Background: People with HIV have a higher risk of developing non-AIDS-defining cancers in older age, leading to a significant population living with two conditions, HIV and cancer. There is an increasing interest in cannabis use for symptom management in people with chronic conditions; in 2023, the American Nurses Association officially recognised cannabis nursing as a specialty nursing practice focusing on the care of individuals seeking education/guidance in the therapeutic use of cannabis, supporting the urgency of its research. However, the scientific literature lacks a synthesised review in the focused populations. Aim: To explore observational research on cannabis use for symptom management among people with HIV and/or cancer and identify gaps in current knowledge to inform future research and policy development. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist, a literature search of relevant articles was conducted in the databases PubMed (n = 552), PsycInfo (n = 204), CINAHL (n = 164) and Embase (n = 976). Upon screening 1738 articles, 142 were identified for full-text review and 51 were retained for data extraction. Results: There were more studies evaluating cannabis use among people with cancer than with HIV and no studies among people living with comorbid HIV and cancer. Most studies were cross-sectional with limited metrics on the perceived effectiveness and safety of cannabis use for symptom management and its dosing/mode of delivery for reducing symptoms. While studies focused on cannabis therapy under the provision of healthcare providers, individuals reported obtaining information about cannabis from friends/family/the Internet. Implications for cannabis nursing: This body of research could be strengthened by rigorous longitudinal study designs to build causal relationships on the therapeutic effects of cannabis use and the inclusion of reliable and valid symptom assessment measures over time, which facilitates developing clinical practice guidance and policymaking in cannabis nursing. Patient or public contribution: No patient or public contribution.

BACKGROUND: Over the last decade, augmented reality (AR) has emerged in health care as a tool for visualizing data and enhancing simulation learning. AR, which has largely been explored for communication and collaboration in nonhealth contexts, could play a role in shaping future remote medical services and training. This review summarized existing studies implementing AR in real-time telemedicine and telementoring to create a foundation for health care providers and technology developers to understand future opportunities in remote care and education. OBJECTIVE: This review described devices and platforms that use AR for real-time telemedicine and telementoring, the tasks for which AR was implemented, and the ways in which these implementations were evaluated to identify gaps in research that provide opportunities for further study. METHODS: We searched PubMed, Scopus, Embase, and MEDLINE to identify English-language studies published between January 1, 2012, and October 18, 2022, implementing AR technology in a real-time interaction related to telemedicine or telementoring. The search terms were "augmented reality" OR "AR" AND "remote" OR "telemedicine" OR "telehealth" OR "telementoring." Systematic reviews, meta-analyses, and discussion-based articles were excluded from analysis. RESULTS: A total of 39 articles met the inclusion criteria and were categorized into themes of patient evaluation, medical intervention, and education. In total, 20 devices and platforms using AR were identified, with common features being the ability for remote users to annotate, display graphics, and display their hands or tools in the local user's view. Common themes across the studies included consultation and procedural education, with surgery, emergency, and hospital medicine being the most represented specialties. Outcomes were most often measured using feedback surveys and interviews. The most common objective measures were time to task completion and performance. Long-term outcome and resource cost measurements were rare. Across the studies, user feedback was consistently positive for perceived efficacy, feasibility, and acceptability. Comparative trials demonstrated that AR-assisted conditions had noninferior reliability and performance and did not consistently extend procedure times compared with in-person controls. CONCLUSIONS: Studies implementing AR in telemedicine and telementoring demonstrated the technology's ability to enhance access to information and facilitate guidance in multiple health care settings. However, AR's role as an alternative to current telecommunication platforms or even in-person interactions remains to be validated, with many disciplines and provider-to-nonprovider uses still lacking robust investigation. Additional studies comparing existing methods may offer more insight into this intersection, but the early stage of technical development and the lack of standardized tools and adoption have hindered the conduct of larger longitudinal and randomized controlled trials. Overall, AR has the potential to complement and advance the capabilities of remote medical care and learning, creating unique opportunities for innovator, provider, and patient involvement.

