OBJECTIVE: Preoperative oral carbohydrate loading is a component of enhanced recovery after surgery protocols. The aim of this study is to investigate the effects of preoperative oral carbohydrate loading on postoperative clinical outcomes in spinal surgery patients.
METHODS: This is a prospective case-control study.
METHODS: This study was conducted with patients who underwent spinal surgery from October 1, 2020 to October 1, 2021 in a neurosurgery clinic of an education and research hospital. The intervention group (n = 46) ingested 800 mL oral carbohydrate drinks at least 8 hours before surgery. The postoperative clinical outcomes were nausea, vomiting, antiemetic and analgesic drug medication, inflammation, and bleeding. The first flatus and defecation time, oral intake time, mobilization time, and length of stay in hospital were assessed postoperatively. Adverse events were monitored up to 24 hours postoperatively. The control group (n = 46) underwent routine fasting protocols.
RESULTS: Lower rates of vomiting and bleeding during and after surgery and earlier defecation time and first mobilization time were determined in the intervention group, and the difference compared with the control group was statistically significant.
CONCLUSIONS: Preoperative oral carbohydrate loading is a nonpharmacological intervention that has a positive effect on postoperative clinical outcomes in patients who underwent spinal surgery and should be included in the enhanced recovery after surgery protocol.

UNASSIGNED: To investigate the status quo of empathic fatigue, professional identity, and sleep quality of nursing staff in nursing institutions. To analyze the correlation between empathic fatigue, professional identity and sleep quality of nursing staff.
UNASSIGNED: This is a cross-sectional study. The method of convenient sampling was used to select 224 nursing workers from the older adult\'s institutions in the Panjin area as the investigation objects. The nurses\' general data questionnaire, the Chinese version of the compassion fatigue short scale, the nurses\' professional identity Scale, and the Pittsburgh Sleep Quality Index were used as evaluation tools. SPSS26.0 statistical software was used to sort out and analyze the data.
UNASSIGNED: There was a positive correlation between empathic fatigue and sleep quality; there was a negative correlation between empathy fatigue and professional identity. Occupational identity and sleep quality were negatively correlated.
UNASSIGNED: There is a correlation between empathic fatigue, professional identity, and sleep quality of nursing workers. Empathy fatigue is positively correlated with sleep quality. Empathy fatigue was negatively correlated with professional identity. Occupational identity was negatively correlated with sleep quality. To provide a theoretical basis for the management of older adult\'s nursing staff and the formulation of corresponding management systems and policies, promote the mental health of older adult\'s nursing staff, improve sleep quality, and provide a theoretical basis and reference for future intervention research.

BACKGROUND: Preoperative malnutrition is a significant factor in patients with pancreatic tumors undergoing pancreaticoduodenectomy. The aim of this study was to assess the association between preoperative malnutrition and delayed discharge within a ten-day timeframe and potential correlations between preoperative malnutrition and postoperative surgical complications.
METHODS: A retrospective cohort study was conducted, recruiting a final sample of 79 patients with benign or malignant cephalic pancreatic tumors from 2015 to 2022. The risk of malnutrition was assessed using the Malnutrition Universal Screening Tool, while length of hospital stay and relevant clinical data were extracted from clinical documentation.
RESULTS: The preoperative malnutrition risk was high in 21.52% of the sample, moderate in 36.71%, and low in 41.77%. Body mass index (BMI) (p = 0.007) and postoperative surgical complications (p < 0.001) were significantly correlated with delayed discharge. No statistically significant differences were found between levels of malnutrition risk and delayed discharge (p = 0.122), or postoperative surgical complications (p = 0.874).
CONCLUSIONS: Postoperative complications and BMI emerge as significant risk factors. The limited sample size may have compromised the collection of homogeneous and significant data. Future studies should evaluate the implementation of personalized nutritional screening tools, nutritional assessment plans, and the involvement of specialized health professionals.

BACKGROUND: With the increased integration of technologies in the healthcare sector, it is important to understand the benefits emerging technologies may play to reduce demands on the health care system. The Steadiwear antivibration glove shows promise for enhancing the independence in functional abilities for persons with essential tremors and for alleviating the need for support from the health care system. The objective of this study was to examine Registered Nurses\' (RN) perceptions of the potential for the Steadiwear antivibration glove to reduce the need for in-person support from community healthcare workers.
METHODS: Eleven RNs, experienced in providing care in rural communities, participated in a semi-structured interview sharing their perspectives towards use of the Steadiwear antivibration glove in community practice settings. Thematic analysis guided by Braun and Clarke was undertaken.
RESULTS: Nurses described the value of this technology to reduce client needs for support for activities of daily living (e.g., dressing, feeding) and independent activities of daily living (e.g., banking, transportation).
CONCLUSIONS: Enhanced access to this technology may reduce the need for nursing and personal care support from the health system. Therefore the Steadiwear antivibration glove also shows potential to delay and/or prevent the need for more intensive support and mitigate the need for transition to a long-term care facility.

