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Cole B. Enhancing clinical reasoning and student confidence through pediatric simulation. J Pediatr Nurs 2024; 78:e432-e437. [PMID: 39122581 DOI: 10.1016/j.pedn.2024.08.005] [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] [Received: 04/09/2024] [Revised: 08/03/2024] [Accepted: 08/04/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND The education-to-practice gap is magnified in pediatric nursing due to decreasing pediatric content offered in undergraduate programs, including less pediatric clinical time and inconsistent and inadequate clinical experiences. PURPOSE Examine student perceptions of learning and confidence by comparing a high-fidelity pediatric simulation series and acute care pediatric clinical. METHODS The SET-M tool compared settings and included open-ended questions to add insight. SAMPLE In an undergraduate nursing program in a university in the Midwest United States, 124 students completed the anonymous survey rating each experience for learning and confidence in assessment, clinical decision-making, communication, and safety. RESULTS Students rated the simulation series higher than clinical for all categories except patient communication. CONCLUSION Student perceptions of learning in high-fidelity simulation revealed increased confidence and competence and the belief that simulation complements the clinical experience and bridges the theory and clinical courses.
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Affiliation(s)
- Britt Cole
- Department of Nursing, Miami University, 1601 University Blvd., Hamilton, OH 45011, United States of America.
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El-Awaisi A, Yakti OH, Elboshra AM, Jasim KH, AboAlward AF, Shalfawi RW, Awaisu A, Rainkie D, Al Mutawa N, Major S. Facilitators and barriers to interprofessional collaboration among health professionals in primary healthcare centers in Qatar: a qualitative exploration using the "Gears" model. BMC PRIMARY CARE 2024; 25:316. [PMID: 39192182 PMCID: PMC11348528 DOI: 10.1186/s12875-024-02537-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 07/22/2024] [Indexed: 08/29/2024]
Abstract
BACKGROUND The number of patients seeking medical care is increasing, necessitating more access to primary healthcare services. As several of these patients usually present with complex medical conditions, the need for interprofessional collaboration (IPC) among health professionals in primary care is necessary. IPC is essential for facing the increasing and challenging healthcare demands. Therefore, the facilitators of and the barriers to IPC should be studied in the hope that the results will be used to promote such endeavors. OBJECTIVES This study aimed to explore the perspectives of different health professionals regarding the facilitators of and the barriers to IPC in the primary healthcare settings in Qatar. METHODS A qualitative study using focus groups was conducted within the Primary Health Care Corporation (PHCC) in Qatar. Several health professionals were invited to participate in the focus groups. The focus groups were uniprofessional for general practitioners (GPs), nurses, and dentists, while they were interprofessional for the other health professionals. Focus groups were audio-recorded and transcribed verbatim and validated by the research team. The data were analyzed by deductive thematic analysis using the "Gears" Conceptual Model as a coding framework. RESULTS Fourteen focus groups were conducted involving 58 participants (including 17 GPs, 12 nurses, 15 pharmacists, 3 dentists, and 11 allied health professionals) working in PHCC in Qatar. The findings revealed a spectrum of factors influencing IPC, categorized into four main domains: Macro, Meso, Micro, and individual levels, with each accompanied by relevant barriers and facilitators. Key challenges identified included a lack of communication skills, insufficient professional competencies, and power imbalances, among others. To address these challenges, recommendations were made to implement dedicated training sessions on IPC, reduce hierarchical barriers among different health professionals, and enhance the effectiveness of existing systems. Conversely, it was emphasized that projects and campaigns focused on IPC, alongside the development of enhanced communication skills and the presence of supportive leadership, as essential for facilitating effective IPC in PHCCs. CONCLUSION The interplay between the meso, macro, micro, and individual levels highlight the significance of a multifaceted approach to interventions, aiming to enhance the successes of IPC. While initiatives like interprofessional education training are underway, numerous challenges persist before achieving improved collaboration and more efficient integration of IPC in the PHCC setting.
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Affiliation(s)
- Alla El-Awaisi
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar.
| | | | - Abier Mohamed Elboshra
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Kawthar Hasan Jasim
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Alzahraa Fathi AboAlward
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | | | - Ahmed Awaisu
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Daniel Rainkie
- College of Pharmacy, Dalhousie University, Halifax, Canada
| | - Noora Al Mutawa
- Primary Health Care Corporation, Doha, Qatar
- Department of Clinical Academic Education, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Stella Major
- Division of Medical Education, Weill Cornell Medicine - Qatar, Doha, Qatar
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Brown T, Roberts E, Lizarondo L, McArthur A, Basnet P, Basukoski M, Cheng S, Findlay B, Gao J, Joshua RK, Jun R, Kennedy R, Laing M, Lawler M, Ling R, Lo Y, Lockwood C, Mandla A, Milnes C, Rule ML, Taylor J, Thornton A. Improving the quality of medication administration practices in a tertiary Australian hospital: a best practice implementation project. JBI Evid Implement 2024:02205615-990000000-00115. [PMID: 39016533 DOI: 10.1097/xeb.0000000000000446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2024]
Abstract
INTRODUCTION Medication safety is an important health priority that focuses on preventing harm from medication-related events. Unsafe medication administration practices can lead to errors, which can cause avoidable injury (or harm) to patients. OBJECTIVES This paper reports on an evidence implementation project conducted in a large tertiary hospital in Australia to improve nursing compliance with best practice recommendations for medication administration. METHODS The project was guided by JBI's seven-phase approach to evidence implementation, using audit and feedback and a structured framework to identify barriers, enablers, and implementation strategies. RESULTS The project resulted in improved compliance with best practice recommendations. This was achieved through multimodal strategies, including education, improved access to resources, and targeted feedback and discussion sessions to encourage culture and behavior change. CONCLUSIONS The project improved nurses' medication administration practices, specifically in performing independent second checks. Collaborative efforts of the project leads facilitated the review of medication administration policy and the development of staff education resources. Patient engagement remains an area for improvement, along with the potential need for further ongoing medication education. SPANISH ABSTRACT http://links.lww.com/IJEBH/A237.
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Affiliation(s)
| | | | - Lucylynn Lizarondo
- JBI, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Alexa McArthur
- JBI, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
| | | | | | | | | | - Jessica Gao
- St Vincent's Hospital, Sydney, NSW, Australia
| | | | - Rosa Jun
- St Vincent's Hospital, Sydney, NSW, Australia
| | | | - Michelle Laing
- Gorman Unit, St Vincent's Health Network Sydney, Sydney, NSW, Australia
| | | | - Rachel Ling
- St Vincent's Hospital, Sydney, NSW, Australia
| | - Yin Lo
- St Vincent's Hospital, Sydney, NSW, Australia
| | - Craig Lockwood
- JBI, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
| | | | - Cate Milnes
- St Vincent's Hospital, Sydney, NSW, Australia
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Bsoul N, Ning L, Cai L, Mazmanyan D, Porter D. Evidence-based clinical practice guidelines for the management of acute ankle injuries according to: a PRISMA systematic review and quality appraisal with AGREE II. BMC Musculoskelet Disord 2024; 25:523. [PMID: 38978052 PMCID: PMC11229291 DOI: 10.1186/s12891-024-07655-z] [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] [Received: 03/10/2024] [Accepted: 07/02/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Acute ankle injuries are commonly seen in emergency rooms, with significant social impact and potentially devastating consequences. While several clinical practice guidelines (CPGs) related to ankle injuries have been developed by various organizations, there is a lack of critical appraisal of them. The purpose of this systematic review is to identify and critically appraise evidence-based clinical practice guidelines (EB-CPGs) related to acute ankle injuries in adults. METHOD We conducted searches in the Cochrane Library, MEDLINE, EMBASE databases, WHO, and reviewed 98 worldwide orthopedic association websites up until early 2023. Two authors independently applied the inclusion and exclusion criteria, and each evidence-based clinical practice guideline (EB-CPG) underwent independent critical appraisal of its content by all four authors using the Appraisal of Guidelines for REsearch and Evaluation (AGREE II) instrument. AGREE II scores for each domain were then calculated. RESULTS This review included five evidence-based clinical practice guidelines. The mean scores for all six domains were as follows: Scope and Purpose (87.8%), Stakeholder Involvement (69.2%), Rigour of Development (72.5%), Clarity of Presentation (86.9%), Applicability (45.6%), and Editorial Independence (53.3%). CONCLUSION The number of EB-CPGs related to ankle injuries are limited and the overall quality of the existing evidence-based clinical practice guidelines (EB-CPGs) for ankle injuries is not strong, with three of them being outdated. However, valuable guidance related to Ottawa rules, manual therapy, cryotherapy, functional supports, early ambulation, and rehabilitation has been highlighted. Challenges remain in areas such as monitoring and/or auditing criteria, consideration of the target population's views and preferences, and ensuring editorial independence. Future guidelines should prioritize improvements in these domains to enhance the quality and relevance of ankle injury management. SYSTEMATIC REVIEW Systematic review.
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Affiliation(s)
- Najeeb Bsoul
- Tsinghua University, Beijing, China
- First Affiliated Hospital of Tsinghua University, Beijing, China
| | - Liang Ning
- Tsinghua University, Beijing, China.
- First Affiliated Hospital of Tsinghua University, Beijing, China.
| | - Leyi Cai
- Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Davit Mazmanyan
- Tsinghua University, Beijing, China
- First Affiliated Hospital of Tsinghua University, Beijing, China
| | - Daniel Porter
- Tsinghua University, Beijing, China
- First Affiliated Hospital of Tsinghua University, Beijing, China
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Khemai C, Leão DLL, Janssen DJA, Schols JMGA, Meijers JMM. Interprofessional collaboration in palliative dementia care. J Interprof Care 2024; 38:675-694. [PMID: 38757957 DOI: 10.1080/13561820.2024.2345828] [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: 05/04/2022] [Accepted: 04/16/2024] [Indexed: 05/18/2024]
Abstract
Interprofessional collaboration (IPC) is essential for high-quality palliative care (PC) for persons with dementia. The aim of this scoping review was to identify IPC approaches in palliative dementia care and explore the elements constituting these approaches. We performed a search in PubMed, CINAHL, and PsychINFO using the Joanna Briggs Institute Reviewers' manual and PRISMA guidelines, and conducted content analysis of the included articles. In total, 28 articles were included, which described 16 IPC approaches in palliative dementia care. The content analysis revealed three overall elements of these approaches: 1) collaborative themes, 2) collaborative processes, and 3) resources facilitating collaboration. Frequently reported collaborative themes embraced pain management and providing care in the dying phase. These themes were addressed through intertwined collaborative processes including communication, coordination, assessing and monitoring, and reflecting and evaluating. To ensure optimal IPC in palliative dementia care, various resources were required, such as PC knowledge, skills to manage symptoms, skills to communicate with collaborators, and a facilitating environment. In conclusion, the identified IPC approaches in palliative dementia care involve diverse collaborating professionals who mainly manage symptoms, prepare for the dying phase and require material and immaterial resources to enable optimal IPC in palliative dementia care.
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Affiliation(s)
- C Khemai
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - D L L Leão
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - D J A Janssen
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
- Department of Research and Development, Ciro, Horn, the Netherlands
| | - J M G A Schols
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - J M M Meijers
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
- Zuyderland Care, Zuyderland Medical Centre, Sittard-Geleen, the Netherlands
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Brown CL, Tittlemier BJ, Tiwari KK, Loewen H. Interprofessional Teams Supporting Care Transitions from Hospital to Community: A Scoping Review. Int J Integr Care 2024; 24:1. [PMID: 38618048 PMCID: PMC11012160 DOI: 10.5334/ijic.7623] [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: 03/30/2023] [Accepted: 03/11/2024] [Indexed: 04/16/2024] Open
Abstract
Introduction Poor outcomes following the transition from hospital back to community living are common, especially for older adults with complex health and social care needs. Some health care systems now have multiple interprofessional teams (in hospital and community) to support care transitions. These teams will need to be well coordinated to improve care transition outcomes. Methods We conducted a scoping review to identify and map peer-reviewed literature on how interprofessional teams are working together to support older adults transitioning from hospital back to the community. We used the six-stage framework developed by Levac and colleagues (2010). Procedures were guided by the Joanna Briggs Institute scoping review guidelines. Results Our structured search and screening process resulted in 70 articles, published between 2000 and 2022, from 14 counties. Within these articles, 26 programs were described that used interprofessional teams in both the hospital and community. Discussion The qualitative articles suggested that effective teamwork is very important for promoting care transition quality, but the quantitative research did not report on team-related outcomes. Quantitative research has described, but not evaluated, strategies for promoting interprofessional collaboration. Conclusion Future research should focus on evaluating processes used to promote effective interprofessional teamwork in care transition interventions.
