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Fiol-deRoque MA, Valderas JM, Arias de la Torre J, Serrano-Ripoll MJ, Gens-Barberà M, Sánchez-Freire E, Martín-Luján FM, Olry de Labry A, Ricci-Cabello I. Evaluation of the psychometric performance of the Spanish and Catalan versions of the patient reported experiences and Outcomes of Safety in Primary Care (PREOS-PC)-Compact questionnaire. Eur J Gen Pract 2024; 30:2296573. [PMID: 38197321 PMCID: PMC10783822 DOI: 10.1080/13814788.2023.2296573] [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: 03/07/2023] [Accepted: 12/04/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Patients provide a unique, irreplaceable, and essential perspective in evaluating patient safety. The suite of Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) tools are a notable exception to the scarcity of patient-reported patient safety measures. Full evaluation of their performance has only been attempted for the English version, thereby limiting its international applicability. OBJECTIVES To assess the psychometric performance of the Spanish and Catalan versions of the PREOS-PC-Compact. METHODS Cross-sectional validation study. We used Classical Test Theory methods to examine scale score distribution, internal consistency, and construct validity; and Item Response Theory (IRT) methods to further explore construct validity. RESULTS 3287 patients completed the Spanish version, and 1007 the Catalan version. Similar results were obtained for both versions. Confirmatory Factor Analysis supported a single construct for each scale. The correlations between PREOS-PC-Compact scales and known group analysis suggested adequate construct validity (inconclusive for known groups at the provider level). All four multi-item scales demonstrated adequate internal consistency reliability (α > 0.7), which was only confirmed for test-retest reliability for 'Practice activation.' A sample between 60-90 patients per practice was estimated sufficient to produce scores with reliability > 0.7 for all scales except for harm scales. IRT models showed disordered thresholds for 'Practice activation' and 'Harm burden' but showed excellent fit after reducing the response categories. CONCLUSION The Spanish and Catalan versions of the PREOS-PC-Compact are broadly valid and reliable tools to measure patient safety in Spanish primary care centres; confirmation of lower-than-expected test-rest reliability merits further examination .
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Affiliation(s)
- Maria A. Fiol-deRoque
- Research Group in Primary Care and Promotion – Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Spain
- Prevention and Health Promotion Research Network (redIAPP)/Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
| | - José M. Valderas
- Centre for Research in Health Systems Performance, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Family Medicine, National University Health System, Singapore, Singapore
| | - Jorge Arias de la Torre
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- CIBER Biomedical Research Center in Epidemiology and Public Health (CIBERESP), Health Institute Carlos III (ISCIII), Madrid, Spain
- Institute of Biomedicine, University of Leon, Leon, Spain
| | - Maria J. Serrano-Ripoll
- Research Group in Primary Care and Promotion – Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Spain
- Prevention and Health Promotion Research Network (redIAPP)/Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
| | - Montserrat Gens-Barberà
- Quality and Patient Safety Central Functional Unit, Gerència d‘Atenció Primària Camp de Tarragona, Catalan Institute of Health (ICS), Tarragona, Spain
- Research Group in Quality and Patient Safety, Institut Universitari d’Investigació en l’Atenció Primària-IDIAP Jordi Gol, Catalan Institute of Health (ICS), Tarragona, Spain
| | - Encarna Sánchez-Freire
- Quality and Patient Safety Unit, Gerència d‘Atenció Primària Catalunya Central, Catalan Institute of Health (ICS), Barcelona, Spain
| | - Francisco M. Martín-Luján
- Primary Healthcare Research Support Unit-Camp de Tarragona, Institut Universitari d’Investigació en l’Atenció Primària-IDIAP Jordi Gol, Catalan Institute of Health (ICS), Tarragona, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili (URV), Reus, Spain
| | - Antonio Olry de Labry
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Research Group in Health and Gender, Andalusian School of Public Health, Granada, Spain
| | - Ignacio Ricci-Cabello
- Research Group in Primary Care and Promotion – Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Spain