BACKGROUND: Artificial intelligence (AI) chatbots are emerging educational tools for students in healthcare science. However, assessing their accuracy is essential prior to adoption in educational settings. This study aimed to assess the accuracy of predicting the correct answers from three AI chatbots (ChatGPT-4, Microsoft Copilot and Google Gemini) in the Italian entrance standardized examination test of healthcare science degrees (CINECA test). Secondarily, we assessed the narrative coherence of the AI chatbots\' responses (i.e., text output) based on three qualitative metrics: the logical rationale behind the chosen answer, the presence of information internal to the question, and presence of information external to the question.
METHODS: An observational cross-sectional design was performed in September of 2023. Accuracy of the three chatbots was evaluated for the CINECA test, where questions were formatted using a multiple-choice structure with a single best answer. The outcome is binary (correct or incorrect). Chi-squared test and a post hoc analysis with Bonferroni correction assessed differences among chatbots performance in accuracy. A p-value of < 0.05 was considered statistically significant. A sensitivity analysis was performed, excluding answers that were not applicable (e.g., images). Narrative coherence was analyzed by absolute and relative frequencies of correct answers and errors.
RESULTS: Overall, of the 820 CINECA multiple-choice questions inputted into all chatbots, 20 questions were not imported in ChatGPT-4 (n = 808) and Google Gemini (n = 808) due to technical limitations. We found statistically significant differences in the ChatGPT-4 vs Google Gemini and Microsoft Copilot vs Google Gemini comparisons (p-value < 0.001). The narrative coherence of AI chatbots revealed \"Logical reasoning\" as the prevalent correct answer (n = 622, 81.5%) and \"Logical error\" as the prevalent incorrect answer (n = 40, 88.9%).
CONCLUSIONS: Our main findings reveal that: (A) AI chatbots performed well; (B) ChatGPT-4 and Microsoft Copilot performed better than Google Gemini; and (C) their narrative coherence is primarily logical. Although AI chatbots showed promising accuracy in predicting the correct answer in the Italian entrance university standardized examination test, we encourage candidates to cautiously incorporate this new technology to supplement their learning rather than a primary resource.
BACKGROUND: Not required.

BACKGROUND: How healthcare professionals understand and use concepts of social and cognitive capabilities will influence their behaviour and their understanding of others\' behaviour. Differing understandings of concepts might lead to healthcare professionals not acting in accordance with other healthcare professionals\' expectations. Therefore, part of the problem concerning errors and adverse incidents concerning social and cognitive capabilities might be due to varying understandings of concepts among different healthcare professionals. This study aimed to examine the variations in how educators at the Copenhagen Academy for Medical Education and Simulation talk about social and cognitive capabilities.
METHODS: The study was conducted using semi-structured interviews and directed content analysis. The codes for the analysis process were derived from existing non-technical skills models and used to show variations in how the participants talk about the same concepts.
RESULTS: Educators with a background as nurses and physicians, talked differently about leadership and decision-making, with the nurses paying greater attention to group dynamics and external factors when describing both leadership and decision-making, whereas physicians focus on their individual efforts.
CONCLUSIONS: We found patterned differences in how the participants described leadership and decision-making that may be related to participants\' professional training/background. As it can create misunderstandings and unsafe situations if nurses and physicians disagree on the meaning of leadership and decision-making (without necessarily recognising this difference), it could be beneficial to educate healthcare professionals to be aware of the specificity of their own concepts, and to communicate what exactly they mean by using a particular concept, e.g. \"I want you to coordinate tasks\" instead of \"I want better leadership\".

Background and Purpose: This study aims to develop a valid and reliable measurement tool that can evaluate the views of clinical nurses on school-hospital cooperation and the scale of nurses. Methods: Within the scope of validity analyses for the development of the scale, content validity index, construct validity, and known group validity were used. Standard error, Cronbach\'s alpha coefficient, item-total score correlation, and scale response bias methods were used within the scope of reliability analyses. Results: In the final version of the developed scale, the Kaiser-Meyer-Olkin value was 0.90, and Bartlett\'s test result was χ2: 2819.610, p < 0.001. It was determined that the total variance of the scale was 45.33%, and the Cronbach\'s alpha coefficient was 0.857. In the scale response bias analysis, the Hotelling T² value was 3585.645. Conclusions: It was found that the Nurses\' Views of School-Hospital Cooperation Scale is a valid and reliable measurement tool.

