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To conceptualise information distortion in Electronic Health Records (EHRs), with the goal of providing a theoretical foundation for improving documentation practices.
A concept analysis.
Walker and Avant's strategy for concept analysis was used. The defining attributes, antecedents and consequences were identified.
A comprehensive search was conducted across PubMed, Web of Science, Embase, CINAHL and Scopus from their inception to December 2024. Studies published in English that addressed information distortion in EHRs were included.
A total of 37 studies were included. The three defining attributes were: real-world health truth, representation of reality and mismatch relationship. Antecedents were divided into five categories: people-related factors, equipment factors, regulatory factors, working environment factors and management factors. The consequences of information distortion in EHRs included threats to patient safety, poor operational performance, eroded trust, compromised research quality and health inequity.
This concept analysis enhances the understanding of information distortion in EHRs and provides a foundation for further empirical validation. The findings may contribute to the development of measurement instruments and strategies to mitigate information distortion in healthcare settings.
By undertaking a concept analysis of information distortion in EHRs, healthcare professionals will be better equipped to recognise and assess this ethical phenomenon, thereby supporting the development of targeted interventions to mitigate potential harms to healthcare practices. In addition, the clarity of this concept could provide a new angle from which to analyse the origins of flawed EHR documentation and its ripple effects across healthcare systems.
No patient or public involvement.
To retrieve, evaluate and summarise the best evidence for non-pharmacological management of sleep disturbances in ICU patients, and to provide basis for clinical nursing practice.
This study was an evidence summary followed by the evidence summary reporting standard of Fudan University Center for Evidence-based Nursing.
All evidence on non-pharmacological management of sleep disturbances in ICU patients from both domestic and international databases and relevant websites was systematically searched, including guidelines, expert consensuses, best practice, clinical decision-making, evidence summaries and systematic review.
UpToDate, BMJ Best Practice, Joanna Briggs Institute, Scottish Intercollegiate Guidelines Network, National Guideline Clearinghouse, National Institute for Health and Clinical Excellence, Yi Maitong Guidelines Network, Registered Nurses Association of Ontario, Canadian Medical Association: Clinical Practice Guideline, Guidelines International Network, WHO, the Cochrane Library, CINAHL, Embase, PubMed, Web of Science, CNKI, WanFang database, VIP database, SinoMed, The American Psychological Association, European Sleep Research Society, American Academy of Sleep Medicine and National Sleep Foundation were searched from the establishment of the databases to June 1, 2024.
A total of 18 pieces of literature were included, involving 4 guidelines, 2 expert consensuses, 1 best practice and 11 systematic reviews. 25 pieces of evidence covering 4 categories of risk factors, sleep monitoring, non-pharmaceutical intervention, education and training were summarised.
This study summarises the best evidence for non-pharmacological management of sleep disturbances in ICU patients. In clinical application, medical staff should make professional judgements and fully combine clinical situations and patient preferences to select evidence, laying a theoretical foundation for later empirical research to reduce the incidence of sleep disturbances in ICU patients and improve the sleep quality of critically ill patients.
Medical staff can refer to the best evidence to provide reasonable non-pharmacological management plans for sleep disturbances in ICU patients, improving their sleep quality and life satisfaction.
The management of sleep disturbances in critically ill patients has not received sufficient attention and standardisation. This study summarises 25 pieces of the best evidence for non-pharmacological management of sleep disturbances in critically ill patients. Accurate and standardised evaluation and monitoring are the foundation of sleep management for ICU patients. This summary of evidence can help ICU nurses enhance their clinical practice.
This evidence summary followed the evidence summary reporting specifications of Fudan University Center for Evidence-based Nursing, which were based on the methodological process for the summary of the evidence produced by the Joanna Briggs Institute. This study was based on the evidence summary reporting specifications of the Fudan University Center for the Evidence-based Nursing; the registration number is ‘ES20231708’.
No Patient or Public Contribution.
