Multidisciplinary Collaboration Research Articles

The Complex Interplay of Variables in Extubation Decision-Making Following Pediatric Cardiac Surgery: A Narrative Review.

Pediatric cardiac surgery poses significant challenges in developing countries, where a considerable number of children require intervention for congenital heart disease (CHD). The utilization of endotracheal intubation and anesthesia is pivotal in conducting surgical or angiography procedures on patients with CHD exhibiting diverse anatomical and hemodynamic characteristics. The decision to extubate pediatric patients following cardiac surgery remains a crucial element of postoperative care. This article explores the complexities surrounding extubation decision-making in this population, emphasizing the critical role of surgical, physiological, and postoperative factors. Various preoperative and intraoperative factors influence the timing of extubation. Early extubation is increasingly prevalent, offering benefits like reduced length of stay and minimized drug exposure. Multidisciplinary collaboration and protocol-driven strategies contribute to improved extubation outcomes, emphasizing the need for a comprehensive approach in pediatric cardiac surgery. Future research can focus on the implementation and efficacy of standardized extubation procedures involving collaboration among healthcare experts.

A new repository of electrical resistivity tomography and ground-penetrating radar data from summer 2022 near Ny-Ålesund, Svalbard

Abstract. We present the geophysical data set acquired in summer 2022 close to Ny-Ålesund (western Svalbard, Brøggerhalvøya Peninsula, Norway) as part of the project ICEtoFLUX. The aim of the investigation is to characterize the role of groundwater flow through the active layer as well as through and/or below the permafrost. The data set is composed of electrical resistivity tomography (ERT) and ground-penetrating radar (GPR) surveys, which are well-known geophysical techniques for the characterization of glacial and hydrological processes and features. Overall, 18 ERT profiles and 10 GPR lines were acquired, for a total surveyed length of 9.3 km. The data have been organized in a consistent repository that includes both raw and processed (filtered) data. Some representative examples of 2D models of the subsurface are provided, that is, 2D sections of electrical resistivity (from ERT) and 2D radargrams (from GPR). The resistivity models revealed deep resistive structures, probably related to the heterogeneous permafrost, which are often interrupted by electrically conductive regions that may relate to aquifers and/or faults. The interpretation of these data can support the identification of the active layer, the occurrence of spatial variation in soil conditions at depth, and the presence of groundwater flow through the permafrost. To a large extent, the data set can provide new insight into the hydrological dynamics and polar and climate change studies of the Ny-Ålesund area. The data set is of major relevance because there are few geophysical data published about the Ny-Ålesund area. Moreover, these geophysical data can foster multidisciplinary scientific collaborations in the fields of hydrology, glaciology, climate, geology, and geomorphology, etc. The geophysical data are provided in a free repository and can be accessed at https://doi.org/10.5281/zenodo.10260056 (Pace et al., 2023).

Surgical treatment of torticollis secondary to the presence of a congenital paracondylar process: illustrative case.

A paracondylar process is an abnormal bony exostosis arising from the skull base lateral to the occipital condyle and extending inferiorly toward the transverse process of the atlas. Paracondylar processes are typically identified incidentally and vary in size from a small protuberance to an elongated process. The authors present the first pediatric case of torticollis secondary to a congenital paracondylar process successfully treated with resection of the paracondylar process and sternocleidomastoid release. Cadaveric dissection, three-dimensional models, intraoperative imaging guidance, and multidisciplinary collaboration were paramount to a successful surgical outcome. https://thejns.org/doi/10.3171/CASE2447.

Revolutionizing Gastrointestinal Disorder Management: Cutting-Edge Advances and Future Prospects.

In recent years, remarkable strides have been made in the management of gastrointestinal disorders, transforming the landscape of patient care and outcomes. This article explores the latest breakthroughs in the field, encompassing innovative diagnostic techniques, personalized treatment approaches, and novel therapeutic interventions. Additionally, this article emphasizes the use of precision medicine tailored to individual genetic and microbiome profiles, and the application of artificial intelligence in disease prediction and monitoring. This review highlights the dynamic progress in managing conditions such as inflammatory bowel disease, gastroesophageal reflux disease, irritable bowel syndrome, and gastrointestinal cancers. By delving into these advancements, we offer a glimpse into the promising future of gastroenterology, where multidisciplinary collaborations and cutting-edge technologies converge to provide more effective, patient-centric solutions for individuals grappling with gastrointestinal disorders.

