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Arjama AL. Ethical issues in long-term care settings: Care workers' lived experiences. Nurs Ethics 2024; 31:213-226. [PMID: 37541651 PMCID: PMC11181730 DOI: 10.1177/09697330231191277] [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] [Indexed: 08/06/2023]
Abstract
BACKGROUND Professional care workers face ethical issues in long-term care settings (LTCS) for older adults. They need to be independent and responsible, despite limited resources, a shortage of skilled professionals, global and societal changes, and the negative reputation of LTCS work. RESEARCH AIM Our aim was to describe the care workers' lived experiences of ethical issues. The findings can be used to gain new perspectives and to guide decision-making to improve the quality of care, occupational well-being and nursing education. RESEARCH DESIGN Focus group interviews were analyzed using a hermeneutic-phenomenological method. The analysis comprised three steps: naïve reading, structural analysis, and comprehensive understanding. PARTICIPANTS AND RESEARCH CONTEXT We randomly sampled LTCS service providers in Finland and 53 care workers with different educational backgrounds from seven organizations participated in focus group interviews in 2021. ETHICAL CONSIDERATIONS This was a sensitive study, which was connected to the participants' individual views of the world, professional ethics and social and health care legislation. The participants' provided informed consent and their anonymity was guaranteed. FINDINGS Care workers spoke about their lived experiences of ethical issues in an emotional way, using practical examples. They talked about how they were experts at caring and advocating for residents, balanced the responsibilities of their different roles, and defended their work to the wider society. The care workers said that ethical aspects of their work were too difficult to solve on their own. There were elements of their working environment and practices that caused unnecessary strain and they needed the commitment of managers, organizations, and society to solve ethical issues in LTCS. CONCLUSIONS Ethical issues were related to the well-being of both residents and care workers and reflected both internal and external pressures. Some issues could not be resolved by individuals and needed input from managers, organizations, and society.
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Terzi N, Fournier A, Lesieur O, Chappé J, Annane D, Chagnon JL, Thévenin D, Misset B, Diehl JL, Touati S, Outin H, Dauger S, Sement A, Drault JN, Rigaud JP, Laurent A. Perceived Quality of Life in Intensive Care Medicine Physicians: A French National Survey. J Intensive Care Med 2024; 39:230-239. [PMID: 37709265 DOI: 10.1177/08850666231199937] [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] [Indexed: 09/16/2023]
Abstract
Purpose: There is a growing interest in the quality of work life (QWL) of healthcare professionals and staff well-being. We decided to measure the perceived QWL of ICU physicians and the factors that could influence their perception. Methods: We performed a survey coordinated and executed by the French Trade Union of Intensive Care Physicians (SMR). QWL was assessed using the French version of the Work-Related Quality of Life (WRQoL) scale, perceived stress using the French version of 10 item-Perceived Stress Scale (PSS-10) and group functioning using the French version of the Reflexivity Scale, the Social Support at Work Questionnaire (QSSP-P). Results: 308 French-speaking ICU physicians participated. 40% perceived low WRQoL, mainly due to low general well-being, low satisfaction with working conditions and low possibility of managing the articulation between their private and professional lives. Decreased QWL was associated with being a woman (p = .002), having children (p = .022) and enduring many monthly shifts (p = .022). Conclusions: This work highlights the fact that ICU physicians feel a significant imbalance between the demands of their profession and the resources at their disposal. Communication and exchanges within a team and quality of social support appear to be positive elements to maintain and/or develop within our structures.
