Objective:To assess the effectiveness of simulation-based learning regarding the management of post-COVID complications in terms of knowledge,clinical decision-making ability,and self-efficacy among nursing students.M...Objective:To assess the effectiveness of simulation-based learning regarding the management of post-COVID complications in terms of knowledge,clinical decision-making ability,and self-efficacy among nursing students.Methods:This was a quasi-experimental study conducted among 1152nd-year nursing students.The participants were selected by a simple random sampling technique.The participants were divided into an experimental(n=56)and a comparison group(n=59)by a random table method.Data were analyzed using descriptive and inferential statistics with SPSS version 20.Results:There were significant differences in mean post-test knowledge scores(P=0.03)and mean post-test self-efficacy scores(P=0.001)between the experimental and the comparison groups while the difference in mean post-test clinical decision-making ability scores between the two groups was non-significant(P=0.07).A positive correlation was found between knowledge and clinical decision-making ability in pre-test(P=0.03)and in post-test(P<0.001)and a non-significant correlation was found between pre-test knowledge and self-efficacy score(P=0.52)among the experimental group.Conclusions:Simulation-based learning regarding the management of post-COVID complications is effective among nursing students.Simulation labs should be established in health care settings where simulation training can be provided for updating the knowledge,clinical decision-making ability,and self-efficacy of nursing personnel during program installment and continuous nursing education.展开更多
Diagnostic errors are prevalent in critical care practice and are associated with patient harm and costs for providers and the healthcare system.Patient complexity,illness severity,and the urgency in initiating proper...Diagnostic errors are prevalent in critical care practice and are associated with patient harm and costs for providers and the healthcare system.Patient complexity,illness severity,and the urgency in initiating proper treatment all contribute to decision-making errors.Clinician-related factors such as fatigue,cognitive overload,and inexperience further interfere with effective decision-making.Cognitive science has provided insight into the clinical decision-making process that can be used to reduce error.This evidence-based review discusses ten common misconceptions regarding critical care decision-making.By understanding how practitioners make clinical decisions and examining how errors occur,strategies may be developed and implemented to decrease errors in Decision-making and improve patient outcomes.展开更多
Artificial Intelligence(AI)is a type of intelligence that comes from machines or computer systems that mimics human cognitive function.Recently,AI has been utilized in medicine and helped clinicians make clinical deci...Artificial Intelligence(AI)is a type of intelligence that comes from machines or computer systems that mimics human cognitive function.Recently,AI has been utilized in medicine and helped clinicians make clinical decisions.In gastroenterology,AI has assisted colon polyp detection,optical biopsy,and diagnosis of Helicobacter pylori infection.AI also has a broad role in the clinical prediction and management of gastrointestinal bleeding.Machine learning can determine the clinical risk of upper and lower gastrointestinal bleeding.AI can assist the management of gastrointestinal bleeding by identifying high-risk patients who might need urgent endoscopic treatment or blood transfusion,determining bleeding stigmata during endoscopy,and predicting recurrence of gastrointestinal bleeding.The present review will discuss the role of AI in the clinical prediction and management of gastrointestinal bleeding,primarily on how it could assist gastroenterologists in their clinical decision-making compared to conventional methods.This review will also discuss challenges in implementing AI in routine practice.展开更多
Nurses must be enlightened that clinical reasoning, clinical decision making, and clinical judgement are the key elements in providing safe patient care. It must be incorporated and applied all throughout the nursing ...Nurses must be enlightened that clinical reasoning, clinical decision making, and clinical judgement are the key elements in providing safe patient care. It must be incorporated and applied all throughout the nursing process. The impact of patients’ positive outcomes relies on how nurses are effective in clinical reasoning and put into action once clinical decision making occurs. Thus, nurses with poor clinical reasoning skills frequently fail to see and notice patient worsening condition, and misguided decision making arises that leads to ineffective patient care and adding patients suffering. Clinical judgment on the other hand denotes on the outcome after the cycle of clinical reasoning. Within this context, nurses apply reflection about their actions from the clinical decision making they made. The process of applying knowledge, skills and expertise in the clinical field through clinical reasoning is the work of art in the nursing profession in promoting patient safety in the course of delivering routine nursing interventions. Nurses must be guided with their sound clinical reasoning to have an optimistic outcome and prevent iatrogenic harm to patients. Nurses must be equipped with knowledge, skills, attitude and values but most importantly prepared to face the bigger picture of responsibility to care for every patient in the clinical field.展开更多
