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Shiri R, Nikunlaakso R, Laitinen J. Effectiveness of Workplace Interventions to Improve Health and Well-Being of Health and Social Service Workers: A Narrative Review of Randomised Controlled Trials. Healthcare (Basel) 2023; 11:1792. [PMID: 37372909 DOI: 10.3390/healthcare11121792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/30/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Health and social service workers face high levels of workload and job stressors, which can affect their health and well-being. Therefore, it is important to evaluate the effectiveness of workplace interventions that aim to improve their mental and physical health outcomes. This review summarizes the findings of randomized controlled trials (RCTs) that examined the impact of different types of workplace interventions on various health indicators among health and social service workers. The review searched the PubMed database from its inception to December 2022 and included RCTs that reported on the effectiveness of organizational-level interventions and qualitative studies that explored barriers and facilitators to participation in such interventions. A total of 108 RCTs were included in the review, covering job burnout (N = 56 RCTs), happiness or job satisfaction (N = 35), sickness absence (N = 18), psychosocial work stressors (N = 14), well-being (N = 13), work ability (N = 12), job performance or work engagement (N = 12), perceived general health (N = 9), and occupational injuries (N = 3). The review found that several workplace interventions were effective in improving work ability, well-being, perceived general health, work performance, and job satisfaction and in reducing psychosocial stressors, burnout, and sickness absence among healthcare workers. However, the effects were generally modest and short-lived. Some of the common barriers to participation in workplace interventions among healthcare workers were inadequate staff, high workload, time pressures, work constraints, lack of manager support, scheduling health programs outside work hours, and lack of motivation. This review suggests that workplace interventions have small short-term positive effects on health and well-being of healthcare workers. Workplace interventions should be implemented as routine programs with free work hours to encourage participation or integrate intervention activities into daily work routines.
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Affiliation(s)
- Rahman Shiri
- Finnish Institute of Occupational Health, P.O. Box 18, 00032 Helsinki, Finland
| | - Risto Nikunlaakso
- Finnish Institute of Occupational Health, P.O. Box 18, 00032 Helsinki, Finland
| | - Jaana Laitinen
- Finnish Institute of Occupational Health, P.O. Box 18, 00032 Helsinki, Finland
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Lickiewicz J, Husum TL, Ruud T, Siqveland J, Musiał Z, Makara-Studzińska M. Measuring Staff Attitudes to Coercion in Poland. Front Psychiatry 2021; 12:745215. [PMID: 34867536 PMCID: PMC8635088 DOI: 10.3389/fpsyt.2021.745215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/29/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction: Coercion can be defined as the use of force to limit a person's choices. In Poland, coercive measures may tend to be overused. However, there is limited information regarding the attitudes of nurses toward coercion in psychiatric settings and the factors influencing any decisions to use coercion. Aims: To validate the Staff Attitudes to Coercion Scale (SACS) for a group of psychiatric nurses and psychiatrists, to compare the said with the original Norwegian SACS version, and to compare nurses' attitudes with those displayed by psychiatrists. A second aim was to understand the relationship between self-efficacy and attitudes to coercion. Method: We surveyed 351 psychiatric nurses and psychiatrists rating SACS and GSES (General Self Efficacy Scale). We validated the SACS factor structure using confirmatory principal component factor analysis, calculated the internal consistency of subscales, and analyzed the test-retest reliability and face validity of the subscales themselves. Further, we analyzed the differences in attitudes toward coercion between nurses and psychiatrists, as well as whether there was an association between GSES and the SACS subscales. We compared the means on the SACS items between three countries-Germany, Norway, and Poland. Results: The confirmatory factor analysis of the Polish version of SACS found the same factor structure with three factors as was displayed in the original Norwegian SACS, except that one item was loaded on another factor. Internal consistency was acceptable for the factors on coercion as security and the coercion as offending, and unacceptable for the factor on coercion as treatment. Test-retest reliability was excellent for all the three subscales. Face validity was high for the factor coercion as security, partly present for coercion as offending, and not present for coercion as treatment. The subscale Coercion as Treatment was rated significantly higher by nurses than by psychiatrists, but there was no difference for the two other subscales. There was no significant association between the General Self-Efficacy Scale and any of the SACS subscales. The biggest differences in attitudes toward forms of coercion was noted between Poland and Germany. Discussion: The three-factor structure of SACS was the best solution for the Polish nurses and psychiatrists. The attitudes toward coercion differed between the two groups, but a low correlation was computed for the SACS subscales and self-efficacy. There is a cultural diversity visible amongst the three countries examined. Reduction in the use of coercion is a priority worldwide. More knowledge about the process involved in using coercive measures may contribute to this. The use of coercive interventions may harm patients and threaten patients' rights. Thus, education is needed for pre-service and in-service nurses alike.
