Background As hospitals expand their roles within transforming health systems, their governance structures must adapt to changing demands, with novel leadership structures evolving to meet new challenges. Objective This review aims to provide a comprehensive overview on the evidence of the influence of hospital C-level positions on key organisational performance parameters. It maps key concepts from the existing literature relating to hospital performance and leadership and identifies mediators and moderators of top management team impacts based on the Upper-Echelons-Theory. Methods The scoping review was conducted according to the Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews, covering studies from 1990 to the present. Eligible studies addressed at least one identifiable hospital C-Suite role and one hospital-wide leadership effect. Results Out of 5,430 articles identified, 60 were included. The analysis covers seven distinct C-Suite roles and their effects on six performance dimensions: quality of care, structural quality, patient satisfaction, work satisfaction, financial performance, and process efficiency. Conclusions The findings suggest that the influence of C-Suite positions on hospital performance is multifaceted, with the Chief Executive Officer's influence extending beyond financial performance to shaping the quality of care. Additionally, the impact of newer roles such as the Chief Quality Officer, as well as leadership roles like the Chief Medical Officer and Chief Nursing Officer, appear to depend on a collaborative approach and alignment with the Chief Executive Officer. From a policy perspective, the findings emphasise that hospital governance, shaped by regulations, determines key performance indicators and strategic priorities.

Aim: CPR training for schoolchildren to increase bystander CPR-rates is widely applied. HCPs are regarded as the instructor gold standard, but using non-HCP instructors (e.g., peer-tutors, schoolteachers, medical students) challenges that. This systematic review assesses whether cardiopulmonary resuscitation (CPR) training for children led by peer-tutors, schoolteachers, or medical students results in different learning outcomes to training by health-care professionals (HCPs). Methods: We searched studies that compared CPR training for schoolchildren (population) delivered by peer-tutors, schoolteachers, or medical students (intervention), with training led by HCPs (comparison), assessing student knowledge, skills, willingness and/or confidence to perform CPR (outcome). We included randomized and non-randomized controlled trials (study design). Medline, Embase, Psychinfo, Cinahl, Cochrane, Scopus, Web of Science, and Eric were searched from inception until December 23rd, 2023 (timeframe). Two independent reviewers performed title, abstract, full text screening, bias assessment, and grading of certainty of evidence. We followed the Preferred Reporting Items for a Systematic Review and Meta-Analysis (PRISMA) guidelines, and registered the review with PROSPERO. Results: Of 9'092 studies identified, 14 were included. Comparison of intervention groups to HCP-led training showed similar overall results (knowledge, skills, self-confidence). Superior results for HCP training were only reported for 'ventilation volume', while schoolteachers and medical students achieved superior knowledge transfer. A meta-analysis was possible for 'compression depth' between peer-tutors and HCPs showing no significant differences. Certainty of evidence was 'low' to 'very low'. Conclusion: This systematic review of CPR training for school children revealed that peer-tutors, schoolteachers and medical students achieve similar educational outcomes compared to those of HCPs. Non-HCPs training schoolchildren is an appropriate cost-efficient alternative and easy to implement in school curricula.

Background: Good oral health is an important part of healthy ageing, yet there is limited understanding regarding the status of oral health care for older people globally. This study reviewed evidence (policies, programs, and interventions) regarding oral health care for older people. Methods: A systematic search of six databases for published and grey literature in the English language by the end of April 2022 was undertaken utilising Arksey and O'Malley's scoping review framework. Results: The findings from oral health policy documents (n = 17) indicated a lack of priorities in national health policies regarding oral health care for older people. The most common oral health interventions reported in the published studies (n = 62) included educational sessions and practical demonstrations on oral care for older adults, nurses, and care providers. Other interventions included exercises of facial muscles and the tongue, massage of salivary glands, and application of chemical agents, such as topical fluoride. Conclusion: There is currently a gap in information and research around effective oral health care treatments and programs in geriatric dental care. Efforts must be invested in developing guidelines to assist both dental and medical healthcare professionals in integrating good oral health as part of healthy ageing. Further research is warranted in assessing the effectiveness of interventions in improving the oral health status of the elderly and informing approaches to assist the integration of oral health into geriatric care.

