Quality Patient Safety Research Articles

The Impact of Nurse Education on Patient Safety and Quality Control

In this review we explain the role of nurses in improving healthcare in hospitals and how the interest of nurse education make different in increasing patient safety especially in ICU and in cases of thrombosis, stroke and all dangerous cases need to speed and skill. The role of nurses is as important as the role of doctor as they cable of diagnoses and this role not limited to doctors. The searches have proven that the quality care and patient safety has been highly improved after the nurse education in all over the world. Nursing students need to be taught how to ensure and improve patient safety since nurses play a critical role in enhancing patient safety. Many nursing students contest their competency in patient safety issues, despite the fact that educators have long recognized that undergraduate education is crucial in providing nurses with the patient safety competencies required to practice. Among hospital workers, nurses make up the largest single component. The planning stage of the educational program is where to start when deciding which outcomes to assess. To design a worthwhile educational activity, educators need to be able to precisely pinpoint students' knowledge or skill deficiencies. The Nursing Outcomes Classification (NOC), which is "a comprehensive, standardized classification of patient outcomes developed to evaluate the effects of interventions provided by nurses and other healthcare professionals," can be consulted by nurse educators since education is built upon foundations.

NURSING STRUCTURAL EMPOWERMENT: A CONCEPT ANALYSIS

Background: The concept of empowerment originated from the social sciences in the twentieth century. The concept was adopted in nursing to increase the professional progress of nursing sciences. The concept of empowerment is used in nursing as two constructs: structural and psychological.
 Objectives: The purpose of this paper is to perform a concept analysis of structural empowerment from a nursing perspective.
 Methods: Walker and Avant’s method of concept analysis was used
 Results: Autonomy and influence are considered major attributes of the structural empowerment concept in nursing. The method used for concept analysis provided purposeful clarification of the concept and confirmed the findings of the analysis.
 Conclusion: Structural empowerment in nursing has contributed positively to nurses, patient care, and organizations. It is linked to better quality effects, patient safety, and work effectiveness. Among leadership, it is associated with enhanced role satisfaction. Both inside and outside of organizational contexts, educational programs should play a part in developing empowerment since empowered nurses are more inclined to exercise skills like decision-making, problem-solving, and caregiving. Entail instructional programs to foster critical thinking, leadership, and better comprehension of nursing.

Determination of emergency department patient utilization and staffing at the University of the Philippines-Philippine General Hospital (UP-PGH)

Objective: In developing staffing plans for emergency departments (EDs), a multifaceted approach must be considered without compromising quality of care, patient safety and personnel satisfaction. This study aims to determine the temporal trend of patient attendance and staffing in a major tertiary hospital ED to assist in establishing an optimal staffing pattern.
 Methods: A 1-year retrospective ED census review of adult patients at the University of the Philippines-Philippine General Hospital (UP-PGH) was undertaken. One-way analysis of variance (ANOVA) with post hoc Fisher-Hayter pairwise comparisons were utilized to determine if the ED consults and admissions were significantly (P<0.05) associated with the month of the year and day of the week.
 Results: A total 43,632 consults at the UP-PGH ED, averaging of 3,636 per month or 121 per day, were seen in 2019. Results indicated statistically significant differences between monthly [F (11,353) =16.45; P<0.0001] and between daily means [F (6,358) =4.19; P=0.0004]. The most number of consults occur during August, September, October and November while admissions were highest during April and October. It was busiest during Mondays and afternoon shifts (1400-2200 hours) with majority arriving as urgent in acuity. Mortality was also highest during the afternoon shifts. 
 Conclusion: The temporal variations in patient visits and acuity described in our study can be used as a template for workforce scheduling and resource allocation to meet the demands in the provision of care at the ED.

