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.

Analysis of Clinical Experience Using Kolb’s Experiential Learning Theory: Postgraduate Medical Surgical Nursing Track Students in Selected Sub-Specialties at the University Teaching Hospital of Kigali, Rwanda

BackgroundClinical experiences provide an opportunity for nursing students to integrate theoretical knowledge into practice, and analyze their learning using a theoretical model. Students do not take this opportunity unless it is intentionally included by the facilitators. These observations from the second cohort of medical surgical nursing students with their facilitators, regarding their clinical training period in selected sub-specialties at the University Teaching Hospital of Kigali (CHUK) aimed at developing students’ analytical and observational skills while developing clinical skills.MethodsThe study involved nine medical surgical nursing students who were in different subspecialties at CHUK from 7th January up to the 20th February, 2019. Informed observational approach and concomitant reporting were used to validate their learning and gain clinical experience. The students used Kolb’s Experiential Learning Theory to analyze their experience, with the focus on innovative skills.ResultsAll medical surgical nursing students reported that they improved their knowledge and skills during clinical practice, while broadening their outlook.ConclusionKolb’s Experiential Learning Theory is useful in validating and bridging theoretical learning to clinical practice.Rwanda J Med Health Sci 2021;4(3):430-436

Denture characteristics, oral hygiene practice and periodontal changes of partial denture wearers and non-denture wearers in a Teaching Hospital- A comparative study

Background: There can be localized periodontal inflammation around abutment teeth of dentures as a result of plaque accumulation. This study assessed the periodontal changes of removable partial denture wearers compared to that of non-denture wearers. Methodology: Participants were recruited from the prosthodontic and restorative outpatient clinics of Lagos University Teaching Hospital. The self-administered questionnaire was used to collect information on socio-demographics, denture characteristics, periodontal changes and oral hygiene practice of participants. Periodontal status assessed included gingival inflammation, plaque accumulation and tooth mobility. Data was analyzed using SPSS version 20 (IBM SPSS Armonk, New York) and presented as frequencies and percentages. Test for significance was done using Chi-square statistics, and the level of statistical significance was set at P < 0.05. Results: A total of 96 participants between age 16 and 74years were recruited with mean age of 40±14.5years. There were 56 females and 40 males (F:M; 1.4:1). Fifty-four denture wearers and forty-two non-denture wearers were recruited into the study. Among participants wearing partial denture, 49(90.7%) had gingival inflammation; 45(91.8%) had mild inflammation compared to 4.8% participants who are non-denture wearers. 29(53.7%) denture wearers had fair oral hygiene while most 31(73.8%) non-denture wearers had excellent oral hygiene. Abutment teeth in denture wearers had tooth recession; mostly on the upper arch and also posteriorly. Conclusion: The periodontal inflammation, tooth recession and mobility in denture wearers were worse compared to non-denture wearers. Thus, they need to be motivated for more adequate oral hygiene practices and have regular recall system to monitor their periodontal health.

Monitoring of bone fractured healing using biochemical markers among patients attending federal teaching hospital abakaliki and bone setter home in onueke ebonyi state, Nigeria

The monitoring of bone fractured healing using Alkaline phosphatase, calcium ion and inorganic phosphate was evaluated among patients with fractured bone in two different centers, Alex Ekwueme Federal University Teaching Hospital Abakaliki and Bone Setters Home, Onueke, Ezza in Ebonyi State between August 2017 and September 2018. : A total of 90 adults patients from 18 years to 78 years were examined using phenolphthalein monophosphate colorimetric end point method. Out of the 90 patients, 30 were healthy normal subjects, another 30 were patients in AE-FUTHA while the remaining 30 patients were in bone setter home. : Patients without bone fracture had the least mean serum level of alkaline phosphatase, 28.5 ± 9.0µl followed by those admitted in bone setter home with a mean serum level of 38.2±17.9µl while patients admitted in AE-FUTHA had the highest mean serum level of 41.4±6.5µl (P&#60;0.05). The mean serum level of calcium was significantly higher 10.9± 2.6mg/dl in healthy normal patients compared to mean serum level of 9.2 ± 3.3mg/dl and 7.4 ± 1.3mg/dl for patients admitted in AE-FUTHA and bone setter home respectively. The mean serum level of inorganic phosphate indicate that patients admitted in bone setter home had the highest mean of 4.1 ± 1.0mg/dl followed by patients admitted in AE-FUTHA 3.4 ± 0.2mg/dl while that of healthy normal individuals had the least mean serum level of 3.2 ± 0.5mg/dl. : Out of the three parameters examined, alkaline phosphatase test was more precise, reliable and patient doctor friendly; hence it can be used as a veritable tool to monitor the process of bone fracture healing effectively.

