Responsibility Of Doctors Research Articles

National and international tendencies in the formation of talkative abilities for the Promotion of Health

Introduction: the development of the process of formation of talkative abilities for the promotion of health constitutes a necessity to complete the integral general doctor's social responsibility Objective: to determine the international and national tendencies in connection with the formation of talkative abilities for the promotion of health Methods: it was used as method rector the dialectical one. Of the theoretical level: the historical-logical, analytic-synthetic and the inductive-deductive one. As empiric method the documental revision. Results: as international tendencies they were in this investigation: scarce published works, little emphasis in talkative abilities, formal incorporation of the formation of talkative abilities in the curricula of the medicine schools, boarding of the talkative abilities with more emphasis in the communication in the doctor-patient relationship and not in the activities of promotion of health in the APS, reorientation of the formation of talkative abilities with focus of primary attention of health.. In Cuba, they were: limitations of the systematic and integral boarding of the formation of talkative abilities for the promotion of health, isolated treatment of the value of the talkative abilities for the promotion of health in the solution of problems in the primary attention of health, recognition of the value of the talkative abilities for the promotion of health in the solution of problems in the primary attention of health, inclusion of curricular strategies in study plans guided to the formation of necessary talkative abilities for the promotion of health in the APS ,necesidad of improvement of the didactic boarding of the talkative abilities in the educational strategies for years and subjects in the study plans

ENHANCING THE QUALITY OF EMERGENCY ADMISSION CLERKING IN NEUROSURGERY: A COMPARATIVE STUDY OF TRADITIONAL METHODS VERSUS A SURGICAL CLERKING PROFORMA

Background: Accurate and comprehensive documentation during emergency admissions is crucial for ensuring patient safety. This is especially important in high-risk environments such as neurosurgery. Traditional freehand clerking methods often result in incomplete or inconsistent records, potentially compromising patient care. This study aimed to evaluate the impact of introducing a structured surgical clerking proforma on the quality of emergency admission clerking in a tertiary care neurosurgery unit. Methods: A three-phase comparative audit was conducted, comprising an initial audit of traditional clerking methods (Cycle 1), the implementation of a surgical clerking proforma, and a subsequent re-audit using the proforma (Cycle 2). Data were collected retrospectively from 40 patient records in Cycle 1 and prospectively from 30 patient records in Cycle 2. The completeness of documentation was assessed across 31 key parameters, and statistical significance was determined using paired t-tests on simulated data. Results: The introduction of the surgical clerking proforma resulted in significant improvements in documentation completeness, particularly for parameters such as the Consultant Responsible and Reviewing Doctor, which saw increases of 30% and 32.5%, respectively (p<0.05). These improvements underscore the effectiveness of the proforma in standardizing and enhancing the reliability of clinical documentation. Conclusion: The structured surgical clerking proforma significantly improved the quality of emergency admission documentation in the neurosurgery unit. The findings support the broader adoption of such proformas across various medical specialties to enhance the accuracy, consistency, and reliability of clinical records, ultimately contributing to improved patient care and safety.

