Medication Errors Research Articles

PENTINGNYA MENJAMIN PENERAPAN PRINSIP 6 BENAR PEMBERIAN OBAT GUNA MENINGKATKAN KESELAMATAN PASIEN DI RUMAH SAKIT

Abstract The role of nurses in the medication process involves administration, monitoring drug responses, and educating patients. Mistakes in medication administration can lead to toxic effects on patient health, such as drug poisoning, drug allergies, vomiting, and even death. Therefore, nurses are a critical factor in the success of treatment in healthcare services, especially in hospitals. Various efforts have been made to reduce the incidence of medication errors, including the implementation of safe medication administration principles. Research by Nursery, Septi (2023) revealed observational data regarding patient identification during medication administration. It was found that, at the time of drug administration, 50% of nurses did not identify the patient, three nurses (30%) called out the patient’s name without checking the identification wristband, and two nurses (20%) correctly identified the patient by checking the wristband. Observations related to the principle of correct medication showed that four nurses (40%) did not explain to the patient what medication was being given. Regarding the principle of correct dosage, it was noted that three nurses (30%) were not accustomed to calculating dosages using formulas and tended to guess instead; two nurses (20%) calculated dosages by asking colleagues, while five nurses (50%) were skilled in calculating dosages. Nurses responsible for administering injections relied solely on a staff logbook and did not document the information immediately in the patient status book. Out of 15 patient status books reviewed, only 9 (60%) were fully completed by nurses, while 6 (40%) were not filled out completely. The research findings indicate that career advancement, including work experience and the education level of nurses, significantly influences the implementation of the "Six Rights" of medication administration. The significant correlation between work experience and education level regarding the application of the "Six Rights" principle suggests that junior nurses require supportive learning processes and mentorship from more experienced nurses. This activity results in an increased understanding among nurses of the importance of the "Six Rights" principles in preventing adverse events, such as medication errors, ultimately enhancing the quality of nursing care. Keywords: Six Rights of Medication Administration, Nurses

The Role of Nursing in Reducing Medical Errors: Best Practices and Systemic Solutions

Medical errors remain a significant challenge in healthcare, contributing to patient harm and increased costs. As frontline caregivers, nurses play a pivotal role in minimizing these errors by implementing best practices and advocating for systemic improvements. This article explores the various types of medical errors and emphasizes the critical role of nursing interventions in error prevention. Key best practices discussed include effective communication strategies such as SBAR, medication management protocols, and the use of technological tools like Electronic Health Records (EHR) and Barcode Medication Administration (BCMA). Additionally, the article addresses the importance of continuous training, fatigue management, and interdisciplinary collaboration in reducing error rates. Systemic solutions are also reviewed, including fostering a culture of safety, ensuring adequate staffing, and implementing evidence-based protocols. The findings suggest that while nurses are integral to preventing errors, healthcare institutions must provide the necessary support and resources to optimize their efforts in promoting patient safety. Ultimately, the article highlights the need for both individual and organizational commitment to reducing medical errors.

High-risk medication errors: Insight from the UK National Reporting and learning system

BackgroundEnsuring patient safety is of paramount importance in healthcare systems. Rising concerns about medical errors in the UK have necessitated a greater focus on studying the nature of such errors, particularly those involving high-risk medications. ObjectivesTo conduct a retrospective analysis of incidents related to patient safety in the UK based on data from the National Rporting and Learning System (NRLS). MethodsThis study was conducted based on a review of the National Reporting and Learning System (NRLS) patient safety reports published between January 1, 2015, and December 31, 2015. NHS Improvement provides details regarding incidents following approval using a data-sharing agreement. In total, 1500 incidents were analszed and equally divided among the three categories of high-risk drugs: opioids, insulin, and anticoagulants. Excel® features and deductive reasoning (thematic analysis) were used for data analysis. ResultsThe results showed that the insulin category had both the highest risk and most errors compared with anticoagulants and opioids. These errors primarily result from issues related to administering, prescribing, and dispensing the drugs. Inadequate drug checks, communication difficulties among staff and patients, and high staff workloads are often linked to these errors. ConclusionThis study confirms that the NRLS database is a valuable source of data, and the suggestions put forth, based on these results, could contribute to the formulation of measures that diminish the occurrence of errors related to high-risk drugs in healthcare settings. Information technology should enhance medication safety by tracking the process of medication use.

