Quality Of Patient Care Research Articles

Use of ambient AI scribing: Impact on physician administrative burden and patient care.

418 Background: Medical documentation is necessary to describe encounters for clinical and billing purposes. The increasing time required for medical documentation is contributing to provider stress and burnout. Physicians divide their time and attention between patients and the electronic health record (EHR), negatively impacting the patient physician relationship. Methods: 49 physicians from Texas Oncology participated in a pilot from November 2023 to April 2024 using Deep Scribe (DS) ambient artificial intelligence (AI) technology to document patient clinic visits. Subspecialties of medical oncology, radiation oncology, urology, and breast surgery completed opinion surveys pre and post pilot. Provider adoption, weekly usage, satisfaction scores were measured. Evaluation and management (E&M) diagnosis codes for office visits conducted pre-pilot were reviewed for over 27,000 patient encounters and compared to over 4,500 DS patient encounters. Hierarchical condition category (HCC) codes captured via DS AI were compared to manual capture of billing codes in the pre-pilot period. Results: 77% of providers adopted DS AI technology during the pilot. Median turnaround time for notes was less than 3 minutes. Average satisfaction score was 81%. 91% of providers stated DS was easy to use. 60% of providers believed DS improved the quality of documentation. Providers reported on average 1.5 hours per provider time saved per week. The average number of billed diagnosis codes for non- DS patients was 3 per patient. For the DS patients, the average billed diagnosis per patient was 4.1. Diagnosis codes were categorized as cancer, and other non-cancer HCCs using the CMS-HCC model category version 22. Of the top ten HCC categories, cancer diagnosis codes were better captured by manual coding, whereas DS captured more non-cancer HCC codes across multiple systems, most significantly in endocrine and cardiovascular systems. Conclusions: Data from this pilot study shows physicians reported DS AI improved quality of their documentation and saved physicians’ time. Billing data shows increase capture of non-cancer HCC codes. Use of AI in medical documentation can decrease physician burden and improve quality of patient care. E&M Diagnosis Codes Non-Deep Scribe Deep Scribe Patient visit count 27,236 4,584 Diagnosis code count 82,231 18,702 Average 3.0 4.1 Median 2 3 Mode 2.0 1.0

Knowledge and Performance on Intravenous Medication Administration to Patients: A Cross-Sectional Observational Study Among Nurses of Nepal.

To evaluate knowledge and performance levels regarding intravenous (IV) medication administration to patients among nurses working in paediatric centers of Nepal. A cross-sectional descriptive observational study. Enumerative sampling method was used for participant selection from the four hospitals having paediatric units. Data were collected using knowledge survey and observational checklist on four phases of IV medication administration. Of 115 nurses, 14 (12.2%) had adequate knowledge about IV medication administration whereas none had good level and only 20 nurses (17.4%) had fair level of performance. There was a weak negative correlation between knowledge and practice scores. Nurses working 8-h shifts had better performance than those working 6-h shifts; however, the recommended nurse-patient ratio was not maintained in 80% of observed shifts. The findings highlight the importance of upgrading nurses' knowledge and professional competencies on medication administration to improve the quality of patient care.

The quality of nursing care in dying children from the nurses’ point of view in Iran: A cross-sectional study

BackgroundNowadays, the quality of nursing care is one of the most essential factors in health services and patient care. The quality of end-of-life care is of high importance, especially in vulnerable groups such as children. In the final stages of life, the needs of patients and their companions, as well as stressful conditions cause avoidance of participation in treatment, and dissatisfaction of caregivers which can reduce the quality of patient care. The present study aimed to examine the quality of nursing care in children from the point of view of nurses in hospitals related to Birjand, Iran. Materials and methodsThe present descriptive study was conducted on 350 nurses. The data collection tools used in this study were demographic questionnaire and Quality Patient Care Scale (QUALPAC). ResultsA total of 270 completed questionnaires were entered into the statistical analysis. The average quality of nursing care score in dying children was 266.17 ± 27.79. Also, the results of the present study showed that the gender, age, marital status, and work experience of nurses have no significant effect on the quality of nursing care in dying children from the nurses’ viewpoint. ConclusionThe quality of nursing care of dying children from the point of view of nurses was satisfactory. Nurses reported that the physical dimension of nursing care had the highest quality and the psychosocial dimension had the lowest quality. Therefore, psychological support and follow-ups for improving social support for these clients are suggested to the nursing managers and healthcare administrators.

