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Introduction: “Pay-For-Performance” are performance-based payment or other incentive schemes in which ‘rewards’ are based on specific qualitative targets. Although in the international healthcare arena these programs have been tested extensively, in Greece the literature is scarce. Aim: A description of programs that provide performance-based financial incentives in health care, a presentation of their key features, and a summary of the views of nurses and other health care professionals from their experience with such programs. Methodology: Research data search methodology in PubMed, Scopus and Google Scholar, online databases was followed. Results: Although in Pay-For-Performance type schemes, a commonly accepted definition has not been attributed globally yet, they do share some common characteristics: 1) the focus of the fields they address i.e. primary care, specialized services and hospitals; 2) the domain of application such as quality, access and efficiency; 3) the measures of performance, e.g. quality or efficiency indicators; and 4) the payment or reward rules. The attitudes and opinions of health professionals referring to such programs are both positive and negative. Conclusions: The literature suggests that the pay-for-performance based movement in healthcare remains fragmented in implementation, with moderate results and slow progress. Health professionals’ attitudes are rather positive, however, nurses in particular, express doubts and inequities in implementation. These projects are considered too recent to be evaluated. The future of these programs depends on the evolution and adaptation of their technical features, acceptance by healthcare professionals, and further in-depth research into their overall outcomes

Introduction: Research competition induces hospitals to engage in clinical trials. Many hospitals are launching clinical trial research programs but may experience many initial difficulties mainly in the organization. Aim:The purpose of this review was to investigate the development of an operational plan for conducting clinical research. Methodology: A search was conducted for critical articles collected through: PubMed, Google Scholar and MEDICI during the period 2000-2020. Results: Clinical trials are designed to control the safety and efficacy of experimental therapies. However, researchers often find it difficult to find patients in clinical trials. Before starting a clinical trial, coordinators should ensure the development of organizational engagement and research culture, the accurate evaluation of available resources, the definition of the target population, secure appropriate and adequate staffing, the definition of the policies and procedures necessary to attract the candidate patients and the study in a safety and quality environment. Hospitals and other health service providers compete to form ideal clinical environments that can serve as the primary point of contact for pharmaceutical companies wishing to conduct clinical trials at their premises. Conclusions: Although the penetration of clinical studies into the health system has demonstrated many benefits for patients and the development of medical care and innovation, as well as for the financial support of hospitals and their general contribution to the economy of a country, their implementation is restricted mainly by bureaucracy, institutional and political failures.

Introduction: Increased life expectancy has risen in most parts of the world, indicating an improvement in public hygiene, diet and healthcare. Yet, the elderly remain a relatively frail population susceptible to a wide range of physical risks. The purpose of this review is to investigate the causes and risks of falls in the elderly. Method: A literature search was carried out using systematic reviews and research articles in the following databases: MEDLINE, CINAHL and MEDICAL-CHECK, as well as in individual Greek scientific journals. The search terms used were combinations of the following terms: ‘falls’, ‘elderly’, ‘nursing’, ‘falls prevention’, ‘falls assessment’, ‘falls risk’, as well as the corresponding terms in Greek, during the last twenty years. Results: The systematic search yielded 400 articles in English and 9 in Greek. Of these, 102 were included and the rest rejected because they did not meet the entry criteria. In particular, 60 articles were found in MEDLINE, 40 in CINAHL and 2 in Google scholar. Finally selected for critical discussion 20 articles.The findings were categorized in the following four major subgroups and elaborated accordingly: Exogenous factors, Endogenous factors, Financial burden of falls and Prevention and education. Discussion: As falls are a frequent and dangerous phenomenon for the elderly, healthcare professionals should be able to assess the capabilities of older people, especially in terms of balance and recommend suitable exercise programs. A simple exercise program should aim at the best possible outcome by involving a combination of activities, which include walking, cycling, aerobic drills and other resistance exercises. Such an exercise protocol can therefore be used to improve the static and dynamic balance of the elderly. Conclusions: In conclusion, as the number and percentage of elderly people continue to increase worldwide, new approaches to preventing falls are imperative. It is more difficult is to treat the consequences of falls than prevent them. Causes need to be identified and programs designed to promote health and prevention of falls which should be implemented through both hospital and community services in a seamless way.

The article's abstract is not available.

The current Coronavirus 2019-20 pandemic first appeared in Greece at the end of February 2020. The majority of the cases were related to travelers from Italy. Following the confirmation of the first three cases in Greece, on February 27th, all countrywide events were canceled. To date, (i.e. September 11, 2020) the total number of cases of the virus confirmed in the country is 12,734 and the number of deaths is 300. Following the opening of the border to tourists at the end of June, the daily number of confirmed cases increased, mainly due to those being detected following tests at the country's entry points.