Clinical reasoning, the art of medicine and artificial intelligence

"Clinical reasoning" refers to all the thought processes that physicians use to make a diagnosis and determine a treatment and care plan. Artificial intelligence (AI) will enhance, improve, and accelerate human clinical diagnostic thinking, but it is unlikely to replace it. Its application in medicine has the potential to drastically reduce medical diagnostic errors and give doctors more time to care for their patients. Here, we provide an overview of some of the key elements of clinical diagnostic reasoning and the potential impacts of AI on clinical reasoning.

Healthcare Provider Burnout: Red Flag for a Rising Epidemic.

This article aims to broaden the understanding of burnout in healthcare providers, its causes, and its reduction strategies. The objectives are to raise awareness, facilitate early intervention, and, ultimately, improve the overall well-being of healthcare providers and the quality of patient care. The study investigated healthcare-provision-associated burnout, an often-unrecognized syndrome affecting professionals worldwide, and its prevalence. It also examined the impact of burnout on patient outcomes, safety, and provider health and well-being. Here, we delve into the triad of burnout attributes: emotional exhaustion, depersonalization, and decreased personal accomplishment. Specific causes, such as work-life balance, workplace environment, and communication/teamwork, are investigated. The existing literature and studies we report explore the pathophysiological effects of burnout, including its impact on health, sleep patterns, and the alarming correlation with suicide. The prevalence of burnout among healthcare providers is between 30% and 50%. Burnout is a significant factor contributing to poor patient outcomes and threatening patient safety. Furthermore, burnout can induce physical symptoms, including psychological, cardiovascular, and gastrointestinal disorders. We emphasize the importance of identifying and preventing burnout to maintain the overall integrity of healthcare providers and eliminate vulnerabilities for harm to their patients. Burnout awareness should be a priority from the early stages of healthcare providers' careers because it is crucial for maintaining their well-being, preventing medical errors, and sustaining high-quality patient care. The identification and prevention of burnout are deemed vital not only for the well-being of healthcare providers but also to safeguard against potential harm to patients. This article calls for increased awareness of burnout, its underlying causes, and the implementation of effective reduction strategies in the healthcare profession.

Perceptions of Cognitive Load and Workload in Nurse Handoffs: A Comparative Study Across Differing Patient-Nurse Ratios and Acuity Levels.

Medical errors, often resulting from miscommunication and cognitive lapses during handoffs, account for numerous preventable deaths and patient harm annually. This research examined nurses' perceived workload and cognitive load during handoffs on hospital units with varying patient acuity levels and patient-nurse ratios. Conducted at a southeastern US medical facility, the study analyzed 20 handoff dyads using the National Aeronautics and Space Administration Task Load Index to measure perceived workload and cognitive load. Linear regressions revealed significant associations between patient acuity levels, patient-nurse ratios, and National Aeronautics and Space Administration Task Load Index subscales, specifically mental demand (P = .007) and performance (P = .008). Fisher exact test and Wilcoxon rank sum test showed no significant associations between these factors and nurses' roles (P > .05). The findings highlight the need for targeted interventions to manage workload and cognitive load, emphasizing standardized handoff protocols and technological aids. The study underscores the variability in perceived workload and cognitive load among nurses across different units. Medical-surgical units showed higher cognitive load, indicating the need for improved workload management strategies. Despite limitations, including the single-center design and small sample size, the study provides valuable insights for enhancing handoff communications and reducing medical errors.

