Improve Patient Quality Of Care Research Articles

The Progress and Future of Artificial Intelligence in Nursing Care: A Review

Introduction The utilization of novel technologies in contemporary times not only reduces the cost associated with healthcare but also improves the efficiency of hospital resources and elevates the standard of medical assistance. One of the new technologies used in the field of health is Artificial Intelligence (AI). The purpose of this study is to investigate the application of AI in the field of nursing. Materials and Methods The present investigation was conducted in the year 2023 utilizing a review methodology and an innovative scientific inquiry. Comprehensive research was performed in reliable databases such as PubMed, Scopus, Google Scholar, Science Direct, and Springer, using the keywords AI, smart hospital, nursing, and health care to accomplish the intended objectives. From 2016 to 2023,120 articles were chosen as the initial selection. Studies that were not related to the subject matter were excluded from the analysis afterward. Results After searching and eliminating duplicate articles through objective screening, a total of 98 articles were reviewed, with 63 ultimately selected for the study. Within the realm of nursing care, research has been conducted in various areas, such as electronic health records (13 studies), health information collection and analysis (27 studies), healthcare cost analysis (16 studies), and the implementation of smart technology and hospitals (7 studies). The integration of AI technology has shown promise in enhancing nursing care by reducing diagnostic errors, improving emergency response times, improving patient care quality and psychological support, and enabling remote care for elderly patients through the use of smart technology. Conclusion AI is a significant technological advancement that can directly impact the operational effectiveness of healthcare organizations. This is achieved through the optimization of healthcare business processes and the enhancement of patient safety. However, limited research has been conducted regarding the affordability and economic aspects of AI implementation. Therefore, it is advisable for healthcare policymakers to establish the necessary infrastructure to leverage this technology, which will facilitate a more effective therapeutic and economic approach.

Evaluating knowledge management practices in a hospital pharmacy: A comprehensive investigation

Background: Knowledge management practices in healthcare settings play a crucial role in improving patient care quality and operational efficiency. However, the understanding and implementation of these practices in Oshakati Hospital pharmacy, Namibia, remain unclear. Methods: A structured questionnaire was administered to 26 participants, including pharmacists, pharmacist interns, and pharmacist assistants, to assess knowledge-sharing frequency, documentation practices, technology effectiveness, and the overall knowledge management effectiveness. Results: The study found no significant relationship between work experience and knowledge management practices, indicating potential gaps in understanding and implementation of knowledge management strategies. Participants showed moderate attitudes towards knowledge sharing, with technology perceived as moderately effective in facilitating knowledge management. Conclusion: Enhancing knowledge management practices at Oshakati Hospital pharmacy is crucial to address existing gaps, improve collaboration, and elevate pharmaceutical care standards in the region. Implementing a comprehensive health information system and integrating innovative technologies can enhance knowledge extraction and patient interactions, ultimately improving healthcare outcomes.

Therapeutic radiographer prescribing practices in the United Kingdom: Questionnaire survey

IntroductionNon-medical professionals in the United Kingdom (UK) have been granted prescribing rights to improve patient care quality and cost-effectiveness. There is limited evidence on how therapeutic radiographer prescribers have impacted medicine management or patient services. MethodsAn online survey was conducted amongst non-medical prescribing therapeutic radiographers in the UK between 2019 and 2022. The study teams initially analysed the individual data sets, subsequently combined, and secondary analysis was performed to provide a UK perspective, to understand the services provided and identify areas for improvement. Data was analysed using descriptive statistics from Microsoft Excel® and SPSS®. Results74 non-medical prescribing therapeutic radiographers who were predominantly over 40 years old and in full-time work participated. The main job categories were consultant radiographers (n = 23, 31.1%) and advanced practice practitioners (n = 18, 24.3%). Many use their prescribing qualifications (87.5%, n = 62), issuing a mean of 15 independent and seven items by supplementary and prescribing per week. Most received assessment and diagnostic skills training before prescribing courses (91.6%, n = 67). Respondents prescribed from a median of six areas, with the highest being in GI (82%), skin (68%), infections (58%), urinary tract disorders (55%) and ear, nose, and oropharynx conditions (54%). ConclusionThis study presents the first report on therapeutic radiographers prescribing in the UK, offering insights into current practices and highlighting the success of non-medical prescribing. Therapeutic radiographers’ roles continue to expand into advanced practice and medicine-prescribing responsibilities, contributing to holistic and patient-centred care. Implications for practiceThe results are relevant for nations grappling with oncology workforce shortages and contemplating similar roles for therapeutic radiographers. The study can be a valuable resource for policymakers and healthcare organisations worldwide.

