A 4-year outbreak of MRSA ST72-MRSA-IV type t1597 in a surgical high dependency unit in Ireland linked to repeated healthcare worker recolonisation.

Background: Patients undergoing cardiac surgery are identified as high risk for infection, including MRSA. An outbreak of MRSA was identified when two patients experienced MRSA infection concurrently in a cardiothoracic high dependency unit with uncommon detection of MRSA previously and an established screening programme.

Methods: An outbreak control team was convened and interventions applied including refresher training in hand and environmental hygiene, review of practice with regard to aseptic access of medical devices and consideration of antibiotic use in the unit.

A distinctive profession? Building professional identity and knowledge for intellectual disability nursing education.

Intellectual disability nursing students can struggle to build a professional identity and make sense of their extensive curriculum and its application to practice. In this article Legitimation Code Theory (LCT) and Critical Discourse Analysis (CDA) are used to facilitate an examination of the organising principles underlying intellectual disability nursing and the relationships agents construct between intellectual disability and other nursing divisions. In particular this paper explores the relationship with general nursing, and examines the connections and boundaries that intellectual disability nursing builds with general nursing, and their implications.

A Realist Review Protocol into the Contexts and Mechanisms That Enable the Inclusion of Environmental Sustainability Outcomes in the Design of Lean Healthcare Improvement Interventions.

Healthcare makes a significant contribution to the social, economic and environmental benefits of communities. It is correspondingly a significant employer and consumer of both energy and consumables, often at high costs. Lean, a quality improvement methodology focuses on the elimination of non-value add (NVA) activities (steps that do not add value from the perspective of the customer) to improve the flow of people, information or goods.

The Relationship Between Attitudes Toward Death, Rumination, and Psychological Resilience of Oncology Nurses.

Objectives: The study aimed to examine the relationship between attitudes toward death, rumination, and psychological resilience of oncology nurses.

Methods: The study design was cross-sectional. Data were collected from 118 oncology nurses using the Demographic Data Form, Work-Related Rumination Scale, Connor-Davidson Resilience Scale Short Form, and Death Attitude Profile-Revised Scale.

Decreasing Perioperative Opiate Use During Pancreaticoduodenectomy Using Transversus Abdominus Plane Blocks: A Review of the Literature.

Background: Pancreatoduodenectomy is a highly complex surgical procedure associated with high postoperative morbidity and mortality. Treatment of postoperative pain is crucial to preventing chronic pain and further complications. Opioids are the leading treatment modality for acute postoperative pain for all surgical procedures in the US, contributing to the opioid epidemic, a crisis causing death and lifelong impairment in many patients.

Unmet care needs of women who have undergone breast cancer surgery: A scoping review.

Aim: To summarize the evidence regarding the unmet care needs of women who have undergone breast cancer surgery and identify research gaps.

Design: A scoping review.

Data Sources: This review entailed a systematic search in EMBASE, Medline via PubMed, CINAHL Complete, APA PsycINFO, Cochrane Library, Web of Science and Scopus (up until 30 July 2023).

Using Lean Six Sigma in a Private Hospital Setting to Reduce Trauma Orthopedic Patient Waiting Times and Associated Administrative and Consultant Caseload.

In Ireland, the extent of outpatient orthopedic waiting lists results in long waiting times for patients, delays in processing referrals, and variation in the consultant caseload. At the study site, the Define, Measure, Analyze, Improve, and Control (DMAIC) Lean Six Sigma framework was applied to evaluate sources of Non-Value-Added (NVA) activity in the process of registering and triaging patients referred to the trauma orthopedic service from the Emergency Department. A pre- (October-December 2021)/post- (April-August 2022) intervention design was employed, utilizing Gemba, Process Mapping, and the TIMWOODS tool.

Perceptions of nursing students and faculty members towards academic integrity and professionalism in Saudi Arabia: A cross-sectional study.

Background: Maintaining and nourishing academic integrity along with professionalism in nursing education is integral and imperative to the development of the nursing profession. However, evidence shows that academic dishonesty and incompetency exist and are raising problems among college students of all disciplines including nursing. To date, limited studies have been conducted in this area in Saudi Arabia.

