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Kiljunen O, Savela RM, Välimäki T, Kankkunen P. Managers' perceptions of the factors affecting resident and patient safety work in residential settings and nursing homes: A qualitative systematic review. Res Nurs Health 2024; 47:397-408. [PMID: 38522016 DOI: 10.1002/nur.22382] [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: 10/19/2023] [Revised: 01/23/2024] [Accepted: 03/15/2024] [Indexed: 03/25/2024]
Abstract
Identifying ways to ensure resident safety is increasingly becoming a priority in residential settings and nursing homes. The aim of this qualitative systematic review was to identify, describe, and assess research evidence on managers' perceptions regarding the barriers and facilitators of daily resident and patient safety work in residential settings and nursing homes. A qualitative systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist. Published studies were sought through academic databases: Academic Search Premier, CINAHL, PubMed (MEDLINE), Scopus, SocINDEX, and Web of Science Core Collection in April 2023. Finally, 12 studies were included. The results of the included studies were synthesized using thematic synthesis after data extraction. According to the results, (1) competent staff and material resources; (2) management and culture; (3) communication, networks, optimal use of expertise; and (4) effective use of guidelines, rules, and regulations play a significant role in the success of resident and patient safety work. The findings revealed that promoting resident safety should not be seen solely as the responsibility of individual residential or nursing home personnel, as it requires multiprofessional cooperation and access to wider networks. Staff and managers must be receptive to learning, changing, and improving safety. Moreover, to ensure resident safety, it is essential to ensure that the organizations support safety work in residential and nursing home units.
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Affiliation(s)
- Outi Kiljunen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Roosa-Maria Savela
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Tarja Välimäki
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Päivi Kankkunen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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Wang Z, Shi Y, Shao L, Xie X, Li X, Zhang J. Adverse event reporting attitude and its individual and organizational predictors among nursing staff: A multisite study in Chinese nursing homes. Geriatr Nurs 2024; 58:104-110. [PMID: 38788557 DOI: 10.1016/j.gerinurse.2024.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 05/06/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024]
Abstract
This study explored the status of adverse event reporting attitudes and its predictors among nursing staff in Chinese nursing homes. A cross-sectional study was conducted with 475 nursing staff, and they completed sociodemographic and facility-related questionnaire, Incident Reporting Attitude Scale, Adverse Event Reporting Awareness Scale, and Nursing Home Survey on Patient Safety Culture. Univariate analysis and multiple linear regression models were performed. The mean score for adverse event reporting attitude was 125.87 (SD=15.35). The predictors included individual variables, such as education level (β=0.129, p = 0.001) and working years (β=-0.102, p = 0.007), and organizational variables, such as patient safety culture (β=0.503, p < 0.001) and adverse event reporting awareness (β=0.261, p < 0.001). These factors explained 35.3 % of total variance. Managers in nursing homes should strengthen team-targeted education and training for nursing staff with longer working years and lower educational backgrounds. Meanwhile, a simplified and non-punitive reporting system should be established to create positive safety management climate.