Authors' objectives: Objective The aim of this health technology assessment (HTA) is to evaluate the safety, effectiveness and economic impact of folate testing in an asymptomatic general population and in patients with suspected folate deficiency due to the presence of symptoms, underlying medical disorders or external factors. In addition, ethical, legal, social and organisational issues related to folate testing are investigated.

Interprofessional education (IPE) has grown in popularity over the years because it is effective in training future health professionals and serves as the engine of productivity in healthcare-related research. The research team, consisting of higher education faculty in various health profession disciplines, conducted a systematic review of existent IPE literature targeting both graduate and under-graduate students. The main purpose of the systematic review was to categorize research and analyze IPE studies to determine sub-constructs that entail both barriers and facilitators often related to occurrences in primary provider, learner, and researcher IPE initiatives. If identified, IPE training and related curriculum plans were also analyzed in this review. The research team wanted to identify any/all potential instances of the use of research activities in coordination with IPE training to identify underlying constructs to support future college and program-specific andragogy initiatives. Review results demonstrate three categorical constructs related to IPE initiatives in higher education health professions programs (provider, learner, and researcher stakeholder perspectives). Results further demonstrate provider IPE challenges surrounding limited resources and a willingness to participate, while both patient experience and teamwork foci were identified as common IPE session themes. Further, the learners' perspectives included a challenge related to a willingness to participate, as well as the patient experience focus. Review constructs were further validated using supplementary topic modeling. To the best of our knowledge, this is the first study that combined systematic review with a supplementary topic modeling. Findings support ongoing pedagogy and research efforts related to IPE activities for health professions programs in higher education.

Introduction: Coordination of healthcare professionals seems to be particularly important for patients with complex chronic disease, as they present a challenging interplay of conditions and symptoms. As one solution, to counteract or prevent this, improving collaboration between general practitioners (GPs) and specialists has been the aim of studies by linking or coordinating their services along the continuum of care. This scoping review summarises role distributions and components of this collaboration that have potential for improvement for the care of patients with complex chronic conditions. Methods: Scoping review as a knowledge synthesis for components of collaboration and role distributions between medical specialists and GPs in intervention studies. The PubMed database was searched for literature from 2010-2020. Results: Literature search and reference screening generated 2,174 articles. 30 articles originating from 22 unique projects were included in our synthesis. In the interventions to improve collaboration, the GP is most commonly in charge of patient management and extends the scope of practice. The specialist provides support when needed. Clear definition of roles, resources for knowledge transfer and education from specialists are commonly utilised interventions. Typically, combinations of process and system changes addressing communication and coordination issues are applied. Most interventions improve provider and patient satisfaction, health outcomes, and reduce care fragmentation. Conclusion: This review showed that interventions to improve collaboration between GPs and medical specialists seem promising. Further efforts should be made to test and apply the findings systematically in broad clinical practice.

Aim To assess the effect of lubricants on reducing perineal trauma during vaginal delivery. Methods PubMed, Embase, the Cochrane Library, CINAHL, China National Knowledge Infrastructure, China Biology Medicine disc, WanFang databases, and , were searched for literature up to 25 June 2021. Randomized controlled trials published in English or Chinese that compared the vaginal application of lubricant with standard care for women were included. Two reviewers independently performed study screening, data extraction, risk of bias assessment, and certainty of evidence assessment. Pooled effect sizes and corresponding 95% confidence intervals (CI) were calculated using meta-analysis. Results Nineteen trials enrolling 5445 pregnant women were included. Compared with standard care, women using lubricants had a lower incidence of perineal trauma (risk ratio [RR] 0.84, 95% CI 0.76-0.93; low certainty evidence), second-degree perineal laceration (RR 0.72, 95% CI 0.64-0.82; moderate certainty evidence) and episiotomy (RR 0.77, 95% CI 0.62-0.96; very low certainty evidence), and had a shorter duration of the second-stage labor (MD -13.72 min, 95% CI -22.68 to -4.77; very low certainty evidence). Conclusion Lubricants might reduce the incidence of perineal trauma, especially second-degree perineal laceration, and shorten the duration of the second-stage labor. More well-designed studies will continue developing high-quality evidence in this field.

