Hospital Program Research Articles

Cancer patients' expectations of advance care planning: Atypological content analysis of qualitative interviews.

Advance care planning (ACP) can help to elicit cancer patients'preferences in a discussion process to promote person-centred medical decision-making. Expectations are known to be highly relevant determinants of decisional processes. So far, however, little is known about cancer patients' expectations of ACP that lead to acceptance or refusal of the programme. Thepresented study, therefore, aims to explore cancer patients' expectations of ACP. Semi-structured interviews were conducted with a purposeful sample of 27 cancer patients consenting to or refusing a newly implemented ACP programme in a German university hospital. Data were analysed using typological content analysis. We identified five different expectation clusters in relation to ACP. Consenting participants held expectations about the impact of ACP that were either 'ego-centred' or 'family-centred'. Refusers had expectations based on ignorance and misinformation, or-if they had already completed an advance directive-expectations to avoid unpleasant redundancy, perceiving no additional benefit but a burden from ACP. Finally, refusers in particular expressed expectations of delegated responsibility at the end of life, including anticipation of proxy decision-making. Our study results suggest that expectation-modifying measures could be taken to positively influence cancer patients' expectations and thus the acceptance of ACP. In this respect, reducing ignorance and misguided expectations plays a decisive role. Especially in family constellations with expected delegation of responsibility and dependence at the end of life, it might be important to promote ACP as a family-intervention to improve family outcomes.

Tata Kelola Rekam Medis Berbasis Elektronik dalam Kasus Pelaporan Pasien COVID-19 dengan Metode Rapid Application Development di RSUD AL IHSAN

Information on hospitalized patients with COVID-19-19 is available through the Corona Virus Disease 2019 Reporting Information System. As with the problem in every hospital, the officer in charge of collecting COVID-19 patient data is still not effective, such as recording data and lab reports of suspected COVID-19 cases before entering them into the information system using COVID-19 recording forms and Microsoft Excel. This of course results in late and inaccurate data delivery, resulting in difficulties in monitoring the spread of COVID-19 and COVID-19 mitigation programs in hospitals. In this investigation, the researchers used Rapid Application Development (RAD), a software development technique that prioritizes rapid iterations of the development cycle. Development teams can use the RAD methodology to concentrate on prototyping work and then quickly iterate depending on input from users or related parties. With this method, we have more leeway to adapt to future COVID-19-19 reporting requirements and rules. The creation of an information system that allows medical personnel or field personnel to relay case data directly from the scene is an example of the implementation of RAD in COVID-19-19 reporting This allows for proper data collection. The results obtained from the application of methods with problems that occur in COVID-19 reporting cases The process of collecting and reporting COVID-19 data becomes more effective, this system can also help officers in monitoring COVID-19 cases so that they can provide the necessary information to the COVID-19 response team.

Study of the Quality of Health Services for Inpatients at Enrekang District Hospital

The quality of health services is what refers to the level of perfection of health services in causing satisfaction in each patient. The more perfect the satisfaction felt, the better the quality of health services. In organizing efforts to maintain the quality of health services in hospitals, it is inseparable from the nursing profession which plays an important role because nursing services guarantee high-quality nursing care in quality control programs in hospitals, considering that nursing services take place continuously for 24 hours a day. This study generally aims to determine the level of patient satisfaction with nurse services in terms of assurance, empathy, and responsiveness. This type of research is quantitative using a questionnaire measuring instrument, the sampling method is saturated sampling of 156 respondents. The results showed that there were variations in statements regarding nurse service satisfaction in the inpatient unit of Enrekang Hospital. Most respondents stated that they were satisfied with nurse services in terms of assurance, which involved dexterity and skill, thoroughness, explanation and observation of nurses every time they performed medical actions. Most respondents stated that they were satisfied with the nurse's service in terms of empathy (attention) which involves patience, chivalry, the attitude of the nurse whenever asked for help and always asking about the progress of the patient's illness.

Rethinking Psychomotor Assessment in Hospitality and Tourism: Miller's Pyramid Perspective

This conceptual paper aims to explore the applicability of Miller's Pyramid as a framework for designing psychomotor assessments in the field of hospitality and tourism education. While Miller's Pyramid was originally developed for healthcare education, its structured approach to assessing psychomotor skills development has the potential to benefit other education fields, including hospitality and tourism. The paper begins by discussing the evolution and growth of hospitality and tourism programs, emphasizing the increasing demand for practical skills in these fields. It then delves into the psychomotor learning domain in hospitality and tourism education, drawing parallels to Simpson's Psychomotor Domain. The paper concludes by proposing how Miller's Pyramid can be adapted to design effective psychomotor assessments tailored to hospitality and tourism programs.

Voluntary sports programs for individuals with mental health disorders: The trainer's view.