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Affiliation(s)
- Zhangan Wang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Ying Shi
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Lu Shao
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Xiyan Xie
- Department of Nursing, Home for the Aged Guangzhou, Guangdong, China
| | - Xiaozhen Li
- Department of Health Management, the People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - June Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
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Scott J, Sykes K, Waring J, Spencer M, Young-Murphy L, Mason C, Newman C, Brittain K, Dawson P. Systematic review of types of safety incidents and the processes and systems used for safety incident reporting in care homes. J Adv Nurs 2024. [PMID: 38895931 DOI: 10.1111/jan.16264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/15/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024]
Abstract
AIMS To identify the safety incident reporting systems and processes used within care homes to capture staff reports of safety incidents, and the types and characteristics of safety incidents captured by safety incident reporting systems. DESIGN Systematic review following PRISMA reporting guidelines. METHODS Databases were searched January 2023 for studies published after year 2000, written in English, focus on care homes and incident reporting systems. Data were extracted using a bespoke data extraction tool, and quality was assessed. Data were analysed descriptively and using narrative synthesis, with types and characteristics of incidents analysed using the International Classification for Patient Safety. DATA SOURCES Databases were CINAHL, MEDLINE, PsycINFO, EMBASE, HMIC, ASSISA, Nursing and Allied Health Database, MedNar and OpenGrey. RESULTS We identified 8150 papers with 106 studies eligible for inclusion, all conducted in high-income countries. Numerous incident reporting processes and systems were identified. Using modalities, typical incident reporting systems captured all types of incidents via electronic computerized reporting, with reports made by nursing staff and captured information about patient demographics, the incident and post-incident actions, whilst some reporting systems included medication- and falls-specific information. Reports were most often used to summarize data and identify trends. Incidents categories most often were patient behaviour, clinical process/procedure, documentation, medication/intravenous fluids and falls. Various contributing and mitigating factors and actions to reduce risk were identified. The most reported action to reduce risk was to improve safety culture. Individual outcomes were often reported, but social/economic impact of incidents and organizational outcomes were rarely reported. CONCLUSIONS This review has demonstrated a complex picture of incident reporting in care homes with evidence limited to high-income countries, highlighting a significant knowledge gap. The findings emphasize the central role of nursing staff in reporting safety incidents and the lack of standardized reporting systems and processes. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE The findings from this study can inform the development or adaptation of safety incident reporting systems in care home settings, which is of relevance for nurses, care home managers, commissioners and regulators. This can help to improve patient care by identifying common safety issues across various types of care home and inform learning responses, which require further research. IMPACT This study addresses a gap in the literature on the systems and processes used to report safety incidents in care homes across many countries, and provides a comprehensive overview of safety issues identified via incident reporting. REPORTING METHOD PRISMA. PATIENT OR PUBLIC CONTRIBUTION A member of the research team is a patient and public representative, involved from study conception.
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Affiliation(s)
- Jason Scott
- Northumbria University, Newcastle upon Tyne, UK
| | - Kate Sykes
- Northumbria University, Newcastle upon Tyne, UK
| | | | - Michele Spencer
- North Tyneside Community and Health Care Forum, North Shields, UK
| | | | - Celia Mason
- Northumbria University, Newcastle upon Tyne, UK
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Lund SB, Skolbekken JA, Mosqueda L, Malmedal W. Making Neglect Invisible: A Qualitative Study among Nursing Home Staff in Norway. Healthcare (Basel) 2023; 11:healthcare11101415. [PMID: 37239698 DOI: 10.3390/healthcare11101415] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Research shows that nursing home residents' basic care needs are often neglected, potentially resulting in incidents that threaten patients' safety and quality of care. Nursing staff are at the frontline for identifying such care practices but may also be at the root of the problem. The aim of this study was to generate new knowledge on reporting instances of neglect in nursing homes based on the research question "How is neglect reported and communicated by nursing home staff?" METHODS A qualitative design guided by the principles of constructivist grounded theory was used. The study was based on five focus-group discussions (20 participants) and 10 individual interviews with nursing staff from 17 nursing homes in Norway. RESULTS Neglect in nursing homes is sometimes invisible due to a combination of personal and organizational factors. Staff may minimize "missed care" and not consider it neglect, so it is not reported. In addition, they may be reluctant to acknowledge or reveal their own or colleagues' neglectful practices. CONCLUSION Neglect of residents in nursing homes may continue to occur if nursing staff's reporting practices are making neglect invisible, thus proceeding to compromise a resident's safety and quality of care for the foreseeable future.
