Organizational Factors Associated With Nurses’ Competence in Averting Failure to Rescue in Acute Care Settings

Background: Organizational characteristics are the main concerns of nursing practice in acute care settings. The present study aimed to assess the organizational factors associated with nurses’ competence in averting Failure to Rescue (FTR) in acute care settings. Methods: This was a descriptive and correlational study. A purposive sampling technique was used to collect the necessary data from the study respondents. In total, 173 of the 204 eligible registered nurses providing sudden, urgent, and emergency direct care to patients in the identified acute care settings of Olabisi Onabanjo University Teaching Hospital in Sagamu City, Nigeria participated in this study. A self-structured 38-item questionnaire, including 4 parts (demographic characteristics, knowledge on FTR, competence in averting FTR, & organizational factors) was employed for data collection. The obtained data were analyzed in SPSS V. 22 using descriptive statistics (i.e. frequency, percentages, mean, standard deviation, & tables) as well as Spearman’s Rho correlation to test the hypotheses based on the assumptions that the variables were measured on an ordinal scale at P<0.05. Results: Most nurses presented a high level of knowledge regarding FTR with a mean score of 5.91. Besides, they were moderately competent in averting FTR with a mean score of 29.3. A significant correlation was also detected between organizational characteristics and the studied nurses’ level of competence in averting FTR (P=0.026). Conclusion: The present study data revealed that FTR could be reduced in acute care settings by the modification of organizational factors.

High SARS-CoV-2 Seroprevalence among Healthcare Workers in Bamako, Mali

In Mali, a country in West Africa, cumulative confirmed COVID-19 cases and deaths among healthcare workers (HCWs) remain enigmatically low, despite a series of waves, circulation of SARS-CoV-2 variants, the country’s weak healthcare system, and a general lack of adherence to public health mitigation measures. The goal of the study was to determine whether exposure is important by assessing the seroprevalence of anti-SARS-CoV-2 IgG antibodies in HCWs. The study was conducted between November 2020 and June 2021. HCWs in the major hospitals where COVID-19 cases were being cared for in the capital city, Bamako, Mali, were recruited. During the study period, vaccinations were not yet available. The ELISA of the IgG against the spike protein was optimized and quantitatively measured. A total of 240 HCWs were enrolled in the study, of which seropositivity was observed in 147 cases (61.8%). A continuous increase in the seropositivity was observed, over time, during the study period, from 50% at the beginning to 70% at the end of the study. HCWs who provided direct care to COVID-19 patients and were potentially highly exposed did not have the highest seropositivity rate. Vulnerable HCWs with comorbidities such as obesity, diabetes, and asthma had even higher seropositivity rates at 77.8%, 75.0%, and 66.7%, respectively. Overall, HCWs had high SARS-CoV-2 seroprevalence, likely reflecting a “herd” immunity level, which could be protective at some degrees. These data suggest that the low number of cases and deaths among HCWs in Mali is not due to a lack of occupational exposure to the virus but rather related to other factors that need to be investigated.

Health education for hospitalized patient in nursing care: a conceptual analysis

ABSTRACT Objectives: to define the concept of Health Education of Hospitalized Patient. Methods: the study used the conceptual analysis based on Walker and Avant strategies: Derivation, Synthesis, and Analysis of the concept. Researchers conducted 35 interviews with nurses who worked in direct care to patients admitted to a Hospital-School, and a bibliographic search on the CINAHL, Medline/PubMed®, Scopus, Web of Science, LILACS, and BDENF databases. Results: the study identified the antecedents, attributes, and consequences of the concept and defined the concept of Health Education of Hospitalized Patient as “the action of sharing knowledge about the promotion, prevention, recovery and rehabilitation concerning to health based on reciprocity between nurses and patients, family members and companions, in a systematized or unsystematic way”. Final Considerations: the identification of antecedents, attributes, consequences, and empirical references enabled the theoretical definition unprecedented of this concept and its applicability in practice, contributing to science and hospital nursing care.

