Search Results (218)

Background/Objectives: Pressure injuries are a significant concern among older adults, particularly in community-based long-term care settings where prolonged immobility is prevalent. This study aimed to identify factors influencing sacral interface pressure in community-dwelling older adults, with an emphasis on support surface usage and clinical risk indicators. Methods: A total of 210 participants aged 65 years and older, all receiving long-term care services in South Korea, were enrolled in this study. Sacral interface pressure was measured in the supine position using a portable pressure mapping device (Palm Q7). General characteristics, Braden Scale scores, Huhn Scale scores, and mattress usage were assessed. Data were analyzed using descriptive statistics, t-tests, chi-square tests, and logistic regression. Results: Mattress non-use was identified as the strongest predictor of elevated sacral interface pressure (OR = 6.71, p < 0.001), followed by Braden Scale scores indicating moderate risk (OR = 4.8, p = 0.006). Huhn Scale scores were not significantly associated with interface pressure. These results suggest that support surface quality and skin condition have a stronger impact on interface pressure than mobility-related risk factors. Conclusions: The findings highlight the importance of providing high-quality pressure-relieving mattresses and implementing standardized nursing assessments to reduce the risk of pressure injuries. Integrating smart technologies and expanding access to advanced support surfaces may aid in developing tailored preventive strategies for vulnerable older adults. Full article

Background/Objectives: Effective teamwork is crucial for minimizing human error in healthcare settings. Medical teams, typically composed of physicians and nurses, supported by auxiliary professionals, achieve better outcomes when they possess strong collaborative competencies. High-quality teamwork is associated with fewer adverse events and complications and lower mortality rates. Based on this background, the objective of this study is to analyze the perception of non-technical skills and immediate learning outcomes in interprofessional simulation settings based on E-CRM items. Methods: A cross-sectional observational study was conducted involving participants from the official postgraduate Medicine and Nursing programs at the Catholic University of Murcia (UCAM) during the 2024–2025 academic year. Four interprofessional E-CRM simulation sessions were planned, involving randomly assigned groups with proportional representation of medical and nursing students. Teams worked consistently throughout the training and participated in clinical scenarios observed via video transmission by their peers. Post-scenario debriefings followed INACSL guidelines and employed the PEARLS method. Results: Findings indicate that 48.3% of participants had no difficulty identifying the team leader, while 51.7% reported minor difficulty. Role assignment posed moderate-to-high difficulty for 24.1% of respondents. Communication, situation awareness, and early help-seeking were generally managed with ease, though mobilizing resources remained a challenge for 27.5% of participants. Conclusions: This study supports the value of interprofessional education in developing essential competencies for handling urgent, emergency, and high-complexity clinical situations. Strengthening interdisciplinary collaboration contributes to safer, more effective patient care. Full article

Background: This study examined risk factors for syndrome novel coronavirus 2 virus (SARS-CoV-2) infection and self-reported adherence to infection prevention and control (IPC) measures among healthcare workers (HCWs) at a hospital in Thailand near the Myanmar border. Methods: From March to July 2022, HCWs aged ≥ 18 with COVID-19 exposure at Mae Sot General Hospital completed a questionnaire on IPC adherence, training, and COVID-19 knowledge. Nasopharyngeal samples were collected bi-weekly for SARS-CoV-2 testing. A mobile application was used for real-time monitoring of daily symptoms and exposure risks. Chi-square, Fisher’s exact tests, and log-binomial regression were performed to investigate association. Results: Out of 289 (96.3%) participants, 27 (9.9%) tested positive for SARS-CoV-2, with cough reported by 85.2% of cases. Nurse assistants (NAs) had a higher risk of infection (adjusted relative risk [aRR] 3.87; 95% CI: 0.96–15.6). Working in inpatient departments (aRR 2.37; 95% CI: 1.09–5.15) and COVID-19 wards (aRR 5.97; 95% CI: 1.32–26.9) was also associated with increased risk. While 81.7% reported consistent hand hygiene, 37% indicated inadequate IPC knowledge. Conclusions: HCWs, especially NAs and those in high-risk departments, should receive enhanced IPC training. Real-time digital monitoring tools can enhance data collection and HCW safety and are likely to be useful tools for supporting surveillance and data collection efforts. Full article

