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Aims and objectives: To explore the role that Donor Transplant Co‐ordinators have played and the future potential of Specialist Nurses for Organ Donation (SN‐ODs), within organ donation strategies in the UK and other countries. Background: Organ donation and transplantation rates vary extensively around the world. However, there is a universal shortage of deceased donors, prompting different approaches to increase transplantation rates. Within the UK, the Clinical Lead for Organ Donation and Specialist Nurse in Organ Donation undertake a key role in the implementation of the Organ Donation Strategy. The Human Transplantation (Wales) Act 2015 is a recent development which facilities a deemed (presumed) consent approach to organ donation, the Specialist Nurse in Organ Donation undertakes a major role identifying the potential donor in this situation by confirming the deemed consent status of the donor and supporting bereaved relatives. UK governments in England and Scotland are currently seeking legislative changes to an opt‐out system of organ donation, in line with the Wales change. Design: This discursive paper explores the role from Donor Transplant Co‐ordinator to Specialist Nurse in Organ Donation (SN‐OD) within organ donation policy in different settings, but with a specific focus on the UK. The paper clarifies the current and future potential of nurses working with bereaved families when requesting authorisation for donation. Implications for nursing: The current scope and future potential of Donor Transplant Co‐ordinator and Specialist Nurse in Organ Donation roles need better recognition. Little empirical data exist about the key role that these nurses play in the organ donation process, especially in relation to gaining authorisation to proceed to donation. Conclusion: There is a need to clarify the role of the Specialist Nurse in Organ Donation and their impact on improving rates of organ donation. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to examine relationships between internationally educated nurses’ (IENs’) performance in a registered nurse competency assessment process and the outcomes of their nursing registration applications. Assessments of nursing practice competencies, IEN applicant characteristics and registration outcomes were explored.Design/methodology/approach This is a secondary statistical analysis of a subset of IEN application data from a previous study in combination with assessment data from an additional database. Application data between 2008 and 2011 were analyzed using univariate/bivariate analyses and regression models to explore the relationship of performance in the assessment process and outcomes of the registration process.Findings Competency categories IEN applicants had difficulties with (from least to most) were Professional Responsibility and Accountability, Ethical Practice, Self-Regulation, Service to the Public, Knowledge-Based Practice: Specialized Body of Knowledge and Knowledge-Based Practice: Competent Application of Knowledge. IENs educated in the UK and USA had the highest scores and odds of meeting competencies. Applicants educated in India and Asia had lower scores and odds ratios. All national entry-to-practice examination and registration eligibility competencies were significantly related to registration outcomes. Applicants passing the exam had higher competency scores while applicants ineligible for registration had lower competency scores.Research limitations/implications Limitations include integrity of data extracted from active databases, IEN motivation to complete the RN registration process and conversion of assessment scales for research analysis.Originality/value Results inform regulation policies that improve IEN registration processes and may be informative to regulators, assessment centers, educational institutions and IENs. [ABSTRACT FROM AUTHOR]

Out-of-hospital cardiac arrest (OHCA) is a global health concern with an incidence rate of 50-60 per 100,000 person-years. To improve OHCA survival rates, several cardiac arrest registries have been set up in North America and Europe, such as the Resuscitation Outcomes Consortium, Cardiac Arrest Registry to Enhance Survival, Ontario Prehospital Advanced Life Support and European Registry of Cardiac Arrest. In Asia, however, there was previously no concerted effort in prehospital emergency care research owing to differences in prehospital emergency medical services systems, data collection methods and outcome reporting between countries. Recognising the need for a collaborative prehospital emergency care research group in Asia, researchers from seven countries in the Asia-Pacific region (including Japan, South Korea, Taiwan, Thailand, United Arab Emirates-Dubai, Singapore and Malaysia) established the Pan-Asian Resuscitation Outcomes Study (PAROS) clinical research network in 2010. This paper gives the overview, methodology and research accomplishments of the PAROS network. [ABSTRACT FROM AUTHOR]

