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Perfetto K, Pozzobon L, Sears K, O'Hara J, Ross-White A, Duhn L. Care partner engagement in patient safety at the direct care level in hospital: a qualitative systematic review protocol. JBI Evid Synth 2024:02174543-990000000-00354. [PMID: 39252554 DOI: 10.11124/jbies-24-00066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
OBJECTIVE The objective of this systematic review is to understand the experiences of care partner engagement in patient safety at the direct care level from the perspective of care partners, patients, and health care professionals. INTRODUCTION Care partner engagement is a strategy for promoting patient safety in hospitals at the direct care level (ie, at the point where patient care is delivered). When present, care partners can increase safety by watching, listening, and taking action to protect admitted patients. To improve care partner presence policies and safety engagement strategies within hospitals, a comprehensive understanding of the current qualitative evidence about the breadth of experiences of care partner engagement in patient safety is required. INCLUSION CRITERIA This review will include qualitative studies that consider the experiences of care partners, adult patients, and health care professionals. The engagement of care partners in patient safety within pediatric hospital settings will not be considered. METHODS This review will follow the JBI methodology for systematic reviews of qualitative evidence. A preliminary literature search was conducted in MEDLINE and a full search strategy was developed for MEDLINE, Embase, CINAHL, and PsycINFO (all via Ovid), as well as the Cochrane Database of Systematic Reviews and JBI Evidence Synthesis. The JBI approach to study selection, critical appraisal, data extraction, data synthesis, and assessment of confidence will be followed. Two reviewers will test the screening criteria and data extraction protocol. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42023476286.
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Affiliation(s)
- Kayley Perfetto
- Health Quality Programs, School of Nursing, Queen's University, Kingston, ON, Canada
| | - Laura Pozzobon
- Health Quality Programs, School of Nursing, Queen's University, Kingston, ON, Canada
| | - Kim Sears
- Health Quality Programs, School of Nursing, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Health Care Quality, Queen's University, Kingston, ON, Canada
| | - Jane O'Hara
- THIS Institute, University of Cambridge, Cambridge, England
| | - Amanda Ross-White
- Queen's Collaboration for Health Care Quality, Queen's University, Kingston, ON, Canada
- Bracken Health Science Library, Queen's University, Kingston, ON, Canada
| | - Lenora Duhn
- Health Quality Programs, School of Nursing, Queen's University, Kingston, ON, Canada
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Lekman J, Lindén E, Ekstedt M. The challenge of risk prevention in home healthcare-An interview study with nurses in municipal care. Scand J Caring Sci 2023; 37:1067-1078. [PMID: 37222406 DOI: 10.1111/scs.13181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/26/2023] [Accepted: 05/07/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND Safety in home healthcare has garnered increased attention as more people are receiving care for complex conditions at home. The prerequisites for providing safe care at home differ from those in hospitals. Malnutrition, falls, pressure ulcers and inappropriate medication commonly follow poor risk assessments, causing unnecessary suffering and costs. Therefore, risk prevention in home healthcare needs to be prioritised and studied more closely. AIM To describe nurses' experiences of performing risk prevention in municipal home healthcare. METHODS Qualitative inductive approach, using semi-structured interviews with 10 registered nurses in a municipality in southern Sweden. Data underwent qualitative content analysis. FINDINGS The analysis resulted in three main categories and one overarching theme describing nurses' experiences of risk prevention in home healthcare. Getting everyone onboard comprises the categories: Managing safety while respecting the patient's self-determination, which covers patient participation, the strategic importance of respecting different views of risks and information and the fact that healthcare workers are guests in the patient's home. Finding ways to make it work touches upon the relational aspect, including next-of-kin and promoting a common understanding to prevent risks. Being squeezed between resources and requirements refers to ethical dilemmas, teamwork, leadership and organisational prerequisites. CONCLUSION Patient habits, living conditions and limited awareness of risks is a challenge in risk prevention in home healthcare, where patient participation plays a pivotal role. Risk prevention in home healthcare needs to be initiated at an early stage of disease and ageing and should be seen as a process where early health-promoting interventions can prevent the development and accumulation of risks over time. Long-term cross-organisational collaborations and patients' physical, mental and psychosocial conditions also need to be taken into account.
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Affiliation(s)
- Jonatan Lekman
- Department of Health and Caring Sciences, Linnaeus University, Kalmar/Växjö, Sweden
| | | | - Mirjam Ekstedt
- Department of Health and Caring Sciences, Linnaeus University, Kalmar/Växjö, Sweden
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
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Sarkhosh S, Abdi Z, Ravaghi H. Engaging patients in patient safety: a qualitative study examining healthcare managers and providers' perspectives. BMC Nurs 2022; 21:374. [PMID: 36581873 PMCID: PMC9801597 DOI: 10.1186/s12912-022-01152-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Patients can play an essential role in improving patient safety by becoming actively involved in their health care. The present study aimed to qualitatively explore healthcare providers' (HCPs) and managers' perceptions on patient participation in patient safety processes. METHODS This qualitative study carried out in three teaching hospitals in Tehran, Iran. The data were collected through semi-structured interviews with 31 HCPs and managers working at public teaching hospitals, medical universities and the Ministry of Health. The data were analyzed using thematic analysis. RESULTS Three main themes and 21 sub-themes emerged from the interviews. Participants believed that patients and their families can play an effective role in maintaining and improving patient safety through different roles. However, a variety of barriers were identified at patients, providers, and system levels hindering patient participation in delivering safe care. CONCLUSION The participants identified facilitators and barriers to patient engagement in safety-orientated activities at multiple patients, providers, and system levels, indicating that complex, multifaceted initiatives must be designed to address the issue. This study encourages further research to enhance the understating of the problems and solutions to patient involvement in safety initiatives in the Iranian healthcare setting.
