Improve Patient Care Research Articles

Perceptions of Dental Faculty and Postgraduate Residents towards Learning Professionalism through DOPS Assessments of Implants

ABSTRACT Objective: One of the essential characteristics that define a career is professionalism, which encompasses commitments, actions, standards, and objectives. Background: The study was aimed to assess the perception of dental faculty and residents towards DOPS as a method to assess professionalism and also the perception of participants towards inclusion of professionalism assessments in the dental curriculum. Method: This descriptive cross sectional study was conducted amongst forty three Prosthodontic postgraduate residents and twenty faculty members from ten different dental colleges in India in the year 2023.Views regarding professionalism were assessed using the Modified Australian Medical Council (AMC) DOPS assessment form. We measured Professionalism score from the DOPS assessments conducted six times within a year of the residents in different dental colleges of India. The resident was evaluated by two different faculty members in order to minimize subjective bias. The scores range from 1 to 5, with 1 representing the least amount of professionalism displayed and 5 representing the best. Data was analyzed using SPSS version 23. Descriptive statistics was done using mean score. Results: DOPS Assessment score of professionalism for Prosthodontic postgraduate residents and feedback from participants, post graduates and faculty at the end of last assessment was considered for conclusion. They showed increase in DOPS score and positive attitude towards dental professionalism. The participants believed that DOPS assessment is an effective way to improve professionalism. Conclusion: Academic dishonesty may continue with unethical behaviors in professional practice of a healthcare professional. Hence, it becomes vital to address academic dishonesty lapses among oral health sciences students to ensure the future safety of patients and improvement in patient care.

A scoping review of patient safety checklists in dentistry.

Not much is known about safety checklists use in dentistry. We aim to examine, assess, and provide a comprehensive understanding of the current knowledge concerning the use of checklists to improve patient safety in dentistry. We conducted a comprehensive literature search using Medline and Embase for studies that use or describe the development of dental patient safety checklists. All study designs were included for citations published through December 2023. Following abstract and full-text screening, 27 studies remained for data extraction and analysis. Oral surgery emerged as the main dental specialty where the utilization and evaluation of checklists were primarily concentrated (n = 15). The majority of the included studies described either checklist development, their implementation, or both (n = 18). Only 6 studies assessed the effectiveness of checklists in improving patient safety outcomes. Of the effectiveness studies, five found a decrease in incidents and dental adverse events, along with an improvement in patient care and safety, associated with the use of checklists. This scoping review highlights the limited current knowledge regarding checklist use and effectiveness in reducing adverse events across dental practices; it demonstrates the need on how to best guide the profession towards implementing this important evidence-based patient safety tool. Checklists are effective tools to improve patient safety and have become integral to medical practice. Dentistry can also benefit from these tools to improve patient safety.

Endometriosis in Focus: Modern Therapeutic Approaches for Enhanced Patient Outcomes - Review

Endometriosis (EM) is a chronic condition affecting millions of women globally, characterized by the growth of endometrial-like tissue outside the uterus. This review highlights the latest advancements in understanding and treating endometriosis, focusing on new therapeutic strategies aimed at improving patient care. The article briefly discusses the pathogenesis of endometriosis and reviews traditional treatment methods, including hormonal therapies (progestins, GnRH agonists, and oral contraceptives) and surgical interventions. It then explores the limitations of these conventional therapies and delves into newer strategies targeting specific molecular pathways, offering more effective symptom relief with fewer side effects. Emerging treatments that modulate the immune response and reduce inflammation are also examined, along with innovative approaches to pain management, both pharmacological and non-pharmacological. The review further considers alternative and supportive therapies, such as dietary changes, gut microbiota interventions, and complementary treatments like acupuncture, which may improve the overall management of endometriosis. This review emphasizes the shift toward more personalized, holistic care in treating endometriosis, with a focus on emerging therapies like Aromatase Inhibitors, GnRH receptor antagonists, and hormone receptor modulators. These approaches represent a significant advancement in improving the quality of life for women with this condition.

MRI deep learning models for assisted diagnosis of knee pathologies: a systematic review.

