Providing Patient Care Research Articles

Assessment of the Knowledge regarding Ventilator Care Bundle among Final Year BSc. Nursing Students of Mysuru City

Background: Ventilator-associated pneumonia (VAP) is nosocomial pneumonia found in 9–27% of patients on mechanically assisted ventilator and is also a major threat to the recovery of patients receiving mechanical ventilation. It usually occurs within 48 h after tracheal intubation. Preventing VAP is one of the important safety issues in critically ill patients receiving mechanical ventilation. Intensive care nurses are in the best position to put the evidence-based guidelines into practice as they are at the patient’s bedside 24 hours a day and therefore, they play an important role in the prevention of VAP. Knowledgeable and skilled nurses are crucial in providing patient care, timely and correct decision minimizes the risks to patient. 1 Prevention and control of ventilator associated pneumonia are dependent on education and awareness of ICU staff towards the problem and on the application of evidence-based strategies. Aim: The aim of the present study was to assess the knowledge regarding ventilator care bundle among Final year BSc. Nursing students of selected nursing colleges at Mysuru cityDesign: Descriptive, non-experimental research designSample and sampling technique: Convenience sampling technique was adopted to select 60 final year BSc nursing students of selected nursing colleges at Mysuru city. Structured Knowledge questionnaire was used to assess the selected personal variables and to assess the knowledge regarding ventilator care bundle among final year BSc nursing students.Results: The study findings revealed that Majority 19(75%) of nursing students got information through health personnels, 05(25%) from electronic mass media and study findings also revealed the findings revealed that majority 41(68.4%) B.SC nursing studentshad average knowledge.Conclusion: Analysis of findings revealed that majority nursing students 50(83.3%) had average knowledge regarding ventilator care bundle. Hence there is need to conduct educational programme to enhance the knowledge and develop desirable attitude regarding Preventing the ventilator associated pneumonia.

The Italian version of the Nurses' Cancer Pain Management Competency Scale: a validation study.

The Nurses' Cancer Pain Management Competency Scale is a tool to explore nurses' competencies and subjective experiences in cancer pain management, and to help nurses understand their current shortcomings in cancer pain management. Furthermore, based on the scale's specific score, nurses can evaluate their lack of understanding about cancer pain management, advance research into this area, and enhance their capacity to control cancer pain while providing patient care. The scale is currently available only in English and in Chinese. The aim of this study was to translate the new scale and measure its reliability and validity in the Italian context. Methodological research model. The population of this methodological study included Italian nurses working in the oncology departments of 21 hospitals in Northern, Southern and Central Italy; the sample involved 243 nurses who met the inclusion criteria. Cronbach's alpha of the scale was 0.814. The Guttman half-reliability of the scale was 0.819. Nurses' cancer pain management competency includes four factors, which accounted for 71.43% of the cumulative variance: the context of pain management, pain assessment and measurement, management of pain, and multidimensional nature of pain. On a 4-point scale for total competency, the mean score was 2.65 ±0.89. The multidimensional nature of pain (2.88 ±0.76) was the factor that showed the highest mean score, whereas the management of pain factor was the lowest (2.52 ±0.73). Nurses' cancer pain management competency can be assessed using the Italian version of the Nurses' Cancer Pain Management Competency Scale, which has strong validity and reliability.

The challenges faced by early-career international medical graduates in general practice and the opportunities for support: a mixed methods study

ABSTRACT Background Recruiting and retaining International Medical Graduates (IMGs) has been identified as a key component in addressing the ongoing workforce crisis in general practice. However, research shows IMG General Practitioners (GPs) face unique challenges compared to their UK-trained counterparts, impacting their welfare, retention in the workforce, and ability to provide patient care. Aim This study examined the challenges facing early-career IMG GPs, the help and support they access and want to access, and their perceptions and utilisation of the help and support available. Design and setting A mixed-methods study that collected primary data in an online survey and interviews between March and May 2023. Method Early-career IMG GPs based in South West England were invited to complete an online survey consisting of 5-point Likert-scale and free-text questions. Interviews were completed with key informants and some survey respondents. Qualitative data were analysed thematically. Data from the survey and interviews were analysed and merged using a convergent parallel design. Results Based on 29 survey replies and 9 interviews, four interrelated themes were identified: (i) communication and language, (ii) racism, unequal treatment, and developing coping mechanisms (iii), exclusion and being ‘othered’, and (iv) adapting to new ways of living and working. Although some IMG GPs access help and support, many feel this is insufficient and poorly accessible. Conclusion IMG GPs face interrelated and unique challenges in their personal and professional lives and do not feel adequately supported by the NHS. Addressing this disconnect will be vital to sustaining the general practice workforce.

