1
|
Wang W, Wang S, Sun Q, Zhang Z, Zhou C, Zhang Q, Mei Y. Translation and psychometric validation of the Patient Participation Culture Tool for healthcare workers in Chinese nursing context. BMC Nurs 2024; 23:565. [PMID: 39148077 PMCID: PMC11328431 DOI: 10.1186/s12912-024-02065-x] [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: 01/08/2024] [Accepted: 06/05/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND Promoting patient participation stands as a global priority in nursing care. Currently, there is a lack of a standardized tool to assess the culture of patient participation from the perspective of nurses in China. AIMS To translate and examine the validity and reliability of the Patient Participation Culture Tool for healthcare workers (PaCT-HCW) on general hospital wards in Chinese nursing context. METHODS A cross-sectional research study was conducted among 812 nurses. Brislin's recommendations were adhered to during the translation of the scale. Validity was assessed using construct validity, content validity, and face validity. Split-half reliability, test-retest reliability, and internal consistency reliability were used to evaluate dependability. The study was guided and reported following the STROBE checklist and recommendations for reporting the results of studies of instrument and scale development and testing. RESULTS The Chinese version of PaCT-HCW (the PaCT-HCW-C) exhibits good face validity and content validity. A rigorous exploratory factor analyse verified a six-factor (competence, support, perceived lack of time, information sharing and dialogue, response to questions and acceptance of a new role) scale structure with a cumulative variance contribution of the factors with 44 items of 68.840%. With a Cronbach's α coefficient of 0.962, split-half reliability of 0.866, and intraclass correlation coefficients of 0.989, the instrument demonstrates great reliability. Confirmatory factor analysis results validated the consistency of the six factors with the structure of the PaCT-HCW-C scale. CONCLUSIONS The 44-item PaCT-HCW-C is a valid and reliable instrument with satisfactory psychometric properties. It could serve as a tool for assessing the effectiveness of international programs aimed at fostering patient participation from the perspective of nurses, while also providing insights from China's practical experiences.
Collapse
Affiliation(s)
- Wenna Wang
- School of Nursing and Health, Zhengzhou University, No. 100, Kexue Avenue, Zhongyuan District, Zhengzhou, Henan, China
| | - Shanshan Wang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Qianqian Sun
- School of Nursing and Health, Zhengzhou University, No. 100, Kexue Avenue, Zhongyuan District, Zhengzhou, Henan, China
| | - Zhenxiang Zhang
- School of Nursing and Health, Zhengzhou University, No. 100, Kexue Avenue, Zhongyuan District, Zhengzhou, Henan, China.
| | - Chenxi Zhou
- School of Nursing and Health, Zhengzhou University, No. 100, Kexue Avenue, Zhongyuan District, Zhengzhou, Henan, China
| | - Qiushi Zhang
- School of Nursing and Health, Zhengzhou University, No. 100, Kexue Avenue, Zhongyuan District, Zhengzhou, Henan, China
| | - Yongxia Mei
- School of Nursing and Health, Zhengzhou University, No. 100, Kexue Avenue, Zhongyuan District, Zhengzhou, Henan, China.
| |
Collapse
|
2
|
Groves PS, Farag A, Perkhounkova Y, Sabin JA, Witry MJ, Wright B. Nurse judgements of hospitalized patients' safety concerns are affected by patient, nurse and event characteristics: A factorial survey experiment. J Clin Nurs 2024. [PMID: 39008405 DOI: 10.1111/jocn.17372] [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: 03/20/2024] [Revised: 05/29/2024] [Accepted: 07/04/2024] [Indexed: 07/17/2024]
Abstract
AIM To test the influences of patient, safety event and nurse characteristics on nurse judgements of credibility, importance and intent to report patients' safety concerns. DESIGN Factorial survey experiment. METHODS A total of 240 nurses were recruited and completed an online survey including demographic information and responses to eight factorial vignettes consisting of unique combinations of eight patient and event factors. Hierarchical multivariate analysis was used to test influences of vignette factors and nurse characteristics on nurse judgements. RESULTS The intraclass coefficients for nurse judgements suggest that the variation among nurses exceeded the influence of contextual vignette factors. Several significant sources of nurse variation were identified, including race/ethnicity, suggesting a complex relationship between nurses' characteristics and their potential biases, and the influence of personal and patient factors on nurses' judgements, including the decision to report safety concerns. CONCLUSION Nurses are key players in the system to manage patient safety concerns. Variation among nurses and how they respond to scenarios of patient safety concerns highlight the need for nurse-level intervention. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE Complex factors influence nurses' judgement, interpretation and reporting of patients' safety concerns. IMPACT Understanding nurse judgement regarding patient-expressed safety concerns is critical for designing processes and systems that promote reporting. Multiple event and patient characteristics (type of event and apparent harm, and patient gender, race/ethnicity, socioeconomic status, and communication approach) as well as participant characteristics (race/ethnicity, gender, years of experience and primary hospital area) impacted participants' judgements of credibility, degree of concern and intent to report. These findings will help guide patient safety nurse education and training. REPORTING METHOD STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION Members of the public, including patient advocates, were involved in content validation of the vignette scenarios, norming photographs used in the factorial survey and testing the survey functionality.
Collapse
Affiliation(s)
| | - Amany Farag
- College of Nursing, University of Iowa, Iowa City, Iowa, USA
| | | | - Janice A Sabin
- School of Medicine, Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, USA
| | - Matthew J Witry
- College of Pharmacy, University of Iowa, Iowa City, Iowa, USA
| | - Brad Wright
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| |
Collapse
|
3
|
Hriberšek M, Eibensteiner F, Bukowski N, Yeung AWK, Atanasov AG, Schaden E. Research areas and trends in family-centered care in the 21st century: a bibliometric review. Front Med (Lausanne) 2024; 11:1401577. [PMID: 38933103 PMCID: PMC11201138 DOI: 10.3389/fmed.2024.1401577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Abstract
Introduction Family-centered care (FCC) is a model of care provision that sees a patient's loved ones as essential partners to the health care team and positively influences the psychological safety of patients and loved ones. Objectives This review aims to present an overview of impactful publications, authors, institutions, journals, countries, fields of application and trends of FCC in the 21st century as well as suggestions on further research. Methods The Web of Science Database was searched for publications on FCC between January 2000 and Dezember 2023. After screening for duplicates, VOS Viewer and CiteSpace were used to analyze and visualize the data. Results Scientific interest in FCC has grown and resulted in the scientific output of 4,836 publications originating from 103 different countries. Based on the frequent author keywords, FCC was of greatest interest in neonatology and pediatrics, nursing, critical and intensive care, end-of-life and palliative care, and patient-related outcomes. The recent research hotspots are "patient engagement," "qualitative study," and "health literacy." Conclusion FCC has gained recognition and spread from the pediatric to the adult palliative, intensive, end-of-life and geriatric care settings. This is a very reassuring development since adults, especially when older, want and need the assistance of their social support systems. Recent research directions include the involvement of patients in the development of FCC strategies, health literacy interventions and the uptake of telemedicine solutions.
Collapse
Affiliation(s)
- Mojca Hriberšek
- Ludwig Boltzmann Institute Digital Health and Patient Safety (LBG), Vienna, Austria
- Medical University of Vienna, Vienna, Austria
| | - Fabian Eibensteiner
- Ludwig Boltzmann Institute Digital Health and Patient Safety (LBG), Vienna, Austria
- Clinical Department of Pediatric Nephrology and Gastroenterology, University Clinic for Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Nils Bukowski
- Ludwig Boltzmann Institute Digital Health and Patient Safety (LBG), Vienna, Austria
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
| | - Andy Wai Kan Yeung
- Ludwig Boltzmann Institute Digital Health and Patient Safety (LBG), Vienna, Austria
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Atanas G. Atanasov
- Ludwig Boltzmann Institute Digital Health and Patient Safety (LBG), Vienna, Austria
- Institute of Genetics and Animal Biotechnology, Polish Academy of Sciences, Magdalenka, Poland
| | - Eva Schaden
- Ludwig Boltzmann Institute Digital Health and Patient Safety (LBG), Vienna, Austria
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
4
|
Jiang S, Wu Z, Zhang X, Ji Y, Xu J, Liu P, Liu Y, Zheng J, Zhao L, Chen J. How does patient-centered communication influence patient trust?: The roles of patient participation and patient preference. PATIENT EDUCATION AND COUNSELING 2024; 122:108161. [PMID: 38308973 DOI: 10.1016/j.pec.2024.108161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/07/2023] [Accepted: 01/17/2024] [Indexed: 02/05/2024]
Abstract
OBJECTIVE The aim of this study was to examine the effects of patient-centered communication, patient participation, and patient preference on patient trust in the context of China. METHODS A cross-sectional survey was conducted involving 217 cancer patients in China. Mediation and moderation analyses were performed to examine the relationships among the study variables. RESULTS First, patient-centered communication increased patient participation in decision-making, which, in turn, enhanced patient trust. Second, patient-centered communication did not have a direct effect on patient trust. Third, patient preference for a passive role in decision-making weakened the relationship between patient participation and patient trust. CONCLUSION The results underscore the significant effect of facilitating patient participation in linking patient-centered communication to patient trust. However, medical communication should also respond to patients' preferred roles in the decision-making process. PRACTICE IMPLICATIONS Doctors should provide patients with opportunities to ask questions and express their concerns. In addition, they should evaluate patients' preferred degree of involvement before inviting them to contribute so as to respect their preferences and values.
Collapse
Affiliation(s)
- Shaohai Jiang
- Department of Communications and New Media, National University of Singapore, Singapore 999002, Singapore
| | - Zhengyu Wu
- School of Public Affairs, Xiamen University, Xiamen 361000, China
| | - Xiaoyu Zhang
- China Agricultural Film and Television Center, Beijing 100020, China
| | - Ying Ji
- Department of Thoracic Surgery, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | | | - Peng Liu
- Beijing Hospital, Beijing 100020, China
| | - Yan Liu
- Cancer Hospital Chinese Academy of Medical Science, Beijing 100020, China
| | - Jie Zheng
- Department of neurosurgery, Huashan Hospital, Fudan University, Shanghai 200000, China
| | - Liang Zhao
- Cancer Hospital Chinese Academy of Medical Science, Beijing 100020, China
| | - Jingxi Chen
- College of Arts and Media, Tongji University, Weixin Building, No.4800 Cao'an Road, Jiading District, Shanghai 201801, China.
| |
Collapse
|
5
|
Areia M, Dias LP, Matos P, Figueiredo D, Neves AL, da Costa ED, Loureiro CC, Boechat JL, Reis AB, Simões P, Taborda‐Barata L, Fonseca JA, Sá‐Sousa A, Jácome C. Public involvement in chronic respiratory diseases research: A qualitative study of patients', carers' and citizens' perspectives. Health Expect 2024; 27:e13917. [PMID: 38375962 PMCID: PMC10768873 DOI: 10.1111/hex.13917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 09/06/2023] [Accepted: 11/06/2023] [Indexed: 02/21/2024] Open
Abstract
INTRODUCTION Patient and public involvement (PPI) initiatives involving patients with chronic respiratory disease (CRD) are rare. Therefore, this study aimed to explore the perspectives of patients with CRD, carers and interested citizens regarding the relevance and need for a PPI network and suggestions for its implementation. METHODS A qualitative study based on focus groups was conducted. Recruitment occurred through invitations on social media platforms and to patients who have participated in previous asthma studies of the team. Three focus groups were conducted, via video conference, using a semi-structured guide. Thematic analysis was performed by two independent researchers and discussed with the extended team. RESULTS Fifteen patients with CRD, one carer and one interested citizen (13 females, median 36 (range: 18-72) years) participated. All participants acknowledged the importance of implementing a collaborative network and demonstrated interest in being integrated. Participants acknowledged the importance of their involvement in several phases of the research cycle. The main aim identified for this network was to facilitate communication between patients and researchers. Participants regarded the integration of patients, carers, researchers and healthcare professionals from different scientific areas as relevant. The use of digital platforms to attract members and support the work, together with group dynamics and regular meetings, were some of the most relevant practical considerations for implementing the network. The identified facilitators for their engagement were sharing experiences, researchers' and healthcare professionals' support and feedback and schedule flexibility. The identified barriers included the amount of time dedicated, low health/digital literacy and the potential detachment of nondiagnosed patients or those with low symptom impact in daily life. CONCLUSION Patients, carers and citizens acknowledged the relevance of implementing a collaborative network and demonstrated interest in active participation in every stage of the health research cycle. A deeper knowledge of the barriers and facilitators identified in this study could support implementing these initiatives in Portugal. PATIENT OR PUBLIC CONTRIBUTION This study was designed by a research team that included one patient with asthma and one carer. They were specifically involved in building the study protocol and the interview guide. They also gave feedback regarding the electronic consent form and the short sociodemographic questionnaire created, namely by removing noncontributing words or phrases and rewording expressions. The lay summary was written by another patient with asthma. All participants of this study were invited to implement and integrate the ConectAR network-a collaborative network of research in respiratory health. PUBLIC SUMMARY In Portugal, chronic respiratory patients do not have an active role as 'coinvestigators'. This study aimed to acknowledge if patients and citizens considered a patient and public involvement network useful, whose main purpose would be to facilitate communication between patients and researchers. A study based on online group interviews was carried out with patients with chronic respiratory diseases and interested citizens, both recruited on social media platforms. Participants considered that bringing together patients, carers, researchers and healthcare professionals is valuable because sharing different experiences and perspectives may help patients to improve their daily lives and increase research quality. In conclusion, patients agree that implementing a collaborative network with researchers and healthcare professionals and participating in the health research cycle is quite preponderant. Acknowledging what can help and deter this network may be beneficial to implementing this type of initiative in Portugal.