There is strong evidence that physical activities (PAs) are an important factor in increasing and maintaining mental health as well as in preventing relapse after mental health disorders. Physical activity is an important part of the treatment program in psychiatric hospitals. However, when individuals with mental health disorders (IMHD) leave the hospitals in Switzerland (CH), there are few possibilities to do physical activity in a given setting. One of them are voluntary sports groups for individuals with mental health disorders (SGPSY), which have been growing continuously in CH since 2016. Yet, little is known about these groups and their training settings. Therefore, the present study explores challenges, barriers, and enablers for participation in SGPSY from the point of view of the trainers of these groups. Additionally, as the sustainable implementation of SGPSY relies on the trainer, the study aims to identify reasons/motivations as well as the personality characteristics of the SGPSY trainers. Semi-structured interviews were conducted with 15 trainers of SGPSY in CH during spring 2022. Interviews were audiotaped, transcribed, and analyzed using thematic analysis in nVivo. Participants identified several intrapersonal (lack of motivation and fitness, mood problems, etc.), interpersonal (conflicts between participants), and structural barriers (time/location) that hinder IMHD from participating in SGPSY. The participating trainer reported that trainer might be helpful in overcoming the barriers by supporting IMHD as enablers. They rate social skills to be essential for the successful management and organization of SGPSY, as well as the ability to set boundaries to protect one's private life and sports skills expertise. The reasons for their engagement as trainers of SGPSY were the satisfaction of doing sports with IMHD and to improve the physical activities habits of IMHD. The findings of the study highlight the need to upskill the trainers of SGPSY in order to improve recruitment of the future trainers of SGPSY by focusing on the assessment of appropriate personality characteristics of trainers and their motives. Additionally, these findings should be integrated in the educational materials of Swiss disabled sports systems. Further research should validate the results from SGPSY participants' point of view.

Investigating the effectiveness of conventional hospitality education curriculum in shaping Millennials’ career commitment: an empirical inquiry

ABSTRACT This research paper investigates the impact of conventional curriculum design in hospitality programs on Millennials’ commitment to a career in the hospitality industry. Quantitative data was collected through a survey to gather the perceptions and feedback of Indonesian hospitality graduates. The results revealed a significant influence of theoretical knowledge and complementary industry-relevant soft skills on Millennials’ career commitment. However, the practical curriculum did not show the same influence, as respondents expressed concerns about the physical demands of the hospitality industry, which negatively affected their commitment to a career in the field. These findings provide valuable insights for hoteliers, suggesting the need for strategic adjustments in their employment plans to ensure a sustainable workforce supply, particularly among Millennial hospitality graduates. Additionally, the study underscores the importance of modernising hospitality education curriculum design, highlighting the more significant impact of theoretical knowledge and relevant soft skills on career commitment compared to practical skills.

Pengaruh Program Orientasi Terhadap Tingkat Kecemasan dan Tingkat Kepatuhan Pasien Baru di Ruang Bedah Rumah Sakit X Palangka Raya

New patients to the hospital face anxiety due to changes in environment, illness, financing, health workers, loss of privacy and sense of security. Non-compliance with hospital rules and hospital programs. Anxiety and non-compliance can aggravate major health problems, resulting in changes in physical function, quality of life, medication adherence, poor use of healthcareresources. New patient orientation will adapt the patient to the hospital situation and environment. This study aims to obtain an overview of the effect of the orientation program on the level of anxiety and compliance of new patients in the X Hospital Surgery Room, using the quasi experiment pre-test- post-test method with control group design on 56 respondents divided into control and intervention. Quasi experiment pre-test- post-test method with control group design on 56 respondents divided into control group and intervention group.The study found a decrease in anxiety and an increase in new patient compliance and there was an effect of providing an orientation module for reducing anxiety and increasing new patient compliance in the patient group.The new patient orientation module has a positive effect on reducing new patient anxiety and increasing patient compliance during treatment. The results of this study have implications for nursing services that the orientation program can increase compliance and reduce the anxiety of newly admitted patients. The recommendation of this study is that health care facilities must have a good and structured orientation program to improve the adaptation of new patients to the treatment room environment.