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Affiliation(s)
- Jakub Lickiewicz
- Department of Health Psychology, Jagiellonian University Medical College, Kraków, Poland
| | - Tonje Lossius Husum
- Centre for Medical Ethics, The University of Oslo, Oslo, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Torleif Ruud
- Mental Health Service, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, The University of Oslo, Oslo, Norway
| | - Johan Siqveland
- Mental Health Service, Akershus University Hospital, Lørenskog, Norway
| | - Zofia Musiał
- Department of Clinical Nursing, Jagiellonian University Medical College, Krakow, Poland
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Lei R, Jiang X, Liu Q, He H. Nurse education to reduce physical restraints use in ICU: A scoping review. Nurs Crit Care 2020; 27:824-837. [PMID: 32969127 DOI: 10.1111/nicc.12557] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 09/07/2020] [Accepted: 09/11/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Physical restraints are defined as a manual approach to reduce a patient's physical movement and has been regarded as a protective nursing measure in the intensive care unit (ICU) to avoid unplanned extubation, falls, and other unexpected events. However, the limitations and changes associated with physical restraints have been verified by several studies. Restraint minimization has been advocated by studies worldwide; however, the most effective interventions are still being explored. AIM To identify and map nurse education strategies that reduce the use of physical restraints in the ICU. DESIGN AND METHODS A systematic literature search that followed the steps of a scoping review was performed in the Cochrane, PubMed, Embase, CINAHL, CNKI, Wan Fang Data, and VIP databases. We included studies that focused on nurse education aiming to reduce the use of physical restraints and/or use physical restraints reasonably. RESULTS The included studies (n = 12) described a variety of education strategies. Two delivery modes, eight common course durations, 14 main topics, two types of teaching methods with various materials, and two kinds of outcome measurements were identified and compared. CONCLUSION There are a variety of nurse education activities that could effectively improve ICU nurses' knowledge, attitudes, and behaviours towards physical restraints. However, the strategies of nurse education, such as delivery mode, teaching methods, and outcome measurements, require further study. RELEVANCE TO CLINICAL PRACTICE Nurse education on physical restraints should be carried out in ICUs. Online courses, practical sessions, and simulated scenarios should be a part of future nurse education. In addition to nurses' knowledge and attitude changes, frequency of physical restraints and other patient-related outcomes should also be considered for outcome evaluation.
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Affiliation(s)
- Ruobing Lei
- Nursing Department; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders (Chongqing); China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, P.R. China
| | - Xiaoping Jiang
- Nursing Department; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders (Chongqing); China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, P.R. China
| | - Qin Liu
- School of Public Health and Management, Research Center for Medicine and Social Development, Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, P.R. China
| | - Hui He
- Nursing Department; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders (Chongqing); China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, P.R. China
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Investigation of the Effect of ACT-SMART on Nurses’ Perceived Level of Violence Management in Emergency Section. PREVENTIVE CARE IN NURSING AND MIDWIFERY JOURNAL 2020. [DOI: 10.52547/pcnm.9.4.39] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Thibaut B, Dewa LH, Ramtale SC, D'Lima D, Adam S, Ashrafian H, Darzi A, Archer S. Patient safety in inpatient mental health settings: a systematic review. BMJ Open 2019; 9:e030230. [PMID: 31874869 PMCID: PMC7008434 DOI: 10.1136/bmjopen-2019-030230] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Patients in inpatient mental health settings face similar risks (eg, medication errors) to those in other areas of healthcare. In addition, some unsafe behaviours associated with serious mental health problems (eg, self-harm), and the measures taken to address these (eg, restraint), may result in further risks to patient safety. The objective of this review is to identify and synthesise the literature on patient safety within inpatient mental health settings using robust systematic methodology. DESIGN Systematic review and meta-synthesis. Embase, Cumulative Index to Nursing and Allied Health Literature, Health Management Information Consortium, MEDLINE, PsycINFO and Web of Science were systematically searched from 1999 to 2019. Search terms were related to 'mental health', 'patient safety', 'inpatient setting' and 'research'. Study quality was assessed using the Hawker checklist. Data were extracted and grouped based on study focus and outcome. Safety incidents were meta-analysed where possible using a random-effects model. RESULTS Of the 57 637 article titles and abstracts, 364 met inclusion criteria. Included publications came from 31 countries and included data from over 150 000 participants. Study quality varied and statistical heterogeneity was high. Ten research categories were identified: interpersonal violence, coercive interventions, safety culture, harm to self, safety of the physical environment, medication safety, unauthorised leave, clinical decision making, falls and infection prevention and control. CONCLUSIONS Patient safety in inpatient mental health settings is under-researched in comparison to other non-mental health inpatient settings. Findings demonstrate that inpatient mental health settings pose unique challenges for patient safety, which require investment in research, policy development, and translation into clinical practice. PROSPERO REGISTRATION NUMBER CRD42016034057.