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Affiliation(s)
- Samaneh Sarkhosh
- grid.411746.10000 0004 4911 7066Master of Health Services Administration, School of Health Management and Information Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Zhaleh Abdi
- grid.411705.60000 0001 0166 0922National Institute of Health Research (NIHR), Tehran University of Medical Sciences, Tehran (TUMS), Tehran, Iran
| | - Hamid Ravaghi
- grid.411746.10000 0004 4911 7066School of Health Management and Information Sciences, Iran University of Medical Sciences (IUMS), No. 6, Rashid Yasemi St. Vali-E-Asr Ave, P.O Box: 1996713883, Tehran, Iran
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Eknemar M, Persson F, Nilsson A. Patients' Experiences of Patient-Controlled Sedation: An Interview Study of Patients who Underwent Endoscopy. J Perianesth Nurs 2022; 37:883-888. [PMID: 35595604 DOI: 10.1016/j.jopan.2022.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/25/2022] [Accepted: 01/25/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Patient-controlled sedation (PCS) allows patients to self-administer sedative drugs during endoscopic retrograde cholangiopancreatography (ERCP). There is a paucity of research on the experiences of patients who used PCS. Therefore the purpose of this study was to describe the perioperative experiences of patients who used PCS during ERCP. DESIGN Prospective study using semi-structured interviews. METHODS Qualitative content analysis facilitated a latent understanding of the manifest content. FINDINGS Eleven interviews revealed three main themes and underlying categories that summarized the patient experience: participation (control and perioperative sedation); communication (personnel, information, safety, insecurity, and concern); and sensation (effects and side effects). CONCLUSIONS The participatory experience of PCS resulted not from the opportunity for patient involvement but, rather, the establishment of a patient-professional relationship. Specifically, the interactions between patients and health care professionals played a vital role in the patients' overall experience of PCS.
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Affiliation(s)
- Marcus Eknemar
- Department of Medical and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden; Department of Anesthesia and Intensive Care, Malmö, Sweden
| | - Fredrik Persson
- Department of Medical and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden; Department of Anesthesia and Intensive Care, Linköping, Region Östergötland, Sweden
| | - Andreas Nilsson
- Department of Medical and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden; Department of Anesthesia and Intensive Care, Linköping, Region Östergötland, Sweden.
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Abu-Rumman A, Al Shraah A, Al-Madi F, Alfalah T. The impact of quality framework application on patients’ satisfaction. INTERNATIONAL JOURNAL OF HUMAN RIGHTS IN HEALTHCARE 2022. [DOI: 10.1108/ijhrh-01-2021-0006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This study aims to explore if the application of the customer results criteria contained within the King Abdullah II Award for Excellence (KAIIAE) is correlated with high levels of patient satisfaction within a large hospital based in Jordan.
Design/methodology/approach
Using a mixed methodology, supported by a pragmatist theoretical approach, a satisfaction survey was conducted with patients accessing the hospital as an in-patient across a range of specialities gathering feedback about different aspects of their care. The results were compared with a self-assessment completed by different speciality teams about the existence and maturity of customer result arrangements implemented as a result of the (KAIIAE).
Findings
The findings confirmed that quality awards such as the KAIIAE can effectively be applied in a health-care setting and can help provide a framework for improving patient experience and satisfaction. A correlation was found with those specialties that self-assessed themselves more highly in terms of these arrangements and the overall levels of patient satisfaction with that specialty, suggesting that the products of working towards the KAIIAE such as establishing effective patient experience monitoring arrangements and improved learning from complaints, has a positive impact on patient satisfaction.
Originality/value
There are limited studies which focus specifically on customer results and on the use of the KAIIAE more generally. This study therefore makes a valuable contribution in adding to the debate about the strategic value of working towards formal quality improvement models and awards in health-care settings.
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Oliveira TGPD, Diniz CG, Carvalho MPM, Corrêa ADR, Rocha PK, Manzo BF. Involvement of companions in patient safety in pediatric and neonatal units: scope review. Rev Bras Enferm 2022; 75:e20210504. [DOI: 10.1590/0034-7167-2021-0504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/30/2021] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objectives: to describe scientific evidence on the involvement of companions in patient safety, from their own perspective and health professionals’ perspective in neonatal and pediatric units. Methods: scoping review carried out according to The Joanna Briggs Institute’s recommendations, in eight databases, following the Preferred Reporting Items checklist for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist, between 2011 and 2021. Results: the 13 studies included highlighted the importance of companions’ involvement in patient safety and the prevention of adverse events. However, they pointed out failures in communication and weakness in the training of professionals, which were obstacles to their involvement. The strengthening of health education, multidisciplinary rounds and educational technologies were highlighted as strategies to expand the involvement of companions. Final Considerations: this study directs elements for health professionals and managers to rethink the companions’ role in patient safety and development of collective strategies.
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Teixeira CC, Bezerra ALQ, Paranaguá TTDB, Afonso TC. Professionals’ beliefs in patient involvement for hospital safety. Rev Bras Enferm 2022; 75:e20210359. [DOI: 10.1590/0034-7167-2021-0359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 12/22/2021] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objectives: to analyze the beliefs of health care professionals about the benefits of patient involvement in care during hospitalization. Methods: a descriptive, exploratory, qualitative study was conducted with 87 health professionals from a teaching hospital. Semi-structured interviews were conducted between December 2019 and January 2020 - data was submitted to content analysis and interpreted in light of Rosenstock’s Model of Beliefs in Health. Results: participants included nursing technicians, nurses, doctors, and other professionals. The categories “Professionals’ beliefs about patient involvement in care”, “Practices of patient involvement in care” and “Factors favoring patient involvement in hospital care” emerged. The perception of professionals revealed the influence of patient involvement in care outcomes and benefits for the safety of care. Final Considerations: involving the patient in care is associated with the healthcare professional’s belief in the benefits of this practice for reducing incidents.