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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Abdi Z, Ravaghi H, Sarkhosh S, Nafar H, Khani S, Letaief M. Patient and family engagement in patient safety in the Eastern Mediterranean Region: a scoping review. BMC Health Serv Res 2024; 24:765. [PMID: 38918854 PMCID: PMC11202252 DOI: 10.1186/s12913-024-11198-3] [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: 12/06/2023] [Accepted: 06/12/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Patients can play a key role in delivering safe care by becoming actively involved in their health care. This study aimed at reviewing the literature for evidence of patients' and families' engagement in patient safety in the Eastern Mediterranean Region (EMR). METHODS We conducted a scoping review of the literature published in English using PubMed, Medline, CINAHL, Scopus, ISI Web of Science, and PsycINFO until June 2023. RESULTS A total of 9019 studies were screened, with 22 meeting the inclusion criteria. Our review found few published studies of patient and family engagement in patient safety research in the EMR. Thirteen studies explored the attitudes, perceptions, and/or experiences / preferences of patients, families, and healthcare providers (HCPs) regarding patient engagement in patient safety. Nine publications reported patient involvement in patient safety activities at varying levels. Three categories of factors were identified that may affect patient involvement: patient-related (e.g., lack of awareness on their role in preventing harms, unwillingness to challenge HCPs' authority, and cultural barriers); HCP-related (e.g., negative attitudes towards patient engagement, poor patient-provider communication, and high workload); and healthcare setting-related (e.g., lack of relevant policies and guidelines, lack of training for patients, and HCPs, and lack of patient-centered approach). CONCLUSION This review highlighted limitations in the current literature on patient and family engagement in patient safety in the EMR, including both the depth of evidence and clarity of concepts. Further research is needed to explore how to actively involve patients and their families, as well as to determine whether such involvement translates into improved safety in practice.
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Affiliation(s)
- Zhaleh Abdi
- National Institute of Health Research (NIHR), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Hamid Ravaghi
- Department of Universal Health Coverage/Health Systems (UHS), World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Samaneh Sarkhosh
- School of Health Management and Information Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Hamideh Nafar
- School of Health Management and Information Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | | | - Mondher Letaief
- Department of Universal Health Coverage/Health Systems (UHS), World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt
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Fiol-deRoque MA, Mansilla GV, Maderuelo-Fernández JA, Tamayo-Morales O, Martín-Luján F, Astier-Peña P, Chacón-Docampo M, Orrego C, Gens-Barberà M, Andreu-Rodrigo P, Ricci-Cabello I. Evaluation of SINERGIAPS, an intervention to improve patient safety in primary healthcare centers in Spain based on patients' perceptions and experiences: a protocol for a hybrid type I randomized clinical trial. Front Public Health 2024; 12:1324940. [PMID: 38596515 PMCID: PMC11003190 DOI: 10.3389/fpubh.2024.1324940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 03/05/2024] [Indexed: 04/11/2024] Open
Abstract
Background Adverse events in the primary care setting result in a direct cost equivalent to at least 2.5% of total healthcare spending. Across OECD countries, they lead to more than seven million avoidable hospital admissions annually. In this manuscript, we describe the protocol of a trial aimed at evaluating the effectiveness of SinergiAPS (a patient-centered audit and feedback intervention) in reducing avoidable hospital admission and explore the factors that may affect its implementation. Methods We will conduct a 24-month, parallel, open-label, multicenter, pragmatic, hybrid type 1 randomized clinical trial. 118 primary healthcare centers with wide geographical distribution in Spain will be randomly assigned (ratio 1:1) to two groups. The intervention group will receive two audits (baseline and intermediate at 12 months) based on information collected through the administration of the PREOS-PC questionnaire (a measure of patient-reported patient safety) to a convenience sample of 100 patients per center. The intervention group will receive reports on the results of both audits, along with educational resources aimed at facilitating the design and implementation of safety improvement plans. The control group will receive care as usual. The primary outcome will be the rate of avoidable hospitalizations (administrative data). Secondary outcomes: patient-reported patient safety experiences and outcomes (PREOS-PC questionnaire); patient safety culture as perceived by professionals (MOSPSC questionnaire); adverse events reported by healthcare professionals (ad hoc questionnaire); the number of safety improvement actions which the re has implemented (ad hoc questionnaire). Outcome data will be collected at baseline and 24 months follow-up. For the evaluation of the implementation of the SinergiAPS intervention, we will draw on the Consolidated Framework for Implementation Research (CFIR). We will collect and analyze qualitative and quantitative data (30 individual interviews, implementation logbooks; questionnaires for professionals from intervention centers, and level of use of the SinergiAPS web tool). Discussion This study will expand the scarce body of evidence existing regarding the effects and implementation of interventions aimed at promoting patient and family engagement in primary healthcare, specifically for enhancing patient safety. The study has the potential to produce an impact on clinical practice, healthcare systems, and population health.Clinical Trial Registration: https://clinicaltrials.gov/study/NCT05958108?term=sinergiAPS&rank=1 (NCT05958108).