Alcohol use disorders among healthcare professionals: a call for action.

Alcohol consumption and harmful and hazardous drinking are significant contributors to the global burden of disease, accounting for about 3 million deaths each year globally. Owing to their stressful work environment, healthcare professionals are at a high risk of experiencing physical and mental health problems, particularly alcohol use disorders. Alcohol use disorder among healthcare professionals is of concern as it is associated with decreased work productivity and performance and associated ill health and cognitive impairment. This review, therefore, aimed to gather evidence on the prevalence and associated factors for alcohol use disorders among healthcare professionals. The findings revealed a high prevalence of alcohol use disorders among healthcare professionals, which were worsened during the COVID-19 pandemic. Additionally, there was a glaring dearth of studies conducted in low- and middle-income countries. Urgent interventions and support systems are therefore needed to address these issues. A comprehensive approach, considering individual and organizational factors, alongside evidence-based interventions, training and support programs, can promote workforce well-being and improve the quality of patient care. It is imperative to integrate alcohol use screening, preventive and treatment interventions with primary healthcare and psychiatry services.This will help ensureearly diagnosis and timelyinitiation of preventive and therapeutic measures, reducing the risk of missed opportunities. Furthermore, offering effective human resource management support services to healthcare professionals would significantly enhance their well-being and help prevent alcohol use disorders.

Presenteeism among nurses: An integrative review

BackgroundPresenteeism, a phenomenon in which employees attend work despite physical or mental limitations, is prevalent among nurses and has negative implications for patients, healthcare organizations, and nurses themselves. ObjectiveWe aimed to present the current state of knowledge on presenteeism in nursing, focusing on prevalence rates, reasons, influencing factors, and consequences. DesignWe performed an integrative review. MethodsWe searched databases for studies on presenteeism in the nursing workforce published between 2018 and 2024. This review included 44 studies that met the inclusion criteria, specifically 38 quantitative studies, 4 qualitative studies, and 2 reviews. ResultsThe results indicated that the prevalence of nurses exhibiting symptoms of presenteeism varies between 32% and 94%. The influencing factors include workload, team culture, age, childcare responsibilities, job insecurity, and leadership practices. Presenteeism can lead to significant individual and organizational consequences such as increased health issues among nurses, decreased quality of patient care, and higher healthcare costs. Most studies were focused on nurses who work in hospitals, with only one study addressing nurses who work in nursing homes. ConclusionThis review highlights the high prevalence of presenteeism among nurses and its multifaceted causes and effects. This underscores the need for increased awareness and training of both nurses and management teams regarding the importance of addressing presenteeism. Further research is needed in settings such as nursing homes and outpatient care to understand the unique challenges and impacts in these environments. Efforts should focus on improving working conditions, fostering supportive organizational cultures, and implementing effective leadership practices to mitigate the negative effects of presenteeism.

