Hospital Experience Research Articles (Page 1)

Background: Perinatal asphyxia is one of the leading causes of neonatal mortality, ranking third after sepsis and prematurity. It is also a major contributor to childhood morbidity. However, the most concerning consequence is its impact on the brain, which can lead to long-term neurological impairment. Objective: The objective of this study was to observe the short-term neurodevelopmental outcomes in neonates affected by perinatal asphyxia. Methodology: This study was a prospective cohort study conducted at department of neonatology, Bangladesh Shishu Hospital & Institute (BSH&I) from January 2023 to December 2023; Total 429 newborn were screening among them 46 newborns with perinatal asphyxia fulfilling the inclusion criteria were included in the study. Inclusion criteria were; Term (37-41 week gestational age) and late preterm (34-36 week gestational age) newborns. Newborns satisfying the American Academy of Pediatrics/American College of Obstetrician criteria of perinatal asphyxia. Exclusion criteria were; Early preterm and Babies with an antenatally diagnosed significant congenital malformation or clinically suspected TORCH infection. Results: Among 429 newborn babies 46 were found perinatal asphyxia and their prevalence rate was 10.7%. Regarding hospital outcomes, 39(84.8%) were discharged, while 7(15.2%) were expired. The duration of hospital stay varied, with 10 newborns (21.7%) staying for less than 7 days, 22 (47.8%) staying between 7-14 days, and 14 (30.4%) staying for more than 14 days. A significant association was found between the HIE stage and hospital outcomes (p<0.05). In majority cases (87.5%) low HINE scores were predominantly observed in HIE Stage III, while high scores were associated with HIE Stage I. Conclusion: There is a significant association between the severity of Hypoxic-Ischemic Encephalopathy (HIE) and both neurological outcomes and hospital discharge status. Infant who presented with more severe brain injury at birth tended to have high risk of development of significant neurological impairment. J Shaheed Suhrawardy Med Coll 2024; 16(1): 28-32

Background: Juvenile Idiopathic Arthritis (JIA) is a leading cause of chronic inflammatory joint disease in children. It has the potential to cause both short-term and long-term childhood morbidity and substantial disability which leave a long-lasting impact on the quality of life. Aim: To evaluate disease characteristics profile in children with Juvenile Idiopathic Arthritis (JIA) subtypes, effective medication and their outcome. Methods: This retrospective study was carried out using the medical records of follow-up center of the Rheumatology department of Bangladesh Shishu Hospital and Institute from January 2021 to December 2023.Ninety-five children who were diagnosed as JIA in this period were enrolled in this study. Data regarding clinical findings as articular, extra articular and systemic manifestations, biochemical profile, preferred drug, and remission or relapse rates of JIA subtypes were evaluated. Results: Among 95 cases 68 were male and 27 were female. Male : Female ratio being 2.5:1. Age range of the patients was 1 year to 15 years. Maximum number of patients presented beyond 5 years of age (67%). Duration of illness was less than 6 months in the majority (61%). In terms of disease characteristics, enthesitis related arthritis (ERA) were the most frequent (34.74%) followed by systemic JIA (29.47%). Arthritis was found in 100% of JIA patients. Knee and ankle were the most frequently affected joints accounting for 80% of the cases in both poly and oligoarticular subtypes. In this study, fever was found in 37.89% and morning stiffness in 36.84% cases. Rash was detected 64% in Systemic Juvenile Idiopathic Arthritis (sJIA) patients. In this study 10.52% of JIA had joint contractures and/or deformities. Uveitis, hepatomegaly and or splenomegaly, pericarditis were relatively infrequent. A life-threatening complication of sJIA, macrophage activation syndrome (MAS) was present in 14% cases. At initial presentation, overall 36.84% in JIA cases were anemic. Leukocytosis was in 52.63% and 33% cases had thrombocytosis. ESR and CRP were raised 34.73% and 56.84% respectively of JIA patients. Both ESR and CRP elevation were in sJIA. Rheumatoid factor positivity was 8.42% of overall JIA, half of patients were polyarticular. ANA was positive 38% in oligoarticular, 23% in polyarticular. HLA-B27 was positive 79% in ERA. The overall response rate to therapy was 45%. 27% had clinical remission on medication and 18% had remission off medication while 52% still had the active disease and 3% expired. Conclusion: The profile of JIA subtypes differ from each other. Used NSAID and steroids in the early period of disease was an effective treatment, especially addition of Methotrexate (MTX). Treatment with biologic agents in some of our patients flared after combination therapy with NSAID, steroids and MTX after 2 years became clinical remission. Northern International Medical College Journal Vol. 15 No. 1-2 July 2023-January 2024, Page 660-666