Despite showing encouraging outcomes, the precision of deep learning (DL) models using different convolutional neural networks (CNNs) for diagnosis remains under investigation. This systematic review aims to summarise the status of DL MRI models developed for assisting the diagnosis of a variety of knee abnormalities. Five databases were systematically searched, employing predefined terms such as 'Knee AND 3D AND MRI AND DL'. Selected inclusion criteria were used to screen publications by title, abstract, and full text. The synthesis of results was performed by two independent reviewers. Fifty-four articles were included. The studies focused on anterior cruciate ligament injuries (n = 19, 36%), osteoarthritis (n = 9, 17%), meniscal injuries (n = 13, 24%), abnormal knee appearance (n = 11, 20%), and other (n = 2, 4%). The DL models in this review primarily used the following CNNs: ResNet (n = 11, 21%), VGG (n = 6, 11%), DenseNet (n = 4, 8%), and DarkNet (n = 3, 6%). DL models showed high-performance metrics compared to ground truth. DL models for the detection of a specific injury outperformed those by up to 4.5% for general abnormality detection. Despite the varied study designs used among the reviewed articles, DL models showed promising outcomes in the assisted detection of selected knee pathologies by MRI. This review underscores the importance of validating these models with larger MRI datasets to close the existing gap between current DL model performance and clinical requirements. Question What is the status of DL model availability for knee pathology detection in MRI and their clinical potential? Findings Pathology-specific DL models reported higher accuracy compared to DL models for the detection of general abnormalities of the knee. DL model performance was mainly influenced by the quantity and diversity of data available for model training. Clinical relevance These findings should encourage future developments to improve patient care, support personalised diagnosis and treatment, optimise costs, and advance artificial intelligence-based medical imaging practices.

Comparing the impact of different transfusion medicine teaching methods—A mobile application versus task-based learning—On two dimensions of clinical competence among nursing students: A quasi-experimental study

AimTo evaluate and compare the impact of a transfusion medicine training course delivered via two different teaching methods—a mobile application and task-based learning—on nursing students' knowledge and clinical decision-making skill. BackgroundTo advance nursing education and clinical competence, it is crucial to integrate innovative methods, such as mobile applications and task-based learning, that promote active and competency-based learning. Evaluating these methods provides educators with insights to enhance nursing students' knowledge and clinical decision-making skill, ultimately improving patient care and supporting professional development. DesignA quasi-experimental study using a pretest-intervention-posttest design with a control group. MethodsThis study included 82 nursing students from the 6th to 8th semesters, selected through convenience sampling and randomly assigned to three groups—mobile application (n=30), task-based learning (n=30) and control (n=30). The first group received educational content through a mobile application, the second group through task-based learning and the control group received no intervention. Data were collected using a valid and reliable three-part researcher-made tool, including a demographic/educational checklist and questionnaires on knowledge and clinical decision-making skill, administered before and two weeks after the intervention. Analysis was done using paired t-test, analysis of covariance and Bonferroni post hoc test, with a significance level set at p<0.05. ResultsFollowing the intervention, both intervention groups showed a significant increase in knowledge and clinical decision-making skill scores (p<0.05). Although both groups had higher knowledge scores than the control group, the differences were not significant (p>0.05). In contrast, clinical decision-making scores were significantly higher in both intervention groups compared with the control (p<0.05). No significant differences were observed between the intervention groups regarding the mean post-test knowledge and clinical decision-making skill scores (p>0.05). ConclusionBoth teaching methods effectively improved nursing students' knowledge and clinical decision-making skills in transfusion medicine. To leverage these findings effectively, educational authorities should integrate mobile applications and task-based learning into nursing curricula, test these methods in various settings to assess their impact and use the findings to update curricula in line with current educational needs.

Photon-counting computed tomography versus energy-integrating computed tomography for detection of small liver lesions: comparison using a virtual framework imaging.

