Hospital Wards Research Articles

Application of AMORE therapy in the Quality of life of chronic Kidney Patients

Rationale: Quality of life constitutes an indicator of well-being in patients with chronic diseases. Natural and Traditional Medicine has demonstrated effectiveness in increasing the quality of life in patients with chronic non-communicable conditions; However, there is no evidence of its results on the quality of life of patients with chronic kidney disease. Objectives: Determine the application of Natural and Traditional Medicine through a comprehensive system of therapies in patients with chronic kidney disease with the aim of raising their quality of life. Method: A descriptive cross-sectional observational study was carried out in a group of patients admitted to the Nephrology ward of the university hospital. Manuel Ascunce Domenech, to whom the comprehensive therapy called, AMORE was applied, with the objective of determining their quality of life before and after it was applied. The variables were taken into account: Age, sex, APP, Quality of life and Adverse reactions. Results: of the total number of patients treated, 18 were male, for 62%, of the total number of patients studied; their average age was 51 years. Quality of life at the beginning of treatment was evaluated as: Regular and at the end of treatment it was raised to Good. Conclusions: At the end of the treatment, it was determined that the comprehensive therapy of Natural and Traditional Medicine, AMORE, positively influences the Quality of life of the admitted chronic kidney patient.

Detection of delirium in older patients-A point prevalence study in surgical and non-surgical hospital wards.

To (i) determine the prevalence of delirium and identify delirium subtypes in surgical and non-surgical patients aged ≥65 years, (ii) determine whether certain precipitating factors affect the prevalence of delirium and (iii) review patients' medical records for description of delirium symptoms and the presence of International Classification of Diseases (ICD-10) coding for delirium in discharge summaries. Despite being a robust predictor of morbidity and mortality in older adults, delirium might be inadequately recognised and under-reported in patients' medical records and discharge summaries. A point prevalence study (24-h) of patients ≥65 years from surgical and non-surgical wards was therefore conducted in a tertiary university hospital. The study was approved by the Data Protection Officer at the university hospital (2018/3454). Patients were assessed for delirium with 4AT and delirium subtypes with the Delirium Motor Subtype Scale. Information about room transfers, need and use of sensory aids and medical equipment was collected onsite. Patients' medical records were reviewed for description of delirium symptoms and of ICD-10 codes. Overall, 123 patients were screened (52% female). Delirium was identified in 27% of them. Prevalence was associated with advanced age (≥85 years). The uncharacterised delirium subtype was most common (36%), followed by hypoactive (30%), hyperactive (24%) and mixed (9%). There were significant associations between positive screening tests and the need and use of sensory aids. Delirium symptoms were described in 58% of the patients who tested positive for delirium and the ICD-10 code for delirium was registered in 12% of these patients' discharge summaries. The high prevalence of delirium and limited use of discharge codes highlight the need to improve the identification of delirium in hospital settings and at discharge. Increased awareness and detection of delirium in hospital settings are vital to improve patient care.

Clinical study of antibacterial medical textiles containing polyhydroxyalkanoate oligomers for reduction of hospital-acquired infections

The prevention and control of hospital-acquired infections remain a significantchallenge worldwide, as textiles used in hospital wards are highly involved in transmission processes. This paper reports a new antibacterial medical fabric used to prepare hospital pillowcases, bottom sheets and quilt covers for controlling and reducing hospital-acquired infections. The medical fabric was composed of blended yarns of staple polyester (PET) and degradable poly(3-hydroxybutyrate co-3-hydroxyvalerate) (PHBV)/polylactic acid (PLA) fibres, which were coated with polylactide oligomers (PLAO), which are environmentally friendly and safe antimicrobial agents with excellent thermal stability in high-temperature laundry. A clinical trial was conducted, with emphasis on the bacterial species that were closely related to the infection cases in the study hospital. After 7 days of use, 94% of PET/PHBV/PLA-PLAO fabric retained <20colony-forming units/100cm2 of the total bacterial amount, meeting hygiene and cleanliness standards. This study demonstrates the potential of fabrics containing polyhydroxyalkanoate oligomers as highly effective, safe and long-lasting antimicrobial medical textiles that can effectively reduce the incidence of hospital-acquired infections.

