05). Students of medicine attended the lectures and performed the activity with the educational game, without the learning assessment. All of the students answered a question, using a 5-point Likert-type scale, concerning whether they thought the activity with the game was useful for learning. The mean scores obtained by the dentistry, pharmacy, and medicine students were 4.7 ± 0.6, 4.9 ± 0.3, and 4.3 ± 0.1, respectively. The educational game increased the learning of the undergraduate students, in agreement with their opinions of the strategy.Nurse education in the UK has undergone a radical change over the past 30 years. The integration of nursing students within practice has evolved from an apprenticeship style to bespoke mentoring support. To act as mentors, registered nurses must have met stage 2 outcomes of the Nursing and Midwifery Council (NMC) Standards to Support Learning and Assessment in Practice, which clearly stipulate that mentors should have a reduced clinical commitment when supporting students, with one hour per week being protected, in addition to the 40% of time through direct or indirect supervision with their mentor/sign off mentor when facilitating a student on their final 12-week experience. However, this does not seem to be the case in reality. A qualitative study comprising six semi-structured interviews was undertaken across one health and social care trust. Data were analysed using Braun and Clarke's thematic analysis. A number of themes and subthemes were identified engagement (barriers versus strategies), support (inclusivity versus exclusivity), and lack of recognition (strategic versus organisational). Due to the expected changes of supervising and assessing nursing students in practice, it is imperative that an innovative, collaborative and engaged approach is facilitated from all key stakeholders to ensure the sustainability of supporting and assessing students by registered nurses and the safeguarding of the public within clinical practice.The tone of research has changed, says Janet Scammell, Associate Professor (Nursing), Bournemouth University, and it is important that nurses consider the extent of user involvement when undertaking or citing research.BACKGROUND Online self-management education programmes are now recommended for people with type 2 diabetes to improve self-management capacities. There is limited evidence to determine whether such programmes improve the health outcomes for midlife adults with diabetes. AIMS The purpose of this systematic review was to assess the impact of online self-management interventions with digital consulting on glycated haemoglobin (HbA1c), total cholesterol, blood pressure, diabetes distress, self-efficacy, and depression in midlife adults. METHODS A systematic review was undertaken searching Medline, Embase and CINAHL. Studies were appraised using the Cochrane Collaboration's tool. RESULTS Eight studies were included. Online interventions resulted in the improvement of HbA1c (pooled mean difference on HbA1c -0.35%, 95% CI (-0.52, -0.18), P less then 0.001). A narrative synthesis was conducted for all secondary outcomes. No conclusions could be drawn on the impact of these outcomes. CONCLUSION Online interventions improve HbA1c. Further research is needed for secondary outcomes.In light of the emergence of the new coronavirus in China, Emeritus Professor Alan Glasper, from the University of Southampton, discusses the response strategies adopted by international and national public health agencies.Humour is a centuries-old phenomenon studied by many disciplines. Social and personal identity play a role in the creation, recognition, understanding, appreciation and use of humour. This study, which used interpretative phenomenological analysis to explore preregistration nursing students' experiences of the use of humour in the UK clinical setting, highlights what affects the students' use of humour. The influence of sex, age, and culture and ethnicity on the participants' use of humour with patients and healthcare staff is evidenced and explored; the influence of sex did not strictly follow traditional expectations.Catherine Milne and colleagues present the findings of their review, ccna2@juno.com.BACKGROUND Leg ulcers are a significant burden and reduce patients' quality of life. In recent years, a plethora of information has been issued regarding leg ulcer management and 'the demographics of patients affected in the community. However, little is known about the leg ulcer population and how these patients should be managed in acute hospitals. AIM To compare the demographic data of inpatients with leg ulcers referred to the tissue viability service in a large teaching hospital with data on leg ulcer populations in acute and community settings. METHODS Inpatient demographic data were retrospectively obtained from electronic patient records. A literature search identified studies regarding leg ulcer populations in acute and community settings. RESULTS The patient population in acute settings is around 10 years older than that in community settings, with much greater levels of comorbidity and higher mortality rates. CONCLUSION An improved understanding of inpatients with leg ulcers would allow investigations and interventions to be targeted better, enabling evidence-based, patient-centred referral and care pathways. Further research is required to understand the aetiology and outcomes of leg ulcers for the inpatient population.John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses two patient safety reports, which stress the importance of taking proper action when patient safety incidents occur.Hard-to-heal wounds are a major public health problem that incur high economic costs. A major source of morbidity, they can have an overwhelming impact on patients, caregivers and society. In contrast to acute wound healing, which follows an 'orderly and timely reparative process', the healing of hard-to-heal wounds is delayed because the usual biological progression is interrupted. This article discusses hard-to-heal wounds, the impact they have on patients and healthcare systems, and how biofilms and other factors affect the wound-healing process. Controlling and preventing infection is of utmost importance for normal wound healing. Rational use of anti-infectious agents is crucial and is particularly relevant in the context of rising healthcare costs. Knowledge of the complex relationship between hard-to-heal wounds, biofilm formation and wound healing is vital for efficient management of hard-to-heal wounds.Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers what powers are available to ministers, health and local authorities to minimise the spread of the novel coronavirus and the disease it causes.Poor oral hygiene is an important risk factor for the development of non-ventilator hospital-associated pneumonia (NV-HAP), which imposes a significant burden on the NHS. This study aimed to establish whether the use of a 24-hour oral care kit and an oral care assessment tool can meet the needs of patients on an acute stroke unit. In comparison with the same period the preceding year, the introduction of the oral care kit and assessment tool improved compliance with oral care by more than 4 times; the overall costs of antibiotics to treat NV-HAP patients fell by 79%, with the number of doses falling by 70%, and the mortality rate decreased from 27% to 20%. According to a survey of multidisciplinary team (MDT) members keeping oral care tools available at the point of use saved time, and the oral health of patients on the unit improved after the introduction of the oral care kit and assessment tool. Almost all MDT members would recommend the use of the kit over previous interventions.BACKGROUND Type 2 diabetes mellitus is one of the most common diseases worldwide. The demands on health services are rising as more people are diagnosed with the condition. In order to meet this demand, eHealth systems are increasingly being integrated into nursing care. METHODS Between November 2018 and February 2019, a literature search was carried out in the databases PubMed and CINAHL. RESULTS Twenty articles were found on nurses' use of eHealth systems, the majority with patients with diabetes. From this research, it would seem that eHealth systems have had a proven positive influence on patients' state of health and understanding of therapy. Subjectively perceived communication with the nursing staff also improved. Problems can arise in the implementation phase. CONCLUSION In the future, increasingly, nurses will have to integrate eHealth systems into the treatment of patients with type 2 diabetes. It is important that nurses understand such systems in order to guarantee a sustainable and successful implementation.BACKGROUND Surgical and wound site infections (SWSIs) are the second most frequent type of healthcare-associated Infection. One way of preventing SWSIs is by adhering to the principles of asepsis. However, many nurses struggle to apply the principles of aseptic non-touch technique (ANTT) during wound management. AIM To identify the barriers and enablers that influence nurses' adherence to the principles of ANTT during wound care. METHOD A literature search using a systematic approach was carried out. Four databases were searched to identify relevant studies published between January 1993 and December 2018. Titles and abstracts were reviewed. Studies that met the inclusion criteria were reviewed for quality. https://www.selleckchem.com/products/sbi-0640756.html The extracted data were then synthesised. FINDINGS A total of seven studies fulfilled the requirements for inclusion. Three themes emerged and were found to be the most dominant factors influencing adherence to the principles of ANTT material and resources, nurse education, and nurses' behaviour. CONCLUSION Nurses' compliance with aseptic practice is directly influenced by environmental and psychological factors. Ensuring compliance to ANTT may require an integrated approach involving local, national and worldwide organisations, in collaboration with higher education institutions that teach nurses and similar healthcare professionals.Sleep disturbance is common in patients in the intensive care unit (ICU). Numerous factors can contribute to this. High noise and light levels, nursing interventions and medication administration are major factors. This study investigated the demographic and environmental factors that might adversely affect ICU patients' quality of sleep. Data were collected from 103 patients using a demographic data sheet, the Freedman Quality of Sleep Scale and the Richards-Campbell Sleep Scale. Patients' demographic characteristics were found to have no significant effects on their perceived quality of sleep. Environmental factors, including noise, light, nursing interventions, diagnostic testing, the administration of medication, talking and phones ringing, were significantly related to the patients' perceived quality of sleep.BACKGROUND A foot ulcer is a severe complications of diabetes, and patients' cultural backgrounds can greatly influence how they manage this condition. AIM To explore the experience of people of the Batak Karo ethnic group in Indonesia in diabetic foot ulcer treatment. METHODS This was a phenomenological study where a purposeful sample of 10 people with diabetic foot ulcers participated in in-depth interviews. Data analysis was thematic using Van Manen's hermeneutic approach. RESULTS Five themes emerged from the study data beliefs about health disorders; physical, psychological, social and spiritual changes; traditional treatments; cultural beliefs; and seeking health services. DISCUSSION People in the Batak Karo ethnic group strongly believe in supernatural powers and magic, and take part in a variety of traditional ceremonies to treat diabetic foot ulcers. They also use traditional treatments, including herbs. Nurses treating different ethnic groups, such as the Batak Karo people, should be culturally aware and competent to provide adequate care for them.