Improve Patient Care Research Articles

Exploration of the Molecular and Phylogenetic Aspects of Brucella intermedia (Ochrobactrum intermedia)

Brucella bacteria are among the oldest known zoonotic pathogens and they have become iconic case studies in infectious diseases. Genome comparisons have led to the reclassification of the genus Ochrobactrum, with its individual species now being categorized as Brucella. This study aims to isolate and molecularly identify Ochrobactrum intermedia from Iraqi patients. One hundred seventy urine samples were collected from patients with various conditions suspected of brucellosis. Based on identification by the VITEK compact system, two of the bacterial isolates were identified as Brucella intermedia (Ochrobactrum intermedia) species. This was confirmed by polymerase chain reaction using genus-specific primers for the 16S rRNA and recA genes which are specific for B.intermedia. The 16S rRNA gene sequences were aligned using BLAST and the BioEdit program. It was observed that there was a remarkable 99% similarity among the Brucella intermedia sequences. The affiliation of the two novel strains of B. intermedia, identified as Brucella intermedia strain BC-TCC 16S ribosomal RNA gene (OP415407) and Brucella intermedia strain Baghdadies 16S ribosomal RNA gene (OP415409), was confirmed through the analysis of both 16S rRNA and recA genes. These findings suggest that the use of 16S RC-PCR and sequencing in clinical settings can improve patient care by increasing the sensitivity of detection and identification of bacterial pathogens, resulting in more diagnoses of bacterial infections. By studying novel strains in a phylogenetic tree, researchers can learn more about the diversity of a species and can identify potential new threats to human and animal health.

Development and Testing of an Instrument to Measure Professionalism in Nursing.

Background and Purpose: Evaluation of professionalism in nursing has proven challenging as no objective measurement tool exists. The purpose of this study was to develop and test the Professionalism in Nursing Scale (PNS) for reliability and validity, which will facilitate evaluation of the constructs of professionalism in nursing. Participants were senior nursing students and registered nurses with at least a baccalaureate degree and a minimum of 3 years of experience working either in academia at an accredited university or in a practice setting in a Magnet hospital. Methods: Methodological research was used to design an instrument that measures professionalism in nursing. Phase 1 included item development, scaling, and evaluation of the content validity index, using 10 content experts. Phase 2 included pilot and field testing using participants meeting the inclusion criteria. Questionnaires were sent electronically to evaluate the relevance of each attribute of professionalism using a Likert scale. Phase 3 was scale evaluation, including reliability and validity of the PNS. Results: Final results of exploratory factor analysis supported a 33-item five-factor model. The factors were named Ethics and Interprofessional Collaboration, Excellence, Professional Engagement, Caring, and Self-Awareness. The overall reliability rate of the PNS was 0.97. Findings demonstrated the reliability and validity of the PNS for measuring professionalism in academic and clinician nurses and nursing students. Conclusions: Measuring professionalism in nursing can assist driving improvement of patient care, accountability, and team collaboration. A discussion of the PNS within the context of academia and clinical practice, along with implications for research, practice, education, and policy will be presented.

Metaverse in surgery - origins and future potential.

The metaverse refers to a collective virtual space that combines physical and digital realities to create immersive, interactive environments. This space is powered by technologies such as augmented reality (AR), virtual reality (VR), artificial intelligence (AI) and blockchain. In healthcare, the metaverse can offer many applications. Specifically in surgery, potential uses of the metaverse include the possibility of conducting immersive surgical training in a VR or AR setting, and enhancing surgical planning through the adoption of three-dimensional virtual models and simulated procedures. At the intraoperative level, AR-guided surgery can assist the surgeon in real time to increase surgical precision in tumour identification and selective management of vessels. In post-operative care, potential uses of the metaverse include recovery monitoring and patient education. In urology, AR and VR have been widely explored in the past decade, mainly for surgical navigation in prostate and kidney cancer surgery, whereas only anecdotal metaverse experiences have been reported to date, specifically in partial nephrectomy. In the future, further integration of AI will improve the metaverse experience, potentially increasing the possibility of carrying out surgical navigation, data collection and virtual trials within the metaverse. However, challenges concerning data security and regulatory compliance must be addressed before the metaverse can be used to improve patient care.

