Journal of evaluation in clinical practice
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The aim of this research is to determine the relationship between nurses' burnout status and their intention to leave the job during the COVID-19 pandemic. ⋯ This study determined that as nurses' burnout level increased, their intention to quit their jobs increased.
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Observational Study
Effect of a Contamination Prevention Activity Against Contamination of Blood Culture.
Blood culture is important in the diagnosis of blood infections and the identification of treatment strategies. Increased contamination in blood culture is a reduction in quality of care. This retrospective observational study, set in an emergency department in Japan, aims to elucidate the contamination rate before and after the introduction of contamination prevention activities. ⋯ Prevention activities including specific use of a blood culture cart and careful adherence to a checklist were not associated with a significant decrease in contamination rate in our hospital. Further studies based in hospitals with greater rates of contamination may see higher rates of reduction.
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Telehealth has been consistently viewed as a viable solution for addressing healthcare inaccessibility and mitigating the impact of health workforce shortages in rural areas. However, despite high utilisation in rural areas, little is known about the unintended consequences of telehealth in terms of unexpected benefits and drawbacks. ⋯ This study provides insights into the unintended consequences of telehealth. While telehealth has improved certain aspects of healthcare in rural areas such as the improved support for rural clinicians and the reduced disruption to patients' daily routines, it has also introduced unforeseen challenges such as the transfer of medicolegal burden to local clinicians in rural emergency care facilities to compensate for the absence of physical examinations. These findings feed into decision-making useful for informing and improving telehealth implementation in rural Australia to maximise unexpected benefits, minimise risks, and ensure the long-term viability of telehealth services.
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Antibiotic resistance (AR) is a growing concern as a result of the widespread and excessive use of antibiotics. Because of this, China's health authorities have implemented a number of antibiotic control measures, including a requirement that the intensity of antibiotic usage stay within 40.00 DDDs. This study, which used a tertiary general hospital in Sichuan Province as an example, examined the hospital's trend in antibiotic use from 2021 to 2023, the relationship between antibiotic use and hospitalization days and CMI, and the viability of 40.000 DDDs in light of the evolving medical landscape. ⋯ Hospitals should concentrate on the issue of surgical departments' lengthy preoperative prophylactic medication times. AUD management should also be dynamically modified based on CMI, particularly in departments in the second quadrant (low CMI and high AUD). Furthermore, it is challenging to maintain the hospital AUD target value of 40.00 DDDs under the new medical model, given the decline in hospitalization days of discharged patients and the high prevalence of infectious diseases. It is also unclear whether this target value is still appropriate given the current state of medicine.
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Zero-event counts are common in clinical studies, particularly when assessing rare adverse events. These occurrences can result from low event rates, short follow-up periods, and small sample sizes. When both intervention and control groups report zero events in a clinical trial, the study is referred to as a double-zero-event study, which presents methodological challenges for evidence synthesis. There has been ongoing debate about whether these studies should be excluded from evidence synthesis, as traditional two-stage meta-analysis methods may not estimate an effect size for them. Recent research suggests that these studies may still contain valuable clinical and statistical information. ⋯ We advocate for retaining double-zero-event studies in meta-analyses and emphasise the importance of carefully considering their role in FI assessments. Including these studies ensures a more accurate evaluation of the robustness of clinical results in evidence synthesis.