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Johnson NL, Moeckli J. Conceptualizations of interprofessional communication in intensive care units: findings from a scoping review. JOURNAL OF COMMUNICATION IN HEALTHCARE 2024; 17:130-142. [PMID: 38197399 DOI: 10.1080/17538068.2023.2297124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
BACKGROUND Clinical errors in intensive care units (ICUs) are consistently attributed to communication errors. Despite its importance for patient safety and quality in critical care settings, few studies consider interprofessional communication as more than the basic exchange of information. METHODS We conducted a scoping review of interprofessional communication in ICUs to (1) characterize how communication is defined and measured and (2) identify contributions the field of health communication can make to team communication in ICUs. Through a series of queries in PubMed and Communication and Mass Media Complete databases, we identified and compared persistent gaps in how communication is framed and theorized in 28 publications from health services and 6 from social science outlets. We identified research priorities and suggested strategies for discussing communication more holistically in future health services research. RESULTS 34 articles published from 1999 to 2021 were included. Six explicitly defined communication. Six were published in social science journals, but none were authored by a communication studies scholar. Half of the articles addressed communication as a transaction focused on information transfer, and the other half addressed communication as a process. CONCLUSIONS Methodological implications are identified with the intent to encourage future interdisciplinary collaboration for studying communication in ICUs. We discuss the importance of (1) using language to describe communication that facilitates interdisciplinary engagement, (2) prioritizing communication as a process and using qualitative methods to provide insight, and (3) engaging health communication theories and experts to assist in developing more fruitful research questions and designs.
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Affiliation(s)
- Nicole L Johnson
- VA Office of Rural Health, Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA
- Center for Access & Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA
| | - Jane Moeckli
- VA Office of Rural Health, Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA
- Center for Access & Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA
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Pantha S, Jones M, Gray R. Stakeholders' Perceptions of How Nurse-Doctor Communication Impacts Patient Care: A Concept Mapping Study. NURSING REPORTS 2023; 13:1607-1623. [PMID: 37987412 PMCID: PMC10661264 DOI: 10.3390/nursrep13040133] [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: 08/12/2023] [Revised: 09/26/2023] [Accepted: 11/03/2023] [Indexed: 11/22/2023] Open
Abstract
There is some evidence that aspects of nurse-doctor communication are associated with the quality of care and treatment patients receive whilst they are in hospital. To date, no studies have examined stakeholder perceptions on how patient care is influenced by clinical communication between nurses and doctors. We conducted a concept mapping study to generate a deep understanding of how clinical communication impacts patient care. Concept mapping has six phases: preparation, idea generation, structuring, representation, interpretation, and utilization. A total of 20 patients, 21 nurses, and 21 doctors participated in the study. Brainstorming generated 69 discreet statements about how nurse-doctor communication impacts patient care. The structuring (rating and clustering) phase was completed by 48 participants. The data interpretation workshop selected a five-cluster solution: effective communication, trust, patient safety, impediments to patient care, and interpersonal skills. On the final concept map, the five clusters were arranged in a circle around the center of the map. Clusters were relatively equal in size, suggesting that each concept makes a broadly equal contribution to how nurse-doctor communication influences patient care. Our study suggests that there are multiple aspects of clinical communication that impact patient care. Candidate interventions to enhance nurse-doctor communication may need to consider the complex nature of interprofessional working. Registration: This study was prospectively registered with the Open Science Framework (OSF) on 09.07.2020 (osf.io/9np8v/) prior to recruiting the first participant.
