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Sarkar U, McDonald K, Motala A, Smith P, Zipperer L, Wachter RM, Shanman R, Shekelle PG. Pragmatic Insights on Patient Safety Priorities and Intervention Strategies in Ambulatory Settings. Jt Comm J Qual Patient Saf 2019; 43:661-670. [PMID: 29173287 DOI: 10.1016/j.jcjq.2017.06.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 06/10/2017] [Accepted: 06/13/2017] [Indexed: 11/27/2022]
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Berglund Kristiansson E, Källman U. Healthcare staff's views on the patients' prerequisites to be co-creator in preventing healthcare-associated infections. Scand J Caring Sci 2019; 34:314-321. [PMID: 31250941 PMCID: PMC7328682 DOI: 10.1111/scs.12730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 05/23/2019] [Indexed: 11/30/2022]
Abstract
Background Every year, patients are affected by suffering and death caused by adverse events in connection with health care and the most common adverse events are healthcare‐associated infections (HAI). The Swedish Patient Act from 2015 strengthens the patient's position in health care; however, there is lack of knowledge of how healthcare staff experience the possibilities to make the patient involved in the preventive work of HAI. Aim To describe healthcare professionals' views on the patient's prerequisites to be co‐creator in preventing HAI in connection with hospital care. Method This study had a qualitative descriptive design with semi‐structured individual interviews. Qualitative inductive content analysis was used to analyse the transcribed interview data. The study setting was a hospital in Sweden in 2015. Interviews were carried out among six healthcare professionals. Results In the analysis, 5 themes and 14 categories were identified in three different domains: Organisation, Healthcare staff and Patient. The result indicates an obstacle in each domain for the patient to become co‐creator in preventing HAI. In Organisation domain, a lack of organizational structure such as elaborated working methods to involve the patient was pointed out. In the domain Healthcare staff, it showed that the professionals allocate the responsibility of preventing HAI to the patient but only if they had to or if they trusted the patient. In the Patient domain, the result states that the patient was perceived as passive; they did not take own initiatives to get involved. Conclusion The patient has an important role in successful HAI prevention work and should be considered as an obvious co‐creator. Nevertheless, this study shows that neither organisation nor healthcare staff are sufficiently prepared for this. The organisation must make an anchored, structured and systematic work centred on the patient's needs and give more support both to healthcare professionals and patients.
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Affiliation(s)
| | - Ulrika Källman
- Research Department, Region Västra Götaland, South Älvsborg Hospital, Borås, Sweden
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Reprint of: Patient participation in nursing bedside handover: A systematic mixed-methods review. Int J Nurs Stud 2019; 97:63-77. [PMID: 31181413 DOI: 10.1016/j.ijnurstu.2019.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 08/30/2017] [Accepted: 10/22/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Numerous reviews of nursing handover have been undertaken, but none have focused on the patient's role. OBJECTIVES To explore how patient participation in nursing shift-to-shift bedside handover can be enacted. DESIGN Systematic mixed- methods review. DATA SOURCES Three search strategies were undertaken in July-August 2016: database searching, backwards citation searching and forward citation searching. To be included, papers had to either be research or quality improvement (QI) projects focusing on the patient role. Fifty-four articles were retrieved, including 21 studies and 25 QI projects. REVIEW METHODS Screening, data extraction and quality appraisal was undertaken systematically by two reviewers. Research studies and QI projects were synthesised separately using thematic synthesis, then the results of this synthesis were combined using a mixed-method synthesis table. RESULTS Segregated synthesis of research of patients' perceptions revealed two contrasting categories; patient-centred handover and nurse-centred handover. Segregated synthesis of research of nurses' perceptions included three categories: viewing the patient as an information resource; dealing with confidential and sensitive information; and enabling patient participation. The segregated synthesis of QI projects included two categories: nurse barriers to enacting patient participation in bedside handover; and involving patients in beside handover. Once segregated findings were configured, we discovered that the patient's role in bedside handover involves contributing clinical information related to their care or progress, which may influence patient safety. Barriers related to nurses' discomfort encouraging patient participation and worries for sharing confidential and sensitive information. The way nurses approach patients, and how patient-centred they are, constitute further potential barriers. Strategies to improve patient participation in handover include training nurses, making handovers predictable for patients and increasing the interpersonal approach during handover. CONCLUSIONS Using research and QI projects allowed diverse findings to expand each other and identify gaps between research and heuristic knowledge. Our review showed the tension between standardising handovers and making them predictable for patient participation, while promoting tailored and flexible handovers. Further investigation of this issue is required, to understand how to train nurses to achieve this and prepare patients to do this. Many barriers and strategies identified were from QI projects and the nurse perspective, thus caution interpreting results is required. We recommend steps be taken in the future to ensure high quality QI projects.
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The Relationship Between Patients' Safety-Related Behaviors and Safety Events and Patient Experiences in Korean Hospitals. Res Theory Nurs Pract 2019; 33:115-133. [PMID: 31123158 DOI: 10.1891/1541-6577.33.2.115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE There is increasing interest in patient participation in healthcare aimed at enhancing safety. The purposes of this study were to examine levels of patients' safety-related behaviors and to determine their relationships with safety events and care experiences. METHODS A cross-sectional survey was conducted with 360 patients in two tertiary general hospitals in Korea. The final dataset consisted of 341 patient responses. A questionnaire was developed to collect information concerning patients' safety-related behaviors, care experiences, and the occurrence of safety events. Univariate and multivariate analyses were performed. RESULTS On average, patients participated in 10.0 (SD 5.4) safety-related behaviors. Sixty-five (19.1%) patients reported experiencing at least one adverse event related to medical management. The mean problem score for care experience was 39.4 (SD 27.8) out of 100.0. Multiple logistic analysis showed that patients with adequate health literacy and higher activation levels were more likely to have high safety-related behavior participation levels. High participation in safety-related behaviors was negatively associated with the occurrence of safety events. However, no significant relationship was found between patient participation and the total problem scores for care experience. IMPLICATIONS FOR PRACTICE These findings suggest that efforts to support patients with limited health literacy and low activation levels are needed to facilitate patient participation. Active participation in safety-related behaviors can contribute to improving patient safety.
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Effect of Patient Participation on Nurse and Patient Outcomes in Inpatient Healthcare. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16081344. [PMID: 30991640 PMCID: PMC6518109 DOI: 10.3390/ijerph16081344] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/10/2019] [Accepted: 04/11/2019] [Indexed: 11/17/2022]
Abstract
Using service-dominant logic as a theoretical lens, this study investigated the co-production of healthcare service and service value co-creation between nurses and patients. The main objective of this study was to: (1) examine the effect of patient participation on patient satisfaction and nurses' attitudes and behaviors; (2) examine boundary conditions of the effect of patient participation on patients and nurses. We proposed that patient participation positively impacted patient satisfaction and nurse job satisfaction, work engagement, and helping behaviors. We further proposed that first inpatient stay and length of stay moderated the effect of patient participation on patient satisfaction, and nurses' sociodemographic characteristics moderated the effect of patient participation on nurse job satisfaction, work engagement, and helping behaviors. Using survey data from 282 nurses and 522 inpatients from a public hospital in China, we found that the effect of patient participation on patient satisfaction was contingent upon first inpatient stay and length of stay. We also found that patient participation improved nurse job satisfaction, work engagement, and helping behaviors. Furthermore, nurses' sociodemographic characteristics, namely age and organizational tenure, moderated the effect of patient participation on nurse job satisfaction, but not on work engagement and helping behaviors. Theoretical and practical implications of our findings were discussed.
