BMJ open
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Multicenter Study
Medication double-checking procedures in clinical practice: a cross-sectional survey of oncology nurses' experiences.
Double-checking is widely recommended as an essential method to prevent medication errors. However, prior research has shown that the concept of double-checking is not clearly defined, and that little is known about actual practice in oncology, for example, what kind of checking procedures are applied. ⋯ Double-checking is well regarded by oncology nurses as a procedure to help prevent errors, with jointly checking being used most frequently. Our results show that the notion of independent checking needs to be transferred more actively into clinical practice. The high frequency of reported interruptions during and caused by double-checks is of concern.
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To explore final-year students' and clinical supervisors' experiences of alignment and misalignment with future Foundation Year 1 (F1) posts in an assistantship programme in the UK. ⋯ Our findings suggest that alignment with students' first F1 post enhances the assistantship experience. Further longitudinal assessment is required to examine whether and how this translates into improvements in functioning and reductions in stress and anxiety during this transitional period.
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Multicenter Study Pragmatic Clinical Trial
Early intervention of patients at risk for acute respiratory failure and prolonged mechanical ventilation with a checklist aimed at the prevention of organ failure: protocol for a pragmatic stepped-wedged cluster trial of PROOFCheck.
Acute respiratory failure (ARF) often presents and progresses outside of the intensive care unit. However, recognition and treatment of acute critical illness is often delayed with inconsistent adherence to evidence-based care known to decrease the duration of mechanical ventilation (MV) and complications of critical illness. The goal of this trial is to determine whether the implementation of an electronic medical record-based early alert for progressive respiratory failure coupled with a checklist to promote early compliance to best practice in respiratory failure can improve the outcomes of patients at risk for prolonged respiratory failure and death. ⋯ The study was approved by the institutional review boards. Results will be published in peer-reviewed journals and presented at international meetings.
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Observational Study
Healthcare use among preschool children attending GP-led urgent care centres: a descriptive, observational study.
Urgent care centres' (UCCs) hours were developed with the aim of reducing inappropriate emergency department (ED) attendances in England. We aimed to examine the presenting complaint and outcomes of care in 2 general practitioner (GP)-led UCCs with extended opening times. ⋯ Two-thirds of preschool children attending GP-led UCCs do so out of hours, despite the majority being registered with a GP. The case mix is comparable with those presenting to an ED setting, with the majority managed exclusively by the GPs in the UCC before discharge home. Further work is required to understand the benefits of a GP-led urgent system in influencing future use of services especially emergency care.
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Observational Study
Factors associated with prolonged length of stay following cardiac surgery in a major referral hospital in Oman: a retrospective observational study.
Two objectives were set for this study. The first was to identify factors influencing prolonged postoperative length of stay (LOS) following cardiac surgery. The second was to devise a predictive model for prolonged LOS in the cardiac intensive care unit (CICU) based on preoperative factors available at admission and to compare it against two existing cardiac stratification systems. ⋯ Patient management can be tailored for individual patient based on their treatments and personal attributes to optimise resource allocation. Moreover, a simple predictive score system to enable identification of patients at risk of prolonged CICU stay can be developed using data that are routinely collected by most hospitals.