Background: Non‐pharmacologic interventions might be effective to reduce the incidence of delirium in pediatric intensive care units (PICU). Aim: To explore expert opinions and generate informed consensus decisions regarding the content of a non‐pharmacologic delirium bundle to manage delirium in PICU patients. Study design: A two‐round online Delphi study was conducted from February to April 2021. PICU experts (nurses, physicians, researchers, physical therapists, play specialists, and occupational therapists) located in Europe, North America, South America, Asia, and Australia participated. Results: We developed a questionnaire based on the outcomes of a comprehensive literature search in the domains: 1) cognition support; 2) sleep support; and 3) physical activity support. Under these domains, we listed 11 strategies to promote support with 61 interventions. Participants rated the feasibility of each intervention on a 9‐point Likert scale (ranging from 1 strongly disagree to 9 strongly agree). A disagreement index and panel median were calculated to determine the level of agreement among experts. In the second round, participants reassessed the revised statements and ranked the interventions in each domain in order of importance for age groups: 0–2, 3–5, and 6–18 years of age. During the first Delphi round, 53 of 74 (72%) questionnaires were completed, and in the second round 45 of 74 (61%) were completed. Five of the highest ranked interventions across the age groups were: 1) developing a daily routine, 2) adjusting light exposure according to the time of day, 3) scheduling time for sleep, 4) providing eyeglasses and hearing aids if appropriate, 5) encouraging parental presence. Conclusions: Based on expert consensus, we developed an age‐specific non‐pharmacologic delirium bundle of interventions to manage delirium in PICU patients. Relevance to Clinical Practice: An age‐specific Non‐Pharmacological Delirium bundle is now ready to be tested in the PICU and will hopefully reduce pediatric delirium. [ABSTRACT FROM AUTHOR]

Background: In the neonatal intensive care unit, immigrant parents may experience even greater anxiety than other parents, particularly if they and the nurses do not share a common language. Aim: To explore the complex issues of trust and the nurse–mother relationship in neonatal intensive care units when they do not share a common language. Design and methods: This study has a qualitative design. Individual semi-structured in-depth interviews and two focus group interviews were conducted with eight immigrant mothers and eight neonatal intensive care unit nurses, respectively. Data analysis was based on Braun and Clarke's thematic analytic method. Ethical considerations: Approval was obtained from the hospital's Scientific Committee and the Data Protection Officer. Interviewees were informed in their native language about confidentiality and they signed an informed consent form. Results: Trust was a focus for mothers and nurses alike. The mothers held that they were satisfied that their infants received the very best care. They seemed to find the nurses' care and compassion unexpected and said they felt empowered by learning how to care for their infant. The nurses discussed the mother's vulnerability, dependency on their actions, attitudes and behaviour. Discussion: Lack of a common language created a challenge. Both parties depended on non-verbal communication and eye contact. The nurses found that being compassionate, competent and knowledgeable were important trust-building factors. The mothers were relieved to find that they were welcome, could feel safe and their infants were well cared for. Conclusion: The parents of an infant admitted to the neonatal intensive care unit have no choice but to trust the treatment and care their infant receives. Maternal vulnerability challenges the nurse's awareness of the asymmetric distribution of power and ability to establish a trusting relationship with the mother. This is particularly important when mother and nurse do not share a verbal language. The nurses worked purposefully to gain trust. [ABSTRACT FROM AUTHOR]

The lack of gender diversity in the nursing profession has long been recognized as a cause for concern. Female nurses in many practice settings across nations continue to outnumber their male counterparts. Male nursing students may have perceived differences in the way they are treated in clinical practice; however, limited studies have been conducted to determine the unique perspectives of these students in terms of gender bias in their clinical learning. To address this knowledge gap, this study employed a qualitative descriptive approach to explore the experiences of male nursing students in clinical learning in an Asian context. Specifically, we examined the insights emerging from the thoughts and feelings of male nursing students from interactions with their clinical mentors, patients, and peers in their encounters during their clinical placement. From November 2019 to July 2020, data were collected through semi-structured interviews from 22 male participants aged 21-30 years (mean age: 22.7), enrolled in a prelicensure Bachelor of Nursing (honors) program in Hong Kong. Four themes emerged after a qualitative content analysis: (1) while the School of Nursing welcomes men, clinical settings are another story due to pragmatic considerations; (2) you are welcomed because you may be seen as a helper with greater physical strength; (3) male nursing students feel alienated in the obstetrics and gynecology practicum; (4) more male role models are desired in the clinical setting. Our findings indicate the need to promote gender awareness among faculty and clinical mentors, understand the factors hindering and facilitating the clinical practicum for male nursing students, improve the male nursing experience during the maternity practicum, and ensure access to more male role models to boost role socialization and learning. [ABSTRACT FROM AUTHOR]