The global spread of diabetes poses serious threats to public health requiring a patient-centered approach based both on interprofessional collaboration (IPC) given by the cooperation of several different health professionals, and patients' perspective through the assessment of Patient-Reported Outcomes (PROs). The aim of the present study is to evaluate the impact of interprofessional collaboration interventions, for the management of type 2 diabetes in primary care settings, through PROs. A systematic review and meta-analysis was conducted querying the PubMed, Scopus and Embase databases. Out of the 1961 papers initially retrieved, 19 met the inclusion criteria. Interprofessional collaboration is significantly associated with an increase in both patient's satisfaction (SMD 0.32 95% CI 0.05-0.59) and in the mental well-being component of the HRQoL (SMD 0.18; 95% CI 0.06-0.30), and there was also promising evidence supporting the association between an interprofessional approach and an increase in self-care and in generic and specific quality-of-life. No statistical differences were found, supporting the positive impact on IPC interventions on the physical component of the HRQoL, depression, emotional distress, and self-efficacy. In conclusion, the effect of IPC impacts positively on the few areas assessed by PROMs. Policymakers should promote the widespread adoption of a collaborative approach as well as to endorse an active engagement of patients across the whole process of care.

Objectives: This study aimed to: (1) Map existing evidence about the use of collaborative writing applications (CWAs) during pandemics; (2) Describe CWAs' positive and negative effects on knowledge translation (KT) and knowledge management (KM) during pandemics; and (3) Inventory the barriers and facilitators that affect CWAs' use to support KT and KM during pandemics. Materials and methods: Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews, we conducted a scoping review of the literature reporting the use of CWAs during pandemics published between 2001 and 2021. Two reviewers undertook the screening, study selection and qualitative thematic analysis. Results: We identified a total of 46 studies. CWAs were used for the following two purposes: KT and KM (23 of 46) anddisease surveillance and infodemiology (20 of 46). Three studies addressed both purposes. Influenza was the focus of most studies (15 of 46), followed by COVID-19 (10 of 46).We identified and classified 24 barriers and 66 facilitators into four categories (factors related to the CWAs, users' knowledge and attitude towards CWAs, human environment, and organizational environment). We also found 74 positive and 7 negative effects that were classified into processes and outcomes. Conclusion: CWAs offer the potential to accelerate KT and KM during pandemics. Their scalability and adaptability to different contexts makes them well suited to support the urgent KT and KM needed in the context of rapidly changing knowledge during pandemics. While their speed and cost as disease surveillance systems compare favorably with existing surveillance systems, the primary challenge is to ensure the accuracy of information shared.

Objective: to evaluate the cost-effectiveness of point-of-care leukocyte analyzers to aid in the diagnosis of airway infections in the SUS.Method: this is a cost-effectiveness study using a deterministic model developed from a decision tree.Results: the use of devices to perform diagnostic tests at the point of treatment has become increasingly popular and accepted around the world in view of the increased demand for care and the need to reduce the time it takes to return exam results to optimization of outcomes. After the Roll Back of the decision tree, the most cost-effective strategy was a white blood cell count-driven clinical investigation using the point-of-care analyzer to guide antibiotic prescribing.Conclusion: Evidence suggests that the use of POC analyzers for WBC counts and differentials at the point of care is a cost-effective alternative as part of a strategy to aid in the diagnosis and therapeutic management of cases of non-specific acute respiratory infections.