AI and Cloud Computing in Healthcare: Transforming Patient Care with AWS and Java

A new era in healthcare is being ushered in by the convergence of artificial intelligence (AI) and cloud computing, which will significantly improve patient care through improved diagnosis, individualized treatment planning, and effective patient management. This article explores the potent combination of Java and Amazon Web Services (AWS) and how these technologies may be used to develop cutting-edge AI-driven healthcare solutions that optimize healthcare operations and dramatically enhance patient outcomes. Together with Java's robust and flexible programming environment, healthcare providers can leverage AWS's scalable infrastructure and advanced machine learning capabilities to create and implement sophisticated AI models that analyze massive amounts of medical data at a speed and accuracy never seen before. These developments are making it possible to make more accurate diagnoses, customized treatment plans, and proactive patient monitoring, which can result in better clinical judgment and possibly life-saving measures. But even as we consider the enormous positive effects these technologies have on society, we also have to face the ethical problems they raise, such as issues with data privacy, potential biases in algorithms, and unequal access to cutting-edge medical treatments.

Assessment for Quality of Life for Patients with Chronic Kidney Diseases in Saudi Arabia: A Cross-Sectional Study

Introduction: Studying the quality of life (QoL) for patients with Chronic Kidney Disease (CKD) is crucial as it provides insights into their well-being, treatment effectiveness, and healthcare needs. Understanding factors affecting QoL can lead to improved patient care and interventions tailored to enhance their overall quality of life.

Remote Healthcare: Development of a Centralized Patient Monitoring System for Ward Patients.

Patient monitoring is an essential practice in healthcare settings to assess well-being and medical conditions. This study proposes a central patient monitoring system enabling healthcare personnel to have a comprehensive perspective of multiple patients' health state from a central location. The proposed prototype enables healthcare providers to detect and respond to changes in patients' condition efficiently. The project contains multiple patient monitoring units with each measuring temperature, ECG, SpO2, and heart rate along with a display on a centralized screen. The hardware of monitors is placed at each patient bed connected with all the patients and the result of each patient can be seen from the general ward counter. Different sensors are used to design monitoring units and are connected with node MCU through different pin connections. Node MCU sends the information gathered from sensors to the Raspberry pi unit using Wi-Fi. The real-time data of patients are being displayed and saved using server “thing speak”. There are different options on the server window to switch between different patients’ real time results to monitor them. The proposed prototype uses computer technology to monitor the vital signs of multiple patients on a single monitor from a centralized location using internet which may eventually reduce the time and workload of medical staff leading to improved patient care.

Fostering collaboration: an exploration of knowledge exchange between Rongoā Māori practitioners and surgical clinicians.

This research investigates the potential for collaboration of Rongoā Māori, the Indigenous healing practices of Māori, with New Zealand's contemporary healthcare system. It aims to bridge the gap between Rongoā Māori and Western medicine by exploring the perspectives of practitioners from both fields, identifying barriers to integration, and highlighting potential areas for collaboration. Qualitative interviews were conducted with both Rongoā practitioners and Western surgeons. The data collected were subjected to thematic analysis to extract key themes related to the integration process, challenges faced, and the potential for mutual recognition and respect between the two healing paradigms. The study reveals a deep respect for Rongoā Māori among Western surgeons but identifies significant systemic barriers that impede its integration. These include bureaucratic challenges and the absence of clear referral pathways. Rongoā practitioners express concerns over being overlooked within the healthcare system and highlight a lack of awareness among healthcare professionals about their practices. Despite these challenges, there is a shared interest in collaborative approaches to healthcare that respect and incorporate Rongoā Māori. The findings underscore the need for systemic changes to facilitate the integration of Rongoā Māori into mainstream healthcare, including the development of clear referral pathways and initiatives to raise awareness among healthcare professionals. The study highlights the need for a more collaborative healthcare approach that values the contributions of Rongoā Māori, aiming to improve patient care through holistic practices.

