bluuebunny/crossref_metadata_2025_split huggingface dataset:
The relevance, feasibility and benchmarking of nursing quality indicators: A Delphi study
Authors: Koch Daniel , Kutz Alexander , Conca Antoinette , Wenke Juliane , Schuetz Philipp , Mueller Beat 
Published: October 2020

AbstractAimsTo identify indicators of nursing care performance by identifying structures, processes, and outcomes that are relevant, feasible and have the potential for benchmarking in Swiss acute hospitals.DesignA modified Delphi‐Consensus Technique.MethodsWe examined 19 indicators based on the current evidence and that were pre‐selected by nursing scientists. Between August–October 2019, a consortium of experts (representatives of different cantons, hospitals, and healthcare roles in Switzerland) determined the relevance, feasibility, and suitability for benchmarking these indicators in two‐round modus of digital survey. Consensus was defined a priori by at least 75% agreement on the highest level of a 3‐point Likert‐type scale.ResultsThe response rate was 70.4% in the first and 68.4% in the second round. In round one consensus was reached for three indicators on relevance but for none of the indicators regarding feasibility or potential for benchmarking. For round two, the experts suggested two additional indicators (new total of 21 indicators). Of 21 indicators, consensus was reached on twelve regarding relevance, seven regarding feasibility, and two regarding the potential for benchmarking.ConclusionA national expert consortium defined 12 of 21 nursing care indicators as relevant. Feasibility, however, was estimated only among seven indicators and a consensus on suitability for benchmarking was reached for two nursing‐sensitive indicators.ImpactThe results show how the indicators to evaluate nursing care performance, which have been identified as priority by Canadian nursing scientists, are assessed in a different setting. There are many overlaps, but also some differences in the assessment of the indicators between the different settings. Different health systems prioritize the indicators to evaluate nursing care performance differently, which is why national surveys are important for the compilation of their own (priority) indicator sets.
Peripheral intravenous catheter non‐infectious complications in adults: A systematic review and meta‐analysis
Authors: Marsh Nicole , Webster Joan , Ullman Amanda J. , Mihala Gabor , Cooke Marie , Chopra Vineet , Rickard Claire M. 
Published: October 2020

AbstractAimsThe aim of this systematic review and meta‐analysis was to summarize and quantify peripheral intravenous catheter‐related complications.DesignThis systematic review is reported by means of the Cochrane process for randomized controlled trials and the Meta‐analysis of Observation Studies in Epidemiology for cohort studies.Data sourcesThe Cochrane Central Register of Controlled Trials, PubMed, CINAHL and EMBASE databases, clinical trial registries such as ClinicalTrials.gov and the reference list of included studies were searched from 2000 ‐April 2019.Review MethodsUsing a purpose designed data extraction tool, two authors independently identified studies for full review, data extraction and quality assessment. Dichotomous outcomes were pooled after Freeman–Tukey double arcsine transformation using random‐effects meta‐analysis; estimates of heterogeneity were taken from inverse‐variance fixed‐effect models.ResultsSeventy observational studies and 33 randomized controlled trials were included (76,977 catheters). Peripheral intravenous catheter‐related complications were as follows: phlebitis (with definition) 19.3%, phlebitis (without definition) 4.5%, infiltration/extravasation 13.7%, occlusion 8%, leakage 7.3%, pain 6.4% and dislodgement 6.0%. Subgroup analysis found infiltration/extravasation for emergency department‐inserted catheters was significantly higher (25.2%; p = .022) than for those inserted in other departments and pain was significantly higher (p < .001) in countries with developing economies compared with developed economies.ConclusionPeripheral intravenous catheter complications are unacceptably common worldwide. This review suggests substantial and multi‐specialty efforts are needed to address the sequalae associated with complications. The potential benefits for patients and health services are considerable if complications are reduced.ImpactPeripheral intravenous complications interrupt important treatment which can be distressing for patients and result in longer hospital stays with increased healthcare costs. This review found phlebitis and infiltration are the most prevalent reason for catheter failure. These results provide nurses with a strong evidence base for the development of effective interventions for practice which are vital for preventing poor outcomes for patients with peripheral intravenous catheters.
Effect of a compassion fatigue resiliency program on nurses’ professional quality of life, perceived stress, resilience: A randomized controlled trial
Authors: Pehlivan Tuğba , Güner Perihan 
Published: October 2020