Bridging the gap: How investing in advanced practice nurses could transform emergency care in Africa.

This paper aims to highlight the vital importance of investing in advanced practice nursing (APN) for enhancing emergency care throughout Africa. APN's role is increasingly recognized as pivotal in optimizing healthcare, particularly in emergency settings in Africa. It offers improved patient care quality and strengthens the healthcare workforce. Evidence is drawn from successful implementations of APN in various healthcare environments. This includes the development of APN-specific curricula and training, mentorship initiatives, clinical supervision, and defining advanced nursing roles within healthcare organizations. Investing in APNs in emergency care in Africa can lead to improved quality and access to care, cost-effectiveness, enhanced patient outcomes and satisfaction, and opportunities for professional development and career advancement in the healthcare workforce. Despite facing barriers in implementation, APN in emergency care presents innovative solutions. Investing in APN can help healthcare entities and policymakers surmount these challenges, providing specialized patient care and improving health outcomes. The discussion emphasizes the benefits such as enhanced access to care, reduced healthcare costs, and improved patient outcomes, alongside bolstering the healthcare workforce. The necessity and benefits of investing in APN for emergency care in Africa are clear. It is crucial for improving healthcare delivery and outcomes. APN investment leads to a more competent and efficient nursing workforce, capable of addressing complex emergencies and improving patient care. The paper advocates for policies that support APN development and integration into the healthcare system, emphasizing the need for research to assess APN's long-term impact and establish best practices for its implementation in emergency care across Africa.

Building large-scale registries from unstructured clinical notes using a low-resource natural language processing pipeline

Building clinical registries is an important step in clinical research and improvement of patient care quality. Natural Language Processing (NLP) methods have shown promising results in extracting valuable information from unstructured clinical notes. However, the structure and nature of clinical notes are very different from regular text that state-of-the-art NLP models are trained and tested on, and they have their own set of challenges. In this study, we propose Sentence Extractor with Keywords (SE-K), an efficient and interpretable classification approach for extracting information from clinical notes and show that it outperforms more computationally expensive methods in text classification. Following the Institutional Review Board (IRB) approval, we used SE-K and two embedding based NLP approaches (Sentence Extractor with Embeddings (SE-E) and Bidirectional Encoder Representations from Transformers (BERT)) to develop comprehensive registry of anterior cruciate ligament surgeries from 20 years of unstructured clinical data at a multi-site tertiary-care regional children's hospital. The low-resource approach (SE-K) had better performance (average AUROC of 0.94 ± 0.04) than the embedding-based approaches (SE-E: 0.93 ± 0.04 and BERT: 0.87 ± 0.09) for out of sample validation, in addition to minimum performance drop between test and out-of-sample validation. Moreover, the SE-K approach was at least six times faster (on CPU) than SE-E (on CPU) and BERT (on GPU) and provides interpretability. Our proposed approach, SE-K, can be effectively used to extract relevant variables from clinic notes to build large-scale registries, with consistently better performance compared to the more resource-intensive approaches (e.g., BERT). Such approaches can facilitate information extraction from unstructured notes for registry building, quality improvement and adverse event monitoring.

A Review of E-commerce As Part From the Excelence Movement Theory in Hospital Management System

<p align="justify">The e-commerce market in Indonesia has experienced substantial growth over the years, particularly during the COVID-19 pandemic. With advancements in Information and Communication Technology (ICT), numerous companies, including hospitals, have altered their operational methods and customer interactions. This paper aims to investigate the application of e-commerce as a constituent of the Excellence Movement Theory within Hospital Management Systems. The review methodology involves conducting a literature search on relevant material pertaining to the core issue at hand. The findings illustrate how implementing an e-commerce platform within hospitals can enhance administrative processes' efficiency, improve patient care quality, and generate additional revenue from sales of healthcare products and services. Additionally, several challenges associated with utilizing an e-commerce platform in hospital management systems are addressed in this discussion. By incorporating e-commerce into hospital management practices through this review process, it can become an essential element of Indonesia's excellence movement strategy for managing hospitals effectively.</p>