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Affiliation(s)
| | - Alicia Fournier
- Laboratoire de Psychologie : Dynamiques Relationnelles et Processus Identitaires (PsyDREPI), Université de Bourgogne Franche-Comté, Dijon, France
| | - Olivier Lesieur
- Intensive Care Unit, Saint Louis Hospital, La Rochelle, France
| | - Julien Chappé
- Laboratoire de Psychologie : Dynamiques Relationnelles et Processus Identitaires (PsyDREPI), Université de Bourgogne Franche-Comté, Dijon, France
| | - Djillali Annane
- General Intensive Care Unit, Hôpital Raymond Poincaré (APHP), Université de Versailles SQY and Université Paris Saclay, Garches, France
| | - Jean-Luc Chagnon
- General Intensive Care Unit, Centre hospitalier de Valenciennes, Valenciennes, France
| | - Didier Thévenin
- Médecine Intensive Réanimation, Centre Hospitalier de Lens, Lens, France
| | - Benoit Misset
- Intensive Care Department and Burn Center, University Hospital, Liège, Belgium
| | - Jean-Luc Diehl
- Service de médecine intensive Réanimation, Hôpital Européen Georges Pompidou, Université de Paris, Paris, France
| | - Samia Touati
- Réanimation médico-chirurgicale, Groupement hospitalier public du sud de l'Oise, Creil, France
| | - Hervé Outin
- Médecine Intensive Réanimation, Centre Hospitalier Intercommunal de Poissy - Saint-Germain-en-Laye 10 rue du Champ Gaillard, Poissy Cedex, France
| | - Stéphane Dauger
- Paediatric Intensive Care Unit, Robert-Debré University Hospital, Paris, France
| | - Arnaud Sement
- Réanimation Polyvalente, Centre Hospitalier Mont de Marsan, Urrugne, Nouvelle-Aquitaine, France
| | | | | | - Alexandra Laurent
- Laboratoire de Psychologie : Dynamiques Relationnelles et Processus Identitaires (PsyDREPI), Université de Bourgogne Franche-Comté, Dijon, France
- Department of Anaesthesiology and Critical Care Medicine, Dijon University Medical Centre, Dijon, France
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Panahi-Qoloub A, Zohari Anboohi S, Nasiri M, Vasli P. The impact of the education program based on dimensions of quality of work life among emergency medical services providers. BMC Health Serv Res 2024; 24:260. [PMID: 38419034 PMCID: PMC10903000 DOI: 10.1186/s12913-024-10610-2] [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: 10/07/2023] [Accepted: 01/17/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Quality of work life is a vital factor for health care providers. This study aimed to determine the impact of the education program based on dimensions of quality of work life among emergency medical services employees. METHODS The quasi-experimental study was conducted on 100 emergency medical services employees in Tehran, Iran, who were chosen using a convenience sampling method (50 in the intervention group and 50 in the control group). The information was gathered using a Demographic Questionnaire and a Walton Quality of Work Life Questionnaire with eight dimensions. The research was carried out in three stages: design, implementation, and evaluation of the education program. During the design phase, the educational needs of the participants were determined in terms of the dimensions of the quality of work life and work and total living space. The education program on work-life quality was implemented in four virtual group sessions, emphasizing the educational needs identified through uploading educational content to the WhatsApp application. The evaluation was conducted in two stages: before the education program and three months after the program. With a significance level of 0.05, the data was analyzed using SPSS version 24 software. RESULTS The results revealed that an education program on the quality of work life and its dimensions, emphasizing strategies to improve work and total living space, can improve the score of this dimension in the intra-group comparison of both the intervention and control groups (p = 0.046), as well as in the inter-group comparison, at the three-month post-intervention stage, there is a significant difference and a significant increase (p = 0.030), but it does not have a significant effect on the quality of work life and its other dimensions. CONCLUSION It is recommended that emergency medical services managers plan to improve the quality of working life of their employees, particularly in terms of work and total living space.
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Affiliation(s)
- Ali Panahi-Qoloub
- Student Research Commitee, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sima Zohari Anboohi
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvaneh Vasli
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Vali Asr Ave., Ayatollah Hashemi-Rafsanjani Cross Road, Tehran, Iran.
