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Wisner K, Lopez M. Clinical Nurses' Perceptions of a "Brain-Friendly" Peer Feedback Program. J Nurs Care Qual 2024; 39:330-336. [PMID: 39024648 DOI: 10.1097/ncq.0000000000000780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
BACKGROUND While clinicians routinely observe issues with safety and quality, they may not always speak up and intervene. Peer feedback supports nurses to speak up about errors or near misses and actively improve nursing care quality. Effective peer feedback requires addressing barriers to speaking up. PURPOSE The purpose of this mixed methods study was to evaluate a'brain-friendly'peer feedback program´s effect on clinical nurses´ perceptions of peer review. METHODS Nurses were surveyed before and after the implementation of a peer feedback program that integrated social cognitive neuroscience principles. Open comments were analyzed using thematic analysis. RESULTS Responses to nearly half of survey questions improved. Thematic analysis identified institutional and personal barriers to peer feedback use, revealing the personal and social complexity of speaking up. CONCLUSIONS Social cognitive neuroscience may enhance peer feedback programs. Research using immersive qualitative methods is needed to better understand factors supporting or impeding peer feedback.
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Affiliation(s)
- Kirsten Wisner
- Author Affiliations: Magnet Department, Salinas Valley Health, Salinas, California
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Tsai HW, Issenberg SB, Chen YC, Kang EYN, Chen HW, Wu JC. Transforming medical students' speaking-up behaviors in medical errors: The impact of simulation and personalized debriefing. MEDICAL TEACHER 2024:1-7. [PMID: 39150862 DOI: 10.1080/0142159x.2024.2390039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 08/05/2024] [Indexed: 08/18/2024]
Abstract
INTRODUCTION Sharing mental models is essential for high-performance teams, and speaking up is key for exchanging critical insights, especially during medical errors. Understanding how health providers and trainees voice their concerns is crucial for improving speaking-up behavior. This study aims to fill a gap in the literature by examining how medical students speak up when they encounter medical errors and assessing the impact of training on their speaking-up patterns. METHOD A quasi-experimental study involving 146 students, who were divided into two groups, was conducted in Northern Taiwan. One group of students encountered life-threatening scenario before intervention, followed by a faculty-led personalized debriefing session, then a non-life-threatening scenario after the intervention. Another group of students underwent these sessions in the reverse order. Students' Speaking-up patterns, including expression style, form and attitude, and their speaking-up confidence were assessed at pre- and post-intervention scenarios. RESULTS During pre-intervention scenario, in expression style, 50 students (34.5%) addressed their concerns to medical errors with direct expression and 14 students (9.7%) utilized indirect hint to express their concerns. In expression form, 31 students (21.4%) addressed their concerns to medical errors with affirmative sentences and 33 students (22.8%) asked questions to express their concerns. In speaking-up attitude, 47 students (32.4%) used unoffensive words, while 17 students (11.7%) used offensive words. After intervention, significantly change of speaking-up styles, forms, and attitude were observed along with their speaking-up confidence (p < 0.001). DISCUSSION Medical students are inclined to speak up in the event of medical errors using more direct expression and affirmative sentences, along with increased speaking-up confidence after simulation scenario learning and faculty-led personalized debriefing. Healthcare educators can focus more on discussing with students the advantages and disadvantages of various approaches of speaking-up in medical errors, helping them to develop effective speaking-up behaviors in a variety of medical contexts.
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Affiliation(s)
- Hung-Wei Tsai
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, R.O.C
| | - S Barry Issenberg
- University of Miami Gordon Center for Simulation and Innovation in Medical, Education, Miami, FL, USA
| | - Yi-Chun Chen
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, R.O.C
- Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, R.O.C
| | - Enoch Yi-No Kang
- Institute of Health Policy & Management, College of Public Health, National Taiwan University, Taipei, R.O.C
- Department of Health Care Management, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, R.O.C
- Evidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, Taipei, R.O.C
| | - Hui-Wen Chen
- Center for Education in Medical Simulation, Taipei Medical University, Taipei, R.O.C
| | - Jen-Chieh Wu
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, R.O.C
- Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, R.O.C
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Mohd Nawawi MH, Ibrahim MI. Nurses' perceptions of patient handoffs and predictors of patient handoff perceptions in tertiary care hospitals in Kelantan, Malaysia: a cross-sectional study. BMJ Open 2024; 14:e087612. [PMID: 39107013 PMCID: PMC11308887 DOI: 10.1136/bmjopen-2024-087612] [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: 04/15/2024] [Accepted: 07/23/2024] [Indexed: 08/09/2024] Open
Abstract
OBJECTIVES To study nurses' perceptions of patient handoffs in tertiary care hospitals in Kelantan, Malaysia, and to identify predictors of these perceptions. DESIGN Cross-sectional study. SETTING Three tertiary care hospitals in Kelantan, Malaysia, February-March 2023. PARTICIPANTS The study's inclusion criteria were nurses who were Malaysian citizens, working in shifts and possessing a minimum of 6 months of work experience. Nurses holding administrative positions and those unavailable during the study period were excluded from participation. A stratified proportionate random sampling method was employed, and a 100% response rate was achieved, with all 418 selected nurses participating in the study. OUTCOME MEASURES Nurses' perceptions of patient handoffs were assessed using the validated Hospital Patient Handoff Questionnaire. Predictors of these perceptions were identified through multiple linear regression analysis. RESULTS The study revealed an overall positive perception of handoffs, with a mean score of 3.5 on a 1-5 scale. Receiving formal in-service training on handoff practices (regression coefficient 0.089, 95% CI: 0.016 to 0.161) and expressing satisfaction with the handoff process (regression coefficient 0.330, 95% CI: 0.234 to 0.425) were positively associated with nurses' perceptions. Working in the paediatric department was associated with a lower perception of handoffs (regression coefficient -0.124, 95% CI: -0.195 to -0.053). CONCLUSIONS Formal in-service training, satisfaction and working in the paediatric department were significantly associated with nurses' perceptions of patient handoffs in Kelantan. These findings suggest the need for tailored interventions to improve handoff processes and enhance patient safety. Further research could explore the effectiveness of specific training programmes targeting these identified predictors.