ABSTRACT Objective: Intensive efforts are made to discharge patients successfully after mental health hospitalisation. However, there is limited knowledge about the usefulness of patients’ subjective assessments of their ability to adjust after discharge, and especially, the potential benefits of combining scales. Method: One week before discharge, 107 inpatients (aged 19–65 years), mostly hospitalized for schizophrenia (63%), were individually interviewed and completed the following scales: Sense of Coherence, Adaptability, Adjustment, Patients’ perceptions of hospitalisation, and background data. Three months later, discharged patients reported on (a) attendance at the regional outpatient clinic for follow-up and (b) re-hospitalisation in a mental health (MH) hospital. Results: The study findings indicate that the number of prior hospitalisations and the patient's subjective satisfaction with the hospitalisation significantly contributed to predicting later maladjustment. Additionally, patients’ responses to the Adjustment Scale retrospectively predicted their satisfaction with hospitalisation. Discussion: Patients’ subjective evaluation of their hospitalisation experience appears to be partly influenced by their prospective assessment of their ability to re-adjust after discharge. Therefore, it is valuable to explore the utility of a combined measure that includes ongoing data collection of patients’ hospitalisation experiences and their feelings of readiness for discharge, which could help reduce re-hospitalisation rates.

Aortitis and periaortitis include a heterogeneous group of conditions, which may be idiopathic or secondary to infectious diseases or non-infectious inflammatory disorders. Therefore, treatment differ considerably depending on the underlying cause. Our aim was to assess the administered treatment and therapeutic response in a wide series of patients with aortitis and periaortitis from a single reference University center. Retrospective and observational study of patients with aortitis and/or periaortitis from a referral center in Northern Spain. The main outcomes include: clinical remission (absence of clinical symptoms), complete remission (absence of clinical symptoms and analytical normalization), and imaging remission (absence of clinical symptoms and normalization of imaging alterations). Safety data during evolution were also evaluated. We included 134 patients (87 female/47 male) (mean age: 55.1 ± 9.1years) with 132 aortitis and two periaortitis. The main diagnostic method was the positron emission tomography (PET), showing a non-specific increase in 18F-FDG uptake of the aorta with/without its major branches. The patients were treated with: glucocorticoids (n = 128; 95.5%), conventional immunosuppressive drugs (n = 68; 50.7%), biological therapy (n = 45; 33.5%), antibiotics (n = 3; 2.2%), and surgery (n = 6; 4.5%). After a mean follow-up of 39.2 ± 26.7months, 72 patients (53.7%) experienced clinical remission, 64 (47.8%) complete remission and only 15 (11.2%) imaging remission. Aortitis and periaortitis are conditions that require an early diagnosis and treatment. Glucocorticoids are the first line of treatment in patients with non-infectious aortitis or periaortitis. 18F-FDG PET/CT scan is a useful imaging technique to evaluate the disease activity and response to therapy.