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Iwakiri K, Sotoyama M, Takahashi M, Liu X. Organization factors influencing quality of work life among seniors' care workers with severe low back pain. J Occup Health 2023; 65:e12378. [PMID: 36597868 PMCID: PMC9811339 DOI: 10.1002/1348-9585.12378] [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: 09/20/2022] [Revised: 11/13/2022] [Accepted: 11/29/2022] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES The prevalence of work-related low back pain (LBP) is high among care workers and can negatively affect quality of work life (QWL). To improve workplace satisfaction, this study aimed to identify factors influencing QWL among seniors' care workers with severe LBP. METHODS A questionnaire survey including items on demographics, qualifications, basic job responsibilities, job stressors, LBP severity, QWL, and job satisfaction was conducted in 2018. In total, 1000 senior care facilities were selected via random sampling and eight care workers per institution were asked to complete the survey. Multiple logistic regression analysis was used to identify independent factors influencing QWL of care workers with and without severe LBP. RESULTS Data from 1247 care workers with severe LBP and 2009 with nonsevere LBP were included in the analysis. Overall QWL was lower in the severe LBP group than in the nonsevere LBP group. In both groups, human relationships, workplace support, discretionary responsibility level, and working hours or time off were identified as common factors influencing QWL. In the severe LBP group, the salary was also a significant influence on QWL, while in the nonsevere LBP group, the number of workers, promotion or official position, and caregiving technique were identified as significant QWL factors. CONCLUSIONS The QWL of care workers with severe LBP was strongly influenced by salary. Since care workers suffering from severe LBP are working for a salary while enduring the pain and do not have found a worth doing, they need to prevent LBP and get job satisfaction and self-progress.
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Affiliation(s)
- Kazuyuki Iwakiri
- National Institute of Occupational Safety and HealthKawasakiJapan
| | - Midori Sotoyama
- National Institute of Occupational Safety and HealthKawasakiJapan
| | - Masaya Takahashi
- National Institute of Occupational Safety and HealthKawasakiJapan
| | - Xinxin Liu
- National Institute of Occupational Safety and HealthKawasakiJapan
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Cranley LA, Yeung L, Tu W, McGillis Hall L. Healthcare aide involvement in team decision‐making in long‐term care: A narrative review of the literature. J Clin Nurs 2022. [DOI: 10.1111/jocn.16573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 08/17/2022] [Accepted: 10/14/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Lisa A. Cranley
- Lawrence S. Bloomberg Faculty of Nursing University of Toronto Toronto Ontario Canada
| | - Lily Yeung
- Lawrence S. Bloomberg Faculty of Nursing University of Toronto Toronto Ontario Canada
| | - Wendy Tu
- Lawrence S. Bloomberg Faculty of Nursing University of Toronto Toronto Ontario Canada
- Home and Community Care Support Services Newmarket Ontario Canada
| | - Linda McGillis Hall
- Lawrence S. Bloomberg Faculty of Nursing University of Toronto Toronto Ontario Canada
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Koszalinski RS, Sturdevant DL, Olmos B, Kachale-Netter M, Smith P, Gordon J. "We Were Just Taking Our Marching Orders and Moving Forward With Whatever We Were Given": Policy Implications of Pandemic Quarantine and Social Isolation in Older Persons. THE PUBLIC POLICY AND AGING REPORT 2022; 32:136-139. [PMID: 36276435 PMCID: PMC9576014 DOI: 10.1093/ppar/prac020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Rebecca S Koszalinski
- Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Diana L Sturdevant
- Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Brenda Olmos
- Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Molly Kachale-Netter
- Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Patsy Smith
- Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Julie Gordon
- Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City, USA
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Buja A, Damiani G, Manfredi M, Zampieri C, Dentuti E, Grotto G, Sabatelli G. Governance for Patient Safety: A Framework of Strategy Domains for Risk Management. J Patient Saf 2022; 18:e769-e800. [PMID: 35067624 DOI: 10.1097/pts.0000000000000947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Adverse events in healthcare are primarily due to system failures rather than individuals. Risk reduction strategies should therefore focus on strengthening systems, bringing about improvements in governance, and targeting individual practices or products. The purpose of this study was to conduct a scoping review to develop a global framework of management strategies for sustaining a safety-oriented culture in healthcare organizations, focusing on patient safety and the adoption of good safety-related practices. METHODS We conducted a search on safety-related strategies in 2 steps. The first involved a search in the PubMed database to identify effective, broadly framed, cross-sector domains relevant to clinical risk management strategies in healthcare systems. In the second step, we then examined the strategies adopted by running a scoping review for each domain. RESULTS Our search identified 8 strategy domains relevant to patient safety: transformational leadership, patient engagement, human resources management quality, innovation technology, skills certification, education in patient safety, teamwork, and effective communication. CONCLUSIONS This scoping review explores management strategies key to healthcare systems' efforts to create safety-oriented organizations. Improvement efforts should focus particularly on the domains identified: combined together, they would nurture an overall safety-oriented culture and have an impact on preventable adverse events.
