METHODS: This was an observational, cross-sectional survey using a convenience sampling method conducted at the University Malaya Medical Centre (UMMC) In-Patient Pharmacy. A validated online questionnaire assessed user satisfaction and task duration.
RESULTS: A total of 21 pharmacists and 18 pharmacy assistants participated in the survey. Most pharmacists (n = 17/21) were confident in the system, and both pharmacists and pharmacy assistants perceived it to be beneficial for patients (n = 33/39) and for reducing medication errors (n = 32/39). Pharmacy assistants spent approximately 5.34 hours on traditional work including filling medication orders (1.44 hours) after automated tablet dispensing and packaging system (ATDPS) implementation. Pharmacists spent 1.19 hours filling medication orders and 1.71 hours checking/verifying them, in contrast.
CONCLUSION: Pharmacists focused mainly on clinical duties with healthcare colleagues, while pharmacy assistants handled various medication orders. Nevertheless, ATDPS reduced pharmacy staff workload in medication handling, achieving user satisfaction.
METHODS: The study involves conducting a global survey to fitness coaches, sports scientists, analysts, and physicians with experience in load monitoring within football. The research adheres to the principles of the Helsinki Declaration and complies with General Data Protection Regulation standards, with ethical approvals obtained from multiple Ethics Committees across various countries, including Tunisia. A consortium of professionals collaboratively crafted the survey instrument, dividing it into seven sections, each addressing specific aspects of workload monitoring in football. Survey reliability will undergo evaluation in a pilot study utilizing Cronbach's alpha and intraclass correlation coefficient. To ensure inclusivity, the survey will be translated into multiple languages, facilitating participation from diverse regions. As such, survey distribution will consider online platforms (such as social media) and email invitations, with a specific focus on engaging football clubs, federations, and professional networks. The targeted sample size will remain at 385 participants. Statistical analysis planning encompasses descriptive examination, exploration of variable relationships, hypothesis testing, and qualitative analyses of participant feedback and recommendations regarding load monitoring practices.
EXPECTED RESULTS: Expected outcomes include i) A comprehensive global overview of training and match load monitoring practices in football, ii) The identification of emerging trends, an improved understanding of training optimization processes, and iii) The development of practical recommendations to enhance player well-being and performance.
CONCLUSION: This study will contribute to the ongoing development of knowledge in the field of football workload monitoring.
METHODS: A scoping review was carried out using the Arksey and O'Malley methodological framework. The search strategy was developed iteratively, with three main aspects: general practice/primary care contexts, risk assessment/decision support tools, and workload-related factors. Three databases were searched in 2019, and updated in 2021, covering articles published since 2009: Medline (Ovid), HMIC (Ovid) and Web of Science (TR). Double screening was completed by two reviewers, and data extracted from included articles were analysed.
RESULTS: The search resulted in 5,594 references, leading to 95 full articles, referring to 87 studies, after screening. Of these, 36 studies were based in the USA, 21 in the UK and 11 in Australia. A further 18 originated from Canada or Europe, with the remaining studies conducted in New Zealand, South Africa and Malaysia. Studies examined the use of eCDS tools and reported some findings related to their impact on workload, including on consultation duration. Most studies were qualitative and exploratory in nature, reporting health professionals' subjective perceptions of consultation duration as opposed to objectively-measured time spent using tools or consultation durations. Other workload-related findings included impacts on cognitive workload, "workflow" and dialogue with patients, and clinicians' experience of "alert fatigue".
CONCLUSIONS: The published literature on the impact of eCDS tools in general practice showed that limited efforts have focused on investigating the impact of such tools on workload and workflow. To gain an understanding of this area, further research, including quantitative measurement of consultation durations, would be useful to inform the future design and implementation of eCDS tools.
BACKGROUND: Given the high incidence of coronavirus and shortage of nurses in Iranian hospitals, learning about nurses' intention to care for patients with COVID-19 is important.
DESIGN: In this cross-sectional study, 648 Iranian nurses were surveyed during March 2020. The online questionnaire consisted of two parts. The mediating role was explored for the following: job satisfaction and commitment in the association of workload, quality of supervisor, extra-role behaviours, and pay satisfaction with the intention to care. The study adhered to STROBE checklist for cross-sectional studies.
RESULTS: The results of this study show that job satisfaction and organisational commitment mediated the relationship of nurses' workload, quality of supervisor, extra-role behaviours, and pay satisfaction with the intention to care for patients with COVID-19.
CONCLUSION: The results of the study indicate the importance of job satisfaction and organisational commitment as mechanisms that help to understand the association of nurses' workload, quality of supervisor, extra-role behaviours and pay satisfaction with the intention to care during the COVID-19 pandemic.
RELEVANCE TO CLINICAL PRACTICE: Hospital managers need to attend to the role of nurses' job satisfaction and other organisational factors to ensure that they can cope with the challenges of the COVID-19 pandemic.
Materials and Methods: We retrospectively collected data comparing patient numbers pre-COVID-19, and prospectively during the early COVID-19 pandemic. We have collected the numbers and nature of outpatient orthopaedic attendances to fracture clinics and elective services, inpatient admissions and the number of fracture neck of femur operations performed.