Relationship of workload with fatigue and sleep quality in female exercisers

Fatigue is a critical issue for female exercisers that may lead to medical errors, degradation in performance, decreased mental acuity, and social problems. Poor sleep quality is also a contributing factor to the fatigue experienced by female exercisers. Overwork is a factor causing poor sleep quality in female exercisers. The present study aimed to investigate the relationship between workload, fatigue, and sleep quality among female exercisers in the Sleman Regency District. A cross-sectional study was conducted from December 2023 to March 2024 using a self-reported questionnaire. The questionnaire included the Workload questionnaire adapted from the National Aeronautics and Space Administration Task Load Index, the Leeds Sleep Evaluation Questionnaire (LSEQ), and the Subjective Self Rating of Fatigue Assessment Scale (FAS) from the WHO Quality of Life Assessment Instrument (WHOQOL-EF) with 200 respondents in Sleman Regency. The PLS equation model was used to analyze the relationship between workload, sleep quality, fatigue, and the indicators of each instrument. The results showed that female exercisers who were over 40 years old, had children at home, had informal work, did daily exercise in the evening, and had a work schedule in the night had a higher risk of fatigue and poorer sleep quality than those below 40 years old who didn’t have children at home, had formal work, did daily exercise in the morning, and had a work schedule in the morning. A subjective self-rating test was used to measure fatigue, sleep quality, and workload. The training load and intensity of exercise programs influenced fatigue levels, which affected sleep quality. Female exercisers may face challenges balancing exercise with other commitments, such as family responsibilities, leading to overtraining and fatigue. The PLS model test showed a significant relationship between sleep quality and the level of perceived fatigue (p-value = 0.000). Workload significantly impacts sleep quality and fatigue risk in female exercisers. Therefore, managing workload is crucial to improving sleep quality and reducing fatigue risk.

Resident physician burnout and association with working conditions, psychiatric determinants, and medical errors: A cross-sectional study.

Burnout has become a significant occupational concern for resident physicians, primarily attributed to chronic workplace stressors, inadequate work-life balance, high expectation from attending staffs, steep learning curve, and limited patient care experience. The study aimed to investigate the prevalence and associated factors of burnout in medical residents. This cross-sectional study was conducted online questionnaire of all specialists in a university hospital from September to October 2022. Burnout was assessed using the Maslach Burnout Inventory-Human Services Survey for Medical Personnel. The data collection encompassed information on socio-demographics, working conditions, psychiatric issues, and medical errors as potential predictive variables. To analyze the association between these factors and burnout, a confounder summary score model was employed in four separate models utilizing multivariable logistic regression. A total of 238 participants, the average age of participants was 28.1 years (SD 2.7), and 56.2% of them were female. Weekly working hours averaged 75 (SD 21.8). Burnout prevalence was 46.3%. This prevalence was characterized by high levels of emotional exhaustion (57.1%) and depersonalization (36.1%), along with low levels of personal accomplishment (52.4%). Summary of association in each domain with burnout were as follow: demographic determinants, (adjusted odds ratio (aOR) 2.80, 95% CI 1.68-4.64), working conditions (aOR 2.97, 95% CI 1.54-5.71), psychiatric determinants (aOR 2.47, 95% CI 1.77-3.45) medical errors (aOR 2.14, 95% CI 1.05-4.34). Medical residency training programs should provide a supportive system that actively monitors and addresses depressive symptoms. Implementing preventive measures, such as increasing pay rates, can play a role in mitigating burnout.

Impact of nurse turnover on patient care in a private healthcare facility in UAE

Aim: The aim of this study was to determine the pattern and impact of nurse turnover in a private healthcare facility in United Arab Emirates (UAE) and also to recommend the management strategies that could be adopted to overcome the problem of nurse turnover. Back ground: Global healthcare organizations are in a precarious situation due to the increasing attrition among healthcare professionals. Nurse turnover is an issue of international concern causing widening of supply - demand gaps in the healthcare industry. Despite the acknowledged importance of managing nurse turnover in hospitals, the pattern, causes and consequences of nurse turnover in UAE are poorly understood. Method and analysis: This is an empirical, descriptive, quantitative survey based research conducted in a private healthcare facility in UAE. Results: Hospital witnessed significant nurse shortage secondary to higher nurse turnover. More than two thirds (69.9%) nurses showed intention to leave the organization. Higher nurse turnover intentions were significantly associated with job satisfaction (p<0.01) and workload (p<0.001). Patient fall and medication errors were not significantly associated with nurse turnover however there was significant reduction in patient satisfaction score for nurse services in the hospital. Conclusion: Higher work load, lack of conducive work environment, lack of managerial support mainly contributed to job dissatisfaction and are the key drivers for nurse turnover. Decline in patient satisfaction implied compromised quality of care. However larger trials are needed to effectively implement administrative strategies to overcome the nurse turnover problem.

Ethical leadership in health-care organizations - a scoping review.