Introduction: Heart failure (HF) is one of the leading causes of hospitalization and mortality in the United States. Heart transplantation (HT) remains the definitive treatment for end-stage HF, sometimes preceded by left ventricular assist device (LVAD) implantation as a bridge to transplant. However, national data on inpatient outcomes for HT recipients with and without LVAD bridging remain limited. Methods: We analyzed the Nationwide Readmissions Database (NRD) from 2016–2019 to identify adult patients who underwent HT and were discharged between January and November of each year. Patients with missing data on event time or length of stay were excluded. Survey-weighted procedures were applied to account for the complex sampling design. We compared inpatient outcomes between patients who received LVAD implantation during the same index hospitalization and those who did not. Data were analyzed using SAS 9.4. Results: We identified 11,351 weighted adult patients who underwent HT from January to November 2016–2019. Of these, 2% (n=233) received LVAD during the same index hospitalization. LVAD recipients were younger (mean age: 50.7 vs. 53.3 years) and less likely to be female (23% vs. 27%) compared to non-LVAD patients. They also had higher rates of comorbidities, including acute encephalopathy (35% vs. 15%), advanced chronic kidney disease (19% vs. 9%), and cardiac cachexia (42% vs. 21%) (all p < 0.001). LVAD recipients required more intensive inpatient interventions, such as percutaneous coronary intervention (1.7% vs. 0.6%), coronary artery bypass grafting (3.4% vs. 0.2%), intra-aortic balloon pump (27% vs. 19%), extracorporeal membrane oxygenation (28% vs. 9%), and peripheral VAD (63% vs. 4%) (all p < 0.001). These patients experienced longer hospital stays (mean: 85 vs. 38 days) and higher inpatient mortality (15% vs. 5%, p < 0.0007), as well as greater 30-day readmission mortality (1.3% vs. 0.2%, p = 0.01). Multivariable analysis identified acute encephalopathy, coagulopathy, and cardiac cachexia as independent predictors of inpatient mortality after adjusting for age, sex, kidney disease, and LVAD bridging. Conclusion: Heart transplant recipients requiring LVAD implantation during the same hospitalization experience significantly worse inpatient outcomes, including higher mortality and resource utilization. Early identification and risk stratification of these patients may help guide perioperative management and improve outcomes.

Predictive factors for distant metastasis in early cutaneous melanoma: A 20-year experience of a Turkish tertiary referral hospital.

Translated article] Success after surgical treatment of unstable hip prosthesis: 12 years of experience in a third level hospital

Success and limitations of the French public health strategy after 2 years of large implementation of respiratory syncytial virus prophylaxis: experience of a tertiary hospital (2018-2025).

Exploring preschool children's understanding of hospitals: Perceptions, experiences, and suggestions.

To determine the relationship between nursing care satisfaction levels and nursing image perceptions of patients hospitalized in inpatient units of a university hospital. This is a descriptive, correlational and cross-sectional study. The study data were collected from 610 patients hospitalized in the inpatient units of a university hospital with the Introductory Information Form, Patient Perception of Hospital Experience with Nursing Care and the Nursing Image Scale. Descriptive analyses, independent groups t-test, one-way analysis of variance, Mann-Whitney U test, Kruskal-Wallis test and Spearman correlation analysis were employed in the analysis of the data. It was determined that the Nursing Image Scale scores differed statistically significantly according to the participants' age, education level, state of thinking that they received quality nursing care and nursing image perception of the participants. It can be stated that the satisfaction of the patients participating in the study with the nursing care provided is high, and the nursing image they perceive is at a high level and positive. A positive and significant relationship was found between the participants' nursing care satisfaction levels and their perceptions of nursing image (r=0.502, p<0.01). The results of the study are very important in terms of showing the effect of the image of nursing not only in terms of the development of the profession but also on the perception of the care provided. It is recommended that health institutions and managers determine more strategies in this regard because it affects the preferability of their institutions and the satisfaction of the care provided.