Effect of trace elements in the immune system of pregnant women attending antenatal clinic in alex ekwueme federal university teaching hospital

Copper, iron, selenium and zinc are important trace elements during pregnancy. They function as antioxidants and play major roles in strengthening the immune system. This study evaluates the importance of these trace elements in the immune system and their concentrations during pregnancy. These trace elements were evaluated using 75 pregnant women attending antenatal clinic in Alex Ekwueme Federal University Teaching Hospital, Abakaliki as Test participants and 75 non-pregnant women were used as control participants. The analysis was done using Atomic Absorption Spectrophotometer. The socio-demographic, Obstetrics and Gynaecological characteristics of the participants were obtained using questionnaire. A cross-sectional comparative study design was adopted for this. The results showed that the mean and standard deviation (M±SD) in mg / l of the test and control of trace elements (copper, iron, selenium and zinc) are; 0.13±0.03 and 0.38±0.03, 0.48±0.07 and 0.82±0.09, 0.86±0.11 and 0.94±0.07, 0.52±0.07 and 0.52±0.05 respectively. Also mean levels of Cu and Fe were significantly decreased in the pregnant women than in control (p=&#60;0.001; 0.002) respectively. Nevertheless, there was no statistically significant differences between selenium and zinc levels in the pregnant women when compared to their controls (p=0.575; 0.982) respectively. Low concentration of iron is suggestive of iron deficiency and this study revealed 65.3% non-compliance to routine iron supplement given during antenatal. Trimester, age and parity appeared not to have any significant effect on the level of these trace elements. Hence, there is need to ensure the intake well-balanced meal to optimize copper levels during pregnancy.

Autonomy, Motivation, and Digital Pedagogy Are Key Factors in the Perceptions of Spanish Higher-Education Students toward Online Learning during the COVID-19 Pandemic

This paper proposes a development model of the adaptation capacity of students to digital transformation in university teaching through three constructs: motivations, digital pedagogy, and student autonomy. For this study, an ad hoc scale was created to record the adaptation capacity of students to digital transformation. The sample was 483 students from the University of Seville (Spain), to whom an online survey was administered during the development of online teaching in the period of November 2020 using the Google Forms platform. The findings of this study showed that university student motivation acquired a greater threshold than autonomy, whose threshold in turn, was greater than that of digital pedagogy in the ability to adapt to online teaching and that the capacity of adaptation to the online modality is explained by the perception that university students have of the usefulness, products, and learning outcomes, among others. In conclusion, the lack of adequate and enabled study spaces is key to developing the online model. We consider all these aspects as prospective research objectives.

A nomogram for Antenatal Estimation of Cephalopelvic Disproportion in Primiparous Women based on MRI Measurements

Objective: To develop and validate a predictive model assessing the risk of cesarean delivery in primiparous women based on the findings of magnetic resonance imaging (MRI) studies. Design: Observational study Setting: University teaching hospital. Population: 168 primiparous women with clinical findings suggestive of cephalopelvic disproportion. Methods: All women underwent MRI measurements prior to the onset of labor. A nomogram model to predict the risk of cesarean delivery was proposed based on the MRI data. The discrimination of the model was calculated by the area under the receiver operating characteristic curve (AUC) and calibration was assessed by calibration plots. The decision curve analysis was applied to evaluate the net clinical benefit. Main Outcome Measures: Cesarean delivery. Results: A total of 88 (58.7%) women achieved vaginal delivery, and 62 (41.3%) required cesarean section caused by obstructed labor. In multivariable modeling, the maternal body mass index before delivery, induction of labor, bilateral femoral head distance, obstetric conjugate, fetal head circumference and fetal abdominal circumference were significantly associated with the likelihood of cesarean delivery. The discrimination calculated as the AUC was 0.845 (95% CI: 0.783-0.908; P < 0.001). The sensitivity and specificity of the nomogram model were 0.918 and 0.629, respectively. The model demonstrated satisfactory calibration. Moreover, the decision curve analysis proved the superior net benefit of the model compared with each factor included. Conclusion: Our study provides a nomogram model that can accurately identify primiparous women at risk of cesarean delivery caused by cephalopelvic disproportion based on the MRI measurements.

Ética, Desarrollo Sostenible y Responsabilidad Social desde la docencia en instituciones de educación superior latinoamericanas

El presente documento muestra los resultados de un análisis de las reflexiones vertidas por docentes y funcionarios universitarios de ocho países de América Latina, quienes participaron en las dos ediciones de un diplomado internacional, producto de la colaboración entre la Unión de Responsabilidad Social Universitaria Latinoamericana (URSULA) y la Universidad Michoacana de San Nicolás de Hidalgo, cuyo eje de trabajo fue el análisis del impacto que tiene la labor docente sobre el desarrollo sostenible. El estudio se desarrolló desde un enfoque mixto. Mediante un análisis de contenido se analizaron cualitativamente 410 contribuciones realizadas por quienes participaron en el diplomado y, posteriormente, se llevó a cabo un análisis de frecuencias para cuantificarlas en torno a los ámbitos y metas del Modelo de Responsabilidad Social Universitaria propuesto por URSULA. El trabajo concluye señalando que la docencia universitaria debe ser revalorada, en términos de su contribución al desarrollo sostenible, pues a través de su ejercicio se materializa la pertinencia social de la formación profesional mediante el desarrollo de prácticas y contenidos que acerquen al estudiantado a la realidad económica, social y ambiental en que viven. Palabras clave: Ethics, Sustainable Development and Social Responsability from university teaching in Latin American higher education institutions