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Affiliation(s)
- Mohd Hanif Mohd Nawawi
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, 16150, Kelantan, Malaysia
| | - Mohd Ismail Ibrahim
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, 16150, Kelantan, Malaysia
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Ngo TP, Burke Draucker C, Barnes RL, Kwon K, Reising DL. Peer Collaborative Clinical Decision Making in Nursing Simulation: A Theoretical Framework. J Nurs Educ 2024; 63:435-443. [PMID: 38979733 DOI: 10.3928/01484834-20240505-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
BACKGROUND Collaboration and decision making among nursing students are essential competencies in nursing education. However, how students collaborate and make decisions in simulation is a complex phenomenon and not well understood. This study aimed to develop a framework that describes peer collaborative clinical decision making (PCCDM) among nursing students in simulation. METHOD Charmaz's constructivist grounded theory method was used. The sample included 32 participants (16 dyads) from two nursing programs. RESULTS The PCCDM framework described three interrelated functional domains (cognition, behavior, and emotion) experienced through three interrelated processes (awareness, communication, and regulation), alternating between individual and collaborative spaces and changing across time according to the simulation's acuity levels. CONCLUSION The PCCDM framework provides a model that reflects how these processes unfold over time in simulations, which can be applied in nursing simulation, classroom, and clinical settings that require students to make collaborative decisions. [J Nurs Educ. 2024;63(7):435-443.].
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Lassoued L, Gharssallah I, Tlili MA, Sahli J, Kouira M, Abid S, Chaieb A, Khairi H. Impact of an educational intervention on patient safety culture among gynecology-obstetrics' healthcare professionals. BMC Health Serv Res 2024; 24:704. [PMID: 38840130 PMCID: PMC11151572 DOI: 10.1186/s12913-024-11152-3] [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: 08/11/2023] [Accepted: 05/28/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND In recent years, patient safety has begun to receive particular attention and has become a priority all over the world. Patient Safety Culture (PSC) is widely recognized as a key tenet that must be improved in order to enhance patient safety and prevent adverse events. However, in gynecology and obstetrics, despite the criticality of the environment, few studies have focused on improving PSC in these units. This study aimed at assessing the effectiveness of an educational program to improve PSC among health professionals working in the obstetric unit of a Tunisian university hospital. METHODS We conducted a quasi-experimental study in the obstetric unit of a university hospital in Sousse (Tunisia). All the obstetric unit's professionals were invited to take part in the study (n = 95). The intervention consisted of an educational intervention with workshops and self-learning documents on patient safety and quality of care. The study instrument was the French validated version of the Hospital Survey on Patient Safety Culture. Normality of the data was checked using Kolmogorov-Smirnov test. The comparison of dimensions' scores before and after the intervention was carried out by the chi2 test. The significance level was set at 0.05. RESULTS In total, 73 participants gave survey feedback in pre-test and 68 in post-test (response rates of 76.8% and 71.6, respectively). Eight dimensions improved significantly between pre- and post-tests. These dimensions were D2 "Frequency of adverse events reported" (from 30.1 to 65.6%, p < 0.001), D3 "Supervisor/Manager expectations and actions promoting patient safety" (from 38.0 to 76.8%, p < 0.001), D4 "Continuous improvement and organizational learning" (from 37.5 to 41.0%, p < 0.01), D5 "Teamwork within units" (from 58.2 to 79.7%, p < 0.01), D6 "Communication openness" (from 40.6 to 70.6%, p < 0.001), and D7 "Non-punitive response to error" (from 21.1 to 42.7%, p < 0.01), D9 "Management support for patient safety" (from 26.4 to 72.8%, p < 0.001), and D10 "Teamwork across units" (from 31.4 to 76.2%, p < 0.001). CONCLUSIONS Educational intervention, including workshops and self-learning as pedagogical tools can improve PSC. The sustainability of the improvements made depends on the collaboration of all personnel to create and promote a culture of safety. Staff commitment at all levels remains the cornerstone of any continuous improvement in the area of patient safety.
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Affiliation(s)
- Latifa Lassoued
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, LR12ES03, 4000, Tunisie
- Service de Gynécologie Obstétrique CHU Farhat Hached, Sousse, 4000, Tunisie
| | - Ines Gharssallah
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, LR12ES03, 4000, Tunisie
- Service de Gynécologie Obstétrique CHU Farhat Hached, Sousse, 4000, Tunisie
| | - Mohamed Ayoub Tlili
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, LR12ES03, 4000, Tunisie.
- Department of Nursing Administration, College of Nursing, University of Hail, Hail, Saudi Arabia.
| | - Jihene Sahli
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, LR12ES03, 4000, Tunisie
| | - Mouna Kouira
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, LR12ES03, 4000, Tunisie
- Service de Gynécologie Obstétrique CHU Farhat Hached, Sousse, 4000, Tunisie
| | - Skender Abid
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, LR12ES03, 4000, Tunisie
- Service de Gynécologie Obstétrique CHU Farhat Hached, Sousse, 4000, Tunisie
| | - Anouar Chaieb
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, LR12ES03, 4000, Tunisie
- Service de Gynécologie Obstétrique CHU Farhat Hached, Sousse, 4000, Tunisie
| | - Hedi Khairi
- Université de Sousse, Faculté de Médecine de Sousse, Sousse, LR12ES03, 4000, Tunisie
- Service de Gynécologie Obstétrique CHU Farhat Hached, Sousse, 4000, Tunisie
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Kim ARJ, Nishino K, Bujang MA, Zulkifli Z, Inthaphatha S, Yamamoto E. What inhibits "speaking up" for patient safety among healthcare workers? A cross-sectional study in Malaysia. HUMAN RESOURCES FOR HEALTH 2024; 22:35. [PMID: 38807123 PMCID: PMC11134733 DOI: 10.1186/s12960-024-00916-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 05/16/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND In healthcare, "speaking up" refers to when healthcare workers raise concerns regarding patient safety through questions, sharing information, or expressing their opinion to prevent harmful incidents and ensure patient safety. Conversely, withholding voice is an act of not raising concerns, which could be beneficial in certain situations. Factors associated with speaking up and withholding voices are not fully understood, especially in strong authoritarian societies, such as Malaysia. This study aimed to examine the factors associated with speaking up and withholding the voices of healthcare workers in Malaysia, thus providing suggestions that can be used in other countries facing similar patient safety challenges. METHODS This cross-sectional study was conducted in a tertiary hospital in Sarawak State, Malaysia. Data were collected from 474 healthcare workers from 43 departments using a self-administered questionnaire for speaking up and withholding voices measures in 4 weeks prior to data analysis as well as socio-demographic factors of healthcare workers (sex, age group, profession, department, weekly work hours for patient care, years of employment in the hospital, and the hierarchical level) and speaking up related climate of the working environment were recorded. Data were analyzed using descriptive statistics. Logistic regression was performed to find out (adjusted) odds ratio of frequent speaking up and withholding voices. RESULTS Nurse compared to doctors and healthcare workers with short weekly working hours were more likely to speak up. Healthcare workers in emergency and intensive care department, those with short years of employment, and those who worked at low hierarchical levels were less likely to speak up. Healthcare workers in discouraging environment towards speaking up were more likely to withhold their voices. CONCLUSIONS This study demonstrates the characteristics of healthcare workers who speak up and those who withhold their voices in Malaysia. To ensure patient safety and prevent harm, it is essential to establish an encouraging environment that promotes speaking up and prevents withholding voices among healthcare worker, especially in circumstances where multiple types of healthcare workers with different socio-demographic backgrounds work together.