Postdocs Focus on Research-Surgeons Provide Patient Care.

Postdocs Focus on Research-Surgeons Provide Patient Care.

P-713. Two Seasons of Admissions Screening for Influenza and RSV Among a Highly Immunocompromised Patient Population

Abstract Background To facilitate early detection and prompt isolation of infected patients during the 2022-23 and 2023-24 fall/winter seasons, the NIH Clinical Center, a clinical research hospital serving a significantly immunocompromised patient population, augmented symptom screening with Influenza and RSV testing of all patients on admission. Methods Nasopharyngeal (NP) swabs were collected on admission from November 2022-April 2023 and September 2023-April 2024. All samples were tested for Influenza and RSV by PCR on the Panther Fusion® SARS-CoV-2/FluA/B/RSV Assay (Hologic, Inc.) or the Xpert® Xpress CoV-2/Flu/RSV test. Patients who disclosed symptoms on admission were tested using the BioFire® Respiratory Panel. Medical chart reviews and discussions with patient care providers elucidated whether cases identified on admission were asymptomatic. Results Of 3197 NP swabs collected from patients admitted to our hospital, 31 swabs were from patients who were symptomatic on admission. Of the remaining 3166 NP swabs (from 2352 unique patients, as some patients had multiple admissions), 17 patients were found to be infected: 7 (0.22%) Influenza A, 1 (0.03%) Influenza B, and 9 (0.28%) RSV. Of these patients that were asymptomatic on admission, 8 (47%) subsequently disclosed symptoms (1 with recent confirmed diagnosis of Rhinovirus/Enterovirus infection), 2 (12%) disclosed a recent history of an unknown respiratory infection, and 7 (41%) were asymptomatic. Seven Influenza A and 8 RSV infections were detected between the months of November and January, yielding positivity rates of 0.57% and 0.66%, respectively, during these months when community transmission was highest. Conclusion Admission surveillance for Influenza and RSV during months of increased community transmission allowed us to isolate seventeen patients on admission who would likely not have been appropriately isolated based on symptom screening alone. Admission surveillance testing, in conjunction with symptomatic surveillance, is important to identify infected patients promptly during increased respiratory virus activity in the community, and especially for institutions serving immunocompromised patients. Disclosures All Authors: No reported disclosures

Experience of home monitoring of children with complex CHD during the COVID-19 pandemic: lessons learnt.

The COVID-19 pandemic presented unique challenges to global healthcare. Face-to-face outpatient care was dramatically reduced. This study implemented a remote consultation service via a mobile app (Pexip) to monitor patients with major CHD. Study design was quasi-experimental and prospective. Remote consultations were carried out at a tertiary paediatric cardiology centre in Northern Ireland. Children with major CHD aged 0-16years in Northern Ireland. The intervention was a Pexip-enabled remote consultation. Primary outcome measures included the number of attendances to hospital both initiated and avoided via remote consultation. Remote consultations were conducted by doctor and/or cardiac specialist nurse or by specialist nurse alone (52% vs. 48%). In the study, 32 patients enrolled; three were non-responders and a further two excluded. There were 201 remote consultations delivered (mean = 7.4). There were 12 admissions to hospital resulting from the remote consultation; the commonest indication was abnormal oxygen saturations (42%). There were 38 hospital attendances avoided, predominantly related to infant feeding and medication advice (both 42%). A significant number of unnecessary hospital attendances were avoided (n = 38). Remote consultation technology proved a user-friendly and valuable adjunct to the provision of ongoing specialist patient care in challenging circumstances. There was a reduction in parental anxiety, and both parents and clinicians found this initiative beneficial to patient care. There was prompt identification of unwell children on remote consultations.

