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Early and accurate identification of high-risk patients with peripheral intravascular catheter (PIVC)-related phlebitis is vital to prevent medical device-related complications.

This paper aims to examine if using video recordings help students raise their awareness of the development of their oral presentation skills by reviewing video recordings of their presentations. For this study, all students who took a Financial Accounting class in the academic year 2018--2019 at Lincoln University (LU) were video-recorded when presenting. Participants were asked to review their video recordings, assess their performance, and record their reflections by using a Self-Assessment Questionnaire (SAQ). The results indicated that the students' attitude toward recording the presentations was highly positive. The predominant response was that this new learning activity increased students' awareness of the importance of presentation skills without provoking their anxiety. Participants were able to observe that certain delivery skills such as good preparation, self-confidence, eye contact, and voice quality needed improvement. For managerial implications, LU, through its Writing and Speaking Center (WSC), offered thirty-minute sessions with a presentation coach to improve students' communication skills and prepare them to give a more polished presentation in class. In comparing the practice presentation at the WSC with the final in-class presentation, students were observed to be more confident, better prepared, and less nervous during the final presentation. However, we observed that the practice presentation did not carry the same weight as the final presentation as the practice presentation was neither graded nor delivered in front of an instructor or a wider audience.

Background: Approximately 25% of hospitalised adults require an indwelling urinary catheter (IDC) during their hospital stay. IDCs expose patients to risks of infectious and non-infectious complications. Aims: To identify IDC prevalence, assess adherence to clinical practice guidelines and patient-reported involvement in IDC care for adult hospital inpatients. Methods: This point prevalence study was conducted in 22 wards in a single quaternary hospital. Data was collected by clinical and research nurses working in pairs on a single day. Study outcomes were reported descriptively as frequencies and percentages. Results: Of 502 patients included, 77 (15.3%) had an IDC (median duration 99.6 h). The median age of patients with an IDC was 64 years (interquartile range 22–88 years), 54 (70%) were male and one-quarter (n = 19; 25%) of IDCs were inserted at another hospital. More than half (n = 44; 57%) of the 77 IDCs had no documented removal plan. Three patients were unavailable for review for observed clinical practices, and it was found 43% (n = 32/74) lacked a securement device. Of 77 people with IDCs, there were 44 patient responses, and 27 (61.4%) patients did not know the reason for their catheter. Discussion: Areas for improvement included securement device use, timely removal plans and patient education for the reason for the device. Regular point prevalence studies to assess use and adherence to clinical practical guidelines can improve safety outcomes for patients requiring IDCs. [ABSTRACT FROM AUTHOR]

Background: A quarter of patients who present to emergency departments (EDs) have difficult intravenous access (DIVA), making it challenging for clinicians to successfully place a peripheral intravenous catheter (PIVC). Some literature suggests that guidewire PIVC improves first‐insertion success rate. Aim: The aim was to determine the clinical and cost‐effectiveness of a novel long PIVC (5.8 cm) with a retractable coiled guidewire (GW‐PIVC) for patients with DIVA, compared with standard care PIVCs. Methods: A pragmatic randomized controlled trial was conducted in two Australian EDs. Eligible participants were adults assessed as meeting DIVA criteria. Participants were randomized (1:1 ratio; stratified by hospital) to either GW‐PIVC (long) or standard care group (short or long PIVC). The use of ultrasound was discretionary in the standard care group and was recommended in the GW‐PIVC group due to the pragmatic design that was primarily testing the GW‐PIVC rather than the ultrasound use. Primary outcome was first‐insertion success and secondary outcomes included all‐cause device failure, patient and staff satisfaction, and cost‐effectiveness. The analysis was intention to treat. Results: A total of 446 participants were randomized and 409 received PIVCs. The use of GW‐PIVC, compared with standard PIVC, had a lower first‐insertion success rate (68% vs. 77%, odds ratio [OR] 0.65, 95% confidence interval [CI] 0.43–0.99, p < 0.05). There was no difference in PIVC failure (134.0 per 1000 catheter days [GW‐PIVC] vs. 111.8 [standard PIVC] per 1000 catheter days, hazard ratio 1.18, 95% CI 0.72–1.95). Both participant (8/10 vs. 9/10, median difference [MD] −1.00, 95% CI −1.37 to −0.63) and clinician (8/10 vs. 10/10, MD −2.00, 95% CI −2.37 to −1.63) satisfaction was lower with GW‐PIVCs compared with standard PIVCs. More nurses inserted standard PIVCs than GW‐PIVCs (56.9% vs. 36.5%) and had less confidence in their ultrasound skills (28.0% vs. 46.6% self‐claimed as advanced/expert users). The cost per participant of GW‐PIVC insertions was 2.46 times greater than standard PIVC insertions ($AU80.24 vs. $AU32.57). Conclusions: GW‐PIVCs had significantly lower first‐insertion success and non–significantly higher all‐cause catheter failure. Additional training and device design familiar to clinicians are vital factors to enhance the likelihood of successful future implementation of GW‐PIVCs. [ABSTRACT FROM AUTHOR]

