Prioritize Patient Care Research Articles

"I'm quite proud of how we've handled it": health professionals' experiences of returning additional findings from the 100,000 genomes project.

Participants in the 100,000 Genomes Project (100kGP) could consent to receive additional finding (AF) results, individual variants relating to genes associated with susceptibility to cancer and familial hypercholesterolemia (FH). In the study reported here, qualitative interviews were used to explore the experiences of National Health Service (NHS) professionals from across England who were tasked with returning over 80,000 "no AF" results and 700 positive AF results to 100kGP participants. Interviews were conducted with 45 professionals from a range of backgrounds, including Genetic Counsellors, Clinical Geneticists, FH Clinical Nurse Specialists and Clinical Scientists. Interviews were analysed using a codebook thematic analysis approach. Returning AF results has been a significant endeavour, with challenges for pathways, administrative processes and clinical and laboratory time when the capacity of NHS services is already stretched. Professionals discussed going "above and beyond" to prioritise patient care through pathway design, additional clinics, overtime, longer appointments and provision of follow-up appointments. Professionals also described facing practical and emotional challenges when returning AFs. Benefits for patients from receiving AFs in the 100kGP were highlighted and professionals were generally positive about offering clinically actionable AFs within routine NHS clinical care. Professionals were, however, cautious around the implementation of AFs into routine care and felt more research and discussion was needed to determine which AFs to offer, approaches to consent and communication of results, costs and the potential strain on NHS capacity and resources. Further consultation is required with careful review of pathways and resources before offering AFs in clinical practice.

Implementing Triage-Bot: Supporting the Current Practice for Triage Nurses.

In Canada, emergency departments (ED) have 15.1 million unscheduled visits every year; this has been suggested to indicate that patients rely on ED to address the gaps experienced by 6.5 million Canadians who lack a primary care provider. When this large number of visits is coupled with a predicted shortage of 100,000 nurses in Canada by 2030, ED can be expected to face resource limitations, which highlights the importance of triage systems as a source of immediate support. Technology that incorporates innovative analytical methods, automation of routine, and efficient processing can be leveraged to enhance patient outcomes, streamline clinical processes, and improve the overall quality and efficiency of healthcare delivery. This paper aims to highlight how the Triage-Bot, a proposed AI system, can assist ED nurses when triaging patients. The Triage-Bot system is based on the Canadian Triage and Acuity Scale (CTAS), which currently serves as a standardized and highly effective tool for prioritizing patient care in emergency departments across the country. Pre-set and open-ended questions are asked using voice and video, allowing patients to describe their health concerns and conditions. Triage-Bot automatically measures the following vital signs: heart rate (HR), heart rate variability (HRV), oxygen saturation (SpO2), respiratory rate (RR), blood pressure (BP), blood glucose (BG), and stress. The system uses artificial intelligence models, particularly those with a deep learning approach that simultaneously analyzes both the user's facial expression and voice tone. Implementation: A systematic review addressed the implications of AI in nursing and concluded that it could contribute to patient care by providing personalized instructions and/or remotely monitoring patients. The Triage-Bot system can be implemented in healthcare facilities, such as emergency department waiting rooms. The information it collects can then be added to a patient's health records to support nurses in assessing the severity of each patient's condition. Limitations: If the system is accessed without a nurse's guidance, it is imperative that the user receives information regarding when to visit a healthcare provider or ED. Continuous improvements in Triage-Bot's accessibility for patients with varying abilities are required to ensure that the system remains user-friendly during times of illness. The voice and text interaction can also be influenced by a user's understanding of language, culture, and age-related factors.

