Clinical Research Directory

Evaluation of a Specialised Tracheostomy Team for the Management of Patients With a Tracheostomy Cannula in a Belgium General Hospital: A Retrospective Study.

Patients admitted to intensive care units (ICUs) frequently require prolonged mechanical ventilation. Difficulties in weaning from mechanical ventilation represent an important indication for performing a tracheotomy, which involves creating a temporary opening in the trachea into which a cannula is inserted. This procedure is often confused with a tracheostomy, in which a permanent stoma is created. Tracheotomy offers several clinical benefits, including increased patient comfort, reduced sedation requirements, decreased work of breathing, improved oral hygiene, a lower risk of ventilator-associated pneumonia, and lower mortality. With the increasing use of the percutaneous technique, the procedure is increasingly performed by intensivists. Consequently, the number of patients with a tracheostomy cannula in the ICU is increasing. Following clinical stabilisation, these patients are transferred to inpatient wards throughout the hospital according to their underlying pathology. However, nurses working on these wards encounter tracheostomy-related care less frequently, which may include suctioning, wound care, cannula care, and decannulation. Despite the availability of clinical procedures and protocols, a lack of knowledge, skills, and confidence in providing safe tracheostomy-related care persists. This increases the risk of complications such as cannula obstruction, infection, hypoxaemia, dislodgement, and bleeding. To address this issue, specialised multidisciplinary tracheostomy teams are increasingly being implemented. The aim of this retrospective study is to answer the following research question: What is the impact of a specialised multidisciplinary tracheostomy team on clinical outcomes in hospitalised patients with a tracheostomy cannula?

Impact of Medication Reconciliation at Discharge on Potentially Inappropriate Medications in the Elderly : Community-hospital Coordination

The geriatric population is exposed to poly-medication. Furthermore, old people have important pharmacodynamic and pharmacokinetic changes that expose to much drug iatrogenic. Adverse drug effects are a great cause for hospitalization that is why the knowledge of the complete list of medications taken by the patient is necessary. The poly-medication in elderly can lead to extremely serious clinical consequences and significant costs. Reference documents specific to geriatrics guide the doctor in therapeutic choices. On the one hand, the Laroche's criteria lists all PIM of the French pharmacopoeia in elderly. On the other hand, STOPP/START criteria are a tool for detect PIM listing inappropriate drugs and criteria of potentially drug omissions. This has been validated in French language. It is important that any changes proposed by the geriatrician resulting in just prescription is sustainable beyond the hospitalization to prevent the recurrence of adverse effects. Effective community-hospital coordination is essential. Medication reconciliation is defined as the formal process of checking the complete, accurate list of a patient's previous medication - including drug name, dosage, frequency, and route - and comparing it with the prescription after a transition of care (on admission, after transfer to another medical unit, and/or at discharge). Two groups of patients will be created, one for which medication reconciliation at discharge will be practiced and the other a similar process but not standardized. Four to eight weeks after the discharge, the member of the pharmacy team is calling the usual community pharmacy to get the first non-hospital prescription by fax and compare the number of PIM with the prescription before hospitalization.

Hospital-at-Home Education as Implementation Tool - RCT

To enhance implementation of Hospital-at-home (HaH) in Scandinavia, the Nordic Digital Health \& Education (NorDigHE) project has developed a comprehensive virtual education on HaH for clinical staff. The goal of this clinical trial is to evaluate whether an online education for clinical staff can enhance the implementation of HaH services in hospitals across Denmark, Norway, and Sweden. The primary outcome of the RCT is HaH implementation measured at organization level, understood as a change in clinical practice by increased HaH activity. Secondary outcomes are HaH knowledge and motivation among clinical staff as well as patient days in hospital, days hospitalized at home, 30-day readmission, and mortality. Researchers will compare hospitals receiving the NorDigHE education (intervention group) to hospitals continuing treatment as usual (control group) to see if the education leads to greater adoption of HaH and changes in service delivery. Participants will: * Complete baseline, 3-month, and 6-month surveys assessing HaH activity, staff knowledge, and motivation. * Participate in a 12-month follow-up assessment (intervention group only). * Be invited (patients, staff, and management) to take part in semi-structured interviews to share experiences and preferences related to HaH. * (For staff in the intervention group) Complete the NorDigHE virtual education program embedded in the WHO Fast-IM. After the study, the control group will be offered access to the NorDigHE education as a participant retention measure.

The Effect of Gardening Activities on Anxiety and Psychosocial Symptoms of Hospitalized Children

The experience of hospitalization in childhood can often lead to traumatic consequences. Various practices (play, art therapy, music therapy, etc.) are used to help children cope with this process. In recent years, attention has been drawn to nature-based approaches in addition to existing practices. Within the scope of this approach, this study was planned in a parallel group (experimental-control) randomized controlled experimental design to determine the effect of garden activities on anxiety levels and psychosocial symptoms of hospitalized children aged 6-12 years. Hypotheses of the study H1: The gardening activities program applied to hospitalized children; H1a: There is an effect on children's anxiety. H1b: There is an effect on psychosocial symptoms of children. In this direction, the population of the study will consist of children between the ages of 6-12 in the children's ward of University Research and Application Hospital. The sample size determined as a result of G\*power analysis was found as control (18) and intervention (18). The research will be conducted between September 2024 and June 2025. 'Child Descriptive Information Form', "Child Follow-up Form", "Child Anxiety Scale-Conditioning" and "Psychosocial Symptoms Diagnostic Scale for Hospitalized Children" will be used for data collection. The data collection process consists of three stages: pre-intervention period, intervention period and post-intervention period. Children in the intervention group will have three sessions of gardening activities within the scope of the 'Gardening Activities Program' during their hospitalization. Children in the control group will receive services within the scope of the routine treatment and nursing care protocol of the clinic during hospitalization.