Diagnostic value of serum hyperbilirubinemia as an early important predictive factor for complicated appendicitis: Minia University Hospital experience

Background Nurses are increasingly vulnerable to occupational pressures that threaten their professional well-being. These challenges are particularly pronounced in high-acuity settings, where workload, emotional demands, and environmental stressors can impact compassion satisfaction, burnout, and turnover intention. Objective: The aim of this study is to determine whether there are significant differences in Compassion Satisfaction, Burnout, secondary traumatic stress, and Turnover Intentions among nurses based on their assigned clinical area and years of nursing experience in a tertiary hospital in Abu Dhabi. Methods A descriptive-comparative design was used. Constructs were measured using validated instruments to assess whether significant differences existed in CS, BO, STS and TI across various nurse characteristics, inferential statistical tests were conducted. A one-way Analysis of Variance (ANOVA) was used to examine differences across nurse characteristics, with significance set at p &amp;lt; 0.05. The Professional Quality of Life Scale (ProQOL, Version 5) was used to measure Compassion Satisfaction, Burnout, and Secondary Traumatic Stress, while the Turnover Intention Scale (TIS-6) assessed intention to leave. Results The study included a total sample of N = 211 nurses across multiple units and designations. No statistically significant differences in Compassion Satisfaction, Burnout, Secondary Traumatic Stress, or Turnover Intention across nurse designations (Charge Nurse, Staff Nurse, Practical Nurse), although Practical Nurses reported slightly more favorable scores, particularly in burnout, which approached significance ( p = 0.065). Turnover intention differed significantly by clinical unit [Welch’s ANOVA F (7, 56.3) = 2.58, p = 0.022], with the lowest scores in Operating Theaters/Perioperative Care and the highest in Emergency and Maternity units. Conclusion While nurse designation and years of experience were not associated with significant differences in professional quality of life, clinical unit assignment emerged as a key factor influencing turnover intention. These findings underscore the role of organizational and environmental conditions over demographic factors in shaping nurse retention. The trend of increased burnout and turnover intention among charge nurses suggests the need for improved leadership support and resilience-building initiatives, even though it is not statistically significant. These findings highlight the importance of implementing targeted strategies such as resilience training, structured mentorship, and leadership development programs to mitigate burnout and reduce turnover intention among nurses.

Lived Experiences of Hospitalization among School-Age Children: A Phenomenological Study

Introduction: Laparoscopic surgery has evolved rapidly in recent years and is considered a standard procedure in Paediatric surgery1. Recent advanced in the paediatric laparoscopy have largely concentrated on reducing the size of incisions needed to operate2. Now a days an increasing number of diagnostic and therapeutic surgical procedures are being done laparoscopically3. Methods: This retrospective paediatric laparoscopic study was carried in Dhaka Medical College and Hospital over a period of 2 years from Jan 2023 to Dec 2024. For different surgical conditions, age ranged 2 months to 12 years were operated laparoscopically for different surgical conditions. Results: A total 264 patients were operated laparoscopically. Out of them laparoscopic hernia repair was done on 85 patients, followed by laparoscopic appendectomy was in 59 patients, laparoscopic orchiopexy was in 51 patients, laparoscopic cholecystectomy was in 24 patients, laparoscopic assisted pull through was in 11 patients, diagnostic laparoscopy was in 10 patients, laparoscopic assisted ano rectoplasty was in 07 patients, laparoscopic pyeloplasty was in 03 patients, laparoscopic ovarian cystectomy was in 03 patients, laparoscopic excision of prostatic utricle was in 03 patients, others procedures was in 8 patients. Conclusion: Laparoscopic surgery is becoming the standard of care for many paediatric conditions. There is an increased demand from referring physicians as well as the public for laparoscopic surgery. Careful preparation and training are the cornerstones of successful outcome. Journal of Paediatric Surgeons of Bangladesh (2021) Vol. 12 (1 &amp; 2):24-29