Nurses’ View towards the Use of Robotic during Pandemic COVID-19 in Indonesia: A Qualitative Study

Background: Rapid advances in artificial intelligence and robotics have alleviated difficulties for patients, hospitals, and the industry as a whole. However, the health care system is identically human-centered at its core, and many healthcare professions may not be ready to work with robots. Understanding nurses' views toward robotics can help integrate robotic technologies into future patient care. Objectives: This study aimed to explore how nurses view using robotics during the COVID-19 pandemic. Methods: This study used a qualitative descriptive technique to registered nurses who provide direct care to the patients with COVID-19 recruited from two hospitals in Indonesia. Purposive sampling was used to select respondents with criteria of those who had worked for at least one year and were willing to participate—the analysis used qualitative content analysis. Results: A total of 20 female nurses with an average age of 32.8 ± 4.0 years participated in this study. The qualitative findings revealed three themes with nine sub-themes, namely the use of robotic in nursing care (sub-theme: reducing the risk of COVID-19 transmission, monitoring patients remotely, and helping in providing care), the burden of using robotic in nursing care (sub-theme: digital literacy in nursing care, culture difference in providing care, changing care practice habits, and safety concern, and attitude toward robotic in nursing care (sub-theme: negative response). Conclusions: This study explored nurses' views on the usage of robotics during the pandemic COVID-10. It implies that a strategic plan would have many benefits and limitations, such as nursing care burden, negative attitude, and cultural awareness.

THE POLISH SAFETY MODEL FOR CHILD AND YOUTH TOURISM – LEGAL ASPECTS

Purpose. Analysis of the legal solutions adopted in Poland relating to the ensuring safe practice of various forms of tourism during the school year when the school acts as a tour operator and in the period free from classes, when recreation is organised by entities conducting economic activity. Method. The implemented methods is critical analysis of legal acts and literature on the subject. Results. In the study, the necessity is shown to modify the adopted legal solutions in order to clarify the responsibilities of the school headmaster, in terms of ensuring the safety of school trip participants by teachers, depending on the type of tourist activity, especially in relation to active tourism. On the other hand, the recreation of children and adolescents is based on the provision of appropriate staff with the appropriate authorisation, and on the control activities of state bodies and relevant services. Research and conclusion limitations. Analysis of specific legal regulations and selected general regulations, which indirectly relate to the safety of organizing activities when it comes to children and youth tourism. Practical implications. In the research, it has been shown that the school principal, as the entity responsible for ensuring the safety of students during events and excursions organised by the school, has to rely on too general provisions of the legislation, especially with reference to the number of teachers in relation to the number of students under their direct care, without taking into account the particular form of excursion within the framework of active tourism. Originality. The article is an attempt to synthesize the problem of the model of safety adopted in Poland for school tourism and recreation of children and adolescents in the period free from classes. Type of work. In the article, the results of theoretical research are presented.

Occupational stress in healthcare workers during a COVID-19 pandemic

Healthcare workers experience overwhelming occupational and psycho-emotional stress during COVID-19 pandemic. Occupational stress leads to emotional burnout, can cause anxiety, depression and other psychopathological symptoms, influencing the quality of medical care. Existing situation necessitates to define risk factors, influencing occupational stress in healthcare workers in order to develop ways and methods to overcome it. Aim of the study was to identify socio-psychological factors associated with occupational stress in healthcare workers during the COVID-19 epidemic in Ukraine. Using a specially designed questionnaire, an online survey of 1,100 medical workers was conducted in all regions of Ukraine. Questioning was carried out over three weeks from 30.03.2020 to 21.04.2020, during the period of quarantine. The majority of respondents were female medical workers (79.9%). Age of respondents: up to 30 years – 179 (16.2%), from 31 to 60 – 824 (75.0%), over 60 – 97 (8.8%), among them doctors – 695 (63.1%) 236 nurses (21.5%), more than a third are general practitioners. Direct care for patients with COVID-19 was provided by 170 (15.5%) medical personnel. The analysis of the results of the questionnaire enabled to determine the peculiarities of medical worker`s response to the situation in connection with COVID-19 and highlight the emotional and behavioral factors associated with stress that are significant for most respondents. The study answered the questions regarding the perceived risk associated with the spread, contamination and death related to coronavirus. The most significant factors affecting the occurrence of stress in medical workers are identified. Along with this, factors contributing to stress coping have been identified as well. For subsequent statistical processing, all respondents were divided into two groups depending on the severity of the anxiety/fear. Comparison of these groups by socio-demographic indicators was done using the test χ2. There were no statistically significant differences between groups in all socio-demographic indicators, except for age. That is, only the age factor affected the severity of anxiety/fear among healthcare workers due to COVID-19 (p<0.05). Comparative analysis to assess the severity of stress in groups was performed using the Mann-Whitney U test. Healthcare workers with severe anxiety/fear have a high risk for development of occupational stress during a COVID-19 pandemic (p<0.01). In conclusion, the need for the development and implementation of methods for the prevention of occupational stress in medical workers in the current epidemic situation is substantiated.