Collapse
Affiliation(s)
- Margarida Areia
- Allergy and Clinical Immunology UnitCentro Hospitalar Vila Nova de Gaia/EspinhoVila Nova de GaiaPortugal
| | - Liliana P. Dias
- Allergy and Clinical Immunology UnitCentro Hospitalar Vila Nova de Gaia/EspinhoVila Nova de GaiaPortugal
| | - Paula Matos
- CINTESIS@RISE, Health Research Network, Faculty of MedicineUniversity of PortoPortoPortugal
| | - Daniela Figueiredo
- CINTESIS@RISE, School of Health SciencesUniversity of AveiroAveiroPortugal
| | - Ana L. Neves
- CINTESIS@RISE, Health Research Network, Faculty of MedicineUniversity of PortoPortoPortugal
- MEDCIDS–Department of Community Medicine, Information and Health Decision SciencesFaculty of Medicine, University of PortoPortoPortugal
- Department of Primary Care and Public HealthImperial College LondonLondonUK
| | | | - Cláudia C. Loureiro
- Pneumology UnitHospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de CoimbraCoimbraPortugal
| | - José L. Boechat
- CINTESIS@RISE, Health Research Network, Faculty of MedicineUniversity of PortoPortoPortugal
- Department of PathologyBasic and Clinical Immunology, Faculty of Medicine of the University of PortoPortoPortugal
- Allergy UnitInstituto CUF Porto e Hospital CUF PortoPortoPortugal
| | - António B. Reis
- Utopia Academy, Utopia, Innovation on Digital Media LabUniversidad Carlos III de MadridMadridSpain
| | - Pedro Simões
- CICS‐UBI Health Sciences Research Centre, CACB‐Clinical Academic Centre of BeirasUniversity of Beira InteriorCovilhãPortugal
- UBIAir—Clinical and Experimental Lung Centre, CACB‐Clinical Academic Centre of BeirasUniversity of Beira InteriorCovilhãPortugal
- UCSP Fundão, ACeS Cova da BeiraCovilhãPortugal
| | - Luís Taborda‐Barata
- CICS‐UBI Health Sciences Research Centre, CACB‐Clinical Academic Centre of BeirasUniversity of Beira InteriorCovilhãPortugal
- UBIAir—Clinical and Experimental Lung Centre, CACB‐Clinical Academic Centre of BeirasUniversity of Beira InteriorCovilhãPortugal
- Department of ImmunoallergologyCovada Beira University Hospital Centre, CACB‐Clinical Academic Centre of BeirasCovilhãPortugal
| | - João A. Fonseca
- CINTESIS@RISE, Health Research Network, Faculty of MedicineUniversity of PortoPortoPortugal
- MEDCIDS–Department of Community Medicine, Information and Health Decision SciencesFaculty of Medicine, University of PortoPortoPortugal
- Allergy UnitInstituto CUF Porto e Hospital CUF PortoPortoPortugal
| | - Ana Sá‐Sousa
- CINTESIS@RISE, Health Research Network, Faculty of MedicineUniversity of PortoPortoPortugal
- MEDCIDS–Department of Community Medicine, Information and Health Decision SciencesFaculty of Medicine, University of PortoPortoPortugal
| | - Cristina Jácome
- CINTESIS@RISE, Health Research Network, Faculty of MedicineUniversity of PortoPortoPortugal
- MEDCIDS–Department of Community Medicine, Information and Health Decision SciencesFaculty of Medicine, University of PortoPortoPortugal
| |
Collapse
|
6
|
Chauhan A, Newman B, Manias E, Joseph K, Leone D, Walpola RL, Seale H, Smith AB, Harrison R. Creating safer cancer care with ethnic minority patients: A qualitative analysis of the experiences of cancer service staff. Health Expect 2024; 27:e13979. [PMID: 39102700 PMCID: PMC10825879 DOI: 10.1111/hex.13979] [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] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/12/2023] [Accepted: 01/12/2024] [Indexed: 08/07/2024] Open
Abstract
INTRODUCTION Effective consumer engagement practices can enhance patient safety. This is important for consumers from ethnic minority backgrounds who are exposed to increased risk of patient safety events. Using the Systems Engineering Initiative for Patient Safety model, this study explored staff experiences of creating opportunities for engagement with consumers from ethnic minority backgrounds to contribute to their cancer care safety. METHOD A qualitative study was conducted using semistructured interviews with cancer service staff from four cancer services across two states in Australia. Purposive sampling was used to recruit healthcare staff from a diverse range of professions. Data were analysed using the Framework Analysis method. RESULTS Fifty-four interviews were conducted with healthcare staff. Analysis of the qualitative interview data identified enablers and associated challenges that contributed to creating a shared understanding between consumers and staff of the information, processes, expectations and problems arising in care. Enablers and challenges are reported in relation to four themes: (1) co-creating safety through shared understanding of care processes; (2) tools and technologies support planned communication; (3) organisational policy levers exist but lack implementation in direct care and (4) formal tasks incorporate consumer engagement more readily than informal interactions. CONCLUSION The availability of infrastructure and resources to support communication with consumers from ethnic minority backgrounds was limited to specific tasks across the cancer care continuum. Strategies implemented by health services to foster effective communication during formal interactions now require expansion to support and create conditions for effective consumer engagement during informal and everyday care tasks. The use of innovative language support tools and cultural considerations are required at the service and system level to support consumer engagement in all types of care interactions. PUBLIC AND PATIENT INVOLVEMENT The study was embedded within a larger project that included a consumer investigator and was guided by a consumer advisory group (CAG). These consumer team members have lived experience of cancer and are from diverse ethnic backgrounds. CAG members provided feedback on the draft interview guide and participant information for this study.
Collapse
Affiliation(s)
- Ashfaq Chauhan
- Centre for Health Systems and Safety Research, Australian Institute of Health InnovationMacquarie UniversityMacquarie ParkNew South WalesAustralia
| | - Bronwyn Newman
- Centre for Health Systems and Safety Research, Australian Institute of Health InnovationMacquarie UniversityMacquarie ParkNew South WalesAustralia
| | - Elizabeth Manias
- School of Nursing and MidwiferyMonash UniversityClaytonVictoriaAustralia
| | - Kathryn Joseph
- Centre for Health Systems and Safety Research, Australian Institute of Health InnovationMacquarie UniversityMacquarie ParkNew South WalesAustralia
| | - Desiree Leone
- Multicultural Health ServicesWestern Sydney Local Health DistrictNorth ParramattaNew South WalesAustralia
| | - Ramesh L. Walpola
- School of Health SciencesUNSW SydneyKensingtonNew South WalesAustralia
| | - Holly Seale
- School of Population HealthUNSW SydneyKensingtonNew South WalesAustralia
| | - Allen Ben Smith
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSWCamperdownNew South WalesAustralia
- Ingham Institute for Applied Medical ResearchLiverpoolUK
| | - Reema Harrison
- Centre for Health Systems and Safety Research, Australian Institute of Health InnovationMacquarie UniversityMacquarie ParkNew South WalesAustralia
| |
Collapse
|
7
|
Frank C, Rantala A, Svensson A, Sterner A, Green J, Bremer A, Holmberg B. Ethics rounds in the ambulance service: a qualitative evaluation. BMC Med Ethics 2024; 25:8. [PMID: 38238736 PMCID: PMC10795226 DOI: 10.1186/s12910-024-01002-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/09/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND It is a common ethical challenge for ambulance clinicians to care for patients with impaired decision-making capacities while assessing and determining the degree of decision-making ability and considering ethical values. Ambulance clinicians' ethical competence seems to be increasingly important in coping with such varied ethical dilemmas. Ethics rounds is a model designed to promote the development of ethical competence among clinicians. While standard in other contexts, to the best of our knowledge, it has not been applied within the ambulance service context. Thus, the aim of this study was to describe ambulance clinicians' experiences of participating in ethics rounds. METHODS This was a qualitative descriptive study, evaluating an intervention. Data were collected through sixteen interviews with ambulance clinicians who had participated in an intervention involving ethics rounds. The analysis was performed by use of content analysis. RESULTS Two themes describe the participants' experiences: (1) Reflecting freely within a given framework, and (2) Being surprised by new insights. The following categories form the basis of the themes; 1a) Gentle guidance by the facilitator, 1b) A comprehensible structure, 2a) New awareness in the face of ethical problems, and 2b) Shared learning through dialogue. CONCLUSION Incorporating structured ethics rounds seems to create a continuous development in ethical competence that may improve the quality of care in the ambulance service. Structured guidance and facilitated group reflections offer ambulance clinicians opportunities for both personal and professional development. An important prerequisite for the development of ethical competence is a well-educated facilitator. Consequently, this type of ethics rounds may be considered a useful pedagogical model for the development of ethical competence in the ambulance service.
Collapse
Affiliation(s)
- Catharina Frank
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden.
- Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden.
- Department of Health Sciences, Red Cross University College, Stockholm, Sweden.
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Växjö, SE-352 52, Sweden.
| | - Andreas Rantala
- Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
- Department of Ambulance Service, Region Skåne, Helsingborg, Sweden
| | - Anders Svensson
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
- Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden
- Department of Ambulance Service, Region Kronoberg, Sweden
| | - Anders Sterner
- Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden
- Faculty of Caring Sciences, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Jessica Green
- Department of Ambulance Services, Region Kalmar County, Kalmar, Sweden
| | - Anders Bremer
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
- Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden
| | - Bodil Holmberg
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
- Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden
| |
Collapse
|
8
|
Daraghmeh H, Ayed A, Salameh B, Fashafsheh I. Factors of Missed Nursing Care in Intensive Care Units: Palestinian Perspective. Crit Care Nurs Q 2024; 47:62-70. [PMID: 38031309 DOI: 10.1097/cnq.0000000000000494] [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: 12/01/2023]
Abstract
Maintaining a high standard of nursing care is imperative for ensuring patient safety. Several factors significantly impact the provision of nursing care, including work environment resources, personnel coordination, work systems, and head nurse leadership. In addition, each nurse's clinical and academic career also plays a role in shaping the quality of care provided to patients. This article reports results of a cross-sectional study aimed to identify the different types of missed nursing care and the factors that contribute to them, as perceived by nurses, and second, to investigate how nurses' characteristics may relate to the occurrence of missed nursing care. Data for this study were obtained through a self-administered questionnaire that was distributed to participants working in an intensive care unit. The study included a final sample size of 176 participants, all of whom worked in intensive care unit hospitals located in the north region of Palestine. The study found that handwashing, setting up meals for patients who feed themselves, discharge planning, and response to a call light were the most frequently missed nursing care activities. The primary factors identified as reasons for missed nursing care were inadequate availability of labor and material resources, along with communication issues. Efforts to address these identified issues can potentially lead to improved quality of nursing care in intensive care units.
