluate the effects of omalizumab self-administration at home compared with hospital administration on asthma control. Method: Medical records of 45 patients diagnosed with severe atopic asthma, treated with omalizumab in our clinic, and subsequently transitioned to self-injection at home after appropriate training were retrospectively reviewed. These patients were monitored regularly for at least 1 year before and after the transition. The asthma control level was assessed by using the Asthma Control Test (ACT). Results: The ACT score average 1 year after home use was significantly higher than 1 year before home use (0.047); however, the scores before and after 6 months and 3 months home use were similar. A significant reduction in the number of exacerbations was observed after home medication use (p = 0.050), whereas no significant differences were detected in systemic steroid use or emergency admissions. The presence of eosinophilia and comorbidities did not significantly affect periodic ACT values after home use. Conclusion: Our study demonstrated the safety and efficacy of omalizumab for home administration in patients with severe atopic asthma, and it should be emphasized that proper patient selection and training are crucial to ensure the safety of home therapy. It is effective in both symptom control and prevention of exacerbations, and the effectiveness of home use was not diminished by the presence of comorbidities or eosinophilia compared with hospital use.

Unveiling the complexities of patient safety in hospital settings: A holistic approach to overcoming challenges.

Unveiling the complexities of patient safety in hospital settings: A holistic approach to overcoming challenges.

Exploring the intersection of caregiving burden, parenting stress, and self-efficacy in caregivers of children born with esophageal atresia.

Exploring the intersection of caregiving burden, parenting stress, and self-efficacy in caregivers of children born with esophageal atresia.

Compassion fatigue, psychological resilience, moral sensitivity, and humanistic caring ability in clinical nurses: a structural equation model

BackgroundThe level of nursing humanistic caring ability, as a core topic in the development of nursing discipline, directly affects the quality of nursing services and patient health outcomes. Although existing studies have focused on the negative impact of compassion fatigue on nursing staff’s professional status, the intrinsic mechanism of its role with humanistic caring ability has not been systematically elucidated, and in particular, the mediating role of compassion fatigue and clinical nurses’ humanistic caring ability still lacks empirical evidence. In view of this, the present study aimed to investigate the effects of compassion fatigue on clinical nurses’ humanistic caring ability and its mediating role, with a view to providing a theoretical basis for optimizing nurses’ mental health management and humanistic literacy training.ObjectiveThis study aimed to construct and empirically test a structural equation model to clarify the pathways through which compassion fatigue affects clinical nurses’ humanistic caring ability. Specifically, it investigated whether psychological resilience and moral sensitivity serve as mediating variables in this relationship, thereby providing theoretical and empirical support for interventions to enhance nurses’ humanistic caring ability in clinical settings.MethodsThis study employed the the Compassion Fatigue Scale, the Nurses’ Humanistic Caring Ability Scale, the Psychological Resilience Scale, and the Moral Sensitivity Questionnaire to survey 724 clinical nurses from three general hospitals in Henan Province, China, between June and September 2024.Data analysis was conducted using SPSS 25.0, while AMOS 26.0 was utilized for model mapping and mediation path analysis.ResultsCompassion fatigue was a significant negative predictor of their humanistic caring ability (r= -0.537, P < 0.01), and psychological resilience and moral sensitivity acted as chain mediators between compassion fatigue and humanistic caring ability (β= -0.015, P < 0.01).ConclusionsClinical nurses’ compassion fatigue was significantly associated with their humanistic caring ability, with psychological resilience and moral sensitivity acting as chain mediators between the two. Therefore, hospital administrators should pay attention to the situation of nurses’ compassion fatigue and humanistic caring ability, and develop a series of targeted measures to enhance their humanistic caring ability with psychological resilience and moral sensitivity as the entry point.Clinical trial numberNot applicable.

Determinants of implementing patient-centred care in developing countries: a case study of Kahama Municipal Hospital in Tanzania.