INTRODUCTION: The unique attributes of distributed ledger blockchain systems including robust security, immutability, transparency, and decentralisation, make them highly suitable solutions for many healthcare-related problems. This review examines the potential applications for blockchain technology in the field of orthopaedics, by taking a systematic approach to the evolving blockchain literature and mapping potential use cases against the current needs of orthopaedic practice. METHOD: A literature search was performed using Pubmed, EMBASE, OVID and the Cochrane library with the primary aim of identifying detailed accounts of blockchain solutions and use cases in healthcare. These articles were then reviewed and mapped against current orthopaedic practice to illustrate applications specific to that specialty. RESULTS: One hundred and forty-one papers were identified which described case studies, simulations, or detailed proposals of blockchain solutions in healthcare. Most studies described blockchain solutions at the simulated or prototype testing phase, with only 10 case studies describing blockchains in "real-world" use. The most frequently cited use cases for blockchain technology involved the storage, security and sharing of electronic medical records. Other blockchain solutions focused on the "Internet of Things", research, COVID 19, supply chains and radiology. There were no solutions focusing specifically on orthopaedics. Many of the described blockchain solutions had considerable scope for application in orthopaedic practice however, providing the potential for greater inter-institutional collaboration, cross border data exchange, enhanced patient participation, and more robust and transparent research practices. CONCLUSION: Blockchain solutions for healthcare are increasing in number and scope and have multiple applications relevant to orthopaedic practice. The orthopaedic community needs to be aware of this innovative and growing field of computer science so that surgeons can leverage the power of blockchain safely for the future of orthopaedics.

Background: This systematic review aimed to investigate the reliability of ultrasound method compared with digital vaginal examinations in detecting cervical dilation. Methods: We searched Cochrane (CENTRAL), MEDLINE, EMBASE, CINAHL, ISI Web of Science Core Collection, Trip Database, PubMed, DARE and NHS EED, HTA, and PROSPERO. Ten observational studies with a total sample size of 856 were included in the meta-analysis. Results: The intraclass correlation coefficient (ICC) values ranged between 0.21 and 0.69. The fixed-effect models for the ultrasound test showed an average of ICC (r = 0.32 (95% CI 0.26-0.38). Correlation between two methods was poor (r = 0.359, 95% CI 0.26-0.44). In nulliparous and multigravida participants the correlation between ultrasound measurements and digital examinations was (r = 0.349, 95% CI 0.25-0.43) and ICC (r = 0.676, 95% CI 0.419-0.833), respectively. Conclusion: Trans-perineal ultrasonography seems to be a reliable method for assessing labor progression in multigravida women, but its usage in nulliparous women needs further studies.

Characteristics and research collaboration of registered systematic reviews (SRs) on treatment modalities for coronavirus disease-2019 (COVID-19) remain unclear. This study analysed research collaboration, interventions and outcome measures in registered SRs on COVID-19 treatments and pointed out the relevant problems. PROSPERO (international prospective register of systematic reviews) was searched for SRs on COVID-19 treatments as of 2 June 2020. Excel 2016 was used for descriptive analyses of the extracted data. VOSviewer 1.6.14 software was used to generate network maps for collaborations between countries and institutions. A total of 189 SRs were included, which were registered by 301 institutions from 39 countries. China (69, 36.50%) exhibited the highest output. Cooperation between countries was not close enough. As an institution, the Chengdu University of Traditional Chinese Medicine (7, 3.70%) had the highest output. There was close cooperation between institutions. Interventions included antiviral therapy (81, 42.86%), respiratory support (16, 8.47%), circulatory support (11, 5.82%), plasma therapy for convalescent patients (11, 5.82%), immunotherapy (9, 4.76%), TCM (traditional Chinese medicine) treatment (9, 4.76%), rehabilitation treatment (5, 2.65%), anti-inflammatory treatment (16, 8.47%) and other treatments (31, 16.40%). Concerning antiviral therapy (81, 42.86%), the most commonly used antiviral agents were chloroquine/hydroxychloroquine (26, 13.76%), followed by remdesivir (12, 6.35%), lobinavir/ritonavir (11, 5.82%), favipiravir (5, 2.65%), ribavirin (5, 2.65%), interferon (5, 2.65%), abiron (4, 2.12%) and abidor (4, 2.12%). The most frequently used primary and secondary outcomes were the mortality rate (92, 48.68%) and hospital stay length (48, 25.40%), respectively. The expression of the outcomes was not standardised. Many COVID-19 SRs on treatment modalities have been registered, with a low completion rate. Although there was some collaboration between countries and institutions in the currently registered SRs on treatment modalities for COVID-19 on PROSPERO, cooperation between countries should be further enhanced. More attention should be directed towards identifying deficiencies of outcome measures, and the standardisation of results should be maximised.

