Search results for: clinical care

Authors: Haoyi Sheng

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China's aging tendency is becoming increasingly severe, which leads to the embarrassing situation of "getting old before getting wealthy". The traditional pension model does not comply with the need of today. Relying on "Internet Plus", it can efficiently integrate information and resources and meet the personalized needs of elderly care. It can reduce the operating cost of community elderly care facilities and lay a technical foundation for providing better services for the elderly. The key for providing help for the elderly in the future is to effectively integrate technology, make good use of technology, and improve the efficiency of elderly care services. The effective integration of traditional home care, community care, intelligent elderly care equipment and medical resources to create the "Internet Plus" community intelligent pension service mode has become the future development trend of aging care. The research method of this paper is to collect literature and conduct theoretical research on community pension firstly. Secondly, the combination of suitable aging design and "Internet Plus" is elaborated through research. Finally, this paper states the current level of intelligent technology in old-age care and looks into the future by understanding multiple levels of "Internet Plus". The development of community intelligent pension mode and content under "Internet Plus" has enormous development potential. In addition to the characteristics and functions of ordinary houses, residential design of endowment housing has higher requirements for comfort and personalization, and the people-oriented is the principle of design.

Keywords: ageing tendency, 'Internet Plus', community intelligent elderly care, elderly care service model, technology

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Authors: D. Mulligan, D. Casey

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Introductory Statement: Delegation is when a registered nurse (RN) transfers a task or activity that is normally within their scope of practice to another person (delegatee). RN delegation is common practice with unregistered staff, e.g., student nurses and health care assistants (HCAs). As the role of the HCA is increasingly embedded as a direct care and support role, especially in long-term residential care for older adults, there is RN uncertainty as to their role as a delegator. The assignment is when a task is transferred to a person that is within the role specification of the delegatee. RNs in long-term care (LTC) for older people are increasingly working in teams where there are less RNs and more HCAs providing direct care to the residents. The RN is responsible and accountable for their decision to delegate and assign tasks to HCAs. In an interpretive, multiple case studies to explore how delegation of tasks by RNs to HCAs occurred in long-term care settings in Ireland the importance of the RN understanding their scope of practice emerged. Methodology: Focus group interviews and individual interviews were undertaken as part of a multiple case study. Both cases, anonymized as Case A and Case B, were within the public health service in Ireland. The case study sites were long-term care settings for older adults located in different social care divisions, and in different geographical areas. Four focus group interviews with staff nurses and three individual interviews with CNMs were undertaken. The interactive data analysis approach was the analytical framework used, with within-case and cross-case analysis. The theoretical lens of organizational role theory, applying the role episode model (REM), was used to understand, interpret, and explain the findings. Study Findings: RNs and CNMs understood the role of the nurse regulator and the scope of practice. RNs understood that the RN was accountable for the care and support provided to residents. However, RNs and CNM2s could not describe delegation in the context of their scope of practice. In both cases, the RNs did not have a standardized process for assessing HCA competence to undertake nursing tasks or interventions. RNs did not routinely supervise HCAs. Tasks were assigned and not delegated. There were differences between the cases in relation to understanding which nursing tasks required delegation. HCAs in Case A undertook clinical vital sign assessments and documentation. HCAs in Case B did not routinely undertake these activities. Delegation and assignment were influenced by the organizational factors, e.g., model of care, absence of delegation policies, inadequate RN education on delegation, and a lack of RN and HCA role clarity. Concluding Statement: Nurse staffing levels and skill mix in long-term care settings continue to change with more HCAs providing more direct care and support. With decreasing RN staffing levels RNs will be required to delegate and assign more direct care to HCAs. There is a requirement to distinguish between RN assignment and delegation at policy, regulation, and organizational levels.

Keywords: assignment, delegation, registered nurse, scope of practice

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Authors: Mdoe Mwajuma Bakari, Mselle Lilian Teddy, Kibusi Stephen Mathew

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Background: Due to the increase of caesarean section (CS), many women are discharge early to their home. Women should be aware on how to take care of themselves at home after CS. Evidence shows non-uniform health education on home care after CS are provided to post CS mothers because of lack of standard home care guideline on home after CS; as existing guidelines explore only care of women in hospital setting, for health care workers. There is a need to develop post CS home care guide; exploring contents of home based care education after CS provided by nurse midwives will inform the development of the guide. Objective: To explore the content of health education provided by nurse midwives to post CS mother about home care after hospital discharge in Dodoma, Tanzania. Methodology: An exploratory qualitative study using in-depth interview was conducted in this study using triangulation of data collection method; where 14 nurse midwives working in maternity unit and 11 post CS mother attending their post-natal clinic were recruited. Content analysis was used to generate themes that describe health education information provided by nurse midwives to post CS mother about home care after hospital discharge. Results: The study found that, nutrition health education, maternal and newborn hygiene care of caesarean wound at home were the component of health education provided to post CS mothers by nurse midwives. Contradicting instruction were found to be provided to post CS mothers. Conclusion: This study reported non-uniform health education provided by the nurse midwives on home care after CS. Despite of the fact that nurse midwives recognizes the need to provide health education to the post CS mothers, there is a need to develop home care guideline as a reference for their education to ensure uniform package of education is provided to post CS mothers in order to improve recovery of post CS mothers from CS.

Keywords: caesarean section, home care, discharge education, homecare after caesarean section

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Authors: S. Abed, S. O’Neill

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This research explored ward nurses’ views about the characteristics of effective nurse leaders in the context of Iraq as a developing country, where the delivery of health care continues to face disruption and change. It is well established that the provision of modern health care requires effective nurse leaders, but in countries such as Iraq the lack of effective nurse leaders is noted as a major challenge. In a descriptive quantitative study, a survey questionnaire was administered to 210 ward nurses working in two public hospitals in a major city in the north of Iraq. The participating nurses were of the opinion that the effectiveness of their nurse leaders was evident in their ability to demonstrate: good clinical knowledge, effective communication and managerial skills. They also viewed their leaders as needing to hold high-level nursing qualifications, though this was not necessarily the case in practice. Additionally, they viewed nurse leaders’ personal qualities as important, which included politeness, ethical behaviour, and trustworthiness. When considered against the issues raised in interviews with a smaller group (20) of senior nurse leaders, representative of the various occupational levels, implications identify the need for professional development that focuses on how the underpinning competencies relate to leadership and how transformational leadership is evidenced in practice.