Objective:A study was conducted about the putative links of older rural Australians'health knowledge and preparation with their quality of involvement in patient-general practitioner(GP)communication during health...Objective:A study was conducted about the putative links of older rural Australians'health knowledge and preparation with their quality of involvement in patient-general practitioner(GP)communication during health intake visits.Methods:It was a cross-sectional study between January 2021 and April 2022.The 32-item quality of involvement in communication scale was designed and incorporated into the SurveyGizmo software.This online survey was administered by sending an email request to the Renmark Rotary Club,which actively promoted this study across five rural towns in South Australia.121 participants completed the surveys.Mean-sum scores were calculated based on the questionnaire responses to evaluate outcomes,specifically initiation of information,active participation,and emotional expression.We employed different methods including t-tests,ANOVA,and leaner regressions to analyse data.Results:The demographic profile of participants characterised by a female predominance(58.7%,71/121),a majority falling within the 65-<70 age bracket(47.1%,57/121),and a high level of educational attainment(58.7%had completed high school or higher,71/121).Additionally,35%of the participants predominantly spoke a language other than English at home.Regarding the initiation of information with GPs,the mean sum-score was(20.5+3.7),indicating a marginally above-average level of engagement.Contrarily,the active participation was suboptimal,as suggested by a mean sum score of(35.9±6.3).Furthermore,the emotional expression was relatively low,with a mean score of(13.9±1.8).Substantial variations were discerned in the quality of patient-GP communication,contingent upon factors such as educational background,language spoken at home,health literacy,and preparatory measures for clinical visits.Participants who predominantly spoke a language other than English at home demonstrated significantly lower levels of information initiation with their GPs(P<0.o01).Higher educational attainment was positively correlated with increased active participation(P<0.001).Enhanced health literacy and thorough visit preparation were significantly associated with increased levels of active participation(P<0.001).Conclusion:Meaningful engagement through recognition,empowerment,and support(health literacy programs)for older rural adults is suggested for improving their quality of involvement in communication with GPs.展开更多
This literature review primarily aims to explore and synthesise the previous studies in simulation education research conducted over the past five years related to the effects of simulation training on the self-effica...This literature review primarily aims to explore and synthesise the previous studies in simulation education research conducted over the past five years related to the effects of simulation training on the self-efficacy of undergraduate pre-registration nursing students. The second aim of this study is to explore additional outcome variables that were examined in the previous studies. Five electronic databases were searched systematically. These databases were MEDLINE, CINAHL Plus, Scopus, Embase and PsycINFO. The PICO model was employed to identify the search terms, with a thesaurus being used to provide synonyms. Reference lists of relevant articles were examined and hand searches of journals were also undertaken. The quality of each study was assessed using the Simulation Research Rubric (SRR). A total of 11 studies were included. All studies explored the impact of simulation education on undergraduate pre-registration nursing. Six studies explored nursing students’ competence and performance and two papers examined their critical thinking. Problem solving, learning motivation, communication skills and knowledge acquisition were examined once. The majority of studies indicated that simulation training has a positive impact on pre-registration nursing students’ self-efficacy and other outcome variables. Furthermore, the study results indicate that simulation training is more dependable than traditional training, and students were extremely satisfied with the simulation training. However, most of the studies included in this review had several gaps, including study design, sample size and dissimilarities between the scales used. Further research with large samples, reliable and valid instruments, and outcomes measures (such as critical thinking and transferability of skills) is required to provide better insight into the effectiveness of simulation in undergraduate nursing education. .展开更多
In 1948, the first clinical paper adopting the protocol of randomized and controlled design was published in British Medical Journal by Bradford Hill,a noted British biostatistician, who introduced rigorous theory of ...In 1948, the first clinical paper adopting the protocol of randomized and controlled design was published in British Medical Journal by Bradford Hill,a noted British biostatistician, who introduced rigorous theory of mathematical statistics into clinical design the first time and successfully evaluated the therapeutic effect of streptomycin on tuberculosis.展开更多