Background: Engaged scholarship includes the coproduction and use of research by partnerships that blend research, policy and/or practice perspectives. This way of doing research attempts to bridge-the-gap between knowledge and its application. Recent reviews have described practices that support engagement and involve the community in research and patients in healthcare but there is less known about how to engage individuals working to inform public policy. Aims and objectives: The purpose of this research was to articulate the actions and context that support the coproduction and use of research to inform public policy decisions. The study focuses on partnerships between researchers and stakeholders working in public policy across different levels and sectors of government. Methods: A scoping review methodology was used. Relevant articles were identified from six electronic bibliographic databases of peer-reviewed literature. Findings: A total of 9904 articles were screened and 375 full-text articles were assessed for eligibility. The included 11 studies were from research partnerships internationally and described actions and contextual factors contributing to the coproduction and use of research to inform public policy. Key actions included facilitating frequent interactions with public policy stakeholders, joint planning for research, and collaboration to execute data collection and analysis. Contextual factors included clarity in responsibilities, prior relationships, and mutual respect for partner priorities and perspectives. Conclusions: Key actions and contextual factors were identified in this review and warrant further study to strengthen research-policy partnerships and their outcomes.

AIMS: The aim of this systematic review is to understand strategies to influence patient outcomes by synthesizing existing evidence on effective interventions for teamwork, delegation and communication between registered nurses (RNs) and nursing assistants (NAs). BACKGROUND: Three-quarters of deaths in hospitals are related to breakdowns in teamwork and communication. Acute care systems utilize teams of RNs and NAs for primary delivery of nursing care. Research has been conducted to improve the partnership between the dyad. Literature reviews are needed to synthesize the effectiveness of delegation and communication interventions between RNs and NAs on patient outcomes. METHODS: The authors applied Whittemore and Knafl's integrative review methodology to conduct an integrative review of the literature. Databases searched included Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, and PubMed along with reference searches. Included articles were intervention studies related to teamwork, delegation, or communication between RNS and NAs, conducted in the United States, and published from 2000-2019. Methodological quality was assessed utilizing the Mixed Methods Assessment Tool (MMAT). The Systems Engineering Initiative for Patient Safety (SEIPS) model 2.0 was applied as a guiding framework to analyze the findings. RESULTS: Seven articles met the inclusion criteria. The interventions in these articles focused on building a foundation of trust and respect through simulation, education, and mindful communication. Four of the seven articles measured patient outcomes including patient falls, hospital-acquired pressure injuries, and patient satisfaction. Three articles reported decreased patient falls, two articles reported increased patient satisfaction, while one article reported a reduction in pressure injury. Five of the studies reported improved teamwork and/or communication, and two studies reported improved job satisfaction. CONCLUSIONS: There has been limited research on the impact of the RN-NA relationship on patient safety and care outcomes. The existing research demonstrates a need for interventions to foster a dynamic and effective relationship between RNs and NAs. There is a need for more interventional studies linking improved teamwork, delegation, and communication between the RN and NA to patient outcomes such as falls, hospital-acquired pressure injury. IMPLICATIONS FOR NURSING MANAGEMENT: Several interventions exist to improve teamwork and communication between the RN-NA dyad. Leaders need to assess their own culture and develop interventions to build and maintain high performing teams. Future research is necessary to develop interventions aimed at improving delegation from RNs to NAs for applicable activities.