Background: The longitudinal RisCoin study investigated risk factors for COVID-19 vaccination failure among healthcare workers (HCWs) and patients with inflammatory bowel disease (IBD) at a University Hospital in Germany. Since the hospital served as the study sponsor and employer of the HCW, we implemented a custom mobile application. We aimed to evaluate the implementation, adherence, benefits, and limitations of this study’s app. Methods: The app allowed secure data collection through questionnaires, disseminated serological results, and managed bidirectional communication. Access was double-pseudonymized and irreversibly anonymized six months after enrollment. Download frequency, login events, and questionnaire submissions between October 2021 and December 2022 were analyzed. Multivariable logistic regression identified factors associated with app adherence. Results: Of the 3979 participants with app access, 3622 (91%) used the app; out of these, 1016 (28%) were “adherent users” (≥12 submitted questionnaires). App adherence significantly increased with age. Among HCW, adherent users were more likely to be non-smokers (p < 0.001), working as administrators or nursing staff vs. physicians (p < 0.001), vaccinated against influenza (p < 0.001), and had not travelled abroad in the past year (p < 0.001). IBD patients exposed to SARS-CoV-2 (p = 0.0133) and those with adverse events following the second COVID-19 vaccination (p = 0.0171) were more likely adherent app users. Despite technical issues causing dropout or non-adherence, the app served as a secure solution for cohort management and longitudinal data collection. Discussion: App-based cohort management enabled continuous data acquisition and individualized care while providing flexibility and anonymity for the study team and participants. App usability, technical issues, and cohort characteristics need to be thoroughly considered prior to implementation to optimize usage and adherence in clinical research. Full article

Background: Pressure ulcers (PUs) remain a prevalent complication in intensive care unit (ICU) settings, especially among immobilized patients. The impact of structured, nursing-led mobilization protocols on PU prevention and recovery remains underexplored. Objective: To evaluate the impact of nursing-led mobilization protocols on the incidence and progression of PUs in critically ill patients. Methods: In this retrospective observational cohort study, 188 ICU patients were admitted during one of two consecutive periods of care: conventional care (6-hourly repositioning) and an advanced nursing-led protocol (3-hourly repositioning with support surfaces and specialized nurse training), which replaced conventional care as standard in our institution. The primary outcome included new PU development for patients with no pre-existing ulcers or worsening/non-progression of pre-existing ulcers at discharge; ICU mortality was evaluated as a secondary outcome. Results: Among patients without pre-existing ulcers (n = 155), new PU incidence did not significantly differ between groups, even after adjusting for SOFA score (OR 0.40, 95% CI: 0.05 TO 3.17; p = 0.374). However, in patients with pre-existing ulcers (n = 33), the advanced care group showed improvement (53.3% versus 0% in the conventional group, OR 0.07, 95% CI: 0.01–0.64; p = 0.012); this effect was independent of initial SOFA score. Mortality was associated with the SOFA score, but not with the type of care. Conclusions: While advanced nursing-led mobilization did not reduce PU incidence, it significantly improved existing ulcer outcomes. Findings support the integration of structured protocols for high-risk ICU patients, especially those with existing ulcers. Full article

Background/Objectives: Aortic stenosis is a common heart disease, particularly among elderly patients. Transcatheter aortic valve implantation (TAVI) offers a minimally invasive alternative method to surgical valve replacement for high-risk patients. Although clinical guidelines for TAVI are well established, standardized nursing care pathways are lacking. This systematic review aims to clarify the nursing role in the pre-, peri-, and postoperative phases of TAVI. Methods: This review was conducted in accordance with the PRISMA guidelines. After applying the eligibility criteria, ten studies were selected from five databases: PubMed, Scopus, CINAHL, Web of Science, and the Cochrane Library. The work was registered in the PROSPERO database with the ID number CRD420251061863. Results: The analysis revealed the following: (1) a strong emphasis on preoperative patient education, often led by nurse coordinators; (2) perioperative nursing roles in conscious sedation protocols and early mobilization; (3) a lack of standardized rehabilitative protocols, especially in the preoperative phase; and (4) an emerging but insufficiently evaluated role of the TAVI nurse coordinator in multidisciplinary care. Most studies concentrated on postoperative care, outcomes, follow-up, and rehabilitation, but the small sample sizes limited the strength of the conclusions. Conclusions: Nurses play a vital role in multidisciplinary TAVI teams. There is an urgent need for evidence-based nursing guidelines to standardize care, improve clinical outcomes, and address the needs of TAVI patients. This review highlights the pivotal contribution of nursing to the success of TAVI. Full article

