Care Setting
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2021 ◽  
Vol 75 (10) ◽  
Varalakshmi Niranjan ◽  
Aleksandra Sliwinska ◽  
Fufei Chen ◽  
Srinath Ramanan ◽  
Narinder Maheshwari ◽  

2021 ◽  
Vol Publish Ahead of Print ◽  
T.J. Kasperbauer ◽  
Amy Waltz ◽  
Brenda Hudson ◽  
Bridget Hawryluk ◽  
Courtney Moore ◽  

2021 ◽  
Waldo Beausejour ◽  
Simon Hagens

BACKGROUND Canadian nurses are at the forefront of patient care delivery. While the Canadian health care system is embracing digital health, nurses are bound to integrate virtual care into practice. In early 2020, more Canadian nurses delivered care virtually than three years before. OBJECTIVE This study sought to uncover the professional and care setting related characteristics of the nurses who delivered care virtually in 2020 and to investigate the factors driving the uptake of virtual care by nurses prior to the pandemic of COVID-19. METHODS We utilized data from the 2017 and 2020 National survey of Canadian nurses. This survey collected data on the use of digital health technologies in nursing practice. It concerned regulated nursing professionals working in different health care settings and from different domains of nursing practice. We combined Chi-square independence test and logistic regression analysis to uncover the main drivers of virtual care uptake by nurses in 2020. RESULTS In early 2020, prior to the pandemic of COVID-19, nurses who delivered care virtually were predominantly nurse practitioners (85%), more likely to work in a primary or community care setting (62%), or in an urban setting (62%). Factors like nursing designation (P < .01), perceived quality of care at the health facility where the nurses practiced (P < .01), and the type of patient record keeping system they had access to (P < .05) had a statistically significant effect on the probability for nurses to deliver care virtually in early 2020. Furthermore, nurses’ perception of the quality of care they delivered through virtual technologies was statistically associated with their perception of the skills (Chi-square=308.66, P < .01) and knowledge (Chi-square=283.39, P < .01) to use these technologies. CONCLUSIONS The study revealed some disparities in the uptake of virtual care by nurses across geographic regions. From an allocation standpoint, this finding should help decision-makers to pinpoint gaps in digital health utilization. Similarly, discrepancies in the use of virtual health across nursing designation have some implications for leadership at the care settings and for nurse educators in terms of competences and training for nurses at all levels of practice. Moreover, care settings are strongly encouraged to modernize their patient record keeping system as access to EMRs tended to influence the adoption of virtual care, which could foster interoperability. Finally, policy-related factors should not be overlooked when it comes to virtual care technologies integration in nursing practice.

Parvin Khalili ◽  
Ali Esmaeili Nadimi ◽  
Hamid Reza Baradaran ◽  
Leila Janani ◽  
Afarin Rahimi-Movaghar ◽  

Abstract Background Self-reported substance use is more likely to be influenced by underreporting bias compared to the biological markers. Underreporting bias or validity of self-reported substance use depends on the study population and cannot be generalized to the entire population. This study aimed to compare the validity of self-reported substance use between research setting and primary health care setting from the same source population. Methods and materials The population in this study included from Rafsanjan Youth Cohort Study (RYCS) and from primary care health centers. The sample from RYCS is made up 607 participants, 113 (18.62%) women and 494 (81.38%) men and sample from PHC centers is made up 522 individuals including 252 (48.28%) women and 270 (51.72%) men. We compared two groups in respect of prevalence estimates based on self-reported substance use and urine test. Then for evaluating validity of self-reported substance use in both group, the results of reference standard, urine tests, were compared with the results of self-reported drug use using measures of concordance. Results The prevalence of substance use based on urine test was significantly higher in both settings compared to self-reported substance use over the past 72 h. The sensitivity of self-report substance use over the past 72 h in research setting was 39.4, 20, 10% and zero for opium, methadone, cannabis and amphetamine, respectively and in primary health care setting was 50, 20.7, 12.5% and zero for opium, methadone, cannabis and amphetamine, respectively. The level of agreement between self-reported substance use over the past 72 h and urine test indicated fair and moderate agreement for opium in both research and primary health care settings, respectively and also slight agreement for methadone and cannabis in both settings were reported. There was no significant difference between the two groups in terms of self-reported substance use. For all substances, the level of agreement increased with longer recall periods. The specificity of self-report for all substances in both groups was more than 99%. Conclusion Individuals in primary health care setting were more likely to self-reported substance use than in research setting, but setting did not have a statistically significant effect in terms of self-reported substance use. Programs that rely on self-reported substance use may not estimate the exact prevalence of substance use in both research and primary health care settings, especially for substances that have a higher social stigma. Therefore, it is recommended that self-report and biological indicators be used for more accurate evaluation in substance use studies. It is also suggested that future epidemiological studies be performed to reduce bias of social desirability and find a method providing the highest level of privacy.