Photon-counting computed tomography (PCCT) has the potential to provide superior image quality to energy-integrating CT (EICT). We objectively compare PCCT to EICT for liver lesion detection. Fifty anthropomorphic, computational phantoms with inserted liver lesions were generated. Contrast-enhanced scans of each phantom were simulated at the portal venous phase. The acquisitions were done using DukeSim, a validated CT simulation platform. Scans were simulated at two dose levels ( 1.5 to 6.0mGy) modeling PCCT (NAEOTOM Alpha, Siemens, Erlangen, Germany) and EICT (SOMATOM Flash, Siemens). Images were reconstructed with varying levels of kernel sharpness (soft, medium, sharp). To provide a quantitative estimate of image quality, the modulation transfer function (MTF), frequency at 50% of the MTF ( ), noise magnitude, contrast-to-noise ratio (CNR, per lesion), and detectability index ( , per lesion) were measured. Across all studied conditions, the best detection performance, measured by , was for PCCT images with the highest dose level and softest kernel. With soft kernel reconstruction, PCCT demonstrated improved lesion CNR and compared with EICT, with a mean increase in CNR of 35.0% ( ) and 21% ( ) and a mean increase in of 41.0% ( ) and 23.3% ( ) for the 1.5 and 6.0mGy acquisitions, respectively. The improvements were greatest for larger phantoms, low-contrast lesions, and low-dose scans. PCCT demonstrated objective improvement in liver lesion detection and image quality metrics compared with EICT. These advances may lead to earlier and more accurate liver lesion detection, thus improving patient care.

Understanding external carotid artery collateralisation after cerebral revascularisation in moyamoya disease: insights from quantitative analysis

BackgroundThis study aims to quantitatively evaluate collateralisation angiogenesis ratio (CAR) of external carotid artery and intracranial arterial residual volumes (ARV) postcerebral revascularisation in moyamoya disease (MMD) and elucidate the factors...

Cyber-Securing Medical Devices Using Machine Learning: A Case Study of Pacemaker

This study aims to enhance the cybersecurity framework of pacemaker devices by identifying vulnerabilities and recommending effective strategies. The objectives are to pinpoint cybersecurity weaknesses, utilize machine learning to predict security breaches, and propose countermeasures based on analytical trends. The literature review highlights the transformation of pacemaker technology from basic, fixed-rate devices to sophisticated systems with wireless capabilities, which, while improving patient care, also introduce significant cybersecurity risks. These risks include unauthorized entry, data breaches, and life-threatening device malfunctions. The methodology in this study utilizes a quantitative research approach using the WUSTL-EHMS-2020 dataset, which includes network traffic features, patients' biometric features, and attack label. The step-by-step method of machine learning prediction includes data collection, data preprocessing, feature engineering, and models’ training using Support Vector Machines (SVM) and Gradient Boosting Machines (GBM). The implementation results used evaluation metrics like accuracy, precision, recall, and F1 score to show that GBM model outperformed the SVM model. The GBM model achieved higher accuracy of 95.1% compared to 92.5% for SVM, greater precision of 99.6% compared to 96.7% for SVM, better recall of 94.9% compared to 42.7% for SVM, and a higher F1 score of 76.3% compared to 59.0% for SVM, making GBM model more effective in predicting cybersecurity threats. This study concludes that GBM is an effective machine learning model for enhancing pacemaker cybersecurity by analyzing network traffic and biometric data patterns. Future recommendations for improving the pacemaker cybersecurity include implementing GBM model for threat predictions, integration with existing security measures, and regular model updates and retraining.

Perceptions and attitudes toward digital dentistry among dental professionals: a questionnaire survey study

In recent decades, digital technologies have become increasingly essential in dentistry, continuing the field's long-standing necessity of cutting-edge technology and innovation.The objective of the study was to determine the perception and attitude of dentists towards the use of digital technology.A Questionnaire study was conducted amongst 400 dental professionals. The questionnaire was sent electronically to all participants. The data from the filled forms was then compiled in a spreadsheet. The data was analyzed using IBM-SPSS (Statistical Package for Social Studies) Version 22. P value was taken as statistically significant (P-Value &amp;#60; 0.05). 58% dental professionals did not receive any training. 42% dental professionals have received formal training or education in digital dentistry during their professional career while 58% didn’t receive any training. 62% of professionals have noted changes in treatment outcomes or patient satisfaction since integrating digital dentistry technologies into their practice. 77% of participants expressed a willingness to adopt CAD/CAM systems in their practices. More than 75% were optimistic about bright future of digital technologies in dentistry in improving patient care and treatment outcomes.The majority of dental professionals were in the favor of incorporation of digital dentistry into clinical practice. Initial high cost of equipment’s and lack of formal training were the major barrier for incorporating digital technologies in routine clinical practice.