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Affiliation(s)
- Sandesh Pantha
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia;
| | - Martin Jones
- Department of Rural Health, University of South Australia, Whyalla Noorie, SA 5608, Australia;
| | - Richard Gray
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia;
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3
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Vincelette C, D'Aragon F, Stevens LM, Rochefort CM. The characteristics and factors associated with omitted nursing care in the intensive care unit: A cross-sectional study. Intensive Crit Care Nurs 2023; 75:103343. [PMID: 36371393 DOI: 10.1016/j.iccn.2022.103343] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 10/13/2022] [Accepted: 10/24/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Prior research showed that work environment features in acute care settings influence nurses' capacity to provide care and impacts patient outcomes (e.g., falls). However, little is known about this phenomenon in the intensive care unit. The objectives of this study were to describe the characteristics of omitted nursing care, and to examine the associations between work environment features, omitted nursing care and nurse-reported outcomes in the intensive care unit. METHODS An electronic cross-sectional correlational study was conducted in the province of Quebec, Canada. Over September 2021, nurses were asked to complete the Healthy Work Environment Assessment Tool (HWEAT), the Intensive Care Unit Omitted Nursing Care instrument (ICU-ONC) and to report their perceptions of nurse-reported outcomes (e.g., quality of care). The associations between these variables were estimated using multivariable cluster-robust regression models, adjusted for nurse and hospital characteristics. RESULTS A total of 493 nurses from 42 distinct hospitals participated to this study. On average, nurses felt that their work environment was acceptable, and that the quality and safety of patient care was good. Basic care activities (e.g., mobilisation) were most frequently reported as omitted as opposed to those related to surveillance and medical interventions. In multivariable analyses, higher work environment scores were associated with reduced omitted nursing care scores (p < 0.001) and better ratings for nurse-reported outcomes (p < 0.001). Also, higher omitted nursing care scores were associated with more negative perceptions about the quality and safety of care (p < 0.001). CONCLUSION Our study portrays the characteristics and some factors associated with omitted nursing care in the intensive care unit. Further research should determine whether intensive care nurses' reports of organisational features and omitted nursing care are associated with objectively captured patient outcomes.
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Affiliation(s)
- Christian Vincelette
- School of Nursing, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Longueuil, Québec, Canada; Research Center Charles-LeMoyne-Saguenay-Lac-Saint-Jean sur les innovations en santé, Longueuil, Québec, Canada; Research Center du Centre hospitalier Universitaire de Sherbrooke (CRCHUS), Sherbrooke, Québec, Canada.
| | - Frédérick D'Aragon
- Research Center du Centre hospitalier Universitaire de Sherbrooke (CRCHUS), Sherbrooke, Québec, Canada; Department of Anesthesiology, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Longueuil, Québec, Canada.
| | - Louis-Mathieu Stevens
- Department of surgery, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada; Research Center, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.
| | - Christian M Rochefort
- School of Nursing, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Longueuil, Québec, Canada; Research Center Charles-LeMoyne-Saguenay-Lac-Saint-Jean sur les innovations en santé, Longueuil, Québec, Canada; Research Center du Centre hospitalier Universitaire de Sherbrooke (CRCHUS), Sherbrooke, Québec, Canada.
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Igarashi R. Status and Educational Effects of Practical Nursing Training for Medical Students as Part of Interprofessional Education. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231175035. [PMID: 37324052 PMCID: PMC10262645 DOI: 10.1177/23821205231175035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 04/24/2023] [Indexed: 06/17/2023]
Abstract
Objectives The WHO has recognized the importance of multidisciplinary education and recommended its promotion worldwide. In our medical school, students experience practical nursing training in their first year to promote multidisciplinary education. Herein, we clarified the learning experiences of medical students during a practical nursing training for enhancing multidisciplinary collaborative education. Methods A questionnaire about nursing practice was conducted after training completion. Regarding attitudes during the training, the nurses in charge of shadowing evaluated the students, and the students also evaluated themselves. The survey results were analyzed qualitatively, and the attitude evaluation results quantitatively. Results There were 76 students who provided informed consent, of whom 55 completed the survey. Three main learning areas were extracted from survey: Nursing treatment, support, and communication activities (7 categories), Nursing care for hospitalized patients (3 categories), Multidisciplinary collaboration through effective communication and coordination (2 categories). On the first training day, the scores of evaluation by others were higher than those of self-evaluation in 6 items. On the second day, the scores of self-evaluation were higher than those of evaluation by others in "Actively learning" and "Communicating appropriately with medical staff and patients." Conclusion Through the training, students learned about Nursing treatment, support, and communication activities; Nursing care for hospitalized patients; and Multidisciplinary collaboration through effective communication and coordination. The training enabled the students to understand the doctors' roles in the clinical setting, and to reflect on what doctors should be. Leaning from nursing training is highly beneficial for medical students.