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Affiliation(s)
- Alex Ren Jye Kim
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
- Quality and Training Unit, Sarawak General Hospital, Ministry of Health Malaysia, 93586, Kuching, Sarawak, Malaysia
| | - Kimihiro Nishino
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan.
| | - Mohamad Adam Bujang
- Clinical Research Centre, Sarawak General Hospital, Ministry of Health Malaysia, 93586, Kuching, Sarawak, Malaysia
| | - Zubalqiah Zulkifli
- Quality and Training Unit, Sarawak General Hospital, Ministry of Health Malaysia, 93586, Kuching, Sarawak, Malaysia
| | - Souphalak Inthaphatha
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan
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Kent F, Haruta J. Culture and context in Interprofessional education: Expectations in Australia and Japan. MEDICAL EDUCATION 2024. [PMID: 38728120 DOI: 10.1111/medu.15424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 04/08/2024] [Accepted: 04/17/2024] [Indexed: 05/12/2024]
Abstract
The attributes of collaborative practice in health care vary across contexts, necessitating the adaptation of interprofessional education curricula to prepare students for the collaborative practice expected in their respective health care systems. Culture, when conceptualised through an organisational lens, allows an analysis of the shared assumptions, beliefs and values, without seeking to reduce to a uniform construct. This article explores the differences in interprofessional education competencies between Australia and Japan and considers the systems and patient expectations, which underpin each. While collaborative competence exhibits some similarities across contexts, competency frameworks differ in emphasis, language and key terminology, which highlight multiple points of difference in the expectations of interprofessional collaborative practice across contexts. There are education and practice consequences of these different perspectives of collaborative practice, in an increasingly mobile international workforce.
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Affiliation(s)
- Fiona Kent
- Education Portfolio, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
- Health Professions Education Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Junji Haruta
- Medical Education Center, School of Medicine, Keio University, Tokyo, Japan
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Maddineshat M, Safi-Keykaleh M, Ghaleiha A, Sadeghian E. Speaking Up: Exploring Mental Health Care Workers' Patient Safety Concerns. J Psychosoc Nurs Ment Health Serv 2024:1-9. [PMID: 38709102 DOI: 10.3928/02793695-20240424-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
PURPOSE To explore the perspectives and experiences of mental health care workers (MHCWs) when speaking up about patient safety concerns. METHOD A qualitative study was performed at Farshchian (Sina) Hospital in Iran, involving the purposive sampling of MHCWs from three inpatient psychiatric wards. From July to October 2022, semi-structured interviews were conducted with 23 participants. Data were analyzed using conventional content analysis. RESULTS Three major patient safety themes were identified: (a) Voicing Concerns for Daily Safety (subthemes: daily safety check-ins and speaking up to prevent patient harm); (b) Speaking Up to Save Future Lives (subthemes: whistleblowing, leadership, and being open to communication); and (c) Hesitating to Speak Up (sub-themes: ineffectiveness of raising one's voice and whispering). CONCLUSION MHCWs have various concerns about speaking up or staying silent. Failure to communicate can result in adverse events and missed opportunities to address patient safety. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].
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Ahn S, Kim DE. Adaptation and validation of a Korean version of the speaking up about patient safety questionnaire (KSUPS-Q). BMC Nurs 2024; 23:293. [PMID: 38685014 PMCID: PMC11057173 DOI: 10.1186/s12912-024-01891-3] [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: 10/13/2023] [Accepted: 03/22/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Speaking up by healthcare providers is an essential assertive communication strategy for ensuring patient safety and preventing incidents. However, more is needed to know about speaking up and instruments to assess it in the Korean context. Therefore, we assessed the psychometric properties of the Korean version of the Speaking Up about Patient Safety Questionnaire (KSUPS-Q) for measuring speaking up-related behavior and climate among nurses. METHODS The translation and adaptation process followed the guidelines of the International Society for Pharmacoeconomics and Outcomes Research and the World Health Organization. Content validity was assessed by a six-member expert panel using the content validity index. In total, 314 nurses participated in an online survey to examine the psychometric properties. Internal consistencies were tested using Cronbach's alpha and McDonald's omega. Confirmatory factor analyses were conducted to examine the subscales' construct. The convergent validity of the speaking up-related climate scale was assessed by testing correlations with teamwork and safety climate domains of the Safety Attitudes Questionnaire. In addition, we investigated the convergent validity of the speaking up-related behavior scale by examining its correlation with the climate scale. RESULTS The reliability of the 11-item behavior scale was satisfactory. Confirmatory factor analysis confirmed that a three-subscale model (perceived concerns, withholding voice, and speaking up) was appropriate (CFI = 0.98, TLI = 0.98, and SRMR = 0.05). Furthermore, the 11-item climate scale demonstrated satisfactory internal consistency. A three-subscale model (psychological safety, encouraging environment, and resignation) was confirmed (CFI = 0.98, TLI = 0.97, and SRMR = 0.05). The convergent validity of the climate scale was verified based on correlations with the teamwork (r = 0.68, p < 0.001) and safety climate (r = 0.68, p < 0.001) domains of the Safety Attitudes Questionnaire. In addition, speaking up-related behavior and climate showed a significant association, indicating that the behavior scale is conceptually valid. CONCLUSIONS This study demonstrates that the KSUPS-Q is a valid and reliable instrument in Korea. This instrument can help nurse managers simultaneously monitor the behavior and climate of their organizations and evaluate the outcomes of interventions to enhance speaking up. Future research is needed to explore diverse factors contributing to speaking up, including clinical roles, team relationships, and supportive culture, to identify areas requiring further improvement.
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Affiliation(s)
- Shinae Ahn
- Department of Nursing, Wonkwang University, Jeonbuk, Republic of Korea
| | - Da Eun Kim
- College of Nursing and Research Institute of Nursing Innovation, Kyungpook National University, Daegu, Republic of Korea.