Transformer-Based Classification of User Queries for Medical Consultancy

The need for skilled medical support is growing in the era of digital healthcare. This research presents an innovative strategy, utilizing the RuBERT model, for categorizing user inquiries in the field of medical consultation with a focus on expert specialization. By harnessing the capabilities of transformers, we fine-tuned the pre-trained RuBERT model on a varied dataset, which facilitates precise correspondence between queries and particular medical specialisms. Using a comprehensive dataset, we have demonstrated our approach’s superior performance with an F1-score of over 91.8%, calculated through both cross-validation and the traditional split of test and train datasets. Our approach has shown excellent generalization across medical domains such as cardiology, neurology and dermatology. This methodology provides practical benefits by directing users to appropriate specialists for prompt and targeted medical advice. It also enhances healthcare system efficiency, reduces practitioner burden, and improves patient care quality. In summary, our suggested strategy facilitates the attainment of specific medical knowledge, offering prompt and precise advice within the digital healthcare field.

A Discrete Mathematics Approach for Understanding Risk Factors in Overactive Bladder Treatment.

Introduction Discrete mathematics, a branch of mathematics that includes graph theory, combinatorics, and logic, focuses on discrete mathematical structures. Its application in the medical field, particularly in analyzing patterns in patient data and optimizing treatment methods, is invaluable. This study, focusing on post-void residual (PVR) urine following overactive bladder (OAB) treatment, utilized discrete mathematics techniques to analyze PVR and its associated risk factors. Methods A retrospective study was conducted on 128 OAB patients who received intradetrusor onabotulinum toxin A injections between 2020 and 2022. Network graphs based on graph theory were used to analyze correlations between clinical variables, and clustering analysis was performed with PVR as the primary variable. Results The network graph analysis revealed that frailty, daytime frequency, and nocturia episodes were closely related to PVR. Clustering analysis with PVR as the primary variable divided the patients into three groups, suggesting that the group with particularly high frailty (Cluster 1) is at high risk for PVR. Moreover, significant differences in clinical indicators such as age, voiding efficiency, Overactive Bladder Symptom Score, and International Consultation on Incontinence Questionnaire-Short Form were observed in the remaining two clusters (Cluster 0 and 2). Conclusion This study demonstrates the effectiveness of discrete mathematics methods in identifying risk factors for PVR after OAB treatment and in distinguishing clinical subgroups based on patient characteristics. This approach could contribute to the formulation of individualized treatment strategies and the improvement of patient care quality. Further development and clinical application of this methodology are expected in future research.

Review Article on the Role of Effective Leadership in Crisis Management

Effective leadership is critical in various domains, including healthcare, small-scale enterprises, and crisis management. In the healthcare sector, competent leadership is vital for improving patient care quality, achieving targeted health outcomes, and managing crises effectively. Studies highlighted the positive impact of effective leadership on patient satisfaction, reduced health risks, and improved overall healthcare delivery. In addition, effective leadership played a pivotal role in managing the COVID-19 pandemic by directing responses and ensuring public health protection. In small-scale enterprises, research emphasized the importance of leadership style in determining organizational performance. Transactional leadership showed a significant positive effect on performance, while transformational leadership, though positive, did not have a strong influence. The studies recommended prioritizing transactional leadership in the early stages and gradually transitioning to transformational leadership as businesses mature. Overall, these research articles underscore the indispensable role of effective leadership in addressing challenges, inspiring confidence, and fostering resilience. Leadership emerges as a critical driver of positive outcomes, be it in providing quality healthcare, enhancing organizational performance, or navigating crises. The findings offer valuable insights into the significance of strong leadership across various domains and its impact on individual lives and organizational success.