BACKGROUND: Digital competencies are essential for nurses to actively participate in the digitisation of healthcare systems. Therefore, it is important to assess their skill levels to identify strengths and areas for improvement.
METHODS: This study aims to investigate nurses\' knowledge, attitudes, behaviours, subjective norms and behavioural control regarding digital health. A knowledge-attitude-practice model guided the development of a structured questionnaire divided into six sections. A sample of 480 registered nurses of Naples will be involved in the study. After conducting a pretest, an invitation will be publicised through the institutional communication channels of Nurses Provincial Order of Naples. Nurses will respond via a unique link or quick response code sent through a PEC email system (a legally valid email system, which guarantees delivery and receipt). They will have 30 days to complete the survey, scheduled between May and July 2024.
BACKGROUND: No ethics committee approval was required, as the study does not involve minors, direct or indirect physical or physiological harm to participants, or clinical trials. Anonymity will be guaranteed at all data collection and processing levels. The results will be broadly distributed through conference presentations and peer-reviewed publications. The effective use of digital technologies by healthcare professionals can bring significant improvements to healthcare services and help improve the health of individuals and community health. The study\'s findings will serve as a foundation for developing and implementing educational programmes related to eHealth and telemedicine, promoting the harmonisation of such programmes.

OBJECTIVE: This study aims to investigate the status of transition shock and test the mediating effect of job embeddedness on the nursing work environment and transition shock among new nurses.
BACKGROUND: Transition shock, primarily experienced during the first two years of employment, manifests itself as an unsettling or discordant experience among new nurses, which is caused by the gap between theoretical learning and clinical practice.
METHODS: This is a cross-sectional survey study, following the STROBE guidelines.
METHODS: A cross-sectional study was conducted among 435 new nurses from November to December 2022 in Hunan Province, China. The participants were recruited to complete a sociodemographic information questionnaire and rank 3 standardized scales of transition shock (Cronbach\'s alpha = 0.918), job embeddedness (Cronbach\'s alpha = 0.890) and nursing work environment (Cronbach\'s alpha = 0.946). Then, the data were analysed by SPSS 26.0 and mediation testing was performed using Hayes\' PROCESS macro (Model 4). A p value of < 0.05 was deemed statistically significant.
RESULTS: The mean score with standard deviation of the transition shock scale in new nurses was 88.86 (22.50). The place of origin, working months and weekly working hours were the significant sociodemographic factors that affected the transition shock score in new nurses. Transition shock was found to be negatively related to both job embeddedness (r = -0.468, p < 0.001) and nursing work environment (r = -0.416, p < 0.001), while job embeddedness mediated the relationship between transition shock and nursing work environment (R2 = 0.262, F = 30.455, p < 0.001).
CONCLUSIONS: New nurses from rural areas and with longer weekly working hours are more prone to transition shock. Those with 6-12 months of employment experience more pronounced transition shock than those with less than 6 months. In addition, the nursing work environment can not only directly influence transition shock for new nurses but also indirectly influence it through job embeddedness. These findings provide a basis for hospitals to develop strategies to effectively address transition shock in new nurses and ultimately solve the nursing shortage issue.

OBJECTIVE: To evaluate the effectiveness of utilizing the integrated pulmonary index for capnography implementation during sedation administered by nurses.
METHODS: Cluster-randomized trial.
METHODS: Participants were enrolled from the interventional radiology department at an academic hospital in Canada. Nurses were randomized to either enable or disable the Integrated Pulmonary Index feature of the capnography monitor. Procedures were observed by a research assistant to collect information about alarm performance characteristics. The primary outcome was the number of seconds in an alert condition state without an intervention being applied.
RESULTS: The number of seconds in an alarm state without intervention was higher in the group that enabled the integrated pulmonary index compared to the group that disabled this feature, but this difference did not reach statistical significance. Likewise, the difference between groups for the total alarm duration, total number of alarms and the total number of appropriate alarms was not statistically significant. The number of inappropriate alarms was higher in the group that enabled the Integrated Pulmonary Index, but this estimate was highly imprecise. There was no difference in the odds of an adverse event (measured by the Tracking and Reporting Outcomes of Procedural Sedation tool) occurring between groups. Desaturation events were uncommon and brief in both groups but the area under the SpO2 90% desaturation curve scores were lower for the group that enabled the integrated pulmonary index.
CONCLUSIONS: Enabling the integrated pulmonary index during nurse-administered procedural sedation did not reduce nurses\' response times to alarms. Therefore, integrating multiple physiological parameters related to respiratory assessment into a single index did not lower the threshold for intervention by nurses.
UNASSIGNED: The time it takes to respond to capnography monitor alarms will not be reduced if the integrated pulmonary Iindex feature of capnography monitors is enabled during nurse-administered procedural sedation.
CONCLUSIONS: Results do not support the routine enabling of the integrated pulmonary index when nurses use capnography to monitor patients during procedural sedation as a strategy to reduce the time it takes to initiate responses to alarms.
UNASSIGNED: CONSORT.
UNASSIGNED: There was no patient or public contribution.
BACKGROUND: This study was prospectively registered at ClinicalTrials.gov (ID: NCT05068700).