Improve Patient Quality Of Care Research Articles

B-UMCS: Blockchain-enabled Unified Medical Consultancy Service.

The advent of blockchain technology within the healthcare domain has signified a paradigm shift, transitioning from an emerging trend to an essential infrastructure component that ensures decentralization, transparency, integrity, and persistent availability. Despite its potential, the healthcare sector has not fully capitalized on the vast array of benefits blockchain technology offers. Most existing works utilized blockchain technology within a specific healthcare entity's services but not among several healthcare organizations. They notably lack the provision for direct communication and knowledge transfer between doctors from different hospitals. Therefore, this paper introduces a pioneering Blockchain-based Unified Medical Consultancy Service (B-UMCS) that leverages blockchain's robustness to revolutionize telehealth services by (a) alleviating the shortage of medical expertise through facilitating the interconnection of physicians from diverse hospitals and geographical areas onto a consolidated platform, (b) promoting the seamless sharing of medical consultations, electronic health records (EHRs), and expert insights while upholding rigorous security and privacy protocols, (c) integrating the inherent security mechanisms of blockchain with the distributed data storage functionality offered by the Interplanetary File System (IPFS). This work details the B-UMCS's components, interactions, smart contracts, protocols, algorithms, storage and transmission of EHRs, and their corresponding implementations. The evaluations of the proposed B-UMCS reveal that it secures and facilitates the sharing of EHRs and enables healthcare professionals to collaborate and exchange expertise seamlessly across institutional boundaries. They are additionally ensuring that healthcare providers can offer their knowledge in an efficient and scalable manner. Overall, B-UMCS not only addresses the current challenges in healthcare data security and accessibility but also opens new avenues for collaboration and knowledge sharing among healthcare professionals, ultimately contributing to improving patient care quality.

Viêm tĩnh mạch tại vị trí lưu kim luồn tĩnh mạch ngoại biên và một số yếu tố liên quan tại Trung tâm Thần kinh, Bệnh viện Bạch Mai

Introduction: Peripheral venous catheter-related phlebitis is a common complication in healthcare facilities, causing pain, disrupting treatment, and potentially leading to severe complications.Objective: This study investigates the incidence and risk factors associated with peripheral intravenous catheter-related phlebitis. Method: A prospective cross-sectional descriptive study was conducted using a self-designed questionnaire and the Visual Infusion Phlebitis (VIP) Scale to assess the degree of phlebitis. The study included 347 inpatients treated in the Emergency and Intensive Care Unit, Neurology Center, at Bach Mai Hospital. Data were collected from medical records and clinical observation. Results: Among the studied patients, the incidence of phlebitis was 17.6%, and 4.3% of catheter insertion sites exhibited signs of inflammation. Grade 1 and 2 were the most common phlebitis (43.1% and 54.2%), with a small number of grade 3 cases (2.8%) and no cases of grade 4 or 5. Factors such as catheter insertion sites in the forearm, elbow, or ankle; underlying conditions like hypertension, cerebral hemorrhage, pneumonia; paralysis; continuous fluid infusion; and certain intravenous medications were identified as being associated with an increased risk of phlebitis. Conclusion: Phlebitis at the PVC site is a significant concern during treatment in ICU and Neurology centers. Proper catheter site selection and effective management of underlying conditions can help reduce the risk of phlebitis. These findings may assist in developing clinical guidelines to improve patient care quality.