Implementation of An Advance Care Planning Intervention in Dialysis Clinics.

Sharing Patient's Illness Representations to Increase Trust (SPIRIT) is an evidence-based advance care planning intervention targeting dialysis patients and their surrogate decision-makers. To address SPIRIT's implementation potential, we report on a process evaluation in our recently completed five-state cluster-randomized trial. A descriptive study of implementation within a randomized clinical trial. 231 patient-surrogate dyads and 60 dialysis care providers in the 22 active intervention clinics. Status as a patient/surrogate, care provider, or care provider "champion" who all were randomized to clinics implementing the SPIRIT implementation. OUTCOME(S): (1) Intervention reach (e.g., number of dyads who received SPIRIT relative to each clinic's census); (2) fidelity (e.g., champions' self-evaluation checklists, patient and surrogate surveys); (3) sustainability (patient, surrogate and dialysis care provider acceptability surveys); and (4) context (e.g., clinic characteristics). 191 (82.7%) completed SPIRIT session 1 and 146 (76.4% of 191) completed the optional session 2. Of the 40 champions, 34 completed at least one SPIRIT session 1. Champions reported that all six intervention steps were completed in 98% to 100% of their sessions. The median duration of session 1 and session 2 were 60 minutes and 15 minutes, respectively. The acceptability surveys suggested a high-level of acceptance by patients, surrogates, and providers. Champions reported the main benefits of SPIRIT to be enhanced learning; communication; and improved relationships for patients, surrogates, and providers. The challenges champions reported were scheduling a time that worked for the patient, surrogate, and champion; feeling torn between SPIRIT and other clinical demands; and the emotional burden on the champions themselves. The lack of data on actual continued use of SPIRIT and low provider participation in acceptability survey. This study suggests that SPIRIT was delivered with high fidelity and was experienced positively by stakeholders. However, challenges such as staffing and emotional burden required clinic-level support and warrant future studies testing implementation strategies to address these barriers.

Symptom and problem burden, performance status and palliative care phases in specialist palliative care: cross-sectional analysis of care episodes

ObjectivesPalliative care phases (stable, unstable, deteriorating, terminal and bereavement) are useful in describing the palliative care situation of patients/relatives and their care needs as well as the suitability of care...

Impact of Anatomical Research Projects for Medical Students: A Cross-Sectional Survey of Academic and Professional Skills, Clinical Aspirations and Appreciation of Anatomy.

In the third year of pre-clinical medicine (known as Part II of the Natural Sciences Tripos at the University of Cambridge), students have the opportunity to lead a primary research project on clinically relevant anatomy, often involving donor dissection. This descriptive study used a cross-sectional survey to explore the effects of undertaking an anatomical research project on students' attitudes, interests, and a variety of academic and professional skills. Of 45 students who were invited to participate in this study, 40 responded. Of these, 30 students (75%) had performed cadaveric dissection. Projects increased students' interests in academic careers (36% or 90% agreed/strongly agreed) and scientific inquiry, with 30 students (75%) undertaking subsequent research. Many students (30/40; 75%) strongly agreed their projects highlighted the importance of considering the scientific literature when providing patient care. Most (39/40; 97.5%) felt that there was scope for further anatomical research to appreciate and explore anatomical variation. Many students (32/40; 80%) strongly agreed that projects improved their self-directed learning skills. Inductive thematic analysis of free-text answers identified themes of improved academic, practical, and professional skills such as negotiation, responding to questions, presenting at conferences, and liaising with experts and non-experts. These results suggest that anatomical primary research through this program effectively fosters academic aptitude and interest, as well as the practical and professional skills necessary to thrive in academia and clinical medicine. Aspirations for a surgical career were strengthened and valuable anatomical context was provided.