Keywords: health care, nurse education, nursing in Iraq, nurse leadership

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Authors: Pei Yi Lin

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Objective: The objective of this study is to use machine learning methods to build an early prediction classifier model for acute delirium to improve the quality of medical care for intensive care patients. Background: Delirium is a common acute and sudden disturbance of consciousness in critically ill patients. After the occurrence, it is easy to prolong the length of hospital stay and increase medical costs and mortality. In 2021, the incidence of delirium in the intensive care unit of internal medicine was as high as 59.78%, which indirectly prolonged the average length of hospital stay by 8.28 days, and the mortality rate is about 2.22% in the past three years. Therefore, it is expected to build a delirium prediction classifier through big data analysis and machine learning methods to detect delirium early. Method: This study is a retrospective study, using the artificial intelligence big data database to extract the characteristic factors related to delirium in intensive care unit patients and let the machine learn. The study included patients aged over 20 years old who were admitted to the intensive care unit between May 1, 2022, and December 31, 2022, excluding GCS assessment <4 points, admission to ICU for less than 24 hours, and CAM-ICU evaluation. The CAMICU delirium assessment results every 8 hours within 30 days of hospitalization are regarded as an event, and the cumulative data from ICU admission to the prediction time point are extracted to predict the possibility of delirium occurring in the next 8 hours, and collect a total of 63,754 research case data, extract 12 feature selections to train the model, including age, sex, average ICU stay hours, visual and auditory abnormalities, RASS assessment score, APACHE-II Score score, number of invasive catheters indwelling, restraint and sedative and hypnotic drugs. Through feature data cleaning, processing and KNN interpolation method supplementation, a total of 54595 research case events were extracted to provide machine learning model analysis, using the research events from May 01 to November 30, 2022, as the model training data, 80% of which is the training set for model training, and 20% for the internal verification of the verification set, and then from December 01 to December 2022 The CU research event on the 31st is an external verification set data, and finally the model inference and performance evaluation are performed, and then the model has trained again by adjusting the model parameters. Results: In this study, XG Boost, Random Forest, Logistic Regression, and Decision Tree were used to analyze and compare four machine learning models. The average accuracy rate of internal verification was highest in Random Forest (AUC=0.86), and the average accuracy rate of external verification was in Random Forest and XG Boost was the highest, AUC was 0.86, and the average accuracy of cross-validation was the highest in Random Forest (ACC=0.77). Conclusion: Clinically, medical staff usually conduct CAM-ICU assessments at the bedside of critically ill patients in clinical practice, but there is a lack of machine learning classification methods to assist ICU patients in real-time assessment, resulting in the inability to provide more objective and continuous monitoring data to assist Clinical staff can more accurately identify and predict the occurrence of delirium in patients. It is hoped that the development and construction of predictive models through machine learning can predict delirium early and immediately, make clinical decisions at the best time, and cooperate with PADIS delirium care measures to provide individualized non-drug interventional care measures to maintain patient safety, and then Improve the quality of care.

Keywords: critically ill patients, machine learning methods, delirium prediction, classifier model

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Authors: Junaid Ahmed, Nandita Shenoy

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Maintaining lifelong knowledge and skills is essential for safe clinical practice. Continuing Professional Development (CPD) is an established method that can facilitate lifelong learning. It focuses on maintaining or developing knowledge, skills and relationships to ensure competent practice.To date, relatively little has been done to comprehensively and systematically synthesize evidence to identify subjects of interest among practising dentist. Hence the aim of our study was to identify areas in clinical practice that would be favourable for continuing professional dental education amongst practicing dentists. Participants of this study consisted of the practicing dental surgeons of Mangalore, a city in Dakshina Kannada, Karnataka. 95% of our practitioners felt that regular updating as a one day program once in 3-6 months is required, to keep them abreast in clinical practice. 60% of subjects feel that CPD programs enrich their theoretical knowledge and helps in patient care. 27% of them felt that CPD programs should be related to general dentistry. Most of them felt that CPD programs should not be charged nominally between one to two thousand rupees. The acronym ‘CPD’ should be seen in a broader view in which professionals continuously enhance not only their knowledge and skills, but also their thinking,understanding and maturity; they grow not only as professionals, but also as persons; their development is not restricted to their work roles, but may also extend to new roles and responsibilities.

Keywords: continuing professional development, competent practice, dental education, practising dentist

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Authors: A. Kulprasutidilok

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In order to address the social factors of elderly health care, researcher and community members have turned to more inclusive and participatory approaches to research and interventions. One such approach, community-based participatory research (CBPR) in public health, has received increased attention as the academic and public health communities struggle to address the persistent problems of disparities in the use of health care and health outcomes for several over the past decade. As Thailand becomes an ageing society, health services and proper care systems specifically for the elderly group need to be prepared and well established. The purpose of this assignment was to study the health problems and was to explore the process of community participation in elderly health care. Participants in this study were member of elderly group of Paisanee Ramintra 65 community in Bangkok, Thailand. The results indicated two important components of community participation process in elderly health care: 1) a process to develop community participation in elderly health care, and 2) outcomes resulting from such process. The development of community participation consisted of four processes. As for the outcomes of the community participation development process, they consisted of elderly in the community got jointly and formulated a group, which strengthened the project because of collaborative supervision among themselves. Moreover, inactive health care services have changed to being energetic and focus on health promotion rather than medical achievement and elderly association of community can perform health care activities for chronically illness through the achievement of this development; consequently, they increasingly gained access to physical, cognitive, and social activity.

Keywords: community-based participatory research, elderly, heath care, Thailand.

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Authors: Wesahl Domingo, Prinslean Mahery

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Our paper focuses on the rights’ to contact and care of fathers in the heterosexual context, despite the reality of same sex parenting in South Africa. We argue that despite the new South African Children’s Act framework creating a shift from the idea of parental power over a child to the notion that parents have parental responsibilities and rights in respect of a child. This shift has however not fundamentally changed the constant battle that parents and other interested parties have over children. In most cases it is fathers who must battle to either maintain contact with their child/ren or fight to have care (which includes custody) of their child/ren. This is the case whether or not the father was married to the mother of the child in question. In part one of the paper, we deal with the historical development of rights to care and contact and describe the current system in the context of case law and legislation in South Africa. Part two provides a critical analysis of a few anthologies of “what fathers are complaining about.” In conclusion, in part three, we outline the way forward –“moving beyond the adversarial approach” through the “care of ethics approach.” So what is the care perspective? The care perspective is a relational ethic which views the primary moral concern as of creating and sustaining responsive connection to others. We apply the care of ethics approach to parenting plans and family law mediation in the context of fathers’ rights to care and contact. We argue by avoiding the adversarial system and engaging in a problem solving process focused on finding solutions for the future, divorcing parents can turn their attention to their children rather than battling each other.

