Palestine Polytechnic University

Professionalism and ethical reasoning are core competencies in medical education, yet evidence from Palestine is limited. This cross-sectional study surveyed 441 medical students from five accredited universities (≥ 4th year, hospital-based training) using a structured questionnaire that included demographics, professionalism items, and 12 case-based scenarios adapted from clinical practice and professional guidelines. An Ethical Reasoning Score (ERS; range 0–12) was derived from correct responses. Descriptive, chi-square, and logistic regression analyses were applied. Students performed well in basic scenarios but showed weaker reasoning in domains such as digital professionalism and interpersonal etiquette. Higher ERS was significantly associated with prior ethics training (p = 0.001), female gender, and inter-university variation. Findings indicate uneven ethical competence among Palestinian medical students, underscoring the need for scenario-based teaching, targeted curricular reform, and inter-university collaboration to strengthen professionalism and ethical reasoning.

Background:Electronic Medical Records (EMRs) have become essential tools in modern healthcare, enhancing efficiency, safety, and quality of care. However, multiple factors influence nurses' satisfaction with EMR use. Aim:To assess nurses' work satisfaction with EMR use and identify associated facilitators and barriers among nurses in Palestinian governmental hospitals. Methods:A cross-sectional quantitative design was employed. A convenience sample of 190 nurses from medical and surgical wards was recruited. Data were collected using a self-administered questionnaire covering demographics, work environment variables, and an adapted version of the Nursing Work Satisfaction Questionnaire (NWSQ). Sample size was determined using G*Power software. Data were analyzed using SPSS. Results:Among 190 nurses, 51.1% were aged 20-30 years, with nearly equal gender distribution. Most (63.1%) had received EMR training, and 53.2% perceived the system as user-friendly. 52.1% were satisfied with their work using EMRs. Regression analysis demonstrated that ease of system use (β = 0.274, p < .001), EMR training (β = 0.230, p = .020), technical support satisfaction (β = 0.148, p = .012), and age (β = 0.194, p = .045) remained significant predictors of nurses' work satisfaction after adjustment. The regression model explained 23.4% of the variance in work satisfaction (R 2 = .234). Conclusion:Nurses in Palestinian governmental hospitals reported moderate satisfaction with EMR use. Factors such as training, system usability, technical support, and age significantly contributed to satisfaction. Strengthening these areas may enhance the integration and effectiveness of EMRs in nursing practice.

Choosing the most appropriate strategy between retrofitting and reconstructing an existing building is a difficult and complex decision-making issue, which requires extensive knowledge, skills and experience from project managers. Today, due to the variety of available technologies and the need to take into account the balance between the environmental impacts and the growing requirements for buildings, including technological, economic, functional, etc., the decision for green building managers is becoming harder. whether to construct a new building or retrofit an existing one while maintaining acceptable levels of indoor comfort and energy performance. In order to take an environmentally-conscious decision, the environmental impacts of the entire life during the construction phase for the two approaches must be known. This study performed a comparative Life cycle assessment LCA on a new retrofitted extension in the Holy Family Hospital as a case study to determine whether the retrofit was a right decision. The assessment was carried out with the online calculator One Click LCA (2015) to measure and compare the impact of environmental pressures related to the embodied energy and embodied CO2 to take a less impact decision between reconstructing and retrofitting an existing building. The findings reveal a strong link between retrofit strategies and the energy sector, highlighting their role in reducing embodied energy, CO2 emissions, and primary energy demand. The results showed that retrofit decision reduced the carbon emissions and the embodied energy by 36% and 24% respectively, compared with the demolishing and rebuilding the existing part of the case study. Where the material extraction and production had the largest share among the construction phase. Moreover, The retrofit scenario results in a substantially lower social cost of carbon than reconstruction, reflecting a reduction of approximately 64% and demonstrating the clear social and climate advantage of retrofit interventions. The method used in this paper can be useful to order to make more sustainable choices at the building’s construction, retrofitting, and maintenance levels. The novelty of this study lies in offering a quantified, decision-oriented comparison between retrofit and reconstruction at the construction stage, grounded in embodied energy and embodied carbon metrics rather than relying solely on operational performance.

