BackgroundHealth care institutions need to construct management strategies for patients diagnosed with acute coronary syndrome (ACS) that focus on evidence‐based treatments, adherence to treatment guidelines, and organized care. These help to reduce variations as well as the mortality and morbidity rates, which indicates the critical need for standardized care and adherence to evidence‐based practices for patients hospitalized with ACS. The care pathways translate research and guidelines into clinical practice to close the gap between the guidelines and the clinical practices.ObjectivesThis review focuses on identifying the indicators used to evaluate ACS care pathways and their effect on the care process and clinical outcomes.MethodsThis review follows the preferred reporting items for systematic reviews and meta‐analyses (PRISMA) guidelines. The systematic research was conducted using five research databases. Two groups were created by dividing the studies according to their year of publication. The first group included those studies published from 1997 to 2007 (“Group 1”), while the second included those published from 2008 to 2018 (“Group 2”). Selected studies were screened using the Effective Public Health Practice Project (EPHPP) quality assessment tool.ResultsSeventeen studies were included in this review. One study was a randomized controlled trial, 14 were predesigns and postdesigns, and two were longitudinal observational designs. The Group 1 studies demonstrated that ACS care pathways had a positive effect on reducing the length of the hospital stay and the door‐to‐balloon times. Similar effects were observed for the Group 2 studies.ConclusionImplementing ACS care pathway helps to organize care processes and decrease treatment delays as well as improve the patient outcomes without adverse consequences for patients or additional resources and costs. While the current level of evidence is inadequate to warrant a formal recommendation, there is a need for more studies with an emphasis on well‐designed randomization to measure patient outcomes.
Background: Vaccine hesitancy in Saudi Arabia continues even after reaching 17 million doses. This study was conducted to comprehensively assess coronavirus disease 2019 (COVID-19) vaccine hesitancy in adult people who ignore the COVID-19 vaccine in the Saudi Arabian population and explore community awareness of public health after 17 million doses of COVID-19 vaccination.Methods: A cross-sectional survey was used in this study. The questionnaire included three domains: demographic information, vaccine hesitancy by the health belief model related to the COVID-19 vaccine, and hesitancy by attitude and conspiracy towards the COVID-19 vaccine. A total of 401 adults participated in this study.Results: The respondents' perceptions of COVID-19 susceptibility and severity showed that the participants did not feel at risk nor believe that COVID-19 was serious. Connivance beliefs were found to be associated with reliance on social media as a major source of information about COVID-19 vaccines, and lack of trust in vaccine manufacturers (pharmaceutical companies). The majority of the respondents were concerned about the efficacy and safety of the COVID-19 vaccine, which can be reported as a major barrier to vaccination.Recommendations: To increase vaccination rates, health authorities need to communicate both the benefits and risks of vaccination. In addition, we recommend using a qualitative study to understand and evaluate the participants' concepts in depth.
Background: The literature review on the implementation of care pathways is very diverse, there are active implementation and passive implementation. Therefore, the best strategy of implementation of the care pathway is still unclear. Objective: This literature review aimed to identify the component of the development and implementation of the care pathway. Methods: The research was conducted on five research databases. To optimize the research strategy, keywords used were identified via the medical subject headings (Mesh terms), their synonyms, and using operators such as truncation, wildcard, and Boolean operators. For quantitative studies, JBI Meta-Analysis of Statistics Assessment and Review Instrument (MAStARI) was utilized to assess the quality of studies. Furthermore, the quality assessment of qualitative studies was based on JBI Qualitative Assessment and Review Instrument (QARI). Results: The search revealed 1015 articles. Of these, 11 articles met the inclusion criteria for this review. One randomized controlled trial was reported. The majority of these articles reported baseline and post-implementation pathway. The studies emerged from the United Kingdom, the United States, Singapore, the Netherlands, Canada, and Australia. The implementation process is completed through four phases. The planning phase assesses the current practice and determines whether the provided health care is in compliance with the guidelines, a crucial step before implementing care pathways. The reviewed studies reported different methods: site visiting, preaudit chart, structured questionnaire. The design phase begins with the selection of an appropriate clinical condition, then an agreement about the components of care pathways which based on the questionnaire and Delphi. The majority of reviewed studies reported that the implementation phase is based on the education of staff. However, specific details related to the education sessions of the care pathways were not discussed. Finally, the evaluation phase was used audit charts, questionnaire and focus group. Inadequate reliability and validity of the questionnaire were noted. Conclusions: Existing data demonstrate there is agreement on four mean phases when applying care pathways, however, there are still a diversity of key factors of each phase.
