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Mep Coretta Chipeta,1,2 Hei-Fen Hwang1 1School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan; 2Nursing and Midwifery Department, Mzuzu University, Mzuzu, MalawiCorrespondence: Mep Coretta Chipeta, Mzuzu University, Faculty of Health Sciences, Nursing and Midwifery Department, P/ Bag 201, Luwinga, Malawi, Email mepcoretta@gmail.com; mepchipeta@gmail.comPurpose: This paper aimed to define and characterize the nursing student-faculty (NS-F) relationship in clinical practice.Methods: An integrated literature review was conducted in PubMed, Scopus, and CINAHL from December 6th to 25th, 2023. The final review included 15 articles. The analysis employed the concept analysis method by Walker and Avant to identify antecedents, attributes, and outcomes of the NS-F relationship.Results: The common attributes were caring, interpersonal connectedness, motivation, and constructive communication. A clinical learning environment and contact between nursing students and faculty are the antecedents whilst positive consequences are but not limited to a positive learning environment, motivation, well-being, and empowerment.Conclusion: The findings from this analysis can be applied in practice to improve clinical education by guiding nurse faculty and students to implement effective interactions that promote the professional and academic development of nursing students. The findings offer practical implications for enhancing student-faculty relationships, leading to better learning outcomes in clinical settings.Keywords: student-teacher interaction, clinical support, nursing education, academic development, professional growth, learning environment

While very much in its infancy in terms of becoming an established tool, the use of digital technology in community nursing is steadily growing, despite the persistent barriers to, and challenges encountered in its uptake and implementation. The mobile nature and high workload of a community nurse's daily practice should facilitate the rapid uptake of time-saving technology. However, there are indications that technology may not be the panacea it was originally proclaimed to be. Francesca Ramadan elaborates on the past and present applications of digital technology in community nursing and delves into the principles that should shape the future potential of tools such as artificial intelligence, automation technologies and clinical decision support systems. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) is bringing revolutionary changes in healthcare, especially in improving communication between patients and doctors and supporting clinical decisions. The background of this study is the increasing complexity of modern healthcare which requires more efficient tools in managing communication and decision-making. The purpose of this study was to evaluate the effectiveness of ChatGPT in improving patient-physician communication, supporting clinical decisions, and increasing patient engagement. The methods used included a combination of qualitative data collection through interviews with healthcare professionals and quantitative data analysis from electronic medical records to evaluate the impact of ChatGPT. The results showed that ChatGPT significantly improved patientphysician communication, provided evidence-based recommendations, and automated repetitive tasks, ultimately improving patient satisfaction and care outcomes. The implications of this study suggest that AI integrations such as ChatGPT can reduce the administrative burden on healthcare workers and enable more efficient and personalized care delivery. Ethical and technical challenges related to data privacy and bias in AI systems remain a concern going forward. [ABSTRACT FROM AUTHOR]

BackgroundPatient portals allow communication with clinicians, access to test results, appointments, etc, and generally requires another set of log-ins and passwords, which can become cumbersome, as patients often have records at multiple institutions. Social credentials (eg, Google and Facebook) are increasingly used as a federated identity to allow access and reduce the password burden. Single Federated Identity Log-in for Electronic health records (Single-FILE) is a real-world test of the feasibility and acceptability of federated social credentials for patients to access their electronic health records (EHRs) at multiple organizations with a single sign-on (SSO).ObjectiveThis study aims to deploy a federated identity system for health care in a real-world environment so patients can safely use a social identity to access their EHR data at multiple organizations. This will help identify barriers and inform guidance for the deployment of such systems.MethodsSingle-FILE allowed patients to pick a social identity (such as Google or Facebook) as a federated identity for multisite EHR patient portal access with an SSO. Binding the identity to the patient's EHR records was performed by confirming that the patient had a valid portal log-in and sending a one-time passcode to a telephone (SMS text message or voice) number retrieved from the EHR. This reduced the risk of stolen EHR portal credentials. For a real-world test, we recruited 8 patients and (or) their caregivers who had EHR data at 2 independent health care facilities, enrolled them into Single-FILE, and allowed them to use their social identity credentials to access their patient records. We used a short qualitative interview to assess their interest and use of a federated identity for SSO. Single-FILE was implemented as a web-based patient portal, although the concept can be readily implemented on a variety of mobile platforms.ResultsWe interviewed the patients and their caregivers to assess their comfort levels with using a social identity for access. Patients noted that they appreciated only having to remember 1 log-in as part of Single-FILE and being able to sign up through Facebook.ConclusionsOur results indicate that from a technical perspective, a social identity can be used as a federated identity that is bound to a patient's EHR data. The one-time passcode sent to the patient's EHR phone number provided assurance that the binding is valid. The patients indicated that they were comfortable with using their social credentials instead of having to remember the log-in credentials for their EHR portal. Our experience will help inform the implementation of federated identity systems in health care in the United States.