Background/Objectives: In hospital settings, the wide variability of acute and complex chronic conditions—among both adult and pediatric patients—requires advanced approaches to detect early signs of clinical deterioration and the risk of transfer to the intensive care unit (ICU). Nursing diagnoses (NDs), standardized representations of patient responses to actual or potential health problems, reflect nursing complexity. However, most studies have focused on the total number of NDs rather than the individual role each diagnosis may play in relation to outcomes such as ICU transfer. This study aimed to identify and rank the specific NDs most strongly associated with ICU transfers in hospitalized adult and pediatric patients. Methods: A retrospective, monocentric observational study was conducted using electronic health records from an Italian tertiary hospital. The dataset included 42,735 patients (40,649 adults and 2086 pediatric), and sociodemographic, clinical, and nursing data were collected. A random forest model was applied to assess the predictive relevance (i.e., variable importance) of individual NDs in relation to ICU transfers. Results: Among adult patients, the NDs most strongly associated with ICU transfer were Physical mobility impairment, Injury risk, Skin integrity impairment risk, Acute pain, and Fall risk. In the pediatric population, Acute pain, Injury risk, Sleep pattern disturbance, Skin integrity impairment risk, and Airway clearance impairment emerged as the NDs most frequently linked to ICU transfer. The models showed good performance and generalizability, with stable out-of-bag and validation errors across iterations. Conclusions: A prioritized ranking of NDs appears to be associated with ICU transfers, suggesting their potential utility as early warning indicators of clinical deterioration. Patients presenting with high-risk diagnostic profiles should be prioritized for enhanced clinical surveillance and proactive intervention, as they may represent vulnerable populations. Full article

Background/Objectives: The leakage of 5-fluorouracil (5-FU) from elastomeric infusion pumps used in cancer therapy poses a potential risk of unintentional exposure to multiple individuals, including patients’ relatives and healthcare professionals, and may also compromise the accurate administration of 5-FU dosages to patients. This study aimed to develop, validate, and apply an analytical method to detect and quantify 5-FU residues on the external surfaces of infusion pumps. Methods: A high-performance liquid chromatography with diode-array detection (HPLC-DAD) method was optimized for the quantification of 5-FU contamination across different components of the infusion pump, including the hard casing, infusion tubing, and catheter connection port. A mobile phase containing 5% acetic acid was used to obtain more efficient separation of 5-FU and the detection was performed at 260 nm. The method was evaluated for linearity, sensitivity, precision, accuracy, selectivity, robustness, and stability. Results: The method demonstrated linearity within the range of 0.150 to 3.000 µg/cm², with limits of detection and quantification of 0.05 µg/cm² and 0.14 µg/cm², respectively. Relative standard deviations ranged from 1.8% to 12.7%, and accuracy exceeded 85%. In real sample analysis, detectable residues were found around the catheter connection port. Conclusions: This screening-oriented method addresses an existing gap, as previous contamination reports were based solely on self-reported user observations. The detection of 5-FU residues highlights the critical need for safe handling practices and the consistent use of personal protective equipment (PPE) to protect healthcare workers, especially nursing staff involved in the removal of the infusion pumps, after treatment. Full article

Background: Osteoporotic hip fractures in the elderly significantly impact mobility and quality of life. Optimising early management is crucial for improving the functional outcomes. Methods: This single-centre retrospective cohort study included patients with femoral trochanteric (n = 142) or femoral neck fractures (n = 127) treated between January 2016 and March 2023. The patients were divided into ambulatory and non-ambulatory groups based on their walking ability at discharge from the rehabilitation hospital. The explanatory variables included age, sex, fracture type, surgical method, pre-surgical days, hospital days, dementia, and the Nursing Needs Score (NNS). Results: The most common age group was 85–89 years old. Only 23.4% of patients underwent surgery within 2 days of admission. The median hospital stay was 20 days in acute care and 52 days in rehabilitation hospitals. Walking ability declined in 66.9% of the patients. Pre-injury mobility and acute care hospital NNS were identified as independent predictors of ambulatory outcomes. Conclusions: Pre-injury mobility and the Nursing Needs Score (NNS) assessed at the acute care hospital were identified as critical determinants of postoperative ambulatory status. These findings highlight the importance of community collaboration and preventive rehabilitation strategies aimed at improving basic mobility, maintaining cognitive function, and preserving walking ability. Full article

