1
|
Hotta S, Ashida K, Tanaka M. Night Physician-Nurse Collaboration: Developing the Scale of Physicians' Difficulties and Exploring Related Factors in Acute Care Hospitals. J Multidiscip Healthc 2024; 17:2831-2845. [PMID: 38881754 PMCID: PMC11180433 DOI: 10.2147/jmdh.s454578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/18/2024] [Indexed: 06/18/2024] Open
Abstract
Background Responding to inpatient deterioration is less favorable at night than during the day, and this may be related to barriers in collaboration between physicians and nurses. However, there had been no way to assess the problem. This study aimed to develop a scale for physicians to measure difficulties in nighttime collaboration with nurses in response to deteriorating inpatients and to identify factors associated with the developed scale scores. Methods We developed a draft scale of Nighttime Collaboration Difficulties between Nurses and Physicians for Physicians (NCDNP-P) based on key informant interviews with physicians. Psychometric validations, including structural validity, criterion-related validity, and reliability tests, were conducted among physicians who worked on night duty or on call in acute-care hospitals in Japan using a cross-sectional web-based questionnaire. Multiple linear regression analyses were performed using independent variables including individual backgrounds, style of working at night, and facility characteristics. Results By performing exploratory factor analysis, we confirmed the structural validity of the NCDNP-P, consisting of seven items and two domains (Domain 1: Dissatisfaction with reporting, Domain 2: Barriers to working with nurses). Cronbach's alpha and McDonald's omega coefficients were 0.81-0.84 and 0.81-0.89, respectively. The criterion-related validity for interprofessional collaboration was confirmed. Multiple regression analysis revealed that the variables employment status, number of night shifts, frequency of nighttime calls about patients under another physician's charge, and handover between physicians before changing shifts were statistically significantly associated with NCDNP-P scores. Conclusion We developed the NCDNP-P, confirming its reliability and validity. Identified factors reflect physicians' characteristics and the problems experienced working at night and may be associated with barriers in nighttime collaboration. The NCDNP-P can highlight issues in clinical settings and lead to the consideration of initiatives to address such issues.
Collapse
Affiliation(s)
- Soichiro Hotta
- Department of Adult Health Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Kaoru Ashida
- Department of Nursing, College of Nursing, Kanto Gakuin University, Kanazawa-ku, Yokohama, Japan
| | - Makoto Tanaka
- Department of Adult Health Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| |
Collapse
|
2
|
Alnezary FS, Alamri AR, Alrehaili RD, Alnizari DS, Alzahrani F, Mahmoud M, Almutairi MS, Kurdi A, Godman B. Managing infectious diarrhea among young children in community pharmacies in Saudi Arabia and the implications for AMR. Front Pediatr 2024; 12:1342493. [PMID: 38562134 PMCID: PMC10982503 DOI: 10.3389/fped.2024.1342493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Diarrhea remains a major global health issue for children under five, contributing substantially to morbidity and mortality. Community pharmacists play a pivotal role in the management of these children; however, their competence in managing childhood diarrhea in Saudi Arabia is under-researched. This is important to ensure optimal patient care. Method Simulated patients (SPs) presenting with three pediatric diarrhea scenarios were used to evaluate pharmacists' practice in terms of their counselling, history taking, over-the-counter (OTC) prescribing, medication instructions, diet/fluid advice, and/or information provision. Pharmacists' practice was categorized into adequate, less adequate, and poor. Results 182 community pharmacists, primarily male and non-Saudi, participated in the study, of which 60% were in chain pharmacies. Only 5% showed adequate practice in currently managing pediatric diarrhea. Of the 182 simulated patient visits, 62% received medication in all three scenarios and 20% were referred to physicians, with 16% of pharmacists failing to provide any form of intervention. The main medications recommended were kaolin (34%), pectin (34%) and metronidazole (11%). While most pharmacists (86%) asked about the patient's identity and age, 15% provided incorrect management information, 16% failed to provide guidance on the prescribed medicines, and 18% dispensed antimicrobials without a valid prescription. Conclusion A high level of inadequate management of pediatric diarrhea in Saudi Arabia was observed. This highlights the need for extensive training to improve community pharmacists' practice in service delivery including providing counselling and advice on the appropriate management of childhood diarrhea. The latter is particularly important to reduce antimicrobial resistance.