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Affiliation(s)
- Cara L. Brown
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | | | - Hal Loewen
- Health Sciences Librarian, Neil John Maclean Health Science Library, Winnipeg, MB, Canada
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Negm LMMA, Mersal FA, Fawzy MS, Rajennal AT, Alanazi RS, Alanazi LO. Challenges of nursing students during clinical training: A nursing perspective. AIMS Public Health 2024; 11:379-398. [PMID: 39027388 PMCID: PMC11252586 DOI: 10.3934/publichealth.2024019] [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: 01/01/2024] [Revised: 03/09/2024] [Accepted: 03/11/2024] [Indexed: 07/20/2024] Open
Abstract
Clinical training plays a fundamental role in nursing students' acquisition of professional capabilities. This study aimed to explore the perceived challenges nursing students face during clinical training. An explorative cross-sectional study was applied. A proportionate, stratified, random sample was enrolled in the study with inclusive criteria, including nursing students (2nd - 4th year) and interns who attended their internship in regional hospitals. A validated electronic questionnaire was used for data collection, which consisted of three sections and 29 items. The section that focused on the difficulties experienced by nursing students during their practical training included six elements: teachers, healthcare professionals, the students themselves, tasks, time management, and the location of the training. Another section inquired about the students' perspectives on the benefits of clinical training. A three-point "Likert scale" was applied. The findings indicated that mild (24%), moderate (62%), and severe (14%) degree of challenges were perceived by the study participants. The mean score for the total challenges during clinical training was 2.00 ± 0.28, and there were variations in the perceived challenges among grade levels. In conclusion, there are variations in the perceived challenges during clinical training among different grade levels. These challenges were related to teachers, health workers, the students, tasks, the time, and the place. Enhancing the nursing curricula alignment with practical training objectives is recommended, focusing on the development of technical and interpersonal skills with appropriate guidance, alongside positive clinical settings to help nursing students learn and boost their confidence in their approach.
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Affiliation(s)
- Lobna Mohamed Mohamed Abu Negm
- Department of Emergency and Intensive Care Nursing, Faculty of Nursing, Northern Border University, Arar 73213, Saudi Arabia
| | - Fathia Ahmed Mersal
- Department of Public Health Nursing, Faculty of Nursing, Northern Border University, Arar 73213, Saudi Arabia
| | - Manal S. Fawzy
- Unit of Medical Research and Postgraduate Studies, Faculty of Medicine, Northern Border University, Arar 73213, Saudi Arabia
- Department of Biochemistry, Faculty of Medicine, Northern Border University, Arar 73213, Saudi Arabia
| | - Ajitha Thankarajan Rajennal
- Department of Medical Surgical Nursing, Faculty of Nursing, Northern Border University, Arar 73213, Saudi Arabia
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Mbalinda SN, Najjuma JN, Gonzaga AM, Livingstone K, Musoke D. Understanding and barriers of professional identity formation among current students and recent graduates in nursing and midwifery in low resource settings in two universities: a qualitative study. BMC Nurs 2024; 23:146. [PMID: 38429682 PMCID: PMC10908141 DOI: 10.1186/s12912-024-01795-2] [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: 10/09/2023] [Accepted: 02/11/2024] [Indexed: 03/03/2024] Open
Abstract
INTRODUCTION In the changing healthcare landscape, a strong professional identity serves as a cornerstone for nurses. Therefore, transformative educational approaches that include professional judgement, reasoning, critical self-evaluation and a sense of accountability are required to foster professional identity. We explored the understanding and barriers to professional identity formation among recent graduates and students of midwifery and nursing in Uganda. METHODS A descriptive qualitative research design employing focus groups was used to collect data from student nurses and midwives from Makerere University, Mbarara University, and recent graduates in nursing and midwifery programs attending their internship training at Mulago National and Mbarara Regional Referral hospitals. Thematic analysis was used to analyse the data. RESULTS A total of 33 students and 26 recent graduates participated in the study. The participants who reported understanding Professional identity in nursing and midwifery mentioned that these are principles, characteristics and values, competencies, ethics and code of conduct, sense of belonging and professionalism that define the nursing profession and practice. Barriers to the formation of professional identity were provided under two themes: education and health service delivery. The education theme included subthemes like nursing educators not working in clinical settings and inadequate clinical mentoring. Under the health service delivery theme, subthemes emerged included high workload, lack of interprofessional collaboration, many levels of nursing and midwifery practice, no clear scope of practice for different levels of nursing and midwifery practice, Low esteem among nurses and midwives, media and lack of policy implementation. CONCLUSION AND RECOMMENDATION Participants were knowledgeable about professional identity in nursing/midwifery. They faced several challenges and barriers in professional identity formation during their training and internship. We recommend a need to streamline the scope of practice and enhance clinical mentorship and engagement of leadership in nursing in developing professional identity among students.
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Affiliation(s)
- Scovia Nalugo Mbalinda
- Department of Nursing, School of Medicine, College of Health Sciences, Makerere University, Kampala, PO Box 7072, Uganda.
| | - Josephine Nambi Najjuma
- Department of Nursing, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Aloysius Mubuuke Gonzaga
- Department of Radiology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Kamoga Livingstone
- Department of Nursing, School of Medicine, College of Health Sciences, Makerere University, Kampala, PO Box 7072, Uganda
| | - David Musoke
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
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Crunenberg R, Charles C, Lallemand A, Buret L, Philippe G, Ethgen O. Interpretative phenomenological analysis of the collaboration among healthcare professionals in the nursing home setting. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2024; 13:100424. [PMID: 38516547 PMCID: PMC10955404 DOI: 10.1016/j.rcsop.2024.100424] [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: 07/06/2023] [Revised: 02/12/2024] [Accepted: 02/16/2024] [Indexed: 03/23/2024] Open
Abstract
Background The theory of planned behavior (TPB) postulates that behavioral performance is guided by the intention to perform that behavior, influenced by attitudes, subjective norms, and perceived behavioral control. This framework can be applied to studying interprofessional collaboration among healthcare professionals to enhance patient safety and public health within nursing homes. Objectives This study aimed to explore the roles of physicians, pharmacists, and nurses in the interprofessional collaboration process while identifying facilitators and barriers to effective collaboration among healthcare professionals. Methods A qualitative interpretative phenomenological analysis (IPA) was carried out. Individual semi-structured interviews were conducted with 19 healthcare professionals. Qualitative data were then integrated and analyzed through the lens of the TPB. Findings The IPA revealed the ten following themes, considered as both facilitators and barriers to interprofessional collaboration among healthcare professionals in the nursing home setting: communication, roles and responsibilities, willingness and recognition of collaboration's importance, mutual knowledge, trust, confidence, support from decision-makers, protocols, and technology were considered as facilitators while distance was considered as a barrier. Conclusion Enhancing pharmacist-physician collaboration and refining pharmacist-nurse collaboration were essential goals. Intention for collaboration was influenced by attitudes (such as communication and mutual understanding), subjective norms (including support from decision-makers), and perceived behavioral control (such as confidence and adherence to protocols and technology). Addressing these factors could improve collaboration, enhancing residents' quality of life and professionals' sense of achievement.
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Affiliation(s)
- Robin Crunenberg
- Faculty of Medicine, Department of Pharmacy, Center for Interdisciplinary Research on Medicines (CIRM), University of Liège, Liège, Belgium
- Faculty of Medicine, Department of Public Health, Epidemiology and Health Economics, University of Liège, Belgium, Liège, Belgium
| | - Camille Charles
- Faculty of Medicine, Department of Pharmacy, Center for Interdisciplinary Research on Medicines (CIRM), University of Liège, Liège, Belgium
| | - Alice Lallemand
- Faculty of Medicine, Department of Pharmacy, Center for Interdisciplinary Research on Medicines (CIRM), University of Liège, Liège, Belgium
| | - Laetitia Buret
- Faculty of Medicine, Department of General Medicine, University of Liège, Liège, Belgium
| | - Geneviève Philippe
- Faculty of Medicine, Department of Pharmacy, Center for Interdisciplinary Research on Medicines (CIRM), University of Liège, Liège, Belgium
| | - Olivier Ethgen
- Faculty of Medicine, Department of Public Health, Epidemiology and Health Economics, University of Liège, Belgium, Liège, Belgium
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Rahayu SA, Widianto S, Defi IR, Abdulah R. Does power distance in healthcare teams linked to patient satisfaction? A multilevel study of interprofessional care teams in a referral hospital in Indonesia. BMC Health Serv Res 2024; 24:83. [PMID: 38229081 DOI: 10.1186/s12913-023-10534-3] [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: 03/19/2023] [Accepted: 12/28/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Interprofessional care teams collaborate to provide care to patients in hospitals to ensure their full recovery. To provide quality patient care, healthcare workers must have a comprehensive understanding of each other's roles and collaborate effectively. Good interpersonal skills are also essential for maintaining cooperative and collaborative relationships, listening, and respecting other team member's values and positions. Therefore, this study aimed to investigate the effect of power distance in interprofessional care on patients' satisfaction. METHOD A quantitative study was conducted in a hospital by using a questionnaire instrument to collect information from patients and members of the interprofessional care team. The respondents included 10 geriatric, 19 palliative, 36 cancer, 8 burn, and 18 medical intermediate care (MIC) teams. Subsequently, a hierarchical regression analysis was conducted to examine whether interprofessional care could significantly predict the relationship between team power distance and patient satisfaction. RESULTS The measurement of the effect of power distance in interprofessional care among doctors, nurses, pharmacists, and nutritionists on patient satisfaction revealed nonsignificant results. However, the final analysis indicated negative coefficients with regard to power distance for nutritionists (-0.033098), nurses (-0.064912), and pharmacists (-0.006056). These findings indicated that the power distance associated with these professions was linked with decreased patient satisfaction. CONCLUSIONS The results suggested that power distance within an interprofessional care team can reduce patient satisfaction.
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Affiliation(s)
- Susi Afrianti Rahayu
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, 45363, Indonesia
- Bumi Siliwangi College of Pharmacy, Bandung, Indonesia
| | - Sunu Widianto
- Department of Management and Business, Faculty of Economics and Business, Universitas Padjadjaran, Jatinangor, 45363, Indonesia
| | - Irma Ruslina Defi
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Padjadjaran, Jatinangor, 45363, Indonesia
- Department of Physical Medicine and Rehabilitation, Hasan Sadikin Hospital, Bandung, Indonesia
| | - Rizky Abdulah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, 45363, Indonesia.
- Center for Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia.
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Attieh S, Loiselle CG. Cancer Care Team Functioning during COVID-19: A Narrative Literature Review and Synthesis. Curr Oncol 2024; 31:335-349. [PMID: 38248107 PMCID: PMC10814830 DOI: 10.3390/curroncol31010022] [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: 11/28/2023] [Revised: 12/24/2023] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
Amid pandemics, health care teams face unprecedented challenges, requiring significant efforts to sustain optimal functioning and navigate rapid practice changes. It is therefore crucial to identify factors affecting team functioning in these contexts. The present narrative review more specifically summarizes the literature on key elements of cancer teams' functioning during COVID-19. The search strategy involved four main databases (i.e., Medline OVID, EMBASE, PsycINFO, and CINAHL), as well as Google Scholar, from January 2000 to September 2022. Twenty-three publications were found to be relevant. Each was read thoroughly, and its content summarized. Across publications, three key themes emerged: (1) swiftly adopting virtual technology for communication and interprofessional collaboration, (2) promoting team resilience, and (3) encouraging self-care and optimizing team support. Our findings underscore key team functioning elements to address in future pandemics. More research is needed to document the perspectives of broader-based team members (such as patients and lay carers) to inform more comprehensive evidence-based team functioning guidelines.
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Affiliation(s)
- Samar Attieh
- Department of Experimental Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H4A 3J1, Canada
| | - Carmen G. Loiselle
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3A 2M7, Canada;
- Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H4A 3T2, Canada
- Segal Cancer Center, CIUSSS Centre-Ouest, Montreal, QC H3T 1E2, Canada
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Hovland C, Gergis M, Milliken B, DeBoth Foust K, Niederriter J. The value of learning virtual interprofessional collaboration during a pandemic and the future "new normal": health professions students share their experiences. J Interprof Care 2024; 38:87-94. [PMID: 37422881 DOI: 10.1080/13561820.2023.2232401] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/15/2023] [Accepted: 06/26/2023] [Indexed: 07/11/2023]
Abstract
This exploratory study looked at the experiences of social work, occupational therapy, and nursing students who participated in an interprofessional simulation that was offered virtually due to the impact of COVID-19. The simulation was a one-day event that introduced advanced care planning to the students through an IPE team approach and incorporated various learning and teaching modalities. Using conventional content analysis of the post-program survey data from 255 students (35 occupational therapy; 87 social work; and 133 nursing), three primary themes were identified for the value of learning virtual interprofessional collaboration during a pandemic: (1) catalyst for telehealth education; (2) patient, family & professional safety; and (3) connection and continuity of care. In addition, students identified four primary themes that were learned and perceptions of what could lie ahead beyond the simulation: (1) patient & family convenience and inclusion; (2) expand interprofessional team involvement; (3) alleviate disparities/increase access; and (4) the "new normal" of virtual IP Collaboration.