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Soyer Er Ö, Gül İ. The Speaking Up Climate of Nurses for Patient Safety Concerns and Unprofessional Behaviors: The Effects of Teamwork and Safety Climate. J Perianesth Nurs 2024:S1089-9472(23)01070-5. [PMID: 38493404 DOI: 10.1016/j.jopan.2023.12.008] [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: 10/19/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 03/18/2024]
Abstract
PURPOSE This study aims to investigate the influence of teamwork and safety climate on nurses' speaking up for patient safety concerns and unprofessional behaviors. DESIGN This study incorporates a cross-sectional research design. METHODS The study included 217 surgical nurses employed in a Turkish university hospital. The research data were collected between April and June 2023 using the Teamwork Climate, Safety Climate Survey, Speaking Up Climate for Patient Safety, and Speaking Up Climate for Professionalism instruments. The relationships between these scales were assessed using Pearson correlation analysis. The Turkish validity and reliability of the Speaking Up Climate for Patient Safety and Speaking Up Climate for Professionalism scales were verified. The research model was tested using path analysis. FINDINGS The mean age of the 217 surgical nurses was 25.88 ± 5.64 years. Teamwork climate showed a positive effect on safety climate and speaking up climate about patient safety concerns and unprofessional behaviors. Safety climate showed a positive association with nurses' speaking up climate about patient safety concerns and unprofessional behaviors. CONCLUSIONS Teamwork climate and safety climate both positively affect the speaking up climate about patient safety concerns and unprofessional behaviors. Nurse managers who wish to promote a culture of speaking up about patient safety and unprofessional behaviors should prioritize improvements in the teamwork climate and safety climate.
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Affiliation(s)
- Özlem Soyer Er
- Surgical Nursing Department, Afyonkarahisar Health Sciences University, Faculty of Health Sciences, Afyonkarahisar, Turkey
| | - İsa Gül
- Department of Healthcare Management, Faculty of Health Sciences, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
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Finney D, Cornell P, Howie L, Parker L, Wylie R, Livermore P. Evaluating a competency framework for rheumatology nurses. Nurs Stand 2024; 39:61-66. [PMID: 38248136 DOI: 10.7748/ns.2024.e12111] [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] [Accepted: 05/11/2023] [Indexed: 01/23/2024]
Abstract
The Royal College of Nursing (RCN) competency framework for rheumatology nurses was developed in 2020. As part of the framework proposal, a service evaluation was planned following the framework's roll-out to determine its usefulness and acceptability. The aim of this evaluation was to explore rheumatology nurse specialists' answers to the research question: 'What was your experience of using the RCN's rheumatology competency framework?' A total of 14 rheumatology nurse specialists were interviewed and shared their opinions regarding the competency framework. Five themes were identified: personal usage; benefits to managers; inequalities and inequity in nursing; ideas for improvement; and general properties. The findings of this evaluation demonstrated the value of the framework, which enabled rheumatology nurse specialists to document the competency level they were working at and to identify their future training needs.
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Affiliation(s)
- Diana Finney
- rheumatology, Sussex MSK Partnership, Brighton, England
| | - Patricia Cornell
- University Hospitals Dorset NHS Foundation Trust, Bournemouth, England
| | - Lisa Howie
- spinal department, Morriston Hospital, Swansea Bay University Health Board, Swansea, Wales
| | - Louise Parker
- long-term conditions, Nursing Department, Royal College of Nursing, London, England
| | - Ruth Wylie
- Great North Children's Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, England
| | - Polly Livermore
- rheumatology department, Great Ormond Street Hospital for Children NHS Foundation Trust, London, England
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Chong RIH, Yaow CYL, Chong NZY, Yap NLX, Hong ASY, Ng QX, Tan HK. Scoping review of the second victim syndrome among surgeons: Understanding the impact, responses, and support systems. Am J Surg 2024; 229:5-14. [PMID: 37838505 DOI: 10.1016/j.amjsurg.2023.09.045] [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: 07/07/2023] [Revised: 09/11/2023] [Accepted: 09/30/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND It is thought that 50% of healthcare providers experience Second Victim Syndrome (SVS) in the course of their practice. The manifestations of SVS varies between individuals, with potential long-lasting emotional effects that impact both the personal lives and professional clinical practice of affected persons. Although surgeons are known to face challenging and high-stress situations in their profession, which can increase their vulnerability to SVS, majority of studies and reviews have focused squarely on nonsurgical physicians. METHODS This scoping review aimed to consolidate existing studies pertaining to a surgeon's experience with SVS, by broadly examining the prevalence and impact, identifying the types of responses, and evaluating factors that could influence these responses. The scoping review protocol was guided by the framework outlined by Arksey and O'Malley and ensuing recommendations made by Levac and colleagues. Three databases (MEDLINE, EMBASE and Cochrane Library) were searched from inception till March 19, 2023. RESULTS A total of 13 articles were eligible for thematic analysis based on pre-defined inclusion criteria. Effects of SVS were categorized into Psychological, Physical and Professional impacts, of which Psychological and Professional impacts were particularly significant. Factors affecting the response were categorized into complication type, surgeon factors and support systems. CONCLUSION SVS adds immense psychological, emotional and physical burden to the individual surgeon. There are key personal, interpersonal and environmental factors that can mitigate or exacerbate the effects of SVS, and greater emphasis needs to be placed on improving availability and access to services to help surgeons at risk of SVS.
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Affiliation(s)
- Ryan Ian Houe Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Clyve Yu Leon Yaow
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Nicole Li Xian Yap
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Qin Xiang Ng
- Health Services Research Unit, Singapore General Hospital, Singapore; MOH Holdings Pte Ltd., Singapore.
| | - Hiang Khoon Tan
- Department of Head and Neck Surgery, Singapore General Hospital, Singapore
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Huyen NTT, Tsakitzidis G, Tam NM, Valcke M, Chuong HV, Wens J. Perceptions and experiences of primary healthcare providers toward interprofessional collaboration in chronic disease management in Hue, Vietnam. J Interprof Care 2024; 38:52-61. [PMID: 37366565 DOI: 10.1080/13561820.2023.2227650] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 04/19/2023] [Accepted: 06/08/2023] [Indexed: 06/28/2023]
Abstract
In Vietnam, each primary care community health center (CHC) consists of a multi-professional team with six disciplines, including a physician, assistant physician, nurse, pharmacist, midwife, and Vietnamese traditional physician, who are able to meet the majority of patient's needs at the primary care level. How they collaborate, especially in chronic disease management (CDM), is still limited described in the literature. This study aims to gain insight into the perceptions and the experiences of primary health care providers (PHCPs) toward interprofessional collaboration (IPC) in CDM in CHCs in (Hue) Vietnam. A qualitative study of descriptive phenomenology was performed using two focus groups and 15 semi-structured interviews with PHCPs from six professions relevant to CDM in CHCs. The data were analyzed using NVivo 12.0 with a thematic analysis method by a multiprofessional research team. From the analysis, the data were classified into three main themes: "lack of collaborative practice," "knowledge," and "facilitators and barriers to IPC." This study provided evidence of the awareness that actual collaboration in daily care is fragmentarily organized and that PHCPs try to finish their tasks within their profession. PHCPs work multiprofessionally and lack shared decision-making in patient-centered care. There is a need to develop an interprofessional education program and training to address these deficiencies in the Vietnamese context to improve interprofessional collaboration in health care.
