Search Results (667)

Background: Missed nursing care, defined as essential patient care that is omitted or delayed, is a growing source of concern due to its effects on healthcare quality and patient safety. Our aims in this study were twofold: first, we examined the extent and types of missed nursing care, and second, we analyzed the relationship between the care missed by hospital nurses and the staffing and resource adequacy in an academic medical center. Methods: A descriptive cross-sectional study was conducted during the period between November 2022 and July 2023. Data were collected using a self-administered questionnaire that comprised items on socio-demographic and work-related characteristics, items on staffing and resource availability, and items from the ‘MISSCARE’ Survey. Results: The most frequently missed nursing care involved pressure-relieving interventions (Mean = 2.39) and ambulation/mobilization (Mean = 2.27), while medication administration (Mean = 1.60) and glucose monitoring (Mean = 1.56) were missed the least. Labor resource inadequacy (β = 0.315, p < 0.001) and communication and teamwork deficits (β = 0.285, p < 0.001) were positively associated with missed nursing care, whereas staffing and resource adequacy showed an inverse association (β = −0.164, p = 0.006). The model explained 49.8% of the variance in missed nursing care (R² = 0.498). Conclusions: These findings highlight that missed nursing care is a system-level issue primarily associated with staffing and resource constraints rather than individual characteristics. Improving staffing adequacy, resource availability, and interprofessional collaboration may reduce care omissions and enhance patient safety in Saudi Arabian academic medical centers. Full article

Background: Trauma-informed education (TIE) has become commonplace in nursing education; however, little is known about students’ experience of this and its impact on their practice. Aim: This study aimed to evaluate and explore mental health nursing students’ perspectives on TIE, and its impact on their practice, to contribute to the knowledge and evidence base that informs nursing and broader healthcare education. Methods: This qualitative, phenomenological study used a conversation café approach to focus group interviews (n = 3) with final year mental health nursing students (n = 11), reported using the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Analysis: The data generated was analysed using reflective thematic analysis. Findings: Three themes were identified: 1. a compass for practice; 2. mental health nursing: between paradigms; and 3. supporting personal development and wellbeing. Integrating TIE within nursing education can support students to adopt the principles of trauma-informed care (TIC) both personally and in their practice. Improved self-awareness, recognition of trauma and adopting self-care strategies were valuable in supporting personal resilience and wellbeing and in managing the challenges of mental health practice. Conclusions/Recommendations: TIE has the potential to have a positive impact on wellbeing; therefore, its integration should be considered for all healthcare programmes. Further interprofessional research is needed to establish the longer-term impact of TIE as students progress into their nursing careers. Full article

Critical thinking is emphasized across ACPE Standards 2025, the Pharmacist Patient Care Process, interprofessional education (IPE) frameworks, and licensure preparation (NAPLEX). Despite this, pharmacy education lacks a practical, theory-grounded framework that operationalizes critical thinking as an observable, assessable reasoning process, particularly in team-based and interprofessional contexts. We developed the AIM (Analyze–Interpret–Manage) framework by integrating the Delphi Consensus definition of critical thinking with the AAC&U VALUE framework, translating foundational theory into a concise, measurable, stage-based model applicable to both individual and collective cognition. AIM was tested using qualitative analysis of transcripts of student team discursive narratives of an assigned IPE scenario. Reasoning behaviors were coded by AIM stage and mapped to the 2016 IPEC Core Competencies and the 2025 NAPLEX competencies to ensure professional relevance and external validity. AIM reliably distinguished discrete stages of critical thinking across teams, revealing consistent patterns in how learners analyzed information, interpreted clinical and ethical significance, and managed decisions collaboratively. Mapping demonstrated strong alignment between AIM stages and IPEC and NAPLEX competencies. Our novel AIM framework offers a scalable approach for defining, teaching, and assessing team-based critical thinking in pharmacy education. By operationalizing critical thinking as a staged reasoning process aligned with professional standards, AIM fills a critical gap between educational theory, interprofessional practice, and licensure preparation. Full article