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Affiliation(s)
- Stine Borgen Lund
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - John-Arne Skolbekken
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Laura Mosqueda
- Keck School of Medicine, University of Southern California, Los Angeles, CA 91803, USA
| | - Wenche Malmedal
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
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McGrane N, O'Regan S, Dunbar P, Dunnion M, Leistikow I, Keyes L. Management and reporting of safety incidents by residential care facilities in Ireland: A thematic analysis of statutory notifications. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4936-e4949. [PMID: 35876121 DOI: 10.1111/hsc.13905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 06/07/2022] [Accepted: 06/18/2022] [Indexed: 06/15/2023]
Abstract
The prevention of safety incidents (SI) in health and social care settings is an ongoing undertaking. Limited research has been conducted on SIs outside of acute care. Internationally residential care facilities (RCFs) are typically regulated to promote quality and safeguarding. A part of this regulation is the statutory responsibility of RCFs to notify the regulator about SIs. Notifications include details surrounding SIs and are used to inform the regulatory monitoring approach. The recent development of the Database of Statutory Notifications from Social Care in Ireland facilitates in-depth analysis of notifications which can be used to inform the management of SIs and thus, improve quality and safety. The aim of this study was to analyse narratives provided in statutory notifications for older persons and people with disability, in order to identify current management of SIs, system vulnerabilities and reporting practices. A Qualitative Descriptive approach was taken. A random sample of notifications received in 2018 was drawn and stratified by service-type and notification-type. Data extraction was conducted against priori agreed target areas of management, system vulnerabilities and reporting practices. Inductive thematic analysis was used identifying two parent themes: 'chronology' and 'regulatory input'. 'Chronology' subthemes included 'pre-event', 'immediate response' and 'continued response'. Measures that are resident focused and follow policies and protocols in RCFs to prevent or mitigate the seriousness of SIs were evident in the immediate response and continued response. The actions taken in the immediate and continued response in turn became part of the pre-event of future SIs. Under 'regulatory input' subthemes included 'inaccurate reporting', 'lines of inquiry', 'requests for further information', 'identification of repetitive patterns' and 'satisfactory conclusion'. In conclusion, RCFs manage SIs with short and longer term actions focused on resident wellbeing. These actions in turn become part of the pre-event of future SIs. Regulatory input highlighted regulatory burden.
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Affiliation(s)
- Niall McGrane
- Health Information and Quality Authority of Ireland (HIQA), Cork, Ireland
| | - Stephaine O'Regan
- Health Information and Quality Authority of Ireland (HIQA), Cork, Ireland
| | - Paul Dunbar
- Health Information and Quality Authority of Ireland (HIQA), Cork, Ireland
| | - Mary Dunnion
- Health Information and Quality Authority of Ireland (HIQA), Cork, Ireland
| | - Ian Leistikow
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, The Netherlands
- Dutch Health and Youth Care Inspectorate, Utrecht, The Netherlands
| | - Laura Keyes
- Health Information and Quality Authority of Ireland (HIQA), Cork, Ireland
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Using health information technology in residential aged care homes: An integrative review to identify service and quality outcomes. Int J Med Inform 2022; 165:104824. [DOI: 10.1016/j.ijmedinf.2022.104824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/07/2022] [Accepted: 06/22/2022] [Indexed: 11/24/2022]
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Afolalu OO, Jordan S, Kyriacos U. Medical error reporting among doctors and nurses in a Nigerian hospital: A cross-sectional survey. J Nurs Manag 2021; 29:1007-1015. [PMID: 33346942 DOI: 10.1111/jonm.13238] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/04/2020] [Accepted: 12/15/2020] [Indexed: 12/29/2022]
Abstract
AIM To compare doctors' and nurses' perceptions of factors influencing medical error reporting. BACKGROUND In Nigeria, there is limited information on determinants of error reporting and systems. METHODS From the total workforce (N = 600), 140 nurses and 90 doctors were selected by random sampling and completed the questionnaire February to March 2017. RESULTS All 140 nurses and 90 doctors approached responded. Inter-professional differences in response to sentinel events showed that 55/140, 39.3% nurses and 48/90, 53.3% doctors would never report wrong medicines administered and 49/138, 35.5% nurses and 35/90, 38.9% doctors would never report a haemolytic transfusion error. Some respondents (72/140, 51.4% nurses vs. 29/90, 32.2% doctors) were unaware of reporting systems. Most (77/140, 55% nurses vs. 48/90, 53.3% doctors) considered these to be ineffective and confounded by a 'blame culture'. Perceived barriers included lack of confidentiality; facilitators included clear guidelines about protection from litigation. CONCLUSIONS Error reporting is suboptimal. Nurses and doctors have a minimal common understanding of barriers to error reporting and demonstrate inconsistent practice. IMPLICATIONS FOR NURSING MANAGEMENT Suboptimal reporting of serious adverse events has implications for patient safety. Managers need to prioritize education in adverse events, clarify reporting procedures and divest the organisation of a 'blame culture'.