Background: Mechanical force skin injuries are common for critical care patients, especially neonates. Currently, identification and severity assessments of injuries are dependent on clinical experience and/or utilization of severity tools. Compared with adults, neonates sustain skin injuries in different anatomical locations and have decreased layers of healthy tissue (from 0.9 to 1.2 mm) creating questions around direct application of adult injury severity scales reliant on visual assessment. Aim: The aim of this scoping review (ScR) was to investigate severity scales used to report hospital acquired skin injuries for neonates. Methods: This study utilized the 2015 Joanna Briggs Institute methodology for scoping reviews and is reported according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses for Scoping Reviews extension. PubMed, CINAHL, COCHRANE Central, Scopus, and the reference lists of included studies were searched for studies published between 2001 and 2023, that included severity scales use within neonatal population. Two authors independently identified studies for full review, data extraction, and quality assessment. Results: A systematic database search returned 1163 records. After full test review of 109 studies, 35 studies were included. A majority of studies included were cohort or action research and conducted in the United States of America. Most studies (57%, n = 20) reported skin injuries acquired throughout the body, 14 (40%) of the studies reported the nasal area alone and one study reported no anatomical location. A total of nine severity scales or combination of scales were utilized within studies (n = 31) and four studies did not report a scale. Various versions of scales from the National Pressure Ulcer Advisory Panel (n = 16), European Pressure Ulcer Advisory Panel (n = 8) or Neonatal Skin Condition Score (n = 4) were reported, compared with locally developed classifications/scales (n = 4). Scales were predominantly of ordinal grouping (74%, n = 26) or categorical assessment (14%, n = 5). Only one scale from 2004 was validated for neonates. Conclusion: Neonatal skin injuries will continue to be reported subjectively until severity scales are consistently applied or other measurements are identified to support assessment. Additionally, without skin injury assessment uniformity, critical examination of effectiveness of skin care treatment practices will have subjective comparison. This review suggests there is a need for consistent skin assessment and severity scales that are valid for the neonatal population and their unique skin considerations. Relevance to Clinical Practice: In the context of neonatal skin, with its unique characteristics and heightened risk for injury, clinicians must stage, categorise, and describe injury locations to provide objective information on injury severity. Given the risk for injuries across the entire body, including mucous membranes, describing the depth of the injury is essential regardless of the anatomical site. Although not originally designed for this population, a modified version of the National Pressure Injury Advisory Panel (NPIAP) classification system, which incorporates additional classifications (e.g., skin tears), remains the most applicable severity assessment system currently available. This should be supplemented by clinical images or detailed descriptive language (e.g., subtle redness) until rigorously validated severity and assessment scales, based on neonatal data, are developed—particularly for infants born at less than 27 weeks gestation. [Correction added on 25 October 2024, after first online publication: The Relevance to Clinical Practice subsection in Abstract has been added on this version.] [ABSTRACT FROM AUTHOR]