Blood Culture Contamination Rates in Bloomington, Association with Patient History

Background/Objective: Blood cultures are vital for diagnosing infections and directing antibiotic therapy to causative organisms in systemically ill patients. Blood culture contamination contributes to increased costs, longer lengths of stay, and unnecessary antibiotic use. Certain patient histories and demographics have been associated with higher contamination rates. Identifying contamination risk factors within the hospital may allow for improvements in patient care.
 Methods: Patient demographics, history, and blood culture information were identified through a chart review for all adult blood cultures collected in January 2023 at the IU Health Bloomington Hospital. Patient characteristics collected included age, race, ethnicity, BMI, and a number of comorbidities (COPD, diabetes, etc.). Blood culture characteristics, including the number of cultures drawn, hospital setting, etc., were also collected. A comparative analysis was performed between positive, negative, and contaminated cultures.
 Results: In January, 443 adult patients had blood cultures collected at IUH Bloomington hospital, with contamination in 33 cases (7.4%). Patients with contaminated cultures had a higher prevalence of hypertension (75.8%) compared to those with negative cultures (61.9%). Type II diabetes was more prominent in the contaminated culture group (36.4%) than the negative culture group (31.3%). 15.2% of patients with contaminated cultures resided in extended care facilities, while only 12.3% of patients with negative cultures did so. Most contaminated cultures (97%) were drawn in the emergency department, with 3% collected in medical-surgical units/floor level of care.
 Conclusion: Features of patient history, demographics, and culture collection may be associated with higher blood culture contamination rates.
 Scientific/Clinical/Policy Impact and Implications: This data will be expanded into the entire 1st quarter of 2023 to further identify trends in culture contamination. Findings may present opportunities for quality improvement in patient care as IUH Bloomington looks to further reduce their rates of contaminated cultures.

Challenges associated with the availability, accessibility, and use of antivenoms for treating snakebite envenoming in Ghana: A MaxDiff experiment design

Successful snakebite envenoming (SBE) treatment requires safe, effective, and quality-assured antivenom products specifically tailored to combat endemic venomous snake species. This study aims to identify the challenges associated with the availability, accessibility, and use of antivenoms for treating SBE. The data for this study were obtained from a cross-sectional study involving healthcare workers from two districts (namely Afram Plains North and Afram Plains South) in the Eastern Region of Ghana. Through the MaxDiff design methodology, we quantify the challenges associated with the availability, accessibility, and use of antivenoms. Responses from a simple random sample of 203 healthcare workers were included in this study. Participants identified the high cost of antivenoms as the most challenging factor that limits the availability, accessibility, and use of antivenoms for treating SBE. Other important challenges were the lack of access to effective antivenoms in remote areas when needed and the increased use of unorthodox and harmful practices, followed by resort to unorthodox and harmful practices and the lack of effective antivenoms to address envenoming from local species in some instances. However, poor outcomes from using substandard antivenoms, stock-outs, inadequate number of manufacturers, and the resort to substandard, cheap, and harmful antivenoms were traded off. Also, poor utilization of antivenoms, suboptimal utilization of antivenoms (low quality, under-dose), use of ineffective, substandard antivenoms, and flooding of the market with products that have not been evaluated thoroughly were underscored. Our findings provide essential data to guide discussions on barriers to the availability, accessibility, and use of antivenoms for treating SBE to improve the supply of antivenoms, enhance the effectiveness of snakebite treatment, and improve patient care quality in Ghana. Multi-component strategies are needed to address the challenges identified, such as intensified advocacy, ongoing education and community engagement, healthcare worker training, and leveraging institutional and governance structures.

Machine Learning Predictions on Outpatient No-Show Appointments in a Malaysia Major Tertiary Hospital.

A no-show appointment occurs when a patient does not attend a previously booked appointment. This situation can cause other problems, such as discontinuity of patient treatments as well as a waste of both human and financial resources. One of the latest approaches to address this issue is predicting no-shows using machine learning techniques. This study aims to propose a predictive analytical approach for developing a patient no-show appointment model in Hospital Kuala Lumpur (HKL) using machine learning algorithms. This study uses outpatient data from the HKL's Patient Management System (SPP) throughout 2019. The final data set has 246,943 appointment records with 13 attributes used for both descriptive and predictive analyses. The predictive analysis was carried out using seven machine learning algorithms, namely, logistic regression (LR), decision tree (DT), k-near neighbours (k-NN), Naïve Bayes (NB), random forest (RF), gradient boosting (GB) and multilayer perceptron (MLP). The descriptive analysis showed that the no-show rate was 28%, and attributes such as the month of the appointment and the gender of the patient seem to influence the possibility of a patient not showing up. Evaluation of the predictive model found that the GB model had the highest accuracy of 78%, F1 score of 0.76 and area under the curve (AUC) value of 0.65. The predictive model could be used to formulate intervention steps to reduce no-shows, improving patient care quality.