Association of clinical knowledge with patient care ownership among resident physicians: a nationwide cross-sectional study in Japan

PurposeBoth clinical knowledge and patient care ownership (PCO) are crucial to the provision of quality patient care and should be acquired during training. However, the association between these two concepts is under-examined. Here, we conducted a nationwide cross-sectional study to investigate the association between clinical knowledge and PCO among resident physicians in Japan.MethodsFrom January 17 to March 31, 2024, we conducted an anonymous, online, self-administered survey for a series of PCO research projects. The survey targeted medical residents who took the General Medicine In-Training Examination (GM-ITE). The mean of the Japanese version of the PCO Scale was used as outcome variable. The primary explanatory variable was total GM-ITE score, while the secondary explanatory variables were GM-ITE category scores in medical knowledge. We conducted multivariable linear regression analysis, controlling for postgraduate years, sex, number of assigned inpatients, weekly working hours, type of hospital, and size of hospital.ResultsWe included 1836 participants in our statistical analysis. Multivariable linear regression analysis revealed that after adjustment for possible confounders, GM-ITE total scores showed a significantly negative association with PCO in the highest score quartile (adjusted mean difference − 0.20, 95% confidence interval (CI) -0.33 to -0.07, compared with the lowest score quartile). Additionally, after controlling for possible confounding factors, scores for symptomatology and clinical reasoning showed a dose-dependent negative association with PCO (adjusted mean difference − 0.17, 95% CI -0.30 to -0.03 for the highest score quartile compared with the lowest score quartile). No significant dose-dependent associations were found for the other categories.ConclusionsThese findings suggest the presence of potential challenges in the simultaneous fostering of clinical knowledge and PCO during residency training. This underscores the need for educators to actively engage in the reconsideration of current postgraduate training strategies, with the aim of effectively cultivating both clinical knowledge and PCO among medical residents.

Reproductive cancer cryopreservation services: Patient information, clinical advice, and support.

Fertility preservation services must offer information to patients, prior to their visit, so that they have time to read and digest the information, and also have the opportunity to write down any questions they wish to ask at the oncofertility consultation appointment. Appointments must be offered immediately, based on a specifically designed referral form. Each fertility service providing oncology cryopreservation should have a robust map of the patient's journey to include referral, counseling session, medical consultation, informed consent, treatment plan, and follow-up. Consent for fertility preservation should only be obtained after thorough assessment and discussion with the patient. It must contain basic aspects such as duration of storage, right to dispose or choose alternatives, wishes about stored material if death occurs, and need for patient contact on an annual basis. Appropriate legal advice should be sought in the process of establishing oncology cryopreservation services, most importantly related to patient consent. Ethical and legal aspects of fertility cryopreservation must be considered in the provision of care for cancer patients. Cancer patients attending for cryopreservation have significant concerns in relation to the success of the process, time frame to return for cancer treatment, and safety. Two major nonmedical aspects, coping ability and mortality, are best addressed by counselors and highlight the need to offer this type of psychological support to all cancer patients attending for fertility preservation. The role of genetic counseling is to discuss any potential risks of transmission of the disease to the resulting offspring and offer genetic testing when appropriate. A service based on availability of comprehensive information coupled with in-house implications counseling will have a positive impact and improve the overall care of patients attending for fertility cryopreservation and this should be standard care.

Barriers and Factors Affecting Nursing Communication When Providing Patient Care in Jeddah.

Background/Objectives: Effective communication between nurses and patients plays a crucial role in the delivery of quality healthcare services, especially when caring for patients from diverse cultural backgrounds. It fosters trust, understanding, and collaboration and contributes to better health outcomes and satisfactory nurse-patient relationships. The aim of the study is to assess the factors and barriers affecting nurses' communication when providing care for patients from diverse cultural backgrounds in Jeddah, Saudi Arabia. Methods: A cross-sectional quantitative descriptive design is used with an online survey instrument. The study involved registered nurses employed in Jeddah's hospitals. The study utilized a convenience sample for data collection and used the latest version of the statistical package for the social sciences (SPSS version 21) for data entry and analysis. Results: A study of 367 participants found significant barriers to nurse-patient communication, with a mean score of 2.84 on a three-point scale. Key challenges included language differences between nurses and patients with a mean score of 2.87, and cultural and religious differences with a mean score of 2.83 and 2.81, as well as nurses' communication skills, attitudes, and self-confidence and patients' awareness, attitudes, and resistance to communication. The multifaceted nature of these barriers emphasizes the need for targeted interventions to improve nurse-patient interactions and enhance care quality. Conclusions: The study highlights the impact of various factors on effective communication between nurses and patients, emphasizing the need for nurses to develop their communication skills and to receive adequate training from nursing officials.