Medication interruptions and associated factors among nurses working in pediatric unit at a selected referral hospital in Rwanda

Introduction: Interruptions have been proven to cause medication administration errors in pediatric settings. Therefore, this study assessed the medication interruptions and associated factors among nurses in a pediatric unit at a selected referral hospital in Rwanda. Methods: A descriptive observational study was conducted among 59 nurses using a developed observational checklist. Data were entered into SPSS, version 26. Descriptive and inferential statistics were used to analyze the data. The IRB of the University of Rwanda approved the study. Results: Among the 414 medication administrations observed, 149 (36%) had interruptions. The main source of interruption was technical problem (14.5%) with interruption from direct care (12%) as the main reason. The factors associated with interruption occurrence were shift of the day, time of medication round, duration and phase of medication administration and nurse perception (p = 0.001), age (p=0.046), educational level (p = 0.044) and professional experience (p = 0.031). Conclusion: The existence of medication interruptions is evident with associated factors predominantly being demographics and technical. Therefore, the authors recommended that an in-service training program for nurses regarding medication administration errors. The hospital leadership should address the technical problems including availing the required materials for medication administration. French title: Interruptions médicamenteuses et facteurs associés chez les infirmières travaillant dans l'unité pédiatrique d'un hôpital de référence sélectionné au Rwanda Introduction : Il a été prouvé que les interruptions provoquent des erreurs d'administration de médicaments en milieu pédiatrique. Par conséquent, cette étude a évalué les interruptions de médication et les facteurs associés chez les infirmières d'une unité de pédiatrie d'un hôpital de référence sélectionné au Rwanda. Méthode de l'étude : Une étude observationnelle descriptive a été menée auprès de 59 infirmières à l'aide d'une liste de contrôle d'observation élaborée. Les données ont été saisies dans SPSS, 26. Des statistiques descriptives et inférentielles ont été utilisées pour analyser les données. L'IRB de l'Université du Rwanda a approuvé l'étude. Résultats de l'étude : Parmi les 414 administrations de médicaments observées, 149 (36 %) ont subi des interruptions. La principale source d'interruption était un problème technique (14,5 %) avec l'interruption des soins directs (12 %) comme principale raison. Les facteurs associés à l'occurrence d'interruption étaient décalage de la journée, heure de la tournée de médicaments, durée et phase d'administration des médicaments et perception de l'infirmière (p = 0,001), âge (p=0,046), niveau d'éducation (p = 0,044) et expérience professionnelle (p = 0,031). Conclusion : L'existence d'interruptions de médication est évidente avec des facteurs associés principalement démographiques et techniques. Par conséquent, les auteurs recommandent un programme de formation continue pour les infirmières concernant les erreurs d'administration de médicaments. La direction de l'hôpital devrait résoudre les problèmes techniques, notamment en mettant à disposition les matériaux requis pour l'administration des médicaments.

Evaluation of Patient-Initiated Direct Care Mobile Phone–Based Teledermatology During The COVID-19 Pandemic