Introduction: The burden of disease associated with tobacco use has prompted a substantial increase in tobacco-related research, but the breadth of this literature has not been comprehensively examined. This review examines the nature of the research addressing the action areas in World Health Organization's Framework Convention on Tobacco Control (FCTC), the populations targeted and how equity-related concepts are integrated. Method: A scoping review of published reviews addressing tobacco control within the primary prevention domain. We searched PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Educational Resources Information Centre, and PsycInfo from 2004 to 2018. Results: The scoping review of reviews offered a "birds-eye-view" of the tobacco control literature. Within the 681 reviews meeting inclusion criteria, there was a strong focus on smoking cessation targeting individuals; less attention has been given to product regulation, packaging, and labeling or sales to minors. Equity-related concepts were addressed in 167/681 (24.5%); few were focused on addressing inequity through structural and systemic root causes. Conclusion: This analysis of foci, trends, and gaps in the research pursuant to the FCTC illustrated the particular action areas and populations most frequently addressed in tobacco control research. Further research is needed to address: (1) underlying social influences, (2) particular action areas and with specific populations, and (3) sustained tobacco use through the influence of novel marketing and product innovations by tobacco industry. Implications: This scoping review of the breadth of tobacco control research reviews enables a better understanding of which action areas and target populations have been addressed in the research. Our findings alongside recommendations from other reviews suggest prioritizing further research to support policymaking and considering the role of the tobacco industry in circumventing tobacco control efforts. The large amount of research targeting individual cessation would suggest there is a need to move beyond a focus on individual choice and decontextualized behaviors. Also, given the majority of reviews that simply recognize or describe disparity, further research that integrates equity and targets various forms of social exclusion and discrimination is needed and may benefit from working in collaboration with communities where programs can be tailored to need and context.

BACKGROUND: Patients and families are often referred to as important partners in collaborative mental health care (CMHC). However, how to meaningfully engage them as partners remains unclear. We aimed to identify strategies for engaging patients and families in CMHC programs for depression and anxiety disorders. METHODS: We updated a Cochrane review of CMHC programs for depression and anxiety disorders. Searches were conducted in Cochrane CCDAN and CINAHL, complemented by additional database searches, trial registry searches, and cluster searches for 'sibling' articles. Coding and data extraction of engagement strategies was an iterative process guided by a conceptual framework. We used narrative synthesis and descriptive statistics to report on findings. FINDINGS: We found 148 unique CMCH programs, described in 578 articles. Most programs (96%) featured at least one strategy for engaging patients or families. Programs adopted 15 different strategies overall, with a median of two strategies per program (range 0-9 strategies). The most common strategies were patient education (87% of programs) and self-management supports (47% of programs). Personalized care planning, shared decision making, and family or peer supports were identified in fewer than one third of programs. LIMITATIONS: Our search strategy was designed to capture programs evaluated in clinical trials and so other innovative programs not studied in trials were likely missed. CONCLUSION: Most CMHC programs for depression and anxiety disorders adopted a limited number of strategies to engage patients and families in their care. However, this review identifies numerous strategies that can be used to strengthen the patient- and family-centeredness of collaborative care.

Background: To analyze the collaboration and reporting quality of the systematic reviews of social welfare in the Campbell collaboration online library. Methods: The Campbell collaboration online library was searched for systematic reviews of social welfare and the basic information extracted in order to assess the reporting quality of systematic reviews using a MOOSE checklist. BICOMS-2 and UCINET software were used to produce the social network, and Comprehensive Meta Analysis (Version 2) and STATA 13.0 were used to analyze the related data. Results: Fifty-seven systematic reviews of social welfare were included. Twenty-eight items of the included social welfare systematic reviews were rated as complete (≥70%). There were significant differences between ≤2013 and ≥ 2014 in five items. These differences were as follows: research published by one organization or more than one organization in one item, more than three authors or less than four authors in two items, and one country or more than one country in six items. It's completed about researches with more than one organization, three authors or more than one country. Some items were found to have a low reporting rate of studies published before 2014, by one organization, with less than four authors or one country, respectively. The social network of authors and organizations showed good collaboration. Conclusions: Some items could be further improved with regard to the rate of reporting systematic reviews of social welfare in the Campbell collaboration online library. This could improve the overall quality of social welfare systematic reviews.