Keywords: fathers' right to care, contact, custody, family law

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Authors: Sylvie Ekanga Lumumba

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Background and Significance of the Study: Over the past three decades, the perception of sexual violence has changed significantly, it is now recognized that men and boys are victims of sexual violence. However, the body of research on male victims and particularly on their attackers is much more limited. Research on the above is thus more than required. To contribute to the above quest for further studies, the researcher conducted this study on sexual violence perpetrated against men and boys by women, in the Municipality of Ibanda, Town of Bukavu, Province of South Kivu, Democratic Republic of Congo. The main study objectives were the following: to investigate on the statement of sexual violence perpetrated against men and boys in the Municipality of Ibanda, to investigate into its consequences and the statement of medical and psycho-social care given to victims. Methodology: Data were collected using valid and reliable Survey Questionnaire and Interview Schedule. Study population: the 85,882 men and boys from the Municipality of Ibanda. Sampling: led to 150 men and boys, received discreetly by the researcher during November-December 2015. Major findings: First, findings related to sexual abuse and its procedure: 74.2% of men and boys were victims of sexual violence perpetrated by a woman, more than a year ago. 13.3% however, were victims for less than a year now. 79.7% of victims have experienced sexual violence by a sexual act; 3.9% through the intention of the woman to cause the death of the victim, by serious injury to the genitals. The Second group of findings related to the consequences of sexual violence revealed that HIV/AIDS is the most important physical consequence experienced by 77.3 % of victims. Physical psychological consequences are: urinary or defecation problems (72.7%); while key psycho-emotional and behavioral consequence is: living a state of deep shame and humiliation: 68.8%. As for sexual consequences: 71.1% indicated a chronic avoidance of sexual activity and 57% reported sexual dysfunctions. The third group of findings is related to medical and psycho-social care: repetitively, more than 80% of male victims affirmed that with the help of friends and traditional healers, they took care of themselves for all the eight WHO phases of clinical care of rape victims, this was hence not effectively done. Concluding Statement: for this study, the statement of sexual violence of men and boys by women in the Eastern Congo and its consequences are not researched upon and are underestimated; the study also revealed that the care of male victims is grossly ill-conducted, as opposed to female victims care. It therefore calls for further research and further vulgarization of the research results, to convince other stakeholders (politicians for example) to immediately take action.

Keywords: sexual violence, men and boys, medical care, psycho-social care

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Authors: Lie-Fen Lin, Tzu-Hsuan Lin, Ching-Heng Lin

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Hospice care for terminally ill patients provides not only a better quality of life but also cost-saving benefits. However, the utilization of home-based hospice care (HBH care) remains low even for countries covered by National Health Insurance (NHI) programs in Taiwan. In the current commercial insurance policy, only hospital-based hospice benefits were covered. It may have an influence on the insureds chosen to receive end-of-life care in a hospitalized manner. Thus, how to propose a feasible method to advocate HBH care utilization rate of public health policies is an important issue. A total of 130,219 cancer decedents in the year 2011-2013 from the National Health Insurance Research Database (NHIRD) in Taiwan were included in this study. By adding a day volume pays benefits of HBH care as a commercial insurance rider, will provide alternative benefits for the insureds. A multiple-state Markov chain model was incorporated to estimate the transition intensities of patients in different states at the end of their lives (Non-hospice, HBH, hospital-based hospice), and the premiums were estimated. HBH care insurance benefits provide financial support and reduce the burden of care for patients. The rate-making of this product is very sensitive while the utilization rate is rising, especially for high ages. The proposed HBH care insurance is a feasible way to reduce the financial burden, enhance the care quality and family satisfaction of insureds. Meanwhile, insurance companies can participate in advocating a good medical policy to enhance the social image. In addition, the medical costs of NHI can reduce effectively.

Keywords: home-based hospice care, commercial insurance, Markov chain model, the day volume pays

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Authors: Danielle A. Walker, Kyle L. Johnson, Tara B. Thomas, Sandor Dorgo, Jacen S. Moore

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Approximately 37 million people worldwide are infected with the Human Immunodeficiency Virus (HIV), with the majority located in sub-Saharan Africa. The relationship existing between HIV incidence and socioeconomic inequity confirms the critical need for programs promoting HIV education, prevention and treatment access. This literature review analyzed 36 sources with a specific focus on the Democratic Republic of Congo, whose critically low socioeconomic status and education rate have resulted in a drastically high HIV rates. Relationships between HIV testing and treatment and barriers to care were explored. Cultural and religious considerations were found to be vital when creating and implementing HIV education and testing programs. Partnerships encouraging active support from community-based spiritual leaders to implement HIV educational programs were also key mechanisms to reach communities and individuals. Gender roles were highlighted as a key component for implementation of effective community trust-building and successful HIV education programs. The efficacy of added support by hospitals and clinics in rural areas to facilitate access to HIV testing and care for people living with HIV/AIDS (PLWHA) was discussed. This review highlighted the need for healthcare providers to provide a network of continued education for PLWHA in clinical settings during disclosure and throughout the course of treatment to increase retention in care and promote medication adherence for viral load suppression. Implementation of culturally sensitive models that rely on community familiarity with HIV educators such as ‘train-the-trainer’ were also proposed as efficacious tools for educating rural communities about HIV. Further research is needed to promote community partnerships for HIV education, understand the cultural context of gender roles as barriers to care, and empower local health care providers to be successful within the HIV Continuum of Care.

Keywords: cultural sensitivity, Democratic Republic of the Congo, education, HIV

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Authors: Fares Mahdi

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Background: Infection control is an important concern for all health care professionals, especially nurses. Nurses have a higher risk for both self-acquiring and transmitting infections to other patients. Aim of this study: to assess nurses' knowledge regarding infection control for wound care. Methodology: a descriptive research design was used in the study. The total number studied sample was 200 nurses, were conducting in Amran Public Hospitals in Amran City- Yemen. The study covered sample nurses in the hospital according to the study population; a standard closed-ended questionnaire was used to collect the data. Results: The results showed less than half (37.5 %) of nurses were from 22 May Hospital, also followed by (62.5%) of them were from Maternal and Child Hospital. Also according to the department name. Most (22.5%) of nurses worked in an intensive care unit, followed by (20%) of them were working in the pediatric world, also about (19%) of them were working in the surgical department. While in finally, only about (8.5%) of them worked from another department. According to course training, The results showed about (21%) of nurses had course training in wound care management. At the same time, others (79%) of them have not had course training in wound care management. According to the total nurse's knowledge of infection control for wound care, that find more than two-thirds (68%) of nurses had fair knowledge according to total all of nurse's knowledge of infection control wound care. Conclusion:The results showed that more than two-thirds (68%) of nurses had fair knowledge according to total all of the nurse's knowledge of infection control for wound care. Recommendations: There should be providing training program about infection control masseurs and it's important for new employees of nurses. Providing continuing refreshment training courses about infection control programs and about evidence-based practice in infection control for all health care teams.

