A cognitive task analysis of final year nursing students' situation awareness in simulated deteriorating patient events: A mixed methods study.

Aim: The aim of this study was to: (1) use cognitive task analysis to describe final year nursing students situation awareness in recognising, responding and escalating care of deteriorating patients in ward settings; and (2) make recommendations for training and practice.

Design: A mixed methods cognitive task analysis with a convergent triangulation design.

Method: Data collection involved observations of 33 final year nursing students in simulated deteriorating patient scenarios and retrospective cognitive interviews.

Navigating complexity of the medication management system within the home setting-a functional resonance analysis method (FRAM) analysis of people with dementia and their carers' experiences.

Background: There is a strong imperative to support people with dementia to live independently in their homes for as long as possible. A starting point is to understand how they manage medications on a daily basis.

Aim: To understand how people with dementia and their informal carers manage medications within the home setting to inform the identification of opportunities to improve medication management.

The microbial pathology of maternal perinatal sepsis: A single-institution retrospective five-year review.

Introduction: Greater than half of in-hospital maternal deaths are caused by sepsis, a condition that occurs when infection exceeds local tissue containment and results in organ dysfunction. Determining the source of infection can be challenging. Microbiological cultures of the uterine cavity are often difficult to obtain, so antimicrobial susceptibility results may not be available to guide treatment.

Trends in instrument preference for operative vaginal delivery in a tertiary referral center: 2008-2021.

Objective: To examine temporal trends in operative vaginal deliveries as well as the ratio between vacuum and forceps deliveries over 15 years in a large tertiary hospital.

Methods: This retrospective study assessed prospectively collected data from 2008 to 2021. Women with greater than 37 weeks of gestation who underwent an operative vaginal delivery were included.

Hospital at home: A systematic review of how medication management is conceptualised, described and implemented in practice-A study protocol.

Introduction: Hospital at Home (H@H) is a method of healthcare delivery, where hospital level interventions are conducted in the patient's usual place of residence, offering an alternative to hospital admission. This often includes the ability to perform point of care diagnostics and treat conditions using a range of treatments traditionally associated with hospital admission, including intravenous medicines and oxygen. H@H services have been established worldwide but there is a wide variation in definition and delivery models and currently no documented evidence supporting the delivery of medicines and medicines management within the H@H model.

Using video reflexive ethnography to explore the use of variable rate intravenous insulin infusions.

Background: The use of variable rate intravenous insulin infusion (VRIII) is a complex process that has consistently been implicated in reports of error and consequent harm. Investment in patient safety has focused mainly on learning from errors, though this has yet to be proved to reduce error rates. The Resilient Health Care approach advocates learning from everyday practices.

Situation awareness and the mitigation of risk associated with patient deterioration: A meta-narrative review of theories and models and their relevance to nursing practice.

Background: Accurate situation awareness has been identified as a critical component of effective deteriorating patient response systems and an essential patient safety skill for nursing practice. However, situation awareness has been defined and theorised from multiple perspectives to explain how individuals, teams and systems maintain awareness in dynamic task environments.

Aim: Our aim was to critically analyse the different approaches taken to the study of situation awareness in healthcare and explore the implications for nursing practice and research as it relates to clinical deterioration in ward contexts.

Modelling the use of variable rate intravenous insulin infusions in hospitals by comparing Work as Done with Work as Imagined.

Background: Variable rate intravenous insulin infusions (VRIIIs) are widely used to treat elevated blood glucose (BG) in adult inpatients who are severely ill and/or will miss more than one meal. VRIIIs can cause serious harm to the patient if used incorrectly. Recent safety initiatives have embraced the Resilient Health Care (RHC) approach to safety by understanding how VRIIIs are expected to be used (Work as Imagined, 'WAI') and how it is actually used in everyday clinical care (Work as Done, 'WAD').

Uterine didelphys: diagnosis, management and pregnancy outcome.

This report addresses and discusses two cases of uterine didelphys in pregnancy. The first case describes the diagnosis, management and subsequent pregnancies in a 28-year-old woman, para 2, with known didelphys uterus, left-obstructed hemi-vagina and ipsilateral renal agenesis. This uterine anomaly was diagnosed at 13 years of age, after pelvic imaging identified a haematocolpos and two uteri.

Detailed analysis of 'work as imagined' in the use of intravenous insulin infusions in a hospital: a hierarchical task analysis.

Objective: Variable rate intravenous insulin infusions (VRIII) is a high-risk medication that has a potential to cause significant patient harm if used in error. Complex preparation of VRIII in clinical areas and the need for frequent monitoring and adjustment increase the complexity of using VRIII. An emerging approach, called Resilient Healthcare, proposes understanding complexity of work by exploring how work is assumed to be done and compare it with everyday work.

Resilient Health Care: a systematic review of conceptualisations, study methods and factors that develop resilience.

Background: Traditional approaches to safety management in health care have focused primarily on counting errors and understanding how things go wrong. Resilient Health Care (RHC) provides an alternative complementary perspective of learning from incidents and understanding how, most of the time, work is safe. The aim of this review was to identify how RHC is conceptualised, described and interpreted in the published literature, to describe the methods used to study RHC, and to identify factors that develop RHC.