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Hwang JI, Kim SW, Chin HJ. Patient Participation in Patient Safety and Its Relationships with Nurses' Patient-Centered Care Competency, Teamwork, and Safety Climate. Asian Nurs Res (Korean Soc Nurs Sci) 2019; 13:130-136. [PMID: 30898671 DOI: 10.1016/j.anr.2019.03.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 03/08/2019] [Accepted: 03/12/2019] [Indexed: 11/26/2022] Open
Abstract
PURPOSE This study's aim was to examine degrees of patient participation in patient safety activities in hospitals and to investigate their relationships with nurses' patient-centered care competency (PCC), teamwork, and safety climate. METHODS A cross-sectional study design was used. Data were collected with 479 nurses from two general hospitals in Seoul, Korea, using a questionnaire designed to collect data on patient participation in patient safety activities, PCC, teamwork perceptions, and safety climate. The response rate was 74.1% (N = 355). Data were analyzed using descriptive statistics and multiple logistic regression analysis. RESULTS The mean score for patient participation was 2.76 ± 0.46 of 4.0. The mean scores for PCC, teamwork, and safety climate were 3.61 ± 0.46, 3.64 ± 0.41, and 3.35 ± 0.57 of 5.0, respectively. Nurses who experienced high patient participation in patient safety activities (≥ 3.0) had higher scores for PCC, teamwork, and safety climate. Multiple logistic regression analysis revealed that PCC (OR = 2.31, 95% CI = 1.14-4.70) and safety climate (OR = 2.51, 95% CI = 1.09-5.78) scores were the significant factors associated with patient participation. CONCLUSION The degree of patient participation in patient safety activities was not high. Nurses' PCC, teamwork, and safety climate were positively related with patient participation. In particular, the findings indicate that enhancing nurses' competency for patient-centered care and creating a strong safety climate are important to promote patient participation for safer health care.
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Affiliation(s)
- Jee-In Hwang
- Department of Nursing, Kyung Hee University College of Nursing Science, Seoul, Republic of Korea.
| | - Sung Wan Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Ho Jun Chin
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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Bucknall T, Fossum M, Hutchinson AM, Botti M, Considine J, Dunning T, Hughes L, Weir-Phyland J, Digby R, Manias E. Nurses' decision-making, practices and perceptions of patient involvement in medication administration in an acute hospital setting. J Adv Nurs 2019; 75:1316-1327. [PMID: 30697809 DOI: 10.1111/jan.13963] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/26/2018] [Accepted: 11/20/2018] [Indexed: 12/28/2022]
Abstract
AIMS To describe nurses' decision-making, practices and perceptions of patient involvement in medication administration in acute hospital settings. BACKGROUND Medication errors cause unintended harm to patients. Nurses have a major role in ensuring patient safety in medication administration practices in hospital settings. Investigating nurses' medication administration decision-making and practices and their perceptions of patient involvement, may assist in developing interventions by revealing how and when to involve patients during medication administration in hospital. DESIGN A descriptive exploratory study design. METHODS Twenty nurses were recruited from two surgical and two medical wards of a major metropolitan hospital in Australia. Each nurse was observed for 4 hr, then interviewed after the observation. Data were collected over six months in 2015. Observations were captured on an electronic case report form; interviews were audio-recorded and transcribed verbatim. Data were analysed using descriptive statistics and content and thematic analysis. RESULTS Ninety-five medication administration episodes, of between two and eight episodes per nurse, were observed. A total of 56 interruptions occurred with 26 of the interruptions being medication related. Four major themes emerged from the interviews: dealing with uncertainty; facilitating, framing and filtering information; managing interruptions and knowing and involving patients. CONCLUSION Nurses work in complex adaptive systems that change moment by moment. Acknowledging and understanding the cognitive workload and complex interactions are necessary to improve patient safety and reduce errors during medication administration. Knowing and involving the patient is an important part of a nurses' medication administration safety strategies.
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Affiliation(s)
- Tracey Bucknall
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Faculty of Health, Deakin University, Geelong, Vic., Australia.,Alfred Health, Melbourne, Vic., Australia
| | - Mariann Fossum
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Faculty of Health, Deakin University, Geelong, Vic., Australia.,Alfred Health, Melbourne, Vic., Australia.,Centre for Caring Research-Southern Norway, Department of Health and Nursing Science, University of Agder, Grimstad, Norway
| | - Alison M Hutchinson
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Faculty of Health, Deakin University, Geelong, Vic., Australia.,Monash Health, Melbourne, Vic., Australia
| | - Mari Botti
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Faculty of Health, Deakin University, Geelong, Vic., Australia.,Epworth HealthCare, Melbourne, Vic., Australia
| | - Julie Considine
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Faculty of Health, Deakin University, Geelong, Vic., Australia.,Eastern Health, Melbourne, Vic., Australia
| | - Trisha Dunning
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Faculty of Health, Deakin University, Geelong, Vic., Australia.,Barwon Health, Geelong, Vic., Australia
| | - Lee Hughes
- Alfred Health, Melbourne, Vic., Australia
| | | | - Robin Digby
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Faculty of Health, Deakin University, Geelong, Vic., Australia
| | - Elizabeth Manias
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Faculty of Health, Deakin University, Geelong, Vic., Australia
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Gillespie A, Reader TW. Patient-Centered Insights: Using Health Care Complaints to Reveal Hot Spots and Blind Spots in Quality and Safety. Milbank Q 2018; 96:530-567. [PMID: 30203606 PMCID: PMC6131356 DOI: 10.1111/1468-0009.12338] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Policy Points: Health care complaints contain valuable data on quality and safety; however, there is no reliable method of analysis to unlock their potential. We demonstrate a method to analyze health care complaints that provides reliable insights on hot spots (where harm and near misses occur) and blind spots (before admissions, after discharge, systemic and low-level problems, and errors of omission). Systematic analysis of health care complaints can improve quality and safety by providing patient-centered insights that localize issues and shed light on difficult-to-monitor problems. CONTEXT The use of health care complaints to improve quality and safety has been limited by a lack of reliable analysis tools and uncertainty about the insights that can be obtained. The Healthcare Complaints Analysis Tool, which we developed, was used to analyze a benchmark national data set, conceptualize a systematic analysis, and identify the added value of complaint data. METHODS We analyzed 1,110 health care complaints from across England. "Hot spots" were identified by mapping reported harm and near misses onto stages of care and underlying problems. "Blind spots" concerning difficult-to-monitor aspects of care were analyzed by examining access and discharge problems, systemic problems, and errors of omission. FINDINGS The tool showed moderate to excellent reliability. There were 1.87 problems per complaint (32% clinical, 32% relationships, and 34% management). Twenty-three percent of problems entailed major or catastrophic harm, with significant regional variation (17%-31%). Hot spots of serious harm were safety problems during examination, quality problems on the ward, and institutional problems during admission and discharge. Near misses occurred at all stages of care, with patients and family members often being involved in error detection and recovery. Complaints shed light on 3 blind spots: (1) problems arising when entering and exiting the health care system; (2) systemic failures pertaining to multiple distributed and often low-level problems; and (3) errors of omission, especially failure to acknowledge and listen to patients raising concerns. CONCLUSIONS The analysis of health care complaints reveals valuable and uniquely patient-centered insights on quality and safety. Hot spots of harm and near misses provide an alternative data source on adverse events and critical incidents. Analysis of entry-exit, systemic, and omission problems provides insight on blind spots that may otherwise be difficult to monitor. Benchmark data and analysis scripts are downloadable as supplementary files.
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Gandarillas MÁ, Goswami N. Merging current health care trends: innovative perspective in aging care. Clin Interv Aging 2018; 13:2083-2095. [PMID: 30425463 PMCID: PMC6203171 DOI: 10.2147/cia.s177286] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Current trends in health care delivery and management such as predictive and personalized health care incorporating information and communication technologies, home-based care, health prevention and promotion through patients’ empowerment, care coordination, community health networks and governance represent exciting possibilities to dramatically improve health care. However, as a whole, current health care trends involve a fragmented and scattered array of practices and uncoordinated pilot projects. The present paper describes an innovative and integrated model incorporating and “assembling” best practices and projects of new innovations into an overarching health care system that can effectively address the multidimensional health care challenges related to aging patient especially with chronic health issues. The main goal of the proposed model is to address the emerging health care challenges of an aging population and stimulate improved cost-efficiency, effectiveness, and patients’ well-being. The proposed home-based and community-centered Integrated Healthcare Management System may facilitate reaching the persons in their natural context, improving early detection, and preventing illnesses. The system allows simplifying the health care institutional structures through interorganizational coordination, increasing inclusiveness and extensiveness of health care delivery. As a consequence of such coordination and integration, future merging efforts of current health care approaches may provide feasible solutions that result in improved cost-efficiency of health care services and simultaneously increase the quality of life, in particular, by switching the center of gravity of health delivery to a close relationship of individuals in their communities, making best use of their personal and social resources, especially effective in health delivery for aging persons with complex chronic illnesses.