Background: Clinical mentors are experienced practitioners who play an important role in encouraging the professional development of students in clinical areas. The responsibility of clinical mentorship in nursing is often difficult to maintain. However, there is a dire need for clinical mentorship in maternity units, especially in South African hospitals were high maternal mortality rates remain alarmingly high. Aim: This study aimed to describe the perceptions of registered midwives regarding the clinical mentorship of midwifery students. Setting: The study occurred in a semi-rural state regional hospital in the eThekwini district, KwaZulu-Natal. Methods: A qualitative exploratory and descriptive design was conducted using in-depth individual interviews with midwives in maternity units. A purposive and convenient sampling method recruited 17 registered midwives from 3 maternity care areas within a single setting. Interviews were audio-recorded and all data were analysed using qualitative content analysis. Results: Five categories emanated from this study namely, sharing knowledge and skills; encouraging role model behaviour; promoting self-worth; Is a challenging task; and requiring additional support. Conclusion: Clinical mentorship has a reciprocal effect on teaching and learning in maternity care areas and encouraged registered midwives to lead as role-models. The process demands competence, professionalism, and leading by example. Despite the confidence, satisfaction and interest in clinical mentorship, registered midwives often find the process challenged by patient care priorities. Therefore, registered midwives require additional support to mentor students in clinical practice. Contribution: This article shows that clinical mentorship places various challenges on registered midwives and formal mentorship training could be beneficial.

Background: With the removal of many barriers to direct-to-consumer telehealth during the COVID-19 pandemic, which resulted in a historic surge in the adoption of telehealth into ongoing practice, health systems must now identify the most efficient and effective way to sustain these visits. The Medical University of South Carolina Center for Telehealth developed a Telehealth Centralized Support team as part of a strategy to mature the support infrastructure for the continued large-scale use of outpatient virtual care. The team was deployed as the Center for Telehealth rolled out a new ambulatory telehealth software platform to monitor clinical activity, support patient registration and virtual rooming, and ensure successful visit completion. Methods: A multi-method, program-evaluation approach was used to describe the development and composition of the Telehealth Centralized Support Team in its first 18 months utilizing the Reach, Effectiveness, Adoption, Implementation, Maintenance framework. Results: In the first 18 months of the Telehealth Centralized Support team, over 75,000 visits were scheduled, with over 1500 providers serving over 46,000 unique patients. The team was successfully deployed over a large part of the clinical enterprise and has been well received across the health system. It has proven to be a scalable model to support enterprise-level virtual health care delivery. Conclusions: While further research is needed to evaluate the long-term program outcomes, the results of its early implementation suggest great promise for improved telehealth patient and provider satisfaction, the more equitable delivery of virtual services, and more cost-effective means for supporting virtual care. [ABSTRACT FROM AUTHOR]

Background: Cardiology procedures are often life-saving and time-critical, but some are so infrequent that health care staff may have rarely encountered them in practice or need to refresh their skills rapidly. Videos demonstrating procedures have the potential to assist health care professionals and support safe patient care. This scoping review explores the research literature involving the use of video by health care professionals in hospitals.Aim: To identify what is known from research regarding the use of video to support clinical procedures in hospitals or health care facilities.Method: The Joanna Briggs Institute Scoping review methodology guided our systematic search of peer-reviewed evidence related to video use to support procedures in a hospital or health care facility. Data sources included the electronic databases: ProQuest, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, Excerpta Medica dataBASE (EMBASE), Scopus, and PubMed.Findings: Seventeen (17) studies that met the inclusion criteria were included in the review, all published between 2012 and 2022. Since 2005, YouTube has become the dominant platform for publishing or sourcing videos related to clinical procedures. Studies to date can be summarised under five themes: 1) video content and purpose, 2) target audience, 3) video hosting site-internal websites versus YouTube, 4) curated versus original 'homegrown' video content, and 5) video development process.Discussion/conclusion: Research on the development and utility of videos to support clinical procedures is emerging, with the ability to host videos on platforms such as YouTube becoming more accessible in recent years. All videos were designed to enhance health care professionals' existing knowledge and skills within their scope of practice. The available literature suggests that video can be a valuable clinical resource for both simple and skilled procedures. Video resources can help clinicians perform or assist with rare procedures, providing 'just in time' patient safety prompts and information. [ABSTRACT FROM AUTHOR]