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Affiliation(s)
- Cynthia Hovland
- School of Social Work, College of Health, Cleveland State University, Cleveland, OH, USA
| | - Mary Gergis
- School of Nursing, College of Health, Cleveland State University, Cleveland, OH, USA
| | - Barbara Milliken
- Occupational Therapy Program, College of Health, Cleveland State University, Cleveland, OH, USA
| | - Kelle DeBoth Foust
- Occupational Therapy Program, College of Health, Cleveland State University, Cleveland, OH, USA
| | - Joan Niederriter
- School of Nursing, College of Health, Cleveland State University, Cleveland, OH, USA
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13
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Badge A, Chandankhede M, Gajbe U, Bankar NJ, Bandre GR. Employment of Small-Group Discussions to Ensure the Effective Delivery of Medical Education. Cureus 2024; 16:e52655. [PMID: 38380198 PMCID: PMC10877665 DOI: 10.7759/cureus.52655] [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: 11/30/2023] [Accepted: 01/21/2024] [Indexed: 02/22/2024] Open
Abstract
The changing landscape of medical education has made small-group discussions crucial components. These sessions, including problem-based learning (PBL), case-based learning (CBL), and team-based learning (TBL), revolutionize learning by fostering active participation, critical thinking, and practical skills application. They bridge theory with practice, preparing future healthcare professionals for the dynamic challenges of modern healthcare. Despite their transformative potential, there are challenges in faculty preparation, resource allocation, and effective evaluation. The best practices include aligning discussions with curriculum goals, skilled facilitation, promoting active participation, and robust assessment strategies. Looking ahead, adapting to emerging health trends, ongoing research, and evolving healthcare demands will ensure the continued relevance and effectiveness of small-group discussions, shaping competent and adaptable healthcare providers equipped for the ever-evolving healthcare landscape.
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Affiliation(s)
- Ankit Badge
- Microbiology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Manju Chandankhede
- Biochemistry, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Ujwal Gajbe
- Anatomy, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Nandkishor J Bankar
- Microbiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Gulshan R Bandre
- Microbiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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14
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Ranusch A, Lin YJ, Dorsch MP, Allen AL, Spoutz P, Seagull FJ, Sussman JB, Barnes GD. Role of Individual Clinician Authority in the Implementation of Informatics Tools for Population-Based Medication Management: Qualitative Semistructured Interview Study. JMIR Hum Factors 2023; 10:e49025. [PMID: 37874636 PMCID: PMC10630856 DOI: 10.2196/49025] [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: 05/19/2023] [Revised: 08/16/2023] [Accepted: 09/02/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Direct oral anticoagulant (DOAC) medications are frequently associated with inappropriate prescribing and adverse events. To improve the safe use of DOACs, health systems are implementing population health tools within their electronic health record (EHR). While EHR informatics tools can help increase awareness of inappropriate prescribing of medications, a lack of empowerment (or insufficient empowerment) of nonphysicians to implement change is a key barrier. OBJECTIVE This study examined how the individual authority of clinical pharmacists and anticoagulation nurses is impacted by and changes the implementation success of an EHR DOAC Dashboard for safe DOAC medication prescribing. METHODS We conducted semistructured interviews with pharmacists and nurses following the implementation of the EHR DOAC Dashboard at 3 clinical sites. Interview transcripts were coded according to the key determinants of implementation success. The intersections between individual clinician authority and other determinants were examined to identify themes. RESULTS A high level of individual clinician authority was associated with high levels of key facilitators for effective use of the DOAC Dashboard (communication, staffing and work schedule, job satisfaction, and EHR integration). Conversely, a lack of individual authority was often associated with key barriers to effective DOAC Dashboard use. Positive individual authority was sometimes present with a negative example of another determinant, but no evidence was found of individual authority co-occurring with a positive instance of another determinant. CONCLUSIONS Increased individual clinician authority is a necessary antecedent to the effective implementation of an EHR DOAC Population Management Dashboard and positively affects other aspects of implementation. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s13012-020-01044-5.
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Affiliation(s)
- Allison Ranusch
- Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | - Ying-Jen Lin
- Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Michael P Dorsch
- College of Pharmacy, University of Michigan, Ann Arbor, MI, United States
- Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, MI, United States
| | - Arthur L Allen
- Veterans Affairs, Salt Lake City Health Care System, Salt Lake City, UT, United States
| | - Patrick Spoutz
- Veterans Integrated Service Network 20 Northwest Network, Vancouver, WA, United States
| | - F Jacob Seagull
- Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Jeremy B Sussman
- Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, United States
- Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, MI, United States
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Geoffrey D Barnes
- Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, United States
- Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, MI, United States
- Division of Cardiovascular Medicine, Department of Internal Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI, United States
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15
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Rivera J, Malone S, Puerto-Torres M, Prewitt K, Counts L, Wiphatphumiprates P, Sakaan F, Al Zebin Z, Arias AV, Bhattacharyya P, Gunasekera S, Johnson S, Kambugu J, Kaye EC, Mandrell B, Mack J, McArthur J, Mendez A, Morrissey L, Sharara-Chami R, Snaman J, Sniderman E, Luke DA, Graetz DE, Agulnik A. CritCom: assessment of quality of interdisciplinary communication around deterioration in pediatric oncologic patients. Front Oncol 2023; 13:1207578. [PMID: 37886167 PMCID: PMC10598383 DOI: 10.3389/fonc.2023.1207578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023] Open
Abstract
Background High-quality clinical care requires excellent interdisciplinary communication, especially during emergencies, and no tools exist to evaluate communication in critical care. We describe the development of a pragmatic tool focusing on interdisciplinary communication during patient deterioration (CritCom). Methods The preliminary CritCom tool was developed after a literature review and consultation with a multidisciplinary panel of global experts in communication, pediatric oncology, and critical care to review the domains and establish content validity iteratively. Face and linguistic validity were established through cognitive interviews, translation, and linguistic synthesis. We conducted a pilot study among an international group of clinicians to establish reliability and usability. Results After reviewing 105 potential survey items, we identified 52 items across seven domains. These were refined through cognitive interviews with 36 clinicians from 15 countries. CritCom was piloted with 433 clinicians (58% nurses, 36% physicians, and 6% other) from 42 hospitals in 22 countries. Psychometric testing guided the refinement of the items for the final tool. CritCom comprised six domains with five items each (30 total). The final tool has excellent reliability (Cronbach's alpha 0.81-0.86), usability (93% agree or strongly agree that the tool is easy to use), and similar performance between English and Spanish tools. Confirmatory factor analysis was used to establish the final 6-domain structure. Conclusions CritCom is a reliable and pragmatic bilingual tool to assess the quality of interdisciplinary communication around patient deterioration for children in diverse resource levels globally. Critcom results can be used to design and evaluate interventions to improve team communication.
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Affiliation(s)
- Jocelyn Rivera
- Pediatric Emergency Department, Hospital Infantil Teletón de Oncología (HITO), Querétaro, Mexico
| | - Sara Malone
- Washington University in St. Louis, Brown School, St. Louis, MO, United States
| | - Maria Puerto-Torres
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - Kim Prewitt
- Washington University in St. Louis, Brown School, St. Louis, MO, United States
| | - Lara Counts
- Washington University in St. Louis, Brown School, St. Louis, MO, United States
| | - Parima Wiphatphumiprates
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - Firas Sakaan
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - Zebin Al Zebin
- Pediatric Hematology and Oncology, King Hussein Cancer Center, Amman, Jordan
| | - Anita V. Arias
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | | | - Sanjeeva Gunasekera
- Department of Pediatric Oncology National Cancer Institute, Maharagama, Sri Lanka
| | - Sherry Johnson
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - Joyce Kambugu
- Pediatric Oncology, Uganda Cancer Institute, Kampala, Uganda
| | - Erica C. Kaye
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - Belinda Mandrell
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - Jennifer Mack
- Department of Hematology and Oncology, Dana-Farber Cancer Institute and Boston Children’s Hospital, Boston, MA, United States
| | - Jennifer McArthur
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - Alejandra Mendez
- Pediatric Intensive Care Unit, Unidad Nacional de Oncología pediátrica (UNOP), Guatemala City, Guatemala
| | - Lisa Morrissey
- Department of Hematology and Oncology, Dana-Farber Cancer Institute and Boston Children’s Hospital, Boston, MA, United States
| | - Rana Sharara-Chami
- Pediatric Critical Care Medicine, American University of Beirut, Beirut, Lebanon
| | - Jennifer Snaman
- Department of Hematology and Oncology, Dana-Farber Cancer Institute and Boston Children’s Hospital, Boston, MA, United States
| | - Elizabeth Sniderman
- Northern Alberta Children’s Cancer Program, Stollery Children’s Hospital, Edmonton, AB, Canada
| | - Douglas A. Luke
- Washington University in St. Louis, Brown School, St. Louis, MO, United States
| | - Dylan E. Graetz
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - Asya Agulnik
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, United States
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16
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Malone S, Rivera J, Puerto-Torres M, Prewitt K, Sakaan F, Counts L, Al Zebin Z, Arias AV, Bhattacharyya P, Gunasekera S, Johnson S, Kambugu J, Kaye EC, Mandrell B, Mack JW, McArthur J, Mendez A, Morrissey L, Sharara-Chami R, Snaman J, Sniderman E, Luke DA, Graetz DE, Agulnik A. A new measure for multi-professional medical team communication: design and methodology for multilingual measurement development. Front Pediatr 2023; 11:1127633. [PMID: 37334217 PMCID: PMC10272604 DOI: 10.3389/fped.2023.1127633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/09/2023] [Indexed: 06/20/2023] Open
Abstract
Background As implementation science in global health continues to evolve, there is a need for valid and reliable measures that consider diverse linguistic and cultural contexts. A standardized, reproducible process for multilingual measure development may improve accessibility and validity by participants in global health settings. To address this need, we propose a rigorous methodology for multilingual measurement development. We use the example of a novel measure of multi-professional team communication quality, a determinant of implementation efforts. Methods The development and translation of this novel bilingual measure is comprised of seven steps. In this paper, we describe a measure developed in English and Spanish, however, this approach is not language specific. Participants are engaged throughout the process: first, an interprofessional panel of experts and second, through cognitive interviewing for measure refinement. The steps of measure development included: (1) literature review to identify previous measures of team communication; (2) development of an initial measure by the expert panel; (3) cognitive interviewing in a phased approach with the first language (English); (4): formal, forward-backward translation process with attention to colloquialisms and regional differences in languages; (5) cognitive interviewing repeated in the second language (Spanish); (6) language synthesis to refine both instruments and unify feedback; and (7) final review of the refined measure by the expert panel. Results A draft measure to assess quality of multi-professional team communication was developed in Spanish and English, consisting of 52 questions in 7 domains. This measure is now ready for psychometric testing. Conclusions This seven-step, rigorous process of multilingual measure development can be used in a variety of linguistic and resource settings. This method ensures development of valid and reliable tools to collect data from a wide range of participants, including those who have historically been excluded due to language barriers. Use of this method will increase both rigor and accessibility of measurement in implementation science and advance equity in research and practice.