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Affiliation(s)
- Ryoko Igarashi
- Department of Medical Education, Tokyo Medical University, Tokyo, Japan
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Riman KA, Davis BS, Seaman JB, Kahn JM. The Use of Electronic Health Record Metadata to Identify Nurse-Patient Assignments in the Intensive Care Unit: Algorithm Development and Validation. JMIR Med Inform 2022; 10:e37923. [DOI: 10.2196/37923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 08/26/2022] [Accepted: 10/22/2022] [Indexed: 11/11/2022] Open
Abstract
Background
Nursing care is a critical determinant of patient outcomes in the intensive care unit (ICU). Most studies of nursing care have focused on nursing characteristics aggregated across the ICU (eg, unit-wide nurse-to-patient ratios, education, and working environment). In contrast, relatively little work has focused on the influence of individual nurses and their characteristics on patient outcomes. Such research could provide granular information needed to create evidence-based nurse assignments, where a nurse’s unique skills are matched to each patient’s needs. To date, research in this area is hindered by an inability to link individual nurses to specific patients retrospectively and at scale.
Objective
This study aimed to determine the feasibility of using nurse metadata from the electronic health record (EHR) to retrospectively determine nurse-patient assignments in the ICU.
Methods
We used EHR data from 38 ICUs in 18 hospitals from 2018 to 2020. We abstracted data on the time and frequency of nurse charting of clinical assessments and medication administration; we then used those data to iteratively develop a deterministic algorithm to identify a single ICU nurse for each patient shift. We examined the accuracy and precision of the algorithm by performing manual chart review on a randomly selected subset of patient shifts.
Results
The analytic data set contained 5,479,034 unique nurse-patient charting times; 748,771 patient shifts; 87,466 hospitalizations; 70,002 patients; and 8,134 individual nurses. The final algorithm identified a single nurse for 97.3% (728,533/748,771) of patient shifts. In the remaining 2.7% (20,238/748,771) of patient shifts, the algorithm either identified multiple nurses (4,755/748,771, 0.6%), no nurse (14,689/748,771, 2%), or the same nurse as the prior shift (794/748,771, 0.1%). In 200 patient shifts selected for chart review, the algorithm had a 93% accuracy (ie, correctly identifying the primary nurse or correctly identifying that there was no primary nurse) and a 94.4% precision (ie, correctly identifying the primary nurse when a primary nurse was identified). Misclassification was most frequently due to patient transitions in care location, such as ICU transfers, discharges, and admissions.
Conclusions
Metadata from the EHR can accurately identify individual nurse-patient assignments in the ICU. This information enables novel studies of ICU nurse staffing at the individual nurse-patient level, which may provide further insights into how nurse staffing can be leveraged to improve patient outcomes.
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Tong M, Gilmore-Bykovskyi A, Block L, Ramly E, White DW, Messina ML, Bartels CM. Rheumatology Clinic Staff Needs: Barriers and Strategies to Addressing High Blood Pressure and Smoking Risk. J Clin Rheumatol 2022; 28:354-361. [PMID: 35696986 PMCID: PMC9529788 DOI: 10.1097/rhu.0000000000001868] [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] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Patients with rheumatologic conditions are at elevated risk of cardiovascular disease (CVD) due to inflammatory and traditional risk factors, such as high blood pressure (BP) and smoking. However, rheumatology clinics rarely address traditional risk factors, although they are routinely assessed and modifiable in primary care. The present study sought to (1) characterize rheumatology clinic staff's work process for addressing high BP and smoking and (2) identify barriers and strategies for effective management of these risk factors. METHODS We conducted 7 focus groups with medical assistants, nurses, and scheduling staff from 4 adult rheumatology clinics across 2 health systems (BP focus groups, n = 23; smoking, n = 20). Transcripts were analyzed using thematic analysis to elucidate barriers and strategies. RESULTS We found 3 clinic work processes for the management of high BP and smoking risk: (1) risk identification, (2) follow-up within the clinic, and (3) follow-up with primary care and community resources. Within these processes, we identified barriers and strategies grouped into themes: (1) time, (2) clinic workflows, (3) technology and resources, (4) staff's attitudes and knowledge, and (5) staff's perceptions of patients. The most pervasive barriers were (1) no structured system for follow-up and (2) staff confidence and skill in initiating conversations about health-related behavior change. CONCLUSIONS Our study identified generalizable gaps in rheumatology staff's work processes and competencies for addressing high BP and smoking in patients. Future efforts to support staff needs should target (1) systems for follow-up within and outside the clinic and (2) conversation support tools.