Collapse
Affiliation(s)
- Faris S. Alnezary
- Department of Pharmacy Practice, College of Pharmacy, Taibah University, Madinah, Saudi Arabia
| | - Amira R. Alamri
- Department of Pharmacy Practice, College of Pharmacy, Taibah University, Madinah, Saudi Arabia
| | - Rafa D. Alrehaili
- Department of Pharmacy Practice, College of Pharmacy, Taibah University, Madinah, Saudi Arabia
| | - Dina S. Alnizari
- Department of Pharmacy Practice, College of Pharmacy, Taibah University, Madinah, Saudi Arabia
| | - Fahad Alzahrani
- Department of Pharmacy Practice, College of Pharmacy, Taibah University, Madinah, Saudi Arabia
| | - Mansour Mahmoud
- Department of Pharmacy Practice, College of Pharmacy, Taibah University, Madinah, Saudi Arabia
| | - Masaad S. Almutairi
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim, Saudi Arabia
| | - Amanj Kurdi
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Clinical Pharmacy, College of Pharmacy, Hawler Medical University, Erbil, Iraq
- Department of Clinical Pharmacy, College of Pharmacy, Al-Kitab University, Kirkuk, Iraq
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| |
Collapse
|
3
|
Datta V, Srivastava S, Lalwani K, Garde R, Patnaik SK, Venkatagiri P, Pradeep J, Bangal V, Pemde H, Kumar A, Sooden A, Vijayan S, Sawleshwarkar K, Mehta R, Raina N, Khanna R, Singh V, Singh P, Saha K, Sharma C, Jain S. Creating and sustaining a digital community of practice for quality improvement in South-East Asia during the COVID-19 pandemic. BMJ Open Qual 2023; 12:e002370. [PMID: 37863508 PMCID: PMC10603542 DOI: 10.1136/bmjoq-2023-002370] [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: 04/11/2023] [Accepted: 06/11/2023] [Indexed: 10/22/2023] Open
Abstract
INTRODUCTION Ensuring quality of care in Low and Middle Income countries (LMICs) is challenging. Despite the implementation of various quality improvement (QI) initiatives in public and private sectors, the sustenance of improvements continues to be a major challenge. A team of healthcare professionals in India developed a digital community of practice (dCoP) focusing on QI which now has global footprints. METHODOLOGY The dCoP was conceptualised as a multitiered structure and is operational online at www.nqocncop.org from August 2020 onwards. The platform hosts various activities related to the quality of care, including the development of new products, and involves different cadres of healthcare professionals from primary to tertiary care settings. The platform uses tracking indicators, including the cost of sustaining the dCoP to monitor the performance of the dCoP. RESULT Since its launch in 2020, dCoP has conducted over 130 activities using 13 tools with 25 940 registration and 13 681 participants. From April 2021, it has expanded to countries across the South-East Asia region and currently has participants from 53 countries across five continents. It has developed 20 products in four thematic areas for a targeted audience. dCoP is supporting mentoring of healthcare professionals from five countries in the South-East Asia region in their improvement journey. Acquiring new knowledge and improvement in their daily clinical practice has been reported by 93% and 80% of participants, respectively. The dCoP and its partners have facilitated the publication of nearly 40 articles in international journals. CONCLUSION This dCoP platform has become a repository of knowledge for healthcare professionals in the South-East Asia region. The current paper summarises the journey of this innovative dCoP in an LMIC setting for a wider global audience.