Telemedicine and information technology in health care management: Perspectives and barriers among the nursing students

BACKGROUND: Telemedicine refers to using electronic information and telecommunication technologies to support numerous aspects of healthcare, including clinical care, patient and professional education and training, public health, and health administration. However, many challenges hinder the widespread adoption of telemedicine by healthcare providers. This study aimed to assess the perspectives and barriers in telemedicine and information technology in health care management among nursing students. MATERIALS AND METHODS: A cross-sectional study was conducted among 60 nursing students enrolled in the third and fourth years. The sample was selected using a nonprobability purposive sampling technique from students studying at the Applied Medical Science Colleges for Females, University of Bisha. Data collection was facilitated through a structured questionnaire, and the gathered data were analyzed using SPSS version 22. The study was conducted between August 15, 2022 and November 20, 2022. RESULTS: 61% of students believe that telemedicine will lead to a reduction in travel time, costs, and effort. Approximately two-fourths of the sample’s perspectives revolve around concerns regarding privacy, medical errors, and camera comfort. However, more than 30% of participants agree that telemedicine will improve the quality of patient care, decrease waiting times, be beneficial for patient care in remote areas, and assist in providing appropriate information during emergency. 59% of respondents identified the lack of time or busy schedules as the most frequently reported barrier to using telemedicine. Following this, concerns regarding privacy, confidentiality, unreliable Internet connections, and inadequate knowledge about computer technology and Information Management Systems were also commonly cited as barriers. These factors were identified as the primary obstacles hindering the progress of telemedicine. CONCLUSION: This study concluded that telemedicine is a critical tool to address the challenges of limited medical resources in healthcare facilities. However, reduced healthcare costs and waiting time and improved patient access to healthcare in remote areas all helped promote telemedicine implementation. In these remote areas, telemedicine has the potential to bridge this distance and facilitate healthcare.

Workplace violence and nurses' psychological well-being: The mediating role of burnout and the moderating role of psychological resilience

Workplace violence can harm healthcare professionals. It can cause bodily harm, psychological distress, and even death. Moreover, it creates an unpleasant workplace that lowers morale and productivity. To provide quality patient care without fear of danger or intimidation, healthcare organizations must keep their personnel safe from violence. This article examines workplace violence and nurses' psychological relationship with nurses' burnout as the mediator. Psychological resilience's moderating role between workplace violence and nurses' psychological well-being is also examined. The data of this study includes 945 nurses from 15 university hospitals in Turkey. The proposed model was tested by using hierarchical multiple regression analysis. This study showed that workplace violence and burnout negatively affect nurses' mental health. Psychological resilience also weakens the relationship between workplace violence and nurses' psychological well-being. The study suggests that healthcare administrators may build a secure and supportive workplace by enacting workplace violence prevention and response policies. They can also be trained in recognizing and responding to warning signals of violence. Nurses should feel safe reporting violence concerns. Moreover, nurses with high workplace violence and low psychological well-being must emphasize psychological resilience's buffering effect.

Quality improvement scorecards driving innovation and best practice in a large community oncology practice.

417 Background: Lean Six Sigma Visual Management dashboards, or scorecards, are visual tools designed to drive and improve quality patient care, operationalize best practices, and promote a culture of operational excellence. Practice scorecards create a disciplined problem-solving culture where root causes are identified, and systemic process-based improvements are implemented. Scorecards are created to show full practice data transparency, allowing all employees and sites to see each other’s data. Scorecards are designed so that providers can efficiently review the maximum amount of data, following a Green, Yellow, Red visual cue to signify goal adherence. Methods: Phase 1 (2018 – 2019): Clinical scorecards were created and introduced to all staff on a weekly basis focusing on a few key patient metrics (ex: pain scale, pain care plan, ACP, PHQ-9, teaching/consents, patient portal access). Phase 2 (2020 – 2022): Clinical scorecards were expanded with additional patient care initiatives. New nurse navigator scorecards created (ex: patient teaching and survivorship visits). New physician and APP scorecards created with practice-specific provider metrics. Phase 3 (2023 – 2024): Scorecards updated yearly to match practice quality initiatives. New dashboards for non-clinical employees initiated. Physician and APP compensation changed to include quality metric performance tied to financial incentive. Results: Over the course of 5 years, OHC quality scorecard metrics improved from below national averages (red) to exceeding top-tier threshold goals (green). Scorecard utilization increased across all areas of the business, expanding from one scorecard in 2018 to eight in 2024. Scorecards increased overall practice data transparency leading to increase practice quality metric performance. OHC staff utilize scorecards on a weekly, monthly, and quarterly basis to drive quality improvement adherence. Improved outcomes through full data transparency increased staff participation and ownership in quality metrics and led to achieved shared savings in managed care programs. Example of metrics and results: Patient NCCN Staging 36% (2588/7263) to 96% (10299/10749), Teaching/Consents 37% (423/1147) to 97% (3067/3160), and Oral regimen NCCN entry 69% (586/845) to 98% (1037/1055). Conclusions: Visual Management dashboards or practice scorecards are instrumental in driving and supporting practice change. Scorecards allowed OHC staff to efficiently visualize practice-wide actionable data with eye-catching colors to promote optimal clinical performance. As increased data procurement is on the rise, practices can empower their staff to drive change through data utilization. OHC’s scorecards have proven to bridge the gap to goal, facilitate transparent data sharing, and empower providers and staff toward collaboration and embracing operational excellence.