Introduction: Because virtually no theories were available to explain unique characteristics of Asian women's leadership in nursing, a middle-range theory on women's leadership in Asian culture was previously published. To reflect recent political and social changes in different countries, there is a necessity to refine the theory. The purpose of this article is to present the refined middle-range theory on Asian women's leadership in nursing. Methodology: Using an integrative approach, the theory was further developed based on two major sources: literature reviews and exemplars/cases from six different countries. Results: The Refined Middle-Range Theory on Women's Leadership in Asian Culture has two main domains: (a) leadership frames and (b) leadership contexts. The domain of leadership contexts has been extended with two additional main concepts including demographic contexts and health workforce/system contexts. Discussion: The refined theory is expected to guide Asian women's leadership in nursing across the globe. [ABSTRACT FROM AUTHOR]

The article focuses on outbreak of epidemics and pandemics including Ebola, Severe Acute Respiratory Syndrome (SARS) and Coronavirus (COVID-19) and mentions implementation of lockdown of Hubei province. Topics discussed including nursing informatics community responding to crisis and lessons learned, reduction of impact of the disease on the country's healthcare system and e-learning technologies to ensure nursing students.

Aims and objectives: To explore how communication in neonatal intensive care units (NICUs) between immigrant mothers and nurses take place without having a common language, and how these mothers experience their NICU stay. Background: Admission of infants to NICU affects both parents and infants. Immigrant mothers constitute a vulnerable hospital population in need of culturally, linguistically and individually tailored information. Design and methods: The study had a qualitative design reported according to the COREQ criteria. Eight mothers who spoke neither Scandinavian nor English went through individual semi‐structured interviews. Six mother–nurse interactions were observed, and eight nurses' experiences were explored through focus‐group interviews. All interviews were audio recorded and transcribed verbatim. The analysis was thematic and hermeneutic in character. Results: Interpreters were present during the consultations with the physicians, but rarely during the daily nurse‐mother interactions. Nurses focused on daily routines, infant care guidance and mother–infant attachment. The mothers learned through demonstrations and hands‐on guidance. Language barriers made it difficult to assess the mothers' understanding, but the mothers expressed that they felt adequately included in the care of their infant and well informed and guided. Even so, both mothers and nurses expressed desire to use interpreters more regularly. The pictorial communication boards available lacked important vocabulary needed in neonatal nursing contexts and their use furthermore interrupted the mother–nurse conversation. Conclusion: Body language, simple words, guesswork, trial and error characterised the nurse–mother interaction. The nurses adopted various communication strategies to help the mothers understand and give them a voice. Competent interpreters were used during meetings with physicians, but not during daily bedside guidance and information giving by nurses. Relevance to clinical practice: Knowledge of immigrant mothers' and nurses' communication strategies and how both parties think, feel and act to overcome communication problem is necessary to improve clinical practice and reduce communication barriers. [ABSTRACT FROM AUTHOR]