Evolution of Pulmonary Embolism Response Teams in the United States: A Review of the Literature.

Pulmonary embolism (PE) is a significant cause of cardiovascular mortality, with varying presentations and management challenges. Traditional treatment approaches often differ, particularly for submassive/intermediate-risk PEs, because of the lack of clear guidelines and comparative data on treatment efficacy. The introduction of pulmonary embolism response teams (PERTs) aims to standardize and improve outcomes in acute PE management through multidisciplinary collaboration. This review examines the conception, evolution, and operational mechanisms of PERTs while providing a critical analysis of their implementation and efficacy using retrospective trials and recent randomized trials. The study also explores the integration of advanced therapeutic devices and treatment protocols facilitated by PERTs. PERT programs have significantly influenced the management of both massive and submassive PEs, with notable improvements in clinical outcomes such as decreased mortality and reduced length of hospital stay. The utilization of advanced therapies, including catheter-directed thrombolysis and mechanical thrombectomy, has increased under PERT guidance. Evidence from various studies, including those from the National PERT Consortium, underscores the benefits of these multidisciplinary teams in managing complex PE cases, despite some studies showing no significant difference in mortality. PERT programs have demonstrated potentials to reduce morbidity and mortality, streamlining the use of healthcare resources and fostering a model of sustainable practice across medical centers. PERT program implementation appears to have improved PE treatment protocols and innovated advanced therapy options, which will be further refined as they are employed in clinical practice. The continued expansion of the capabilities of PERTs and the forthcoming results from ongoing randomized trials are expected to further define and optimize management protocols for acute PEs.

Case Report : Navigating the uncommon: Medicopsis romeroi-induced corneal ulcer

Abstract* This report details a rare case of corneal infection caused by Medicopsis romeroi, highlighting clinical presentation, diagnostic methods, treatment, and outcome. An early adolescence male, after recent corneal tear repair, presented acute eye pain, redness, and decreased vision for 1 day. He underwent corneal tear repair elsewhere post vegetative matter-related swimming injury. Ophthalmic examination revealed a 2.5*3.3mm ulcer around sutures. Corneal scrapings enabled microscopy and culture. With lesion worsening, tissue adhesive (TA) and bandage contact lens (BCL) were applied. Fungal culture identified Medicopsis romeroi. Patient's history, clinical course, and treatment were documented. Microscopy unveiled fungal hyphae, later confirmed as Medicopsis romeroi. Treatment included topical/systemic antifungals. Post-TA + BCL, significant improvement followed, with re-epithelialization, scarring. This report underscores the importance of considering rare fungal pathogens like Medicopsis romeroi in cases of corneal ulcers, especially in individuals with unusual risk factors. Timely diagnosis through microscopy and fungal culture, coupled with tailored antifungal treatment led to successful management and favorable patient outcomes. This case also emphasizes the significance of vigilant clinical observation, precise laboratory analysis, and multidisciplinary collaboration between ophthalmologists and microbiologists in managing atypical ocular infections.

The Revised Sexual Experiences Survey Victimization Version (SES-V): Conceptualization, Modifications, Items and Scoring

ABSTRACT The Sexual Experiences Survey [SES] is considered the gold standard measure of non-consensual sexual experiences. This article introduces a new victimization version [SES-V] developed by a multidisciplinary collaboration, the first revision since 2007. The 2024 SES-V is designed to measure the construct of sexual exploitation since the 14th birthday. Notable revisions are adoption of a freely given permission standard for non-consent, introduction of new tactics and acts, including made to perform or to penetrate another person’s body, tactics-first wording order, and emphasis on gender and sexual orientation inclusivity. The SES-V is modularized to allow whole or partial administration. Modules include Non-contact, Technology-facilitated, Illegal (largely penetrative), and Verbally pressured sexual exploitation. Tables provide item text, multiple scoring approaches, module follow-up, specific incident description and demographics. Future plans include developing a scoring algorithm based on weighting our hypothesized dimensions of sexual exploitation severity: invasiveness, pressure, and norm violation combined with frequency. This article is the first in a special issue on the SES-V. Subsequent articles focus on the taxonomies and literature that informed each module. The issue concludes with two empirical papers demonstrating the feasibility and validity of the SES-V: (1) psychometric comparison with the 2007 SES-SFV; and (2) prevalence data from a census-matched adult community sample.

