1,720,963 research outputs found
Management strategies of dysglycaemia in critically ill adult patients : a scoping review
Full text linkDissertation (MNurs)--University of Pretoria, 2023.Management strategies of dysglycaemia in critically ill adult patients: a scoping review.
Background: Dysglycaemia comprises of hypoglycaemia, hyperglycaemia and glycaemic variability. It is a biomarker of disease severity and my lead to increased mortality in critically ill patients. Dysglycaemia is common in critically ill patients and also presents in non-diabetic patients. However, blood glucose/dysglycaemia management strategies for critically patients remain ad hoc, which increases the risks for complications associated with dysglycaemia.
Objective: The objective of the study was to explore, identify and map the evidence available on management strategies of dysglycaemia in critically ill adult patients in the critical care unit, and to identify evidence gaps relating to the management of dysglycaemia in critically ill adult patients.
Design: A Scoping review was done according to the Joanna Briggs Institute (JBI) methodology.
Data source and search strategy: Medline and CINAHL databases were searched to identify articles that examine glucose control in the critical care unit (CCU). Articles that were published from 2001 until 2023 were evaluated and the search was limited to articles published in English. We used the following search terms: Glucose monitoring OR glucose control OR glycaemic control OR dysglycaemia NOT Diabetes mellitus OR Diabetes OR Diabetic AND Critically ill OR intensive care patients OR critical care patients. Only original articles were included while case reports as well as editorial letters, opinion papers, and surveys were excluded. The search strategy was compiled by the author and an experienced information specialist executed the search.
Eligibility criteria and study selection: Population - (i) patients 18 years or older, (ii) female and male patients, (iii) patients of any race and ethnicity, (iv) patients admitted to the critical care unit following a medical or surgical diagnosis, (v) studies from 2001 up to 2023. Concept – Sampling method of blood glucose, frequency monitored, target range of blood glucose guiding treatment (hypo or hyper), method of Insulin or Dextrose administration, evaluation. Context – Critical care units and high care units.
All publications were screened by the researcher and a supervisor. Results were discussed, and the screening and data extraction process was amended as necessary, before making final decisions. Titles, abstracts, and full texts of all the publications were screened by the researcher and supervisor independently to ascertain inclusions. Disagreements were settled without the need for a 3rd party involvement.
Once the results were available, it was exported into EndNote and Rayyan, an online systematic review software. Duplicates were removed by the researcher, and articles were reviewed for inclusion and exclusion. Additional relevant material was not deemed necessary, so no authors were contacted during this period. Lastly, reference lists were searched and screened for potential sources.
Data extraction: A data charting form was created in Excel and data extraction variables were drawn up as columns. This was done to ensure important details were not omitted and to ensure that the data captured were in line with the study’s objectives and inclusion criteria. The data charting form was continuously updated. With the aid of a data extraction tool created for this study, the data from the eligible studies were then charted. The form was used to capture all the relevant data and specific key characteristics regarding included variables of blood glucose control. Only one reviewer charted the results independently and these were reviewed by another reviewer. Disagreements were solved through discussion.
Results: The primary search strategy identified 2261 potentially relevant papers (see Figure 2). Duplicates were removed at this stage (in Rayyan), and a total of 1908 articles remained. Articles which had restricted access to full text was 160. A total of 1748 records remained at this stage. The titles and abstracts, as well as full-text articles were screened, of which 1732 were excluded. The selection at this stage included 16 studies. Two (2) additional studies were identified through a manual search of the reference lists of these studies. Uncertainty existed over the optimum treatment goal for glycaemia in the critically ill population. The largest prospective multicenter trial, which revealed an increase in mortality in patients receiving intense insulin therapy, could not duplicate the findings of randomized controlled trials from the early 2000s that showed a benefit of very tight glucose control. The present research largely focused on the clinical benefit and hypoglycaemia risk of intensive insulin therapy; however, there was no consensus on the ideal blood glucose control range, the patients who should receive it, when to initiate treatment, and how to minimize the risk.