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Affiliation(s)
- Sara Malone
- Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| | - Jocelyn Rivera
- Department of Pediatrics, Hospital Infantil Teletón de Oncologia (HITO), Querétaro, Mexico
| | - Maria Puerto-Torres
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Kim Prewitt
- Center for Public Health Systems Science, Washington University, St. Louis, MO, USA
| | - Firas Sakaan
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Lara Counts
- Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| | - Zebin Al Zebin
- Pediatric Hematology and Oncology, King Hussein Cancer Center, Amman, Jordan
| | - Anita V Arias
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | | | | | - Sherry Johnson
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Joyce Kambugu
- Pediatric Oncology, Uganda Cancer Institute, Kampala, Uganda
| | - Erica C Kaye
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Belinda Mandrell
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Jennifer W Mack
- Department of Hematology and Oncology, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA, United States
| | - Jennifer McArthur
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Alejandra Mendez
- Pediatric Intensive Care Unit, Unidad Nacional de Oncologia Pediatrica (UNOP), Guatemala City, Guatemala
| | - Lisa Morrissey
- Department of Hematology and Oncology, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA, United States
| | - Rana Sharara-Chami
- Pediatric Critical Care Medicine, American University of Beirut, Beirut, Lebanon
- Pediatric Intensive Care Unit, LJ Murphy Inova Children's Hospital, Fairfax, VA, United States
| | - Jennifer Snaman
- Department of Hematology and Oncology, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA, United States
| | - Elizabeth Sniderman
- Northern Alberta Children's Cancer Program, Stollery Children's Hospital, Edmonton, AB, Canada
| | - Douglas A Luke
- Center for Public Health Systems Science, Washington University, St. Louis, MO, USA
| | - Dylan E Graetz
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Asya Agulnik
- Division of Critical Care Medicine, Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
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Teles S, Crudo V, Sangrar R, Langlois S. Enabling Patients as Partners on Virtual Teams: A Scoping Review. J Patient Exp 2023; 10:23743735231177205. [PMID: 37283697 PMCID: PMC10240866 DOI: 10.1177/23743735231177205] [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: 06/08/2023] Open
Abstract
Developing partnerships among patients and healthcare providers improves quality of virtual care. Successful patient engagement is influenced by digital literacy. Although adults (35-64) with chronic health challenges may be motivated to use virtual services, they may not have the required skills or orientation to effectively participate on their virtual team. This scoping review aimed to identify resources available to enable adults with chronic health challenges to participate as partners on their virtual teams. Peer-reviewed and grey literature data from 2011 to 2022 were searched. A total of 432 peer-reviewed and 357 grey literature sources were retrieved and screened, and 14 and 84 sources, respectively, met the inclusion criteria. Relevant information from the sources was extracted and analyzed in duplicate and synthesized qualitatively. Key findings include (1) virtual workflow processes/frameworks, (2) 'webside manner' guidelines which emphasize "the how" as opposed to "the what" of facilitating team interactions, and (3) virtual patient support personnel. Overall, analyses suggest there are persisting gaps to be addressed in synchronous virtual care resources for adults with chronic health challenges.
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Affiliation(s)
- Sabrina Teles
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Vanessa Crudo
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Ruheena Sangrar
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Sylvia Langlois
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Centre for Advancing Collaborative Healthcare and Education, University Health Network and University of Toronto, Toronto, Canada
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18
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Kauff M, Bührmann T, Gölz F, Simon L, Lüers G, van Kampen S, Kraus de Camargo O, Snyman S, Wulfhorst B. Teaching interprofessional collaboration among future healthcare professionals. Front Psychol 2023; 14:1185730. [PMID: 37303913 PMCID: PMC10250594 DOI: 10.3389/fpsyg.2023.1185730] [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: 03/13/2023] [Accepted: 05/02/2023] [Indexed: 06/13/2023] Open
Abstract
Healthcare has become more complex in recent years. Such complexity can best be addressed by interprofessional teams. We argue that to ensure successful communication and cooperation in interprofessional teams, it is important to establish interprofessional education in health-related study programs. More precisely, we argue that students in health-related programs need to develop interprofessional competencies and a common language, experience interprofessional contact, build inclusive identities and establish beliefs in the benefit of interprofessional diversity. We give examples how these goals can be implemented in interprofessional education. We also discuss challenges and future avenues for respective research healthcare professionals.
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Affiliation(s)
| | | | | | | | | | | | - Olaf Kraus de Camargo
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Stefanus Snyman
- Centre for Community Technologies, Nelson Mandela University, Gqeberha, South Africa
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Muusse JSC, Zuidema R, van Scherpenseel MC, Velde SJT. Influencing factors of interprofessional collaboration in multifactorial fall prevention interventions: a qualitative systematic review. BMC PRIMARY CARE 2023; 24:116. [PMID: 37193995 DOI: 10.1186/s12875-023-02066-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/27/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND With the ageing population worldwide, falls are becoming a severe and growing health problem. Interprofessional multifactorial fall prevention interventions (FPIs) have effectively prevented falls in community-dwelling older adults. However, the implementation of FPIs often fails due to a lack of interprofessional collaboration. Therefore, gaining insight into the influencing factors of interprofessional collaboration in multifactorial FPI's for older adults living in the community is essential. Consequently, our aim was to provide an overview of factors influencing interprofessional collaboration in multifactorial FPIs for community-dwelling older adults. METHODS This qualitative systematic literature research was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Pubmed, CINAHL, and Embase electronic databases have been systematically searched for eligible articles, with a qualitative design. The quality was appraised using the Checklist for Qualitative Research by the Joann Briggs Institute. The findings were inductively synthesized using a meta-aggregative approach. Confidence in the synthesized findings was established using the ConQual methodology. RESULTS Five articles were included. Analysis of the included studies resulted in 31 influencing factors for interprofessional collaboration, which were labelled as findings. These findings were summarized in ten categories and combined into five synthesized findings. Results showed that communication, role clarity, information sharing, organization, and interprofessional aim influence interprofessional collaboration in multifactorial FPIs. CONCLUSIONS This review provides a comprehensive summary of findings on interprofessional collaboration, specifically in the context of multifactorial FPIs. Knowledge in this area is considerably relevant given the multifactorial nature of falls, which demands an integrated, multidomain approach, including both health and social care. The results can be utilized as a fundament for developing effective implementation strategies aiming to improve interprofessional collaboration between health and social care professionals working in multifactorial FPIs in the community.
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Affiliation(s)
- J S C Muusse
- Physical Therapy Sciences, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - R Zuidema
- Research Centre for Healthy and Sustainable Living, Research Group Proactive Care for Elderly People Living at Home, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - M C van Scherpenseel
- Research Centre for Healthy and Sustainable Living, Research Group Innovation of Human Movement Care, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - S J Te Velde
- Research Centre for Healthy and Sustainable Living, Research Group Innovation of Human Movement Care, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands
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McNulty JP, Politis Y. Empathy, emotional intelligence and interprofessional skills in healthcare education. J Med Imaging Radiat Sci 2023; 54:238-246. [PMID: 37032263 DOI: 10.1016/j.jmir.2023.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 04/11/2023]
Abstract
According to the World Health Organization (WHO), health professionals maintain the health of citizens through evidence-based medicine and caring. Students enroled in health professional programmes are required to have successfully attained all core learning outcomes by reaching key milestones throughout the course of their studies, demonstrating they have developed the required graduate skills and attributes upon completion of the programme. While some of the knowledge, skills and competencies that make up these learning outcomes are very discipline specific, there are more general professional skills across all disciplines which are difficult to define, such as empathy, emotional intelligence and interprofessional skills. These are at the heart of all health professional programmes that once defined, can be mapped through curricula and further evaluated. Literature will be presented on these three professional skills: empathy, emotional intelligence, and interprofessional skills, based on studies that focussed primarily in health professional programmes and highlight some of the key findings and issues at undergraduate and postgraduate levels. The paper will present the need for these skills to be defined and then mapped through curricula so that students are better supported in their professional development. Empathy, emotional intelligence and interprofessional skills transcend the discipline specific skills and as such it is important that all educators consider how best these may be fostered. Efforts should also be made to further the integration of these professional skills within curricula to produce health professionals with an enhanced focus on person-centred care.
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Affiliation(s)
- Jonathan P McNulty
- Radiography and Diagnostic Imaging, School of Medicine, University College, Ireland.
| | - Yurgos Politis
- Center for Teaching and Learning, Central European University, Vienna, Austria
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21
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Ismail F, Pretorius M, Peterson C, Yelverton C. The prevalence of chiropractic-related terminology on South African chiropractors' webpages: a cross-sectional study. Chiropr Man Therap 2023; 31:11. [PMID: 37013658 PMCID: PMC10071643 DOI: 10.1186/s12998-023-00483-3] [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: 09/14/2022] [Accepted: 03/20/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Effective communication is imperative for successful interprofessional collaborative interactions that augment both patient-centred and evidence based care. Inquiry into the prevalence of chiropractic-related terminology on South African chiropractor's webpages has not been explored to date. The implications of such analysis could indicate the professions' ability to effectively communicate in interdisciplinary settings. METHOD From 1 to 15 June 2020, Google search was used to identify the webpages (excluding social media accounts) of South African private practice chiropractors registered with the Allied Health Professions Council of South Africa (AHPCSA). Webpages were word-searched for eight chiropractic terms with context: subluxation; manipulate(-ion); adjust(-ing/-ment); holism(-tic); alignment; vital(-ism/-istic); wellness; and innate intelligence. Data collected was transferred to an Excel spreadsheet. Accuracy of information was verified by the researchers through a process of double checking. The number of instances each term was used, and certain socio-demographic data were recorded. Descriptive statistics and bivariate analyses were used to summarise and analyse the data. RESULTS Among 884 AHPCSA-registered South African chiropractors, 336 webpages were identified and analysed. From 1 to 15 June 2020, the most commonly found terms on 336 South African chiropractic webpages were 'adjust(-ing/-ment)', 'manipulate/manipulation', and 'wellness', with prevalence estimates of 64.1% (95% confidence interval [CI], 59.0% to 69.2%), 51.8% (95% CI, 46.5% to 57.1%), and 33.0% (95% CI, 28.2% to 38.2%), respectively. The least commonly found terms were 'innate intelligence' and 'vital(-ism/-istic)', with prevalence estimates of 0.60% (95% CI, 0.16% to 2.1%) and 0.30% (95% CI, 0.05% to 1.7%), respectively. Manipulate(-ion) was used more by male chiropractors (p = 0.015). The longer a chiropractor was in practice the more likely they were to use profession-specific terms (p = 0.025). The most frequently occurring combination of terms were adjust(-ing/-ment) and manipulate(-ion), found in 38 out of 336 webpages (11.3%; 95% CI, 8.4% to 15.1%). CONCLUSION The use of chiropractic-related terminology on South African chiropractic webpages was common, with the prevalence of term use varying by type of terms, by gender of the chiropractor, and by clinical practice experience. Better understanding of the effects of chiropractic terminology use on interprofessional and patient interactions and communication is warranted.
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Affiliation(s)
- F Ismail
- Department of Chiropractic, Faculty of Health Sciences, University of Johannesburg, Beit Street, Doornfontein, South Africa.
| | - M Pretorius
- Department of Chiropractic, Faculty of Health Sciences, University of Johannesburg, Beit Street, Doornfontein, South Africa
| | - C Peterson
- Department of Chiropractic, Faculty of Health Sciences, University of Johannesburg, Beit Street, Doornfontein, South Africa
| | - C Yelverton
- Department of Chiropractic, Faculty of Health Sciences, University of Johannesburg, Beit Street, Doornfontein, South Africa
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Prabhath S, Handady G, Herle G, Kamath MG, Ramanathan HP. Importance of interprofessional collaboration in teaching diabetic foot self-management: Perceptions of health care professionals. Med J Armed Forces India 2023. [DOI: 10.1016/j.mjafi.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Sudeshika T, Deeks LS, Naunton M, Peterson GM, Kosari S. Interprofessional collaboration within general practice teams following the inclusion of non-dispensing pharmacists. J Pharm Policy Pract 2023; 16:49. [PMID: 36945030 PMCID: PMC10031930 DOI: 10.1186/s40545-023-00550-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 03/08/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Pharmacists have been included in general practice teams to provide non-dispensing services in the Australian Capital Territory (ACT) since 2016. Interprofessional collaboration and team effectiveness are key considerations in providing high-quality patient care. These concepts have not been well studied following the inclusion of a pharmacist in general practice teams. METHODS A mixed methods study was conducted to explore collaboration between pharmacists and health professionals in eight general practices in the ACT, where pharmacists were included in their teams. A validated survey instrument was adapted and utilised to assess the changes in interprofessional collaboration over time following the addition of a pharmacist. Another validated survey was utilised to explore team effectiveness at the end of the study. Semi-structured interviews, with a thematic analysis, were conducted with a purposeful sample of general practice staff members to understand the factors influencing the development of interprofessional collaboration. RESULTS In total, 56 and 41 participants completed the baseline and follow-up survey, including 26 who completed both surveys to assess the change in collaboration over time. Interprofessional collaboration scores were high initially and did not change over time. Team effectiveness was also high at the end of the study. Twenty-one individuals participated in interviews, which generated four main interrelated themes related to interprofessional collaboration: professional working relationships, trust, commitment to collaboration, and barriers to collaboration. Trust was integral to professional working relationships and commitment to collaboration. The barriers to collaboration included not having a role description for pharmacists, inadequate interest to initiate working relationships, lack of dedicated time for interaction, lack of utilisation, and poor awareness of pharmacist-led activities in general practice. CONCLUSION Interprofessional collaboration was initially high and not influenced by the addition of a pharmacist, perhaps reflecting the inherent nature of the general practices willing to include a pharmacist within their team. Introducing a clear job description for pharmacists, and dedicating time to interact with pharmacists, could be beneficial in improving trust and professional working relationships and enhancing collaboration between the pharmacists and other general practice team members.
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Affiliation(s)
- Thilini Sudeshika
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia.