BackgroundStudies of the associations between soft drinks and the risk of cancer showed inconsistent results. No previous published systematic reviews and meta-analysis has investigated a dose-response association between exposure dose and cancer risk or assessed the certainty of currently available evidence. Therefore, we aim to demonstrate the associations and assessed the certainty of the evidence to show our confidence in the associations.MethodsWe searched Embase, PubMed, Web of Science, and the Cochrane Library from inception to Jun 2022, to include relevant prospective cohort studies. We used a restricted cubic spline model to conduct a dose-response meta-analysis and calculated the absolute effect estimates to present the results. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of the evidence.ResultsForty-two articles including on 37 cohorts enrolled 4,518,547 participants were included. With low certainty evidence, increased consumption of sugar-sweetened beverages (SSBs) per 250 mL/day was significantly associated with a 17% greater risk of breast cancer, a 10% greater risk of colorectal cancer, a 30% greater risk of biliary tract cancer, and a 10% greater risk of prostate cancer; increased consumption of artificially sweetened beverages (ASBs)re per 250 mL/day was significantly associated with a 16% greater risk of leukemia; increased consumption of 100% fruit juice per 250 mL/day was significantly associated with a 31% greater risk of overall cancer, 22% greater risk of melanoma, 2% greater risk of squamous cell carcinoma, and 29% greater risk of thyroid cancer. The associations with other specific cancer were no significant. We found linear dose-response associations between consumption of SSBs and the risk of breast and kidney cancer, and between consumption of ASBs and 100% fruit juices and the risk of pancreatic cancer.ConclusionsAn increment in consumption of SSBs of 250 mL/day was positively associated with increased risk of breast, colorectal, and biliary tract cancer. Fruit juices consumption was also positively associated with the risk of overall cancer, thyroid cancer, and melanoma. The magnitude of absolute effects, however, was small and mainly based on low or very low certainty of evidence. The association of ASBs consumption with specific cancer risk was uncertain.

目的:系统评价Teach-back健康教育对脑卒中病人康复效果的影响。方法:计算机检索PubMed、EMbase、Web of Science、the Cochrane Library、CINAHL、中国生物医学文献数据库(SinoMed)、中国知网、维普数据库、万方数据库。检索时间均为建库至2022年1月。依据Cochrane手册6.1.0质量评价标准对纳入文献进行评价，采用RevMan 5.4软件进行系统评价。结果:共纳入11项研究，共1 018例病人。Meta分析结果显示，试验组肢体运动功能[MD=9.98,95%CI(7.19,12.77),P<0.000 01]、焦虑情绪[SMD=-0.86,95%CI(-1.31,-0.42),P=0.000 1]、抑郁情绪[SMD=-0.99,95%CI(-1.41,-0.57),P<0.000 01]、健康素养[SMD=2.66,95%CI(2.26,3.07),P<0.000 01]、日常生活自理能力[SMD=1.52,95%CI(0.83,2.21),P<0.000 1]改善程度均优于对照组，差异有统计学意义...

OBJECTIVES: Humour is an integral part of communication and often used in education to support learning, build relationships, lessen stress, and create a positive environment. This paper presents results from an integrative review of literature that aimed to explore how humour is used in nursing education. DESIGN: Integrative literature review. DATA SOURCES: CINAHL, INFORMIT, Medline and Proquest education. REVIEW METHODS: An integrative review of published research was conducted in the above-mentioned databases during March to June 2022. A hand search in reference lists of published articles was also conducted. Search terms followed PEO (population, exposure and outcome) and included 'Faculty, Nursing', 'Nurse* Student*', 'Baccalaureate', 'Humo?r', 'Laugh*', 'Wit', 'Fun*', 'Comedy', 'Educat*', 'Teach*', 'Learn*' and 'Curricul*'. Inclusion criteria stated articles must have a research component investigating how humour is used and received by students in nursing education. The articles were peer reviewed and published after 2001. Conference abstracts, editorials and articles describing the use of humour in nursing education without research evidence were excluded. Grey literature was not included. RESULTS: The search yielded two hundred and one articles, 10 of which met the inclusion criteria. Studies were primarily qualitative (n = 9) with 1 quantitative study. Five themes were found among the articles (1) Humour builds social relationships (2) Humour aids learning/critical thinking (3) Humour and stress relief (4) Humour to focus attention and (5) Negative use of humour. CONCLUSION: Findings suggest that the use of humour in nursing education lowers stress, improves attention, increases focus and improved information retention. However, findings also conclude that negative humour is not conducive to learning. Research is needed to explore the use of humour in nurse education in order to develop teaching approaches that include culturally sensitive humour to enhance the student learning experience and reduce stress.

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.