Background: Misuse of antibiotics is a well-known driver of antibiotic resistance. Given the decentralized model of the Indian health system and the shortage of allopathic doctors in rural areas, a wide variety of healthcare providers cater to the needs of patients in urban and rural settings. This qualitative study explores the drivers of antibiotic use among formal and informal healthcare providers as well as patients accessing care at primary health centers across Paschim Bardhaman district in West Bengal. Materials and methods: We conducted 28 semi-structured, in-depth interviews with four groups of healthcare providers (allopathic doctors, informal health providers, nurses, and pharmacy shopkeepers) as well as patients accessing care at primary health centers and hospitals across Paschim Bardhaman district. Qualitative data was analyzed using the framework method in an inductive and deductive manner. Results: Our results indicate that patients demand antibiotics from healthcare providers and seek the fastest cure possible, which influences the prescription choices of healthcare providers, particularly informal health providers. Many allopathic doctors provide antibiotics without any clinical indication due to inconsistent follow up, lack of testing facilities, risk of secondary infections, and unhygienic living conditions. Pharmaceutical company representatives actively network with informal health providers and formal healthcare providers alike, and regularly visit providers even in remote areas to market newer antibiotics. Allopathic doctors and informal health providers frequently blame the other party for being responsible for antibiotic resistance, and yet both display interdependence in referring patients to one another. Conclusions: A holistic approach to curbing antibiotic resistance in West Bengal and other parts of India should focus on strengthening the capacity of the existing public health system to deliver on its promises, improving patient education and counseling, and including informal providers and pharmaceutical company representatives in community-level antibiotic stewardship efforts. [ABSTRACT FROM AUTHOR]

Medical errors are of economic importance and can contribute to serious adverse events for patients. Medical errors refer to preventable events resulting from healthcare interactions, whether these events harm the patient or not. In Kuwait, there is a paucity literature detailing the causes, forms, and risks of medical errors in their state-funded healthcare facilities. This study aimed to explore medical errors, their causes and preventive strategies in a Kuwait tertiary hospital based on the perceptions and experience of a cross-section of healthcare professionals using a questionnaire with 27 open (n = 10) and closed (n = 17) questions. The recruited healthcare professionals in this study included pharmacists, nurses, physicians, dentists, radiographers, hospital administrators, surgeons, nutritionists, and physiotherapists. The collected data were analysed quantitatively using descriptive statistics. A total of 203 participants filled and completed the survey questionnaire. The frequency of medical errors in Kuwait was found to be high at 60.3% ranging from incidences of prolonged hospital stays (32.9%), adverse events and life-threatening complications (32.3%), and fatalities (20.9%). The common medical errors result from incomplete instructions, incorrect dosage, and incorrect route of administration, diagnosis errors, and labelling errors. The perceived causes of these medical errors include high workload, lack of support systems, stress, medical negligence, inadequate training, miscommunication, poor collaboration, and non-adherence to safety guidelines among the healthcare professionals. [ABSTRACT FROM AUTHOR]

Introduction: Safety climate, which provides a snapshot of safety culture, is rarely measured in Indonesian healthcare organisations because there are no validated surveys that can be administered in its native language, Bahasa Indonesia. The objectives of this study were to translate and linguistically adapt the Safety Attitudes Questionnaire into Bahasa Indonesia, and investigate the internal construct validity and reliability of the translated survey. Methods: The Safety Attitudes Questionnaire was translated into Indonesian language through forward and backward translation. The internal construct validity and reliability of the translated survey was assessed using Rasch analysis which examines overall model fit, unidimensionality, response format, targeting, internal consistency reliability and item bias. Results: A total of 279 nurses (response rate 82%) completed the Indonesian version of the Safety Attitudes Questionnaire. Most respondents were Division 2 registered nurses (n = 209; 75%), female (n = 174; 62%), and aged less than 30 years (n = 187; 67%). All six domains of the Indonesian version of the Safety Attitudes Questionnaire demonstrated unidimensionality (t-test less than 0.05 threshold value). However, suboptimal targeting (ceiling effect) was observed in all domains, and had at least one misfitting item (item fit residual beyond ±2.5) Item bias was also evident in most domains. Conclusion: This study has translated and validated an Indonesian version of the Safety Attitudes Questionnaire for the first time. Whilst there was general support to sum items to obtain domain scores, further work is required to refine the response options as well as the wording and number of items in this survey to improve its overall measurement properties. [ABSTRACT FROM AUTHOR]