This study identifies instruments for assessing the burden on family caregivers of cancer patients and evaluates their psychometric properties using COSMIN criteria.
A systematic review based on COSMIN methodology.
The review adhered to PRISMA guidelines. Relevant studies were identified through searches in PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang Database, and China Science and Technology Journal Database, covering literature from inception to September 2024. Included studies focused on developing or validating measurement tools and assessing psychometric properties such as reliability, internal consistency and construct validity. Two independent researchers screened the literature, extracted data and evaluated psychometric properties using COSMIN criteria while assessing evidence quality via the GRADE method.
A total of 32 studies were included, encompassing 17 tools for assessing caregiver burden. None reported measurement error, cross-cultural validity or responsiveness. The Caregiver's Burden Scale in End-of-Life Care (CBS-EOLC) demonstrated strong reliability, validity and internal consistency, receiving a strong recommendation for clinical practice. In contrast, the Zarit Burden Interview (ZBI), Family Caregiver Burden Interview Scale (FBIS) and Bakas Caregiving Outcomes Scale (BCOS) are not recommended due to insufficient supporting evidence. Other tools showed weak evidence, leading to weak recommendations.
The CBS-EOLC exhibits comprehensive psychometric properties suitable for clinical applications. The ZBI, FBIS and BCOS lack adequate supporting evidence and are not recommended. Future research should focus on measurement error, cross-cultural validity and responsiveness to enhance these tools' applicability and reliability.
This review provides evidence for healthcare providers to select instruments for assessing caregiver burden in cancer patients.
This systematic review highlights the need for comprehensive assessments of caregiver burden based on COSMIN guidelines.
This study is a systematic review with no patient or public participation.
This study aimed to establish a comprehensive set of nursing-sensitive quality indicators (NSQIs) for patients with dysphagia following tracheotomy due to acquired brain injury (ABI), based on the ‘structure-process-outcome’ model.
A Delphi survey.
The research utilised a mixed-methods approach, including systematic literature reviews, qualitative interviews and two rounds of Delphi expert consultations. A diverse team comprising specialists in dysphagia rehabilitation and nursing management conducted the research, which involved defining and refining NSQIs through extensive evaluations and consensus among recruited experts.
The finalised NSQI includes 4 structural indicators, 13 process indicators and 4 outcome indicators, covering key aspects such as resource allocation, patient assessment and clinical outcomes. The expert consensus provides verification. Kendall's harmony coefficients are 0.304 and 0.138 (p < 0.001), respectively, and the mean importance assignments of indicators at all levels are 3.90–5.00. The final care of patients with tracheotomy and dysphagia after brain injury was constructed. The evaluation indicators include a total of 4 first-level indicators, 23 second-level indicators and 52 third-level indicators.
The established NSQIs offer a systematic framework to enhance the quality of nursing care for ABI patients with posttracheotomy dysphagia. This model facilitates precise monitoring and proactive management of nursing practices, promising better patient outcomes and streamlined care processes.
This study develops targeted NSQIs to improve dysphagia management in ABI patients’ posttracheotomy, fostering better patient outcomes and advancing nursing education through essential specialised training.
Expert-driven insights from experienced clinicians informed the NSQIs, ensuring their relevance and effectiveness in enhancing patient-centred care.
As a chronic skin disease, psoriasis often affects the physical, psychological and social status of the patient, which in turn impacts on their experience of illness and needs. However, there is no review of qualitative research that integrates and analyses the experiences and needs of these three influences from a holistic perspective.
This review follows the ENTREQ guidelines. Six English databases (JBI, Cochrane Library, PubMed, PsyINFO, CINAHL and Embase) and three Chinese databases (CNKI, VIP and Wanfang) were searched from January 2012 to October 2022. Literature was included if it was relevant to the experience of illness and caring needs of patients with psoriasis. The JBI-QARI was used to rate the quality of included studies.
Eleven studies were included in the meta-synthesis. Four analytical themes were identified for analysis: physical challenges, psychological discomfort, social phenomena and caring needs.