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Affiliation(s)
- Nguyen Thi Thanh Huyen
- Department of Family Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerpen, Belgium
| | - Giannoula Tsakitzidis
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerpen, Belgium
| | - Nguyen Minh Tam
- Department of Family Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Martin Valcke
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Huynh Van Chuong
- The Education Quality Management Agency, Ministry of Education and Training, Vietnam
| | - Johan Wens
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerpen, Belgium
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Chua WL, Wee LPC, Lim JYG, Yeo MLK, Jones D, Tan CK, Khan FA, Liaw SY. Automated rapid response system activation-Impact on nurses' attitudes and perceptions towards recognising and responding to clinical deterioration: Mixed-methods study. J Clin Nurs 2023; 32:6322-6338. [PMID: 37087695 DOI: 10.1111/jocn.16734] [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: 09/27/2022] [Revised: 02/12/2023] [Accepted: 04/05/2023] [Indexed: 04/24/2023]
Abstract
AIM To explore general ward nurses' attitudes and perceptions towards recognising and responding to clinical deterioration in a hospital with automated rapid response system activation. BACKGROUND There is growing interest in deploying automated clinical deterioration notification systems to reduce delayed or failed recognition and response to clinical deterioration of ward patients. However, little is known about its impact on ward nurses' perspectives and work patterns. DESIGN A mixed-methods study. METHODS Online survey of 168 registered nurses and individual interviews with 10 registered nurses in one acute hospital in Singapore. The study adhered to the STROBE checklist for cross-sectional studies and the COREQ guidelines for qualitative studies. RESULTS Many nurses (38.1%) rarely performed patient assessments or observations other than vital signs assessment to assess for early signs of clinical deterioration. About 30% were worried about being criticised for calling the primary team doctors. Four themes emerged from the qualitative analysis: automated rapid response system activation as a safety net, being more cautious with vital signs monitoring, the NEWS2 alone is inadequate, and ward nurses as the 'middleman' between the intensive care unit outreach nurse and primary team doctors. CONCLUSIONS Although nurses value the automated rapid response system activation as a safety net to minimise delays in accessing urgent critical care resources, it does not address the sociocultural barriers inherent in escalation of care. Although the automated system led nurses to be more cautious with vital signs monitoring, it does not encourage them to perform comprehensive patient assessments to detect early signs of deterioration. RELEVANCE TO CLINICAL PRACTICE Nurse education on assessing for clinical deterioration should focus on the use of broader patient assessment skills other than vital signs. Sociocultural barriers to escalation of care remain a key issue that needs to be addressed by hospital management. NO PATIENT OR PUBLIC CONTRIBUTION No patients, service users, care-givers or members of the public were involved in the study.
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Affiliation(s)
- Wei Ling Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Li-Phing Clarice Wee
- Department of Nursing Administration, Ng Teng Fong General Hospital, National University Health System, Singapore
| | - Jia Ying Germaine Lim
- Department of Nursing, Ng Teng Fong General Hospital, National University Health System, Singapore
| | - Min Li Kimberly Yeo
- Department of Nursing, Ng Teng Fong General Hospital, National University Health System, Singapore
| | - Daryl Jones
- Intensive Care Unit, Austin Health, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
- Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia
| | - Chee Keat Tan
- Department of Intensive Care Medicine, Ng Teng Fong General Hospital, National University Health System, Singapore
| | - Faheem Ahmed Khan
- Department of Intensive Care Medicine, Ng Teng Fong General Hospital, National University Health System, Singapore
| | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Gencer O, Duygulu S. Speak-Up Behavior of Oncology Nurses: Organizational Trust and Structural Empowerment as Determinants. J Nurs Adm 2023; 53:453-459. [PMID: 37585495 DOI: 10.1097/nna.0000000000001315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
OBJECTIVE The aim of this study is to examine the mediating roles of organizational trust and structural empowerment on the speak-up behavior of oncology nurses. BACKGROUND Organizational trust can create opportunities for a good working environment. Structural empowerment is an important factor affecting the speak-up behavior of nurses. The intermediary roles of organizational trust and structural empowerment on speak-up behavior are not specific. METHODS A correlational descriptive research design was used, and 232 nurses from 2 different hospital levels (the Ministry of Health hospital and university hospital) responded to 4 questionnaires. RESULT The results reflect that organizational trust and structural empowerment are a factor on nurses' speak-up behavior. CONCLUSION The findings demonstrate that a work environment where organizational trust is developed and a structural empowerment framework is in place contributes to nurses' speak-up behavior among oncology nurses.
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Affiliation(s)
- Ozge Gencer
- Author Affiliations: Nurse and PhD Candidate (Gencer), Education Unit, Ankara Etlik City Hospital; and Associate Professor (Dr Duygulu), Faculty of Nursing, Hacettepe University, Ankara, Turkey
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Lee SE, Repsha C, Seo WJ, Lee SH, Dahinten VS. Room of horrors simulation in healthcare education: A systematic review. NURSE EDUCATION TODAY 2023; 126:105824. [PMID: 37121075 DOI: 10.1016/j.nedt.2023.105824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/23/2023] [Accepted: 04/10/2023] [Indexed: 05/25/2023]
Abstract
OBJECTIVES A room of horrors simulation is one tool that healthcare educators use to improve learners' awareness of patient safety hazards and other critical matters in a safe and controlled environment. This review aimed to summarize research on use of room of horrors simulation in healthcare education, examine its effectiveness, and recommend directions for future education and research. DESIGN A systematic review of the literature. DATA SOURCES Relevant publications in English were identified in PubMed, Embase, CINAHL, Scopus, and dissertation databases, and through a manual search of the reference lists of included articles. REVIEW METHODS The systematic review and its reporting process conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Included articles were evaluated for quality using the Mixed Methods Appraisal Tool. Two authors independently extracted data from each article, and two additional authors confirmed the accuracy of the extracted data. The "horrors" used in the studies' simulations were mapped into 13 different incident types. RESULTS Sixteen studies were included in the final review. All of them were conducted in Western countries. Simulation scenarios were developed based on existing resources, expert guidance, or patient safety concerns frequently reported at a particular institution. The number of horrors per scenario ranged from nine to 68, with the most common being medication-related and clinical procedure-related incidents. Participants completed a room of horrors simulation as individuals, a team, or both. When competing as a team, the team sizes ranged from two to 11. Studies reported high participant satisfaction. CONCLUSIONS Room of horrors simulation is a useful teaching tool for healthcare students and professionals. However, there is little conclusive evidence about the ideal composition and size of teams, and therefore this merits more research attention, as does attention to the longer term impacts on learners.