A rare case of Anti-Jk3 Alloimmunization

Abstract Introduction/Objective The Kidd blood group system was discovered in 1951 and consists of two antithetical antigens, Jka and Jkb, in addition to a third high-incidence antigen, Jk3. Jk null, also known as Jk(a-b-), is an extremely rare blood group in which all Kidd antigens are absent. Jk is a urea transporter found in the renal medulla, and Jk-deficient individuals are unable to concentrate urine to its maximum concentration. If these individuals are exposed to the Jk antigen via transfusion or pregnancy, they are able to produce antibodies against the Jk3 antigen with a high incidence. Jk3 is expressed in over 99.9% of the blood donor pool, which has severe clinical implications and complicates transfusion. Methods/Case Report CASE PRESENTATION: A 68-year-old male was admitted to the Stanford Medical Center with chronic right midshaft tibia osteomyelitis and a sinus drainage tract for a right tibial diaphysectomy. His test for antibodies was positive. Plasma from the patient is reactive with all tested cells except auto control, AHG in PEG, and solid phase. Phenotyping yielded negative results for Jka and Jkb, suggesting that the antibody is Jk3. Anti-Jk3 was eliminated by adsorption and rendered nonreactive. Results (if a Case Study enter NA) NA Conclusion Anti-Jk3 should be suspected in a previously pregnant or transfused patient during antibody screening and identification if it demonstrates the pattern of an antibody reacting to all cells in the panel, i.e., reacting to a high- frequency antigen with negative autocontrol. Awareness on the part of blood bank personnel regarding the variability of the blood group phenotype and the capricious nature of Kidd antibodies may aid in the improved management of these patients. It is recommended that patients with rare antibodies carry an antibody ID card indicating the rare antibody they have to prevent further exposure. A patient may be advised to undergo an autologous transfusion. Fortunately, the patient’s procedures were uncomplicated, so a blood transfusion was unnecessary. Awareness on the part of blood bank staff regarding the variability of the blood group phenotype and the unpredictability of Anti-Jk3 may aid in improving patient care. To prevent further exposure, it is recommended that patients with rare antibodies carry an Antibody ID card indicating the rare antibody they possess.Jk3 antigen blood donors are underrepresented in the general donor pool. It is recommended to develop a systematic recruitment for Jk3 antigen donors.

Multifaceted Interventions to Enable Elimination of Clinician-ordered Blood Smear Reviews: A Rural Academic Medical Center Experience

Abstract Introduction/Objective Blood smears (BS) evaluate a variety of clinical disorders. At Geisinger, clinician ordered pathologist review of blood smears (CBS) have increased despite usage of highly sophisticated hematology analyzers and automatic blood smear (ABS) review criteria. We hypothesized that CBS impact pathologists’ and technologists’ workloads and increase costs and turn-around times, with rare improvement in value-based patient care. This study aimed to analyze CBS ordering practices and improve the utilization of BS review. Methods/Case Report In October 2020, a prospective CBS utilization study was completed by 8 clinical pathologists for 172 CBS. Subsequently, a clinical question was required for CBS orders from January 1, 2022, to January 1, 2023, to investigate clinician ordering practices based on campus, department, and indications. Findings were used to support new interventions including: clinician education; cancellation of repeat BS ordered within 24 hours, creation of alternative tests (schistocyte technologist smear review, clinician order for independent slide review), standardization of morphology reporting, ABS audits, and elimination of orderable CBS replaced by an electronic BS review request, that is reviewed by a clinical pathologist prior to determine if a BS is indicated. Results (if a Case Study enter NA) Part of the Conclusions section for Lab Practice abstract. Conclusion Prospective utilization audit of 172 CBS orders showed 17% changed clinical management. Audit of 3,693 CBS orders demonstrated common reasons for review included tick-borne illness, hemolysis, erythrocytosis, thrombocytosis, and iron deficiency anemia. Systematic implementation of multiple interventions enabled the elimination of CBS, with no known adverse effect on patient management to date. The streamlined BS review guidelines allowed for better-allocation of resources, appropriate patient turn-around times, empowerment of laboratory technologists and reduced hospital costs. We propose maximizing the incorporation of technologist skills to improve the utilization and efficiency of BS reviews and establishing standardized, evidence-based, and institutional- specific guidelines to determine BS reviews.

Innovations in ultrasound training in obstetrics.

