Background: Quality-of-care improvement and prevention of practice errors is dependent on nurses' adherence to the principles of patient safety. Aims: This paper aims to provide a systematic review of the international literature, to synthesise knowledge and explore factors that influence nurses' adherence to patient-safety principles. Methods: Electronic databases in English, Norwegian, and Finnish languages were searched, using appropriate keywords to retrieve empirical articles published from 2010-2019. Using the theoretical domains of the Vincent's framework for analysing risk and safety in clinical practice, we synthesized our findings according to 'patient', 'healthcare provider', 'task', 'work environment', and 'organisation and management'. Findings: Six articles were found that focused on adherence to patient-safety principles during clinical nursing interventions. They focused on the management of peripheral venous catheters, surgical hand rubbing instructions, double-checking policies of medicines management, nursing handover between wards, cardiac monitoring and surveillance, and care-associated infection precautions. Patients' participation, healthcare providers' knowledge and attitudes, collaboration by nurses, appropriate equipment and electronic systems, education and regular feedback, and standardization of the care process influenced nurses' adherence to patient-safety principles. Conclusions: The revelation of individual and systemic factors has implications for nursing care practice, as both influence adherence to patient-safety principles. More studies using qualitative and quantitative methods are required to enhance our knowledge of measures needed to improve nurse' adherence to patient-safety principles and their effects on patient-safety outcomes.

The umbilical cord is a helical and tubular blood conduit connecting the foetus to the placenta. The umbilical cord achieves its final form by the 12th week of gestation and normally contains two arteries and a single vein, all embedded in Wharton's jelly. The structure of the umbilical cord receives only a cursory glance during many obstetric ultrasound examinations: with imaging limited to documenting the number of vessels within the cord and the insertion sites at the foetus and placenta. Extensive research into blood flow characteristics of the umbilical cord arteries has been undertaken and is now widely applied in contemporary ultrasound practice. In contrast, investigation of umbilical vein blood flow is only instigated in instances of foetal compromise when the spectral waveform of the ductus venosus and pulsations in the vein are scrutinised. The current level of ultrasound imaging of the umbilical vein demonstrates a lack of appreciation and knowledge about a structure that is crucial to sustaining foetal life.The goal of this review is to increase awareness of the importance of the umbilical cord. In addition, this review will provide an information platform for undertaking and critically analysing research into the umbilical cord by providing a summary of cord embryology, structure, foetal venous circulation and mechanisms of blood flow within the umbilical cord vein.

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Background and PurposeThe need for high-quality long-term healthcare services is increasing across the globe as the population ages. Strategies for improving transitional care from hospital to home are needed. This study aimed to explore the perspectives of patients aged 65 years and over and their family caregivers transitioning from hospital to home in an urban area of Turkey.MethodsThematic analysis of in-depth semi-structured interviews was conducted with older patients (n = 14), with at least one chronic disease and admitted to the hospital for a minimum of 3 days, and family caregivers (n = 11) who voluntarily participated.ResultsMain themes were “confused feelings of safety and stress”; “worried about being left alone”; and “disrupted healthcare journey.” The proactive rehabilitation model was used to elaborate on the study findings and interpret the perspectives and experiences of older patients and their family caregivers, which can be used for improving the quality of care after discharge from hospital.Implications for PracticeA high-quality transitional care program requires taking care of the feeling of safety in older patients and their family caregivers by the multidisciplinary team and their enhanced involvement in care initiatives after hospital discharge.