Background: Antibiotic misuse and overuse remain a critical driver of antimicrobial resistance (AMR), a global health threat associated with increased morbidity, mortality, and healthcare costs. In Greece, where antibiotic consumption and resistance rates are among the highest in Europe, community pharmacists are well-positioned to contribute to antimicrobial stewardship efforts. Objective: This study aimed to assess the knowledge and attitudes of community pharmacists in Achaia, Western Greece, regarding antibiotic use and AMR, in order to identify knowledge gaps and inform future educational interventions. Methods: A cross-sectional survey was conducted between May and July 2023 among 207 pharmacists using a structured, self-administered questionnaire. The survey assessed demographics, knowledge of antibiotic indications, dispensing practices, and awareness of AMR. Statistical analysis included Chi-square tests and multivariate logistic regression. Results: Pharmacists demonstrated high levels of knowledge regarding appropriate antibiotic use in conditions such as sore throat (95%), bronchitis (76%), influenza (77.5%), and diarrhea (95%). However, knowledge was lower for rhinitis (60%) and sinusitis (56%). Almost all pharmacists (99%) were aware of AMR, and 86% perceived it as a significant public health issue in Greece. Logistic regression showed that pharmacists with 5–10 years of experience were significantly less likely to believe that antibiotics are always effective (OR = 0.08, p = 0.042). Conclusion: Pharmacists in Western Greece are generally well-informed about antibiotic use and AMR, yet misconceptions persist, especially for viral infections. Targeted educational interventions, interprofessional collaboration, and stricter enforcement of prescription regulations are needed to strengthen the role of pharmacists in combating AMR at the community level. Full article

Background: Most ICU patients are in the terminal phase and require complex palliative care support and End-of-Life Care (EoLC). Nurses play a central role in symptom management, emotional support, and shared decision-making. However, evidence on nurses’ experiences in providing EoLC remains fragmented and lacks a comprehensive synthesis. Objective: This review aimed to identify, map, and synthesize global evidence on ICU nurses’ experiences in delivering EoLC, including challenges, coping strategies, and implications for critical care nursing practice. Methods: A scoping review was conducted following Arksey and O’Malley’s framework and PRISMA-ScR guidelines. Systematic searches were performed in the PubMed, Scopus, and EBSCOhost databases for studies published between 2015 and 2025. Thematic analysis was applied to the qualitative studies to identify patterns and key issues. Results: Twelve qualitative studies conducted in diverse countries met the inclusion criteria. Five major themes emerged: (1) emotional and moral challenges; (2) cultural and spiritual influences; (3) communication and interprofessional collaboration; (4) professional development and organizational support; and (5) resource constraints. These findings indicate that ICU nurses’ experiences with EoLC are multidimensional and shaped by the cultural context and institutional policies. Conclusions: ICU nurses’ experiences with EoLC reflect complex ethical, emotional, and organizational dimensions. Improving care quality requires structured training, organizational support, and culturally sensitive policies to strengthen critical care nursing practice. Full article

In recent years, forest bathing has gained popularity worldwide due to its many positive effects on health. In the face of increasing urbanization and limited access to natural forests, digital forest bathing is a promising alternative. Digital forest bathing could also be an option for people with restricted mobility, which could be a way to make the health-promoting effects of forests more accessible. This systematic review examines the current state of research on digital forest bathing, considers the associated effects, and highlights the technical possibilities and thereby consolidates the currently limited evidence base in this emerging field. For literature identification, the databases APA, PsycInfo, PubMed, PubPsych, Scopus, and Google Scholar were searched. A total of four studies were included. The results indicate that digital forest bathing could have positive effects on relaxation and well-being that could be comparable to real-life forest bathing, and summarize how interventions were technically implemented across the included studies. As there are still a few studies on digital forest bathing, the implementation of the research varies greatly, and some studies have risks of bias; the results presented here should be interpreted with caution. In addition to a critical examination of the study designs and quality, suggestions for further research in this area are given, and key methodological constraints relevant for interpreting early effects are outlined. Full article