Health Care Workers’ Trust in Leadership: Why It Matters and How Leaders Can Build It

Rebuilding patient trust in the US health care system has received considerable attention recently, but there has been little focus on health care workers' (HCWs) trust in the leaders of health care delivery organizations. This study explores (1) the professional impact on HCWs of trusting the leaders of the organizations where they work and (2) the leadership actions that build HCWs' trust. The authors examined these questions using a survey that was crowdsourced to 353 HCWs through social media posts and e-mails from national health organizations. For each open-ended question, qualitative codes were identified, iteratively finalized, and applied to each response. Descriptive statistics were used to analyze the closed-ended questions and examine how often each qualitative code was raised. One in five (20.2%) HCWs trusted leadership "very much," more than a third (36.9%) trusted "somewhat," and 42.9% had lower levels of trust. Almost all (97.7%) reported that the degree of trust they had in their organization's leadership affected them professionally. Among HCWs who trusted their organization's leadership, the most common impact was feeling professional satisfaction, followed by providing higher-quality work. HCWs described three main ways health care organization leaders earned their trust: communicating effectively (being transparent and soliciting HCWs' input), treating HCWs well (with respect and kindness and providing good compensation), and prioritizing patient care. The findings suggest health care organizations would benefit from leaders seeking to earn HCWs' trust. With trust in leadership, HCWs report higher work quality and greater professional satisfaction.

Robotic versus Mini-Laparoscopic Colposacropexy to Treat Pelvic Organ Prolapse: A Retrospective Observational Cohort Study and a Medicolegal Perspective.

Background: POP (pelvic organ prolapse) involves the descent of one or more pelvic organs downwards with or without protrusion from the vaginal opening, caused by the relaxation and weakening of ligaments, connective tissue, and pelvic muscles. Such an outcome negatively impacts the quality of life. The gold standard procedure for repairing apical compartment prolapse is colposacropexy (CS) to secure the anterior and posterior walls of the vagina to the anterior longitudinal sacral ligament, located anteriorly to the sacral promontory, using a mesh. Several surgical approaches are feasible. Laparotomic or minimally invasive methods, including laparoscopic or robotic ones, can restore the horizontal axis of the vagina and typically involve concomitant hysterectomy. Methods: This study is based on 80 patients who underwent CS at Palermo's Ospedali Riuniti Villa Sofia-Cervello from 2019 to 2023. Women aged 35-85 at the time of surgery were divided into two groups: 40 patients underwent mini-laparoscopic surgery, and 40 patients underwent robotic surgery. The following parameters were accounted for: demographic data (initials of name and surname, age), preoperative clinical diagnosis, date of surgery, surgical procedure performed, estimated intraoperative blood loss, duration of surgical intervention, length of hospital stay, postoperative pain assessed at 24 h using the VAS scale, and any complications occurring in the postoperative period. Mini-laparoscopic CS (Minilap) and robotic CS (Rob) were then compared in terms of outcomes. Results: In the Minilap group, 11 patients out of 40 had a preoperative diagnosis of vaginal vault prolapse. The average age in this group was 61.6. Five of these patients had isolated cystocele, while the rest presented vaginal stump prolapse linked to cystocele, rectocele, or both. The remaining 29 patients in the Minilap group had a preoperative diagnosis of uterovaginal prolapse, also associated with cystocele, rectocele, or both, or isolated in nine cases. In the Rob group (average age: 60.1), 13 patients were diagnosed with vaginal prolapse (isolated or associated with cystocele), while the remaining 27 had a diagnosis of uterovaginal prolapse. In the Minilap group, the average procedure duration was 123.3 min, shorter than the Rob group (160.1 min). Conclusions: The data collected throughout this prospective study point to the mini-laparoscopic approach as being preferable over the robotic one in terms of surgical procedure length, intraoperative blood loss, postoperative pain, and aesthetic outcome. Hospital stay duration and post operative complication rates were similar for both groups. The innovative and ever-progressing nature of such procedures calls for novel standards prioritizing patient care as well as medicolegal viability.

