Nursing Students’ Errors in Preparation and Administration of Intravenous Drugs

Background & Objective: The intravenous administration of drugs is a complex process in which errors may cause detrimental outcomes for patients and an increase in healthcare costs. This study was performed to ascertain the frequency, type and causes of errors made by senior nursing students in intravenous drug preparation and administration. Methods: In this descriptive study which was conducted in four wards (internal, surgery, Coronary Care Unit, and neurosurgery) in two teaching hospitals in Arak, 52 nursing students were observed during preparation and administration of intravenous drugs between 7 to 8 times by an observer. Errors were checked in each step. The observer intervened in case a potential error was about to happen and this was considered as an error too. Data was collected using a researcher made questionnaire. Results: In 372 registered observations, 153 errors were detected, while in 139 cases, at least one error occurred. The most frequent error in drug preparation was in solvent and diluting (2.68%). The most common error in administration was inappropriate infusion rate (11.55%). The most common cause of errors was inadequate pharmacologic knowledge (18.95%). Most errors in drug field were related to heparin (10 cases), ceftazidime (7 cases) phenytoin (6 cases) dopamine (6 cases), and vancomycin (5 cases). Conclusion: This study shows that making errors in intravenous drug preparation and administration is highly probable amongst nursing students. Educational content should be designed in order to reduce these errors. Also it seems that the strategy of unsupervised medication administration by senior nursing students needs to be revised. Keywords: Intravenous drug, Preparation error, Administration error, Nursing student

The Role of Social Intelligence and Resilience in Explaining Students’ Distress Tolerance: A Study during Covid-19 Pandemic

IL RUOLO DELL’INTELLIGENZA SOCIALE E DELLA RESILIENZA NELLO SPIEGARE LA TOLLERANZA AL DISAGIO DEGLI STUDENTI: UNO STUDIO DURANTE LA PANDEMIA DI COVID-19 Abstract Understanding the factors that influence or correlate with distress tolerance is very important. Therefore, the aim of this study was to investigate the role of social intelligence and resilience in explaining college students’ distress tolerance. A descriptive correlational study was carried out on 260 male college students of Farhangian University of Birjand, Iran in 2020/21. They completed Social Intelligence Scale, Resilience Scale, and Distress Tolerance Questionnaire. The results showed that there was a direct and significant relationship between social intelligence and distress tolerance (r = 0.473; p <0.001), as well as resilience and distress tolerance (r = 0.608; p = 0.008). Also, the coefficient of determination showed that the components of social intelligence and resilience up to 65% can explain the variance of students’ distress tolerance. Psychological interventions such as promoting social intelligence and effective resilience can be used to prevent and control the college students’ distress especially during Covid-19 pandemic

The Experiences of Healthcare Professional Students about the Educational Impacts of Mobile Learning

The role of mobile devices in learning processes is growing rapidly and it is imperative to assess the effect of this technology. This paper explores the experience of healthcare professional students with regard to the educational impacts of mobile learning. We conducted a qualitative study using a conventional qualitative content analysis based on Graneheim and Lundman (2004) method to collect and analyze the experiences of 23 healthcare professional students. Two themes, each with subthemes, emerged from the findings: (1) perceived benefit in learning process, and (2) reflective self-assessment. The results revealed that mobile learning has a positive impact on both the process and the outcome of learning in healthcare professional students. Therefore, creating a supportive condition to promote mobile learning is recommended

La Paradoja de la Aceptación y el Rechazo: La Percepción de los Estudiantes Profesionales de la Salud sobre la Aceptación del Aprendizaje Móvil en la Universidad de Ciencias Médicas de Irán