Conclusion: There’s more to blood glucose measurement than meets the eye. It is much more comprehensive and is not as simple as sampling blood for testing, and a lot of factors need to be taken into consideration. There are many diverse and different views regarding target range of blood glucose, frequency of testing, and sampling of blood. Conclusions cannot simply be drawn from the articles as there were too many diverse views and results.Nursing ScienceMNursUnrestrictedFaculty of Health SciencesSDG-03:Good heatlh and well-bein
Stirring the Forensic Nursing Pot in South Africa
Full text linkThis is a brief summary of forensic nursing in South Africa and the development of a forensic nursing specialization
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Patient safety culture in critical care units in public hospitals of Tshwane region
Full text linkDissertation (MSc (Nursing))--University of Pretoria, 2023.The results of this study revealed the overall rating of the patient safety culture at the three selected hospitals as good. But a few aspects of the patient safety culture in these hospitals deserve attention to improve. Those aspects that need attention to improve are the staff shortages and long working hours. Another element that needs attention is that hospital management is not providing adequate resources to improve patient safety. Whereas the aspects related to communication and the supervisor who considered staff‘s suggestions to improve patient safety were rated the highest and required no attention to improvementUP Post graduate bursaryNursing ScienceMasters (Nursing)UnrestrictedFaculty of Health SciencesSDG-03:Good heatlh and well-bein
Co-creating a work-based interprofessional education programme for collaborative practice in maternity services in Botswana
Full text linkThesis (PhD (Nursing Science))--University of Pretoria, 2024.Background: Interprofessional collaboration is the foundation for improved patient and provider satisfaction, as well as increased organisational efficiency. Poor collaborative practices and communication failures have been identified as major contributors to preventable adverse events, organisational inefficiency, patient and provider dissatisfaction, and increased health care costs. The Joint Commission on Root Causes and Percentages for Sentinel Events reported poor communication and teamwork for 60% to 70% of adverse events and medical mishaps in health care systems between 2004 and 2015. Root cause analysis of maternal deaths yielded similar results in low- and middle-income countries. Poor communication and teamwork contribute to the lack of capacity and support to engage in interprofessional collaborative practice. Therefore, health care professionals should receive context-based work-based training in inter-professional collaborative care. Interprofessional collaborative care promotes patient-centred care and self- management, which improves healthcare outcomes. It also strengthens healthcare systems, resulting in better service delivery and health outcomes.
Aim: The aim of the study was to co-create a work-based interprofessional education programme to enhance collaborative patient care in the context of hospital-based maternal health services in Botswana.
The objectives were divided into three phases, which aligned to the Design-Based Research (DBR), used as a methodological framework:
Phase 1: Analysis of practical problems Phase 2: Development of solutions
Phase 3: Iterative cycles of testing and refinement
Methodology: The Design-Based Research (DBR) was used as a methodological framework.
Multimethod research designs were used to assist in the development of the training programme, which included a scoping review and a qualitative, the Criteria for Describing and Evaluating Training Interventions in Healthcare Professionals and a consensus design.
In Phase 1, a scoping review was conducted to explore the considerations for promoting the implementation of work-based interprofessional education programmes. A stakeholder analysis followed and then a workshop with seven stakeholders provided their perspectives on the development of an interprofessional collaborative programme for maternity care healthcare professionals. In addition, women’s and healthcare professionals' perceptions and experiences with interprofessional collaboration in a maternity care setting were explored. In Phase 2, the data collected in Phase 1 informed experts in research, clinical care and programme development to develop a work-based interprofessional education programme. In Phase 3, an online expert survey with qualitative (open-ended) and quantitative (Likert scale) questions was conducted to validate the co-created work-based interprofessional education programme.
Findings: In Phase 1, data from the scoping review revealed limited articles (n=28) explicitly addressing interprofessional collaboration in maternity settings. Although some educational institutions offered interprofessional collaboration training as part of undergraduate curricula, including maternity care, qualified professionals were rarely given this training. Four themes emerged as issues to consider when developing and implementing interprofessional collaboration intervention: resource mobilisation, conducive learning environment, healthcare professional valuation, and barriers to interprofessional collaboration/education implementation.
The findings of the stakeholder analysis and engagement revealed that the following key stakeholders should participate at various stages of the study, beginning with the design phase and ending with the evaluation of the implemented training programme: (1) Health care providers and beneficiaries; (2) Curriculum development and training specialists; (3) Interprofessional Collaboration and Education networks and champions; (4) Quality/assurance (Validation and Evaluation) groups, and (5) Strategist/policy developer/advocacy groups.
Evidence from the workshop with stakeholders confirmed the lack of interprofessional collaboration in maternity settings and provided insight into the needs, implementation concerns, and competency gaps associated with interprofessional collaboration in the maternity care setting, as well as how the training programme should be structured to address interprofessional competency gaps. The stakeholders suggested that we name the programme ‘MabogoDinku a Thebana’, which loosely translates as 'together we can'. The programme was consequently renamed Mabogo-Dinku work-based interprofessional education programme for collaborative care in maternity care setting.
In-depth interviews with women (n=13) and healthcare professionals (n=27) revealed that they perceived poor communication, disrespectful behaviour, ineffective teamwork practices, a lack of understanding of each other's roles and responsibilities, ineffective resource coordination, hierarchical power struggles, and weak collaborative leadership as interrelated factors that influenced the delivery of interprofessional collaborative care.
