Provide Quality Care Research Articles

USO INDISCRIMINADO DOS OPIOIDES POR PROFISSIONAIS DE SAÚDE: UMA REVISÃO INTEGRATIVA

Introduction: The opioid epidemic is a global public health crisis that affects several regions, including one that is not always highlighted: health professionals. General objective: to analyze the complexity of the indiscriminate use of opioids by health professionals. Method: This is an integrative literature review, following five stages with a search in the LILACS, BDENF, MEDLINE, and SciELO databases from 2019 to 2024. Results: 109 articles were found; 06 articles were used to prepare the study. Discussion: According to the Brazilian guidelines on opioid abuse, patients with chronic pain and healthcare professionals are among the groups most at risk of acquiring opioid dependence. Concern about the abuse of psychoactive substances by healthcare professionals is not new. Historically, the population of doctors and other healthcare workers has been more exposed to the risk of abusing psychoactive substances, including prescription drugs such as benzodiazepines, opiates and amphetamines. Conclusion: The disordered use of opioids by healthcare professionals is a multifaceted problem that requires a comprehensive and collaborative approach to combat. Healthcare institutions, regulatory bodies and society in general have an important role to play in promoting a safer and more supportive working environment. Emphasizing the importance of the mental health and well-being of healthcare professionals, as well as implementing preventive measures and effective interventions, is essential to reducing opioid use and ensuring that these professionals can continue to provide quality care while protecting their own health and safety.

Jungian Psychodrama and Nursing Education.

Nursing, by its philosophy, is the process of providing quality care with an existential, humanitarian and holistic approach. In this context, nursing education aims to develop the intellectual, emotional and social skills of students to the greatest extent by reinforcing them with ideals. The psychodrama method, which can be a significant part of the therapeutic process of individuation and self-realisation, may be seen as a way for this. Psychodrama, which is a group psychotherapy method, is practiced worldwide under different styles and schools for the therapeutic processes of individuals. Jungian psychodrama is an approach that combines analytical psychology and drama therapy and aims to discover and transform the inner worlds of individuals. This article discusses the fundamental concepts and principles of Jungian psychodrama, the relationships of psychodrama with the profession of nursing, education in this profession and how Jungian psychodrama can be employed in nursing.

Empowering Dementia Communication via Virtual Reality AI-Driven Simulations

The use of effective communication skills is essential for direct care workers to provide quality care for persons living with dementia (PLWD) in long-term service and support settings (LTSS). However, direct care workers often report feeling unprepared, lacking competence in care, and fear interacting with PLWD. This proof-of-concept study proposes Virtual reality Communication Training Optimizing Real-world Interactions (VICTORI) intervention, aiming to develop and evaluate the usability, acceptability, and preliminary effectiveness of virtual reality (VR) simulated communication training for direct care workers using artificial intelligence (AI)-generated patients with dementia. Care-related and social communication scenarios in dementia care will be developed, based on current literature, our validated communication instrument, and AI technology. Six modules consisting of pre-briefing, simulation facilitation, and de-briefing will be developed, refined, and evaluated based on an advisory board of experts and direct care workers’ quantitative and qualitative feedback. To test the usability, acceptability, and effectiveness of the VICTORI intervention, we will use a single group pre- and post-test intervention design, integrating quantitative measures and qualitative semi-structured interviews in this mixed-methods study. Thirty direct care workers will be recruited at two LTSS in North Texas. Direct care workers will participate in six VR-AI simulation commu-nication training sessions that include communication with AI-generated patients, real-time feedback, and detailed evaluation of communication behaviors. Each simulation will be recorded to further evaluate the partici-pant’s communication skills using the Dyadic Communi-cation Observational coding scheme in Dementia care (DCODE). Additionally, participants' potential side effects during VR simulation will be assessed using continuous physiological data and self-reported questionnaires at each simulation session. Communication knowledge and com-petence in dementia care will be assessed before and after training using self-reported questionnaires. Direct care workers will also be interviewed to assess acceptability and satisfaction with the VICTORI training. This proposal will introduce innovative training methods that leverage AI technology into communication training in dementia care. Objective assessments, including AI-based feedback, physiological data, and observational assessments, ensure the reliability and validity of the data to evaluate plausibility of VICTORI intervention.