Results: The number of outpatient attendances for a musculoskeletal complaint to Accident and Emergency and the number of virtual fracture clinic reviews reduced by almost 50% during COVID-19. The number of face-to-face fracture clinic follow-ups decreased by around 67%, with a five-fold increase in telephone consultations. Inpatient admissions decreased by 33%, but the average number of fracture neck of femur operations performed has increased by 20% during COVID-19 compared to pre-COVID-19 levels.
Conclusion: We have noted a decrease in some aspects of the trauma and orthopaedic outpatient workload, such as leisure and occupational-related injuries but an increase in others, such as fracture neck of femurs. Many injuries have significantly reduced in numbers and we consider that a model could be developed for treating these injuries away from the acute hospital site entirely, thereby allowing the acute team to focus more appropriate major trauma injuries.
PURPOSE: The purpose of this simulation study was to establish a reference percentage value that can be used to effectively reduce the size and polygons of the 3D mesh without drastically affecting the dimensions of the prosthesis itself.
MATERIAL AND METHODS: Fifteen different maxillary palatal defects were simulated on a dental cast and scanned to create 3D casts. Digital bulbs were fabricated from the casts. Conventional bulbs for the defects were fabricated, scanned, and compared with the digital bulb to serve as a control. The polygon parameters of digital bulbs were then reduced by different percentages (75%, 50%, 25%, 10%, 5%, and 1% of the original mesh) which created a total of 105 meshes across 7 mesh groups. The reduced mesh files were compared individually with the original design in an open-source point cloud comparison software program. The parameters of comparison used in this study were Hausdorff distance (HD), Dice similarity coefficient (DSC), and volume.
RESULTS: The reduction in file size was directly proportional to the amount of mesh reduction. There were minute yet insignificant differences in volume (P>.05) across all mesh groups, with significant differences (P
METHODS: An online questionnaire was distributed to cytopathology laboratories in 24 Asia-Pacific countries to explore the impact of restrictive measures on access to health care, use of general and personal protective equipment (PPE), and changes in cytology workflow and workload from February to April 2020.
RESULTS: A total of 167 cytopathology laboratories from 24 countries responded to the survey; the majority reported that restrictive measures that limited the accessibility of health care services had been implemented in their cities and/or countries (80.8%) and their hospitals (83.8%). The respondents noted that COVID-19 had an impact on the cytologic workflow as well as the workload. Approximately one-half of the participants reported the implementation of new biosafety protocols (54.5%) as well as improvements in laboratory facilities (47.3%). Rearrangement or redeployment of the workforce was reported in 53.3% and 34.1% of laboratories, respectively. The majority of the respondents reported a significant reduction (>10%) in caseload associated with both gynecological (82.0%) and nongynecological specimens (78.4%). Most laboratories reported no significant change in the malignancy rates of both gynecological (67.7%) and nongynecological specimens (58.7%) compared with the same period in 2019.
CONCLUSIONS: The results of the survey demonstrated that the COVID-19 pandemic resulted in a significant reduction in the number of cytology specimens examined along with the need to implement new biosafety protocols. These findings underscore the need for the worldwide standardization of biosafety protocols and cytology practice.
Aims: To explore how impairments could affect the self-esteem of physically disabled people and how healthcare professionals and social support boost their self-esteem.
Materials and Methods: This study was conducted qualitatively whereby face-to-face interviews were conducted among 10 participants with physical disabilities. Participants were recruited from two rehabilitation centres in Kuantan, namely Community-based rehabilitation and rehabilitation, occupational therapy, and physiotherapy of public hospital in Kuantan. Interviews were conducted using the developed interview guide that explored on the disabled peoples' self-esteem and motivation, feelings toward attitude of the healthcare professionals, and satisfaction toward the physical, services, and social support from the healthcare professionals. Thematic analysis was done to identify the themes emerged from the interview transcripts.
Results: Five males and five females with age ranging from 31 to 58 years were interviewed. Five are still working or studying post impairments. Participants claimed being low self-esteem resulted from negative perception from the society, issue of rejection, being discriminated, and difficulty in getting support from the society. Most of the participants asserted that they gained their motivation and self-esteem due to the continuous support from various groups, such as their spouses, family members, colleagues, employers, and healthcare professionals.
Conclusions: Despite heavy workload and stressful working environment, positive attitude showed by the healthcare professionals is highly praised. Hence, this will indirectly improve the self-esteem, motivation, and rehabilitation progress of physically disabled people.
METHODS: Semi-structured interviews were conducted among 31 medical doctors in three Malaysian government hospitals on the implementation of the Total Hospital Information System (THIS) between March and May 2015. A thematic qualitative analysis was performed on the resultant data to deduce the relevant themes.
RESULTS: Five themes emerged as the factors influencing workarounds to the HIS: (a) typing skills, (b) system usability, (c) computer resources, (d) workload, and (e) time.
CONCLUSIONS: This study provided the key factors as to why doctors were involved in workarounds during the implementation of the HIS. It is important to understand these factors in order to help mitigate work practices that can pose a threat to patient safety.