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Affiliation(s)
- Michelle Tong
- From the Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Laura Block
- School of Nursing, University of Wisconsin-Madison
| | | | | | - Monica L Messina
- Rheumatology Division, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Christie M Bartels
- Rheumatology Division, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
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Sela Y, Artom T, Rosen B, Nissanholtz-Gannot R. Primary Care Physicians' Perceptions on Nurses' Shared Responsibility for Quality of Patient Care: A Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10730. [PMID: 36078444 PMCID: PMC9518020 DOI: 10.3390/ijerph191710730] [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: 07/06/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
Nurses are key players in primary care in Israel and in the efforts to improve its quality, yet a survey conducted among primary care physicians (PCPs) in 2010 indicated that 40% perceived the contribution of nurses to primary care quality as moderate to very small. In 2020, we conducted a cross-sectional survey using self-report questionnaires among PCPs employed by health plans to examine the change in PCPs' perceptions on nurses' responsibility and contributions to quality of primary care between 2010 and 2020. Four-hundred-and-fifty respondents completed the questionnaire in 2020, as compared to 605 respondents in 2010. The proportion of PCPs who perceive that nurses share the responsibility for improving the quality of medical care increased from 74% in 2010 to 83% in 2020 (p < 0.01). Older age, males, self-employment status, and board certification in family medicine independently predicted reduced PCP perception regarding nurses' responsibility for quality-of-care. PCPs who believed that nurses contribute to quality of practice were 7.2 times more likely to perceive that nurses share the responsibility for quality-of-care. The study showed that over the past decade there was an increase in the extent to which PCPs perceive nurses as significant partners in improving quality of primary care.
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Affiliation(s)
- Yael Sela
- Nursing Science Department, Faculty of Social and Community Sciences, Ruppin Academic Center, Emeq-Hefer 4025000, Israel
| | - Tamar Artom
- Smokler Center for Health Policy Research, Myers-JDC-Brookdale Institute, Jerusalem 9103702, Israel
| | - Bruce Rosen
- Smokler Center for Health Policy Research, Myers-JDC-Brookdale Institute, Jerusalem 9103702, Israel
| | - Rachel Nissanholtz-Gannot
- Department of Health Systems Management, School of Health Sciences, Ariel University, Ariel 4076414, Israel
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Cimiotti JP, Becker ER, Li Y, Sloane DM, Fridkin SK, West AB, Aiken LH. Association of Registered Nurse Staffing With Mortality Risk of Medicare Beneficiaries Hospitalized With Sepsis. JAMA HEALTH FORUM 2022; 3:e221173. [PMID: 35977257 PMCID: PMC9142874 DOI: 10.1001/jamahealthforum.2022.1173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 04/03/2022] [Indexed: 11/17/2022] Open
Abstract
Question Is registered nurse workload associated with mortality among Medicare beneficiaries who are admitted to an acute care hospital with a diagnosis of sepsis? Findings In this cross-sectional study of 1958 acute care hospitals and 702 140 Medicare beneficiaries with a diagnosis of sepsis, an increase in registered nurse hours per patient day was associated with a 3% decrease in 60-day mortality in these older adults, a finding that was statistically significant. Meaning The study results suggest that the hours of care provided by registered nurses is likely associated with the outcomes of patients with a diagnosis of sepsis. Importance Sepsis is a major physiologic response to infection that if not managed properly can lead to multiorgan failure and death. The US Centers for Medicare & Medicaid Services (CMS) requires that hospitals collect data on core sepsis measure Severe Sepsis and Septic Shock Management Bundle (SEP-1) in an effort to promote the early recognition and treatment of sepsis. Despite implementation of the SEP-1 measure, sepsis-related mortality