Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

A time–motion observation study to measure and analyse clinical nursing workload in an acute care hospital in Singapore

Internationally, there are concerns about rising nursing workforce shortages, which could be attributed to both recruitment and retention issues. As the population rapidly ages in Singapore, there is an increase in demand for more trained nurses to staff new facilities. Given the problem that Singapore is facing, there is a need for other solutions besides increasing recruitment rate. A time-motion study of nurses’ workload can assist us in determining how and what nurses spend their time on during their working shift. Work processes can then be studied to allow for improvements and implementation of strategies to ease nurses’ workload. Results of the current study demonstrated four main processes (preparing and clearing requisites, documentation, care coordination, transportation) that can be improved upon. Some of these processes do not require dedicated nursing skills; and can potentially be performed for other staff members. Results also demonstrated that nurses spent significantly less time on patient care activities as compared to nurses in United States; with as much as 31% of the nurses’ time being spent on documentation. Future studies can target on the effectiveness of strategies to improve the efficiency and quality of nursing care

Older nurses: A literature review on challenges, factors in early retirement and workforce retention

Introduction: The widespread shortage of nurses has been exacerbated by an ageing workforce. Though skilled and productive, older nurses are more vulnerable to the physical and mental demands of nursing. Hence, this review was performed to determine the existing evidence on challenges faced by older nurses, factors which promote or deter retirement and strategies that could help in their retention. The results of this review would help with the implementation of age-friendly initiatives to enable older nurses to work longer, while simultaneously allowing institutions to maintain high-quality nursing care. Methods: A search was done using three databases, namely MEDLINE, the Nursing and Allied Health Literature (CINAHL) and PsycINFO. Primary studies and reviews published between 2004 and 2015 were retrieved. Keywords used were ‘older nurses’, ‘retirement’, ‘re-employment’ and ‘retention’. Results: Articles retrieved were mainly qualitative studies. A few quantitative surveys and reviews were reported. The definition of older nurses was inconsistent across the literature. Personal health concerns and limitations, computerisation and shift work were common challenges faced by older nurses, while monetary factors, health and workload were consistent themes on early retirement. Financial reasons were also identified as factors associated with retention, along with flexible schedules. Almost all strategies suggested in the literature for retaining older nurses lacked empirical testing. Conclusion: The ageing process may render certain tasks less desirable and more challenging for the older nurses. Employers could pay attention to the needs of an older workforce through improved workplace practices and being familiar with factors associated with early retirement and retention

Leadership style of nurse managers as perceived by registered nurses: A cross-sectional survey

Given rapid changes in the health care landscape, nurse leaders need to be equipped with effective leadership skills. Those who are aware of their styles of working and its impact on their employees could adopt a better leadership style. The study aim was to assess the leadership styles of nurse leaders, as perceived by their employees. The secondary objectives were to explore differences between self-ratings and others’ ratings of leadership styles, as well as correlation between perceived leadership styles and organisational outcomes. A cross-sectional survey was conducted among registered nurses from four inpatient wards in an acute tertiary hospital in Singapore. Respondents were asked to complete a questionnaire that consisted of demographic questions, the Multifactor Leadership Questionnaire and the Organizational Commitment Questionnaire, as well as a Three-index item Questionnaire, to elicit turnover intention. A total of 111 completed surveys (37% response) were received. Overall, registered nurses reported that their nurse leaders exhibited both transformational and transactional leadership behaviours and, to a lesser extent, laissez-faire. Of interest was the finding that nurse leaders in this study tend to rate themselves higher than others rate them. The results implied a need to incorporate self-awareness elements in nursing leadership development programmes

Nasogastric tube placement confirmation: where we are and where we should be heading

Background: Insertion of a tube via the nasal passage is a common procedure which has been practiced for many years. There are various ways to assess the position of the nasogastric tube (NGT). Objectives: The objective of this study was to discuss the advantages and limitations of each method of NGT placement confirmation, to identify gaps in literature, and provide suggestions for future research. Methods: A search was performed with Pubmed, CINAHL, and Embase. The following keywords were used: “nasogastric,” “tube,” “placement,” “insertion,” and “measurement.” The results were narrowed down to those with full text available, published in the English language, those published within the last 10 years, and those studies done in the adult population. The reference lists of those articles were also referred to and relevant articles were retrieved. A final 26 relevant articles were included in this review, including six that were published more than 10 years ago but still relevant in this review. Results: A method to confirm NGT placement that is accurate, affordable, does not require gastric aspirates, and is able to be used not only upon insertion but also at regular intervals is lacking. Conclusions: This article provides a summary of the different methods of NGT placement confirmation and discusses their advantages and limitations. Gaps in literature and suggestions for future research were also deliberated

Promoting research competence: introduction of the nursing research immersion program in Singapore General Hospital