Contemporary large language models (LLMs) may have utility for processing unstructured, narrative free-text clinical data contained in electronic health records (EHRs) — a particularly important use-case for mental health where a majority of routinely-collected patient data lacks structured, machine-readable content. A significant problem for the United Kingdom's National Health Service (NHS) are the long waiting lists for specialist mental healthcare. According to NHS data (NHS Digital, 2024), in each month of 2023, there were between 370,000 and 470,000 individual new referrals into secondary mental healthcare services. Referrals must be triaged by clinicians, using clinical information contained in the patient's EHR to arrive at a decision about the most appropriate mental healthcare team to assess and potentially treat these patients. The ability to efficiently recommend a relevant team by ingesting potentially voluminous clinical notes could help services both reduce referral waiting times and with the right technology, improve the evidence available to justify triage decisions. We present and evaluate three different approaches for LLM-based, end-to-end ingestion of variable-length clinical EHR data to assist clinicians when triaging referrals. Our model is able to deliver triage recommendations consistent with existing clinical practices and its architecture was implemented on a single GPU, making it practical for implementation in resource-limited NHS environments where private implementations of LLM technology will be necessary to ensure confidential clinical data are appropriately controlled and governed. Code available at: https://github.com/NtaylorOX/BespokeLLM_Triage. • Mental health EHR data presents unique challenges for LLMs. • Variable length clinical data can be ingested by existing LLM architectures. • Bespoke LLMs perform well for specific clinical tasks such as triaging patients. [ABSTRACT FROM AUTHOR]

Background: Artificial intelligence-based clinical decision support (AI-CDS) tools have great potential to benefit intensive care unit (ICU) patients and physicians. There is a gap between the development and implementation of these tools. Objective: We aimed to investigate physicians' perspectives and their current decision-making behavior before implementing a discharge AI-CDS tool for predicting readmission and mortality risk after ICU discharge. Methods: We conducted a survey of physicians involved in decision-making on discharge of patients at two Dutch academic ICUs between July and November 2021. Questions were divided into four domains: (1) physicians' current decision-making behavior with respect to discharging ICU patients, (2) perspectives on the use of AI-CDS tools in general, (3) willingness to incorporate a discharge AI-CDS tool into daily clinical practice, and (4) preferences for using a discharge AI-CDS tool in daily workflows. Results: Most of the 64 respondents (of 93 contacted, 69%) were familiar with AI (62/64, 97%) and had positive expectations of AI, with 55 of 64 (86%) believing that AI could support them in their work as a physician. The respondents disagreed on whether the decision to discharge a patient was complex (23/64, 36% agreed and 22/64, 34% disagreed); nonetheless, most (59/64, 92%) agreed that a discharge AI-CDS tool could be of value. Significant differences were observed between physicians from the 2 academic sites, which may be related to different levels of involvement in the development of the discharge AI-CDS tool. Conclusions: ICU physicians showed a favorable attitude toward the integration of AI-CDS tools into the ICU setting in general, and in particular toward a tool to predict a patient's risk of readmission and mortality within 7 days after discharge. The findings of this questionnaire will be used to improve the implementation process and training of end users. [ABSTRACT FROM AUTHOR]

Background: Midwifery students in South Africa place great value on the clinical support they receive from midwifery practitioners. Adequate clinical support should help midwifery students to practice procedures safely and independently, allowing them to be competent upon degree completion. Aim: To describe the clinical support and perceived competency levels of midwifery students. Setting: Public hospitals in KwaZulu-Natal. Methods: The researcher chose a quantitative research method using a descriptive design. An all-inclusive purposive and convenience sampling method was undertaken to recruit midwifery students from an undergraduate nursing programme at a university in KwaZulu-Natal. Gatekeepers permission and ethics approval was obtained from the university’s registrar and research ethics committee. A self-evaluation questionnaire describing the clinical support and perceived competency levels was completed by 60 respondents. Data were analysed using International Business Machines Corporation Statistical Package for Social Sciences (IBM-SPSS) Version 27. Results: The results highlighted that the clinical support midwifery students received, was beneficial to their clinical learning outcomes. Eighty per cent of clinical support offered to midwifery students was obtained through clinical supervision. Ninety-three per cent of respondents revealed that the clinical support they received were from midwifery practitioners (without a speciality qualification). Although students rated themselves as competent in 88.6% of midwifery procedures, poor outcomes were identified in 11.4% procedures. Conclusion: Midwifery practitioners play a significant role in supporting midwifery students during clinical placement. Advancing the roles of midwifery practitioners through mentorship training is likely to strengthen the quality of clinical support provided and thus improve the competence levels of midwifery students. Contribution: The findings in this paper are valuable in developing clinical support training guidelines for midwifery practitioners.