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Affiliation(s)
- Alessandra Buja
- From the Department of Cardiological, Thoracic, Vascular Sciences and Public Health, Padova
| | | | - Mariagiovanna Manfredi
- From the Department of Cardiological, Thoracic, Vascular Sciences and Public Health, Padova
| | - Chiara Zampieri
- From the Department of Cardiological, Thoracic, Vascular Sciences and Public Health, Padova
| | - Elena Dentuti
- University of Padua School of Nursing Sciences, Padova
| | - Giulia Grotto
- From the Department of Cardiological, Thoracic, Vascular Sciences and Public Health, Padova
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Beynon C, Siegel EO, Supiano K, Edelman LS. Working Dynamics of Licensed Nurses and Nurse Aides in Nursing Homes: A Scoping Review. J Gerontol Nurs 2022; 48:27-34. [PMID: 35511065 DOI: 10.3928/00989134-20220405-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Collaboration between licensed nurses (LNs) and nurse aides (NAs) is critical in the provision of quality care for residents living in nursing homes (NHs). The current scoping review explores how working dynamics between LNs and NAs in the NH setting are researched and described in the literature. Thirty-five articles were identified and reviewed that address the LN/NA relationship in the context of (a) the LN role as a supervisor and leader; (b) variation in structure; (c) expanding, understanding, and supporting staff roles; and (d) communication. We found that the LN/NA relationship has been primarily explored through the LN lens and often studied in the context of role expansion and revision associated with new models of care. Our contribution to the literature includes the following main points: efforts to improve LN/NA collaboration may be hindered without substantial structural change; collaboration may be limited within the hierarchal LN/NA relationship; LNs and NAs in NHs need greater support, recognition, and empowerment; and NAs require a representative voice. [Journal of Gerontological Nursing, 48(5), 27-34.].
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Beynon C, Supiano K, Siegel EO, Edelman LS, Hart SE, Madden C. Collaboration Between Licensed Nurses and Certified Nurse Aides in the Nursing Home: A Mixed Methods Study. Res Gerontol Nurs 2022; 15:16-26. [PMID: 35044861 DOI: 10.3928/19404921-20211209-05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The current mixed methods study explored how nursing team collaboration is perceived and experienced in four nursing homes (NHs) in the western United States. Licensed nurses (LNs) and certified nurse aides (CNAs) completed two survey tools to assess their perception of collaboration and team-work in their current work environment. LNs and CNAs were paired and interviewed individually and as a caregiving pair to explore the lived experience of collaboration in NH residents' care. Quantitative survey results were analyzed, and participants reported a collaborative working environment with equally strong ratings in the following categories: partnership, cooperation, and coordination; they agreed with statements reflective of teamwork, including team structure, leadership, situation monitoring, mutual support, and communication. No significant differences were found between LN and CNA responses or between team members in any of the four participating facilities. Qualitative survey data were analyzed using a thematic analysis approach. Findings revealed five primary themes, including essential elements in successful team collaboration-perspective, coworker connection, communication, mutual support, and "it makes a difference"-and ways teamwork and collaboration impact resident care. These findings provide rich insights into successful LN/CNA collaboration for academic and clinical LN and CNA educators. [Research in Gerontological Nursing, 15(1), 16-26.].
