Journal of evaluation in clinical practice
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To meet concerns about ethical and unethical behavior in their work environments and workplaces, organizations began establishing ethics programs that contain ethics committees (ECs). There is now a tradition and diverse use of ECs for ethical decision-making in many different organizational settings. In addition, ECs have been subject to many publications in books and articles in the scientific literature. Yet, until now no comparative analysis has been published that brings together ECs' practices in different sectors. ⋯ Based on the exploratory analysis in this study, we conclude that there are the following three distinct main requirements for the functionality of ECs: (1) a dialog between EC members and other stakeholders, (2) an approach that considers various possible modes (reactive, screening, moderating, and preventive) to enhance the quality of ECs' decision-making processes and (3) an outreach to all relevant EC stakeholders for the further validation of the main requirements found for ECs functionality.
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Schizophrenia is a complex mental health disorder that not only affects the individual diagnosed but also has profound implications for their families and caregivers. This paper aims to shed light on the emotional, social and practical challenges faced by caregivers, as well as the coping mechanisms they employ to navigate the complexities of caregiving. ⋯ Caregivers often experience a wide range of emotions, from love and empathy to frustration and helplessness, as they navigate the challenges of supporting their loved ones with schizophrenia. Additionally, caregivers may face stigma, social isolation and financial strain, further complicating their caregiving journey.
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The threat of the H5N1-influenza virus prompts reflection on COVID-19 pandemic experiences. This paper integrates insights from a first responder using the Cynefin framework to advocate for an adaptive strategic approach to future pandemics. Balancing individual freedoms with containment measures serves to leverage the human capital needed for rapid learning and resource distribution. ⋯ Both operate within scale free human systems which must adapt to existential challenges such as pandemics. Experience leading to knowledge and understanding occurs simultaneously at all dimensions of human existence. Ultimately, adaptive leadership and decentralized decision-making, supported by the best available knowledge, enable effective pandemic management and restoration of normal societal functions.
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Observational Study
The Effect of Lean Hospital Practices on Nurses' Direct Care Activities: Time and Motion Study.
This study investigates the effects of lean management practices on nurses' direct patient care activities and the interruptions they encounter in healthcare settings. The literature indicates that lean management enhances efficiency and improves patient care. Increased nursing time per patient correlates with better outcomes; however, rising patient loads and frequent interruptions hinder nurses' ability to deliver effective care, jeopardising patient safety. Addressing these inefficiencies is essential, given nurses' critical role in ensuring quality care. ⋯ Lean management effectively reduces waste and improves direct patient care time, enhancing patient safety and care quality. Continuous improvement initiatives in nursing practices are essential for success.
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Throughout the twentieth century and beyond, a global trend of declining mortality rates and an increase in life expectancies was noted until the onset of the coronavirus disease 2019 (COVID-19) pandemic. A reduction in life expectancies was observed in most countries, including South Asia, during 2020 and 2021 due to the excess mortality caused by the pandemic. ⋯ These findings highlight the pandemic's profound impact on mortality dynamics, emphasising the need for targeted interventions to mitigate its long-term effects on population health and longevity.