ASSESSMENT OF NURSES' KNOWLEDGE REGARDING SAFE PATIENT LIFTING AND HANDLING IN TERTIARY CARE HOSPITALS

Safe patient handling is a critical aspect of nursing care, aimed at preventing musculoskeletal injuries among healthcare providers and ensuring patient safety. In Pakistan, nurses face challenges such as limited access to handling equipment and inconsistent training, increasing their risk of injury and affecting patient care quality. Objective: This study assesses nurses' knowledge of safe patient lifting and handling and explores demographic and professional factors influencing this knowledge. Methods: A cross-sectional study was conducted among 200 nurses at the Department of Nursing, Superior University, Lahore, using a self-structured questionnaire. The questionnaire comprised demographic and professional information, alongside a 15-item knowledge assessment on safe patient handling. Correct responses were scored, and the mean score was calculated to categorize knowledge as "good" or "poor." Data analysis was conducted using SPSS version 22.0, employing descriptive statistics and chi-square tests for associations, with p≤0.05 considered significant. Results: Of the 200 nurses surveyed, 56.0% demonstrated good knowledge of safe patient handling, while 44.0% exhibited poor knowledge. Significant associations were found between knowledge levels and gender, qualifications, work position, and department. Females and those with advanced qualifications had higher knowledge levels, while age and work experience showed no significant influence. Nurses who had received training reported higher knowledge, though the difference was not statistically significant (p=0.16). Conclusion: The findings indicate that a significant proportion of nurses lack adequate knowledge of safe patient handling, highlighting the need for enhanced training and resources. Targeted interventions considering demographic and professional variations can bridge knowledge gaps and promote safer handling practices, reducing occupational risks and improving patient care quality. Further studies are recommended to explore institutional policies and cultural factors that may impact the adoption of safe patient-handling practices in Pakistan.

Corporate Social Responsibility Programs and Employee Retention: The Mediating Effects of Employee Trust in Organization

ABSTRACTThis study aims to examine the impact of corporate social responsibility initiatives on employee retention rates in private hospitals in Jordan. Additionally, this study investigates the mediator function of employee trust in private hospitals regarding the relationship between CSR initiatives and employee retention. A stratified sample of 363 personnel from private hospitals in northern Jordan is used, representing four distinct groups: physicians, nurses, technicians, and administrators. The data analysis uses the structural equation modeling (SEM) technique. The results indicate that corporate social responsibility (CSR) measures and trust in private hospitals in Jordan benefit employee retention. Furthermore, the level of trust in hospitals plays a crucial role in mediating the connection between corporate social responsibility (CSR) initiatives and the ability to retain employees. These findings hold promise for the healthcare sector in Jordan, offering potential solutions to the pressing issue of employee retention and the potential to improve patient care quality significantly.

Advancing Pharmaceutical Care in Community Pharmacies in Poland: A Blueprint for Enhanced Patient Care Quality.

Background: This article reviews the current state of pharmaceutical care in community pharmacies in Poland and proposes a collaborative framework for its advancement. While pharmaceutical care has evolved significantly worldwide, with Europe leading the way, Poland has lagged in its development. Although Polish pharmacists are well-qualified and community pharmacies are numerous, pharmaceutical care remains underdeveloped. Methods: We conducted a literature review and analyzed case studies from European countries with advanced pharmaceutical services. Based on these findings, we collaborated with policy makers, commissioners, and academics to develop a framework for enhancing pharmaceutical care in Poland. The plan emphasizes integrating seven key services into Polish community pharmacies. Results: Our proposed framework outlines seven essential pharmaceutical services: medicine use reviews, new medicine services, minor ailment services, repeat prescription services, integrated prevention programs, cardiovascular disease prevention programs, and vaccination programs. Evidence from other European countries suggests that implementing these services could significantly improve health outcomes and patient quality of life. This is particularly important in light of Poland's ageing population, the rising prevalence of chronic diseases, and the healthcare system's increasing burden due to polypharmacy. Conclusions: The proposed framework presents a practical and collaborative approach to advancing pharmaceutical care in Poland. By adopting these key services, community pharmacies could play a more integral role in improving patient care quality and alleviating pressure on the broader healthcare system.