AbstractAimsThis study aimed to conduct a short‐ and long‐term Compassion Fatigue Resiliency Program and compare its impact on nurses’ professional quality of life, perceived stress, and resilience.DesignThe research was conducted between January 2017 January 2019 as a randomized controlled trial.MethodsThe sample comprised 125 oncology–haematology nurses randomly assigned to a Experimental I, Experimental II, or control group. The Compassion Fatigue Resiliency Program was conducted with the nurses as an intervention. Experimental I received a short‐term program (5 hr per day for 2 days, 10 hr in total) while Experimental II received a long‐term one (5 weeks, 2 hr per week, 10 hr in total). Measurements were obtained during pre‐ and post‐test and at 3‐, 6‐, and 12‐month follow‐ups. Research hypotheses were analysed using multilevel models.ResultsThe results of multilevel model analyses showed there was no statistically significant difference between mean scores for compassion fatigue, burnout, perceived stress, and resilience of nurses in the short‐ or long‐term groups or of those in the control group. Mean compassion satisfaction scores of nurses in the short‐ or long‐term groups were significantly higher than those in the control group. Mean compassion satisfaction scores of nurses in the short‐ or long‐term groups were significantly higher than the control group's pre‐test mean after 6 and 12 months.ConclusionThis study concluded that short‐ or long‐term programs had no influence on compassion fatigue, burnout, perceived stress, and resilience; however, both programs positively affected compassion satisfaction. We recommend that further studies be conducted, which will help determine the effectiveness of new programs.ImpactCaring for patients with cancer can generate work‐related stress that can negatively affect oncology nurses’ physical and emotional health, which could lead to compassion fatigue. The program provided nurses with an opportunity to improve their compassion satisfaction. Because there was no difference between both programs regarding mean compassion satisfaction scores, a short‐term program may be preferred to encourage more participation among nurses. We also recommend further studies should be conducted that include environmental improvements along with the training programs.Trial registered at ClinicalTrials.gov (The name of the trial register: Effect of a Compassion Fatigue Resiliency Program; the clinical trial registration number: NCT04372303).
Effects of upright positions during the second stage of labour for women without epidural analgesia: A meta‐analysis
Authors: Zang Yu , Lu Hong , Zhang Huixin , Huang Jing , Ren Lihua , Li Chunying 
Published: October 2020

AbstractAimsTo assess the effects of upright positions on maternal outcomes for women without epidural analgesia in comparison with recumbent positions during the second stage of labour.BackgroundUpright positions have many physiological advantages. The underlying benefits and risks of upright positions during the second stage of labour have been reported in many studies but the results are divergent.DesignA meta‐analysis of randomized controlled trials.Data sourcesThe Cochrane Library, PubMed, Embase, CINAHL and ProQuest databases were systematically searched from inception to 17 June 2019.Review methodsWe conducted the quality appraisal using the Cochrane Collaboration's tool and performed meta‐analyses using the Review Manager 5.3 software. The primary outcomes were instrumental vaginal delivery and the duration of the second stage of labour.ResultsOverall, 12 studies including 4,314 women were included. Upright positions significantly decreased the rate of instrumental vaginal delivery (risk ratio [RR] = 0.74, 95% CI 0.59–0.93), shortened the active pushing phase (mean difference [MD] = −8.16 min, 95% CI −16.29 to −0.02), decreased the rate of severe perineal trauma (RR = 0.35, 95% CI 0.14–0.87) and episiotomy (RR = 0.52, 95% CI 0.29–0.92), but significantly increased the rate of second‐degree perineal trauma (RR = 1.45, 95% CI 1.10–1.90). However, there was no significant difference in the duration of the second stage of labour or postpartum haemorrhage.ConclusionsUpright positions are beneficial for improving maternal outcomes. Several results should be considered with caution. Researchers need to clarify the definition of upright positions and conduct large, robust studies in the future to provide stronger evidence.ImpactThis meta‐analysis explores a crucial issue in intrapartum care and clarifies the benefits and possible risks of upright positions in the second stage of labour. Midwives and obstetricians are encouraged to apply upright positions depending on women's preferences and labour progress but should take measures to prevent perineal trauma.
Ethical leadership and decision authority effects on nurses’ engagement, exhaustion, and turnover intention
Authors: McKenna Jayne , Jeske Debora 
Published: October 2020