The purpose of this study is to explore the impact of EL style on key variables in health-care settings. Very few studies investigate the impact and outcomes of EL on health-care organizations. Synthesis of evidence will assist health-care leaders in making informed decisions about the outcomes they can expect from practicing EL. Arksey and O'Malley's five-stage framework is used for conducting the scoping review. The databases include Scopus, Emerald Insight and Web of Science. A total of 22 studies were finally considered for scoping review. The data are presented in terms of years, sampling techniques, sample size, data collection methods, and the directional relationship of the variables with EL. Managers should be trained in EL style as it promotes the sustainability of the environment and organizations. Furthermore, EL should be promoted in health-care organizations as it improves employee resilience and voicing behavior and reduces instances of adverse events and medication errors, thus making the hospital a better and safer place. This is one of the studies investigating the EL implications for health-care managers.

Drug–drug interaction extraction based on multimodal feature fusion by Transformer and BiGRU

Understanding drug–drug interactions (DDIs) plays a vital role in the fields of drug disease treatment, drug development, preventing medical error, and controlling health care-costs. Extracting potential from biomedical corpora is a major complement of existing DDIs. Most existing DDI extraction (DDIE) methods do not consider the graph and structure of drug molecules, which can improve the performance of DDIE. Considering the different advantages of bi-directional gated recurrent units (BiGRU), Transformer, and attention mechanisms in DDIE tasks, a multimodal feature fusion model combining BiGRU and Transformer (BiGGT) is here constructed for DDIE. In BiGGT, the vector embeddings of medical corpora, drug molecule topology graphs, and structure are conducted by Word2vec, Mol2vec, and GCN, respectively. BiGRU and multi-head self-attention (MHSA) are integrated into Transformer to extract the local–global contextual DDIE features, which is important for DDIE. The extensive experiment results on the DDIExtraction 2013 shared task dataset show that the BiGGT-based DDIE method outperforms state-of-the-art DDIE approaches with a precision of 78.22%. BiGGT expands the application of multimodal deep learning in the field of multimodal DDIE.

Collection and use of patient-reported experience measures: approach to improve health care

Abstract Background Patient experience is one of the fundamental determinants of healthcare quality. There is progress in the collection of PREM in national level for hospitalized patients since 2020 in Latvia. Aim Analyze (2020.-2022.) in-patients Top-box rates about communication, share-decision making, patient safety and Net Promoter Score (NPS). Methods Project starting point was 2019. Agreement with EC, Sant’Anna School, Ministry of Health and Centre for Disease Prevention and Control of Latvia. Since 2020, the collection of PREM has been taking place regularly in hospitals (around 40% from all hospitals) and on average 20% response rate of those who agreed to participate in the survey. PREM questionnaire according to HCAHPS (Consumer Assessment of Healthcare Providers and Systems) standards, including Picker Institute patient experience questions. In line with OECD (Organization for Economic Co-operation and Development) recommendations, patient safety issues are also included. Top-box rates (most positive response) and percentiles (25th - 75th) were calculated. Results Totally 17019 adult (18 years and more) patient responses were analyzed with response rate 20.3% (n = 83983). 74.6% (67.5-78.2) during hospital stay doctors always explain things in a way you could understand and sufficiently involved in the decision-making process of treatment - 75.0% (70.1-81.4). During hospital stay 4.1% (n = 601) experienced patient safety incidents which were patient-reported. The most common groups were wrong patients, medication errors, incl. adverse drug reactions and falls. Hospitals achieved a NPS of 61 for 3 year period (2020.-2022.). Conclusions Collecting information about the patient experience may be the starting point for engaging patients and moving to more patient-centered health care. The results of these in-patient PREM data can be used to identify areas of improvement and make changes to better meet the needs and expectations of their patients. Key messages • It is a good practice for the implementation of new health care quality data - patient experience reported measures at the national level. • Feedback about the patient experience on regular basis provides insight into patient needs, preferences and values, which can help to improve the quality and safety of care.

