Hospital Wards Research Articles

Prevalence of Drug Resistance and Pathogenic Factors of Pseudomonas aeruginosa Isolates Recovered from Hospitalized Patients

Background: Humans can develop both acute and chronic infections from Pseudomonas aeruginosa, a bacterium that is a prominent cause of nosocomial infections, as well as respiratory, urinary tract, burn, wound, ear, eye, and bloodstream infections. Objectives: This study aimed to identify antibiotic resistance in P. aeruginosa strains obtained from hospitalized patients and assess the frequency of virulence genes. Methods: In this cross-sectional study, 86 strains of P. aeruginosa were isolated from patients in various hospital wards in Shiraz and Yasuj in 2021. Antibiotic susceptibility was tested using the disk diffusion method, while the frequency of virulence genes (aprA, phzM, phzS) and antibiotic resistance genes (blaGES, blaSPM, blaVIM) was evaluated using PCR and specific primers. Results: The P. aeruginosa isolates showed the highest antibiotic resistance to imipenem and the lowest resistance to piperacillin-tazobactam. PCR amplification of aprA, phzM, and phzS genes indicated that aprA had the highest frequency among the isolates, with a prevalence of 98.8%. The frequencies of phzM and phzS were 96.5% and 91.9%, respectively. Conclusions: This study revealed a high prevalence of the virulence genes aprA, phzM, and phzS in P. aeruginosa isolates. Given the bacterium’s resistance to many antibiotics, clinicians should exercise caution when prescribing antibiotics, particularly for infections caused by P.aeruginosa.

Modification of the National Early Warning Score (NEWS) Observation Sheet for Patient Emergency Conditions in Hospitals

Background: Currently, the trend of patients admitted to the hospital is increasingly complex and has many co-morbidities, some of which the patient's condition will suddenly worsen or become critical, due to various interrelated causes such as weak monitoring systems and staff reactions to emergencies. Delays in treatment or inadequate care for patients who are treated in the Hospital Ward can result in several adverse conditions, namely increased patients transferred to the ICU (Intensive Care Unit), increased LOS (Lenght of Stay) in the hospital, heart attacks, or patient death. Purpose: The purpose of this study to analyze the differences in the modification of the NEWS observation sheet on the emergency conditions of patients at the hospital. Methods: The type of research used is quasi-experimental with a pre-test-post-test control group design. With a population of 160 patients and a total patient sample of 62 patients with 31 patients for the intervention group and 31 patients for the control group. How to take samples with purposive sampling technique. The independent variables in this study were the NEWS observation sheet and the NEWS modification, while the dependent variable was the patient's emergency condition. The instruments in this study were NEWS observation sheets and NEWS modifications, integrated patient development record sheets, pre-test and post-test sheets. Data analysis used Wilcoxon test and Mann Whitney test with a value of α = 0.05. Results: The results showed that the modification of the NEWS (National Early Warning Score) observation sheet with a graphic was more influential than the NEWS observation sheet in increasing vital sign monitoring with p=0.00, while the NEWS observation sheet as a control had an influence with a significant level of p=0.043, both the model shows that it is equally influential in detecting changes in patient conditions and as an aid in communicating with other health workers. Conclusion: The conclusion of this study is that after being given a modified NEWS observation sheet which is a scoring system that is simple, practical and proven to increase alertness and response to signs of bad physiological changes so that patient safety can be monitored optimally and mortality rates can decrease.