Religious dress in the healthcare setting: Unpacking legal arguments and balancing individual rights

This article explores the complex debate surrounding healthcare providers seeking to express their religious beliefs through the wearing of religious attire considering critical legal, ethical, and practical aspects. Drawing insights from the jurisprudence of the European Court of Human Rights and European Court of Justice, it sheds light on the implications for healthcare settings. The study highlights the sensitivity of the healthcare context, where specific arguments surface, such as the debated significance of religious neutrality given the vulnerability of patients and concerns about health and safety. Difficulties may arise when patients feel discomfort when treated by visibly religious healthcare providers. However, patients’ preferences regarding the religious neutrality of healthcare providers cannot be generalised, especially when considering the needs of certain minoritised communities. Furthermore, questions can be raised about the admissibility of potentially accommodating prejudice through prohibitions on religious dress. The article further examines hygiene and safety arguments used by healthcare institutions to restrict religious attire, arguing that while health and safety standards are crucial, scientific support for outright bans is limited, especially considering the possibility of reasonable adjustments. The central theme is the necessity for balanced considerations while upholding religious freedom and prioritising patient care, with particular emphasis going on the idea that the needs of patients cannot be generalised.

Ethical issues and proposed solutions in conducting practical assessment of medical students involving patients.

Practical assessment involving patients plays a vital role in medical education, allowing students to demonstrate their clinical competencies. However, there are significant ethical concerns associated with these assessments that require careful consideration and resolution. The primary ethical concerns include violation of patient autonomy, lack of written informed consent, power dynamics, cultural differences, potential harm to patients, breach of privacy and confidentiality, discomfort to admitted patients, financial loss to patients, impact on other patients' care, and delays in workup/procedures. To address these concerns, measures such as respecting patient autonomy, obtaining written informed consent, ensuring patient safety, exploring alternative methods, providing reimbursement, resource planning, creating a supportive environment, developing cultural competency, putting in place a feedback system, prioritising patient care, and implementing ethical oversight and monitoring are recommended. The formulation of a guideline could be a crucial starting point, and it should be integrated into a broader ethical framework that encompasses education and training, ethical oversight, ongoing monitoring, and a culture that prioritises ethical conduct.

Emergency Patient Triage Improvement through a Retrieval-Augmented Generation Enhanced Large-Scale Language Model

Objectives Emergency medical triage is crucial for prioritizing patient care in emergency situations, yet its effectiveness can vary significantly based on the experience and training of the personnel involved. This study aims to evaluate the efficacy of integrating Retrieval Augmented Generation (RAG) with Large Language Models (LLMs), specifically OpenAI's GPT models, to standardize triage procedures and reduce variability in emergency care. Methods We created 100 simulated triage scenarios based on modified cases from the Japanese National Examination for Emergency Medical Technicians. These scenarios were processed by the RAG-enhanced LLMs, and the models were given patient vital signs, symptoms, and observations from emergency medical services (EMS) teams as inputs. The primary outcome was the accuracy of triage classifications, which was used to compare the performance of the RAG-enhanced LLMs with that of emergency medical technicians and emergency physicians. Secondary outcomes included the rates of under-triage and over-triage. Results The Generative Pre-trained Transformer 3.5 (GPT-3.5) with RAG model achieved a correct triage rate of 70%, significantly outperforming Emergency Medical Technicians (EMTs) with 35% and 38% correct rates, and emergency physicians with 50% and 47% correct rates (p < 0.05). Additionally, this model demonstrated a substantial reduction in under-triage rates to 8%, compared with 33% for GPT-3.5 without RAG, and 39% for GPT-4 without RAG. Conclusions The integration of RAG with LLMs shows promise in improving the accuracy and consistency of medical assessments in emergency settings. Further validation in diverse medical settings with broader datasets is necessary to confirm the effectiveness and adaptability of these technologies in live environments.

