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Background: Management of opioid withdrawal in hospital settings is crucial to improve treatment completion and health outcomes among patients who use opioids, such as heroin. Evidence-based clinical guidelines can support responsive provision of opioid substitution therapy (OST). In England there is no standardised application of guidance for substance dependence management across National Health Service (NHS) Hospitals. A recent review of NHS hospital policies identified varying approaches to managing opioid withdrawal and procedural barriers to timely medication. Objective: To develop a clinical guideline for opioid withdrawal management in acute NHS hospital trusts to be tested and evaluated as part of the iHOST (Improving Hospital Opioid Substitution Therapy) research intervention. Methods: We undertook a deliberative guideline development process. The University London College Hospital (UCLH) substance dependence guideline was used as a template, with key points of revision informed by evidence review, consultations with hospital staff and people with opioid dependence. A multidisciplinary working group deliberated evidence statements to develop recommendations. These were reviewed by an oversight committee comprising representatives from key stakeholder organisations. The team authored the guideline with iterative review by the oversight committee, key stakeholders and UCLH clinical governance committees. Results: Deliberation focused on three key domains: (1) identifying opioid dependence and promptly continuing existing OST prescriptions; (2) initiating or re-titrating OST; (3) ensuring safety and continuity of care at discharge. Changes to the UCLH guideline included removal of mandatory urine drug testing prior to OST; increasing initial methadone titration dose; and provision for a higher day-one titration dose when specific safety criteria are met. A new titration schedule for sublingual buprenorphine was incorporated. Discharge planning to ensure continuity of community care and reduce risk of opioid overdose was emphasised, with allowance for bridging prescriptions of OST and naloxone provision on hospital discharge. Conclusion: The iHOST clinical guideline aims to remove procedural barriers to opioid withdrawal management for hospital inpatients. It is intended to be implemented by other NHS hospitals, which could improve access to OST and reduce discrepancies in treatment access and completion. Study registration: ISRCTN47320412 https://doi.org/10.1186/ISRCTN47320412. [ABSTRACT FROM AUTHOR]

Aim: To update the competences and learning outcomes and their evaluation, educational methods and education quality assurance for the training of contemporary specialists in periodontology, including the impact of the 2018 Classification of Periodontal and Peri‐implant Diseases and Conditions (2018 Classification hereafter) and the European Federation of Periodontology (EFP) Clinical Practice Guidelines (CPGs). Methods: Evidence was gathered through scientific databases and by searching for European policies on higher education. In addition, two surveys were designed and sent to program directors and graduates. Results: Program directors reported that curricula were periodically adapted to incorporate advances in diagnosis, classification, treatment guidelines and clinical techniques, including the 2018 Classification and the EFP CPGs. Graduates evaluated their overall training positively, although satisfaction was limited for training in mucogingival and surgical procedures related to dental implants. Traditional educational methods, such as didactic lectures, are still commonly employed, but they are now often associated with more interactive methods such as case‐based seminars and problem‐based and simulation‐based learning. The evaluation of competences/learning outcomes should employ multiple methods of assessment. Conclusion: An update of competences and learning outcomes of specialist training in periodontology is proposed, including knowledge and practical application of the 2018 Classification and CPGs. Harmonizing specialist training in periodontology is a critical issue at the European level. [ABSTRACT FROM AUTHOR]

The article discusses a study on laparoscopic cholecystectomy performed by a surgical care practitioner, which sparked debate and received over 15,000 downloads. Questions were raised regarding ethical approval, training opportunities, and the role of surgeons in training. The Royal College of Surgeons of England does not support surgical care practitioners undertaking laparoscopic cholecystectomies. The study authors responded to questions about the necessity of training the practitioner, the impact on trainees, and the responsibility in case of complications. The authors emphasized the SCP's extensive training and experience, as well as the supervision provided during the procedures. [Extracted from the article]

The article discusses the psychological challenges faced by children with tracheostomies and their families, highlighting the stress and worry associated with tracheostomy care. The study aims to explore parents' thoughts on the psychological support offered in a tertiary pediatric setting through in-depth interviews. Results show a high demand for psychological support among families, emphasizing the importance of continuity of care and extended support beyond the tracheostomy insertion. The study reveals no perceived stigma in accessing psychological services, with parents actively seeking referrals for support. [Extracted from the article]

Background: There is increasing awareness of the importance of the transformation of mental health systems. Launched in 2019, the WHO Special Initiative for Mental Health seeks to accelerate access to quality and affordable care for mental health conditions as an integral component of Universal Health Coverage. Nine countries are currently engaged with the initiative. Methods: This study reviewed processes of implementation—and progress achieved—across all settings by late 2022. It involved review of 158 documents provided by WHO relating to Special Initiative activities and 42 interviews with country-level stakeholders, WHO Regional and HQ personnel engaged with the initiative, and core donors. Documents were thematically coded using a template based upon the WHO framework of health system building blocks. Responses to structured interviews were coded based on an emergent thematic framework. Results: Documentation reported similar achievements across all domains; however challenges were reported most frequently in relation to service delivery, leadership and governance, and workforce. Issues of financing were notable in being twice as likely to be reported as a challenge than a success. Interviews indicated four major areas of perceived achievement: establishing a platform and profile to address mental health issues; convening a multi-stakeholder, participatory engagement process; new, appropriate services being developed; and key developments in law, policy, or governance around mental health. The planning process followed for the initiative, senior country-level buy-in and the quality of key personnel were the factors considered most influential in driving progress. Ambivalent political commitment and competing priorities were the most frequently cited challenges across all interviewees. Conclusions: The role of the Special Initiative in raising the profile of mental health on national agendas through a participatory and inclusive process has been widely valued, and there are indications of the beginnings of transformational shifts in mental health services. To secure these benefits, findings suggest three strategic priorities: increasing political prioritisation and funding for systems-level change; clearly articulating sustainable, transformed models of care; and promoting feasible and contextualised measures to support accountability and course correction. All are of potential relevance in informing global strategies for mental health systems transformation in other settings. [ABSTRACT FROM AUTHOR]