Comparing Left Atrial Low Voltage Areas in Sinus Rhythm and Atrial Fibrillation Using Novel Automated Voltage Analysis: A Pilot Study.

Background: Low voltage areas (LVAs) have been proposed as surrogate markers for left atrial (LA) scar. Correlation between voltages in sinus rhythm (SR) and atrial fibrillation (AF) have previously been measured via point-by-point analysis. We sought to compare LA voltage composition measured in SR to AF, utilizing a high-density automated voltage histogram analysis (VHA) tool in those undergoing pulmonary vein isolation (PVI) for persistent AF (PeAF).

"I am in a Fight with My Brain": A Qualitative Study on Cancer-Related Ruminations of Individuals with Cancer.

Objective: This study aimed to determine the cancer-related ruminations from the subjective perspectives of individuals with cancer.

Data Sources: The study adopted a qualitative design, and participants (N = 16) were individuals with cancer. The analysis and interpretation of data were carried out according to the phenomenological-hermeneutical method.

"Cancer Never Goes Out of Your Mind Even for a Single Second". Cancer-Related Ruminations From the Perspectives of Cancer Survivors.

Objective: This study aimed to explore a deeper understanding of how cancer survivors experience and manage ruminative thoughts.

Data Sources: A descriptive qualitative design. The study was conducted with cancer survivors (n = 21).

Making a Sustainable Difference to People, Processes and Systems: Whole-Systems Approaches to Process Improvement in Health Systems.

The eighteen papers in this Special Issue, 'Whole-Systems Approaches to Process Improvement in Health Systems', address an enduring challenge in healthcare: to improve efficiency with existing or reduced resources, while maintaining safe and effective care [...

The use of music for children and adolescents living with rare diseases in the healthcare setting: a scoping review study protocol.

Interest in the application of music in the health, social care and community contexts is growing worldwide. There is an emerging body of literature about the positive effects of music on the well-being and social relationships of children and adult populations. Music has also been found to promote social interaction, communication skills, and social-emotional behaviours of children with medically complex care needs.

Covid-19-related ruminations: A qualitative study based on the perspectives of the cancer survivors.

Cancer survivors can develop repetitive ruminations due to the unexpected and challenging effects of Covid-19. This qualitative descriptive design study aimed to comprehend the Covid-19-related ruminations from the subjective perspective of cancer survivors (n = 33), accessed via online Facebook self-help groups of a cancer association. A semi-structured interview guide was used for data collection followed by systematic analysis.

Using a Combined Lean and Person-Centred Approach to Support the Resumption of Routine Hospital Activity following the First Wave of COVID-19.

The unexpected advent of the COVID-19 pandemic led to a sudden disruption of routine medical care, with a subsequent reorganization of hospital structures and of care. Case studies are becoming available in the literature referring to the logistical difficulties involved in a hospital resuming normal activity following the first COVID-19 lockdown period. This paper details the experience of a study site, a private hospital in Dublin, Ireland, in the redesign of service delivery in compliance with new COVID-19 prevention regulations to facilitate the resumption of routine hospital activity following the first wave of COVID-19.

The Use of Lean Six Sigma Methodology in the Reduction of Patient Length of Stay Following Anterior Cruciate Ligament Reconstruction Surgery.

The purpose of this study was to reduce the length of stay of anterior cruciate ligament reconstruction patients within a private hospital in Ireland, reducing any non-value-added activity in the patient pathway, with the goal of increasing patient flow, bed capacity, and revenue generation within the hospital system, while maintaining patient satisfaction. We used a pre-/post-intervention design and Lean Six Sigma methods and tools to assess and improve the current process. A reduction in inpatient length of stay by 57%, and a reduction in identified non-value-added activity by 88%, resulted in a new day-case surgery pathway for anterior cruciate ligament reconstruction patients.

A Case Study of a Whole System Approach to Improvement in an Acute Hospital Setting.