AI and Cloud Computing in Healthcare: Transforming Patient Care with AWS and Java

A new era in healthcare is being ushered in by the convergence of artificial intelligence (AI) and cloud computing, which will significantly improve patient care through improved diagnosis, individualized treatment planning, and effective patient management. This article explores the potent combination of Java and Amazon Web Services (AWS) and how these technologies may be used to develop cutting-edge AI-driven healthcare solutions that optimize healthcare operations and dramatically enhance patient outcomes. Together with Java's robust and flexible programming environment, healthcare providers can leverage AWS's scalable infrastructure and advanced machine learning capabilities to create and implement sophisticated AI models that analyze massive amounts of medical data at a speed and accuracy never seen before. These developments are making it possible to make more accurate diagnoses, customized treatment plans, and proactive patient monitoring, which can result in better clinical judgment and possibly life-saving measures. But even as we consider the enormous positive effects these technologies have on society, we also have to face the ethical problems they raise, such as issues with data privacy, potential biases in algorithms, and unequal access to cutting-edge medical treatments. The goal of this thorough investigation is to present a fair assessment of the revolutionary potential of artificial intelligence (AI) and cloud computing in the healthcare industry, while also discussing the wider ramifications and obligations associated with incorporating these formidable technologies into our healthcare systems.

Theory of optimising radiation protection among diagnostic radiographers depicted as a model.

When radiation protection practices are suboptimal, it becomes necessary to take additional steps to optimise practices. Therefore, this study aimed to develop a model to facilitate radiation protection among diagnostic radiographers. The study was conducted in South Africa. A theory-generating design consisting of three steps was used to develop the model: (1) the central concept was identified, defined and classified; (2) relationship statements were created and (3) the model was developed, described and evaluated. The model was premised on the central concept of facilitating a transformative radiation protection environment and occurs in four phases: (1) relationship, (2) working, (3) termination and (4) independent phases. The radiography manager and radiographer enter the relationship phase of the model because of discord regarding radiation protection in their department and work together to optimise radiation protection. The model's purpose, assumptions, context, structure and process are described. A model to facilitate radiation protection among radiographers was conceptualised to optimise radiation protection. The model details the steps the radiography manager and radiographer take to co-create optimal radiation protection practices. Radiation protection compliance among radiographers is paramount to ethical radiography practice, and the model provides a guide to optimise radiation protection. In any radiography department where radiation protection may be lacking, the model provides a road map of possibilities for change. Ultimately, radiation protection compliance improves patient care and outcomes.

Development of a Hospital Wide Inpatient Frailty Screening Pathway in a Model-2 Hospital

Abstract Background Our model-2 hospital is experiencing a higher proportion of frail older adults presenting to our medical assessment unit (MAU) and via direct ward admissions. Frailty increases the risk of co-morbidity, falls and mortality during hospital admission. Screening for frailty a point of admission allows early identification of these patients who are at higher risk of adverse outcomes. Early frailty screening also assists healthcare professionals with multidisciplinary team (MDT) management and treatment plans. Our hospital frailty committee established a frailty screening pathway for all inpatients aged 75 years and older to screen for frailty and minimise the risk of adverse outcomes secondary to frailty. Methods A hospital wide consultant chaired frailty committee was established with stakeholders from the MDT. Two separate screening pathways were developed, one for MAU admissions and one for direct ward admissions. A standardised frailty policy and standardised operating procedure (SOP) with algorithm illustration were compiled. Hospital wide education emphasised the development of a bespoke Clinical Frailty Score (CFS) sticker in conjunction with referral pathways to the newly established Clinical Nurse Specialist (CNS) For The Older Adult. In each pathway CFS-screening is completed for adults ≥75years at first-point of contact using the CFS, a score ≥6 triggers onward referral, CNS for inpatient and public health nurse for MAU discharged patients. Results Both pathways are established and used effectively and routinely on a daily basis. Associated educational sessions have emphasised the importance of frailty in our inpatient cohort. Conclusion The developed algorithms have been useful for identifying frailty and improving patient care with onward CNS referral. Future audits will assess effectiveness of screening and support advancement of frailty committee objectives via supporting business cases for resourcing.