Background： The reported mortality rate of mushroom-induced acute liver failure with conventionaltreatment is 1.4%–16.9%. Emergency liver transplantation may be indicated and can be the only curativetreatment option...Background： The reported mortality rate of mushroom-induced acute liver failure with conventionaltreatment is 1.4%–16.9%. Emergency liver transplantation may be indicated and can be the only curativetreatment option. This study aimed to assess the prognostic value of criteria for emergency livertransplantation in predicting 28-day mortality in patients with mushroom-induced acute liver injury.Methods： A retrospective cohort study was performed between January 2005 and December 2015. Alladult patients aged≥18 years admitted with mushroom intoxication at our emergency department wereevaluated. All patients with acute liver injury, defined as elevation of serum liver enzymes （〉5 timesthe upper limit of normal, ULN） or moderate coagulopathy （INR 〉 2.0） were included. The ability of the King’s College, Ganzert’s, and Escudié’s criteria to predict 28-day mortality was evaluated.展开更多
In China,there are three basic clinical decision-making modes for patients,namely patients autonomous decision-making mode,family decision-making mode and patient and family codetermination.They were produced under th...In China,there are three basic clinical decision-making modes for patients,namely patients autonomous decision-making mode,family decision-making mode and patient and family codetermination.They were produced under the unique background of Chinese medicine,Confucian philosophy and law in China,l this paper,the concepts,advantages and disadvantages of these three decision-making modes were analyzed In addition,some suggestions were put forward for the improvement.The first is that we suggest to establis standards for choosing decision-making modes;the second is to further learn and publicize relevant laws;thirdly the legal system needs to be further refined;and the last one is to carry out ethical ward round.展开更多
Computerized decision support(CDS) is the most advanced form of clinical decision support available and has evolved with innovative technologies to provide meaningful assistance to medical professionals. Critical care...Computerized decision support(CDS) is the most advanced form of clinical decision support available and has evolved with innovative technologies to provide meaningful assistance to medical professionals. Critical care clinicians are in unique environments where vast amounts of data are collected on individual patients, and where expedient and accurate decisions are paramount to the delivery of quality healthcare. Many CDS tools are in use today among adult and pediatric intensive care units as diagnostic aides, safety alerts, computerized protocols, and automated recommendations for management. Some CDS use have significantly decreased adverse events and improved costs when carefully implemented and properly operated. CDS tools integrated into electronic health records are also valuable to researchers providing rapid identification of eligible patients, streamlining data-gathering and analysis, and providing cohorts for study of rare and chronic diseases through data-warehousing. Although the need for human judgment in the daily care of critically ill patients has limited the study and realization ofmeaningful improvements in overall patient outcomes, CDS tools continue to evolve and integrate into the daily workflow of clinicians, and will likely provide advancements over time. Through novel technologies, CDS tools have vast potential for progression and will significantly impact the field of critical care and clinical research in the future.展开更多
文摘Objective:To assess the effectiveness of simulation-based learning regarding the management of post-COVID complications in terms of knowledge,clinical decision-making ability,and self-efficacy among nursing students.Methods:This was a quasi-experimental study conducted among 1152nd-year nursing students.The participants were selected by a simple random sampling technique.The participants were divided into an experimental(n=56)and a comparison group(n=59)by a random table method.Data were analyzed using descriptive and inferential statistics with SPSS version 20.Results:There were significant differences in mean post-test knowledge scores(P=0.03)and mean post-test self-efficacy scores(P=0.001)between the experimental and the comparison groups while the difference in mean post-test clinical decision-making ability scores between the two groups was non-significant(P=0.07).A positive correlation was found between knowledge and clinical decision-making ability in pre-test(P=0.03)and in post-test(P<0.001)and a non-significant correlation was found between pre-test knowledge and self-efficacy score(P=0.52)among the experimental group.Conclusions:Simulation-based learning regarding the management of post-COVID complications is effective among nursing students.Simulation labs should be established in health care settings where simulation training can be provided for updating the knowledge,clinical decision-making ability,and self-efficacy of nursing personnel during program installment and continuous nursing education.
