Interventions to improve nurse-family communication in the emergency department: A scoping review

AIM

To determine and describe what interventions exist to improve nurse-family communication during the waiting period of an emergency department visit.

BACKGROUND

Communication between nurses and families is an area needing improvement. Good communication can improve patient outcomes, satisfaction with care and decrease patient and family anxiety.

DESIGN

Scoping Review.

METHODS

A scoping review was conducted following the Joanna Briggs Institution methodology: (1) identify the research question, (2) define the inclusion criteria, (3) use a search strategy to identify relevant studies using a three-step approach, (4) select studies using a team approach, (5) data extraction, (6) data analysis, and (7) presentation of results.

DATA SOURCES

Medline, CINAHL, EMBASE, PsychInfo and grey literature were searched on 3 August 2022.

RESULTS

The search yielded 1771 articles from the databases, of which 20 were included. An additional seven articles were included from the grey literature. Paediatric and adult interventions were found targeting staff and family of which the general recommendations were summarised into communication models.

CONCLUSION

Future research should focus on evaluating the effectiveness of interventions using a standardised scale, understanding the specific needs of families, and exploring the communication models developed in this review.

IMPLICATIONS FOR CLINICAL PRACTICE

Communication models for triage nurses and all emergency department nurses were developed. These may guide nurses to improve their communication which will contribute to improving family satisfaction.

REPORTING METHOD

PRISMA-ScR.

TRIAL AND PROTOCOL REGISTRATION

Protocol has been registered with the Open Science Framework, registration number 10.17605/OSF.IO/ETSYB.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Changes in parental anxiety and intention to demand antibiotics: A longitudinal study among parents during the COVID-19 pandemic

AIMS

Assessing the effects of the COVID-19 pandemic on parental anxiety and preferences for antibiotic treatment can help inform antibiotic stewardship strategies. Therefore, this study aimed to examine COVID-19 pandemic-related changes in parental anxiety levels, their intentions to demand antibiotics and frequencies of practising preventative behaviours.

DESIGN

This longitudinal quantitative study compared two groups of parents, those from Victoria and Western Australia, who experienced high and low COVID-19 risk, respectively.

METHODS

Participants were recruited through an online panel to complete three waves of surveys between October 2020 and August 2021. Anxiety scores and frequency of preventative behaviours were analysed using mixed-effects tobit regression, considering time, state, and their interaction as fixed effects predictors. Intention to demand antibiotics was modelled using multinomial logistic regression, with time, state, and their interaction as the predictors.

RESULTS

The final longitudinal sample comprised 50 participants from Victoria and 51 from Western Australia. Parental anxiety did not significantly change over time for either state. Intention to demand antibiotics was also stable over time within each state; however, participants from Victoria exhibited stronger intentions to demand antibiotics compared to those from Western Australia. Frequencies of parental preventative behaviours declined from Wave 1 to Wave 2 before increasing again in Wave 3, but only for Western Australia.

CONCLUSION

This longitudinal study among Australian parents found stable parental anxiety and intention to demand antibiotics within each state. However, the intention to demand antibiotics and preventative behaviours varied between states as per the COVID-19 risk. Thus, viral pandemics may not affect judicious antibiotic use, though the intention to demand antibiotics may increase in states with high COVID-19 risk.

IMPACT

Though parental anxiety may not impact antibiotic stewardship during viral respiratory illness outbreaks, tailored messaging to maintain appropriate antibiotic use may be necessary, especially when the disease risk is high.

N. S, Clerc P, Carciumaru R, Alqurashi W, Rajagopal M, Kammerer E, Leung J, Wright B, Scott SD. Family caregivers' emotional and communication needs in Canadian pediatric emergency departments

OBJECTIVES

To describe the extent to which caregivers' emotional and communication needs were met during pediatric emergency department (PED) visits. Secondary objectives included describing the association of caregiver emotional needs, satisfaction with care, and comfort in caring for their child's illness at the time of discharge with demographic characteristics, caregiver experiences, and ED visit details.