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Affiliation(s)
- Bethan Thibaut
- NIHR Imperial Patient Safety Tranlsational Research Centre, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Lindsay Helen Dewa
- NIHR Imperial Patient Safety Tranlsational Research Centre, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Sonny Christian Ramtale
- NIHR Imperial Patient Safety Tranlsational Research Centre, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Danielle D'Lima
- Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Sheila Adam
- NIHR Imperial Patient Safety Tranlsational Research Centre, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Hutan Ashrafian
- NIHR Imperial Patient Safety Tranlsational Research Centre, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Ara Darzi
- NIHR Imperial Patient Safety Tranlsational Research Centre, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Stephanie Archer
- NIHR Imperial Patient Safety Tranlsational Research Centre, Department of Surgery and Cancer, Imperial College London, London, UK
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, Cambridgeshire, UK
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Hartley H, Smith JD, Vandyk A. Systematic Review of Continuing Education Interventions for Licensed Nurses Working in Psychiatry. J Contin Educ Nurs 2019; 50:233-240. [PMID: 31026324 DOI: 10.3928/00220124-20190416-10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 11/27/2018] [Indexed: 11/20/2022]
Abstract
Continuing education is an important part of nursing practice. These interventions help maintain clinical competence and are mandated by regulatory bodies. Often, continuing education interventions are created ad hoc and implemented without testing or formal evaluation of learning outcomes. In the current health care context, where resources are limited, educators are pressed to do more with less. Having access to a repository of existing continuing education interventions will facilitate the use of evidence-informed learning strategies and save valuable time by reducing duplication of efforts. Therefore, this systematic review aimed to explore continuing education interventions for licensed nurses working in psychiatry. All standard systematic review procedures were followed, including double screening, data extraction, and quality appraisal. This article presents an inventory of existing interventions, including summaries, as well as the reported effectiveness of each for nursing outcomes. Generally, the continuing education interventions result in positive nurse-related outcomes, such as increased knowledge, confidence, and skills, or improved attitudes; however, more rigorous research is needed to advance science in this area. [J Contin Educ Nurs. 2019;50(5):233-240.].
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Eskandari F, Abdullah KL, Zainal NZ, Wong LP. The effect of educational intervention on nurses' knowledge, attitude, intention, practice and incidence rate of physical restraint use. Nurse Educ Pract 2018; 32:52-57. [PMID: 30029085 DOI: 10.1016/j.nepr.2018.07.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 04/05/2018] [Accepted: 07/12/2018] [Indexed: 11/19/2022]
Abstract
The use of physical restraint exposes patients and staff to negative effects, including death. Therefore, teaching nursing staff to develop the improve knowledge, skills, and attitudes regarding physical restraint has become necessary. A quasi-experimental pre-post design was used to evaluate the effect of educational intervention on nurses' knowledge, attitude, intention, practice and incidence rate of physical restraint in 12 wards of a hospital using a self-reported questionnaire and a restraint order form in Malaysia. The educational intervention, which included a one-day session on minimising physical restraint use in hospital, was presented to 245 nurses. The results showed a significant increase in the mean knowledge, attitude sand practice score and a significant decrease in the mean intention score of nurses to use physical restraint after intervention. There was a statistically significant decrease in the incidence rate of physical restraint use in the wards of the hospital except geriatric-rehabilitation wards after intervention.
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Affiliation(s)
- Fatemeh Eskandari
- Department of Nursing Sciences, Faculty of Medicine, University of Malaya, Malaysia.
| | - Khatijah Lim Abdullah
- Head of Department of Nursing Sciences, Faculty of Medicine, University of Malaya, Malaysia.
| | - Nor Zuraida Zainal
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Malaysia.
| | - Li Ping Wong
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia.
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Vaona A, Banzi R, Kwag KH, Rigon G, Cereda D, Pecoraro V, Tramacere I, Moja L. E-learning for health professionals. Cochrane Database Syst Rev 2018; 1:CD011736. [PMID: 29355907 PMCID: PMC6491176 DOI: 10.1002/14651858.cd011736.pub2] [Citation(s) in RCA: 134] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The use of e-learning, defined as any educational intervention mediated electronically via the Internet, has steadily increased among health professionals worldwide. Several studies have attempted to measure the effects of e-learning in medical practice, which has often been associated with large positive effects when compared to no intervention and with small positive effects when compared with traditional learning (without access to e-learning). However, results are not conclusive. OBJECTIVES To assess the effects of e-learning programmes versus traditional learning in licensed health professionals for improving patient outcomes or health professionals' behaviours, skills and knowledge. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, five other databases and three trial registers up to July 2016, without any restrictions based on language or status of publication. We examined the reference lists of the included studies and other relevant reviews. If necessary, we contacted the study authors to collect additional information on studies. SELECTION CRITERIA Randomised trials assessing the effectiveness of e-learning versus traditional learning for health professionals. We excluded non-randomised trials and trials involving undergraduate health professionals. DATA COLLECTION AND ANALYSIS Two authors independently selected studies, extracted data and assessed risk of bias. We graded the certainty of evidence for each outcome using the GRADE approach and standardised the outcome effects using relative risks (risk ratio (RR) or odds ratio (OR)) or standardised mean difference (SMD) when possible. MAIN RESULTS We included 16 randomised trials involving 5679 licensed health professionals (4759 mixed health professionals, 587 nurses, 300 doctors and 33 childcare health consultants).When compared with traditional learning at 12-month follow-up, low-certainty evidence suggests that e-learning may make little or no difference for the following patient outcomes: the proportion of patients with low-density lipoprotein (LDL) cholesterol of less than 100 mg/dL (adjusted difference 4.0%, 95% confidence interval (CI) -0.3 to 7.9, N = 6399 patients, 1 study) and the proportion with glycated haemoglobin level of less than 8% (adjusted difference 4.6%, 95% CI -1.5 to 9.8, 3114 patients, 1 study). At 3- to 12-month follow-up, low-certainty evidence indicates that e-learning may make little or no difference on the following behaviours in health professionals: screening for dyslipidaemia (OR 0.90, 95% CI 0.77 to 1.06, 6027 patients, 2 studies) and treatment for dyslipidaemia (OR 1.15, 95% CI 0.89 to 1.48, 5491 patients, 2 studies). It is uncertain whether e-learning improves or reduces health professionals' skills (2912 health professionals; 6 studies; very low-certainty evidence), and it may make little or no difference in health professionals' knowledge (3236 participants; 11 studies; low-certainty evidence).Due to the paucity of studies and data, we were unable to explore differences in effects across different subgroups. Owing to poor reporting, we were unable to collect sufficient information to complete a meaningful 'Risk of bias' assessment for most of the quality criteria. We evaluated the risk of bias as unclear for most studies, but we classified the largest trial as being at low risk of bias. Missing data represented a potential source of bias in several studies. AUTHORS' CONCLUSIONS When compared to traditional learning, e-learning may make little or no difference in patient outcomes or health professionals' behaviours, skills or knowledge. Even if e-learning could be more successful than traditional learning in particular medical education settings, general claims of it as inherently more effective than traditional learning may be misleading.