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Bezerril MDS, Moreno IM, Ayllón FS, Lira ALBDC, Cogo ALP, Santos VEP. ANÁLISE DO CONCEITO DE PACIENTE EXPERT SEGUNDO O MODELO DE WALKER E AVANT. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2021-0167pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: analisar o conceito de Paciente Expert no modelo de Walker e Avant. Método: análise teórica de conceito realizada em novembro de 2019 em bases de dados nacionais e internacionais com amostra final de 21 estudos, nos quais investigaram-se o país, ano de publicação, área da saúde, participantes, conceito, atributos, antecedentes e consequentes. Os dados quantitativos foram analisados de forma descritiva simples e os qualitativos organizados em figuras. Os conceitos identificados foram processados com apoio do software Interface de R pour Analyses Multidimensionnelles de Textes et de Questionnaires. Resultados: destacaram-se o Reino Unido (10, 47,6%); o ano de 2015 (04; 19,1%); a enfermagem como área de conhecimento mais evidenciada (05; 23,8%); e pacientes como participantes (18; 72,0%). A respeito dos elementos teóricos, a autogestão do cuidado (04;19,5%) foi o atributo que mais sobressaiu; evidenciaram-se, ainda, o aumento de pessoas com doenças crônicas (10;18,5%) como antecedente, a integração social/comunitária (14;24,5%) em meio aos consequentes, e os vocábulos patient expert, condition e health mediante o processamento dos conceitos apresentados pelos estudos incluídos na amostra final. Conclusão: a análise conceitual permitiu determinar a origem do conceito Paciente Expert, os diferentes campos de atuação desse sujeito, as habilidades desenvolvidas em prol do autocuidado e o seu real significado, o qual é definido como um indivíduo ativo no seu autocuidado com habilidades necessárias para gerenciar sua condição clínica e auxiliar outros em situação semelhante.
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Bezerril MDS, Moreno IM, Ayllón FS, Lira ALBDC, Cogo ALP, Santos VEP. ANALYSIS OF THE EXPERT PATIENT CONCEPT ACCORDING TO WALKER AND AVANT'S MODEL. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2021-0167en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to analyze the Expert Patient concept in Walker and Avant's model. Method: theoretical concept analysis conducted in November 2019 on national and international databases with a final sample of 21 studies, in which the following data were investigated: country, year of publication, area of knowledge, participants, concept, attributes, antecedents, and consequences. The quantitative data were analyzed in a simple descriptive way and the qualitative data were organized in figures. The concepts identified were processed with the aid of the Interface de R pour Analyses Multidimensionnelles de Textes et de Questionnaires software program. Results: the United Kingdom (10; 47.6%) stood out, as well as the year 2015 (04; 19.1%), Nursing as the most evidenced area of knowledge (05; 23.8%), and patients as participants (18; 72.0%). With regard to the basic elements, care self-management (04;19.5%) was the most relevant attribute; in addition, the increase in the number of people with chronic diseases (10;18.5%) and social/community integration (14;24.5%) were evidenced as the most important antecedent and consequence, respectively. Additionally, the terms expert patient, condition and health stood out in the processing of the concepts presented in the studies included in the final sample. Conclusion: concept analysis allowed determining the origin of the Expert Patient concept, the different fields of action of this subject, the self-care skills developed and their actual meaning, which is defined as an individual actively engaged in self-care and with the required skills to manage their clinical condition and help others in a similar situation.
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Souza ADZD, Hoffmeister LV, Moura GMSSD. FACILITATORS AND BARRIERS OF PATIENT INVOLVEMENT IN HOSPITAL SERVICES: INTEGRATIVE REVIEW. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2020-0395en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective to identify the facilitating factors and barriers that influence patient involvement in hospital services. Method integrative review; search of articles published between January 2011 and December 2020, in the electronic databases PubMed, Web of Science, Cinahl, Lilacs and Scopus, using descriptors related to "patient involvement", Barriers, Facilitators, in English, Spanish and Portuguese. Data collection was performed from May to June 2021, identifying 32 publications that met the inclusion criteria. Results the analysis resulted in three categories of facilitating factors and barriers: communication, actors of involvement and organizational culture, allowing the elaboration of a theoretical model of patient involvement. This model shows that in the centrality of the process are the actors involved, that is, patients and professionals, inserted in an organizational context, being influenced by leadership, culture, environment, available resources and processes, where communication permeates as a basis for involvement. Conclusion the facilitating factors and barriers identified in this review, synthesized in a theoretical model, allow transcending theoretical knowledge for practice. The complexity to operationalize this model requires patients, professionals, health services and society join forces to make this theoretical proposition a practice incorporated by the services.