Many sectors now embrace the concept of a digital environment where various kinds of sensors and local processors are linked to exchange information. These concepts have been used to build a variety of goods. The healthcare sector is one where many advancements are being made. The majority of illnesses may be prevented and treated with the help of medications. By taking the right medications, many dangerous and dangerous disorders may be healed. The suggested system includes an IoT-enabled medication reminder system that notifies patients when it is time to take their medications which makes the nursing practices to support healthcare needs quite easy and efficient. By giving audio-visual alert, it reminds the patient to take their medications at the appropriate time. The system aids in keeping track of the patient's medical information and medication administration. [ABSTRACT FROM AUTHOR]

Background: There are 15,632 nursing homes (NHs) in the United States. NHs continue to receive significant policy attention due to high costs and poor outcomes of care. One strategy for improving NH care is use of health information technology (HIT). A central concept of this study is HIT maturity, which is used to identify adoption trends in HIT capabilities, use and integration within resident care, clinical support, and administrative activities. This concept is guided by the Nolan stage theory, which postulates that a system such as HIT moves through a series of measurable stages. HIT maturity is an important component of the rapidly changing NH landscape, which is being affected by policies generated to protect residents, in part because of the pandemic. Objective: The aim of this study is to identify structural disparities in NH HIT maturity and see if it is moderated by commonly used organizational characteristics. Methods: NHs (n=6123, >20%) were randomly recruited from each state using Nursing Home Compare data. Investigators used a validated HIT maturity survey with 9 subscales including HIT capabilities, extent of HIT use, and degree of HIT integration in resident care, clinical support, and administrative activities. Each subscale had a possible HIT maturity score of 0-100. Total HIT maturity, with a possible score of 0-900, was calculated using the 9 subscales (3 x 3 matrix). Total HIT maturity scores equate 1 of 7 HIT maturity stages (stages 0-6) for each facility. Dependent variables included HIT maturity scores. We included 5 independent variables (ie, ownership, chain status, location, number of beds, and occupancy rates). Unadjusted and adjusted cumulative odds ratios were calculated using regression models. Results: Our sample (n=719) had a larger proportion of smaller facilities and a smaller proportion of larger facilities than the national nursing home population. Integrated clinical support technology had the lowest HIT maturity score compared to resident care HIT capabilities. The majority (n=486, 60.7%) of NHs report stage 3 or lower with limited capabilities to communicate about care delivery outside their facility. Larger NHs in metropolitan areas had higher odds of HIT maturity. The number of certified beds and NH location were significantly associated with HIT maturity stage while ownership, chain status, and occupancy rate were not. Conclusions: NH structural disparities were recognized through differences in HIT maturity stage. Structural disparities in this sample appear most evident in HIT maturity, measuring integration of clinical support technologies for laboratory, pharmacy, and radiology services. Ongoing assessments of NH structural disparities is crucial given 1.35 million Americans receive care in these facilities annually. Leaders must be willing to promote equal opportunities across the spectrum of health care services to incentivize and enhance HIT adoption to balance structural disparities and improve resident outcomes. [ABSTRACT FROM AUTHOR]