Incidence, Knowledge, Attitude and Practice of Healthcare Workers Regarding Needle Stick Injuries at a Tertiary Care Hospital in Riyadh, Saudi Arabia

Background: A needle stick injury is a serious occupational health hazard in health care settings. Health care workers are at risk of bloodborne diseases and the psychological consequences of these injuries. Objectives: we aimed in this study to assess the prevalence of NSI among health care workers in King Saud Medical City and to assess their knowledge, attitude and practices regarding needle stick injuries. Methods: A cross-sectional study was conducted from 17th August 2022 until 30th November 2023. A structured questionnaire from Saudi Ministry of Health guidelines was used to collect the data. The content validity was evaluated by four academics from King Khalid University in Abha, and some minor changes were made. Results: As regard the prevalence of NSI, out of 220 participants, 132 individuals did not report any needle-stick injuries (NSI). While 92.3% of participants accurately defined NSI and acknowledged blood-borne disease transmission risks, only 39.1% followed preventive measures like recapping needles and proper disposal. There were knowledge gaps observed, with varying awareness levels on Hepatitis B and C prevention. Participants demonstrated awareness of post-exposure guidelines but lacked knowledge on immediate actions to take post-injury. Attitudes towards NSI varied, with a significant percentage 44.1% prioritizing patient care over healthcare worker safety. Interestingly, significant support was shown for immediate reporting of sharp injuries and the belief that NSIs are preventable. In terms of practice, adherence to safe needle practices varied, with the majority 90.9% using assigned disposal containers and being vaccinated against Hepatitis B, but not all receiving recent training on safe devices. Conclusion: This study revealed that NSIs remain a prevalent occupational health hazard among healthcare workers. Although a significant number of participants demonstrated adequate knowledge and awareness of NSIs and bloodborne disease transmission risks, there were noticeable gaps in their implementation of preventive measures and immediate post-injury actions. Attitudes towards NSIs varied, with some prioritizing patient care over healthcare worker safety. However, there was strong support for the immediate reporting of sharp injuries and belief in the preventability of NSIs.

Exploring the causes and consequences of non-nursing tasks among nurses in Jordan: An in-depth qualitative investigation

AimTo investigate the perceptions of Jordanian nurses regarding Non-Nursing Tasks (NNTs) and their consequences, as well as the underlying factors that contribute to the occurrence of NNTs. BackgroundNurses play a crucial role in providing high-quality patient care, but they often engage in NNTs, which can hinder their ability to deliver care effectively. Western countries have primarily conducted research on NNTs, while Middle Eastern countries such as Jordan have received limited attention. Expanding our understanding of NNTs is essential for improving nursing care. MethodsA qualitative-exploratory approach was adopted. The research was conducted at three hospitals in Amman, Jordan. A purposeful sampling approach was used to select the participant and a focus group-interview method was used to gather the data. The derived data were analyzed using a thematic analysis approach. ResultsThe final sample of this study included 38 participants. The findings highlighted that nurses often perform NNTs due to staff shortages and limited resources, as well as weaknesses in nursing administration and education. The finding also highlights the consequences of NNTs on nurses' professional lives, including impaired nursing care, physical and mental health strain, and a lack of efficiency and productivity. ConclusionsThe present study's results provide valuable insights into the impact of NNTs on nurses in Jordan. These findings underscore the need for healthcare stakeholders to actively address the issue of NNTs. It also emphasized the need for more explicit job descriptions and processes, along with support for nurses to fulfilling their responsibilities and prioritizing patient care.

How SWAT Changed the Conversation: Implementation of a Discharge SWAT Team Improves Morale and Facilitates Communication During the COVID-19 Pandemic.