Work disparities, such as unfairness in pay or unequal distribution of work experienced by nurses in long-term care (LTC), can impact the retention and health of this workforce. Background: Despite the significant impact of disparities on nurses' health in LTC, a literature review on work disparities of nurses in LTC has not been conducted. Method: This scoping review aimed to explore the nature and extent of research on meso-level work disparities experienced by nurses in LTC and its links with nurse health and well-being. Five databases were searched: MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), SCOPUS, and CINAHL (EBSCO host). Results: Of the 5652 articles retrieved, 16 studies (14 quantitative and 2 qualitative) published between 1997 and 2024 met the inclusion criteria. A total of 53 work disparities were identified. Only four articles investigated the association of a work disparity with a variable of health (e.g., physical, mental, or poor general health). Conclusions: The results suggest that more attention to how disparities impact nurses' health and lived experiences is warranted. Meso-level disparities from this review provide an initial basis to consider possibilities in the workplace, especially in supporting equity and opportunities for health and well-being at work (e.g., through fair access to professional growth opportunities and a more equitable balance of work expectations and demands of nursing staff). Future studies of the intersection of macro- and meso-level factors are needed to inform better workplace practices and social and economic policies to support the well-being, health, and safety of nurses at work in LTC. [ABSTRACT FROM AUTHOR]

Questions: What are the current barriers and facilitators to the role of ED physiotherapists? How do ED physiotherapists believe their role may be optimised within the context of the ED? Design: Mixed methods study using a cross sectional survey. Participants: Australian physiotherapists currently providing services to patients within an Australian emergency department. Intervention: N/A. Outcome measures: The survey included questions related to the level of integration of ED physiotherapy into emergency department teams and wider health system, and open answer questions to identify the factors which impact and influence ED physiotherapy practice, and the future of ED physiotherapy. Results: 1 - Organisational culture, 2 - training and credentialling, 3 - governance, legislation and policies, 4 - funding, and 5 - advocacy and research were the five major themes generated from participant comments on existing facilitators and barriers to their role and the role of ED physiotherapists nationally. Six themes were generated from participant comments regarding the strategies to overcome barriers and facilitate an increased contribution by ED physiotherapists in the future: 1 - Training opportunities and specialisation pathways, 2 - Organisational culture, 3 - Governance, legislation and policies, 4 - Funding, 5 - Advocacy, 6 - Medicolegal Risks. Conclusion: Australian emergency department physiotherapists perceive their roles and emergency physiotherapy service provision to be impacted by complex and multi-factorial influences. The overall contribution of ED physiotherapy is susceptible to influence from non-linear interactions of various agents and factors which span all levels of the health system. Trial registration: N/A. Key Messages: What was already known on this topic Very little was previously known regarding the perceptions of ED physiotherapists and how to increase their contribution to emergency department care. ED staff understanding of ED physiotherapy role was previously identified as the main barrier to the ED physiotherapist's role. What this study adds This study demonstrated and details the complex and multifactorial influences which are perceived to impact ED physiotherapists currently and into the future. This research may be used to better inform healthcare redesign and innovation to improve ED physiotherapist's ability to respond to ED workforce shortages and increased demand. [ABSTRACT FROM AUTHOR]

Background: One strategy for supporting a hospital or health system's board of directors (Board), with their quality oversight responsibility is to review the organization's performance on quality measures. But for large systems, the number of measures needing review is quite burdensome and makes priority setting difficult. Our goal was to develop a scoring method that summarizes multiple quality measures together, while still maintaining the Board's opportunity to examine individual measures where there are specific concerns. Methods: We calculated an overall health system-level composite performance score using six publicly reported healthcare-associated infections reported by the Centers for Medicare and Medicaid Services on their Care Compare website [central-line associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), surgical site infections (SSIs) for colon surgery and abdominal hysterectomy, hospital-onset Methicillin-resistant Staphylococcus aureus bacteremia (MRSA), and hospital-onset Clostridioides difficile (C. diff)], where relative weights assigned to each infection type reflect the severity of patient harm. We also calculated a health-system composite performance target. For individual infection types, we calculated system-wide scores and targets and categorized individual hospital performance into three performance categories. Results: The health system's composite score between 2015 and 2019 ranged from a high of 1.10 to a low of 0.71. The health system's composite score in 2017–2019 was better than the composite target. Of the 34 measures used to calculate the 2019 composite score, 20 were better than internal standardized infection ratio (SIR) targets, seven were between internal targets and SIR of 1.0, and seven were worse than SIR of 1.0. Discussion: The Board communicated they find this composite score reporting approach helpful for streamlining their understanding of HAI performance, as compared to traditional approaches of reporting out individual performance measures. Approaches that streamline Board review of quality and safety performance are important as we hold Board members accountable for overseeing quality, seek greater engagement from the Board, and work to minimize measure review overload. [ABSTRACT FROM AUTHOR]

High‐cost medicines (HCMs) can be clinically impactful for individual patients but are also subject to variable funding mechanisms. Public hospitals and health services are often asked to fund HCMs, but inconsistent processes frequently create large variations in care. CATAG (Council of Australian Therapeutic Advisory Groups) is the Australian peak national advisory body for the quality use of medicines in hospitals and health services, with all states and territories collaborating to support Drug and Therapeutics Committees (DTCs). CATAG has developed national Guiding Principles to assist DTCs to effectively govern HCMs. An established process for the development of CATAG Guiding Principles was undertaken to develop these Guiding Principles. This includes the formation of an Expert Advisory Group (EAG) comprising individuals with recognised expertise, development of draft principles and stakeholder consultation from within the CATAG membership and externally. All feedback was discussed, and changes were agreed upon. The final version was approved by the EAG and CATAG members. This document represents a summary of the seven Guiding Principles developed, covering the areas of governance, application and assessment, communication, training and resourcing. Although many outstanding priorities still exist, including the development of national coordination regarding HCM assessment, these Guiding Principles offer a basis to navigate this complex area. [ABSTRACT FROM AUTHOR]

Background National action plans (NAPs) are key instruments for governing antimicrobial resistance (AMR). In Europe, we can now observe many countries updating their NAPs which raise two key research questions; what substantial modifications are states opting for, and how do they wish to address challenges related to AMR governance in a comparative perspective? Methods Building on a previous analytical classification, we address these two questions by examining data of updated versions of NAPs in 13 European Union member states covering seventeen elements related to AMR governance. Results Our results substantiate the large variation with regard to both substantive issues and governance-related matters. Most tellingly, they highlight the growing importance of the One Health approach in updated versions of NAPs. Our analysis also shows that while substantive issues remain important, One Health and the coordination and collaboration issues it entails are becoming more salient in the second or third generation of NAPs. Conclusions Updated NAPs suggest that EU member states are becoming increasingly knowledgeable on the causes and consequences of AMR and how it needs to be addressed. The enhanced level of knowledge also leads these countries to address the next set of issues and challenges; to improve domestic and international coordination and collaboration. Thus, the revised NAPs present a noticeable development from substantive issues towards governance issues. [ABSTRACT FROM AUTHOR]

The article comments on a study on the significant role of the chief pharmacy officer in pharmacy data analytics to support their enterprise. Topics discussed include requirements to establishing a pharmacy data analytics program, the need to build and maintain a dedicated team, and key steps in building a culture of decision making across team members and leaders.