An Overview of the Prevalence and Effects of Back Pain among Nurses in Zambia

Topic: This mini-review addresses the critical issue of back pain among nurses in Zambia, highlighting the occupational health challenges they face within a resource-limited healthcare system. Type of Review: This is a literature mini-review synthesizing recent research findings and theoretical frameworks relevant to back pain in nursing. Main Focus: The review focuses on the prevalence, causes, and potential interventions for back pain among Zambian nurses, emphasizing the need for culturally relevant health messaging and systemic changes within the healthcare environment. Gaps Identified: While existing literature outlines various factors contributing to back pain, there is a notable lack of longitudinal studies assessing the long-term effectiveness of proposed interventions, as well as limited exploration of broader systemic issues within the Zambian healthcare infrastructure. Conclusions: Addressing back pain among Zambian nurses requires a comprehensive approach that includes tailored educational initiatives, effective workload management, and improvements in ergonomic support within healthcare settings. Practical Implications: The findings suggest actionable strategies for healthcare institutions to enhance nurse well-being, which in turn can improve patient care quality. Policy Implications: Policymakers are encouraged to implement systemic changes that address staffing shortages and improve workplace ergonomics, thereby fostering a healthier work environment for healthcare professionals. Relevance: This mini-review contributes to the ongoing discourse on occupational health in resource-limited settings, offering insights that are valuable for researchers, healthcare practitioners, and policymakers striving to enhance the working conditions and health outcomes for nurses worldwide.

Nursing Work Engagement, Professional Quality of Life, and Intent to Leave: A Structural Equation Modeling Pathway Analysis.

Work engagement, professional quality of life (ProQOL), and intent to leave (ITL) significantly impact organizational behaviors and outcomes. Understanding the complex interrelationships among nurse work engagement, ProQOL, and ITL is essential for improving nurse retention, job satisfaction, and patient outcomes. In previous investigations, work engagement, ProQOL, and ITL relationships have primarily been analyzed individually. A more integrated approach is needed to gain a comprehensive understanding of these factors in the nursing profession. This study was designed to evaluate the interrelationships among work engagement, ProQOL (compassion satisfaction [CS], burnout, and secondary traumatic stress [STS]), and ITL in nurses using structural equation modeling path analysis. This was a quantitative descriptive study. Data were collected from registered nurses in the United States ( n = 900) using the Utrecht Work Engagement Scale, the ProQOL-5 (CS, burnout, and STS), and a demographics datasheet (including a one-item ITL question). The proposed theoretical model, incorporating major constructs, was tested using structural equation modeling. Level of work engagement in nurses impacts ITL through ProQOL. Among the mediating variables, burnout (0.31) had the largest total effect on ITL, followed by STS (0.12) and CS (-0.12). Burnout and STS were found to correlate with ITL directly, whereas CS was found to correlate with ITL indirectly. Promoting work engagement, addressing burnout and STS, and fostering CS can positively influence nurse retention and job satisfaction, ultimately improving patient care quality. Healthcare leaders and policymakers should implement strategies to enhance nurse engagement, reduce burnout, and cultivate compassion satisfaction to increase nurse retention and improve organizational outcomes.

Prevalence of compassion fatigue among post-graduate trainees in Pakistan: A cross-sectional study.

To determine the prevalence of compassion fatigue, compassion satisfaction and burnout and identify the socio-demographic and work-related factors associated with compassion fatigue among FCPS Part-II trainees in Pakistan. A cross-sectional study of FCPS-II trainees was conducted using stratified sampling at multiple centers over six months. Data was collected through an online, self-administered survey, which consisted of the 30-item ProQOL-V and a socio-demographic and work-related characteristics questionnaire. Informed consent was obtained from all participants. Data was analysed using SPSS 26 for descriptive stats, one-sample t-test, Pearson correlation, and multivariate linear regression at a 95% significance level. Out of 460, only 392 trainees completely filled the online survey (completion rate: 90.74%). The study found that 78.80% of postgraduate trainees experienced moderate levels of compassion fatigue (CF) (Mean = 27.6, SD = 6.3), with moderate burnout (BO) (75.50%, Mean = 26.6, SD = 5.9), while moderately high Compassion satisfaction (CS) (90.60%, Mean = 33.3, SD = 5.5). Compared to normative data, compassion fatigue levels were significantly elevated among post-graduate trainees (p < 0.001). Significant correlations were observed between CF and BO (r =0.59), CF and CS (r = -0.20), and BO and CS (r = -0.63). Factors associated with higher CF included family dependents (p = 0.029), longer working hours (p < 0.001), and inadequate sleep (p < 0.001). Trainees in "Poor" work environments reported higher CF levels than those in "Excellent" environments (p < 0.001). Additionally, engaging in self-care activities such as exercise, prayer, and socialising were associated with lower CF levels (p < 0.05). The study revealed that many postgraduate trainees experience moderate compassion fatigue and burnout, with a strong positive correlation between CF and BO. Compassion satisfaction inversely related to both CF and BO, highlighting the need to boost CS. Factors like longer work hours, poor sleep, family dependents and unfavorable work conditions were linked to higher Compassion Fatigue. Conversely, engaging in self-care practices like prayer, meditation, exercise, and socialising is associated with decreased compassion fatigue levels. These results stress the importance of tailored interventions to enhance trainees' well-being and ultimately improve patient care quality.