The use of electronic health records in advanced practice nursing education: a scoping review

Electronic health records are integral to the advanced practice registered nurse role, yet access and training during academic preparation are profoundly limited. Lack of exposure to electronic health records prevents students from becoming fully prepared for the responsibilities of clinical practice and potentially impacts quality of care, patient safety, and communication among patients and providers. This scoping review of 20 articles on electronic health record use in advanced practice registered nursing student education shows significant gaps in current research. Nine articles were classified as research. The remaining 11 were non-research reports of teaching innovations describing the use of simulated electronic health records in graduate nursing education or the use of an electronic health record in interprofessional education activities. Most of the limited research did not use valid and reliable instruments or robust designs, employed disparate approaches and tools to study the phenomenon, and measured low-level outcomes such as student navigation and confidence in using electronic health records. The non-research literature draws attention to the deficits in educational resources, including unaffordable electronic health records for academic use. Although rigorous evidence is lacking, a common theme throughout the reviewed literature was the benefit of simulation to develop electronic health record skills.

Effectiveness of simulation-based cesarean section education on improving non-physician clinician midwife’s competency in performing cesarean section in Ethiopia: a quasi-experimental study

BackgroundSimulation-based education enhances fundamental and clinical knowledge, procedural abilities, teamwork, and communication skills, as well as quality of care and patient safety. Due to excessive clinical loads and a lack of physicians, even classic teaching methods like bedside instruction are constrained in low-income settings. Thus, this study aimed to ascertain if simulation-based cesarean section education successfully raises non-physician clinician midwives’ competency in Ethiopia.MethodsA quasi-experimental study design triangulated with a qualitative design was implemented. Sixty Masters Clinical Midwifery students (29 intervention and 31 control) were taken in 5 universities. Three questionnaires (knowledge, confidence levels, and skills) were used. Qualitative data was also collected from 14 participants. The data were analyzed using SPSS version 25. Descriptive and inferential analyses were conducted. P < 0.05 was used for statistical significance. A difference-in-difference with a 95% confidence level was employed to control the potential confounders for knowledge and self-confidence. Multiple linear regression was fitted to identify the independent effect of simulation-based education interventions while controlling for other variables. Thematic analysis was performed using MAXQDA 2020.ResultThe age of the respondents varies from 24 to 34 years, with the control group’s mean age being 28.8 (± 2.3) years and the intervention group’s mean age being 27.2 (± 2.01) years. The intervention and control groups’ pre-intervention and post-intervention knowledge scores showed a statistically significant difference. There was a substantial increase in self-confidence mean scores in both the intervention and control groups and between the pre-intervention and post-intervention periods in both the intervention and control groups. Furthermore, there was a substantial improvement in cesarean section skills in the intervention group as compared to the control group (59.6 (3.3) vs. 51.5 (4.8). The qualitative findings supported these.ConclusionsThe study showed that simulation-based education improved students’ procedural knowledge, self-confidence, and skills. As a result, professional care teams can create simulation-based teaching packages to help students prepare for their residency.

Quality Improvement and Patient Safety Rounds—A New Paradigm in Cardiothoracic Surgery

BackgroundThe delivery of cardiothoracic health care is complex, and despite best efforts, adverse patient outcomes do occur. There is significant heterogeneity in morbidity and mortality rounds within and between institutions as well as undertones of a “blame and shame” culture prohibitive to meaningful quality assessment and improvement of patient care. The Quality Improvement and Patient Safety (QIPS) program was designed to address these issues. MethodsQIPS is built on the Donabedian model of quality and established phase-of-care adverse event analysis. It focuses on cultivating a culture of transparency. Every case review yields important demographic data, event factors, and the case inflection point, creating an institution-specific QIPS database. The QIPS format was presented by The Society of Thoracic Surgeons Workforce on Patient Safety at 2 Society of Thoracic Surgeons webinar series in December 2021 and August 2022. Descriptive data on both presentations were collected. ResultsThe December 2021 webinar had 75 unique viewers from 13 countries, and there were 343 asynchronous playbacks. The August 2022 webinar had 38 unique viewers from 9 countries and 310 asynchronous playbacks. ConclusionsThe standardized QIPS methods allow consistent recording of event factors and the inflection point, which are root causes of case morbidity or mortality. Dedication to the program will build a granular databank and identify recurring individual or system issues to launch quality improvement initiatives that address institution-specific needs. QIPS is simple, effective, and reproducible and seeks to create a culture of patient-centered quality and excellence in cardiothoracic surgery programs.