PACTA-Ped: Antimicrobial stewardship programme in a tertiary care hospital in Spain

IntroductionFighting against antimicrobial resistance is a current priority, and further efforts need to be made to improve antimicrobial prescribing and reduce the spread of infections in paediatric care settings. MethodsWe conducted a prospective longitudinal study on the use of antimicrobials from the time the antimicrobial stewardship programme (ASP) was introduced in January 2016 to December 2017 (period 2 [P2]) in our children’s hospital. We compared the obtained results on antimicrobial prescribing with retrospective data from the period preceding the introduction of the ASP (2014–2015, period 1 [P1]). The sample consisted of paediatric inpatients who received broad-spectrum antimicrobials, antifungals or intravenous antibiotherapy lasting more than 5 days. We compared the use of antimicrobials in P1 versus P2. ResultsA total of 160 patients were included during P2. The antibiotics for which a recommendation was made most frequently were meropenem (41.6%) and cefotaxime (23.4%). In 45% of care episodes, the consultant recommended “no change” to the prescribed antimicrobial. The final rate of acceptance of received recommendations by the prescribing physicians was 89%. We found average decreases of 27.8% in the days of treatment per 1000 inpatient days and 22.9% in the number of antimicrobial starts per 1000 admissions in P2. The use of carbapenems, cephalosporins and glycopeptides decreased in P2 compared to P1. The average annual cost of antimicrobial treatment decreased from є150 356/year during P1 to є98 478/year in P2. ConclusionOur ASP achieved a significant decrease in the use of broad-spectrum antibiotics and antifungals. The costs associated with antimicrobial prescribing decreased following the introduction of the ASP, which was a cost-effective action in this study period.

Midwifes’ educational program in a public maternity hospital, the past, the presence and the future

Midwifes’ educational program in a public maternity hospital, the past, the presence and the future

Feasibility and Efficacy of Addiction-Focused Eye Movement Desensitization Reprocessing in Adults with Substance Use Disorder

ABSTRACT Purpose Addiction-focused eye movement desensitization reprocessing (AF-EMDR) is a viable add-on therapy to treat memories that drive addiction cravings. However, little research has explored AF-EMDR and its effects in people with substance abuse disorder (SUD). The purposes of this study were to determine the feasibility of conducting AF-EMDR and to test the preliminary efficacy of AF-EMDR on overall cravings experienced by persons with SUD, craving, perseverations associated with addiction, and irrational cognitions related to addiction. Methods This pilot study used a two-arm randomized controlled trial (RCT) design with an experimental group (AF-EMDR + cognitive behavioral therapy [CBT]) and a control group (CBT Only). Thirty participants were recruited from a residential program or a partial hospitalization program in a recovery center in Florida, from October 2021 through January 2022 and randomly assigned to the experimental group (n = 15) or the control group (n = 15). Results All participants adhered to the four-session 60-min AF-EMDR intervention and post-intervention data collection; 98.33% completed all four sessions. Results indicated significant reductions in cravings, perseverative thoughts about substance of choice, and irrational cognitions among participants in both the experimental (AF-EMDR + CBT) and control (CBT Only) groups during the intervention; however, there was no significant difference between groups. Conclusions The results showed positive trends in decreasing craving. However, more clinical trials with a larger sample are necessary to assess the efficacy and sustainability of such effects in persons with SUD.

A Nurse’s Performance, Personality, and Situation Awareness in Fall Risk Prevention

One indicator of a nurse’s performance evaluation regarding implementing patient safety programs in hospitals is the risk of a patient falling. An audit of fall risk prevention at Siloam Hospitals in Surabaya was used to evaluate nurses’ performance in preventing patient falls. The impact of personality and situation awareness characteristics on the nurse’s output performance in preventing fall risk was examined. A cross-sectional research design was used in the observational analytic research method. Forty-five nurses made up the total sample. The EPPS and SEAFAP questionnaire were the instruments used in the data analysis, which applied the linear regression test. The following personal characteristics have a p-value of 0.05 or less: Order (p-value 0.016), Autonomy (p-value 0.019), Affiliate (p-value 0.012), Succorance (p-value 0.012), and Nurturance (p-value 0.009). With a p-value of 0.040, situation awareness impacts output performance. Both overall personality and situation awareness have a p-value of 0.006 and influence output performance, respectively. Situation awareness and personality-based needs have an impact on output performance. To provide specific solutions to improve the probability of patients falling, the recommendations for enhancing the fall risk prevention programs can be carried out through discussion and interviews.

Feasibility and preliminary effectiveness of a cognitive-behavioral, family-centered partial hospitalization program for adolescents with anorexia nervosa and atypical anorexia nervosa at six- and twelve-month follow-up.

This study examined the feasibility and preliminary effectiveness of a cognitive-behavioral, family-centered partial hospitalization program (PHP) for adolescents with anorexia nervosa (AN) and atypical AN (AAN), and described the outpatient services received following discharge. Participants (N=31) completed anthropometric and self-report assessments at admission, discharge, and six and twelve months after discharge from the PHP. Descriptive statistics explored markers of feasibility. Paired samples t-tests evaluated changes in weight and eating disorder (ED) symptomatology from admission to discharge, admission to six-month follow-up, and admission to twelve-month follow-up. Descriptive statistics and effect sizes compared symptoms at each timepoint between participants with AN and AAN. Results indicated that we were successful at recruiting greater than 50% of adolescents approached for this study. We collected follow-up data from more than 70% of participants at discharge, but did not meet this retention benchmark at six-month and twelve-month follow-ups. The entire sample demonstrated significant improvements in weight and ED symptomatology from admission to discharge, and generally maintained these improvements at six- and twelve-month follow-up. While descriptive statistics suggested that participants with AN and AAN received similar outpatient services following discharge from the PHP, those with AN experienced greater improvement in self-reported ED symptomatology than those with AAN at six- and twelve-month follow-up. These findings provide preliminary support for the efficacy of PHPs in treating adolescents with AN and AAN. Further research with larger sample sizes should investigate whether adolescents with AAN experience poorer outcomes than those with AN following discharge from a PHP.