Improve quality of patient care for systemic lupus erythematosus in China by enhancing the construction of Centers of Excellence.

Improve quality of patient care for systemic lupus erythematosus in China by enhancing the construction of Centers of Excellence.

A Novel Web-Based and Mobile Application to Measure Real-Time Moral Distress: An Initial Pilot and Feasibility Study.

Moral distress (MoD) is a vital clinical indicator linked to clinician burnout and provider concerns about declining patient care quality. Yet it is not routinely assessed. Earlier, real-time recognition may better target interventions aimed at alleviating MoD and thereby increase provider well-being and improve patient care quality. Combining two validated MoD instruments (the Moral Distress Thermometer [MDT] and the Measure of Moral Distress for Healthcare Professionals [MMD-HP]), the authors developed a novel mobile and Web-based application environment to measure and report levels MoD and their associated causes. This app was tested for basic feasibility and acceptability in two groups: graduate nursing students and practicing critical care nurses. The MDT app appears feasible and acceptable for future use. All participants (n = 34) indicated the MDT app was satisfying to use, and 91.2% (n = 31) indicated the app was "very appropriate" for measuring MoD. In addition, 84.2% (n =16) of practicing nurses indicated the app fit either "somewhat well" (47.4%, n = 9) or "very well" (36.8%, n = 7) into their typical workday, and 68.4% (n = 13) said they were either "extremely likely" or "somewhat likely" to use the app daily in clinical practice. Education about moral distress and its associated causes proved important to the MDT app's success. It is ready for future validity and reliability testing, as well as examining usability beyond nursing, longitudinal data monitoring, and possible leveraging to pre- and postintervention evaluation studies.

Impact of Person-Organization-Fit on Patient Care Quality

Background: Person- organization -fit has great impact on patient care quality, without person-organization-fit patient care quality cannot be achieved. Today attention of health care organizations is diverted toward their benefit and they are not providing proper resources to staff nurses so, quality of patient care is compromised. Purpose of study: This research was done to determine impact of person-organization-fit on patient care quality. Methodology: A Quantitative, Descriptive, Cross sectional study done. Population was staff nurses of Services hospital Lahore, sample size was 150 with 5% of confidence error and 95% confidence interval. Research tool was adopted questionnaire on 5 points Likert scale (LS) with close ended questions. Descriptive statistics was used to measure demographic data. Linear regression was used to determine impact of person-organization-fit on patient care quality. Results: Study findings showed that there is strong positive relation between person- organization –fit and patient care quality. Moreover results showed reliability and validity of questions. 70% respondent’s values did not match their organizational values, 57.7% respondents not explaining procedure before perform,74% not encouraging patients for decision making, 62% respondents not involving patients in hospital care. Practical Implication: This study is beneficial for the organization as it will acknowledge health care organization about person-organization fit and patient care quality at their setting. It will help to improve patient care quality by making policies and rules to make their employees fit in an organization. This study will be beneficial for the employee as well as it will build them more professionally. They will be satisfied with their job performance and professional development. This study will be beneficial for organization as it will increase the productivity of organization. Conclusion: Study findings indicated that person -organization -fit has strong positive relation with patient care quality care quality; if person will be fit in organization patient care quality will be improved. Majority of respondents are not fit in their organization.70% nurses responded that their individual values did not match with their organizational values. Some respondents are providing some aspects of patient care quality but majority of respondents are missing important aspects of patient care quality. It is concluded that nurses are performing some aspects of patient care quality effectively but many other aspects are compromised due to person organization unfit. Person organization fit must be improved to improve patient care quality Keywords: POF Person- organization fit, Quality of patient care, Employees Satisfaction, LS Likert Scale, Productivity of organization.

Are Nurse Coordinators Really Performing Coordination Pathway Activities? A Comparative Analysis of Case Studies in Oncology.