Practice Trends in (C)APD Assessment and Management: A Survey of Audiologists in Kerala.

Aims Present study investigates the current trends in (Central) Auditory Processing Disorder [(C)APD] assessment and management practices among Audiologists practicing in Kerala, India. Materials and Methods The questionnaire for the survey was developed based on the Knowledge, Attitude, and Practices(KAP) model and underwent validation by experts in Audiology. Online survey was conducted to collect data from Audiologists practicing in Kerala, with a valid RCI-CRR number. Descriptive statistics were used to analyze the responses. Results The majority of participants held bachelor's degrees and completed training modules on the assessment of (C)APD during their undergraduate studies. However, clinical exposure was very low. Even though 59.2% of participants reported that they were performing screening for (C)APD, the use of standardized screening tools was limited. Only 35% of participants reported that they were performing diagnostic evaluation. However, the rest of the participants used only speech-in-noise tests for (C)APD evaluation. The participants who performed management of (C)APD were even fewer, at only 13.4%. Lack of facilities, inadequate patient load, and lack of practical exposure were major obstacles to (C)APD assessment and management. The majority of participants strongly agreed that Audiologists are the most qualified persons to deal with (C)APD; however, the practice trends obtained from the study suggest that Audiologists have a really poor practice in this area. Conclusion The study highlights the need for standardized assessment tools, improved training opportunities, and increased awareness among Audiologists regarding (C)APD. Multidisciplinary collaboration and further research are essential for enhancing (C)APD assessment and management practices in Kerala.

A Multidisciplinary Approach to Increase Dysphagia Compliance in Stroke Patients.

BACKGROUND: The objective was to optimize conditions that increase dysphagia compliance after stroke-a measure recognized by The Joint Commission in designating institutions as primary or comprehensive stroke centers and by the American Heart Association that promotes stroke treatment adherence and bestows achievement and quality awards. Failure to meet stroke measures, including medication documentation, may produce poor patient outcomes that directly affect consumer confidence and choice of treatment facility. Stroke patient care requires multidisciplinary team collaboration to manage multiple factors; variations in practice create fallouts that need correction, the absence of which jeopardizes standards for maintaining stroke center designation. PURPOSE: Aims were to determine the nature of dysphagia fallouts in our quaternary academic teaching hospital, assess multidisciplinary workflows and barriers to success, and develop strategies to enhance dysphagia compliance. DESCRIPTION: We used a multidisciplinary approach using James Reason's Swiss cheese model to examine compliance. The clinical nurse specialist interviewed physicians, advanced practice providers, pharmacists, speech-language pathologists (SLPs), nurses, and informaticists to ascertain discipline-specific success barriers, targeting top issues for each discipline to develop solutions. Unit educators unified their dysphagia reduction strategies; physicians, pharmacists, and informaticists collaborated to clarify standardized medication route orders and to increase electronic health record swallow screen visibility to multidisciplinary users; and SLPs adjusted workflow and documentation. EVALUATION: Outcomes included reinforcing correct nursing charting, pharmacy oral-to-feeding tube conversion order revision, optimization of delivery and awareness of medication routes, electronic health record system enhancements, and SLPs aligning documentation with nursing medication administration. The multidisciplinary approach proved successful and increased dysphagia compliance by 9.6% ( P = .001). These outcomes contributed to a successful The Joint Commission survey, redesignation as a comprehensive stroke center, and American Heart Association Gold Plus achievement award.

Typology of solutions addressing diagnostic disparities: gaps and opportunities.