Assessing Skin Tear Knowledge Among Nurses: A Multicentre Cross-Sectional Survey.

To assess the knowledge of nurses in Chinese hospitals regarding skin tears, focusing on evaluating their understanding and proficiency in managing and preventing skin tears, exploring the impact of demographic and professional factors on their knowledge levels and identifying specific areas where additional training or education is needed. This study is a multicentre cross-sectional survey conducted in the Henan province of China using a stratified cluster sampling method. The study utilised the Chinese version of the Skin Tear Knowledge Assessment Instrument (OASES) for evaluating nurses' knowledge levels based on a questionnaire comprising 22 questions on the online platform Wenjuanxing (www.wjx.cn). All questions had to be answered, with only one option selectable per question. Response validity was ensured by excluding questionnaires that showed a clear response pattern, were completed in under 60 s, or scored 0 points. Descriptive analysis, item-level analysis and multiple linear regression analysis were performed. A total of 1675 clinical nurses participated in this study. Age was a significant factor influencing skin tear knowledge, with older nurses (age, 41-60 vs. 18-40 years) demonstrating higher knowledge scores. Additionally, female nurses exhibited higher average knowledge scores compared to male nurses. Further, different departments, education levels, job titles and having completed relevant courses significantly influenced skin tear knowledge among nurses. However, on multivariate analyses, we found that working in the intensive care unit, having a higher education background and job title and having studied courses on wound, ostomy or incontinence were independent factors influencing knowledge on skin tear, indicating the need for targeted educational interventions. In conclusion, targeted educational interventions and continuous professional development are essential to bridge the identified knowledge gaps among nurses in Chinese hospitals regarding skin tear management. The Strengthening the Report of Observational Studies in Epidemiology checklist guidelines were followed. Enhancing nurses' knowledge and skills in skin tear management through targeted educational programmes could improve patient care quality, reduce the incidence of skin tears and promote better wound care outcomes in clinical settings. This study addresses the problem of knowledge gaps in skin tear management among nurses. The main findings indicate varied understanding and significant factors influencing this knowledge. The research impacts nurses and patients in Chinese hospitals, emphasising the need for specialised training and professional development to improve skin tear management and patient care. No patient or public contribution.

Correlation between learning styles and attitudes toward interprofessional education among medical students: a cross-sectional study

BackgroundInterprofessional teamwork improves patient care quality, safety, and health outcomes. Interprofessional education (IPE) is crucial in today’s medical education to prepare students for the workforce as integral members of a collaborative team. The diversity of IPE learners indicates the importance of exploring the relationship between learning styles and attitudes toward IPE. The purpose of this study was to investigate the relationship between learning styles and attitudes toward IPE.MethodsA cross-sectional study was conducted between August 2023 and September 2023 in 49 colleges located in the south-eastern region of China. A convenience sampling approach was employed, selecting 500 students majoring in Clinical Medicine and Nursing. The students completed an online questionnaire, which included sociodemographic characteristics, educational characteristics, interprofessional educational characteristics, learning styles, and the readiness for interprofessional learning scale, and Kolb’s learning style inventory. Descriptive statistics, Spearman’s correlation, and multiple linear regression analysis were used to analyze the data.ResultsThe most learners are diverger (93.2%), followed by assimilator (3.4%), accommodator (2.6%), and Converger (0.8%). The total score on the RIPLS was 69.70 (7.42), ranging from 48 to 88. A statistical relationship could be established between learning styles and attitudes toward IPE.Conclusion conceptualization and active experimentation learning modes and convergers were closely linked with positive attitudes toward IPE. Gender, age, and study stress can affect attitudes toward IPE. This study highlights the need for medical education curricula to integrate innovative teaching methods such as PBL, role-playing, scenario simulation and clinical early exposure to strengthen professional identity, and improve abilities related to interprofessional learning.