“Understanding Dementia Together”: The Design, Delivery and Evaluation of a Collaborative Inter-professional Dementia Workshop for Healthcare Students

Abstract Background A collaborative, multi-disciplinary team input is crucial for the optimal management of a person with dementia. Interprofessional learning (IPL) has benefits at undergraduate level. Allowing students to engage in IPL pre-qualification enables them to understand the value of a collaborative approach in improving patient care, and this insight may cultivate future collaboration. The aim of this study was to develop, deliver and evaluate an IPL dementia workshop for healthcare students across a broad range of relevant disciplines. A secondary aim was to determine the extent of perceived clinical application of learned knowledge in students who completed the workshop and subsequently underwent clinical placement. Methods This study adopted a social constructivist pedagogical approach. A steering group was formed which included faculty members from 11 healthcare disciplines. Disciplines represented included medicine, nursing, dentistry, physiotherapy, radiography, radiation therapy, audiology, speech and language therapy, pharmacy, occupational therapy and paramedicine. Kern's map for the development of a curriculum in medical education informed the development of the intervention. The Alzheimer's Disease Knowledge Scale questionnaire was used to assess students’ knowledge. Results 102 students completed the pre and post workshop surveys. There was a statistically significant increase in student's knowledge (t (11) = -5.251, p≤0.001) and communication scores (Z=-7.792, p≤0.001) post workshop. The follow up of students on clinical placement showed a perceived behavioural change in communication modification, with 79% of students stating that they have changed the way they communicate with a person with dementia. Conclusion The findings of this study provide insight into the optimum modes of design and delivery of an IPL dementia workshop, state of knowledge, confidence, and role recognition across a broad spectrum of healthcare students. The longitudinal follow up of students on clinical placement established perceived behavioural change due to the training.

The Development And Implementation Of A Multi-Factorial Falls Assessment Tool In A Pathfinder Service

Abstract Background Falls are a common complaint of older adults who present to the Pathfinder service. Pathfinder offers alternative care pathways to older adults when they phone 999 for low acuity concerns. As part of the service, Occupational Therapists and Physiotherapists provide home-based assessments and interventions. The aims of this project were firstly, to develop a falls assessment tool to assist therapists’ compliance with guidelines relating to older adults who have fallen and secondly, to ensure consistency of assessment and intervention among therapists on the team. Methods A falls assessment tool was created in line with the most recent world falls guidelines (Montero-Odasso et al., 2022). The initial roll out began on October 1st, 2024, when the tool was used to assess older adults who presented to the Pathfinder service following a fall. After three months, areas of poor compliance and barriers with usability of the tool were highlighted from a chart review and stakeholder engagement. The document was then revised based on this feedback. From February 1st, 2024, the tool was then used with all older adults who presented to the service. Compliance was re-audited at the end of April 2024 and therapists on the team were surveyed to gather user feedback. Results As a result of the falls assessment tool, compliance with the World Falls Guidelines increased initially from 54% to 86% but continued to improve when reviewed seven months post implementation. Qualitative data was universally positive when stakeholders were surveyed with benefits identified as: improving patient care, consistency across the therapy team and a useful means of communication. Conclusion The development and implementation of a falls assessment tool into the practice of a Pathfinder service increased compliance with the most recent world falls guidelines and received positive feedback from all key stakeholders.

