Exploring the influencing factors of patient safety competency of clinical nurses: a cross-sectional study based on latent profile analysis.

BACKGROUND: Clinical nurses play an important role in ensuring patient safety. Nurses' work experience, organizational environment, psychological cognition, and behavior can all lead to patient safety issues. Improving nurses' attention to patient safety issues and enhancing their competence in dealing with complex medical safety issues can help avoid preventable nursing adverse events. Therefore, it is necessary to actively identify the latent profiles of patient safety competency of clinical nurses and to explore the influencing factors. METHODS: A cross-sectional design was conducted. A total of 782 Chinese registered nurses were included in the study. Demographic characteristics questionnaire, Error Management Climate scale, Security Questionnaire, Proactive Behavior Performance scale and Patient Safety Competency Self-Rating Scale of Nurses were used. Latent profile analysis (LPA) was performed to categorize nurses into latent subgroups with patient safety competency differences. Multinomial logistic regression was conducted to explore the influencing factors of nurses' patient safety competency (PSC) in different latent profiles. RESULTS: A total of 782 questionnaires were valid. Nurses' PSC was positively related to error management climate, and psychological safety and proactive behavior. The PSC score was 121.31 (SD = 19.51), showing that the PSC of clinical nurses was at the level of the medium on the high side. The error management climate score was 70.28 (SD = 11.93), which was at a relatively high level. The psychological safety score was 61.21 (SD = 13.44), indicating a moderate to low level. The proactive behavior score was 37.60 (SD = 7.33), which was at a high level. The latent profile analysis result showed that three groups of profile models were fitted acceding to the evaluation of PSC. They were defined as Low-competency Group (74 (9.5%)), Medium-competency Group (378 (48.3%)) and High-competency Group (330 (42.2%). Working years, professional titles, departments, error management climate, psychological security and proactive behavior were the influencing factors of PSC in three latent profiles. CONCLUSIONS: The PSC of clinical nurses had obvious classification characteristics, and the main influencing factors were working years, professional titles, working departments, error management climate, psychological security and proactive behavior. This study suggests that managers should pay attention to the continuous cultivation of patient safety competence among clinical nurses, provide targeted intervention measures for nurses at different work stages, professional titles, and departments, and use efficient management strategies to create a positive error management atmosphere. In patient safety management, providing nurses with more psychological security is conducive to stimulating more proactive behaviors and continuously improving the level of patient safety competence.

The effect of an escape room game on college nursing students' learning attitude and game flow experiences in teaching safe medication care for the elderly: an intervention educational study.

BACKGROUND: In the context of an aging population, the Gerontological Nursing course is becoming more and more important. Escape room games have been shown to have a positive effect on nursing education, but they have not been applied in the Gerontological Nursing course. The purpose of this study was to investigate the effects of adding an escape room game-based learning activity at the end of classroom teaching in a Gerontological Nursing course on nursing students' learning attitude and game flow experience. METHODS: In April 2023, a total of 84 nursing students from two classes at a medical school in Northeast China were selected for the study, and the classes were divided into a test group (n = 41) and a control group (n = 43). Both groups received regular classroom teaching on "Safe Medication Care for the Elderly", and the test group participated in an escape room game at the end of the classroom teaching. General information about the nursing students in both groups was collected prior to participation; learning attitude were measured before and after participation; and game flow experience was measured before and after participation in the test group. Data were analyzed using independent samples t-tests and paired samples t-tests. RESULTS: There was no statistically significant difference in the general information and learning attitude of nursing students between the two groups before participation. After participation, the total learning attitude score of nursing students in the test group was (73.17 ± 1.67) and that of the control group was (61.63 ± 2.66), and the difference was statistically significant (p < 0.001, Cohen's d = 5.196). The game flow experience of nursing students in the test group before and after participation was (63.27 ± 2.48) and (81.29 ± 2.49), respectively, and the difference between before and after was statistically significant (p < 0.001, Cohen's d = 5.253). CONCLUSIONS: During the teaching process of the Gerontological Nursing course, an escape room game added at the end of classroom teaching can improve nursing students' learning attitude and also help them to have a good game flow experience. These findings suggest that teaching activities based on the escape room game have considerable practical application value.

Effect of family education program on cognitive impairment, anxiety, and depression in persons who have had a stroke: A randomized, controlled study.

People who have had a stroke face high risks of cognitive impairment, anxiety, and depression. Health education for family members contributes to better outcomes in various diseases, but the effects of health education on family members of people who have had a stroke are unclear. The aim of the present study was to evaluate the effects of the family member education program (FMEP) on cognitive impairment, anxiety, and depression in persons who have had a stroke. In total, 144 persons who experienced a stroke were randomly allocated to the FMEP group or control group (1:1 ratio). In the FMEP group, the FMEP and conventional treatment were provided, while in control group only conventional treatment was provided. The increase in the Montreal Cognitive Assessment (MOCA) score from baseline to 12 months (M12 - baseline) in the FMEP group was higher compared with the control group, and the FMEP led to a decreased cognitive impairment rate (MOCA score ≤26) after 12 months compared to the control group. Changes in the Hospital Anxiety and Depression Scale anxiety and depression score (M12 - baseline) decreased in the FMEP group compared with the control group. Fewer participants with depression and a lower depression grade were observed in the FMEP group compared with the control group. The FMEP could reduce cognitive impairment, anxiety, and depression in persons who have had a stroke.

Hepatitis C virus NS3 RNA helicase activity is modulated by the two domains of NS3 and NS4A.

To determine whether the two domains of hepatitis C virus (HCV) NS3 and the NS4A interact with each other to regulate the RNA unwinding activity, this study compares the RNA unwinding, ATPase and RNA binding activities of three forms of NS3 proteins--the NS3H protein, containing only the helicase domain, the full-length NS3 protein, and the NS3-NS4A complex. The results revealed that NS3 displayed the weakest RNA helicase activity, not because it had lower ATPase or RNA binding activity than did NS3H or NS3-NS4A, but because it had the lowest RNA unwinding processivity. A mutant protein, R1487Q, which contained a mutation in the helicase domain, displayed a reduced protease activity as compared to the wild-type NS3-NS4A. Together, these results suggest the existence of interactions between the two domains of NS3 and the NS4A, which regulates the HCV NS3 protease and RNA helicase activities.