Background: Midwifery students in South Africa place great value on the clinical support they receive from midwifery practitioners. Adequate clinical support should help midwifery students to practice procedures safely and independently, allowing them to be competent upon degree completion. Aim: To describe the clinical support and perceived competency levels of midwifery students. Setting: Public hospitals in KwaZulu-Natal. Methods: The researcher chose a quantitative research method using a descriptive design. An all-inclusive purposive and convenience sampling method was undertaken to recruit midwifery students from an undergraduate nursing programme at a university in KwaZulu-Natal. Gatekeepers permission and ethics approval was obtained from the university's registrar and research ethics committee. A self-evaluation questionnaire describing the clinical support and perceived competency levels was completed by 60 respondents. Data were analysed using International Business Machines Corporation Statistical Package for Social Sciences (IBM-SPSS) Version 27. Results: The results highlighted that the clinical support midwifery students received, was beneficial to their clinical learning outcomes. Eighty per cent of clinical support offered to midwifery students was obtained through clinical supervision. Ninety-three per cent of respondents revealed that the clinical support they received were from midwifery practitioners (without a speciality qualification). Although students rated themselves as competent in 88.6% of midwifery procedures, poor outcomes were identified in 11.4% procedures. Conclusion: Midwifery practitioners play a significant role in supporting midwifery students during clinical placement. Advancing the roles of midwifery practitioners through mentorship training is likely to strengthen the quality of clinical support provided and thus improve the competence levels of midwifery students. Contribution: The findings in this paper are valuable in developing clinical support training guidelines for midwifery practitioners. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to provide insight for improvement in care for young adults diagnosed with cancer (YADC), by identifying underemphasized outcomes that strongly matter to YADC and the gaps in care that may limit achieving these outcomes for this unique and vulnerable population. Methods: Twenty-seven YADC, ages 25–39, participated in unstructured discussions focusing on topics relating to diagnosis, daily experiences living with cancer outside of the clinical setting, goals, concerns, and clinical care experience. Most participants engaged in group discussions using Experience Group methodology. Discussions were designed to collect information on three dimensions of health: capability, comfort, and calm (CCC). Data were coded using thematic analysis with NVivo software. Results: Several themes were identified within the CCC framework: capability in terms of confronting mortality at a young age, losing youthful identity and control over major life course decisions, especially fertility, and debilitating side effects, comfort in terms of the lack of understanding from peers and family and the fear of cancer recurrence, and calm was discussed as the difficulty of making complex medical decisions, financial toxicity, and loss of clinical support in survivorship. Conclusion: This research highlighted four care additions that are important for YADC: (1) concise and understandable education about their condition and treatment; (2) same-age support groups; (3) fertility support; and (4) better care transitions for life after cancer. These findings emphasize the importance of creating a collaborative, multidisciplinary care team and a holistic approach with care innovations that support clinicians to meet the unique needs of YADC. [ABSTRACT FROM AUTHOR]

Objective: To examine how nurse managers in metropolitan healthcare organisations in Western Australia perceive intergenerational mentoring and its place in the contemporary workforce. Background: Mentoring in nursing has benefits for professional career success, new role transition and as a strategy to mitigate negative workplace influences. Study design and methods: A qualitative descriptive study with 20 nurse managers from public and private health services. Face to face semi-structured interviews were held at a neutral location. The interview schedule included 10 questions which were audio-recorded and transcribed verbatim. Thematic analysis was applied to data to generate themes and present the results. Results: Four main themes were identified: conceptualising mentoring, adding value, influences and support mechanisms, and workforce investment. The nurse managers described the positive and negative aspects of their understanding of intergenerational mentoring practice in the contemporary clinical setting. Discussion: The nurse managers highlighted the importance of life experience in mentoring relationships and how mentoring was generationally bi-directional. As part of everyday nursing practice mentoring was evident despite clinical and organisational challenges. Clear benefits identified were the creation of a positive workforce, promotion of quality patient-centred care, and retention of staff. Mentoring has traditionally occurred face to face however, the recent coronavirus pandemic has provided a catalyst for increasing the use of online mentoring across all generations. Conclusion: The nurse managers were willing to be involved in intergenerational mentoring in either a mentor or mentee role or both. This view of practice occurred throughout the professional work life of nurses with benefits for all generations and the continuity of organisational values. Implications for practice: Mentoring is a practice necessary for promoting best practice in patient care and effective relationships in teams of staff. Consideration of accessibility through e-mentoring could increase involvement and take mentoring forward in the digital age. [ABSTRACT FROM AUTHOR]

Background: In 2013, the Dahlgren Memorial Library (DML) at the Georgetown University Medical Center began using text mining software to enable its clinical informationists to quickly retrieve specific, relevant information from MEDLINE abstracts while on patient rounds. Description: In 2013, DML licensed the use of the Linguamatics I2E text-mining program, and DML’s clinical informationist began using it to text mine MEDLINE abstracts on patient rounds. In 2015, DML installed I2E on a server at Georgetown and negotiated with Elsevier to obtain the right to download and text mine the full text of clinical journals in ScienceDirect to support clinical decision making. In 2016, the license agreements for the New England Journal of Medicine and the BMJ platform were modified to allow text mining. In 2018, PubMed Central open access content was added to the Linguamatics license. Results: DML’s informationists found that they were able to quickly find useful information that was not retrievable by traditional methods, and clinicians reported the information was valuable. Conclusion: The ability to text mine MEDLINE abstracts and selected journal articles on patient rounds has allowed DML’s clinical informationists to quickly search large amounts of medical literature that can be used to answer physicians’ clinical questions. DML plans to acquire additional journal articles from selected publishers in the future, which should increase the usefulness of the project. Virtual Projects are published on an annual basis in the Journal of the Medical Library Association (JMLA) following an annual call for virtual projects in MLAConnect and announcements to encourage submissions from all types of libraries. An advisory committee of recognized technology experts selects project entries based on their currency, innovation, and contribution to health sciences librarianship.