Abstract Background and Aims A significant number of patients undergo kidney transplantation from hemodialysis (HD) with an arteriovenous fistula (AVF). There is evidence of AVF-related cardiotoxicity, particularly in high-flow fistulas, due to increased cardiac mass. However, its impact on cardiovascular events, mortality, or renal graft function remains unclear. There is no consensus on AVF management after transplantation, leading to high variability in clinical practice among centers. Factors such as cardiac status, graft prognosis, and future dialysis and vascular access options are crucial when considering AVF closure. This study aims to review vascular access management in the kidney transplant outpatient clinic at Hospital Infanta Sofía. Method We conducted a descriptive cross-sectional observational study including 71 kidney transplant recipients followed in a non-transplant center. The vascular access history was reviewed, and a Doppler ultrasound was performed on functioning AVFs. Results Among the 71 patients, 35 came from HD (49%), 29 from peritoneal dialysis (41%), and 7 underwent preemptive transplantation (10%). Of the HD patients, 8 had a tunneled catheter (23%), and 27 had an AVF (77%). At the time of the study, 21 AVFs were non-functioning (78%), and 6 were functioning (22%). Among the non-functioning AVFs, 12 cases (57%) were due to spontaneous thrombosis, while 9 cases (43%) resulted from surgical closure, performed on average 6 years post-transplant, mainly due to aneurysms (6 cases, 67%). Among the functioning AVFs, all were native, with a mean arterial flow (Qa) of 1634 ml/min. In 3 cases (50%), Qa exceeded 1500 ml/min, with one case reaching 3000 ml/min. This patient was the only one who required hospitalization for heart failure (HF) after transplantation. All patients with a functioning AVF had preserved left ventricular ejection fraction (LVEF), though two exhibited mild left ventricular hypertrophy. Conclusion The management of AVFs in kidney transplant recipients is a subject of debate, especially when these fistulas remain functional post-transplant. In this study, a high rate of spontaneous thrombosis (57%) and a significant prevalence of surgical closure due to aneurysms (43%) was observed. These findings are consistent with previous studies suggesting that most AVFs do not remain functional in the long term, but their management remains an area of clinical uncertainty. The presence of a functional AVF, especially with high arterial flows, can have significant implications for the patient's cardiovascular health. In fact, in our study, the only patient who was hospitalized due to heart failure had an elevated Qa of 3000 ml/min. This is consistent with the literature, which has documented that high-flow AVFs can induce a hemodynamic burden on the cardiovascular system, contributing to the development of heart failure. It is important to note that the lack of consensus regarding the management of functional AVFs post-kidney transplantation has led to a heterogeneous practice across centers. Some prefer to close AVFs preventively, while others take a more conservative approach, intervening only when signs of heart failure or renal graft dysfunction appear. The decision to close or not close the AVF should consider multiple factors, such as cardiovascular status, graft function, and the potential future need for vascular access for dialysis.

Patient-centered care (PCC) aims to personalise healthcare services by focusing on patients' preferences, needs, and values in medical practices. This approach enhances both patient satisfaction and quality of life while contributing to reduced healthcare costs and addressing inequalities. This study aims to examine the competencies of nurses in patient-centered care and the care perceptions of the patients who received care from these nurses. This is a cross-sectional and descriptive study. The data were collected through printed questionnaires administered to participants. The data were collected from 28 nurses (response rate: 73.7%) working in the inpatient units of a training and research hospital and from 199 patients they cared for between January 2024 and July 2024. Data collection tools included the "Patient-Centered Care Competency (PCCC) Scale" and the "Patient Perception of Hospital Experience With Nursing (PPHEN) Scale." Parametric data were analysed using the Student's t-test and One-Way ANOVA, while non-parametric data were analysed using the Mann-Whitney U test and Kruskal-Wallis test, depending on the number of groups compared. Pearson's correlation test was applied to examine the relationships between variables. The average total score on the PCCC Scale of nurses was 73.81 ± 7.71. The subscale scores were as follows: Respect for Perspective 25.77 ± 3.15, Patient Participation 21.40 ± 2.73, Patient Comfort 13.40 ± 1.67, and Advocacy for Patient Rights 13.22 ± 1.36. The average score for the Perception of Nursing Care of patients was 63.06 ± 11.95. A statistically significant difference was found between care perception scores according to patients' marital status, childbearing status, and education level (p < 0.05). However, a statistically significant positive correlation was observed between patients' age and their PPHEN scores (r = 0.220, p = 0.002), According to Pearson's correlation test, no statistically significant relationship was found between nurses' PCCC scores and PPHEN scores (r = 0.156, p = 0.437). It was found that the nurses' overall and subscale scores for PCCC and average scores for patients' perception of nursing care were high. Additionally, patients' marital status, having children, and educational level were identified as factors influencing their perception of care. While no statistically significant correlation was found between the PCC scores of nurses and the PPHEN scores reported by patients, an interesting finding emerged: there was a significant positive correlation between patients' age and their PPHEN scores.