Collapse
Affiliation(s)
- Hameed Daraghmeh
- Ministry of health/Nablus-Palestine (Mr Daraghmeh); and Department of Nursing, Arab American University of Jenin, Jenin, Palestine (Drs Ayed, Salameh, and Fashafsheh)
| | | | | | | |
Collapse
|
9
|
Nollen JM, Brunsveld-Reinders AH, Peul WC, van Furth WR. Patient perspectives on indwelling urinary catheters and fluid balances after transsphenoidal pituitary surgery: a qualitative study. BMJ Open 2023; 13:e069598. [PMID: 36940939 PMCID: PMC10030659 DOI: 10.1136/bmjopen-2022-069598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
OBJECTIVES To explore the perceptions and experiences of patients who underwent transsphenoidal pituitary gland and (para)sellar tumour surgery regarding indwelling urinary catheters (IDUCs) and the postoperative fluid balance. DESIGN Qualitative study using semistructured interviews based on the attitudes, social influence and self-efficacy model and expert knowledge. PARTICIPANTS Twelve patients who underwent transsphenoidal pituitary gland tumour surgery and received an IDUC during or after surgery. SETTING One patient was interviewed in the endocrinology outpatient clinic and 11 patients were interviewed on the neurosurgery ward. RESULTS Five major themes emerged: (1) conflicting information and preoperative expectations, (2) IDUCs perceived as patient-friendly during bedrest, particularly for women, (3) little room for patients' opinions, (4) physical and emotional limitations and (5) fluid balance causes confusion. Information regarding IDUC placement and fluid balance given to patients both preoperatively and postoperatively did not meet their expectations, which led to confusion and uncertainty. The IDUC was perceived as preferable if bedrest was mandatory, preferred particularly by women. Patient could not mobilise freely due to the IDUC and felt ashamed, judged by others and dependent on nurses. CONCLUSIONS This study provides insight into the challenges patients experience in relation to the IDUC and fluid balance. Perceptions on the necessity of an IDUC varied among patients and were influenced by both physical and emotional impediments. A clear, frequent and daily communication between healthcare professionals and patients to evaluate IDUC and fluid balance use is necessary to increase patient satisfaction.
Collapse
Affiliation(s)
- Jeanne-Marie Nollen
- Department of Neurosurgery, Leiden University Medical Center, Leiden, Netherlands
| | | | - Wilco C Peul
- Department of Neurosurgery, Leiden University Medical Center, Leiden, Netherlands
| | - Wouter R van Furth
- Department of Neurosurgery, Leiden University Medical Center, Leiden, Netherlands
| |
Collapse
|
10
|
Bokek-Cohen Y. Does racism toward nurses increase as treatment invasiveness rises? Nurs Inq 2023:e12547. [PMID: 36755498 DOI: 10.1111/nin.12547] [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: 11/01/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 02/10/2023]
Abstract
One of the unspoken issues in public discourse in most countries is the racism of patients toward nurses who originate from a different ethnic group than theirs. The aim of the present study is to examine whether patients' racism toward nurses increases as the invasiveness of treatment rises. This study was conducted in Israel, a highly conflictual society where Jews and Arabs live together and meet in the same health facilities. Despite the tension and sometimes animosity caused by the political situation, members of each group regularly encounter members of the other group during the provision of health-care, both as patients and as medical and nursing staff. A study questionnaire which presented nine nursing treatments of diverse levels of invasiveness was filled out by Arab and Jewish participants. They were asked to convey their preference for an Arab or a Jewish nurse for each treatment. Results of Logistic Regression Analyses reveal that in both sectors, racism toward nurses increases as the treatment invasiveness rises. These findings are discussed in light of the concept of social distance, and serve as an empirical basis for several proposed practical recommendations for eradicating racism against nurses.
Collapse
Affiliation(s)
- Ya'arit Bokek-Cohen
- Department of Behavioral Sciences, Israel Academic College of Ramat-Gan, Ramat Gan, Israel.,School of Nursing, The Academic College of Tel-Aviv-Jaffa, Tel Aviv, Israel
| |
Collapse
|
11
|
Abstract
Patient safety is a critical and long-standing issue in nursing research. The purposes of this study were to explore the knowledge structure of patient safety and to provide a direction for future research by offering new perspectives and a theoretical clarification of patient safety in nursing. Keyword network analysis was performed by extracting keywords from abstracts of 6072 published articles. To reflect nursing perspectives, focus group interviews were conducted and Kim's typology consisting of four domains was used as the framework of analysis. Visualized knowledge structure showed avoiding medication error and preventing pressure ulcers or falls remain important topics within this research field. The distribution of core keywords as per four domains was in the following order: practice, client, environment, and client-nurse domain. Within the client domain, patients' harm-related core keywords were limited to physical harm. The detailed knowledge structure consisted of five themes: patient, preventable patient harm, practice, error, and environment. It comprised risk assessment for patients' characteristics and environmental elements surrounding patient and nursing practice, and risk management using information as knowledge-based nursing practice. Regarding further research, we suggest a multidimensional approach to patient harm, and the utilization of the client-nurse relationship and information systems as strategies for patient safety.
Collapse
|
12
|
Groves PS, Bunch JL, Hanrahan KM, Sabadosa KA, Sharp B, Williams JK. Patient Voices in Hospital Safety during the COVID-19 Pandemic. Clin Nurs Res 2023; 32:105-114. [PMID: 36250248 PMCID: PMC9577816 DOI: 10.1177/10547738221129711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Hospitalized patients and their families may be reluctant to express safety concerns. We aimed to describe safety and quality concerns experienced by hospitalized patients and families and factors and outcomes surrounding decisions about voicing concerns, including those related to the COVID-19 pandemic. We conducted semi-structured interviews with 19 discharged inpatients or family members in a qualitative descriptive design. Some participants reported concern about staff competency or knowledge, communication and coordination, potential treatment errors, or care environment. Factors influencing feeling safe included healthcare team member characteristics, communication and coordination, and safe care expectations. Reasoning for voicing concerns often included personal characteristics. Reasons for not voicing concerns included feeling no action was needed or the concern was low priority. Outcomes for voicing a concern were categorized as resolved, disregarded, and unknown. These findings support the vital importance of open safety communication and trustworthy response to patients and family members who voice concerns.
Collapse
Affiliation(s)
- Patricia S. Groves
- University of Iowa, IA, USA,Patricia S. Groves, College of Nursing, University of Iowa, 50 Newton Road, Iowa City, IA 52242, USA.
| | | | - Kirsten M. Hanrahan
- University of Iowa, IA, USA,University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | | | - Brittaney Sharp
- University of Iowa, IA, USA,University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | | |
Collapse
|
13
|
Ledlie S, Gomes T, Dolovich L, Bailey C, Lallani S, Frigault DS, Tadrous M. Medication errors in community pharmacies: Evaluation of a standardized safety program. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2022; 9:100218. [PMID: 36632372 PMCID: PMC9827048 DOI: 10.1016/j.rcsop.2022.100218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
Background The mandated reporting of medication-related errors in community pharmacies including incidents resulting in inappropriate medication use and near misses intercepted before reaching the patient can be utilized as learning opportunities to aid in the prevention of future events. Objectives To examine reporting uptake, trends, and initial learnings from medication errors reported by community pharmacists to the Assurance and Improvement in Medication Safety (AIMS) Program based in Ontario, Canada between April 1st, 2018, and June 30th, 2021. Methods A descriptive analysis was conducted of all events reported to the AIMS Program during the study period. The web-based reporting form includes a series of mandatory and optional fields completed by the reporter. Individual medications were grouped into broader classes prior to conducting the analysis. Results Among the 31,768 event reports received from 2856 community pharmacies, there were 19,639 incidents and 12,129 near misses. Low reporting followed by a rapid increase was observed during expansion of the AIMS Program in 2018, with almost 60% of Ontario community pharmacies submitting at least 1 event over the study period. In most cases (90.5%), no patient harm was reported. The most frequent event types involved the incorrect drug (19.5%), concentration (17.2%) or quantity (14.5%). Approximately 25% of events were identified by the involved patient or their agent. When looking at medication classes, antihypertensives, opioids and antidepressants were involved in over one-quarter of overall and higher severity events. Environmental staffing problems and interruptions were the contributory factor and sub-factor most frequently reported, respectively. Conclusions This study provides insights into engagement with the AIMS Program by Ontario community pharmacy teams since implementation in 2018. The identification of the circumstances and medications associated with both incidents and near misses, aids in the continued development of strategies and processes to help prevent future events.
Collapse
Affiliation(s)
- Shaleesa Ledlie
- Li Ka Shing Knowledge Institute, Unity Health, Toronto, Ontario, Canada
- Ontario Drug Policy Research Network, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Tara Gomes
- Li Ka Shing Knowledge Institute, Unity Health, Toronto, Ontario, Canada
- Ontario Drug Policy Research Network, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Lisa Dolovich
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | | | - Saira Lallani
- Ontario College of Pharmacists, Toronto, Ontario, Canada
| | | | - Mina Tadrous
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Women's College Research Institute, Toronto, Ontario, Canada
- Corresponding author at: Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College St, Toronto, ON M5S 3M2, Canada.
| |
Collapse
|
14
|
Tubic B, Finizia C, Zainal Kamil A, Larsson P, Engström M. Patients' experience of patient safety information and participation in care during a hospital stay. Nurs Open 2022; 10:1684-1692. [PMID: 36315031 PMCID: PMC9912399 DOI: 10.1002/nop2.1423] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 05/21/2022] [Accepted: 10/11/2022] [Indexed: 11/07/2022] Open
Abstract
AIM Having a culture of safety is crucial when providing high-quality health care, yet preventable adverse events are common in the Swedish healthcare system, especially in the field of surgical care. Research shows that patient participation can improve patient safety. This study aimed to explore patients' experience of the safety leaflet, "Your safety in hospital," including participation in care and feelings of safe care. DESIGN This study uses a descriptive qualitative study design. METHODS Twenty patients from surgical wards received patient safety leaflets and participated in semi-structured interviews during their hospital stay. Data were analysed using qualitative content analysis. RESULTS Three categories emerged from the analysis: Positive and negative experiences of provided information, Experiences of participation in own care, and Feelings of being safe arising from a perception of good quality care. Most participants were satisfied with their participation in their care and felt safe during their hospital stay. Oral information about the safety leaflet from healthcare personnel was lacking.
Collapse
Affiliation(s)
- Bojan Tubic
- Institute of Clinical Sciences, Department of Orthopaedics, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Orthopaedic Surgery, Region Västra GötalandSahlgrenska University HospitalGothenburgSweden
| | - Caterina Finizia
- Department of Otorhinolaryngology, Region Västra GötalandSahlgrenska University HospitalGothenburgSweden,Department of Otorhinolaryngology, Head and Neck SurgeryInstitute of Clinical Sciences, Sahlgrenska Academy, University of GothenburgGothenburgSweden
| | - Asra Zainal Kamil
- Department of Surgery ÖstraRegion Västra Götaland, Sahlgrenska University HospitalGothenburgSweden
| | - Pernilla Larsson
- Department of Surgery ÖstraRegion Västra Götaland, Sahlgrenska University HospitalGothenburgSweden
| | - My Engström
- Institute of Health and Care Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Surgery Sahlgrenska, Region Västra GötalandSahlgrenska University HospitalGothenburgSweden
| |
Collapse
|
15
|
Guo X, Wang Y, Wang L, Yang X, Yang W, Lu Z, He M. Effect of a fall prevention strategy for the older patients: A quasi-experimental study. Nurs Open 2022; 10:1116-1124. [PMID: 36178024 PMCID: PMC9834535 DOI: 10.1002/nop2.1379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 03/02/2022] [Accepted: 09/06/2022] [Indexed: 01/19/2023] Open
Abstract
AIM To explore the effect of a fall prevention strategy on older patients based on the Patient Engagement Framework. DESIGN A longitudinal quasi-experimental quantitative design. METHODS Older patients who met the inclusion criteria were recruited from geriatric, oncology, neurology and cardiology departments of a teaching general hospital in China. Development of a fall prevention intervention strategy for older patients was based on the Patient Engagement Framework. Patients in the intervention group were given this fall prevention strategy (N = 58), and those in the control group were given conventional measures (N = 58). The following indicators were compared between the two groups after intervention: (a) number of falls; (b) Knowledge-Attitude-Practice (KAP) score; (c) Modified Fall Efficacy Scale score. RESULTS After the implementation of an intervention strategy in older patients, the number of falls decreased from 3 to 0; the score of KAP and Modified Fall Efficacy Scale was promoted (p < .05).