Domiciliary Care Service at a Tertiary Centre

Background: The domiciliary service comprises of medical and rehabilitation services done at the home of patients to ensure uninterrupted care upon early discharge, render support to the family members in training the caregiver and to reduce readmission by providing quality care. Objective: To explore the facilitators and barriers of domiciliary services at Hospital Seberang Jaya (HSJ), Penang. Methods: A total of 53 respondents (34 trained nurses, 8 sisters, 5 matrons, 4 occupational therapists and 2 physiotherapists) involved in domiciliary care from the medical, surgical, orthopedics and pediatrics wards were interviewed using a semi-structured questionnaire as homogenous focus groups or as individuals, audio recorded, transcribed and thematically analyzed. Results: 3 domains were identified as facilitators and barriers; Health System factors, Health professional and Patient and Caregiver factors. In facilitators, health system factors (ongoing measures in domiciliary updates, having a reference file in ward, cluster hospital concept and a dedicated person in charge). Health professional factors (teamwork, synchronized explanation and pre planned discharge), patient and caregiver factors (suitable caregiver, locale convenience of health facility) and finally the proactiveness, motivating and supportive factors that encompasses all 3. The Health System barriers were (inadequacy in; man power, public information and ineffective domiciliary team). Health Professionals Barriers were (bias selection of cases and default in responsibilities). Patient and Caregiver Barriers (unsuitable caregiver, misconception on nursing role, lacking confidence to learn and financial issues). Encompassing all were lack in continual monitoring, communication and supervision. Conclusions: For a successful domiciliary care, health system factor, health professional factors, patient and caregiver factors need to be addressed. Its Implementation will involve all stakeholders to work for a common goal for an effective delivery of domiciliary services at HSJ.

Barriers and enablers towards integrated care for sexual violence victims in humanitarian settings

Abstract Background Sexual violence (SV) is a complex public health issue that necessitates a coordinated multisectoral response. Ideally, this response should be provided through an integrated care package to strengthen timely access and comprehensive care for victims. However, in humanitarian settings with high levels of SV, care is often offered through fragmented silos, exacerbating the burden on the health workforce and victims. Methods Using the Valentijn framework, a qualitative, real-time Delphi study was conducted with 17 SV care experts representing 7 geographical subregions to gain informed opinions on key contextual and health system barriers and enablers for integrated care for SV victims in humanitarian settings. Results Challenges and enablers reported across the diversity of the participants’ contexts showed consistency. Contextual challenges included volatile contexts, collapsed health systems, and poor infrastructure. Professional challenges included a lack of expertise among healthcare providers (HCPs), high staff attrition, and compassion fatigue among HCPs. Health systems challenges included poor referral and coordination mechanisms, insufficient resources, misaligned donor-programme priorities and low prioritisation of SV comprehensive care. Key enablers reported were effective networking, community engagement, capacity building, co-locating services, participatory management, promoting staff’s sense of ownership, digitalised information systems, and joint patient files. Conclusions The sustainability of integrated care for SV victims can be strengthened by ensuring HCPs access regular psychological support and training and are incentivised to provide quality care. Regular coordination among actors, including donors, can support integrating care that responds to patients’ holistic needs. Further research is needed to assess HCPs’ and SV victims’ experiences of current service delivery and how to optimise integrated care in humanitarian settings. Key messages • Addressing care providers challenges in humanitarian settings, such as high attrition, lack of training, psychosocial support, and burnout, can ensure proper integration of sexual violence care. • Integration of sexual violence care demands systemic changes, including aligning donor-programme goals, building accountability mechanisms and the buy-in of political and community leaders.