SIMULATION TRAINING: INTERNATIONAL EXPERIENCE AND DEVELOPMENT STRATEGY IN UKRAINE

The article presents information on the relevance of simulation training in modern medical education. Leading specialists emphasize the need to learn practical and communication skills, be able to work more intensively in a team; they also note that simulation training can significantly contribute to the achievement of these educational goals under present-day conditions. Simulation training, beginning at the undergraduate or graduate level, can help overcome a number of challenges, such as patient safety issues, ethical issues related to the acquisition and development of skills in interacting with real patients, the need to standardize learning experiences, competency assessments, and medical certification, the need for rapid staff adaptation (staff turnover), promotion of high standards of medical care, increasing the scope of the doctor's responsibility. In addition, simulation training makes it possible to practice more or less typical clinical situations with severe consequences, to promote the acquisition of relevant knowledge and skills, to improve technical skills, to practice the provision of medical care by an interdisciplinary team and individually. The experience of the simulation training development in some countries and a brief history of the foundation of the first simulation training centers in Ukraine are presented. The advantages of simulation training, which allow them to be widely used in educational activities are emphasized. The development of a training program is important in the work of the simulation center and is based on the capacity of simulation training and involves practicing technical and non-technical skills in managing certain situations in accordance with the guidelines. Debriefing (discussion) is necessary so that participants can evaluate their actions during training. Thus, simulation training is an effective method for practicing relevant skills and team interaction in doctor training. Team building experiences are offered using the simulation training, the individual characteristics of students that did not appear in traditional classes are revealed, the ability to conduct a discussion, dialogue and draw conclusions is acquired. A compulsory stage in stimulation training should be the assessment process, therefore it is necessary to notice the reaction of the participants, their satisfaction with the process, and the evaluation of the achievement of the tasks set. This will allow to improve the quality of the learning process and learning materials, to make changes in the training program. A questionnaire can be used for this purpose. The participants assess the relevance of the topic, individual levels of the simulation training and offer possible topics to advance the training program, express their wishes regarding the feasibility, frequency and points of further simulation training and the development of new frameworks. Communication skills are particularly important for doctors and can be actively developed in working conditions of our stimulation center. To conduct doctor training, it is optimal to establish simulation centers with experienced staff and a program developed to meet the needs of the rapidly changing medical landscape.

KNOWLEDGE, ATTITUDE, AND PRACTICES ON BIOMEDICAL WASTE MANAGEMENT AMONG MEDICAL INTERNS OF A TERTIARY CARE HOSPITAL IN NORTH KARNATAKA

Objective: Every health-care personnel is expected to have adequate knowledge, good attitude, safe practice, and capacity to guide others for appropriate biomedical waste (BMW) collection and management. The study aims to assess the knowledge, attitude and practices regarding BMW management among the budding yet responsible doctors- the medical interns in ESIC Medical College and Hospital, Gulbarga. Methods: A cross-sectional study was conducted among all the 81 interns currently posted in ESIC Medical College and Hospital, Gulbarga. Data were collected using pre-designed and semi-structured questionnaire to assess the knowledge, attitude, and practices on BMW management. Results: The study found that a majority (69.1%) of interns demonstrated fair knowledge regarding BMW management. Majority (93.8–98.8%) of the interns showed a positive attitude towards BMW segregation, self-responsibility, observation of charts at workplace, and training on BMW management. Furthermore, only 12.3% interns viewed BMW management as an extra burden on work. However, only 44.4% of interns were pre-treating liquid waste, and 50.6% were using a needle hub cutter. Alarmingly, 23.3% indicated that they would not report injuries. Conclusion: BMW management practices can be further improved with strict supervision and incorporation of BMW management in the assessment of internship completion in addition to periodic training

Responsibility Of Doctors In Medical Services To Patients According To Laws And Regulations

A doctor's legal responsibility is a doctor's "relationship" to legal provisions in carrying out his profession. The responsibility of a doctor in the field of law is divided into three parts, namely the responsibility of a doctor in the field of civil law (Articles 1365, 1366, 1426) criminal, (Article 322, Article 351, Article 356 of the Criminal Code regarding abuse, Article 359, Article 360, and Article 378 of the Criminal Code regarding acts of fraud and ethical responsibility. Legal protection for patients in health services claiming their rights as regulated in Article 276 of the Health Law, can claim compensation for health workers and/or health providers who cause losses due to errors or negligence of doctors.