Ultrasound technology is critical in obstetrics, enabling detailed examination of the fetus and maternal anatomy. However, increasing complexity demands specialised training to maximise its potential. This study explores innovative approaches to ultrasound training in obstetrics, focussing on enhancing diagnostic skills and patient safety. This review examines recent innovations in ultrasound training, including competency-based medical education (CBME), simulation technologies, technology-based resources, artificial intelligence (AI), and online-learning platforms. Traditional training methods such as theoretical learning, practical experience, and peer learning are also discussed to provide a comprehensive view of current practises. Innovations in ultrasound training include the use of high-fidelity simulators, virtual reality (VR), augmented reality (AR), and hybrid-learning platforms. Simulation technologies offer reproducibility, risk-free learning, diverse scenarios, and immediate feedback. AI and machine learning facilitate personalised-learning paths, real-time feedback, and automated-image analysis. Online-learning platforms and e-learning methods provide flexible, accessible, and cost-effective education. Gamification enhances learning motivation and engagement through educational games and virtual competitions. The integration of innovative technologies in ultrasound training significantly improves diagnostic skills, learner confidence, and patient safety. However, challenges such as high costs, the need for comprehensive instructor training, and integration into existing programs must be addressed. Standardisation and certification ensure high-quality and consistent training. Future developments in AI, VR, and 3D printing promise further advancements in ultrasound education. Innovations in ultrasound training in obstetrics offer significant improvements in medical education and patient care. The successful implementation and continuous development of these technologies are crucial to meet the growing demands of modern obstetrics.

Building and Sustaining Public Trust in Health Data Sharing for Musculoskeletal Research: Semistructured Interview and Focus Group Study.

Although many people are supportive of their deidentified health care data being used for research, concerns about privacy, safety, and security of health care data remain. There is low awareness about how data are used for research and related governance. Transparency about how health data are used for research is crucial for building public trust. One proposed solution is to ensure that affected communities are notified, particularly marginalized communities where there has previously been a lack of engagement and mistrust. This study aims to explore patient and public perspectives on the use of deidentified data from electronic health records for musculoskeletal research and to explore ways to build and sustain public trust in health data sharing for a research program (known as "the Data Jigsaw") piloting new ways of using and analyzing electronic health data. Views and perspectives about how best to engage with local communities informed the development of a public notification campaign about the research. Qualitative methods data were generated from 20 semistructured interviews and 8 focus groups, comprising 48 participants in total with musculoskeletal conditions or symptoms, including 3 carers. A presentation about the use of health data for research and examples from the specific research projects within the program were used to trigger discussion. We worked in partnership with a patient and public involvement group throughout the research and cofacilitated wider community engagement. Respondents were supportive of their health care data being shared for research purposes, but there was low awareness about how electronic health records are used for research. Security and governance concerns about data sharing were noted, including collaborations with external companies and accessing social care records. Project examples from the Data Jigsaw program were viewed positively after respondents knew more about how their data were being used to improve patient care. A range of different methods to build and sustain trust were deemed necessary by participants. Information was requested about: data management; individuals with access to the data (including any collaboration with external companies); the National Health Service's national data opt-out; and research outcomes. It was considered important to enable in-person dialogue with affected communities in addition to other forms of information. The findings have emphasized the need for transparency and awareness about health data sharing for research, and the value of tailoring this to reflect current and local research where residents might feel more invested in the focus of research and the use of local records. Thus, the provision for targeted information within affected communities with accessible messages and community-based dialogue could help to build and sustain public trust. These findings can also be extrapolated to other conditions beyond musculoskeletal conditions, making the findings relevant to a much wider community.

Effectiveness of website-based education program on activities of daily living and fear of falls among sub-acute stroke survivors: a pilot study in South Gujarat Region of India

BackgroundStroke survivors and their caregivers have numerous and diverse educational needs, many of which are unmet because of inadequate training from healthcare professionals. As stroke recovery and rehabilitation can continue for years post-stroke, it is critical that stroke survivors are provided with and have access to a range of support options and evidence-based information. Website-based education programs (WEP) have been adopted in recent years to manage health problems. The present pilot study aims to evaluate the effect of WEP on activities of daily living (ADLs) and the fear of falls among sub-acute stroke survivors.MethodsA total of 16 eligible post-stroke survivors were recruited from multiple study settings across Surat City of Gujarat state in western India and were randomly assigned using a lottery method to either the experimental group (n = 8) receiving WEP or the control group (n = 8) receiving conventional physiotherapy for 4 weeks. Outcome measures were the Indian Stroke Scale (ISS), Modified Barthel Index (MBI), and Falls Efficacy Scale-International (FES-I).ResultsBoth groups showed statistically significant improvements in all outcomes but the experimental group showed more significant improvements in ADLs and fear of falls among sub-acute stroke survivors (p < 0.05).ConclusionWEP for sub-acute stroke survivors is an effective intervention. It improves the performance of ADLs for stroke survivors and helps in better fall management indicating that web-based education programs shall be implemented on a regular basis to improve patient care.