Federica Canzan ◽  
Elisabetta Mezzalira ◽  
Giorgio Solato ◽  
Luigina Mortari ◽  
Anna Brugnolli ◽  

Despite the worldwide promotion of a “restraint-free” model of care due to the questionable ethical and legal issues and the many adverse physical and psychosocial effects of physical restraints, their use remains relatively high, especially in the intensive care setting. Therefore, the aim of the present study was to explore the experiences of nurses using physical restraints in the intensive care setting. Semi-structured interviews with 20 nurses working in intensive care units for at least three years, were conducted, recorded, and transcribed verbatim. Then, the transcripts were analyzed according to the qualitative descriptive approach by Sandelowsky and Barroso (2002). Six main themes emerged: (1) definition of restraint, (2) who decides to restrain? (3) reasons behind the restraint use, (4) physical restraint used as the last option (5) family involvement, (6) nurses’ feelings about restraint. Physical restraint evokes different thoughts and feelings. Nurses, which are the professionals most present at the patient’s bedside, have been shown to be the main decision-makers regarding the application of physical restraints. Nurses need to balance the ethical principle of beneficence through this practice, ensuring the safety of the patient, and the principle of autonomy of the person.

Cureus ◽  
2021 ◽  
Joseph Anderson ◽  
Joanna Walsh ◽  
Martin Anderson ◽  
Rachel Burnley

2021 ◽  
Vol 63 (1) ◽  
Indiran Govender ◽  
Selvandran Rangiah ◽  
Ramprakash Kaswa ◽  
Doudou Nzaumvila

In this study, we outlined the types of malnutrition amongst children, the causes of malnutrition intervention at the primary health care level and some recommendations to alleviate childhood malnutrition in South Africa.

2021 ◽  
Mugsien Rowland ◽  
Anthonio Oladele Adefuye

Abstract Background: Delivering pre-hospital emergency care has the potential to be hazardous, and the patient could experience an adverse event. Despite these potential, yet known, threats, little is known about patient safety in the pre-hospital care setting, in contrast to in-hospital care. In South Africa, there are no reports on patient safety and human error issues in the pre-hospital care setting. This study investigated the perspectives of emergency care practitioners (ECPs) in South Africa on the types of errors that occur in the pre-hospital emergency care setting, as well as factors that influence patient safety and precipitate errors during pre-hospital care.Methods: This research was designed as an exploratory study that used a questionnaire administered on 2000 ECPs to obtain their perceptions on factors the influence human error and patient safety in the pre-hospital emergency care environment. Results: Of the 2000 questionnaires distributed, 1,510 were returned, giving a response rate of 76%. Analysis of the respondents’ responses in relation to the types of human errors in the pre-hospital environment yielded five dominant themes, namely errors relating to poor judgement, poor skill/knowledge, fatigue, and communication, and human error. According to the participants, inadequate equipment, environmental factors, personal safety concerns, practitioner’s incompetence, and ineffective teamwork are the top five factors that influence patient safety in the pre-hospital emergency care setting. The majority (65.1%; p < 0.001) of public sector ECPs reported that they had not received training on patient safety, nor do they have a protocol for managing medical error at their workplace (65.7%; p < 0.007). Conclusion: In conclusion, this study investigated paramedics’ views on types of errors that occur in the pre-hospital emergency care setting, and factors that influence patient safety and precipitate errors during pre-hospital care. It was found that public-sector emergency medical service (EMS) in South Africa seldom train their staff on patient safety or have a protocol for managing medical error. The study advocates that, to overcome medical errors, EMS in South Africa should establish a culture of safety that focuses on system improvement and personnel training.

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Heather L. Rogers ◽  
Susana Pablo Hernando ◽  
Silvia Núñez - Fernández ◽  
Alvaro Sanchez ◽  
Carlos Martos ◽  

PurposeThis study aims to elucidate the health care organization, management and policy barriers and facilitators associated with implementation of an evidence-based health promotion intervention in primary care centers in the Basque Country, Spain.Design/methodology/approachSeven focus groups were conducted with 49 health professionals from six primary care centers participating in the Prescribing Healthy Life program. Text was analyzed using the Consolidated Framework for Implementation Research (CFIR) focusing on those constructs related to health care organization, management and policy.FindingsThe health promotion intervention was found to be compatible with the values of primary care professionals. However, professionals at all centers reported barriers to implementation related to: (1) external policy and incentives, (2) compatibility with existing workflow and (3) available resources to carry out the program. Specific barriers in these areas related to lack of financial and political support, consultation time constraints and difficulty managing competing day-to-day demands. Other barriers and facilitators were related to the constructs networks and communication, culture, relative priority and leadership engagement. A set of six specific barrier-facilitator pairs emerged.Originality/valueImplementation science and, specifically, the CFIR constructs were used as a guide. Barriers and facilitators related to the implementation of a health promotion program in primary care were identified. Healthcare managers and policy makers can modify these factors to foster a more propitious implementation environment. These factors should be appropriately monitored, both in pre-implementation phases and during the implementation process, in order to ensure effective integration of health promotion into the primary care setting.

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