https://www.um.edu.mt/library/oar/handle/123456789/318 2026-06-05T08:12:03Z 2026-06-05T08:12:03Z https://www.um.edu.mt/library/oar/handle/123456789/147120 2026-06-04T13:36:01Z 2026-01-01T00:00:00Z

Title: The process of informed consent and decision-making in invasive aesthetic procedures Abstract: Background: Informed consent is a key component of ethical, patient-centred healthcare delivery, ensuring individuals are thoroughly informed about the risks, benefits and alternatives of procedures. Given the increasing number of aesthetic procedures being carried out and the limited research on individuals’ understanding of the risks, benefits and alternatives of informed consent in aesthetic procedures, this research study sought to explore the process of informed consent and the decision-making process of individuals undergoing invasive aesthetic procedures. To address this aim, this research study was guided by three objectives; To explore and examine the informed consent process in invasive aesthetic procedures, to explore the decision-making process in invasive aesthetic procedures and to examine how demographic factors influence patients’ understanding of informed consent in aesthetic procedures. Methodology: A parallel convergent mixed-methods design was adopted. Data was collected using a self-developed structured questionnaire, which underwent face and content validation (n=270) and semi-structured interviews (n=8), from individuals who underwent invasive aesthetic procedures. Quantitative data was analysed using descriptive and inferential statistics, while qualitative data was analysed thematically. Data was converged to identify congruencies and discrepancies. Findings: Participants perceived themselves as being less informed about risks and potential complications compared to the benefits of the procedure. However, individuals were overall satisfied with the consent process, suggesting that insufficient risk information did not influence their final decision to undergo the procedure. Furthermore, participants mentioned dissatisfaction with their self-image and low self-esteem as the main factors influencing their decision to undergo an aesthetic procedure, often outweighing concerns about potential risks or complications. Conclusion: The findings suggest that informed consent in invasive aesthetic procedures serves as a useful but not decisive component of decision-making, as choices were also strongly influenced by personal motivations. This highlights the need to improve ethical, patient-centred consent practices that better address risk understanding and underlying patient motivations. Description: M.Sc.(Melit.)

2026-01-01T00:00:00Z Silvana, Gastaldi Giovanni, Satta Tartari, Ermira Mookerjee, Siddharth Benedetta, Allegranzi https://www.um.edu.mt/library/oar/handle/123456789/146883 2026-06-01T07:08:37Z 2026-01-01T00:00:00Z

Title: Global adoption and readiness for artificial intelligence (AI) and digital health technologies in infection prevention and control (IPC) : a WHO global survey Authors: Silvana, Gastaldi; Giovanni, Satta; Tartari, Ermira; Mookerjee, Siddharth; Benedetta, Allegranzi Abstract: Background Artificial intelligence and digital health technologies may strengthen Infection Prevention and Control through enhanced surveillance, decision-making, and workforce training. However, global evidence on their uptake and perceived usefulness among IPC professionals remains limited. Methods This cross-sectional online survey coordinated by the World Health Organization between 21 March and 17 April 2025 assessed awareness, adoption, perceived usefulness, barriers, and facilitators related to AI-enabled and digital technologies in IPC. Descriptive analyses used item-specific denominators. Technology use analyses were restricted to current users, while perception-based analyses included all respondents answering each item. Likert-scale usefulness items were analysed as ordinal variables using medians and interquartile ranges (IQRs). Results Of 444 responses received across the six WHO regions, 441 were valid for analysis. Most respondents reported some familiarity with AI and digital technologies, although only 24.5% reported current use and 6.8% reported formal training. Among current users, the most frequently reported technologies were AI-based analysis for IPC research, semi-automatic surveillance systems, AI-supported teaching tools, and AI-based antimicrobial resistance detection tools. Perceived usefulness was generally favourable, with a median score of 4 (IQR 2) for eight of nine assessed applications; environmental disinfection scored lower (median 3, IQR 3). The main reported barriers were lack of training and skills (74.4%), limited funding (71.4%), and integration challenges with existing systems (43.3%). Conclusions This global IPC survey identified a substantial gap between awareness and routine implementation of AI-enabled and digital technologies. Adoption remains limited despite favourable perceptions, highlighting workforce capacity, funding, and system integration as the principal implementation constraints.

2026-01-01T00:00:00Z Schiavone, Natalya Scicluna Ward, Corinne https://www.um.edu.mt/library/oar/handle/123456789/146593 2026-05-20T12:12:46Z 2026-01-01T00:00:00Z

