ObjectivesThis study aims to clarify the profiles of the psychological antecedents of vaccine hesitancy among Shanghai nurses with a person-centered approach.MethodsA population-based cross-sectional online survey was conducted on Shanghai nurses from July to August 2021 (N = 1,928). In the online survey, participants were asked to report their sociodemographic, the 5C vaccine hesitancy components, their knowledge level of COVID-19 vaccine and vaccination, and the COVID-19 vaccination uptake intention and attention to vaccine news. Latent profile analysis was used to reveal distinct profiles of vaccine hesitancy.ResultsThe results revealed four profiles, including “believers” (68.9%; high confidence and collective responsibility), “free riders” (12.7%; similar characteristics to believers, except for a low collective responsibility), “middlemen” (14.6%; middle in all 5C constructs), and “contradictors” (3.7%; high in all 5C constructs). Compared to believers, middlemen were younger, more likely to be female, childless, less educated, held lower professional titles, had fewer years of nursing service, sometimes or never complied with recommended vaccinations, had satisfactory or poor self-assessed health status, had no work experience during the COVID-19 epidemic, and possessed greater levels of knowledge. Free riders were more likely to work in community health centers and have a lower degree than believers. Contradictors were more likely to work in community health centers, had junior college degrees or lower, and had no work experience during the COVID-19 epidemic than believers. From the highest to the lowest on vaccination intention and attention to vaccine news were believers, then free riders, contradictors, and finally middlemen.ConclusionThis study could aid in the development of personalized vaccination strategies based on nurses' vaccine hesitancy profiles and predictors. In addition to vaccine believers, we identified other three profiles based on their 5C psychological antecedents, emphasizing the significance of establishing tailored vaccination campaigns. Further research into the prevalence of profile structure in other groups of healthcare workers is required.

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IntroductionThe high incidence of unsafe anaesthetic care leads to adverse events and increases the burden on patient safety. An important reason for unsafe anaesthesia care is the lack of non-technical skills (NTS), which are defined as personal cognitive, social or interpersonal skills, among anaesthetists. The anaesthetists’ NTS (ANTS) behavioural marker system has been widely used to evaluate and improve anaesthetists’ behavioural performance to ensure patient safety. This protocol describes a planned systematic review aiming to determine the validity and reliability of the ANTS behavioural marker system and its application as a tool for the training and assessment of ANTS and for improving patient safety.Methods and analysisThis systematic review follows the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol. Studies that applied the ANTS behavioural marker system in a meaningful way, including using the ANTS behavioural marker system to guide data collection, analysis, coding, measurement, and/or reporting, which have been published in peer-reviewed journals, will be eligible. A citation search strategy will be employed. We will search Scopus and Web of Science for publications from 2002 to May 2022, which cite the three original ANTS behavioural marker system publications by Fletcheret al. We will also search the references of the relevant reviews for additional eligible studies. For each study, two authors will independently screen papers to determine eligibility and will extract the data. The quality of the included studies will be assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklists. A framework analysis approach that consists of five steps—familiarisation, identifying a thematic data extraction framework, indexing, charting, mapping and interpretation—will be used to synthesise and report the data.Ethics and disseminationEthics approval is not required for this study. The findings will be disseminated primarily through peer-reviewed publications and conference presentations.PROSPERO registration numberCRD42022297773.

At present, health-care systems in the United States face enormous challenges in providing quality care, characterized by safe, effective, efficient, patientcentered, timely, and equitable care while containing health-care costs [1,2]. To understand and address patients' increasingly complicated health-care needs, we need safe access to quality information that is characterized by integrity, reliability, and accuracy [3], and establish mutually beneficial relationships among a multidisciplinary team of professionals [4].Traditional paper-based clinical workflow produces many issues such as illegible handwriting, inconvenient access, the possibility of computational prescribing errors, inadequate patient hand-offs, and drug administration errors. These problems can lead to medical errors, omissions, and duplications and, ultimately, poor patient outcomes and compromised quality of care [2].Electronic health records (EHR) is a major achievement in the health information technology [5]. It is deemed a promising solution to improve the interoperability of patients' information across health-care settings and achieve a more cost-effective, safer, and higher quality of care [3,6]. Electronic medical records

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