The main objective of qualitative research is to improve the depth of understanding about issues of concern which are of particular value when conducting studies on health care issues. The qualitative methodology of ethnography is the study of a specific group or culture being explored in-depth. Its validity refers to whether the ethnographer’s interpretation of the data is what it means to those providing it and to the degree by which results may be representative or generalized. However, the limitations of using this technique include the risk of misinterpretations if and when the health care researcher has not fully understood or remains unfamiliar with the social norms of those being studied. Of the various qualitative methods available for health care research, this paper provides essential information and insights into the ethnographic methodology with specific relevance to health related research and nursing in particular. Data collection in ethnography can be achieved via one or a combination of interviews, observations, document/media reviews or questionnaires. Subsequent data analysis is performed via specific, rigorous standardized techniques as described in this chapter. It is important in ethnography to use a rigorous and solid reporting process as opposed to simply compiling anecdotal information. Ethnographic research in health care entails extensive fieldwork, availability of time, resources and interviewing skills. Yet, this method of enquiry can be a key contributor in expanding the knowledge base of contemporary health care by providing constructive insights into the world of patients and staff alike.

Introduction: Migratory processes are inherent to humans due to comparisons between the environment where they live and the resources they have, and a different environment, in which there may exist with hope for a better resources and possibilities.. Aim: Exploration of the migrants’ health problems and the barriers they face accessing health in the southern European hosting countries.Methodology: A systematic review was undertaken using the following databases: PubMed, SciELO, CINAHL, ProQuest, Google Scholar and Scopus, with combinations of search key words: “immigration”, “health system impact”, “immigration AND Europe”, in English and Spanish. The search revealed 85 papers published between 2013 and 2018, 35 of which were included in this study. The search was performed during December of 2018 and January 2019. Results: Results were grouped in three main categories, in terms of relevance and significance as follows: ‘Economic impact of migration on public health’, ‘Barriers and experiences of migrants in the health system’ and ‘Migrants’ health problems’. Immigrants are reported to use emergency services as an entrance into the health care system but make limited overall use of specialised medical services. Lifelong experiences from their own health care system, can affect immigrants’ expectations of health-illness and care concepts, i.e. these concepts may conflict with the new health care practices they are facing. Most of the research carried out about migrants’ is focused on the disparities between them and non-migrant population. The results show a relative shortage of actual studies focusing on the needs of those in need of health care. Conclusions: Migration is a multilevel phenomenon involving many different ethnic groups and moreover, different layers within these groups.

Introduction: Many authors tempt to balance the recognition of shortcomings and study limitations with the risk of having their paper rejected. Yet, before any attempt to run a study, a researcher needs to recognise the meaning and operational definitions of the terms ‘limitations’ and ‘delimitations’ in biomedical research. Aim: to define, review and elaborate how limitations and delimitations are currently acknowledged in the nursing and biomedical literature and their implications in health care studies. Methods: A critical literature review was undertaken, focusing on papers debating the core essence of research limitations and associated concepts. Initial searches yielded >300 papers of which only 25 were appropriate for this paper’s needs. Results: It is evident that any research attempt inevitably carries limitations and delimitations regarding its underlying theories, study design, replication potential, shortcomings in data collection and questionnaire design, insufficient subgroups or data for robust statistical analysis, narrow time span for data collection, lack of consideration for seasonal differences and missing data, causal relationships, measurement errors, study setting, population or sample, ethical parameters, data collection/analysis, result interpretations and corresponding conclusions. Delimitations require challenging the assumptions of the researchers and openly exposing shortcomings that might have been better tackled. Some authors cite study limitations solely because it is required by journal policy. Under these circumstances, the weakest limitation may be put forward in an attempt to ‘safeguard’ the study’s chance of being published. Researchers need to be aware of the wide range of limitations and delimitations and address them early in the research process Conclusions: Constructive rethinking and restructuring of the global nursing and biomedical research agenda is necessary to upgrade the profession and reassure the public. Thus, authors should openly and extensively report their research limitations, delimitations and assumptions in order to improve the quality of their findings and the interpretation of the evidence presented. On the contrary, when any of these key elements are neglected, overlooked or hushed, the study kudos is jeopardised.