Paramedics and emergency medical technicians’ perceptions of geriatric trauma care in Saudi Arabia

BackgroundSaudi ambulance clinicians face unique challenges in providing prehospital care to older trauma patients. Limited geriatric-specific training and complex needs of this population hinder effective management, leading to adverse outcomes. This study explores the perceptions of Saudi ambulance clinicians regarding geriatric trauma care and identify facilitators and barriers to improved care.MethodsA qualitative study was conducted using a purposive sample of Saudi paramedics and ambulance technicians from Riyadh and Makkah using online semi-structured interviews and analysed using the framework method.ResultsThe qualitative study recruited twenty participants and identified that they reported age-related challenges including physiological changes, polypharmacy, and communication difficulties. They all wanted training and guidelines to improve their knowledge. They reported struggling with communication difficulties, inaccurate adverse outcomes predictions, difficult intravenous cannulations, and cultural restrictions affecting care provision for female patients. We identified organisational barriers (e.g. lack of shared patient records and lack of guidelines) and cultural barriers (e.g. barriers to assessing women, attitudes towards older people, and attitudes towards paramedics) that influenced implementation of knowledge.ConclusionAmbulance clinicians in Saudi Arabia want guidelines and training in managing older trauma patients but these need to take into account the organisational and cultural barriers that we identified to facilitate implementing knowledge and changing practice to providing improved care.

Impact of Psychosocial and Palliative Care Training on Nurses' Competences and Care of Patients With Cancer in Cameroon: Protocol for Quasi-Experimental Study.

Cancer is a leading cause of global mortality, accounting for nearly 10 million deaths in 2020. This is projected to increase by more than 60% by 2040, particularly in low- and middle-income countries. Yet, palliative and psychosocial oncology care is very limited in these countries. This study describes a protocol for the development, implementation, and evaluation of a psychosocial oncology and palliative care course on Cameroonian practicing nurses' knowledge, self-perceived competence, and confidence in palliative and psychosocial oncology care provision for patients with cancer. A single group pre-posttest design, incorporating both quantitative and qualitative methods will be used. First, a psychosocial oncology and palliative care course for practicing nurses in Cameroon will be developed. This course will then be implemented with 50 practicing nurses purposefully selected from 2 oncology units in the Littoral region and 4 hospitals in the Southwest region of Cameroon. Finally, to assess the impact of the training program we will undertake a pre and posttest survey of nurses' palliative and psychosocial oncology competences, a pre and post training audit of patients' nursing records to examine nurses' practice of palliative and psychosocial oncology care and undertake a critical-incident interview of nurses' transfer of learning to practice. Descriptive and inferential statistics will be used to analysis quantitative data, while qualitative data will be analyzed using the framework approach. This study was funded in September 2023. The training program development was initiated in March 2024 and completed in June 2024. Baseline data collection commenced in May 2024 and as of September 2024, we had collected data from 300 patient record. Training implementation is planned for October-December 2024, and post intervention data will be started in October 2024 and continue till April 2025. Data analysis will commence in October 2024 and we aim to publish study findings in peer review journals by November 2025. This study will improve our understanding of Cameroonian nurses' palliative and psychosocial oncology competency gaps. It will result in the development of a palliative care and psychosocial oncology course and in the training of 50 nurses in psychosocial oncology and palliative care in Cameroon. This study will inform strategies for future psychosocial oncology and palliative care training initiatives in Cameroon and other low- and middle-income countries. DERR1-10.2196/64871.

Challenges and Resilience: Leadership, PQOL, and Moral Distress Amidst The COVID-19 Crisis

To appreciate how the professional demands brought on by the corona virus disease - 2019 (COVID-19) pandemic impacted nurses and other healthcare workers' morale and general quality of life (QOL), and how it influenced their capacity to serve patients. For healthcare professionals who are providing patient care, this pandemic presents the prospect of a poor work-life balance and heightened Moral Distress (MD). Research that was semi-structured with outpatient healthcare professionals (HCP) was conducted using a converging multidisciplinary design with snowball sampling techniques. As a consequence of the apparent lack of support from decision-making leadership, the availability of personal protective equipment (PPE), and the frequently shifting legislation, healthcare professionals (HCPN) reported an increase in moral agony and a decrease in their professional quality of life (PQOL). By implementing shared governance, training in crisis management, and increased communication, executive leadership may be able to prevent a decrease in PQOL and an increase in MD among front-line HCPNs.

