Healthcare-associated infections (HAI) are one of the major concerns worldwide, posing significant challenges to healthcare professionals’ education and training. This study intended to measure nursing students’ perceptions regarding their learning experiences on HAI prevention and control. In the first phase of the study, a cross-sectional and descriptive study with a convenience sample composed of undergraduate nursing students from Portugal, Spain, Poland, and Finland was conducted to develop the InovSafeCare questionnaire. In the second phase, we applied the InovSafeCare scale in a sample of nursing students from two Portuguese higher education institutions to explore which factors impact nursing students’ adherence to HAI prevention and control measures in clinical settings. In phase one, the InovSafeCare questionnaire was applied to 1326 students internationally, with the instrument presenting adequate psychometric qualities with reliability results in 14 dimensions. During phase two, the findings supported that Portuguese nursing students’ adherence to HAI prevention and control measures is influenced not only by the curricular offerings and resources available in academic settings, but also by the standards conveyed by nursing tutors during clinical placements. Our findings support the need for a dedicated curricular focus on HAI prevention and control learning, not only through specific classroom modules, innovative resources, and pedagogical approaches, but also through a complementary and coordinated liaison between teachers and tutors in academic and clinical settings.
Healthcare-associated infections are one of the major concerns worldwide. This study presents the development and the validation process of the InovSafeCare scale and aimed at identifying and measuring the ecosystem variables related to healthcare-associated infection (HCAI) prevention and control practices in European nurse students. Qualitative and quantitative approaches were used to (1) elaborate an item pool related to the educational environment, the healthcare setting environment, and the attitudes, beliefs, and performance of the nursing students regarding HCAI prevention and control and (2) analyze psychometric properties of the scale using factor analysis. The validated InovSafeCare scale was applied to undergraduate nursing students of five European Higher Education Institutions. The partial least square structural equation modeling (PLS-SEM) method with SMART-PLS3 software was used. The study sample consists of 657 nursing students, who responded a self-report inventory. From the analyzed data were identified 14 factors. The InovSafeCare scale reveals good validity and reliability of the dimensions in different European countries.
<p>The geomorphological and geological characteristics of karst regions are very specific and complex, affecting the hydrological processes significantly. Due to the enormous heterogeneity and non-linearity of karst terrains, the hydrodynamic functioning of karst watersheds considerably differs from non-karst watersheds. Quantifying and understanding the influence of these watershed characteristics in the hydrodynamics of karst and non-karst areas is crucial for managing water resources and extreme hydrological episodes, particularly in the present scenario of hydroclimatic variability and uncertainty.</p><p>The present study establishes a comparison between two watersheds: (i) a karst basin (An&#231;os) composed of Middle Jurassic karstified limestones, dominated by a rough plateau that promotes the infiltration, and (i) a non-karst basin (Arunca) characterized by Upper Jurassic and Cretaceous marly limestones, and Cenozoic thick mudstones deposits (low permeability promoting surface runoff). The rivers' water level was logged every 20 minutes by a gauge station from 2010 to 2020, and the rainfall was also registered for the same period.</p><p>The objectives of this study are (i) to examine, from a quantitative perspective, the influence of geomorphological and geological characteristics on the runoff coefficient using statistical analysis; (ii) to quantify the rainfall-runoff lag time and the recession coefficients from the analysis of storm hydrographs simultaneously in both watersheds; (iii) to deepen the knowledge about the behavior of each watershed in flood episodes through hydrological simulation.</p><p>The results showed that geomorphological and geological watershed characteristics play an essential role in the hydrodynamic functioning of the An&#231;os and Arunca watersheds. Furthermore, the outcomes of this study revealed a pronounced contrast between the two watersheds in the reaction to rainfall and mainly in the first stage of the recession limb. It should be highlighted that the non-karst watershed presents a faster and more extreme hydrological behavior expressed in a peak hydrograph. On the reverse, the karst watershed demonstrated a higher storage capacity, revealed by the shape of the recession curve.</p>
BackgroundDespite living in the high tech era, there is still a lack of software tools to help pharmacists to carry out their common tasks, pharmaceutical care being one of the most important.PurposeDesigning a friendly intuitive application to gather, assess and use patients’ demographic and clinical information to obtain better results in pharmaceutical care.Material and methodsWe created a Filemaker database compatible with computers and tablets. Its interface was designed with Adobe PhotoshopCC. Prior to this, a bibliographical review on pharmaceutical care was performed to decide which data would be useful for pharmacists to collect.ResultsAn iPadMini optimised (1024x669) ‘.fmp12’ file was obtained. The main page grants access to patient records. Each one allows demographic and clinical data, including history, current diagnosis and evolution to be collected. A button panel give access to the remaining areas. ‘Therapy’ section is set to collect pharmacotherapy data (drug, dose, interval, administration route, prescription date). To make follow-up easier, drugs can be flagged into five categories (restricted duration, possibility of intravenous to oral switching, common adverse reactions, potential contraindications and dose adjustment needs). A similar table records nutritional treatments. ‘Laboratory’ gathers the most relevant haematologic (cell counts, coagulation, haemoglobin, etc), biochemical (glucose, ion levels, etc) and microbiologic (culture findings, susceptibility testings) parameters related to pharmaceutical care. It calculates MDRD4 creatinine clearance, and warns the user if values are out of range. ‘PRIME zone’ allows recording of pharmaceutical problems, risk issues, drug Interactions, treatment mismatches and efficacy facts. Users can record how each problem is managed, and if they were able to influence clinicians (accepted, rejected or non-assessable interventions). The database is provided with a search engine, and can print a ‘.pdf’ case report.ConclusionOur database aims to make pharmacotherapy management easier, improving detection of medication related problems and allowing bedside work. In a pilot study in over 28 patients, our colleagues perceived an increase in the amount and quality of interventions to clinicians, but also regretted spending too much time when gathering data, due to the fact that the database cannot automatically collect data from official sources. Despite having enhanced our database functionality, Filemaker does not fulfil our needs, and professional software development would be desirable, which requires further funding.No conflict of interest
Prevent and control healthcare-associated infections (HAIs) is a priority in healthcare assistance, not only due to present COVID-19 pandemic. Annually, around 3.2 million patients are affected by one of these infections and it is estimated that without controlling them, by 2050, 10 million more people could die every year, with especial relevance among elderly with infectious situations representing a third of mortality in people over 65 years old. Higher Education Institutions (HEI) in healthcare area have an important role in this panorama, by preparing students to be future professionals, stimulating them to have an innovative and entrepreneurial approach to today's real-life challenges. A mixed-methods research was conducted, at European level (in Portugal, Finland, Poland and Spain), to facilitate learning of good practices on HAIs prevention and control while developing innovative solutions. 1475 participants were enrolled, from all partner HEI: 79 professors and mentors were interviewed (individual or focus group), 1326 final year nursing students made a self-report inventory (application of InovSafeCare Scale) and 70 students participated on focus group (agile piloting of the Model). The result of this research is a pedagogical model that mixes dimensions and methods that take nursing students closer to the demands of HAIs prevention and control and capacitates them to transfer knowledge to work settings with an innovative and entrepreneurial perspective -the InovSafeCare Model.
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