Development of an augmented reality (AR) glasses system for medical safety measures using artificial intelligence (AI)

Medical errors are not generally disclosed but they do happen and vary in severity. By prioritising patient safety, Dr Kohei Tanaka, a clinical engineer from the Tokyo University of Technology, wants to find a solution for preventing medical errors or, at the very least, ensuring they don’t escalate into serious incidents. The solution Tanaka is working on combines artificial intelligence (AI) with augmented reality (AR) glasses. The idea is that the glasses will provide medical professionals with accurate and reliable information at critical times. By providing them with rapid access to real-time data, the expectation is that this will reduce critical errors. As part of the validation process, newly qualified nurses will compare current training methods with training using his AR glasses and also complete a questionnaire on the viability of the glasses. So far, the researchers have been able to verify the retention of data provided through the glasses for a period of about three months and believe large-scale verification will reveal the mechanism of long-term memory in the future. By providing accurate, up-to-date information in a visual (still images and video) and auditory format, the glasses assist with the rapid delivery of critical data. However, there remain question marks regarding how much data can be effectively presented to the operator at the point of use as information overloading is to be avoided. The system included a voice-synthesised text reading guide as well as the display through the bone conduction earpiece within the device, which means the user can continue with the procedure while listening to the voice guide, reading reliance on visuals and thereby increasing safety.

Creating a safe space: medical students’ perspectives on using actor simulations for learning communication skills

BackgroundCommunication skills are an essential part of clinical competence that need to be acquired during health professions education. Simulations are extensively used for learning communication skills and have long been integral to medical degree programmes. In this research we use qualitative methodology to explore fourth-year medical students’ experiences in simulations aimed at improving versatile doctor-patient communication, focusing on their learning with trained actors.MethodsThe data comprises reflective writings from 208 fourth-year medical students, gathered after a communication skills course. These students provided informed consent for their writings to be included in the research. We performed an inductive qualitative content analysis on the textual data, with findings presented as themes, supported by categories, codes, and excerpts from raw data to enhance the trustworthiness of the analysis.ResultsWe identified eight key themes capturing students’ learning experiences through simulations: practising in a safe learning environment, valuing feedback, gaining new perspectives, finding simulations valuable and enjoyable, boosting confidence and self-knowledge, and viewing simulations as authentic and engaging learning opportunities. Some students offered critical perspectives on simulations. Throughout the course, students learned diverse aspects of patient care, emotional and behavioural communication dynamics, and lessons from medical errors. Some students offered critical perspectives on simulations, and a few indicated they did not learn anything new.ConclusionsA safe learning environment is vital for encouraging learners to explore, make errors, and absorb feedback to improve their communication with patients. Students predominantly valued the communication skills training with actors and the constructive feedback received and given in the debriefing discussions. However, some students expressed critical views toward simulations. Simulations are not static; they evolve and require continual improvements. Hence, we advocate for the ongoing exploration and enhancement of communication skills learning methods, including simulations, with careful consideration for students’ vulnerability and the importance of psychological safety. Additionally, it is critical to address students’ perceptions that certain clinical teachers prioritise biomedical knowledge over communication skills. Providing tailored training for teachers regarding the learning methods and the desired outcomes of communication courses is essential.

Electronic Health Record Adoption and Its Effects on Healthcare Staff: A Qualitative Study of Well-Being and Workplace Stress

Adopting electronic health records (EHRs) offers improved communication and information sharing and reduces medical staff errors. Despite these potential benefits, EHR adoption often introduces new challenges for healthcare staff, including increased administrative burdens and workplace stress. This study examines the impact of EHR systems on the well-being and workplace stress of healthcare staff in a hospital setting. Using a qualitative multi-perspective research approach, 16 guideline-based interviews were conducted to explore experiences, insight, and perceptions surrounding the anticipated introduction of EHRs. Data analysis reveals a complex interplay between the perceived advantages of EHRs, such as improved data accessibility and patient safety, and the challenges related to increased workload. Based on interviewers’ perceptions, emerging themes were categorized as technostress creators or inhibitors. The findings highlight a dual impact of EHRs: while participants acknowledged improvements in patient safety and information access, they also expressed concerns about increased workload, technostress, and potential disruptions to team dynamics. This study identified two major themes: “EHR Adoption as a Double-Edged Sword” and “EHRs’ Influence on Professional Dynamics”. These findings underscore the need for organizational readiness and staff support to mitigate the negative impacts of EHRs on healthcare workers’ well-being and job satisfaction.