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10
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Ber R, London D, Senan S, Youssefi Y, Harter DH, Golfinos JG, Pacione D. Perioperative team communication through a mobile app for improving coordination and education in neurosurgery cases. J Neurosurg 2021; 136:1157-1163. [PMID: 34560644 DOI: 10.3171/2021.4.jns21485] [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: 02/23/2021] [Accepted: 04/13/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Miscommunication and poor coordination among surgical teams are known causes of preventable medical harms and operating room inefficiencies and inhibit surgical training. Technology may help overcome these challenges. This study used the personal experience of one of the authors as a former Air Force F-15 pilot to design a combat aviation pre- and postoperative communication workflow in the neurosurgery department and tested its effect on safety, efficiency, and education. The authors hypothesized that the adoption of this workflow through a tailored technological platform will increase compliance and improve the chances of sustainability. METHODS Data were prospectively collected from neurosurgery cases before (January-May 2020) and after (June-October 2020) implementation of this workflow. Briefing and debriefing were executed using a custom mobile platform and were defined as nonmandatory for all participants. All faculty and residents who operated at NYU Langone Medical Center (Tisch campus) during the intervention period were enrolled on the platform. Primary outcomes were morbidity and mortality per the department's criteria, and intraoperative last-minute requests as reported by operating room staff in a double-blinded fashion. Secondary outcomes were user responses on the subjective questionnaires. RESULTS Data were collected from 637 and 893 cases during the preintervention and intervention periods, respectively. The average briefing rates for residents and surgeons were 71% and 81%, respectively, and the average debriefing rates for residents and surgeons were 67% and 88%. There was no significant difference in preoperative risk score between the preintervention and intervention patient populations (p = 0.24). The rate of intraoperative last-minute requests significantly decreased from 16.6% (35/211) to 10.5% (35/334, p = 0.048). There was no significant change in morbidity and mortality between the preintervention and intervention periods. On subjective questionnaires there was a statistically significant improvement in safety, efficiency, and educational aspects of the cases during the intervention period. CONCLUSIONS Implementation of aviation-like structured team communication practices in the neurosurgery department through a technological platform improved education and communication between surgical teams and led to a reduction in last-minute surgical requests that could impact costs.
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Affiliation(s)
| | | | - Samya Senan
- 2Perioperative Services, NYU School of Medicine, New York, New York
| | - Yasmin Youssefi
- 2Perioperative Services, NYU School of Medicine, New York, New York
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Douglas JW, Jung SE, Noh H, Ellis AC, Ferguson CC. "If They Don't Like You, They Are Not Going to Eat for You": Individual and Interpersonal Factors Affecting Certified Nursing Assistants' Ability to Provide Mealtime Assistance to Residents With Dementia. THE GERONTOLOGIST 2021; 61:552-562. [PMID: 33000128 DOI: 10.1093/geront/gnaa145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES In long-term care facilities in the United States, certified nursing assistants (CNAs) provide mealtime assistance to residents with dementia, a task that substantially increases caregiver burden due to the time and attention required. The aim of this qualitative study was to explore the individual and interpersonal barriers and facilitators CNAs experience when providing mealtime assistance to residents with dementia. RESEARCH DESIGN AND METHODS Focus group questions were developed based on the corresponding levels of the Social Ecological Model. Using purposive sampling, 9 focus groups were conducted with 53 CNAs who had at least 1 year of experience as a CNA working with older adults. Focus groups were audio-recorded and transcribed verbatim. Data were analyzed using the directed content analysis approach. RESULTS CNAs reported individual skills, training, and personal characteristics that affected their ability to provide mealtime assistance. At the interpersonal level, CNAs identified their relationships with residents, residents' family members, and other health care professionals as factors that affect their ability to provide mealtime assistance. DISCUSSION AND IMPLICATIONS These findings provide evidence for strategies that administrators can utilize to reduce caregiver burden by improving the mealtime experience. First, CNAs need adequate training, particularly to develop communication skills. Developing verbal communication skills may improve interpersonal relationships between CNAs and residents' family members and other coworkers. Developing nonverbal communication skills may foster an improved relationship between CNAs and their residents with dementia. Future research should evaluate interventions that seek to improve these skills to determine their impact on the mealtime experience.