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Affiliation(s)
- Maria A. Fiol-deRoque
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, Palma, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain
| | - Georgina Vidal Mansilla
- Unitat de Qualitat i Seguretat dels Pacients, Gerència Territorial Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain
| | - José A. Maderuelo-Fernández
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Avenida de Portugal, Salamanca, Spain
| | - Olaya Tamayo-Morales
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Francisco Martín-Luján
- Unitat de Suport a la Recerca de Tarragona, Institut de d'investigació en l'Atenció Primària Jordi Gol (IDIAP Jordi Gol), Institut Català de la Salut, Tarragona, Spain
| | - Pilar Astier-Peña
- Unitat de Qualitat i Seguretat dels Pacients, Gerència Territorial Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain
- Unitat de Suport a la Recerca de Tarragona, Institut de d'investigació en l'Atenció Primària Jordi Gol (IDIAP Jordi Gol), Institut Català de la Salut, Tarragona, Spain
| | - Macarena Chacón-Docampo
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain
- I-Saude Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Vigo, Spain
| | - Carola Orrego
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain
- Avedis Donabedian Research Institute (FAD) – Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Montserrat Gens-Barberà
- Unitat de Qualitat i Seguretat dels Pacients, Gerència Territorial Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain
- Unitat de Suport a la Recerca de Tarragona, Institut de d'investigació en l'Atenció Primària Jordi Gol (IDIAP Jordi Gol), Institut Català de la Salut, Tarragona, Spain
| | - Pilar Andreu-Rodrigo
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, Palma, Spain
| | - Ignacio Ricci-Cabello
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, Palma, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Farokhzadian J, Eskici GT, Molavi-Taleghani Y, Tavan A, Farahmandnia H. Nursing students' patient safety competencies in the classroom and clinical settings: a cross-sectional study. BMC Nurs 2024; 23:47. [PMID: 38233931 PMCID: PMC10792773 DOI: 10.1186/s12912-024-01708-3] [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: 09/07/2022] [Accepted: 01/03/2024] [Indexed: 01/19/2024] Open
Abstract
INTRODUCTION Patient safety is one of the critical indicators of providing qualified and high-quality health care services. Determining nursing students' patient safety competencies will significantly contribute to the literature. Therefore, this study aimed to investigate Iranian nursing students' patient safety competencies in classroom and clinical settings. METHODS In this cross-sectional study data were collected from 215 nursing of a university of medical sciences between February and May 2022, using a general questionnaire form and the Health Professional Education in Patient Safety Survey. Data analysis was done using descriptive and analytical statistics such as percentage, mean and paired-samples t-test. RESULTS The mean scores of nursing students' the Health Professional Education in Patient Safety Survey were 3.50 ± 0.55 in the classroom and 3.45 ± 0.57 in the clinical setting. The highest mean scores of nursing students were in subdimension of "clinical safety" in both the clinical (3.91 ± 1.13) and classroom settings (3.91 ± 0.78). In addition, a statistically significant difference was found in patient safety learning confidence in the classroom versus clinical setting in the "culture of safety" subdimension. CONCLUSION It appears that current educational programs provide opportunities to improve nursing students' patient safety, but they are not enough. Nurse educators should apply new teaching methods and evaluate clinical strategies to meet educational needs.