Child Age and Risk of Medication Error: A Multisite Children's Hospital Study

ObjectiveTo examine associations between patient age and medication errors among pediatric inpatients. Study designSecondary analysis of datasets generated from two tertiary pediatric hospitals: (1) prescribing errors identified from chart reviews for patients on nine general wards at hospital A between April 22 to July 10, 2016, June 20 to September 20, 2017, and June 20 to September 30, 2020; prescribing errors from five wards at hospital B in the same periods; and (2) medication administration errors assessed by direct prospective observation of 5,137 administrations on nine wards at hospital A. Multilevel models examined the association between patient age and medication errors. Age was modeled using restricted cubic splines to allow for nonlinearity. ResultsPrescribing errors increased nonlinearly with patient age (P=0.01), showing little association from ages 0 to 3 years and then increasing with age until around 10 years, and remaining constant through the teenage years. Administration errors increased with patient age, with no association from 0 to around 8 years and then a steady rise with increasing age (P=0.03). The association differed by route: linear for oral, no association for intravenous infusions, and U-shaped for intravenous injections. ConclusionsOlder age is an unrecognized risk factor for medication error on general wards in pediatric hospitals. Contributors to risk may be the clinical profiles of these older children or the general level of attention paid to medication practices for this group. Further investigation may allow the design of more targeted interventions to reduce errors.

Fear of COVID-19, Health Anxiety and Work-Family Conflict in Nurses Working in the COVID-19 Ward.

COVID-19 is an example of an epidemic and sudden crisis that has affected many aspects of life and work and identifying the factors that contribute to its impact can help prevent similar crises in the future. The purpose of this study was to investigate fear of COVID-19, health anxiety, and work-family conflict in nurses working in COVID-19 wards in hospitals affiliated with the Tehran University of Medical Sciences (TUMS). This descriptive-analytical study used a census method to survey 226 nurses working in eight hospitals affiliated with TUMS. Demographics information and three questionnaires including; the Fear of COVID-19 Scale, Short Health Anxiety Inventory, and Work-Family Conflict Scale were completed online. Data were analyzed using descriptive statistics and analytical statistics, and a significance level of p < 0.05 was considered. Structural equation modeling test showed that work-family conflict had an effect on health anxiety, and health anxiety had an effect on fear of COVID-19 (p < 0.05). The severity of the effect of work-family conflict on health anxiety was 0.73, and the severity of the effect of health anxiety on fear of COVID-19 was 0.46. Work-family conflict had an indirect effect on fear of COVID-19 mediated only by health anxiety (p < 0.05) and the severity of the indirect effect was 0.33. Health anxiety plays a mediating role in the relationship between work-family conflict and fear of COVID-19. Workplaces should provide more support to their employees during a crisis such as the COVID-19 pandemic, and prevention programs should be implemented to decrease anxiety.

Behind the Hospital Ward: In-Hospital Mortality of Type 2 Diabetes Mellitus Patients in Indonesia (Analysis of National Health Insurance Claim Sample Data).

The rising global prevalence of diabetes mellitus, a chronic metabolic disorder, poses significant challenges to healthcare systems worldwide. This study examined in-hospital mortality among patients diagnosed with non-insulin-dependent diabetes mellitus (NIDDM) of ICD-10, or Type 2 Diabetes Mellitus (T2DM), in Indonesia, utilizing hospital claims data spanning from 2017 to 2022 obtained from the Indonesia Health Social Security Agency or Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan. The analysis, which included 610,809 hospitalized T2DM patients, revealed an in-hospital mortality rate of 6.6%. Factors contributing to an elevated risk of mortality included advanced age, the presence of comorbidities, and severe complications. Additionally, patients receiving health subsidies and those treated in government hospitals were found to have higher mortality risks. Geographic disparities were observed, highlighting variations in healthcare outcomes across different regions. Notably, the complication of ketoacidosis emerged as the most significant risk factor for in-hospital mortality, with an odds ratio (OR) of 10.86, underscoring the critical need for prompt intervention and thorough management of complications to improve patient outcomes.