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Affiliation(s)
| | - Louíse Viecili Hoffmeister
- Universidade NOVA de Lisboa, Portugal; Comprehensive Health Research Center, Portugal; Escola Superior de Enfermagem de Lisboa, Portugal
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Souza ADZD, Hoffmeister LV, Moura GMSSD. FACILITADORES E BARREIRAS DO ENVOLVIMENTO DO PACIENTE NOS SERVIÇOS HOSPITALARES: REVISÃO INTEGRATIVA. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2020-0395pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo identificar os fatores facilitadores e as barreiras que influenciam no envolvimento do paciente nos serviços hospitalares. Método revisão integrativa; realizada busca de artigos publicados entre janeiro de 2011 e dezembro de 2020, nas bases eletrônicas PubMed, Web of Science, Cinahl, Lilacs e Scopus, utilizando descritores relacionados a “patient involvement”, Barriers, Facilitators, nos idiomas inglês, espanhol e português. Coleta de dados realizada de maio a junho de 2021, identificando-se 32 publicações que atenderam aos critérios de inclusão. Resultados a análise resultou em três categorias de fatores facilitadores e barreiras: comunicação, atores do envolvimento e cultura organizacional, permitindo a elaboração de um modelo teórico de envolvimento do paciente. Esse modelo mostra que na centralidade do processo estão os atores envolvidos, ou seja, pacientes e profissionais, inseridos em um contexto organizacional, sendo influenciados pela liderança, cultura, ambiente, recursos disponíveis e processos, onde a comunicação perpassa como base para o envolvimento. Conclusão os fatores facilitadores e as barreiras identificadas nesta revisão, sintetizados num modelo teórico, permitem transcender o conhecimento teórico para a prática. A complexidade para operacionalizar esse modelo requer que pacientes, profissionais, serviços de saúde e sociedade unam os esforços para tornar esta proposição teórica em uma prática incorporada pelos serviços.
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Affiliation(s)
| | - Louíse Viecili Hoffmeister
- Universidade NOVA de Lisboa, Portugal; Comprehensive Health Research Center, Portugal; Escola Superior de Enfermagem de Lisboa, Portugal
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John J, Brown ME. The impact of longitudinal integrated clerkships on patient care: a qualitative systematic review. EDUCATION FOR PRIMARY CARE 2021; 33:137-147. [PMID: 34702143 DOI: 10.1080/14739879.2021.1980438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Longitudinal Integrated Clerkships (LIC) are a relatively novel type of clinical placement model within medical education, particularly within the UK. The research on LICs primarily focuses on the impact of the model on students, tutors, communities, and organisations. The impact of LICs on patients has not yet been adequately synthesised. This systematic review aims to fill this gap by examining empirical evidence regarding the impact of LICs on patient care using quality-of-care measures, namely, health process measures and outcome measures. METHODS A systematic search was conducted in MEDLINE, PsycINFO, Academic Search Premier, Education Research Complete, CINAHL Complete, ERIC, Web of Science, and Scopus. Two reviewers independently conducted the screening process for study selection. Results across studies were analysed and summarised by thematic analysis. RESULTS The reviewers screened 1632 records. Seven studies met the inclusion criteria following a full-text review, from which four themes were created. Three themes describe health process measures, including: 1) Advocacy within healthcare system, 2) Provision of supplementary and personalised care, and 3) Providing companionship with care. One theme described a health outcome measure: Therapeutic Alliance. CONCLUSION Current evidence demonstrates an overall beneficial impact of LICs on patient health processes and outcome measures. However, the available evidence is weak and limited. Further research is required to illuminate the true impact of LICs on patient health.
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Affiliation(s)
- Jomcy John
- School of Medicine, Cardiff University, Cardiff, UK.,Health Professions Education Unit, Hull York Medical School, University of York, York, UK
| | - Megan El Brown
- Health Professions Education Unit, Hull York Medical School, University of York, York, UK.,Medical Education Innovation and Research Centre, Imperial College London, London, UK
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Gyberg A, Henoch I, Lepp M, Ulin K. Framing healthcare professionals in written adverse events: A discourse analysis. Nurs Inq 2021; 29:e12461. [PMID: 34553446 DOI: 10.1111/nin.12461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 09/02/2021] [Accepted: 09/04/2021] [Indexed: 11/27/2022]
Abstract
Healthcare professionals have a major responsibility to protect patients from harm. Despite vast efforts to decrease the number of adverse events, the progression of patient safety has internationally been acknowledged as slow. From a social construction perspective, it has been argued that the understanding of patient safety is contextual based on historical and structural rules, and that this meaning construction points out different directions of possible patient safety actions. By focusing on fact construction and its productive and limiting effect on how something can be understood, we explored the discourses about healthcare professionals in 29 written reports of adverse events as reported by patients, relatives, and healthcare professionals. Through the analysis, a discourse about the healthcare professionals as experts was found. The expert role most dominantly included an understanding that adverse events were identified through physical signs and that patient safety could be prevented by more strictly following routines and work procedures. We drew upon the conclusion that these regimes of truth brought power to the expert discourse, to the point that it became difficult for patients and relatives to engage in patient safety actions on their terms.
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Affiliation(s)
- Anna Gyberg
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Medicine, Geriatrics and Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ingela Henoch
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Angered Hospital, Gothenburg, Sweden
| | - Margret Lepp
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Østfold University College, Halden, Norway.,School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
| | - Kerstin Ulin
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Medicine, Geriatrics and Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden
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Chegini Z, Arab-Zozani M, Shariful Islam SM, Tobiano G, Abbasgholizadeh Rahimi S. Barriers and facilitators to patient engagement in patient safety from patients and healthcare professionals' perspectives: A systematic review and meta-synthesis. Nurs Forum 2021; 56:938-949. [PMID: 34339525 DOI: 10.1111/nuf.12635] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 05/19/2021] [Accepted: 07/18/2021] [Indexed: 12/12/2022]
Abstract
AIMS To explore patients' and healthcare professionals' (HCPs) perceived barriers and facilitators to patient engagement in patient safety. METHODS We conducted a systematic review and meta-synthesis from five computerized databases, including PubMed/MEDLINE, Embase, Web of Science, Scopus and PsycINFO, as well as grey literature and reference lists of included studies. Data were last searched in December 2019 with no limitation on the year of publication. Qualitative and Mix-methods studies that explored HCPs' and patients' perceptions of barriers and facilitators to patient engagement in patient safety were included. Two authors independently screened the titles and the abstracts of studies. Next, the full texts of the screened studies were reviewed by two authors. Potential discrepancies were resolved by consensus with a third author. The Mixed Methods Appraisal Tool was used for quality appraisal. Thematic analysis was used to synthesize results. RESULTS Nineteen studies out of 2616 were included in this systematic review. Themes related to barriers included: patient unwillingness, HCPs' unwillingness, and inadequate infrastructures. Themes related to facilitators were: encouraging patients, sharing information with patients, establishing trustful relationship, establishing patient-centred care and improving organizational resources. CONCLUSION Patients have an active role in improving their safety. Strategies are required to address barriers that hinder or prevent patient engagement and create capacity and facilitate action.