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Affiliation(s)
- Alberto Vaona
- Azienda ULSS 20 ‐ VeronaPrimary CareOspedale di MarzanaPiazzale Ruggero Lambranzi 1VeronaItaly37142
| | - Rita Banzi
- IRCCS ‐ Mario Negri Institute for Pharmacological ResearchLaboratory of Regulatory Policiesvia G La Masa 19MilanItaly20156
| | - Koren H Kwag
- IRCCS Galeazzi Orthopaedic InstituteClinical Epidemiology UnitVia R. Galeazzi, 4MilanItaly20161
| | - Giulio Rigon
- Azienda ULSS 20 ‐ VeronaPrimary CareOspedale di MarzanaPiazzale Ruggero Lambranzi 1VeronaItaly37142
| | | | - Valentina Pecoraro
- IRCCS ‐ Mario Negri Institute for Pharmacological ResearchLaboratory of Regulatory Policiesvia G La Masa 19MilanItaly20156
| | - Irene Tramacere
- Fondazione IRCCS Istituto Neurologico Carlo BestaDepartment of Research and Clinical Development, Scientific DirectorateVia Giovanni Celoria, 11MilanItaly20133
| | - Lorenzo Moja
- University of MilanDepartment of Biomedical Sciences for HealthVia Pascal 36MilanSwitzerland20133
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Tölli S, Partanen P, Kontio R, Häggman-Laitila A. A quantitative systematic review of the effects of training interventions on enhancing the competence of nursing staff in managing challenging patient behaviour. J Adv Nurs 2017; 73:2817-2831. [PMID: 28556934 DOI: 10.1111/jan.13351] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2017] [Indexed: 11/27/2022]
Abstract
AIMS This systematic quantitative review identifies and summarizes the current knowledge and effects of training interventions for managing patients' challenging behaviour. BACKGROUND Challenging behaviour is an acknowledged worldwide healthcare problem and its management can have a huge impact on quality of care. Evidence-based training interventions that focus on managing challenging behaviour are needed, but few tools for the systematic evaluation of these interventions are currently offered. DESIGN A quantitative systematic review following the 2008 Centre for Reviews and Dissemination guidelines. DATA SOURCES CINAHL, Scopus, PsycInfo, PubMed and Cochrane were searched using the same terms for papers published in English from 2005-2015. REVIEW METHODS Studies were assessed for quality and risk of bias, according to the Cochrane Effective Practice and Organisation of Care Group criteria. A narrative summary was conducted. RESULTS We included 17 studies and evaluated 16 training interventions. Interventions were classified into four key themes: disengagements, communication, controlling behavioural symptoms and restrictive measures. Our review showed that interventions were more likely to decrease violent incident rates and increase staff confidence than change staff attitudes or increase knowledge. The elements of competence used to manage challenging behaviour were measured unilaterally. The evidence provided by studies was largely weak. CONCLUSION The variety of measurements used in the studies made comparing the effectiveness of the training interventions difficult. An individual's competence to manage challenging behaviour needs to be defined and a comprehensive scale for evaluating competence is also needed. Patient safety should be included in future evaluations.