INTRODUCTION: management of tuberculosis (TB) and Human Immunodeficiency Virus (HIV) within primary health care (PHC) facilities involve nursing students as part of them integrating theory to practice. Clinical learning for nursing students requires adequate support from the Nursing Education Institution (NEI) and nursing professionals. Given the dearth of literature regarding clinical support for nursing students in the management of TB/HIV in PHC setting, this study is aimed at exploring and describing nursing students' experiences regarding clinical support. METHODS: a phenomenological design was used to explore and describe the experiences of nursing students using an individual, unstructured, in-depth interview. Audio-taped interviews were transcribed verbatim and analysed using Atlas TI software. RESULTS: themes derived from the study were factors inhibiting clinical support which incorporated shortage of professional nurses (PNs), lack of accompaniment, fear of managing TB/HIV patients and negative attitudes of PNs; outcomes of poor clinical support included inability to integrate TB/HIV theory to practice and lack of confidence among nursing students; nursing students' desired outcomes through clinical support included becoming a competent TB/HIV nurse and the ability to integrate TB/HIV theory to practice; and strategies to strengthen and promote clinical support in TB/HIV management through strengthened occupational health and safety learning, provision of knowledge regarding post-exposure prophylaxis and infection control, and appointed clinical PN for students in each facility. CONCLUSION: the development of policies for clinical support, increasing supervision, appointment of clinical preceptors and accompanists in facilities where nursing students are placed would promote clinical learning within the NEI and the production of competent and confident nurses.

Background: Older adults face barriers to specialty care, such as occupational therapy (OT), and these challenges are worse for rural older adults. While in-home video telehealth may increase access to OT, older adults' health- and technology-related challenges may necessitate caregiver assistance., Objective: This study examines caregiver assistance with in-home OT video telehealth visits from the perspectives of OT practitioners at Veterans Health Administration (VHA)., Methods: A web-based national survey of VHA OT practitioners about caregivers' role in video telehealth was conducted between January and February 2022. Survey items were developed with input from subject matter experts in geriatrics and OT and identified patient factors that necessitate caregiver participation; the extent to which caregivers assist with different types of tasks (technological and clinical tasks); and the perceived facilitators of, benefits of, and barriers to caregiver involvement., Results: Of approximately 1787 eligible VHA OT practitioners, 286 (16% response rate) participated. Not all survey items required completion, resulting in different denominators. Most respondents were female (183/226, 81%), White (163/225, 72.4%), and occupational therapists (275/286, 96.2%). Respondents were from 87 VHA medical centers, the catchment areas of which served a patient population that was 34% rural, on average (SD 0.22). Most participants (162/232, 69.8%) had >10 years of OT experience serving a patient cohort mostly aged ≥65 years (189/232, 81.5%) in primarily outpatient rehabilitation (132/232, 56.9%). The top patient factors necessitating caregiver involvement were lack of technical skills, cognitive impairment, and advanced patient age, with health-related impairments (eg, hearing or vision loss) less frequent. Technological tasks that caregivers most frequently assisted with were holding, angling, moving, repositioning, or operating the camera (136/250, 54.4%) and enabling and operating the microphone and setting the volume (126/248, 50.8%). Clinical tasks that caregivers most frequently assisted with were providing patient history (143/239, 59.8%) and assisting with patient communication (124/240, 51.7%). The top facilitator of caregiver participation was clinician-delivered caregiver education about what to expect from video telehealth (152/275, 55.3%), whereas the top barrier was poor connectivity (80/235, 34%). Increased access to video telehealth (212/235, 90.2%) was the top-rated benefit of caregiver participation. Most respondents (164/232, 70.7%) indicated that caregivers were at least sometimes unavailable or unable to assist with video telehealth, in which case the appointment often shifted to phone., Conclusions: Caregivers routinely assist VHA patients with in-home OT video visits, which is invaluable to patients who are older and have complex medical needs. Barriers to caregiver involvement include caregivers' challenges with video telehealth or inability to assist, or lack of available caregivers. By elucidating the caregiver support role in video visits, this study provides clinicians with strategies to effectively partner with caregivers to enhance older patients' access to video visits., (©Megan Elizabeth Gately, Dylan E Waller, Emily E Metcalf, Lauren R Moo. Originally published in JMIR Rehabilitation and Assistive Technology (https://rehab.jmir.org), 14.03.2024.)

