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Time to Hang Up the Gloves: A Scoping Review of Evidence on Non‐Sterile Glove Use During Intravenous Antimicrobial Preparation and Administration

ABSTRACT

Aims

To systematically summarise evidence related to the use of non-sterile gloves when preparing and administering intravenous antimicrobials.

Design

Scoping review.

Methods

A rigorous scoping review was undertaken following Arksey and O'Malley's (2005) framework and the modified Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review guidelines (2018). Five databases and grey literature were included in the search. Literature published between 2009 and 2024 was included.

Data Sources

Five databases (Medline, CINAHL, EMBASE, Scopus and Web of Science) and the grey literature were searched in February 2024.

Results

Three studies were included; however, none directly addressed correct non-sterile glove use during intravenous antimicrobial preparation or administration in clinical practice.

Conclusion

We found no evidence to support the use of non-sterile gloves in intravenous antimicrobial preparation. There is an urgent need for rigorous research to inform the development of clear guidelines on non-sterile glove use to underpin evidence-based decision-making in nursing and other health professional education, improve patient outcomes, reduce healthcare costs and promote environmental sustainability in healthcare.

Implications

Inappropriate use of non-sterile gloves for preparing and administering intravenous antimicrobials hinders correct hand hygiene practices and increases healthcare-associated infections, healthcare costs and waste.

Impact

A critical gap in the existing evidence was a key finding of this review, highlighting the urgency for evidence-based guidelines to improve patient safety outcomes, reduce healthcare costs and promote environmental sustainability in healthcare.

Reporting Method

This scoping review adhered to the relevant EQUATOR guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) reporting checklist.

Patient of Public Contribution

This study did not include patient or public involvement in its design, conduct or reporting.

Trial and Protocol Registration

The protocol was registered on Open Science Framework (https://doi.org/10.17605/OSF.IO/QY4J2).

Effectiveness of Multidisciplinary Transitional Care Interventions on Functional Status, Quality of Life and Readmission Rates in Stroke Patients: A Systematic Review and Meta‐Analysis

ABSTRACT

Aim

To evaluate the effectiveness of multidisciplinary transitional care interventions on functional status, quality of life and readmission rates of stroke patients.

Design

Quantitative systematic review and meta-analysis.

Methods

Studies with interventions to ease the hospital-to-home transition of stroke patients that were delivered by multidisciplinary teams consisting of registered healthcare professionals from at least two disciplines were included. Cochrane Risk of Bias tool was used for quality appraisal.

Data Sources

Seven electronic databases (PubMed, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Scopus and Web of Science) were searched for randomised controlled trials delivering transitional care interventions to hospitalised stroke patients.

Results

Thirty-one randomised controlled trials were included in the final review. The studies featured multidisciplinary teams of two to nine professionals, most commonly nurses, physicians and physiotherapists. Although multidisciplinary care improved functional status and quality of life scores, the impact on readmission rates was inconclusive. Meta-analysis revealed significant improvements in functional status when care involved physicians, care coordinators (often nurses) or had teams of more than two healthcare professionals. Significant improvement in quality of life was also reported when care involved physicians or in teams with more than two healthcare professionals.

Conclusions

Multidisciplinary transitional care interventions show promise in improving functional status and quality of life after stroke. Their effectiveness depends on team composition and coordination, particularly the inclusion of physicians and care coordinators. Future research should address reporting gaps and evaluate broader strategies to reduce hospital readmissions.

Implications for Profession and Patient Care

Impact (Addressing)

What problem did the study address? ○

The effectiveness of multidisciplinary transitional care interventions for stroke patients.

Evaluated the role of various healthcare professionals within these teams.

What were the main findings? ○

Multidisciplinary transitional care interventions significantly enhance stroke patients' functional status, especially within the first 3 months.

Teams with care coordinators (often nurses) and supportive physicians improve functional outcomes, with effective communication being crucial despite underreporting of specific practices.

Teams comprising of more than two health professionals can significantly improve stroke patients' functional status.

Where and on whom will the research have an impact? ○

Healthcare institutions and providers: The findings can guide healthcare institutions in developing and implementing effective transitional care services for stroke patients.

Stroke patients: Patients receiving multidisciplinary transitional care are likely to experience enhanced functional recovery and improved ability to perform daily activities.

Policymakers and researchers: The study highlights the need for more detailed reporting and research on communication practices within multidisciplinary teams and the importance of evaluating underreported outcomes like readmission rates.

Reporting Method

Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) checklist.

Patient or Public Contribution

No Patient or Public Contribution.

Factors associated with risk of falling among younger inpatients in a mental health setting—A systematic review

Abstract

Aim

To synthesise evidence related to risk factors of falls among younger mental health inpatients age ≤65 years old.

Background

Hospitalised patients with mental illness are at increased risk of falling. Specific risk factors for falls for younger inpatients are poorly understood.

Design

Systematic review.

Methods

Medline, CINAHL, APA PsycINFO, Scopus and Web of Science were searched for studies published in English till December 2022. The review followed the 2020 PRISMA checklist. Odds ratios and P values of significant risk fall factors and the frequency of factors related to circumstances of falls were extracted.

Results

Nine studies were included and 95 risk factors, across seven categories were extracted. These categories included socio-demographic, fall-related factors, functional status, health and mental status, psychiatric diagnosis and assessment, medication, and staff related factors. Factors related to medication, health and mental status are most reported. Majority of the patients sustained minor or no injury from the fall and circumstances of fall vary across studies.

Conclusion

Factors strongly associated with risk of falls were dizziness, use of psychotropics and antihypertensive drugs. A meta-analysis of risk factors was not possible due to different dependent variables studied, controlled confounding variables and control groups used.

Relevance to clinical practice

Fall prevention is relevant to all patients in mental health settings. Approaches to fall risk assessment and management need to be better tailored to younger mental health patients in the psychiatric setting.

Patient and public contribution

Patient or public contribution was not possible because of the study design.

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