Collapse
Affiliation(s)
- Vikram Datta
- Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences & Dr Ram Manohar Lohia Hospital, New Delhi, Delhi, India
| | - Sushil Srivastava
- Pediatrics, University College of Medical Sciences, New Delhi, Delhi, India
| | | | - Rahul Garde
- Quality Improvement, NQOCN, New Delhi, Delhi, India
| | - Suprabha K Patnaik
- Neonatology, Bharati Vidyapeeth Deemed University Medical College, Pune, Maharastra, India
| | | | - Jeena Pradeep
- Nursing, Ministry of Health and Family Welfare, India, New Delhi, Delhi, India
- Pediatrics, Kalawati Saran Children's Hospital, New Delhi, Delhi, India
| | - Vidhyadhar Bangal
- Obstetrics and Gynaecology, Pravara Institute of Medical Sciences, Loni, Maharashtra, India
- Centre for Social Medicine, Pravara Institute of Medical Sciences, Loni, Maharashtra, India
| | - Harish Pemde
- Paediatrics, Lady Hardinge Medical College, New Delhi, Delhi, India
| | - Achala Kumar
- Nursing, Ministry of Health and Family Welfare, India, New Delhi, Delhi, India
| | - Ankur Sooden
- Private Sector Engagement, JSI India, New Delhi, Delhi, India
| | - Shreeja Vijayan
- Child Health Nursing, Choithram College of Nursing and Choithram Hospital & Research Centre, Indore, Madhya Pradesh, India
| | | | | | - Neena Raina
- World Health Organization - South East Asia Regional Office, New Delhi, Delhi, India
| | - Rajesh Khanna
- World Health Organization - South East Asia Regional Office, New Delhi, Delhi, India
| | - Vivek Singh
- Health Section, UNICEF India, New Delhi, Delhi, India
| | | | - Khushboo Saha
- The University of Texas Southwestern Medical Center at Dallas Library, Dallas, Texas, USA
| | - Chhavi Sharma
- Pediatrics, Kalawati Saran Children's Hospital, New Delhi, Delhi, India
| | - Sonam Jain
- Quality Improvement, NQOCN, New Delhi, Delhi, India
| |
Collapse
|
4
|
An HY, Choi YJ, Lee SH, Kim MS, Park HJ, Kim BK, Choi JY, Kang HJ, Lee S, Hong KT. Introduction of Supervisor-Type Pediatric Hospitalists in a Tertiary Children's Hospital: Experiences in a Hematology/Oncology Ward. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1400. [PMID: 37628399 PMCID: PMC10453551 DOI: 10.3390/children10081400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023]
Abstract
(1) Background: Hospitalists are healthcare providers who focus on hospitalized patients, but research on the roles of pediatric hospitalists is lacking. This study investigates the role of a supervisor-type hospitalist in a pediatric hematology/oncology ward at a tertiary children's hospital, assessing the impact on satisfaction levels among patient caregivers, resident physicians, and nurses. (2) Methods: A retrospective analysis and online surveys were conducted to assess satisfaction levels before and after the introduction of hospitalists in the Department of Pediatric Hematology/Oncology at Seoul National University Children's Hospital in the Republic of Korea. (3) Results: The introduction of hospitalists led to a 19.3% reduction in prescription error interventions over six months. Unexpected transfers to the intensive care unit decreased from 1.4% to 0.7% (p = 0.229). Patient caregivers reported elevated satisfaction levels with physicians (rated 8.47/10), and there was a significant enhancement in overall satisfaction among nurses (increasing from 3.23 to 4.23/5, p < 0.001). The majority of resident physicians (83.3%) expressed contentment with the hospitalist system, with 77% indicating an interest in transitioning to a hospitalist role. However, these resident physicians also expressed concerns regarding job stability. (4) Conclusions: Supervisor-type pediatric hospitalists have the potential to elevate satisfaction levels not only among patient caregivers but also among nurses and resident physicians, showing promise in improving medical care quality. Nonetheless, ensuring favorable perception and securing job stability within the hospitalist system are pivotal for achieving successful implementation.
Collapse
Affiliation(s)
- Hong Yul An
- Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Children’s Hospital, Seoul 03080, Republic of Korea; (H.Y.A.); (Y.J.C.); (M.S.K.); (H.J.P.); (B.K.K.); (J.Y.C.); (H.J.K.)