INTRODUCTION: One aspect of evidencebased nursing education is the ability to learn, appraise and adopt research findings. The use of Evidence-Based Practice, (EBP), is the art and skill of integrating all appropriate research findings in conjunction professional reasoning, clinical expertise, and additionally, patient’s own contributions and their individual circumstances. In this sense, EBP enables clinical staff to provide the best possible quality of care to meet the complex demands of their patients and families. AIM: the main objectives of this paper are: - to describe the processes of EBP and show strategies which may integrate EBP into professional nursing education. – to unfold the challenges of implementing EBP within contemporary nursing curricula. METHOD: A critical appraisal of the EBP nursing literature was undertaken within the last decade via Google scholar, Cinhal and Medline using the following keywords separately and in combination: EBP, Nursing Curricula, Nursing Education. RESULTS: The most valued applied educational intervention that integrates EBP in nursing education includes: -Discussing the nursing intervention, levels of evidence, and the quality of resources used to gather information –Offering practical suggestions to reinforce EBP during actual clinical experiences and conferences which also allow students time to discuss suitable strategies and solutions. –Collaborating with clinical managers, nurses, faculty staff and students to discuss topics such as their clinical experiences, practice-based articles, research reports, and clinical guidelines. The outcome of this review clearly indicates the need for students to find to find empirical evidence which shows and supports nursing interventions that should be implemented during clinical practice. DISCUSSION: By using real-life situations from clinical experiences, nurse students can learn to devise appropriate clinical questions; gather valid information accordingly, evaluate the kudos and relevance of the evidence; and finally adapt this information into their daily practice. Conclusions: For nurse tutors and students to maximize the best use of EBP, they should be able to reach a level of competence whereby they can: critically discussed search evidence, evaluate the nature of evidence, discuss critically the concept of EBP in nursing, understand the process of systematic search of the literature, appraise critically the skills required to implement evidence in clinical practice., Kanıta dayalı hemşirelik eğitiminin bir yönü, araştırma bulgularını öğrenme, değerlendirme ve benimseme yeteneğidir. Kanıt Temeli Uygulamasının (EBP) kullanımı, tüm uygun araştırma bulgularını profesyonel akıl yürütme, klinik uzmanlık ve ek olarak hastanın kendi katkıları ve bireysel koşulları ile bütünleştirme sanatı ve becerisidir. Bu anlamda EBP, klinik personelinin hastalarının ve ailelerinin karmaşık taleplerini karşılamak için mümkün olan en iyi bakım kalitesini sunmasını sağlar. AMAÇ: Bu yazının ana amaçları: - EBP’nin süreçlerini tanımlamak ve EBP’yi profesyonel hemşirelik eğitimine entegre edebilecek stratejiler göstermek. - EBP’yi çağdaş hemşirelik müfredatında uygulamadaki zorlukları ortaya çıkarmak. YÖNTEM: EBP hemşireliği literatürünün son on yılda kritik bir değerlendirmesi, aşağıdaki anahtar kelimeleri ayrı ayrı ve kombinasyon halinde kullanarak Google bilgini, Cinhal ve Medline aracılığıyla yapılmıştır: EBP, Hemşirelik Müfredatı, Hemşirelik Eğitimi. BULGULAR: EBP’yi hemşirelik eğitimine entegre eden en değerli uygulamalı eğitim müdahalesi: -Hemşirelik müdahalesini, kanıt seviyelerini ve bilgi toplamak için kullanılan kaynakların kalitesini tartışma - Öğrencilere uygun stratejileri ve çözümleri tartışmaları için zaman tanıyan gerçek klinik deneyimler ve konferanslar sırasında EBP’yi pekiştirmek için pratik önerilerde bulunmak. –Klinik deneyimleri, uygulamaya dayalı makaleler, araştırma raporları ve klinik rehberler gibi konuları tartışmak için klinik yöneticileri, hemşireler, öğretim üyeleri ve öğrencilerle işbirliği yapmak. Bu derlemenin sonucu, öğrencilerin klinik uygulama sırasında uygulanması gereken hemşirelik girişimlerini gösteren ve destekleyen ampirik kanıtlar bulma ihtiyacını açıkça göstermektedir. TARTIŞMA: Klinik deneyimlerden kaynaklanan gerçek yaşam durumlarını kullanarak, hemşire öğrenciler uygun klinik sorular tasarlamayı öğrenebilir; geçerli bilgiyi buna göre toplayın, şerefinizi ve kanıtların uygunluğunu değerlendirin; ve nihayet bu bilgiyi günlük uygulamalarına uyarlayın. Sonuçlar: Hemşire öğretmenleri ve öğrencilerinin EBP’yi en iyi şekilde kullanmalarını en üst düzeye çıkarmak için, aşağıdakileri yapabildikleri bir yeterlilik seviyesine ulaşabilmeleri gerekir: araştırma kanıtlarını eleştirel olarak tartışmak, kanıtların niteliğini değerlendirebilmek, hemşirelikte eleştirel olarak EBP kavramını tartışabilmek, literatürdeki sistematik araştırma süreci, klinik uygulamada kanıt uygulamak için gereken becerileri eleştirel bir şekilde değerlendirir.

Introduction: Effective organization and operation of the emergency departments (EDs) is a modern challenge for the Greek health system as heterogeneity can be observed in their operation. Although in some hospitals EDs are housed in modern facilities with high hygiene and safety standards as well as with organized screening systems, unfortunately, this is not a common pattern that can be observed in most cases. Aim: The aim of the present study was to explore and compare the EDs of Thessaloniki, regarding their infrastructure, procedures and health and safety status. Methodology: The study sample consists of eight hospitals of Thessaloniki. The study is based on mixed methodology. Initially, a qualitative approach was undertaken through personal observation of the site and the operation of the EDs via a strictly structured observation form. The recordings were then quantified and were used for grading the hospitals which were subsequently grouped according to similar characteristics. Results: The average score is 0.74 with a range from 0.50 to 0.92. The best-performance was recorded in the health and safety category (0.81), while the lower recordings were related to facilities (0.69) and results for organizational issues (triage) were satisfactory (0.72). Hospitals were categorized into four different groups based on their functional characteristics, indicating apparent heterogeneity in the management and organization. Conclusions: Results suggest the need to identify the degree of divergence of EDs in aspects of organization and explore further ways of achieving convergence. It is therefore necessary to extend this study to the rest of Greece in order to establish the differences further in order to be able to propose the implementation of nation-wide triage method and single mode of management in EDs.