Continuous Vital Sign Monitoring on Hospital Wards and Postoperative Mortality

Continuous Vital Sign Monitoring on Hospital Wards and Postoperative Mortality

Assessment and management of constipation in post-operative patients in the spinal surgery ward: a best practice implementation project.

Constipation is a common complication following spinal surgery that can result in distension, abdominal pain, infection, and even intestinal perforation. This study reports on an evidence-based implementation project to reduce the incidence of constipation in spinal surgery wards. The project was conducted in the spinal surgery ward of a general tertiary hospital in Changsha City, China, from March to August 2022. We used the JBI Implementation Framework and the JBI Model of Evidence-Based Healthcare for audits and feedback. Data were collected and analyzed using JBI's Practical Application of Clinical Evidence System (PACES) software. Seven audit criteria were developed based on the best practice recommendations summarized by JBI. A baseline audit was conducted with 20 nurses and 50 patients in the spinal surgery ward, and a follow-up audit was conducted using the same sample size and setting. The baseline audit revealed compliance below 46% for five of the seven criteria. Strategies developed to address poor compliance included educating nurses and patients, developing a post-operative constipation risk assessment sheet, organizing stakeholder focus group meetings, establishing a constipation management routine, and effective empowerment of nurses. The follow-up audit showed positive compliance results, with the highest rate for Criterion 7 (100%) and the greatest increase for Criterion 2 (from 0% to 78%). Furthermore, the incidence of post-operative constipation decreased from 48% to 16%. The project improved compliance with audit criteria, reduced the incidence of constipation, and enhanced the efficiency of quality management in the spinal surgery ward. http://links.lww.com/IJEBH/A186.

Analysis of the Adequacy of Nurse Staffing Level through the Estimation of Nursing Activity Hours and Implementation of Focus Group Interviews in a Tertiary Hospital: Using a Mixed-Method Design

This study aimed to examine the adequacy of current nurse staffing levels by identifying nursing activities and workload. The study used a mixed-method design. A nursing activity survey was conducted using the work sampling method over 2 working days with 119 general ward nurses. A focus group interview was conducted with 12 nurses. Quantitative and qualitative data were analyzed using SPSS 20.0 and content analysis, respectively. The most amount of time was spent on medication (in direct nursing) and electronic medical record documentation (in indirect nursing). The appropriate nurse-to-patient ratio is 1:7.7 for the day shift, 1:9.0 for the evening shift, and 1:11.9 for the night shift. However, the current nurse-to-patient ratio is 1:9.4, 1:11.0, and 1:13.8 for the day, evening, and night shifts, respectively. Therefore, the current nurse staffing level is insufficient for the workload. In the focus group interview, the main reasons cited for being unable to complete tasks within working hours were communication and coordination, and the nursing electronic medical record. The essential nursing activities of basic nursing and emotional support were overlooked owing to a heavy workload. Therefore, an adequate nurse staffing level should be higher than the measured quantitative workload. These results suggest the general wards of tertiary hospitals should evaluate the adequacy of their current nurse staffing and allocate sufficient nurses to improve patient safety and nursing care quality.

Pilot evaluation of a digital approach to occupational therapy home assessments: acceptability and efficiency compared with usual practice in a hospital.

Pre-discharge home assessments by occupational therapists facilitate safe and timely discharge from hospital and are associated with better health outcomes. Digital technology offers the potential to reduce duplication of documentation and improve communication and sharing of home assessment findings. This quality improvement project evaluated time-cost; clinician satisfaction and confidence; and acceptability of the use of a digital approach to home assessments. A prospective, cross-sectional design was used to compare usual practice with the digital approach across two sub-acute wards in a large metropolitan hospital in Queensland, Australia. Time to document and conduct home assessments as well as clinician satisfaction and confidence were compared using descriptive statistics. Clinician perspectives about the home assessment approaches were collected through a survey and analyzed using content analysis. Home assessment and documentation time were significantly lower for the home assessments conducted using the digital approach compared with usual practice assessments. Clinician satisfaction with using digital technology was higher. The introduction of this simple technology reduced clinicians' time to conduct home assessments and document home assessment reports. The project was well received by occupational therapy clinicians. http://links.lww.com/IJEBH/A187.