Keywords: assessment, knowledge, infection control, wound care, nurses, amran hospitals

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Authors: Petronella Lunda, Catharina Susanna Minnie, Welma Lubbe

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Background This review aimed to provide healthcare professionals with a scientific summary of the best available research evidence on factors influencing respectful perinatal care. The review question was ‘What were the perceptions of midwives and doctors on factors that influence respectful perinatal care?’ Methods A detailed search was done on electronic databases: EBSCOhost: Medline, OAlster, Scopus, SciELO, Science Direct, PubMed, Psych INFO, and SocINDEX. The databases were searched for available literature using a predetermined search strategy. Reference lists of included studies were analysed to identify studies missing from databases. The phenomenon of interest was factors influencing maternity care practices according to midwives and doctors. Pre-determined inclusion and exclusion criteria were used during the selection of potential studies. In total, 13 studies were included in the data analysis and synthesis. Three themes were identified and a total of nine sub-themes. Results Studies conducted in various settings were included in the study. Multiple factors influencing respectful perinatal care were identified. During data synthesis, three themes emerged: healthcare institution, healthcare professionals, and women-related factors. Alongside the themes were sub-themes human resources, medical supplies, norms and practices, physical infrastructure, healthcare professional competencies and attributes, women’s knowledge, and preferences. The three factors influence the provision of respectful perinatal care; addressing them might improve the provision of the care. Conclusion Addressing factors that influence respectful perinatal care is vital towards the prevention of compromised patient care during the perinatal period as these factors have the potential to accelerate or hinder provision of respectful care.

Keywords: doctors, maternity care, midwives, obstetrician, perceptions, perinatal care, respectful care

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Authors: Hui Ling Chen

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This article describes the experience of caring for a 68-year-old lung cancer patient undergoing the initial stage of concurrent chemotherapy and radiation therapy during the period of October 21 to November 16. In this study, the author collected data through observation, interviews, medical examination, and the use of Roy’s adaptation model as a guide for data collection and assessment. This study confirmed that chemotherapy induced nausea and vomiting, and radiation therapy impaired skin integrity. At the same time, the patient experienced an anxious reaction to the initial cancer diagnosis and the insertion of subcutaneous infusion ports at the start of medical treatment. Similarly, the patient’s wife shares his anxiety, not to mention the feeling of inadequacy from the lack of training in cancer care. In response, the nursing intervention strategy has included keeping the patient and his family informed of his treatment progress, transfer of cancer care knowledge, and providing them with spiritual support. For example, the nursing staff has helped them draw up a mutually agreeable dietary plan that best suits the wife’s cooking skills, provided them with knowledge in pre- and post-radiation skin care, as well as means to cope with nausea and vomiting reactions. The nursing staff has also worked on building rapport with the patient and his spouse, providing them with encouragement, caring attention and companionship. After the patient was discharged from the hospital, the nursing staff followed up with caring phone calls to help the patient and his family make life-style adjustments to normalcy. The author hopes that his distinctive nursing experience can be useful as a reference for the clinical care of lung cancer patients undergoing the initial stage of concurrent chemotherapy and radiation therapy treatment.

Keywords: lung cancer, initiate diagnosis, concurrent chemotherapy and radiation therapy, nursing care

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Authors: Maria Monica D. Espinosa

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This study aimed to identify and examine the characteristics of an effective leader in a Hospital institution from the perspectives of military nurse-managers. The researcher extracted the different facets of leadership from the stories of six nurse- managers from a military hospital. The stories which are in pre-reflective stage convey an unbiased perspective from which clinical leadership may be defined. Using Phenomenology as a method of Research, the lived experiences of the military nurse-managers served as empirical data which were reflected upon until the formulation of insights. The information from the co-researchers became gallows from which the characteristics of effective leadership in the clinical area were drawn. These insights were synthesized through layers of reflection that resulted to the knowledge about clinical leadership. The reflections are the following, (a) Clinical leaders develop their skills through experiences and hardwork; (b) Clinical leaders are devoted; (c) Clinical leaders are focused; (d) Clinical leaders are good in interpersonal relationship; (e) Clinical leaders are mentors; (f) Clinical leaders seek affirmation and recognition; and (g) Clinical leaders are responsible and dependable. The common themes that emerged from the nurse manager’s stories showed that clinical leadership maybe attained if leaders possessed the following traits, (a) The gift to establish a steadfast and firm management; (b) The proficiency to guide and encourage others towards the achievement of their goals and objectives; (c) The ability to instigate participative and collaborative work among his/her subordinates and (d) The aptitude and skill to address the institutional concerns in their unit. In the future, Clinical leaders should continually adapt an evaluation program on how they can relate socially with their subordinates, the result of which can be used as a basis in developing strategies on relationship enhancement. Moreover, they should empower the nurses by allowing them to voice out their opinions and concerns regarding assignments, role expectations, and workload issues to improve and strengthen the relationships among nurses. Lastly, they can incorporate a collaborative strategy to promote professional socialization attitudes of nurse managers who work with staff nurses to improve the quality of their proficiencies and enhance a positive clinical environment.

Keywords: clinical leadership, experiences, implications, military nurse - managers, phenomenology

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Authors: Ilana Margalith, Yaron Niv

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One of the most important factors of professional health treatment is teamwork, in which each discipline contributes its expert knowledge, thus ensuring quality and a high standard of care as well as efficient communication (one of the International Patient Safety Goals). However, in most countries, students are educated separately by each health discipline. They are exposed to teamwork only during their clinical experience, which in some cases is short and skill-oriented. In addition, health organizations in most countries are hierarchical and although changes have occurred in the hierarchy of the medical system, there are still disciplines that underrate the unique contributions of other health professionals, thus, young graduates of health professions develop and base their perception of their peers from other disciplines on insufficient knowledge. In order to establish a wide-ranging perception among nursing students as to the contribution of different health professionals to the health of their patients, students at the Clalit Nursing Academy, Rabin Campus (Dina), Israel, participated in an interdisciplinary clinical discussion with students from several different professions, other than nursing, who were completing their clinical experience at Rabin Medical Center in medicine, health psychology, social work, audiology, physiotherapy and occupational therapy. The discussion was led by a medical-surgical nursing instructor. Their tutors received in advance, a case report enabling them to prepare the students as to how to present their professional theories and interventions regarding the case. Mutual stimulation and acknowledgment of the unique contribution of each part of the team enriched the nursing students' understanding as to how their own nursing interventions could be integrated into the entire process towards a safe and speedy recovery of the patient.

