Search Results (23)

Background: With so much emphasis currently on Social Determinants of Health (SDOH), we examined the characteristics of U.S. hospitals making commitments to SDOH and engagement with community social determinant programs and activities (CSDPAs). Methods: This cross-sectional study used the 2021 American Hospital Association (AHA) Annual Survey with a total of 5992 hospitals included. The dependent variables were the community social determinants composite score, community partnership composite score, and the use of CSPDAs to assess outcomes. Results: Hospitals most influenced by payment policies and regulations were most likely to engage in CSDPAs. Hospitals with ACOs implement 3.38 more CSPDAs and hospitals participating in bundled payments are 41% more likely to address SDOH (OR = 1.41, 95% CI = [1.14, 1.75]). Hospitals in competitive markets and hospitals with ≥400 beds are positively associated with both SDOH activities and partnerships. Teaching hospitals, not-for-profit hospitals, Medicare mix, and rural hospitals, as well as market competition, were positively associated with higher levels of CSDPAs. Conclusion: Reimbursement requirements, organizational size and resources, and external pressures were shown as drivers for hospitals to implement CSDPAs. Full article

Introduction: Chronic neck pain is a prevalent condition that challenges physical therapists (PTs) due to its multifactorial etiology. Differential diagnosis is crucial for identifying the underlying causes and providing appropriate interventions. However, the extent to which PTs apply and understand differential diagnostic criteria remains unclear. This study aimed to evaluate the knowledge, attitudes, and behaviors of PTs in France regarding the differential diagnosis of chronic neck pain. Materials and Methods: An online questionnaire was designed to assess PTs’ beliefs, attitudes, knowledge, and clinical application of differential diagnostic criteria in chronic neck pain. The survey was distributed nationwide and included questions regarding demographic data, theoretical knowledge, practical application, and perceived barriers. A total of 80 responses were collected and analyzed using descriptive and inferential statistics. Results: The results revealed moderate levels of theoretical knowledge among participants, with 62% correctly identifying key criteria for differential diagnosis. However, only 45% reported consistently applying these criteria in clinical practice. Common barriers included time constraints (70%), lack of access to advanced diagnostic tools (55%), and insufficient training (40%). Attitudes towards the importance of differential diagnosis were predominantly positive, with 85% recognizing its relevance for improving patient outcomes. Conclusions: This study highlights a gap between PTs’ knowledge and the practical application of differential diagnosis criteria in chronic neck pain. Addressing barriers such as training and resource availability could enhance clinical practices. Future efforts should focus on integrating these competencies into professional development programs to improve diagnostic accuracy and patient care. Full article

Objective: This study investigates alarm fatigue among ICU nurses in China and its influencing factors to optimize alarm management. Methods: This study was conducted using a cross-sectional design. In May 2022, electronic questionnaires were distributed to ICU nurses in Beijing tertiary hospitals, using the Chinese version of the alarm fatigue scale and equipment alarm records. Data were analyzed using SPSS 26. Results: Results showed an average alarm fatigue score of 20.70 ± 6.54 (out of 52), indicating a moderate-to-low level. Nurses’ self-assessed health, work attitude, alarm accuracy, and frequency of simultaneous alarms significantly influenced fatigue levels (p < 0.05). Principal component analysis identified five factors, with work intensity, mental health, false alarm rate, and job responsibility being significant predictors (95% CI excluded zero). Alarm records revealed an average of 621 daily alarms in ICUs, 93.93% from monitors, with a false alarm rate of 56.36%, and only 43.64% being valid. Conclusions: This study highlights the multi-factorial nature of alarm fatigue and the need to improve alarm systems and nurse support. Full article

IV line connectors often become contaminated between infusions, which leads to line infections. A flexible shield was developed to prevent this by means of passive protection. It was tested in a simulated bedside environment and protected from touch contamination as well as airborne transmission of skin bacteria to the connector hub. This flexible shield can compensate for the unavoidable human factor infection control lapses that occur during IV line handling by healthcare workers. Full article