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Affiliation(s)
| | - Gulcan Taskiran Eskici
- Department of Nursing Management, Faculty of Health Sciences, Ondokuz Mayis University, Samsun, Turkey
| | - Yasamin Molavi-Taleghani
- Health Management and Economics Research Center, Department of Health Services Management, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Asghar Tavan
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hojjat Farahmandnia
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
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Jones-Hooker C, Tyndall DE, Forbes TH. The Disruption of Patient Ambulation Care Processes by COVID-19: Revealing the Value of Visitor Assistance. J Nurs Adm 2023; 53:520-525. [PMID: 37747175 DOI: 10.1097/nna.0000000000001328] [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: 09/26/2023]
Abstract
OBJECTIVE To explore the impact of COVID-19 on care processes and ambulation outcomes. BACKGROUND COVID-19 forced hospital leaders to make systems-level changes that disrupted patient ambulation. The impact of these changes on the ambulation of hospitalized patients was unknown. The Systems Engineering Initiative for Patient Safety model was used to explore ambulation from a systems perspective. METHODS A single-case study research design was used to investigate patient ambulation in a major medical center. Data from 12 interviews with interdisciplinary leaders were analyzed. RESULTS Staff shortages and visitor restrictions were identified as the main work system barriers to ambulation. These barriers disrupted usual ambulation processes and supported the value of visitor assistance with ambulation. CONCLUSIONS This study provides a systems-level perspective of missed ambulation during COVID-19, which revealed the value of ambulation assistance provided by visitors. Findings may be used to support the continued and increased involvement of family members and visitors in the process of ambulation.
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Affiliation(s)
- Christa Jones-Hooker
- Author Affiliations: Nursing Instructor (Dr Jones-Hooker), Wake Technical Community College, Raleigh; and Associate Professor (Dr. Tyndall), School of Nursing, UNC Wilmington, Wilmington, North Carolina; and Assistant Professor (Dr Forbes), College of Nursing, East Carolina University, Greenville, North Carolina
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Nurmeksela A, Kulmala M, Kvist T. Patient satisfaction - results of cluster analysis of finnish patients. BMC Health Serv Res 2023; 23:629. [PMID: 37312180 DOI: 10.1186/s12913-023-09625-y] [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: 05/16/2022] [Accepted: 05/31/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Healthcare providers must understand patients' expectations and perceptions of the care they receive to provide high-quality care. The purpose of this study is to identify and analyse different clusters of patient satisfaction with the quality of care at Finnish acute care hospitals. METHODS A cross-sectional design was applied. The data were collected in 2017 from three Finnish acute care hospitals with the Revised Humane Caring Scale (RHCS) as a paper questionnaire, including six background questions and six subscales. The k-means clustering method was used to define and analyse clusters in the data. The unit of analysis was a health system encompassing inpatients and outpatients. Clusters revealed the common characteristics shared by the different groups of patients. RESULTS A total of 1810 patients participated in the study. Patient satisfaction was categorised into four groups: dissatisfied (n = 58), moderately dissatisfied (n = 249), moderately satisfied (n = 608), and satisfied (n = 895). The scores for each subscale were significantly above average in the satisfied patient group. The dissatisfied and moderately dissatisfied patient groups reported scores for all six subscales that were clearly below the average value. The groups significantly differed in terms of hospital admission (p = .013) and living situation (p = .009). Patients representing the dissatisfied and moderately dissatisfied groups were acutely admitted more frequently than patients in other groups and were more likely to live alone than satisfied and moderately satisfied patients. CONCLUSION The results mostly demonstrated high levels of patient satisfaction; however, the perceptions of minority populations of dissatisfied patients should be assessed to identify shortcomings in the care provided. More attention should be paid to acutely admitted patients who are living alone and the pain and apprehension management of all patients.