Keywords: health professions' students, interdisciplinary clinical discussion, nursing education, patient safety

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Authors: Mostafa Najim, Alaa Rahhal, Fadi Khir, Safae Abu Yousef, Amer Aljundi, Feryal Ibrahim, Aliaa Amer, Ahmed Soliman Mohamed, Samira Saleh, Dekra Alfaridi, Ahmed Mahfouz, Sumaya Al-Yafei, Faraj Howady, Mohamad Yahya Khatib, Samar Alemadi

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Background: Coronavirus disease 2019 (COVID-19) increases the risk of coagulopathy among critically ill patients. Although the presence of antiphospholipid antibodies (aPLs) has been proposed as a possible mechanism of COVID-19 induced coagulopathy, their clinical significance among critically ill patients with COVID-19 remains uncertain. Methods: This prospective observational study included patients with COVID-19 admitted to intensive care units (ICU) to evaluate the prevalence and clinical significance of aPLs, including anticardiolipin IgG/IgM, anti-β2-glycoprotein IgG/IgM, and lupus anticoagulant. The study outcomes included the prevalence of aPLs, a primary composite outcome of all-cause mortality, and arterial or venous thrombosis among aPLs positive patients versus aPLs negative patients during their ICU stay. Multiple logistic regression was used to assess the influence of aPLs on the primary composite outcome of mortality and thrombosis. Results: A total of 60 critically ill patients were enrolled. Of whom, 57 (95%) were male, with a mean age of 52.8 ± 12.2 years, and the majority were from Asia (68%). Twenty-two patients (37%) were found to have positive aPLs; of whom 21 patients were positive for lupus anticoagulant, whereas one patient was positive for anti-β2-glycoprotein IgG/IgM. The composite outcome of mortality and thrombosis during ICU did not differ among patients with positive aPLs compared to those with negative aPLs (4 (18%) vs. 6 (16%), aOR= 0.98, 95% CI 0.1-6.7; p-value= 0.986). Likewise, the secondary outcomes, including all-cause mortality, venous thrombosis, arterial thrombosis, discharge from ICU, time to mortality, and time to discharge from ICU, did not differ between those with positive aPLs upon ICU admission in comparison to patients with negative aPLs. Conclusion: The presence of aPLs does not seem to affect the outcomes of critically ill patients with COVID-19 in terms of all-cause mortality and thrombosis. Therefore, clinicians may not screen critically ill patients with COVID-19 for aPLs unless deemed clinically appropriate.

Keywords: antiphospholipid antibodies, critically ill patients, coagulopathy, coronavirus

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Authors: Longtao He, Han Wu

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Summary: As the need for elder care increases in China due to a growing aging population and, in particular, rising cancer rates, it becomes increasingly important to also support family caregivers, who are often the main source of care. We used a qualitative meta-synthesis to systematically evaluate and integrate the caregiving experiences of family caregivers of elderly cancer patients as revealed by articles published in Chinese journals. Findings: Nine studies are included in the final analysis. The caregiver experiences they describe are synthesized into three primary themes: care needs, care burden, and care gains, with numerous secondary themes. Besides the findings that seem to align with other findings across cultures, we have highlighted three main discoveries from the synthesis that may be quite specific to the Chinese context: 1. more sub-themes related to specific caregiving skills caregivers of cancer patients; 2. a call for health professionals to improve their communication skills with family caregivers; 3. the important role of filial piety. Applications: Our findings can be used to help health social workers and relevant policymakers in China support family caregivers by identifying the education and training required for caregivers, ways to make the most of potential care gains, and ways to ease care burdens.

Keywords: cancer, Chinese family caregivers, caregiving skills, care burden, care gains, health social work

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Authors: Recep Kesli, Gulsah Asik, Cengiz Demir, Onur Turkyilmaz

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Objective: Pseudomonas aeruginosa (P. aeruginosa) is an important nosocomial pathogen which causes serious hospital infections and is resistant to many commonly used antibiotics. P. aeruginosa can develop resistance during therapy and also it is very resistant to disinfectant chemicals. It may be found in respiratory support devices in hospitals. In this study, the antibiotic resistance of P. aeruginosa strains isolated from bronchial aspiration samples was evaluated retrospectively. Methods: Between October 2013 and September 2015, a total of 318 P. aeruginosa were isolated from clinical samples obtained from various intensive care units and inpatient patients hospitalized at Afyon Kocatepe University, ANS Practice and Research Hospital. Isolated bacteria identified by using both the conventional methods and automated identification system-VITEK 2 (bioMerieux, Marcy l’etoile France). Antibacterial resistance tests were performed by using Kirby-Bauer disc (Oxoid, Hampshire, England) diffusion method following the recommendations of CLSI. Results: Antibiotic resistance rates of identified 318 P. aeruginosa strains were found as follows for tested antibiotics; 32 % amikacin, 42% gentamicin, 43% imipenem, 43% meropenem, 50% ciprofloxacin, 57% levofloxacin, 38% cefepime, 63% ceftazidime, and 85% piperacillin/tazobactam. Conclusion: Resistance profiles change according to years and provinces for P. aeruginosa, so these findings should be considered empirical treatment choices. In this study, the highest and lowest resistance rates found against piperacillin/tazobactam % 85, and amikacin %32.

Keywords: Pseudomonas aeruginosa, antibiotic resistance rates, intensive care unit, Pseudomonas spp.