The implementation of evidence-based practice (EBP) is crucial for improving patient outcomes and healthcare delivery, yet it faces significant challenges in acute care settings due to organisational barriers, resource limitations, and leadership complexities. This study explores how ward managers (WMs) facilitate knowledge utilisation (KU) and promote EBP adoption in these environments. A longitudinal qualitative case study was conducted over eight months in two acute care hospitals in the East Midlands, England. Data were collected through semi-structured interviews with 23 WMs, nonparticipant observations, and document analysis. Thematic analysis was used to identify key findings. Six themes emerged: navigating leadership challenges, overcoming organisational and resource barriers, sustaining EBP through learning networks, integrating technology, tailoring EBP to patient-centred care, and providing emotional support for staff. Hybrid leadership strategies, combining directive and collaborative approaches, were critical in addressing barriers, fostering engagement, and embedding EBP into workflows. Mentorship and resource management also played pivotal roles. The study highlights the need for tailored leadership strategies, innovative resource utilisation, and sustainable learning networks to overcome systemic challenges and promote EBP. These findings provide actionable insights for fostering evidence-informed care environments in resource-constrained acute care settings. Full article

Slips and fall-related accidents cause a significant number of injuries in hospitals. Due to constant movement of doctors and nurses across different departments in hospitals such as OPD, trauma centres, and ICUs, there are possible interactions of their footwear with slippery floorings (e.g., wet or with soap suds), which may cause unexpected slips. To date, there is a lack of understanding on the traction of different footwear worn by hospital staff. This impedes the selection of appropriate floorings and footwear for preventing slips and falls in hospitals. In this work, the traction performances of twelve common footwear designs, worn by hospital staff, were tested on three different floorings at important locations, i.e., an outpatient department, trauma centre, and ICU entrance, at a busy public hospital. Oblique tread patterns are recommended for moderately rough floors under dry and Lizol conditions. Horizontally oriented patterns are better for smoother floors in dry conditions, while vertically oriented patterns are ideal for areas with frequent contaminant exposure. No specific recommendation can be made for soap-contaminated floors due to the contaminant’s high viscosity. The results also indicated the strong influence of flooring roughness on the measured traction, over footwear tread parameters. Also, liquid soaps were observed to significantly reduce footwear–floor traction. The findings are anticipated to be valuable to hospital management for the selection of appropriate high-traction floorings, and provide important guidelines for footwear selection, for the mitigation of slips and falls in hospitals. Full article

Hospital and health system bankruptcies and closures continue to rise in the United States. They are troubling news not only for patients and communities but also for insurance companies. Hospital closures often lead to higher costs for insurers due to increased claim denials, delayed payments, reduced provider network and access to care, higher out-of-network costs, and a disruption of our healthcare system. These factors ultimately impact the health insurance companies’ bottom lines as well as their ability to manage patient care effectively with the risk of causing customer/patient dissatisfaction. Insurance companies can help prevent hospital closures, especially in rural areas, by implementing some of the following mechanisms: timely and adequate payments; improved patient-centric payment systems; and standby capacity payments to cover minimum fixed costs. Such early strategic investments have the potential to offset the higher costs for insurance companies associated with hospital closures and improve the sustainability of the U.S. healthcare system. Full article

The role of clinical trials cannot be ignored due to its contribution to innovative treatment, therapies, and drug development in promoting quality service delivery. We investigated and explored the management aspect of clinical trials and its impact on healthcare service delivery within the NHS. A qualitative methodology with an interpretivism approach was adopted to collect data from nine participants using a purposive sampling method in the management of clinical trials at the NHS. A semi-structured interview with open-ended questions and probing techniques conducted via Microsoft Teams was used as a data collection tool. The collected data were thematically analysed with the support of NVivo 14 software. The staffs’ perceptions were somewhat effective and highlights required improvement for better performance regarding clinical trial management at the NHS setting. The findings represent improved patient outcomes, increasing evidence-based decision making, and the development of innovative therapies and research infrastructure could be some positive impacts of the effective management of clinical trials. However, the findings show that improvement in stakeholder collaboration and communication is vital to combat the existing challenges such as regulatory hurdles and issues in participant recruitment, retention, and communication. The findings provide practical values and insight into the staff working in the management of clinical trial processes and the audiences relevant to this field. A comprehensive understanding of the proactive measures and factors that are essential for the improvement of clinical trial management has been interpreted. In the hospital’s settings, supervision and improvement of clinical trials are necessary to promote innovative therapies, research infrastructure, and quality patient care and service delivery. Full article