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Affiliation(s)
- Seung Eun Lee
- Yonsei University College of Nursing, 50-1 Yonsei-ro, Seodaemun-gu, 03722 Seoul, South Korea.
| | - Christine Repsha
- Boston College William F. Connell School of Nursing, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, United States of America.
| | - Won Jin Seo
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, 03722 Seoul, South Korea.
| | - Sang Hwa Lee
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, 03722 Seoul, South Korea.
| | - V Susan Dahinten
- School of Nursing, University of British Columbia, T-201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada.
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Choi H, Jeon Y, Lee U, Ahn J, Kim H. Technology-based interactive communication simulation for Korean nurses: A randomized controlled repeated-measures design. NURSE EDUCATION TODAY 2023; 128:105879. [PMID: 37352764 DOI: 10.1016/j.nedt.2023.105879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 05/26/2023] [Accepted: 06/12/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND Effective and standardized technology-based communication simulations addressing diverse clinical situations for novice nurses are limited. OBJECTIVES This study evaluated the efficacy of the Technology-based Interactive Communication Simulation for Nurses on communication competency (knowledge, self-efficacy, skills, and clarity), compassion, and assertiveness among novice nurses. DESIGN We used a randomized controlled repeated-measures design. Participants were randomly assigned to either the intervention (Technology-based Interactive Communication Simulation for Nurses) or attention control group and completed the assigned program, the questionnaire thrice (i.e., before, immediately after, and four weeks after the program), and the e-simulation twice (i.e., immediately after and four weeks after the program). SETTINGS AND PARTICIPANTS Korean nurses with six months to two years of experience recruited from five secondary and tertiary hospitals participated in the study at a private, quiet place of their choice. METHODS The intervention comprises two simulation cases across different formats: (1) an interactive communication simulation for various clinical situations followed by a tailored debriefing; and (2) a video showing a conflict between a nurse and caregiver and between nurses, followed by a self-reflection activity. Communication skills and clarity were also evaluated by raters. Data analyses included descriptive analyses, t-tests, chi-square tests, and a generalized estimating equation model. RESULTS In total, 142 nurses (73 in the intervention and 69 in the attention control groups) participated in the programs, and 128 participated through the four-week follow-up. Technology-based Interactive Communication Simulation for Nurses significantly improved communication knowledge and self-efficacy and compassion among novice nurses compared to the attention control program, and its effects were maintained for four weeks. The group difference in communication skills and clarity evaluated by the raters was also significant. CONCLUSION Technology-based Interactive Communication Simulation for Nurses is effective in enhancing the communication competence of novice nurses. Future studies should analyze assertiveness in Korean healthcare settings.
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Affiliation(s)
- Heeseung Choi
- College of Nursing, Seoul National University, Jongno-gu, Seoul 03080, Republic of Korea; Research Institute of Nursing Science, Seoul National University, Jongno-gu, Seoul 03080, Republic of Korea
| | - Yeseul Jeon
- College of Nursing, Seoul National University, Jongno-gu, Seoul 03080, Republic of Korea.
| | - Ujin Lee
- College of Nursing, Incheon Catholic University, Yeonsu-gu, Incheon 21987, Republic of Korea
| | - Junggeun Ahn
- College of Nursing, Seoul National University, Jongno-gu, Seoul 03080, Republic of Korea
| | - Hannah Kim
- College of Nursing, Seoul National University, Jongno-gu, Seoul 03080, Republic of Korea
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Jeong JH, Kim SS. South Korean Nurses' Experiences of Speaking up for Patient Safety and Incident Prevention. Healthcare (Basel) 2023; 11:1764. [PMID: 37372881 DOI: 10.3390/healthcare11121764] [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: 05/11/2023] [Revised: 06/08/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Despite the importance of speaking up for patient safety, hesitancy to do so remains a major contributing factor to communication failure. This study aimed to investigate the experiences of South Korean nurses in speaking up to prevent patient safety incidents. Twelve nurses responsible for patient safety tasks or with experience in patient safety education were recruited from five hospitals (three university hospitals, two general hospitals) in city "B". Data were collected through open-ended questions and in-depth interviews, transcribed, and analyzed using the inductive content analysis method. The study resulted in the identification of four main categories and nine subcategories that captured commonalities among the experience of the 12 nurses. The four main categories were as follows: the current scenario of speaking up, barriers to speaking up, strategies for speaking, and confidence training. There is a scarcity of research on speaking-up experiences for patient safety among nurses in South Korean. Overall, it is necessary to overcome cultural barriers and establish an environment that encourages speaking up. In addition, developing speaking-up training programs for nursing students and novice nurses is imperative to prevent patient safety incidents.
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Affiliation(s)
- Jeong Hee Jeong
- Department of Nursing Science, Kyungsung University, Busan 48434, Republic of Korea
| | - Sam Sook Kim
- Department of Nursing, Daedong College, Busan 46270, Republic of Korea
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19
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Lee SE, Choi J, Dahinten VS, Lee H, Ji H, Kim E. Registered nurses’ perceptions and experiences with speaking up for patient safety in hospitals. Collegian 2023. [DOI: 10.1016/j.colegn.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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20
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Lee M, Ong YH, Martimianakis MA. Ideological dilemmas of healthcare professionals who do not speak up at interprofessional team meetings. J Interprof Care 2023; 37:1-10. [PMID: 35285379 DOI: 10.1080/13561820.2022.2037530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
In healthcare settings, speaking up is considered essential for patient safety. Indeed, voice opportunities are widely available mandatory mechanisms for speaking up at the routine interprofessional team meetings of our study site. Yet, healthcare professionals in team meetings often do not go beyond straightforward reporting of test results and biomedical-functional parameters, suggesting that members with psycho-social information related to the patient are not participating fully in team meetings. Post-meeting interviews with some of the team members revealed the moments of silence and the ideological contradictions underlying team discussions. We explored silences and contradictions as argumentative meanings inherent in naturally occurring speech. The identification of opposing meanings tells of ideological dilemmas that may explain why healthcare practitioners do not speak up vigorously. We identified three such dilemmas: the ideology of working in teams versus the ideology of working solo; the ideology of autonomy versus the ideology of paternalism; and the ideology of collectivism versus the ideology of individuality. The dilemmas made visible the dimensions of silence as well as silencing as an imposition of silence from above. We suggest focussing on mapping disciplinary and interpretive differences and their effects amongst team members may motivate voice. Further studies should explore the affective dimensions of silence in interprofessional team meetings.