- Department of Pharmacy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, 20400, Sri Lanka.
| | - Louise S Deeks
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia
| | - Mark Naunton
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia
| | - Gregory M Peterson
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS, 7005, Australia
| | - Sam Kosari
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia
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Frey-Vogel AS, Pugsley L, Dzara K. A Nurse/Intern Partnership Program Accelerates Positive Relationship Formation Between Pediatric Interns and Pediatric Nurses. Acad Pediatr 2023; 23:225-232. [PMID: 35537673 DOI: 10.1016/j.acap.2022.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/28/2022] [Accepted: 05/01/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND The relationship between nurses and interns affects the quality of patient care; efforts to improve this relationship are necessary for optimal care. Previously, relationship formation was found to depend on mutual trust, respect, effective communication, and undergoing the process of role formation, all of which require time. This led to the hypothesis that instituting a Nurse/Intern Partnership Program (NIPP) would accelerate relationship formation. METHODS Using a semi-structured interview guide, prior to NIPP implementation, one nurse (n = 5) and 2 second-year resident (total n = 6) focus groups were held. After implementation, one nurse (n = 6) and one intern (n = 9) focus group were held. The focus group data were analyzed using the 5 stages of qualitative research framework. RESULTS Thematic data analysis with 3 independent coders supported the previously developed model of relationship formation; the NIPP accelerated relationship formation between nurses and interns through creating an early ally, improving communication, and increasing role understanding. The program may have improved the culture of the pediatric unit. The interns reported more of a positive impact of the NIPP on nurse/intern relationship than the nurses. CONCLUSIONS The NIPP was positively received by pediatric residents and nurses and successfully accelerated relationship formation between the 2 groups.
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Affiliation(s)
- Ariel S Frey-Vogel
- Department of Pediatrics, Harvard Medical School and Mass General for Children (AS Frey-Vogel), Boston, Mass.
| | - Lori Pugsley
- Department of Nursing, Massachusetts General Hospital and Mass General for Children (L Pugsley), Boston, Mass
| | - Kristina Dzara
- Department of Biomedical Informatics and Medical Education and Center for Leadership and Innovation in Medical Education, University of Washington School of Medicine (K Dzara), Seattle, Wash
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Exploration of Ward-Based Nurses' Perspectives on Their Preparedness to Recognize Clinical Deterioration: A Scoping Review. J Patient Saf 2023; 19:99-109. [PMID: 36729628 DOI: 10.1097/pts.0000000000001085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Despite initiatives in the early recognition of clinical deterioration, the incidence of failure to recognize clinical deterioration in patients continues to occur contributing to the ongoing rise of in-hospital mortality and morbidity. OBJECTIVE The aim of the study was to explore and appraise the research evidence that related to ward-based nurses' preparedness to recognize the clinically deteriorating patient. METHODS A scoping review was undertaken as this approach enabled the researchers to investigate the breadth of the available evidence through broad inclusion criteria. A comprehensive database search was conducted through the Cochrane Library; Cumulative Index to Nursing and Allied Health Literature; MEDLINE; ProQuest; PubMed; and Wiley Online Library. Each article was critically appraised and analyzed using a critical appraisal tool and thematic analysis, respectively. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews checklist. RESULTS Twelve primary sources of literature met the eligibility criteria. Through thematic analyses 6 primary themes were identified: implication of experience on preparedness; interprofessional and intraprofessional relationships; knowledge of calling criteria, process and procedures; requirement for a supportive system and culture; existence of hierarchy within healthcare impacting care; and clinical deterioration as an education opportunity. CONCLUSIONS This review identified central issues that impacted on ward-based nurses' preparedness. Further development of collaborative, supportive professional relationships across-and-within disciplines is needed. Effective use of clinical deterioration situations as educational opportunities would also assist nurses' preparedness through skill and knowledge development. However, more research evidence will be needed because of the limited data available on the topic.
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Prasitanarapun R, Kitreerawutiwong N. The development of an instrument to measure interprofessional collaboration competency for primary care teams in the district health system of health region 2, Thailand. BMC PRIMARY CARE 2023; 24:55. [PMID: 36849902 PMCID: PMC9972642 DOI: 10.1186/s12875-023-02013-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/20/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Evidence shows that interprofessional collaboration (IPC) practice contributes to the quality of health care. However, there are limited instruments to assess IPC in providing primary care in the district health system (DHS) in Thailand. The aim of this study is to develop a valid and reliable instrument to assess the IPC competency of primary care team members in DHSs. METHODS This study was designed as an exploratory mixed methods study. In the qualitative phase, 37 participants, including policymakers, practitioners, and academics with experience in primary care, were involved. Data were analysed using thematic analysis, and trustworthiness was verified by triangulation and peer debriefing. In the quantitative phase, content validity, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and reliability were conducted, and the final version of the questionnaire was evaluated with 497 participants. RESULTS The findings showed an I-CVI range of 0.86-1.00 and S-CVI/UA = 0.87 for 49 items with a 5-point Likert scale. EFA suggested six factors: 1) collaborative teamwork, 2) population- and community-centred care, 3) communication and mutual respect, 4) clarification of roles and responsibilities, 5) interprofessional reflection, and 6) interprofessional values and mixed skills. In the CFA results, the model fit indices were acceptable (CFI = 0.99, RMSEA = 0.049, SRMR = 0.043) or slightly less than the goodness-of-fit values (GFI = 0.84). All subscales showed acceptable Cronbach's alpha values with a range of 0.86-0.94. CONCLUSIONS The developed IPC competency instrument was confirmed its validity and reliability that contributes to assessing the IPC competency of primary care teams in DHSs. This information provides evidence to support tailored intervention to promote the IPC competency of primary care team work to achieve a common goal.
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Affiliation(s)
- Raphiphaet Prasitanarapun
- Faculty of Public Health, Naresuan University, Muang District, Phitsanulok Province, Thailand
- Boromarajonani College of Nursing, Uttaradit, Faculty of Nursing, Praboromarajchanok Institute, Ministry of Public Health, Nonthaburi, Thailand
| | - Nithra Kitreerawutiwong
- Faculty of Public Health, Naresuan University, Muang District, Phitsanulok Province, Thailand.
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Ohta R, Sano C. The Effectiveness of Family Medicine-Driven Interprofessional Collaboration on the Readmission Rate of Older Patients. Healthcare (Basel) 2023; 11:healthcare11020269. [PMID: 36673637 PMCID: PMC9859164 DOI: 10.3390/healthcare11020269] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 01/13/2023] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
Interprofessional collaboration (IPC) for older patient care among family physicians, dentists, therapists, nutritionists, nurses, and pharmacists in the rural hospital care of older patients could improve the hospital readmission rate. However, there is a lack of interventional studies on IPC for improving the readmission rate among Japanese older patients in rural hospitals. This quasi-experimental study was performed on patients >65 years who were discharged from a rural community hospital. The intervention was IPC implementation with effective information sharing and comprehensive management of older patients’ conditions for effective discharge and readmission prevention; implementation started on 1 April 2021. The study lasted 2 years, from 1 April 2021 to 31 March 2022 for the intervention group and from 1 April 2020 to 31 March 2021 for the comparison group. The average participant age was 79.86 (standard deviation = 15.38) years and the proportion of men was 45.0%. The Cox hazard model revealed that IPC intervention could reduce the readmission rate after adjustment for sex, serum albumin, polypharmacy, dependent condition, and Charlson Comorbidity Index score (hazard ratio = 0.66, 95% confidence interval: 0.54−0.81). Rural IPC intervention can improve inpatient care for older patients and decrease readmission rates. Thus, for effective rural IPC interventions, family physicians in hospitals should proactively collaborate with various medical professionals to improve inpatient health outcomes.
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Affiliation(s)
- Ryuichi Ohta
- Community Care, Unnan City Hospital, 699-1221 96-1 Iida, Daito-cho, Unnan 699-1221, Japan
- Correspondence: ; Tel.: +81-90-5060-5330
| | - Chiaki Sano
- Department of Community Medicine Management, Faculty of Medicine, Shimane University, 89-1 Enya cho, Izumo 693-8501, Japan
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Alquwez N. Association between nurses' experiences of workplace incivility and the culture of safety of hospitals: A cross-sectional Study. J Clin Nurs 2023; 32:320-331. [PMID: 35098598 DOI: 10.1111/jocn.16230] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/10/2021] [Accepted: 01/18/2022] [Indexed: 12/14/2022]
Abstract
AIM AND OBJECTIVES This article examined the association between workplace incivility experiences of nurses and patient safety (PS) culture in hospitals. BACKGROUND Workplace incivility, which is characterised by low-intensity behaviours with unclear intention to harm and disruption of workplace ambiance of mutual respect, may threaten the work environment, resulting in an unhealthy and unsafe workplace. DESIGN Cross-sectional study. METHOD This study surveyed 261 nurses in Saudi Arabia from June 2019 to August 2019 using the 'Hospital Survey of Patients' Safety Culture' and the 'Nurse Incivility Scale'. A multiple linear regression was performed with unit- and hospital-level PS culture as the dependent variables. RESULTS 'Organizational learning-continuous improvement' and 'Teamwork within units' were recognised as PS culture strengths. The nurses reported workplace incivility from patient/visitor as the most frequently experienced (mean = 2.27, standard deviation = 0.88). Working in Hospital B (ß = 0.24, p < .001, 95%CI = 0.15, 0.33) and having a baccalaureate degree in nursing (ß = 0.13, p = .014, 95%CI = 0.03, 0.23) were associated with better perceptions of unit-level PS, whereas working in medical-surgical wards (ß = -0.16, p = .002, 95%CI = -0.26, -0.06) and in intensive care units (ß = -0.19, p = .002, 95%CI = -0.32, -0.07) and experiencing patient/visitor incivility (ß = -0.09, p = .004, 95%CI = -0.15, -0.03) were associated with poor unit-level PS culture perceptions. Experiences of general incivility (ß = -0.24, p < .001, 95%CI = -0.35, -0.13) and supervisor incivility (ß = -0.26, p = .011, 95%CI = -0.46, -0.06) were associated with poor hospital-level PS culture perceptions. CONCLUSIONS Workplace incivility from patients/visitors had a negative association with unit-level PS culture perceptions, whereas experiences on general and supervisor incivilities had an adverse relationship with hospital-level PS culture perceptions. RELEVANCE TO CLINICAL PRACTICE The study emphasises the call to eradicate any form of incivility in healthcare settings to guarantee a PS culture. Hospital and nursing managers should prioritise the creation and implementation of policies aimed at eliminating uncivil behaviours in clinical settings to ensure that unit- and hospital-level PS culture are above standards.
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Affiliation(s)
- Nahed Alquwez
- Nursing Department, College of Applied Medical Sciences, Shaqra University, Al Dawadmi, Saudi Arabia
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Sudeshika T, Naunton M, Peterson GM, Deeks LS, Guénette L, Sharma R, Freeman C, Niyonsenga T, Kosari S. Interprofessional Collaboration and Team Effectiveness of Pharmacists in General Practice: A Cross-National Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:394. [PMID: 36612716 PMCID: PMC9819811 DOI: 10.3390/ijerph20010394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/17/2022] [Accepted: 12/24/2022] [Indexed: 06/17/2023]
Abstract
As team-based care continues to evolve, pharmacists have been included in general practice teams in many countries, to varying extents, to improve medication use and patient safety. However, evidence on interprofessional collaboration and team effectiveness of pharmacists in general practice is sparse. This study aimed to compare the extent of interprofessional collaboration and team effectiveness of general practice pharmacists in Australia with international sites (Canada and the UK), and identify the factors associated with interprofessional collaboration and team effectiveness. General practice pharmacists from Australia, Canada, and the UK were identified through professional organisations and networks, and invited to participate in an online survey, adapted from existing validated tools. The survey explored interprofessional collaboration through four sub-domains (professional interactions, relationship initiation, trust and role clarity, and commitment to collaboration) and team effectiveness of general practice pharmacists. Of the 101 respondents (26 from Australia, 44 from Canada and 31 from the UK), 79% were female and 78% were aged below 50 years. Interprofessional collaboration and team effectiveness appeared to be high and similar between countries. Total scores for collaboration of pharmacists were 86.1 ± 7.4 in Australia, 88.5 ± 7.5 in the UK, and 89.1 ± 7.3 in Canada (mean ± SD, where higher scores represent more advanced collaboration), while the team effectiveness scores of the pharmacists were 88.6 ± 14.6 in Canada, 91.8 ± 14.6 in Australia and 97.5 ± 14.0 in the UK. Pharmacists who had worked in general practice for a longer time showed advanced interprofessional collaboration while those who worked exclusively in general practice had higher scores for team effectiveness. Overall, general practice pharmacists in the three countries were highly collaborative with general practitioners. Long-term employment and longer work hours could enhance interprofessional collaboration and team effectiveness in general practice pharmacists by improving trust and working relationships over time.