Alarm fatigue and sleep quality in healthcare workers

Abstract Background Alarm fatigue, a prevalent issue in medical settings, arises when healthcare professionals are exposed to an overwhelming number of clinical alarms, leading to desensitization and decreased responsiveness. The constant alertness required due to medical device alarms in hospitals can severely disrupt the quality of sleep for medical personnel. This study aims to demonstrate whether there is a relationship between alarm fatigue and sleep quality in medical staff. For the research project, it was decided to carry out the study in three European neighbouring countries: Poland, Slovakia and the Czech Republic Methods The the survey was carried out in three European countries: Poland, Slovakia, and the Czechia from June to July 2023. The study was attended by a total of 756 participants. The study used: a socio-demographic metric; Alarm Fatigue Assessment Questionnaire and The Pittsburgh Sleep Quality Index to evaluates sleep quality. Results Among the 756 survey participants, 603 (79.76%) had poor sleep quality (6-21 PSQI points), 147 (19.44%) had good sleep quality (0-5 PSQI points), and 6 (0.79%) did not answer. The analysis of sleep quality scores for participating countries shows that sleep problems were significantly higher in Slovakia and Poland than in the Czech Republic. Alarm fatigue levels were determined for respondents in every country in this study. The statistical difference between countries is significant. In Slovakia and Poland, the levels of alarm fatigue caused by medical devices were significantly higher than in the Czech Republic. With regards to sleep quality, there is a positive correlation between alarm fatigue and sleep problems. A statistically significant positive correlation was obtained for all three countries. Conclusions The study found that workers in the health system are exposed to alarm fatigue, and that this in turn can reduce sleep quality. The consequences of this may be reflected in patient safety. Key messages • The results of the study clearly indicate that quality of work should be ensured by developing protocols for managing medical device alarms. • Combatting alarm fatigue among medical personnel is vital for public health as it reduces medical errors caused by sleep deprivation.

Effect on comprehension of an AI patient-friendly hospital discharge letter: a quasi-RCT

Abstract Background During transition from hospital to home care, discharge letters serve as a bridge of information between hospital physicians, general practitioners, and patients. However, the complexity of these letters often hinders patient comprehension, leading to medication errors and adverse outcomes. We assessed the effect on patients’ comprehension and satisfaction of using AI to transform discharge letters into patient-friendly versions. Methods An online quasi-randomized controlled parallel-group trial was conducted in Italy. A synthetic discharge letter for a chronic obstructive pulmonary disease patient was drafted. GPT-4 rephrased the letter into an easier-to-understand version. Participants were assigned to receive either the original or AI-generated letter and completed comprehension assessments and satisfaction survey. Results Out of 460, 166 participants received the original letter, and 175 the AI version. The AI group showed significantly higher comprehension scores (median 4;IQR 2-4 vs. 2; IQR1-2, p < 0.001) and outperformed the control group in understanding diagnosis, medications, and antibiotic instructions. Perceived satisfaction was higher in the AI group across all measures (p < 0.001). Health literacy was a good predictor of comprehension in both arms (p = 0.013; p = 0.015). Subgroup analysis revealed the AI letter nearly bridged the comprehension gap between non-healthcare individuals and healthcare professionals receiving the original letter. Conclusions AI-optimized discharge letters improved patient understanding, and satisfaction compared to traditional letters. The study underscores the influence of sociodemographic factors like healthcare experience and health literacy on comprehension, advocating for adaptive communication strategies. These findings contribute to discussions about integrating AI in healthcare to develop patient-centered communication approaches. Key messages • AI-generated patient-friendly discharge letters significantly improved comprehension and satisfaction compared to traditional letters. • Integrating AI in healthcare communication can help bridge comprehension gaps and promote patient-centered care.

Patient and practice characteristics related to patient’s consent for health data exchange

Abstract Background Sharing patient health data electronically between healthcare providers can prevent medical errors and improve patient safety. In the Netherlands, exchange of health information is facilitated on a national level and is only allowed with patient consent. Consequently, it is important to know which factors are related to this patient consent. Methods Routine electronic health records data from up to 10% of Dutch general practices (sourced from the Nivel Primary Care Database) were utilized, covering the period from 2016 to 2020. We examined whether patient consent for health data exchange varied depending on patient and practice characteristics, which are expected to have a relationship with granting consent for health data exchange. Therefore, multilevel analysis was performed. Results The percentage of patients granting consent ranged between 40%-50% in the period 2016 to 2019, while this was 97% in 2020, due to the governmental corona opt-in regulation. Significant disparities were observed across several of the included patient and practice characteristics in relation to patient consent for all the years examined. In most years, patient consent provision varied by gender, age, socioeconomic position, location, and healthcare use. Practice characteristics showed notable differences in patient consent across information systems, patient volumes, and practice types over all years examined. Conclusions We observed significant variations in patient consent for health data exchange, both among the included patient (need) and practice characteristics. These differences may stem from unequal exposure to opportunities to grant consent, differences in risk of inadequate communication between healthcare providers, levels of health literacy, and practice resources. These factors should be taken into account by policymakers when further implementing and upscaling the national health data exchange system. Key messages • Variations in patient consent for health data exchange were observed among different patient groups and general practices. • Variations in patient consent for health data exchange may stem from unequal exposure to opportunities to grant consent, levels of health literacy, and practice resources, among other factors.