Artificial intelligence (AI) has emerged as a transformative force in enhancing patient safety within hospital settings. This perspective explores the various applications of AI in improving patient outcomes, including early warning systems, predictive analytics, process automation, and personalized treatment. We also highlight the economic benefits associated with AI implementation, such as cost savings through reduced adverse events and improved operational efficiency. Moreover, the perspective addresses how AI can enhance pharmacological treatments, optimize diagnostic testing, and mitigate hospital-acquired infections. Despite the promising advancements, challenges related to data quality, ethical concerns, and clinical integration remain. Future research directions are proposed to address these challenges and harness the full potential of AI in healthcare. Full article

In a dynamic healthcare industry, aligning the goals and objectives of hospitals and physicians through integration has been suggested to influence performance. Physicians’ leadership and active involvement in governance can direct resource usage, Electronic Health Record (EHR) implementation, price negotiation, better coordination, and continuity of services for patients, thus affecting performance. This study aimed to examine the relationship between physician integration and hospital performance, investigating both financial and quality outcomes. We used a longitudinal study design. Our sample was hospital-level data from 2014 to 2019, which contained 6000 U.S. hospital-year observations. The dependent variables were quality outcomes (readmission rates) and financial outcomes (total and operating margins). The independent variable explored three dimensions of integration: high, low, and overall integration. Findings showed no impact of hospital–physician integration on quality outcomes and financial performance. High-integration hospitals did not show any significant relationships with quality outcomes and financial performance compared to hospitals that did not have high integration. Hospital–physician integration may have little potential to bring clinical integration even though vertical integration is present. A commitment to improving quality as a strategic priority may be vital in impacting quality outcomes, followed by financial performance. Full article

Health systems around the world continue to experience healthcare workforce shortages, including shortages of nurses. This results in staff experiencing prolonged shifts and other stressors, which are linked to burnout, yet burned-out staff are then entrusted with the provision of patient care, despite healthcare facilities being regarded as safety-critical areas. It is assumed that the situation may have been worsened by the COVID-19 pandemic. This scoping review aims to identify the prevalence of burnout among nurses in Europe before and during the pandemic, the factors associated with this burnout, and its impact on patient safety. A literature search was conducted in the MEDLINE database; search terms included Nurse and Burnout and Patient Safety and their synonyms. The search limits used were English language, 2013 to 2023 publication years, original published research only (excluding review papers, dissertations, and unpublished reports), and studies conducted in European countries. A total of 16 papers were included for analysis: four indicated burnout levels of study participants, while 11 gave scores for individual burnout symptoms. Almost all studies indicated factors that were linked to burnout or individual dimensions of burnout. A few papers touched on the implications of these factors on patient safety. The review findings concluded that the few studies providing burnout levels on study participants could not give a clear picture of the burnout prevalence among nurses across Europe, either in general, before, or during the pandemic; therefore, this objective was not achieved and more research is required to establish this. Several factors thematically classified as sociodemographic, personal, organizational, and patient/client-related were linked to burnout. However, there were some contradictions in sociodemographic factors. Low personal accomplishment was the most common symptom of burnout before the pandemic, followed by emotional exhaustion and lastly depersonalization. Emotional exhaustion took the lead during the COVID-19 pandemic, followed by low personal accomplishment, and depersonalization remained the least common. More research is needed to establish the relationship between burnout and these factors. Full article