Pathogen-Directed Antimicrobial Stewardship Audit Rounds: Evaluation of an Objectively Planned, Clinical Microbiology-Driven Antimicrobial Stewardship Approach to Influence Antimicrobial Prescriptions of Prescribers.

Correct and prompt antimicrobial prescription modifications by the treating team based on the culture and antimicrobial susceptibility test (AST) reports are crucial. Pathogen-directed antimicrobial stewardship (PD-AMS) audit rounds are a clinical microbiology-driven approach to combine prompt appropriate patient management goals with goals of preventing irrational and improper use of antimicrobials. The study was a prospective before-after interventional study to evaluate the effectiveness of PD-AMS audit rounds in modifying antimicrobial usage by prescribers on an individual patient basis. It is divided into a two-month pre-intervention phase (no active advice is given with passive monitoring) and an intervention phase for four months, with antimicrobial therapy-related advice during PD-AMS rounds taken as "Intervention."Antimicrobial advice was objectively classified into various categories. The PD-AMS audit round was conducted for all inpatients with a culture-proven bloodstream infection with a pathogen, and objectively classified antimicrobial advice was given through bedside rounds, telephonically, and/or written advice forms. Compliance with the advice was monitored on the next day (or at the end of 24 hours) of the PD-AMS round. The compliance with culture AST report regarding antimicrobial prescription modifications improved significantly in the intervention phase compared to the pre-intervention phase as follows: overall (83.8% (612/730) vs. 56.7% (242/427)); medicine alliance (87.4% (263/301) vs. 57.8% (115/199)); surgery alliance (87.2% (170/195) vs. 54.0% (87/161)); pediatric alliance (87.3% (138/158) vs. 66.7% (26/39)); oncology alliance (53.9% (41/76) vs. 28.6% (8/28)); critical care locations (82.0% (260/317) vs. 62.7% (89/142)); and in-patient departments (85.2% (352/413) vs. 53.7% (153/285)). The clinical microbiology team should mandatorily conduct an objectively planned PD-AMS audit round to improve patient care and management and antimicrobial prescriptions through a mutual discussion with prescribers and to help address their doubts.

Optimizing Diagnosis and Management of Ventilator-Associated Pneumonia: A Systematic Evaluation of Biofilm Detection Methods and Bacterial Colonization on Endotracheal Tubes

Healthcare-associated infections, such as ventilator-associated pneumonia and biofilm formation on intubation cannulas, impose significant burdens on hospitals, affecting staffing, finances, and patient wellbeing, while also increasing the risk of patient mortality. We propose a research study aimed at exploring various methodologies for detecting these infections, discovered in the biofilm on medical devices, particularly tracheal cannulas, and understanding the role of each method in comprehending these infections from an etiological perspective. Our investigation also involves an analysis of the types of endotracheal tubes utilized in each case, the bacteria species identified, and strategies for combating biofilm-associated infections. The potential impact of our research is the substantial improvement of patient care through enhanced diagnosis and management of these infections.

Navigating the omics landscape in precision medicine: A bidirectional approach to patient care

This paper presents a novel bidirectional approach to precision medicine that combines proteomic, peptidomic and metabolomic analyzes with clinical data and genome-wide association studies (GWAS). This innovative strategy improves patient care by enabling a dynamic exchange from “patient to molecular pathway” and back, which significantly refines patient cohort stratification, improves diagnostic accuracy and personalizes treatment strategies. At the heart of this approach is the use of comprehensive multi-omics data to improve patient management by tailoring interventions to individual molecular profiles. This two-way flow not only optimizes treatment based on real-time insights from molecular pathways, but also improves the application of GWAS results in clinical scenarios. Advanced computational tools such as machine learning and network analysis are critical for navigating these complex data sets and translating intricate molecular data into actionable treatment plans. This integrated, adaptive framework promises to reshape the future of healthcare by tailoring treatments to patients' unique biological and genetic profiles.