Systematic Literature Review: Penerapan Manajemen Keselamatan dan Kesehatan Kerja di Puskesmas

The research evaluates the implementation of Occupational Safety and Health (K3) in Indonesian Community Health Centers (Puskesmas), with a focus on risk management, standard preventive measures, and fatal work accidents. Despite efforts to implement an Occupational Safety and Health Management System (SMK3), research shows gaps in the understanding and awareness of Community Health Center officers regarding standard preventive measures. Fatal accidents, such as electric shocks and fires, highlight the need for holistic risk management. Recommendations include regular training, equipment maintenance, and ongoing evaluation to improve OSH practices in these health facilities. These measures support the quality of healthcare and patient safety. This research was conducted using a systematic literature review guided by the PICO Framework to formulate specific and focused research questions. This research shows that careful planning has a key role in the successful implementation of Occupational Safety and Health (K3) in Community Health Centers, with the use of technology such as web-based reporting systems to increase efficiency. Continuous evaluation is an important instrument for identifying successes and challenges in K3 implementation, while external involvement and support is needed to overcome internal and external obstacles. Constraints such as lack of resources are the main focus, but evaluation also opens up opportunities for improvement, especially in the implementation of K3 policies and procedures. Optimizing K3 planning strategies is the key to increasing compliance and effectiveness of K3 management at the Community Health Center level, with an expanded focus on continuous supervision and monitoring.

Evaluating the Effectiveness of Isolation Precautions in Controlling the Spread of Multidrug-Resistant Organisms in Hospitals: A meta-analysis

In this meta-analysis, we evaluated the effectiveness of isolation precautions in preventing the spread of Multidrug-Resistant Organisms (MDROs) in hospital settings, focusing on contact precautions, use of Personal Protective Equipment (PPE), and cohorting of patients. Through a comprehensive literature search, 48 studies were included, highlighting the significant role these measures play in mitigating MDRO transmission. Findings demonstrate that isolation precautions, particularly contact precautions and PPE usage, significantly reduce MRSA and VRE transmission rates. Cohorting patients also proves effective, especially during outbreaks. This study underscores the importance of implementing stringent, evidence-based isolation precautions across healthcare settings to enhance patient safety and healthcare quality. The results advocate for continuous education, adherence monitoring, and tailored infection control strategies to address the dynamic challenges of MDROs in healthcare environments.

A PLS-SEM Analysis of Factors Determining Medical Personnel Performance in a Tertiary Referral Hospital

Background: Health workers’ performance is essential to the effective delivery of hospital healthcare services, which can determine the quality of care and patient safety. Employees’ job performance becomes more crucial for tertiary hospitals where advanced and subspecialty care is provided to treat high-risk and critical emergency patients. Objectives: This study was conducted to develop a conceptual framework for understanding the factors that affect medical personnel's performance at the hospital, with perception as the intervening variable. Methods: This cross-sectional study used an online self-administered survey tool, in which 119 responses were collected from health workers who provide Comprehensive Emergency Obstetric and Newborn Care (CEmONC) in a tertiary hospital in Padang, Indonesia. A partial least squares structural equation model (PLS-SEM) was constructed to analyze the factors determining medical personnel performance. Results: The study showed that personal perceptions significantly correlate with health workers’ job performance, with attitudes and motivations found to have a powerful effect on the forming of perceptions. In addition, their performance is also significantly influenced by the aspects of quality, quantity, timeliness, effectiveness, teamwork, and commitment. However, the study does not support the relationship between knowledge, expectations, or actual performance with the medical employee’s job performance. Conclusion: This result suggests the hospital management team in the tertiary hospital considers these factors to improve healthcare services quality and promote a supportive work environment to improve the medical personnel’s performance.