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Affiliation(s)
- Joy W Douglas
- Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa
| | - Seung Eun Jung
- Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa
| | - Hyunjin Noh
- School of Social Work, The University of Alabama, Tuscaloosa
| | - Amy C Ellis
- Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa
| | - Christine C Ferguson
- Department of Human Nutrition and Hospitality Management, The University of Alabama, Tuscaloosa
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Diep AN, Paquay M, Servotte JC, Dardenne N, Istas L, Van Ngoc P, Charlier M, Ghuysen A, Donneau AF. Validation of a French-language version of TeamSTEPPS® T-TPQ and T-TAQ questionnaires. J Interprof Care 2021; 36:607-616. [PMID: 34000961 DOI: 10.1080/13561820.2021.1902293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Teamwork training and evaluation are essential to enhance safety and quality of care. The lack of the psychometric testing of the TeamSTEPPS® Teamwork Attitudes Questionnaire (T-TAQ) and Teamwork Perceptions Questionnaire (T-TPQ) across different language and cultural settings has questioned their widespread use because such attitudes and perceptions are highly subjective and context-bound. The present study aims to translate the T-TAQ and T-TPQ into the French language and validate the psychometric properties of the two questionnaires in a public health context. A forward-backward translation process, panel reviewing, and pilot testing in two rounds were followed to develop the French versions. Confirmatory factor analysis (CFA) and Cronbach's alpha were used to examine the factor structure and internal consistency, whereas two-way mixed Intraclass Correlation Coefficient (ICC) was performed to assess test-retest reliability. A total of 235 healthcare professionals in the French-speaking community of Belgium completed the T-TAQ and T-TPQ. After two to four weeks, 102 participants took part in the second round. Despite good fit indices as revealed by the CFA and Cronbach's alpha from 0.53 to 0.75 for the five dimensions of the T-TAQ and 0.76 to 0.79 for the T-TPQ, the squared correlations among the constructs were higher than the average variance extracted. Two-way mixed ICCs indicated fair to good test-retest reliability for all the five constructs of the two questionnaires, except the leadership scale of the T-TAQ. The French-language versions of the T-TAQ and T-TPQ were semantically equivalent and culturally relevant with adequate test-retest reliability as compared to the English versions. These two instruments might be used to capture the overall attitude toward teamwork and perceptions of team skills and behaviors. Yet, further research is advisable to refine the scales to establish the discriminant validity of the different dimensions and discriminative power of the instruments.
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Affiliation(s)
- Anh Nguyet Diep
- Public Health Sciences Department, University of Liège, Liège, Belgium.,Information Technology Department, Can Tho University, Can Tho, Vietnam
| | - Méryl Paquay
- Medical Simulation Center of Liège, University of Liège, Public Health Sciences Department, Liège, Belgium
| | | | - Nadia Dardenne
- Public Health Sciences Department, University of Liège, Liège, Belgium
| | - Laure Istas
- Plateforme Pour l'Amélioration Continue de la Qualité des Soins et de la Sécurité des Patients, Brussels, Belgium
| | - Pauline Van Ngoc
- Unité de Recherche Soins Primaires et Santé Département de Médecine Générale, University of Liège, Liège, Belgium
| | - Mathilde Charlier
- Public Health Sciences Department, University of Liège, Liège, Belgium
| | - Alexandre Ghuysen
- Public Health Sciences Department, University of Liège, Liège, Belgium.,Medical Simulation Center of Liège, University of Liège, Public Health Sciences Department, Liège, Belgium
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Buljac-Samardzic M, Doekhie KD, van Wijngaarden JDH. Interventions to improve team effectiveness within health care: a systematic review of the past decade. HUMAN RESOURCES FOR HEALTH 2020; 18:2. [PMID: 31915007 PMCID: PMC6950792 DOI: 10.1186/s12960-019-0411-3] [Citation(s) in RCA: 145] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 09/05/2019] [Indexed: 05/19/2023]
Abstract