Buildings as reflectors of societal values: what features of psychiatric wards reveal about stigma

Abstract Built Environment (BE) features bearing domestic attributes align with the concept of psychosocial re-integration. To understand the level of de-institutionalisation in relation to mental health infrastructure, a series of 29 case studies occurred in four countries from 2000 onwards. We collected data from Europe, the UK, New Zealand and more recently in the US: England (n = 15), France (n = 5), New Zealand (n = 4) and the US (n = 5). This included five acute wards in England and five in France in 2000-2004, two further acute wards in England in 2015-2017, four facilities in New Zealand in 2017-2020 (catering also for the Māori population), six further wards (older adult rehab, older adult dementia, acute, rehab, PICU, older adults) and two forensic wards in England and five wards in the US in three different hospitals (one mental health and four mental health wards in general hospital: two adult and two adolescent) in 2023-2024. An architectural checklist was developed to evaluate the traits of the exterior and interior and measure the degree of institutionalisation vs homelikeness for mental health buildings. Cross-country comparison revealed recent case studies to be closer to the institutional end with increased anti-ligature features. Most NZ and the US samples were the most institutional ones. The checklist revealed that acuity was potentially not a determinant of institutional versus domestic buildings. Data shown that very few features were universally present, questioning what is the absolute minimum in relation to the illness rather than the policies. The US sample provides further food for thought, especially in relation to the location of psychiatric wards inside general hospitals and the reasons that lead to this. Finally, by looking at the BE for mental health, we uncover issues regarding the service provision and institutional prejudices connected to stigma. This questions the adequacy of de-institutionalisation policies in certain contexts. Key messages • The study of the architecture of healthcare facilities can depict aspects related to the health service provision and raise questions about the effectiveness of rehabilitation strategies. • The architecture of psychiatric wards questions the success of some de-institutionalisation decision-making in a cross-country comparison.

Experiences with paediatric hospital health care: a cross-sectional study among paediatric patients

Abstract Background The measurement of patient experiences is gaining importance in many healthcare systems, including the Slovenian one. The need for a national survey on patient experiences in the paediatric inpatient settings emerged recently. Methods The survey took into account various aspects of inpatient healthcare such as admission, hospital staff, safety, food and discharge from hospital. As part of the study, children/parents were able to give praise and suggestions for improvements. We used three different questionnaires adapted to the cognitive abilities of children - a child questionnaire for the age group 9-13 years in paper form, an online adolescent questionnaire for the age group 14-18 years, and an online parent questionnaire for the age group 0 (1 month)-8 years. The questionnaires were cognitively tested and piloted before national rollout. Results The national survey was conducted between September 2023 and March 2024 and included paediatric patients who spent at least one night in an acute paediatric hospital ward. The survey included 25 paediatric wards and totally 1965 questionnaires were valid for analysis. The rough response rate was 17,6 %. The first preliminary results of the qualitative analysis suggest that surveyed paediatric patients and their parents rate highly inpatient health care services received, however they point out also to areas that need improvement such as environmental factors (noise, temperature), food, infrastructure (outdated facilities & equipment) and in some cases attitude of hospital staff. Conclusions National institute of public health carried out the first national survey on paediatric patient reported experience measures in acute hospitals in Slovenia. The results of this survey will be used to improve the quality of inpatient health care services in paediatric wards, as well renew focus on the requirements of European charter of children rights and United Nations Convention on the Rights of the Child. Key messages • National institute of public health carried out the first national survey on paediatric patient reported experience measures in hospitals in Slovenia. • The results of this survey will be used to drive hospital quality improvements.

Elevated hospital floor-based HDU (POPUP-HDU): a new safe alternative to PICU for high-risk neuromuscular and syndromic children undergoing scoliosis surgery.