Collapse
Affiliation(s)
- Xiaobei Guo
- Nursing Department, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Ying Wang
- Nursing Department, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Lei Wang
- Nursing Department, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Xueke Yang
- Nursing Department, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Weimei Yang
- Internal Medicine, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Zhihui Lu
- Nursing Department, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Mei He
- Intensive Care Medicine, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| |
Collapse
|
16
|
Li C, Xu X, He L, Zhang M, Li J, Jiang Y. Questionnaires Measuring Patient Participation in Patient Safety-a systematic review. J Nurs Manag 2022; 30:3481-3495. [PMID: 35593487 DOI: 10.1111/jonm.13690] [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: 06/21/2021] [Revised: 05/13/2022] [Accepted: 05/16/2022] [Indexed: 02/05/2023]
Abstract
AIM The purpose of this review was to evaluate the content, validity and reliability of patient-reported questionnaires on patient participation in patient safety. BACKGROUND Patient participation in patient safety is one of the key strategies that are increasingly regarded as a critical intervention to improve the quality of safety care. EVALUATION A systematic review was conducted according to PRISMA guidelines. The content, reliability and validity of patient-reported questionnaires on patient participation in patient safety were assessed. KEY ISSUES Twenty-seven studies were included for data extraction and synthesis. The questionnaire contents most commonly used to describe patient participation in patient safety were 'attitudes and perceptions', 'experience', 'information and feedback' and 'willingness'. Internal consistency was evaluated for seventeen questionnaires, and test-retest reliability was tested for four questionnaires. Content validity was assessed among all included questionnaires, and structural validity was evaluated for twelve questionnaires. CONCLUSIONS Future research targeting the different safety issues is still indispensable for developing patient-reported questionnaires with great psychometric quality in validity, reliability, feasibility and usability in patient participation in patient safety. IMPLICATIONS FOR NURSING MANAGEMENT Clinical nurses should consider the internal consistency, test-retest reliability, content validity and structural validity of the questionnaires that have been positively appraised for methodological quality before use.
Collapse
Affiliation(s)
- Caili Li
- West China School of Nursing, Sichuan University/West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Xiaofeng Xu
- Trauma Center ward 2, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Lingxiao He
- Tauma center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Mingming Zhang
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Jing Li
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Yan Jiang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, P.R. China
| |
Collapse
|
17
|
Vaismoradi M, Fredriksen Moe C, Ursin G, Ingstad K. Looking through racism in the nurse-patient relationship from the lens of culturally congruent care: A scoping review. J Adv Nurs 2022; 78:2665-2677. [PMID: 35441739 PMCID: PMC9544978 DOI: 10.1111/jan.15267] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/19/2022] [Accepted: 04/05/2022] [Indexed: 02/06/2023]
Abstract
AIM This review aimed to identify the nature of racism in the nurse-patient relationship and summarize international research findings about it. DESIGN A scoping review of the international literature. DATA SOURCES The search process encompassed three main online databases of PubMed (including MEDLINE), Scopus and Embase, from 2009 until 2021. REVIEW METHODS The scoping review was informed by the Levac et al.'s framework to map the research phenomenon and summarize current empirical research findings. Also, the review findings were reflected in the three-dimensional puzzle model of culturally congruent care in the discussion section. RESULTS The search process led to retrieving 149 articles, of which 10 studies were entered into data analysis and reporting results. They had variations in the research methodology and the context of the nurse-patient relationship. The thematical analysis of the studies' findings led to the development of three categories as follows: bilateral ignition of racism, hidden and manifest consequences of racism and encountering strategies. CONCLUSION Racism threatens patients' and nurses' dignity in the healthcare system. There is a need to develop a framework of action based on the principles of culturally congruent care to eradicate racism from the nurse-patient relationship in the globalized context of healthcare. IMPACT Racism in the nurse-patient relationship has remained a relatively unexplored area of the nursing literature. It hinders efforts to meet patients' and families' needs and increases their dissatisfaction with nursing care. Also, racism from patients towards nurses causes emotional trauma and enhances job-related stress among nurses. Further research should be conducted on this culturally variant phenomenon. Also, the participation of patients and nurses should be sought to prohibit racism in healthcare settings.
Collapse
Affiliation(s)
| | | | - Gøril Ursin
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - Kari Ingstad
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| |
Collapse
|
18
|
Kao HFS, Hung CC, Lee BO, Tsai SL, Moreno O. Patient Participation in Healthcare Activities: Nurses' and Patients' Perspectives in Taiwan. Nurs Health Sci 2021; 24:44-53. [PMID: 34914182 DOI: 10.1111/nhs.12911] [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: 07/26/2021] [Revised: 11/17/2021] [Accepted: 11/29/2021] [Indexed: 11/30/2022]
Abstract
Patient participation in healthcare activities is key in producing successful patient-centered care. However, little is known about both nurses' and patients' perspectives regarding patient participation in East Asia. This paper compared and contrasted perspectives of patient participation in healthcare activities between nurses and patients, using a qualitative study with a purposive sample of 39 nurses and 15 patients. A semi-structured interview was applied to focus groups for nurses, and face-to-face interview for patients. Content analysis was utilized to analyze the data, and common themes and subthemes were identified showing three similarities- authoritative culture, participation behaviors, and obstacles to participation; and two differences- sources of acquiring patient-related health information and responsible party. Nurses and patients did not entirely view participation in healthcare activities congruently. Relevant clinical practices are also suggested, including respecting patients' autonomy, nurses' using layman language to explain, patients' understanding the meaning behind their participation behaviors, recognizing obstacles faced to enhance patient participation with adjusted nursing workload, actively providing needed health information, and leading patients to realize that they will be responsible for their health behaviors after discharge. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
| | - Chang-Chiao Hung
- Department of Nursing & Nursing Department, Chang Gung University of Science and Technology & Chia-Yi Chang Gung Memorial Hospital, ChiaYi, Taiwan
| | - Bih-O Lee
- College of Nursing, Kaohsiung Medical University, Taiwan
| | - Shu-Ling Tsai
- Department of Nursing, Chang Gung University of Science and Technology, ChiaYi, Taiwan
| | - Oscar Moreno
- School of Nursing, The University of Texas at El Paso, USA
| |
Collapse
|
19
|
Tobiano G, Chaboyer W, Dornan G, Teasdale T, Manias E. Older patients' engagement in hospital medication safety behaviours. Aging Clin Exp Res 2021; 33:3353-3361. [PMID: 33945114 DOI: 10.1007/s40520-021-01866-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/16/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Increasing age is associated with more medication errors in hospitalised patients. Patient engagement is a strategy to reduce medication harm. AIMS To measure older patients' preferences for and reported medication safety behaviours, identify the relationship between preferred and reported medication safety behaviours and identify whether perceptions of medication safety behaviours differ between groups of young-old, middle-old and old-old patients (65-74 years, 75-84 years, and ≥ 85 years). METHODS A survey, which included the Inpatient Medication Safety Involvement Scale (IMSIS) was administered to 200 older patients from medical settings, at one hospital. Data were analysed using descriptive statistics, Spearman's rho and the Kruskal-Wallis test. RESULTS Patients reported a desire to ask questions (59.5% n = 119) and check with healthcare professionals if they perceived that a medication was wrong (86.5% n = 173) or forgotten (87.0% n = 174). Patients did not have particular preferences, which differed from their experiences in terms of viewing the medication administration chart and self-administering medications. Preferred and reported behaviours correlated positively (r = 0.46-0.58, n = 200, p ≤ 0.001). Young-old patients preferred notifying healthcare professionals of perceived medication errors more than middle-old and old-old patients (p ≤ 0.05). CONCLUSIONS Older patients may prefer verbal medication safety behaviours like asking questions and notifying healthcare professionals of medication errors, over viewing medication charts and self-administering medications. The young-old group wanted to identify perceived medication errors more than other age groups. Older patients are willing to engage in medication safety behaviours, and healthcare professionals and organisations need to embrace this engagement in an effort to reduce medication harm.
Collapse
Affiliation(s)
- Georgia Tobiano
- National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Parklands Drive, Southport, QLD, 4222, Australia.
- Gold Coast University Hospital, Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, QLD, 4215, Australia.
| | - Wendy Chaboyer
- National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Parklands Drive, Southport, QLD, 4222, Australia
| | - Gemma Dornan
- Gold Coast University Hospital, Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, QLD, 4215, Australia
| | - Trudy Teasdale
- Gold Coast University Hospital, Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, QLD, 4215, Australia
| | - Elizabeth Manias
- School of Nursing and Midwifery, Deakin University and Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| |
Collapse
|
20
|
Acha BV, Ferrandis ED, Ferri Sanz M, García MF. Engaging People and Co-Producing Research with Persons and Communities to Foster Person-Centred Care: A Meta-Synthesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312334. [PMID: 34886070 PMCID: PMC8656837 DOI: 10.3390/ijerph182312334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 11/26/2022]
Abstract
Introduction: Engagement and co-production in healthcare research and innovation are crucial for delivering person-centred interventions in underserved communities, but the knowledge of effective strategies to target this population is still vague, limiting the provision of person-centred care. Our research aimed to identify essential knowledge to foster engagement and co-production. Materials and Methods: A meta-synthesis research design was used to compile existing qualitative research papers on health communication, engagement, and empowerment in vulnerable groups in high-income countries (HICs) from 2008 to 2018. A total of 23 papers were selected and analysed. Results: ‘Design and recruitment’ and ‘engagement and co-production’ thematic areas are presented considering the factors related to researcher–communities attunement and the strategical plans for conducting research. The insights are discussed in light of the literature. Long-term alliances, sustainable structures, and strengthened bonds are critical factors for producing real long-term change, empowering persons and communities, and paving the way to person-centred care. Conclusions: The enhancement of the recruitment, involvement, and empowerment of traditionally disengaged communities and individuals depends on the awareness and analysis of social determinants, power differentials and specific tactics, and the capacity of researchers and individuals to apply all these principles in real-world practice.
Collapse
Affiliation(s)
- Beatriz Vallina Acha
- Polibienestar Research Intitute-Instituto de Investigación de Políticas de Bienestar Social: Edificio Institutos de Investigación, Campus de Tarongers, University of Valencia, 46022 Valencia, Spain;
- Senior Europa S.L.–Kveloce I + D + i: C/Roger de Lauria 10–7, 46002 Valencia, Spain; (M.F.S.); (M.F.G.)
- Correspondence:
| | - Estrella Durá Ferrandis
- Polibienestar Research Intitute-Instituto de Investigación de Políticas de Bienestar Social: Edificio Institutos de Investigación, Campus de Tarongers, University of Valencia, 46022 Valencia, Spain;
| | - Mireia Ferri Sanz
- Senior Europa S.L.–Kveloce I + D + i: C/Roger de Lauria 10–7, 46002 Valencia, Spain; (M.F.S.); (M.F.G.)
| | - Maite Ferrando García
- Senior Europa S.L.–Kveloce I + D + i: C/Roger de Lauria 10–7, 46002 Valencia, Spain; (M.F.S.); (M.F.G.)
| |
Collapse
|
21
|
Li Z, Marshall AP, Lin F, Ding Y, Chaboyer W. Pressure injury prevention practices among medical surgical nurses in a tertiary hospital: An observational and chart audit study. Int Wound J 2021; 19:1165-1179. [PMID: 34729917 PMCID: PMC9284631 DOI: 10.1111/iwj.13712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/13/2021] [Accepted: 10/20/2021] [Indexed: 11/26/2022] Open
Abstract
Pressure injuries are frequently occurring adverse events in hospitals, negatively impacting patient safety and quality of care. Most pressure injuries are avoidable if effective prevention strategies are used. However, the extent to which various settings influence their use of prevention strategies is unknown. The aim of this study was to describe and compare pressure injury prevention strategies used by medical and surgical nurses in the Chinese context. In this observational study, we used semi-structured observations with chart audits to collect data in two medical and two surgical wards in a tertiary hospital from June to December 2020. Observations were patient-focused; any prevention practices the patient received were recorded, and a chart audit was used to identify documented prevention strategies. The frequency of each prevention strategy was reported, and differences between medical and surgical wards were analysed using independent t-test or χ2 test. A total of 577 patients (n = 294, 50.9% medical; n = 283, 49.1% surgical) were observed and their charts audited. Risk assessment was completed on admission for all patients. Repositioning was the most frequently used strategy, with about 84% (n = 486) patients being repositioned regularly. However, skin care, nutritional risk screening and the use of support surfaces were suboptimal. Patient education was not commonly observed but was documented in 75% (n = 433) of audited charts. More medical patients' skin was kept clean and hydrated, but more surgical patients received barrier creams, had a support surface and received more nutrition support and if a prone position was used, they were more likely to be turned after 2 hr and to be repositioned after sitting in a chair for an hour. Prevention strategies were more likely to be documented in surgical patients' charts. Despite pressure injury prevention guideline recommendations provided various prevention strategies for nurses to apply, the observed use of some strategies such as nutrition, skin care and support surfaces was not ideal. Nurses relied heavily on repositioning for pressure injury prevention. Most pressure injury prevention practices need improvement although surgical patients generally received better preventative care. These findings can facilitate clinicians and nurse managers when tailoring future pressure injury prevention work.