STUDY DESIGN

Electronic surveys with medical record review were deployed at ten Canadian PEDs from October 2018 -March 2020. A convenience sample of families with children <18 years presenting to a PED were enrolled, for one week every three months, for one year per site. Caregivers completed one in-PED survey and a follow-up survey, up to seven days post-visit.

RESULTS

This study recruited 2005 caregivers who self-identified as mothers (74.3%, 1462/1969); mean age was 37.8 years (SD 7.7). 71.7% (1081/1507) of caregivers felt their emotional needs were met. 86.4% (1293/1496) identified communication with the doctor as good/very good and 83.4% (1249/1498) with their child's nurse. Caregiver involvement in their child's care was reported as good/very good 85.6% (1271/1485) of the time. 81.8% (1074/1313) of caregivers felt comfortable in caring for their child at home at the time of discharge. Lower caregiver anxiety scores, caregiver involvement in their child's care, satisfactory updates, and having questions adequately addressed positively impacted caregiver emotional needs and increased caregiver comfort in caring for their child's illness at home.

CONCLUSION

Approximately 30% of caregivers presenting to PEDs have unmet emotional needs, over 15% had unmet communication needs, and 15% felt inadequately involved in their child's care. Family caregiver involvement in care and good communication from PED staff are key elements in improving overall patient experience and satisfaction.

Mutuality in nurse-caregiver relationships in pediatric nursing: A concept analysis

PROBLEM

Mutuality is often used in literature in the context of family-centered care and therapeutic relationship building. A therapeutic relationship is necessary to deliver family-centered care, strengthen family health and function, increase patient and family satisfaction, reduce anxiety, and empower decision-makers. Despite mutuality being such an important concept, it is not well defined in the literature.

ELIGIBILITY CRITERIA

The Walker and Avant method for concept analysis was used. The databases Medline, PSYCHInfo, CINHAL and Nursing & Allied Health were searched for texts in English from 1997 to 2021 using specific search terms.

SAMPLE

Of the 248 results, 191 articles were screened and 48 met inclusion criteria.

RESULTS

Mutuality was found to be a process of dynamic reciprocity whereby the partners contribute uniquely to their shared goals, values, or purposes.

CONCLUSION

Mutuality is an important aspect of family-centered care and is used throughout nursing and advanced nursing practice.

IMPLICATIONS

The concept of mutuality should be incorporated into family-centered care policies, as without it, family-centered care cannot be established. Further research should be done to develop methods or educational techniques to establish and maintain mutuality in advanced nursing practice.

Does antibiotic awareness campaigns exposure decrease intention to demand antibiotic treatment? Testing a structural model among parents in Western Australia

Antimicrobial resistance (AMR) is one of the key public health concerns the world is facing today. The effect of antibiotic awareness campaigns (AACs) on consumer behaviour has been documented in the literature with mixed results. Understanding the mechanism for how AACs affect target populations is vital in designing effective and tailored campaigns. Using structural equation modelling our study examined the relationships among people's exposure to antibiotic awareness campaigns, knowledge of AMR prevention, AMR risk perception, and intention to seek antibiotic treatment. This study also tested the moderating effect of anxiety and societal responsibility on preventing AMR, and on their intention to demand antibiotic treatment mediated by knowledge of AMR prevention and risk-perception. Primary data was generated using an online survey of 250 Western Australian parents. We tested our hypotheses using reliability and validity tests and structural equation modelling. Our results show that exposure to AACs alone may not be enough to change parental intention to demand antibiotic prescription for their children. Parental risk perception of AMR and parental anxiety affect intention to demand antibiotics, and the view that AMR is a social responsibility has a moderating effect on intention to demand antibiotics. These factors could be considered and combine messaging strategies in designing future antibiotic awareness campaigns.