Systematic review: Nurses' safety attitudes and their impact on patient outcomes in acute-care hospitals.

AIMS: The aim of this review was to synthesize the best available evidence on the impact of nurses' safety attitudes on patient outcomes in acute-care hospitals. DESIGN: Systematic review with a narrative synthesis of the available data. DATA SOURCES: Data sources included MEDLINE, Cumulative Index of Nursing and Allied Health Literature, Scopus and Web of Science Core Collection. Studies published up to March 2021 were included. REVIEW METHODS: This review was conducted using guidance from the Joanna Briggs Institute for Systematic Reviews and reported as per the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. RESULTS: A total of 3,452 studies were identified, and nine studies met the inclusion criteria. Nurses with positive safety attitudes reported fewer patient falls, medication errors, pressure injuries, healthcare-associated infections, mortality, physical restraints, vascular access device reactions and higher patient satisfaction. Effective teamwork led to a reduction in adverse patient outcomes. Most included studies (N = 6) used variants of the Hospital Survey on Patient Safety Culture to assess nurses' safety attitudes. Patient outcomes data were collected from four sources: coded medical records data, incident management systems, nurse perceptions of adverse events and patient perceptions of safety. CONCLUSION: A positive safety culture in nursing units and across hospitals resulted in fewer reported adverse patient outcomes. Nurse managers can improve nurses' safety attitudes by promoting a non-punitive response to error reporting and promoting effective teamwork and good communication

Improvement and enhancement of clavulanic acid production in Streptomyces clavuligerus using vegetable oils

Clavulanic acid (CA) is a potent inhibitor of β-lactamases. Oil can be used as a source of carbon and energy in CA production. To develop a policy for enhanced production of CA, the selection of a production medium and an optimum pH, different vegetable oils as carbon source have been used. The effects of different medium containing vegetable oil on cell growth and CA yield production during the fermentation of Streptomyces clavuligerus ATCC 27064 were demonstrated. In this study, three out of eight tested oils supported CA production. Medium containing olive oil showed two-fold higher CA yield than glycerol containing medium. The highest productivity was obtained at initial pH 7. We concluded that using olive oil as a sole source of carbon and energy for cultivation of S. clavuligerus is a promising strategy for CA production. It has several scientific advantages and economic benefits that lead to increased antibiotic titre and can be considered as a cheaper alternative compared to carbohydrates. The results of this study can be applied for the efficient production of β-lactamase inhibitory antibiotics.Key words: Clavulanic acid, enzymes, β-lactamases, vegetable oils, Streptomyces clavuligerus

Recent Advances Using Supercritical Fluid Techniques for Pulmonary Administration of Macromolecules via Dry Powder Formulations

Growing demands on a suitable formulation method that ensures the stability of the active compound coupled with the limitations of current methods (milling, lyophilization, spray drying, and freeze spray drying) has brought wide attention to supercritical fluid (SCF) technology. Advantages of using the SCF technology comprise its high abilities, adaptability in providing alternative processing methods, high compressibility and diffusivity of the supercritical fluid, capability as an alternative for conventional organic solvents, and the option to attain different processing parameters which would be otherwise difficult to conduct with traditional methods. This review proposes to present an up-to-date outlook on dry powder pulmonary formulations of macromolecules using SCF technology

Innovative Blockchain-Based Applications - State of the Art and Future Directions

Recently, blockchain technology has increasingly being used to provide a secure environment that is immutable, consensus-based and transparent in the finance technology world. However, significant efforts have been made to use blockchain in other fields where trust and transparency are required. The distributed power and embedded security of blockchain leverage the operational efficiency of other domains to be immutable, transparent, and trustworthy. The trust of the published literature in blockchain technology is centered on crypto-currencies. Therefore, this paper addresses this gap and presents to the user several applications in many fields, including education, health, carbon credits, robotics, energy, pharmaceutical supply chains, identity management, and crypto-currency wallets. This paper overviews the knowledge on blockchain technology, discusses the innovation of blockchain technology based on the number of applications which have been introduced, describes the challenges associated with blockchain technology, and makes suggestions for future work

Development of self-nanoemulsifying drug delivery systems for the enhancement of solubility and oral bioavailability of fenofibrate, a poorly water-soluble drug

Kazi Mohsin,1 Rayan Alamri,1 Ajaz Ahmad,2 Mohammad Raish,3 Fars K Alanazi,1 Muhammad Delwar Hussain4 1Kayyali Chair for Pharmaceutical Industry, Department of Pharmaceutics, 2Department of Clinical Pharmacy, 3Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 4Department of Pharmaceutical and Biomedical Sciences, College of Pharmacy, California Health Science University, Clovis, CA, USA Background: Self-nanoemulsifying drug delivery systems (SNEDDS) have become a popular formulation option as nanocarriers for poorly water-soluble drugs. The objective of this study was to investigate the factor that can influence the design of successful lipid formulation classification system (LFCS) Type III SNEDDS formulation and improve the oral bioavailability (BA) of fenofibrate. Materials and methods: LFCS Type III SNEDDS were designed using various oils, water-soluble surfactants, and/or cosolvents (in considering the polarity of the lipids) for the model anticholesterol drug, fenofibrate. The developed SNEDDS were assessed visually and by measurement of the droplet size. Equilibrium solubility of fenofibrate in the SNEDDS was conducted to find out the maximum drug loading. Dynamic dispersion studies were carried out (1/100 dilution) in water to investigate how much drug stays in solution after aqueous dispersion of the formulation. The BA of SNEDDS formulation was evaluated in the rat. Results: The results from the characterization and solubility studies showed that formulations containing mixed glycerides were highly efficient SNEDDS as they had higher solubility of the drug and produced nanosized droplets. The dispersion studies confirmed that SNEDDS (containing polar mixed glycerides) can retain >98% drug in solution for >24 hours in aqueous media. The in vivo pharmacokinetics parameters of SNEDDS formulation in comparison with pure drug showed significant increase in Cmax and AUC0–t, ~78% and 67%, respectively. The oral BA of fenofibrate from SNEDDS in rats was ~1.7-fold enhanced as compared with the BA from pure drug. Conclusion: Fenofibrate-loaded LFCS Type III SNEDDS formulations could be a potential oral pharmaceutical product for administering the poorly water-soluble drug, fenofibrate, with an enhanced oral BA. Keywords: lipid-based formulation, self-nanoemulsifying drug delivery systems, fenofibrate, solubility improvement, oral bioavailabilit