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Affiliation(s)
- Zahra Chegini
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Morteza Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Georgia Tobiano
- Nursing and Midwifery Education Research Unit, Gold Coast University Hospital, Gold Coast, Australia
| | - Samira Abbasgholizadeh Rahimi
- Department of Family Medicine, McGill University, Montreal, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
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Morey S, Magnusson C, Steven A. Exploration of student nurses' experiences in practice of patient safety events, reporting and patient involvement. NURSE EDUCATION TODAY 2021; 100:104831. [PMID: 33676347 DOI: 10.1016/j.nedt.2021.104831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 01/26/2021] [Accepted: 02/21/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND/INTRODUCTION Qualified and student nurses remain at the forefront of dealing with, and reporting, patient safety events or incidents. There has been limited exploration of whether and how the patient's perspective is represented by staff or student nurses using formal reporting systems. OBJECTIVES The overall aim of the study was to explore the student nurses' experiences in practice of patient safety events they were themselves directly or indirectly involved in. This specifically explored the subsequent reporting and inclusion of the patient perspectives that may or may not have taken place. DESIGN A qualitative approach to this research was selected using the principles of thematic analysis to analyse data gathered from focus groups of student nurses across all year groups. SETTING Three universities participated in the study located in the north east, south east and east of England. PARTICIPANTS Student nurses from across the year groups attended focus groups. METHODS Following ethical approval and informed consent, participants took part in focus groups within each university setting. Data were transcribed verbatim and analysed using thematic analysis. RESULTS Three themes were identified: the benefit of reporting and patient involvement, the barriers experienced by the students in reporting and the support needed to ensure they do the right thing in practice. CONCLUSION Learning for students from patient safety incidents is important and seeking patients' views and perceptions adds to the learning experience. There are however challenges for the student in practice in both reporting and patient involvement. Resources are needed that follow and feed into the student learning alongside a workforce that see the benefit of learning from those we care for.
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Affiliation(s)
- Sarah Morey
- Northumbria University, Coach Lane Campus, Coach Lane, Newcastle-Upon-Tyne NE77TR, United Kingdom.
| | - Carin Magnusson
- University of Surrey, Stag Hill University Campus, Guildford. GU27XH, United Kingdom.
| | - Alison Steven
- Northumbria University, Coach Lane Campus, Coach Lane, Newcastle-Upon-Tyne NE77TR, United Kingdom.
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Giap TTT, Park M. Implementing Patient and Family Involvement Interventions for Promoting Patient Safety: A Systematic Review and Meta-Analysis. J Patient Saf 2021; 17:131-140. [PMID: 33208637 DOI: 10.1097/pts.0000000000000714] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The aims of the study were to evaluate and to quantify the effects of patient and family involvement (PFI) interventions on patient safety by synthesizing the available global data. METHODS Four databases were searched to identify relevant studies that have assessed the impact of PFI on patient safety up to March 2019. Reference lists of potential selected articles were also used to identify additional relevant studies. Effect sizes (ESs) were calculated using random and fixed effects models. Statistical heterogeneity was measured using the I2 test. RESULTS Twenty-two studies met the review criteria. The meta-analysis showed that PFI were beneficial in significantly reducing adverse events (ES = -0.240, P < 0.001), decreasing the length of hospital stay (ES = -0.122, P < 0.001), increasing patient safety experiences (ES = 0.630, P = 0.007), and improving patient satisfaction (ES = 0.268, P = 0.004). However, the PFI interventions did not significantly enhance the perception of patient safety (ES = 0.205, P = 0.09) or the quality of life (ES = 0.057, P = 0.61). Moreover, moderate-to-high heterogeneity was found for all impacts except adverse events (I2 = 0%) and length of hospital stay (I2 = 35%). A funnel plot indicated a low degree of publication bias for the adverse event outcome. CONCLUSIONS The synthesized evidence in this review demonstrates the benefits of PFI for promoting patient safety. However, further studies should extend the research scope to fill the existing gaps for both the type of PFI interventions and the patient safety outcomes.
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Affiliation(s)
- Thi-Thanh-Tinh Giap
- From the College of Nursing, Chungnam National University, Daejeon, Republic of Korea
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Assessing the Effect of Unit Champion-Initiated Audits on Fall Rates: Improving Awareness. J Nurs Care Qual 2021; 35:227-232. [PMID: 32433145 DOI: 10.1097/ncq.0000000000000449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Inpatient falls remain challenging with repercussions that can include patient injury and increased hospital expense. Fall rates were consistently above the national benchmark. An initiative to reduce fall rates was use of Fall Champion Audits (FCAs). PURPOSE The aim of this study was to assess the effect of FCAs on patient fall rates. METHODS FCAs were piloted on a medical-oncology unit. An interrupted time series design was used to assess the effect of FCAs on fall rates. INTERVENTION FCA is an audit conducted by the unit fall champion that assesses fall risk, interventions, and barriers among staff and patients. RESULTS Analysis suggested a significant decrease in fall rates from pre- (3.75) to postimplementation (1.62). FCAs worked in conjunction with a division-wide fall program in reducing fall rate. CONCLUSIONS FCAs, in conjunction with a fall program, are a feasible intervention in reducing fall rates.