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Affiliation(s)
- Sirpa Tölli
- Oulu University of Applied Sciences, Finland.,University of Eastern Finland, Kuopio, Finland
| | | | - Raija Kontio
- Lohja Hospital Area, Hospital District of Helsinki and Uusimaa and University of Helsinki, Finland
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Khalil AI, Al Ghamdi MAM, Al Malki S. Nurses’ knowledge, attitudes, and practices toward physical restraint and seclusion in an inpatients’ psychiatric ward. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/17542863.2017.1329330] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Amal Ibrahim Khalil
- Faculty of Nursing, Menoufyia University, Egypt
- College of Nursing, King Saud Bin Abdul-Aziz University for Health Sciences, Jeddah, Saudi Arabia
| | | | - Sarah Al Malki
- College of Nursing, King Saud Bin Abdul-Aziz University for Health Sciences, Jeddah, Saudi Arabia
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Kong EH, Song E, Evans LK. Effects of a Multicomponent Restraint Reduction Program for Korean Nursing Home Staff. J Nurs Scholarsh 2017; 49:325-335. [PMID: 28384390 DOI: 10.1111/jnu.12296] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE Physical restraints are used frequently in Korea, suggesting a growing need for access to programs focused on reduction. The aim of this study was to evaluate the effects of a multicomponent restraint reduction program (MRRP) for nursing staff in Korean nursing homes. DESIGN A cluster-randomized, single-blind, controlled pretest-posttest design was used. A total of 122 nursing staff (nurses and geriatric care assistants) in two Korean nursing homes participated in this study: 62 in the experimental group (EG) and 60 in the control group (CG). METHODS Nursing staff in the EG home received the MRRP comprising three educational sessions (two classroom-based and one web-based) and two unit-based consultations. Three instruments were used to measure nursing staff's knowledge, perceptions, and attitudes regarding physical restraints. Data were collected immediately before and after the intervention, and again 1 and 3 months later. FINDINGS Repeated measures analysis of variance showed significant differences between groups in knowledge (p < .001), perceptions (p < .001), and attitudes (p = .011) over time. These significant improvements in the MRRP group (EG) were sustained over the 3-month period. CONCLUSIONS The MRRP effectively improved the knowledge, perceptions, and attitudes of nursing home staff about restraint use with older adults. Additional studies are recommended to evaluate effects of its components while using larger samples and rigorous research methods and measurements, and the inclusion of boosters or other supports to sustain change. CLINICAL RELEVANCE These results provide valuable knowledge regarding a multicomponent intervention for changing nursing home staff attributes that likely influence clinical practice. Elements of the educational content and methods found useful for nursing home staff may also be effective in vocational and continuing education as well as for families of older nursing home residents.
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Affiliation(s)
- Eun-Hi Kong
- Xi, Associate Professor, Gachon University, College of Nursing, Gyeonggi-do, Korea (ROK)
| | - Eunjin Song
- Doctoral student, Kyung Hee University, College of Nursing Science, Seoul, Korea (ROK)
| | - Lois K Evans
- Xi, Professor Emerita of Nursing, University of Pennsylvania, School of Nursing, Philadelphia, PA, USA
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Degerfält J, Sjöstedt S, Fransson P, Kjellén E, Werner MU. E-learning programs in oncology: a nationwide experience from 2005 to 2014. BMC Res Notes 2017; 10:39. [PMID: 28086959 PMCID: PMC5234116 DOI: 10.1186/s13104-017-2372-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 01/04/2017] [Indexed: 11/23/2022] Open
Abstract
Background E-learning is an established concept in oncological education and training. However, there seems to be a scarcity of long-term assessments of E-learning programs in oncology vis-á-vis their structural management and didactic value. This study presents descriptive, nationwide data from 2005 to 2014. E-learning oncology programs in chemotherapy, general oncology, pain management, palliative care, psycho-social-oncology, and radiotherapy, were reviewed from our databases. Questionnaires of self-perceived didactic value of the programs were examined 2008–2014. Results The total number of trainees were 4693, allocated to 3889 individuals. The trainees included medical doctors (MDs; n = 759), registered nurses (RNs; n = 2359), radiation therapy technologists (n = 642), and, social and health care assistants (SHCAs; n = 933). The E-learning covered 29 different program classifications, comprising 731 recorded presentations, and covering 438 themes. A total of 490 programs were completed by the trainees. The European Credit Transfer and Accumulation System (ECTS; 1 ECTS point equals 0.60 US College Credit Hours) points varied across the educational programs from 0.7 to 30.0, corresponding to a duration of full-time studies ranging between 15 to 900 h (0.4–24 weeks) per program. The total number of ECTS points for the trainee cohort, was 20,000 corresponding to 530,000 full-time academic hours or 324.0 standard academic working years. The overall drop-out rate, across professions and programs, was 10.6% (499/4693). The lowest drop-out rate was seen for RNs (4.3%; P < 0.0001). Self-reported evaluation questionnaires (2008–2014) were completed by 72.1% (2642/3666) of the trainees. The programs were overall rated, on a 5-categorical scale (5 = excellent; 1 = very inferior), as excellent by 68.6% (MDs: 64.9%; RNs: 66.8%; SHCAs: 77.7%) and as good by 30.6% (MDs: 34.5%; RNs: 32.4%; SHCAs: 21.5%) of the responders. Conclusions This descriptive study, performed in a lengthy timeframe, presents high-volume data from multi-professional, oncological E-learning programs. While the E-learning paradigm, across professions, seems to have been well received, it is imperative that prospective studies, benchmarking against traditional training methods, are carried out, examining the hypothesized didactic value of our E-programs. Electronic supplementary material The online version of this article (doi:10.1186/s13104-017-2372-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jan Degerfält
- Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Barngatan 2B, 221 85, Lund, Sweden
| | | | - Per Fransson
- Department of Nursing, Umeå University, 901 87, Umeå, Sweden
| | - Elisabeth Kjellén
- Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Barngatan 2B, 221 85, Lund, Sweden
| | - Mads U Werner
- Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Barngatan 2B, 221 85, Lund, Sweden. .,Multidisciplinary Pain Center 7612, Neuroscience Center, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen O, Denmark.