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Affiliation(s)
- Mary Lee
- Health Outcomes & Medical Education Research, National Healthcare Group, Singapore
| | - Yu Han Ong
- Health Outcomes & Medical Education Research, National Healthcare Group, Singapore
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21
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Jin J, Son YJ, Tate JA, Choi J. Challenges and Learning Needs of Nurse-Patients' Family Communication: Focus Group Interviews With Intensive Care Unit Nurses in South Korea. Eval Health Prof 2022; 45:411-419. [PMID: 35337208 PMCID: PMC9630962 DOI: 10.1177/01632787221076911] [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: 12/29/2022]
Abstract
Intensive care unit (ICU) nurses are expected to facilitate effective day-to-day communication with patients and family members at the bedside. To date, communication training for ICU health care professionals has targeted mainly intensivists-in-training, but there is limited data on communication experience and needs to be evaluated among ICU nurses. This qualitative study used focus group interviews to explore daily communication experiences with patients' families and communication training needs and preferences among ICU nurses in South Korea. Five focus group interviews were conducted with 27 ICU nurses (4-6 nurses per group). The results of inductive qualitative content analysis highlighted four main categories: "Perceived difficulties during communication," "burden from working conditions," "endeavors to promote communication skills," and "strategies for cultivating effective communication." Regarding suggestions for future communication training, nurses preferred interactive learning with peer-support over traditional methods (e.g., lectures). Nurses also suggested that communication training for ICU nurses should include learning skills appropriate for difficult situations (e.g., angry family members). Findings from this study can serve as a framework for stakeholders in ICU care and healthcare education (e.g., hospital and nursing administrators, nurse educators) when designing communication training to support ICU nurses with their practical knowledge and communication skills.
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Affiliation(s)
- Juhye Jin
- Department of Nursing, College of
Health and Life Science, Korea National University of
Transportation, Jeungpyeong, South Korea
| | - Youn-Jung Son
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
| | - Judith A. Tate
- The Ohio State University, College of
Nursing, Columbus, OH, USA
| | - JiYeon Choi
- Mo-Im Kim Nursing Research
Institute, Yonsei University College of
Nursing, Seoul, South Korea,JiYeon Choi, Yonsei University College of
Nursing, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea.
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22
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Effectiveness of speak-up training programs for clinical nurses: A scoping review. Int J Nurs Stud 2022; 136:104375. [PMID: 36327680 DOI: 10.1016/j.ijnurstu.2022.104375] [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: 05/24/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Speaking up about patient safety concerns is critical when bedside nurses encounter unsafe situations. Training programs that encourage nurses' speaking up behavior have been introduced, but there is limited evidence regarding whether such training leads to behavior change or improves patient safety. OBJECTIVE The aim of this review was to identify the effectiveness of speak-up training programs for clinical nurses, focusing on program content and outcomes. DESIGN A scoping review was conducted using the Joanna Briggs Institute methodology and reported according to the Cochrane and Preferred Reporting Items for Systematic Review and Meta-Analyses Extension for Scoping Reviews guidelines. METHODS This study used bibliographic databases of PubMed, Embase, PsycINFO, Scopus, ProQuest Dissertations and Theses Global for the English language, and NDSL, KCI, RISS, KISS, and DBpia for the Korean language. The literature search used a combination of keywords and subject headings related to speak-up training programs for nurses or any type of nurse training program with an assertiveness component. Training outcomes were evaluated according to the 4-level Kirkpatrick model. RESULTS A total of 4808 references were retrieved, of which 21 articles were selected. These 21 studies were conducted in different parts of the world and published from 1981 to 2020. Speak-up training primarily increased some degree of nurses' levels of assertiveness and speak-up behavior, and also led to secondary outcomes such as job stress, work motivation, and communication conflicts. Most studies (n = 19) applied traditional training formats which consisted of multi-session lectures and practice, whereas three studies applied new methodologies such as high-fidelity simulations and online learning. According to the Kirkpatrick model, five studies assessed reactions to speak-up training (level 1), all studies evaluated learning as a result of training (level 2), two studies measured the effect of speak-up training on nurses' behavior (level 3), and one study evaluated nurses' results (level 4) while no studies evaluated patient-level outcomes. CONCLUSIONS Speak-up training for nurses can improve their levels of assertiveness or speak-up behaviors. Despite inconsistent or mixed findings, speak-up training has the potential to improve nurses' psychological well-being, leading to positive organizational performance. New training methods are directed at specialized education for clinical situations. Future speak-up training should consist of training programs based on real clinical situations in which team members participate together to comprehensively evaluate the effect of training on behavioral changes of health professionals as well as patient safety.
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Ota T, Tan C, Ishii A, Shiotani H. Do differences in chronotypes affect sleep and health-related quality of life of nursing students? A cross-sectional study. Chronobiol Int 2022; 39:1435-1443. [PMID: 36043479 DOI: 10.1080/07420528.2022.2117049] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Nursing students experience higher levels of stress and more sleep-related problems than other students; however, the relationship of chronotype to nursing students' sleep status and health-related quality of life (HRQOL) is unclear. This cross-sectional, observational study investigated whether chronotype affected Japanese nursing college students' sleep and HRQOL. Nursing students completed the Attribute Questionnaire about Subject Background, Japanese Version Morningness‒Eveningness Questionnaire (MEQ), Munich Chrono-Type Questionnaire‒Japanese Version (MCTQ), Japanese Version of the Pittsburgh Sleep Quality Index (PSQI), SF-12v2 Standard, Japanese Version 2.0 (SF-12), Japanese Translation of Profile of Mood States 2nd Edition‒Adult Short (POMS2). Of the 241 students (mean age 20.16 ± 1.80 years; 80.9% female), 80 (33.2%) had evening, 142 (58.9%) had intermediate, and 19 (7.9%) had morning chronotype. The overall total PSQI score was 6.86 ± 2.97. Additionally, 141 students (64.1%) scored ≥ 6, suggesting disturbed sleep. Approximately 80% of the evening chronotype students had a total PSQI score of 8.34 ± 3.11, clearly indicating disturbed sleep. Sleep-related parameters (total PSQI score, bedtime, sleep latency, wake-up time, sleep duration, social jetlag) were worse in evening than in other chronotypes. SF-12 and POMS2 did not differ among chronotypes. Thus, evening chronotype nursing students require sleep-related support from early on.