Title: Exploring nurses’ knowledge, attitudes, and perceptions of medication errors in a general hospital in Malta – a cross-sectional survey Authors: Schiavone, Natalya; Scicluna Ward, Corinne Abstract: Background: Medication errors (MEs) continue to pose a significant risk to patient safety despite established safety measures. Nurses are central to administering medications, and their knowledge, experience, and work environment influence both the likelihood of errors and whether they are reported. This study explored nurses’ perspectives on MEs, reporting practices, and barriers to reporting in a general hospital in Malta. Methods: A quantitative cross-sectional study was conducted using an anonymous online questionnaire informed by the Theory of Planned Behaviour. Of the 429 nurses invited, 301 completed the survey (response rate 70.2%). The questionnaire addressed the prevalence of MEs, reporting behaviours, knowledge of medications, perceived contributing factors, and attitudes towards reporting. Descriptive and inferential statistics were used to analyse the data. Results: Most nurses (88%, n = 265/301) reported having made at least one medication error. Reporting was inconsistent: 54% (n = 163/301) had never reported an error, 35% (n = 105/301) reported some, and only 11.6% (n = 35/301) reported all incidents. The area of work was significantly linked to perceived barriers and reporting behaviour. Nurses in reliever pools (92.6%), medical wards (89.9%), and surgical wards (79.7%) were more likely to feel concerns or barriers about reporting. Reporting practices also varied by area, with lower reporting in paediatric (36.8%) and orthopaedic wards (44.0%) and higher reporting in reliever pools (67.9%). While most nurses valued reporting (89%, n = 268/301), only 34% (n = 102/301) would report errors causing no harm, and 78% (n = 235/301) were reluctant to report colleagues. Conclusions: The findings reveal that MEs are common and underreported. Knowledge gaps, communication challenges, and systemic issues such as staffing shortages create barriers to safe medication management. Fear of repercussions further discourages reporting, highlighting the need for supportive, transparent practices. Hospitals should foster a non-punitive reporting culture, strengthen training, and improve interprofessional communication. Addressing these challenges can reduce medication errors and enhance patient safety and care quality.

2026-01-01T00:00:00Z Clari, Marco Conti, Alessio Berthelsen, Connie Bieber, Anja Brajshori, Naime Henriques, Adriana Huber, Claudia Kane, Ros Kyranou, Maria Lethin, Connie Sammut, Roberta Velonaki, Venetia Sofia Vrbnjak, Dominika Wiisak, Johanna Zabalegui, Adelaida Albanesi, Beatrice Casabona, Elena Riva-Rovedda, Federica Ingerslev Loft, Mia Sixtus Jensen, Claus Suhonen, Riitta Meyer, Gabriele Karavani, Nikoletta Costa, Andreia Pajnkihar, Majda Romih, Gregor Alite Cerezuela, Paula Vizcaya-Moreno, M. Flores Bökberg, Christina Hofstetter-Hefti, Gabriela Cooke, Samuel https://www.um.edu.mt/library/oar/handle/123456789/145515 2026-04-13T13:47:36Z 2026-01-01T00:00:00Z

Title: Nursing decision-making for health policies during the COVID-19 pandemic in Europe : the ENVISION study Authors: Clari, Marco; Conti, Alessio; Berthelsen, Connie; Bieber, Anja; Brajshori, Naime; Henriques, Adriana; Huber, Claudia; Kane, Ros; Kyranou, Maria; Lethin, Connie; Sammut, Roberta; Velonaki, Venetia Sofia; Vrbnjak, Dominika; Wiisak, Johanna; Zabalegui, Adelaida; Albanesi, Beatrice; Casabona, Elena; Riva-Rovedda, Federica; Ingerslev Loft, Mia; Sixtus Jensen, Claus; Suhonen, Riitta; Meyer, Gabriele; Karavani, Nikoletta; Costa, Andreia; Pajnkihar, Majda; Romih, Gregor; Alite Cerezuela, Paula; Vizcaya-Moreno, M. Flores; Bökberg, Christina; Hofstetter-Hefti, Gabriela; Cooke, Samuel Abstract: Background: The participation of nurse leaders in decision-making has been described as vital for healthcare organisations. However, their involvement in health policy-making is still suboptimal and their contribution is frequently unnoticed. This study aimed to understand the contribution of nurse leaders in decision and policy-making during the COVID-19 pandemic to inform future health crisis management.; Methods: A qualitative study using a thematic approach was carried out together with the European Academy of Nursing Science between January 2022 to December 2023.; Findings: 74 nurse leaders from 14 different European countries were interviewed. During COVID-19 pandemic, nurse leaders contributed to redesign nursing care delivery, opening COVID wards, designing vaccination units, and readapting nursing students’ curricula. Nurse leaders addressed the uncertainty through shared decision-making, based on real-time knowledge and available evidence. Self-confidence, empathy, and the ability to adapt to a changing situation were considered essential to fulfil their professional duties. Due to the lack of effective ready-made solutions, nurse leaders were concerned about the consequences of their decisions throughout the pandemic, generating feelings of anxiety and uncertainty.; Conclusion: The pandemic made the role and competence of nurse leaders more visible, highlighting the importance of their contribution to healthcare systems.; Implications for nursing and nursing policy: The results of this study highlight the urgent need for healthcare systems to improve their preparedness for future health crises. Moreover, due to the fundamental contribution that nurse leaders had on the management of the pandemic, from clinical to educational settings, the position of nurse leaders in decision-making processes must be strengthened. Description: Supplementary Information is available within this record.

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