A framework to guide the commissioning of healthcare services for people seeking asylum in England

Abstract The increasing number of people seeking asylum (PSA) in England, compounded by delays in processing their cases, has led to an urgent need for tailored practices to overcome barriers to healthcare access. While local examples of excellence in healthcare provision for PSA exist, a national framework to guide healthcare for these groups is lacking, leading to fragmentation and inconsistency in service provision. This collaborative research project with the British Red Cross took a co-production approach, involving three peer researchers with lived experience from the outset. From a literature review of case studies on improving access to healthcare for PSA, a preliminary framework of good practice was developed and explored with participants with lived experience of seeking asylum during three in-person workshops refined this. Finally, two focus groups with policymakers and healthcare professionals (HCPs) explored challenges in commissioning services, ensuring final framework relevance to the policy context. In total, 60 participants with lived experience attended three workshops and 19 policymakers and HCPs attended focus groups. Workshop participants emphasised the critical role of improving communication in healthcare settings and educating HCPs and PSA on entitlements and the NHS system. Policymakers highlighted the importance of robust leadership and a standardised national approach that can be adapted locally. Capacity constraints within the NHS and primary care system were highlighted as barriers to good quality care provision. Findings were collated into a practical framework, describing five pillars of good practice; 1)Working in partnership; 2) Upskilling the healthcare workforce; 3) Including lived experience voices; 4) Improving data on local needs; and 5) Strengthening pathways into healthcare. The framework provides guidance to enhance the accessibility, consistency and quality of healthcare services for PSA, addressing critical gaps in the current system. Key messages • A novel framework to guide commissioning and provision of healthcare for people seeking asylum has been developed, drawing from existing pockets of excellence to aid a consistent national approach. • The framework presents five pillars of systemic good practice, highlighting the importance of strategic partnerships, workforce training and data collection in providing good quality care.

Associations Between Nursing Students' Knowledge, Skills, and Attitudes and Participation in Experiential Learning on Care for People With Disabilities.

Experiential learning activities on care for people with disabilities (PWD) would help nursing students develop the knowledge, skills, and attitudes (KSAs) needed to provide quality care for PWD. The purpose of this study was to evaluate the perceived changes in nursing students' KSAs related to the care for PWD following participation in health assessment and prevention (HAP) experiential learning activities. This was a quasi-experimental, pre- and posttest educational intervention study. Nursing students (n=160) attended multiple experiential learning activities as a required part of their HAP coursework and completed a pre and posttest survey to assess changes in their KSAs. Participation in experiential learning activities on care for PWD was associated with significant increases in perceived knowledge, skills and positive attitudes toward PWD. Experiential learning activities aligned with core competencies for health care providers caring for PWDs have the potential to change nursing care and address health inequities for this population.

The Role of Nursing Guidelines on Successful License Renewal for Nurses and Midwives in Ubungo District Public Hospitals in Tanzania

In the recent years, nurses and mid wives are struggling to keep their knowledge current knowledge and skills current and relevant through to changing requirements and situations. Through engaging in continuing professional development (CPD), care givers become updated knowledge and practice to provide quality care to patients. This study sought to unveil the role of CPD on license renewal of midwives and nurses with a special focus on Ubungo district as Ubungo has more health Centres as compared to other districts in Dar es Salaam. Specifically, the study sought to determine the role of nursing guidelines on successful license renewal for Nurses and Midwives in Ubungo District Public Hospitals, The study was guided by the Kirkpatrick Model as the theoretical framework. The study used descriptive research design while simple random and purposive sampling techniques were used to select members of sample size who were 99 respondents. The target population of the study included all public hospitals, dispensaries and health centres located in the Ubungo district. The data was collected using documents review, in-depth interview, and structured interviews, and then analyzed using content analysis, narrative analysis, and descriptive analysis. Findings revealed that the CPD acquisition and license renewal guidelines are available at the Tanzania nursing and midwifery council(TNMC) website, however, they require registration and login to access them. The license acquisition process was through paper document submission at the TNMC office and later on changed to online in 2022. Apart from insufficient computers and limited internet access, some challenges result from nurses and midwives negative attitude towards license renewal as they tend to not renew them until there is a tactical advantage such as a promotion. Management staff at the hospitals also does not focus on license renewal as they focus more on accomplishment of daily tasks, and only care when a malpractice occurs. CPD points determine the eligibility of the license renewal applicant. The study concludes that the online availability of CPD guidelines is a good way of reaching all stakeholders. The study recommends awareness raising activities regarding access to the guidelines, raise more awareness regarding the online license renewal system, and design more effective and efficient means of stakeholder outreach.