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Authors: Bernice Boafoaa Gyapong, Anne Jones, Sam Bassett, Janet Anderson

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Background: Maternal mortality and morbidity are global concerns, especially in sub-Saharan Africa (SSA). Most maternal mortalities occur at the time of birth. Quality intrapartum care is essential for improving maternal and newborn health outcomes. This scoping review aimed to assess and describe the quality of care during childbirth in SSA to provide an overview of the regional trend of the quality of intrapartum care, the challenges to quality care provision, and identify research gaps. Methods: A scoping review based on Arksey and O’Malley’s scoping review framework was conducted. Medline, CINAHL, PsycINFO, and maternal-infant databases were searched to identify the relevant studies for this review. A narrative summary was presented using themes based on the Donabedian structure, process, and outcome quality of care model. Results: A total of five hundred and forty-seven (547) publications were identified. Fifty-six (56) studies conducted in twenty (20) countries were included in the review. Thirty-four (34) were quantitative, sixteen (16) were qualitative, and six (6) were mixed methods. Most of the studies were related to the process component of quality of care. The provision of emergency obstetric care services, infrastructure, and availability of essential staff and equipment for perinatal care was inadequate in many facilities, particularly rural and peripheral health facilities. Many women experienced disrespectful care during childbirth. Routine care during labour and delivery was observed to be sub-optimal, yet some women reported high satisfaction with care. The use of health facilities for delivery was lower in health centres compared to hospitals. Conclusion: There are variations in the quality of maternity care provided in SSA. Intrapartum care quality is generally deficient in SSA, particularly in peripheral health facilities, health centres, and community clinics. Many of the quality-of-care issues identified are related to the structure component. Stakeholders must develop interventions that comprehensively address these interrelated issues to improve maternal healthcare quality, especially in primary healthcare facilities.

Keywords: quality of care, maternity health, Sub-Saharan Africa, intrapartum

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Authors: Mohammed S. Bhader, Abdullah A. Ghaddaf, Anas Alamoudi, Amal Abualola, Renad Kalantan, Noura Alkhulaifi, Ibrahim Halawani, Mohammed Alhindi

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Background: Noninvasive neurally adjusted ventilatory assist (NAVA) is a relatively new mode of noninvasive ventilation with promising clinical and patient-ventilator outcomes for preterm infants. The aim of this systematic review was to compare NAVA to nasal continuous or positive airway pressure (NCPAP) or intermittent positive airway pressure (NIPP) for preterm infants. Methods: We searched the online databases Medline, Embase, and CENTRAL. We included randomized controlled trials (RCTs) that compared NAVA to NCPAP or NIPP for preterm infants < 37 weeks gestational age. We sought to evaluate the following outcomes: noninvasive intubation failure rate, desaturation rate, the fraction of inspired oxygen (FiO2), and length of stay in the neonatal intensive care unit (NICU). We used the mean difference (MD) to represent continuous outcomes, while the odds ratio (OR) was used to represent dichotomous outcomes. Results: A total of 11 RCTs that enrolled 429 preterm infants were deemed eligible. NAVA showed similar clinical outcomes to NCPAP or NIPP with respect to noninvasive intubation failure (RR for NAVA versus NCPAP: 0.82, 95% confidence interval (CI): 0.49 to 1.37), desaturation rate (RR for NAVA versus NCPAP: 0.69, 95%CI: 0.36 to 1.29; RR for NAVA versus NIPP: 0.58, 95%CI: 0.08 to 4.25), FiO2 (MD for NAVA versus NCPAP: –0.01, 95%CI: –0.04 to 0.02; MD for NAVA versus NIPP: –7.16, 95%CI: –22.63 to 8.31), and length of stay in the NICU (MD for NAVA versus NCPAP: 1.34, 95%CI: –4.17 to 6.85). Conclusion: NAVA showed similar clinical and ventilator-related outcomes compared to the usual care noninvasive respiratory support measures NCPAP or NIPP for preterm infants.

Keywords: preterm infants, noninvasive neurally adjusted ventilatory assist, NIV-NAVA, non-invasive ventilation, nasal continuous or positive airway pressure, NCPAP, intermittent positive airway pressure ventilation, NIPP, respiratory distress syndrome, RDS

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Authors: Ying Li, Rui Hu, Shizhen Chen, Xin Zhou, Yunhuang Yang

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Prostate cancer is one of the leading causes of cancer-related death among men. Prostate-specific antigen (PSA), a specific product of prostatic epithelial cells, is an important indicator of prostate cancer. Though PSA is not a specific serum biomarker for the screening of prostate cancer, it is recognized as an indicator for prostate cancer recurrence and response to therapy for patient’s post-prostatectomy. Since radical prostatectomy eliminates the source of PSA production, serum PSA levels fall below 50 pg/mL, and may be below the detection limit of clinical immunoassays (current clinical immunoassay lower limit of detection is around 10 pg/mL). Many clinical studies have shown that intervention at low PSA levels was able to improve patient outcomes significantly. Therefore, ultra-sensitive and precise assays that can accurately quantify extremely low levels of PSA (below 1-10 pg/mL) will facilitate the assessment of patients for the possibility of early adjuvant or salvage treatment. Currently, the commercially available ultra-sensitive ELISA kit (not used clinically) can only reach a detection limit of 3-10 pg/mL. Other platforms developed by different research groups could achieve a detection limit as low as 0.33 pg/mL, but they relied on sophisticated instruments to get the final readout. Herein we report a microfluidic platform for point-of-care (POC) detection of PSA with a detection limit of 0.5 pg/mL and without the assistance of any equipment. This platform is based on a previously reported volumetric-bar-chart chip (V-Chip), which applies platinum nanoparticles (PtNPs) as the ELISA probe to convert the biomarker concentration to the volume of oxygen gas that further pushes the red ink to form a visualized bar-chart. The length of each bar is used to quantify the biomarker concentration of each sample. We devised a long reading channel V-Chip (LV-Chip) in this work to achieve a wide detection window. In addition, LV-Chip employed a unique enzyme-free ELISA probe that enriched PtNPs significantly and owned 500-fold enhanced catalytic ability over that of previous V-Chip, resulting in a significantly improved detection limit. LV-Chip is able to complete a PSA assay for five samples in 20 min. The device was applied to detect PSA in 50 patient serum samples, and the on-chip results demonstrated good correlation with conventional immunoassay. In addition, the PSA levels in finger-prick whole blood samples from healthy volunteers were successfully measured on the device. This completely stand-alone LV-Chip platform enables convenient POC testing for patient follow-up in the physician’s office and is also useful in resource-constrained settings.