Objective: A qualitative study was conducted to explore the perception of healthcare professional students about mobile learning acceptance. Method: The study was performed using a conventional content analysis method. The subjects were the students of medical sciences in Iran University of Medical Science. Sampling was based on a purposeful sampling method. Twenty-three students took part in semi-structured interviews until data saturation was reached. Results: The main theme was “the paradox of acceptance and rejection” with three categories; (1) perceived attraction (sub-categories: learning with the excitement of entertainment, the attraction of multimedia learning environment and enthusiasm for electronic learning); (2) perceived ease (sub-categories: easy access to information anytime and anywhere and easy and effortless use); and (3) perceived conflict (sub-categories: teachers’ contradictory behavioral patterns, contradiction about value of online information, friends’ contradictory behavioral patterns, and digital gap between generations in family). Conclusion: The three categories found in the study placed the students in a dilemma of using or not using mobile learning. They had doubts about accepting mobile technology as a legitimate educational tool. Taking these factors into account and managing them can pave the way for mobile learning in the students.Se realizó un estudio cualitativo para explorar la percepción de los estudiantes profesionales de la salud sobre la aceptación del aprendizaje móvil. El estudio se realizó utilizando un método de análisis de contenido convencional. Los sujetos fueron estudiantes de medicina en la Universidad de Ciencias Médicas de Irán. El muestreo se basó en un método de muestreo útil. Veintitrés estudiantes participaron en entrevistas semiestructuradas hasta que se alcanzó la saturación de datos. El tema principal fue "la paradoja de la aceptación y el rechazo" con tres categorías: (1) atracción percibida (subcategorías: aprendizaje con la emoción del entretenimiento, la atracción del entorno de aprendizaje multimedia y el entusiasmo por el aprendizaje electrónico); (2) facilidad percibida (subcategorías: acceso fácil a la información en cualquier momento y en cualquier lugar y uso fácil y sin esfuerzo); y (3) conflicto percibido (subcategorías: patrones de comportamiento contradictorios de los docentes, contradicción sobre el valor de la información en línea, patrones de comportamiento contradictorios de los amigos y brecha digital entre generaciones en la familia). Las tres categorías encontradas en el estudio colocaron a los estudiantes en un dilema de usar o no el aprendizaje móvil. Tenían dudas sobre la aceptación de la tecnología móvil como una herramienta educativa legítima. Tener en cuenta estos factores y gestionarlos puede allanar el camino para el aprendizaje móvil en los estudiantes

The educational effects of mobile learning on students of medical sciences: A systematic review in experimental studies

Introduction: The demand for mobile learning in the medical sciences educational program is increasing. The present review study gathers evidence highlighted by the experimental studies on the educational effects of mobile learning for medical sciences students. Methods: The study was carried out as a systematic literature search published from 2007 to July 2017 in the databases PubMed/ Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Knowledge (Thomson Reuters), Educational Resources and Information Center (ERIC), EMBASE (Elsevier), Cochrane library, PsycINFO and Google Scholar. To examine quality of the articles, a tool validated by the BEME Review was employed. Results: Totally, 21 papers entered the study. Three main themes emerged from the content of papers: (1) improvement in student clinical competency and confidence, (2) acquisition and enhancing of students’ theoretical knowledge, and (3) students’ positive attitudes to and perception of mobile learning. Level 2B of Kirkpatrick hierarchy had been examined by all the papers and seven of them had reported two or more outcome levels, but level 4 was not reported in the papers. Conclusion: Our review showed that the students of medical sciences had positive response and attitudes to mobile learning. Moreover, implementation of mobile learning in medical sciences program might lead to valuable educational benefits and improve clinical competence and confidence along with theoretical knowledge, attitudes, and perception of mobile learning. The results indicated that mobile learning strategy in medical education can positively affect learning in all three domains of Bloom’s Taxonomy

Randomized Controlled Trial of a Peer Based Intervention on Cardiac Self-efficacy in Patients Undergoing Coronary Artery Bypass Graft Surgery: a 3-year Follow-up Results

Background: Self-efficacy is one's belief in ability to succeed in specific situations and considerable factor to maintaining healthy behaviors. It has an important role in person-centred care and significantly improves after effects of heart attacks. This study aimed to investigate the effects of a peer based intervention on cardiac self-efficacy of the patients after bypass surgery.Methods: In this clinical trial study, 60 patients undergoing bypass surgery were chosen and assigned equally into the control and intervention groups. The patients were assigned into two groups by block randomization. While routine education was presented to the patients in the control group, intervention group were taught using the peer education in two sessions. Cardiac self-efficacy of all the selected patients was assessed orderly in 36-month (3 years) follow-up after surgery. Inclusion criteria used to choose the suitable patients were as the following: no record of CABG surgery, understanding and talking Persian language, willingness to participate in the research, age between 40 and 70 years, no dementia, confusion, mental and psychological problems which might hinder their participation. In addition, exclusion criteria in this study were patient’s death, serious physical problems after CABG surgery, emergency and unexpected surgeries, or cancellation the CABG surgery due to patient’s situation. Data was collected using cardiac self-efficacy scale and analyzed using chi-square, independent t-test and Kolmogorov-Smirnov tests. Results: The patients in both groups were homogenous in terms of demographic data. The mean score of cardiac self-efficacy in the intervention group was significantly different from control group in 3- year follow-up after surgery (P&lt;0.038).Conclusions: Based on this study, accomplishment of peer based intervention can be a beneficial educative-supportive approach in cardiac surgery fields.

