1
|
Michl G, Bail K, Turner M, Paterson C. Identifying the impact of audit and feedback on the professional role of the nurse and psychological well-being: An integrative systematic review. Nurs Health Sci 2024; 26:e13095. [PMID: 38438280 DOI: 10.1111/nhs.13095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 11/29/2023] [Accepted: 01/20/2024] [Indexed: 03/06/2024]
Abstract
This systematic review aimed to critically synthesis evidence to identify the impact that audit and feedback processes have on the professional role of the nurse and psychological well-being. Little is known about the extent to which audit and feedback processes can positively or negatively impact the professional role of the nurse and psychological well-being. An integrative systematic review was conducted. Covidence systematic review software was used to manage the screening process. Data extraction and methodological quality appraisal were conducted in parallel, and a narrative synthesis was conducted. Nurse participation and responsiveness to audit and feedback processes depended on self-perceived motivation, content, and delivery; and nurses viewed it as an opportunity for professional development. However, audit was reported to negatively impact nurses' psychological well-being, with impacts on burnout, stress, and demotivation in the workplace. Targeting framing, delivery, and content of audit and feedback is critical to nurses' satisfaction and successful quality improvement.
Collapse
Affiliation(s)
- Gabriella Michl
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Kasia Bail
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Murray Turner
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Catherine Paterson
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Robert Gordon University, Aberdeen, UK
- Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
- Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| |
Collapse
|
2
|
Michl G, Paterson C, Bail K. 'It's all about ticks': A secondary qualitative analysis of nurse perspectives about documentation audit. J Adv Nurs 2023; 79:3440-3455. [PMID: 37106563 DOI: 10.1111/jan.15685] [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: 06/06/2022] [Revised: 03/02/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023]
Abstract
AIM To understand how nurses talk about documentation audit in relation to their professional role. BACKGROUND Nursing documentation in health services is often audited as an indicator of nursing care and patient outcomes. There are few studies exploring the nurses' perspectives on this common process. DESIGN Secondary qualitative thematic analysis. METHODS Qualitative focus groups (n = 94 nurses) were conducted in nine diverse clinical areas of an Australian metropolitan health service for a service evaluation focussed on comprehensive care planning in 2020. Secondary qualitative analysis of the large data set using reflexive thematic analysis focussed specifically on the nurse experience of audit, as there was the significant emphasis by participants and was outside the scope of the primary study. RESULTS Nurses': (1) value quality improvement but need to feel involved in the cycle of change, (2) highlight that 'failed audit' does not equal failed care, (3) describe the tension between audited documentation being just bureaucratic and building constructive nursing workflows, (4) value building rapport (with nurses, patients) but this often contrasted with requirements (organizational, legal and audit) and additionally, (5) describe that the focus on completion of documentation for audit creates unintended and undesirable consequences. CONCLUSION Documentation audit, while well-intended and historically useful, has unintended negative consequences on patients, nurses and workflows. IMPACT Accreditation systems rely on care being auditable, but when individual legal, organizational and professional standards are implemented via documentation forms and systems, the nursing burden is impacted at the point of care for patients, and risks both incomplete cares for patients and incomplete documentation. NO PATIENT OR PUBLIC CONTRIBUTION Patients participated in the primary study on comprehensive care assessment by nurses but did not make any comments about documentation audit.