Electronic Health Records (EHRs) have revolutionized patient care and data management, but their integration may disrupt workflow. Palestine recently introduced EHRs in their hospitals, yet no local data exist on nursing workflow. This study aims to assess the impact of EHRs on workflow efficiency and associated factors among nurses with direct paper-to-EHR transition experience. A quantitative, cross-sectional study design was employed. A convenience sample of 185 nurses was recruited from medical and surgical wards across selected hospitals. Data were collected via a structured questionnaire and analyzed using SPSS version 29 using descriptive statistics and multiple linear regressions, with significance set at p < 0.05. A total of 185 nurses participated, with the majority aged 25-34 years (61.6%). Most had 5-10 years of experience (42.2%). Overall, 70% of nurses reported high or very high workflow efficiency with EHR use (M = 3.59, SD = 0.75). EHRs were perceived to improve access to patient information (63.2%), reduce documentation time (63.8%), and support teamwork and communication, although 50.8% reported workflow interruptions due to technical issues. Multiple regression identified EHR user-friendliness (β = 0.261, p < 0.001), training (β = 0.243, p = 0.024), technical support (β = 0.184, p = 0.005), and age (β = -0.223, p = 0.037) as significant predictors of workflow efficiency. EHRs positively influence nurses' workflow; transition-experienced nurses highlight usability and training as significant predictor factors. Enhancing these areas can optimize clinical performance.

BACKGROUND:Tele-Intensive Care Unit (Tele-ICU) models have expanded rapidly in response to global critical care workforce shortages, rising patient acuity and the demands of the COVID-19 pandemic. Contemporary evidence shows substantial variation in Tele-ICU configurations and outcomes, underscoring the need for an updated synthesis that evaluates clinical, staff-related and system-level effects across diverse settings. AIM:To examine the implementation and impact of Tele-ICU models on critical care outcomes and to compare results across hub-and-spoke, hybrid, consultative and tele-recovery configurations. STUDY DESIGN:A systematic review was conducted and reported according to PRISMA 2020 and Joanna Briggs Institute guidelines. PubMed, CINAHL, Scopus, Web of Science and Google Scholar were searched for peer-reviewed studies published between January 2020 and October 2025. Owing to heterogeneity in Tele-ICU models, outcomes and effect measures, a narrative synthesis was performed. RESULTS:Sixteen studies published between 2020 and 2025 were included, comprising quantitative, qualitative and mixed-methods designs conducted across high-, middle- and low-resource healthcare settings. Overall, Tele-ICU implementation was associated with reductions in ICU and hospital mortality, improved adherence to evidence-based clinical protocols, enhanced interprofessional communication and reduced clinician documentation burden. Hub-and-spoke and hybrid Tele-ICU models demonstrated the most consistent clinical and workforce benefits, whereas consultative and low-cost models primarily improved access to specialist care in resource-limited contexts. Across studies, nursing roles expanded to include digital patient surveillance, tele-round coordination, protocol facilitation and virtual family communication. Evidence regarding long-term sustainability and cost-effectiveness was limited and inconsistently reported. CONCLUSIONS:Tele-ICU models enhance clinical performance, support nursing practice and improve system-level responsiveness across diverse contexts. While benefits are consistent, outcomes vary by model design, local infrastructure and implementation readiness. Longitudinal and economic evaluations are needed to inform sustainable, scalable Tele-ICU strategies. RELEVANCE TO CLINICAL PRACTICE:Tele-ICU models support bedside nurses by improving access to specialist input, strengthening adherence to evidence-based care and enhancing patient safety. Evidence shows that Tele-ICU reduces workload, improves communication and enables nurses to coordinate digital monitoring and family updates, contributing to more consistent and equitable critical care delivery, particularly in high-acuity and resource-limited settings.