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Affiliation(s)
- Olamide O Afolalu
- Division of Nursing and Midwifery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Sue Jordan
- School of Human and Health Sciences, Swansea University, Wales, UK
| | - Una Kyriacos
- Division of Nursing and Midwifery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Johannessen T, Ree E, Aase I, Bal R, Wiig S. Exploring challenges in quality and safety work in nursing homes and home care - a case study as basis for theory development. BMC Health Serv Res 2020; 20:277. [PMID: 32245450 PMCID: PMC7118914 DOI: 10.1186/s12913-020-05149-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 03/24/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Management, culture and systems for better quality and patient safety in hospitals have been widely studied in Norway. Nursing homes and home care, however have received much less attention. An increasing number of people need health services in nursing homes and at home, and the services are struggling with fragmentation of care, discontinuity and restricted resource availability. The aim of the study was to explore the current challenges in quality and safety work as perceived by managers and employees in nursing homes and home care services. METHOD The study is a multiple explorative case study of two nursing homes and two home care services in Norway. Managers and employees participated in focus groups and individual interviews. The data material was analyzed using directed content analysis guided by the theoretical framework 'Organizing for Quality', focusing on the work needed to meet quality and safety challenges. RESULTS Challenges in quality and safety work were interrelated and depended on many factors. In addition, they often implied trade-offs for both managers and employees. Managers struggled to maintain continuity of care due to sick leave and continuous external-facilitated change processes. Employees struggled with heavier workloads and fewer resources, resulting in less time with patients and poorer quality of patient care. The increased external pressure affected the possibility to work towards engagement and culture for improvement, and to maintain quality and safety as a collective effort at managerial and employee levels. CONCLUSION Despite contextual differences due to the structure, size, nature and location of the nursing homes and home care services, the challenges were similar across settings. Our study indicates a dualistic contextual dimension. Understanding contextual factors is central for targeting improvement interventions to specific settings. Context is, however, not independent from the work that managers do; it can be and is acted upon in negotiations and interactions to better support managers' and employees' work on quality and safety in nursing homes and home care.
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Affiliation(s)
- Terese Johannessen
- Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Kjell Arholms gate 39, 4021, Stavanger, Norway.
