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Guan T, Chen X, Li J, Zhang Y. Factors influencing patient experience in hospital wards: a systematic review. BMC Nurs 2024; 23:527. [PMID: 39090643 PMCID: PMC11295641 DOI: 10.1186/s12912-024-02054-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/30/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Patient experience plays an essential role in improving clinical effectiveness and patient safety. It's important to identify factors influencing patient experience and to improve quality of healthcare. OBJECTIVE To identify factors that influence patient experience in hospital wards. METHODS We conducted a systematic review including six databases; they were PubMed, CINAHL, Embase, PsycInfo, ProQuest, and Cochrane. Studies were included if they met the inclusion criteria. The JBI checklist was used to perform quality appraisal. We used 5 domains of the ecological model to organize and synthesize our findings to comprehensively understand the multi-level factors influencing the issue. RESULT A total of 138 studies were included, and 164 factors were identified. These factors were integrated into 6 domains. All domains but one (survey-related factors) could be mapped onto the attributes of the ecological framework: intrapersonal, interpersonal, institutional, community, and public policy level factors. All factors had mixed effect on patient experience. The intrapersonal level refers to individual characteristics of patients. The interpersonal level refers to interactions between patients and healthcare providers, such as the caring time spent by a nurse. The institutional level refers to organizational characteristics, rules and regulations for operations, such as hospital size and accreditation. The community level refers to relationships among organizations, institutions, and informational networks within defined boundaries, such as a hospital located in a larger population area. Public policy level refers to local, state, national, and global laws and policies, including health insurance policies. The sixth domain, survey-related factors, was added to the framework and included factors such as survey response rate and survey response time. CONCLUSION The factors influencing patient experience are comprehensive, ranging from intrapersonal to public policy. Providers should adopt a holistic and integrated perspective to assess patient experience and develop context-specific interventions to improve the quality of care. PROSPERO REGISTRATION NUMBER CRD42023401066.
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Affiliation(s)
- Tingyu Guan
- School of Nursing, Fudan University, Shanghai, China
- Department of Nursing, Fudan University Zhongshan Hospital, Shanghai, China
| | - Xiao Chen
- Department of Nursing, Fudan University Zhongshan Hospital, Shanghai, China
| | - Junfei Li
- School of Nursing, Fudan University, Shanghai, China
- Department of Nursing, Fudan University Zhongshan Hospital, Shanghai, China
| | - Yuxia Zhang
- Department of Nursing, Fudan University Zhongshan Hospital, Shanghai, China.
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Naughton C, de Foubert M, Cummins H, McCullagh R, Wills T, Skelton DA, Dahly D, O’Mahony D, Ahern E, Tedesco S, Sullivan BO. Implementation of a Frailty Care Bundle (FCB) Targeting Mobilisation, Nutrition and Cognitive Engagement to Reduce Hospital Associated Decline in Older Orthopaedic Trauma Patients: Pretest-Posttest Intervention Study. J Frailty Sarcopenia Falls 2024; 9:32-50. [PMID: 38444547 PMCID: PMC10910252 DOI: 10.22540/jfsf-09-032] [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] [Accepted: 01/22/2024] [Indexed: 03/07/2024] Open
Abstract
Objective To implement and evaluate a Frailty Care Bundle (FCB) targeting mobilisation, nutrition, and cognition in older trauma patients to reduce hospital associated decline. Methods We used a two group, pretest-posttest design. The FCB intervention was delivered on two orthopaedic wards and two rehabilitation wards, guided by behaviour change theory (COM-B) to implement changes in ward routines (patient mobility goals, nurse assisted mobilisation, mealtimes, communication). Primary outcomes were patient participants' return to pre-trauma functional capability (modified Barthel Index - mBI) at 6-8 weeks post-hospital discharge and average hospital daily step-count. Statistical analysis compared pre versus post FCB group differences using ordinal regression and log-linear models. Results We recruited 120 patients (pre n=60 and post n=60), and 74 (pre n=43, post n=36) were retained at follow-up. Median age was 78 years and 83% were female. There was a non-significant trend for higher mBI scores (improved function) in the post compared to pre FCB group (OR 2.29, 95% CI 0.98-5.36), associated with an average 11% increase in step-count. Conclusion It was feasible, during the Covid-19 pandemic, for multidisciplinary teams to implement elements of the FCB. Clinical facilitation supported teams to prioritise fundamental care above competing demands, but sustainability requires ongoing attention. ISRCTN registry: ISRCTN15145850 (https://doi.org/10.1186/ISRCTN15145850).