The article focuses on the regulatory challenges of adaptive medical machine learning (ML) models, arguing that they should not be classified as perpetual research. Topics include the inadequacies of defining adaptive ML as research; the burdensome implications of this classification for patients and healthcare systems; and the need for a practical regulatory framework that addresses significant changes in ML systems while leveraging existing clinical governance structures.

The article discusses the role of anaesthesia associates in the UK and their scope of practice. The findings from the National Audit Project of the Royal College of Anaesthetists show that anaesthesia associates have a wide range of responsibilities, including inducing anaesthesia without direct supervision, leading a cardiac arrest, and providing anaesthesia for high-risk patients and major surgeries. However, these responsibilities go beyond the agreed scope of practice for anaesthesia associates. The article explores the implications of these findings for future healthcare delivery and discusses the concerns and opinions of doctors regarding the role of anaesthesia associates. It also highlights the need for clear identification of roles, titles, and qualifications to ensure patient safety and transparency. The article suggests that collaboration between anaesthetists and anaesthesia associates is crucial for the successful implementation of these roles. It also mentions the international perspective on non-physician anaesthetists and the importance of learning from other countries' experiences. The article concludes by emphasizing the need for regulation and the importance of addressing the concerns of doctors and patients in order to ensure safe and effective healthcare delivery. [Extracted from the article]

The COVID-19 pandemic raises the question of austerity's problematic social toll for health in the south of Europe. Has EU economic governance constrained health spending? If so, have these spending levels led to inequalities, which in turn shaped responses to the pandemic? EU economic governance is often dismissed as ineffective because of its poor track record of compliance. Yet austerity is blamed for negative health outcomes. This article shows that the EU fiscal rule is a determinant of health because it affects fiscal policies of European countries. First, the analysis of EU member states during 1995–2018 shows that austerity policies affect health spending and health inequalities. Euro-area countries under the EU Excessive Deficit Procedure significantly consolidated their health spending. The contractionary effect was concentrated in southern countries, contributing to rising health inequalities across the core and periphery. Finally, the analysis shows the pandemic implications of health inequalities, as periphery countries with a track record of high consolidation display more stringent (and costly) COVID-19 response models. This analysis contributes to understanding the supranational determinants of health in the EU, showing the pervasive spillover effects of the fiscal framework on national health policies. [ABSTRACT FROM AUTHOR]

Background: Identifying women aged 30–39 years at increased risk of developing breast cancer would allow them to receive screening and prevention offers. For this to be feasible, the practicalities of organising risk assessment and primary prevention must be acceptable to the healthcare professionals who would be responsible for delivery. It has been proposed that primary care providers are best placed to deliver a breast cancer risk assessment and primary prevention pathway. The present study aimed to investigate a range of primary care provider's views on the development and implementation of a breast cancer risk assessment and primary prevention pathway within primary care for women aged 30–39 years. Methods: Twenty-five primary care providers working at general practices in either Greater Manchester or Cambridgeshire and Peterborough participated in five focus groups (n = 18) and seven individual interviews. Data were analysed thematically and organised using a framework approach. Results: Three themes were developed. Challenges with delivering a breast cancer risk assessment and primary prevention pathway within primary care highlights that primary care are willing to facilitate but not lead delivery of such a pathway given the challenges with existing workload pressures and concerns about ensuring effective clinical governance. Primary care's preferred level of involvement describes the aspects of the pathway participants thought primary care could be involved in, namely co-ordinating data collection for risk assessment and calculating and communicating risk. Requirements for primary care involvement captures the need to provide a training and education package to address deficits in knowledge prior to involvement. Additionally, the reservations primary care have about being involved in the management of women identified as being at increased risk are discussed and suggestions are provided for facilitating primary care to take on this role. Conclusions: Despite optimism that primary care might lead a breast cancer risk assessment and primary prevention pathway, participants had a range of concerns that should be considered when developing such a pathway. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to explain and categorize key ethical concerns about integrating large language models (LLMs) in healthcare, drawing particularly from the perspectives of clinicians in online discussions. Materials and methods: We analyzed 3049 posts and comments extracted from a self-identified clinician subreddit using unsupervised machine learning via Latent Dirichlet Allocation and a structured qualitative analysis methodology. Results: Analysis uncovered 14 salient themes of ethical implications, which we further consolidated into 4 overarching domains reflecting ethical issues around various clinical applications of LLM in healthcare, LLM coding, algorithm, and data governance, LLM's role in health equity and the distribution of public health services, and the relationship between users (human) and LLM systems (machine). Discussion: Mapping themes to ethical frameworks in literature illustrated multifaceted issues covering transparent LLM decisions, fairness, privacy, access disparities, user experiences, and reliability. Conclusion: This study emphasizes the need for ongoing ethical review from stakeholders to ensure responsible innovation and advocates for tailored governance to enhance LLM use in healthcare, aiming to improve clinical outcomes ethically and effectively. [ABSTRACT FROM AUTHOR]

The given text provides summaries of multiple articles and research studies related to anesthesia and healthcare practices. The summaries cover a wide range of topics, including professional communication, trauma care, theater efficiency, dental sedation, mentoring networks, and more. These summaries offer valuable insights into various aspects of anesthesia and healthcare practices, making them useful for library patrons conducting research in these areas. It is suggested that addressing factors such as professional hierarchy, gender, and experience can improve communication and patient outcomes in peri-operative teams. [Extracted from the article]

Background: The poor prognosis and clinical presentation of malignant fungating wounds (MFWs) can lead to service users experiencing various dimensions of fear. Aim: This article encourages district nurses (DNs) to explore the psychological factors associated with MFWs in the community setting. Method: The reviewed literature discusses DN practice, with supplementary sources utilised to provide a wider perspective on the multifaceted nature of the subject. Findings: Guidelines advocate that DNs should promptly initiate dialogue to address fears, establish trust and enable service users with MFWs to express concerns, thus facilitating a holistic provision of care. It is crucial to leverage the multidisciplinary team and engage with other agencies to provide support for service users. Effective leadership qualities play a vital role in initiating practice changes that ultimately benefit service users, while also considering clinical governance aspects. [ABSTRACT FROM AUTHOR]