To optimize the perioperative management experiences for breast cancer patients undergoing direct-to-implant-based breast reconstruction, and provide reference for clinical practice. A comprehensive review of recent domestic and international literature was conducted to systematically summarize the key points of perioperative management for direct-to-implant-based breast reconstruction, including preoperative health education, intraoperative strategies, and postoperative management measures, along with an introduction to the clinical experiences of West China Hospital of Sichuan University. Standardized perioperative management can effectively reduce the incidence of complications and achieve excellent cosmetic outcomes and quality of life after operation. Preoperative management includes proactive health education to alleviate patients' anxiety and improve treatment compliance, as well as comprehensive assessment by surgeons of the patient's physical condition and reconstructive expectations to select the most appropriate implant. Intraoperative management consists of strict aseptic technique, minimizing implant exposure, preserving blood supply to the nipple-areola complex (e.g., by using minimally invasive techniques or indocyanine green angiography, etc), and meticulous hemostasis. Postoperative management encompasses multimodal analgesia, individualized drain management (such as early removal or retaining a small amount of fluid to optimize contour), infection prevention and control (including topical and systemic antibiotics, ultrasound-guided minimally invasive drainage), guidance on rehabilitation exercises (early activity restriction followed by gradual recovery), and regular follow-up to evaluate aesthetic results and monitor for complications. Establishing a standardized, multidisciplinary perioperative management framework markedly enhances surgical safety and patient satisfaction, thereby providing a replicable benchmark for direct-to-implant-based breast reconstruction across diverse clinical settings.

BackgroundAlthough 10–50% of patients in hospital experience urinary continence issues many do not receive guideline-recommended care. We developed and tested a co-created practice-change package that improved then maintained the proportion of symptomatic inpatients receiving a urinary continence assessment, diagnosis, and management plan. In this present study we aimed to categorise clinicians’ perceptions of urinary continence care as barriers or enablers, and determine any change after implementation of the package.MethodsOverall, fifteen adult wards (acute = 3, rehabilitation = 7, acute and rehabilitation = 5) in 12 Australian hospitals (large city = 4, regional = 8) participated. All wards were to receive the practice-change package during the study. The selected implementation strategies addressed barriers identified before implementation, and targeted inpatient clinicians. These clinicians were invited to complete a web-based questionnaire before and immediately after the 6-month implementation phase.The questionnaire was aligned to 13/14 domains of the Theoretical Domains Framework. It included 57 subitems covering assessment, diagnosis, management, or general continence care. A 5-point Likert scale was used (e.g. “strongly agree” to “strongly disagree”). To categorise responses, each subitem was dichotomised as positive (e.g. “agree”, “strongly agree”) or neutral/ negative (“unsure”, “disagree”, “strongly disagree”). Subitems were classified and colour coded as barriers (< 60% positive responses, red), neutral (60–69% positive, orange) or enablers (> 69% positive, green). Changes from before to after-implementation were assessed.ResultsClinicians from 12 hospitals participated before-implementation (n=291, 82% female, 88% nursing), and from 10/12 hospitals (n=195, 86% female, 94% nursing) after-implementation. Two hospitals withdrew as the start of their implementation phase coincided with the onset of COVID-19.After implementation substantial improvements in perceptions were observed in 7/13 TDF domains: “skills”, “knowledge”, “memory”, “beliefs about capabilities”, “emotion”, “environmental context and resources”, and “social and professional role”. Three domains (“goals”, “beliefs about consequences” and “reinforcement”) were high scoring enablers at both timepoints. Three domains had limited or no change (“social influences”, “intentions”, “behaviour regulation”). ConclusionCategorisation and colour-coding of perceptions can assist end-users to quickly understand the data, identify areas for improvement, and changes after-implementation. The results helped to identify and explain which implementation strategies appeared to be successful in changing practice, and which ones need refining.Trial and protocol registrationThis study was retrospectively registered on the 8 July 2021 in the ANZCTR (ACTRN12621000883819). The protocol is available at JMIR Research Protocols doi: 10.2196/22902 https://www.researchprotocols.org/2021/2/e22902.