Prevalence of compassion fatigue among post-graduate trainees in Pakistan: A cross-sectional study.

To determine the prevalence of compassion fatigue, compassion satisfaction and burnout and identify the socio-demographic and work-related factors associated with compassion fatigue among FCPS Part-II trainees in Pakistan. A cross-sectional study of FCPS-II trainees was conducted using stratified sampling at multiple centers over six months. Data was collected through an online, self-administered survey, which consisted of the 30-item ProQOL-V and a socio-demographic and work-related characteristics questionnaire. Informed consent was obtained from all participants. Data was analysed using SPSS 26 for descriptive stats, one-sample t-test, Pearson correlation, and multivariate linear regression at a 95% significance level. Out of 460, only 392 trainees completely filled the online survey (completion rate: 90.74%). The study found that 78.80% of postgraduate trainees experienced moderate levels of compassion fatigue (CF) (Mean = 27.6, SD = 6.3), with moderate burnout (BO) (75.50%, Mean = 26.6, SD = 5.9), while moderately high Compassion satisfaction (CS) (90.60%, Mean = 33.3, SD = 5.5). Compared to normative data, compassion fatigue levels were significantly elevated among post-graduate trainees (p < 0.001). Significant correlations were observed between CF and BO (r =0.59), CF and CS (r = -0.20), and BO and CS (r = -0.63). Factors associated with higher CF included family dependents (p = 0.029), longer working hours (p < 0.001), and inadequate sleep (p < 0.001). Trainees in "Poor" work environments reported higher CF levels than those in "Excellent" environments (p < 0.001). Additionally, engaging in self-care activities such as exercise, prayer, and socialising were associated with lower CF levels (p < 0.05). The study revealed that many postgraduate trainees experience moderate compassion fatigue and burnout, with a strong positive correlation between CF and BO. Compassion satisfaction inversely related to both CF and BO, highlighting the need to boost CS. Factors like longer work hours, poor sleep, family dependents and unfavorable work conditions were linked to higher Compassion Fatigue. Conversely, engaging in self-care practices like prayer, meditation, exercise, and socialising is associated with decreased compassion fatigue levels. These results stress the importance of tailored interventions to enhance trainees' well-being and ultimately improve patient care quality.

Weekly touch calls with high-risk cohort of patients with commercial Medicare Advantage to reduce avoidable hospital admissions.