文摘Diagnostic errors are prevalent in critical care practice and are associated with patient harm and costs for providers and the healthcare system.Patient complexity,illness severity,and the urgency in initiating proper treatment all contribute to decision-making errors.Clinician-related factors such as fatigue,cognitive overload,and inexperience further interfere with effective decision-making.Cognitive science has provided insight into the clinical decision-making process that can be used to reduce error.This evidence-based review discusses ten common misconceptions regarding critical care decision-making.By understanding how practitioners make clinical decisions and examining how errors occur,strategies may be developed and implemented to decrease errors in Decision-making and improve patient outcomes.
文摘Artificial Intelligence(AI)is a type of intelligence that comes from machines or computer systems that mimics human cognitive function.Recently,AI has been utilized in medicine and helped clinicians make clinical decisions.In gastroenterology,AI has assisted colon polyp detection,optical biopsy,and diagnosis of Helicobacter pylori infection.AI also has a broad role in the clinical prediction and management of gastrointestinal bleeding.Machine learning can determine the clinical risk of upper and lower gastrointestinal bleeding.AI can assist the management of gastrointestinal bleeding by identifying high-risk patients who might need urgent endoscopic treatment or blood transfusion,determining bleeding stigmata during endoscopy,and predicting recurrence of gastrointestinal bleeding.The present review will discuss the role of AI in the clinical prediction and management of gastrointestinal bleeding,primarily on how it could assist gastroenterologists in their clinical decision-making compared to conventional methods.This review will also discuss challenges in implementing AI in routine practice.
文摘Nurses must be enlightened that clinical reasoning, clinical decision making, and clinical judgement are the key elements in providing safe patient care. It must be incorporated and applied all throughout the nursing process. The impact of patients’ positive outcomes relies on how nurses are effective in clinical reasoning and put into action once clinical decision making occurs. Thus, nurses with poor clinical reasoning skills frequently fail to see and notice patient worsening condition, and misguided decision making arises that leads to ineffective patient care and adding patients suffering. Clinical judgment on the other hand denotes on the outcome after the cycle of clinical reasoning. Within this context, nurses apply reflection about their actions from the clinical decision making they made. The process of applying knowledge, skills and expertise in the clinical field through clinical reasoning is the work of art in the nursing profession in promoting patient safety in the course of delivering routine nursing interventions. Nurses must be guided with their sound clinical reasoning to have an optimistic outcome and prevent iatrogenic harm to patients. Nurses must be equipped with knowledge, skills, attitude and values but most importantly prepared to face the bigger picture of responsibility to care for every patient in the clinical field.
基金financed by the Flinders University College of Business,Government and Law Large Project Grant[Grant Number:100031.21].
文摘Objective:A study was conducted about the putative links of older rural Australians'health knowledge and preparation with their quality of involvement in patient-general practitioner(GP)communication during health intake visits.Methods:It was a cross-sectional study between January 2021 and April 2022.The 32-item quality of involvement in communication scale was designed and incorporated into the SurveyGizmo software.This online survey was administered by sending an email request to the Renmark Rotary Club,which actively promoted this study across five rural towns in South Australia.121 participants completed the surveys.Mean-sum scores were calculated based on the questionnaire responses to evaluate outcomes,specifically initiation of information,active participation,and emotional expression.We employed different methods including t-tests,ANOVA,and leaner regressions to analyse data.Results:The demographic profile of participants characterised by a female predominance(58.7%,71/121),a majority falling within the 65-<70 age bracket(47.1%,57/121),and a high level of educational attainment(58.7%had completed high school or higher,71/121).Additionally,35%of the participants predominantly spoke a language other than English at home.Regarding the initiation of information with GPs,the mean sum-score was(20.5+3.7),indicating a marginally above-average level of engagement.Contrarily,the active participation was suboptimal,as suggested by a mean sum score of(35.9±6.3).Furthermore,the emotional expression was relatively low,with a mean score of(13.9±1.8).Substantial variations were discerned in the quality of patient-GP communication,contingent upon factors such as educational background,language spoken at home,health literacy,and preparatory measures for clinical visits.Participants who predominantly spoke a language other than English at home demonstrated significantly lower levels of information initiation with their GPs(P<0.o01).Higher educational attainment was positively correlated with increased active participation(P<0.001).Enhanced health literacy and thorough visit preparation were significantly associated with increased levels of active participation(P<0.001).Conclusion:Meaningful engagement through recognition,empowerment,and support(health literacy programs)for older rural adults is suggested for improving their quality of involvement in communication with GPs.