Exploring the influence of a massive open online course (MOOC) for preparing rehabilitation professionals to meet the needs of forcibly displaced persons

BackgroundTo assist in the global training of rehabilitation professionals to address the unique needs of forcibly displaced persons, a free massive open online course (MOOC) was developed. This study aimed to explore self-perceived knowledge following completion of courses within the MOOC, ability to implement changes in practice, and participant engagement with the MOOC content.MethodsThe Kirkpatrick Model was used to assess the effectiveness of the course with a focus on reaction, learning, and behavior. Participant interaction with the course content was explored using thematic analysis of the MOOC’s discussion forum content. Participants in the MOOC were asked to complete pre and post-surveys of self-perceived knowledge regarding the rehabilitation of displaced persons. Mean within-subject pre and post-MOOC data were compared using the Mann U Whitney test. Knowledge implementation after six months was assessed with a follow-up survey.ResultsSelf-reported knowledge following completion of the MOOC improved significantly on individual survey questions (p≤.004) as well as composite score (p < .001). Six months following completion of the course, participants noted the ability to implement multiple strategies into practice. Three themes emerged from the discussion forum postings: (1) Understanding the persons lived experience to provide effective, holistic, patient-centered care, (2) Communication to develop a sense of connection and facilitate the provision of quality care, and (3) The importance of culturally responsive practice.ConclusionThe MOOC effectively delivered the fundamental knowledge to address the complex needs of displaced individuals among a diverse group of practicing rehabilitation professionals and can play a role in preparing the rehabilitation workforce for increased population displacement, alongside specialist programs in related themes.

Nurse Experiences of Caring for Medically Compromised Adolescents With Eating Disorders in General Hospital Environments: A Scoping Review.

Eating disorders encompass a spectrum of mental health conditions that are characterised by a preoccupation with eating, exercise, body weight or shape. The trajectory of eating disorders can result in hospitalisation for medical complications, such as electrolyte imbalance, extremely low weight and other medical issues that require urgent inpatient attention. Typically, care for adolescents with medically compromised eating disorders occurs in general medical settings, with most care provided by nurses who may or may not have the training and experience to provide quality care for this complex mental health condition. The aim of this scoping review is to examine literature surrounding the experience of nurses caring for adolescents admitted to general medical wards (non-mental health settings) with medically compromised eating disorders. We used Arksey and O'Malley's (2005) five-step scoping review process to conduct this review. A systematic search of the literature located 476 relevant papers, and after screening, 10 were included in the final review. Most included papers were qualitative in methodology, with one using a mixed-methods design. The papers examined in this scoping review found common themes among nurses who were providing care for adolescents with medically compromised eating disorders being cared for in medical wards (non-mental health settings): a lack of preparation to care for individuals with eating disorders, a high emotional and psychological toll on nurses providing care and a degree of stigma towards adolescents with eating disorders, including a belief that eating disorders were a 'choice.' This review indicates that to provide quality and safe care for adolescents with eating disorders admitted to general medical wards, nurses require specialised training. In addition, the care of adolescents with medically compromised eating disorders requires the support of trained mental health nurses, especially where nurses on general medical wards are novice or have limited mental health training. We recommend further research into support structures to prevent burnout and turnover that is prevalent when providing care to individuals with eating disorders.