Patient-centred care (PCC) is one of the six key attributes of healthcare quality. However, despite its significant contribution to improving healthcare quality, PCC is often poorly implemented. This study aimed to explore the determinants of effective PCC implementation among healthcare providers at Kahama Municipal Hospital in Tanzania. To explore the determinants influencing the effective implementation of PCC among healthcare providers at Kahama Municipal Hospital in Tanzania. A qualitative approach was used, with 21 healthcare providers recruited through purposive and convenience sampling methods. Data were collected through focus group discussions and key informant interviews, and content analysis was employed to analyse the data. The study was conducted at Kahama Municipal Hospital, in the Kahama Municipal Council of the Shinyanga region, Tanzania, from February to June 2019. As a referral hospital, Kahama Municipal Hospital serves a vast catchment area, including rural and semiurban communities across more than eight regions in Tanzania's Lake and Western zones. The study identified several factors related to healthcare professionals, including awareness of PCC, staff motivation, heavy workload, professional competencies and effective communication. Organisational-related determinants, such as the absence of ethical guidelines, a lack of a clear organisational culture and the absence of specific policies and guidelines on PCC, were also found to affect its effective implementation. PCC is recognised at Kahama Municipal Hospital, but key barriers hinder its implementation, including unclear policies, lack of a PCC-focused vision, staff shortages, excessive workloads, low motivation, limited practical exposure and communication issues. To improve PCC implementation, healthcare policymakers and hospital administrators should: (1) establish clear PCC policies, (2) integrate a patient-centred vision into leadership, (3) address workforce shortages, (4) provide targeted training on PCC and (5) boost staff motivation through recognition and career development. Implementing these measures will improve care quality and health outcomes. Further large-scale research is needed to assess PCC implementation across Tanzania and guide national policy.

International internship and employability readiness of management students in state colleges and universities in the Philippines

This study examines the international internship experiences and employability readiness of undergraduate students in hospitality, tourism, entrepreneurship, and business administration at the State University of Negros Island Region (NIR) and Western Visayas. A total of 327 graduating fourth-year students were randomly selected to participate in the survey. Most participants were aged 17 to 18 (61.5%), and slightly more than half were male (53.2%). The analysis of departmental roles showed that students were most involved in sales and marketing (92.4%), while fewer were interested in front office and housekeeping positions (19.9%). Assessments of employability skills—such as communication, adaptability, teamwork, and work ethics—showed moderate readiness, indicating that students have basic skills but still need further development. Among business administration students, human resources and operational management were the most preferred career areas. The findings emphasize the importance of international internships in helping students build key skills for global employment, including cross-cultural communication and problem-solving. As globalization continues to impact the job market, the study highlights the need for universities to strengthen their internship programs to better prepare students for international career opportunities. Overall, this research provides useful insights into the factors that influence employability readiness in these growing and dynamic fields.

Barriers and perceptions of WHONET/BacLink adoption in Nepal: A qualitative study of clinical microbiology laboratories.

The International Vaccine Institute-led CAPTURA (Capturing Data on Antimicrobial Resistance Patterns and Trends in Use in Regions of Asia) project delivered capacity building activities to strengthen antimicrobial resistance surveillance activities in Nepal. The CAPTURA project trained 97 laboratory personnel from 19 hospitals on the use of WHONET/BacLink software to manage microbiology data in Nepal during 2020-2021. Approximately two years later, the trainees were followed up by phone to assess implementation status and effectiveness of the training. An inductive approach was used for coding and categorization of their response, and themes were generated for analysis. Trainees from ten hospitals agreed to respond regarding their experience. We found that two out of the ten hospitals were using the WHONET/BacLink software, with one each within and outside the national AMR surveillance network. The remaining eight hospitals never implemented the system despite receiving the training. Key barriers to implementation included, hospital administration prioritizing other interoperable software, limited ongoing training, inability to export data from an LIS, limited real-time assistance with technical issues, and poor confidence in analyzing data. In addition, limited human resources and minimal capacity-building activities resulted in a lack of confidence in using the system independently, which were also identified as barriers. Implementing WHONET/BacLink software in hospital settings can be challenging due to various factors, including a lack of knowledge and confidence among users, a lack of time and human resources to use the software effectively, and a lack of interoperability with other hospital management systems. Real-time support and follow-up activities potentially reinforce the skills and knowledge delivered during the training.