Implementation of the ID-PALL Assessment Tool for Palliative Care Needs: A Feasibility and Prevalence Study in a Tertiary Hospital.

Identifying patients who require palliative care is a major public health concern. ID-PALL is the first screening instrument developed and validated to differentiate between patients in need of general versus specialized palliative care. This study aimed to (1) evaluate user satisfaction and the facilitators and barriers for ID-PALL use and (2) assess the prevalence of patients who require palliative care. A mixed methods study with an explanatory sequential design. Over a six-month period, patients admitted to two internal medicine wards of a Swiss tertiary hospital were screened by nurses and physicians with ID-PALL, two to three days after hospitalization. Nurses and physicians completed a questionnaire and participated in focus groups. Out of 969 patients, ID-PALL was completed for 420 (43.3%). Sixty percent of patients assessed needed general palliative care and 26.7% specialized palliative care. From the questionnaire and focus groups, five subthemes were identified concerning facilitators and barriers: organization, knowledge, collaboration, meaning, and characteristics of the instrument. ID-PALL was recognized as an easy-to-use and helpful instrument that facilitates discussion between health care professionals about palliative care. The difficulties in using ID-PALL in nurse-physician collaboration and the paucity of referrals to the palliative care team were highlighted. ID-PALL helped to identify a very high prevalence of palliative care needs among internal medicine patients in a tertiary hospital setting. Although regarded as helpful and easy to use, challenges remain concerning interprofessional implementation and inclusion of palliative care specialists, which may be met by automatic referrals in case of specialist needs.

Focus on Pneumonia After Organ Transplantation: Is There a Need for Specific Medical Care in the Emergency Department?

Pneumonia is a major cause of hospitalization and has a substantial impact on health care costs. Diagnosis and treatment of pneumonia in solid organ transplant (SOT) patients remain a challenge for clinicians in the emergency department. This study aimed to evaluate demographic features, clinical patterns, history of hospitalization, and diagnosis of adult patients after organ(s) transplantation (liver, kidney, pancreas) with severe pneumonia requiring hospitalization. The aim is to determine whether patients undergoing SOT receive or require specific care and whether they need to be prioritized. This was a single-center observational study of adult patients after SOT with severe pneumonia requiring hospitalization. The data set for the analysis included only patients with pneumonia as the main reason for hospitalization. The diagnosis of pneumonia was suspected based on the American Thoracic Society criteria. The study revealed that the standard of care for patients with a history of SOT did not significantly differ from care provided to the non-SOT patients with pneumonia admitted to the same hospital during a 94-week period. There were notable differences, such as post-transplant patients being transferred more quickly to the hospital ward, having longer hospital stays, and receiving antibiotics earlier than the non-SOT group.

The effectiveness of a brief intervention for intensive care unit patients with hazardous alcohol use: a randomized controlled trial.