BACKGROUND A high variety of team interventions aims to improve team performance outcomes. In 2008, we conducted a systematic review to provide an overview of the scientific studies focused on these interventions. However, over the past decade, the literature on team interventions has rapidly evolved. An updated overview is therefore required, and it will focus on all possible team interventions without restrictions to a type of intervention, setting, or research design. OBJECTIVES To review the literature from the past decade on interventions with the goal of improving team effectiveness within healthcare organizations and identify the "evidence base" levels of the research. METHODS Seven major databases were systematically searched for relevant articles published between 2008 and July 2018. Of the original search yield of 6025 studies, 297 studies met the inclusion criteria according to three independent authors and were subsequently included for analysis. The Grading of Recommendations, Assessment, Development, and Evaluation Scale was used to assess the level of empirical evidence. RESULTS Three types of interventions were distinguished: (1) Training, which is sub-divided into training that is based on predefined principles (i.e. CRM: crew resource management and TeamSTEPPS: Team Strategies and Tools to Enhance Performance and Patient Safety), on a specific method (i.e. simulation), or on general team training. (2) Tools covers tools that structure (i.e. SBAR: Situation, Background, Assessment, and Recommendation, (de)briefing checklists, and rounds), facilitate (through communication technology), or trigger (through monitoring and feedback) teamwork. (3) Organizational (re)design is about (re)designing structures to stimulate team processes and team functioning. (4) A programme is a combination of the previous types. The majority of studies evaluated a training focused on the (acute) hospital care setting. Most of the evaluated interventions focused on improving non-technical skills and provided evidence of improvements. CONCLUSION Over the last decade, the number of studies on team interventions has increased exponentially. At the same time, research tends to focus on certain interventions, settings, and/or outcomes. Principle-based training (i.e. CRM and TeamSTEPPS) and simulation-based training seem to provide the greatest opportunities for reaching the improvement goals in team functioning.
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Affiliation(s)
- Martina Buljac-Samardzic
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Bayle building, p.o. box 1738, 3000 DR Rotterdam, The Netherlands
| | - Kirti D. Doekhie
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Bayle building, p.o. box 1738, 3000 DR Rotterdam, The Netherlands
| | - Jeroen D. H. van Wijngaarden
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Bayle building, p.o. box 1738, 3000 DR Rotterdam, The Netherlands
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Team inclusion and empowerment among nursing staff in long-term care. Geriatr Nurs 2019; 40:487-493. [DOI: 10.1016/j.gerinurse.2019.03.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 03/09/2019] [Accepted: 03/15/2019] [Indexed: 11/18/2022]
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A Saturated Approach to the Four-Phase, Brain-Based Simulation Framework for TeamSTEPPS® in a Pediatric Medicine Unit. Pediatr Qual Saf 2018; 3:e086. [PMID: 30229197 PMCID: PMC6135559 DOI: 10.1097/pq9.0000000000000086] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 05/16/2018] [Indexed: 11/26/2022] Open
Abstract
Introduction Although many organizations have reported successful outcomes as a result of Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), implementation can be challenging, with its share of administrative obstacles and lack of research that shows observable change in practice. Methods This quantitative, pretest/posttest design pilot research used a combination of classroom simulation-based instruction and in situ simulation in a Pediatrics department in an urban academic center. All personnel with direct patient care responsibilities (n = 547) were trained in TeamSTEPPS in an 8-week period. TeamSTEPPS course knowledge scores were compared pretraining to posttraining using the Wilcoxon rank-sum test. The performance of two-day and overnight shift teams, pre- and postintervention was assessed using the TeamSTEPPS Team Performance Observation Tool. Results TeamSTEPPS course knowledge improved from the beginning of the course to completion with median scores of 16 and 19, respectively (P < 0.001). Both day and evening postintervention groups demonstrated greater team performance scores than their control counterparts. Specifically, postintervention day shift team showed the greatest improvement and demonstrated more TeamSTEPPS behaviors. Conclusion This pilot study involving 1 department in an urban hospital showed that TeamSTEPPS knowledge and performance could be improved to increase patient safety and reduce medical errors. However, teams need to be trained within a shorter period so they can apply a shared-model of teamwork and communication. Leaders and educators throughout the department must also reinforce the behaviors and include them in every education intervention.