Dementia Classification Approach Based on Non-Singleton General Type-2 Fuzzy Reasoning

Dementia is the most critical neurodegenerative disease that gradually destroys memory and other cognitive functions. Therefore, early detection is essential, and to build an effective detection model, it is required to understand its type, symptoms, stages and causes, and diagnosis methodologies. This paper presents a novel approach to classify dementia based on a data set with some relevant patient features. The classification methodology employs non-singleton general type-2 fuzzy sets, non-singleton interval type-2 fuzzy sets, and non-singleton type 1 fuzzy sets. These advanced fuzzy sets are compared with traditional singleton fuzzy sets to evaluate their performance. The Takagi–Sugeno–Kang TSK inference method is used to handle fuzzy reasoning. In the process, the parameters of the membership functions (MFs) and rules are obtained using ANFIS, and non-singleton MFs are optimized with PSO. The results demonstrate that non-singleton general type-2 fuzzy sets improve classification accuracy compared to singleton fuzzy sets, demonstrating their ability to model the uncertainties inherent in the diagnosis of dementia. This improvement suggests that non-singleton fuzzy systems offer a more robust framework for developing effective diagnostic tools in the medical domain. Accurate classification of dementia is of utmost importance to improve patient care and advance medical research.

Improving patient care in the emergency department in a selected hospital: a study on patient centered care

Background: Patient-centred care is founded on the principle of active patient and family engagement at all levels of care, enabling them to take ownership of treatment decisions. As patients are best positioned to understand their unique needs and priorities, their involvement is crucial. This study seeks to evaluate the patient centered care delivered by the healthcare providers, specifically doctors and nurses in the emergency department setting. Methods: A Questionnaire-based method was employed to collect data from a sample of 72 patients in the emergency department, assessing patient centered care in the selected tertiary care teaching hospital. The study was conducted between 1st May 2023 to 31st May 2023. Results: The study revealed that patients rated their care experience as very good, achieving high ratings across various dimensions, with the following mean and standard deviation scores: “Patient preference” 4.06±1.13, “Physical comforts” 3.99±1.04, “Coordination of care” 4.03±1.06. “Information and education” 4.08 ±1.06, “Communication” 4.06±1.07, with respect to “Continuity and Transition” 4.13±1.07 and “Family and Friends” 4.24±1.08. These ratings demonstrate a high level of satisfaction with care quality. Conclusions: Patient centered care is a healthcare approach that prioritizes patient needs and values. Its about working together with patients to provide flexible and personalized care. This study found that emergency department staff understand the importance of patient centered care and its benefit for patients and healthcare organisations.

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.

Multidisciplinary Travel Health Education: Current Status and Rationale for Standardized Competencies.

This perspective highlights the inconsistent integration of travel health education across medical, nursing and pharmacy educational programmes globally and calls for standardized travel health competencies based on the International Society of Travel Medicine’s (ISTM) Body of Knowledge to help improve patient care outcomes as global travel returns to pre-pandemic levels.

Usage of Antifungal Agents in Pediatric Patients Versus Adults: Knowledge and Gaps.

Invasive fungal infections (IFIs) present significant challenges in managing hospitalized and immunocompromised pediatric patients, contributing to high morbidity and mortality. Despite advancements in diagnostics and treatment, outcomes remain suboptimal due to unique clinical epidemiology, lack of pediatric-specific trials, and varied pharmacokinetics. The emergence of new antifungal classes and agents has expanded our options for preventing and treating IFIs in children, enhancing the safety and effectiveness of antifungal therapy. The oral formulations of ibrexafungerp, fosmanogepix and olorofim along with the extended dosing intervals of rezafungin show promising features for effective antifungal treatment in pediatrics. Despite the promising potential of novel antifungal drugs, their performance in heavily immunosuppressed patients remains unstudied. Until then, dedicated antifungal stewardship programs for high-risk patients are essential to optimize therapeutic outcomes, improve patient care, and limit the emergence of resistance.