Workload

工作量
  • 文章类型: Systematic Review
    在本研究中,我们旨在系统评估目前关于执行机器人辅助前列腺癌根治术(RARP)的外科医生术中工作量的证据.到2024年4月,在PubMed-MEDLINE和WebofScience数据库中使用以下搜索词进行了系统搜索:“工作量和机器人辅助的根治性前列腺切除术”,“工作量和机器人前列腺癌根治术”,“任务负荷和机器人根治性前列腺切除术”,“任务负荷和机器人辅助前列腺癌根治术”和“NASA-TLX和机器人辅助前列腺癌根治术”通过结合人口,干预,比较,和结果(PICO)术语,遵循系统评价和荟萃分析(PRISMA)指南的首选报告项目。因此,我们选择了包括接受机器人根治性前列腺切除术(I)的前列腺癌患者(P)并报告工作量/任务负荷问卷(C)的研究,以评估执行机器人辅助根治性前列腺切除术(O)的外科医生的术中工作量/任务负荷。共确定了11项研究。在研究中,使用美国国家航空航天局任务负荷指数(NASA-TLX)和/或手术任务负荷指数(SURG-TLX)评估了外科医生在RARP期间的工作量。研究的NASA-TLX总评分范围为22.7±3.2至62.0±6.4。精神和身体的需求,流动中断,外科医生的经验,使用单个或多个端口,外科医生与手术室其他工作人员之间的关系可能会影响控制台外科医生的术中工作量。我们审查的研究表明,尽管有精神需求,RARP仍为控制台外科医生提供可接受的工作量。
    In the present study, we aimed to systematically evaluate the current evidence regarding the intraoperative workload of surgeons performing robot-assisted radical prostatectomy (RARP) for prostate cancer. A systematic search was carried out in the PubMed-MEDLINE and Web of Science databases through April 2024 using the following search terms: \"workload AND robot assisted radical prostatectomy\", \"workload AND robotic radical prostatectomy\", \"task load AND robotic radical prostatectomy\", \"task load AND robot assisted radical prostatectomy\" and \"NASA-TLX AND robot assisted radical prostatectomy\" by combining population, intervention, comparison, and outcome (PICO) terms, following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. We therefore selected studies that included patients with prostate cancer (P) who underwent robotic radical prostatectomy (I) and reported a workload/task load questionnaire (C) to assess the intraoperative workload/task load of the surgeon performing robot-assisted radical prostatectomy (O). A total of 11 studies were identified. The surgeon\'s workload during RARP was assessed using the National Aeronautics and Space Administration task load index (NASA-TLX) and/or the surgery task load index (SURG-TLX) in the studies. Total NASA-TLX scores of the studies ranged from 22.7 ± 3.2 to 62.0 ± 6.4. Mental and physical demands, flow interruptions, surgeon experience, the use of single or multiple ports, and the relationship between the surgeon and other staff in the operating theater may play a role in the intraoperative workload of the console surgeon. The studies we reviewed suggest that RARP offers an acceptable workload for the console surgeon despite its mental demands.
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  • 文章类型: Journal Article
    评估生命支持培训的有效性,特别强调团队在临床和教育成果方面的能力。
    这项系统评价是前瞻性注册的(PROSPEROCRD42023473154),并遵循PICOST(人口,干预,比较,结果,研究设计,时间帧)格式。包括所有随机对照试验和非随机研究,评估接受生命支持培训的学习者,并特别强调在任何情况下(实际和模拟复苏)的团队能力。未发表的研究被排除在外。Medline,从开始到2023年8月(2024年1月18日更新),搜索了Embase和Cochrane数据库以及试验注册中心。两名研究人员进行了标题和摘要筛选,全文筛选,数据提取,偏倚风险评估(使用RoB2和ROBINS-I)和证据确定性评估(使用等级)。PRISMA报告清单用于报告结果。没有获得资金来进行这项系统审查。
    文献检索出5470份手稿。删除2073个副本后,审阅其余文章的标题和摘要,得出31篇文章全文审阅。其中,最终纳入了17项研究。这些研究涉及以下培训水平:基本生命支持,成人高级生命支持,儿科和新生儿复苏。大多数研究(n=16)以模拟的方式评估结果,只有一项实际复苏的研究。所有培训环境中的研究都显示了生命支持培训的中立性和/或益处,特别强调团队能力。团队能力培训提高了CPR技能表现和CPR质量。改进的具体团队能力包括领导力,通信,决策和任务管理。没有观察到不期望的效果。由于显著的方法学异质性,无法进行Meta分析。由于缺乏数据,无法进行亚组分析。偏见评估的风险从一些问题到严重不等。由于偏倚和不精确的风险,证据的总体确定性被评为低到非常低。
    这项系统评价确定了非常低和低确定性的证据,几乎完全来自模拟研究。这些研究及其发现是异质的,但表明教学团队能力可以提高复苏技能表现和CPR质量。以及提高团队能力,特别是领导,通信,决策,和任务管理。需要进一步的研究,以了解团队能力培训干预措施的最佳配置,并了解对临床结果和成本效益的影响。
    UNASSIGNED: To evaluate the effectiveness of life support training with specific emphasis on team competencies on clinical and educational outcomes.