| | - Eline Ree
- Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Kjell Arholms gate 39, 4021, Stavanger, Norway
| | - Ingunn Aase
- Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Kjell Arholms gate 39, 4021, Stavanger, Norway
| | - Roland Bal
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, The Netherlands
| | - Siri Wiig
- Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Kjell Arholms gate 39, 4021, Stavanger, Norway
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Braiki R, Douville F, Hasine AB, Souli I. [Factors of reporting adverse events in a Tunisian hospital.]. SANTE PUBLIQUE 2020; Vol. 31:553-559. [PMID: 31959256 DOI: 10.3917/spub.194.0553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION We wish to integrate an adverse events reporting system in a Tunisian University Hospital. However, before the implantation of this system, it is important to identify the factors that may influence the reporting, so it is primordial to conduct a study which aims to determine influencing factors of adverse events reporting according to the perception of health care professionals. METHOD A cross-sectional descriptive study was conducted between July and September 2014, using a questionnaire which was developed in the light of Reason’s works on safety culture (1990; 1997), and the Pffeifer, Manser and Wahner (2010) model of influencing factors of adverse events reporting. This questionnaire was self-administered to 46 physicians, 21 health technicians, 65 nurses and 18 practical nurses working in a Tunisian Hospital. Data analysis was conducted using SPSS. RESULTS The main obstacles identified were: lack of staff training (78.7%) and lack of precision on the types of events reported (76.7%). However, the three main facilitators are the establishment of a safety culture (88%), the commitment of decision makers in the safety culture (81.3%) and the absence of punishment (78, 7%). CONCLUSION A policy and managerial consideration of the main factors influencing reporting of adverse events, as well as suggestions from health professionals, is necessary to ensure a good adoption of the reporting system by healthcare institutions in Tunisia.
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Bourbonnais A, Rousseau J, Lalonde MH, Meunier J, Lapierre N, Gagnon MP. Perceptions and needs regarding technologies in nursing homes: An exploratory study. Health Informatics J 2019; 26:1714-1727. [PMID: 31797712 DOI: 10.1177/1460458219889499] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Two of the most salient problems in nursing homes are the responsive behaviours and falls of older people living with Alzheimer's disease and related disorders. Intelligent videomonitoring and mobile applications are potential technologies that may help prevent and manage these problems. However, evidence for the needs for technologies in nursing homes is scarce. This study aimed to explore the perceptions and needs of care managers, and of formal and family caregivers in nursing homes regarding these potential technologies. With an exploratory qualitative design based on Rogers' diffusion of innovation theory, individual interviews and a content analysis were conducted. Results show that the potential users of these technologies consider them relevant in nursing homes. The characteristics that would make these technologies useful in nursing homes are described. These results could be used to develop useful technologies to improve the quality of clinical practice in nursing homes.
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Affiliation(s)
| | - Jacqueline Rousseau
- Université de Montréal, Canada; Research Centre of the Institut universitaire de gériatrie de Montréal, Canada
| | | | | | - Nolwenn Lapierre
- Research Centre of the Institut universitaire de gériatrie de Montréal, Canada
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11
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Bourbonnais A, Rousseau J, Lalonde MH, Meunier J, Lapierre N, Gagnon MP. Conditions and ethical challenges that could influence the implementation of technologies in nursing homes: A qualitative study. Int J Older People Nurs 2019; 14:e12266. [PMID: 31475466 DOI: 10.1111/opn.12266] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/26/2019] [Accepted: 07/18/2019] [Indexed: 11/28/2022]
Abstract
AIM To explore the conditions that may influence the implementation of an interactive mobile application (app) and an intelligent videomonitoring system (IVS) in nursing homes (NHs) and the ethical challenges of their use. BACKGROUND There is a lack of knowledge about implementing technologies in NHs and the ethical challenges that might arise. In past studies, nursing care teams expressed the need for technologies offering clinical support. Technologies like an IVS and an app could prove useful in NHs to prevent and manage falls and responsive behaviours. DESIGN An exploratory qualitative study was conducted with care managers, family caregivers and formal caregivers in five NHs. METHODS Each participant was shown a presentation of a potential app and a short video on an IVS. It was followed by an individual semi-structured interview. A conventional content analysis was performed. FINDINGS Potential users found it would be possible to implement these technologies in NHs even if resistance could be expected. To facilitate adoption and achieve clinical benefits, the implementation of technologies should be pilot-tested, and coaching activities should be planned. Ethical risks were considered already present in NHs even without technologies, for example, risks to privacy. Strategies were proposed, for instance, to adapt the code of ethics and procedures. Some potential prejudices about the interest and abilities of older staff, nurses' aides, and family caregivers to use technology were identified. CONCLUSIONS Through rigorous and ethical implementation, technologies supporting clinical care processes could benefit older people living in NHs, as well as their relatives and the staff. IMPLICATIONS FOR PRACTICE Various strategies are proposed to successfully implement technologies. Effort should be made to avoid prejudices during implementation, and procedures should be adapted to mitigate possible ethical challenges.