continues to challenge acute care hospitals nationwide. Objective To determine if registered nurse workload was associated with mortality in Medicare beneficiaries admitted to an acute care hospital with sepsis. Design, Setting, and Participants This cross-sectional study used 2018 data from the American Hospital Association Annual Survey, CMS Hospital Compare, and Medicare claims on Medicare beneficiaries age 65 to 99 years with a primary diagnosis of sepsis that was present on admission to 1 of 1958 nonfederal, general acute care hospitals that had data on CMS SEP-1 scores and registered nurse workload (indicated by registered nurse hours per patient day [HPPD]). Patients with sepsis were identified based on 29 International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes. Data were analyzed throughout 2021. Exposures SEP-1 score and registered nurse staffing. Main Outcomes and Measures The patient outcome of interest was mortality within 60 days of admission. Hospital characteristics included number of beds, ownership, teaching status, technology status, rurality, and region. Patient characteristics included age, sex, transfer status, intensive care unit admission, palliative care, do-not-resuscitate order, and a series of 29 comorbid diseases based on the Elixhauser Comorbidity Index. Results In total, 702 140 Medicare beneficiaries (mean [SD] age, 78.2 [8.7] years; 360 804 women [51%]) had a diagnosis of sepsis. The mean SEP-1 score was 56.1, and registered nurse HPPD was 6.2. In a multivariable regression model, each additional registered nurse HPPD was associated with a 3% decrease in the odds of 60-day mortality (odds ratio, 0.97; 95% CI 0.96-0.99) controlling for SEP-1 score and hospital and patient characteristics. Conclusions and Relevance The results of this cross-sectional study suggest that hospitals that provide more registered nurse hours of care could likely improve SEP-1 bundle compliance and decrease the likelihood of mortality in Medicare beneficiaries with sepsis.
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Affiliation(s)
- Jeannie P. Cimiotti
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Edmund R. Becker
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Yin Li
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
| | | | - Scott K. Fridkin
- Rollins School of Public Health, Emory University, Atlanta, Georgia
- School of Medicine, Emory University, Atlanta, Georgia
| | - Anna Beth West
- School of Medicine, Emory University, Atlanta, Georgia
- VA Quality Scholars Program, Atlanta VA Health Care System, Atlanta, Georgia
| | - Linda H. Aiken
- School of Nursing, University of Pennsylvania, Philadelphia
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Kitayama M, Unoki T, Matsuda Y, Matsuishi Y, Kawai Y, Iida Y, Teramoto M, Tatsuno J, Hamamoto M. Development and initial validation of the Japanese healthy work environment assessment tool for critical care settings. PLoS One 2022; 17:e0268124. [PMID: 35552559 PMCID: PMC9098038 DOI: 10.1371/journal.pone.0268124] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 04/22/2022] [Indexed: 11/18/2022] Open
Abstract
AIM This study aims to translate the Healthy Work Environment Assessment Tool (HWE-AT) into Japanese and evaluate its validity and reliability. DESIGN AND METHODS The authors followed the guidelines for scale translation, adaptation, and validation in cross-cultural healthcare research. After translation and back-translation, a series of pilot studies were conducted to assess comprehensibility. Subsequently, an expert panel established the content validity. Content validity was calculated using the content validity index (CVI). Finally, we verified the construct validity and calculated the test-retest reliability. RESULTS The updated HWE-AT achieved sufficient comprehensibility after conducting the two pilot tests. Content validity was calculated using the scale-level CVI/average and all the items were 1.00. The content validity indices CFI and RMSEA were 0.918 and 0.082, respectively. Intraclass correlation coefficients for all dimensions ranged from 0.618 to 0.903, indicating acceptable test-retest reliability. Our findings suggest that the Japanese version of the HWE-AT has good validity and reliability.