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Affiliation(s)
- Miguel Ángel Gandarillas
- Department of Social Psychology and Methodology, Faculty of Psychology, Autonomous University of Madrid, Spain
| | - Nandu Goswami
- Physiology Division, Otto Loewi Center of Vascular Biology, Immunity and Inflammation, Medical University of Graz, Graz, Austria, .,Department of Health Science, Alma Mater Europea University, Maribor, Slovenia,
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Jerofke‐Owen T, Dahlman J. Patients’ perspectives on engaging in their healthcare while hospitalised. J Clin Nurs 2018; 28:340-350. [DOI: 10.1111/jocn.14639] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 07/10/2018] [Accepted: 08/02/2018] [Indexed: 12/26/2022]
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Alzyood M, Jackson D, Brooke J, Aveyard H. An integrative review exploring the perceptions of patients and healthcare professionals towards patient involvement in promoting hand hygiene compliance in the hospital setting. J Clin Nurs 2018; 27:1329-1345. [PMID: 29423965 DOI: 10.1111/jocn.14305] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2018] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To review patients' and healthcare professionals' perceptions of patient involvement in promoting hand hygiene compliance in the hospital setting. BACKGROUND Initiatives continue to emphasise the importance of involving patients in their safety at the point of care. A patient-centred care approach aimed to empower patients to become active members of the healthcare team. However, understanding the perceptions of patients and healthcare professionals of patient involvement in promoting hand hygiene compliance among healthcare professionals has yet to be fully explored. DESIGN Integrative literature review. METHODS A five-stage review process informed by Whittemore and Knafl's methodology was conducted. MEDLINE and CINAHL were searched for papers published between January 2009-July 2017. Data were extracted manually, organised using NVivo 11 and analysed using thematic analysis. RESULTS From an identified 240 papers, 19 papers were included in this review. Thematic analysis revealed two main themes with three related subthemes. Patients were willing to remind healthcare professionals (especially nurses) to wash their hands, healthcare professionals perception towards patients' involvement varied from one study to another. However, an overall positive attitude towards patient involvement was related to how patients asked and how healthcare professionals responded to being asked. CONCLUSION There is limited evidence regarding patients' actual intention to ask healthcare professionals to wash their hands, and some evidence that patients are reluctant to do so. Further research is required to understand this area thoroughly, including which situations patients would feel more empowered to speak up. RELEVANCE TO CLINICAL PRACTICE Simple messages promoting patient involvement may lead to complex reactions in both patients and healthcare professionals. It is unclear, yet how patients and staff react to such messages in clinical practice. There is a need for a deeper understanding of how they can work together to support harm free care.
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Affiliation(s)
- Mamdooh Alzyood
- Faculty of Health and Life Sciences, Oxford Institute of Nursing, Midwifery, and Allied Health Research (OxINMAHR), Oxford Brookes University, Oxford, UK
| | - Debra Jackson
- Faculty of Health and Life Sciences, Oxford Institute of Nursing, Midwifery, and Allied Health Research (OxINMAHR), Oxford Brookes University, Oxford, UK
| | - Joanne Brooke
- Faculty of Health and Life Sciences, Oxford Institute of Nursing, Midwifery, and Allied Health Research (OxINMAHR), Oxford Brookes University, Oxford, UK
| | - Helen Aveyard
- Faculty of Health and Life Sciences, Oxford Institute of Nursing, Midwifery, and Allied Health Research (OxINMAHR), Oxford Brookes University, Oxford, UK
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Malfait S, Van Hecke A, Van Biesen W, Eeckloo K. Is privacy a problem during bedside handovers? A practice-oriented discussion paper. Nurs Ethics 2018; 26:2288-2297. [PMID: 30134750 PMCID: PMC7323750 DOI: 10.1177/0969733018791348] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Bedside handover is the delivery of the nurse-to-nurse handover at the patient’s bedside.
Although increasingly used in nursing, nurses report many barriers for delivering the
bedside handover. Among these barriers is the possibility of breaching the patient’s
privacy. By referring to this concept, nurses add a legal and ethical dimension to the
delivery of the bedside handover, making implementation of the method difficult or even
impossible. In this discussion article, the concept of privacy during handovers is being
discussed by use of observations, interviews with nurses, and interviews with patients.
These findings are combined with international literature from a narrative review on the
topic. We provide a practice-oriented answer in which two mutually exclusive possibilities
are discussed. If bedside handover does pose problems concerning privacy, this situation
is not unique in healthcare and measures can be taken during the bedside handover to
safeguard the patient. If bedside handover does not pose problems concerning privacy,
privacy is misused by nurses to hide professional uncertainties and/or a reluctance toward
patient participation. Therefore, a possible breach of privacy—whether a justified
argument or not—is not a reason for not delivering the bedside handover.
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Affiliation(s)
- Simon Malfait
- Ghent University Hospital, Belgium; Ghent University, Belgium
| | - Ann Van Hecke
- Ghent University Hospital, Belgium; Ghent University, Belgium
| | - Wim Van Biesen
- Ghent University Hospital, Belgium; Ghent University, Belgium
| | - Kristof Eeckloo
- Ghent University Hospital, Belgium; Ghent University, Belgium
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Austvoll‐Dahlgren A, Johansen M. "A waste of time without patients": The views of patient representatives attending a workshop in evidence-based practice. J Evid Based Med 2018; 11:191-199. [PMID: 29938926 PMCID: PMC6175114 DOI: 10.1111/jebm.12303] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 01/23/2018] [Indexed: 01/11/2023]
Abstract
BACKGROUND Shared decision-making is a central element of evidence-based practice (EBP). Training in EBP has traditionally focused on providers, but there is an increasing interest in developing such educational resources for patients. The aim of this study is to explore the views of patient representatives attending a workshop in EBP. METHODS We conducted three focus groups with participants attending EBP workshops in 2013, 2014, and 2015. We used the framework method for content analysis. We reviewed the transcribed interviews independently and assigned initial codes and final categories to the transcriptions. We created an analytical framework and a flow diagram to visualize the category hierarchy and the relationship between categories. RESULTS We identified two main themes; "How to facilitate training in evidence-based practice for patients," and "Outputs of training in evidence based practice for patients." Training in EBP for patient representatives "should reflect the principles EBP," and include interaction with both health professionals and other representatives. The educational needs of representatives are much the same as those of health professionals, and the training should therefore be "on a par with professionals." The relevance of such training may depend on the representatives' mandate, and costs might be an important barrier. Important outputs of such training include "becoming a knowledge manager," "enabling participation and informed decisions" and "re-defining the patient representatives' role." CONCLUSIONS The findings of this study suggest that training in EBP is attractive to patient representatives with outputs perceived important. Organizers should consider the principles of EBP when planning such training.