Pertanggungjawaban Hukum Dokter terhadap Pasien di Instalasi Kamar Bedah

With the increasing need for medical services and developments in technology, doctors and patients are often faced with various legal issues related to health care. The role of doctors in society is crucial because of the knowledge and skills needed to diagnose and treat disease, as well as maintain patient health. A surgeon is a specialist doctor who treats diseases, injuries or emergency conditions in the body through surgical methods (operatives) carried out in the operating room installation. The doctor's legal responsibility towards patients in the operating room installation is based on several relevant legal principles, the principle of informed consent or consent in treatment is an important factor in determining whether the doctor is responsible or not. Patients must be given adequate information about the diagnosis, procedures, risks, and treatment alternatives before giving consent for medical treatment. What are the rights and obligations between the doctor and patient in the agreement before surgery, as well as the agreement between the doctor and patient after the patient has received this information. Research methods using normative law are methods used to study legal rules as a system that can be linked to certain legal events. Secondary data uses tertiary legal data, secondary legal data and tertiary legal data from books, literature, publications and statutory sources related to all discussions. From this research it was found that every human being has the human right to live a healthy life and a doctor has ethical and professional responsibilities in carrying out his duties. The relationship between doctors and patients is regulated by applicable laws and regulations. It can be concluded that the legal responsibility of doctors towards patients in operating rooms is very important in medical practice. As health professionals, physicians have an ethical and legal obligation to provide safe, competent, and responsible care to their patients. If a doctor fails to meet expected standards of care or commits negligence that results in injury or harm to a patient, they may be legally liable.

Concordancia de los registros de prescripción de medicamentos en el paciente quirúrgico hospitalizado

IntroductionElectronic prescription is the prescription system that allows healthcare professionals to send medication prescriptions directly to community pharmacies and the outpatient unit of Hospital Pharmacy Services for dispensing. However, there is difficulty in obtaining a reliable pharmacotherapeutic history in chronic patients through electronic prescription upon hospital admission as a critical point for adequate treatment adaptation. Therefore, the pharmacist as a member of the multidisciplinary team must ensure, through medication conciliation, an adequate transition of care through the correct management of the treatment that the chronic patient requires during their hospitalization. ObjectivesTo evaluate the quality of electronic prescription records for routine chronic treatment by analyzing the concordance of the electronic prescription. Material and methodsObservational, cross-sectional and retrospective study at the General University Hospital of Elche. Hospitalized patients in charge of the Orthopedic Surgery and Traumatology, Urology and Neurosurgery Services in which the responsible doctor requested medication reconciliation by the Pharmacy Service between January 2022 - December 2022 were included. Results378 patients, 209 (55.3%) women and 169 (44.7%) men, with a mean age±standard deviation of 71.0±11.6 years and 69.0±11.8 years, respectively. The total percentage of patients with discrepancies in the electronic prescription with respect to the usual chronic treatment was 60.6%, reflecting that only 39.4% of the patients had non-discordant electronic prescriptions. ConclusionsMore than half of hospitalized surgical patients present discrepancies in the medications prescribed in the home electronic prescription, which justifies the importance of treatment reconciliation upon admission carried out by hospital pharmacists.

Doctor's Responsibility for Delegation of Authority to Nurses that Cause Unexpected Events

Health, recognized as an essential entitlement for every individual according to the 1945 Constitution of the Republic of Indonesia, holds substantial implications for community well-being. Article 28 H paragraph (1) upholds the entitlement of all individuals to health services, with the state being accountable for ensuring the availability of sufficient public service facilities. Nevertheless, the scarcity of physicians and healthcare professionals in Indonesia poses challenges to health services, particularly evident in the low ratio of doctors per 1000 population. Collaboration between doctors and nurses is imperative, with the delegation of authority serving as a form of joint action. However, understanding the legal aspects of authority delegation often proves to be an intricate matter in this professional relationship. This study aims to explore the practice of handing over physicians to nurses at Rajagaluh Health Center and the factors that influence its implementation. With a legal approach and positivism paradigm, this study uses qualitative descriptive methods with primary data from the Rajagaluh Health Center and secondary sources from books, journals, websites, and related research. The research instrument focused on medical record analysis to collect data related to the practice of delegation of authority, influence factors, and responsibilities of doctors for unexpected events. The study aims to contribute theoretically to the advancement of science, particularly in the realm of health law. Simultaneously, it endeavors to enhance practical comprehension regarding the delegation of authority between doctors and nurses, along with offering a comprehensive perspective on patient safety within

Gender and Class-wise Comparison of Stressors and Perceived Levels of Depression, Anxiety and Stress among the 2nd Versus 5th Year Medical Students