Screening for hazardous alcohol use and performing brief interventions (BIs) are recommended to reduce alcohol-related negative health consequences. We aimed to compare the effectiveness (defined as an at least 10% absolute difference) of BI with usual care in reducing alcohol intake in intensive care unit survivors with history of hazardous alcohol use. We used Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) score to assess history of alcohol use. Emergency admitted adult ICU patients in three Finnish university hospitals, with an AUDIT-C score > 5 (women), or > 6 (men). We randomized consenting eligible patients to receive a BI or treatment as usual (TAU). BI was delivered by the time of ICU discharge or shortly thereafter in the hospital ward. Control patients received TAU. The primary outcome was self-reported alcohol consumption during the preceding week 6 and 12months after randomization. Secondary outcomes were the change in AUDIT-C scores from baseline to 6 and 12months, health-related quality of life, and mortality. The trial was terminated early due to slow recruitment during the pandemic. We randomized 234 patients to receive BI (N = 117) or TAU (N = 117). At 6months, the median alcohol intake in the BI and TAU groups were 6.5g (interquartile range [IQR] 0-141) and 0g (0-72), respectively (p = 0.544). At 12months, it was 24g (0-146) and 0g (0-96) in the BI and TAU groups, respectively (p = 0.157). Median change in AUDIT-C from baseline to 6months was - 1 (- 4 to 0) and 2 (- 6 to 0), (p = 0.144) in the BI and TAU groups, and to 12months - 3 (- 5 to - 1) and - 4 (- 7 to - 1), respectively (p = 0.187). In total, 4% (n = 5) of patients in the BI group and 11% (n = 13) of patients in the TAU group were abstinent at 6months, and 10% (n = 12) and 15% (n = 17), respectively, at 12months. No between-groups difference in mortality emerged. As underpowered, our study cannot reject or confirm the hypothesis that a single BI early after critical illness is effective in reducing the amount of alcohol consumed compared to TAU. However, a considerable number in both groups reduced their alcohol consumption. ClinicalTrials.gov (NCT03047577).

Length of hospital stay in involuntary admissions in Greece: a 10-year retrospective observational study

PurposeThe treatment of mental disorders has shifted from inpatient wards to community-based settings in recent years, but some patients may still have to be admitted to inpatient wards, sometimes involuntarily. It is important to maintain the length of hospital stay (LoS) as short as possible while still providing adequate care. The present study aimed to explore the factors associated with the LoS in involuntarily admitted psychiatric patients.MethodsA ten-year retrospective chart review of 332 patients admitted involuntarily to the inpatient psychiatric ward of the General University Hospital of Ioannina, Northwestern Greece, between 2008 and 2017 was conducted.ResultsThe mean LoS was 23.8 (SD = 33.7) days and was relatively stable over the years. Longer-stay hospitalization was associated with schizophrenia-spectrum disorder diagnosis, previous hospitalizations and the use of mechanical restraint, whereas patients in residential care experienced significantly longer LoS (52.6 days) than those living with a caregiver (23.5 days) or alone (19.4 days). Older age at disease onset was associated with shorter LoS, whereas no statistically significant differences were observed with regard to gender.ConclusionWhile some of our findings were in line with recent findings from other countries, others could not be replicated. It seems that multiple factors influence LoS and the identification of these factors could help clinicians and policy makers to design more targeted and cost-effective interventions. The optimization of LoS in involuntary admissions could improve patients’ outcomes and lead to more efficient use of resources.

Nanopore sequencing of influenza A and B in Oxfordshire and the United Kingdom, 2022–23

We evaluated Nanopore sequencing for influenza surveillance. Influenza A and B PCR-positive samples from hospital patients in Oxfordshire, UK, and a UK-wide population survey from winter 2022-23 underwent Nanopore sequencing following targeted rt-PCR amplification. From 941 infections, successful sequencing was achieved in 292/388(75%) available Oxfordshire samples: 231(79%) A/H3N2, 53(18%) A/H1N1, and 8(3%) B/Victoria and in 53/113(47%) UK-wide samples. Sequencing was more successful at lower Ct values. Most same-sample replicate sequences had identical haemagglutinin segments (124/141, 88%); 36/39(92%) Illumina vs. Nanopore comparisons were identical, and 3(8%) differed by 1 variant. Comparison of Oxfordshire and UK-wide sequences showed frequent inter-regional transmission. Infections were closely-related to 2022-23 vaccine strains. Only one sample had a neuraminidase inhibitor resistance mutation. 849/941(90%) Oxfordshire infections were community-acquired. 63/88(72%) potentially healthcare-associated cases shared a hospital ward with ≥1 known infectious case. 33 epidemiologically-plausible transmission links had sequencing data for both source and recipient: 8 were within ≤5 SNPs, of these, 5(63%) involved potential sources that were also hospital-acquired. Nanopore influenza sequencing was reproducible and antiviral resistance rare. Inter-regional transmission was common; most infections were genomically similar. Hospital-acquired infections are likely an important source of nosocomial transmission and should be prioritised for infection prevention and control.