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Lahti ME, Kontio RM, Välimäki M. Impact of an e-Learning Course on Clinical Practice in Psychiatric Hospitals: Nurse Managers' Views. Perspect Psychiatr Care 2016; 52:40-8. [PMID: 25624098 DOI: 10.1111/ppc.12100] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 11/12/2014] [Accepted: 12/09/2014] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND e-Learning is one way to provide continuing education and has been shown to be an effective method. However, little is known about how psychiatric organizations benefit from continuing education. PURPOSE The aim of this study was to use Kirkpatrick's four-level model to evaluate an e-learning continuing education course from the perspectives of nursing managers in psychiatric hospital organizations. DESIGN AND METHODS This qualitative design evaluated one e-learning course using Kirkpatrick's model as an evaluation frame. FINDINGS Nursing managers noticed positive, neutral, and negative reactions after the course. Nursing managers also reported that the nurses' learning evolved.
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Affiliation(s)
- Mari E Lahti
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Raija M Kontio
- Department of Psychiatry, Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Tuusula, Finland
| | - Maritta Välimäki
- Department of Nursing Science, University Hospital of Turku, University of Turku, Turku, Finland
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Pitkänen A, Kontio R, Lahti M, Katajisto J, Välimäki M. The Impact of an eLearning Course on Nurses’ Attitudes towards Mental Illness. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/ojn.2015.511107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kontio R, Pitkänen A, Joffe G, Katajisto J, Välimäki M. eLearning course may shorten the duration of mechanical restraint among psychiatric inpatients: a cluster-randomized trial. Nord J Psychiatry 2014; 68:443-9. [PMID: 24274836 DOI: 10.3109/08039488.2013.855254] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The management of psychiatric inpatients exhibiting severely disturbed and aggressive behaviour is an important educational topic. Well structured, IT-based educational programmes (eLearning) often ensure quality and may make training more affordable and accessible. AIMS The aim of this study was to explore the impact of an eLearning course for personnel on the rates and duration of seclusion and mechanical restraint among psychiatric inpatients. METHODS In a cluster-randomized intervention trial, the nursing personnel on 10 wards were randomly assigned to eLearning (intervention) or training-as-usual (control) groups. The eLearning course comprised six modules with specific topics (legal and ethical issues, behaviour-related factors, therapeutic relationship and self-awareness, teamwork and integrating knowledge with practice) and specific learning methods. The rates (incidents per 1000 occupied bed days) and durations of the coercion incidents were examined before and after the course. RESULTS A total of 1283 coercion incidents (1143 seclusions [89%] and 140 incidents involving the use of mechanical restraints [11%]) were recorded on the study wards during the data collection period. On the intervention wards, there were no statistically significant changes in the rates of seclusion and mechanical restraint. However, the duration of incidents involving mechanical restraints shortened from 36.0 to 4.0 h (median) (P < 0.001). No statistically significant changes occurred on the control wards. CONCLUSIONS After our eLearning course, the duration of incidents involving the use of mechanical restraints decreased. However, more studies are needed to ensure that the content of the course focuses on the most important factors associated with the seclusion-related elements. The eLearning course deserves further development and further studies. The duration of coercion incidents merits attention in future research.
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Affiliation(s)
- Raija Kontio
- Raija Kontio, Ph.D., Assistant Chief of Department of Psychiatry, Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital , Finland
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Lahti M, Kontio R, Pitkänen A, Välimäki M. Knowledge transfer from an e-learning course to clinical practice. NURSE EDUCATION TODAY 2014; 34:842-847. [PMID: 24075712 DOI: 10.1016/j.nedt.2013.09.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 08/29/2013] [Accepted: 09/02/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Continuing education is essential in improving practical psychiatric nursing skills. However, little is known about how knowledge gained in continuing education is transferred to nurses' daily work. OBJECTIVES To describe the transfer of knowledge gained from an e-learning course to daily practice. DESIGN Qualitative study design. SETTINGS One hospital district in Southern Finland with three specialized psychiatric wards (acute, rehabilitation, geriatric wards). PARTICIPANTS Nursing staff (N=53) were recruited and 35 participated voluntarily in the e-learning continuing education course in spring 2009. METHODS The data comprised nurses' reflective writing during the e-learning course and course evaluation forms completed after the course. We used qualitative design with inductive content analysis to analyze nurses' writings. RESULTS The nurses were willing and able to transfer what they learned to their daily practice including the course themes, communication and co-operation among staff members, understanding of preventive and alternative treatment methods and critical thinking regarding one's own work. After the e-learning course the nurses were able to identify development areas such as issues related to staff members' daily work, the patient's role on the ward, alternative methods to avoid coercion, issues pertaining to the care environment on the ward, psychiatric nurses' education, and making an action plan for aggressive situations. All nurses would recommend the course to other nurses. CONCLUSIONS New knowledge is easily adopted and transferred to daily practice.