Reversible Switching between Nonporous and Porous Phases of a New SIFSIX Coordination Network Induced by a Flexible Linker Ligand.

Closed-to-open structural transformations in flexible coordination networks are of potential utility in gas storage and separation. Herein, we report the first example of a flexible SiF-pillared square grid material, [Cu(SiF)(L)] (L = 1,4-bis(1-imidazolyl)benzene), . exhibits reversible switching between nonporous () and several porous (, , , and ) phases triggered by exposure to N, CO, or HO.

Preventing skin staining: an effective iron infusion protocol.

Purpose: To implement a safe and effective intravenous iron infusion protocol to prevent skin staining.

Design/methodology/approach: Mixed methods approach was utilised including education, auditing, self-reported survey, patient information leaflet and patient feedback. In total 25 healthcare professionals completed the survey and 15 patients provided feedback.

Understanding safety differently: developing a model of resilience in the use of intravenous insulin infusions in hospital in-patients-a feasibility study protocol.

Background: Intravenous insulin infusions are considered the treatment of choice for critically ill patients and non-critically ill patients with persistent raised blood glucose who are unable to eat, to achieve optimal blood glucose levels. The benefits of using intravenous insulin infusions as well as the problems experienced are well described in the scientific literature. Traditional approaches for improving patient safety have focused on identifying errors, understanding their causes and designing solutions to prevent them.

Skin staining following intravenous iron infusion.

This report describes the case of a 36-year-old woman, gravida 3, para 2, at 11 weeks' gestation, who received a ferric carboxymaltose infusion for iron deficiency anaemia after medical management of a miscarriage. The following morning, light brown skin staining was noted at the infusion site, and the staining was present 2 months later at follow-up. Skin staining following intravenous iron infusion is a rare but important side effect.

Educational Interventions to Enhance Situation Awareness: A Systematic Review and Meta-Analysis.

We conducted a systematic review to evaluate the comparative effectiveness of educational interventions on health care professionals' situation awareness (SA). We searched MEDLINE, CINAHL, HW Wilson, ERIC, Scopus, EMBASE, PsycINFO, psycARTICLES, Psychology and Behavioural Science Collection and the Cochrane library. Articles that reported a targeted SA intervention or a broader intervention incorporating SA, and an objective outcome measure of SA were included.

Coordination Network That Reversibly Switches between Two Nonporous Polymorphs and a High Surface Area Porous Phase.

We report a 2-fold interpenetrated primitive cubic (pcu) network X-pcu-5-Zn, [Zn(DMTDC)(dpe)] (HDMTDC = 3,4-dimethylthieno[2,3- b]thiophene-2,5-dicarboxylic acid, dpe = 1,2-di(4-pyridyl)ethylene), that exhibits reversible switching between an as-synthesized "open" phase, X-pcu-5-Zn-α, and two nonporous or "closed" polymorphs, X-pcu-5-Zn-β and X-pcu-5-Zn-γ. There are two unusual features of X-pcu-5-Zn. The first relates to its sorption properties, which reveal that the α form exhibits high CO uptake (ca.

A comprehensive spectroscopic study of the polymorphs of diflunisal and their phase transformations.

Understanding phase transitions in pharmaceutical materials is of vital importance for drug manufacturing, processing and storage. In this paper we have carried out comprehensive high-resolution spectroscopic studies on the polymorphs of the non-steroidal anti-inflammatory drug diflunisal that has four known polymorphs, forms I-IV (FI-FIV), three of which have known crystal structures. Phase transformations during milling, heating, melt-quenching and exposure to high relative humidity were investigated using Raman and terahertz spectroscopy in combination with differential scanning calorimetry and X-ray powder diffraction.

Learning to teach: how a formal teaching qualification improved our practice.

In this article, guest writers Sonya Lipczynska and Clare Crowley from King's College London discuss the learning that occurred when they undertook a Postgraduate Certificate in Academic Practice in Higher Education (PGCAPHE). In particular, they identify how their exploration of relevant learning and teaching theory on the course helped them to evaluate their library instruction teaching practice with medical and dental students. They highlight how they made changes and improvements to the delivery of these sessions based on greater consideration of inclusivity and the characteristics of both individuals and broader student groups.

Tumour bed delineation for partial breast/breast boost radiotherapy: what is the optimal number of implanted markers?

Purpose: International consensus has not been reached regarding the optimal number of implanted tumour bed (TB) markers for partial breast/breast boost radiotherapy target volume delineation. Four common methods are: insertion of 6 clips (4 radial, 1 deep and 1 superficial), 5 clips (4 radial and 1 deep), 1 clip at the chest wall, and no clips. We compared TB volumes delineated using 6, 5, 1 and 0 clips in women who have undergone wide-local excision (WLE) of breast cancer (BC) with full-thickness closure of the excision cavity, in order to determine the additional margin required for breast boost or partial breast irradiation (PBI) when fewer than 6 clips are used.