    UNASSIGNED: This systematic review was prospectively registered (PROSPERO CRD42023473154) and followed the PICOST (population, intervention, comparison, outcome, study design, timeframe) format. All randomized controlled trials and non-randomized studies evaluating learners undertaking life support training with specific emphasis on team competencies in any setting (actual and simulated resuscitations) were included. Unpublished studies were excluded. Medline, Embase and Cochrane databases as well as trial registries were searched from inception to August 2023 (updated January 18, 2024). Two researchers performed title and abstract screening, full-text screening, data extraction, assessment of risk of bias (using RoB2 and ROBINS-I) and certainty of evidence (using GRADE). PRISMA reporting checklist was used to report the results. No funding was obtained to perform this systematic review.
    UNASSIGNED: The literature search identified 5470 manuscripts. After the removal of 2073 duplicates, reviewing the remaining articles\' titles and abstracts yielded 31 articles for full-text review. Of these, 17 studies were finally included. The studies involved the following training levels: basic life support, adult advanced life support, paediatric and neonatal resuscitations. Most studies (n = 16) evaluated outcomes in simulated, and only one study in actual resuscitations. Studies included in all training contexts showed either neutrality and/or benefits of life support training with specific emphasis on team competencies. Team competencies training improved CPR skill performance and CPR quality. Specific team competencies that improved included leadership, communication, decision-making and task management. No undesirable effects were observed. Meta-analysis was not possible due to significant methodological heterogeneity. Sub-group analysis was impossible due to lack of data. Risk of bias assessment ranged from some concerns to serious. Overall certainty of evidence was rated as low to very low due to risk of bias and imprecision.
    UNASSIGNED: This systematic review identified very low and low certainty evidence, almost entirely derived from simulation studies. The studies and their findings were heterogenous but suggest that teaching team competencies can improve resuscitation skills performance and CPR quality, as well as improve team competencies, specifically leadership, communication, decision-making, and task management. Further research is required to understand optimal configuration of team competencies training interventions and to understand the effect on clinical outcomes and cost-effectiveness.
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  • 文章类型: Journal Article
    目的:确定并提供有关急诊科劳动力健康的现有证据。
    方法:范围审查。
    方法:急诊科(ED)。
    方法:CINAHL,MEDLINE,搜索APAPsycINFO和WebofScience,没有发布时间参数。还筛选了用于全文审查的文章的参考列表,以查找其他论文。
    方法:所有同行评审,如果:(1)参与者包括以员工为基础的全职ED,(2)ED劳动力福祉是研究的关键组成部分,(3)英语可用,(4)主要重点不是倦怠或其他与精神疾病相关的变量。
    结果:搜索确定了6109篇论文,其中34篇论文被纳入综述。大多数论文使用定量或混合方法进行调查设计,使用深入的定性方法探索ED劳动力福祉的证据非常有限。干预措施占审查研究的41%。调查结果强调了ED员工福祉的紧迫问题,由一系列人际关系促成,组织和个人挑战(例如,高工作负载,缺乏支持)。然而,有限的证据基础,现有文献中脆弱的概念化和与幸福的联系意味着研究结果既不一致也不具有结论性。
    结论:本范围审查强调需要进行更多高质量的研究,特别是使用定性方法和制定ED劳动力福祉的工作定义。
    OBJECTIVE: To identify and present the available evidence regarding workforce well-being in the emergency department.
    METHODS: Scoping review.
    METHODS: The emergency department (ED).