Collapse
Affiliation(s)
- Gabriella Michl
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Catherine Paterson
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, Canberra, Australian Capital Territory, Australia
- Robert Gordon University, Aberdeen, UK
| | - Kasia Bail
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia
- Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, Canberra, Australian Capital Territory, Australia
| |
Collapse
|
3
|
Nool I, Tupits M, Parm L, Hõrrak E, Ojasoo M. The quality of nursing documentation and standardized nursing diagnoses in the children's hospital electronic nursing records. Int J Nurs Knowl 2023; 34:4-12. [PMID: 35343084 DOI: 10.1111/2047-3095.12363] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 02/24/2022] [Indexed: 01/11/2023]
Abstract
AIM The aim of the paper is to compare the quality of nursing documentation in the Children's Hospital before and after the NANDA-I nursing diagnoses training. METHODS Research employed the interventional study design, and pre-post study design. Before and after the NANDA-I nursing diagnoses training, 50 nursing records were analyzed in the interventional pre-post study, using D-Catch instrument. RESULTS The most often documented problem-centered nursing diagnosis before training was anxiety and after the training, hyperthermia. The most common risk diagnoses before and after the training was risk of infection. Before the training, one health promotion diagnosis was determined in the nursing records, and after the training the number increased to four. The highest value was given to readability of the nursing documentation both before and after the training. The lowest score before the training was given to the quality determiners of the accurate nursing diagnoses and after the training given to the determiners of the results' quantity. The sum score of documenting the nursing interventions was the most inconsistent before the training and after the training. The most consistent was the readability of the nursing records before and after the training. Statistically significant differences in the improvement of quality were revealed in all areas except for the readability of the nursing documentation and the quantity of nursing assessment. CONCLUSIONS The results of the study revealed that following the training, the quality of nursing documentation improved, the wording of the nursing diagnoses improved, and the number of accurate nursing diagnoses had increased. IMPLICATIONS FOR NURSING PRACTICE Results of the research provide an overview of the importance of the training in improving the quality of nursing documentation and aid the educators in planning the trainings, focusing more on the challenges in the documentation.
Collapse
Affiliation(s)
- Irma Nool
- Senior Lecturer at the Chair of Nursing, Tallinn Health Care College, Tallinn, Estonia
| | - Mare Tupits
- Senior Lecturer at the Chair of Nursing, Tallinn Health Care College, Tallinn, Estonia
| | - Lily Parm
- Senior Lecturer at the Chair of Nursing, Tallinn Health Care College, Tallinn, Estonia
| | - Eha Hõrrak
- Junior Lecturer at the Chair of Nursing, Tallinn Health Care College, Tallinn, Estonia
| | - Merle Ojasoo
- Associate Professor at the Chair of Nursing, Tallinn Health Care College, Tallinn, Estonia
| |
Collapse
|
4
|
Gusar I, Lazinica A, Klarin M. Work motivation, job satisfaction, and nursing record-keeping: do they differ in surgery and internal disease departments? CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2020. [DOI: 10.15452/cejnm.2020.11.0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
5
|
Bergström A, Ehrenberg A, Eldh AC, Graham ID, Gustafsson K, Harvey G, Hunter S, Kitson A, Rycroft-Malone J, Wallin L. The use of the PARIHS framework in implementation research and practice-a citation analysis of the literature. Implement Sci 2020; 15:68. [PMID: 32854718 PMCID: PMC7450685 DOI: 10.1186/s13012-020-01003-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 05/20/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The Promoting Action on Research Implementation in Health Services (PARIHS) framework was developed two decades ago and conceptualizes successful implementation (SI) as a function (f) of the evidence (E) nature and type, context (C) quality, and the facilitation (F), [SI = f (E,C,F)]. Despite a growing number of citations of theoretical frameworks including PARIHS, details of how theoretical frameworks are used remains largely unknown. This review aimed to enhance the understanding of the breadth and depth of the use of the PARIHS framework. METHODS This citation analysis commenced from four core articles representing the key stages of the framework's development. The citation search was performed in Web of Science and Scopus. After exclusion, we undertook an initial assessment aimed to identify articles using PARIHS and not only referencing any of the core articles. To assess this, all articles were read in full. Further data extraction included capturing information about where (country/countries and setting/s) PARIHS had been used, as well as categorizing how the framework was applied. Also, strengths and weaknesses, as well as efforts to validate the framework, were explored in detail. RESULTS The citation search yielded 1613 articles. After applying exclusion criteria, 1475 articles were read in full, and the initial assessment yielded a total of 367 articles reported to have used the PARIHS framework. These articles were included for data extraction. The framework had been used in a variety of settings and in both high-, middle-, and low-income countries. With regard to types of use, 32% used PARIHS in planning and delivering an intervention, 50% in data analysis, 55% in the evaluation of study findings, and/or 37% in any other way. Further analysis showed that its actual application was frequently partial and generally not well elaborated. CONCLUSIONS In line with previous citation analysis of the use of theoretical frameworks in implementation science, we also found a rather superficial description of the use of PARIHS. Thus, we propose the development and adoption of reporting guidelines on how framework(s) are used in implementation studies, with the expectation that this will enhance the maturity of implementation science.