Diagnostic disparities are preventable differences in diagnostic errors or opportunities to achieve diagnostic excellence. There is a need to summarize solutions with explicit considerations for addressing diagnostic disparities. We aimed to describe potential solutions to diagnostic disparities, organize them into an action-oriented typology with illustrative examples, and characterize these solutions to identify gaps for their further development. During four human-centered design workshops composed of diverse expertise, participants ideated and clarified potential solutions to diagnostic disparities and were supported by environmental literature scan inputs. Nineteen individual semi-structured interviews with workshop participants validated identified solution examples and solution type characterizations, refining the typology. Our typology organizes 21 various types of potential diagnostic disparities solutions into four primary expertise categories needed for implementation: healthcare systems' internal expertise, educator-, multidisciplinary patient safety researcher-, and health IT-expertise. We provide descriptions of potential solution types ideated as focused on disparities and compare those to existing examples. Six types were characterized as having diagnostic-disparity-focused examples, five as having diagnostic-focused examples, and 10 as only having general healthcare examples. Only three solution types had widespread implementation. Twelve had implementation on limited scope, and six were mostly hypothetical. We describe gaps that inform the progress needed for each of the suggested solution types to specifically address diagnostic disparities and be suitable for the implementation in routine practice. Numerous opportunities exist to tailor existing solutions and promote their implementation. Likely enablers include new perspectives, more evidence, multidisciplinary collaborations, system redesign, meaningful patient engagement, and action-oriented coalitions.

Lichen sclerosus of the oral mucosa: a hidden phenomenon.

Oral lichen sclerosus (OLS) represents a diagnostic challenge even for expert dermatologists due to its rarity and subtle clinical manifestations. Only few cases have been reported in literature to date. OLS typically presents with whitish macules in the oral cavity. Histopathological examination remains crucial for definitive diagnosis, with characteristic features including epithelial atrophy, subepithelial hyalinization, loss of elastic fibers, and lymphocytic infiltration. Management strategies vary depending on lesion size and symptomatic presentation, with topical or intralesional corticosteroids being the most commonly used treatment modalities. Long-term monitoring is recommended due to the potential for malignant transformation, although no cases have been reported to date. Greater awareness and understanding of OLS are essential for accurate diagnosis and effective management. Based on these findings, we recommend performing an accurate evaluation of the oral mucosa, especially when dealing with patients affected by genital or extragenital lichen sclerosus (LS). Moreover, we emphasize the importance of multidisciplinary collaboration between dermatologists and other specialists of oral disorders, such as dentists. This short review briefly summarizes available data on OLS, highlighting its diverse clinical presentations and diagnostic challenges. Despite its infrequent occurrence, OLS should be considered in the differential diagnosis of white macules in the oral cavity.

Liver autotransplantation and atrial reconstruction on a patient with multiorgan alveolar echinococcosis: a case report

BackgroundAlveolar echinococcosis (AE) primarily affects the liver and potentially spreads to other organs. Managing recurrent AE poses significant challenges, especially when it involves critical structures and multiple major organs.Case presentationWe present a case of a 59-year-old female with recurrent AE affecting the liver, heart, and lungs following two previous hepatectomies, the hepatic lesions persisted, adhering to major veins, and imaging revealed additional diaphragmatic, cardiac, and pulmonary involvement. The ex vivo liver resection and autotransplantation (ELRA), first in human combined with right atrium (RA) reconstruction were performed utilizing cardiopulmonary bypass, and repairs of the pericardium and diaphragm. This approach aimed to offer a potentially curative solution for lesions previously considered inoperable without requiring a donor organ or immunosuppressants. The patient encountered multiple serious complications, including atrial fibrillation, deteriorated liver function, severe pulmonary infection, respiratory failure, and acute kidney injury (AKI). These complications necessitated intensive intraoperative and postoperative care, emphasizing the need for a comprehensive management strategy in such complicated high-risk surgeries.ConclusionsThe multidisciplinary collaboration in this case proved effective and yielded significant therapeutic outcomes for a rare case of advanced hepatic, cardiac, and pulmonary AE. The combined approach of ELRA and RA reconstruction under extracorporeal circulation demonstrated distinct advantages of ELRA in treating complex HAE. Meanwhile, assessing diaphragm function during the perioperative period, especially in patients at high risk of developing pulmonary complications and undergoing diaphragmectomy is vital to promote optimal postoperative recovery. For multi-resistant infection, it is imperative to take all possible measures to mitigate the risk of AKI if vancomycin administration is deemed necessary.

Multidisciplinary Collaboration in Hospitals via Patient- and Process-Oriented Units: A Longitudinal Study.