Facilitators and barriers of the rational drug use hospital program in Thailand

Facilitators and barriers of the rational drug use hospital program in Thailand

How do family doctors respond to reduced waiting times for cancer diagnosis in secondary care?

Reducing waiting times is a priority in public health systems. Efforts of healthcare providers to shorten waiting times could be negated if they simultaneously induce substantial increases in demand. However, separating out the effects of changes in supply and demand on waiting times requires an exogenous change in one element. We examine the impact of a pilot programme in some English hospitals to shorten waiting times for urgent diagnosis of suspected cancer on family doctors’ referrals. We examine referrals from 6,666 family doctor partnerships to 145 hospitals between 1st April 2012 and 31st March 2019. Five hospitals piloted shorter waiting times initiatives in 2017. Using continuous difference-in-differences regression, we exploit the pilot as a ‘supply shifter’ to estimate the effect of waiting times on referral volumes for two suspected cancer types: bowel and lung. The proportion of referred patients breaching two-week waiting times targets for suspected bowel cancer fell by 3.9 percentage points in pilot hospitals in response to the policy, from a baseline of 4.8%. Family doctors exposed to the pilot increased their referrals (demand) by 10.8%. However, the pilot was not successful for lung cancer, with some evidence that waiting times increased, and a corresponding reduction in referrals of −10.5%. Family doctor referrals for suspected cancer are responsive at the margin to waiting times. Healthcare providers may struggle to achieve long-term reductions in waiting times if supply-side improvements are offset by increases in demand.

5.30 The Double-Edged Sword: Child Externalizing Behaviors and Parental Stress in a Partial Hospitalization Program

5.30 The Double-Edged Sword: Child Externalizing Behaviors and Parental Stress in a Partial Hospitalization Program

5.4 Utilizing Measurement-Based Care in a Partial Hospitalization Program

5.4 Utilizing Measurement-Based Care in a Partial Hospitalization Program

1.66 Quality Assessment of Preparedness and Readiness of Child and Adolescents to Recover in Partial Hospitalization Programs

1.66 Quality Assessment of Preparedness and Readiness of Child and Adolescents to Recover in Partial Hospitalization Programs

52.3 Integrating Caregiver Skills and Support in a Partial Hospitalization Program

52.3 Integrating Caregiver Skills and Support in a Partial Hospitalization Program

6.34 Examining the Impact of Restorative Yoga on Anxiety in Children Admitted to the Hasbro Partial Hospitalization Program

6.34 Examining the Impact of Restorative Yoga on Anxiety in Children Admitted to the Hasbro Partial Hospitalization Program

Evaluation of a mentoring program for junior medical staff at a tertiary paediatric hospital: Uptake, impact and sustainability

Introduction: Mentoring for doctors has benefits for mentors, mentees and their employment organisations. There are emerging examples of formal mentoring programs in hospitals. There remains limited published data evaluating self-selection models for participant satisfaction and long-term outcomes. Our aim was to explore the experience of mentors and mentees who opted in to the dyad mentoring program at the Royal Children’s Hospital (RCH) to understand the longevity of the mentoring relationships and to understand the utilisation of the supporting mentoring tools. Methods: A mixed-methods study was conducted. In 2020, 174 eligible doctors were invited to complete a survey containing multiple-choice and Likert-scale questions to explore Moore’s outcome levels for evaluating continuing medical education. Of the eligible cohort, 66 (38%) responded, and of these, 14 volunteered for in-depth individual interviews. Descriptive statistics from survey responses were used to calculate number and frequency of responses, and inductive thematic analysis was used to identify themes from transcribed interviews as part of a phenomenological approach. Results: One third of mentees and 68.8% (22/32) of mentors reported ongoing relationships beyond the 10-month formal program. A “cycle of mentoring” was evident, with mentees returning to the program as mentors. Four key qualitative themes were identified: “broad benefits” of mentoring, “it’s a relationship and it takes work”, “giving back” and “program foundations”. Outcomes in domains of participation, satisfaction, learning and organisational culture change were identified. Conclusion: The mentoring program at RCH has demonstrated positive impact and long-term sustainability. The program structure could be replicated in different settings.