A Podcast on Patient and Physician Perspectives in the Holistic Care of Heart-Related Challenges of Type 2 Diabetes.

Type 2 diabetes (T2D) frequently coexists with cardiorenal complications. Therefore, a holistic approach to patient management is required, with specialists such as primary care physicians, cardiologists, endocrinologists, and nephrologists working together to provide patient care. Although glycemic control is important in the management of T2D, patients with T2D and acceptable glycemic control are still at risk from cardiovascular (CV) events such as stroke, heart attack, and heart failure (HF). Therefore, management of other risk factors, such as high blood pressure, high cholesterol, smoking cessation, and excess bodyweight, are imperative for reducing the risk of CV disease and HF in patients with T2D. In addition to pharmacological interventions, patient self-care, including beneficial dietary changes, regular exercise, and smoking cessation are critical for improving heart health and reducing the risk of CV events and progression of HF. In this podcast, a patient with lived experience of the heart-related challenges of T2D and a cardiologist discuss the link between T2D and heart-related complications, the pharmacological interventions and lifestyle modifications that can be used to reduce the risk of CV events and prevent HF, and the complexities of engaging with the healthcare system when managing multiple comorbidities. The discussion highlights the importance of patient education and empowerment for the management of heart-related challenges of T2D, and the central role of collaborative care between physicians of multiple specialties to reduce CV risk for patients with T2D.

Evaluating the Knowledge, Attitudes and Practices of Early Career Pharmacists Concerning Opioid Use Disorder (OUD) and Co-morbid Mental Health Conditions: Predicting Patients Health Outcomes in Nigeria

Background: This study aims to evaluate the understanding, perceptions and practices of early career pharmacists concerning opioid use disorder and its associated mental health outcomes for patients in Nigeria. The research seeks to identify the level of knowledge that these pharmacists possess about opioid-related issues and the mental health challenges that often accompany them. By examining their attitudes and practices, the study intends to uncover potential gaps in education and training that may affect the quality of care provided to patients suffering from these interconnected health conditions. Methodology: This was a cross-sectional survey conducted across the six geopolitical zones in Nigeria. We used evidence of licensure and not more than 5 years in practice to identify eligible participants. Information sheets were sent to all potential participants through email. If interested, they signed the consent form and sent the survey online to be completed and returned within 24 hours. Results: Descriptive statistics were used to summarize the data. Out of 514 participants, the majority had accurate knowledge of basic questions as well as a negative attitude regarding how comfortable in providing patient care as well as in monitoring and assessment. 342 (66.5%) respondents and 357 (69.5%) respondents were neutral on the information regarding the percentage of patients that achieve treatment adherence and average patient satisfaction respectively, while (166, 32.3%) (128, 24.9%) reported low/negative treatment adherence and patient satisfaction respectively. Conclusion: By fostering improved knowledge and attitudes among pharmacists, it is possible to mitigate the stigma associated with mental health issues, thereby enhancing treatment adherence and ultimately leading to better health outcomes. The findings show that in as much as the knowledge of these medical conditions is substantial, the negative outcomes persist.

Barriers and facilitators in the acquisition of diabetes knowledge among tertiary-care nurses in central and southern Malawi: an exploratory-descriptive qualitative study