Background: Medical profession is being dominated by female students, but little attention is being paid on making them emotionally and physically competent to match their corresponding gender with whom they have to work in parallel in the near future. Research is crucial in this area to identify their needs and provide solutions.
 Objectives: To identify female and male gender-related depression, anxiety and stress (DAS) among the undergraduate medical students enrolled in the second versus final year of University College of Medicine and Dentistry (UCMD), The University of Lahore (UOL) and highlight the intricate web of stressors that these medical students encounter.
 Method: A concurrent mixed method study was conducted on a random sample of 200 medical students of 2nd and 5th year with equal gender distribution. DASS21 scale was used to assess Depression, Anxiety and Stress. Qualitative and quantitative data were collected on Google forms. Quantitative data were analyzed descriptively and the qualitative data by manual thematic analysis
 Results: The 2nd year female students had significantly higher stress than their male counterparts. No statistically significant difference was appreciated within the 5th year gender wise though the females had relatively higher DASS levels. No significant difference on DASS21 was observed within the same gender between the two academic years. The female and male students reported fear of failure and less preparation time versus syllabus load as their major stressors respectively. 
 Conclusion: The study has identified the stressors that influence the wellbeing of medical students and presented their depression, anxiety and stress comparison with respect to their gender and seniority. It has indicated the need to empower females emotionally at the level of their upbringing to formative medical years. Furthermore, male students must learn to manage time and be responsible doctors.

Legal Analysis of the Doctor's Responsibility Towards the Completeness of Patient Medical Records in the Framework of Fulfilling Patient Rights in the Hospital

Doctors have a legal responsibility to ensure that patient medical records are complete and accurate. A legal analysis of the doctor's responsibility for the completeness of patient medical records in order to fulfill patient rights in hospitals is an important study to ensure that patient rights are fulfilled in accordance with the standards set by applicable laws and regulations. A comprehensive analysis of the doctor's responsibility and the importance of complete medical records is expected to create a better health care system that respects and fulfills patient rights optimally. This study uses a normative legal method. The conclusions of this study are: 1) The doctor's legal responsibility for fulfilling the patient's right to obtain complete Medical Records as a form of the patient's right to information in health services. This right is protected and regulated in a number of legal regulations. Fulfillment of the method of obtaining the contents of Medical Records to patients must also pay attention to and follow the procedures as stipulated in the laws and regulations. 2) The legal consequences of the doctor's legal responsibility if they violate the fulfillment of the patient's right to complete Medical Records, including: 1) criminal sanctions, namely imprisonment for a maximum of 1 (one) year and a maximum fine of Rp. 50,000,000.00 (fifty million rupiah) (Article 79 point b of the Medical Practice Law Law No. 29 of 2004), 2) civil sanctions in the form of compensation by the Hospital or the doctor to the patient (Article 1365 of the Civil Code) and 3) administrative sanctions in the form of written warnings and/or recommendations for revocation or revocation of accreditation status. (Minister of Health Regulation 24 of 2022 concerning Medical Records).

Balancing care and responsibility: The role of the general practitioner in specialist referrals.

Referrals are a critical component of the Australian healthcare system, with referrals from general practitioners (GPs) to non-GP specialists making up the majority of medical referrals. Given the key role referrals have in primary healthcare, it is important that GPs understand their legal and professional responsibilities when providing a referral and ensure they refer appropriately and effectively to provide the best healthoutcomes for patients. This article explores GP referrals to other health professionals and aims to describe a doctor's medicolegal obligations and responsibilities when making a referral. The responsibility of GPs in the referral process reflects their central coordinating role as providers of primary care, and the reliance patients place upon them to adviseand recommend treatment and investigations. Understanding the medicolegal obligations and responsibilities when writing a referral can help GPs find the right balance between respecting patient autonomy and the professional obligation to take reasonable steps to ensure referrals and investigations are acted upon appropriately. The key to an effective referral process is clear communication between practitioners and patients, to help align the expectations of all involved so they can agree and implement a shared treatment plan in the interests of the patient.