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Affiliation(s)
- Anu Nurmeksela
- Faculty of Health Sciences, Department of Nursing Science, University Lecturer University of Eastern Finland, P.O. Box 1627, Kuopio, 70211, Finland.
| | - Markus Kulmala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Research Centre for Health Promotion, P.O. Box 35, Jyväskylä, FI-40014, Finland
| | - Tarja Kvist
- Department of Nursing Science, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, Kuopio, 70211, Finland
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Tobiano G, Manias E, Thalib L, Dornan G, Teasdale T, Wellwood J, Chaboyer W. Older patient participation in discharge medication communication: an observational study. BMJ Open 2023; 13:e064750. [PMID: 36958781 PMCID: PMC10040044 DOI: 10.1136/bmjopen-2022-064750] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/25/2023] Open
Abstract
OBJECTIVE To describe the extent to which older patients participate in discharge medication communication, and identify factors that predict patient participation in discharge medication communication. DESIGN Observational study. SETTING An Australian metropolitan tertiary hospital. PARTICIPANTS 173 older patients were observed undertaking one medication communication encounter prior to hospital discharge. OUTCOME Patient participation measured with MEDICODE, a valid and reliable coding framework used to analyse medication communication. MEDICODE provides two measures for patient participation: (1) Preponderance of Initiative and (2) Dialogue Ratio. RESULTS The median for Preponderance of Initiative was 0.7 (IQR=0.5-1.0) and Dialogue Ratio was 0.3 (IQR=0.2-0.4), indicating healthcare professionals took more initiative and medication encounters were mostly monologue rather than a dialogue or dyad. Logistic regression revealed that patients had 30% less chance of having dialogue or dyads with every increase in one medication discussed (OR 0.7, 95% CI 0.5 to 0.9, p=0.01). Additionally, the higher the patient's risk of a medication-related problem, the more initiative the healthcare professionals took in the conversation (OR 1.5, 95% CI 1.0 to 2.1, p=0.04). CONCLUSION Older patients are passive during hospital discharge medication conversations. Discussing less medications over several medication conversations spread throughout patient hospitalisation and targeting patients at high risk of medication-related problems may promote more active patient participation, and in turn medication safety outcomes.
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Affiliation(s)
- Georgia Tobiano
- NHMRC CRE in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
- Gold Coast University Hospital, Southport, Queensland, Australia
| | - Elizabeth Manias
- School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
- School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
- Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
| | - Lukman Thalib
- Department of Biostatistics, Istanbul Aydin University, Istanbul, Turkey
| | - Gemma Dornan
- Gold Coast University Hospital, Southport, Queensland, Australia
| | - Trudy Teasdale
- Gold Coast University Hospital, Southport, Queensland, Australia
| | - Jeremy Wellwood
- Gold Coast University Hospital, Southport, Queensland, Australia
| | - Wendy Chaboyer
- NHMRC CRE in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
- School of Nursing and Midwifery, Griffith University, Southport, Queensland, Australia
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Yoo HJ, Shim J. The impact of family care visitation programme on patients and caregivers in the intensive care unit: A mixed methods study. J Clin Nurs 2023. [PMID: 36876455 DOI: 10.1111/jocn.16650] [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: 07/24/2022] [Revised: 01/12/2023] [Accepted: 01/26/2023] [Indexed: 03/07/2023]
Abstract
AIMS To track changes in the haemodynamic and respiratory indicators of patients and evaluate families' caring experiences via the visitation programme in the intensive care unit (ICU). BACKGROUND Although most people recognise the importance of family care visitation programme in the ICU, objective research results on the effect on patients and caregivers are still insufficient. DESIGN Mixed methods. METHODS In this a quasi-experimental investigation and qualitative study, after executing the programme with families of ICU patients in a general hospital in South Korea from June to July 2019, changes in haemodynamic and respiratory indicators for control (n = 28) and experimental groups (n = 28) were analysed; the experimental group families' experiences were analysed through in-depth interviews; the qualitative study's reporting rigour was checked against the COREQ guidelines and TREND checklist for a quasi-experimental study. Qualitative and quantitative data were examined using content analysis and repeated-measures analysis of variance, respectively. RESULTS There was a significant change in systolic and diastolic blood pressure in the haemodynamic indicator, and the respiratory indicator in both groups increased slightly over time and then gradually stabilised; there were no significant differences or interactions between groups regarding time of systolic blood pressure. The respiratory rate significantly decreased only in the experimental group. There was a significant increase in oxygen saturation over time, as well as interactions between time and group and between groups. Four themes were extracted from families' experiences. CONCLUSION The haemodynamic and respiratory indicators of the group using patient- and family-centred care (PFCC) showed a stable effect on critically ill patients, which increased families' satisfaction. In future, interventions should encourage family participation in the ICU for successful PFCC. RELEVANCE TO CLINICAL PRACTICE The findings provided evidence for the importance of PFCC through changes in objective haemodynamic and respiratory indicators.