Children undergoing either posterior spinal fusion (PSF) or index insertion of growing rods for neuromuscular or genetic/syndromic scoliosis may require post-operative care on the paediatric intensive care unit (PICU). Demands on this limited resource result in frequent bed shortage related cancellations. In response, an ad-hoc or 'pop-up' ward-based high-dependency unit (POPUP-HDU) was developed. This converts a ward bed to POP-HDUbed for the required time. This study assesses the safety and efficacy of postoperative management that utilises POPUP-HDU as an alternative to a PICU bed. Retrospective review of 111 consecutive children undergoing posterior surgery for scoliosis between June 2016 and April 2023. The inclusion criteria included a diagnosis of genetic/syndromic or neuromuscular scoliosis; PSF or primary insertion of distraction-based growth rods and requirement for postoperative care in a PICU. We excluded those children that were mandated to go to PICU post-operatively for any reason by the anaesthetic team. 49 patients (mean age 13.0years) were managed on PICU, and 62 (mean age 11.4years) on POPUP-HDU. The groups were matched with respect to body weight, curve magnitude, operative duration, type of fusion procedure performed, the presence of cardiac malformations, the use of home breathing support, the number of operated levels, pelvic instrumentation and intraoperative blood loss. 8 patients in the PICU, and 16 in the POP-HDU groups were readmitted back to PICU following step-down to the hospital ward (p = 0.27). The median PICU length of stay was 1day in the PICU group and less than a day in POPUP-HDU (for those that needed to be subsequently admitted to PICU). The median total length of hospital stay was 10days in the PICU group, and 8days in POPUP-HDU (p < 0.05). 14 patients developed medical complications in the PICU group, compared to 19 in POPUP-HDU. There were no bedshortage cancellations in POPUP-HDU, compared to 23 in PICU. For children with neuromuscular, genetic or syndromic scoliosis undergoing PSF or growth rods that are not deemed suitable for immediate ward-level post-operative care, POPUP-HDU provided a safe alternative to PICU for appropriate patients and was associated with shorter hospital stay and fewer cancellations for lack of PICU beds. Therapeutic Level III.

Individual Resilience among Adult Children of Parents with Bipolar Disorder in Chinese Society: An Inductive and Deductive Content Analysis Approach.

Nurses can help children of parents with mental illness discover their resilience. However, previous studies have focused on their experience in Western settings and have limited understanding of a Chinese cultural context. This study aims to explore individual resilience emerging from adult children's experience of living with parents with bipolar disorder in Chinese society within the framework of character strengths and possible cultural components. A content analysis with both inductive and deductive approaches. Twenty adults participated in this study. Interviews were conducted while the participants' parents were hospitalized in an acute psychiatric hospital ward. The framework of character strengths confirmed five emergent themes of individual resilience in this study: courage, temperance, humanity, knowledge and wisdom, and transcendence. Character strengths are an adequate framework for understanding of individual resilience. Chinese adult children develop resilience by regulating their emotions, respecting their parents, engaging in self-discipline, and positively interpreting adversity.

Prevalence of Anxiety and Suicidal Ideation in Nurses Working in COVID-19 Wards Compared to Nurses From Other Hospital Wards During the Pandemic

Background and Objectives: Investigating the level of anxiety and suicidal thoughts in nurses during the COVID-19 pandemic can play an important role in helping them clinically to prevent the development of psychological symptoms in them. In this regard, this study aims to investigate the prevalence of anxiety and suicidal ideation in nurses working in COVID-19 wards compared to nurses from other departments. Methods: In this analytical cross-sectional study, participants were 347 nurses from two hospitals (Shahid Beheshti and Kamkar) in Qom, Iran in 2021. Nurses were divided into two groups working in COVID-19 and non-COVID wards. The data collection tools were a demographic form, Beck’s anxiety inventory, and the Beck scale for suicidal ideation. The data was analyzed in SPSS software version 22 using independent t-test or ANOVA for quantitative data and chi-square test for qualitative data. The significance level was set at 0.05. Results: Among participants, 139(40.1%) were in the COVID group and 208(59.9%) were in the non-COVID group. Nurses in the COVID group had significantly higher anxiety scores than nurses in the non-COVID group (P&lt;0.001), but there was no significant difference between COVID and non-COVID groups in suicidal ideation (P=0.979). Conclusion: There is a high prevalence of anxiety among nurses working in COVID-19 wards compared to nurses from other wards. Therefore, it is recommended to use psychological treatments to reduce the anxiety and suicidal thoughts of these nurses during the COVID-19 pandemic.