Assessment of clinical miscoding errors and potential financial their implications on healthcare management – A case of local hospital in Najran, Saudi Arabia

BackgroundHealthcare systems can potentially improve their safety, quality of service, and performance efficiency with a cost reduction, through the introduction and implementation of healthcare information management systems. This study aims to examine the frequency of miscoding errors in principal and secondary diagnoses, exploring demographic and coder-related factors contributing to these errors through the use of the QuadraMed system. The study also investigates the association of coding errors with patient safety and service quality to estimate the potential financial implications resulting from these inaccuracies in the healthcare system. MethodsThis analytical cross-sectional retrospective study was conducted at a local hospital in Najran, Saudi Arabia, from July 2021 to February 2022 using the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) coding system. The costing and financial data were collected from the reimbursement department for eligible 750 patient cases in terms of payment mode, services availed, and length of stay. The financial claims were evaluated to estimate the impact on the quality of service and patient safety. The reimbursement amount was calculated based on codes. The data were analyzed using SPSS and the odds ratio was calculated to estimate the risk of major coding errors in different departments. ResultsPrimary codes 240 (32%) and 40 (5.3) secondary codes were reviewed and percentages and inaccuracies were calculated after recording. The percentage of inaccurate medical codes in principal diagnosis was 57(26.8%) and the percentage of inaccurate medical codes in secondary diagnosis was 21 (9.9%). The primary diagnostic codes have more coding errors with a total number of 240 (32%) coding errors with a moderate level of agreement between the original coder and independent coder with a kappa value of 0.462. The identified recording was done by the independent coder, and the secondary diagnostic code showed 40 (5.3%) cases, with a poor kappa value of 0.128. The results showed the highest number of primary diagnostic codes was among surgery clinics 79 (63.2%). The highest number of secondary diagnostic codes were reported among consultant clinics 12 (9.6%) ConclusionsThe study concludes that the identification of miscoding in the healthy population has a financial impact on the healthcare organization's infrastructure.

Burnout and patient safety culture assessment in a secondary care hospital.

To identify employee burn-out and assess its impact on patient safety culture. This cross-sectional study was carried out amongst healthcare providers (HCP) of Tehsil Head Quarter Manawan Hospital, Lahore from April 1st till 30th, 2023, who had been working for at least one year and directly involved in patient care. Two questionnaires were used; the Maslach Burnout Inventory (MBI) to assess level of burnout, and Agency for Healthcare Research and Quality (AHRQ) patient safety culture survey. After obtaining informed consent, 59 participants were enrolled in this study. High degree of occupational exhaustion (OE) 42.9% was seen amongst doctors and 57.1% had low degree of personal accomplishment (PA) compared to all other health care providers. Significant association was observed between two sub-scales of MBI (p<0.05). No significant association was observed in working hours, designated positions and burnout (p>0.05). Statistically weak correlation existed between burnout and patient safety culture (r=0.075, p=0.580). Awareness on incident reporting was in 43.3% of participants; of which 31% had reported at least one event in last 12 months. Overall, 76% employees consider their work unit reliable for providing safe patient care. Burnout was observed in employees, particularly high degree in attending physicians. However, team work, high level of personal accomplishment and incident reporting culture, served as protective factors for patient safety and safe working environment and culture.

The Impact of Health Informatics on Radiologist, Laboratory Technician, Pharmacist-Physician Collaboration, and Patient Outcomes

Health informatics has revolutionized the way healthcare professionals collaborate and deliver care, with significant implications for patient outcomes. This abstract explores the impact of health informatics on the collaboration between radiologists, laboratory technicians, pharmacists, and physicians, and its influence on patient outcomes. The abstract provides an overview of the role of health informatics in facilitating communication, information sharing, and decision-making among these healthcare professionals. It also discusses the potential benefits and challenges associated with integration of health informatics in collaborative care, and highlight the importance of leveraging technology to improve patient safety, treatment efficacy, and overall healthcare quality. The review concludes that, the professions of radiologists, laboratory technicians, chemists, doctors, and patient outcomes have all been significantly impacted by health informatics. Healthcare practitioners are now able to make better decisions thanks to the increased efficiency and accuracy of diagnostic imaging and laboratory tests brought about by the integration of technology and data management systems. Electronic prescribing and medication management systems have improved collaboration between chemists and doctors, guaranteeing safe and efficient pharmaceutical use. The application of health informatics has also helped patients receive more individualized care, better communication, and access to health information. All things considered, the use of health informatics has changed the way that healthcare is delivered and may continue to enhance patient outcomes in the future.