Prevalence of medication-related problems in complex chronic patients and opportunities for improvement

ObjectiveTo estimate the prevalence of medication-related problems in patients treated in continuous care units and to identify the therapeutic areas in which these problems were more concentrated. MethodObservational descriptive prospective study. Review of clinical histories and outpatient treatment by a hospital pharmacist. Communicating medication-related problems detected to the responsible doctor. Analysis of the therapeutic areas in which the problems were most concentrated. Results85 patients were reviewed, and 368 potential medication-related problems were identified. The areas with the most prevalent medication-related problems were the long-term use of hypnotics, sub-optimal analgesia, optimizable antidepressant treatment, statins in patients older than 75 years in primary prevention and in those with high-intensity doses in secondary prevention, patients with heart failure without angiotensin-converting enzyme inhibitors, and proton-pump inhibitors without indication. ConclusionsTraining interventions should be implemented and computer assistance should be developed to help avoid the most prevalent medication-related problems.

Analysis the Completeness of Integrated Patient Development Records in Diabetes Mellitus Patients

The Integrated Patient Development Record documents interprofessional collaboration in patient care for health services, especially for patients with chronic problems, including diabetes mellitus. This study aims to determine the completeness of integrated patient progress records in diabetes mellitus patients. This type of research uses a qualitative descriptive method with a sample of 45 people and interviews with five respondents. Based on the research results, 11 forms (24.5%) had data filled in, and 34 forms (75.5%) had incomplete data. The problem factor in filling out integrated patient progress notes lies in verifying the responsible doctor and the results of the service provider's professional instructions. This is due to the large number of patients and limited time. The author provides suggestions for filling out integrated patient progress notes to support accreditation document service standards: a) increase the professional accuracy of service providers in filling out incomplete integrated patient progress notes. b) there needs to be socialization regarding standard operational procedures for integrated patient recording to minimize incomplete forms.

Implementation of REST API in Web Service System for Medical Resume Provision

This research seeks to develop a web service system that functions as a medical resume provision via RESTful API. Accurate and comprehensive medical records are critical in the identification and diagnosis of patients. Medical resumes, which summarize a patient's healthcare services and are completed by the responsible doctor, are an essential component of medical records. Electronic medical record systems can aid in patient care, and a patient's prior health history is crucial in developing a holistic and continuous treatment plan. Unfortunately, patients often require a fresh medical examination due to a lack of past health data. The proposed system can interconnect with other electronic medical record systems and facilitate the exchange of medical resume data between hospitals. This research employs the waterfall development system. The resultant system provides patient medical resumes from participating hospitals, offering a solution to the problem of inconsistent patient information and clinical data, and improves service quality and diagnosis accuracy based on available data.

中国护士处方权立法的问题检视与路径优化: 基于《深圳经济特区医疗条例》第65条的分析

The “Shenzhen Special Economic Zone Medical Regulations” has taken the lead in implementing the “nurses’ prescription right” in China, but there are still many regulatory restrictions and problems in the full implementation of nurses’ prescription right in China. The rights and responsibilities of the new doctor-nurse relationship after the prescription right are unclear, and the relevant management institutions and supervision mechanisms are not perfect after the implementation of the nurses’ prescription right legislation. This paper believes that in order to improve the legislation of nurses’ prescription right in the future, it is necessary to reasonably determine the access standards for nurses’ prescription right, clarify the doctor's supervision responsibility for nurses’ prescription right, and improve the supporting guarantee and management mechanism for nurses’ prescription right.