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van Belle E, Zwakhalen SMG, Caris J, Van Hecke A, Huisman-de Waal G, Heinen M. Tailoring of the Tell-us Card communication tool for nurses to increase patient participation using Intervention Mapping. J Clin Nurs 2018; 27:621-630. [PMID: 28722789 DOI: 10.1111/jocn.13968] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2017] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To describe the tailoring of the Tell-us Card intervention for enhanced patient participation to the Dutch hospital setting using Intervention Mapping as a systematic approach. BACKGROUND Even though patient participation is essential in any patient-to-nurse encounter, care plans often fail to take patients' preferences into account. The Tell-us Card intervention seems promising, but needs to be tailored and tested before implementation in a different setting or on large scale. DESIGN Description of the Intervention Mapping framework to systematically tailor the Tell-us Card intervention to the Dutch hospital setting. METHODS Intervention Mapping consists of: (i) identification of the problem through needs assessment and determination of fit, based on patients and nurses interviews and focus group interviews; (ii) developing a logic model of change and matrices, based on literature and interviews; (iii) selection of theory-based methods and practical applications; (iv) producing programme components and piloting; (v) planning for adoption, implementation and sustainability; and (vi) preparing for programme evaluation. RESULTS Knowledge, attitude, outcome expectations, self-efficacy and skills were identified as the main determinants influencing the use of the Tell-us Card. Linking identified determinants and performance objectives with behaviour change techniques from the literature resulted in a well-defined and tailored intervention and evaluation plan. CONCLUSIONS The Tell-us Card intervention was adapted to fit the Dutch hospital setting and prepared for evaluation. The Medical Research Council framework was followed, and the Intervention Mapping approach was used to prepare a pilot study to confirm feasibility and relevant outcomes. RELEVANCE TO CLINICAL PRACTICE This article shows how Intervention Mapping is applied within the Medical Research Council framework to adapt the Tell-us Card intervention, which could serve as a guide for the tailoring of similar interventions.
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Affiliation(s)
- Elise van Belle
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sandra M G Zwakhalen
- Research School CAPHRI, Department of Health Services Research, Maastricht University, MD Maastricht, The Netherlands
| | - Josien Caris
- Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Ann Van Hecke
- Faculty of Medicine and Health Sciences, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Getty Huisman-de Waal
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maud Heinen
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
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Braga LM, Parreira PM, Oliveira ADSS, Mónico LDSM, Arreguy-Sena C, Henriques MA. Phlebitis and infiltration: vascular trauma associated with the peripheral venous catheter. Rev Lat Am Enfermagem 2018; 26:e3002. [PMID: 29791668 PMCID: PMC5969824 DOI: 10.1590/1518-8345.2377.3002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 01/12/2018] [Indexed: 11/30/2022] Open
Abstract
Objective: to determine the incidence rate and risk factors for the nursing-sensitive
indicators phlebitis and infiltration in patients with peripheral venous
catheters (PVCs). Method: cohort study with 110 patients. Scales were used to assess and document
phlebitis and infiltration. Socio-demographic variables, clinical variables
related to the PVC, medication and hospitalization variables were collected.
Descriptive and inferential analysis and multivariate logistic models were
used. Results: the incidence rate of phlebitis and infiltration was respectively 43.2 and
59.7 per 1000 catheter-days. Most PVCs with these vascular traumas were
removed in the first 24 hours. Risk factors for phlebitis were: length of
hospital stay (p=0.042) and number of catheters inserted (p<0.001); risk
factors for infiltration were: piperacillin/tazobactan (p=0.024) and the
number of catheters inserted (p<0.001). Conclusion: the investigation documented the incidence of nursing-sensitive indicators
(phlebitis and infiltration) and revealed new risk factors related to
infiltration. It also allowed a reflection on the nursing care necessary to
prevent these vascular traumas and on the indications and contraindications
of the PVC, supporting the implementation of the PICC as an alternative to
PVC.
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Affiliation(s)
- Luciene Muniz Braga
- Departamento de Medicina e Enfermagem, Universidade Federal de Viçosa, Viçosa, MG, Brazil
| | - Pedro Miguel Parreira
- Unidade Científico-Pedagógica de Enfermagem Fundamental, Escola Superior de Enfermagem de Coimbra, Coimbra, Portugal
| | | | | | - Cristina Arreguy-Sena
- Departamento de Enfermagem Aplicada, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
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Vandewalle J, Malfait S, Eeckloo K, Colman R, Beeckman D, Verhaeghe S, Van Hecke A. Patient safety on psychiatric wards: A cross-sectional, multilevel study of factors influencing nurses' willingness to share power and responsibility with patients. Int J Ment Health Nurs 2018; 27:877-890. [PMID: 28795468 DOI: 10.1111/inm.12376] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/26/2017] [Indexed: 11/27/2022]
Abstract
The World Health Organization highlights the need for more patient participation in patient safety. In mental health care, psychiatric nurses are in a frontline position to support this evolution. The aim of the present study was to investigate the demographic and contextual factors that influence the willingness of psychiatric nurses to share power and responsibility with patients concerning patient safety. The patient participation culture tool for inpatient psychiatric wards was completed by 705 nurses employed in 173 psychiatric wards within 37 hospitals. Multilevel modelling was used to analyse the self-reported data. The acceptance of a role wherein nurses share power and responsibility with patients concerning patient safety is influenced by the nurses' sex, age, perceived competence, perceived support, and type of ward. To support nurses in fulfilling their role in patient participation, patient participation-specific basic and continuing education should be provided. Managers and supervisors should recognize and fulfil their facilitating role in patient participation by offering support to nurses. Special attention is needed for young nurses and nurses on closed psychiatric wards, because these particular groups report being less willing to accept a new role. Ward characteristics that restrict patient participation should be challenged so that these become more patient participation stimulating. More research is needed to explore the willingness and ability of psychiatric nurses to engage in collaborative safety management with patients who have specific conditions, such as suicidal ideation and emotional harm.
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Affiliation(s)
- Joeri Vandewalle
- Department of Public Health, Ghent University, Ghent, Belgium.,Research Foundation Flanders, Brussels, Belgium
| | - Simon Malfait
- Department of Public Health, Ghent University, Ghent, Belgium.,Ghent University Hospital, Ghent, Belgium
| | - Kristof Eeckloo
- Department of Public Health, Ghent University, Ghent, Belgium.,Ghent University Hospital, Ghent, Belgium
| | - Roos Colman
- Department of Public Health, Ghent University, Ghent, Belgium
| | | | - Sofie Verhaeghe
- Department of Public Health, Ghent University, Ghent, Belgium.,Department of Health Care, VIVES University College, Roeselare, Belgium
| | - Ann Van Hecke
- Department of Public Health, Ghent University, Ghent, Belgium.,Ghent University Hospital, Ghent, Belgium
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68
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Ringdal M, Chaboyer W, Ulin K, Bucknall T, Oxelmark L. Patient preferences for participation in patient care and safety activities in hospitals. BMC Nurs 2017; 16:69. [PMID: 29200965 PMCID: PMC5696683 DOI: 10.1186/s12912-017-0266-7] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 11/13/2017] [Indexed: 12/03/2022] Open
Abstract
Background Active patient participation is a patient safety priority for health care. Yet, patients and their preferences are less understood. The aim of the study was to explore hospitalised patients’ preferences on participation in their care and safety activities in Sweden. Methods Exploratory qualitative study. Data were collected over a four-month period in 2013 and 2014. Semi-structured interviews were conducted with 20 patients who were admitted to one of four medical wards at a university hospital in Sweden. Data were analysed using thematic analysis. Results Nine men and eleven women, whose median age was 72 years (range 22–89), were included in the study. Five themes emerged with the thematic analysis: endorsing participation; understanding enables participation; enacting patient safety by participation; impediments to participation; and the significance of participation. This study demonstrated that patients wanted to be active participants in their care and safety activities by having a voice and being a part of the decision-making process, sharing information and possessing knowledge about their conditions. These factors were all enablers for patient participation. However, a number of barriers hampered participation, such as power imbalances, lack of patient acuity and patient uncertainty. Patients’ participation in care and patient safety activities seemed to determine whether patients were feeling safe or ignored. Conclusion This study contributes to the existing literature with fundamental evidence of patients’ willingness to participate in care and safety activities. Promoting patient participation begins by understanding the patients’ unique preferences and needs for care, establishing a good relationship and paying attention to each patient’s ability to participate despite their illness.