Hospital overcrowding and delays in discharge are serious issues in the modern health care landscape and can lead to poor patient outcomes and health care personnel (HCP) burnout. The goal of this project was to develop a collaborative forum where HCP representing the entire spectrum of the inpatient care team, including case management team members, could connect to discuss challenges and barriers to patient discharge. The following describes the development, implementation, and outcomes of the discharge SWAT (Solutions, Wins, Actions, and Tactics) team, which is a 30-min virtual daily meeting where discussion is primarily centered around challenges in discharging individual patients and addressing case manager needs. The primary aim of SWAT meetings is fostering a positive atmosphere to address barriers to discharge while prioritizing patient care and outcomes. This study was conducted in a 40-hospital academic health system in the United States. SWAT meetings were first implemented at a representative flagship facility in a health system. HCP at this first facility were surveyed to assess satisfaction with SWAT meetings. SWAT meetings then were implemented at the majority of facilities in a 40-hospital academic health system. During SWAT implementation, average inpatient length of stay (LOS) and patient care transitions were monitored for participating and nonparticipating service lines. Among surveyed HCP, the majority view SWAT meetings favorably and reported that it was a valuable use of their time and positively impacted their work in the patient discharge space. Nonprovider and case management staff in particular valued the SWAT meetings and found them beneficial. LOS remained stable for patients under the care of participating providers, despite the upheaval of the ongoing COVID-19 pandemic, and the research team also observed a positive impact of SWAT meetings on appropriate inpatient care transitions.

The readiness of Saudi nursing interns for the professional role.

The nursing education program offers opportunities to prepare nursing students with the knowledge and skills required for their professional roles. The level of their readiness and confidence will affect their ability to provide effective and sufficient nursing care. The purpose of this study is to assess nursing interns readiness for professional roles. To accomplish the study's objectives, a cross-sectional, descriptive design was employed. All nursing interns who graduated from the KAU School of Nursing in the academic year 2018-2019 were recruited from different hospitals in Jeddah, Saudi Arabia, from March 2019 until May 2019. Participants completed the Casey-Fink Readiness for Practice Survey. Descriptive statistics were conducted to answer the research questions. The results of this study demonstrated that the students felt ready and confident to assume their professional nursing roles. The students had some difficulties with managing multiple patients and certain skills, such as how to deal with dying patients and prioritize patient care needs. The findings of this study showed the students felt entirely ready for the professional nursing role. The nursing college at King Abdul-Aziz University is making a great effort to prepare its students for their professional roles. We still need to develop skills and clinical competencies in preparation for effective professional roles. In addition, continuous assessment is considered important for patient safety, to increase nurses' work retention, and to enhance professional nurse confidence and the quality of care they must provide.

Stress, Appraisal, Coping and Adaptation of Family Caregivers of Patients on Dialysis: A Transactional Theory Approach

The primary purpose of this research was to determine the levels of stress, appraisal, coping, and adaptation among family caregivers. The study employed a quantitative descriptive research design. There were 402 respondents involved in this study who completed a survey questionnaire. The results demonstrated that family caregivers experienced moderate stress levels, yet exhibited exceptional levels of appraisal, coping, and adaptation. The data analysis led to the conclusion that family caregivers of dialysis patients face stressors, including financial burden, but cope well. They feel supported, satisfied, and in control of their caregiving experiences. They also manage their responsibilities well by adjusting to their work, social life, and finances, and prioritizing patient care. To address these findings, the researcher recommends that healthcare providers establish tailored stress management and counseling programs to support family caregivers of dialysis patients. By providing such resources, healthcare providers can help caregivers manage the range of stressors they face on a daily basis. Furthermore, social workers should continue offering emotional support and resources to caregivers, which will help maintain their positive appraisal and sense of control over their caregiving experiences. Empowering family caregivers in this way can help them feel better equipped to tackle the challenges that come with caring for their loved ones.

Scoring big: Aligning inpatient clinical pharmacy services through implementation of an electronic scoring system.