Perlindungan Hukum Terhadap Korban Malpraktik Layanan Kesehatan Berbasis Telemedicine

Every organization of health services always has the potential to pose risks that can be detrimental to patients, including telemedicine-based health services. Telemedicine is a form of electronic-based health service so that doctors and patients cannot meet face to face. Currently there are 3 regulations governing telemedicine, namely Permenkes No. 20 of 2019, Decree of the Minister of Health Number HK.01.07/MENKES/4829/2021 Concerning Guidelines for Health Services Through Telemedicine During the Corona Virus Disease 2019 Pandemic, and Perkonsil No.74 of 2020. However, there are no regulations that concretely regulate legal protection for patients who feel aggrieved by telemedicine-based health services. This article discusses the legal relationship and risks of providing telemedicine-based health services as well as legal protection for patients who experience losses in these services. In the implementation of Telemedicine, there is a legal relationship between the patient, the doctor and the platform. It should be remembered that services for health that require direct action cannot be carried out through telemedicine so that each party in telemedicine needs to understand that there are conditions that can be carried out with telemedicine and not. The form of doctor's responsibility in telemedicine is the absolute responsibility of the doctor for his patient, and the patient's prosecution rights in telemedicine are similar to face-to-face-based health services.

Electroconvulsive Therapy for Neuroleptic Malignant Syndrome: A case report

IntroductionNeuroleptic malignant syndrome (NMS) is a rare syndrome observed in around 0.2% of psychiatric patients. This syndrome consists of the presentation of muscular rigidity, tachycardia, hyperpyrexia, leukocytosis and elevated levels of CPK. Any antipsychotic drug, including atypical ones, can cause this syndrome. This being an idiosyncratic response to dopamine receptor antagonist medications.The use of ECT in patients suffering from NMS is very effective, seeing the progressive resolution of the picture in the first sessions.ObjectivesThe patient was a 43-year-old man, whose somatic history only highlights hypothyroidism, and according to his psychiatric history, he was diagnosed of mental retardation and paranoid schizophrenia. He was a resident of a group home. And he was recently admitted to a mid-stay psychiatric unit. During this admission, the responsible doctor added haloperidol to his medication regimen. His other medications at the time were; valproic acid, risperidone and trazodone. A few days later, the patient began to present a dysthermic sensation (presenting a temperature of 39ºC) and drowsiness. A laboratory tests and a chest X-ray was performed, highlighting: leukocytosis and an increase in elevated creatine phosphokinase (CPK).Due to his recent exposure to 2 different antipsychotics, with fever, rigidity, and elevated CPK, we considered NMS. Antipsychotics were withdrawn and supportive measures were started. Within the next 2 days, his CPK level began to decline and the fever and leukocytosis resolved. But without resolving muscle rigidity. At the same time, he began to exhibit staring, negativism and prejudice delusions. Therefore, electroconvulsive therapy sessions were started.Methods.ResultsAfter the third session, his catatonic symptoms increased to better; he became more verbal, with less negativism and the psychotic symptomatology ceased. After the fifth session of ECT, he returned to his initial level and was able to walk to the bathroom without assistance and perform other activities of daily living.ConclusionsIt is extremely important that professionals specialized in psychiatry become familiar with ECT and consider this technique as treatment in cases of neuroleptic malignant syndrome.Disclosure of InterestNone Declared

DOCTOR'S LEGAL RESPONSIBILITY FOR UNLAWFUL ACTIONS AGAINST MEDICAL ACTION ERRORS

This study analyzed the responsibility of a doctor who commits an unlawful act when giving a medical error to his patient. This study examined how a doctor's action qualifies as an unlawful act in a medical action error and the doctor's legal responsibility in a medical action error from a civil, criminal, and administrative perspective. Metode This research is a doctrinal legal research, with a statute approach and an analytical approach. The results of the study showed that an unlawful act occurs when a doctor performs a medical action contrary to law, or contrary to medical science, and the medical action does not get the patient's consent. Medical action errors are seen from the perspective of civil law from two theories, namely breach of contract (default) and negligence, as well as from the perspective of criminal law in committing a medical action error. Generally, errors can be defined by the intent (dolus/opzet) and negligence/omissions (culpa) that are also considered elements of not meeting medical professional standards, service standards, and standard operating procedures. Then the perspective of administrative law; Judging from administrative violations committed by doctors, this legal violation can be seen from administrative violations regarding the authority to practice medicine and administrative violations regarding medical services. Based on Law 36 of 2009 concerning health, namely in the form of granting rights to victims of malpractice to hold doctors responsible for medical malpractice, in order to compensate for loss caused by doctor's errors or negligence, civil compensation claims may be filed or combined criminal prosecutions pursued. Additionally, the Indonesian Medical Discipline Honorary Council (MKDKI) may issue decisions imposing disciplinary sanctions on doctors who are proven guilty, allowing the council to make compensation claims in criminal proceedings before the court.