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Tiferes J, Bisantz AM. The impact of team characteristics and context on team communication: An integrative literature review. APPLIED ERGONOMICS 2018; 68:146-159. [PMID: 29409629 DOI: 10.1016/j.apergo.2017.10.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 09/13/2017] [Accepted: 10/29/2017] [Indexed: 06/07/2023]
Abstract
Many studies on teams report measures of team communication; however, these studies vary widely in terms of the team characteristics, situations, and tasks studied making it difficult to understand impacts on team communication more generally. The objective of this review is systematically summarize relationships between measures of team communication and team characteristics and situational contexts. A literature review was conducted searching in four electronic databases (PsycINFO, MEDLINE, Ergonomics Abstracts, and SocINDEX). Additional studies were identified by cross-referencing. Articles included for final review had reported at least one team communication measure associated with some team and/or context dimension. Ninety-nine of 727 articles met the inclusion criteria. Data extracted from articles included characteristics of the studies and teams and the nature of each of the reported team and/or context dimensions-team communication properties relationships. Some dimensions (job role, situational stressors, training strategies, cognitive artifacts, and communication media) were found to be consistently linked to changes in team communication. A synthesized diagram that describes the possible associations between eleven team and context dimensions and nine team communication measures is provided along with research needs.
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Affiliation(s)
- Judith Tiferes
- Department of Industrial and Systems Engineering, University at Buffalo, The State University of New York, United States.
| | - Ann M Bisantz
- Department of Industrial and Systems Engineering, University at Buffalo, The State University of New York, United States
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Abstract
Hospice aides are integral to the delivery of home hospice care and play an essential role in the effective communication and collaboration of the hospice interdisciplinary team. Despite their critical role, little is known about hospice aides' perceptions of their role in providing hospice services. This qualitative study explores hospice aides' perspectives of their work, their relationships with patients, families and interdisciplinary team members, and their contributions to end-of-life care. Two focus groups of hospice aides (N = 13), and 16 hours of observation of in-home caregiving were conducted. Focus group data were inductively and iteratively coded, and three themes were identified: 1) "We're the eyes and ears", 2) "We're kept out of the loop", and 3) "We have no voice." Aides described themselves as front-line providers based on the close relationships they formed with patients and family members, yet felt under-recognized by members of the hospice team. Observational field notes were reexamined with themes to confirm convergence of qualitative and observational data. Better understanding of their role could enhance integration of aides into patient- and family-centered team interactions, leading to both improved patient and family outcomes and retention and support of this critical component of the hospice workforce.
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Abstract
In 2015, the Academy for Leadership in Long-Term Care received a grant to provide interprofessional training on the strategies and techniques of TeamSTEPPS®. The results indicated significant changes in the participants' teamwork and communication strategies to improve resident safety. In part one of this article, the discussion includes the background, literature review, and design of this TeamSTEPPS academic partnership. J Contin Educ Nurs. 2016;47(11):490-492.
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Gray JA, Lukyanova V. Examining Certified Nursing Assistants’ Perceptions of Work-Related Identity. Creat Nurs 2017; 23:112-120. [DOI: 10.1891/1078-4535.23.2.112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: The purpose of this study was to examine certified nursing assistants’ (CNAs’) perceptions of their work identity within the context of their relationships with nursing facility residents and residents’ family members. Such information can help clarify CNAs’ roles and respond to their job needs. Although CNAs provide valuable care for residents, they often experience low status at work; it is important that they have opportunities to find value in their work.Methods: Eight focus groups were conducted with 45 CNAs from 4 nursing facilities. Thematic analysis and role theory were used to analyze the data.Results: Participants identified with the roles of connector, advocate, overloaded worker, and companion.Conclusions: CNAs expressed a lack of work-related control in the advocate and overloaded worker roles, and satisfaction in the companion role. Adequate organizational resources can help CNAs gain more satisfaction and effectiveness in their work.
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