Occupational burnout in nuclear medicine technologists working in Australia and New Zealand - results of a multi-national survey.

Occupational burnout can be associated with negative feelings about the workplace and feeling that a person's efforts are of little consequence. Within a healthcare setting, occupational burnout can be attributed to a high workload or a non-supportive work environment. Higher levels of burnout are associated with increased absenteeism and turnover, increased medical errors and decreased patient care. The aim of this study was to investigate the levels of occupational burnout within nuclear medicine technologists (NMTs) working in Australia and New Zealand. An online questionnaire was distributed via QuestionPro. The questionnaire consisted of four sections, including the Professional Quality of Life Scale (ProQOL) Version 5 (2009) measuring compassion satisfaction, burnout and secondary traumatic stress in the workplace. For this study, only the burnout component of this scale is reported. There were 162 survey responses. Of the 18 New Zealand participants, 10 (56%) reported moderate levels of burnout. Of the 144 Australian participants, 114 (79%) reported moderate levels of burnout. No NMTs reported high levels of burnout. All states of Australia were represented in the survey, with Queensland, Western Australia and Victoria having the highest number of participants reporting moderate levels of burnout. This study revealed that more than half of New Zealand participants and three quarters of Australian participants reported moderate levels of burnout. It is imperative to address the wellbeing needs of NMTs working in Australia and New Zealand at an individual and organisational level to support NMTs to be more engaged in their work and help organisations retain staff.

Ethical issues after the earthquake in Turkey: A qualitative study on nurses' perspectives.

After natural disasters, the urgent need for survival and rescue operations for those trapped in the rubble results in a heightened demand for healthcare services. Nurses are pivotal in addressing the consequences of such calamities. Nurses operating in critical conditions encounter numerous challenges, including safety issues and ethical quandaries. The ethical considerations primarily revolve around the limitations, duties, and modified norms of care administered by nurses during disasters, presenting both significant and complex challenges. The study was designed to elucidate the nature and essence of nurses' care experiences and to offer an in-depth depiction of the ethical dilemmas while attending to individuals injured in the earthquake. A descriptive phenomenological design was used in this research. A total of 16 nurses who worked for at least 7 days in field hospitals in any of the earthquake regions after the 2023 earthquake in Turkey participated in the research. The research was conducted between March 13 and March 20, 2023. Data were collected by face-to-face interview method with a semistructured form. The steps of Colaizzi's phenomenological method were used to analyze the qualitative data. The study involved a group of 16 Turkish nurses, aged between 20 and 36 years. Through data analysis, four primary themes, 14 subthemes, and 25 codes were identified. The principal themes derived from the interviews included "humanitarian duties," "non-adherence to ethical principles," "respect for the injured," and "medical errors." In this intricate process, it becomes paramount to enhance support for nurses in the domains of management, education, and psychosocial assistance, thereby nurturing their individual and professional acumen, commitment, and ethical sensitivity. Refining the guidelines and professional standards that encapsulate the principles to be adhered to by nurses in disaster scenarios, coupled with providing comprehensive training in both medical and ethical competencies, represents a significant avenue for advancement. Focused training on crisis management will enable nurses to render ethically informed decisions and bolster their professional proficiency. Natural disasters, including earthquakes, pose significant ethical challenges for healthcare professionals, especially nurses who play a pivotal role in delivering care during these emergencies. Issues such as resource allocation and triage, the duty of care and ensuring continuity of care, informed consent and communication, cultural sensitivity, and providing psychosocial support are critical ethical considerations for nursing policies in earthquake situations. Addressing these ethical issues in nursing policies related to earthquakes is crucial for maintaining the integrity of healthcare delivery, preserving public trust, and ensuring the well-being of both the injured and healthcare providers during times of crisis.