文摘This literature review primarily aims to explore and synthesise the previous studies in simulation education research conducted over the past five years related to the effects of simulation training on the self-efficacy of undergraduate pre-registration nursing students. The second aim of this study is to explore additional outcome variables that were examined in the previous studies. Five electronic databases were searched systematically. These databases were MEDLINE, CINAHL Plus, Scopus, Embase and PsycINFO. The PICO model was employed to identify the search terms, with a thesaurus being used to provide synonyms. Reference lists of relevant articles were examined and hand searches of journals were also undertaken. The quality of each study was assessed using the Simulation Research Rubric (SRR). A total of 11 studies were included. All studies explored the impact of simulation education on undergraduate pre-registration nursing. Six studies explored nursing students’ competence and performance and two papers examined their critical thinking. Problem solving, learning motivation, communication skills and knowledge acquisition were examined once. The majority of studies indicated that simulation training has a positive impact on pre-registration nursing students’ self-efficacy and other outcome variables. Furthermore, the study results indicate that simulation training is more dependable than traditional training, and students were extremely satisfied with the simulation training. However, most of the studies included in this review had several gaps, including study design, sample size and dissimilarities between the scales used. Further research with large samples, reliable and valid instruments, and outcomes measures (such as critical thinking and transferability of skills) is required to provide better insight into the effectiveness of simulation in undergraduate nursing education. .
文摘In 1948, the first clinical paper adopting the protocol of randomized and controlled design was published in British Medical Journal by Bradford Hill,a noted British biostatistician, who introduced rigorous theory of mathematical statistics into clinical design the first time and successfully evaluated the therapeutic effect of streptomycin on tuberculosis.
文摘Background： The reported mortality rate of mushroom-induced acute liver failure with conventionaltreatment is 1.4%–16.9%. Emergency liver transplantation may be indicated and can be the only curativetreatment option. This study aimed to assess the prognostic value of criteria for emergency livertransplantation in predicting 28-day mortality in patients with mushroom-induced acute liver injury.Methods： A retrospective cohort study was performed between January 2005 and December 2015. Alladult patients aged≥18 years admitted with mushroom intoxication at our emergency department wereevaluated. All patients with acute liver injury, defined as elevation of serum liver enzymes （〉5 timesthe upper limit of normal, ULN） or moderate coagulopathy （INR 〉 2.0） were included. The ability of the King’s College, Ganzert’s, and Escudié’s criteria to predict 28-day mortality was evaluated.
文摘In China,there are three basic clinical decision-making modes for patients,namely patients autonomous decision-making mode,family decision-making mode and patient and family codetermination.They were produced under the unique background of Chinese medicine,Confucian philosophy and law in China,l this paper,the concepts,advantages and disadvantages of these three decision-making modes were analyzed In addition,some suggestions were put forward for the improvement.The first is that we suggest to establis standards for choosing decision-making modes;the second is to further learn and publicize relevant laws;thirdly the legal system needs to be further refined;and the last one is to carry out ethical ward round.
文摘Computerized decision support(CDS) is the most advanced form of clinical decision support available and has evolved with innovative technologies to provide meaningful assistance to medical professionals. Critical care clinicians are in unique environments where vast amounts of data are collected on individual patients, and where expedient and accurate decisions are paramount to the delivery of quality healthcare. Many CDS tools are in use today among adult and pediatric intensive care units as diagnostic aides, safety alerts, computerized protocols, and automated recommendations for management. Some CDS use have significantly decreased adverse events and improved costs when carefully implemented and properly operated. CDS tools integrated into electronic health records are also valuable to researchers providing rapid identification of eligible patients, streamlining data-gathering and analysis, and providing cohorts for study of rare and chronic diseases through data-warehousing. Although the need for human judgment in the daily care of critically ill patients has limited the study and realization ofmeaningful improvements in overall patient outcomes, CDS tools continue to evolve and integrate into the daily workflow of clinicians, and will likely provide advancements over time. Through novel technologies, CDS tools have vast potential for progression and will significantly impact the field of critical care and clinical research in the future.