Background: Last Aid Courses (LACs) for the public aim to enhance the public discussion about dying, death and grief and to increase the awareness for palliative care throughout the whole society. Based on the wishes and needs of professionals from health and social care and results from previous studies on LACs, a longer Last Aid Course Professional (LACP) was developed. The aim of the present study was to evaluate the experiences and views of course participants and instructors on the Last Aid Course Professional (LACP) with ten teaching hours including the foundations of palliative care based on the storyline method. Methods: A mixed-methods approach was used including qualitative and quantitative data from a questionnaire for LACP participants and focus group interviews of LACP instructors. Results: A total of 394 of the 422 participants participated in the study by returning a questionnaire (response rate 93%). The age ranged from 21 to 81 years (median 45 years). In addition, 14 instructors participated in two focus group interviews. The results from the questionnaires showed that 84% of all participants assess the course as useful for all professionals working in health and social care. The qualitative data show that the LACP was well accepted by different organizations and participants from different professions. The participants welcome the opportunity for interprofessional exchange and the possibility for a change in perspective, as well as getting insight from different perspectives, reflecting on ethical challenges, and working on different options for action in palliative care. Lack of staff was the main barrier for participation in the LACP. Conclusions: The LACP is very well accepted by the participants and is a good option for palliative care education for professionals from health and social care. Full article

Optimizing medication management and improving patient health outcomes depend primarily on the strength of primary healthcare services, where collaboration between general practitioners (GPs) and pharmacists plays a critical role. This scoping review aimed to identify the main facilitators and barriers influencing pharmacist–GP collaboration. The review was conducted in line with PRISMA-ScR guidelines. A comprehensive search of PubMed, Scopus, and Web of Science identified studies published in English between January 2019 and May 2025, of which twenty met the inclusion criteria. Key facilitators of collaboration included pharmacist co-location within GP practices, clearly defined professional responsibilities, access to shared electronic health records, and supportive government policies. Barriers most frequently reported were limited communication pathways, insufficient interprofessional training, and financial constraints. Overall, the findings suggest that effective pharmacist–GP collaboration relies on structural integration, professional trust, and policy initiatives that enable sustained cooperation. Long-term investment in collaborative infrastructure and workforce development will be essential to strengthen primary care, support patient outcomes, and ensure more efficient use of healthcare resources. Full article

Background: Digital transformation in healthcare has advanced rapidly in hospitals and primary care, while long-term care facilities have often lagged behind. In nursing homes, nurses play a central role in coordinating care and accessing medical expertise, yet digital tools to support these tasks remain inconsistently implemented. The CareConnect study, funded under the German Model Program for Telecare (§ 125a SGB XI), aimed to develop and implement a multiprofessional telecare system tailored to nursing home care. Objective: This implementation study examined the feasibility, acceptability, and early adoption of a multiprofessional telecare system in nursing homes, focusing on implementation processes, contextual influences, and facilitators and barriers to integration into routine nursing workflows. Methods: A participatory implementation design was employed over 15 months (June 2024–August 2025), involving a university hospital, two nursing homes (NHs), and four medical practices in an urban region in Germany. The telecare intervention consisted of scheduled video-based teleconsultations and interdisciplinary case discussions supported by diagnostic devices (e.g., otoscopes, dermatoscopes, ECGs). The implementation strategy followed the Standards for Reporting Implementation Studies (StaRI) and was informed by the Consolidated Framework for Implementation Research (CFIR). Data sources included telecare documentation, nurse surveys, researcher observations, and structured feedback discussions. Quantitative and qualitative data were analyzed descriptively and triangulated to assess implementation outcomes and mechanisms. Results: A total of 152 documented telecare contacts were conducted with 69 participating residents. Most interactions occurred with general practitioners (48.7%) and dermatologists (23%). Across all contacts, in 79% of cases, there was no need for an in-person visit or transportation. Physicians rated most cases as suitable for digital management, as indicated by a mean of 4.09 (SD = 1.00) on a 5-point Likert scale. Nurses reported improved communication, time savings, and enhanced technical and diagnostic skills. Key challenges included delayed technical integration, interoperability issues, and varying interpretations of data protection requirements across facilities. Conclusions: This pilot study suggests that telecare can be feasibly introduced and accepted in nursing home settings when implemented through context-sensitive, participatory strategies. Implementation science approaches are essential for understanding how telecare can be sustainably embedded into routine nursing home practice. Full article