Randomized Controlled Trial of a Peer Based Intervention on Cardiac Self-efficacy in Patients Undergoing Coronary Artery Bypass Graft Surgery: a 3-year Follow-up Results

Background: Self-efficacy is one's belief in ability to succeed in specific situations and considerable factor to maintaining healthy behaviors. It has an important role in person-centred care and significantly improves after effects of heart attacks. This study aimed to investigate the effects of a peer based intervention on cardiac self-efficacy of the patients after bypass surgery.Methods: In this clinical trial study, 60 patients undergoing bypass surgery were chosen and assigned equally into the control and intervention groups. The patients were assigned into two groups by block randomization. While routine education was presented to the patients in the control group, intervention group were taught using the peer education in two sessions. Cardiac self-efficacy of all the selected patients was assessed orderly in 36-month (3 years) follow-up after surgery. Inclusion criteria used to choose the suitable patients were as the following: no record of CABG surgery, understanding and talking Persian language, willingness to participate in the research, age between 40 and 70 years, no dementia, confusion, mental and psychological problems which might hinder their participation. In addition, exclusion criteria in this study were patient’s death, serious physical problems after CABG surgery, emergency and unexpected surgeries, or cancellation the CABG surgery due to patient’s situation. Data was collected using cardiac self-efficacy scale and analyzed using chi-square, independent t-test and Kolmogorov-Smirnov tests. Results: The patients in both groups were homogenous in terms of demographic data. The mean score of cardiac self-efficacy in the intervention group was significantly different from control group in 3- year follow-up after surgery (P&lt;0.038).Conclusions: Based on this study, accomplishment of peer based intervention can be a beneficial educative-supportive approach in cardiac surgery fields.

The global, regional, and national burden of adult lip, oral, and pharyngeal cancer in 204 countries and territories:A systematic analysis for the Global Burden of Disease Study 2019

Importance Lip, oral, and pharyngeal cancers are important contributors to cancer burden worldwide, and a comprehensive evaluation of their burden globally, regionally, and nationally is crucial for effective policy planning.Objective To analyze the total and risk-attributable burden of lip and oral cavity cancer (LOC) and other pharyngeal cancer (OPC) for 204 countries and territories and by Socio-demographic Index (SDI) using 2019 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates.Evidence Review The incidence, mortality, and disability-adjusted life years (DALYs) due to LOC and OPC from 1990 to 2019 were estimated using GBD 2019 methods. The GBD 2019 comparative risk assessment framework was used to estimate the proportion of deaths and DALYs for LOC and OPC attributable to smoking, tobacco, and alcohol consumption in 2019.Findings In 2019, 370 000 (95% uncertainty interval [UI], 338 000-401 000) cases and 199 000 (95% UI, 181 000-217 000) deaths for LOC and 167 000 (95% UI, 153 000-180 000) cases and 114 000 (95% UI, 103 000-126 000) deaths for OPC were estimated to occur globally, contributing 5.5 million (95% UI, 5.0-6.0 million) and 3.2 million (95% UI, 2.9-3.6 million) DALYs, respectively. From 1990 to 2019, low-middle and low SDI regions consistently showed the highest age-standardized mortality rates due to LOC and OPC, while the high SDI strata exhibited age-standardized incidence rates decreasing for LOC and increasing for OPC. Globally in 2019, smoking had the greatest contribution to risk-attributable OPC deaths for both sexes (55.8% [95% UI, 49.2%-62.0%] of all OPC deaths in male individuals and 17.4% [95% UI, 13.8%-21.2%] of all OPC deaths in female individuals). Smoking and alcohol both contributed to substantial LOC deaths globally among male individuals (42.3% [95% UI, 35.2%-48.6%] and 40.2% [95% UI, 33.3%-46.8%] of all risk-attributable cancer deaths, respectively), while chewing tobacco contributed to the greatest attributable LOC deaths among female individuals (27.6% [95% UI, 21.5%-33.8%]), driven by high risk-attributable burden in South and Southeast Asia.Conclusions and Relevance In this systematic analysis, disparities in LOC and OPC burden existed across the SDI spectrum, and a considerable percentage of burden was attributable to tobacco and alcohol use. These estimates can contribute to an understanding of the distribution and disparities in LOC and OPC burden globally and support cancer control planning efforts