The mediating and moderating role of recovery experience between occupational stress and turnover intention in nurses caring for patients with COVID-19.

This study aimed to investigate the relationships among occupational stress, recovery experience and turnover intention among nurses caring for patients with coronavirus disease 2019 (COVID-19). The high turnover intention among nurses affect patient safety quality of patient care. The cross-sectional study design was used. This study was guided by STROBE. Convenience sampling identified 202 registered nurses working in the COVID-19 wards of three tertiary general hospitals in two cities in South Korea. The collected data were analysed using SPSS version 26.0, and the PROCESS macro in SPSS was employed to estimate path coefficients and assess the adequacy of the model. The moderating effects of recovery experience on the pathway in which occupational stress of the participants affects turnover intention were verified using model 1 of the SPSS PROCESS macro proposed by Hayes. The recovery experience did not significantly mediate the relationship between occupational stress and turnover intention. However, it had significant moderating effect on the relationship between occupational stress and turnover intention (β = .005, 95% CI [.001, .010]). The effect of occupational stress on turnover intention was dependent on recovery experience. The results revealed that occupational stress among nurses caring for patients with COVID-19 affect the turnover intention and the level of recovery experience moderates this relationship. Thus, not only during the COVID-19 pandemic but also during challenging times of various infectious disease outbreaks, hospitals can enhance the health and well-being of nurses and promote the retention of nursing staff. During the COVID-19 pandemic, nurses have been exposed to understaffing and overwhelming workloads. However, policies for nurses' welfare and benefits are still insufficient, even as the pandemic comes to an end. The results of this study indicate that sufficient rest and appropriate nursing personnel are of utmost importance to nurses. No patient or public contribution.

Facilitating and Inhibiting Factors of Clinical Knowledge Sharing among Medical Specialists in University Hospitals.

Clinical knowledge sharing (CKS) is one of the key points of knowledge management in the field of health and significantly increases the quality of care and patient safety. It also provides the achievement of an efficient system in hospitals and educational and treatment centers involved in clinical processes in order to make the best clinical decisions. The purpose of this research is to identify the factors that facilitate and inhibit CKS among medical specialists in the educational-treatment hospitals in Iran. This was an applied qualitative study with the conventional content analysis method conducted in 2022. The data collection tool was a semi-structured interview. The participants were 13 medical specialists and sub-specialists working in educational-treatment hospitals of the country, who were selected by purposeful and snowball sampling. The method of data analysis was based on Graneheim and Lundman's five-step method, which was followed by codes, sub-categories, main categories, and classifications. After conducting the interviews and assessing their content, finally, 193 codes were extracted, which were identified in two general classification of facilitating and inhibiting factors with 92 and 101 concepts, respectively. Facilitating factors in the three main categories of "education in the context of culture, society and university", "planning and implementation management", and "behavioral-motivational factors" and inhibiting factors in the four main categories of "infrastructural, policy-making and cultural challenges", "technological and scientific infrastructural challenges", "personality-behavioral challenges", and "financial and non-financial motivations" were classified. The participants of the research pointed out the effective role of CKS in keeping them up-to-date in the use of diagnostic, therapeutic, and even drug prescribing methods. According to their belief, knowledge sharing (KS) in the clinical setting will reduce diagnostic errors and cause the primordial prevention of diseases as well as increase the knowledge and awareness of the society members.

Поддержка МИС IPSG.2. Повышение эффективности коммуникаций.

Ensuring high quality of medical care and patient safety is one of the most important tasks of modern medicine. Medical information systems (MIS) can make a significant contribution to achieving this result. MIS are important for the creation of clinical safety system due to their capabilities of access to information, unification of medical technological processes, organization of communication between participants of the therapeutic and diagnostic process, including the transmission of signals and warnings about the occurrence of critical events. When critical events are detected, MIS with different degree of automation is able to send a notification about them to the addressee – the attending physician or other responsible person, which allows to quickly take measures and prevent possible complications, contributing to improving the level of clinical safety and improving the quality of medical care. The article discusses the implementation of one of the ways to improve the efficiency of communications, namely, the transmission of messages when critical results of tests or other critical conditions of the patient are detected using the tools included in the MIS.