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Affiliation(s)
- Thilini Sudeshika
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
- Department of Pharmacy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya 20400, Sri Lanka
| | - Mark Naunton
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
| | - Gregory M. Peterson
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS 7005, Australia
| | - Louise S. Deeks
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
| | - Line Guénette
- Faculty of Pharmacy, Laval University, Quebec, QC GIV 0A6, Canada
| | - Ravi Sharma
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
- Bedfordshire Hospitals NHS Foundation Trust, Luton LU4 0DZ, UK
| | - Christopher Freeman
- School of Pharmacy, Faculty of Health and Behavioural Sciences, University of Queensland, Woolloongabba, QLD 4102, Australia
- Faculty of Medicine, The University of Queensland, Herston, QLD 4006, Australia
- Metro North Hospital and Health Service, Herston, QLD 4006, Australia
| | - Theo Niyonsenga
- Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
| | - Sam Kosari
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
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Frenk J, Chen LC, Chandran L, Groff EOH, King R, Meleis A, Fineberg HV. Challenges and opportunities for educating health professionals after the COVID-19 pandemic. Lancet 2022; 400:1539-1556. [PMID: 36522209 PMCID: PMC9612849 DOI: 10.1016/s0140-6736(22)02092-x] [Citation(s) in RCA: 69] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/17/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
The education of health professionals substantially changed before, during, and after the COVID-19 pandemic. A 2010 Lancet Commission examined the 100-year history of health-professional education, beginning with the 1910 Flexner report. Since the publication of the Lancet Commission, several transformative developments have happened, including in competency-based education, interprofessional education, and the large-scale application of information technology to education. Although the COVID-19 pandemic did not initiate these developments, it increased their implementation, and they are likely to have a long-term effect on health-professional education. They converge with other societal changes, such as globalisation of health care and increasing concerns of health disparities across the world, that were exacerbated by the pandemic. In this Health Policy, we list institutional and instructional reforms to assess what has happened to health-professional education since the publication of the Lancet Commission and how the COVID-19 pandemic altered the education process.
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Affiliation(s)
- Julio Frenk
- Office of the President, University of Miami, Coral Gables, FL, USA
| | | | - Latha Chandran
- Department of Medical Education and Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, FL, USA.
| | - Elizabeth O H Groff
- Department of Public Health Sciences, University of Miami, Coral Gables, FL, USA
| | - Roderick King
- Department of Pediatrics and Department of Health Policy and Management, University of Maryland Medical System, Baltimore, MD, USA
| | - Afaf Meleis
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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Italian Translation and Validation of the Readiness for Interprofessional Learning Scale (RIPLS) in an Undergraduate Healthcare Student Context. Healthcare (Basel) 2022; 10:healthcare10091698. [PMID: 36141309 PMCID: PMC9498412 DOI: 10.3390/healthcare10091698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/30/2022] [Accepted: 09/02/2022] [Indexed: 11/25/2022] Open
Abstract
Interprofessional education requires that two or more professionals learn from and with each other to allow effective collaboration and improve health outcomes. Thus far, the interprofessional collaboration of healthcare students might be assessed using the Readiness for Interprofessional Learning Scale (RIPLS), which is currently not available in its Italian version. This study aimed to provide the intercultural adaptation of the RIPLS in Italian (I-RIPLS) and assess its validity and reliability. A two-phase validation study was performed in 2020, using a single-centre approach in students enrolled in the medical degree, physiotherapy, nursing, and dentistry courses at an Italian-speaking university in Albania. The first phase of the study determined the cross-cultural adaptation of the items by involving two translators who followed a forward and backward translation process. In the second phase, a sample of 414 students was enrolled. The preliminary corrected item-total correlations showed that five items did not show significant item-to-total correlations. Even if their deletion was not mandatory for generating a suitable correlation matrix for factor analysis, the advantages of keeping only items contributing to a more stable measurement with a shorter scale represented the rationale for removing items with non-significant item-to-total correlation from the correlation matrix before testing the dimensionality of the I-RIPLS with factor analysis. The answers from the first 50% of responders (n = 207) were used to determine the most plausible dimensionality of the I-RIPLS by employing an exploratory factor analysis (EFA), and the second 50% were used to cross-validate the most plausible dimensionality derived from EFA by employing confirmatory factor analysis (CFA) models. The most plausible dimensionality from EFA, by acknowledging the interpretation of the scree plot, the eigenvalues greater than 1, a parallel analysis, and the previous theoretical dimensions of the tool had two factors with adequate internal consistency. The CFA confirmed the two-factor solutions and the internal consistency for each domain. The I-RIPLS has 14 items with adequate evidence of validity and reliability. Future research should revise the tool for pursuing cross-cultural multigroup measurement invariance.
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McInerney J, Seedhouse D, Pettit M, Roberts S, Druva R, Lewicki S. Interdisciplinary interprofessional education using an online learning environment called values exchange: A qualitative investigation. J Med Radiat Sci 2022; 69:309-317. [PMID: 35475599 PMCID: PMC9442323 DOI: 10.1002/jmrs.584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 03/19/2022] [Accepted: 03/30/2022] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Interprofessional education (IPE) is implemented throughout the curricula of student healthcare professions as it is understood to provide positive impact on patient outcomes in the clinical environment. There are different methods to provide IPE such as through online learning or traditional face-to-face methods. However, there is a lack of research surrounding the use of Online Learning Environments (OLEs) to teach IPE. METHODS In a pilot study, seventy-one undergraduate radiography students and twenty Master of Pharmacy students engaged in an ethical scenario using the OLE, Values Exchange (Vx). Following the activity, students were invited to complete an open-ended response question. Fourteen students responded and these data were used for qualitative analysis. RESULTS A thematic analysis of the students' open-ended responses found the emergence of three major themes, namely; understanding the roles of other healthcare professionals, developing self-reflection skills and, preparing for the clinical environment. Students suggested that additional time allocated for undertaking the study would benefit their engagement in the activity. Students would benefit from added engagement in the Vx task in both the short and long term for IPE. CONCLUSION Students are receptive in utilising contemporary approaches such as OLEs in furthering their IPE. Positive interpretations and suggestions by both radiography and pharmacy students in this study demonstrate how Vx as an OLE teaching tool can be used effectively. OLEs can overcome barriers that exist in face-to-face education experiences. OLEs should be considered for greater use within academic curricula of healthcare professions, but only if they have been evaluated for effectiveness.
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Affiliation(s)
- John McInerney
- Department of Medical Imaging and Radiation SciencesMonash UniversityMelbourneAustralia
- Radiology DepartmentRoyal Melbourne HospitalMelbourneAustralia
| | - David Seedhouse
- University of DerbyDerbyUK
- University of Western SydneyPenrithAustralia
| | | | - Simone Roberts
- Department of Medical Imaging and Radiation SciencesMonash UniversityMelbourneAustralia
| | - Ruth Druva
- Department of Medical Imaging and Radiation SciencesMonash UniversityMelbourneAustralia
| | - Sabrina Lewicki
- Department of Medical Imaging and Radiation SciencesMonash UniversityMelbourneAustralia
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Acolhimento e ambiência hospitalar: percepção de profissionais da saúde. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ao032166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Duwel V, de Kort JML, Jacobs SS, Dennert RM, Busari JO. Managing the Mental Health of Healthcare Professionals in Times of Crisis: The Aruban COVID-19 Experience. Healthcare (Basel) 2022; 10:healthcare10071263. [PMID: 35885790 PMCID: PMC9318673 DOI: 10.3390/healthcare10071263] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 12/21/2022] Open
Abstract
Hospital workers in Aruba have been facing an increased demand for healthcare in the unique setting of a Small Island Developing State (SIDS). This study assessed the impact of the first wave of the SARS-CoV-2 pandemic on the mental health of staff at the major hospital in Aruba, examining the differences between employee groups, with the goal of providing recommendations for targeted support and coping strategies in future crises in a small island setting. Patients and methods: In a mixed-method cohort design, Dr. Horacio E. Oduber Hospital staff were asked to complete a 25-item questionnaire about their concerns and worries, organization of work, and general wellbeing; 24% of the hospital staff filled in the questionnaire (mean age 41 ± 11 years, 79% female). Alongside the needs assessment questionnaire, six focus groups were established to explore staff feelings on specific measures taken by hospital management during the COVID-19 crisis. Results: Questionnaire analysis (n = 231) revealed employees’ concerns about infecting their relatives and their financial stability. In particular, nurses were significantly more concerned than other staff groups. In the wellbeing section of the questionnaire, items regarding future security scored poorest, alongside increased levels of tiredness and nervousness. Focus groups discussions revealed frustrations of the hospital staff with the foreign staff brought in to help during the crisis and a need for better leadership and communication practices from hospital management. Conclusions: Comprehensive and holistic approaches should be implemented by the hospital management to prevent occupational burnout and demoralized work ethics and further emotional exhaustion.
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Affiliation(s)
- Veronika Duwel
- Faculty of Health and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
| | | | - Shailing S. Jacobs
- Department of General Medicine, Horacio E. Oduber Hospital, Oranjestad, Aruba;
| | - Robert M. Dennert
- Department of Cardiology, Horacio E. Oduber Hospital, Oranjestad, Aruba;
| | - Jamiu O. Busari
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
- Department of Paediatrics, Horacio Oduber Hospital, Oranjestad, Aruba
- Correspondence: ; Tel.: +297-597-4440; Fax: +297-587-0220
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Inter-Professional-Compassionate pain management during endotracheal suctioning: a valuable lesson from a Chinese surgical intensive care unit. FRONTIERS OF NURSING 2022. [DOI: 10.2478/fon-2022-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Objective
To compare the effects of a pain management program and routine suctioning methods on the level of pain presence and agitation in Chinese adults admitted to the intensive care unit. To disseminate the results from the implementation of the evidence-informed pain management interventions for reducing pain presence and agitation during endotracheal tube suctioning (ETS) and translate the key finding to clinical nursing practice.
Methods
A quasi-experimental study of a two-group post-test design was conducted in adults admitted after surgery to a surgical intensive care unit (SICU) of the Second Affiliated Hospital of Kunming Medical University, Yunnan, China in 2018. Fifty-two adults who met the study eligibility were included after consent, 26 in each group. Patients in the control group received usual care while patients in the intervention group received interventions to reduce agitation and pain-related ETS. The impacts of the intervention on the level of pain presence and agitation were measured at 5 measuring time points using the Chinese versions of Critical-Care Pain Observation Tool (CPOT) and Richmond Agitation Sedation Scale (RASS).
Results
The level of pain presence in the intervention group statistically significantly decreased during, immediately after, and 5 min after suctioning. The level of agitation in the intervention group significantly decreased during and immediately after suctioning.
Conclusions
The findings provide support for the positive pain-relieving effects of the evidence-informed pain-related ETS management interventions when compared with the usual ETS practice. The study interventions were sufficiently effective and safe to maintain patent airway clean and patent as standardized suctioning and helps pain relief. So, evidence-based pain-related ETS management intervention is worthy of recommending to utilize in SICU patients as well as other patients who required suctioning. It is worth noting that integrating pre-emptive analgesia prescription and administration with non-pharmacological intervention plays a critical role in achieving pain relief.
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Thalanjeri P, Balakrishnan G, Vaswani V. Emerging ethical dilemmas in the use of intelligent computer programs in decision-making in health care: an exploratory study. MGM JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.4103/mgmj.mgmj_34_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Van Slingerland KJ, Durand-Bush N. The Acceptability and Appropriateness of a Collaborative, Sport-Centered Mental Health Service Delivery Model for Competitive, and High-Performance Athletes. Front Sports Act Living 2021; 3:686374. [PMID: 34820620 PMCID: PMC8606672 DOI: 10.3389/fspor.2021.686374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 10/04/2021] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to evaluate the acceptability and appropriateness of a sport-centered, collaborative mental health service delivery model implemented within the Canadian Center for Mental Health and Sport (CCMHS) over a period of 16 months. The study is situated within a larger Participatory Action Research (PAR) project to design, implement and evaluate the CCMHS. Primary data were collected from CCMHS practitioners (n = 10) and service-users (n = 6) through semi-structured interviews, as well as from CCMHS stakeholders (n = 13) during a project meeting, captured via meeting minutes. Secondary data derived from documents (e.g., clinical, policy, procedural; n = 48) created by the CCMHS team (i.e., practitioners, stakeholders, board of directors) during the Implementation Phase of the project were reviewed and analyzed to triangulate the primary data. The Framework Method was used to organize, integrate and interpret the dataset. Overall, results indicate that both practitioners and service-users found the model to be both acceptable and appropriate. In particular, practitioners' knowledge and experience working in sport, a robust intake process carried out by a centralized Care Coordinator, and the ease and flexibility afforded by virtual care delivery significantly contributed to positive perceptions of the model. Some challenges associated with interprofessional collaboration and mental health care costs were highlighted and perceived as potentially hindering the model's acceptability and appropriateness.