Collapse
Affiliation(s)
- Zhaoyu Li
- School of Nursing and Midwifery, Griffith University, Menzies Health Institute Queensland, Gold Coast, Queensland, Australia
| | - Andrea P Marshall
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia.,Nursing and Midwifery Education and Research Unit, Gold Coast Health, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Frances Lin
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia.,School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Yanming Ding
- Nursing Department, Peking University First Hospital, Beijing, China
| | - Wendy Chaboyer
- NHMRC Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| |
Collapse
|
22
|
An exploration of the perspectives of individuals and their caregivers on pressure ulcer/injury prevention and management to inform the development of a clinical guideline. J Tissue Viability 2021; 31:1-10. [PMID: 34776327 DOI: 10.1016/j.jtv.2021.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 08/09/2021] [Accepted: 10/25/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Consumer engagement is a requirement of high quality clinical guidelines. Developing strategies to engage consumers and incorporate the perspectives of individuals with or at risk of pressure ulcers/injuries and their informal caregivers was one priority in the recent update of the EPUAP/NPIAP/PPPIA's Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline. AIMS The aims were to determine the goals of individuals and caregivers for pressure ulcer/injury care, priorities for pressure ulcer/injury education and biggest problems related to pressure ulcers/injuries. METHODS An online, anonymous, international 10-item survey, accessible in nine languages was provided to individuals and their caregivers from April to October 2018. Descriptive statistics were used for quantitative data and a thematic analysis approach was used to analyse qualitative data. RESULTS There were 1233 individuals from 27 countries who completed the survey. Overall, individuals and caregivers had similar goals of care. Reducing the size of pressure ulcer/injury was selected more often as a care goal than complete healing. Individuals, compared to caregivers, considered managing pain more important. Qualitative data analysis identified five themes including knowledge, attitudes, and skills; risk factors for pressure ulcer/injury; accessing pressure ulcer/injury care; quality of life for patients and caregivers; and the pressure ulcer/injury. CONCLUSIONS The consumer survey provided consumer engagement and perspective that was incorporated into guideline development, including consideration during evaluation of the relevance and acceptability of recommendations, and assignment of recommendation strength ratings.
Collapse
|
23
|
Vaismoradi M, Fredriksen Moe C, Vizcaya-Moreno F, Paal P. Ethical Tenets of PRN Medicines Management in Healthcare Settings: A Clinical Perspective. PHARMACY 2021; 9:174. [PMID: 34707079 PMCID: PMC8552074 DOI: 10.3390/pharmacy9040174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/16/2021] [Accepted: 10/21/2021] [Indexed: 11/16/2022] Open
Abstract
Prescription and administration of pro re nata (PRN) medications has remained a poorly discussed area of the international literature regarding ethical tenets influencing this type of medication practice. In this commentary, ethical tenets of PRN medicines management from the clinical perspective based on available international literature and published research have been discussed. Three categories were developed by the authors for summarising review findings as follows: 'benefiting the patient', 'making well-informed decision', and 'follow up assessment' as pre-intervention, through-intervention, and post-intervention aspects, respectively. PRN medicines management is mainly intertwined with the ethical tenets of beneficence, nonmaleficence, dignity, autonomy, justice, informed consent, and error disclosure. It is a dynamic process and needs close collaboration between healthcare professionals especially nurses and patients to prevent unethical practice.
Collapse
Affiliation(s)
- Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, 8049 Bodø, Norway;
| | | | - Flores Vizcaya-Moreno
- Department of Nursing, Faculty of Health Sciences, University of Alicante, 03080 Alicante, Spain;
| | - Piret Paal
- WHO Collaborating Centre, Institute of Nursing Science and Practice, Paracelsus Medical University, 5020 Salzburg, Austria;
| |
Collapse
|
24
|
Increasing patient participation in hand hygiene practices in adult surgical wards in a tertiary institution: a best practice implementation project. JBI Evid Implement 2021; 20:53-62. [PMID: 34369896 DOI: 10.1097/xeb.0000000000000290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The WHO states that hospital-acquired infections may be transmitted through contaminated hands. Practicing hand hygiene using alcohol-based handrub or soap and water reduces harmful organisms. The Joanna Briggs Institute (JBI) best practice recommends empowering patients with hand hygiene knowledge and engaging their involvement to strengthen hand hygiene practices. AIMS The aim of this project was to improve hand hygiene among surgical inpatients. METHODS This evidence-based quality improvement project was conducted in three phases: the baseline audit, implementing best practice, and the postimplementation audit. Participants were patients hospitalized in three surgical wards of a 1200-bed acute care tertiary hospital. This project utilized the online JBI Practical Application of Clinical Evidence System and The Getting Research into Practice program to identify barriers and strategies. Nurses provided patients with an education pamphlet and regularly reminded them to improve their hand hygiene practices. RESULTS Ninety-four patients were audited between April and June 2018. Patients' hand hygiene practices improved from 19.1% at baseline audit to 61.7% (P < 0.01) at first follow-up audit. Patients' hand hygiene improved from 48.9 to 72.3% (P = 0.03) before meals, and from 92.6 to 98.9% (P = 0.65) after toileting. The proportion of patients who received a hand hygiene information leaflet in an appropriate language increased from 64.9 to 89.4% (P < 0.01). CONCLUSION Patients' involvement in the hand hygiene program has significantly improved their hand hygiene practices. Patient education and patient information leaflet continue to be an effective strategy to improve knowledge and practices.
Collapse
|
25
|
Factors Influencing Patient-Centeredness among Korean Nursing Students: Empathy and Communication Self-Efficacy. Healthcare (Basel) 2021; 9:healthcare9060727. [PMID: 34204788 PMCID: PMC8231486 DOI: 10.3390/healthcare9060727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/06/2021] [Accepted: 06/10/2021] [Indexed: 11/16/2022] Open
Abstract
In recent years, there is a growing tendency in the extent to which patients wish to be actively involved in processes related to their healthcare and relevant decision-making. This was a cross sectional study. We examined undergraduate nursing students’ patient-centeredness and investigated its associated factors including empathy and communication self-efficacy using a structured questionnaire. A total of 201 undergraduate nursing students who provided written consent to participate in the study completed measures on patient-centeredness (sharing and caring), empathy (fantasy, perspective taking, personal distress, and empathic concern), and communication self-efficacy. The factors affecting patient-centeredness were analyzed using multiple regression. Communication self-efficacy affected patient-centered sharing, while age, empathy (fantasy, personal distress, empathic concern), and communication self-efficacy affected patient-centered caring. Empathy and communication self-efficacy positively affected patient-centeredness. Therefore, strategies that promote empathy and communication self-efficacy are needed to increase patient-centered care competency.
Collapse
|
26
|
Roche D, Jones A. A qualitative study of nurse-patient communication and information provision during surgical pre-admission clinics. Health Expect 2021; 24:1357-1366. [PMID: 34089627 PMCID: PMC8369095 DOI: 10.1111/hex.13270] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 12/13/2022] Open
Abstract
Background Health‐care service users are often being described as ‘co‐producers’ with an active role in their care. However, there are challenges associated with this approach, including how standardization affects personalized care, and the ability of patients to retain high volumes of information. Objective Our study explores patient and nursing perspectives of information provision in the pre‐admission element of an Enhanced Recovery After Surgery programme, an evidence‐based approach implemented to improve the quality of surgical care. Our analysis has been informed by an evidence‐based model developed by Grande et al Patient Educ Couns. 2014;95:281. Design/Setting and participants This was a qualitative study including observations of pre‐admission clinics and semi‐structured interviews across three surgical wards. Patients (n = 21) and registered nurses (n = 21) were purposively selected for interviews. Results Patients welcomed the opportunity for active involvement in their care. However, we also identified informational boundaries and how illness and treatment‐related anxieties were barriers to patient engagement with the information provided. Discussion We recommend that to support a patient‐centred and individualized approach to patient involvement the ‘information (giving) + activation’ element of Grande et al Patient Educ Couns. 2014;95:281 model be reconfigured to allow for ‘information (giving) + exploration +activation’. Conclusion Nurses need to feel empowered to adopt strategies that allow for different informational needs, rather than adopting a one‐size‐fits‐all paternalistic approach. Patient contribution This study focused on patient involvement and we give thanks to all the patients who took part in interviews and those who allowed us to observe their care.
Collapse
Affiliation(s)
- Dominic Roche
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Aled Jones
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| |
Collapse
|
27
|
O'Dowd E, Lydon S, O'Connor P. A multi-perspective exploration of the understanding of patient complaints and their potential for patient safety improvement in general practice. Eur J Gen Pract 2021; 27:35-44. [PMID: 33904345 PMCID: PMC8081321 DOI: 10.1080/13814788.2021.1900109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Healthcare complaints are an under utilised source of information for safety improvement, particularly in general practice settings. Within general practice in Ireland, complaints management is dependent on individual practice policies, with little standardisation nationally, impeding their use for safety improvement. There is a need to understand factors that contribute to unlocking the potential of complaints for safety improvement in general practice in Ireland and internationally. Objectives To explore perceptions of healthcare complaints of general practitioners, practice nurses and managers, medico-legal professionals, and policymakers. Methods Participants were recruited using convenience sampling. Interviews were conducted from November 2019–May 2020, based on a semi-structured interview guide. Data were then transcribed and analysed using content analysis. An iterative process was applied to identify emerging themes from the interviews. Results A total of 29 participants (19 female, 10 male) were interviewed. Three themes emerged from the analysis, ‘why patients submit complaints’, ‘management of complaints’, and ‘impact of complaints’. Subthemes included ‘barriers and facilitators to complaining’, ‘practice processes’ for complaints management, and ‘impacts on staff’ of complaints, among others. Conclusion There is a lot to be learned about how individuals experience complaints, however, this study adds to existing knowledge. The findings from this study can be used to tackle challenges facing complaints management in general practice, including the barriers to complaining for patients and the negative impacts of complaints on the staff, and can also help to build on positive aspects of complaints such as the desire for systemic change among interested parties.
Collapse
Affiliation(s)
- Emily O'Dowd
- Discipline of General Practice, National University of Ireland Galway, Galway, Ireland
| | - Sinead Lydon
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Paul O'Connor
- Discipline of General Practice, National University of Ireland Galway, Galway, Ireland
| |
Collapse
|
28
|
Salehi T, Seyedfatemi N, Mirzaee MS, Maleki M, Mardani A. Nurses' Knowledge, Attitudes, and Practice in Relation to Pharmacovigilance and Adverse Drug Reaction Reporting: A Systematic Review. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6630404. [PMID: 33937402 PMCID: PMC8062168 DOI: 10.1155/2021/6630404] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/23/2021] [Accepted: 03/29/2021] [Indexed: 12/30/2022]
Abstract
AIM To describe and synthesize aspects of knowledge, attitudes, and practice regarding pharmacovigilance and adverse drug reaction (ADR) reporting and to explore associated barriers from a nurse perspective. METHODS A systematic review was conducted. Electronic databases including MEDLINE, Embase, Scopus, and Web of Knowledge from January 2010 to October 2020 were searched. Original observational studies that were written in English and which focused on nurses' knowledge, attitudes, practice, and perceived barriers regarding pharmacovigilance and ADR reporting in various healthcare settings were included. RESULTS Twenty-three studies published in English from 2010 to 2020 were retrieved during the search process. Overall, in the knowledge domain, the median percentages of nurses who were aware of the definitions of ADRs were 74.1%, while only 26.3% were aware of the adverse drug reaction reporting form. In the attitude domain, 84.6% of nurses believed ADR reporting to be important for patient/medicine safety and 37.1% had a fear of legal liability following ADR reporting. Although 67.1% of nurses encountered ADRs during their professional life, only 21.2% had a history of ADR reporting. In addition, lack of knowledge/training (median: 47.1%) was identified as the most common barrier in ADR reporting from a nursing viewpoint. CONCLUSION Despite positive nurse attitudes, knowledge and practice in relation to pharmacovigilance activities and ADR reporting did not occur regularly or often. Improving nurses' knowledge through in-service training and degree-level education and addressing the main barriers of ADR reporting may help to achieve an improved level of reporting.
Collapse
Affiliation(s)
- Tahmine Salehi
- Nursing Care Research Center, Department of Nursing Management, School of Nursing & Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Naiemeh Seyedfatemi
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Saeed Mirzaee
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Maleki
- School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Mardani
- Nursing Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
29
|
Eriksson-Liebon M, Roos S, Hellström I. Patients' expectations and experiences of being involved in their own care in the emergency department: A qualitative interview study. J Clin Nurs 2021; 30:1942-1952. [PMID: 33829575 DOI: 10.1111/jocn.15746] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/14/2021] [Accepted: 02/17/2021] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To investigate patients' experiences of being involved in their care in the emergency department (ED). BACKGROUND Previous research shows that when patients experience involvement during care visits, this increased their trust in the care, gave a sense of control and promoted their autonomy. DESIGN A qualitative descriptive design with semi-structured interviews, using the "Consolidated criteria for reporting qualitative research" (COREQ) checklist. METHODS Using convenience sampling, semi-structured interviews were conducted with 16 patients in the ED. RESULTS The study identified four categories: attention and inattention; communication and understanding; varying levels of participation; and inefficient and inaccessible care. The results show that patients expected to be treated with respect and to be involved in an open dialogue about their care. Patients' experiences of participation were related to their sense of control. CONCLUSIONS Based on the results of the study, the authors found that factors such as dialogue, information, attention and participation affected the patients' involvement during the ED visit. Experiences of involvement and control were linked to patients' experiences of care and of patients as individuals. RELEVANCE TO CLINICAL PRACTICE Healthcare providers' awareness of the importance of paying attention to the patient as an individual, and of the need for simple, continuous communication could facilitate patient involvement in own care.