Interprofessional primary care (IPPC) teams are promoted as an alternative to single profession physician practices in primary care with focus on preventive care and chronic disease management. Characteristics of teams can have an impact on their performance. We synthesized quantitative, qualitative or mixed-methods evidence addressing the design of IPPC teams. We searched Ovid MEDLINE, Embase, CINAHL, and PAIS using search terms focused on IPPC teams. Studies were included if they discussed the influence of team structure, organization, financial arrangements, or policies and procedures, or either health care processes or outputs, health outcomes, or costs, and were conducted in Australia, Canada, the United Kingdom or New Zealand between 2003 and 2016. We screened 11,707 titles, 5366 abstracts, and selected 77 full text articles (38 qualitative, 31 quantitative and 8 mixed-methods). Literature focused on the implications of team characteristics on team processes, such as teamwork, collaboration, or satisfaction of patients or providers. Despite heterogeneity of contexts, some trends are observable: shared space, common vision and goals, clear definitions of roles, and leadership as important to good teamwork. The impacts of these on health care outputs or patient health are not clear. To move the state of knowledge beyond perception of what works well for IPPC teams, researchers should focus on quantitative causal inference about the linkages between team characteristics and patient health.

Background: The nursing profession has a significant evidence to practice gap in an increasingly complex and dynamic health care environment. Objective(s): To evaluate effectiveness of teaching and learning strategies related to a capstone project within a Masters of Nursing program that encourage the development of evidence based practice capabilities. Design: Systematic review that conforms to the PRISMA statement. Sample: Master's Nursing programs that include elements of a capstone project within a university setting. Data Sources/Review Methods: MEDLINE, CINAHL, Cochrane Database of Systematic Reviews, ERIC and Psyclnfo were used to search for RCT's or quasi experimental studies conducted between 1979 and 9 June 2017, published in a peer reviewed journal in English. Results: Of 1592 studies, no RCT's specifically addressed the development of evidence based practice capabilities within the university teaching environment. Five quasi-experimental studies integrated blended learning, guided design processes, small group work, role play and structured debate into Masters of Nursing research courses. All five studies demonstrated some improvements in evidence based practice skills and/or research knowledge translation, with three out of five studies demonstrating significant improvements. Conclusions: There is a paucity of empirical evidence supporting the best strategies to use in developing evidence based practice skills and/or research knowledge translation skills for Master's Nursing students. As a profession, nursing requires methodologically robust studies that are discipline specific to identify the best approaches for developing evidence-based practice skills and/or research knowledge translation skills within the university teaching environment. Provision of these strategies will enable the nursing profession to integrate the best empirical evidence into nursing practice.

Background: Pharmacists have become an integral member of the multidisciplinary team providing clinical patient care in various healthcare settings. Although evidence supporting their role in the care of patients with other disease states is well-established, minimal literature has been published evaluating pharmacist interventions in stroke patients. The purpose of this systematic review is to summarize the evidence evaluating the impact of pharmacist interventions on stroke patient outcomes. Methods: Study abstracts and full-text articles evaluating the impact of a pharmacist intervention on outcomes in patients with an acute stroke/transient ischemic attack (TIA) or a history of an acute stroke/TIA were identified and a qualitative analysis performed. Results: A total of 20 abstracts and full-text studies were included. The included studies provided evidence supporting pharmacist interventions in multiple settings, including emergency departments, inpatient, outpatient, and community pharmacy settings. In a significant proportion of the studies, pharmacist care was collaborative with other healthcare professionals. Some of the pharmacist interventions included participation in a stroke response team, assessment for thrombolytic use, medication reconciliation, participation in patient rounds, identification and resolution of drug therapy problems, risk-factor reduction, and patient education. Pharmacist involvement was associated with increased use of evidence-based therapies, medication adherence, risk-factor target achievement, and maintenance of health-related quality of life. Conclusions: Available evidence suggests that a variety of pharmacist interventions can have a positive impact on stroke patient outcomes. Pharmacists should be considered an integral member of the stroke patient care team.

Objectives To review the literature on interventions to improve team effectiveness and identify their ‘evidence based’-level. Methods Major data bases (PubMed, Web of Science, PsycInfo and Cochrane Library) were systematically searched for all relevant papers. Inclusion criteria were: peer-reviewed papers, published in English between January 1990 and April 2008, which present empirically based studies focussing on interventions to improve team effectiveness in health care. A data abstraction form was developed to summarize each paper. The Grading of Recommendations, Assessment, Development, and Evaluation Scale was used to assess the level of empirical evidence. Results Forty-eight papers were included in this review. Three categories of interventions were identified: training, tools, and organisational interventions. Target groups were mostly multidisciplinary teams in acute care. The majority of the studies found a positive association between the intervention and non-technical team skills. Most articles presented research with a low level of evidence. Positive results in combination with a moderate or high level of evidence were found for some specific interventions: Simulation training, Crew Resource Management training, Team-based training and projects on Continuous quality improvement. Conclusions There are only some studies available with high quality evidence on interventions to improve team effectiveness. These studies show that team training can improve the effectiveness of multidisciplinary teams in acute (hospital) care.