Patient Pathway Coordination (PPC) improves patient care quality and safety, particularly in oncology. PPC roles, such as nurse coordinators (NCs), have positively impacted the quality of patient care and reduced financial costs. However, NCs and their real activities in Health Care Organizations (HCOs) are unclear. Our aim was to identify, quantify, and compare all activities performed by NCs in oncology care settings from an organizational approach. Methods: We used qualitative and quantitative approaches based on case study principles. We accumulated 325 observation hours by shadowing and timing the activities of 14 NCs in four French HCO in oncology. Data analysis was conducted using an analytical framework to investigate the Activity of PAtient PAthway Nurse Coordinators in Oncology (APANCO). Results: Our research generated important findings: (1) NC roles and job titles are not standardized. (2) Non-coordination related activities are important in NC work content. Non-coordination times were consistent with distribution times between ward NCs and NCs in centralized structures. Ward NCs had higher non-coordination activities when compared with NCs in centralized structures. (3) PPC times varied for both ward NCs and NCs in centralized structures. Ward NCs performed less design coordination when compared with NCs in centralized structures, and this latter group also performed more external coordination than ward NCs. Conclusions: NCs do not just perform PPC activities. Their position in HCO structures, wards, or centralized structures, influence their work content. Centralized structures allow NCs to focus on their PPC roles. We also highlight different dimensions of NC work and training requirements. Our study could help managers and decision-makers develop PPC roles in oncology.

THE GENIUS BEHIND GUIDELINES

Medical guidelines are documents containing recommendations which can be used in clinical practice. They are intended to help physicians make informed decisions on diagnostic or treatment dilemmas and help achieve the best outcomes for patients. Medical guidelines are not made overnight. Members of the guidelines development committee, composed of a multidisciplinary panel of experts from key groups, are carefully chosen to produce a high qualityscientificdocument. Thisisachievedthrough atransparent,evidence-baseddecision-makingprocess that is labor intensive and rigorous. This ensures that guidelines are sound, credible and at par with international standards. The process starts by defining the topic and scope for guideline development. Key issues and questions regarding the topic are drafted. Review of questions, literature search, evidence reviews, and committee discussions are done. Available medical evidence are summarized, and grading of evidence is made, until a draft recommendation is developed. Draft guidelines are then reviewed by stakeholders until a final guideline is produced and published. In this special issue, we bring you outputs from this guideline development process - four relevant documents on COVID-19, Pediatric Community Acquired Pneumonia (in collaboration with the Philippine Academy of Pediatric Pulmonologists), Leptospirosis, and Pediatric Immunization (prepared by the National Institutes of Health-Institute of Clinical Epidemiology and funded by the Department of Health ). The guideline development process is imperfect. Some shortcomings include paucity of evidence on certain questions, presence of potential conflicts of interest among members of the committee, limitations in funding, and even time. The major advantage is access to a summarized wealth of evidence on a specific topic to enhance physician expertise, improve healthcare quality, and reduce healthcare cost. Guidelines can also influence health policies so that underrecognized health concerns and services can be made available to the majority. Guidelines should be used with the best interest of the individual patient in mind. They help to improve patient care quality. The complex medical decision making process done by the physician however, should not be limited by simplistic algorithms suggested by guidelines.

Phenotypic and Genotypic Investigation of Carbapenem-Resistant Acinetobacter baumannii in Maharaj Nakhon Si Thammarat Hospital, Thailand.