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Affiliation(s)
- Mio Kitayama
- Nursing Department, Kanazawa Medical University Hospital, Uchinada, Japan
| | - Takeshi Unoki
- School of Nursing, Sapporo City University, Sapporo, Japan
| | - Yui Matsuda
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, United States of America
| | | | - Yusuke Kawai
- Department of Nursing, Fujita Health University Hospital, Toyoake, Japan
| | - Yasuo Iida
- Division of General Education, Natural Sciences, Mathematics, Kanazawa Medical University, Uchinada, Japan
| | - Mio Teramoto
- Teachers College, Columbia University, New York, NY, United States of America
| | - Junko Tatsuno
- Nursing Department, Kokura Memorial Hospital, Kokura, Japan
| | - Miya Hamamoto
- Nursing Department, Tosei General Hospital, Seto, Japan
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Nordfjaern T, Melby L, Kaasbøll J, Ådnanes M. The importance of interdisciplinarity in accommodating patient needs among norwegian nurses. J Psychiatr Ment Health Nurs 2022; 29:25-35. [PMID: 33448106 DOI: 10.1111/jpm.12731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/30/2020] [Accepted: 01/08/2021] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT Previous studies of interdisciplinarity and nursing responsibilities have mainly focused on outcomes such as patient safety, job satisfaction and organizational factors. Mental health nurses often describe role confusion in relation to other health professionals. Opportunities for interdisciplinary communication with other professionals may benefit health care. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE The current large-scale study is the first to investigate whether mental health and SUD nurses' perceptions of their opportunities to accommodate patients' needs are related to interdisciplinarity in the treatment unit and a nursing role with clearly defined responsibilities. Strong interdisciplinarity was associated with greater perceived opportunities to accommodate patients' psychosocial, somatic, and economic and legal needs, while strictly defined nursing roles/responsibilities were related to weaker opportunities to do so. WHAT ARE THE IMPLICATIONS OF PRACTICE The findings highlight the need to address how mental health and SUD nurses organize practice to meet patients' diverse needs Interdisciplinary teamwork could strengthen nurses' ability to address patient needs Finding the best possible balance of providing service in teams or individually could improve resource utilization at the same time as strengthening patient care, and making sure that the patients' various needs are met. ABSTRACT INTRODUCTION: Nurses' roles in specialist mental health and substance use disorder (SUD) treatment services are multidimensional and complex. Their responsibility, autonomy and interdisciplinary collaboration may be of importance for their perceived opportunities to accommodate patients' health needs. Previous studies of interdisciplinarity and nursing responsibilities have mainly focused on outcomes such as patient safety, job satisfaction and organizational factors, and included relatively small samples. The studies have also mainly been conducted in other sectors than the mental health and SUD nursing sectors. AIM/QUESTION The aim of this study is to examine the associations between nurses' roles, interdisciplinarity and their perceived opportunities to accommodate patients' psychosocial, somatic and economic/legal needs. METHOD A cross-sectional web-based questionnaire survey was conducted in a nationwide sample of Norwegian nurses in the mental health, SUD treatment and combined mental health and SUD treatment sectors. Of 5,501 contactable nurses (74% of the population), 1918 (35%) responded. RESULTS The results revealed that interdisciplinarity was significantly associated with greater perceived opportunity to accommodate patient needs, whereas strictly defined nursing roles/responsibilities were associated with less opportunity to accommodate these needs. DISCUSSION/IMPLICATION FOR PRACTICE Facilitation of interdisciplinary collaboration may improve quality of care for patients in mental health and SUD treatment services.