Associated Factors of Low Birth Weight among Newborns at Hospitals in Kisangani, Democratic Republic of Congo

Background: Low birth weight remains a major public health problem in every country in the world. It is a predictor of early neonatal mortality, morbidity and long-term health. The aim of this study was to determine the prevalence of low birth weight and to identify the associated factors in a hospital setting in Kisangani. Material and Methods: An unmatched case-control study was used including all live and full-term births was conducted from 1 December 2023 to 31 May 2024 in the maternity wards of Makiso-Kisangani General Referral Hospital, Mangobo General Referral Hospital, Tshopo General Referral Hospital and Alwaleed Health Centre. A sample of 646 newborns was selected: 86 cases (newborns weighing less than 2500 grams) and 560 controls (newborns weighing 2500 grams or more). Factors associated with prehypertension were identified using logistic regression. Results: The prevalence of low birth weight was 13.4%. Factors associated with low birth weight were maternal age less than 18 years, intergenital interval less than 2 years, maternal infection during pregnancy, high blood pressure, level of primary education and urban residential environment. Conclusion: This study shows that low birth weight remains a public health problem in Kisangani. In addition to shedding light on the other contributing variables and the connections between them, prospective national research would enable the development of preventative measures.

Association Between the Use of Proton Pump Inhibitors and Severe Clinical Outcomes in COVID-19 Patients: A Retrospective Observational Study.

Background Proton pump inhibitors (PPIs) increase the risk of pneumonia secondary to PPI-induced hypochlorhydria. We aim to investigate the association between PPI and disease severity in coronavirus disease 2019 (COVID-19)-positive patients and the risk of hospitalizations in Muscat, Oman. Methodology COVID-19-positive patients aged 18 years and above at the time of diagnosis were included in this retrospective observational study. The details of the patients were retrieved from the electronic health records of the Al Shifa Hospital Information Management System and Tarassud. The composite primary endpoint was COVID-19 admission to a government tertiary hospital ward or intensive care within 14 days of diagnosis. Results A total of 506 COVID-19-positive patients were identified during the specified period. The mean age was 44 ± 15 years. The majority of the patients were Omani, and a female preponderance was observed. Overall, 104 (20.4%) patients were current PPI users. Admission due to COVID-19 was significantly associated with the presence of comorbid conditions such as diabetes mellitus (p = 0.001), hypertension (p = 0.001), and chronic kidney disease (p < 0.001). However, current PPI use (p = 0.140) was not significantly associated with an increased risk of hospitalization. Conclusions This data suggests that the use of PPIs during COVID-19 infection did not increase the risk of severe COVID-19 infection and poor outcomes leading to hospitalization in Muscat, Oman. However, the presence of other medical comorbidities, such as diabetes and hypertension, was associated with a higher risk of adverse clinical symptoms that resulted in hospitalization.

The role of emergency medicine specialists and general practitioners in yellow zone patient management: A case in the Sakarya Province

AbstractBackgroundEmergency departments in Turkey employ both emergency medicine specialists (EMSs) and general practitioners due to an insufficient number of EMSs. Patients are triaged into green, yellow, and red codes based on urgency. Typically, EMSs manage more critical patients (yellow and red codes), while general practitioners handle less urgent cases (green codes).ObjectiveThis study investigates differences in patient management approaches between EMSs and general practitioners in the yellow zone of an emergency department in the Sakarya Province.MethodThis retrospective, cross‐sectional study was conducted at the Sakarya Training and Research Hospital from 31 December 2020 to 31 December 2021. The study included patients aged 18 and older who were assigned to the yellow zone and discharged by the attending physician. Data on patient monitoring times, consultation requests, hospitalization rates, resource utilization, readmission rates, and hospital revenue contributions were collected and analyzed. Statistical analyses were performed using IBM SPSS version 21, comparing the performance of EMSs and general practitioners.ResultThe study included 59 physicians (14 EMSs and 45 general practitioners) and a large number of patients. EMSs had significantly more experience, shorter consultation request times, and higher ICU admission rates. They also ordered fewer MRIs and USGs per patient and made more consultation requests. There was no significant difference between EMSs and general practitioners in terms of the number of examinations, patient observation times, ward hospitalization rates, CT orders, readmission rates, and hospital revenue contributions.ConclusionEMSs demonstrated more efficient use of emergency department resources, effective consultation processes, and higher ICU admission rates, indicating better patient management. Despite the limited scope of this single‐center study, the findings highlight the importance of EMSs in improving emergency care quality. Further research is needed to validate these results across multiple centers.