Identifying and Addressing Errors in Anatomical Pathology: A Survey Analysis

Abstract Introduction/Objective To get an update on potential sources of pre-analytical, analytical, post-analytical and other sources of errors in anatomic pathology and strategies to mitigate such errors. Methods/Case Report The authors designed a 5-question survey in Google software and shared it widely on social media platforms. Results (if a Case Study enter NA) The survey, which garnered 43 responses from staff across various areas of the anatomic pathology laboratory, revealed significant insights. Labeling and fixation/preservation errors emerged as the most prevalent pre-analytical errors, while discrepancies between gross and microscopic examinations were common analytical errors. Specimen handling, inadequate clinical information, and transportation were the most frequently perceived other potential sources of errors. The implications of these findings are clear: robust protocols with multiple identifiers, staff training, and barcode labeling can significantly reduce patient identification errors. Similarly, standardized collection instructions, pre-labeled containers, and meticulous verification processes can effectively minimize such errors. Validated tests, standardized scoring systems, and proper investigation of quality control discrepancies are key to reducing analytical errors. Documented procedures, staff training, regular equipment calibration, and reagent testing are also crucial. Conclusion This study contributes to the literature on the current state of potential sources of errors in anatomic pathology. The study findings and recommendations on strategies to address such errors would improve the performance of the anatomic pathology laboratory and eventually improve patient care.

Proton Pump Inhibitor Usage in Urban vs. Rural Intensive Care Units: A Narrative Review of Implications for Standardization of Care.

Intensive care unit (ICU) patients frequently require and benefit from stress ulcer prophylaxis (SUP) using proton pump inhibitors (PPIs). Despite recognized benefits, PPIs are overutilized in patients who do not have high-risk factors predisposing them to clinically significant gastrointestinal bleeding (CSGIB), including mechanical ventilation and coagulopathy. This overuse increases the risk of adverse effects associated with PPIs. Several urban healthcare systems have created educational initiatives aimed at reducing PPI usage in patients who do not meet recommendations or who are outside the period for serious risk of CSGIB. However, there was no available literature exploring PPI use or educational trends in rural hospitals. This situation presents an opportunity to investigate the disparities in PPI use between rural and urban healthcare settings. This narrative review aimed to assess current data on PPI usage in both urban and rural critical care environments, and to appraise existing practices, ultimately identifying gaps in current literature and informing future guidelines. With these evaluations, this review intended to provide a comprehensive overview of current PPI prescribing practices in the ICU and improve patient care across diverse healthcare settings.

Experiences of Newly Qualified Nurses' Engagement with Quality Improvement in Practice: A Qualitative Follow-Up Study.

Nurse education plays an essential role in preparing future nurses to engage with quality improvement (QI) initiatives in their organisations and improve patient care. However, frontline nurses continue to report that a lack of QI knowledge hinders their abilities to engage in improvement work. In the UK, student nurses are now trained in QI within their degree to enable them to contribute to improvements once qualified. This qualitative follow-up study investigated the sustainability of QI engagement in nurses who undertook QI training and a QI project during their degree and explored the factors influencing their engagement in QI once qualified. This paper followed the COREQ criteria to report upon 10 semi-structured interviews undertaken with registered nurses and focuses on their experiences of QI engagement post-registration. The data were investigated using an inductive thematic analysis and Nvivo 14. Five themes emerged: transition to a newly qualified nurse, QI knowledge decline, influencing factors (hierarchy, leadership, COVID-19 pandemic, data access and location), and skill transferability. This study showed that qualified nurses can sustain their QI knowledge and remain engaged with QI where they experience positive QI leadership and were exposed to ongoing QI activity in their preceptorship year. However, a lack of QI opportunities and a culture which does not consider QI a responsibility of new nurses is seen to hinder engagement. Educational institutions and practice partners require careful collaboration to assess and develop ongoing QI learning activities that support new nurses to engage in QI.