    METHODS: CINAHL, MEDLINE, APA PsycINFO and Web of Science were searched with no publication time parameters. The reference lists of articles selected for full-text review were also screened for additional papers.
    METHODS: All peer-reviewed, empirical papers were included if: (1) participants included staff-based full-time in the ED, (2) ED workforce well-being was a key component of the research, (3) English language was available and (4) the main focus was not burnout or other mental illness-related variables.
    RESULTS: The search identified 6109 papers and 34 papers were included in the review. Most papers used a quantitative or mixed methods survey design, with very limited evidence using in-depth qualitative methods to explore ED workforce well-being. Interventions accounted for 41% of reviewed studies. Findings highlighted pressing issues with ED workforce well-being, contributed to by a range of interpersonal, organisational and individual challenges (eg, high workloads, lack of support). However, the limited evidence base, tenuous conceptualisations and links to well-being in existing literature mean that the findings were neither consistent nor conclusive.
    CONCLUSIONS: This scoping review highlights the need for more high-quality research to be conducted, particularly using qualitative methods and the development of a working definition of ED workforce well-being.
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  • 文章类型: Journal Article
    背景:国际关注的突发公共卫生事件(PHEIC),如COVID-19大流行以及自2000年代初以来发生的其他事件,给医疗保健系统带来了巨大压力。由于额外的工作量,这是卫生和护理人员(HCW)抗议的背景,工作条件和对身心健康的影响。在本文中,我们打算分析与工业行动相关的HCWs的需求,抗议,在COVID-19大流行和其他PHEIC期间发生的罢工和停工(IAPSL);确定这些不满的影响;并描述解决这些IAPSL的相关干预措施。
    方法:我们纳入了2000年1月至2022年3月在PubMed上发表的研究,Embase,Scopus,BVS/LILACS,世界卫生组织的COVID-19研究数据库,ILO,OECD,HSRM,和谷歌灰色文学学者。合格标准是HCWs作为参与者,IAPSL是在COVID-19和其他PHEIC的背景下发生的感兴趣的现象。GRADECERQual用于评估偏倚风险和证据可信度。
    结果:检索了1656条记录,并选择91人进行全文筛选。我们包括18种出版物。全系统的方法,而不是对罢工机构采取有限的方法,使人们有可能了解罢工对医疗保健服务的全部影响。PHEIC倾向于加剧已经不利的HCWs的工作条件,充当HCWs罢工的司机,导致人员短缺,和财务问题,在北方和全球南方,在亚洲和非洲尤其明显。此外,与卫生部门领导和治理不足以及医疗产品和技术缺乏相关的问题(例如,缺乏个人防护设备)是罢工的主要驱动因素,每个人占确定的总司机的25%。
    结论:有必要将重点放在卫生保健系统的准备工作上,以充分应对PHEIC,这包括为HCWs\'IAPSL做准备,在COVID-19大流行的背景下谈了很多。在IAPSL期间,协助决策者制定充分应对人口健康和护理需求的战略的证据至关重要。罢工的主要影响是对医疗保健服务供应的中断。性别不平等是HCWs中的一个主要问题,只有将性别视角与系统方法相结合,才能正确理解罢工对医疗保健服务的全面影响,而不是仅限于罢工机构的无性别区分方法。
    BACKGROUND: Public health emergencies of international concern (PHEICs) as the COVID-19 pandemic and others that have occurred since the early 2000s put enormous pressure on health and care systems. This is being a context for protests by health and care workers (HCWs) because of additional workload, working conditions and effects on mental and physical health. In this paper, we intended to analyze the demands of HCWs associated with industrial actions, protests, strikes and lockouts (IAPSLs) which occurred during COVID-19 pandemic and other PHEICs; to identify the impact of these grievances; and describe the relevant interventions to address these IAPSLs.
    METHODS: We included studies published between January 2000 and March 2022 in PubMed, Embase, Scopus, BVS/LILACS, WHO\'s COVID-19 Research Database, ILO, OECD, HSRM, and Google Scholar for grey literature. Eligibility criteria were HCWs as participants, IAPSLs as phenomenon of interest occurring in the context of COVID-19 and other PHEICs. GRADE CERQual was used to assess risk of bias and confidence of evidence.