A Study on Assessing the Impact of Smoking and Occupational Exposure on COPD Severity.

Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality worldwide, with occupational exposure to respiratory hazards and smoking being significant risk factors for its development and progression. This study aimed to investigate the relationship between occupational exposure and COPD severity among patients admitted to the new medical ward of a public hospital. The research employed a cross-sectional design and involved a sample of 160 COPD patients. Data collection included patient records, face-to-face interviews, and structured questionnaires that gathered demographic information, smoking history, occupational exposure, and disease severity. Quantitative analysis methods were used, with statistical tools such as chi-square tests and correlation analysis applied to assess the relationships between variables. The chi-square test demonstrated a significant association between occupational exposure and COPD severity (χ² = 45.07, df = 8, p = 0.05). Correlation analysis revealed positive relationships between COPD severity and age (r = 0.40), smoking status (r = 0.53), and duration of occupational exposure (r = 0.69). The findings emphasize the critical role of occupational risks and smoking in exacerbating COPD and suggest the need for preventive workplace interventions and stricter regulations to reduce respiratory hazards.

An Assessment of an Inpatient Robotic Nurse Assistant: A Mixed-Method Study

The worldwide nursing shortage has led to the exploration of using robotics to support care delivery and reduce nurses’ workload. In this observational, mixed-method study, we examined the implementation of a robotic nurse assistant (RNA) in a hospital ward to support vital signs measurements, medication, and item delivery. Human–robot interaction was assessed in four domains: usability, social acceptance, user experience, and its societal impact. Patients in a general medicine ward were recruited to participate in a one-time trial with the RNA and a post-trial 75-question survey. Patients’ interactions with the RNA were video recorded for analysis including patients’ behaviours, facial emotions, and visual attention. Focus group discussions with nurses elicited their perceptions of working with the RNA, areas for improvement, and scalability. Sixty-seven patients aged 21–79 participated in the trial. Eight in 10 patients reported positive interactions with the RNA. When the RNA did not perform to expectations, only 25% of patients attributed fault to the RNA. Video analysis showed patients at ease interacting with the RNA despite some technical problems. Nurses saw potential for the RNA taking over routine tasks. However, they were sceptical of real time savings and were concerned with the RNA’s ability to work well with older patients. Patients and nurses suggested greater interactivity between RNA and patients. Future studies should examine potential timesaving and whether time saved translated to nurses performing higher value clinical tasks. The utility of improved RNA’s social capability in a hospital setting should be explored as well.

Operational efficiency effect on nursing workload of tertiary hospital wards in China: A prospective observational study.

To investigate the effect of ward operational efficiency on nursing workload and identify the factors that influence nursing workload. It remains unclear how and to what extent ward operational efficiency can influence nursing workload. A prospective observational study was conducted from July 1, 2022 to June 30, 2023, in one tertiary general hospital in China. Purposive and convenience sampling was used, and 266 470 patients from 66 wards and 52 nurses from 13 wards were recruited. The relationships between operational efficiency and nursing workload and the predictors of nursing workload were analyzed. The STROBE guidelines were followed. The operational characteristics vary by the type of wards. Nursing workloads were positively correlated with case mix index (CMI), rate of level 4 surgery, the number of patients transferred in and out, the number of deaths, total bed days, and the number of emergency admissions and critical illnesses (γs: 0.35-0.56, p<0.05). And the CMI, rate of level 4 surgery, average bed occupancy rate, number of critically ill patients, and total bed days were the predictors of nursing workload (R2=57.3%, p<0.05). This study is the first to discuss the relationship between operational efficiency and nursing workload on the ward level and offers valuable insights into the nursing workload. The operational efficiency of wards affects the nursing workload and needs to be considered both in the measurement of nursing activities and in the sizing of the nursing staff. The study findings provide a full understanding of the relationship between ward operation and nurse staffing, which is helpful for nursing managers to formulate scientific nurse staffing policies.

