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Leung WI, Emery C, Egan R. Improving interprofessional handover on labor and delivery: A needs assessment study. J Interprof Care 2021:1-7. [PMID: 34126849 DOI: 10.1080/13561820.2021.1888901] [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: 03/18/2020] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 10/21/2022]
Abstract
Handover is the transfer of important clinical information between health providers. The current report describes a needs assessment of interprofessional labor and delivery handover at an urban hospital in Canada. The goal of this study was to explore the perceptions of the current handover meeting and opportunities for improvement. Using a constructivist paradigm, we conducted 28 semi-structured inter- views with handover participants. We used a recruitment grid to ensure we included the voices of participants representing each profession involved in interprofessional handover meetings. An inductive process was used to code the interview transcripts and theme the data. Major themes identified were: (1) Interprofessional handover contributes positively to team situational awareness, interprofessional relationships, and team communication; (2) Handover could be better if it had a more defined process; (3) Interprofessional handover can lead to feelings of intimidation; and (4) Interprofessional handovers on the labor and delivery unit in our setting need increased inclusivity of midwives. From these themes, continued development of interprofessional handover meetings on labor and delivery should be aimed at a formal definition of the scope and process for these meetings reducing feelings of intimidation, increased integration of Midwifery providers, and continued improvement of relationships between different professions and practitioners on labor and delivery.
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Affiliation(s)
- Wynne I Leung
- Faculty of Medicine, Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB, Canada
| | - Crystal Emery
- Faculty of Nursing, Department of Health Quality, Queens University, Kingston, ON, Canada
| | - Rylan Egan
- Faculty of Nursing, Department of Health Quality, Queens University, Kingston, ON, Canada
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Bucknall TK, Hutchinson AM, Botti M, McTier L, Rawson H, Hitch D, Hewitt N, Digby R, Fossum M, McMurray A, Marshall AP, Gillespie BM, Chaboyer W. Engaging patients and families in communication across transitions of care: An integrative review. PATIENT EDUCATION AND COUNSELING 2020; 103:1104-1117. [PMID: 32029297 DOI: 10.1016/j.pec.2020.01.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 01/15/2020] [Accepted: 01/23/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To determine the current evidence about patient and family engagement in communication with health professionals during transitions of care to, within and from acute care settings. METHODS An integrative review using seven international databases was conducted for 2003-2017. Forty eligible studies were analysed and synthesised using framework synthesis. RESULTS Four themes: 1) Partnering in care: patients and families should be partners in decision-making and care; 2) Augmenting communication during transitions: intrinsic and extrinsic factors supported transition communication between patients, families and health professionals; 3) Impeding information exchange: the difficulties faced by patients and families taking an active role in transition; and 4) Outcomes of communication during transitions: reported experiences for patients, families and health professionals. CONCLUSION While attitudes towards engaging patients and family in transition communication in acute settings are generally positive, current practices are variable. Structural supports for practice are not always present. PRACTICE IMPLICATIONS Organisational strategies to improve communication must incorporate an understanding of patient needs. A structured approach which considers timing, privacy, location and appropriateness for patients and families is needed. Communication training is required for patients, families and health professionals. Health professionals must respect a patient's right to be informed by regularly communicating.
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Affiliation(s)
- Tracey K Bucknall
- Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125 Australia.
| | | | - Mari Botti
- Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125 Australia
| | - Lauren McTier
- Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125 Australia
| | - Helen Rawson
- Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125 Australia
| | - Danielle Hitch
- Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125 Australia
| | - Nicky Hewitt
- Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125 Australia
| | - Robin Digby
- Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125 Australia
| | - Mariann Fossum
- Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125 Australia
| | - Anne McMurray
- Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125 Australia
| | - Andrea P Marshall
- Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125 Australia
| | - Brigid M Gillespie
- Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125 Australia
| | - Wendy Chaboyer
- Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125 Australia
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Kagan I, Porat N, Barnoy S. The quality and safety culture in general hospitals: patients', physicians' and nurses' evaluation of its effect on patient satisfaction. Int J Qual Health Care 2018; 31:261-268. [DOI: 10.1093/intqhc/mzy138] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 05/03/2018] [Accepted: 06/02/2018] [Indexed: 12/13/2022] Open
Affiliation(s)
- Ilya Kagan
- Nursing Department, Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nurit Porat
- Head, Quality & Safety Unit, Hadassah Hebrew University Medical Centre, Jerusalem, Israel
| | - Sivia Barnoy
- Nursing Department, Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Mixed methods evaluation of a quality improvement and audit tool for nurse-to-nurse bedside clinical handover in ward settings. Appl Nurs Res 2018; 40:80-89. [DOI: 10.1016/j.apnr.2017.12.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 11/21/2017] [Accepted: 12/14/2017] [Indexed: 11/20/2022]
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Eassey D, McLachlan AJ, Brien JA, Krass I, Smith L. "I have nine specialists. They need to swap notes!" Australian patients' perspectives of medication-related problems following discharge from hospital. Health Expect 2017; 20:1114-1120. [PMID: 28306185 PMCID: PMC5600251 DOI: 10.1111/hex.12556] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2017] [Indexed: 11/27/2022] Open
Abstract
Background Research has shown that patients are most susceptible to medication‐related problems (MRPs) when transitioning from hospital to home. Currently, the literature in this area focuses on interventions, which are mainly orientated around the perspective of the health‐care professional and do not take into account patient perspectives and experiences. Objective To capture the experiences and perceptions of Australian patients regarding MRPs following discharge from hospital. Design A cross‐sectional study was conducted using a questionnaire collecting quantitative and qualitative data. Thematic analysis was conducted of the qualitative data. Setting and participants Survey participants were recruited through The Digital Edge, an online market research company. Five hundred and six participants completed the survey. Results A total of 174 participants self‐reported MRPs. Two concepts and seven subthemes emerged from the analysis. The first concept was types of MRPs and patient experiences. Three themes were identified: unwanted effects from medicines, confusion about medicines and unrecognized medicines. The second concept was patient engagement in medication management, of which four themes emerged: informing patients, patient engagement, communication amongst health‐care professionals and conflicting advice. Discussion and conclusion This study provides an important insight into patients’ experiences and perceptions of MRPs following discharge from hospital. Future direction for practice and research should look into implementing patient‐centred care at the time of hospital discharge to ensure the provision of clear and consistent information, and developing ways to support and empower patients to ensure a smooth transition post‐discharge from hospital.