Background: Errors are a common occurrence in all healthcare settings, and the safety of patients is a critical concern that involves multiple factors, including the complex and demanding nature of nursing practice. Nurses, due to their continuous and direct patient care, play a pivotal role in ensuring patient safety. This cross-sectional study aimed to investigate the factors that contribute to errors from the perspectives of nurses in Greek hospitals, with a focus on understanding the challenges they face in their daily practice. Methods: Clinical nurses willingly and anonymously filled out a specific structured questionnaire, the Taxonomy of Error, Root Cause Analysis, and Practice-responsibility (TERCAP) tool that describes the conditions under which an error during clinical practice occurred. The study method included convenience sampling. After obtaining permission, questionnaires were distributed to hospital departments. To accommodate pandemic-related restrictions, an electronic version of the questionnaire was also created for distribution and collection. Analysis of data was accomplished via SPSS 26.0. Results: Five hundred and ninety-seven clinical nurses participated anonymously, reporting errors in almost seven out of ten cases, often attributing them to high workload and staff shortages. Errors were commonly reported during different shifts in this study. Factors such as assigning significant responsibilities to inexperienced staff and inadequate implementation guidelines were highlighted. Conclusions: The in-depth study of nursing errors provides a nuanced understanding of their causes by categorizing them based on various factors. It emphasizes the complexity of challenges and the need to integrate systemic, clinical, and individual factors into intervention strategies, including medication protocols, ongoing training, clear communication, administrative support, and fostering an open communication culture. Full article

The population of Pakistan is increasing, with approximately 2% growth. Over the years, the country’s healthcare system has struggled to meet the needs of the population. Nevertheless, because of shortages compared to population distribution, people are facing primary healthcare challenges, specifically in rural environments. Because of the absence of standard health services, the quality of the health sector deteriorated over time. Therefore, this study aims to compute the shortage of health facilities in Badin, Pakistan, per local health standards. The information related to available health institutes was obtained from the office of the Director-General Health Office with the help of a questionnaire. The current population was determined, and the same was projected up to the year 2035 with the help of a compound interest model. The linear model was executed and found to be significant, with the values of R = 0.996, R² = 0.991, and Sig. F-change = 0.000. The Badin sub-region needed 201 basic health units, 37 rural health centers, and 746 dispensaries. The public health institutes were found unavailable as per demographic standards. This research set a platform for local authorities to take certain actions in framing essential policies to curtail the shortage of health institutions. This study is significant, as it confers existing and futuristic health institute demands. This research can serve as a model for remote sub-regions to address primary healthcare issues, including the fight against diseases and viruses. This research may also contribute to sustainable goal number 3, i.e., Good Health and Well-being. Full article

Backgrounds: The pre-discharge conference (PDC) is crucial for ensuring care continuity based on patients’ preferences and goals. However, there is no quantitative on its effectiveness. We investigated the effectiveness of multidisciplinary PDC on the concordance rate between the preferred (PPEoLC) and actual place of end-of-life care and death. Methods: Overall, 551 older homebound patients (median age, 83.0 years; female, 49.4%; male, 50.6%) receiving continuous home medical care through clinics were enrolled in hospital ward admission from March 2011 to September 2018. Patient demographics, presence or absence of PDCs, statements from patients and their families regarding PPEoLC, and place of death of deceased patients were confirmed from the patients’ medical records, followed by concordance rate analyses between PPEoLC and place of death and a multivariate analysis of home mortality. We used the Mann–Whiney U test to assess attribute data, hypothesis testing to assess the difference in the population proportions, and binominal logistic regression analyses to evaluate the relationship between valuables. Results: In the conference group, the home mortality rate, patients’ and their families’ expression rates, and preferences for their home of PPEoLC were higher (p < 0.001) than those in the non-conference group. The place of death was significantly influenced by family preferences. Conclusions: PDC can affect the place of death of homebound patients, but family preferences rather than patient preferences influence the decision of the patient’s place of death. To better reflect the patient preferences, patient-centered decision support should be provided earlier in the disease process. Full article