WP8.3 - "Effectiveness of Malnutrition Screen and Interventions for Surgical Inpatients - A MUST Score Based Audit"

Abstract Malnutrition significantly impacts surgical inpatients, affecting outcomes like infection rates, hospital stays, and wound healing. This audit evaluates the effectiveness of the Malnutrition Universal Screening Tool (MUST) in identifying at-risk surgical inpatients and examines the subsequent interventions and nutrition assessments. Our prospective audit encompassed surgical inpatients admitted for elective procedures or via the emergency department. Data were collected through patient records and medical charts, focusing on MUST score completion, accuracy, and updates. The audit assessed staff training, consistency in scoring, and the quality of nutrition interventions documented by dietitians. Key findings revealed a high completion rate (83.3%) of MUST scores but identified significant inaccuracies due to insufficient consideration of BMI, weight loss, and acute disease effect. Only a minor percentage (15.6%) of patients had their MUST scores updated. Staff training inadequacies and inconsistent scoring practices were noted. Despite these limitations, clinical teams effectively identified at-risk patients using their judgment and promptly initiated interventions. A malnutrition awareness week was organised with the dieticians, and teaching sessions were conducted for the healthcare staff to enhance understanding and application of the MUST tool. This initiative aimed to raise awareness and improve the quality of malnutrition screening and management. The audit highlights the need for improved accuracy in MUST scoring, enhanced staff training, and ongoing professional development. Recommendations include comprehensive staff training, standardized documentation processes, interdisciplinary collaboration, and patient and family education. This audit underscores the importance of accurate malnutrition screening and effective interventions to improve patient care quality for surgical inpatients. It calls for action plans to address the identified gaps, thereby enhancing malnutrition management within healthcare settings.

Adverse Drug Reaction and Pharmacovigilance in Elder Patient’s Health

A pharmacist is a medical expert who is dedicated to helping patients take medications in a safe and efficient manner. Many Indian hospitals do not consider a pharmacist’s responsibility for medication use or their role as a health care provider in clinical practice. The study's first goal is to comprehend how healthcare professionals view and interact with the clinical role of the Pharmacist. According to the study, general practitioners were only made aware of the role of the clinical Pharmacist following an intervention. The study makes the strong recommendation that other hospital-affiliated health care providers be allowed to take part in educational programs on drug-related topics and be open to collaborating with the clinical Pharmacist to improve patient care. According to the current study, pharmacovigilance program implementation in hospitals is crucial for ensuring safe medication use, preventing adverse drug reactions, and, ultimately, improving patient care quality.

The benefits of nursing professional governance nursing research and evidenced-based practice councils for new graduate nurses

New graduate nurses are an untapped population for nursing professional governance and nursing research and evidenced-based practice councils. New graduate nurses can offer new insights into the management of patient care and nursing workflow. By educating new graduate nurses about the benefits of nursing research and evidence-based practice councils at the start of their careers, an early standard of excellence in the empowerment of applying evidenced-based practice principles to improve patient care quality can occur. This narrative literature inquiry explores new graduate nurses perspective of research and evidence-based practice councils, with the targeted goal of engagement for professional and personal growth as a nurse leader.

OMOP-on-FHIR: A FHIR Server Development to Facilitate Data Interaction with the OMOP-CDM and FHIR for PGHD.

This paper introduces the concept of the implementation of a FHIR server for bidirectional data exchange with the OMOP-CDM. Leveraging FHIR as a metamodel, the implementation aims to promote a more interconnected and patient-centric healthcare ecosystem. The methodology involves utilizing the Java HAPI FHIR API for server architecture and validating the solution through patient data exchange with a FHIR reference implementation server. This initiative signifies a significant advancement in healthcare data interoperability, promising improved patient care quality and clinical research vigor.