Collapse
Affiliation(s)
- Anna Bergström
- Department of Women’s and Children’s health, Uppsala Global Health Research on Implementation and Sustainability (UGHRIS), Uppsala, Sweden
- Institute for Global Health, University College London, London, UK
| | - Anna Ehrenberg
- School of Education, Health, and Social Studies, Dalarna University, Falun, Sweden
- Adelaide Nursing School, University of Adelaide, Adelaide, Australia
| | - Ann Catrine Eldh
- Department of Medicine and Health, Linköping University, Linköping, Sweden
- Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden
| | - Ian D. Graham
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - Kazuko Gustafsson
- School of Education, Health, and Social Studies, Dalarna University, Falun, Sweden
- University Library, Uppsala University, Uppsala, Sweden
| | - Gillian Harvey
- Adelaide Nursing School, University of Adelaide, Adelaide, Australia
| | - Sarah Hunter
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Alison Kitson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
- Green Templeton College, University of Oxford, Oxford, UK
| | - Jo Rycroft-Malone
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancashire, UK
| | - Lars Wallin
- School of Education, Health, and Social Studies, Dalarna University, Falun, Sweden
- Department of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
6
|
Østensen E, Hardiker NR, Bragstad LK, Hellesø R. Introducing standardised care plans as a new recording tool in municipal health care. J Clin Nurs 2020; 29:3286-3297. [PMID: 32472572 DOI: 10.1111/jocn.15355] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/07/2020] [Accepted: 05/09/2020] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To explore how nurses use standardised care plans as a new recording tool in municipal health care, and to identify their thoughts and opinions. BACKGROUND In spite of being an important information source for nurses, care plans have repeatedly been found unsatisfactory. Structuring and coding information through standardised care plans is expected to raise the quality of recorded information, improve overviews, support evidence-based practice and facilitate data aggregation. Previous research on this topic has mostly focused on the hospital setting. There is a lack of knowledge on how standardised care plans are used as a recording tool in the municipal healthcare setting. DESIGN An exploratory design with a qualitative approach using three qualitative methods of data collection. The study complied with the Consolidated Criteria for Reporting Qualitative Research. METHODS Empirical data were collected in three Norwegian municipalities through participant observation and individual interviews with 17 registered nurses. In addition, we collected nursing records from 20 electronic patient records. RESULTS Use of standardised care plans was influenced by the nurses' consideration of their benefits. Partial implementation created an opportunity for nonuse. There was no consensus regarding how much information to include, and the standardised care plans could become both short and generic, and long and comprehensive. The themes "balancing between the old and the new care planning system," "considering the usefulness of standardised care plans as a source of information" and "balancing between overview and detail" reflect these findings. CONCLUSIONS Nurses' use of standardised care plans was influenced by the plans' partial implementation, their views on usefulness and their personal views on the detail required in a care plan. RELEVANCE TO CLINICAL PRACTICE The structuring of nursing records is a fast-growing trend in health care. This study gives valuable information for those attempting to implement such structures in municipal health care.