Introduction and hypothesis There is conflicting evidence on whether intermittent catheterization (IC) is less associated with urinary tract infection (UTI) and more likely to prevent urinary retention than continuous catheterization (CC). We aimed to compare the effect of IC with that of CC on the incidence of postpartum UTI, urinary retention and hemorrhage in laboring women with epidural analgesia. Methods Electronic searches were performed in PubMed, EMBASE and Cochrane Library from their inception to October 2018. We selected RCTs comparing IC with CC in laboring women with epidural analgesia. A meta-analysis was performed using the RevMan software, and a random-effects model was used to pool the effect size. The Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used to rate the quality of evidence. Results Six RCTs (N = 850) were included in this review. The meta-analyses indicated that there was no significant difference between the IC and CC group in the incidence of postpartum UTI (RR = 1.25, 95% CI: 0.91 to 1.71, P = 0.16), postpartum urinary retention (RR = 0.76, 95% CI: 0.21 to 2.77, P = 0.68) and postpartum hemorrhage (RR = 1.72, 95% CI: 0.60 to 4.95, P = 0.31). GRADE assessment results showed that the quality of evidence was low. Conclusions Based on the available evidence, there is no measurable difference in rates of UTI between CC and IC, not that neither stragety decreases UTI, since the included trials do not address this.

PURPOSE: Limited research examining the relationship between team-based models of care and patient satisfaction in the hospital setting is available. The purpose of this literature review was to explore this relationship as well as the relationships between team composition, team-based interventions, patient satisfaction, and other outcomes of care when measured as part of the study. METHODS: A systematic appraisal of research studies published through February 2017 was conducted using PubMed, Cochrane Library, CINAHL, Embase, Ovid, gray literature and Google Scholar. Inclusion criteria were 1) experimental (randomized control trials), quasi-experimental, or non-experimental (cross-sectional) study design; 2) team-based care interventions; 3) hospital setting; 4) patient satisfaction measured as an outcome; and 5) published in English. RESULTS: The literature search yielded 15,247 citations. In total, 142 articles were retrieved for full-text screening; 21 studies met inclusion criteria. Overall, 57% of the studies identified a statistically significant improvement in patient satisfaction associated with team-based care. Team-based care interventions ranged from single team activities such as multidisciplinary rounds to comprehensive team-based models of care. Patient satisfaction scores were greater with teams that had more than two professions and more comprehensive team-based models. About one-quarter of studies that measured patient satisfaction and at least one additional outcome demonstrated improvement in both. CONCLUSIONS: Team-based care may positively affect patient satisfaction. Team composition and type of team intervention appears to influence the strength of the relationship. Improvements in satisfaction are not consistently accompanied by improvements in other outcomes.

BACKGROUND: Management of individuals with chronic kidney disease (CKD) requires a collaborative approach. Nurses have diversified their skills to take on roles which have been traditionally physician-led. The impact of such roles, mainly that of the advanced nurse practitioner (ANP), has not been previously assessed using a systematic approach. OBJECTIVES: The aim of this systematic review (SR) was to determine the impact of the addition of an ANP on patient outcomes in adults with CKD. DESIGN: A SR, following the guidance of PRISMA was undertaken. METHODS: Population: adults with CKD. INTERVENTION: ANP. Databases searched included The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Embase and Medline. MEASUREMENTS: Outcome measures were blood pressure (BP), lipids, haemoglobin A1c (HbA1c), phosphate and parathormone (PTH) measures and recommended medication use. RESULTS: Four studies met the inclusion criteria. All possessed external validity and demonstrated low risk for random sequence generation and allocation concealment but were at high risk of performance bias and detection bias. The addition of an ANP resulted in the superior management of BP in all studies. Three studies reported improved control of low-density lipoprotein (LDL) and PTH. One study reported greater achievement of phosphate control. Glycaemic control was equal in both groups. All studies reported higher rates of recommended medication use. CONCLUSION: The addition of an ANP is superior or equal to the usual care models for the management of BP, LDL, PTH and glycaemic control in adults with CKD.