The Effect of Agile Principles to Improving Patient Care Quality in Riyadh Private Hospitals

The Effect of Agile Principles to Improving Patient Care Quality in Riyadh Private Hospitals

IntelliVent: A Review on Enhancing Patient Care with Advanced Ventilation Systems

IntelliVent: Enhancing Patient Care with Advanced Ventilation System intends to revolutionize mechanical ventilation by creating an automated ventilator that uses an Ambu bag and has complete monitoring features. The system precisely sets and controls respiratory parameters such as tidal volume, respiratory rate, minute ventilation, peak and plateau pressures, I:E ratio, and FiO2 levels utilizing a DC motor-driven cam lever mechanism for precision Ambu bag compression. IntelliVent uses modern sensors to monitor important patient characteristics such as blood pressure, glucose levels, oxygen saturation, body temperature, and platelet count, allowing for dynamic modifications to match unique patient demands. The complex control software offers different ventilation modes and real-time feedback loops, which improves system adaptability and responsiveness. IntelliVent's user-friendly interface, which includes real-time visualization of critical parameters and vital signs, helps clinicians make informed judgments. This project seeks to provide a cost-effective, dependable, and adjustable ventilation solution that will improve patient care quality and efficiency in critical care settings. IntelliVent aims to ensure safety, efficacy, and regulatory compliance through thorough calibration, bench testing, and clinical trials, thereby setting a new standard in mechanical ventilation technology.

Factors contributing to work fatigue among nurses at hospital: A study on the impact of work attitudes, shift schedules, and sleep quality

Background: Fatigue is an essential body protection mechanism, preventing further damage and allowing recovery after rest. In work, especially in the hospital environment, fatigue can affect the performance and well-being of medical personnel, including nurses. This study aims to identify and analyze factors associated with work-related fatigue among Dr. Adjidarmo Regional Hospital nurses. The main focus of this study includes the relationship between gender, length of service, work attitude, shift schedule, and sleep quality on the level of fatigue experienced by nurses. Method: This study adopted a cross-sectional design targeting a population of 256 nurses who are actively practising at Dr Adjidarmo Regional Hospital. The study sample consisted of 75 respondents selected using a random sampling method. Data was collected through questionnaire-based interviews that accessed information from secondary and primary sources. The data obtained were analyzed univariately and bivariately to determine the prevalence and significant relationship between the variables studied and work-related fatigue. Findings: Univariate analysis revealed that out of 75 respondents, 54.7% reported experiencing moderate work-related fatigue. Demographic distribution showed that 74.7% of respondents were female, 81.3% had worked for five years or more, 50.7% showed risky work attitudes, 29.3% worked night shifts, and 52.0% reported poor sleep quality. The results of the bivariate analysis showed a significant relationship between work attitudes (P-value = 0.000), shift schedules (P-value = 0.002), and sleep quality (P-value = 0.000) with the level of work-related fatigue. Conclusion: Based on these findings, it is recommended that shift schedules be distributed evenly during the third shift to reduce nurse fatigue. In addition, stretching exercises and physical activity during work breaks should be encouraged to improve nurses' well-being and reduce fatigue-related problems. This intervention aims to improve nurses' working conditions, which can improve patient care quality and reduce fatigue's negative impact on work performance. Originality/Novelty: This study offers new insights into factors contributing to work-related burnout among nurses, focusing on specific variables such as work attitudes, shift schedules, and sleep quality. The study identifies significant correlations that have not been widely explored in the context of a regional hospital in Indonesia. By providing practical recommendations for redistributing shift schedules and promoting stretching exercises, this study contributes to the development of evidence-based intervention strategies to address burnout in the hospital workplace.

Clinical nurses' work procrastination and smartphone addiction: a potential profile study.