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Affiliation(s)
- Mari Lahti
- University of Turku, Department of Nursing Science, Turku, Finland.
| | - Raija Kontio
- Department of Psychiatry, Hyvinkää Hospital Region, Hospital District of Helsinki and Uusimaa, Finland
| | - Anneli Pitkänen
- Tampere University Hospital, Pirkanmaa Hospital District, Finland
| | - Maritta Välimäki
- Southwest Hospital District, Finland; Southwest Hospital District, Finland
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Azer SA, Hasanato R, Al-Nassar S, Somily A, AlSaadi MM. Introducing integrated laboratory classes in a PBL curriculum: impact on student's learning and satisfaction. BMC MEDICAL EDUCATION 2013; 13:71. [PMID: 23706014 PMCID: PMC3664609 DOI: 10.1186/1472-6920-13-71] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 04/15/2013] [Indexed: 05/26/2023]
Abstract
BACKGROUND With the introduction of integrated problem-based learning (PBL) program in the medical curriculum, there is a need to create laboratory classes that suit students' learning needs and the changes introduced to the curriculum. This paper outlines the development and implementation of four integrated laboratory classes (ILCs) at King Saud University College of Medicine. It also examines whether core concepts addressed in these classes were learned and retained and how the students perceived the ILCs. METHODS ILCs are based on enhancing enquiry-based learning, and encouraging students to work on tasks in small groups (apply and integrate knowledge from biochemistry, pathology and microbiology) and conduct a laboratory procedure (practical part). In two of these ILCs, a pretest comprising 15 multiple-choice questions were administrated at the start of the class and an identical posttest was administrated at the end of these classes. Performance of the students in the Objective Structured Practical Examination (OSPE) at the end of the blocks was also evaluated. Students' perceptions were evaluated using a questionnaire completed at the end of each class. RESULTS A total of 247, 252, 238, and 244 students participated in practical classes covering cerebrospinal fluid infection, small intestine, liver function tests and adrenal gland function, respectively. Students got higher scores in posttests compared to pre-test scores in two classes (12.68 ± 2.03 vs 6.58 ± 3.39 and 13.02 ± 2.03 vs 7.43 ± 2.68, respectively). Paired t-test showed that the difference was significant (P < 0.001) in both tests. The mean scores of students in stations dealing with ILCs at the end of the block examinations were not significantly different from the mean scores for other stations not related to ILCs. The questionnaire indicated that most students expressed positive attitude towards working on tasks and applying knowledge learnt. Students also felt that conducting laboratory procedures and interpreting laboratory findings were valuable to their learning. CONCLUSIONS Given the increase in the posttest scores (short-term retention) and the satisfactory performance of students at the end of block examinations (long-term retention) together with the students' satisfaction, the study suggests that the core concepts addressed in these classes were learned and retained.
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Affiliation(s)
- Samy A Azer
- Medical Education and Curriculum Development & Research Unit, College of Medicine, King Saud University, P O Box 2925, Riyadh 11461, Saudi Arabia
| | - Rana Hasanato
- Department of Pathology, King Saud University, P O Box 2925, Riyadh 11461, Saudi Arabia
| | - Sami Al-Nassar
- Department of Medical Education, King Saud University, P O Box 2925, Riyadh 11461, Saudi Arabia
| | - Ali Somily
- Department of Pathology, King Saud University, P O Box 2925, Riyadh 11461, Saudi Arabia
| | - Muslim M AlSaadi
- Department of Paediatrics, College of Medicine, King Saud University, P O Box 2925, Riyadh 11461, Saudi Arabia
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Kontio R, Hätönen H, Joffe G, Pitkänen A, Lahti M, Välimäki M. Impact of eLearning course on nurses' professional competence in seclusion and restraint practices: 9-month follow-up results of a randomized controlled study (ISRCTN32869544). J Psychiatr Ment Health Nurs 2013; 20:411-8. [PMID: 22672441 DOI: 10.1111/j.1365-2850.2012.01933.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
eLearning may facilitate continuing vocational education, but data on the long-term effects of an eLearning course are lacking. The aim of this study was to explore the long-term impact of an eLearning course entitled ePsychNurse.Net on psychiatric nurses' professional competence in practicing seclusion and restraint and on their job satisfaction and general self-efficacy at 9-month follow-up. In a randomized controlled study, 12 wards were randomly assigned to the ePsychNurse.Net (intervention) or training as usual (control). Baseline and 9-month follow-up data on nurses' knowledge of coercion-related legislation, physical restraint and seclusion, their attitudes towards physical restraint and seclusion, job satisfaction and general self-efficacy were analysed for 137 completers (those who participated in the 9-month follow-up assessment). No between-group differences were found on any variable, with the exception of a change in attitude to seclusion in favour of the control group. The findings of the long-term effects did not differ from the immediate outcomes (3-month follow-up) and the improved level of knowledge acquired and further consolidation of that knowledge did not take place in the 6-month period after the 3-month ePsychNurse.Net course. The ePsychNurse.Net should be further developed and its future modifications will require additional studies, probably with some new outcome measures.