Advancing Patient Safety: Effective Strategies for Reducing Pulmonary Embolism and Deep Venous Thrombosis in Fracture Patients During the Perioperative Period

Postoperative pulmonary emboli and deep venous thrombosis are significant causes of morbidity and mortality and the focus of the Agency for Healthcare Research and Quality Patient Safety Indicator 12 (PSI-12). Early identification of patients at moderate to high risk is critical for implementation of effective prophylaxis strategies. Patients at the highest risk are those who are injured or immobilized and require surgical procedures. Early intervention strategies such as mechanical prophylaxis, pharmacologic prophylaxis, ambulation, and early surgical intervention can reduce patient harm. Using retrospective case review, most postoperative PSI-12 cases at the study site were identified as fracture patients. A multidisciplinary team developed a robust approach for early identification of patients with orthopedic fractures who were at high risk for postoperative events. Interventions included a fracture alert system to identify and prioritize patients who might require early surgical intervention. Focus was placed on pharmacological prophylaxis prior to surgical intervention, and early ambulation after surgery. As a result, PSI-12 events were reduced from eight in the pre-implementation period to none following implementation. A fracture alert system and early surgical intervention with initiation of prophylaxis strategies and postoperative early ambulation can substantially reduce the rate of PSI-12 cases in patients with fractures.

Burnout level in Pakistani dentists during COVID-19 pandemic: Cross-sectional national study

ObjectiveThis study aims to determine the prevalence and degree of Burnout during the COVID 19 pandemic in practicing Pakistani dentists. IntroductionThe COVID-19 pandemic has significantly impacted dental practices worldwide, leading to increased stress and burnout among dental practitioners. Burnout, characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment, can have detrimental effects on the quality of care and patient safety. Previous studies have shown high rates of burnout among healthcare workers, including dentists. The pandemic has added new challenges, such as financial losses and increased costs due to safety protocols. Recognizing and managing burnout is crucial to mitigate its severe consequences. By understanding the prevalence of burnout in this unique context, strategies can be developed to support dental practitioners and improve their well-being. MethodsA cross-sectional study was conducted using a 22-items based validated Maslach Burnout Inventory. The study was conducted between July and September 2021. Practicing dentists across Pakistan were approached via social media platforms. The questions were answered on a 7-point Likert scale. The sums of the scores were used as the evaluation criteria. Data analysis was done using SPSS version 24. Shapiro Wilk test was used to check normality of data. Mann Whitney U and Kruskal Wallis tests were utilized to analyze the differences in the prevalence of burnout amongst the different demographic groups. A P-value of <0.05 was considered as statistically significant. ResultsTotal of 282 dentists responded with 116 (41.1 %) male and 166 (58.9 %) female. Majority of the respondents were postgraduate residents (24.8 %), 47.9 % of the practitioners had 0–3 years of work experience, 48.6 % of the respondents were practicing in the Federal region, and 62.8 % of the subjects were between the age of 25–34. Emotional exhaustion was the major dimension of burnout identified in our study with 47.5 % of the population reporting high levels, while only 23 % of the population showed high levels of depersonalization and 29.4 % showed low sense of personal accomplishment. ConclusionThis study indicates a considerable percentage of burnout in the chosen sample. The mean scores of Emotional Exhaustion, Depersonalization and Diminished sense of personal accomplishment were all found to be in the moderate range, and that appropriate measures should be taken to manage it.