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Affiliation(s)
- Mona Ringdal
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, 40530 Gothenburg, SE Sweden.,Department of Anaesthesiology and Intensive Care, Kungälvs hospital, Kungälv, Sweden
| | - Wendy Chaboyer
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, 40530 Gothenburg, SE Sweden.,National Centre of Research Excellence in Nursing Interventions (NCREN) Menzies Health Institute, School of Nursing, Griffith University, Gold Coast, Australia
| | - Kerstin Ulin
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, 40530 Gothenburg, SE Sweden.,Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Tracey Bucknall
- School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia.,Deakin University's Centre for a Quality and Patient Safety-Alfred Health Partnership, Melbourne, Victoria, Australia
| | - Lena Oxelmark
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, 40530 Gothenburg, SE Sweden.,Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
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69
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Tobiano G, Bucknall T, Sladdin I, Whitty JA, Chaboyer W. Patient participation in nursing bedside handover: A systematic mixed-methods review. Int J Nurs Stud 2017; 77:243-258. [PMID: 29149634 DOI: 10.1016/j.ijnurstu.2017.10.014] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 08/30/2017] [Accepted: 10/22/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Numerous reviews of nursing handover have been undertaken, but none have focused on the patients' role. OBJECTIVES To explore how patient participation in nursing shift-to-shift bedside handover can be enacted. DESIGN Systematic mixed- methods review. DATA SOURCES Three search strategies were undertaken in July-August 2016: database searching, backwards citation searching and forward citation searching. To be included, papers had to either be research or quality improvement (QI) projects focusing on the patient role. Fifty-four articles were retrieved, including 21 studies and 25 QI projects. REVIEW METHODS Screening, data extraction and quality appraisal was undertaken systematically by two reviewers. Research studies and QI projects were synthesised separately using thematic synthesis, then the results of this synthesis were combined using a mixed-method synthesis table. RESULTS Segregated synthesis of research of patients' perceptions revealed two contrasting categories; patient-centred handover and nurse-centred handover. Segregated synthesis of research of nurses' perceptions included three categories: viewing the patient as an information resource; dealing with confidential and sensitive information; and enabling patient participation. The segregated synthesis of QI projects included two categories: nurse barrier to enacting patient participation in bedside handover; and involving patients in beside handover. Once segregated findings were configured, we discovered that the patient's role in bedside handover involves contributing clinical information related to their care or progress, which may influence patient safety. Barriers related to nurses' concerns for the consequences of encouraging patient participation, worries for sharing confidential and sensitive information and feeling hesitant in changing their handover methods. The way nurses approach patients, and how patient-centred they are, constitute further potential barriers. Strategies to improve patient participation in handover include training nurses, making handovers predictable for patients and involving both patients and nurses throughout the change process. CONCLUSIONS Using research and QI projects allowed diverse findings to expand each other and identify gaps between research and heuristic knowledge. Our review showed the tension between standardising handovers and making them predictable for patient participation, while promoting tailored and flexible handovers. Further investigation of this issue is required, to understand how to train nurses and patient views. Many barriers and strategies identified were from QI projects and the nurse perspective, thus caution interpreting results is required. We recommend steps be taken in the future to ensure high quality QI projects.
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Affiliation(s)
- Georgia Tobiano
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus,Parklands Drive, Southport, QLD 4222 Australia.
| | - Tracey Bucknall
- Centre for Quality and Patient Safety, School of Nursing and Midwifery, Faculty of Health, Deakin University and Alfred Health, 221 Burwood Hwy, Burwood, Victoria 3125, Australia; Alfred Health, The Alfred, 55 Commercial Rd, Melbourne, VIC 3004 Australia.
| | - Ishtar Sladdin
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus,Parklands Drive, Southport, QLD 4222 Australia.
| | - Jennifer A Whitty
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich NR4 7TJ, United Kingdom.
| | - Wendy Chaboyer
- National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Parklands Drive, Southport, QLD 4222 Australia.
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Wang Y, Liu W, Shi H, Liu C, Wang Y. Measuring patient safety culture in maternal and child health institutions in China: a qualitative study. BMJ Open 2017; 7:e015458. [PMID: 28706096 PMCID: PMC5734290 DOI: 10.1136/bmjopen-2016-015458] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Patient safety culture (PSC) plays a critical role in ensuring safe and quality care. Extensive PSC studies have been undertaken in hospitals. However, little is known about PSC in maternal and child health (MCH) institutions in China, which provide both population-based preventive services as well as individual care for patients. OBJECTIVES This study aimed to develop a theoretical framework for conceptualising PSC in MCH institutions in China. METHODS The study was undertaken in six MCH institutions (three in Hebei and three in Beijing). Participants (n=118) were recruited through stratified purposive sampling: 20 managers/administrators, 59 care providers and 39 patients. In-depth interviews were conducted with the participants. The interview data were coded using both inductive (based on the existing PSC theory developed by the Agency for Healthcare Research and Quality) and deductive (open coding arising from data) approaches. A PSC framework was formulated through axial coding that connected initial codes and selective coding that extracted a small number of themes. RESULTS The interviewees considered patient safety in relation to six aspects: safety and security in public spaces, safety of medical services, privacy and information security, financial security, psychological safety and gap in services. A 12-dimensional PSC framework was developed, containing 69 items. While the existing PSC theory was confirmed by this study, some new themes emerged from the data. Patients expressed particular concerns about psychological safety and financial security. Defensive medical practices emerged as a PSC dimension that is associated with not only medical safety but also financial security and psychological safety. Patient engagement was also valued by the interviewees, especially the patients, as part of PSC. CONCLUSIONS Although there are some common features in PSC across different healthcare delivery systems, PSC can also be context specific. In MCH settings in China, the meaning of 'patient safety' goes beyond the traditional definition of patients. General well-being, health and disease prevention are important anchor points for defining PSC in such settings.
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Affiliation(s)
- Yuanyuan Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
- Second Outpatient Department, Peking University Third Hospital, Beijing, China
| | - Weiwei Liu
- Second Outpatient Department, Peking University Third Hospital, Beijing, China
| | - Huifeng Shi
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Yan Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
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71
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Oxelmark L, Ulin K, Chaboyer W, Bucknall T, Ringdal M. Registered Nurses’ experiences of patient participation in hospital care: supporting and hindering factors patient participation in care. Scand J Caring Sci 2017; 32:612-621. [DOI: 10.1111/scs.12486] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 04/25/2017] [Indexed: 12/24/2022]
Affiliation(s)
- Lena Oxelmark
- Institute of Health and Care Sciences; the Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Department of Medicine; Sahlgrenska University Hospital; Gothenburg Sweden
| | - Kerstin Ulin
- Institute of Health and Care Sciences; the Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Wendy Chaboyer
- Institute of Health and Care Sciences; the Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Centre of Research Excellence in Nursing Interventions; Gothenburg Sweden
- Menzies Health Institute Queensland; Griffith University; Qld Australia
| | - Tracey Bucknall
- Centre for Quality and Patient Safety; Alfred Health Partnership; Deakin University; Geelong Victoria Australia
- School of Nursing and Midwifery; Faculty of Health; Geelong Victoria Australia
| | - Mona Ringdal
- Institute of Health and Care Sciences; the Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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Abstract
This study explored parents' perspectives regarding their involvement in safety for their hospitalized children. We employed qualitative description and semistructured interviews of parents of children in an urban tertiary hospital ward. Content analysis revealed 4 parent themes: risks to child safety and comfort, hospital role as a protector, participation in safety varies by individual and organizational factors, and balancing safety with "speaking up" interpersonal risks. We suggest key concepts to incorporate into staff education and family engagement/safety programs to develop effective partnerships between clinicians and parents.