Individual, organisational and environmental factors play an significant role in developing and promoting research utilisation among nurses. Building a strong research foundation is important for the future of nursing profession. Research utilisation among newly graduated registered nurses has been reportedly to be low in previous population-based longitudinal studies. Historically, nurses find it difficult to understand the value of a nursing research in the course of their clinical practice therefore a more creative and interactive strategies (experiential learning) are needed to make research relevant to clinical practice. This article describes the efforts of a large teaching hospital in Singapore in promoting and building research competence among nurses in the clinical care setting. An immersion program similar to a research internship offers an in-depth and experiential learning experience. It allows students to learn a new knowledge and skills by being completely immersed and engaged in the prescribed activity. The goal of the immersion program is to develop research skills through active participation in the research process and to develop novice nurses’ ability to implement and evaluate evidence-based project that aimed to improve treatment outcomes of patients. An immersion program such as the one described in this article provides a strategy to promote a culture of evidence-based practice. The experiential knowledge gained through this type of program may advance the nursing profession

Disparity between perceived and physiological risks of falling among older patients in an acute care hospital

Background: Falls are the most frequent adverse events among hospitalised older adults. Previous studies highlighted that older adults might not understand the risk factors associated with falls and may have an altered perception of their actual risk. Aim: To describe differences between perceived and actual physiological risk of falling among older adults and to explore factors associated with the differences. Methods: : A prospective cohort study was done. Older adults (age 65 years and above) were interviewed one-toone at bedside. Morse Fall Scale (MFS) and other risk factors for falls were used to identify the patients’ physiological fall risks. Patients’ perceived risk of falls were assessed using the Falls Efficacy Scale-International (FES-I). Results: Three hundred patients were recruited. Patients’ mean age was 75.3 (SD = ± 6.2). Majority were males (51.7%), lived with others (91.7%), and had received primary school education (35.3%). Based on the MFS, most patients had moderate fall risk (59.7%). Using the FES-I, more than half the patients (59%) interviewed had high concerns about falling. About one-third of the patients’ (31.3%) perceived risk matched with their physiological fall risk (Risk-Aware). Half of the patients’ perceived risks was higher than their physiological fall risk (50.7%) (Risk-Anxious), while the remaining patients’ perceived risks was reported to be lower than their physiological fall risk (18%) (Risk-Taker). Conclusion: Older patients are poor at recognizing their fall risks. Both patients’ perceived and actual fall risks should be evaluated in the inpatient setting in order to inform individualized fall prevention education and strategies

Understanding the influence of resilience on psychological outcomes — Comparing results from acute care nurses in Canada and Singapore

Background: Building resilience among nurses is one of the ways to support and retain nurses in the profession. Prior literature which evaluated influence of resilience on psychological outcomes, were conducted in relatively homogeneous populations. It is of interest to evaluate whether relationships between resilience and psychological outcomes remain consistent across nations and among different nursing populations. Aim: To evaluate a theoretical model of the impact of resilience on burnout (BO), secondary traumatic stress (STS) and compassion satisfaction (CS) by comparing results between nurses in Canada and Singapore. Method: A self-reported questionnaire consisting of questions on demographics, resilience (Connor-Davidson Resilience Scale), and psychological adjustment (Professional Quality of Life) was administered via an online survey. One thousand three hundred and thirty-eight nurses working in two Academic Medical Centres in Singapore responded to the online survey. Similar data was also collected from 329 nurses in Canada. Hypotheses were tested using structural equation modeling. Results: Resilience exerts a significant negative direct impact on STS, and a significant negative direct impact on BO. Additionally, resilience has a positive direct impact on compassion satisfaction. STS exerts a positive direct impact on BO while CS has a negative direct impact on BO. Conclusion: Current study affirmed significant associations between resilience and professional quality of life. Knowledge on resilience is key in informing design and implementation of resilience-building strategies that include professional development, and strengthening of interpersonal skills. A resilience-based approach will help reduce nurses' BO and STS while caring for their patients, and in turn reduce turnover

Enhancing the hospital at home experience

Background Hospital at Home programs have demonstrated to be safe, feasible and cost effective. However, challenges such as infection control, cleanliness, space constraints and insufficient resources may hamper the adoption and effectiveness of such programs. Aims To understand the challenges of providing and receiving healthcare in the community, design a solution to meet the challenges, and to pilot and evaluate the solution. Methods This is a three-phase mixed method study. Phase 1, nurses, patients and caregivers were surveyed to understand their challenges in providing or receiving healthcare at home. Results of the survey in Phase 1 were used in Phase 2 to design a solution. In phase 3, an integrated structure was designed and piloted for stakeholders’ evaluation. Results Twenty nurses and 50 patient-caregiver dyads responded to Phase 1 survey. Physical home environment was most cited by the nurses as their main challenge, particularly the lack of a dedicated and clean space to conduct nursing procedures. Medication management was the greatest challenge faced by the patient-caregiver dyads. Based on these findings, a prototype of an integrated structure was fabricated in Phase 2. Ten patient-caregiver dyads and nine community nurses tested the prototype in Phase 3. The participants found the structure useful to store and organize their healthcare items, and there was ample clean workspace to carry out nursing procedures. Conclusion An integrated structure that can fulfil the physical, spatial and interpersonal needs at an affordable price could be useful in facilitating the delivery of hospital care in the home setting. Patient Contribution Patient-caregiver dyads were key stakeholders in our study. They provided valuable feedback and suggestions on the prototype and design of the integrated structure