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Affiliation(s)
- Daniela Eassey
- Faculty of Pharmacy Camperdown, The University of Sydney, Sydney, NSW, Australia
| | - Andrew J McLachlan
- Faculty of Pharmacy Camperdown, The University of Sydney, Sydney, NSW, Australia.,Centre for Education and Research on Ageing, Concord Repatriation General Hospital, Concord, NSW, Australia
| | - Jo-Anne Brien
- Faculty of Pharmacy Camperdown, The University of Sydney, Sydney, NSW, Australia
| | - Ines Krass
- Faculty of Pharmacy Camperdown, The University of Sydney, Sydney, NSW, Australia
| | - Lorraine Smith
- Faculty of Pharmacy Camperdown, The University of Sydney, Sydney, NSW, Australia
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Abstract
The study purpose was to describe how bedside nurses can use nursing bedside shift report (NBSR) to keep patients safe. NBSR has been recommended as a means of increasing patient safety, but little is known about how or whether it does so. Grounded theory methods were used. Data were collected from 2014 to 2015 with bedside nurses in a pediatric unit with an established NBSR process. The primary process by which bedside nurses use NBSR to keep patients safe is reducing risk of harm through conveying the patient story from shift to shift. Having a perspective from the bedside is a key antecedent to reducing risk of harm, as it supports the nurses' ability to subsequently identify and address risks. Although often seen as a routine exchange of information, how nursing shift report is conducted can impact patient safety. The study reinforces the value of targeting nursing communication to improve patient safety.
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Affiliation(s)
| | - Kirstin A Manges
- The University of Iowa, Iowa City, USA Iowa City VA Healthcare System, IA, USA
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Spinks J, Chaboyer W, Bucknall T, Tobiano G, Whitty JA. Patient and nurse preferences for nurse handover-using preferences to inform policy: a discrete choice experiment protocol. BMJ Open 2015; 5:e008941. [PMID: 26560060 PMCID: PMC4654394 DOI: 10.1136/bmjopen-2015-008941] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Nursing bedside handover in hospital has been identified as an opportunity to involve patients and promote patient-centred care. It is important to consider the preferences of both patients and nurses when implementing bedside handover to maximise the successful uptake of this policy. We outline a study which aims to (1) identify, compare and contrast the preferences for various aspects of handover common to nurses and patients while accounting for other factors, such as the time constraints of nurses that may influence these preferences.; (2) identify opportunities for nurses to better involve patients in bedside handover and (3) identify patient and nurse preferences that may challenge the full implementation of bedside handover in the acute medical setting. METHODS AND ANALYSIS We outline the protocol for a discrete choice experiment (DCE) which uses a survey design common to both patients and nurses. We describe the qualitative and pilot work undertaken to design the DCE. We use a D-efficient design which is informed by prior coefficients collected during the pilot phase. We also discuss the face-to-face administration of this survey in a population of acutely unwell, hospitalised patients and describe how data collection challenges have been informed by our pilot phase. Mixed multinomial logit regression analysis will be used to estimate the final results. ETHICS AND DISSEMINATION This study has been approved by a university ethics committee as well as two participating hospital ethics committees. Results will be used within a knowledge translation framework to inform any strategies that can be used by nursing staff to improve the uptake of bedside handover. Results will also be disseminated via peer-reviewed journal articles and will be presented at national and international conferences.