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Costa MTTCA, Morais KMD, Cavanellas ACSP, Santos VEP, Corrêa ADR, Manzo BF. GAMES AS AN EDUCATIONAL TECHNOLOGY FOR THE INVOLVEMENT OF COMPANIONS IN PEDIATRIC PATIENT SAFETY: A QUALITATIVE STUDY. TEXTO & CONTEXTO ENFERMAGEM 2021. [DOI: 10.1590/1980-265x-tce-2020-0651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective to describe the meaning attributed to the use of a game as an educational technology for the involvement of companions in pediatric patient safety. Method a qualitative study carried out with 16 companions of children admitted to the Pediatric Unit of the public hospital in Minas Gerais, Brazil. Data collection took place from October to December 2019, through semi-structured interviews, after using the game as an educational technology. Symbolic Interactionism was used as the theoretical framework and Inductive Content Analysis, as the method. Results playing the game in search of patient safety was an important strategy for sharing knowledge and co-responsibility for the companions to engage in the pediatric patient safety actions, in addition to a relevant contribution to the prevention of adverse events. On the other hand, the professionals' overload and communication problems stood out as barriers to the establishment of a bond among the health team members and, consequently, the involvement of the companions in patient safety. Conclusion the companions recognized themselves as partners in the prevention of adverse events and highlighted some behavioral changes in favor of patient safety after participating in the playful intervention. Thus, it is considered that the game can be an important and interactive strategy for disseminating information to companions and family members and, consequently, favoring the increased participation of these actors in patient safety actions.
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Ree E, Wiig S, Braithwaite J, Aase I. To what degree and how do healthcare professionals in nursing homes and homecare practice user involvement? A mixed methods study. TIDSSKRIFT FOR OMSORGSFORSKNING 2020. [DOI: 10.18261/issn.2387-5984-2020-02-09] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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20
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Gonçalves KMDM, Costa MTTCA, Silva DCB, Baggio ME, Corrêa ADR, Manzo BF. Ludic strategy for promoting engagement of parents and caregivers in the safety of pediatric patients. ACTA ACUST UNITED AC 2020; 41:e20190473. [PMID: 33111766 DOI: 10.1590/1983-1447.2020.20190473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 04/01/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate a ludic strategy developed to promote the engagement of parents and caregivers in the pediatric patient safety actions. METHOD A qualitative research developed in the action-research modality, using the thematic content analysis method for data treatment, developed with caregivers of children admitted to the pediatric unit of the public hospital of Belo Horizonte, Minas Gerais, between May and October 2018. RESULTS Three thematic categories emerged: Learning about patient safety through the game; Game evaluation as a ludic strategy in promoting patient safety and; Change of perception and behavior of parents and caregivers in safety promotion actions. CONCLUSION The game was deemed as an important tool for patient safety knowledge transfer, motivating parents and caregivers to become more critical and more co-participant as for the hospitalized child care.
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Affiliation(s)
| | | | | | - Manuela Estrela Baggio
- Universidade Federal de Minas Gerais (UFMG), Escola de Enfermagem, Departamento de Enfermagem Básica. Belo Horizonte, Minas Gerais, Brasil
| | - Allana Dos Reis Corrêa
- Universidade Federal de Minas Gerais (UFMG), Escola de Enfermagem, Departamento de Enfermagem Básica. Belo Horizonte, Minas Gerais, Brasil
| | - Bruna Figueiredo Manzo
- Universidade Federal de Minas Gerais (UFMG), Escola de Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública. Belo Horizonte, Minas Gerais, Brasil
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Tobiano G, Jerofke‐Owen T, Marshall AP. Promoting patient engagement: a scoping review of actions that align with the interactive care model. Scand J Caring Sci 2020; 35:722-741. [DOI: 10.1111/scs.12914] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/22/2020] [Accepted: 09/07/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Georgia Tobiano
- Nursing and Midwifery Education and Research Unit Gold Coast Health Southport Qld Australia
- Menzies Health Institute Queensland Griffith University Southport Qld Australia
| | | | - Andrea P. Marshall
- Nursing and Midwifery Education and Research Unit Gold Coast Health Southport Qld Australia
- Menzies Health Institute Queensland Griffith University Southport Qld Australia
- School of Nursing and Midwifery, Griffith University Southport Qld Australia
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22
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Chegini Z, Janati A, Babaie J, Pouraghaei M. Exploring the barriers to patient engagement in the delivery of safe care in Iranian hospitals: A qualitative study. Nurs Open 2020; 7:457-465. [PMID: 31871731 PMCID: PMC6917972 DOI: 10.1002/nop2.411] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 10/01/2019] [Accepted: 10/07/2019] [Indexed: 12/19/2022] Open
Abstract
Aim To investigate barriers to patient engagement in the delivery of safe hospital care. Design Qualitative exploratory study. Methods A qualitative study with 35 Iranian health professionals was conducted from February to April 2019 using semi-structured interviews to elicit their opinions. MAXQDA 11 software was used for data management, and the data were analysed using framework analysis. Results Barriers, which potentially have negative impact on patient engagement in the delivery of safer care, were categorized into four themes. The first category included patient-related barriers such as low levels of health literacy, ineffective education, patient unwillingness and cultural barriers. The second category included staff-related barriers such as the existence of negative attitudes towards engaging patients in matters relating to patient safety, ineffective communication, high workload and the reluctance on the part of physicians to engage with patients. Barriers created by limited resources and inadequate training provided by universities and in the workplace formed the third category and community-related barriers such as the inadequate dissemination of information via the mass media and a lack of community-based services formed the fourth category. Conclusion Results demonstrate the multilayered nature of the significant barriers to the engagement of patients in the delivery of safe care and reflect the need for a collaborative approach between the recipients of care, researchers, care providers and policy makers if these are to be overcome.