- Seoul National University Cancer Research Institute, Seoul 03080, Republic of Korea
- Department of Hospital Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Yun Jung Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Children’s Hospital, Seoul 03080, Republic of Korea; (H.Y.A.); (Y.J.C.); (M.S.K.); (H.J.P.); (B.K.K.); (J.Y.C.); (H.J.K.)
- Department of Hospital Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - So Hye Lee
- College of Nursing, Seoul National University, Seoul 08826, Republic of Korea;
| | - Min Sun Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Children’s Hospital, Seoul 03080, Republic of Korea; (H.Y.A.); (Y.J.C.); (M.S.K.); (H.J.P.); (B.K.K.); (J.Y.C.); (H.J.K.)
| | - Hyun Jin Park
- Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Children’s Hospital, Seoul 03080, Republic of Korea; (H.Y.A.); (Y.J.C.); (M.S.K.); (H.J.P.); (B.K.K.); (J.Y.C.); (H.J.K.)
- Seoul National University Cancer Research Institute, Seoul 03080, Republic of Korea
| | - Bo Kyung Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Children’s Hospital, Seoul 03080, Republic of Korea; (H.Y.A.); (Y.J.C.); (M.S.K.); (H.J.P.); (B.K.K.); (J.Y.C.); (H.J.K.)
- Seoul National University Cancer Research Institute, Seoul 03080, Republic of Korea
- Department of Hospital Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Jung Yoon Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Children’s Hospital, Seoul 03080, Republic of Korea; (H.Y.A.); (Y.J.C.); (M.S.K.); (H.J.P.); (B.K.K.); (J.Y.C.); (H.J.K.)
- Seoul National University Cancer Research Institute, Seoul 03080, Republic of Korea
| | - Hyoung Jin Kang
- Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Children’s Hospital, Seoul 03080, Republic of Korea; (H.Y.A.); (Y.J.C.); (M.S.K.); (H.J.P.); (B.K.K.); (J.Y.C.); (H.J.K.)
- Seoul National University Cancer Research Institute, Seoul 03080, Republic of Korea
- Wide River Institute of Immunology, Hongcheon 25159, Republic of Korea
| | - Saram Lee
- Department of Transdisciplinary Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea
- Department of Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Kyung Taek Hong
- Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Children’s Hospital, Seoul 03080, Republic of Korea; (H.Y.A.); (Y.J.C.); (M.S.K.); (H.J.P.); (B.K.K.); (J.Y.C.); (H.J.K.)
- Seoul National University Cancer Research Institute, Seoul 03080, Republic of Korea
| |
Collapse
|
5
|
Simek K, Edwards M, Levy R, Seltz LB. Impact of a Pediatric Night Float on Medical Students' Education: Clerkship Student Perspectives. Hosp Pediatr 2022; 12:583-589. [PMID: 35603511 DOI: 10.1542/hpeds.2022-006557] [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: 06/15/2023]
Abstract
OBJECTIVES A night float, in which learners work successive overnight shifts, is increasingly used in undergraduate medical education, yet few studies have examined its impact on students. The study objective was to explore third-year medical students' perspectives on the impact on learning of a pediatric night float. METHODS Informed by situated learning theory, we performed a qualitative study using grounded theory methodology to interview 19 third-year medical students who completed a pediatric night float between June 2019 and April 2021. Four coders analyzed data with the constant comparative method. Codes were built using an iterative approach and organized into themes. Discrepancies were resolved by consensus. RESULTS Analysis yielded 4 themes: professional identity formation, learning activities, clinical experiences, and work-life balance. Students described positive and negative educational experiences, which were influenced by how well students integrated into the team. For some students, the night float provided opportunities to admit patients, increase confidence, and build camaraderie, which helped form professional identity. Students felt the night float was key residency preparation. Educational activities included experiential learning, teaching, and receiving feedback. Students admitted more patients and were exposed to a greater diversity of illnesses at night compared with day shifts. Fatigue was common and sending students home before morning handoff impeded their integration into the team. CONCLUSIONS Students described varied impact of the night float on their education. A night float experience was felt to be key residency preparation. For students who felt included in the team a night float may promote professional identity formation.
Collapse
|