Data are limited on utilizing a comprehensive scoring system in the electronic health record to help prioritize, align, and standardize clinical pharmacy services across multiple hospitals and practice models within a health system. The purpose of this article is to describe the development and implementation of an electronic scoring system to help inpatient pharmacists prioritize patient care activities and standardize clinical services across a diverse health system. Inpatient pharmacists from all specialty areas across the health system partnered with health information technology pharmacists to develop a scoring system directly integrated into the electronic health record that would help triage patient care, identify opportunities for pharmacist intervention, and prioritize clinical pharmacy services. Individual variables were built based on documented patient parameters such as use of high-risk medications, pharmacy consults, laboratory values, disease states, and patient acuity. Total overall scores were assigned to patients based on the sum of the scores for the individual variables, which update automatically in real time. The total scores were designed to help inpatient pharmacists prioritize patients with higher scores, thus reducing the need for manual chart review to identify high-risk patients. An electronic scoring system with a tiered point system developed for inpatient pharmacists creates a method to prioritize and align clinical pharmacy services across a health system with diverse pharmacy practice models.

Triage Accuracy of Emergency Nurses: An Evidence-Based Review

IntroductionAccurate triage assessment by emergency nurses is essential for prioritizing patient care and providing appropriate treatment. Undertriage and overtriage remain an ongoing issue in care of patients who present to the emergency department. The purpose of this literature review was to examine factors associated with triage accuracy in the emergency department. MethodsWe conducted an evidence-based literature review using the Cumulative Index to Nursing and Allied Health Literature, PubMed, and Embase. The search focused on peer-reviewed articles in English, available in full text, published between January 2011 and December 2021. ResultsA total of 14 articles met inclusion criteria and revealed the following 3 themes for triage accuracy: triage nurse characteristics, patient characteristics, and work environment. Triage nurses’ accuracy rates ranged from 59.3% to 82%, with experience in triage associated with higher accuracy. Patient characteristics influenced triage accuracy, with nontrauma patients being undertriaged and trauma patients often overtriaged. The work environment played a role, as accuracy rates varied based on shift time and patient volume. Competing systems between prehospital and ED triage posed challenges and affected accuracy during fluctuations in patient volumes. DiscussionThis review underscores the complex nature of ED triage accuracy. It highlights the importance of nurse experience, training programs, patient characteristics, and the work environment in enhancing triage decision making. Enhanced understanding of these factors can inform strategies to optimize triage accuracy and improve patient outcomes.

Development of a high‐power blue diode laser for precision vaporization of prostate tissue for the surgical management of benign prostatic hyperplasia

AbstractThis paper explores the advancement and application of high‐power blue diode lasers in treating benign prostatic hyperplasia (BPH). Addressing the challenges posed by existing techniques, the study focuses on optimizing tissue removal methods. Energy platform for BPH should balance a range of factors, such as operative time, patient conditions, urinary functions, complications, durability, accessibility, and cost, all while prioritizing patient care. Blueray Medical's innovation of high‐power blue diode laser systems for BPH surgery is explored, with emphasis on achieving a balance among these considerations. By illustrating the biomedical effects of lasers and their interaction with soft tissues, particularly emphasizing the role of photon absorption by biomolecules and proteins in tissue behavior, this study outlines the advantages of the high‐power blue diode laser system. The initial laboratory experiments and clinical results consistently align with our theoretical predictions, especially in terms of tissue vaporization efficiency, tissue coagulation, and bleeding control. In conclusion, blue diode lasers hold potential to enhance surgical outcomes for BPH. Their unique properties offer benefits like improved tissue removal rate and reduced thermal damages. Integrating blue laser technology into BPH protocols could lead to shorter hospital stays, cost savings, and expanded patient eligibility, although rigorous clinical studies are needed to fully understand their benefits and limitations.

Mental Health Challenges during COVID-19 Pandemic: Experiences of Primary Healthcare Nurses in Durban, South Africa.