Background Governance, health financing, and service delivery are critical elements of health systems for provision of robust and sustainable chronic disease care. We leveraged the third iteration of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA) to evaluate oversight and financing for kidney care worldwide. Methods A survey was administered to stakeholders from countries affiliated with the ISN from July to September 2022. We evaluated funding models utilized for reimbursement of medications, services for the management of chronic kidney disease, and provision of kidney replacement therapy (KRT). We also assessed oversight structures for the delivery of kidney care. Results Overall, 167 of the 192 countries and territories contacted responded to the survey, representing 97.4% of the global population. High-income countries tended to use public funding to reimburse all categories of kidney care in comparison with low-income countries (LICs) and lower-middle income countries (LMICs). In countries where public funding for KRT was available, 78% provided universal health coverage. The proportion of countries that used public funding to fully reimburse care varied for non-dialysis chronic kidney disease (27%), dialysis for acute kidney injury (either hemodialysis or peritoneal dialysis) (44%), chronic hemodialysis (45%), chronic peritoneal dialysis (42%), and kidney transplant medications (36%). Oversight for kidney care was provided at a national level in 63% of countries, and at a state/provincial level in 28% of countries. Conclusion This study demonstrated significant gaps in universal care coverage, and in oversight and financing structures for kidney care, particularly in in LICs and LMICs. [ABSTRACT FROM AUTHOR]

Background: A better understanding of health system performance requires evaluating achievements and challenges, thereby providing a basis for effective reforms. This systematic review aims to investigate the challenges and weaknesses of leadership and governance-related health policies in Iran. Methods: In this qualitative systematic review, we followed the instructions of the Joanna Briggs Institute (JBI). It encompassed qualitative studies assessing challenges and weaknesses of leadership and governance-related health policies. Thematic synthesis was conducted in three stages to identify common themes. Results: The primary database search yielded 1890 records, of which 152 were fully assessed, resulting in the inclusion of 57 studies in this review. Thematic synthesis produced 157 structured codes and identified 11 main descriptive themes of challenges in leadership and governance-related health policies. These themes included hospital autonomy policy, challenges to the entire health system, governance of medical universities, healthcare payment systems, sustainable universal health insurance coverage, informal payments, insurance systems, induced demand, strategic purchasing of health services, the family physician program, family physician and rural health insurance programs, and primary healthcare human resources. Conclusion: The identified challenges underscore the urgent need for strategic reforms and interventions to overcome the complex issues plaguing the healthcare system. By addressing these challenges, policymakers and top healthcare managers might ensure that the population have access to high-quality care in a more responsive healthcare system. [ABSTRACT FROM AUTHOR]

Service users living with Obsessive compulsive disorder (OCD) often delay or avoid seeking diagnosis or treatment because of a fear of judgement or feelings of shame associated with their obsessions and compulsions. They may feel that their behaviour defies societal norms, which can lead to social isolation, and in turn, further contribute to health inequality. When such individuals present with physical illness and are seen by district nurses, it is imperative that behaviours are understood and approached appropriately. It is important to develop therapeutic relationships and consider their holistic wellbeing. Developing a close working relationship with the mental health team as a multidisciplinary team and using the team as a resource may contribute to the overall health outcome of service users with OCD. [ABSTRACT FROM AUTHOR]

The United Nations Convention on the Rights of Persons with Disabilities and the Sustainable Development Goals stipulate that persons with disabilities have equal rights to access and safely use transport systems. The aim of the current study is to explore stakeholders' perspectives of the relationship and prioritization between safety and accessibility in the Swedish discussion of disability and transport. The data consist of interviews with 15 informants from the National Council for Disability and Transport and other key stakeholders. Reflexive thematic analysis led to identification of four themes: basis for priorities is a matter of governing; challenges to measuring and evaluating different values; importance of knowledge and building forums; and a universal system of accessibility and safety is a challenge. The results indicate the road ahead for a possible holistic and sustainable governance in the transport systems. However, how this will be put into practise is not yet defined. Points of interest: According to several regulations, persons with disabilities have equal rights to safety and accessibility in the transport system. However, there are challenges to combining different concepts and perspectives. Lack of mandates for institutions to address both safety and accessibility leads to goal conflicts and a risk that focuses become entrenched with clearly defined boundaries. There are challenges in evaluating different values and perspectives in relation to accessibility. A facilitating aspect for sustainability regarding safety and accessibility is to create opportunities and systems to allow for the exchange of knowledge. Integration of safety and accessibility may be encouraged by the use of existing sets of holistic approaches (i.e. Vision Zero and Universal Design). [ABSTRACT FROM AUTHOR]

Following the Supreme Court's decision in Dobbs v Jackson Women's Health in June 2022, many states restricted or banned abortion. Medical educators have focused on how this change impacts abortion training for residents, but schools must also adapt undergraduate medical education. Medical schools provide the foundation for future physicians' knowledge and attitudes on abortion. Comprehensive, high-quality abortion education for all medical students is essential for the future of abortion care. Here, we present how education champions can lead curricular improvements in abortion education in the preclinical, clerkship, and postclerkship phases of undergraduate medical education. [ABSTRACT FROM AUTHOR]

We would like the reader to consider the current paediatric point-of-care ultrasound (POCUS) landscape. Even in the most developed European healthcare systems, paediatric POCUS programmes and users mostly operate in silos and are un-, or at best underrepresented by major professional bodies. While international societies focus on the extent and content of POCUS investigations, guidelines and associated evidence, there is little to no established framework for education and clinical governance standards on this explosively advancing field. Borrowing from fluid dynamics, this rapid advancement generates cavitation, leaving providers and educators exposed in certain crucial areas of ongoing clinical practice covered contemporaneously, or worse, post hoc, allowing for clinical governance or medico-legal scrutiny. We give a glimpse into our prospective local POCUS clinical practice initiative and how it complements, advances and affirms our clinical decision making on a daily basis. We'll guide the reader through ward rounds, procedural applications, specialist assessments with allied health professionals, referrals, remote consultations, new patient admissions, and grand rounds. As we are in the process of building a robust, reliable and accountable clinical governance structure around our daily practice, we would also like to demonstrate the need and utility for introductory courses, ongoing educational sessions, established mentorship and regular governance meetings ensuring optimal clinical outcomes. We hope to give insights to clinical practice, deployment, recruitment, education and potential future applications like telemedicine. [ABSTRACT FROM AUTHOR]