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73
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Kullberg A, Sharp L, Johansson H, Brandberg Y, Bergenmar M. Patient satisfaction after implementation of person-centred handover in oncological inpatient care - A cross-sectional study. PLoS One 2017; 12:e0175397. [PMID: 28384314 PMCID: PMC5383334 DOI: 10.1371/journal.pone.0175397] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 03/25/2017] [Indexed: 11/18/2022] Open
Abstract
Effective nurse shift-to-shift handover is a prerequisite for high-quality inpatient care. Combining person-centeredness with the need for improved handover rituals, we introduced and evaluated person-centered handover (PCH) in an oncological inpatient setting. PCH is the shift-to-shift nursing report performed together with the patient according to a set structure focused on patient participation, relevant clinical information, and patient safety. Non-verbal handover, standard at the department, is conducted via the electronic health record, in absence of the patient, and without a set structure. The aim of the study was to compare person-centered handover with non-verbal handover in an oncological inpatient setting with regard to patient satisfaction. A cross-sectional design featuring two points of measurement at one intervention ward and two control wards was applied. The EORTC IN-PATSAT32 questionnaire was used for measuring patient satisfaction. Baseline measurements were taken during the spring of 2014, when all three wards used a non-verbal handover model, and included responses from 116 patients. Follow-up measurements (comparing PCH and non-verbal handover) involved 209 patients and were on-going from September 2014 to May 2015. After the introduction of PCH, one change in patient satisfaction was detected regarding the subscale measuring exchange of information between caregivers. Patients from the intervention ward scored statistically higher after the implementation of PCH when compared to the control wards (p = .0058). The difference remained after a multivariate regression analysis controlling for clinical variables. In conclusion, PCH is feasible in oncological inpatient care but does not seem to affect patient satisfaction.
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Affiliation(s)
- Anna Kullberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Lena Sharp
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- Regional Cancer Centre, Stockholm-Gotland, Stockholm, Sweden
| | - Hemming Johansson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Karolinska University Hospital, Stockholm, Sweden
| | - Yvonne Brandberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Mia Bergenmar
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Center for Digestive Diseases, Karolinska Univserity Hospital, Stockholm, Sweden
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74
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Angelis AD, Pancani L, Steca P, Colaceci S, Giusti A, Tibaldi L, Alvaro R, Ausili D, Vellone E. Testing an explanatory model of nurses' intention to report adverse drug reactions in hospital settings. J Nurs Manag 2017; 25:307-317. [PMID: 28127821 DOI: 10.1111/jonm.12467] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2016] [Indexed: 12/01/2022]
Abstract
AIM To test an explanatory model of nurses' intention to report adverse drug reactions in hospital settings, based on the theory of planned behaviour. BACKGROUND Under-reporting of adverse drug reactions is an important problem among nurses. METHODS A cross-sectional design was used. Data were collected with the adverse drug reporting nurses' questionnaire. Confirmatory factor analysis was performed to test the factor validity of the adverse drug reporting nurses' questionnaire, and structural equation modelling was used to test the explanatory model. RESULTS The convenience sample comprised 500 Italian hospital nurses (mean age = 43.52). Confirmatory factor analysis supported the factor validity of the adverse drug reporting nurses' questionnaire. The structural equation modelling showed a good fit with the data. Nurses' intention to report adverse drug reactions was significantly predicted by attitudes, subjective norms and perceived behavioural control (R² = 0.16). CONCLUSIONS The theory of planned behaviour effectively explained the mechanisms behind nurses' intention to report adverse drug reactions, showing how several factors come into play. IMPLICATIONS FOR NURSING MANAGEMENT In a scenario of organisational empowerment towards adverse drug reaction reporting, the major predictors of the intention to report are support for the decision to report adverse drug reactions from other health care practitioners, perceptions about the value of adverse drug reaction reporting and nurses' favourable self-assessment of their adverse drug reaction reporting skills.
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Affiliation(s)
- Alessia De Angelis
- Department of Nursing, Local Health Authority Roma 4, Civitavecchia, Rome, Italy
| | - Luca Pancani
- Department of Psychology, University of Milan-Bicocca, Milan, Italy
| | - Patrizia Steca
- Department of Psychology, University of Milan-Bicocca, Milan, Italy
| | - Sofia Colaceci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Angela Giusti
- National Center of Epidemiology, Surveillance and Health Promotion National Institute of Health, Rome, Italy
| | - Laura Tibaldi
- Department of Nursing, Local Health Authority Roma 4, Civitavecchia, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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Patient-centred hand hygiene information in orthopaedics units: an evidence-based implementation project. INT J EVID-BASED HEA 2016; 15:22-29. [PMID: 27875344 DOI: 10.1097/xeb.0000000000000094] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIM This project aimed to improve patients' knowledge on the importance of hand hygiene. It involved providing patients with a patient and family education on the importance of hand hygiene using a patient information leaflet that introduces the rationale of hand hygiene, possible consequences of poor hand hygiene, and the seven steps of hand hygiene. METHODS This projected used a preimplementation and postimplementation audit strategy using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research Into Practice programs. The implementation occurred in three phases over a period of 6 months from January 2014 to June 2014. The audits took place in two orthopaedic wards in a large acute care setting tertiary hospital in Singapore and involved a sample size of 54 patients. It involved going through the medical records of the cases, assessment of patient knowledge based on the audit criteria, and checking if the patients received the patient information leaflet on hand hygiene. RESULTS The postimplementation audit found significant improvements in all three audit criteria. The percentage of patients who demonstrated knowledge in the importance of hand hygiene saw an improvement of 48.1%. There was an improvement of 44.5% in nurses' compliance to the documentation of patient education being carried out. The percentage of patients who received a patient information leaflet on hand hygiene saw an increase of 36.1%. CONCLUSION This project demonstrated that a preimplementation and postimplementation audit is a viable method to implement change and translate evidence into practice. Through this project, patients gained an understanding on the importance of hand hygiene and could take better ownership of their well being. This may potentially improve hospitalization experience and benefit health outcomes. The positive results of this project are contributed by the enthusiastic involvement of all the stakeholders, from patients and their caregivers to the bedside nurses and nursing leaders. The sustenance will be an ongoing challenge to the project.
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76
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Tudor Car L, Papachristou N, Gallagher J, Samra R, Wazny K, El-Khatib M, Bull A, Majeed A, Aylin P, Atun R, Rudan I, Car J, Bell H, Vincent C, Franklin BD. Identification of priorities for improvement of medication safety in primary care: a PRIORITIZE study. BMC FAMILY PRACTICE 2016; 17:160. [PMID: 27852240 PMCID: PMC5112691 DOI: 10.1186/s12875-016-0552-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 10/29/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Medication error is a frequent, harmful and costly patient safety incident. Research to date has mostly focused on medication errors in hospitals. In this study, we aimed to identify the main causes of, and solutions to, medication error in primary care. METHODS We used a novel priority-setting method for identifying and ranking patient safety problems and solutions called PRIORITIZE. We invited 500 North West London primary care clinicians to complete an open-ended questionnaire to identify three main problems and solutions relating to medication error in primary care. 113 clinicians submitted responses, which we thematically synthesized into a composite list of 48 distinct problems and 45 solutions. A group of 57 clinicians randomly selected from the initial cohort scored these and an overall ranking was derived. The agreement between the clinicians' scores was presented using the average expert agreement (AEA). The study was conducted between September 2013 and November 2014. RESULTS The top three problems were incomplete reconciliation of medication during patient 'hand-overs', inadequate patient education about their medication use and poor discharge summaries. The highest ranked solutions included development of a standardized discharge summary template, reduction of unnecessary prescribing, and minimisation of polypharmacy. Overall, better communication between the healthcare provider and patient, quality assurance approaches during medication prescribing and monitoring, and patient education on how to use their medication were considered the top priorities. The highest ranked suggestions received the strongest agreement among the clinicians, i.e. the highest AEA score. CONCLUSIONS Clinicians identified a range of suggestions for better medication management, quality assurance procedures and patient education. According to clinicians, medication errors can be largely prevented with feasible and affordable interventions. PRIORITIZE is a new, convenient, systematic, and replicable method, and merits further exploration with a view to becoming a part of a routine preventative patient safety monitoring mechanism.