Background: The increasing demand for elective surgery makes optimizing preoperative assessment a priority. Value-based healthcare aims to provide the highest value for patients at the lowest possible cost through various mechanisms, including reorganizing care into integrated practice units (IPUs). However, few studies have analyzed the effectiveness of implementing virtually led IPUs for preoperative assessment. Methods: We performed a retrospective observational cohort study including patients undergoing elective surgery at a teaching hospital in Madrid, Spain from 1 January 2018 to 31 December 2023, analyzing changes in surgical complications, efficiency, and patient satisfaction between the pre-implementation (2018–2019) and post-implementation (2020–2023) periods. Anesthesiologists’ satisfaction with the virtual assessments was described. During the post-implementation period, preoperative assessment was reorganized as a virtually led IPU. At the IPU appointment, preoperative testing and physical (including airway) examinations were performed by a nurse anesthesiologist. The results were uploaded to the electronic health records, and asynchronous virtual anesthesiologist assessment using a store-and-forward approach was performed. Digital patient education was carried out over the Patient Portal mobile application. Results: A total of 40,233 surgical procedures were included, of which 31,259 were from the post-intervention period. During the post-intervention period, no increase in surgical complications was observed, while same-day cancellations decreased from 4.3% to 2.8% of the total procedures (p < 0.001). The overall process time did not increase, despite the rising number of surgical procedures per year. Patient satisfaction improved. The median time to complete anesthesiologist assessment was significantly lower for virtual assessment (4.5 versus 10 min (p < 0.001), signifying estimated time savings of 716 person-hours per year. Anesthesiologists agreed that virtual assessment was more efficient than in-person evaluation, and half of the participants agreed that virtual preoperative care improved their work–life balance and reduced burnout. Conclusions: A digitally enhanced value-based model of preoperative care can improve efficiency and satisfaction metrics, reducing unnecessary costs and potentially improving the quality of care. Full article

Sarcopenia, characterized by progressive loss of muscle mass and strength, significantly increases health risks in healthy older adults. Resistance training (RT) is believed to counteract sarcopenia through a variety of physiological mechanisms, many of which remain underexplored by public health and physiotherapy professionals. This scoping review aims to consolidate studies that have explored RT programs in mitigating sarcopenia among healthy older adults. A systematic search in four knowledge databases (Web of Science, Scopus, Embase, Cumulative Index for Nursing and Allied Health Sciences Complete) was conducted on 30 April 2024 to consolidate the evidence of RT programs to mitigate sarcopenia risk among healthy older adults. Two reviewers independently screened, consolidated, and synthesized the results based on the Arksey and O’Malley framework. We included 36 studies supporting the RT program for reducing sarcopenia risk among healthy older people. Current evidence, predominantly derived from studies with high selection bias and non-randomized designs, indicates that RT programs may enhance muscle strength in healthy older adults. However, their impact on muscle morphology and mobility appears less pronounced. The dosage and intensity of RT are critical factors influencing these health outcomes. To substantiate the health benefits of RT in healthy older adults and facilitate the translation of research findings into policy-level recommendations, further high-quality, randomized controlled trials are warranted. Full article

Background/Objectives: Oral function assessments in hospitals and nursing facilities are mainly performed by nurses and caregivers but are sometimes not properly assessed. As a result, elderly people are not provided with meals appropriate for their masticatory function, increasing the risk of aspiration and other complications. In the present study, we aimed to examine image analysis conditions in order to create an AI model that can easily and objectively screen masticatory function based on occlusal pressure. Methods: Sampling was conducted at the Hokkaido University of Health Sciences (Hokkaido, Japan) and the university’s affiliated dental clinic in Hokkaido. Results: We collected 241 waveform images of changes in skin shape during chewing over a 20 s test period from 110 participants. Our study used two approaches for image analysis: convolutional neural networks (CNNs) and transfer learning. In the transfer learning analysis, MobileNetV2 and Xception achieved the highest classification accuracy (validation accuracy: 0.673). Conclusions: Therefore, it was determined that analyses of waveform images of changes in skin shape may contribute to the development of a skin change-based screening model as an alternative to the bite pressure test. Full article