This article discusses the need for equitable access to menopause care for women, as they often experience inequitable healthcare. The British Menopause Society aims for every primary healthcare team to have a clinician with a special interest in menopause. The menopause can have a significant impact on women's physical and psychological well-being, and it is important to prioritize access to quality menopause care. The article describes a pilot project in central Liverpool that aims to improve patient access to specialist menopause care and reduce waiting times for appointments. The project involves collaboration between primary care networks and the local menopause service. The article also highlights the importance of women's health hubs, which can bridge the gap between primary and secondary care and provide quicker access to specialists. The funding model for the pilot project involves paying the primary care network per appointment attended. The article concludes by discussing the benefits of this model, including financial sustainability, improved access for patients, and potential capacity for other services. Overall, the pilot project aims to provide cost-effective and accessible menopause care for women in the region. [Extracted from the article]

Aims/Background The prevalence of pressure injuries (PIs) is a widely used clinical indicator of patient safety and quality of care. Nurses' understanding of pressure injury (PI) can significantly impact the treatment outcomes for patients. This study, based on latent profile analysis (LPA), reveals the characteristics associated with PI knowledge levels among clinical nurses in district and county tertiary medical institutions. We aim to help nursing managers formulate training plans accurately so that clinical nurses can provide high-level skin care services for patients. Method In June 2023, 1482 nurse staff from 4 tertiary general hospitals at the district and county level in Chengdu were chosen as research subjects using the convenience sampling method. Responses to the general information questionnaire, the Chinese Version of Pressure Ulcer Knowledge Assessment Tool (C-PUKAT), and the Chinese Version of Attitude towards Pressure ulcer Prevention (C-APuP) were used to compare the population's characteristics based on LPA. Results Three latent profiles of nurses' PI knowledge were identified: weak foundation type (46.3%), strengthening foundation type (42.7%), and special improvement type (11.0%). Subjects' departments, administrative positions, highest degrees and PI prevention attitude scores, as well as whether they have participated in the training, all differed significantly between latent profile groups (p < 0.05). Conclusion The PI knowledge level of nursing staff at the district and county tertiary general hospitals requires urgent improvement. Nursing managers should prioritize the management level and quality of PI training among clinical nursing staff. Precise training programs can be developed based on different categories of nursing staff to enhance their PI knowledge, thereby effectively improving the quality of healthcare for inpatients. [ABSTRACT FROM AUTHOR]

Objectives: Point‐of‐care ultrasound (POCUS) use is widespread in EDs and throughout those practising medicine. Between institutions and specialities, there is widespread variety and training. With this comes the risk of patient harm and backlash to a clinically useful modality. Our objective is to form a statement that encompasses current published and unpublished guidance for creating and maintaining robust POCUS programs in EDs. Methods: Emergency Medicine Ultrasound Group (EMUG) identified this gap and volunteers from the group undertook a literature search of current best practice and institution guidelines relating to POCUS programs. They contacted colleagues from other specialities to find and get access to other countries and colleges' POCUS guidelines. EMUGs regularly run discussion forums (Collab‐labs) and points from these were considered. Recommendations were then formed from these and recurrent unpublished obstacles the group had encountered. The result was reviewed by clinical leaders in ultrasound and POCUS users in Australasia. Results: The recommendations were organised under five pillars: Infrastructure, Governance, Administration, Education and Quality. Conclusion: These recommendations complement existing guidelines and are not intended to replace them; however, we hope to promote discussion and provide reference support for those developing POCUS programs. Implementing a comprehensive and robust ED POCUS program will ensure safe, effective and standardised high‐quality POCUS use, with the aim of improving patient care across Australia and New Zealand. Patient safety will be enhanced through effective risk management and quality assurance and there will be consistency in POCUS education, training and credentialing across institutions. [ABSTRACT FROM AUTHOR]

Aims and method Calls for the integration of spirituality into psychiatric practice have raised concerns about boundary violations. We sought to develop a method to capture psychiatrists’ attitudes to professional boundaries and spirituality, explore consensus and understand what factors are considered. Case vignettes were developed, tested and refined. Three vignettes were presented to 80 mental health professionals (53% said they were psychiatrists; 39% did not identify their professional status). Participants recorded their reactions to the vignettes. Four researchers categorised these as identifying boundary violations or not and analysed the factors considered. Results In 90% of cases, at least three of the four researchers agreed on classification (boundary violation; possible boundary violation; no boundary violation). Participants’ opinion about boundary violations was heterogeneous. There was consensus that psychiatrists should not proselytise in clinical settings. Reasoning emphasised pragmatic concerns. Few participants mentioned their religious beliefs. Equivocation was common. Clinical implications Mental health professionals seem unsure about professional boundaries concerning religion and spirituality in psychiatric practice.

Aims and method The prevalence of delaying psychiatric care until the patient has received ‘medical clearance’, and the definitions and understanding of ‘medical clearance’ terminology by relevant clinicians, are largely unknown. In a service evaluation of adult liaison psychiatry services across England, we explore the prevalence, definitions and understanding of ‘medical clearance’ terminology in three parallel studies: (a) an analysis of trust policies, (b) a survey of liaison psychiatry services and (c) a survey of referring junior doctors. Content and thematic analyses were performed. Results ‘Medical clearance’ terminology was used in the majority of trust policies, reported as a referral criterion by many liaison psychiatry services and had been encountered by most referring doctors. ‘Medical clearance’ was identified as a common barrier to liaison psychiatry referral. Terms were inconsistently used and poorly defined. Clinical implications Many liaison psychiatry services seem not to comply with guidance promoting parallel assessment. This may affect parity of physical and mental healthcare provision.