BackgroundNumerous studies report low diabetes knowledge among nurses in sub-Saharan Africa. However, little is known about the factors that hinder and promote their acquisition of knowledge on diabetes mellitus. Understanding these factors is a pivotal step towards ensuring that nurses are knowledgeable and competent in the provision of care and education for patients with diabetes mellitus.MethodsThe study employed an exploratory-descriptive qualitative (EDQ) approach. Participants were identified from two tertiary hospitals. Twenty-six participants were purposively selected from these facilities. Data were collected through focus group discussions and analysis was done using Braun and Clarke’s approach to thematic analysis.ResultsThe following themes relating to barriers and facilitators in the nurses’ acquisition of diabetes knowledge emerged from the study: (a) individual hindrances; (b) organizational drawbacks; (c) personal ways of knowing; (d) organizational factors enhancing knowledge; and (e) suggestions for improving the nurses’ knowledge.ConclusionsThe study brings to light various challenges and opportunities in the acquisition of diabetes knowledge among tertiary-care nurses in Malawi. Given our study results, we believe that cost-effective measures can be utilised to address the barriers to the acquisition of diabetes knowledge among nurses. This is a crucial step towards ensuring that nurses are knowledgeable and competent in the provision of care for patients with diabetes in low-resource countries.

Embedding a culture of research in Canadian community hospitals: a qualitative study

BackgroundIn Canada, academic hospitals are the principal drivers of research and medical education, while community hospitals provide patient care to a majority of the population. Benefits of increasing community hospital research include improved patient outcomes and access to research, enhanced staff satisfaction and retention and increased research efficiency and generalizability. While the resources required to build Canadian community hospital research capacity have been identified, strategies for strengthening organizational research culture in these settings are not well defined. This study aimed to understand how research culture is experienced and shaped in Canadian community hospitals to provide strategies for strengthening research culture in these settings.MethodsThis qualitative descriptive study, as part of a larger study, explored the underlying dimensions of research culture. Participants were purposefully sampled and included healthcare providers, research staff or hospital administrators from community hospitals across Canada, with non-existent, emerging or established research programs. Data were collected via virtual semi-structured interviews and a demographic questionnaire. Interview transcripts were analyzed using reflexive thematic analysis and Schein’s Model of Organizational Culture as a sensitizing framework. Demographic data were analyzed using descriptive statistics.ResultsA total of 38 participants from 20 Canadian community hospitals described their experiences of research culture illustrating three key themes. As community hospital research programs matured, participants described a shift in research culture whereby research became more embedded in “the way things are done” within the community hospital. Recommended strategies to achieve an embedded culture of research involve: communications; relationship building; mentorship, training and education opportunities; selecting locally relevant studies; and systems-level support. A top-down approach to embedding research culture was contrasted with a bottom-up approach.ConclusionsThis study described the underlying dimensions of community hospital research culture and targeted strategies for strengthening research culture at different levels of research program maturity. Community hospitals without pre-existing research infrastructure were able to foster a culture of research from the bottom-up by emphasizing the value of embedding research in clinical practice. Although challenging, fostering a culture of research from the bottom-up may be necessary to propel research forward and initiate the process to build research capacity within a community hospital.

Adoption of telepharmacy among pharmacists, physicians, and nurses at Hawassa City Public Hospitals, Ethiopia.

Pharmaceutical care in the majority of developing countries is hindered by a lack of techniques, limitations in mobility, and a shortage of staff to provide patient care. However, there is no evidence that professionals intend to use telepharmacy in patient care. To fill this gap, this study was designed to examine whether pharmacists, physicians, and nursing professionals intend to use telepharamcy in their care practice.A cross-sectional investigation was carried out from November 29 to December 30, 2023. A study was conducted at all Hawassa public hospitals. A total of 592 Pharmacists, Physicians, and nurses participated. Simple random sampling and proportional allocation were utilized. A structured self-administered questionnaire was used, and a 5% pretest was administered. The data were entered into Epi Data 4.6 and exported to SPSS 26. The AMOS 23 SEM was also used to describe and assess the degree and significance of the relationships between variables.51.4% (304/592) (95% CI, 47.2-55.4) of the participants intended to use telepharmacy. Performance expectancy (β = 0.23, p-value <0.05), social influence (β = 0.295, p-value <0.05), and digital literacy (β = 0.309, p-value <0.001) had positive relationships with the intention to use telepharmacy. Age and gender were also moderators of performance expectancy in telepharmacy.Overall, Pharmacists', Physicians', and nurses' intentions to use telepharamcy were found to be promising for the future. Performance expectancy, social influence, and digital literacy had a significantly positive influence on the intention to use telepharamcy. Digital literacy had a more significant prediction power than others. The results could be useful in terms of designing emerging systems and understanding users' computer skills.