Changes in healthcare tend to be project-based with whole system change, which acknowledges the interconnectedness of socio-technical factors, not the norm. This paper attempts to address the question of whole system change posed by the special issue and brings together other research presented in this special issue. A case study approach was adopted to understand the deployment of a whole system change in the acute hospital setting along four dimensions of a socio-technical systems framework: culture, system functioning, action, and sense-making.

A Lifestyle Management for Arthritis Group education intervention for people with inflammatory and degenerative arthritis: An observational study.

Background: Occupational therapy self-management groups aim to assist individuals to incorporate health-promoting behaviours and management strategies into their daily routines to promote wellbeing. The Lifestyle Management for Arthritis Group (LMAG) is a 2-h-long, occupational therapy educational-behavioural group intervention adapted from the evidence-based Lifestyle Management for Arthritis Programme (Hammond & Rayner, 2013) and was delivered to inpatients with inflammatory and degenerative arthritis separately.

Aim: The aim of this study was to evaluate the effectiveness of this intervention in an inpatient Rheumatology Rehabilitation setting.

Operation Note Transformation: The Application of Lean Six Sigma to Improve the Process of Documenting the Operation Note in a Private Hospital Setting.

Clinical documentation is a key safety and quality risk, particularly at transitions of care where there is a higher risk of information being miscommunicated or lost. A surgical operation note (ON) is an essential medicolegal document to ensure continuity of patient care between the surgical operating team and other colleagues, which should be completed immediately following surgery. Incomplete operating surgeon documentation of the ON, in a legible and timely manner, impacts the quality of information available to nurses to deliver post-operative care.

Releasing Operating Room Nursing Time to Care through the Reduction of Surgical Case Preparation Time: A Lean Six Sigma Pilot Study.

Healthcare systems internationally are working under increasing demand to use finite resources with greater efficiency. The drive for efficiency utilises process improvement methodologies such as Lean Six Sigma. This study outlines a pilot Lean Six Sigma intervention designed to release nursing time to care within a peri-operative environment; this was achieved by collaborating with stakeholders to redesign the process for laparoscopic hernia surgical case preparation (set up) material.

Redesigning the Process for Scheduling Elective Orthopaedic Surgery: A Combined Lean Six Sigma and Person-Centred Approach.

The Health Service Executive Ireland model of care for elective surgery supports the delivery of elective surgical care in achieving both process and clinical outcomes. This project was conducted in the Orthopaedic Department. Following an outpatient consultation with an orthopaedic surgeon, patients who required surgical intervention were scheduled for their intervention by the administrative team.

Identification of quality indicators of public health nursing practice: "modified Delphi" approach.

Objective: Identify process indicators to measure public health nursing practice during first postnatal visits in Ireland.

Design: Using a RAND/UCLA appropriateness- "modified Delphi" method, a two-round rating and ranking process was completed in 2016. Fifty-nine statements were reviewed for consensus and priority ranking.

Work environment challenging Irish public health nurses' care quality: First postnatal visit.

Objectives: Exploring views and experiences of public health nurses of their work environment and measurement of care practices at first postnatal visits.

Design: An exploratory qualitative design. Data collected using four focus groups and analyzed using thematic analysis.

[The end-tidal carbon dioxide as an early sign and predictor of the return of spontaneous circulation during out-of-hospital cardiac arrest. A systematic review.].

Background: There is no clear evidence on the maximum level of end-tidal carbon dioxide (ETCO) predictor of the return of spontaneous circulation (RSC) after an out-of-hospital cardiorespiratory arrest. The aims of this work was to synthesise and analyse the available evidence on the usefulness of monitoring values ETCO in an out-of-hospital cardiorespiratory arrest as an early sign and prognostic indicator of the RSC.

Methods: Systematic review, with narrative synthesis of the results, of primary studies published in English or Spanish was conducted in Medline, CINAHL, Web of Science, EMBASE, Proquest, Scopus, Cochrane, ÍnDICEs CSIC and CUIDEN of studies that analyse the usefulness of monitoring of the level of ETCO as a sign of the RSC after an out-of-hospital cardiorespiratory arrest.