Antibiotic use and resistance patterns at Rumphi District Hospital in Malawi: a cross-sectional study

BackgroundOveruse of antibiotics is a key driver of antimicrobial resistance (AMR) world-wide. Malawi continues to report rising cases of AMR among both in-patients and out-patients. We investigated antibiotic use and resistance patterns among patients with suspected first line antibiotic treatment failure at Rumphi District Hospital, Malawi.MethodsWe used a cross-sectional study design in which records of patients data on culture and antimicrobial sensitivity tests were extracted, alongside treatment history from 2019 to March, 2023, retrospectively. We also included findings for point prevalence survey (PPS) conducted within four hospital wards in June, 2022 by a well-trained multi-disciplinary team from within the hospital. The data was analyzed for antibiotic use, characterization of pathogens and their susceptibility patterns using Microsoft excel and STATA-14 software.ResultsA total of 85 patients’ data records were reviewed on antibiotics resistance pattern in which 54 (63.5%) were females. Patient antibiotic history captured indicated Metronidazole (23%), Gentamycin (20%) and Doxycycline (23%) as the most frequently used antibiotics among clients referred for microbiological investigations. Among locally available antibiotics with over 50% sensitivity were Chloramphenicol (61%), ciprofloxacin (55%), and ceftriaxone (54%). Penicillins were among antibiotics with highest resistance: ampicillin (100%), amoxyclav (90%), Piperacilin-tazobactam (63%). The majority of patients came from STI clinic and presented with genital discharges 44% (n = 39). Over 80% of the isolated N. gonorrhoeae exhibited a reduced susceptibility to gentamycin. Prevalence of Methicillin resistant staphylococcus Aureus (MRSA) was 46% and were mostly isolated from wound pus. Among 80 data records of the patients reviewed during PPS, Ceftriaxone (54.3%) and Metronidazole (23.3%) emerged as the most frequently used antibiotics in the wards which were prescribed empirically without a microbiological indication.ConclusionIn this study setting, we observed high use of watch antibiotics along with problem of multi-drug resistant infections in patients experiencing clinical failure in a variety of clinical syndromes. The findings underline the need to revamp diagnostic microbiology to increase the uptake of antimicrobial susceptibility testing to guide specific prescriptions of broad-spectrum antibiotics in the watch list.

Antimicrobial utilization pattern in indoor patients of obstetrics and gynecology ward of a tertiary care hospital

Background: Rational prescribing of antimicrobials is fundamentally necessary to reduce incidence of antimicrobial resistance. To evaluate the rationality of antimicrobial prescribing practices in patients admitted to obstetrics and gynecology ward of a tertiary care hospital using ICMR guidelines and to check how many drugs were prescribed from NLEMI. Methods: It was a prospective observational study. Study included newly admitted patients in obstetrics and gynecology ward receiving antimicrobial therapy. Drugs prescribed to the patients during their hospital stay were noted from case sheets in case record form. WHO core and economic indicators were used to analyze prescribing patterns. Medguideindia.com was referred for prices of drugs. Results: Average number of drugs prescribed for a patient admitted in the obstetrics and gynecology ward were 3.22 and 4.31 respectively. Percentage of drugs prescribed by their generic name were 37.11% and 39.42% in obstetrics and gynecology ward respectively. 26.85% and 34.14% of patients received drugs through parenteral route in obstetrics and gynecology wards respectively. All antimicrobials were prescribed from NLEMI. Conclusions: WHO recommends prescribing all drugs by their generic names. Average duration of antimicrobial treatment was higher than recommended average duration suggested by ICMR. ICMR recommends use of 2nd generation cephalosporins but in the present study 3rd generation cephalosporins were used. For rational use of antimicrobials and to reduce their cost it is recommended to prescribe antimicrobials by their generic names and reduce treatment duration by referring to ICMR Guidelines and NLEMI.