Evaluation of a weight‐based process for real‐time accurate confirmation of oral liquid controlled drug balances

AbstractTo meet legislative requirements in Australia, the balance of controlled drugs (CDs) must be confirmed after completion of each transaction. This is particularly challenging for liquid CD formulations, and over the years, health organisations have implemented various methods of performing this task, including the use of visual aids or conversion of bulk formulations to individual unit doses. These methods have a number of limitations. Therefore, this study aimed to evaluate the accuracy and feasibility of a weight‐based method for confirming oral liquid CD balances packed in multidose containers. This study was conducted in a palliative care ward of a metropolitan hospital over a 41‐day period. Morphine mixture 5 mg/1 mL transactions and balance checks were confirmed using weight calculations of the product bottle. The weights were then converted to volume using a locally developed electronic application, which was recorded in the relevant CD registers. The acceptable tolerance per transaction (±0.1 mL) was determined prior to commencement based on 80 test transactions. Throughout the trial period, 407 transactions were undertaken, among which there were no CD discrepancies. Nine nurses provided feedback via an anonymous online survey after the trial, mostly reporting that the new method was more accurate. However, participants also reported that it took on average 3 min longer to complete each transaction. In conclusion, utilising a weight‐based method of confirming liquid CD balances may present a feasible method of meeting legislative requirements related to the recording and accountability of CDs. This project was exempt due to the local policy requirements that constitute research by the Eastern Health Office of Research and Ethics (Reference no: QA24‐100‐111698). The justification for this ethics exemption was as follows: the study conformed with the National Health and Medical Research Council (NHMRC) Ethical considerations in quality assurance and evaluation activities and did not directly affect patient care; written consent was not required from participants per local requirements, however staff were provided verbal and written project information and were informed their participation in the survey was voluntary and anonymous.

A Study of Job Satisfaction of Hospital Staff in Hospital Ward

Introduction: Job satisfaction is defined as “a pleasurable of positive emotional state resulting from the appraisal of one’s bob experiences.” The primary objective of this study is to measure the level of employee satisfaction towards their job. Any employee in any organization has tow tips of job satisfaction. The first is in terms of money gain and second is in terms of mental gains. This study attempts to evaluate the overall job satisfaction of employee in tooth planet dental clinic. Job satisfaction is a result of employee’s perception of how well their job provides those things that are viewed as important. It is generally recognized in the organizational behaviour. Material and Methods: The study was conducted among the sample 20 respondents. Data collected through survey, interview and discussion and with the help of questionnaire, each question in the questionnaire must satisfy the objective of the study. Secondary data are those which have been collected by some other persons for his purpose and published secondary data collected though journals and annual report of the company. The project was carried our tooth planet dental clinic. The collected data were properly edited and processed by computer techniques using excel and word and was entered into a master sheet for analysis and interpretation. Finding and conclusion are based on interpretation of data presented in the form of tables and graphs. Results: In our study 90 % respondents is under 30 years old. 10 % employees under 30-40 years old and employs are under 40-50 years old and no one employees are above 50 years old. In this study 75 % respondents are satisfied with his salary whereas 25 % respondents cannot satisfy with their salary because they want more salary and 0% respondents can’t say anything. It can be interpreted that 20 % respondents say the company cleanness is good, 0 % respondents says the cleanness is somewhat good and 0 % respondents say that company cleanness is somewhat bad. Majority of the employee are agreed with the technology adopted by the organization to finish their work smoothly. Conclusion: Job satisfaction is a key aspect for success of every enterprise, when employees are satisfied work of performance will increase. Job satisfaction of employees in any organization is of paramount importance to achiever the targeted goals on a sustainable basis. The research on the subject has put that building of employee’s competencies and self confidence through training, feedback, and recognition should be a permanent activity of the organization. It is noticed that high job satisfaction is closely related to the feeling of effectiveness on the job.