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Affiliation(s)
- Corina Naughton
- School of Nursing, Midwifery, University College Cork, Cork, Ireland
| | | | - Helen Cummins
- School of Nursing, Midwifery, University College Cork, Cork, Ireland
| | - Ruth McCullagh
- School of Clinical Therapies, University College Cork, Cork, Ireland
| | - Teresa Wills
- School of Nursing, Midwifery, University College Cork, Cork, Ireland
| | - Dawn A. Skelton
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Darren Dahly
- School of Public Health, University College Cork, Cork, Ireland
| | - Denis O’Mahony
- Department of Medicine, University College Cork, Cork, Ireland
| | - Emer Ahern
- Department of Geriatric & Stroke Medicine, Cork University Hospital, Cork, Ireland
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Brueckle MS, Dinh TS, Klein AA, Rietschel L, Petermann J, Brosse F, Schulz-Rothe S, Gonzalez-Gonzalez AI, Kramer M, Engler J, Mergenthal K, Muth C, Voigt K, van den Akker M. Development of an intervention to improve informational continuity of care in older patients with polypharmacy at the interface between general practice and hospital care: protocol for a participatory qualitative study in Germany. BMJ Open 2022; 12:e058016. [PMID: 35387829 PMCID: PMC8987787 DOI: 10.1136/bmjopen-2021-058016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Older patients with multimorbidity, polypharmacy and related complex care needs represent a growing proportion of the population and a challenge for healthcare systems. Particularly in transitional care (hospital admission and hospital discharge), medical errors, inappropriate treatment, patient concerns and lack of confidence in healthcare are major problems that may arise from a lack of information continuity. The aim of this study is to develop an intervention to improve informational continuity of care at the interface between general practice and hospital care. METHODS AND ANALYSIS A qualitative approach will be used to develop our participatory intervention. Overall, 32 semistructured interviews with relevant stakeholders will be conducted and analysed. The stakeholders will include healthcare professionals from the outpatient setting (general practitioners, healthcare assistants, ambulatory care nurses) and the inpatient setting (clinical doctors, nurses, pharmacists, clinical information scientists) as well as patients and informal caregivers. At a series of workshops based on the results of the stakeholder analyses, we aim to develop a participatory intervention that will then be implemented in a subsequent pilot study. The same stakeholder groups will be invited for participation in the workshops. ETHICS AND DISSEMINATION Ethical approval for this study was waived by the Ethics Committee of Goethe University Frankfurt because of the nature of the proposed study. Written informed consent will be obtained from all study participants prior to participation. Results will be tested in a pilot study and disseminated at (inter)national conferences and via publication in peer-reviewed journals. TRIAL REGISTATION NUMBER Clinical Trials Register: registration number DRKS00027649.
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Affiliation(s)
- Maria-Sophie Brueckle
- Institute of General Practice, Goethe University Frankfurt, Frankfurt am Main, Hessen, Germany
| | - Truc Sophia Dinh
- Institute of General Practice, Goethe University Frankfurt, Frankfurt am Main, Hessen, Germany
| | | | - Lisa Rietschel
- Department of General Practice, Dresden University of Technology, Dresden, Germany
| | - Jenny Petermann
- Department of General Practice, Dresden University of Technology, Dresden, Germany
| | - Franziska Brosse
- Department of General Practice, Dresden University of Technology, Dresden, Germany
| | - Sylvia Schulz-Rothe
- Institute of General Practice, Goethe University Frankfurt, Frankfurt am Main, Hessen, Germany
| | | | - Martin Kramer
- Department of General Practice, Dresden University of Technology, Dresden, Germany
| | - Jennifer Engler
- Institute of General Practice, Goethe University Frankfurt, Frankfurt am Main, Hessen, Germany
| | - Karola Mergenthal
- Institute of General Practice, Goethe University Frankfurt, Frankfurt am Main, Hessen, Germany
| | - Christiane Muth
- Department of General Practice and Family Medicine, Medical Faculty OWL, University of Bielefeld, Bielefeld, Germany
| | - Karen Voigt
- Department of General Practice, Dresden University of Technology, Dresden, Germany