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Affiliation(s)
- Zahra Chegini
- Department of Health Services ManagementFaculty of Management and Medical InformaticsTabriz University of Medical SciencesTabrizIran
| | - Ali Janati
- Department of Health Services ManagementFaculty of Management and Medical InformaticsTabriz University of Medical SciencesTabrizIran
- Iranian Center of Excellence in Health ManagementSchool of Management and Medical InformaticsTabriz University of Medical SciencesTabrizIran
| | - Javad Babaie
- Department of Health Services ManagementFaculty of Management and Medical InformaticsTabriz University of Medical SciencesTabrizIran
| | - Mahboub Pouraghaei
- Emergency Medicine Research TeamFaculty of MedicineTabriz University of Medical SciencesTabrizIran
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Park M, Giap TTT. Patient and family engagement as a potential approach for improving patient safety: A systematic review. J Adv Nurs 2019; 76:62-80. [PMID: 31588602 DOI: 10.1111/jan.14227] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 09/02/2019] [Accepted: 09/30/2019] [Indexed: 12/22/2022]
Abstract
AIMS To obtain a comprehensive insight of the impact of patient and family engagement on patient safety and identify issues in implementing this approach. BACKGROUND Patient and family engagement is increasingly emerging as a potential approach for improving patient safety. DESIGN Mixed method multilevel synthesis. DATA SOURCES PubMed, CINAHL, Embase, and Cochrance Library (January 2009-April 2018). REVIEW METHODS The review was conducted according to the principles recommended by the Cochrane Handbook for Systematic Review and in accordance with the PRISMA guidelines. RESULTS Forty-two relevant studies were identified. Common intervention groups included 'direct care' and 'organization' levels with 'consultation' and 'involvement' approaches, while the 'health system' level and 'partnership and shared leadership' approaches were rarely implemented. Findings revealed positive effects of the interventions on patient safety. Most study participants expressed their willingness to engage in or support patient and family engagement. However, existing gaps and barriers in implementing patient and family engagement were identified. CONCLUSION Future research should further focus on issuing consensus guidelines for implementing patient and family engagement in patient safety, extending the research scope for all aspects of patient and family engagement and patient safety and identifying priority areas for action that is suitable for each health facility. IMPACT Policymakers should issue guidelines for implementing patient and family engagement in healthcare systems which would enable healthcare providers to implement patient and family engagement and improve patient safety appropriately and effectively.
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Affiliation(s)
- Myonghwa Park
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - Thi-Thanh-Tinh Giap
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
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24
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Ericsson C, Skagerström J, Schildmeijer K, Årestedt K, Broström A, Pakpour A, Nilsen P. Can patients contribute to safer care in meetings with healthcare professionals? A cross -sectional survey of patient perceptions and beliefs. BMJ Qual Saf 2019; 28:657-666. [PMID: 31018984 PMCID: PMC6716360 DOI: 10.1136/bmjqs-2018-008524] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 03/05/2019] [Accepted: 04/06/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To investigate patients' perceptions of their meetings with healthcare professionals and the extent to which they believe they can influence patient safety in these meetings. DESIGN Cross-sectional survey of patients using a study-specific questionnaire. Data were analysed using both parametric and non-parametric statistics. SETTING The study was conducted in primary and secondary care in three county councils in southeast Sweden by means of a survey questionnaire despatched in January 2017. PARTICIPANTS Survey data were collected from 1445 patients, 333 of whom were complainants (patients who had filed a complaint about being harmed in healthcare) and 1112 regular patients (patients recruited from healthcare units). MAIN OUTCOME MEASURES Patients' perceptions of meetings with physicians and nurses, beliefs concerning patients' contributions to safer care and whether the patients had suffered harm in healthcare during the past 10 years. RESULTS Most respondents reported that it was easy to ask physicians and nurses questions (84.9% and 86.6%) and to point out if something felt odd in their care (77.7% and 80.7%). In general, complainants agreed to a higher extent compared with regular patients that patients can contribute to safer care (mean 1.92 and 2.13, p<0.001). Almost one-third (31.2%) of the respondents (both complainants and regular patients) reported that they had suffered harm in healthcare during the past 10 years. CONCLUSIONS Most respondents believed that healthcare professionals can facilitate patient interaction and increase patient safety by encouraging patients to ask questions and take an active part in their care. Further research will need to identify strategies to support such questioning in routine practice and ensure that it achieves its intended goals.