Trends in gender and ethnic diversity among US psychiatry residents: A 5-year analysis.

This study aims to analyze trends in gender and ethnic diversity among incoming US psychiatry residents over the past 5 years. Physician diversity improves patient care as minority physicians often serve underserved communities and address health disparities. Increasing the representation of women and underrepresented minorities in medicine is essential for preparing a physician workforce that can effectively care for an increasingly diverse population. This study highlights the importance of efforts to enhance diversity within the field of psychiatry.

Assessment of the Psychometric Properties of the Hospital's Culture of Nursing Research Scale Among Nurses.

Background and Purpose: The "Hospital's Culture of Nursing Research Scale" (HCNRS) is a critical assessment tool in health care research. It was created in response to the rising acknowledgment of nursing research's critical role in improving patient care outcomes. This study aimed to develop the HCNRS to assess the nurses' perceptions of the hospital's culture of nursing research. Methods: This study utilized the instrument development design in developing the HCNRS. The study was conducted in Astana, Kazakhstan, from May to September 2023. The study followed three major stages of scale development: "item development," "scale development," and "scale evaluation." "Principal component analysis" (PCA; n = 387) and "confirmatory factor analysis" (CFA; n = 362) were performed in this study. Cronbach's coefficient α was computed for reliability. Results: The PCA on the 32-item HCNRS revealed five factors with an eigenvalue of above 1, contributing 66.0% of the model's total variance. The CFA revealed the following findings supporting the five subscales of the HCNRS-R: χ 2 /df = 2.65, root mean square error of approximation = .068 (90% CI [0.063, 0.072]), comparative fit index = 0.92, Tucker-Lewis index = 0.91, and standardized root mean square residual = .04. Based on the items that loaded in each factor, the subscales were labeled "Research Ethics, Integrity, and Supportive Culture," "Nursing Research Institutionalization," "Hospital's Financial Support and Incentives for Research Initiatives," "Nursing Research Engagement and Innovation," and "Nursing Research Integration and Career Support." The computed Cronbach's coefficient α of the entire scale was .963. For its subscales, the Cronbach's coefficient α ranged from .833 to .953. Conclusions: The study developed a five-factor HCNRS to evaluate the multifaceted aspects of nursing research culture in hospital settings. Health care institutions can utilize this scale to identify areas for improvement in research culture and implement strategies to foster research ethics, integrity, and innovation. This tool can also be used by hospital leaders, policymakers, and nurse researchers seeking to evaluate the research culture within their health care organizations.

Guideline-recommended basic parameter adherence in neurocritical care stroke patients: Observational multicenter individual participant data analysis.

Neurocritical care patients with neurovascular disease often face poor long-term outcomes, highlighting the pivotal role of evidence-based interventions. Although International Guidelines emphasize managing basic physiological parameters like temperature, blood glucose, blood pressure, and oxygen levels, physician adherence to these targets remains uncertain. This study aimed to assess adherence to guideline-based treatment targets for basic physiological parameters in neurocritical care. This multicenter observational study was conducted across eight tertiary University Hospitals in Germany analyzed 474 patients requiring mechanical ventilation (between January 1st and December 31st, 2021). Adherence was defined as the rate of measurements within therapeutic ranges for systolic blood pressure (situation-adapted), mean blood pressure (MAP, 60-90 mmHg), glucose levels (80-180 mg/dl), body temperature (<37.5°C), partial arterial pressure of oxygen (PaO2) 80-120 mmHg und partial arterial pressure of carbon dioxide (PaCO2) 35-45 mmHg during the initial 96 h of hospitalization in 4 hour-intervals. Overall, 70.7% of all measurements were within the predetermined therapeutic ranges including SBP (71.3%), temperature (68.3%), MAP (71.4%), PaO2 (65.2%), PaCO2 (75.0%) and blood glucose (80.7%). This multicenter study demonstrates adherence to guideline-based treatment targets, underscoring the high standards maintained by neurological intensive care units. Our study offers valuable insights into adherence to guideline-based treatment targets for neurocritical care patients in Germany. To improve patient care and optimize therapeutic strategies in neurovascular diseases, further research is needed to examine the impact of these adherence parameters on long-term outcomes.