The Syrian civil war has resulted in one of the largest refugee movements globally, significantly impacting Türkiye due to its geographic proximity. Surgical care represents a critical yet often overlooked aspect of healthcare services required by displaced populations. This study aimed to evaluate the demographic characteristics and surgical procedures performed on migrant patients over a ten-year period at a secondary-level hospital located on Türkiye's southern border. A retrospective cohort study was conducted at Kilis State Hospital between March 2010 and January 2020. Surgical procedures were categorized by department, patient nationality, and type of surgery. Patients operated under the "war code" were analyzed separately to identify conflict-related injury patterns. A total of 52,978 surgical procedures were performed, with 41.76% involving Syrian patients. The mean age was 31.28±20.33 years, and male patients predominated, especially among the war-injured subgroup (91.59%). The most active surgical departments were orthopedics and traumatology (20.63%), gynecology and obstetrics (17.51%), and general surgery (15.67%). Among war-related surgeries, orthopedics, neurosurgery, and plastic surgery departments played major roles. This study highlights the high surgical demand among migrant populations in border regions, especially in conflict settings. Strengthening healthcare infrastructure, maintaining accurate surgical records, and implementing multidisciplinary approaches are essential for meeting these needs. Our findings can inform future policies aimed at improving surgical care for displaced populations.

The fragmentation and decentralization of medical data, including radiological imaging, continue to challenge large-scale observational research across Europe. Artificial intelligence (AI) applied to big datasets is transforming diagnosis and treatments towards precision medicine across many diseases, yet the lack of findable, accessible, and interoperable datasets still limits model development, validation, and final clinical translation. The European Federation for Cancer Images (EUCAIM) project was launched in 2023 to address these challenges by establishing a secure centralized and federated infrastructure for the secondary use of large-scale oncological imaging and related clinical data. By consolidating fragmented datasets, EUCAIM lays the groundwork for harmonized data governance and trusted cross-border sharing. Implementing a robust documentation framework is essential to ensure regulatory compliance, safeguard data integrity, and support secure data flows across institutional and national boundaries, fully aligned with European regulations and ethical standards. EUCAIM builds on the AI for Health Imaging (AI4HI) initiative (PRIMAGE, CHAIMELEON, EuCanImage, ProCancer-I, INCISIVE) and integrates over 94 partners and more than 180 stakeholders spanning medical imaging, high performance computing, data standardization, innovation, and legal compliance. This large collaborative ecosystem reinforces EUCAIM’s role as a reference for General Data Protection Regulation (GDPR) and European Health Data Space Regulation (EHDSR) adherence. This publication presents the real-world experience of integrating imaging and clinical data from a reference university hospital into the EUCAIM infrastructure. It outlines the procedural, ethical, and legal challenges encountered, and details the strategies implemented to ensure compliance with data protection regulations, including privacy, security, and ethical standards. These insights offer a practical framework for future large-scale oncological imaging datasets harmonization and AI development, contributing to scalable, reproducible, and legally compliant research that strengthens Europe’s capacity for trustworthy AI-driven oncology solutions.