Background: The provision of high-quality palliative care is important to nursing practice. However, caring for palliative care patients and their families is challenging within a complex everchanging health environment. Nonetheless the caring, artistic role of the nurse is fundamental to the care of the patient and family. However, this role is currently being overshadowed by the technical and scientific elements of nursing. Methods: A scoping review was conducted utilising Arksey and O'Malley's framework to identify the role and contribution of nurses in caring for patients with palliative care needs. An open time period search of eight electronic databases (MEDLINE, CINAHL, Academic Search Complete, PsycINFO, EMBASE, Web of Science, Scopus and Cochrane Library) was conducted on the 8th of March 2023 and updated on the 30th of April 2024. Screening was performed independently by two reviewers against eligibility criteria with meetings between authors to discuss included papers and form a consensus. Data was extracted relating to palliative care nursing, methodology, key findings, and recommendations. The analysed and summarised data was mapped onto Oldland et al seven domains framework: (a) medical/nursing and technical competence, (b) person centred care, (c) positive interpersonal behaviours, (d) clinical leadership and governance, (e) promotion of safety, (f) management of the environment, and (g) evidence-based practice. Results: Fifty-five papers met the criteria for this review which describes the role and contribution of nurses in caring for palliative patients across all domains of professional practice. The review found the leading areas of nurse contribution were person centred, interpersonal and nursing care aspects, with leadership, managing the environment, patient safety and evidence-based practice evident but scoring lower. The contribution of the nurse in palliative care supports a biopsychosocial-educational approach to addressing the physical, emotional and social needs of patients with palliative care needs and their families across the care continuum. Conclusion: Nurses in palliative care engage in a wide range of roles and responsibilities in caring for patients and their families with palliative care needs. However, there remains minimal evidence on the assessment, intervention, and evaluation strategies used by nurses to highlight the importance of their role in caring for patients and their families in this area. The findings of this review suggest that the artistic element of nursing care is being diluted and further research with a focus on evidencing the professional competence and artistic role of the nurse in the provision of palliative care is required. In addition, research is recommended that will highlight the impact of this care on patient and family care outcomes and experiences. [ABSTRACT FROM AUTHOR]

In recent years, rapidly changing disease profile patterns, shortage & uneven utilization of healthcare professionals contributed massive burden on the Indian healthcare system, which resulted in varying, fragmented, inconsistent healthcare delivery to the patients and poor patient management. Patients often face and experience many challenges like lack of accessibility, poor patient-healthcare provider relationships, and inadequate quality of care, resulting in unnecessary economic burden in managing their health conditions. Thus Indian healthcare reform is essential in enhancing its capacity to fulfill patients' health needs that can be addressed by focusing on key sustainable strategies and initiatives meant for enhancing coordination of care, expanding services accessibility, redeveloping healthcare infrastructure, implementing workforce innovation and strong governance with the incorporation of core principles such as patient-centeredness, integrated care and collaborative care approaches. The clinical and ambulatory pharmacy practice are fragment of the healthcare delivery which delivers pharmaceutical care and fulfils the needs of patients across healthcare settings. This paper focuses on the present & future perspectives of ambulatory pharmacy practice in India and the factors to be considered for implementing it in patient care. [ABSTRACT FROM AUTHOR]

There is a gap in the understanding of the barriers to cancer screening participation and complying with downstream management in the Community of Latin American and Caribbean states (CELAC). Our study aimed to assess barriers across the cancer screening pathway from the health system perspective, and interventions in place to improve screening in CELAC. A standardized tool was used to collect information on the barriers across the screening pathway through engagement with the health authorities of 27 member states of CELAC. Barriers were organized in a framework adapted from the Tanahashi conceptual model and consisted of the following dimensions: availability of services, access (covering accessibility and affordability), acceptability, user–provider interaction, and effectiveness of services (which includes governance, protocols and guidelines, information system, and quality assurance). The tool also collected information of interventions in place, categorized in user‐directed interventions to increase demand, user‐directed interventions to increase access, provider‐directed interventions, and policy and system‐level interventions. All countries prioritized barriers related to the information systems, such as the population register not being accurate or complete (N = 19; 70.4%). All countries implemented some kind of intervention to improve cancer screening, group education being the most reported (N = 23; 85.2%). Training on screening delivery was the most referred provider‐directed intervention (N = 19; 70.4%). The study has identified several barriers to the implementation of cancer screening in the region and interventions in place to overcome some of the barriers. Further analysis is required to evaluate the effectiveness of these interventions in achieving their objectives. [ABSTRACT FROM AUTHOR]

Background: Patients with multiple long-term conditions requires understanding the existing care models to address their complex and multifaceted health needs. However, current literature lacks a comprehensive overview of the essential components, impacts, challenges, and facilitators of these care models, prompting this scoping review. Methods: A scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Extension for Scoping Reviews guideline. Our search encompassed articles from PubMed, Web of Science, EMBASE, SCOPUS, and Google Scholar. The World Health Organization's health system framework was utilized to synthesis the findings. This framework comprises six building blocks (service delivery, health workforce, health information systems, access to essential medicines, financing, and leadership/governance) and eight key characteristics of good service delivery models (access, coverage, quality, safety, improved health, responsiveness, social and financial risk protection, and improved efficiency). Findings were synthesized qualitatively to identify components, impacts, barriers, and facilitators of care models. Results: A care model represents various collective interventions in the healthcare delivery aimed at achieving desired outcomes. The names of these care models are derived from core activities or major responsibilities, involved healthcare teams, diseases conditions, eligible clients, purposes, and care settings. Notable care models include the Integrated, Collaborative, Integrated-Collaborative, Guided, Nurse-led, Geriatric, and Chronic care models, as well as All-inclusive Care Model for the Elderly, IMPACT clinic, and Geriatric Patient-Aligned Care Teams (GeriPACT). Other care models (include Care Management Plus, Value Stream Mapping, Preventive Home Visits, Transition Care, Self-Management, and Care Coordination) have supplemented the main ones. Care models improved quality of care (such as access, patient-centeredness, timeliness, safety, efficiency), cost of care, and quality of life for patients that were facilitated by presence of shared mission, system and function integration, availability of resources, and supportive tools. Conclusions: Care models were implemented for the purpose of enhancing quality of care, health outcomes, cost efficiency, and patient satisfaction by considering careful recruitment of eligible clients, appropriate selection of service delivery settings, and robust organizational arrangements involving leadership roles, healthcare teams, financial support, and health information systems. The distinct team compositions and their roles in service provision processes differentiate care models. [ABSTRACT FROM AUTHOR]

Aims and method Calls for the integration of spirituality into psychiatric practice have raised concerns about boundary violations. We sought to develop a method to capture psychiatrists' attitudes to professional boundaries and spirituality, explore consensus and understand what factors are considered. Case vignettes were developed, tested and refined. Three vignettes were presented to 80 mental health professionals (53% said they were psychiatrists; 39% did not identify their professional status). Participants recorded their reactions to the vignettes. Four researchers categorised these as identifying boundary violations or not and analysed the factors considered. Results In 90% of cases, at least three of the four researchers agreed on classification (boundary violation; possible boundary violation; no boundary violation). Participants' opinion about boundary violations was heterogeneous. There was consensus that psychiatrists should not proselytise in clinical settings. Reasoning emphasised pragmatic concerns. Few participants mentioned their religious beliefs. Equivocation was common. Clinical implications Mental health professionals seem unsure about professional boundaries concerning religion and spirituality in psychiatric practice. [ABSTRACT FROM AUTHOR]