Keywords: point-of-care detection, microfluidics, PSA, ultra-sensitive

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Authors: Khalid Ishola Bello

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Many religions and cultures believe in the existence of invisible beings who co-exist with man on earth. Muslims, for example, believe in malaikah (Angel) and jinn (demon), who have their source of creation from light and flame, respectively. Jinn, according to Islamic texts, possesses unique characteristics which give them an advantage over the man. Invisibility, transforming into or taking possession of another being are parts of advantages jinn have above man. Hence, jinn can attack man and truncate his well-being by causing malfunction of his physiological and psychological realms, which may go beyond physical health care. It is on this background that this paper aims to articulate the possibility of a demonic attack on human health and the care processes recommended by Islam to heal and restore well-being of the victim. Through analysis of the inductive, deductive, and historical approaches, the process of ruqyah (healing method based on recitation of the Qur’an) and hijamah (cupping) therapies shall be analyzed. The finding shows the efficacy of Islamic remedies to demonic possession, which usually complicates health challenges in the care of man. This alternative approach is therefore recommended for holistic health care since physical health care cannot fix spiritual health challenges.

Keywords: wellbeing, healthcare, demonic possession, cupping, jinn

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Authors: Monika Jurkeviciute, Amia Enam, Johanna Torres Bonilla, Henrik Eriksson

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Introduction: Many evaluations of eHealth interventions conclude that the evidence for improved clinical outcomes is limited, especially when the intervention is short, such as one year. Often, evaluation design does not address the feasibility of achieving clinical outcomes. Evaluations are designed to reflect upon clinical goals of intervention without utilizing the opportunity to illuminate effects on organizations and cost. A comprehensive design of evaluation can better support decision-making regarding the effectiveness and potential transferability of eHealth. Hence, the purpose of this paper is to present a feasible and comprehensive design of evaluation for eHealth intervention, including the design process in different contexts. Methodology: The situation of limited feasibility of clinical outcomes was foreseen in the European Union funded project called “DECI” (“Digital Environment for Cognitive Inclusion”) that is run under the “Horizon 2020” program with an aim to define and test a digital environment platform within corresponding care models that help elderly people live independently. A complex intervention of eHealth implementation into elaborate care models in four different countries was planned for one year. To design the evaluation, a participative approach was undertaken using Pettigrew’s lens of change and transformations, including context, process, and content. Through a series of workshops, observations, interviews, and document analysis, as well as a review of scientific literature, a comprehensive design of evaluation was created. Findings: The findings indicate that in order to get evidence on clinical outcomes, eHealth interventions should last longer than one year. The content of the comprehensive evaluation design includes a collection of qualitative and quantitative methods for data gathering which illuminates non-medical aspects. Furthermore, it contains communication arrangements to discuss the results and continuously improve the evaluation design, as well as procedures for monitoring and improving the data collection during the intervention. The process of the comprehensive evaluation design consists of four stages: (1) analysis of a current state in different contexts, including measurement systems, expectations and profiles of stakeholders, organizational ambitions to change due to eHealth integration, and the organizational capacity to collect data for evaluation; (2) workshop with project partners to discuss the as-is situation in relation to the project goals; (3) development of general and customized sets of relevant performance measures, questionnaires and interview questions; (4) setting up procedures and monitoring systems for the interventions. Lastly, strategies are presented on how challenges can be handled during the design process of evaluation in four different countries. The evaluation design needs to consider contextual factors such as project limitations, and differences between pilot sites in terms of eHealth solutions, patient groups, care models, national and organizational cultures and settings. This implies a need for the flexible approach to evaluation design to enable judgment over the effectiveness and potential for adoption and transferability of eHealth. In summary, this paper provides learning opportunities for future evaluation designs of eHealth interventions in different national and organizational settings.

Keywords: ehealth, elderly, evaluation, intervention, multi-cultural

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Authors: Ramy Shaaban

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The purpose of this study was to examine the difference in clinical reasoning skills of students when using virtual audiology cases with and without collaborative assistance from major learning approaches important to clinical reasoning skills and computer-based learning models: Situated Learning Theory, Social Development Theory, Scaffolding, and Collaborative Learning. A quasi-experimental design was conducted at two United States universities to examine whether there is a significant difference in clinical reasoning skills between three treatment groups using IUP Audiosim software. Two computer-based audiology case simulations were developed, and participants were randomly placed into the three groups: no collaboration, virtual collaboration, and live collaboration. The clinical reasoning data were analyzed using One-Way ANOVA and Tukey posthoc analyses. The results show that there was a significant difference in clinical reasoning skills between the three treatment groups. The score obtained by the no collaboration group was significantly less than the scores obtained by the virtual and live collaboration groups. Collaboration, whether virtual or in person, has a positive effect on students’ clinical reasoning. These results with audiology students indicate that combining collaboration models with scaffolding and embedding situated learning and social development theories into the design of future virtual patients has the potential to improve students’ clinical reasoning skills.

Keywords: clinical reasoning, virtual patients, collaborative learning, scaffolding

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Authors: Sheeraz Memon, Namunu C. Maddage, Margaret Lech, Nicholas Allen

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The effect of a clinical environment on the accuracy of the speaker verification was tested. The speaker verification tests were performed within homogeneous environments containing clinically depressed speakers only, and non-depresses speakers only, as well as within mixed environments containing different mixtures of both climatically depressed and non-depressed speakers. The speaker verification framework included the MFCCs features and the GMM modeling and classification method. The speaker verification experiments within homogeneous environments showed 5.1% increase of the EER within the clinically depressed environment when compared to the non-depressed environment. It indicated that the clinical depression increases the intra-speaker variability and makes the speaker verification task more challenging. Experiments with mixed environments indicated that the increase of the percentage of the depressed individuals within a mixed environment increases the speaker verification equal error rates.

Keywords: speaker verification, GMM, EM, clinical environment, clinical depression

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Authors: Chelly Souhir, Harizi Chahida, Hachaichi Aicha, Aissaoui Sihem, Chahed Mohamed Kouni

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Introduction: In Tunisia, few studies have attempted to describe the demand for primary care in a standardized and systematic way. The purpose of this study is to describe the main reasons for demand for care in primary health care, through a survey of the Ariana Governorate PHC and to identify their evolutionary trend compared to last 30 years, reported by studies of the same type. Materials and methods: This is a cross-sectional descriptive study which concerns the study of consultants in the first line of the governorate of Ariana and their use of care recorded during 2 days in the same week during the month of May 2016, in each of these PHC. The same data collection sheet was used in all CSBs. The coding of the information was done according to the International Classification of Primary Care (ICPC). The data was entered and analyzed by the EPI Info 7 software. Results: Our study found that the most common ICPC chapters are respiratory (42%) and digestive (13.2%). In 1996 were the respiratory (43.5%) and circulatory (7.8%). In 2000, we found also the respiratory (39,6%) and circulatory (10,9%). In 2002, respiratory (43%) and digestive (10.1%) motives were the most frequent. According to the ICPC, the pathologies in our study were acute angina (19%), acute bronchitis and bronchiolitis (8%). In 1996, it was tonsillitis ( 21.6%) and acute bronchitis (7.2%). For Ben Abdelaziz in 2000, tonsillitis (14.5%) follow by acute bronchitis (8.3%). In 2002, acute angina (15.7%), acute bronchitis and bronchiolitis (11.2%) were the most common. Conclusion: Acute angina and tonsillitis are the most common in all studies conducted in Tunisia.