Collapse
Affiliation(s)
- M Eriksson-Liebon
- Department of Emergency Medicine in Norrköping, Vrinnevi Hospital, Norrköping, Sweden.,Department of Health, Medicine and Caring Science, Linköping University, Linköping, Sweden
| | - S Roos
- Department of Health, Medicine and Caring Science, Linköping University, Linköping, Sweden
| | - I Hellström
- Department of Health, Medicine and Caring Science, Linköping University, Linköping, Sweden.,Department of Health Care Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| |
Collapse
|
30
|
Groves PS, Bunch JL, Cannava KE, Sabadosa KA, Williams JK. Nurse Sensemaking for Responding to Patient and Family Safety Concerns. Nurs Res 2021; 70:106-113. [PMID: 33630533 DOI: 10.1097/nnr.0000000000000487] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hospitals need to prevent, respond to, and learn from safety risks and events perceived by patients and families, who in turn rely on nurses to respond to and report their safety concerns. OBJECTIVES The aim of the study was to describe the process by which bedside nurses evaluate and determine the appropriate response to safety concerns expressed by patients or their families. METHODS A qualitative design was employed. We recruited inpatient bedside nurses in an 811-bed Midwest academic medical center. Nurses provided demographic information and participated in semistructured interviews designed to elicit narratives related to evaluation and response to patient- or family-expressed safety concerns. Data analysis and interpretation were guided by grounded theory. RESULTS We enrolled 25 nurses representing 22 units. Based on these nurses' experiences, we developed a grounded theory explaining how nurses evaluate a patient or family safety concern. Nurses make sense of the patient's or family's safety concern in order to take action. Achieving this goal requires evaluation of the meaningfulness and reasonableness of the concern, as well as the potential effect of the concern on the patient. Based on this nursing evaluation, nurses respond in ways designed to (a) manage emotions, (b) immediately resolve concerns, (c) involve other team members, and (d) address fear or uncertain grounding in reality. Nurses reported routinely handling safety concerns at the bedside without use of incident reporting. DISCUSSION Safety requires an interpersonal and evaluative nursing process with actions responsive to patient and family concerns. Safety interventions designed to be used by nurses should be developed with the dynamic, cognitive, sensemaking nature of nurses' routine safety work in mind. Being sensitive to the vulnerability of patients, respecting patient and family input, and understanding the consequences of dismissing patient and family safety concerns are critical to making sense of the situation and taking appropriate action to maintain safety. Measuring patient safety or planning improvement based on patient or family expression of safety concerns would be a difficult undertaking using only standard approaches. A more complex approach incorporating direct patient engagement in data collection is necessary to gain a complete safety picture.
Collapse
|
31
|
Groves PS, Bunch JL, Sabadosa KA, Cannava KE, Williams JK. A grounded theory of creating space for open safety communication between hospitalized patients and nurses. Nurs Outlook 2021; 69:632-640. [PMID: 33579513 DOI: 10.1016/j.outlook.2021.01.005] [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: 04/29/2020] [Revised: 11/30/2020] [Accepted: 01/10/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND There is evidence that fear of negative nurse response may prevent hospitalized patients from sharing safety concerns, adversely affecting patient safety. PURPOSE The purpose of the present study was to describe the process by which bedside nurses recognize and respond to safety concerns expressed by patients or their families. METHODS Twenty-five bedside nurses from 30 maternal-child, intensive, medical-surgical, and psychiatric inpatient units within an academic medical center participated in semi-structured interviews. Data were analyzed using grounded theory. FINDINGS Nurses reported creating space for open safety communication to foster trust and maintain patient safety and sense of security. Nurses anticipated safety concerns, invited safety discussion, were accessible, recognized insecurity, reacted in a trustworthy way, shared a plan, and followed up with patient and family. DISCUSSION This process involves multiple interacting components, yet was remarkably consistent across acute care settings, despite differences in nurses, patient populations, and unit cultures.
Collapse
|
32
|
Cho S, Lee E. Effects of Self-Education on Patient Safety via Smartphone Application for Self-Efficacy and Safety Behaviors of Inpatients in Korea. Healthc Inform Res 2021; 27:48-56. [PMID: 33611876 PMCID: PMC7921575 DOI: 10.4258/hir.2021.27.1.48] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 12/22/2020] [Indexed: 11/23/2022] Open
Abstract
Objectives This study aimed to determine whether self-educational intervention on patient safety via a smartphone application could improve the level of self-efficacy and safety behaviors of patients. In addition the effect of change in self-efficacy on the improvement of safety behaviors after self-educational intervention was investigated. Methods A one-group pre- and post-test design and convenience sampling were implemented. Self-educational intervention via smartphone application was provided to 94 participants in a tertiary university hospital in South Korea. The smartphone application included learning contents on why the participation of patients is critical in preventing hospital-acquired infections and surgery-related adverse events during hospitalization. Paired t-tests and hierarchical regression analysis were conducted to assess the effect of self-educational intervention and self-efficacy on the improvement of safety behaviors of patients. Results After the intervention, the level of self-efficacy and safety behaviors significantly increased from 2.53 to 2.95 and from 2.00 to 2.62, respectively. In the hierarchical regression analysis, the change in self-efficacy accounted for 35.4% of the variance in the improvement of safety behaviors. Conclusions The results of this study demonstrated that self-education on patient safety via a smartphone application was an effective strategy to enhance patients’ self-efficacy and safety behaviors. This process could ultimately enhance patient safety by promoting patient involvement during hospitalization and preventing the occurrence of medical errors.
Collapse
Affiliation(s)
- Sumi Cho
- Department of Nursing, Korea Nazarene University, Cheonan, Korea
| | - Eunjoo Lee
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, Korea
| |
Collapse
|
33
|
Ocloo J, Garfield S, Franklin BD, Dawson S. Exploring the theory, barriers and enablers for patient and public involvement across health, social care and patient safety: a systematic review of reviews. Health Res Policy Syst 2021; 19:8. [PMID: 33472647 PMCID: PMC7816359 DOI: 10.1186/s12961-020-00644-3] [Citation(s) in RCA: 115] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 10/13/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The emergence of patient and public involvement (PPI) in healthcare in the UK can be traced as far back as the 1970s. More recently, campaigns by harmed patients have led to a renewed focus on strengthening PPI. There is a growing awareness of the benefits of PPI in research as well as a need to address power inequities and a lack of diversity and inclusion. This review was undertaken to look at evidence for theories, barriers and enablers in PPI across health, social care and patient safety that could be used to strengthen PPI and address a perceived knowledge and theory gap with PPI in patient safety. METHODS We searched MEDLINE, EMBASE and PsycINFO from inception to August 2018, using both MeSH and free-text terms to identify published empirical literature. Protocols in PROSPERO were also searched to identify any systematic reviews in progress. The extracted information was analysed using a narrative approach, which synthesises data using a descriptive method. RESULTS Forty-two reviews were identified and grouped by key outcomes. Twenty-two papers mentioned theory in some form, 31 mentioned equality and diversity (although with no theory mentioned in this area), and only 19 cited equality and diversity as a barrier or enabler. Thirty-four reviews identified barriers and enablers at different organisational levels: personal/individual; attitudes; health professional; roles and expectations; knowledge, information and communication; financing and resourcing; training; general support; recruitment and representation, PPI methods and working with communities and addressing power dynamics. CONCLUSIONS The review findings suggest that a commitment to PPI and partnership working is dependent on taking a whole system approach. This needs to consider the complex individual and organisational enablers and constraints to this process and address imbalances of power experienced by different groups. Addressing equality and diversity and use of a theory-driven approach to guide PPI are neglected areas. The long tradition of involvement across health and social care can provide considerable expertise in thinking about ways to strengthen approaches to PPI. This is especially important in patient safety, with a much newer tradition of developing PPI than other areas of healthcare.
Collapse
Affiliation(s)
- Josephine Ocloo
- Centre for Implementation Science, Health Services, Population and Research Department, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, UK. .,National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) At King's College Hospital NHS Foundation Trust, London, UK.
| | - Sara Garfield
- Imperial College Healthcare NHS Trust, London, UK.,University College London School of Pharmacy, London, UK
| | - Bryony Dean Franklin
- Imperial College Healthcare NHS Trust, London, UK.,University College London School of Pharmacy, London, UK
| | - Shoba Dawson
- Centre for Academic Primary Care, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| |
Collapse
|
34
|
McKinney A, Fitzsimons D, Blackwood B, McGaughey J. Patient and family involvement in escalating concerns about clinical deterioration in acute adult wards: A qualitative systematic review. Nurs Crit Care 2020; 26:352-362. [PMID: 33345386 DOI: 10.1111/nicc.12582] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Despite international standards for recognition and response to deterioration, warning signs are not always identified by staff on acute hospital wards. Patient and family-initiated escalation of care schemes have shown some benefit in assisting early recognition, but are not widely used in many clinical practice areas. OBJECTIVES To explore (a) patients' and relatives' experiences of acute deterioration and (b) patients', relatives' and healthcare professionals' perceptions of the barriers or facilitators to patient and family-initiated escalation of care in acute adult hospital wards. METHODS We conducted a qualitative review using Cochrane methodology. Two reviewers independently screened studies, extracted data, and appraised the quality using a qualitative critical appraisal tool. Findings were analysed using thematic synthesis and confidence in findings was assessed using GRADE-CERQual. SEARCH STRATEGY MEDLINE, CINAHL, EMBASE, PsychINFO databases and grey literature from 2005 to August 2019. INCLUSION CRITERIA Any research design that had a qualitative element and focused on adult patients' and relatives' experiences of deterioration and perceptions of escalating care. RESULTS We included five studies representing 120 participants and assessed the certainty of evidence as moderate using GRADE-CERQual. Findings indicated that a number of patients/relatives have the ability to detect acute deterioration, however, various factors act as both barriers and facilitators to being heard. These include personal factors, perceptions of role, quality of relationships with healthcare staff, and organisational factors. Theoretical understanding suggests that patient and relative involvement in escalation is dependent on both inherent capabilities and the factors that influence empowerment. CONCLUSION This review highlights that patient and family escalation of care interventions need to be designed with the aim of improving patient/relative-clinician collaboration and the sharing of responsibility. RELEVANCE TO PRACTICE These factors need to be addressed to promote more active partnerships when designing and implementing patient and family-initiated escalation of care interventions.
Collapse
Affiliation(s)
- Aidín McKinney
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Donna Fitzsimons
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Bronagh Blackwood
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Jennifer McGaughey
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| |
Collapse
|
35
|
Hammoud S, Amer F, Lohner S, Kocsis B. Patient education on infection control: A systematic review. Am J Infect Control 2020; 48:1506-1515. [PMID: 32512081 DOI: 10.1016/j.ajic.2020.05.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 05/24/2020] [Accepted: 05/27/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Lately, suggestions have been emphasizing the importance of engaging patients and family members in infection control (IC) through participation and education after showing that patients and family members can aid in preventing the transmission of health care-associated infections. However, assessing patient education on IC measures in hospitals is poorly investigated. PURPOSE To identify all available studies in the literature that assessed hospitalized patients' education on IC measures. METHODS PubMed, Embase, and CINAHL were searched from inception till May 6, 2020 without restrictions. We used Strengthening the Reporting of Observational Studies in Epidemiology tool for assessing the reporting quality of each eligible study. MAIN FINDINGS Of the 6,740 identified papers, 25 were eligible for inclusion. Education on health care-associated infections was investigated in 8 studies, education on central line-associated bloodstream infections in 1, education on surgical site infections in 2, education on hand hygiene in 12, education on isolation rationale, precautions, usage of personal protective equipment in 3, and education on respiratory hygiene in 1. In general, a low percentage of patient education on IC was found in most of the included papers. CONCLUSIONS The low percentage of patient education on IC in hospitals highlights the need for additional emphasis on patient involvement in IC. Further studies are needed to assess patient education on several IC measures and to explore the education of family members as well.