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Affiliation(s)
- Tomomi Ota
- Graduate School of Health Sciences, Nursing, Kobe University, Kobe, Japan
| | - Chieko Tan
- School of Health Sciences, Nursing, Kobe Tokiwa University, Kobe, Japan
| | - Atsue Ishii
- Graduate School of Health Sciences, Nursing, Kobe University, Kobe, Japan
| | - Hideyuki Shiotani
- School of Health Sciences, Nursing, Kobe Tokiwa University, Kobe, Japan
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24
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Lee SE, Dahinten VS, Ji H, Kim E, Lee H. Motivators and inhibitors of nurses' speaking up behaviours: A descriptive qualitative study. J Adv Nurs 2022; 78:3398-3408. [PMID: 35765723 DOI: 10.1111/jan.15343] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/19/2022] [Accepted: 06/14/2022] [Indexed: 11/28/2022]
Abstract
AIMS To identify factors that motivate or inhibit nurses' speaking up for patient safety. DESIGN A descriptive qualitative study. METHODS We conducted semi-structured interviews with 15 nurses from four Korean hospitals between December 2020 and January 2021. Data were analysed using inductive content analysis. RESULTS We identified safety culture, supportive unit managers and role models, positive reactions from or familiarity with others, high-risk situations and personal characteristics and beliefs as motivators of nurses' speaking up. Hierarchies and power differentials, seniority and unit tenure, concerns about relationships, and heavy workloads inhibited nurses' speaking up. CONCLUSION Individual, organizational and cultural characteristics influence nurses' decisions on whether or not to voice their concerns, suggestions or ideas. Certain characteristics of Korean culture, such as strong hierarchies and the valuing of good relationships, play an important role in nurses' speaking up behaviours. Our findings can be used to inform educational interventions and management expectations about interpersonal behaviours, especially in a culture where age- and seniority-based hierarchies and collectivism are prevalent. IMPACT Nurses perceived speaking up as a challenging behaviour, and they sometimes withhold their voices even when speaking up is needed for patient safety. We found that individual, organizational, and contextual factors affect the speaking up behaviours of nurses. Nurse managers can create environments that are more supportive of nurses' speaking up behaviours by using inclusive leadership to create psychological safety, by inviting and showing appreciation for staff input, and by helping physicians and senior nurses understand the importance of all nurses' voices. NO PATIENT OR PUBLIC CONTRIBUTION Patient or public contribution does not apply to this study as its purpose was to explore the speaking up experiences of nurses themselves.
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Affiliation(s)
- Seung Eun Lee
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - V Susan Dahinten
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hyunju Ji
- Severance Hospital, Department of Nursing, Graduate School, Yonsei University, Seoul, South Korea
| | - Eunkyung Kim
- Brain Korea 21 FOUR Project, Department of Nursing, Graduate School, Yonsei University, Seoul, South Korea
| | - Hyunjie Lee
- Severance Hospital, Department of Nursing, Graduate School, Yonsei University, Seoul, South Korea
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Workplace Assertiveness of Filipino Hospital Staff Nurses: A Cross-sectional Study. NURSE MEDIA JOURNAL OF NURSING 2021. [DOI: 10.14710/nmjn.v11i3.39314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background: Several studies have demonstrated the significance of assertiveness in the nursing profession. However, there is a lacuna in the literature regarding the level of workplace assertiveness of Filipino nurses.Purpose: This study determined the workplace assertiveness towards nursing colleagues, nursing management personnel, medical doctors, and other members of the health team among hospital staff nurses.Methods: The data in this cross-sectional study were collected from randomly selected staff nurses (n=223) involving two tertiary hospitals in the Philippines using the Workplace Assertive Behavior Questionnaire. Descriptive statistics and tests for differences were used to analyze the data.Results: Results showed that staff nurses had moderate workplace assertiveness. They were less assertive towards the nursing management personnel, and were less likely to provide constructive criticisms and say no to requests. Assertiveness significantly varied based on employment status (p=.001), age (p=.046), years of nursing work experience (p=.037), and years in the present organization (p=.022). A sense of responsibility to patients was the main facilitator while reprimand and fear of repercussions from the nursing management personnel were the major barriers to assertive behaviors.Conclusion: Personal and work environmental factors can inhibit or support assertiveness. This study highlighted some gaps in Filipino staff nurses’ assertiveness at work. Nursing management plays a pivotal role in nurses’ assertiveness. Efforts should be made to address the barriers and improve the assertiveness of staff nurses.
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Oducado RMF. Influence of self-esteem, psychological empowerment, and empowering leader behaviors on assertive behaviors of staff nurses. BELITUNG NURSING JOURNAL 2021; 7:179-185. [PMID: 37469345 PMCID: PMC10353602 DOI: 10.33546/bnj.1424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/16/2021] [Accepted: 05/03/2021] [Indexed: 07/21/2023] Open
Abstract
Background Being assertive is essential skill nurses need to learn and develop. While many studies exist on nurses' assertiveness, there is limited research on the factors associated with Filipino nurses' assertive behaviors. Objective This study examined the correlation of self-esteem, psychological empowerment, and leader empowering behaviors on staff nurses' assertiveness in the workplace. Methods This cross-sectional study conducted in 2019 involved 223 staff nurses working in two tertiary hospitals in the Philippines. Data were gathered using four validated self-reported scales: self-esteem scale, psychological empowerment scale, leader empowering behavior questionnaire, and workplace assertive behavior questionnaire. Correlational analysis using Pearson's r was performed to test the relationship between the key variables. Results The composite scores for the self-esteem, psychological empowerment, empowering leader behaviors, and workplace assertiveness were 32.06 (SD = 3.65), 4.22 (SD = 0.43), 3.86 (SD = 0.51) and 3.61 (SD = 0.55), respectively. Self-esteem (r = 0.216; p = 0.001), psychological empowerment (r = 0.455, p = 0.000), and empowering leader behaviors (r = 0.269; p = 0.000) were significantly correlated with staff nurses' assertiveness in the workplace. Conclusion Self-esteem, nurse leadership behaviors, and empowerment play vital roles in staff nurses' assertiveness. Understanding the factors influencing nurses' assertiveness is important, and looking into these variables can be beneficial for nursing management when developing strategies to build nurses' assertiveness. Thus, it is vital to focus on helping nurses nurture healthy self-esteem and initiate empowering conditions at work to aid nurses in setting healthy boundaries and supporting assertive behaviors at work.
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