| | - Marjan van den Akker
- Institute of General Practice, Goethe University Frankfurt, Frankfurt am Main, Hessen, Germany
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Ng CB, Chang CT, Ong SY, Mahmud M, Lee LC, Chew WY, Hamdan N, Kamaludin RS, Thong KS, Choo SJ. Awareness, expectation and satisfaction towards ward pharmacy services among patients in medical wards: a multi-centre study in Perak, Malaysia. BMC Health Serv Res 2021; 21:1175. [PMID: 34711230 PMCID: PMC8555295 DOI: 10.1186/s12913-021-07185-7] [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: 06/29/2021] [Accepted: 10/18/2021] [Indexed: 11/29/2022] Open
Abstract
Background Patient’s awareness and satisfaction towards ward pharmacy services may influence perception towards effectiveness and safety of drugs, affecting medication adherence and clinical outcome. Nevertheless, studies on local ward pharmacy services were lacking. This study evaluated awareness, expectation and satisfaction of ward pharmacy services among patients in medical wards and determined their association with demographic characteristics. Methods This was a cross-sectional study using self-administered questionnaire conducted in medical wards of fourteen Perak state public hospitals from September to October 2020. In-patients aged ≥18 years old were included. The validated questionnaire had four domains. The student’s t-test, one-way analysis of variance (ANOVA) and multiple linear regression were was employed to evaluate the association between patients’ demographic characteristics with their awareness, expectation and satisfaction towards ward pharmacy services. Results 467 patients agreed to participate (response rate = 83.8%) but only 441 were analysed. The mean age of the patients was 54.9 years. Majority was male (56.2%), Malay (77.3%), with secondary education (62.9%), rural resident (57.1%) and reported good medication adherence (61.6%). The mean awareness score was 49.6 out of 60. Patients were least aware about drug-drug interaction (3.85 ± 1.15) and proper storage of medications (3.98 ± 1.06). Elderly patients (β = − 2.82, P < 0.001) obtained lower awareness score. Patients with tertiary education (β = 3.87, P = 0.001), rural residents (β = 3.65, P < 0.001) and with good medication adherence (β = 2.55, P = 0.002) had higher awareness score. The mean expectation score was 44.0 out of 50. The patients had higher expectation to encounter a polite ward pharmacist (4.51 ± 0.56). Patients with tertiary education (β = 1.86, P = 0.024), rural residents (β = 1.79, P = 0.001) and with good medication adherence (β = 1.48, P = 0.006) demonstrated higher expectation. The mean satisfaction score was 43.6 out of 50. The patients had high satisfaction in language used (4.45 ± 0.57) and level of knowledge demonstrated (4.41 ± 0.62) by the ward pharmacists. Patients with tertiary education (β = 2.16, P = 0.009), rural residents (β = 1.82, P = 0.001) and with good medication adherence (β = 1.44, P = 0.009) demonstrated higher satisfaction, while elderly patients (β = − 1.17, P = 0.031) had lower satisfaction towards ward pharmacy services. Conclusion There was a high level of awareness, expectation and satisfaction towards ward pharmacy services in public hospitals of Perak, Malaysia.
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Affiliation(s)
- Chew Beng Ng
- Pharmacy Department, Hospital Taiping, Ministry of Health Malaysia, Taiping, Malaysia
| | - Chee Tao Chang
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Malaysia.
| | - Su Yin Ong
- Perak Pharmaceutical Services Division, Ministry of Health Malaysia, Ipoh, Malaysia
| | - Maslinatasha Mahmud
- Pharmacy Department, Hospital Parit Buntar, Ministry of Health Malaysia, Parit Buntar, Malaysia
| | - Lay Chin Lee
- Pharmacy Department, Hospital Teluk Intan, Ministry of Health Malaysia, Teluk Intan, Malaysia
| | - Wei Yee Chew
- Pharmacy Department, Hospital Selama, Ministry of Health Malaysia, Selama, Malaysia
| | - Normi Hamdan
- Pharmacy Department, Hospital Seri Manjung, Ministry of Health Malaysia, Seri Manjung, Malaysia
| | - Ros Sakinah Kamaludin
- Pharmacy Department, Hospital Slim River, Ministry of Health Malaysia, Slim River, Malaysia
| | - Kah Shuen Thong
- Pharmacy Department, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Malaysia
| | - Shea Jiun Choo
- Pharmacy Department, Hospital Taiping, Ministry of Health Malaysia, Taiping, Malaysia
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