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To examine the relationship between weight loss and problems with oral intake in institutionalised older adults.
A 1-year longitudinal observational study.
Data were obtained from a prospective study conducted in three nursing homes and two long-term care facilities in Japan. Participants' problems with oral intake were assessed using items published in 2021 by the Japanese Ministry of Health, Labour and Welfare. Baseline and follow-up factors were compared between individuals who experienced a weight loss of 5% or more and those who did not. Separate multivariable logistic regression models were constructed for each oral intake assessment item to examine its independent association with weight loss of 5% or more, accounting for transitions in each item between baseline and the 1-year follow-up.
In total, 172 institutionalised older adults were included in the analysis. Among them, 57 (33.1%) participants experienced a weight decrease of 5% or more. The emergence of somnolence or clouding of consciousness during meals at the 1-year follow-up in participants without these signs at baseline was independently associated with a weight loss of 5% or more, after adjustment for baseline characteristics.
Recognising signs of somnolence or clouding of consciousness during meals may be useful for the early detection and prevention of weight loss in institutionalised older adults.
Early detection of individuals at risk is essential to prevent significant weight loss and its associated adverse outcomes. Recognising somnolence or clouding of consciousness during meals may enable earlier detection and intervention to prevent weight loss and improve the quality of care for older adults.
Strengthening the Reporting of Observational Studies in Epidemiology.
No patient or public contribution.
This study aimed to examine the challenges faced by pediatric nurses in implementing and sustaining clinical handover in intensive care units (ICUs), focusing on identifying key barriers affecting the handover process in these specialised environments.
Pediatric nurses encounter several challenges that hinder the effective implementation of clinical handover in intensive care settings. These challenges can compromise patient safety and care continuity. Understanding these obstacles is essential for identifying areas for improvement and enhancing handover practices in pediatric intensive care units (PICUs) and neonatal intensive care units (NICUs).
A descriptive, cross-sectional study was conducted in the neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) of the specialised university hospital for children in Alexandria, Egypt. The sample included 127 nurses who provided direct care to critically ill children. Participants were selected using convenience sampling. Data were collected using a self-administered questionnaire designed to assess various challenges encountered during the clinical handover process. The questionnaire covered five key areas: nurse-related challenges, handover quality-related challenges, organisational challenges, environmental challenges and communication challenges. Data were analysed using descriptive and inferential statistical methods, including multivariate regression analysis. The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
The study found that the most significant challenges during clinical handover were nurse-related (mean = 74.7, SD = 5.6), followed by organisational challenges (mean = 69.2, SD = 16.7). Statistically significant differences were observed in nurses' characteristics, such as gender, age, marital status, years of experience and the place and duration of handover. Nurses who conducted longer handovers or performed them at the bedside reported fewer challenges compared to those who performed handovers at the nursing station or those with shorter durations.
Pediatric nurses in critical care settings face significant challenges in clinical handover, with barriers such as resistance to change, non-standardised language, time constraints and outdated reports being prominent. Female nurses, older nurses and those working in settings with less standardised handover practices reported more difficulties. Addressing these challenges is critical for improving handover processes, ensuring better patient safety and enhancing care outcomes.
Standardised handover protocols tailored to intensive care workflows, along with targeted training for nurses, are essential to address the identified challenges. These measures will enhance communication, improve handover efficiency and promote patient safety in pediatric ICUs. No patient or public contribution.
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