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THE IMPACT OF CLINICAL LEADERSHIP ON QUALITY AND ACCREDITATION STUDIES IN HEALTH SERVICES. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2021. [DOI: 10.30621/jbachs.955272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Prompahakul C, Keim-Malpass J, LeBaron V, Yan G, Epstein EG. Moral distress among nurses: A mixed-methods study. Nurs Ethics 2021; 28:1165-1182. [PMID: 33888021 DOI: 10.1177/0969733021996028] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Moral distress is recognized as a problem affecting healthcare professionals globally. Unaddressed moral distress may lead to withdrawal from the moral dimensions of patient care, burnout, or leaving the profession. Despite the importance, studies related to moral distress are scant in Thailand. OBJECTIVE This study aims to describe the experience of moral distress and related factors among Thai nurses. DESIGN A convergent parallel mixed-methods design was used. The quantitative and qualitative data were collected in parallel using the Measure of Moral Distress for Healthcare Professionals and interview guide. The analysis was conducted separately and then integrated. PARTICIPANTS Participants were Thai nurses from two large tertiary care institutions in a Southern province of Thailand. ETHICAL CONSIDERATIONS This study was approved by our organization's Institutional Review Board for Health Sciences Research, and by the Institutional Review Boards of the two local institutions in Thailand. Permission from the publisher was received to translate and utilize the Measure of Moral Distress (MMD-HP) under the license number: 4676990097151. RESULTS A total of 462 participants completed the survey questions. The top 7 causes of moral distress were related to system-level root causes and end-of-life care situations. Hierarchical multiple regression showed that work units, considering leaving position, and number of moral distress episodes in the past year were significant predictors of moral distress. Twenty interviews demonstrated three main themes of distressing causes: (1) powerlessness (at patients/family-, team-, and organizational-levels), (2) end-of-life issues, and (3) poor team function (poor communication and collaboration, incompetent healthcare providers, and inappropriate behavior of colleagues). The integration of data from both components indicated that the qualitative interviews enrich the quantitative findings, especially as related to the top 7 causes of moral distress. DISCUSSION Although the experience of moral distress among Thai nurses is similar to studies conducted elsewhere, the patient's and family's religious perspective that ties into the concept of moral distress needs to be explored. CONCLUSIONS Although the root causes of moral distress are similar among different cultures, the experience of Thai nurses may vary according to culture and context.
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Chamangwana IC, Jere D, Kazembe A. Experiences of health care workers' on interprofessional collaborative practice at Mzuzu Central and Ntcheu District hospitals. Malawi Med J 2021; 33:10-15. [PMID: 35509990 PMCID: PMC9023030 DOI: 10.4314/mmj.v33is.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Interprofessional collaborative practice (ICP) is a new approach to delivery of health care. It is the practice which happens when healthcare providers work together with different professionals such as nurse/midwives, medical officers towards a common goal to improve patient outcomes.There is no evidence on healthcare workers' experiences on ICP in Malawi and a study on healthcare workers experiences would provide insight towards ICP. The objective of this study was to describe healthcare workers' experiences on ICP in model wards. Methods We conducted a qualitative exploratory descriptive study at Mzuzu Central and Ntcheu District Hospitals. We purposely selected nurses, clinical officers and medical doctors out of 25 sampled healthcare workers working in model wards. Data were collected through in-depth interviews using a semi-structured interview guide. Hospital authorities provided permission to conduct the study in their sites. Informed consent was obtained from participants before interviews. The study was approved by College of Medicine Research Committee (COMREC). Content analysis was utilized to analyse data. Results Four key themes emerged describing healthcare workers experiences on ICP:Increased management/leadership support in terms of resources and structures, good communication among staff, learning together as group of qualified healthcare workers and students and increased teamwork. Conclusion This study highlights healthcare workers' experiences on ICP: management support, communication, learning together of healthcare workers and teamwork. Findings can be used to inform management and practice for the development and implementation of ICP in service delivery.
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Affiliation(s)
- Immaculate C Chamangwana
- Zomba Mental Hospital, Malawi Ministry of Health, Faculty of Applied Health Studies, Kamuzu College of Nursing, University of Malawi/Kamuzu University of Health Sciences
| | - Diana Jere
- Faculty of Midwifery, Neonatal and Reproductive Health Studies, Kamuzu College of Nursing, University of Malawi/Kamuzu University of Health Sciences
| | - Abigail Kazembe
- Faculty of Community Health (Studies), Kamuzu College of Nursing, University of Malawi /Kamuzu University of Health Sciences
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van Diggele C, Roberts C, Haq I. Optimising student-led interprofessional learning across eleven health disciplines. BMC MEDICAL EDUCATION 2021; 21:157. [PMID: 33722231 PMCID: PMC7962392 DOI: 10.1186/s12909-021-02527-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 01/31/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Provision of effective Interprofessional learning (IPL) opportunities plays a vital role in preparing healthcare students for future collaborative practice. There is an identified need for universities to better prepare students for interprofessional teamwork, however, few large-scale IPL activities have been reported. Additionally, little has been reported on disciplinary differences in student learning experience. The Health Collaboration Challenge (HCC) is a large-scale IPL activity held annually at the University of Sydney. This study sought to explore students' experience of early participation in an interprofessional case-based learning activity, and the similarities and differences in the perceived value of interprofessional (social) learning for each discipline. METHODS In 2018, 1674 students from 11 disciplines (dentistry, oral health, nursing, pharmacy, medicine, occupational therapy, speech pathology, physiotherapy, dietetics, diagnostic radiography, exercise physiology) participated in the HCC. Students worked in teams to produce a video and patient management plan based on a patient case. Participants completed a questionnaire, including closed and open-ended items. Quantitative data were analysed using descriptive statistics. Thematic analysis was used to code and categorise qualitative data into themes. These themes were then applied and quantified at a disciplinary level to measure prevalence. RESULTS In total, 584/1674 (35%) of participants responded to the questionnaire. Overall, students perceived their experience to be largely beneficial to their learning and interprofessional skill development. Positive aspects included opportunities for peer learning, collaboration, networking, and understanding the different roles and responsibilities of other health professions. Negative aspects included the video form of assessment, inequity in assessment weighting across disciplines, the discipline mix within teams and lack of case relevance. CONCLUSION The learning activity provided a framework for students to practice and develop their skills in interprofessional teamwork, as they prepare for increased clinical placements. Overall, students perceived their experience as beneficial to their learning and professional development early in their degree. However, they expressed dissatisfaction with the inequity of assessment weighting across the disciplines; lack of relevance of the case across disciplines; and the activity of producing a video. Further research is needed regarding the ideal number of disciplines to include in teamwork specific to a patient case.
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Affiliation(s)
- Christie van Diggele
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - Chris Roberts
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
- Faculty of Medicine and Health, Sydney Health Professional Research Education Network, The University of Sydney, Sydney, Australia
| | - Inam Haq
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
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Agustina E, Wardhani V, Astari AM. Interprofessional collaboration in pre-anesthesia assessment: Exploring provider's knowledge, attitude, and behaviors. ENFERMERIA CLINICA 2020. [DOI: 10.1016/j.enfcli.2020.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ansa BE, Zechariah S, Gates AM, Johnson SW, Heboyan V, De Leo G. Attitudes and Behavior towards Interprofessional Collaboration among Healthcare Professionals in a Large Academic Medical Center. Healthcare (Basel) 2020; 8:healthcare8030323. [PMID: 32899937 PMCID: PMC7551229 DOI: 10.3390/healthcare8030323] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/01/2020] [Accepted: 09/03/2020] [Indexed: 11/23/2022] Open
Abstract
The increasing rates of comorbidities among patients and the complexity of care have warranted interprofessional collaboration (IPC) as an important component of the healthcare structure. An initial step towards assessing the effectiveness of collaboration requires the exploration of the attitudes and experience of healthcare professionals towards IPC. This online survey aimed to examine the attitudes of healthcare professionals working in a large public academic medical center toward IPC in patient care and the healthcare team, and their behavior and experience regarding IPC. The rankings, according to the perceived importance among the respondents, of the four Interprofessional Education Collaborative (IPEC) core competencies (values/ethics, roles/responsibilities, interprofessional communication, teams/teamwork) were assessed. There were strong but varying levels of consensus among healthcare professionals (N = 551) that IPC facilitates efficient patient care, improves patient problem-solving ability, and increases better clinical outcomes for patients. They acknowledged that IPC promotes mutual respect within the healthcare team and providers’ ability to make optimal patient care decisions. However, overall more than 35% of the respondents did not attend multidisciplinary education sessions (grand rounds, seminars, etc.), and about 23% did not participate in bedside patient care rounds. Interprofessional communication was ranked as the most important IPEC core competence. Although the attitude towards IPC among healthcare professionals is strongly positive, many healthcare professionals face challenges in participating in IPC. Institutional policies that facilitate interprofessional learning and interactions for this group of healthcare professionals should be formulated. Online distance learning and interactions, and simulation-enhanced interprofessional education, are options for addressing this barrier. Hospital administrators should facilitate conducive work environments that promote IPC, based on IPEC core competencies, and promote programs that address the challenges of IPC.
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Affiliation(s)
- Benjamin E. Ansa
- Applied Health Sciences Program, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA; (S.Z.); (A.M.G.); (S.W.J.)
- Institute of Public and Preventive Health, Augusta University, Augusta, GA 30912, USA
- Correspondence: (B.E.A.); (G.D.)
| | - Sunitha Zechariah
- Applied Health Sciences Program, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA; (S.Z.); (A.M.G.); (S.W.J.)
- Morrison Healthcare, Sandy Springs, GA 30350, USA
| | - Amy M. Gates
- Applied Health Sciences Program, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA; (S.Z.); (A.M.G.); (S.W.J.)
- Neonatal Intensive Care Unit, Augusta University Health, Augusta, GA 30912, USA
| | - Stephanie W. Johnson
- Applied Health Sciences Program, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA; (S.Z.); (A.M.G.); (S.W.J.)
- Occupational Therapy, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA
| | - Vahé Heboyan
- Health Economics and Modeling Division, Population Health Sciences Department, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA;
| | - Gianluca De Leo
- Department of Interdisciplinary Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA 30921, USA
- Correspondence: (B.E.A.); (G.D.)
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Busari JO, Yaldiz H, Gans ROB, Duits AJ. Clinical Leadership as an Agent for Change: A Health System Improvement Intervention in Curaçao. J Multidiscip Healthc 2020; 13:787-798. [PMID: 32884278 PMCID: PMC7431449 DOI: 10.2147/jmdh.s262415] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/08/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction The healthcare system in Curaçao is complex, fragmented, and poorly organized and typifies a system in a resource-limited environment. Deficits in competencies and local cultural barriers are factors that hinder sustainable healthcare in such settings and a failure to meet WHO sustainable development goals. This study reports the potential cost-effectiveness and improved health outcomes of the first stage of a healthcare improvement project. The intervention, which is a multidisciplinary team-based leadership training program (MLP), reflects a promising strategy to tackle local healthcare needs. Methods A Multidisciplinary group of healthcare professionals in St. Elisabeth hospital, Curaçao, was selected to 1) participate in the MLP and 2) co-design a healthcare pathway on the management of decubitus ulcers. Using a qualitative research methodology, we conducted interviews to assess the perceived leadership growth, teamwork, and the barriers to the introduction of the new care pathway in their setting. Six themes were identified that explained the perceived leadership development and interprofessional collaboration. These included 1) Professional background, 2) Healthcare pathway design, 3) Resources, 4) Personal development, 5) Collaboration 6) Execution. Conclusion/Implication The participants valued the interdisciplinary approach of this health improvement project and acknowledged the added value of a training program that also addressed personal growth. This study shows how MLPs for health professionals can also serve as catalysts for health improvement efforts in resource-limited environments.
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Affiliation(s)
- Jamiu O Busari
- Department of Pediatrics, Horacio Oduber Hospital, Oranjestad, Aruba.,Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht, the Netherlands
| | - Huriye Yaldiz
- Faculty of Medical Sciences, Radboud University Nijmegen, Nijmegen, the Netherlands
| | - Reinold O B Gans
- Department of Medicine, University Medical Center Groningen, Groningen, Netherlands
| | - Ashley J Duits
- Red Cross Blood Bank Foundation, Willemstad, Curaçao.,Institute for Medical Education, University Medical Center Groningen, Groningen, the Netherlands.,Department of Medical Education, Curaçao Medical Center, Willemstad, Curaçao
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Björklund K, Silén C. Occupational therapy and physiotherapy students' communicative and collaborative learning in an interprofessional virtual setting. Scand J Occup Ther 2020; 28:264-273. [PMID: 32412813 DOI: 10.1080/11038128.2020.1761448] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Interprofessional learning activities can contribute to preparing students to function in health care teams. Although the importance of communication is acknowledged, there is still a lack of understanding about how students learn to communicate interprofessionally. AIM To explore occupational therapist and physiotherapist students learning of skills in interprofessional communication by studying the students' communication while working together with a virtual patient. MATERIAL AND METHODS The students carried out a virtual patient encounter in pairs of two, using one computer per student, sitting side by side. The students' actions and conversations were recorded as video films, the oral communication was transcribed and analysed using qualitative content analysis. RESULTS The students created a social learning environment by posing questions, acknowledging each other and clarifying their professional perspective using familiar professional concepts. Comparing their professional views, students related their peers' statements to their own. Departing from their own profession and using the created open environment, the students' communication led to an interprofessional meaning-making process, with students aiming to understand each other. CONCLUSIONS AND SIGNIFICANCE A reciprocal learning situation was created when students worked together in a virtual setting. Communicating and making shared decisions about a patient can facilitate learning how to communicate interprofessionally and improve students' understanding of their own profession.