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Affiliation(s)
- Hye Jin Yoo
- College of Nursing, Dankook University, Cheonan, South Korea
| | - JaeLan Shim
- College of Nursing, Dongguk University, Gyeongju, South Korea
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Thürlimann E, Verweij L, Naef R. The Implementation of Evidence-Informed Family Nursing Practices: A Scoping Review of Strategies, Contextual Determinants, and Outcomes. JOURNAL OF FAMILY NURSING 2022; 28:258-276. [PMID: 35707895 PMCID: PMC9280703 DOI: 10.1177/10748407221099655] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
There is a lack of knowledge about the successful implementation of family nursing practices. This scoping review maps current knowledge about the implementation of evidence-informed family nursing practices across settings and populations. A systematic search (CINAHL, PubMed, Medline) identified 24 publications, published between 2010 and 2020. We found nurses' implementation experience to be one of disruption, learning, and moving to new ways of practicing. The implementation resulted in benefits to families and self but was marked by fluctuation and partial integration of evidence-informed family nursing practices into care delivery. Uptake was shaped by various contextual determinants, with barriers mainly at the team and organizational levels. We identified low-quality, tentative evidence that capacity-building strategies coupled with dissemination-educational strategies may enable family nursing practice skills and increase the quality of family care. More rigorous research is needed to build further knowledge about effective implementation. Future implementation endeavors should utilize the evolving knowledge base in family nursing and tailor implementation strategies to contextual barriers.
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Affiliation(s)
- Eva Thürlimann
- University of Zurich, Institute for Implementation Science in Health Care, Switzerland
| | - Lotte Verweij
- University of Zurich, Institute for Implementation Science in Health Care, Switzerland
- University Hospital Zurich, Center of Clinical Nursing Science, Switzerland
| | - Rahel Naef
- University of Zurich, Institute for Implementation Science in Health Care, Switzerland
- University Hospital Zurich, Center of Clinical Nursing Science, Switzerland
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Sanchez C, Taylor M, Jones R. Visitor Behaviors Can Influence the Risk of Patient Harm: An Analysis of Patient Safety Reports From 92 Hospitals. PATIENT SAFETY 2022. [DOI: 10.33940/data/2022.6.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Previous research has shown that visitors can decrease the risk of patient harm; however, the potential to increase the risk of patient harm has been understudied.
Methods: We queried the Pennsylvania Patient Safety Reporting System database to identify event reports that described visitor behaviors contributing to either a decreased or increased risk of patient harm. Event reports from January 1 to June 30, 2019, were searched for keywords and reviewed for inclusion criteria. Event reports were manually coded to identify visitor influence on risk of patient harm (e.g., increase or decrease), visitor behavior, and event type.
Results: A total of 427 event reports were analyzed and we identified five categories of visitor behavior that influenced patient safety by either decreasing or increasing the risk of patient harm. We found that 63.7% (272 of 427) of event reports described a visitor behavior that decreased the risk of patient harm and the remaining 36.3% (155 of 427) of reports described behavior that increased the risk of harm. There was a greater variety of visitor behaviors that contributed to an increased risk of patient harm, as opposed to a decreased risk of harm. The visitor behavior most frequently associated with a decreased risk of patient harm was communicating with staff (91.2%, 248 of 272); for example, to inform staff of deterioration of a patient’s condition. The visitor behavior most frequently associated with an increased risk of patient harm was moving a patient (63.2%, 98 of 155). Across the 427 event reports, we found that visitor behavior was associated with seven event types; the falls event type (61.6%, 263 of 427) and medication-related event type (14.8%, 63 of 427) occurred most frequently.