Therapeutic Drug Monitoring of Vancomycin Concentrations for the Management of Bone and Joint Infections: An Urgent Need

Vancomycin is used for the treatment of bone and joint infections (BJI), but scarce information is available about its pharmacokinetic/pharmacodynamic (PK/PD) characteristics. We aimed to identify the risk factors associated with the non-achievement of an optimal PK/PD target in the first therapeutic drug monitoring (TDM). Methods: A retrospective study was conducted in a tertiary hospital from January 2020 to January 2022. Patients with BJI and TDM of vancomycin on day 2 of treatment were included. Initial vancomycin fixed doses (1 g every 8 h or 12 h) was decided by the responsible doctors. According to TDM results, dosage adjustments were performed. An AUC24h/MIC < 400 mg × h/L, between 400 and 600 mg × h/L and >600 mg × h/L, were defined as suboptimal, optimal and supratherapeutic, respectively. Patients were grouped into these three categories. Demographic, clinical and PK characteristics were compared between groups. Nephrotoxicity at the end of treatment was assessed. Results: A total of 94 patients were included: 22 (23.4%), 42 (44.7%) and 30 (31.9%) presented an infratherapeutic, optimal and supratherapeutic PK/PD targets, respectively. A younger age and initial vancomycin dose <40 mg/kg/day were predictive factors for achieving a suboptimal PK/PD target, while older age, higher serum-creatinine and dose >40 mg/kg/day were associated with overexposure. The nephrotoxicity rate was 22.7%. More than 50% of patients did not achieve an optimal PK/PD. Considering age, baseline serum-creatinine and body weight, TDM is required to readily achieve an optimal and safe exposure.

Quality of life and nurse-patient interaction among NH residents: Loneliness is detrimental, while nurse-patient interaction is fundamental.

To investigate the association between perceived nurse-patient interaction and quality-of-life among nursing home residents, adjusted for loneliness, anxiety and depression. Symptoms of anxiety and depression are known to residents of nursing homes along with cognitive impairment, physical inactivity and low quality-of-life. Anxiety, depression and loneliness are found detrimental to NH residents' quality-of-life. The nurse-patient relationship is important for patient's well-being, both in terms of illness and symptom management. Cross-sectional design. Data were collected in 2017 and 2018 from 188 residents in 27 nursing homes resided in two large urban municipalities in Middle and Western Norway. The inclusion criteria were: (1) local authority's decision of long-term NH care; (2) residential stay 3 months or longer; (3) informed consent competency recognised by responsible doctor and nurse; (4) capable of being interviewed, and (5) aged 65 years or older. This article is executed in accordance with STROBE statement. Adjusting for age, sex, anxiety, depression and loneliness, perceived nurse-patient interaction was statistically significant to quality-of-life. While anxiety and depression showed insignificant estimates, loneliness demonstrated a significant relation with quality-of-life. Nurse-patient interaction and loneliness explained together 25% of the variation in quality-of-life. This study suggests that loneliness is frequent as well as more detrimental to quality-of-life among nursing home residents compared to anxiety and depression. Furthermore, the present results show that the nurse-patient interaction represents an essential health-promoting resource for Quality-of-life in this population. Staff nurses need to exercise their awareness of loneliness to meet residents' needs. Nursing educations should provide knowledge about nurse-patient interaction, and students as well as staff nurses in NHs should be trained, for instance by simulation, to use the nurse-patient interaction as a health-promoting resource. Finally, loneliness represents a bigger challenge than depression and anxiety; accordingly, building nurses that are capable of meeting patients' needs and facilitate care that counteracts loneliness is highly warranted.