Background: While Nepal’s maternal mortality ratio (MMR) has improved overall, the proportion of maternal deaths occurring in health facilities and attended to by skilled birth attendants (SBAs), has nearly doubled over 12 years. Although there are numerous socioeconomic, environmental and other factors at play, one possible explanation for this discrepancy between utilization of skilled maternal care services and birth outcomes lies in the quality of care being provided by SBAs. The objective of this study is to determine how competent SBAs are after training, across multiple settings and facility types in Nepal. Methods: We used a quantitative cross-sectional analysis to evaluate a sample of 511 SBAs, all female, from 276 sub-health posts (SHP), health posts (HP), primary healthcare centers (PHC), and district and regional hospitals in the mountain, hill, and terai districts of Nepal. Any SBA actively employed by one of these health facilities was included. SBAs who had received less than three months of training were excluded. Outcomes were measured using SBAs’ scores on a standardized knowledge assessment, clinical skills assessment, and monthly delivery volume, particularly as it compared with the WHO’s recommendation for minimum monthly volume to maintain competence. Results: SBAs on average exhibit a deficiency of both knowledge and clinical skills, failing to meet even the 80-percent standard that is required to pass training (knowledge: 75%, standard deviation 12%; clinical skills: 48%, standard deviation 15%). Moreover, SBAs are conducting very few deliveries, with only 7 percent (38/511) meeting the minimal volume recommended to maintain competence by the WHO, and a substantial fraction (70/511, 14%) performing an average of no monthly deliveries at all. Conclusions: Taken together, our findings suggest that while countries like Nepal have made important investments in SBA programs, these healthcare workers are failing to receive either effective training or sufficient practice to stay clinically competent and knowledgeable in the field. This could in part explain why institutional deliveries have generally failed to deliver better outcomes for pregnant women and their babies. [ABSTRACT FROM AUTHOR]

Hospital accreditation is an effective way to evaluate the quality of a hospital and important tool for improving the standard of the hospitals. Due to improve the quality of health services, hospital accreditation should be supported. Accreditation is a long-term process that demands commitment of the entire organization to work together. The health care professionals skepticism about the positive impact of accreditation programs is the most important barrier to implementation that program. This study aims to assess the perceptions of health professionals on the impact of hospital accreditation and implementation of change towards the delivery of quality patient care in Asian countries. We systematically searched five electronics databases from May 14th - 21st 2018, for eligible systematic reviews in Asia region with English for language limitation. Five publications met the inclusion criteria. Findings from the included studies found positive perceptions of health professionals to hospital accreditation impact on improving the quality of health services. These studies have heterogenic variables to explore the health professional perception toward impact of hospital accreditation and quality of care. The implementation of hospital accreditation requires commitment, support, and motivation from government, leadership, and all human resources in the hospital. There are many factors affecting performance of accreditation such as quality of care, leadership, and culture. These factors need strategies to strengthen the way accreditation for improving quality of care, strengthen leadership, and culture. The findings are expected to provide valuable lessons for preparing or implementing accreditation. [ABSTRACT FROM AUTHOR]

Climate change in the 21st century due to greenhouse gas emissions from anthropogenic activity represents a looming emergency. Warming of the planet with changes in temperature, precipitation, sea level rise, hurricanes, droughts, wildfires, and other environmental impacts are accelerating and contributing to deleterious health consequences including respiratory and cardiovascular effects due to air pollution, vector-borne and infectious diseases, food and water insecurity, and mental health disorders. The economics of climate change are a major consequence resulting from the warming of the planet. [ABSTRACT FROM AUTHOR]

This article compares the doctor-patient communication styles of the United States with those of three Asian countries: Pakistan, Japan, and Thailand. Based on intercultural comparisons drawn between those countries, this analysis reveals that, overall, the United States has very little in common with the philosophical, cultural, societal, and communicative approaches to the traditional doctor-patient communication styles used in these three Asian nations. However, major similarities have been found across all three Asian nations. Although the doctor-patient relationship has been studied extensively in the United States and most of the Western world, rarely do those studies integrate, concurrently within their doctor-patient communication framework, dimensions such as power distance, individualism-collectivism, and communication styles. These are three important concepts in this analysis; they improve our understanding of what constitutes effective doctor-patient communication across dissimilar cultures. [ABSTRACT FROM PUBLISHER]