Validating a Pneumatic Tube System for Blood Product Delivery

Abstract Introduction/Objective Timely delivery of blood products can be of utmost importance to providing quality care. We aimed to validate the use of a high-speed pneumatic tube system (PTS) that was already installed at our hospital. By reducing delivery times, patient resuscitation and survivability can be increased. Methods/Case Report We followed the Association for the Advancement of Blood &amp; Biotherapies (AABB) guidelines to validate a PTS in a large tertiary academic medical center. The requirements include: verifying product suitability, ensuring product integrity, temperature monitoring, transportation time measurements, and proper packaging and tracking of product receipt. We validated the transfer of packed red blood cells (PRBC), plasma, platelets, and cryoprecipitate from the central blood transfusion services lab (BTS) to nursing stations in a separate building up to 1500 feet (&amp;gt;1/4 mile) away using a Swisslog Translogic® PTS Inclusion with foam inside the PTS carriers helped reduce bumps during transit and insulated products from heat. Results (if a Case Study enter NA) The mean temperature of the PRBC was 6.6 degrees Celsius and none exceeded the AABB maximum of 10 degrees Celsius. The mean time for blood products transit to the nursing stations was 3 minutes (m) and 33 seconds (s). The median time was 3m 31s, and it ranged from 2m 18s to 5m 38s. The PTS reduced delivery times of blood products by up to 10-12 minutes compared to manual porters. Conclusion Transporting blood products via PTS is an efficient method that reduces the required manpower and leads to better utilization of resources. However, it is essential to validate the PTS system before implementing it operationally.

Knowledge of aging, attitudes toward older people and willingness to engage in geriatric rehabilitation among rehabilitation students in southwestern China: a cross-sectional study

BackgroundAs the global elderly population rises, providing quality care for older adults is increasingly challenging. Rehabilitation technicians are crucial in this effort. Their knowledge and attitudes significantly impact care quality and their willingness to work with the elderly. While many studies have examined healthcare professionals’ attitudes toward older adults, few focus on rehabilitation students. This study assesses Chinese rehabilitation students’ knowledge of aging, attitudes toward older individuals, willingness to care for them, and the factors influencing these aspects.MethodsA sample of 890 rehabilitation students from three colleges and universities in southwestern China was investigated with a self-administered questionnaire, which included socio-demographic information, the Palmore Facts on Aging Quiz, the Kogan’s Attitude towards Older People Scale and the Chinese Version of the Interpersonal Reactivity Index. Data analyses were conducted using SPSS version 25.0. Descriptive statistics were used to illustrate the demographic characteristics of the respondents. The frequency and percentage of responses was calculated. Means and standard deviations were computed for general knowledge of aging, attitudes toward older people, and empathy. Independent t-tests and one-way ANOVA assessed differences in FAQ, KAOP, and IRI-C scores between groups. Pearson’s correlation examined correlations among general knowledge of aging, attitudes toward older people and empathy ability. Chi-square or Fisher’s exact tests compared willingness to engage in geriatric rehabilitation across different respondent characteristics. Hierarchical multiple regression analysis explored the independent effect of different variables on attitudes toward older people.ResultsThe Chinese rehabilitation students from three colleges and universities in southwestern China displayed a relatively low level of knowledge about aging, but a generally positive attitude towards older people. Females had significantly more positive attitudes toward older people than males(p<0.01). The students who had previous experience of being cared for by (maternal) grandparents, living with the elderly, and taking care of the elderly showed significantly more positive attitudes toward older people (p = 0.001, 0.007 and 0.007, respectively) and a significantly stronger willingness to engage in geriatric rehabilitation(p = 0.013, <0.01 and <0.01, respectively) than those who had not had these experiences. Students with good relationships with older people had more positive attitudes toward the elderly (p < 0.01) and greater willingness to engage in geriatric rehabilitation (p < 0.01). Those with frequent contact with the elderly also showed more positive attitudes (p < 0.01) and a stronger willingness to engage in geriatric rehabilitation (p = 0.002) compared to those with less contact. Knowledge of aging and empathy ability were both significantly positively related to attitudes toward older people and both independent predictors of attitudes toward older people(r = 0.143, p<0.01 and r = 0.337, p<0.01).ConclusionsIt is crucial to prepare rehabilitation students with adequate knowledge and positive attitudes to ensure the quality of rehabilitation and care provided to older people. Educators should adopt effective strategies to promote rehabilitation students’ geriatric rehabilitation knowledge and increase their positive attitudes toward older people.