The complexity of healthcare is increasing, mainly due to the prevalence of multimorbidity in an ageing population. Complex care for patients with multimorbidity requires a multidisciplinary approach. Traditional physician-centered hospital structures do not facilitate the necessary multidisciplinary collaboration. European hospitals are implementing process-based hospital designs with patient- and process-oriented units to stimulate multidisciplinary collaboration. Patient-oriented units are formed based on shared patient groups and focus on care trajectories, while process-oriented units are formed based on having similar processes and focus on efficiency. This study has two aims. First, to study the effect of introduction of these units on multidisciplinary collaboration and perceived impact (efficiency, innovation, and effectiveness). Second, to study whether there are differences between patient- and process-oriented units. A survey-based longitudinal evaluation study was conducted in 2020 and 2022 among physicians in a Dutch hospital to measure multidisciplinary collaboration (relational coordination) and perceived impact (efficiency, innovation, and effectiveness). In addition, open questions were used to enrich the data. Quantitative and qualitative data together suggest that physicians in patient-oriented units notice benefits from the redesign to multidisciplinary units, they perceive higher impact over time. Physicians in process-oriented units achieve a better relationship with the physicians in their unit over time, but they do not perceive impact as high as physicians in patient-oriented units. A process-based design with patient- and process-oriented units is supportive of multidisciplinary collaboration and perceived impact, especially for physicians in patient-oriented units. Physicians in patient-oriented units are positive about the introduction of these units as they feel it contributes to better multidisciplinary patient care. As the results for physicians in process-oriented units may be less directly visible in terms of quality of care, they are less likely to see positive effects, even though their relationships are improving.

471 Enhancing Outcomes and Improving Patient Services in Complex Abdominal Wall Reconstruction Through Multidisciplinary Collaboration

471 Enhancing Outcomes and Improving Patient Services in Complex Abdominal Wall Reconstruction Through Multidisciplinary Collaboration

Clinical analysis of cases of otogenic sigmoid sinus thrombosis in children

Objective:To analyze the clinical characteristics of middle ear mastoiditis combined with sigmoid sinus thrombophlebitis in children. Methods:Author retrospectively analyzed the clinical data of 6 children with middle ear mastoiditis combined with sigmoid sinus thrombophlebitis who were hospitalized in the Department of Infectious Diseases and Department of Neurology with first diagnosis of fever/headache, and subsequently underwent middle ear mastoidectomy in our department. All patients underwent comprehensive otoscopic, audiologic, imaging, and pathogenetic examinations. Clinical manifestations, pathogenetic features, treatment methods and prognosis were summarized, and the follow-up period was 3-6 months. Results:All 6 cases were first diagnosed with intracranial complications such as fever and headache in the internal medicine department. Within one month, all patients developed ear symptoms including pain, discharge, and hearing loss. Audiologic examination revealed conductive hearing loss in five cases and total deafness in one case. MRI, MRV and MRA examinations suggested that there were 6 cases of middle ear infection combined with thrombophlebitis of the ethmoid sinus, of which 3 cases had thrombus in the ethmoid sinus. 6 cases received surgical treatments: 2 cases of radical mastoidectomy+grommet Insertion, and 4 cases of radical mastoidectomy. Pathogenetic examination identified Streptococcus pneumoniae in three cases, Pseudomonas aeruginosa in one case, Enterobacter cloacae complex in one case, and no pathogens were detected in one case. Postoperative pathology was inflammatory granulation in all 6 cases. Follow-up was 3-6 months with no recurrence of intracranial and middle ear lesions on regular review. Conclusion:Children with recurrent fever, headache, and a recent history of acute and chronic otitis media should be evaluated for the possibility of sigmoid sinus thrombophlebitis, and imaging tests should be performed in a timely manner to clarify the diagnosis. Once diagnosed, surgery to remove the lesions around the ethmoid sinus, smooth drainage combined with antibiotic therapy is the most direct and effective treatment, and anticoagulation therapy is given when necessary. Timely diagnosis, multidisciplinary collaboration, and accurate timing of the management of primary foci and comorbidities are crucial to the treatment of the disease.

Traumatic pelvic ring fracture during pregnancy: a systematic review.