This study investigates the implementation of clinical pathways (CPs) for pediatric Dengue Hemorrhagic Fever (DHF) inpatients at Hospital X, a Type C hospital in Indonesia, focusing on the role of management in CP development and compliance. Clinical pathways aim to enhance hospital efficiency, quality of care, and patient satisfaction. However, the study identified several issues in CP implementation, including incomplete documentation, lack of socialization and training among staff, and inadequate managerial involvement in CP development and oversight. Data were collected through in-depth interviews with attending physicians, nurses, pharmacy staff, and medical management, along with analysis of 53 pediatric DHF CPs. Results showed that CP compliance rates were below 80%, and the hospital's organizational role in CP development, as assessed by the ICPAT dimension 6 instrument, was insufficient. Key areas of non-compliance included lack of evidence of clinical governance, integration with other hospital initiatives, and adequate support for CP documentation and variation reporting. Recommendations include increasing management involvement, providing comprehensive training for staff, and implementing regular CP evaluations. The findings highlight the need for stronger multidisciplinary collaboration and hospital management support to optimize CPs, ensure compliance, and improve service quality.. [ABSTRACT FROM AUTHOR]

Background: Large datasets exist in Australia that make de-identified primary healthcare data extracted from clinical information systems available for research use. This study reviews these datasets for their capacity to provide insight into chronic disease care for Aboriginal and Torres Strait Islander peoples, and the extent to which the principles of Indigenous Data Sovereignty are reflected in data collection and governance arrangements. Methods: Datasets were included if they collect primary healthcare clinical information system data, collect data nationally, and capture Aboriginal and Torres Strait Islander peoples. We searched PubMed and the public Internet for data providers meeting the inclusion criteria. We developed a framework to assess data providers across domains, including representativeness, usability, data quality, adherence with Indigenous Data Sovereignty and their capacity to provide insights into chronic disease. Datasets were assessed against the framework based on email interviews and publicly available information. Results: We identified seven datasets. Only two datasets reported on chronic disease, collected data nationally and captured a substantial number of Aboriginal and Torres Strait Islander patients. No dataset was identified that captured a significant number of both mainstream general practice clinics and Aboriginal Community Controlled Health Organisations. Conclusions: It is critical that more accurate, comprehensive and culturally meaningful Aboriginal and Torres Strait Islander healthcare data are collected. These improvements must be guided by the principles of Indigenous Data Sovereignty and Governance. Validated and appropriate chronic disease indicators for Aboriginal and Torres Strait Islander peoples must be developed, including indicators of social and cultural determinants of health. Considerable data are collected on Aboriginal and Torres Strait Islander peoples, extracted from primary healthcare services. We reviewed these datasets for their capacity to provide insight into chronic disease care for Aboriginal and Torres Strait Islander peoples. Most data providers have the potential capability to capture detailed indicators across many chronic diseases. It is critical that more accurate, comprehensive, and culturally meaningful Aboriginal and Torres Strait Islander healthcare data are collected to support evidence-based policy. [ABSTRACT FROM AUTHOR]

Objective: To assess the safety and effectiveness of peripheral vasoactive drugs initiated during pre‐hospital care and retrieval missions, in Queensland, Australia. Methods: Three years of retrospective data was gathered from two sources. Medical notes were reviewed using a search for any patient having 'inotrope' recorded on an electronic medical record. Each case was reviewed to include only peripheral infusions of adrenaline or noradrenaline. Clinical Governance records were searched for adverse events related to vasoactive drugs, alerted for review to ensure complete capture. Results: A total of 418 patients received peripheral infusions of adrenaline and noradrenaline over the 3‐year period. No major complications were recorded either immediately or at Clinical Governance review. Minor complications were recorded in 4.7% of the cases, of which 3.5% occurred with peripheral vasoactives during the presence of the retrieval team. The frequency of use of peripheral vasoactives increased over the study period. Conclusions: In this retrospective data set there were no major complications of peripheral vasoactive drugs. Minor complications were similar to in‐hospital use and related to vascular access and drug delivery. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic catapulted Telehealth to the forefront of Emergency Medicine (EM) as an alternative way of assessing and managing patients. This challenged the traditional idea that EM can only be practised within brick‐and‐mortar EDs. Many Emergency Physicians may find the idea of practising Telehealth in Emergency Medicine (TEM) confronting, particularly in the absence of training and clear practice guidelines. The purpose of the present paper is to describe the current use of TEM in Australasia, and outline the advantages and barriers in adopting this practice domain. [ABSTRACT FROM AUTHOR]

Objective: To explain the new test for complying with the mental health principles under the Mental Health and Wellbeing Act 2022 (Vic). Conclusion: The principles carry over limitations from the previous Mental Health Act 2014 (Vic) while also containing new features. The 'all reasonable efforts to comply' and 'proper consideration' tests resemble the existing test under section 38(1) of the Charter of Human Rights and Responsibilities Act 2006 (Vic) that also apply to public mental health services. Taking these duties together, public mental health services, including hospital and community mental health boards, clinical directors and clinical governance processes, will need to show concrete evidence of specific rights and/or principles being deliberated in their decisions. [ABSTRACT FROM AUTHOR]

Pelvic organ prolapse (POP) is a common condition and is thought to affect approximately 40% of women over the age of 50, with prevalence increasing with age. 1 in 10 women will undergo surgery during their lifetime. Symptomatic women can be offered supervized pelvic floor exercises supported by Specialist Pelvic Floor Physiotherapists, vaginal pessary management or surgical management. This article covers comprehensive assessment, preoperative considerations to support shared decision making, and clinical governance surrounding surgical management of prolapse. It also provides a summary of different surgical techniques for both vaginal and abdominal approach for prolapse. [ABSTRACT FROM AUTHOR]

To analyze the research status of clinical governance (CG); the most productive authors, countries and organizations; connections among research themes. We used a 'funnel model', consisting of 3 layers describing various CG domains and settings. We retrieved bibliometric data from 1998 to 2021 from the Scopus database. Text mining, visual analysis, descriptive statistics and data visualization were performed. Citation bursts were detected. The total number of studies was 2429. On a global scale, there is a swinging trend in publications, with four peaks detected (2000, 2009, 2013, 2021). Citation burst keywords include: "national health service", "medical audit", "psychological aspect", "quality improvement" and "surveys and questionnaires". UK is the most productive and cited country. The most active organizations were in the UK, Australia, USA, Italy and Iran. The most productive journals and authors were identified. The most frequent keywords identified were 'health care quality', 'clinical governance', 'organization and management' and 'medical audit'. Research trends for each CG domain and setting type were reported. By using scientometric methodology, we created a thorough scientific picture on CG, including the mapping of pivotal concepts as a function of time. [ABSTRACT FROM AUTHOR]