Marital Satisfaction, Emotion Regulation and Self-Efficacy in Women with Postpartum Depression

The aim of the study is to explore the relationship between marital satisfaction, emotion regulation, and self-efficacy in women experiencing Postpartum Depression. The sample size consisted of N=100 participants which were women with PPD symptoms who visited the OPD of gynecology ward of government hospitals. The selected population age average was 19 to 35 years. Urdu translated scales of Comprehensive Marital Satisfaction Scale, Depression Anxiety Stress Scale, Emotion Regulation Questionnaire and General Self-Efficacy Scale were used for data collection. The information was analyzed using Pearson Product Moment Correlation, Moderation Analysis and Multiple Regression via SPSS 21 version. The conclusion of this research has been demonstrated that there is weak positive correlation between Marital Satisfaction and severity of PPD in women. This study suggests that as Marital Satisfaction increases, the impact of PPD symptoms decreases. It also showed that Self-Efficacy has a strong and significant effect on PPD symptoms as a moderator.

Development of nursing handoff competency scale: a methodological study

BackgroundNursing handoff competency is the ability of the nurse performing the handoff to select and interpret the necessary information for patient care and to convey it efficiently to the nurse accepting the handoff. Nursing handoff is an important nursing task that ensures nursing care continuity, quality and patient safety. This study aimed to develop a scale to measure nursing handoff competency and verify its validity and reliability.MethodsThis study adopted a methodological design. A research process included three phases: (1) scale development (literature review and interviews); (2) scale validation (validity and reliability); (3) standard setting. Data were collected from 496 clinical nurses currently working in hospital wards, intensive care units, and emergency rooms, and who independently perform a handoff in South Korea.ResultsThe final scale comprises a self-reported 4-points Ilert scale with 25 items based on four factors: knowledge on handoff methods, identification of patient information, judgment and transfer of nursing situation, and “formation of supportive relationships. Construct validity, criterion-related validity, and discrimination validities were verified and the fitness of the scale revealed good results in confirmatory factor analysis. The Cronbach’s α of the whole tool was.912 and the cut-off score for satisfied/unsatisfied was.72.ConclusionsThe developed scale can evaluate the nurse’s handoff competencies and determine whether training is necessary. The measurement results of the scale can be used to select training subjects and compose the contents of the education program.

Lived experiences of COVID-19 patients admitted in isolation wards of healthcare centers in Peshawar, Pakistan: A phenomenological perspective

The emergence of COVID-19 caused a significant global threat, affecting populations worldwide. Its impact extended beyond just physical health, as it inflicted severe damage and challenges to individuals' well-being, leading to a deterioration in mental health. The lived experiences of patients hold a paramount position to explore and understand their perception of care which can ultimately strengthen the health system's delivery domain. This study explores the lived experiences of patients in the isolation ward, their recovery, and the quality of care being provided in the hospital and its effects on their mental health. Study designA phenomenological qualitative study using in-depth interviews. MethodsWe conducted 11 in-depth interviews of COVID-19 patients admitted to the isolation ward of the public hospitals of Peshawar, Pakistan. Participants who stayed for a minimum of 10 days in an isolation ward were included in this study. Interviews were transcribed and analyzed using NVivo 12 software and generated five themes through inductive analysis. ResultsFive themes emerged from the participants' lived experiences: Heading towards the hospital, Health Care Quality, Impact on Mental Health, Recovering from COVID-19 and Back on one's feet. These included all the positive and negative lived experiences. Socio-environmental factors along with their experiences of the disease itself and with the healthcare providers guided their reaction which was important conciliators in their experiences during the pandemic. ConclusionBased on the findings, the environment of isolation had a major influence on the mental well-being of the individuals involved. Considering the important role of the ward environment in shaping patient experiences and outcomes prompts a reevaluation of healthcare practices and policies. By addressing these factors healthcare systems can strive for greater effectiveness, resilience, and compassion in managing the pandemic's impact on patient care.