    RESULTS: 1656 records were retrieved, and 91 were selected for full-text screening. We included 18 publications. A system-wide approach, rather than a limited approach to institutions on strike, makes it possible to understand the full impact of the strike on health and care services. PHEICs tend to aggravate already adverse working conditions of HCWs, acting as drivers for HCWs strikes, leading to staff shortages, and financial issues, both in the North and in the Global South, particularly evident in Asia and Africa. In addition, issues related to deficiencies in leadership and governance in heath sector and lack of medical products and technologies (e.g., lack of personal protective equipment) were the main drivers of strikes, each contributing 25% of the total drivers identified.
    CONCLUSIONS: It is necessary to focus on the preparedness of health and care systems to respond adequately to PHEICs, and this includes being prepared for HCWs\' IAPSLs, talked much in the context of COVID-19 pandemic. Evidence to assist policymakers in defining strategies to respond adequately to the health and care needs of the population during IAPSLs is crucial. The main impact of strikes is on the disruption of health care services\' provision. Gender inequality being a major issue among HCWs, a proper understanding of the full impact of the strike on health and care services will only be possible if gender lens is combined with a systemic approach, rather than gender-undifferentiated approaches limited to the institutions on strike.
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  • 文章类型: Systematic Review
    测量飞行员的心理工作量(MWL)对于提高航空安全至关重要。然而,MWL是一种多维结构,可能受到多种因素的影响。特别是,在更自动化的驾驶舱设置的背景下,传统的评估试点MWL的方法可能面临挑战。心率变异性(HRV)已成为在真实飞行操作中检测飞行员MWL的潜在工具。这篇综述旨在研究HRV与飞行员MWL之间的关系,并使用HRV参数评估基于机器学习的MWL检测系统的性能。根据严格的资格标准,从三个数据库中提取了29篇相关论文进行审查。我们在审查的研究中观察到显著的变异性,包括研究设计和测量方法,以及机器学习技术。在不同MWL水平下,飞行员之间的HRV测量差异观察到不一致的结果。此外,对于开发基于HRV的MWL检测系统的研究,我们检查了不同的模型设置,发现可以使用几种先进的技术来应对特定的挑战。这篇评论为有兴趣采用HRV指标评估MWL并希望将尖端技术纳入MWL测量方法的研究人员和从业人员提供了实用指南。
    Measuring pilot mental workload (MWL) is crucial for enhancing aviation safety. However, MWL is a multi-dimensional construct that could be affected by multiple factors. Particularly, in the context of a more automated cockpit setting, the traditional methods of assessing pilot MWL may face challenges. Heart rate variability (HRV) has emerged as a potential tool for detecting pilot MWL during real-flight operations. This review aims to investigate the relationship between HRV and pilot MWL and to assess the performance of machine-learning-based MWL detection systems using HRV parameters. A total of 29 relevant papers were extracted from three databases for review based on rigorous eligibility criteria. We observed significant variability across the reviewed studies, including study designs and measurement methods, as well as machine-learning techniques. Inconsistent results were observed regarding the differences in HRV measures between pilots under varying levels of MWL. Furthermore, for studies that developed HRV-based MWL detection systems, we examined the diverse model settings and discovered that several advanced techniques could be used to address specific challenges. This review serves as a practical guide for researchers and practitioners who are interested in employing HRV indicators for evaluating MWL and wish to incorporate cutting-edge techniques into their MWL measurement approaches.
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  • 文章类型: Journal Article
    背景:完全分诊(TT)有可能实现更公平地获得初级保健,为了提高整体护理质量,增强健康结果。TT越来越受到公众的关注,政策制定者,和学者。
    目的:为了研究有关TT实施的相关科学文献,报告的患者和工作人员的机遇和挑战,以及对实践的影响。
    方法:Medline,Embase,CINAHL,和Scopus在2013年至2023年2月之间搜索了文章和灰色文献。包括的文件描述了在工作时间的一般实践中TT的实施,并提供了患者/工作人员的观点。患者和利益相关者参与了整个审查过程的每个阶段。使用框架方法综合研究结果。
    结果:总计,全文筛选时包括23份文件。分析强调了一系列TT方法,有时会混淆远程和TT系统。TT被认为增加和减少了工作量。始终如一,患者和工作人员的观点随着TT的使用而恶化。TT可能会增加获得护理的障碍,有可能加剧英国各地的反向护理法。关键的知识差距包括TT系统中的患者共同生产以及接待团队在适应系统以满足患者需求方面的作用。
    结论:TT可以影响患者的通路,安全,和公平。该方法还可能为一般实践产生截然不同的工作风格。这篇综述增加了当前围绕患者通路和TT的辩论,以及对工作人员/患者的后果。这些发现可用于在导航新的GP合同和实施新的TT方法时帮助实践。
    BACKGROUND: Total triage (TT) has the potential to achieve more equitable access to primary care, to improve the overall quality of care, and enhance health outcomes. TT has gained increasing attention from the public, policymakers, and academics.