Based on the findings from Phase 1, a five to seven-week self-paced online work-based interprofessional education programme was co-created.
In phase 3, six IPC experts/champions and e-learning specialists were recruited and provided content validation for the developed programme via a Google survey. The expert validation survey results revealed that the training programme had good content validity, with a mean of 0.88 for section B of the validation tool and 0.94 for section C.
Conclusion: This study describes the co-creation of the Mabogo-Dinku work-based interprofessional education programme, which is intended to improve and support interprofessional collaboration in maternity care settings in low- and middle-income countries. The training programme could support healthcare systems in reducing clinical errors, overcoming hospital-based maternal mortalities and morbidities, reducing healthcare costs and consequently improve quality of care and may be used to guide educators in integrating IPE into their curriculum to close education-practice gaps.Botswana Open UniversityNursing SciencePhD (Nursing Science)UnrestrictedFaculty of Health Science
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Professional quality of life among nurses nurses working in intensive care unit in the selected public hospitals
No full textDissertation (MCur (Clinical))--University Pretoria 2021.Professional quality of life is a quality one feels concerning their work as a helper. Helpers are not only found in nursing but all the professions globally. They may respond to individual, community, national and even to an international crisis. Professional quality of life comprises two aspects, the positive (compassion satisfaction) and the negative (burnout and secondary traumatic stress). The overall concept of professional quality of life is complex because it is associated with characteristics of the work environment (organisational and task wise), the client’s environment (exposure to primary and secondary trauma) and theperson’s environment. If there is an imbalance in the associate characteristics of professional quality of life, the nurses will therefore be deprived of the professional quality of life.
Aim
The overall aim of the study was to determine the professional quality of life amongst intensive care nurses working in the three selected public hospitals in the Tshwane region of the Gauteng Province.
Method
A quantitative,cross-sectional,and observational designis utilised in the study to investigate compassion satisfaction, burnout, and secondary traumatic stress amongst intensive care unit (ICU) nurses working in public hospitals.Probability sampling was employed, whereby participants were randomly selected. The professional quality of life survey will be given to ICU nurses willing to participate in the survey. The data was statistically analysed.
Expected Outcome
The results of this study yielded the level of description of compassion satisfaction, burnout and secondary traumatic stress as indicated by ICU nurses.
Key Concepts
Professional quality of life, compassion satisfaction, burnout, secondary traumatic stress, nurse, intensive care unit (ICU), intensive care unit (ICU) nurses.HWSETANursing ScienceMCur (Clinical)Unrestricte
Exploring Challenges to Teamwork and Strategies to Enhance Teamwork in the Emergency Department of a Private Hospital in Gauteng
Full text linkThesis (MSc (Nursing Science))--University of Pretoria, 2022.Introduction
Effective teamwork in the fast-paced environment of the emergency department is essential to patient safety and staff satisfaction. Patient safety, quality of care and staff satisfaction are directly proportional to the level of teamwork in the emergency department. A shared philosophy and collaboration between healthcare professionals play a vital part in effective teamwork. Maintaining a positive therapeutic relationship is key to ensuring a well-functioning team. Lack of teamwork in the emergency department has damaging effects on patient care and safety, as well as staff satisfaction. The conflict between healthcare professionals is disruptive to the therapeutic environment and teamwork.
Aim and Objectives of the Study
The study aimed was to explore and describe teamwork challenges between healthcare professionals working in the emergency department (ED) of a private hospital by employing the principles of a semi-structured individual interview process. The objectives were to explore and describe the current teamwork challenges in the chosen setting between doctors and nurses and find strategies to overcome challenges.
Research Design and Methods
This study followed a qualitative, descriptive and explorative design to understand and describe the phenomenon of teamwork between healthcare professionals in the selected emergency department. Specifically, the reflective views of the team members regarding the teamwork between doctors and nurses. Set in a private hospital in Gauteng, a sample of five nurses and five doctors from the population of healthcare professionals working in the selected ED, selected by purposive sampling, participated in this study. Data was collected by employing virtual individual interviews, using a semi-structured questions guide, based on an appreciative inquiry perspective. A deductive data analysis process was used to generate themes with categories and sub-categories.
Findings
The study identified three main themes relevant to the perceptions of teamwork challenges in the specified setting:
Theme 1: Poor team satisfaction.
Theme 2: Lacking team unity.
Theme 3: Ineffective leadership.
Based on these themes, several strategies were suggested by the participants to improve the teamwork in the ED. This demonstrates that healthcare professionals possess the necessary knowledge to identify teamwork challenges within their team and understand attainable strategies to enhance effective teamwork.Nursing ScienceMNurUnrestricte
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