The COVID-19 pandemic had a significant impact on the mental health of individuals globally, and primary healthcare (PHC) nurses play a critical role in providing mental healthcare services. However, limited research has explored the experiences of PHC nurses in providing mental healthcare services during the COVID-19 pandemic. This study explored the experiences of PHC nurses in providing mental healthcare services during the pandemic in Durban, South Africa. The aim was to identify the challenges faced by healthcare providers and the potential for innovative approaches to improve access to care. A qualitative, exploratory design guided the study, and data were collected through in-depth interviews with twelve PHC nurses purposively selected. Thematic analysis was used to analyze the data. Findings from interviews with PHC nurses reveal that the pandemic exacerbated existing challenges, including medication adherence issues, fear and uncertainty among patients, vaccine hesitancy, decreased clinic visits, and the mental and emotional toll on both patients and healthcare workers. PHC nurses adapted their services by increasing outreach efforts, prioritizing patient care, and utilizing technology and non-governmental organizations' (NGOs) support. Challenges included reduced patient visits, complexities in healthcare provision, and a lack of adequate support. Positive changes observed include increased mental health awareness among healthcare professionals and younger generations. Recommendations include implementing outreach and awareness campaigns, providing accurate information about COVID-19 and vaccinations, and promoting cultural sensitivity in mental healthcare provision.

Decision-Making Competence and Critical Thinking Ability among Triage Nurses in a Selected Hospital in Batangas, Philippines

Overcrowding and long waiting times remain perennial issues in many emergency departments globally, resulting in unsafe and inefficient care. To facilitate the treatment of patients that arrive in the Emergency Department a triage process is often implemented. Triage enables the Emergency Department staff to prioritize patient care so that patients requiring more immediate care are seen first. This study described the competence and critical thinking ability of triage nurses in a selected hospital in Lipa City, Batangas, Philippines. The quantitative descriptive correlational research design was used in this study. Data was gathered through a self-administered questionnaire that adopted Yoon Critical Thinking Disposition and Triage Decision Making Inventory by Cone (2000). Results showed that decision-making competency is significantly different among different age groups (F=40.93, p&lt;0.0001). Respondents’ critical thinking ability based on objectivity, healthy scepticism, systematicity and intellectual fairness, intellectual curiosity, self-confidence and prudence was at moderate level, with composite means of 3.23, 3.43, 3.22, 3.37, 3.33, 3.28, and 3.27, respectively. Based on the results of the study, participants had a moderate level of critical thinking ability while doing triage. Also, over-all decision-making ability significantly increased with age and years of experience. Furthermore, objectivity, self-confidence, prudence and over-all critical thinking ability are significantly associated with age. Moreover, the triage nurses’ decision-making skills can be greatly influenced by their critical thinking ability.

Decision-Making Competence and Critical Thinking Ability among Triage Nurses in a Selected Hospital in Batangas, Philippines

Overcrowding and long waiting times remain perennial issues in many emergency departments globally, resulting in unsafe and inefficient care. To facilitate the treatment of patients that arrive in the Emergency Department a triage process is often implemented. Triage enables the Emergency Department staff to prioritize patient care so that patients requiring more immediate care are seen first. This study described the competence and critical thinking ability of triage nurses in a selected hospital in Lipa City, Batangas, Philippines. The quantitative descriptive correlational research design was used in this study. Data was gathered through a self-administered questionnaire that adopted Yoon Critical Thinking Disposition and Triage Decision Making Inventory by Cone (2000). Results showed that decision-making competency is significantly different among different age groups (F=40.93, p&lt;0.0001). Respondents’ critical thinking ability based on objectivity, healthy scepticism, systematicity and intellectual fairness, intellectual curiosity, self-confidence and prudence was at moderate level, with composite means of 3.23, 3.43, 3.22, 3.37, 3.33, 3.28, and 3.27, respectively. Based on the results of the study, participants had a moderate level of critical thinking ability while doing triage. Also, over-all decision-making ability significantly increased with age and years of experience. Furthermore, objectivity, self-confidence, prudence and over-all critical thinking ability are significantly associated with age. Moreover, the triage nurses’ decision-making skills can be greatly influenced by their critical thinking ability.&#x0D;

Distinct Clinical Presentations and Outcomes of Hospitalized Adults with the SARS-CoV-2 Infection Occurring during the Omicron Variant Surge.