    OBJECTIVE: To examine relevant scientific literature regarding the implementation of TT, the reported opportunities and challenges for patients and staff, and implications for practice.
    METHODS: Medline, Embase, CINAHL, and Scopus were searched for articles and grey literature between 2013 and February 2023. Included documents described the implementation of TT during in-hours general practice and provided perspectives from patients/staff. Patients and stakeholders were involved throughout each stage of the review process. Findings were synthesised using a framework approach.
    RESULTS: In total, 23 documents were included at full-text screening. Analysis highlights a range of TT approaches, sometimes conflating remote and TT systems. TT was seen to both increase and reduce workload. Consistently, patient and staff views worsened with TT use. TT can increase barriers to care access with potential to exacerbate inverse care laws across the UK. Critical knowledge gaps included patient co-production in TT systems and the role of reception teams to adapt systems to meet patients\' needs.
    CONCLUSIONS: TT can influence patient access, safety, and equity. The approach may also generate profoundly different working styles for general practice. This review adds to current debates surrounding patient access and TT, and consequences for staff/patients. The findings can be used to aid practices when navigating the new GP contract and the implementation of new TT approaches.
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  • 文章类型: Systematic Review
    背景:提供24小时医疗保健需要医生和医学影像团队的轮班工作,同时有助于患者的安全和及时护理。额外的服务压力和人员短缺导致工作量压力,调整后的转变模式和倦怠风险。应寻求证据证明这项工作对工作人员的影响。
    方法:本系统评价遵循PRISMA报告指南,根据乔安娜·布里格斯国际的指导,使用融合混合方法方法。定量趋势和结果是合格的,以便结合定性数据进行主题分析,并在上下文中一起讨论。在初始搜索之后,返回的文章按标题和摘要进行筛选。一个由3名审稿人组成的团队对那些合适的人进行了盲目的批判性评估,从第四个团队成员的质量保证。在JBI评估工具上通过75%阈值的论文被接受进行综合。检索到的适当文章的数据提取是并行进行的。
    结果:在筛查和关键评估之后,返回的13项研究专门针对非顾问医生。没有研究调查放射诊断技师。85%(n=11)报告轮班工作与睡眠/疲劳三个主题之间存在负相关,倦怠和幸福感:包括引入换档模式控制或调整后的换档模式。其余的没有变化,或因维持服务交付的对策而无效的任何改进。
    结论:目标人群的当前工作实践和轮班计划对参与者产生了不利影响-这可以表明诊断放射技师可能会感到疲劳,紧张轮班工作模式导致的倦怠和不良心理健康。
    结论:进一步研究轮班工作对诊断放射技师和其他专职医疗专业人员的影响-与错误和患者安全相关的上述主题有关。对非顾问医生的额外研究,转变工作效果和需要更广泛的服务提供的背景;通过适当的干预措施和教育,以最大限度地理解法律工作实践,症状监测和自我管理。
    BACKGROUND: Delivering 24 h healthcare requires rotational shift work from doctors and the medical imaging team, while contributing to safe and timely care of patients. Additional service pressure and staff shortfall leads to workload pressures, adjusted shift patterns and risk of burnout. Evidence should be sought to the effects of this work on staff.
    METHODS: This systematic review followed PRISMA reporting guidelines, using a convergent mixed methods approach according to Guidance from Joanna Briggs International. Quantitative trends and results were qualified in order to thematically analyse in conjunction with qualitative data and discussed together in context. Following initial searching, returned articles were screened by title and abstract. A team of 3 reviewers undertook blinded critical appraisal of those suitable, with quality assurance from a 4th team member. Papers passing a threshold of 75% on JBI appraisal tools were accepted for synthesis. Data extraction of appropriate articles retrieved was undertaken in parallel.
    RESULTS: Following screening and critical appraisal, 13 studies were returned focusing exclusively on Non Consultant Doctors. No studies investigated diagnostic radiographers. 85% (n = 11) reported negative association between shift work and the three themes of sleep/fatigue, burnout and wellbeing: including after the introduction of shift pattern control or adjusted shift patterns. The remainder showed no change, or any improvement nullified by countermeasures to maintain service delivery.