This systematic review aims to investigate the management and outcomes of pelvic ring fractures (PRFs) during pregnancy, emphasizing maternal and fetal mortality rates, mechanisms of injury, and treatment modalities. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a comprehensive search of databases from 2000 to 2023, identifying 33 relevant studies. Data extraction included demographics, fracture types, treatment methods, and outcomes. Risk of bias was assessed using the JBI criteria. Maternal mortality stood at 9.1%, with fetal mortality at 42.4%. Maternal factors impacting mortality included head trauma and hemodynamic instability. Fetal mortality correlated with mechanisms like motor vehicle accidents and maternal vital signs. Surgical and conservative treatments were applied, with a majority of pelvic surgeries performed before delivery. External fixators proved effective in fracture stabilization. Pelvic ring fractures during pregnancy present significant risks to maternal and fetal health. Early stabilization and vigilant monitoring of maternal vital signs are crucial. Vaginal bleeding/discharge serves as a critical fetal risk indicator. The choice between surgical and conservative treatment minimally influenced outcomes. Multidisciplinary collaboration and tailored interventions are essential in managing these complex cases.

Discrepancy index, treatment complexity index and objective Grading system: correlation between parameters, indices and implications for treatment

Abstract Objectives An assessment of orthodontic treatment duration and results allows for measurable outcomes, goal-setting, and the establishment of patient management standards. It is important information that can be utilised for educational purposes in an orthodontic postgraduate program. The aim of this study was to determine correlations of the parameters within and between the Objective Grading System (OGS), Discrepancy Index (DI) and Treatment Complexity Index (TCI) and identify those factors associated with treatment outcomes and duration. Materials and methods This retrospective cohort study involved a consecutive sampling of 242 pre- and post-treatment patient records from the postgraduate orthodontic clinic between 2013 and 2017. The cases were assessed using the DI, OGS, and TCI pre-treatment. Treatment outcomes were assessed using the OGS. Spearman’s Rank Correlation Coefficients were computed within and between the indices. Multiple and logistic regressions were used to evaluate associations between treatment outcomes and duration, respectively. Results Within DI, significant correlations (p < 0.05) were observed between overjet-overbite, overjet-occlusal relationship, overjet-crowding, overbite-anterior open bite, overbite-crowding, anterior open bite-lateral open bite, anterior open bite-crowding, lingual posterior cross bite-crowding. Within pre-OGS, significant correlations (p < 0.05) were observed between alignment-marginal ridge, alignment-occlusal relationship, alignment-root angulation, overjet-interproximal contact, marginal ridge-buccolingual inclination, marginal ridge-overjet, marginal ridge-occlusal contact, marginal ridge-occlusal relationship, overjet-occlusal contact, overjet-occlusal relationship, overjet-root angulation, occlusal relationship-root angulation, interproximal contact-root angulation. Within TCI, functional appliance correlated with orthognathic surgery (p < 0.001), rapid palatal expansion (RPE) (p = 0.005) and multidisciplinary collaboration (p = 0.001). Pre-OGS correlated with DI (p < 0.001) and TCI (p = 0.026). Cephalometric (p = 0.002) and other conditions (p = 0.031) were associated with treatment outcomes. RPE was associated with extended treatment duration (p = 0.014). Conclusions DI, OGS, and TCI exhibited weak correlations within and between indices. Cephalometric values, clinical conditions, and RPE use should be carefully considered during treatment planning.

Quantum Networks: A New Platform for Aerospace

The ability to distribute entanglement between quantum nodes may unlock new capabilities in the future that include teleporting information across multinode networks, higher resolution detection via entangled sensor arrays, and measurements beyond the quantum limit enabled by networked atomic clocks. These new quantum networks also hold promise for the Aerospace community in areas such as deep space exploration, improved satellite communication, and synchronizing drone swarms. Although exciting, these applications are a long way off from providing a “real-world” benefit, as they have only been theoretically explored or demonstrated in small-scale experiments. An outstanding challenge is to identify near-term use cases for quantum networks; this may be an intriguing new area of interest for the aerospace community, as the quantum networking field would benefit from more multidisciplinary collaborations. This paper introduces quantum networking, discusses the difficulties in distributing entanglement within these networks, highlights recent progress toward this endeavor, and features two current case studies on mobile quantum nodes and an entangled clock network, both of which are relevant to the aerospace community.