Acute Care Nurses' Partnership With Patients to Recognise and Respond to Changes in Patients' Clinical States: AQualitative Study.

To explore and describe acute care nurses' partnership with patients to recognise and respond to changes in patients' clinical states. Acute care nurses' decisions to partner with patients to recognise deterioration in clinical states and to respond by activating a rapid response system improves patient outcomes. Acutely unwell patients can also experience clinical changes that include improvement and deterioration that does not trigger rapid response system activation over the course of hospitalisation from illness and treatment. How acute care nurses partner with patients in response to improvement and deterioration not triggering a rapid response system is not well-understood. An exploratory, descriptive study underpinned by Tanner's Clinical Judgement Model. Using purposive and quota sampling, 20 nurses with direct patient care responsibilities on one medical and one surgical ward in a large Australian hospital were recruited. Nonparticipant observations followed by semistructured interviews were conducted between January and May of 2021. Nurse-patient interactions were observed for 4 h, and verbally described and recorded. Semistructured interviews were recorded and explored nurses' reasoning behind decisions observed. Reflexive thematic analysis was used to analyse the data. Three themes were identified from the data: nurses checking in for changes; nurses forming judgements; and nurses partnering with patients to respond. Acute care nurses promoted subjective assessment based on patients' safety risks. Patients' participation in response to changes was prioritised based on acute care nurses' judgement of safety. Patients receive significant safety benefits when acute care nurses partner with patients in response to their experience of improvement and deterioration during acute illness. Further research should evaluate the sensitivity of subjective cues in patient assessment. Partnership with patients in assessment and management of improvement and deterioration improves the quality and safety of patient care. Assessment frameworks should equally prioritise the use of objective and subjective cues. Nursing education should promote the safety benefits of patient partnerships in responding to patient changes. Equator checklist COREQ. Data collected included description of patients' interactions with study participants.

Fall prevention among adult surgical patients in Tabriz, Iran: a best practice implementation project.

Falling out of bed is the most common unintentional cause of injury among patients and is a major safety problem in health care facilities. Current practices for fall prevention may not always be aligned with established best practices, leading to variability in patient outcomes. This uncertainty underscores the need to assess and improve compliance with best practice guidelines for fall prevention. This project aimed to improve fall prevention in the surgical ward of a general hospital in Tabriz, Iran. This study was guided by the JBI Evidence Implementation Framework. A baseline audit was conducted using eleven audit criteria representing best practices for fall prevention. After the implementation of improvement strategies, a follow-up audit was conducted to evaluate changes in practice. The results revealed significant improvements, notably, fall risk assessment upon admission (87% to 92%), fall risk assessment upon ward transfer (39% to 79%), patient participation in fall risk assessment (26% to 68%), reassessment upon change in condition (53% to 74%), communicating fall prevention information to at-risk patients and their families/caregivers (42% to 63%), engagement of patients (100% to 100%), implementation of targeted strategies (89% to 92%), post-fall assessment and interventions (82% to 87%), revising patient fall risk status and reviewing care management plan (41% to 74%), fall prevention information to patients and their families/caregivers upon discharge (44% to 66%), and person-centered education of health care professionals (77% to 81%). The use of standard clinical audit tools in hospitals can improve the quality of patient care and increase the effectiveness of interventions by identifying weaknesses in the patient care process. http://links.lww.com/IJEBH/A283.

"Doctor, would it surprise you if there were prescribing errors in this patient's medication?" Identifying eligible patients for in-hospital pharmacotherapeutic stewardship: A matched case-control study.

