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The aim of this study was to evaluate the feasibility, acceptability and preliminary effectiveness of I-PASS-structured (Identification—Patient—Action—Situation—Synthesis) bedside nursing handovers on the handover global quality and the patients trust in nurses.
Oral end-of-shift nursing handovers can become moments of patient vulnerability. Moving handovers from nurses' offices to patients' bedsides is a means of improving them; however, implementing this remains a challenge.
This was a Type-1 effectiveness–implementation hybrid study.
We measured the effectiveness using a simple interrupted time series with three measurement points before and after the introduction of I-PASS-structured bedside nursing handovers between August and November 2022. Implementation was explored using multi-method measurements of quantitative and qualitative data. As an implementation strategy, we developed a specific training session, including simulations.
Bedside nursing handovers were introduced into one surgery and one medicine ward, with the 831 handovers evaluated showing significant improvements in handover quality compared to before implementation, although handover duration increased. Patient outcomes validated this change in nursing practice. However, examining nurses' perspectives of the implementation process revealed several obstacles to using bedside nursing handovers that training alone was not strong enough to overcome.
Given the findings of the present project, the use of bedside nursing handovers should be extended to other units by developing strategies that will make the practice sustainable.
Bedside nursing handovers improved handover quality and created a true partnership with the patient: nurses feel more confident about seeing the patient quickly. Patients felt more taken into consideration and safer.
For feasibility reasons, patients and the public were not involved in the design, conduct, reporting or dissemination plans of this research. The trial was prospectively registered before the first participant was recruited under the ISRCTN # 81701569.
Dyspnea is a common chief complaint leading to emergency department (ED) visits. Multiple conditions may cause or be associated with dyspnoea, including bacterial pneumonia, acute heart failure (AHF), exacerbation of chronic obstructive pulmonary disease (COPD) or asthma and pulmonary embolism. Each of these diagnoses has a specific treatment recommended by international guidelines. Inappropriate treatment in the ED is more frequent among elderly patients and is independently associated with in-hospital mortality. Point-of-care ultrasound is immediately available at the bedside. Lung and cardiac ultrasound (LuCUS) offers excellent diagnostic accuracy for bacterial pneumonia, AHF and COPD exacerbations, even in elderly patients. The primary objective of the LUC REED trial is to evaluate the impact of a LuCUS-guided strategy versus standard care on reducing inappropriate treatment of dyspnoea in elderly ED patients.
The LUC REED trial is a prospective, interventional, multicentre, stepped-wedge randomised controlled trial designed to assess the superiority of a LuCUS-guided strategy over standard care in ensuring treatment appropriateness for dyspnoea in elderly ED patients. The study will include 504 patients over 2 years. Patients aged >65 years presenting with acute dyspnoea and signs of severity (respiratory rate ≥22 or SpO2
Ethics final approval was obtained from the Institutional Review Board of France—Est IV on 4 April 2025 (2024-A01678-39). Results will be published in peer-reviewed international journals.
Autism and neurodevelopmental disorders (NDDs) are complex conditions that manifest as significant impairments in social communication and behaviour. Early detection and intervention play a pivotal role in improving outcomes, largely due to the high brain plasticity in infants. The PRECO-TSA study aims to validate the effectiveness of systematic use of the Prévention de l’Autisme (PREAUT) grid for early screening and referral strategies for autism and NDDs in infants, focusing on a coordinated approach that integrates maternal and child protection centre with medical-psychological centres. The goal is to evaluate a streamlined referral system to improve early detection and facilitate effective interventions for children at higher risk of autism.
The PRECO-TSA study is a prospective, pragmatic, multicentre, cluster-randomised controlled trial using an incomplete stepped-wedge design, which maximises external validity. The study includes a 6-month baseline phase, a 3-month semiobservation phase and a 6-month follow-up phase. The 36-month patient inclusion period is followed by a 48-month passive follow-up through the National Health Data System, data collection includes demographic and clinical information, with hierarchical mixed models used to analyse the impact of early screening and referral for autism and NDDs.
This study was funded by the French Ministry of Health (PREPS-20-0186) and was approved by Ile de France I Ethics Committee CPP (number CPPIDF1-2023-DI29-Cat2). The results will be submitted for publication in peer-reviewed journals.
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