Conclusion: The current study provides insight into which visitor behaviors are contributing to a decreased risk of patient harm and adds to the literature by identifying behaviors that can increase the risk of patient harm, across multiple event types. Table 6 and Table 7 outline potential safety strategies that staff and facilities may consider using to target visitor behavior. As outlined in Table 6, the use of warning and instructional signage can be a relatively low-effort and effective strategy to influence visitor behavior and address multiple behavior categories and event types.
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Luiz RB, Estevam LO, Raponi MBG, Felix MMDS, Barbosa MH. Efficacy of educational strategies in patient involvement for safety in care: a systematic review. Rev Gaucha Enferm 2022; 43:e20210198. [DOI: 10.1590/1983-1447.2022.20210198.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 05/02/2022] [Indexed: 11/19/2022] Open
Abstract
ABSTRACT Objective To evaluate the effectiveness of educational strategies in the involvement of hospitalized adult patient for safety in care. Method Systematic review carried out by searching for experimental and quasi-experimental studies, published from January/2010 to December/2021, in PubMed®, Cochrane Library CENTRAL, Scopus, Web of Science, LILACS, CINAHL and EMBASE. Results Twelve studies were included to involve the patient in safe care practices, five (41.7%) experimental and seven (58.3%) quasi-experimental. Different educational strategies were adopted in the articles included: verbal guidance, books, leaflets and folders (n=4; 33.3%); videos, e-books and electronic applications (n=5; 41.7%); poster, leaflets and video (n=3; 25%). Four experimental studies had a high risk of bias (80%) and all quasi-experimental studies had a low risk of bias (100%). Conclusion The use of educational strategies proved to be effective in involving the patient in safe care practices. Considering the heterogeneity between studies, it is recommended carrying out future research.
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Luiz RB, Estevam LO, Raponi MBG, Felix MMDS, Barbosa MH. Eficácia de estratégias educativas no envolvimento do paciente para a segurança no cuidado: revisão sistemática. Rev Gaucha Enferm 2022. [DOI: 10.1590/1983-1447.2022.20210198.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
RESUMO Objetivo Avaliar a eficácia de estratégias educativas no envolvimento do paciente adulto hospitalizado para a segurança no cuidado. Método Revisão sistemática realizada por meio da busca de estudos experimentais e quase-experimentais, publicados de janeiro/2010 a dezembro/2021, no PubMed®, Cochrane Library CENTRAL, Scopus, Web of Science, LILACS, CINAHL e EMBASE. Resultados Foram incluídos doze estudos para envolver o paciente nas práticas seguras do cuidado, cinco (41,7%) experimentais e sete (58,3%) quase experimentais. Diferentes estratégias educativas foram adotadas nos artigos incluídos: orientações verbais, livretos, folhetos e folders (n=4; 33,3%); vídeos, e-book e aplicativos eletrônicos (n=5; 41,7%); pôster, folhetos e vídeo (n=3; 25%). Quatro estudos experimentais apresentaram alto risco de viés (80%) e todos quase-experimentais baixo risco de viés (100%). Conclusão O uso de estratégias educativas se demonstrou eficaz no envolvimento do paciente em práticas seguras do cuidado. Recomenda-se a condução de futuras pesquisas ao se considerar a heterogeneidade entre os estudos.