Development of an instrument to measure the competencies of health professionals in the process of evidence‐based healthcare: A Delphi study

AbstractAimsTo identify and reach consensus on dimensions and criteria of a competence assessment instrument for health professionals in relation to the process of evidence‐based healthcare.DesignA two‐round Delphi survey was carried out from April to June 2023.MethodsConsensus was sought from an expert panel on the instrument preliminarily established based on the JBI Model of Evidence‐Based Healthcare and a rapid review of systematic reviews of relevant literature. The level of consensus was reflected by the concentration and coordination of experts' opinions and percentage of agreement. The instrument was revised significantly based on the combination of data analysis, the experts' comments and research group discussions.ResultsSixteen national and three international experts were involved in the first‐round Delphi survey and 17 experts participated in the second‐round survey. In both rounds, full consensus was reached on the four dimensions of the instrument, namely evidence‐generation, evidence‐synthesis, evidence‐transfer and evidence‐implementation. In round‐one, the instrument was revised from 77 to 61 items. In round‐two, the instrument was further revised to have 57 items under the four dimensions in the final version.ConclusionThe Delphi survey achieved consensus on the instrument. The validity and reliability of the instrument needs to be tested in future research internationally.Implications for the Profession and/or Patient CareSystematic assessment of nurses and other health professionals' competencies in different phases of evidence‐based healthcare process based on this instrument provides implications for their professional development and multidisciplinary team collaboration in evidence‐based practice and better care process and outcomes.ImpactThis study addresses a research gap of lacking an instrument to systematically assess interprofessional competencies in relation to the process of EBHC. The instrument covers the four phases of EBHC process with minimal criteria, highlighting essential aspects of ability to be developed. Identification of health professionals' level of competence in these aspects helps strengthen their capacity accordingly so as to promote virtuous EBHC ecosystem for the ending purpose of improving global healthcare outcomes.Reporting MethodThis study was reported in line with the Conducting and REporting of DElphi studies (CREDES) guidance on Delphi studies.Patient and Public ContributionNo patient or public contribution.

Technology Focus: Wellbore Tubulars (July 2024)

The oil and gas industry has witnessed significant advancements in downhole technology, driving improved efficiency, sustainability, and well integrity. The technical papers here offer valuable insights into these developments, exploring nonmetallic downhole tubulars, collaborative ecosystems, material selection, environmental sustainability, and mechanical evaluation, showing a promising alternative to traditional steel counterparts. Paper SPE 214647 explores operational experiences with glass-reinforced-epoxy-lined tubing, highlighting significant benefits such as corrosion protection, cost savings, and improved well integrity. The journey from pilot to large-scale implementation reveals valuable insights into the technology’s evolution and challenges faced by operators. Complementing this, paper IPTC 23491 emphasizes the pivotal role of ecosystem partners in realizing nonmetallic tubulars. It underscores the need for multidisciplinary collaboration across academia, research institutes, manufacturers, and service providers to navigate challenges and drive innovation effectively. Paper IPTC 23549, included in the recommended reading list, delves into materials and construction aspects critical for successful deployment. It discusses the selection of nonmetallic materials, pipe-construction considerations, and the importance of standardization to meet stringent downhole requirements, signaling a path toward product development and commercialization. Concurrently, paper SPE 214488 addresses mechanical evaluations and interventions in nonmetallic tubulars, showcasing advancements in testing methodologies and tool deployment. Insights gleaned from these evaluations inform future research and development efforts to enhance product reliability and performance. Finally, the carbon life-cycle assessment of nonmetallic tubulars in recommended-reading paper IPTC 24122 underscores environmental sustainability as a driving force behind innovation. By evaluating carbon footprints and life-cycle effects, the industry seeks to adopt ecofriendly solutions without compromising operational efficiency. The synthesis of these papers underscores the transformative potential of nonmetallic downhole tubulars in reshaping oilfield operations. Through collaborative partnerships, material advancements, rigorous testing, and environmental considerations, the industry strives toward safer, more-sustainable, and more-cost-effective solutions. Recommended additional reading at OnePetro: www.onepetro.org. IPTC 23549 Making Nonmetallic Downhole Tubulars a Reality—Materials and Construction by Serena L.M. Goh, Baker Hughes, et al. IPTC 24122 Carbon Life-Cycle Assessment of Nonmetallic Downhole Tubulars by P. Sarmah, Baker Hughes, et al.