282 Background: Patients who have been diagnosed with cancer have an increased risk of complications and potential hospitalization instances. Those in more advanced age groups have an additional risk, especially those of the age group of 65 and higher. Avoidable hospitalizations increase the total cost of care and decrease patient quality of life during treatment. Methods: To reduce potentially avoidable hospital admissions, patients enrolled in a commercial insurance contract were reviewed weekly for a high-risk potential. Criteria for high-risk inclusion included: Any patient &gt;75 years of age receiving treatment; Any patient receiving chemotherapy/radiation combination therapy; Any patient with the following diagnosis: Metastatic lung cancer, Metastatic pancreatic cancer, Multiple myeloma, Breast cancer, Prostate cancer with multiple HCC; Any patient receiving: Cisplatin, Adriamycin, Taxanes, Ifosfimide, Doxorubicin, or Carbo with AUC 4 or greater; Any patient that has had one visit to ER/hospital during the program During the recording period, the high-risk list of patients was reviewed weekly. Before the weekend, each patient identified was contacted by phone by a registered nurse for a weekly “touch call” to address side effects, treatment questions, complications, or concerns. Patients were reminded to contact the practice first when a non-life-threatening concern occurs. Results: The program began on April 1, 2020, with a baseline admission rate of 1.8%. At the conclusion of the program on March 31st, 2023, this cohort of patients had a 53.1% reduction in admission rates from their baseline. Additionally, the reimbursement PPPM was under target yearly, concluding at $65.64, $14.46 below the target amount of $80. The cohort consisted of a range of 36-75 patients per quarter, program total of 185 enrolled patients. Conclusions: Identifying potentially high-risk patients and conducting weekly, personalized calls before the weekend reduced the overall avoidable admission rate. Timely identification and support for high-risk patients reduces the total cost of care and potentially increases patient care quality during treatment. Period Practice Inpatient Admits per 1000 Benchmark Target Target Difference Targeted Reimbursement PPPM Actual Reimbursement PPPM Reimbursement Difference 2020 Q1 1.8% 754 378 $80 2020 Q4 -17.9% 680 233 $80 $75.56 -$4.44 2021 Q4 -31.5% 622 3 $80 $66.66 -$13.34 2022 Q4 -51.3% 602 -235 $80 $65.64 -$14.46

Enhancing readmission prediction models by integrating insights from home healthcare notes: Retrospective cohort study

BackgroundHospital readmission is an important indicator of inpatient care quality and a significant driver of increasing medical costs. Therefore, it is important to explore the effects of postdischarge information, particularly from home healthcare notes, on enhancing readmission prediction models. Despite the use of natural language processing (NLP) and machine learning in prediction model development, current studies often overlook insights from home healthcare notes. ObjectiveThis study aimed to develop prediction models for 30-day readmissions using home healthcare notes and structured data. In addition, it explored the development of 14- and 180-day prediction models using variables in the 30-day model. DesignA retrospective observational cohort study. Setting(s)This study was conducted at Ajou University School of Medicine in South Korea. ParticipantsData from electronic health records, encompassing demographic characteristics of 1819 participants, along with information on conditions, drug, and home healthcare, were utilized. MethodsTwo distinct models were developed for each prediction window (30-, 14-, 180-day): the traditional model, which utilized structured variables alone, and the common data model (CDM)-NLP model, which incorporated structured and topic variables extracted from home healthcare notes. BERTopic facilitated topic generation and risk probability, representing the likelihood of documents being assigned to specific topics. Feature selection involved experimenting with various algorithms. The best-performing algorithm, determined using the area under the receiver operating characteristic curve (AUROC), was used for model development. Model performance was assessed using various learning metrics including AUROC. ResultsAmong 1819 patients, 251 (13.80 %) experienced 30-day readmission. The least absolute shrinkage and selection operator was used for feature extraction and model development. The 15 structured features were used in the traditional model. Moreover, five additional topic variables from the home healthcare notes were applied in the CDM-NLP model. The AUROC of the traditional model was 0.739 (95 % CI: 0.672–0.807). The AUROC of the CDM-NLP model was high at 0.824 (95 % CI: 0.768–0.880), which indicated an outstanding performance. The topics in the CDM-NLP model included emotional distress, daily living functions, nutrition, postoperative status, and cardiorespiratory issues. In extended prediction model development for 14- and 180-day readmissions, the CDM-NLP consistently outperformed the traditional model. ConclusionsThis study developed effective prediction models using both structured and unstructured data, thereby emphasizing the significance of postdischarge information from home healthcare notes in readmission prediction.