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Affiliation(s)
- Lorainne Tudor Car
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Nikolaos Papachristou
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Joseph Gallagher
- UCD Conway Institute, gHealth Research Group, The University College Dublin School of Medicine, Dublin, Ireland
| | - Rajvinder Samra
- Faculty of Health & Social Care, Health & Social Care Programme, The Open University, Milton Keynes, UK
| | - Kerri Wazny
- Usher Institute of Population Health Sciences and Informatics, Centre for Global Health Research, The University of Edinburgh Medical School, Edinburgh, UK
| | - Mona El-Khatib
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Adrian Bull
- Imperial College Health Partners, London, UK
| | - Azeem Majeed
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Paul Aylin
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Rifat Atun
- Department of Global Health and Population & Department of Health Policy and Management, Harvard, Boston USA
| | - Igor Rudan
- Usher Institute of Population Health Sciences and Informatics, Centre for Global Health Research, The University of Edinburgh Medical School, Edinburgh, UK
| | - Josip Car
- Health Services and Outcomes Research Programme, LKCMedicine, Nanyang Technological University, Singapore, Singapore
| | - Helen Bell
- Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UK
| | - Charles Vincent
- Department of Experimental Psychology, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Bryony Dean Franklin
- Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust/UCL School of Pharmacy, London, UK
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Chaboyer W, Bucknall T, Webster J, McInnes E, Gillespie BM, Banks M, Whitty JA, Thalib L, Roberts S, Tallott M, Cullum N, Wallis M. The effect of a patient centred care bundle intervention on pressure ulcer incidence (INTACT): A cluster randomised trial. Int J Nurs Stud 2016; 64:63-71. [PMID: 27693836 DOI: 10.1016/j.ijnurstu.2016.09.015] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 09/14/2016] [Accepted: 09/21/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Hospital-acquired pressure ulcers are a serious patient safety concern, associated with poor patient outcomes and high healthcare costs. They are also viewed as an indicator of nursing care quality. OBJECTIVE To evaluate the effectiveness of a pressure ulcer prevention care bundle in preventing hospital-acquired pressure ulcers among at risk patients. DESIGN Pragmatic cluster randomised trial. SETTING Eight tertiary referral hospitals with >200 beds each in three Australian states. PARTICIPANTS 1600 patients (200/hospital) were recruited. Patients were eligible if they were: ≥18 years old; at risk of pressure ulcer because of limited mobility; expected to stay in hospital ≥48h and able to read English. METHODS Hospitals (clusters) were stratified in two groups by recent pressure ulcer rates and randomised within strata to either a pressure ulcer prevention care bundle or standard care. The care bundle was theoretically and empirically based on patient participation and clinical practice guidelines. It was multi-component, with three messages for patients' participation in pressure ulcer prevention care: keep moving; look after your skin; and eat a healthy diet. Training aids for patients included a DVD, brochure and poster. Nurses in intervention hospitals were trained in partnering with patients in their pressure ulcer prevention care. The statistician, recruiters, and outcome assessors were blinded to group allocation and interventionists blinded to the study hypotheses, tested at both the cluster and patient level. The primary outcome, incidence of hospital-acquired pressure ulcers, which applied to both the cluster and individual participant level, was measured by daily skin inspection. RESULTS Four clusters were randomised to each group and 799 patients per group analysed. The intraclass correlation coefficient was 0.035. After adjusting for clustering and pre-specified covariates (age, pressure ulcer present at baseline, body mass index, reason for admission, residence and number of comorbidities on admission), the hazard ratio for new pressure ulcers developed (pressure ulcer prevention care bundle relative to standard care) was 0.58 (95% CI: 0.25, 1.33; p=0.198). No adverse events or harms were reported. CONCLUSIONS Although the pressure ulcer prevention care bundle was associated with a large reduction in the hazard of ulceration, there was a high degree of uncertainty around this estimate and the difference was not statistically significant. Possible explanations for this non-significant finding include that the pressure ulcer prevention care bundle was effective but the sample size too small to detect this.
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Affiliation(s)
- Wendy Chaboyer
- NHMRC Centre for Research Excellence in Nursing, Griffith University, Gold Coast Campus, QLD 4222, Australia; Menzies Health Institute Queensland, Griffith University, Australia.
| | - Tracey Bucknall
- NHMRC Centre for Research Excellence in Nursing, Griffith University, Gold Coast Campus, QLD 4222, Australia; Alfred Health, Melbourne, Australia; School of Nursing and Midwifery, Deakin University, Geelong, Australia
| | - Joan Webster
- NHMRC Centre for Research Excellence in Nursing, Griffith University, Gold Coast Campus, QLD 4222, Australia; Centre for Clinical Nursing, Royal Brisbane and Women's Hospital, Herston, QLD 4006, Australia
| | - Elizabeth McInnes
- Nursing Research Institute, Australian Catholic University and St. Vincent's Health Australia (Sydney), Darlinghurst, NSW 2010, Australia; School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Australia
| | - Brigid M Gillespie
- NHMRC Centre for Research Excellence in Nursing, Griffith University, Gold Coast Campus, QLD 4222, Australia; Menzies Health Institute Queensland, Griffith University, Australia
| | - Merrilyn Banks
- Nutrition and Dietetics Department, Royal Brisbane and Women's Hospital, Herston, QLD 4006, Australia
| | - Jennifer A Whitty
- NHMRC Centre for Research Excellence in Nursing, Griffith University, Gold Coast Campus, QLD 4222, Australia; School of Pharmacy, Faculty of Health and Behavioural Sciences, University of Queensland, Australia; Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7JT, United Kingdom
| | - Lukman Thalib
- Public Health Program, Department of Public Health, College of Health Sciences, Qatar University, Doha, Qatar
| | - Shelley Roberts
- NHMRC Centre for Research Excellence in Nursing, Griffith University, Gold Coast Campus, QLD 4222, Australia; Menzies Health Institute Queensland, Griffith University, Australia
| | - Mandy Tallott
- NHMRC Centre for Research Excellence in Nursing, Griffith University, Gold Coast Campus, QLD 4222, Australia; Menzies Health Institute Queensland, Griffith University, Australia
| | - Nicky Cullum
- NHMRC Centre for Research Excellence in Nursing, Griffith University, Gold Coast Campus, QLD 4222, Australia; School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL, United Kingdom
| | - Marianne Wallis
- Menzies Health Institute Queensland, Griffith University, Australia; School of Nursing and Midwifery, University of the Sunshine Coast, Sunshine Coast, QLD 4556, Australia
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78
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Rashvand F, Ebadi A, Vaismoradi M, Salsali M, Yekaninejad MS, Griffiths P, Sieloff C. The assessment of safe nursing care: development and psychometric evaluation. J Nurs Manag 2016; 25:22-36. [DOI: 10.1111/jonm.12424] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Farnoosh Rashvand
- Faculty of Nursing & Midwifery; Tehran University of Medical Sciences; Tehran Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center; Nursing Faculty of Baqiyatallah University of Medical Sciences; Tehran Iran
| | | | - Mahvash Salsali
- Faculty of Nursing & Midwifery; Tehran University of Medical Sciences; Tehran Iran
| | | | - Pauline Griffiths
- College of Human and Health Sciences; Swansea University; Swansea UK
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79
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Clancy A, Mahler M. Nursing staffs’ attentiveness to older adults falling in residential care - an interview study. J Clin Nurs 2016; 25:1405-15. [DOI: 10.1111/jocn.13240] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Anne Clancy
- Department of Health and Care Sciences; UiT The Norwegian University of the Arctic; Campus Harstad; Norway
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80
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Cunningham CE, Hutchings T, Henderson J, Rimas H, Chen Y. Modeling the hospital safety partnership preferences of patients and their families: a discrete choice conjoint experiment. Patient Prefer Adherence 2016; 10:1359-72. [PMID: 27555752 PMCID: PMC4968982 DOI: 10.2147/ppa.s105605] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patients and their families play an important role in efforts to improve health service safety. OBJECTIVE The objective of this study is to understand the safety partnership preferences of patients and their families. METHOD We used a discrete choice conjoint experiment to model the safety partnership preferences of 1,084 patients or those such as parents acting on their behalf. Participants made choices between hypothetical safety partnerships composed by experimentally varying 15 four-level partnership design attributes. RESULTS Participants preferred an approach to safety based on partnerships between patients and staff rather than a model delegating responsibility for safety to hospital staff. They valued the opportunity to participate in point of service safety partnerships, such as identity and medication double checks, that might afford an immediate risk reduction. Latent class analysis yielded two segments. Actively engaged participants (73.3%) comprised outpatients with higher education, who anticipated more benefits to safety partnerships, were more confident in their ability to contribute, and were more intent on participating. They were more likely to prefer a personal engagement strategy, valued scientific evidence, preferred a more active approach to safety education, and advocated disclosure of errors. The passively engaged segment (26.7%) anticipated fewer benefits, were less confident in their ability to contribute, and were less intent on participating. They were more likely to prefer an engagement strategy based on signage. They preferred that staff explain why they thought patients should help make care safer and decide whether errors were disclosed. Inpatients, those with immigrant backgrounds, and those with less education were more likely to be in this segment. CONCLUSION Health services need to communicate information regarding risks, ask about partnership preferences, create opportunities respecting individual differences, and ensure a positive response when patients raise safety concerns.