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Gill FJ, Cooper A, Falconer P, Stokes S, Leslie GD. Development of an evidence-based ESCALATION system for recognition and response to paediatric clinical deterioration. Aust Crit Care 2021; 35:668-676. [PMID: 34711495 DOI: 10.1016/j.aucc.2021.09.004] [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: 06/29/2021] [Revised: 09/15/2021] [Accepted: 09/21/2021] [Indexed: 10/20/2022] Open
Abstract
AIM The aim of this study was to develop an evidence-based paediatric early warning system for infants and children that takes into consideration a variety of paediatric healthcare contexts and addresses barriers to escalation of care. METHODS A three-stage intervention development framework consisted of Stage 1: evidence review, benchmarking, stakeholder (health professionals, decision-makers, and health consumers) engagement, and consultation; Stage 2: planning and coproduction by the researchers and stakeholders using action research cycles; and Stage 3: prototyping and testing. RESULTS A prototype evidence-based system incorporated human factor principles, used a structured approach to patient assessment, promoted situational awareness, and included family as well as clinician concern. Family involvement in detecting changes in their child's condition was supported by posters and flyers codesigned with health consumers. Five age-specific observation and response charts included 10 weighted variables and one unweighted variable (temperature) to convey a composite early warning score. The escalation pathway was supported by a targeted communication framework (iSoBAR NOW). CONCLUSION The development process resulted in an agreed uniform ESCALATION system incorporating a whole-system approach to promote critical thinking, situational awareness for the early recognition of paediatric clinical deterioration as well as timely and effective escalation of care. Incorporating family involvement was a novel component of the system.
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Affiliation(s)
- Fenella J Gill
- School of Nursing, Faculty of Health Sciences, Curtin University, GPO Box U1987 Perth, Western Australia 6845, Australia; Perth Children's Hospital, Child & Adolescent Health Services, Western Australia, Australia.
| | - Alannah Cooper
- School of Nursing, Faculty of Health Sciences, Curtin University, GPO Box U1987 Perth, Western Australia 6845, Australia; Perth Children's Hospital, Child & Adolescent Health Services, Western Australia, Australia.
| | - Pania Falconer
- School of Nursing, Faculty of Health Sciences, Curtin University, GPO Box U1987 Perth, Western Australia 6845, Australia; Perth Children's Hospital, Child & Adolescent Health Services, Western Australia, Australia.
| | - Scott Stokes
- Kimberley Regional Paediatric Service, Broome Hospital, Western Australia, Australia.
| | - Gavin D Leslie
- School of Nursing, Faculty of Health Sciences, Curtin University, GPO Box U1987 Perth, Western Australia 6845, Australia.
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Taylor M, Reynolds C, Jones R. Challenges and Potential Solutions for Patient Safety in an Infectious-Agent-Isolation Environment: A Study of 484 COVID-19-Related Event Reports Across 94 Hospitals. PATIENT SAFETY 2021. [DOI: 10.33940/infection/2021.6.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Previous research has shown that patients in infectious-agent isolation are at greater risk for certain types of safety-related events. We conducted a study to explore the relationship between the various types of events that occur in an isolation environment and the associated factors, which may have implications for the likelihood of the event and severity of patient harm. We conducted a query of the Pennsylvania Patient Safety Reporting System (PA-PSRS) database to identify event reports submitted by acute care hospitals between January 1 and September 30, 2020. We identified 484 relevant event reports from 94 hospitals for inclusion in our descriptive study (excluding near-miss events). We measured the frequency of relationship between categories of safety-related event types and 18 categories of associated factors. Among the seven categories of event types, the most frequently identified were skin integrity (141 of 484, 29%), falls (129 of 484, 27%), and medication-related (78 of 484, 16%). Across all 18 categories of associated factors, which had or may have had an influence on the event type, the most frequent were patient’s mental status (80 of 484, 17%), staff’s time to don personal protective equipment (62 of 484, 13%), and patient’s interference with equipment/supplies (45 of 484, 9%). Overall, our results revealed that the frequency of certain associated factors varied considerably from one event type to another, which indicates that the relation between event types and associated factors should guide selection of risk mitigation strategies. We encourage readers to leverage our results along with Table 9, which provides a list of challenges identified in an isolation environment and potential solutions. We envision hospital staff proactively and systematically using the information in our manuscript to facilitate their evaluation of the isolation environment and prioritization of risk mitigation strategies.
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