HoLLiECares - Development of a multi-functional robot for professional care.

Germany's healthcare sector suffers from a shortage of nursing staff, and robotic solutions are being explored as a means to provide quality care. While many robotic systems have already been established in various medical fields (e.g., surgical robots, logistics robots), there are only a few very specialized robotic applications in the care sector. In this work, a multi-functional robot is applied in a hospital, capable of performing activities in the areas of transport and logistics, interactive assistance, and documentation. The service robot platform HoLLiE was further developed, with a focus on implementing innovative solutions for handling non-rigid objects, motion planning for non-holonomic motions with a wheelchair, accompanying and providing haptic support to patients, optical recognition and control of movement exercises, and automated speech recognition. Furthermore, the potential of a robot platform in a nursing context was evaluated by field tests in two hospitals. The results show that a robot can take over or support certain tasks. However, it was noted that robotic tasks should be carefully selected, as robots are not able to provide empathy and affection that are often required in nursing. The remaining challenges still exist in the implementation and interaction of multi-functional capabilities, ensuring ease of use for a complex robotic system, grasping highly heterogeneous objects, and fulfilling formal and infrastructural requirements in healthcare (e.g., safety, security, and data protection).

Trauma-Informed Professional Development: Definitions and Exemplars.

Nurses are frequently exposed to trauma both inside and outside of the hospital setting. This trauma exposure may lead to symptoms that can be harmful to the nurse and make it more difficult for them to provide quality care to patients. Trauma-informed professional development is a strategy that can help nursing professional development practitioners create an environment where recovery after trauma is possible. This article provides definitions and exemplars for practice.

Nurses' perceptions regarding their own professionalism attributes to quality neonatal, infant and under-5 childcare.

Professional nurses are trained to provide quality care. Despite the professional nurses' acquired skill and professionalism attributes, the neonate, infant, and under-5-child mortality rates are high in sub-Saharan Africa. This health care report indicates that sub-Saharan Africa countries face a challenge in reaching the Sustainable Development Goal number 3 by the year 2030 (that is, ensuring healthy lives and reducing the mortality rates of children under 5). It has been reported that professionalism in nursing can improve the quality of care and positively change the health outcomes. This study employed a qualitative exploratory, descriptive design to explore and describe professional nurses' own professionalism attributes to provide quality care to neonates, infants, and under-5 children in the North West province in South Africa. Eight naïve sketches of an all-inclusive sample of invited professional nurses (N = 25; n = 8) were received. The naïve sketch questions were based on the Registered Nurses' Association of Ontario's professionalism attributes. Tesch's eight steps of data-analysis were used, with an independent coder's assistance. The categories included (1) knowledge, (2) spirit of inquiry, (3) accountability, (4) autonomy, (5) advocacy, (6) collegiality and collaboration, (7) ethics and values, and (8) professional reputation, and each category generated sub-themes. Professional nurses are aware of their own professionalism attributes in quality of care of neonates, infants and under-5 children; the 'innovation and visionary' attribute did not emerge, which should receive more attention to strengthen quality care. However, a new attribute, 'professional reputation', reflecting a South African culture-orientated attribute, emerged from the data collected.

Essential Competencies for Oncology in Physical Therapist Professional Education Programs: Results of a Mixed Methods Modified Delphi Study.