Background With advances in telecommunication, especially smartphones, teledermatology services offered by specialists are now being directly requested by the patients themselves. This model is known as patient-initiated, direct care teledermatology. It has been pushed to the forefront due to the COVID-19 pandemic. Objective The objectives of this study were to determine patients’ satisfaction and dermatologists’ confidence when a diagnosis was made via direct care mobile phone–based teledermatology. Methods Patients availing direct care teledermatology services during the COVID-19 pandemic at a tertiary care center were subjected to a questionnaire within 5 days of the teleconsultation to assess patient satisfaction and opinions regarding using this model during and beyond the current COVID-19 pandemic. The dermatologists rated their confidence in making the clinical diagnosis on a scale from 1-10 for every case. Results Of 437 participants, 419 (95.9%) were satisfied with this mode of teledermatology. An overwhelming majority (n=428, 97.9%) felt safe consulting the dermatologist via teleconsultation and not having to visit the hospital during the COVID-19 pandemic. In addition, 269 (61.6%) patients agreed that they would be happy to use a teledermatology service beyond the COVID-19 pandemic. The dermatologists’ confidence score in making an accurate diagnosis ranged from 3 to 10, with a mean of 9.20 (SD 1.12). Conclusions The high levels of patient satisfaction and dermatologists’ confidence scores indicate that direct care mobile phone–based teledermatology may be a useful tool in providing dermatological services in appropriate settings and its use should continue to be explored beyond the COVID-19 pandemic. Conflicts of Interest None declared.

Evaluation of Patient-Initiated Direct Care Mobile Phone–Based Teledermatology During The COVID-19 Pandemic (Preprint)

BACKGROUND With advances in telecommunication, especially smartphones, teledermatology services offered by specialists are now being directly requested by the patients themselves. This model is known as patient-initiated, direct care teledermatology. It has been pushed to the forefront due to the COVID-19 pandemic. OBJECTIVE The objectives of this study were to determine patients’ satisfaction and dermatologists’ confidence when a diagnosis was made via direct care mobile phone–based teledermatology. METHODS Patients availing direct care teledermatology services during the COVID-19 pandemic at a tertiary care center were subjected to a questionnaire within 5 days of the teleconsultation to assess patient satisfaction and opinions regarding using this model during and beyond the current COVID-19 pandemic. The dermatologists rated their confidence in making the clinical diagnosis on a scale from 1-10 for every case. RESULTS Of 437 participants, 419 (95.9%) were satisfied with this mode of teledermatology. An overwhelming majority (n=428, 97.9%) felt safe consulting the dermatologist via teleconsultation and not having to visit the hospital during the COVID-19 pandemic. In addition, 269 (61.6%) patients agreed that they would be happy to use a teledermatology service beyond the COVID-19 pandemic. The dermatologists’ confidence score in making an accurate diagnosis ranged from 3 to 10, with a mean of 9.20 (SD 1.12). CONCLUSIONS The high levels of patient satisfaction and dermatologists’ confidence scores indicate that direct care mobile phone–based teledermatology may be a useful tool in providing dermatological services in appropriate settings and its use should continue to be explored beyond the COVID-19 pandemic.

Navigating the Care Between two Distinct Cultures: A Qualitative Study of the Experiences of Arabic-Speaking Immigrants in Norwegian Hospitals

Background: During the past decades, there has been an increase in the number of immigrants to European and Scandinavian countries. This has challenged the health-care systems, which cater to the needs of patients despite their cultural and linguistic barriers, in these countries. Most studies on this topic have focused on the perspectives of health-care providers in delivering their service. However, the present study was aimed at understanding the lived experiences of Arabic-speaking patients in Norway in terms of their communicational and cultural interactions within the health-care system. The purpose of this qualitative study was to explore the linguistic-, cultural-, and health literacy-based problems experienced by Arabic-speaking patients regarding their interactions within the Norwegian health-care systemMethods: In-depth interviews with 20 participants and researcher’s participant observation were conducted to explore the idiosyncratic details and ascribed meanings that foreign-born patients attach to their everyday experience of the Norwegian health-care system. Thematic analysis was performed on the transcribed and translated versions of the in-depth interviews. Results: The findings of this study indicated three interrelated core themes. Firstly, there exist challenges in understanding and being understood because of linguistic and cultural gaps of newly migrated patients. Secondly, some patients missed the holistic and direct care available in their home countries. Finally, patients were satisfied with the Norwegian health-care system because of its compassion, care, and respect toward them as well as advanced health-care equipment. Conclusion: Arabic-speaking patients in Norwegian hospitals experienced long waiting times and linguistic problems. Hence, a better and specialized interpreter service may resolve problems emanating from communication within the system and the subsequent delays in treatment. Compassionate care and the feeling of respect and love is the core strength of the Norwegian system as perceived by the patients.