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Affiliation(s)
- Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.,Research Centre of the Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Jacqueline Rousseau
- Research Centre of the Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.,School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
| | - Marie-Hélène Lalonde
- Research Centre of the Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Jean Meunier
- Department of Computer Science and Operations Research, Université de Montréal, Montréal, QC, Canada
| | - Nolwenn Lapierre
- Research Centre of the Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Marie-Pierre Gagnon
- Faculty of Nursing, Université Laval, Québec City, QC, Canada.,Research Centre of the Centre hospitalier universitaire de Québec, Québec City, QC, Canada
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12
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Mansouri SF, Mohammadi TK, Adib M, Lili EK, Soodmand M. Barriers to nurses reporting errors and adverse events. ACTA ACUST UNITED AC 2019; 28:690-695. [PMID: 31188653 DOI: 10.12968/bjon.2019.28.11.690] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM this study aimed to assess nurses' views about major barriers to reporting errors and adverse events in intensive care units. METHOD a descriptive analytical study was used to examine barriers to reporting such events. A questionnaire was completed by 251 nurses across seven hospitals in Iran to elicit information about their views on reporting errors and adverse events. RESULTS the study identified three main areas that prevented the reporting of incidents-fear of the consequences after reporting an error, procedural barriers and management barriers. CONCLUSION the most important approach to overcoming barriers that prevent nurses reporting adverse events would be to develop an atmosphere within which all nurses can report errors and the reasons that led to their occurrence honestly and without fear.
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Affiliation(s)
- Seyedeh Fereshteh Mansouri
- MSc Student of Intensive Care Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Tahereh Khaleghdoost Mohammadi
- Instructor, Department of Medical-Surgical Nursing, Social Determinants of Health Research Center, Shahid Beheshti Faculty of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Masoomeh Adib
- PhD Candidate in Nursing Education, Department of Medical-Surgical Nursing, Social Determinants of Health Research Center, Shahid Beheshti Faculty of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Ehsan Kazemnejad Lili
- Associated Professor of Biostatistics, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Mostafa Soodmand
- MSc Student of Medical-surgical Nursing, Student Research Committee, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
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López-Soto PJ, García-Arcos A, Fabbian F, Manfredini R, Rodríguez-Borrego MA. Falls Suffered by Elderly People From the Perspective of Health Care Personnel: A Qualitative Study. Clin Nurs Res 2017; 27:675-691. [PMID: 28446035 DOI: 10.1177/1054773817705532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
An exploratory interpretative study was carried out to recognize the factors regarded by health care professionals as potential obstacles to the evaluation, prevention, and documentation of falls in persons above 65 years of age. Focus groups and questionnaires were carried out. Audio recordings were made, and these were subsequently transcribed and analyzed in accordance with the Bardin's thematic content analysis. Four focus groups of four persons were set up, and 16 questionnaires were returned. Four thematic categories were obtained. The analysis showed a lack of data in records of falls, perhaps for reasons of overwork, lack of motivation, awareness, or consistency in the registration systems in use. Health care professionals document two types of fall, depending on the elderly person's ability to carry out everyday tasks. There is not a rigorous and systematic approach for recording falls. Perspectives from health care professionals could help in analyzing the causes of falls and suggesting comprehensive preventive measures.