Quality of patient Care with new Privatized Healthcare system: A Systematic Review of Technology Integration and Health Insurance"

Background: The quality of patient care is effective for new privatized healthcare system. For providing the effective services to the patients’ technology tools play important role. Also, new privatized healthcare organizations introduce the healthcare insurance. The aim of current systematic review is to explore the quality of patient care with new privatized healthcare system in the context of technology integration and health insurance. Method: A thorough search of databases, including Scopus, PsycINFO, and Web of Science, was conducted in order to categorize relevant research that was published between 2020 and 2024. The inclusion criteria for this research were English-language papers that focused on exploring the quality of patient care with new privatized healthcare system in the context of technology integration and health insurance.Following an initial screening and quality evaluation, eleven studies were included in the synthesis. Results: The study database was searched through electronic databases, identifying 1679 records. 15 unique records were assessed for eligibility based on titles and abstracts. After initial screening, 11 studies were selected for full-text assessment. After independent review, 11 studies met criteria and were included in the systematic review. The selected studies were conducted between 2020-2024 and varied in design. The PRISMA flowchart illustrates the selection process. Quality evaluation involves peer-reviewed journals, overall assessment, and quality management. Conclusion: As the SR concluded that advanced technologies like electronic health records, telemedicine, and predictive analytics can improve patient care and treatment accuracy. However, challenges like rising costs, complex insurance plans, and data security need to be addressed. Effective training for healthcare providers, clear insurance plans, and robust information security systems are crucial for maximizing profits.

Adrenocorticotropic hormone: Therapeutic use and effects in nephrotic syndrome

Background: NS is defined by the presence of significant proteinuria, which leads to low levels of albumin in the blood and the development of edema. This occurs as a result of damage to the glomerular filtration barrier. Corticosteroids are the main therapeutic approach for NS. Prolonged usage of steroids can result in numerous side effects, including steroid resistant NS, which poses a difficult challenge for treatment and can cause substantial morbidity and mortality. Although efforts have been made to decrease the use of steroids by employing non-steroidal immunosuppressive drugs for rapid recovery, these treatments have also exhibited adverse consequences. These difficulties have prompted the notion of utilizing ACTH in these situations. Objective: This study seeks to analyze the efficacy of ACTH by thoroughly examining its mechanism and comparing it to conventional treatment for NS. Summary and important messages: The study demonstrates that ACTH has the potential to not only decrease protein loss but also reduce the occurrence of relapses and the amount of glucosteroids required. This suggests that ACTH could be a viable treatment alternative. The exact mechanism is currently unidentified, while the MCR1 agonism linked to ACTH suggest a renoprotective mechanism that is beneficial in NS. A comprehensive analysis using a large-scale randomized controlled trial is necessary to fully comprehend the effectiveness and safety profile of ACTH in improving the quality of care for patients.

Professional ethics and ethical challenges related to nurses and patients: A narrative review

This study was conducted to evaluate professional ethics and ethical challenges related to nurses and patients. The study establishes a strong link between nursing, spirituality, and ethical performance, with nurses' religious beliefs significantly influencing their approach to patient care. Ethical decision-making is vital in nursing, with patients' rights and information disclosure being top priorities. The shortage of nursing staff and its impact on ethical practices are acknowledged. Rewarding ethical conduct and providing ethical education are recommended to promote ethical behavior among nurses. Ethical distress arises when organizational factors hinder ethical actions, affecting nurses' job satisfaction and patient care quality. Younger and married nurses may experience higher ethical distress, while experience may mitigate it. Overall, nurturing ethical behavior is crucial for better patient outcomes. Nurses often face ethical issues in their clinical practice. Ethical decision-making is now integral to professional nursing, requiring nurses to recognize ethical dilemmas and demonstrate ethical sensitivity in all patient interactions and during interventions, ensuring high-quality patient care and upholding the nursing profession's integrity.