In the medical field, effective time management by clinical nurses is crucial for enhancing the quality of patient care. However, in recent years, with increasing work pressure for clinical nurses, procrastination has become a prevalent issue. Many nurses use smartphones as a way to alleviate stress and manage emotions, but excessive smartphone use could exacerbate procrastination, thereby jeopardizing patient safety and healthcare quality. Therefore, understanding the current state of work procrastination among clinical nurses, its heterogeneity, and exploring the impact of smartphone addiction and demographic factors on different aspects of nurse procrastination hold significant importance for improving patient care quality. This study aims to explore the current state of work procrastination among clinical nurses and identify potential profile categories. It further analyzes the impact of mobile phone addiction and demographic factors on work procrastination among clinical nurses. Convenience sampling was employed to recruit participants from three tertiary hospitals in central China from October to November 2023. Surveys measuring nurses' work procrastination and smartphone addiction were distributed and collected through online platforms. A total of 1,536 nurses participated in this study. Mplus 8.3 statistical software was used for latent profile analysis of clinical nurses' work procrastination, and SPSS 26.0 software was utilized for chi-square tests, rank-sum tests, and multi-classification logistic regression analyses. The median total score for clinical nurses' work procrastination was 21.00 (17.00, 28.00), and three subgroups were identified: low procrastination (66.93%), medium-low procrastination (20.66%), and medium-high procrastination (12.41%). Additionally, logistic regression analysis revealed that smartphone addiction and department atmosphere were common influencing factors for medium-low and medium-high work procrastination. Hospitals with stricter management and nurses holding the position of head nurse were more likely to belong to the low work procrastination group. Nurses with higher incomes or those holding intermediate titles were more prone to medium-low work procrastination, while those experiencing career advancement difficulties were more likely to exhibit medium-high work procrastination (p < 0.05). Clinical nurses' work procrastination is generally at a medium-to-low level, with three subgroups identified: low procrastination, medium-low procrastination, and medium-high procrastination. Additionally, clinical nurses in surgical departments or those with intermediate titles exhibit higher levels of procrastination. Factors such as smartphone addiction, higher monthly income, tense departmental atmosphere, and unsuccessful career advancement are more likely to lead to work procrastination. Conversely, nurses in hospitals with strict management or those holding the position of head nurse exhibit lower levels of work procrastination. Therefore, nursing managers should pay close attention to the work procrastination behaviors of clinical nurses, actively monitor predictive factors among different groups, and provide psychological counseling and relevant training based on individual nurse circumstances. Additionally, it is also essential to focus on and improve departmental atmosphere and nurse smartphone addiction to enhance clinical nurses' work efficiency and reduce work procrastination.

Osteopathy in the Italian healthcare landscape: Perceptions and areas of competence according to healthcare professionals

ObjectivesThe healthcare context aims to create a multidisciplinary culture that places the patient at the center of the care process, and osteopathy plays a significant and evolving role. This study aimed to examine the perceptions of healthcare professionals regarding the role of osteopathy in the Italian hospital healthcare setting. DesignThis cross-sectional observational study involved the collection of 327 questionnaires. Subsequently, data from 302 questionnaires were selected and evaluated in accordance with the inclusion and exclusion criteria. MethodsThe survey was conducted through a questionnaire specifically developed for the study and administered using Google Forms. The questionnaire included specific domains for the analysis of demographic data and data related to the perception of the osteopathic discipline. Electronic distribution of the survey was achieved through a snowball sampling approach, requiring participants' informed consent. ResultsRegarding the age distribution of the respondents, the majority fell within the 25–34 age bracket, constituting 37 % of the sample. When asked about their profession, the vast majority identified as nurses (80 %). It emerged that among the 203 respondents who confirmed seeking osteopathic consultation, the primary motivations were related to musculoskeletal disorders. DiscussionThe evolving healthcare landscape emphasizes the importance of multidisciplinary collaboration. Respondents show a strong inclination toward incorporating osteopathy into interdisciplinary care models. As healthcare shifts towards holistic, patient-centered models, including osteopathy in multidisciplinary teams could enhance therapeutic options and improve patient care quality.

Enhanced Attention Res-Unet for Segmentation of Knee Bones

The objective of this study was to develop a U-net capable of generating highly accurate 3D models of knee bones, in particular the femur. As part of the approach, a U-net was designed, trained, and validated. In order to achieve these goals, a novel architecture was proposed, including an architecture that reduces encoder parameters and incorporates transfer learning, in order to enhance the attention U-net. Additionally, an extra depth layer was added to extract more salient information. Moreover, the model includes a classifier unit to reduce false positives, as well as a Tversky focal loss function, which is an innovative loss function. The proposed architecture achieved a Dice coefficient of 98.05. By using these enhanced tools, clinicians can visualize and analyze knee structures more accurately, improve surgical intervention effectiveness, and improve patient care quality overall.