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Affiliation(s)
- Pablo J López-Soto
- 1 Department of Nursing, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Córdoba, Spain
| | - A García-Arcos
- 1 Department of Nursing, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Córdoba, Spain
| | - F Fabbian
- 2 Clinica Medica, Department of Medical Science, University of Ferrara, Ferrara, Italy
| | - R Manfredini
- 2 Clinica Medica, Department of Medical Science, University of Ferrara, Ferrara, Italy
| | - M A Rodríguez-Borrego
- 1 Department of Nursing, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Córdoba, Spain
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Hong S, Li Q. The reasons for Chinese nursing staff to report adverse events: a questionnaire survey. J Nurs Manag 2017; 25:231-239. [PMID: 28244248 DOI: 10.1111/jonm.12461] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Su Hong
- The 2 Affiliated Hospital & College of Nursing; Harbin Medical University; Harbin China
| | - QiuJie Li
- The 2 Affiliated Hospital & College of Nursing; Harbin Medical University; Harbin China
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Degenholtz HB, Resnick A, Lin M, Handler S. Development of an Applied Framework for Understanding Health Information Technology in Nursing Homes. J Am Med Dir Assoc 2016; 17:434-40. [PMID: 26975206 DOI: 10.1016/j.jamda.2016.02.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 02/01/2016] [Accepted: 02/01/2016] [Indexed: 11/28/2022]
Abstract
There is growing evidence that Health Information Technology (HIT) can play a role in improving quality of care and increasing efficiency in the nursing home setting. Most research in this area, however, has examined whether nursing homes have or use any of a list of available technologies. We sought to develop an empirical framework for understanding the intersection between specific uses of HIT and clinical care processes. Using the nominal group technique, we conducted a series of focus groups with different types of personnel who work in nursing homes (administrators, directors of nursing, physicians, mid-level practitioners, consultant pharmacists, and aides). The resulting framework identified key domain areas that can benefit from HIT: transfer of data, regulatory compliance, quality improvement, structured clinical documentation, medication use process, and communication. The framework can be used to guide both descriptive and normative research.
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Affiliation(s)
- Howard B Degenholtz
- Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, PA.
| | - Abby Resnick
- Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, PA
| | - Michael Lin
- Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, PA
| | - Steven Handler
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA
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Effects of skilled nursing facility structure and process factors on medication errors during nursing home admission. Health Care Manage Rev 2014; 39:340-51. [DOI: 10.1097/hmr.0000000000000000] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wagner LM, Roup BJ, Castle NG. Impact of infection preventionists on Centers for Medicare and Medicaid quality measures in Maryland nursing homes. Am J Infect Control 2014; 42:2-6. [PMID: 24388467 PMCID: PMC7132677 DOI: 10.1016/j.ajic.2013.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 07/17/2013] [Accepted: 07/17/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND Health care-associated infections are the leading cause of morbidity and mortality in US nursing homes (NHs). The objective of the research is to assess the impact of Maryland NH infection preventionists (IPs) on NH quality measures. METHODS Two hundred thirty-four NHs were queried through mailed survey. These survey data were then linked with 2008 quality data from Nursing Home Compare and the On-line Survey Certification of Automated Records. RESULTS Three of the 8 quality measures examined-influenza vaccination for both short- and long-stay residents and pressure ulcer prevention in high-risk residents-were significantly associated with the number of IPs. None of the quality measures were shown to be significant with IPs who received specialized training on infection prevention and management compared with those who did not receive specialized training. CONCLUSION IPs play a critical role in preventing and managing health care-associated infections in nursing homes, especially in the areas of influenza vaccination and pressure ulcer prevention among high-risk nursing home residents. Quality measures that reflect the effects of IP training may not have been elucidated yet. Further research is needed to support the IP role in order for policy to advocate for increased IP funding.
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Affiliation(s)
- Laura M Wagner
- University of California, San Francisco, School of Nursing, Department of Community Health Systems, San Francisco, CA.
| | - Brenda J Roup
- Department of Infection Prevention and Control, Prevention and Health Promotion Administration, Infectious Disease Bureau, Office of Infectious Disease Epidemiology and Outbreak Response, Maryland Department of Health and Mental Hygiene, Baltimore, MD
| | - Nicholas G Castle
- Department of Health Policy & Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
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