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Affiliation(s)
- R Kontio
- Hospital District of Helsinki and Uusimaa, Hyvinkää Hospital Region, Kellokoski Hospital, Tuusula, Finland.
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Gerdtz MF, Daniel C, Dearie V, Prematunga R, Bamert M, Duxbury J. The outcome of a rapid training program on nurses' attitudes regarding the prevention of aggression in emergency departments: a multi-site evaluation. Int J Nurs Stud 2013; 50:1434-45. [PMID: 23433724 DOI: 10.1016/j.ijnurstu.2013.01.007] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 01/25/2013] [Accepted: 01/26/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patient aggression is a common source of occupational violence in emergency departments. Staff attitudes regarding the causes for aggression influence the way they manage it. The Management of Clinical Aggression - Rapid Emergency Department Intervention is a 45 min educational program that aims to promote the use of de-escalation techniques and effective communication skills to prevent patient aggression. OBJECTIVE We sought to evaluate the impact of the program on staff attitudes regarding the prevention and early management of patient aggression. DESIGN A mixed methods approach was used including a pre-test post-test survey of training participants and individual interviews with key stakeholders. SETTING AND SAMPLE The setting was public sector hospital emergency departments located in metropolitan and regional Victoria, Australia. A convenience sample of eighteen emergency departments was recruited via the Victorian Department of Health. PARTICIPANTS Survey participants were nurses and midwives who were employed at the study sites. Interview participants were a purposive sample of nurse unit managers and trainers. METHODS The Management of Aggression and Violence Attitude Scale was administered to training participants immediately before and 6-8 weeks after training. Semi-structured telephone interviews with trainers and managers occurred 8-10 weeks after the intervention. RESULTS Four hundred and seventy one participants completed the pre-test and post-test. Statistically significant shifts were observed in 5/23 items (Wilcoxon Signed Ranks Test: p ≤ 0.01). Despite training, participants were undecided if it was possible to prevent patient aggression, and continued to be unsure about the use of physical restraint. Twenty-eight (82.3%) of managers' and trainers' eligible to be interviewed provided their perceptions of the impact of the program. Overall, these perceptions were consistent with the significant shifts observed in the survey items. CONCLUSION There was limited evidence to demonstrate that the program significantly modified staff attitudes towards the prevention of patient aggression using the Management of Aggression and Violence Attitude Scale. Additional survey items that specifically measure staff attitudes about the use of restraint in emergency settings are needed to better understand decision making about restraining practices. Further work is indicated to quantify the impact of training in practice.
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Affiliation(s)
- Marie Frances Gerdtz
- Department of Nursing, The University of Melbourne, Victoria, Australia; Melbourne Health, Victoria, Australia.
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Paavilainen E, Salminen-Tuomaala M, Leikkola P. Counselling for patients and family members: a follow-up study in the emergency department. ISRN NURSING 2012; 2012:303790. [PMID: 23008782 PMCID: PMC3447345 DOI: 10.5402/2012/303790] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 07/18/2012] [Indexed: 11/24/2022]
Abstract
Although the research indicates that patients and family members are not fully satisfied with the counselling they receive, little is known about the quality of counselling in more detail. The purpose of the study was to describe patients' and their family members' experiences about counselling in emergency department, and follow how these experiences possibly change after the educational intervention for the whole nursing staff of the ED ward. The pre-test-post-test follow-up design was implemented including online continuing education for ED staff. The data were collected via questionnaires from patients and their family members in two phases and analyzed statistically. After online education of staff, experiences of patients and family members concerning counselling were better than before the education. Especially, family members' satisfaction had increased. However, our results also indicated that patients and family members desire more information for example, regarding medications. Care practices had developed towards family-centeredness, which patients and family members appreciate. Online education proved also in some degree its usefulness in educating ED staff, by offering the same education to a staff which works in shifts. Furthermore, family presence and participation practices should be developed by offering possibilities for families to stay with each other on ED ward.
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Affiliation(s)
- Eija Paavilainen
- Nursing Science, Research Collegium, School of Health Sciences, University of Tampere, Etelä-Pohjanmaa Hospital District, 33014 Tampere, Finland
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Abstract
PURPOSE OF REVIEW Involuntary treatment is burdened by the lack of evidence. One of the challenges is the difference in practice across borders in Europe. While reviewing the current literature, a proposal of monitoring guidelines is discussed. RECENT FINDINGS The field is characterized by a small number of dedicated researchers. A study of violence in first-episode psychosis shows that differences in criteria for involuntary admission lead to different prognosis for the patients. The most recent contributions from the cross-national EUNOMIA study point to great variation across countries, regarding frequencies of involuntary admission as well as outcome. The EUNOMIA study provides suggestions for good quality in involuntary admission. A Cochrane review has examined the evidence of involuntary community treatment compared with standard treatment. The effectiveness of involuntary community treatment is limited. The review concludes that the benefits for a small number of patients are outweighed by the high numbers needed to treat in terms of avoided re-admission. SUMMARY Despite pioneering work, involuntary treatment is still caught up in tradition. There is a lack of standard and proof of effectiveness. A proposal of monitoring guidelines for involuntary measures is a first step to improve the situation.
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