AbstractAimThe aim of the present study was to investigate emotional exhaustion, work engagement, and turnover intention in the nursing profession by exploring the antecedent effects of ethical leadership and job components such as decision authority.BackgroundEmotional exhaustion, low work engagement, and high turnover intention are prevalent issues in the nursing profession. The experience of feeling overworked has led to feelings of burnout and low morale among nurses in Ireland, which has prompted the authors to identify potential variables that reduce these outcomes—in this case, ethical leadership and decision authority.DesignA descriptive, cross‐sectional survey design was used across three hospital sites.MethodsA cross‐sectional sample of 89 nurses was recruited from three Irish hospitals to capture the experience of nurses between December 2017 ‐ February 2018. Hypotheses were tested using path model analysis.ResultsEthical leadership positively predicted decision authority among nurses. Ethical leadership also had an indirect effect on all three outcome variables (work engagement, exhaustion, and turnover intention). Further effects were noted in relation to the mediators in relation to the three outcome variables. Decision authority had a positive effect on work engagement and related to lower turnover intention.ConclusionsThe present study demonstrated the role of ethical leadership as a mechanism to positively affect job control and work experience outcomes for nurses at work. Ethical leadership style in hospitals and providing nurses with the authority to make decisions can improve their work experience and help to engage, support, and retain nurses.ImpactThe study found support for the positive role of ethical leadership in relation to decision authority and as a positive predictor of work engagement, negative predictor of emotional exhaustion, and turnover intention among nurses.
Does Social Trust Justify the Public Justification Principle?
Authors: Tahzib Collis 
Published: October 2020

AbstractAccording to public reason liberalism, the state must abide by a principle of public justification. This principle holds that the laws and institutions of society must be in some sense justifiable to, or acceptable to, all reasonable citizens. But why accept the public justification principle? Recently, Kevin Vallier has developed an interesting and empirically informed argument from social trust to public justification. Sustaining a system of social trust within diverse and large‐scale societies, argues Vallier, requires adherence to the public justification principle. After summarizing Vallier’s argument (Section 1), I argue that Vallier’s defence of public justification does not succeed because there are alternative conceptions of democratic discourse and decision‐making that lack a public justification principle yet that could still sustain social trust (Section 2). I then defend this argument against two objections: that alternatives to public justification would produce less social trust (Section 3) and that such alternatives would not produce social trust in the right way (Section 4).
Clinical, electrocardiographic and electrophysiological characteristics, and catheter ablation results of left upper septal premature ventricular complexes
Authors: Kose Sedat , Vurgun Veysel K. , Gokoglan Yalcin , Balli Mehmet , Kabul Hasan K. 
Published: October 2020