The foundation for the microbiology laboratory's essential role in diagnostic stewardship: an ASM Laboratory Practices Subcommittee report.

Diagnostic stewardship (DxS) has gained traction in recent years as a cross-disciplinary method to improve the quality of patient care while appropriately managing resources within the healthcare system. Clinical microbiology laboratorians have been highly engaged in DxS efforts to guide best practices with conventional microbiology tests and more recently with molecular infectious disease diagnostics. Laboratories can experience resistance to their role in DxS, especially when the clinical benefits, motivations for interventions, and underlying regulatory requirements are not clearly conveyed to stakeholders. Clinical laboratories must not only ensure ethical practices but also meet obligatory requirements to steward tests responsibly. In this review, we aim to support clinical microbiology laboratorians by providing the background and resources that demonstrate the laboratory's essential role in DxS. The heart of this review is to collate regulatory and accreditation requirements that, in essence, mandate DxS practices as a long-standing, core element of high-quality laboratory testing to deliver the best possible patient care. While examples of the clinical impact of DxS are plentiful in the literature, here, we focus on the operational and regulatory justification for the laboratory's role in stewardship activities.

Psychoeducational Burnout Intervention for Nurses: Protocol for a Systematic Review.

Nurses face high levels of stress and emotional exhaustion due to heavy workloads and demanding work environments. Prolonged exposure to these stressors predisposes nurses to burnout, which can adversely affect patient care. Addressing burnout among nurses requires a multifaceted approach, involving both personal and organizational strategies. While organizational strategies target systemic workplace issues, personal interventions are often favored for their ease of implementation, immediate benefits, and empowerment of health care workers through stress management and resilience-building. Prioritizing evidence-based interventions to mitigate burnout among nurses is crucial for managing occupational stress and promoting well-being. Person-directed psychoeducation is an effective personal intervention strategy used to equip nurses with the appropriate knowledge and skills to handle stressors, thereby safeguarding their mental health and ensuring high-quality patient care. This protocol proposes a systematic review that aims to identify and assess the effectiveness of person-directed psychoeducational interventions for nurses. The review aims to pinpoint effective interventions that can be implemented to manage burnout and support the mental health of nurses. This systematic review will follow the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. In total of 5 electronic databases (PubMed-MEDLINE, EBSCOhost, Ovid MEDLINE, Scopus, and ScienceDirect) will be searched for studies published between January 1, 2014, and December 31, 2023. The search will encompass 3 main keywords: "nurses," "burnout intervention," and "burnout." Predefined eligibility criteria will guide the screening process. Data will be extracted to address the objectives of the review. The risk of bias for each study will be assessed using Joanna Briggs Institute Critical Appraisal Tools. Preliminary searches have been initiated since February 2024, with the review expected to be completed by June 2024. The expected results will include a comprehensive list of psychoeducational interventions and their effectiveness in reducing burnout among nurses. The review will highlight interventions that demonstrate significant impact in published studies from various countries. Given the rising prevalence of burnout among nurses and its detrimental effects on individuals and health care organizations, the findings from this systematic review are expected to inform health care policy and practice. By evaluating different interventions, it will provide insights into the most effective strategies, contributing to evidence-based practices that support nurses' mental health and well-being. The findings can support stakeholders in developing and implementing targeted strategies to combat nurse burnout, ultimately enhancing the quality of patient care and health care delivery. In addition, the findings will also offer valuable information for researchers, guiding future practice and research in this area. PROSPERO CRD42024505762; https://tinyurl.com/4p84dk3d. DERR1-10.2196/58692.