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Affiliation(s)
- Trond Nordfjaern
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Trondheim, Norway.,Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Line Melby
- Department of Health Research, SINTEF Digital, Trondheim, Norway
| | - Jannike Kaasbøll
- Department of Health Research, SINTEF Digital, Trondheim, Norway.,Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Marian Ådnanes
- Department of Health Research, SINTEF Digital, Trondheim, Norway
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Al‐Shamaly HS. Patterns of communicating care and caring in the intensive care unit. Nurs Open 2022; 9:277-298. [PMID: 34536338 PMCID: PMC8685886 DOI: 10.1002/nop2.1061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/26/2021] [Accepted: 09/02/2021] [Indexed: 11/11/2022] Open
Abstract
AIM To explore the perceptions and experiences of nurses in communicating the care and caring in the intensive care unit (ICU). DESIGN A focused ethnography. METHODS This study was conducted in an Australian metropolitan hospital, in which data were gathered from multiple sources: participant observations, document reviews, interviews, and participant's additional written information - over six months (April-September, 2014). The data were analysed thematically. FINDINGS This study addressed inclusively communicating care and caring to patients, families, nurses and other health professionals in ICU. The findings identified main themes concerning the changing patterns of communicating the care and caring in ICU, various patterns of communication used, enablers and barriers of communicating care and caring, and significant issues in communicating care and caring in ICU. Documentation of patients' psychological and emotional needs, and nurses' caring behaviours are crucial. These findings need further consideration from all stakeholders.
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Ratanto, Hariyati RTS, Mediawati AS, Eryando T. Workload as the most Important Influencing Factor of Medication Errors by Nurses. Open Nurs J 2021. [DOI: 10.2174/1874434602115010204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
This research is motivated by the fact that medication errors are serious threats to the safety of patients in hospitals. Nurses are one of the health workers who play a significant role in preventing these errors.
Objective:
The aim of this quantitative research is to determine the factors that influence the incidence of medication errors by nurses.
Methods:
The adopted method had a correlative descriptive design and used samples obtained from 164 nurses through a purposive sampling technique. The sample inclusion criteria were the nurses who worked in patient’s rooms, those who were healthy and not sick, not currently in school, and were willing to be respondents. Furthermore, the research instruments were questionnaires, which were developed through the Cronbach's alpha validity and reliability test results of 0.681 and 0.873, respectively. Analysis was conducted using the independent t test, X2 (chi-square) and multiple logistic regressions.
Results:
The results showed that the factors which influenced the incidence of medication errors were work experience, motivation, workload, managerial and environmental elements. Moreover, the variable which contributed the most, with a p-value of 0.004 and OR of 5.387 was workload.
Conclusion:
Finally, the following factors, including nurse's workload, motivation, work experience, good managerial management and environmental elements, should be considered when preventing medication errors.
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Abstract
Rationale: Psychological safety is the condition by which members of an organization feel safe to voice concerns and take risks. Although psychological safety is an important determinant of team performance, little is known about its role in the intensive care unit (ICU). Objectives: To identify the factors associated with psychological safety and the potential influence of psychological safety on team performance in critical care. Methods: We performed daily surveys of healthcare providers in 12 ICUs within an integrated health system over a 2-week period. Survey domains included psychological safety, leader familiarity, leader inclusiveness, role clarity, job strain, and teamwork. These data were linked to daily performance on lung-protective ventilation and spontaneous breathing trials. We used regression models to examine the antecedents of psychological safety as well as the influence of psychological safety on both perceived teamwork and actual performance. Results: We received 553 responses from 270 unique providers. At the individual provider level, higher leader inclusiveness (adjusted β = 0.32; 95% confidence interval [CI], 0.24 to 0.41) and lower job strain (adjusted β = -0.07, 95% CI, -0.13 to -0.02) were independently associated with greater psychological safety. Higher psychological safety was independently associated with greater perception of teamwork (adjusted β = 0.30; 95% CI, 0.25 to 0.36). There was no association between team psychological safety and performance on either spontaneous breathing trials (incident rate ratio for each 1-unit change in team psychological safety, 0.85; 95% CI, 0.81 to 1.10) or lung-protective ventilation (incident rate ratio, 0.77; 95% CI, 0.57 to 1.04). Conclusions: Psychological safety is associated with several modifiable factors in the ICU but is not associated with actual use of evidence-based practices.