Background: Nurses have been under heavy workloads since the outbreak of COVID-19 and are at a high risk of infection, leading to a high level of psychosocial risk. This can adversely affect nurses both psychologically and physically. Burnout is caused by prolonged stress during work. In the nursing profession, burnout is common, potentially affecting the well-being of nurses and their productivity. The identification of factors that may contribute to maintaining mental health and reducing burnout among frontline nurses during a pandemic is essential. Purpose: The purpose of this study was to explore how personal resilience, social support, and organizational support impact burnout among frontline staff nurses. Methods: This study involved 129 registered nurses from a COVID-19 designated hospital using four standardized scales. Results: The mean age of the respondents was 29.46 years (standard deviation = 4.89). The mean number of years respondents worked in this organization was 5.60 years and the nursing profession was 4.16 years. Most of the respondents were female and held a bachelor's degree in nursing. Multiple regression analysis was performed to predict burnout. Burnout was statistically significantly predicted by the multiple regression model (R2 = .420, F (3, 125) = 10.941, p < .0001; adjusted R2 = .406). Personal resilience, social support, and organizational support added statistically significantly to the prediction of burnout (p < .05). Conclusion: Findings from multiple regression analysis showed that nurses with low resilience and those who perceived inadequate social and organizational support had a higher risk of reporting more burnout. As a result of a bivariate analysis, there was no significant correlation between nurse variables and burnout level, except for age, which was negatively correlated with burnout level. Accordingly, young nurses tend to experience burnout, and nurse directors and managers must address this problem.
Background Accountability pressure is rising in healthcare, and this demonstrates that the quality of care provided within a residential care setting is of utmost importance. Hostmanship is a quality improvement program focusing on person-centered care in residential care settings. Objectives This study aimed to explore the influencing factors for job satisfaction and intention to leave among healthcare workers and the difference in job satisfaction and intention to leave the employer between residential care centers with and without Hostmanship. Methods A quantitative, cross-sectional study was conducted in sixteen Flemish residential care settings in Belgium. A total of 293 participants completed the questionnaire, divided into two groups: the group with Hostmanship (n = 139), at least one year into a change process implementing Hostmanship, and the group without the Hostmanship program (n = 154). Hierarchical logistic regression analysis estimated effects between demographic characteristics (block one), facility management, staffing and Hostmanship (block two), work characteristics (block three), and work engagement or burnout dimensions (block four) as explanatory variables of job satisfaction and turnover intention as outcome variables. Results This study confirmed the positive impact of social capital and decision latitude on staff member job satisfaction, as shown in previous findings. Age and workload were associated with turnover intentions. A hierarchical logistic regression model explained 68.7 % of the variance in workers' job satisfaction, and a hierarchical logistic regression explained 49.2% of the variance in their intent to leave. Also, no effects were found for Hostmanship on staff job satisfaction and intention to leave. Conclusions This study shows how a quality improvement project such as Hostmanship could produce counterintuitive results for organizations in elderly residential centers. However, results inconsistent with literature were found. It is unclear whether Hostmanship warrants job satisfaction or retaining personnel. Future research must take into consideration success factors when implementing new quality initiatives. A general framework for successful implementation in the healthcare sector should be provided.
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