The unfinished agenda of communicable diseases among children and adolescents before the COVID-19 pandemic, 1990-2019: a systematic analysis of the Global Burden of Disease Study 2019

BACKGROUND: Communicable disease control has long been a focus of global health policy. There have been substantial reductions in the burden and mortality of communicable diseases among children younger than 5 years, but we know less about this burden in older children and adolescents, and it is unclear whether current programmes and policies remain aligned with targets for intervention. This knowledge is especially important for policy and programmes in the context of the COVID-19 pandemic. We aimed to use the Global Burden of Disease (GBD) Study 2019 to systematically characterise the burden of communicable diseases across childhood and adolescence. METHODS: In this systematic analysis of the GBD study from 1990 to 2019, all communicable diseases and their manifestations as modelled within GBD 2019 were included, categorised as 16 subgroups of common diseases or presentations. Data were reported for absolute count, prevalence, and incidence across measures of cause-specific mortality (deaths and years of life lost), disability (years lived with disability [YLDs]), and disease burden (disability-adjusted life-years [DALYs]) for children and adolescents aged 0-24 years. Data were reported across the Socio-demographic Index (SDI) and across time (1990-2019), and for 204 countries and territories. For HIV, we reported the mortality-to-incidence ratio (MIR) as a measure of health system performance. FINDINGS: In 2019, there were 3·0 million deaths and 30·0 million years of healthy life lost to disability (as measured by YLDs), corresponding to 288·4 million DALYs from communicable diseases among children and adolescents globally (57·3% of total communicable disease burden across all ages). Over time, there has been a shift in communicable disease burden from young children to older children and adolescents (largely driven by the considerable reductions in children younger than 5 years and slower progress elsewhere), although children younger than 5 years still accounted for most of the communicable disease burden in 2019. Disease burden and mortality were predominantly in low-SDI settings, with high and high-middle SDI settings also having an appreciable burden of communicable disease morbidity (4·0 million YLDs in 2019 alone). Three cause groups (enteric infections, lower-respiratory-tract infections, and malaria) accounted for 59·8% of the global communicable disease burden in children and adolescents, with tuberculosis and HIV both emerging as important causes during adolescence. HIV was the only cause for which disease burden increased over time, particularly in children and adolescents older than 5 years, and especially in females. Excess MIRs for HIV were observed for males aged 15-19 years in low-SDI settings. INTERPRETATION: Our analysis supports continued policy focus on enteric infections and lower-respiratory-tract infections, with orientation to children younger than 5 years in settings of low socioeconomic development. However, efforts should also be targeted to other conditions, particularly HIV, given its increased burden in older children and adolescents. Older children and adolescents also experience a large burden of communicable disease, further highlighting the need for efforts to extend beyond the first 5 years of life. Our analysis also identified substantial morbidity caused by communicable diseases affecting child and adolescent health across the world. FUNDING: The Australian National Health and Medical Research Council Centre for Research Excellence for Driving Investment in Global Adolescent Health and the Bill & Melinda Gates Foundation

Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Funding: F Carvalho and E Fernandes acknowledge support from Fundação para a Ciência e a Tecnologia, I.P. (FCT), in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences UCIBIO and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy i4HB; FCT/MCTES through the project UIDB/50006/2020. J Conde acknowledges the European Research Council Starting Grant (ERC-StG-2019-848325). V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006.proofepub_ahead_of_prin