Background/Objectives: Oral frailty and hypofunction in older adults are strongly associated with declines in nutritional status, physical function, swallowing ability, and overall health. Isolated interventions usually fail to achieve sufficient improvement since these conditions result from interrelated biological, psychological, and social factors. Multidisciplinary approaches combining oral management, nutritional support, and physical rehabilitation have shown promise. This narrative review synthesized evidence from 15 studies examining multifaceted interprofessional interventions across hospitals, communities, long-term care facilities, and home-care settings. Methods: A structured search of PubMed and Web of Science (2000–2025) identified original studies assessing oral, nutritional, or physical outcomes in older adults post-interprofessional interventions. Fifteen eligible studies were extracted; the findings were integrated using narrative synthesis owing to design and outcome heterogeneity. Results: Educational multidisciplinary interventions improved oral hygiene, caregiver awareness, and oral motor function. Multidisciplinary rehabilitation and multidomain programs consistently improved tongue pressure, swallowing function, mastication ability, appetite, body composition, activities of daily living, and oral intake resumption. Nutrition support team-delivered interventions reduced aspiration risks and improved oral environment and swallowing function. Community-based programs using munchy meals and combined exercises enhanced oral and physical functions. Social participation provided psychological benefits. Home-care dysphagia rehabilitation enabled 69% of tube-fed patients to resume oral intake. Conclusions: This narrative review supports a triadic, interprofessional approach in geriatric care, highlighting consistent improvements in oral function through integrated oral, nutritional, and rehabilitative interventions. Full article

Background: Health care work contributes significantly to greenhouse gas emissions. Primary health care is community-based and focused on wellness and disease prevention. Within primary health care, pharmacists are most frequently the stewards of medicines, supplies, and other tangible products that contribute to carbon footprints. Pharmacists are in a unique position to help adapt to and mitigate climate change-related issues. Objective: To examine pharmacists’ perspectives on climate adaptation and mitigation strategies in primary health care delivery in interprofessional settings. Methods: Semi-structured qualitative interviews with primary care pharmacists were undertaken. Constant-comparative data analysis was used to code and categorize findings. The COREQ system was applied to ensure rigor and quality of research. Results: A total of 21 primary care pharmacists participated in this research. Several core themes emerged as follows: (a) universal agreement that climate change is real and primary health care needs to evolve rapidly to address it; (b) recognition that primary health care is time-pressured and resource constrained so successful solutions need to be pragmatic and work within realities of practice; (c) identification of actionable priorities with high potential for mitigation impact; and (d) mobilization of a coalition to develop system-wide initiatives that could be implemented in primary health care. Conclusions: Collaborative approaches and those that focus on the implementation of regulatory requirements were identified as being most productive in this setting. Full article

Background: Food allergy [FA] is a growing public health concern among school-age children, with schools and childcare/daycare settings representing high-risk environments for accidental exposure and anaphylaxis. Objective: To systematically review evidence on digital health interventions supporting FA education, prevention, and management in school settings. Methods: A systematic search of PubMed, Scopus, Web of Science, and CINAHL was conducted to identify studies published between January 2015 and December 2025 [PROSPERO CRD420251185553]. Eligible studies evaluated e-learning, mHealth, or web-based programs targeting school staff, parents, or students. Results: Sixteen studies met inclusion criteria. Digital health emerged as a catalyst for professional development, interprofessional communication, and health equity within school communities. Interventions consistently improved knowledge, preparedness, and self-efficacy in anaphylaxis management among school staff, strengthened parental empowerment and communication with schools, and supported coping and inclusion among allergic children. Evidence on clinical outcomes; however, remains limited. Conclusions: Digital health can meaningfully enhance school preparedness and reduce inequalities in allergy management. Integrating digital tools into national school health frameworks—particularly where school nursing is not yet institutionalized—may represent a pivotal step toward safer, more equitable inclusion of children with food allergy. Full article

