Conectar
To explore whether large language models (LLMs), Generative Pre-trained Transformer (GPT)-3, GPT-3.5 and GPT-4 can autonomously manage a virtual fracture clinic (VFC) as a marker of their efficacy in an emergency department and with simple orthopaedic trauma.
Simulated UK VFC workflow.
11 clinical scenarios were generated, and GPT-4, GPT-3.5 and GPT-3 were prompted to write clinic letters and management plans.
The Readable Tool was used to assess the clarity of letters. Six independent orthopaedic surgeons then evaluated the accuracy of letters and management plans.
Readability was compared using the Flesch-Kincaid grade level: GPT-4: 9.11 (SD 0.98); GPT-3.5: 8.77; GPT-3: 8.47, and the Flesch readability ease: GPT-4: 56.3; GPT-3.5: 58.2; GPT-3: 59.3. Surgeon-rated accuracy comparisons indicated that GPT-4 exhibited the highest accuracy for management plans (9.08/10 (95% CI 8.25 to 9.9)). This represents a statistically significant progression in the capacity of a LLM to provide accurate management plans compared with GPT-3 at 6.84 (95% CI 5.41 to 8.27) and GPT-3.5 at 7.63 (95% CI 7.23 to 8.13) (p
LLMs can produce high-quality, readable clinical letters for common VFC presentations, and GPT-4 can generate management plans to aid clinicians in their administration. With clinician oversight, appropriately trained LLMs could meaningfully reduce routine administrative work. However, while the results of this study are promising, further evaluation of LLMs is required before they can be deemed safe for managing simple orthopaedic scenarios.
To examine residential aged care staff's experience of death and grief, and their support needs.
A mixed-methods sequential explanatory design, using an online cross-sectional survey that included the Texas Revised Inventory of Grief and the Grief Support in Health Care Scale. Followed by semi-structured interviews with direct care workers and managers working in residential aged care homes were conducted.
Over 60% of participants experienced five or more resident deaths in the previous 12 months. Although, different levels of grief were experienced among different roles, the importance of open communication and opportunities for farewells after resident death was highlighted. Participants suggested support and education to normalise grief and promote self-care.
Recognising staff grief following the resident death is important. Providing support and education may help improve staff wellbeing and contribute to the delivery of high-quality care for both residents and their families.
Staff grief after a resident death needs to be recognised, and continuing education and support are required for their wellbeing.
The STROBE and SRQR checklists were applied.
No Patient or Public contribution.
To co-develop storyboards and scripts for multimedia resources to support the information needs of informal carers (carers) of older adults from Greek, Italian and Chinese (Cantonese- and Mandarin-speaking) Australian backgrounds during hospital-to-home transitions.
A modified experience-based co-design methodology was used to co-develop four storyboards and scripts with Greek, Italian and Chinese Australian carers and advocates from multicultural community-aged care organisations. To promote relevance, a Carer Advisory Group guided the research. The Carer Advisory Group, comprising 10 people, included carers and advocates from participating multicultural community-aged care organisations, a social worker from a large public health service, and policy representatives. Twenty-nine participants took part from June 2023 to April 2024. Data collection involved two rounds of co-development including 2 workshops, 9 small group interviews and 11 individual interviews. Round 1 focused on understanding participants' experiences of older adult care transitions, information needs and advice for other carers. This information was used to develop categories and example quotes to draft four storyboards reflecting participants' descriptions of the carer and patient journey during care transitions. Round 2 involved draft storyboards being presented to the same participants who advised on their acceptability. Certified interpreters and translators were used throughout data collection.
The co-developed categories, four storyboards and scripts are presented. Participants and the Carer Advisory Group agreed that the findings would be used to develop multimedia resources to support the information needs of carers and older adults from Greek, Italian and Chinese Australian backgrounds in care transitions.
The storyboards and scripts for multimedia resources are expected to improve access to information and services for carers and older adults from culturally and linguistically diverse backgrounds. The storyboards and scripts are examples to guide policymakers and leaders in improving transitional care in Australia and internationally.
The reporting of the study has adhered to the COREQ guidelines.
Informal carers were involved in the Carer Advisory Group which provided guidance and consultation to each phase of the project. Their contributions included reviewing the ethics application prior to submission for ethical review, and reviewing storyboards and scripts to optimise the relevance for informal carers and older adults.
To explore clinical nurses’ process of coping during COVID-19 and develop a grounded theory that can be used by leaders to support clinical nurses during a disaster.
The COVID-19 pandemic has provoked widespread disruption to clinical nurses’ work. It is important to understand clinical nurses’ processes of coping during disasters to support the nursing workforce during events such as global pandemics.
We employed the Corbin and Strauss variant of grounded theory methodology, informed by symbolic interactionism, and applied the EQUATOR guidelines for qualitative research publication (COREQ).
Data collection entailed semi-structured interviews with experienced clinical nurses (n =20) across diverse settings. We analysed data by identifying key points in the nurses’ coping processes inductively building concepts around these points.
The predictor of nurses’ outcomes in this grounded theory was their confidence in their ability to cope during the pandemic. When nurses lacked confidence, they experienced working in the context of acute COVID—a state of chaos and anxiety, with negative consequences for nurses. However, when nurses were confident in their abilities to cope with the pandemic, they experienced working in the context of chronic COVID, a calmer state of acceptance. There were many workplace factors that influenced nurses’ confidence, including adequacy of personal protective equipment, clear information and guidance, supportive leadership, teamwork and adequate staffing.
Understanding clinical nurses’ experience of coping during COVID-19 is essential to maintain the nursing workforce during similar disasters.
Nurse leaders can target areas that support nurses’ confidence, such as adequate PPE and staffing. In turn, increased confidence enables clinical nurses to cope during disasters such as a global pandemic.
FreshRSS 