The COVID-19 Omicron variant has imposed a tremendous burden on healthcare services. We characterized the types of the Omicron variant-associated hospitalizations and their associations with clinical outcomes. Consecutive adults hospitalized with COVID-19 during the Omicron variant surge period of 1-14 January 2022, were classified into one of three groups based on their clinical presentations on admission: Group 1-primary COVID-19; Group 2-extrapulmonary manifestations of COVID-19; and Group 3-incidental COVID-19. Of the 500 patients who were hospitalized, 51.4% fell into Group 1, 16.4% into Group 2, and 32.2% into Group 3. The patients in Groups 1 and 2 were older, with higher proportions of comorbidities than patients in Group 3. The Group 1 patients had the highest mortality rate (15.6%), followed by Group 2 (8.5%), and Group 3 (0.6%), with adjusted odds ratios (OR) of 22.65 (95% confidence interval [CI], 2.75-239.46; p = 0.004) and 10.95 (95% CI, 1.02-117.28; p = 0.048), respectively, compared to Group 3. Those in Group 1 showed a greater utilization of intensive care services (15.9%), followed by Group 2 (10.9%), and Group 3 (2.5%), with adjusted ORs of 7.95 (95% CI, 2.52-25.08; p < 0.001) and 5.07 (95% CI, 1.34-19.15; p = 0.017), respectively, compared to Group 3. The patients in Groups 1 and 2 had longer hospitalization stays than the patients in Group 3 (p < 0.001 and p = 0.002, respectively). Older age (≥65 years) was an independent factor associated with longer hospital stays (OR = 1.72, 95% CI, 1.07-2.77). These findings can help hospitals prioritize patient care and service planning for future SARS-CoV-2 variants.

Profile and predictors of babies admitted to SNCUs of two tribal districts of Chhattisgarh.

The neonatal period is the crucial and vulnerable period of the human life cycle. Various research has been conducted worldwide that provide the baseline data on clinical profiles and predictors of outcomes of babies admitted to sick newborn care units (SNCUs). Nonetheless, studies on tribal areas and community outreach areas are rare. In the present study, predictors and profiles of patients admitted to SNCU, in the Dantewada and Bijapur districts of Chhattisgarh, India, were evaluated which shall help prioritize patient care and preventive approaches. This retrospective study was undertaken from January 2019 to December 2020 in the SNCUs of Dantewada and Bijapur. Neonatal and maternal characteristics, course during labor, treatment given to the neonates, and outcome data were obtained and analysed. In total, 1,531 neonates were enrolled in the study. Mothers had a mean age of 25.6 years (standard deviation [SD] ±4.9) with birth spacing less than 2 years (60.3%) and antenatal care (ANC) visits less than 4 (50.4%). Neonates were low birth weight (43.75%) and were home-delivered (15.8%). One hundred forty-nine neonates died. In the multivariate regression model, extremely low birth weight babies, less than 1 kg (odds ratio [OR]: 11.59 confidence interval [CI] 4.625-31.58), gestational age less than 34 weeks (OR: 2.13 CI 1.291-3.532), central cyanosis (OR: 10.40 CI: 3.269-32.35), duration of IV fluid > 3 days (OR: 2.16 CI 0.793-0.880), duration of antibiotic >3 days (OR 0.63 CI 0.408-0.979) were found to be independent predictors of mortality among neonates. The prevalence of newborns aged less than 12 h is higher among the study population. Birth asphyxia, prematurity, neonatal jaundice, and sepsis were fundamental and leading causes of morbidity. Preterm birth and low birth weight babies had significantly high mortality. The government needs to focus on marginalized communities with target-based interventions and policies.