Drivers of unprofessional behaviour between staff in acute care hospitals: a realist review

BackgroundUnprofessional behaviours (UB) between healthcare staff are rife in global healthcare systems, negatively impacting staff wellbeing, patient safety and care quality. Drivers of UBs include organisational, situational, team, and leadership issues which interact in complex ways. An improved understanding of these factors and their interactions would enable future interventions to better target these drivers of UB.MethodsA realist review following RAMESES guidelines was undertaken with stakeholder input. Initial theories were formulated drawing on reports known to the study team and scoping searches. A systematic search of databases including Embase, CINAHL, MEDLINE and HMIC was performed to identify literature for theory refinement. Data were extracted from these reports, synthesised, and initial theories tested, to produce refined programme theories.ResultsWe included 81 reports (papers) from 2,977 deduplicated records of grey and academic reports, and 28 via Google, stakeholders, and team members, yielding a total of 109 reports. Five categories of contributor were formulated: (1) workplace disempowerment; (2) harmful workplace processes and cultures; (3) inhibited social cohesion; (4) reduced ability to speak up; and (5) lack of manager awareness and urgency. These resulted in direct increases to UB, reduced ability of staff to cope, and reduced ability to report, challenge or address UB. Twenty-three theories were developed to explain how these contributors work and interact, and how their outcomes differ across diverse staff groups. Staff most at risk of UB include women, new staff, staff with disabilities, and staff from minoritised groups. UB negatively impacted patient safety by impairing concentration, communication, ability to learn, confidence, and interpersonal trust.ConclusionExisting research has focused primarily on individual characteristics, but these are inconsistent, difficult to address, and can be used to deflect organisational responsibility. We present a comprehensive programme theory furthering understanding of contributors to UB, how they work and why, how they interact, whom they affect, and how patient safety is impacted. More research is needed to understand how and why minoritised staff are disproportionately affected by UB.Study registrationThis study was registered on the international database of prospectively registered systematic reviews in health and social care (PROSPERO): https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021255490.

Employees Job Anxiety - Challenges and Strategies to Deal at a Private Hospital in Kolar - A Case Study

Purpose: Job Anxiety among employees in a private hospital setting can have a number of negative effects on both individuals and the organization as a whole. It can lead to decreased Job satisfaction, increased burnout, decreased productivity, and reduced patient safety and treatment quality. Furthermore, untreated anxiety can lead to absenteeism, high employee turnover, and higher healthcare expenditures for the firm. The goal of this analysis is to explore employee Job Anxiety in the context of a private hospital and propose appropriate techniques. Design/Methodology/Approach: Descriptive statistics and stratified random sampling were employed. The methodology includes the study Plan, study setting up, sources of data, participants, gathering data process, size of the sample, sample plan of action, questionnaire framework, and data analysis. Finding/Result: As a result, there is an important desire to investigate and propose targeted techniques aimed specifically at addressing and mitigating staff Job Anxiety in private hospitals. Such initiatives should take into account the unique features of the private hospital setting, including healthcare personnel's different roles and responsibilities, organizational culture, and available resources. By filling this knowledge gap, private hospitals can help their staff's mental health, increase Job satisfaction, and improve patient care outcomes. The data analysis of this study verified that there is no significant difference in Job Anxiety levels among Male and Female employees at a private Hospital. Originality/Value: The worth of staff Job Anxiety and methods for dealing with it in a private hospital are important because of their contribution to knowledge and potential consequences for improving the general wellness of healthcare personnel and the facility itself. Paper Type: Case study-original research findings

Nurses' perceptions to alleviate dyspnoea in inpatients with advanced cancer while receiving palliative care.

To explore nurses' perceptions to alleviate dyspnoea in inpatients with advanced cancer while receiving palliative care. A descriptive qualitative design. Seven focus groups were conducted with nurses (n = 27) from five specialized palliative care wards in four hospitals in south and southwest Finland. The focus groups were conducted between June and November 2019, and the transcripts were analysed using inductive analysis. The findings revealed three categories: recognizing dyspnoea is a multi-faceted problem, dealing with the complexity of assessment of dyspnoea and strategies for relieving dyspnoea. Nurses perceived the complexity of dyspnoea as a symptom and emphasized the importance of utilizing patients' subjective experiences and consistent assessment scales to determine its severity. Furthermore, nonpharmacological interventions are as pertinent as pharmacological and medical interventions. The findings can assist nurses in selecting appropriate interventions for dyspnoea care, ultimately enhancing the quality of patient care and patient safety.