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Affiliation(s)
- Karin Björklund
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Charlotte Silén
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
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Nyikuri M, Kumar P, Jones C, English M. "But you have to start somewhere….": Nurses' perceptions of what is required to provide quality neonatal care in selected hospitals, Kenya. Wellcome Open Res 2020; 4:195. [PMID: 32587896 PMCID: PMC7309418 DOI: 10.12688/wellcomeopenres.15592.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Kenya has one of the highest rates of neonatal mortality in the world at 22/1,000 live births. Improving the quality of newborn care would greatly improve survival rates. There is an increasing consensus that strong health systems are key to achieving improved health outcomes. However, there is significantly less agreement on what to strengthen in low and middle-income countries such as Kenya. As nurses are the main caregivers in many inpatient settings, efforts aimed at improving the quality of facility care for sick newborn babies need to take into account nurses views and opinions. Our intent in this paper is to describe the current state of the nursing environment and what would be required to improve the quality of those environs from nurses' perspectives. Methods: Between January 2017 and March 2018, we collected data through non-participant observations, unsolicited conversations and review of admission registers. We also conducted 29 individual in-depth interviews with nurses working in the newborn units (NBU) of a public sector hospital (n=10), a private sector hospital (n=11) and a faith-based hospital (n=8). The interviews were digitally audio recorded, transcribed verbatim and, together with observation notes, analysed using thematic content analysis. Results: Nurses as frontline care givers and intervention intermediaries, irrespective of their work contexts, have similar aspirations, needs and expectations from the health systems of how they should be supported to provide quality inpatient care for newborns. These are about the structure of the work environment, especially human resources for health, and the consequences of inadequate structure. They are also about how care is organised and systems that respond to emergencies. Conclusion: Interventions and investments to improve quality need to be directed towards experienced based co-design where we listen to the problems that nurses experience.
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Affiliation(s)
- Mary Nyikuri
- Strathmore University Business School, Strathmore University, P.O. Box 59857 – 00200, Nairobi, Kenya
- KEMRI-Wellcome Trust Research Program, P.O. Box 43640 – 00100, Nairobi, Kenya
| | - Pratap Kumar
- Strathmore University Business School, Strathmore University, P.O. Box 59857 – 00200, Nairobi, Kenya
| | - Caroline Jones
- KEMRI-Wellcome Trust Research Program, P.O. Box 43640 – 00100, Nairobi, Kenya
- Nuffield Department of Clinical Medicine, Centre for Tropical Medicine, University of Oxford, Oxford, UK
| | - Michael English
- KEMRI-Wellcome Trust Research Program, P.O. Box 43640 – 00100, Nairobi, Kenya
- Nuffield Department of Clinical Medicine, Centre for Tropical Medicine, University of Oxford, Oxford, UK
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Druică E, Mihăilă V, Burcea M, Cepoi V. Combining Direct and Indirect Measurements to Assess Patients' Satisfaction with the Quality of Public Health Services in Romania: Uncovering Structural Mechanisms and Their Implications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010152. [PMID: 31878246 PMCID: PMC6981560 DOI: 10.3390/ijerph17010152] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 12/16/2019] [Accepted: 12/21/2019] [Indexed: 12/31/2022]
Abstract
Introduction: Patients' satisfaction was extensively researched over the last decades, given its role in building loyalty, compliance to treatment, prevention, and eventually higher levels of wellbeing and improved health status. Patients' feedback on the perceived quality of health services can be incorporated into practice; therefore, understanding factors and mechanisms responsible for patients' satisfaction allows providers to tailor targeted interventions. Method: A questionnaire assessing patients' perception of the quality of health services was administered to a country-representative sample of 1500 Romanian patients. Using a partial least squares-path modeling approach (PLS-PM), with cross-sectional data, we developed a variance-based structural model, emphasizing the mediating role of trust and satisfaction with various categories of health services. Results: We confirmed the mediating role of trust in shaping the relationship between the procedural accuracy of health professionals, along with the perceived intensity of their interaction with patients, and patients' experienced quality of the health services. We confirmed the mediating role of satisfaction by the categories of services in the relationship between waiting time on the premises, attention received, and the perceived reliability of the information received, as predictors, and the experienced quality of the health services. In addition, indirect assessment of patients' satisfaction is a good predictor for direct assessment, thereby affirming the idea that the results of the two types of evaluations converge. Discussions: One of the most efficient solutions to increase both patients' satisfaction and their compliance is to empower the communication dimension between patients and health practitioners. Given the non-linear relationships among variables, we advocate that, unless the nature of the relationships between satisfaction and its predictors is understood, practical interventions could fail. The most relevant variable for intervention is the degree of attention patients perceive they received. We suggest three methods to turn waiting time into attention given to patients.
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Affiliation(s)
- Elena Druică
- Centre for Research in Applied Behavioural Economics, Faculty of Business and Administration, University of Bucharest, 030018 Bucharest, Romania; (E.D.); (V.M.)
| | - Viorel Mihăilă
- Centre for Research in Applied Behavioural Economics, Faculty of Business and Administration, University of Bucharest, 030018 Bucharest, Romania; (E.D.); (V.M.)
| | - Marin Burcea
- Faculty of Business and Administration, University of Bucharest; 030018 Bucharest, Romania;
| | - Vasile Cepoi
- The Romanian Authority for Quality Assurance in Healthcare, 060022 Bucharest, Romania
- Correspondence:
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Nyikuri M, Kumar P, Jones C, English M. "But you have to start somewhere….": Nurses' perceptions of what is required to provide quality neonatal care in selected hospitals, Kenya. Wellcome Open Res 2019; 4:195. [PMID: 32587896 PMCID: PMC7309418 DOI: 10.12688/wellcomeopenres.15592.1] [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] [Accepted: 11/20/2019] [Indexed: 11/04/2023] Open
Abstract
Background: Kenya has one of the highest rates of neonatal mortality in the world at 22/1,000 live births. Improving the quality of newborn care would greatly improve survival rates. There is an increasing consensus that strong health systems are key to achieving improved health outcomes. However, there is significantly less agreement on what to strengthen in low and middle-income countries such as Kenya. As nurses are the main caregivers in many inpatient settings, efforts aimed at improving the quality of facility care for sick newborn babies need to take into account nurses views and opinions. Our intent in this paper is to describe the current state of the nursing environment and what would be required to improve the quality of those environs from nurses' perspectives. Methods: Between January 2017 and March 2018, we collected data through non-participant observations, unsolicited conversations and review of admission registers. We also conducted 29 individual in-depth interviews with nurses working in the newborn units (NBU) of a public sector hospital (n=10), a private sector hospital (n=11) and a faith-based hospital (n=8). The interviews were digitally audio recorded, transcribed verbatim and, together with observation notes, analysed using thematic content analysis. Results: Nurses as frontline care givers and intervention intermediaries, irrespective of their work contexts, have similar aspirations, needs and expectations from the health systems of how they should be supported to provide quality inpatient care for newborns. These are about the structure of the work environment, especially human resources for health, and the consequences of inadequate structure. They are also about how care is organised and systems that respond to emergencies. Conclusion: Interventions and investments to improve quality need to be directed towards experienced based co-design where we listen to the problems that nurses experience.
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Affiliation(s)
- Mary Nyikuri
- Strathmore University Business School, Strathmore University, P.O. Box 59857 – 00200, Nairobi, Kenya
- KEMRI-Wellcome Trust Research Program, P.O. Box 43640 – 00100, Nairobi, Kenya
| | - Pratap Kumar
- Strathmore University Business School, Strathmore University, P.O. Box 59857 – 00200, Nairobi, Kenya
| | - Caroline Jones
- KEMRI-Wellcome Trust Research Program, P.O. Box 43640 – 00100, Nairobi, Kenya
- Nuffield Department of Clinical Medicine, Centre for Tropical Medicine, University of Oxford, Oxford, UK
| | - Michael English
- KEMRI-Wellcome Trust Research Program, P.O. Box 43640 – 00100, Nairobi, Kenya
- Nuffield Department of Clinical Medicine, Centre for Tropical Medicine, University of Oxford, Oxford, UK
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van Boekholt TA, Duits AJ, Busari JO. Health care transformation in a resource-limited environment: exploring the determinants of a good climate for change. J Multidiscip Healthc 2019; 12:173-182. [PMID: 30881009 PMCID: PMC6400125 DOI: 10.2147/jmdh.s194180] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Purpose In a continued effort to improve the health care services, a project was set up to develop and implement a care pathway for the effective management of pressure ulcers in the St Elisabeth Hospital in Curaçao, the Dutch Caribbean. To ensure the effective implementation of our intervention, we decided to investigate what factors define the implementation climate of a health care institution within a resource-limited environment. Methods We used a participatory tool approach in this study, where a mixed team of health professionals worked on two parts of a health improvement project, namely: 1) workforce leadership development through a clinical leadership training program; and 2) health care quality improvement through the pressure ulcer care pathway development. In-depth interviews were held with ten participants to gain insight into their experiences of the implementation climate in the hospitals and inductive analysis was used to identify the (sub)themes. Results Identified themes that described the implementation climate included: 1) the attitude of staff toward policy changes; 2) vision of the organization; 3) collaboration; 4) transparency and communication; 5) personal development; and 6) resources. These factors were interrelated and associated with several potential consequences such as loss of motivation among staff, loss of creativity to solve issues, the emergence of the feeling “us” vs “them”, short-term solutions to problems, and a sense of suspicion/frustration among staff members. Conclusion From this study, positive subconstructs for a favorable implementation climate in a hospital organization were lacking and those that were identified were suboptimal. The inability to satisfy all the subconstructs seemed to be the consequence of insufficient resources and infrastructure within the current health system. A favorable implementation climate in a resource-limited environment is closely tied to the availability of health care resources and infrastructure.
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Affiliation(s)
- Tessa A van Boekholt
- Department of Public Health, United Nations High Commissioner for Refugees Uganda Operation, Arua, Uganda
| | - Ashley J Duits
- Department of Medical Education, St. Elisabeth Hospital, Willemstad, Curaçao.,Institute for Medical Education, University Medical Center Groningen, Groningen, The Netherlands.,Red Cross Blood Bank Foundation, Willemstad, Curaçao
| | - Jamiu O Busari
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht, The Netherlands, .,Department of Pediatrics, Zuyderland Medical Center, Heerlen, The Netherlands,
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Myron R, French C, Sullivan P, Sathyamoorthy G, Barlow J, Pomeroy L. Professionals learning together with patients: An exploratory study of a collaborative learning Fellowship programme for healthcare improvement. J Interprof Care 2017; 32:257-265. [PMID: 29240524 DOI: 10.1080/13561820.2017.1392935] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Improving the quality of healthcare involves collaboration between many different stakeholders. Collaborative learning theory suggests that teaching different professional groups alongside each other may enable them to develop skills in how to collaborate effectively, but there is little literature on how this works in practice. Further, though it is recognised that patients play a fundamental role in quality improvement, there are few examples of where they learn together with professionals. To contribute to addressing this gap, we review a collaborative fellowship in Northwest London, designed to build capacity to improve healthcare, which enabled patients and professionals to learn together. Using the lens of collaborative learning, we conducted an exploratory study of six cohorts of the year long programme (71 participants). Data were collected using open text responses from an online survey (n = 31) and semi-structured interviews (n = 34) and analysed using an inductive open coding approach. The collaborative design of the Fellowship, which included bringing multiple perspectives to discussions of real world problems, was valued by participants who reflected on the safe, egalitarian space created by the programme. Participants (healthcare professionals and patients) found this way of learning initially challenging yet ultimately productive. Despite the pedagogical and practical challenges of developing a collaborative programme, this study indicates that opening up previously restricted learning opportunities as widely as possible, to include patients and carers, is an effective mechanism to develop collaborative skills for quality improvement.
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Affiliation(s)
- Rowan Myron
- a CLAHRC NWL , Imperial College London/University of West London , London , UK
| | | | - Paul Sullivan
- c Improvement Science , CLAHRC NWL/Imperial College London , UK
| | | | - James Barlow
- e Business School , Imperial College London , London
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