Background: Teamwork and effective communication are widely recognized as essential pillars for the safety and quality of healthcare. However, in Portugal, no validated instrument had previously been available to assess healthcare professionals’ attitudes toward teamwork. This study aimed to translate, culturally adapt, and validate the TeamSTEPPS^® Teamwork Attitudes Questionnaire (T-TAQ) for the Portuguese context, resulting in the Portuguese version of the instrument. Methods: A methodological study with a quantitative approach was developed. The translation and cultural adaptation process followed internationally recognized guidelines. The sample consisted of 162 healthcare professionals (136 nurses and 26 physicians) from a hospital in Lisbon. Exploratory and confirmatory factor analysis techniques were used to assess construct validity. The internal consistency of the scale was analyzed using Cronbach’s alpha coefficient. Results: The Portuguese version comprises 30 items distributed across five dimensions: Effective Leadership Support, Team Functional Performance, Teamwork Coordination, Willingness to Engage in Teamwork, and Team Functioning Supervision. The scale demonstrated a total explained variance of 53.9% and an overall internal consistency coefficient (α) of 0.86, indicating good reliability. Confirmatory factor analysis supported the five-factor structure of the scale (χ²/df = 1.461; CFI = 0.900; GFI = 0.821; RMSEA = 0.054; MECVI = 4.731). Conclusions: The T-TAQ-PT proved to be a valid, reliable, and robust instrument for assessing healthcare professionals’ individual attitudes toward teamwork, contributing to the development of research and clinical practice in the Portuguese context. Full article

Background/Objectives: Dizziness is a symptom of many disorders across a wide range of etiologies. If dizzy patients are seen for vestibular evaluation with an audiologist and no vestibular reason for the patient’s dizziness is found, the medical referral pathway can become convoluted. This can leave patients feeling discouraged and unable to manage their symptoms. Clinically symptomatic chronic respiratory alkalosis (CSCRA) is an acid–base disorder that typically presents with dizziness but is unfamiliar to practitioners in vestibular and balance care settings. Methods: In a retrospective chart review deemed exempt by the Mayo Clinic Institutional Review Board, 74 patients at Mayo Clinic Arizona were included. All had consultations with both Audiology and Aerospace Medicine to assess their dizzy symptoms. Results: After completing vestibular testing, arterial blood gas (ABG) testing, and a functional test developed at Mayo Clinic Arizona called the Capnic Challenge test, 40% of patients were found to have CSCRA contributing to their dizzy symptoms. Many of these patients also had common comorbidities of CSCRA, like postural orthostatic tachycardia syndrome (POTS), migraines, and sleep apnea. Fewer than one-fourth of these patients had measurable vestibulopathies causing their dizziness. Half of the patients referred by the vestibular audiologist to Aerospace Medicine had a diagnosis of CSCRA. Conclusions: Assessment for CSCRA should be considered as a next step for patients presenting with dizziness without a vestibular component. Being aware of the prevalence of CSCRA and its comorbidities may help balance providers offer quality interprofessional referrals and improve patient quality of life. Full article

This pre–post study aimed to determine whether interprofessional education (IPE) combining online and in-person instruction enhanced medical students’ empathy. The IPE program was conducted during the academic years 2022 and 2023 for medical (n = 240) and other healthcare students. Subjects discussed a case scenario involving a patient with chronic myeloid leukemia, sharing their ideas within their team and with other teams. The medical students’ empathy was assessed before and after the IPE program using the Japanese version of the Jefferson Scale of Empathy for Health Professions Students (JSE-HPS). Medical students provided written responses to the question, “What do you think is necessary for the care of patients with cancer, besides medical skills and knowledge?” Empathy-related terms were identified using frequency and co-occurrence analyses. The frequencies before and after the IPE were compared. The median JSE-HPS score rose from 98.0 to 114.0 (p < 0.001, Wilcoxon signed-rank test). The frequency of words categorized as demonstrating empathy increased from 37.9% to 52.9% after the IPE (p < 0.01, chi-square test). Our hybrid IPE program enhanced medical students’ empathy, which was supported by both quantitative and qualitative methods. Full article