OBJECTIVE: To investigate the global impact of COVID-19 on urological providers and the provision of urological patient care.
DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional, web-based survey was conducted from March 30, 2020 to April 7, 2020. A 55-item questionnaire was developed to investigate the impact of COVID-19 on various aspects of urological services. Target respondents were practising urologists, urology trainees, and urology nurses/advanced practice providers.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary outcome was the degree of reduction in urological services, which was further stratified by the geographical location, degree of outbreak, and nature and urgency of urological conditions. The secondary outcome was the duration of delay in urological services.
RESULTS AND LIMITATIONS: A total of 1004 participants responded to our survey, and they were mostly based in Asia, Europe, North America, and South America. Worldwide, 41% of the respondents reported that their hospital staff members had been diagnosed with COVID-19 infection, 27% reported personnel shortage, and 26% had to be deployed to take care of COVID-19 patients. Globally, only 33% of the respondents felt that they were given adequate personal protective equipment, and many providers expressed fear of going to work (47%). It was of concerning that 13% of the respondents were advised not to wear a surgical face mask for the fear of scaring their patients, and 21% of the respondents were advised not to discuss COVID-19 issues or concerns on media. COVID-19 had a global impact on the cut-down of urological services, including outpatient clinic appointments, outpatient investigations and procedures, and urological surgeries. The degree of cut-down of urological services increased with the degree of COVID-19 outbreak. On average, 28% of outpatient clinics, 30% of outpatient investigations and procedures, and 31% of urological surgeries had a delay of >8 wk. Urological services for benign conditions were more affected than those for malignant conditions. Finally, 47% of the respondents believed that the accumulated workload could be dealt with in a timely manner after the COVID-19 outbreak, but 50% thought the postponement of urological services would affect the treatment and survival outcomes of their patients. One of the limitations of this study is that Africa, Australia, and New Zealand were under-represented.
CONCLUSIONS: COVID-19 had a profound global impact on urological care and urology providers. The degree of cut-down of urological services increased with the degree of COVID-19 outbreak and was greater for benign than for malignant conditions. One-fourth of urological providers were deployed to assist with COVID-19 care. Many providers reported insufficient personal protective equipment and support from hospital administration.
PATIENT SUMMARY: Coronavirus disease-19 (COVID-19) has led to significant delay in outpatient care and surgery in urology, particularly in regions with the most COVID-19 cases. A considerable proportion of urology health care professionals have been deployed to assist in COVID-19 care, despite the perception of insufficient training and protective equipment.
METHODS: Using online surveys, availability of specialty manpower and MDTBs among PSTUs was first determined. From the subset of PSTUs with MDTBs, one pediatric surgeon and one pediatric oncologist from each center were queried using 5-point Likert scale questions adapted from published questionnaires.
RESULTS: In 37 (80.4%) of 46 identified PSTUs, availability of pediatric-trained specialists was as follows: oncologists, 94.6%; surgeons, 91.9%; radiologists, 54.1%; pathologists, 40.5%; radiation oncologists, 29.7%; nuclear medicine physicians, 13.5%; and nurses, 81.1%. Availability of pediatric-trained surgeons, radiologists, and pathologists was significantly associated with the existence of MDTBs (P = .037, .005, and .022, respectively). Among 43 (89.6%) of 48 respondents from 24 PSTUs with MDTBs, 90.5% of oncologists reported > 50% oncology-dedicated workload versus 22.7% of surgeons. Views on benefits and barriers did not significantly differ between oncologists and surgeons. The majority agreed that MDTBs helped to improve accuracy of treatment recommendations and team competence. Complex cases, insufficient radiology and pathology preparation, and need for supplementary investigations were the top barriers.
CONCLUSION: This first known profile of pediatric solid tumor care in Southeast Asia found that availability of pediatric-trained subspecialists was a significant prerequisite for pediatric MDTBs in this region. Most PSTUs lacked pediatric-trained pathologists and radiologists. Correspondingly, gaps in radiographic and pathologic diagnoses were the most common limitations for MDTBs. Greater emphasis on holistic multidisciplinary subspecialty development is needed to advance pediatric solid tumor care in Southeast Asia.
Study design: Qualitative.
Place and duration of study: The study was conducted with 32 key informants at the family physician program at the Tabriz University of Medical Sciences between May 2018 and June 2018. Method: This is a qualitative study. A purposeful sampling method was used with only one inclusion criterion for participants: five years of experience in the family physician program. The researchers conducted 17 individual and group non-structured interviews and examined participants' perspectives on the challenges faced in the implementation of the pay-for-performance system in the family physician program. Content analysis was conducted on the obtained data.
Results: This study identified 7 themes, 14 sub-themes, and 46 items related to the challenges in the implementation of pay-for-performance systems in Iran's family physician program. The main themes are: workload, training, program cultivation, payment, assessment and monitoring, information management, and level of authority. Other sub-challenges were also identified.
Conclusion: The study results demonstrate some notable challenges faced in the implementation of the pay-for-performance system. This information can be helpful to managers and policymakers.