AbstractBackgroundTo investigate the clinical, electrocardiographic and electrophysiological characteristics, and results of catheter ablation of left upper septal (LUS) premature ventricular complexes (PVCs) arising from the proximal left fascicular system.MethodsThirty‐one patients who had undergone radiofrequency catheter ablation (RFCA) for idiopathic PVCs were enrolled in the study. All PVCs presented with narrow QRS complexes (<110 ms) with precordial QRS morphology of incomplete right bundle branch block type or identical to the sinus rhythm (SR) QRS morphology. RFCA was applied to the LUS area where the earliest fascicular potential (FP) was recorded during mapping.ResultsThe mean QRS duration during SR and PVCs were 92.3 ± 7.9 and 103.2 ± 7.3 ms, respectively. The mean fascicular potential‐ventricular interval during PVC at the target site was 32.7 ± 2.7 ms. The mean His‐ventricular (H‐V) interval during SR and PVCs were 45.1 ± 2.7 and 21.3 ± 3.6 ms, respectively. Left anterior hemiblock/left posterior hemiblock and left bundle branch block (LBBB) were observed in 16 (53.3%) and 4 (12.9%) patients after RFCA, respectively. The His to FP interval in SR and H‐V interval during PVC were found as significant markers for predicting the postablation LBBB. RFCA was acutely successful in 29 of 31 patients (93.5%) in the first procedure. Two patients had a recurrence of PVCs during follow‐up and one of them underwent a second successful ablation. The overall success rate was 90.3% (28/31) in a mean follow‐up duration of 24.3 ± 15.4 months.ConclusionsLUS‐PVCs have distinctive electrocardiographic and electrophysiologic characteristics and can be managed successfully by focal RFCA with detailed FP mapping of the left upper septum with a mild risk of left bundle branch injury.
Topographical anatomy of the right atrial appendage vestibule and its isthmuses
Authors: Hołda Jakub , Słodowska Katarzyna , Tyrak Kamil , Bolechała Filip , Jasińska Katarzyna A. , Koziej Mateusz , Hołda Mateusz K. , Walocha Jerzy A. 
Published: October 2020

AbstractIntroductionThe right atrial appendage (RAA) vestibule is an area located in the right atrium between the RAA orifice and the right atrioventricular valve annulus and may be a target for invasive transcatheter procedures.Methods and ResultsWe examined 200 autopsied human hearts. Three isthmuses (an inferior, a middle, and a superior isthmus) were detected. The average length of the vestibule was 67.4 ± 10.1 mm. Crevices and diverticula were observed within the vestibule in 15.3% of specimens. The isthmuses had varying heights: superior: 14.0 ± 3.4 mm, middle: 11.2 ± 3.1 mm, and inferior: 10.1 ± 2.7 mm (p < .001). The superior isthmus had the thickest atrial wall (at midlevel: 16.7 ± 5.6 mm), the middle isthmus had the second thickest wall (13.5 ± 4.2 mm), and the inferior isthmus had the thinnest wall (9.3 ± 3.0 mm; p < .001). This same pattern was observed when analyzing the thickness of the adipose layer (superior isthmus had a thickness of 15.4 ± 5.6 mm, middle: 11.7 ± 4.1 mm and inferior: 7.1 ± 3.1 mm; p < .001). The average myocardial thickness did not vary between isthmuses (superior isthmus: 1.3 ± 0.5 mm, middle isthmus: 1.8 ± 0.8 mm, inferior isthmus: 1.6 ± 0.5 mm; p > .05). Within each isthmus, there were variations in the thickness of the entire atrial wall and of the adipose layer. These were thickest near the valve annulus and thinnest near the RAA orifice (p < .001). The thickness of the myocardial layer followed an inverse trend (p < .001).ConclusionsThis study was the first to describe the detailed topographical anatomy of the RAA vestibule and that of its adjoining isthmuses. The substantial variability in the structure and dimensions of the RAA isthmuses may play a role in planning interventions within this anatomic region.
Changes in the expression and function of the PDE5 pathway in the obstructed urinary bladder
Authors: He Weixiang , Xiang Han , Liu Daoquan , Liu Jianmin , Li Mingzhou , Wang Qian , Qian Qiaofeng , Li Yan , Fu Xun , Chen Ping , Guo Yuming , Zeng Guang , Wu Zhonghua , Zhan Daxing , Wang Xinghuan , DiSanto Michael E. , Zhang Xinhua 
Published: October 2020