The objective was to establish consensus-based competencies for oncology within physical therapist professional education programs in the United States. A mixed-methods approach implementing a sequential exploratory design that included 3 phases was used to establish oncology competencies for physical therapist professional education programs. Participants in each phase were physical therapists representing diverse practice settings, experience levels, and geographical regions. Student physical therapists were included in phases 2 and 3. Three online focus groups were followed by an in-person group discussion to establish cancer-related themes, domains of practice, and competencies. Participants evaluated the competencies in a 3-round modified Delphi study for relevance and clarity. Each competency required 80% consensus using a Likert scale (1 = not at all relevant/clear, 5 = extremely relevant/clear). It was not accepted if a competency did not meet the 80% threshold by the end of round 3. Six domains of practice and 28 competencies were developed and evaluated. Within the 6 domains, 21 competencies were accepted: general cancer concepts (n = 4), musculoskeletal system (n = 3), neurologic system (n = 5), integumentary system (n = 2), cardiovascular and pulmonary system (n = 5), and involvement of multiple systems across the lifespan (n = 2). Along with the 21 competencies, participants also recommended 11 overarching oncology themes to incorporate into physical therapist professional education programs. Delivering cancer content using a body systems approach was recommended. As the number of survivors of cancer continues to grow, integration of these essential competencies within physical therapist professional education programs will improve the profession's capacity to provide quality care to meet the societal need of persons living with and beyond cancer. Academic and clinical educators should integrate these competencies to ensure that physical therapist professional education programs appropriately prepare physical therapists for providing care for persons living with and beyond cancer across the lifespan.

Assessing the frontline competency gap: Emergency care perceptions among nurses in Yemen's conflict zone.

Nursing competencies in armed conflict situations are critical for effective response and recovery. This study explores nurses' perceptions regarding their competencies in armed conflict zones to identify areas of proficiency and those requiring further emphasis in training. This cross-sectional descriptive study adhered to the STROBE reporting guidelines. It used a validated questionnaire examining 47 different competencies for nursing in armed conflict zones, which were subsequently ranked to identify those that were valued most and least. In total, 102 questionnaires were returned (85% response rate). The highest-ranked competencies focused on immediate life-saving interventions and personal safety. In contrast, competencies involving broader disaster management, such as understanding organizational disaster plans, post-death care, and risk identification, ranked lower. This observation may indicate a tendency to prioritize direct clinical care over strategic planning and long-term recovery in disaster nursing education. This study highlights the critical need to strengthen emergency care competencies among nurses working in armed conflict zones in Yemen. Its findings underscore the importance of targeted training programs, particularly in complex trauma management and psychological first aid, to address nurses' self-identified competency gaps. Policy implications include prioritizing resource allocation for emergency care infrastructure, implementing competency-based deployment strategies, and ensuring access to mental health support for nurses in working conflict zones. These actions are essential for building a resilient nursing workforce capable of providing quality care amidst the unique challenges of armed conflict.

Prevalence and management of ectopic and molar pregnancies in 17 countries in Africa and Latin America and the Caribbean: a secondary analysis of the WHO multi-country cross-sectional survey on abortion

IntroductionThere are limited global data on ectopic pregnancy (EP) and molar pregnancy (MP), making it important to understand their epidemiology and management across different regions. Our study aimed to describe...

Diabetes complications and sexual health: Addressing them without taboos

In France, 1.5 million women live with diabetes. This chronic metabolic disease disrupts every aspect of the lives of sufferers, right down to the most intimate. The impact of diabetes on women's sexuality is less well documented than for men. Yet a holistic approach to the management of the disease is essential to provide quality care.

Using continuous glucose monitoring to measure and improve quality metrics: Updates on the Healthcare Effectiveness Data and Information Set 2024 Glucose Management Indicator measure.

Value-based diabetes care is a proactive approach to providing quality care to individuals with diabetes. This approach focuses on improving clinical outcomes rather than the volume of services provided. Implementation of value-based diabetes care requires an established set of standardized quality measures against which all stakeholders can assess and benchmark their performance. The National Committee for Quality Assurance recently added the Glucose Management Indicator to its Healthcare Effectiveness Data and Information Set. The Glucose Management Indicator can be used as a measure of glucose control. This article discusses the benefits of value-based care, the importance of diabetes quality measures, and how the rapidly increasing adoption of continuous glucose monitoring is impacting these measures while improving the lives of individuals with diabetes.