    CONCLUSIONS: Current working practices and shift plans in the target population showed detrimental effects on the participants - this can be suggested that Diagnostic Radiographers may suffer fatigue, burnout and poor mental health from stretched shift working patterns.
    CONCLUSIONS: Further study into the effects of shift work on Diagnostic Radiographers and other allied health professionals is indicated - relating to the above themes in the context of errors and patient safety. Additional research into Non Consultant Doctors, shift work effects and the context of wider service delivery required; with suitable interventions and education to maximise understanding of legal working practices, monitoring and self-management of symptoms.
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  • 文章类型: Journal Article
    护理压力的概念及其具体管理与护士压力的其他维度相比,受到的关注较少。因此,为了澄清关怀压力的概念,设计了范围审查研究。本范围审查旨在调查临床护士护理压力的概念,并研究其管理策略。
    这篇综述采用了一种范围审查方法,通过利用广泛的来源来全面绘制该现象的基本概念和属性。包括PubMed在内的国际数据库,Scopus,WebofScience,谷歌学者,和科学信息数据库(SID)进行搜索,以收集直到2023年10月1日发表的相关研究。MESH术语包括“关怀压力”,\"护理\",“压力”,\"护士\",和“压力管理”被使用。两名审稿人独立从全文论文中收集数据,确保每篇论文至少由两名审稿人进行评估。
    在最初搜索的104,094篇文章中,本研究包括22篇文章。高工作负载,传播感染,紧张的想法,紧张的情绪,紧张的沟通是护士护理压力的重要概念和因素。此外,在病人护理轮班期间休息休息,在病房里播放音乐,否认危急情况是减少护理压力的积极和消极应对和管理方法的例子。
    有效的压力管理策略可以带来更好的患者护理和安全性。压力大的护士更容易犯错误或在工作中不那么警惕,影响患者预后。通过解决关怀压力,临床实践可以优先考虑患者的健康。需要进一步的研究来深入研究未来与护士有关的这一关键问题。
    UNASSIGNED: The concept of caring stress and its specific management has received less attention than other dimensions of stress in nurses. Therefore, to clarify the concept of caring stress, a scoping review study was designed. This scoping review aimed to investigate the concept of caring stress among clinical nurses and examine the strategies used for its management.
    UNASSIGNED: This review employed a scoping review methodology to comprehensively map the essential concepts and attributes of the phenomenon by drawing on a wide range of sources. International databases including PubMed, Scopus, Web of Science, Google Scholar, and Scientific Information Database (SID) were searched to gather relevant studies published until October 1, 2023. MESH terms included \"caring stress\", \"care\", \"stress\", \"nurse\", and \"stress management\" were used. Two reviewers independently collected data from full-text papers, ensuring that each paper underwent assessment by at least two reviewers.
    UNASSIGNED: Out of 104,094 articles initially searched, 22 articles were included in this study. High workloads, transmitting the infection, stressful thoughts, stressful emotions, and stressful communications were the significant concepts and factors of caring stress among nurses. Also, rest breaks during patient care shifts, playing music in the ward, and denial of critical situations were examples of positive and negative coping and management ways to reduce caring stress.
    UNASSIGNED: Effective stress management strategies can lead to better patient care and safety. Stressed nurses are more likely to make errors or become less vigilant in their duties, impacting patient outcomes. By addressing caring stress, clinical practice can prioritize patient well-being. Further research is required to delve deeper into this critical issue concerning nurses in the future.
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  • 文章类型: Journal Article
    目的:描述和综合关于诊断放射摄影术中临床决策的文献,来揭示重要的元素,并确定知识差距以进行进一步调查。范围审查问题是:放射诊断技师如何做出临床决定?
    结果:放射技师在做出临床决定之前,在考试期间和之后。射线技师使用的主要信息来源是临床要求,然而,如果他们怀疑什么,他们依赖于同事的观点,而不是基于证据的实践。在临床决策过程中必须考虑许多因素;然而,缺乏自主性,关于临床请求的稀疏信息,缺乏时间会影响这个过程,这可能会导致有效决策的障碍。
    结论:临床决策是基于许多不同的因素,during,在结合不同类型的知识进行考试后,以及X线摄影临床实践中的技术和组织方面。
    结论:有必要将重点放在开发决策要素上。此外,必须更加注重改善放射技师和放射科医师之间的专业内部工作,以促进放射技师根据其临床决策采取行动的机会。
    OBJECTIVE: To describe and synthesise literature on clinical decision-making within diagnostic radiography, to uncover the important elements, and to identify knowledge gaps for further investigation. The scoping review question was: How do diagnostic radiographers make clinical decisions?