Aim: To explore the clinical support experiences of new graduate nurses' (NGNs) and how these experiences influenced their learning, job satisfaction and skill development during their new graduate transition. Background: As supervising NGNs is different to other groups, nurse managers must be aware of NGNs' unique needs to successfully transition to practice. Clinical support is crucial, but little is known about what is effective in supporting the learning and development of clinical capability in this critical period. Methods: Using a qualitative exploratory design, semi‐structured interviews were conducted with NGNs working in a tertiary level teaching hospital in Sydney, Australia. Nurses were interviewed upon completing their 12‐month transitional support programme (TSP) in late 2013–2014. Data were thematically analysed. Results: Twenty‐six NGNs were interviewed. Three major themes identified were as follows: (a) clinical support facilitates learning; (b) conditions required for good clinical support; (c) transforming me. Conclusion: Themes identified specific supportive strategies, including informal and formal clinical support to nurture confidence, competence, professional growth and increase satisfaction of NGNs. Implications for Nursing Management: Findings describe essential clinical support practices for fostering successful NGN transition. [ABSTRACT FROM AUTHOR]

Introduction: management of tuberculosis (TB) and Human Immunodeficiency Virus (HIV) within primary health care (PHC) facilities involve nursing students as part of them integrating theory to practice. Clinical learning for nursing students requires adequate support from the Nursing Education Institution (NEI) and nursing professionals. Given the dearth of literature regarding clinical support for nursing students in the management of TB/HIV in PHC setting, this study is aimed at exploring and describing nursing students' experiences regarding clinical support. Methods: a phenomenological design was used to explore and describe the experiences of nursing students using an individual, unstructured, in-depth interview. Audio-taped interviews were transcribed verbatim and analysed using Atlas TI software. Results: themes derived from the study were factors inhibiting clinical support which incorporated shortage of professional nurses (PNs), lack of accompaniment, fear of managing TB/HIV patients and negative attitudes of PNs; outcomes of poor clinical support included inability to integrate TB/HIV theory to practice and lack of confidence among nursing students; nursing students' desired outcomes through clinical support included becoming a competent TB/HIV nurse and the ability to integrate TB/HIV theory to practice; and strategies to strengthen and promote clinical support in TB/HIV management through strengthened occupational health and safety learning, provision of knowledge regarding post-exposure prophylaxis and infection control, and appointed clinical PN for students in each facility. Conclusion: the development of policies for clinical support, increasing supervision, appointment of clinical preceptors and accompanists in facilities where nursing students are placed would promote clinical learning within the NEI and the production of competent and confident nurses. [ABSTRACT FROM AUTHOR]

Abstract The transition to quality and safety in the new graduate registered nurses' practice remains problematic directly impacting patient outcomes. Effective mentoring during transition serves to enhance experiential learning, allowing the development and establishment of safe, quality nursing practice. Comprehensive understanding of the transition process, including the barriers and effective enablers to transition is the key to effective mentoring. A theoretical framework guided by Duchscher's Stages of Transition Theory and Transition Shock Model and Benner's From novice to expert model can facilitate such understanding. Nurse Theorists play an important part in shaping nurse education and practice and have provided nurse educators and leaders an understanding to shape skill acquisition and the transition process for new graduate registered nurses. The res ultantresearchmodels and theory of these influencial nurses are pertinent to transition of new graduate registered nurses. This paper outlines the theories of Duchscher and Benner and how their research formed the theoretical framework to facilitate the measurement, understanding and improvement of the safety and quality of nursing care and impact the future nursing workforce. Highlights • Benner and Duchscher's theories clarify skill acquisition and the role transition process undertaken by new graduate nurses. • Reports theoretical framework supporting research of clinical practices of new graduate nurses' and their role transition. • Senior nurses understanding of Benner's and Duchscher's theories may assist to enhance the NGRN transition experience. • Socialisation, mentorship, and clinical support is vital for new graduate nurses' safe practice and retention in nursing. • New graduate nurse attrition is costly as it leads to nursing shortages, ultimately impacting patient safety. [ABSTRACT FROM AUTHOR]