Keywords: acute angina, classification of primary care, primary health care, tonsillitis, Tunisia

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Authors: Ashi Gautam, Isha Shukla, Akhil Seghal

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Biosensors are analytical devices that use a biological sensing element to detect and measure a specific chemical substance or biomolecule in a sample. These devices are widely used in various fields, including medical diagnostics, environmental monitoring, and food analysis, due to their high specificity, sensitivity, and selectivity. In this research paper, a machine learning model is proposed for predicting the suitability of skin care products based on biosensor readings. The proposed model takes in features extracted from biosensor readings, such as biomarker concentration, skin hydration level, inflammation presence, sensitivity, and free radicals, and outputs the most appropriate skin care product for an individual. This model is trained on a dataset of biosensor readings and corresponding skin care product information. The model's performance is evaluated using several metrics, including accuracy, precision, recall, and F1 score. The aim of this research is to develop a personalised skin care product recommendation system using biosensor data. By leveraging the power of machine learning, the proposed model can accurately predict the most suitable skin care product for an individual based on their biosensor readings. This is particularly useful in the skin care industry, where personalised recommendations can lead to better outcomes for consumers. The developed model is based on supervised learning, which means that it is trained on a labeled dataset of biosensor readings and corresponding skin care product information. The model uses these labeled data to learn patterns and relationships between the biosensor readings and skin care products. Once trained, the model can predict the most suitable skin care product for an individual based on their biosensor readings. The results of this study show that the proposed machine learning model can accurately predict the most appropriate skin care product for an individual based on their biosensor readings. The evaluation metrics used in this study demonstrate the effectiveness of the model in predicting skin care products. This model has significant potential for practical use in the skin care industry for personalised skin care product recommendations. The proposed machine learning model for predicting the suitability of skin care products based on biosensor readings is a promising development in the skin care industry. The model's ability to accurately predict the most appropriate skin care product for an individual based on their biosensor readings can lead to better outcomes for consumers. Further research can be done to improve the model's accuracy and effectiveness.

Keywords: biosensors, data model, machine learning, skin care

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Authors: Sawyer Spurry

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Problem: Palliative care providers at an academic medical center in Maryland stated medical intensive care unit (MICU) patients are often referred late in their hospital stay. The MICU has performed well below the hospital quality performance metric of 80% of patients who expire with expected outcomes should have received a palliative care consult within 48 hours of admission. Purpose: The purpose of this quality improvement (QI) project is to increase palliative care utilization in the MICU through the implementation of a Nurse-Driven PalliativeTriggerTool to prompt the need for specialty palliative care consult. Methods: MICU nursing staff and providers received education concerning the implications of underused palliative care services and the literature data supporting the use of nurse-driven palliative care tools as a means of increasing utilization of palliative care. A MICU population specific criteria of palliative triggers (Palliative Care Trigger Tool) was formulated by the QI implementation team, palliative care team, and patient care services department. Nursing staff were asked to assess patients daily for the presence of palliative triggers using the Palliative Care Trigger Tool and present findings during bedside rounds. MICU providers were asked to consult palliative medicinegiven the presence of palliative triggers; following interdisciplinary rounds. Rates of palliative consult, given the presence of triggers, were collected via electronic medical record e-data pull, de-identified, and recorded in the data collection tool. Preliminary Results: Over 140 MICU registered nurses were educated on the palliative trigger initiative along with 8 nurse practitioners, 4 intensivists, 2 pulmonary critical care fellows, and 2 palliative medicine physicians. Over 200 patients were admitted to the MICU and screened for palliative triggers during the 15-week implementation period. Primary outcomes showed an increase in palliative care consult rates to those patients presenting with triggers, a decreased mean time from admission to palliative consult, and increased recognition of unmet palliative care needs by MICU nurses and providers. Conclusions: Anticipatory findings of this QI project would suggest a positive correlation between utilizing palliative care trigger criteria and decreased time to palliative care consult. The direct outcomes of effective palliative care results in decreased length of stay, healthcare costs, and moral distress, as well as improved symptom management and quality of life (QOL).

Keywords: palliative care, nursing, quality improvement, trigger tool

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Authors: Areej Alosimi, Heather Wharrad, Katharine Whittingham

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Palliative care is a crucial element in nursing, especially with the steep increase in non-communicable diseases. Providing education in palliative care can help elevate the standards of care and address the growing need for it. However, palliative care has not been introduced into nursing curricula, specifically in Saudi Arabia, evidenced by students' inadequate understanding of the subject. Digital learning has been identified as a persuasive and effective method to improve education. The study aims to assess the feasibility and accessibility of implementing digital learning in palliative care education in Saudi Arabia by investigating the potential of delivering palliative care nurse education via distance learning. The study will utilize a sequential exploratory mixed-method approach. Phase one will entail identifying needs, developing a web-based program in phase two, and intervention implementation with a pre-post-test in phase three. Semi-structured interviews will be conducted to explore participant perceptions and thoughts regarding the intervention. Data collection will incorporate questionnaires and interviews with nursing students. Data analysis will use SPSS to analyze quantitative measurements and NVivo to analyze qualitative aspects. The study aims to provide insights into the feasibility of implementing digital learning in palliative care education. The results will serve as a foundation to investigate the effectiveness of e-learning interventions in palliative care education among nursing students. This study addresses a crucial gap in palliative care education, especially in nursing curricula, and explores the potential of digital learning to improve education. The results have broad implications for nursing education and the growing need for palliative care globally. The study assesses the feasibility and accessibility of implementing digital learning in palliative care education in Saudi Arabia. The research investigates whether palliative care nurse education can be effectively delivered through distance learning to improve students' understanding of the subject. The study's findings will lay the groundwork for a larger investigation on the efficacy of e-learning interventions in improving palliative care education among nursing students. The study can potentially contribute to the overall advancement of nursing education and the growing need for palliative care.

Keywords: undergraduate nursing students, E-Learning, Palliative care education, Knowledge

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