Patient Education in Type 2 Diabetes Mellitus through Continuous Glucose Monitoring Reports

The number of patients with type 2 diabetes mellitus using continuous glucose monitoring (CGM) continues to increase. The combined effects of CGM and patient education have been demonstrated to improve glycemic control more effectively than CGM alone. Therefore, healthcare providers should analyze CGM reports and offer structured, personalized education to patients with type 2 diabetes mellitus. Various features are frequently updated in CGM reports. Thus, healthcare providers should be skilled in using these features to improve the quality of patient care.

Evaluating Short-Term Patient-Reported Outcome Measures Following Total Hip and Knee Replacement: A Comprehensive Review.

Total hip replacement (THR) and total knee replacement (TKR) are widely performed surgical procedures to alleviate pain and improve function in patients with joint-related diseases. Short-term patient-reported outcome measures (PROMs) have become a key metric in assessing the success of these surgeries from the patient's perspective, focusing on early recovery, pain management, mobility, and quality of life. This comprehensive review evaluates the significance of short-term PROMs following THR and TKR, highlighting commonly used tools such as the Oxford Hip Score (OHS), Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and short-form health survey (SF-36). The analysis explores the impact of various factors, such as age, preoperative health status, and surgical technique, on short-term outcomes. Findings from recent studies indicate that while patients generally report improvements in physical function and pain relief within the first six months post-surgery, individual outcomes can vary significantly. Factors like early rehabilitation, mental health, and the presence of postoperative complications can influence the trajectory of recovery and satisfaction levels. Moreover, the review addresses the limitations of current PROMs, including variability in reporting and sensitivity to different patient populations. This review emphasizes the need for more personalized and standardized approaches to PROM assessment to better capture patient experiences and optimize postoperative care. Future research should focus on integrating PROMs with long-term follow-up data and digital health tools to track real-time patient progress, thus enhancing the overall quality of care for THR and TKR patients. Short-term PROMs play a vital role in understanding patient outcomes and guiding clinical practice for joint replacement surgeries.

Quality assessment conferences in surgery

Surgical complications are preventable in up to 50% of cases, actually are various tools to avoid them, one of these are morbidity and mortality conferences. However, there are no guides that define their structure for them to be effective. Objective; Analyze the impact of a new modality of surgical conferences in a sector of benign biliary pathology, called quality evaluation conferences. Methodology: Descriptive observational study where the overall improvement of the sector, the decrease in complications and the quality of patient care are compared. For 6 months, a weekly quality evaluation conference was carried out. It had 5 stages; 1. Analysis of all discharged patients. 2. Review of adverse events. 3. Review of the list and order of patients in the surgical plan. 4. Reproduction of recorded surgeries and review of scientific articles. 5. Review of own scientific works in development. after implementing the conferences, there was a decrease in the number and severity of complications, as well as an improvement in the correct and timely surgical indication. Conclusion; Quality evaluation workshops as an evolution of morbidity and mortality workshops are a novel tool that, when well implemented, can help improve quality standards and in turn be used as a learning option in training centers.

"You Can't Let Go" - A Black Community Leader's Perspective on Engagement and Advocacy.

Lanre Tunji-Ajayi is president and CEO of the Sickle Cell Awareness Group of Ontario (SCAGO). This charitable organization focuses on ameliorating the lives of those living with sickle cell disease by providing evidence-based support to patients and supporting clinical and psychosocial research, health promotion and the development of best practice guidelines. Lanre's passion for this work is personal. Following the death of her brother Sunday Afolabi from preventable and treatable complications of sickle cell disease, Lanre immersed herself in advocacy for community health and quality patient care. In this oral history narrative, Lanre reflects on her decades-long journey advocating for those living with sickle cell disease - a disease which disproportionately affects Black people. Her reflections focus acutely on the challenges she has faced in raising awareness and visibility, including through formal public engagement policy processes. Lanre also speaks to the personal costs she has encountered engaging in this advocacy work and the subtle and institutionalized forms of anti-Black racism that have punctuated this already difficult effort to bring about change.