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Affiliation(s)
- Jean Spinks
- Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Wendy Chaboyer
- National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients, Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Tracey Bucknall
- Faculty of Health, Centre for Quality and Patient Safety, School of Nursing and Midwifery, Deakin University and Alfred Health, Melbourne, Victoria, Australia
| | - Georgia Tobiano
- Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Jennifer A Whitty
- Faculty of Health and Behavioural Sciences, School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia
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Carayon P, Kianfar S, Li Y, Xie A, Alyousef B, Wooldridge A. A systematic review of mixed methods research on human factors and ergonomics in health care. APPLIED ERGONOMICS 2015; 51:291-321. [PMID: 26154228 PMCID: PMC4725322 DOI: 10.1016/j.apergo.2015.06.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 06/01/2015] [Accepted: 06/02/2015] [Indexed: 05/20/2023]
Abstract
This systematic literature review provides information on the use of mixed methods research in human factors and ergonomics (HFE) research in health care. Using the PRISMA methodology, we searched four databases (PubMed, PsycInfo, Web of Science, and Engineering Village) for studies that met the following inclusion criteria: (1) field study in health care, (2) mixing of qualitative and quantitative data, (3) HFE issues, and (4) empirical evidence. Using an iterative and collaborative process supported by a structured data collection form, the six authors identified a total of 58 studies that primarily address HFE issues in health information technology (e.g., usability) and in the work of healthcare workers. About two-thirds of the mixed methods studies used the convergent parallel study design where quantitative and qualitative data were collected simultaneously. A variety of methods were used for collecting data, including interview, survey and observation. The most frequent combination involved interview for qualitative data and survey for quantitative data. The use of mixed methods in healthcare HFE research has increased over time. However, increasing attention should be paid to the formal literature on mixed methods research to enhance the depth and breadth of this research.
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Affiliation(s)
- Pascale Carayon
- Center for Quality and Productivity Improvement and Department of Industrial and Systems Engineering, University of Wisconsin-Madison, USA.
| | - Sarah Kianfar
- Center for Quality and Productivity Improvement and Department of Industrial and Systems Engineering, University of Wisconsin-Madison, USA
| | - Yaqiong Li
- Center for Quality and Productivity Improvement and Department of Industrial and Systems Engineering, University of Wisconsin-Madison, USA
| | - Anping Xie
- Armstrong Institute for Patient Safety and Quality, Johns Hopkins University, USA
| | | | - Abigail Wooldridge
- Center for Quality and Productivity Improvement and Department of Industrial and Systems Engineering, University of Wisconsin-Madison, USA
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Kaye DK, Nakimuli A, Kakaire O, Osinde MO, Mbalinda SN, Kakande N. Gaps in continuity of care: patients' perceptions of the quality of care during labor ward handover in Mulago hospital, Uganda. BMC Health Serv Res 2015; 15:190. [PMID: 25943551 PMCID: PMC4424429 DOI: 10.1186/s12913-015-0850-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 04/24/2015] [Indexed: 11/21/2022] Open
Abstract
Background Client satisfaction is a common outcome measure for quality of care and goal for quality improvement in healthcare. We assessed women’s perceptions of the structure, process and outcome of intrapartum care in Mulago hospital, specifically, labor ward duty shift handovers. Methods Data was collected through 40 in-depth interviews conducted on two occasions: during the time of hospitalization and within 4–6 months after childbirth. Participants were women who delivered at the hospital, of whom some had life-threatening obstetric complications. Data was analyzed by thematic analysis. Results Maternity duty handovers were associated with patient dissatisfaction, particularly the process of hand-over, the decision-making that follows handovers and failure of communication of information to patients and their caretakers. Consequently, duty handovers were perceived inadequate. They were described as gaps in the continuity of care, and contributed to poor quality of care, birth trauma and mothers’ dissatisfaction with the childbirth experience. Conclusion The handover process and practices should be standardized using protocols and checklists. Health workers need training on handover practices, team work and communication skills (so as to improve patient-health provider and provider-provider interaction.
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Affiliation(s)
- Dan K Kaye
- Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
| | - Annettee Nakimuli
- Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
| | - Othman Kakaire
- Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
| | - Michael O Osinde
- Department of Obstetrics and Gynecology, Jinja Regional Hospital, Jinja, Uganda.
| | - Scovia N Mbalinda
- Department of Nursing, School of Health Sciences, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
| | - Nelson Kakande
- Clinical, Operations and Health Services Research Program, Joint Clinical Research Centre, P. O. Box 10005, Kampala, Uganda.
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Spranzi F. Clinical handover on the labour ward: A narrative synthesis of the literature. ACTA ACUST UNITED AC 2014. [DOI: 10.12968/bjom.2014.22.10.738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kerr D, Lu S, McKinlay L. Towards patient-centred care: Perspectives of nurses and midwives regarding shift-to-shift bedside handover. Int J Nurs Pract 2013; 20:250-7. [DOI: 10.1111/ijn.12138] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Debra Kerr
- Victoria University; St Albans Victoria Australia
| | - Sai Lu
- Victoria University; St Albans Victoria Australia
| | - Louise McKinlay
- Centre of Education; Western Health; Footscray Victoria Australia
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