Collapse
|
36
|
Ree E, Wiig S, Braithwaite J, Aase I. To what degree and how do healthcare professionals in nursing homes and homecare practice user involvement? A mixed methods study. TIDSSKRIFT FOR OMSORGSFORSKNING 2020. [DOI: 10.18261/issn.2387-5984-2020-02-09] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
37
|
|
38
|
Abstract
BACKGROUND Patient safety, concerned with the prevention of harm to patients, has become a fundamental component of the global healthcare system. The evidence regarding the status of the patient safety culture in Arab countries in general shows that it is at a suboptimal level due to a punitive approach to errors and deficits in the openness of communications. OBJECTIVES To identify factors contributing to the patient safety culture in Saudi Arabia. DESIGN Systematic review. METHODS A systematic search was carried out in May 2018 in five electronic databases and updated in July 2020-MEDLINE, CINAHL, Embase, PsycINFO and the Cochrane Database of Systematic Reviews. Relevant journals and reference lists of included studies were also hand-searched. Two independent reviewers verified that the studies met the inclusion criteria, assessed the quality of studies and extracted their relevant characteristics. The Yorkshire Contributory Factors Framework (YCFF) was used to categorise factors affecting safety culture in the included papers. RESULTS 14 papers were included and the majority of studies were appraised as being of good quality. Strength and weakness factors that contribute to patient safety culture were identified. Ineffective leadership, a blame culture, workload/inadequate staffing and poor communication are reported as the main factors hindering a positive patient safety culture in Saudi Arabia. Conversely, 'strength' factors contributing to a positive patient safety culture included supportive organisational attitudes to learning/continuous improvement, good teamwork within units and support from hospital management for patient safety. There is an absence of patient perspectives regarding patient safety culture in Saudi Arabia. CONCLUSION Policymakers in the Saudi healthcare system should pay attention to the factors that may contribute to a positive patient safety culture, especially establishing a blame-free culture, improving communications and leadership capacity, learning from errors and involving patient perspectives in safety initiatives. Further research is required to understand in depth the barriers and facilitators to the implementation of a positive patient safety culture in Saudi Arabia.
Collapse
Affiliation(s)
- Abdulmajeed Albalawi
- College of Medical, Veterinary and Life Sciences, Nursing & Health Care School, University of Glasgow, Glasgow, UK
| | - Lisa Kidd
- College of Medical, Veterinary and Life Sciences, Nursing & Health Care School, University of Glasgow, Glasgow, UK
| | - Eileen Cowey
- College of Medical, Veterinary and Life Sciences, Nursing & Health Care School, University of Glasgow, Glasgow, UK
| |
Collapse
|
39
|
Duhn L, Godfrey C, Medves J. Scoping review of patients' attitudes about their role and behaviours to ensure safe care at the direct care level. Health Expect 2020; 23:979-991. [PMID: 32755019 PMCID: PMC7696111 DOI: 10.1111/hex.13117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/10/2020] [Accepted: 07/14/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND To improve harm prevention, patient engagement in safety at the direct care level is advocated. For patient safety to most effectively include patients, it is critical to reflect on existing evidence, to better position future research with implications for education and practice. METHODS As part of a multi-phase study, which included a qualitative descriptive study (Duhn & Medves, 2018), a scoping review about patient engagement in safety was conducted. The objective was to review papers about patients' attitudes and behaviours concerning their involvement in ensuring their safe care. The databases searched included MEDLINE, CINAHL and EMBASE (year ending 2019). RESULTS This review included 35 papers about "Patient Attitudes" and 125 papers about "Patient Behaviours"-indicative of growing global interest in this field. Several patterns emerged from the review, including that most investigators have focused on a particular dimension of harm prevention, such as asking about provider handwashing, and there is less known about patients' opinions about their role in safety generally and how to actualize it in a way that is right for them. While patients may indicate favourable attitudes toward safety involvement generally, intention to act or actual behaviours may be quite different. CONCLUSION This review, given its multi-focus across the continuum of care, is the first of its kind based on existing literature. It provides an important international "mapping" of the initiatives that are underway to engage patients in different elements of safety and their viewpoints, and identifies the gaps that remain.
Collapse
Affiliation(s)
- Lenora Duhn
- School of NursingQueen’s UniversityKingstonONCanada
| | | | | |
Collapse
|
40
|
Wang R, Ping FM, Liu YM, He JL, Du SF, Shi PZ, Chen S, Shi JY. Effect of competence health cultivation on the prevention and control of inadvertent perioperative hypothermia. Rev Assoc Med Bras (1992) 2020; 66:924-930. [PMID: 32844951 DOI: 10.1590/1806-9282.66.7.924] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 01/19/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To explore the feasibility of health competence cultivation on the prevention and control of Inadvertent Perioperative Hypothermia (IPH). METHODS Patients with expected spinal surgery were divided into group A and group B by the random number method. Group B followed routine IPH management, and health training measures for performance and ability were implemented in Group A. The scores of the health competence questionnaire, the temperature at different times, IPH complications, and hospitalization for the two groups were observed and compared. RESULTS The main evaluation indexes, such as the health competence questionnaire score, temperature fluctuations, and IPH complications, during the perioperative period in group A were significantly better than those in group B (p < 0.05). The indexes of anesthesia, total hospital expenses, and health service satisfaction in group A were also significantly better than those in group B, which shows the advantages of cultivating health capabilities in both doctors and patients. CONCLUSION Through health competence cultivation and feasible health management measures, the medical staff can improve the quality of IPH prevention and management.
Collapse
Affiliation(s)
- Ran Wang
- Department of Operative, Affiliated Hospital, Hebei University of Engineering, Handan, Hebei, China
| | - Fu-Min Ping
- Department of Operative, Affiliated Hospital, Hebei University of Engineering, Handan, Hebei, China
| | - Yue-Mei Liu
- 3Department of Pain, Affiliated Hospital, Hebei University of Engineering, Handan, Hebei, China
| | - Jing-Lan He
- 3Department of Pain, Affiliated Hospital, Hebei University of Engineering, Handan, Hebei, China
| | - Shu-Fang Du
- 3Department of Pain, Affiliated Hospital, Hebei University of Engineering, Handan, Hebei, China
| | - Pei-Zhao Shi
- 3Department of Pain, Affiliated Hospital, Hebei University of Engineering, Handan, Hebei, China
| | - Song Chen
- 3Department of Pain, Affiliated Hospital, Hebei University of Engineering, Handan, Hebei, China
| | - Ji-Yue Shi
- Department of Pain, Affiliated Hospital, Hebei University of Engineering, Handan, Hebei, China
| |
Collapse
|
41
|
Forde MF, Coffey A, Hegarty J. Bedside handover at the change of nursing shift: A mixed‐methods study. J Clin Nurs 2020; 29:3731-3742. [DOI: 10.1111/jocn.15403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 06/21/2020] [Accepted: 06/27/2020] [Indexed: 12/26/2022]
Affiliation(s)
| | - Alice Coffey
- Catherine McAuley School of Nursing and Midwifery University College Cork Cork Ireland
- Department of Nursing & Midwifery Health Science Building Northbank Campus University of Limerick Limerick Ireland
| | - Josephine Hegarty
- Catherine McAuley School of Nursing and Midwifery University College Cork Cork Ireland
| |
Collapse
|
42
|
Sands M, Aunger R. Determinants of hand hygiene compliance among nurses in US hospitals: A formative research study. PLoS One 2020; 15:e0230573. [PMID: 32255783 PMCID: PMC7138309 DOI: 10.1371/journal.pone.0230573] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 03/03/2020] [Indexed: 12/02/2022] Open
Abstract
Hand hygiene is the simplest and most effective measure for preventing healthcare-associated infections. Despite the simplicity of this procedure and advances made in infection control, hospital health care workers’ compliance to hand hygiene recommendations is generally low. Nurses have the most frequent patient care interactions, and thus more opportunities to practice hand hygiene. As such, it is important to identify and understand determinants of nurses’ reported compliance. Formative research was undertaken to assess the potential impact of several unexamined factors that could influence HH among nurses: professional role and status, social affiliation, social norms, and physical modifications to the work environment (as well as institutional factors like safety climate). A survey questionnaire was developed primarily to inform the creation of a behaviour change intervention. The survey looked at how these factors influence HH among nurses and sought to identify barriers and levers to reported hand hygiene. It was administered to a survey panel of acute care nurses, working in US hospitals, with a year or more of experience. Multivariate regression modelling suggested that reported hand hygiene compliance was most likely to be a function of a hospital management’s communication openness, perceived performance by peers, increased interactions with patients and other staff members, and the reduction in stress, busyness, and cognitive load associated with role performance. A powerful, effective intervention on HH among nurses therefore could be directed at improving communication openness, consider the impact of perceived performance by peers, increase interactions with patients and staff, and determine how to reduce the stress and cognitive load associated with role performance.
Collapse
Affiliation(s)
- Madeline Sands
- Department of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
- University of Arizona College of Medicine, Tucson, Arizona, United States of America
- * E-mail:
| | - Robert Aunger
- Department of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
43
|
Kim YS, Kim HS, Kim HA, Chun J, Kwak MJ, Kim MS, Hwang JI, Kim H. Can patient and family education prevent medical errors? A descriptive study. BMC Health Serv Res 2020; 20:269. [PMID: 32234042 PMCID: PMC7106564 DOI: 10.1186/s12913-020-05083-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 03/09/2020] [Indexed: 12/26/2022] Open
Abstract
Background This study aims to increase understanding of how patient and family education affects the prevention of medical errors, thereby providing basic data for developing educational contents. Methods This descriptive study surveyed patients, families, and Patient Safety Officers to investigate the relationship between educational contents and medical error prevention. The Chi-square test and ANOVA were used to derive the results of this study. The educational contents used in this study consisted of health information (1. current medicines, 2. allergies, 3. health history, 4. previous treatments/tests and complications associated with them) and Speak Up (1. handwashing, 2. patient identification, 3. asking about medical conditions, 4. asking about test results, 5. asking about behaviour and changes in lifestyle, 6. asking about the care plan, 7. asking about medicines, and 8. asking about medicine interactions). Results In this study, the first criterion for choosing a hospital for treatment in Korea was ‘Hospital with a famous doctor’ (58.6% patient; 57.7% families). Of the patients and their families surveyed, 82.2% responded that hospitals in Korea were safe. The most common education in hospitals is ‘Describe your medical condition’, given to 69.0% of patients, and ‘Hospitalisation orientation’, given to 63.4% of families. The most important factors in preventing patient safety events were statistically significant differences among patients, family members, and Patient Safety Officers (p = 0.001). Patients and families had the highest ‘Patient and family participation’ (31.0% of patients; 39.4% of families) and Patient Safety Officers had the highest ‘Patient safety culture’ (47.8%). Conclusions Participants thought that educational contents developed through this study could prevent medical errors. The results of this study are expected to provide basic data for national patient safety campaigns and standardised educational content development to prevent medical errors.
Collapse
Affiliation(s)
- Yoon-Sook Kim
- Department of Quality Improvement, Konkuk University Medical Centre, 120-1 Neungdong-ro (Hwayang-dong), Gwangjin-gu, Seoul, 05030, South Korea.
| | - Hyuo Sun Kim
- Performance Improvement Team, Uijeongbu St. Mary's Hospital, Uijeongbu, South Korea
| | - Hyun Ah Kim
- Office of Quality Innovation, Samsung Medical Center, Seoul, South Korea
| | - Jahae Chun
- Office of QI, Severance Hospital, Seoul, South Korea
| | - Mi Jeong Kwak
- Quality Improvement Team, Korea University Anam Hospital, Seoul, South Korea
| | - Moon-Sook Kim
- Medical Nursing Department, Seoul National University Hospital, Seoul, South Korea
| | - Jee-In Hwang
- Kyung Hee University College of Nursing Science, Seoul, South Korea
| | - Hyeran Kim
- Department of Quality Improvement, Konkuk University Medical Centre, 120-1 Neungdong-ro (Hwayang-dong), Gwangjin-gu, Seoul, 05030, South Korea
| |
Collapse
|
44
|
Vaismoradi M, Tella S, A. Logan P, Khakurel J, Vizcaya-Moreno F. Nurses' Adherence to Patient Safety Principles: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062028. [PMID: 32204403 PMCID: PMC7142993 DOI: 10.3390/ijerph17062028] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 03/11/2020] [Accepted: 03/16/2020] [Indexed: 12/18/2022]
Abstract
Background: Quality-of-care improvement and prevention of practice errors is dependent on nurses’ adherence to the principles of patient safety. Aims: This paper aims to provide a systematic review of the international literature, to synthesise knowledge and explore factors that influence nurses’ adherence to patient-safety principles. Methods: Electronic databases in English, Norwegian, and Finnish languages were searched, using appropriate keywords to retrieve empirical articles published from 2010–2019. Using the theoretical domains of the Vincent’s framework for analysing risk and safety in clinical practice, we synthesized our findings according to ‘patient’, ‘healthcare provider’, ‘task’, ‘work environment’, and ‘organisation and management’. Findings: Six articles were found that focused on adherence to patient-safety principles during clinical nursing interventions. They focused on the management of peripheral venous catheters, surgical hand rubbing instructions, double-checking policies of medicines management, nursing handover between wards, cardiac monitoring and surveillance, and care-associated infection precautions. Patients’ participation, healthcare providers’ knowledge and attitudes, collaboration by nurses, appropriate equipment and electronic systems, education and regular feedback, and standardization of the care process influenced nurses’ adherence to patient-safety principles. Conclusions: The revelation of individual and systemic factors has implications for nursing care practice, as both influence adherence to patient-safety principles. More studies using qualitative and quantitative methods are required to enhance our knowledge of measures needed to improve nurse’ adherence to patient-safety principles and their effects on patient-safety outcomes.