AbstractOur study aims to explore changes in bladder contractility and the phosphodiesterase type 5 (PDE5) signalling pathway in response to partial bladder outlet obstruction (PBOO). A surgically induced male rat PBOO model and human obstructed bladder tissues were used. Histological changes were examined by H&E and Masson's trichrome staining. Bladder strip contractility was measured via organ bath. The expressions of nitric oxide synthase (NOS) isoforms, PDE5, muscarinic cholinergic receptor (CHRM) isoforms and PDE4 isoforms in bladder were detected by RT‐PCR and Western blotting. The immunolocalization of the PDE5 protein and its functional activity were also determined. PBOO bladder tissue exhibited significant SM hypertrophy and elevated responsiveness to KCl depolarization and the muscarinic receptor agonist carbachol. NOS isoforms, PDE5, CHRM2, CHRM3 and PDE4A were up‐regulated in obstructed bladder tissue, whereas no change in PDE4B and PDE4D isoform expression was observed. With regard to PDE5, it was expressed in the SM bundles of bladder. Interestingly, obstructed bladder exhibited less relaxation responsiveness to sodium nitroprusside (SNP), but an exaggerated PDE5 inhibition effect. The up‐regulation of PDE5 could contribute to the lack of effect on Qmax for benign prostatic hyperplasia/lower urinary tract symptom (BPH/LUTS) patients treated with PDE5 inhibitors. Moreover, PDE5 (with presence of NO) and PDE4 may serve as new therapeutic targets for bladder diseases such as BPH‐induced LUTS and overactive bladder (OAB).
Are cystic fibrosis mutation carriers a potentially highly vulnerable group to COVID‐19?
Authors: Sarantis Panagiotis , Koustas Evangelos , Papavassiliou Athanasios G. , Karamouzis Michalis V. 
Published: October 2020

AbstractUndoubtedly, the new SARS‐CoV‐2 virus poses a grave health threat, plaguing the health and socio‐economic sectors. COVID‐19 disease must be treated quickly and effectively as soon as possible. The main axes in this direction are establishing vaccines, drugs, diagnostic tests, as well as identifying the most vulnerable groups. Probably, there is a correlation between COVID‐19 and cystic fibrosis. Our interest is focused on cystic fibrosis carriers that, due to limited tests, remain undetectable. There is an activation of the inflammatory response in the carriers, as well as in cystic fibrosis patients. First of all, a striking similarity lies between the inflammatory response in COVID‐19 and cystic fibrosis carriers. Notably, ACE‐2 plays the same role in both cases and a similar geographical distribution is observed in both diseases. In conclusion, we suggest that cystic fibrosis mutation carriers are potential members of a certain vulnerable group and the detection of such mutations in the population might be vital for the prevention of SARS‐CoV‐2 virus, and more specifically to limit its serious complications.
Evaluating the appropriateness of clinical decision support alerts: A case study
Authors: Olakotan Olufisayo O. , Yusof Maryati M. 
Published: October 2020

AbstractRationale, aims, and objectivesClinical decision support (CDS) generates excessive alerts that disrupt the workflow of clinicians. Therefore, inefficient clinical processes that contribute to the misfit between CDS alert and workflow must be evaluated. This study evaluates the appropriateness of CDS alerts in supporting clinical workflow from a socio‐technical perspective.MethodA qualitative case study evaluation was conducted at a 620‐bed public teaching hospital in Malaysia using interview, observation, and document analysis to investigate the features and functions of alert appropriateness and workflow‐related issues in cardiological and dermatological settings. The current state map for medication prescribing process was also modelled to identify problems pertinent to CDS alert appropriateness.ResultsThe main findings showed that CDS was not well designed to fit into a clinician's workflow due to influencing factors such as technology (usability, alert content, and alert timing), human (training, perception, knowledge, and skills), organizational (rules and regulations, privacy, and security), and processes (documenting patient information, overriding default option, waste, and delay) impeding the use of CDS with its alert function. We illustrated how alert affect workflow in clinical processes using a Lean tool known as value stream mapping. This study also proposes how CDS alerts should be integrated into clinical workflows to optimize their potential to enhance patient safety.ConclusionThe design and implementation of CDS alerts should be aligned with and incorporate socio‐technical factors. Process improvement methods such as Lean can be used to enhance the appropriateness of CDS alerts by identifying inefficient clinical processes that impede the fit of these alerts into clinical workflow.