(1) Background: Acinetobacter baumannii is well known as a causative agent of severe hospital-acquired infections, especially in intensive care units. The present study characterised the genetic traits of biofilm-forming carbapenem-resistant A. baumannii (CRAB) clinical isolates. Additionally, this study determined the prevalence of biofilm-producing A. baumannii isolates from a tertiary care hospital and investigated the association of biofilms with the distribution of biofilm-related and antibiotic resistance-associated genotypes. (2) Methods: The 995 non-duplicate A. baumannii isolates were identified, and their susceptibilities to different antibiotics were determined using the disk diffusion method. Using the modified microtiter plate assay, the CRAB isolates were investigated for their biofilm formation ability. Hemolysin and protease activities were determined. CRABs were subjected to polymerase chain reaction (PCR) assays targeting blaVIM, blaNDM, blaIMP, blaOXA-23-like, blaOXA-24-like, blaOXA-51-like, csuE and pgaB genes. Individual CRAB isolates were identified for their DNA fingerprint by repetitive element sequence-based (REP)-PCR. (3) Results: Among all A. baumannii isolates, 172 CRABs were identified. The major antibiotic resistance gene among the CRAB isolates was blaOXA-51-like (100%). Ninety-nine isolates (57.56%) were biofilm producers. The most prevalent biofilm gene was pgaB (79.65%), followed by csuE (76.74%). Evidence of virulence phenotypes revealed that all CRAB exhibited proteolytic activity; however, only four isolates (2.33%) were positive for the hemolytic-producing phenotype. REP-PCR showed that 172 CRAB isolates can be divided into 36-DNA fingerprint patterns. (4) Conclusions: The predominance of biofilm-producing CRAB isolates identified in this study is concerning. The characterisation of risk factors could aid in controlling the continual selection and spreading of the A. baumannii phenotype in hospitals, thereby improving patient care quality.

Pharmacy student involvement in population health management of statin quality measures

AbstractBackgroundPharmacists have demonstrated their value in population health management (PHM). With appropriate training, advanced pharmacy practice experience (APPE) students are also well positioned to participate in PHM.MethodsAt Providence Medical Foundation, a PHM workflow was remodeled to be more standardized and incorporate APPE students into the statin quality measure improvement process. This was driven by institutional goals for quality improvement in patient care and creating a better experiential teaching opportunity. APPE students underwent three training sessions and completed clinical review of patient charts, determined statin eligibility, and completed patient outreach. Rates of statin initiation and student feedback were collected. The rates of statins initiated or declined with this new workflow were retrospectively compared to a previous year's workflow, which was pharmacist‐led.InterventionReview pharmacy student involvement with PHM, including statin initiation rates for quality measure improvement as well as student feedback and learning.ResultsAmong the 543 patients included in the remodeled workflow, students started statins for 75 (13.8%) patients while 114 (21%) patients declined statins. Among the 829 patients included in the previous year's traditional workflow, pharmacists started statins for 102 (12.3%) patients while 167 (20.1%) patients declined statins. There was no statistically significant difference in rates of statins started (odds ratio [OR] 0.88; 95% confidence interval [CI] 0.63–1.22; p = 0.41) and statins declined (OR 0.95; CI 0.72–1.25; p = 0.73) between the two groups. Student feedback on this activity was positive with self‐reported improvement in confidence, clinical knowledge, and communication skills.ConclusionsIncorporating pharmacy students into PHM was a valuable learning experience for students and effective for initiating statins to assist with quality measures. Students can be an asset to the team in PHM and help ease resource shortages.

Enhanced Recovery After Caesarean Delivery: A Narrative Review

Enhanced recovery after surgery (ERAS) is a philosophy of perioperative care that has been used in other fields since the 1990s but has only recently been applied to obstetric care in the form of Enhanced Recovery After Caesarean Delivery (ERACS). This review highlights perioperative care in ERACS, ERACS guidelines, and the benefits of ERACS. ERACS is a multimodal-based perioperative management protocol to recover the patient's condition immediately. It maintains preoperative organ function and reduces stress response during surgery. The primary keys in this protocol include preoperative counseling, optimization of nutrition, use of standard anesthetic and multimodal analgesia drugs, and early mobilization. The protocol covers perioperative care, from preoperative, intraoperative and postoperative. It involves a multidisciplinary team of anesthesiologists, surgeons, nurses, and nutritionists. The ERACS has many benefits, including shortening the duration of hospitalization, decreasing anxiety and stress, reducing the risk of postoperative infection, and accelerating the body's recovery. In addition, there are faster functional recovery, minimal complications, and a shorter length of stay. It can also improve patient care quality and reduce opioid exposure and dependence. ERACS aims to provide a comfortable patient experience by accelerating the process of patient care and recovery by prioritizing patient safety. However, the obstacle is consistency in carrying out the ERACS protocol in each related service unit, such as polyclinic, operating rooms, and treatment rooms, to implement each protocol comprehensively and optimally.