    RESULTS: Radiographers make clinical decisions before, during and after examinations. The primary source of information radiographers use is the clinical request, however, if they doubt something, they rely on their colleague\'s points of view rather than evidence-based practice. Many elements must be considered in the clinical decision-making process; however, lack of autonomy, sparse information on the clinical requests, and lack of time affect the process, which can lead to a barrier to effective decision-making.
    CONCLUSIONS: Clinical decisions are made based on many different elements before, during, and after examinations in combination with different types of knowledge, as well as technical and organisational aspects within radiography clinical practice.
    CONCLUSIONS: There is a need to focus on giving more attention to developing the decision-making elements. In addition, there must be more focus on improving intra-professional work between radiographers and radiologists to facilitate radiographers\' opportunities to act on their clinical decisions.
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  • 文章类型: Journal Article
    任务从全科医生(GP)转移到其他卫生专业人员可以解决增加的工作量,但是缺乏非工作时间初级保健(OOH-PC)的证据概述。
    在OOH-PC的临床咨询和家庭访问中,评估从全科医生转移到其他卫生专业人员的任务的内容和质量。
    在2021年12月13日进行了四次数据库文献检索,并于2023年8月进行了更新。我们纳入了研究内容的文章(患者特征,遇到的原因)和/或质量(患者满意度,安全,效率)在OOH-PC面对面接触中的任务转移。两位作者独立筛选了纳入的文章,并使用JBI关键评估清单评估了纳入文章的方法学质量。提取数据,并在叙述性总结中综合结果。
    搜索发现了1829篇文章,最终纳入了在英国或荷兰进行的七篇文章。研究将全科医生与其他卫生专业人员(主要是护士)进行了比较。这些其他卫生专业人员看到了不那么紧急的健康问题的患者,年轻患者,以及健康问题比全科医生复杂的患者。大多数研究得出的结论是,其他卫生专业人员提供了与全科医生水平相对应的安全且高效的护理,但有关生产力的发现尚无定论。
    OOH-PC中其他卫生专业人员提供的护理的安全性和效率水平似乎与全科医生相似,尽管他们主要看到患者表现出不那么紧急和不那么复杂的健康问题。
    从全科医生到其他卫生专业人员的任务转移可以提高非工作时间初级保健的治疗能力。任务转移是为了照顾不太紧急和不太复杂的健康问题的患者。应调查非工作时间初级保健中任务转移的长期影响。
    UNASSIGNED: Task shifting from general practitioners (GPs) to other health professionals could solve the increased workload, but an overview of the evidence is lacking for out-of-hours primary care (OOH-PC).
    UNASSIGNED: To evaluate the content and quality of task shifting from GPs to other health professionals in clinic consultations and home visits in OOH-PC.
    UNASSIGNED: Four database literature searches were performed on 13 December 2021, and updated in August 2023. We included articles that studied content (patient characteristics, reason for encounter) and/or quality (patient satisfaction, safety, efficiency) of task shifting in face-to-face contacts at OOH-PC. Two authors independently screened articles for inclusion and assessed the methodological quality of included articles using the JBI critical appraisal checklist. Data was extracted and results were synthesised in a narrative summary.
    UNASSIGNED: The search identified 1,829 articles, resulting in the final inclusion of seven articles conducted in the UK or the Netherlands. Studies compared GPs with other health professionals (mainly nurses). These other health professionals saw patients with less urgent health problems, younger patients, and patients with less complex health problems than GPs. Most studies concluded that other health professionals provided safe and vastly efficient care corresponding to the level of GPs but findings about productivity were inconclusive.
    UNASSIGNED: The level of safety and efficiency of care provided by other health professionals in OOH-PC seems like that of GPs, although they mainly see patients presenting with less urgent and less complex health problems.
    Task shifting from general practitioners to other health professionals could increase treatment capacity in out-of-hours primary care.Task shifting occurs for care to patients with less urgent and less complex health issues.The long-term implications of task shifting in out-of-hours primary care should be investigated.
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