The ever-increasing flood of information, especially in the medical-clinical field, inter alia due to the increase of data-intensive mobile/wearable devices, is one of the biggest challenges of medical informatics. In this work different possibilities of the integration of wearable devices on the example of the development of a fall prevention system are presented and classified. We started with a commercial off-the-shelf one-on-one system (Shimmer/Arduino) using a Bluetooth connection, integrated via nurse call system as Human-Machine- Interface. During the evaluation of the system we mentioned several new requirements and optimization possibilities. Thus, we adjusted the hardware-software-system; the near-field communication was realized by IEEE802.15.4, we replaced commercial off-the-shelf devices with highly-specialized open hardware in-house developments and we transferred the nurse call integration by setting up our own network and integrating this into an existing (wireless) local area network. With this development, the energy-efficient, simple and intuitive mechanisms of proximity communication via IEEE802.15.4 can be combined with the benefits broadband functionalities, e.g. of Wi-Fi, with both worlds benefits and the compensation of some disadvantages. [ABSTRACT FROM AUTHOR]

Background: Botulinum toxin type A (BoNT-A) injections is the accepted first-line therapy for cervical dystonia (CD), however, numerous patients discontinue treatment early due to perceived sub-optimal relief. To improve BoNT-A therapy for CD, proper assessment of neck motion and selection of relevant muscles and dosing must be met. Kinematic technology may improve treatment outcomes by guiding physicians to better tailor muscle selection and BoNT-A dosing for CD therapy.Methods: 28 CD participants were placed into either group: expert injector determined injection patterns by visual assessment (“vb”) versus injection patterns based on kinematics interpreted by an expert injector (“kb”). Injections occurred at weeks 0, 16 and 32 with follow-ups at weeks 6, 22 and 38. Kinematics utilized four sensors to capture the severity of multiaxial, static neck posturing (e.g., torticollis) and dynamic, spasmodic/tremor movements while participants were seated. Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) score changes were evaluated over 38 weeks.Results: For the “kb” participants, there was a significant 28.8% (− 11.25 points) reduction in TWSTRS total score at week 6, as well as significant reduction in severity and disability TWSTRS sub-scores (parts I and II) with maintained improvement at subsequent visits. As for the “vb” participants had a significant reduction in total TWSTRS score by 28.5% (− 9.84 points) after week 22. Disability score for the “vb” group trended towards improvement over 38 weeks.Conclusion: Clinical judgement guided by kinematic analysis of CD biomechanics can result in faster optimal muscle selections and minimize use of higher BoNT-A doses as compared to visual determination, thereby achieving comparable and potentially better treatment outcomes. [ABSTRACT FROM AUTHOR]

Nurses are faced with challenges regarding inadequate precautionary resources and the lack of support for occupational health practices still experienced in the clinical setting which expose them to the risk of contracting TB and HIV. Hence this study sought to investigate TB/ HIV exposure among nursing students in the clinical practice environment. A cross-sectional descriptive design was used in this study. The study sample included nursing students from first to fourth year level from the School of Nursing Sciences at the North-West University who were purposively selected. A high percentage of nursing students reported that they have experienced a situation where they were afraid that they might have been infected with both TB and HIV. Awareness about post-exposure prophylaxis (PEP) was marked among the majority of nursing students. The uptake of PEP differed across junior and senior levels of nursing students. The results revealed that the higher the level of study, the greater the exposure. The lack of sufficient clinical support from nursing staff and preceptors had equally contributed to the exposure of nursing students to both HIV and TB, therefore, more support must be provided to nursing students. [ABSTRACT FROM AUTHOR]

Background: The competence of ChatGPT (Chat Generative Pre-Trained Transformer) in non-English languages is not well studied., Objective: This study compared the performances of GPT-3.5 (Generative Pre-trained Transformer) and GPT-4 on the Japanese Medical Licensing Examination (JMLE) to evaluate the reliability of these models for clinical reasoning and medical knowledge in non-English languages., Methods: This study used the default mode of ChatGPT, which is based on GPT-3.5; the GPT-4 model of ChatGPT Plus; and the 117th JMLE in 2023. A total of 254 questions were included in the final analysis, which were categorized into 3 types, namely general, clinical, and clinical sentence questions., Results: The results indicated that GPT-4 outperformed GPT-3.5 in terms of accuracy, particularly for general, clinical, and clinical sentence questions. GPT-4 also performed better on difficult questions and specific disease questions. Furthermore, GPT-4 achieved the passing criteria for the JMLE, indicating its reliability for clinical reasoning and medical knowledge in non-English languages., Conclusions: GPT-4 could become a valuable tool for medical education and clinical support in non-English-speaking regions, such as Japan., (©Soshi Takagi, Takashi Watari, Ayano Erabi, Kota Sakaguchi. Originally published in JMIR Medical Education (https://mededu.jmir.org), 29.06.2023.)