This study aims to enhance understanding of the HWAR in Palestine, and identify gaps and weaknesses, thereby enhancing the HWAR's development and optimization. Methods: This qualitative study used an inductive approach to explore the landscape of HWAR. Data were collected from October to November 2019, when 22 semi-structured in-depth interviews - were conducted with experts, academics, leaders, and policymakers purposely selected from government, academia, and non-governmental organization sectors. Data analysis, namely, thematic and ground theory, was performed using Excel and MS programs. Findings: The study revealed an absence of transparent governance and ineffective communication within HWAR systems. National policies and guidelines are problematic, with HWAR mechanisms fractured and needing reform. Licensing for healthcare workers hinges on local education, while monitoring and evaluation of HWAR are deficient. Some institutions adhere to HWAR standards, yet widespread updates and applications are necessary. Coordination among educational, accreditation, and practice sectors is non-systematic. Adequate human resources exist, but we need to improve HWAR management. Operational and political challenges limit HWAR, leading to a focus on immediate responses over sustainable system integration. Conclusion: Boosting HWAR is critical for Palestine, especially after the ongoing conflict and humanitarian crisis that led to the dysfunction of the entire health system facilities. A collaborative strategy across sectors is needed to improve governance and outcomes. It is essential to foster strategic dialogue among academia, regulatory entities, and healthcare providers to enhance the HWAR system. Further study on HWAR's effectiveness is recommended. [ABSTRACT FROM AUTHOR]

Introduction: The health system in Sudan faces several challenges, including increasing numbers of patients, shortages of health supplies, and disparities in the distribution of health services. Guidelines implementation improves patients' outcomes and ensures efficient use of the resources in such a resource limited country. The study aimed to assess the implementation of the clinical practice guidelines among family medicine doctors working in the primary health care centers in Khartoum and Gezira states to provide baseline data about the current practice in Sudan. Methods: Descriptive cross-sectional facility-based survey, conducted from April to December 2021, on 373 of the practicing family-medicine doctors. A total of 101 Primary health care centers were surveyed (77 centers in Khartoum state and 24 in Gezira state). The questionnaire was pilot tested on a small group of physicians to improve clarity and reduce response bias. Descriptive statistics were used to summarize the data and analyzed by frequency tables. Chi square and logistic regression tests were used to determine the association between categorized variables. P value < 0.05 was considered statistically significant. Results: Most of the practicing family-medicine doctors (98.4%) reported implementation of the guidelines. Moreover, (68.6%) of them received training programs which were organized and funded by the Sudan Ministry of Health. The local Sudanese guidelines were difficult to access and not regularly updated. Services unavailability and inaccessibility (87.1%), health insurance factors (83.9%), and patient factors (81.2%) were the most frequent barriers to guidelines implementation. Service cost (79.9%), lack of regular training programs (79.9%), absence of local guidelines (77.2%), lack of continuity in the comprehensive care process (63.0%), and lack of time (57.1%) were also reported as barriers to guidelines implementation. Conclusion: Guidelines implementation is limited by unavailability and inaccessibility of the health services and the health insurance limited coverage. Expansion of the health insurance coverage, organization of continuous training programs, encouragement of regular auditing and issuing regulations to ensure the use of updated guidelines, dissemination of the updated national guidelines along with establishing clinical governance in Sudan can be useful tools for policymakers in the optimum allocation of public health resources. [ABSTRACT FROM AUTHOR]

Background Purpose Methods Results Conclusion and Relevance The concept of health equity by design encompasses a multifaceted approach that integrates actions aimed at eliminating biased, unjust, and correctable differences among groups of people as a fundamental element in the design of algorithms. As algorithmic tools are increasingly integrated into clinical practice at multiple levels, nurses are uniquely positioned to address challenges posed by the historical marginalization of minority groups and its intersections with the use of “big data” in healthcare settings; however, a coherent framework is needed to ensure that nurses receive appropriate training in these domains and are equipped to act effectively.We introduce the Bias Elimination for Fair AI in Healthcare (BE FAIR) framework, a comprehensive strategic approach that incorporates principles of health equity by design, for nurses to employ when seeking to mitigate bias and prevent discriminatory practices arising from the use of clinical algorithms in healthcare. By using examples from a “real‐world” AI governance framework, we aim to initiate a wider discourse on equipping nurses with the skills needed to champion the BE FAIR initiative.Drawing on principles recently articulated by the Office of the National Coordinator for Health Information Technology, we conducted a critical examination of the concept of health equity by design. We also reviewed recent literature describing the risks of artificial intelligence (AI) technologies in healthcare as well as their potential for advancing health equity. Building on this context, we describe the BE FAIR framework, which has the potential to enable nurses to take a leadership role within health systems by implementing a governance structure to oversee the fairness and quality of clinical algorithms. We then examine leading frameworks for promoting health equity to inform the operationalization of BE FAIR within a local AI governance framework.The application of the BE FAIR framework within the context of a working governance system for clinical AI technologies demonstrates how nurses can leverage their expertise to support the development and deployment of clinical algorithms, mitigating risks such as bias and promoting ethical, high‐quality care powered by big data and AI technologies.As health systems learn how well‐intentioned clinical algorithms can potentially perpetuate health disparities, we have an opportunity and an obligation to do better. New efforts empowering nurses to advocate for BE FAIR, involving them in AI governance, data collection methods, and the evaluation of tools intended to reduce bias, mark important steps in achieving equitable healthcare for all. [ABSTRACT FROM AUTHOR]

The number of urgent '2-week-wait' referrals to hospital for people with suspected head and neck cancer being sent by primary care is constantly growing and it is becoming increasingly difficult for head and neck cancer services to meet this demand. In order for trusts to meet their Faster Diagnosis Standards, there needs to be an effective and efficient way to ensure there is capacity for patients to receive the appropriate assessments and diagnostic investigations without compromising the quality of care delivered. This article presents the proposal of introducing a nurse-led 2-week-wait clinic to meet the ever-growing demands on the service. There is discussion of the consultant-led training programme used to upskill an advanced nurse practitioner in a single-centre study, as well as explanation of the processes followed to maintain patient safety throughout the pilot project. There will also be consideration of clinical governance and discussion of how patient satisfaction with the novel service will be measured. [ABSTRACT FROM AUTHOR]