Collapse
Affiliation(s)
- Elisabeth Østensen
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Nicholas R Hardiker
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Line Kildal Bragstad
- Institute of Health and Society and Research Center for Habilitation and Rehabilitation Services and Models (CHARM), University of Oslo, Oslo, Norway
| | - Ragnhild Hellesø
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
7
|
Pithara C, Farr M, Sullivan SA, Edwards HB, Hall W, Gadd C, Walker J, Hebden N, Horwood J. Implementing a Digital Tool to Support Shared Care Planning in Community-Based Mental Health Services: Qualitative Evaluation. J Med Internet Res 2020; 22:e14868. [PMID: 32191210 PMCID: PMC7118546 DOI: 10.2196/14868] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/13/2019] [Accepted: 08/21/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mental health services aim to provide recovery-focused care and facilitate coproduced care planning. In practice, mental health providers can find supporting individualized coproduced care with service users difficult while balancing administrative and performance demands. To help meet this aim and using principles of coproduction, an innovative mobile digital care pathway tool (CPT) was developed to be used on a tablet computer and piloted in the West of England. OBJECTIVE The aim of this study was to examine mental health care providers' views of and experiences with the CPT during the pilot implementation phase and identify factors influencing its implementation. METHODS A total of 20 in-depth telephone interviews were conducted with providers participating in the pilot and managers in the host organization. Interviews were audio recorded, transcribed, anonymized, and thematically analyzed guided by the Consolidated Framework for Implementation Research. RESULTS The tool was thought to facilitate coproduced recovery-focused care planning, a policy and organizational as well as professional priority. Internet connectivity issues, system interoperability, and access to service users' health records affected use of the tool during mobile working. The organization's resources, such as information technology (IT) infrastructure and staff time and IT culture, influenced implementation. Participants' levels of use of the tool were dependent on knowledge of the tool and self-efficacy; perceived service-user needs and characteristics; and perceptions of impact on the therapeutic relationship. Training and preparation time influenced participants' confidence in using the tool. CONCLUSIONS Findings highlight the importance of congruence between staff, organization, and external policy priorities and digital technologies in aiding intervention engagement, and the need for ongoing training and support of those intended to use the technology during and after the end of implementation interventions.
Collapse
Affiliation(s)
- Christalla Pithara
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.,National Institute for Health Research Applied Research Collaboration West at University Hospitals Bristol Foundation Trust, Bristol, United Kingdom
| | - Michelle Farr
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.,National Institute for Health Research Applied Research Collaboration West at University Hospitals Bristol Foundation Trust, Bristol, United Kingdom
| | - Sarah A Sullivan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.,National Institute for Health Research Applied Research Collaboration West at University Hospitals Bristol Foundation Trust, Bristol, United Kingdom.,Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Hannah B Edwards
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.,National Institute for Health Research Applied Research Collaboration West at University Hospitals Bristol Foundation Trust, Bristol, United Kingdom
| | - William Hall
- Avon and Wiltshire Mental Health Partnership NHS Trust, Bristol, United Kingdom
| | | | - Julian Walker
- Avon and Wiltshire Mental Health Partnership NHS Trust, Bristol, United Kingdom
| | - Nick Hebden
- Otsuka Health Solutions, Slough, United Kingdom
| | - Jeremy Horwood
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.,National Institute for Health Research Applied Research Collaboration West at University Hospitals Bristol Foundation Trust, Bristol, United Kingdom
| |
Collapse
|
8
|
Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: a systematic mixed-studies review and qualitative synthesis. Prim Health Care Res Dev 2018; 20:e6. [PMID: 30068402 PMCID: PMC6476399 DOI: 10.1017/s1463423618000488] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim To appraise and synthesize empirical literature on implementation of evidence within community nursing. To explore the use of implementation theory and identify the strategies required for, and the barriers and facilitators to, successful implementation within this context. Background There is an international consensus that evidence-based practice can improve outcomes for people using health and social care services. However, these practices are not always translated into care delivery. Community nursing is a relatively understudied area; little is known about how innovations in practice are implemented within this setting. Methods Systematic mixed-studies review, synthesizing quantitative and qualitative research. The electronic databases AMED, PsycINFO, Ovid Medline, CINAHL Plus, ASSIA, British Nursing Index and EMBASE were used. Two grey literature databases were also searched: OpenGrey and EThOS. English language, peer-reviewed papers published between January 2010 and July 2017 were considered. Criteria included implementation of an innovation and change to practice within adult community nursing. An approach called Critical Interpretive Synthesis was used to integrate the evidence from across the studies into a comprehensible theoretical framework. Results In total, 22 papers were reviewed. Few studies discussed the use of theory when planning, guiding and evaluating the implementation of the innovation (n=6). A number of implementation strategies, facilitators and barriers were identified across the included studies, highlighting the interplay of both service context and individual factors in successful implementation. Conclusion Implementation is an expanding area of research; yet is challenged by a lack of consistency in terminology and limited use of theory. Implementation within community nursing is a complex process, requiring both individual and organizational adoption, and managerial support. Successful adoption of evidence-based practice however, is only possible if community nurses themselves deem it useful and there is evidence that it could have a positive impact on the patient and/or their primary carer.
Collapse
|