The combined physical, psychological and social effects of psoriasis and the consequent caring needs should be emphasised. Health professionals, including doctors and nurses, should be aware of the multiple changes in patients and their coping strategies, provide information about psoriasis, monitor and follow-up regularly over time and obtain feedback to inform further treatment and care so as to develop high-quality therapeutic interventions to help and guide patients with their coping strategies.
These findings describe the physical, psychological and social experiences of illness and caring needs of patients with psoriasis. Healthcare professionals should be more aware of patients' easily overlooked psychological and social distress, providing prompt attention and recognition of patients' experiences and needs, offering relevant assistance and support and enhancing daily, regular follow-up to help them improve their understanding of and ability to manage their illness.
This is a meta-synthesis without direct patient involvement.
Identifying predictors for surgical site infections (SSIs) after emergency surgical treatment for traumatic pulmonary haemorrhage (TPH) is crucial for improving patient outcomes. This study aims to ascertain these predictors. In this comprehensive retrospective study, conducted from January 2020 to December 2023 at our institution, 75 patients were analysed, including a case group of 25 patients with SSIs and a control group of 50 without SSIs post-TPH surgery. Inclusion criteria focused on patients aged 18 and above undergoing thoracotomy or minimally invasive thoracic surgery for TPH. Exclusion criteria included compromised immune systems, chronic pulmonary diseases, prior thoracic surgery or active infections at admission. We assessed several predictors: anaemia; operation time over 2 h; hospital stay over 5 days; intraoperative blood loss exceeding 500 mL; body mass index (BMI) ≥25 kg/m2; age ≥ 50 years; use of surgical drains; the presence of open wounds; diabetes mellitus and non-prophylactic antibiotic use. Statistical analysis involved univariate and multivariate logistic regression, using SPSS Version 27.0. Univariate analysis revealed significant associations between SSIs and surgical drain placement, diabetes mellitus, open wounds and non-prophylactic antibiotic use (p < 0.01). Multivariate analysis confirmed these factors as significant predictors of SSIs, with notable odds ratios. Other variables like anaemia, extended hospital stay, excessive intraoperative blood loss, older age and higher BMI did not significantly predict SSIs. Significant predictors for SSIs following TPH surgery include surgical drain placement, diabetes mellitus, open wounds and non-prophylactic antibiotic use. Identifying and managing these risks is crucial in clinical practice to reduce SSIs incidence and improve patient outcomes.
Knee osteoarthritis (KOA) is not merely a medical condition—it is a prevalent and incapacitating ailment that significantly affects the quality of life for millions worldwide, especially as they age. The incidence of KOA increases year by year with increasing age. This study evaluated the therapeutic efficacy of combining arthroscopy with sodium hyaluronate (SH) in the treatment of wound healing of knee osteoarthritis (KOA) in elderly patients, with a focus on wound healing and overall joint function restoration. Randomized controlled trials (RCTs) evaluating the combination of arthroscopy and SH in geriatric KOA patients were identified through a systematic search of the scientific literature utilizing multiple databases and predefined search criteria. Ultimately, twelve investigations were included in the meta-analysis. Using Stata 15.1 software, data extraction and analysis were conducted using both fixed- and random-effects models, and a sensitivity analysis was conducted to assure the validity of the findings. Compared with arthroscopy alone, the combination of arthroscopy and SH significantly improved the efficiency rate, pain management (as measured by the Visual Analogue Scale), knee function (as measured by the Lysholm Knee Scoring Scale) and decreased levels of the pro-inflammatory cytokines IL-1 and IL-6. The meta-analysis revealed minimal heterogeneity between studies, and the sensitivity analysis validated the results' reliability. The incorporation of SH into arthroscopic procedures for elderly patients with KOA provides significant therapeutic benefits, including improved wound healing, reduced inflammation and enhanced joint function overall. These results support the use of this combined approach in the management of KOA in the elderly population and emphasize the need for additional research to optimize treatment protocols and comprehend long-term outcomes.
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