Collapse
Affiliation(s)
- Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, 8049 Bodø, Norway
- Correspondence: ; Tel.: +47-75517813
| | - Susanna Tella
- Faculty of Health and Social Care, LAB University of Applied Sciences, 53850 Lappeenranta, Finland;
| | - Patricia A. Logan
- Faculty of Science, Charles Sturt University, 2795 Bathurst, Australia;
| | - Jayden Khakurel
- Research Centre for Child Psychiatry, Department of Child Psychiatry, Faculty of Medicine, University of Turku, 20014 Turku, Finland;
| | - Flores Vizcaya-Moreno
- Nursing Department, Faculty of Health Sciences, University of Alicante, 03080 Alicante, Spain;
| |
Collapse
|
45
|
Schuler MS, Horowitz JA. Nursing Students' Attitudes Toward and Empathy for Patients With Substance Use Disorder Following Mentorship. J Nurs Educ 2020; 59:149-153. [DOI: 10.3928/01484834-20200220-05] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 11/04/2019] [Indexed: 11/20/2022]
|
46
|
Andersson Å, Vilhelmsson M, Fomichov V, Lindhoff Larsson A, Björnsson B, Sandström P, Drott J. Patient involvement in surgical care-Healthcare personnel views and behaviour regarding patient involvement. Scand J Caring Sci 2020; 35:96-103. [PMID: 32004397 DOI: 10.1111/scs.12823] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 12/06/2019] [Accepted: 01/10/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND All professions in surgical care have a responsibility to include patients in their health care. By Swedish law, all care should be done in dialogue with the patient. The essential part of health care is the meeting between patient and healthcare professional. In the interaction, a decision can be made, and needs can be identified to a safer care. Previous studies on patient participation have focussed on patients' perspectives in surgical care, but there is a paucity of studies about the personnel's perspective of estimated patient involvement in surgical care. AIM The aim of this study was to identify and describe healthcare personnel's view and behaviour regarding patient involvement in surgical care. METHOD A quantitative study with various professions was conducted. A validated questionnaire was used, remaining questions grouped under following areas: patient involvement, acute phase, hospital time, discharge phase and questions on employment and workplace. RESULTS A total of 140 questionnaires were sent out to a surgical clinic in Sweden, and 102 questionnaires were answered. All professionals stated that clear information is an important part of patient involvement in surgical care. Statistically significant differences existed between the professions in the subscale information. Physicians rated their information higher than the Registered Nurses (p = 0.005) and the practical nurses did (p = 0.001). Hindrances to involving patients were lack of time and other priority tasks. CONCLUSIONS Professionals in surgical care graded information to be the most important thing for patient involvement. Participation in important decisions, including the possibility to express personal views and ask questions, is important factors for patient involvement. Barriers against patient involvement are lack of time and prioritisation of other work activities.
Collapse
Affiliation(s)
- Åsa Andersson
- Department of Surgery and Department of Clinical and Experimental Medicine, County Council of Östergötland, Linköping University, Linköping, Sweden
| | | | - Victoria Fomichov
- Centre for Organisational Support and Development County Council of Östergötland, Linköping University, Linköping, Sweden
| | - Anna Lindhoff Larsson
- Department of Surgery and Department of Clinical and Experimental Medicine, County Council of Östergötland, Linköping University, Linköping, Sweden
| | - Bergthor Björnsson
- Department of Surgery and Department of Clinical and Experimental Medicine, County Council of Östergötland, Linköping University, Linköping, Sweden
| | - Per Sandström
- Department of Surgery and Department of Clinical and Experimental Medicine, County Council of Östergötland, Linköping University, Linköping, Sweden
| | - Jenny Drott
- Department of Surgery and Department of Clinical and Experimental Medicine, County Council of Östergötland, Linköping University, Linköping, Sweden.,Division of Nursing Science, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| |
Collapse
|
47
|
Harris K, Søfteland E, Moi AL, Harthug S, Storesund A, Jesuthasan S, Sevdalis N, Haugen AS. Patients' and healthcare workers' recommendations for a surgical patient safety checklist - a qualitative study. BMC Health Serv Res 2020; 20:43. [PMID: 31948462 PMCID: PMC6966861 DOI: 10.1186/s12913-020-4888-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 01/06/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Patients' involvement in patient safety has increased in healthcare. Use of checklists may improve patient outcome in surgery, though few have attempted to engage patients' use of surgical checklist. To identify risk elements of complications based on patients' and healthcare workers' experiences is warranted. This study aims to identify what the patients and healthcare workers find to be the risk elements that should be included in a patient-driven surgical patient safety checklist. METHOD A qualitative study design where post-operative patients, surgeons, ward physicians, ward nurses, and secretaries from five surgical specialties took part in focus group interviews. Eleven focus groups were conducted including 25 post-operative patients and 27 healthcare workers at one tertiary teaching hospital and one community hospital in Norway. Based on their experiences, participants were asked to identify perceived risks before and after surgery. The interviews were analysed using content analysis. RESULTS Safety risk factors were categorised as pre-operative information: pre-operative preparations, post-operative information, post-operative plans and follow-up. The subcategories under pre-operative information and preparations were: contact information, medication safety, health status, optimising health, dental status, read information, preparation two weeks before surgery, inform your surgical ward, planning your own discharge, preparation on admission and just before surgery. The subcategories under post-operative information, further plans and follow-up were: prevention and complications, restriction and activity, medication safety, pain relief, stomach functions, further care and appointments. Both healthcare workers and patients express the need for a surgical patient safety checklist. CONCLUSION A broad spectre of risk elements for a patient safety checklist were identified. Developing a surgical safety checklist based on these risk elements might reduce complications and unwanted errors. TRAIL REGISTRATION The study is registered as part of a clinical trial in ClinicalTrials.gov: NCT03105713.
Collapse
Affiliation(s)
- Kristin Harris
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063 Kronstad, Bergen, Norway. .,Department of Anesthesia and Intensive Care, Haukeland University Hospital, Postboks 1400, 5021, Bergen, Norway. .,Department of Clinical Medicine, University of Bergen, Postboks 7804, 5020, Bergen, Norway.
| | - Eirik Søfteland
- Department of Anesthesia and Intensive Care, Haukeland University Hospital, Postboks 1400, 5021, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Postboks 7804, 5020, Bergen, Norway
| | - Asgjerd Litleré Moi
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063 Kronstad, Bergen, Norway.,Department of Plastic, Hand and Reconstructive Surgery, National Burn Centre, Haukeland University Hospital, Postboks 1400, 5021, Bergen, Norway
| | - Stig Harthug
- Department of Research and Development, Haukeland University Hospital, Postboks 1400, 5021, Bergen, Norway.,Department of Clinical Science, University of Bergen, Postboks 7804, 5020, Bergen, Norway
| | - Anette Storesund
- Department of Anesthesia and Intensive Care, Haukeland University Hospital, Postboks 1400, 5021, Bergen, Norway.,Department of Research and Development, Haukeland University Hospital, Postboks 1400, 5021, Bergen, Norway
| | - Sebastius Jesuthasan
- Department of Surgery, Førde Comunity Hospital, Postboks 1000, 6807, Førde, Norway
| | - Nick Sevdalis
- Centre for Implementation Science, Health Service & Population Research Department, King's College,16 De Crespigny Park, London, UK, SE5 8AF, UK
| | - Arvid Steinar Haugen
- Department of Anesthesia and Intensive Care, Haukeland University Hospital, Postboks 1400, 5021, Bergen, Norway
| |
Collapse
|
48
|
Chegini Z, Janati A, Babaie J, Pouraghaei M. Exploring the barriers to patient engagement in the delivery of safe care in Iranian hospitals: A qualitative study. Nurs Open 2020; 7:457-465. [PMID: 31871731 PMCID: PMC6917972 DOI: 10.1002/nop2.411] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 10/01/2019] [Accepted: 10/07/2019] [Indexed: 12/19/2022] Open
Abstract
Aim To investigate barriers to patient engagement in the delivery of safe hospital care. Design Qualitative exploratory study. Methods A qualitative study with 35 Iranian health professionals was conducted from February to April 2019 using semi-structured interviews to elicit their opinions. MAXQDA 11 software was used for data management, and the data were analysed using framework analysis. Results Barriers, which potentially have negative impact on patient engagement in the delivery of safer care, were categorized into four themes. The first category included patient-related barriers such as low levels of health literacy, ineffective education, patient unwillingness and cultural barriers. The second category included staff-related barriers such as the existence of negative attitudes towards engaging patients in matters relating to patient safety, ineffective communication, high workload and the reluctance on the part of physicians to engage with patients. Barriers created by limited resources and inadequate training provided by universities and in the workplace formed the third category and community-related barriers such as the inadequate dissemination of information via the mass media and a lack of community-based services formed the fourth category. Conclusion Results demonstrate the multilayered nature of the significant barriers to the engagement of patients in the delivery of safe care and reflect the need for a collaborative approach between the recipients of care, researchers, care providers and policy makers if these are to be overcome.
Collapse
Affiliation(s)
- Zahra Chegini
- Department of Health Services ManagementFaculty of Management and Medical InformaticsTabriz University of Medical SciencesTabrizIran
| | - Ali Janati
- Department of Health Services ManagementFaculty of Management and Medical InformaticsTabriz University of Medical SciencesTabrizIran
- Iranian Center of Excellence in Health ManagementSchool of Management and Medical InformaticsTabriz University of Medical SciencesTabrizIran
| | - Javad Babaie
- Department of Health Services ManagementFaculty of Management and Medical InformaticsTabriz University of Medical SciencesTabrizIran
| | - Mahboub Pouraghaei
- Emergency Medicine Research TeamFaculty of MedicineTabriz University of Medical SciencesTabrizIran
| |
Collapse
|
49
|
Amaniyan S, Faldaas BO, Logan PA, Vaismoradi M. Learning from Patient Safety Incidents in the Emergency Department: A Systematic Review. J Emerg Med 2019; 58:234-244. [PMID: 31843322 DOI: 10.1016/j.jemermed.2019.11.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 11/01/2019] [Accepted: 11/10/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Patient safety incidents are commonly observed in critical and high demanding care settings, including the emergency department. There is a need to understand what causes patient safety incidents in emergency departments and determine the implications for excellence in practice. OBJECTIVE Our aim was to systematically review the international literature on patient safety incidents in emergency departments and determine what can be learned from reported incidents to inform and improve practice. DISCUSSION Patient safety incidents in emergency departments have a number of recognized contributing factors. These can be used as groundwork for the development of effective tools to systematically identify incident risk. Participation in efforts to diminish risk and improve patient safety through appropriate incident reporting is critical for removing barriers to safe care. CONCLUSIONS This review enhances our awareness of contributing factors to patient safety incidents within emergency departments and encourages researchers from different disciplines to investigate the causes of practice errors and formulate safety improvement strategies.
Collapse
Affiliation(s)
- Sara Amaniyan
- Student Research Committe, Semnan University of Medical Sciences, Semnan, Iran
| | - Bjørn Ove Faldaas
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - Patricia A Logan
- Faculty of Science, Charles Sturt University, Bathurst Campus, New South Wales, Australia
| | | |
Collapse
|
50
|
Sarkar U, McDonald K, Motala A, Smith P, Zipperer L, Wachter RM, Shanman R, Shekelle PG. Pragmatic Insights on Patient Safety Priorities and Intervention Strategies in Ambulatory Settings. Jt Comm J Qual Patient Saf 2019; 43:661-670. [PMID: 29173287 DOI: 10.1016/j.jcjq.2017.06.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 06/10/2017] [Accepted: 06/13/2017] [Indexed: 11/27/2022]
|