In this study, we have developed a humanoid nursing care robot with the goal of helping older people realizing achieve various tasks such as assisted mobility, feeding, drinking, defecation, and bathing. This type of robot has the following features: (1) by using an omnidirectional mobility mechanism that does not require space equivalent to the turning radius, there is no risk of the robot itself falling over, and it can be used safely even in the small spaces of the home; (2) by giving the robot two arms with the same structure as a human arm, it is possible to perform a wide variety of nursing care movements; (3) in addition to avoiding bumping into furniture and walls, and to emulate human mobility intelligence, the robot has a high level of intelligence, which is required to understand the needs of the person receiving care and to determine appropriate action. This article presents the concept for the development of a humanoid nursing care robot and the design and basic configuration of the prototype. On the other hand, the care provided by robot is expected not only to eliminate labor shortages, but also improve the quality of care by taking into account the unique characteristics of each person requiring care. Quantitative management of nutritional intake is recognized as a way to improve the quality of care. This article proposes a method to use force sensors to enable a robot to pour water (beverages) quantitatively, and proves its effectiveness through experiments on a humanoid nursing care robot. Full article

Background: Pressure injuries are an ongoing problem commonly managed with the prescription of pressure mattresses. There is conflicting research about the comparable effectiveness of the two types of pressure mattresses, active and reactive. This, coupled with technological advances and an updated understanding of pressure aetiology, means decision-making when prescribing pressure mattresses is complicated. Objective/Design: A pragmatic approach was used to design an equivalence randomised-controlled trial investigating the comparative effectiveness of active and reactive pressure mattresses in a community setting from a wound healing perspective as well as from a user acceptability perspective. Methods: Participants with an existing pressure injury were provided with an active or reactive mattress for wound healing, with wound stages assessed using photography. Usual clinical care was provided based on the protocols of the health care service, including nursing and occupational therapy input. Participants were monitored for the healing of their existing pressure injuries, using the Revised Photographic Wound Assessment Tool. User acceptability feedback was provided through surveys, including impact on comfort, pain levels and bed mobility. An equivalence design was used for data analysis to determine if the surfaces were comparable. Results: Twelve participants completed the study, which found that people on active mattresses healed 11.71 days (95% CI −55.97–31.78 days) quicker than people on reactive mattresses; however, the small sample size meant that a definitive determination could not be made. Users found bed mobility more challenging, and pain levels decreased, regardless of mattress type. Conclusions: A pragmatic methodology is imperative for research in this field due to the complexity of pressure injury healing. Researchers exploring multi-faceted conditions should consider a pragmatic design to ensure transferability of results to the clinical setting. The results from this study were inconclusive when determining the equivalence of active and reactive mattresses due to the small sample size. When choosing a mattress, prescribers need to consider user preferences and mattress features to ensure user acceptability. Full article

This study explores the curriculum of Nursing Bachelor’s degrees across 15 European countries, aiming to describe nursing course curricula and admission requirements and to identify differences and similarities in the implementation of the Bologna Process. The research employs a qualitative and documentary methodology, analyzing curricula from selected higher education institutions involved in the Erasmus+ “Innovative Skills for Nurses” project. The findings reveal variations in the duration of training, with some countries adopting 3-year (180 ECTS) programs, while others require 4-year (240 ECTS) programs. Furthermore, discrepancies were found in the balance between theoretical and clinical education, as well as the availability of optional subjects. Countries with longer training programs tend to offer more consolidated practices and greater alignment with Bologna’s principles, fostering better professional outcomes. The study highlights the challenges posed by non-standardized training durations and their impact on mobility and employability of nursing professionals. These findings may inform future discussions on harmonizing nursing education across Europe to ensure consistency in quality and professional competencies. Full article