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Affiliation(s)
- Carin Ericsson
- Cardiology and Speciality Medicine Centre, Region Ostergotland, Linkoping, Sweden
- Department of Medical and Health Sciences, Linköping University, Linkoping, Sweden
| | - Janna Skagerström
- Department of Medical and Health Sciences, Linköping University, Linkoping, Sweden
- Research and Development Unit, Region Ostergotland, Linkoping, Sweden
| | | | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
- The Research Section, Kalmar County Council, Kalmar, Sweden
| | - Anders Broström
- Department of Nursing, School of Health and Welfare, Jonkoping University, Jonkoping, Sweden
- Department of Clinical Neurophysiology, Region Ostergotland, Linkoping, Sweden
| | - Amir Pakpour
- Department of Nursing, School of Health and Welfare, Jonkoping University, Jonkoping, Sweden
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Per Nilsen
- Department of Medical and Health Sciences, Linköping University, Linkoping, Sweden
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Chegini Z, Janati A, Bababie J, Pouraghaei M. The role of patients in the delivery of safe care in hospital: Study protocol. J Adv Nurs 2019; 75:2015-2023. [PMID: 31087572 DOI: 10.1111/jan.14045] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 02/18/2019] [Accepted: 03/13/2019] [Indexed: 12/17/2022]
Abstract
AIM This paper outlines the protocol for a study aimed at exploring perspectives about the role of patients' in the delivery of safe care in hospital. DESIGN Qualitative exploratory study. METHODS Research Ethics Committee approval for this study was obtained in October 2018. The study will be conducted between February-April 2019 with data collected through focus group discussions and semi-structured interviews and will involve patients and healthcare professionals from hospitals in Tabriz. A descriptive qualitative approach will be adopted, and the data will be managed and analysed using MAXQDA 10 software. DISCUSSION The role of patients in furthering their own safety whilst in hospital cannot be underestimated and the results from this study can be used to support the development of practical strategies that address the delivery of safe hospital care and which involve patients and their caregivers.
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Affiliation(s)
- Zahra Chegini
- Department of Health Services Management, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.,Students' Research Committee, School of Management and Medical Informatics, Tabriz University of Medical Science, Tabriz, Iran
| | - Ali Janati
- Department of Health Services Management, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.,Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Javad Bababie
- Department of Health Services Management, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahboub Pouraghaei
- Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran
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Ree E, Wiig S, Manser T, Storm M. How is patient involvement measured in patient centeredness scales for health professionals? A systematic review of their measurement properties and content. BMC Health Serv Res 2019; 19:12. [PMID: 30621682 PMCID: PMC6323701 DOI: 10.1186/s12913-018-3798-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 12/06/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patient centeredness is an important component of patient care and healthcare quality. Several scales exist to measure patient centeredness, and previous literature provides a critical appraisal of their measurement properties. However, limited knowledge exists regarding the content of the various scales in terms of what type of patient centeredness they represent and how they can be used for quality improvement. The aim of this study was to explore the measurement properties of patient centeredness scales and their content with a special focus on patient involvement, and assess whether and how they can be used for quality improvement. METHODS A systematic review of patient centeredness scales was conducted in Medline, CINAHL, Embase, and SCOPUS in April and May 2017. Inclusion criteria were limited to articles written in English published from 2005 to 2017. Eligible studies were critically appraised in terms of internal consistency and reliability, as well as their content, structural, and cross-cultural validity. Type of studies included were scale-development articles and validation studies of relevant scales, with healthcare personnel as respondents. We used directed content analysis to categorize the scales and items according to Tritter's conceptual framework for patient and public involvement. RESULTS Eleven scales reported in 22 articles were included. Most scales represented individual, indirect, and reactive patient involvement. Most scales included items that did not reflect patient centeredness directly, but rather organizational preconditions for patient centered practices. None of the scales included items explicitly reflecting the use of patient experiences of quality improvement. CONCLUSIONS There is a lack of patient centeredness scales focusing on direct and proactive involvement of patients in quality improvement. It would be useful to develop such instruments to further study the role of patient involvement in quality improvement in healthcare. Furthermore, they could be used as important tools in quality improvement interventions.
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Affiliation(s)
- Eline Ree
- SHARE – Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Siri Wiig
- SHARE – Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Tanja Manser
- SHARE – Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- FHNW School of Applied Psychology, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
| | - Marianne Storm
- SHARE – Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Skagerström J, Ericsson C, Nilsen P, Ekstedt M, Schildmeijer K. Patient involvement for improved patient safety: A qualitative study of nurses' perceptions and experiences. Nurs Open 2017; 4:230-239. [PMID: 29085649 PMCID: PMC5653393 DOI: 10.1002/nop2.89] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 06/19/2017] [Indexed: 11/16/2022] Open
Abstract
Aim To explore nurses’ perceptions and experiences of patient involvement relevant to patient safety. Design Qualitative design using individual semi‐structured interviews. Methods Interviews with registered nurses (n = 11) and nurse assistants (n = 8) were conducted in 2015–2016. Nurses were recruited from five different healthcare units in Sweden. The material was analysed using conventional content analysis. Results The analysis resulted in four categories: healthcare professionals’ ways of influencing patient involvement for safer care; patients’ ways of influencing patient involvement for safer care; barriers to patient involvement for safer care; and relevance of patient involvement for safer care. The nurses expressed that patient involvement is a shared responsibility. They also emphasized that healthcare provider has a responsibility to create opportunities for the patient to participate. According to the nurses, involvement can be hindered by factors related to the patient, the healthcare provider and the healthcare system. However, respondents expressed that patient involvement can lead to safer care and benefits for individual patients.
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Affiliation(s)
- Janna Skagerström
- Research and Development Unit in Region Östergötland and Department of Medical and Health Sciences Linköping University Linköping Sweden
| | - Carin Ericsson
- Centre of Heart and Medicine Region Östergötland Linköping Sweden
| | - Per Nilsen
- Department of Medical and Health Sciences Linköping University Linköping Sweden
| | - Mirjam Ekstedt
- Department of Health and Caring Sciences Linnaeus University Kalmar Sweden.,Department of Learning, Informatics, Management and Ethics Karolinska Institutet Stockholm Sweden
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