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Affiliation(s)
- Charles E Cunningham
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, Michael G DeGroote School of Medicine, McMaster University
- Correspondence: Charles E Cunningham, Ron Joyce Children’s Health Centre, Child and Youth Mental Health Program, 237 Barton Street East, Hamilton, ON L8L 2X2, Canada, Tel +1 905 521 2100 ext 77307, Fax +1 905 577 8453, Email
| | - Tracy Hutchings
- Department of Quality and Performance, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Jennifer Henderson
- Department of Quality and Performance, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Heather Rimas
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, Michael G DeGroote School of Medicine, McMaster University
| | - Yvonne Chen
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, Michael G DeGroote School of Medicine, McMaster University
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81
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Gustavsson S, Gremyr I, Kenne Sarenmalm E. Designing quality of care--contributions from parents: Parents' experiences of care processes in paediatric care and their contribution to improvements of the care process in collaboration with healthcare professionals. J Clin Nurs 2015; 25:742-51. [PMID: 26510719 DOI: 10.1111/jocn.13050] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2015] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES The aim of this article was to explore whether current quality dimensions for health care services are sufficient to capture how parents perceive and contribute to quality of health care. BACKGROUND New quality improvement initiatives that actively involve patients must be examined with a critical view on established quality dimensions to ensure that these measures support patient involvement. DESIGN This paper used a qualitative and descriptive design. METHODS This paper is based on interviews with parents participating in two experience-based co-design projects in a Swedish hospital that included qualitative content analysis of data from 12 parent interviews in paediatric care. RESULTS Health care professionals often overemphasize their own significance for value creation in care processes and underappreciate parents' ability to influence and contribute to better quality. However, quality is not based solely on how professionals accomplish their task, but is co-created by health care professionals and parents. Consequently, assessment of quality outcomes also must include parents' ability and context. CONCLUSIONS This paper questions current models of quality dimensions in health care, and suggests additional sub-dimensions, such as family quality and involvement quality. RELEVANCE TO CLINICAL PRACTICE This paper underscores the importance of involving parents in health care improvements with health care professionals to capture as many dimensions of quality as possible.
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Affiliation(s)
- Susanne Gustavsson
- Skaraborg Hospital, Skövde, Sweden.,Division of Quality Sciences, Department of Technology Management and Economics, CHI-Centre for Healthcare Improvement, Chalmers University of Technology, Gothenburg, Sweden
| | - Ida Gremyr
- Division of Quality Sciences, Department of Technology Management and Economics, Chalmers University of Technology, Gothenburg, Sweden
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82
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Tobiano G, Bucknall T, Marshall A, Guinane J, Chaboyer W. Nurses' views of patient participation in nursing care. J Adv Nurs 2015. [DOI: 10.1111/jan.12740] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Georgia Tobiano
- Centre for Health Practice Innovation; Menzies Health Institute Queensland; Griffith University; Gold Coast Queensland Australia
| | - Tracey Bucknall
- Centre for Quality and Patient Safety; School of Nursing and Midwifery; Deakin University; Melbourne Victoria Australia
- Alfred Health; Melbourne Victoria Australia
| | - Andrea Marshall
- National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients; Centre for Health Practice Innovation; Menzies Health Institute Queensland; Griffith University; Southport Queensland Australia
- Gold Coast Health; Southport Queensland Australia
| | - Jessica Guinane
- School of Nursing and Midwifery; Deakin University; Melbourne Victoria Australia
| | - Wendy Chaboyer
- National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients; Centre for Health Practice Innovation; Menzies Health Institute Queensland; Griffith University; Southport Queensland Australia
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83
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Tobiano G, Bucknall T, Marshall A, Guinane J, Chaboyer W. Patients’ perceptions of participation in nursing care on medical wards. Scand J Caring Sci 2015; 30:260-70. [DOI: 10.1111/scs.12237] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 03/17/2015] [Indexed: 12/15/2022]
Affiliation(s)
- Georgia Tobiano
- Centre for Health Practice Innovation; Menzies Health Institute Queensland; Griffith University; Gold Coast Qld Australia
| | - Tracey Bucknall
- Centre for Quality and Patient Safety; School of Nursing and Midwifery; Deakin University; Melbourne Vic Australia
- Alfred Health; Melbourne Vic Australia
| | - Andrea Marshall
- Centre for Health Practice Innovation; Menzies Health Institute Queensland; Griffith University; Gold Coast Qld Australia
- National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients; Centre for Health Practice Innovation; Menzies Health Institute Queensland; Griffith University; Gold Coast Qld Australia
| | - Jessica Guinane
- School of Nursing and Midwifery; Deakin University; Melbourne Vic Australia
| | - Wendy Chaboyer
- Gold Coast University Hospital; Gold Coast Qld Australia
- National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients; Centre for Health Practice Innovation; Menzies Health Institute Queensland; Griffith University; Gold Coast Qld Australia
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84
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De Angelis A, Colaceci S, Giusti A, Vellone E, Alvaro R. Factors that condition the spontaneous reporting of adverse drug reactions among nurses: an integrative review. J Nurs Manag 2015; 24:151-63. [PMID: 25974355 DOI: 10.1111/jonm.12310] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2015] [Indexed: 11/28/2022]
Abstract
AIM To describe and synthesise previous research on factors conditioning the spontaneous reporting of adverse drug reactions among nurses. BACKGROUND Spontaneous reports of adverse drug reactions by health-care providers, are a main instrument for the continuous evaluation of the risk-benefit ratio of every drug. Under-reporting of adverse drug reactions by all health-care providers, in particular by nurses, is a major limitation to this system. EVALUATION An integrated review of the literature was conducted using MEDLINE, CINAHL, Embase, Scopus databases and Google Scholar. After evaluation for appropriateness related to inclusion/exclusion criteria, 16 studies were included in the final analysis and synthesis. KEY ISSUES Two factors emerged from the study: (1) intrinsic factors related to nurses' knowledge and attitudes; (2) extrinsic factors related to nurses' interaction with health-care organisations and to the relationship between nurses and physicians. Nurses' attitudes that hinder reporting include ignorance, insecurity, fear and lethargy. CONCLUSIONS Nurses are not fully aware of their role in adverse drug reaction reporting. Nurses must acquire greater knowledge to implement specific skills into their daily clinical practice. IMPLICATIONS FOR NURSING MANAGEMENT To improve nurses' reporting of adverse drug reactions, it is necessary to develop management approaches that modify both intrinsic and extrinsic factors.
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Affiliation(s)
- Alessia De Angelis
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Sofia Colaceci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Angela Giusti
- National Centre of Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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