Evaluating a patient's medication list is critical to reduce prescribing errors (PEs), but is a labour- and time-intensive process. Identification of patients at risk of PEs could improve the allocation of scarce time and resources, but currently available prediction tools are not effective. To investigate whether ward doctors can identify patients at risk of PEs. This prospective matched case-control study was conducted on three clinical wards in an academic hospital. Otolaryngology and oncology ward doctors used clinical intuition to select patients requiring a clinical medication review (CMR) (cases). These patients were then matched 1:1 on age (±10years) and number (±1) of prescriptions with patients not selected for CMRs on the internal medicine and upper gastrointestinal surgery ward (controls). A multidisciplinary in-hospital pharmacotherapeutic stewardship team assessed the prevalence of PEs. A total of 387 patients with 5191 prescriptions were included. Overall, 799 PEs affecting 279 patients (72.1%) were identified. Most PEs (58.8%) occurred during hospitalization. There were no significant differences in age, number of prescriptions, sex, renal function or documented allergies or intolerances between the cases and controls or between controls and other patients who did not receive a CMR. The incidence of PEs was higher in cases than in controls (97.5% vs 72.5%, odds ratio= 14.8, 95% confidence interval [CI] 1.8-121.1, P= .002)). The rate of PEs was three times higher in cases than in controls (incidence rate ratio=3.0, 95% CI 2.3-4.0, P< .001). Ward doctors can effectively identify patients with PEs, and thus at risk of medication-related harm, using clinical intuition.

Fall prevention among psychiatric patients in an Iranian hospital: a best practice implementation project.

Falls are the main cause of disability among psychiatric patients, as well as being the most common adverse event in hospitals. The aim of this evidence implementation project was to improve fall prevention and management among psychiatric patients in a neurology ward in an Iranian tertiary psychiatric hospital. This project used the JBI Evidence Implementation Framework, which recommends an audit, feedback, and re-audit strategy. A baseline audit was conducted to evaluate current fall prevention practices among 50 psychiatric patients and 20 health care professionals. The baseline audit was used to identify gaps in compliance. After the implementation of improvement strategies, a follow-up audit was conducted to measure any changes in practice. The baseline and follow-up audits revealed that compliance with best practices improved in ward transfer fall risk assessment (Criterion 2: 87% to 90%), patient participation in fall risk assessment (Criterion 3: 95% to 96%), revising patient fall risk status (Criterion 9: 50% to 86%), and person-centered education of health care providers (Criterion 11: 78% to 96%). Other audit criteria remained unchanged. However, for Criterion 6 on patient engagement in goal-setting and treatment planning, compliance dropped from 100% at baseline to 94% at follow-up. This project successfully increased evidence-based practices regarding fall prevention and management, as well as providing mechanisms for sustaining the practice changes. Future audits are required to further improve outcomes. http://links.lww.com/IJEBH/A267.

Review on Acute Reactions while Administration of Intravenous Medications

The most common invasive procedure that patients admitted to hospital wards likely undergo is intravenous (IV) access. Medications through IV fluid injection is administered to up to 80% of hospital patients. Certain medications, such as phenytoin, vancomycin, ampicillin/sulbactam combinations, steroids, and cefotaxime, might result in abrupt responses when intravenous fluids are administered. antibiotics such as mitomycin, daunorubicin, dactinomycin, and doxorubicin. Antineoplastic drugs such as methotrexate, cyclophosphamide, etoposide, vinorelbine, carboplatin, oxaliplatin, paclitaxel, and epirubicin. Dopamine, noradrenaline, amiodarone, adrenaline, and pituitrin are examples of inotropic substances. Bevacizumab, Cisplatin, Heparin, Glucocorticoids, Tamoxifen, Testosterone, and Antidepressants. When administering IV medication, Clinical Pharmacist are crucial in identifying and reporting drugs that cause acute responses. Clinical Pharmacist can be involved because they can be crucial in ensuring safe pharmaceutical use in hospitals.