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Chaaban T, Hallal R, Carroll K, Rothan-Tondeur M. Cybernetic Communications: Focusing Interactions on Goal-Centered Care. Nurs Sci Q 2021; 34:30-32. [PMID: 33349185 DOI: 10.1177/0894318420965195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In nursing homes, due to time constraints, lack of communication can influence the quality of information exchanged, which influences the outcomes of healthcare for residents. Nurses' proximity to the nursing home resident, their knowledge, and skill serve as an opportunity to communicate and facilitate patient-centered goals and improve treatment decision-making. Concepts within the cybernetic communication literature entail systemic interactive relationships that enable the sharing of knowledge and expertise. These interactions are based on nursing's theoretical knowledge, clinical judgment, and empowerment and are based on patient-centered goals.
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Affiliation(s)
- Taghrid Chaaban
- University Sorbonne Paris Nord, Nursing Science Research Chair, Laboratory Education and Health Practices (LEPS), UFR SMBH, Bobigny, France.,Assistance Publique Hôspitaux de Paris (AP HP), Nursing Sciences Research Chair, Paris, France.,Faculty of Nursing Sciences, Islamic University of Lebanon, Beirut, Lebanon
| | - Rola Hallal
- Faculty of Nursing Sciences, Islamic University of Lebanon, Beirut, Lebanon
| | - Karen Carroll
- Director of Nursing Informatics & Innovation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Monique Rothan-Tondeur
- University Sorbonne Paris Nord, Nursing Science Research Chair, Laboratory Education and Health Practices (LEPS), UFR SMBH, Bobigny, France.,Assistance Publique Hôspitaux de Paris (AP HP), Nursing Sciences Research Chair, Paris, France
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15
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Kerari A, Innab A. The Influence of Nurses' Characteristics on Medication Administration Errors: An Integrative Review. SAGE Open Nurs 2021; 7:23779608211025802. [PMID: 34222653 PMCID: PMC8223601 DOI: 10.1177/23779608211025802] [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] [Received: 02/13/2021] [Accepted: 05/28/2021] [Indexed: 11/15/2022] Open
Abstract
Background Medication administration errors (MAEs) are a frequent cause of morbidity and mortality in acute care settings and can result in a prolonged hospital stay. The WHO estimated that medication errors cost up to $42 billion globally per a year. Therefore, MAEs was among the most common medical errors to occur in acute care settings. Studies of medication error usually focus on system factors, thus creating a gap between what researchers know about the causes of MAEs, and what frontline nurses actually do in the clinical setting. The purpose of this review is to fill a gap in the existing literature by focusing on the relationship between nurses' characteristics and MAEs. Methods Online databases were accessed, including CINAHL, PsycINFO, PubMed, Scopus, and Google Scholar from 2007-2020 period. This review was guided by the methods described by Whittemore and Knafl. Studies that addressed the occurrence of medication errors based on RN demographics were included in this review. The included studies were reviewed and analyzed by the two authors. Results Of the 1141 publications retrieved, 19 studies met inclusion criteria. The result provided strong evidence that nurses' level of education, length of experience, and attendance at training courses, are directly associated with the occurrence of MAEs. There is weak evidence of MAEs being influenced by the age and gender of nurses. Other nurse characteristics, such as cognitive load, frustration with technology, negligence, lack of attentiveness, and nurse ethnicity, are not adequately examined across the reviewed studies necessitates further research. Conclusion Focusing on nurses' characteristics might facilitate other researchers to suggest appropriate interventions that may reduce the incidence of MAEs. Interventional studies may provide convincing evidence as to whether one variable has a causal effect on another variable, and control the influence of confounding variables to enhance the generalizability of the findings.
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Affiliation(s)
- Ali Kerari
- Medical Surgical Department, School of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Adnan Innab
- Nursing Administration and Education Department, School of Nursing, King Saud University, Riyadh, Saudi Arabia
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16
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Kakemam E, Gharaee H, Rajabi MR, Nadernejad M, Khakdel Z, Raeissi P, Kalhor R. Nurses' perception of patient safety culture and its relationship with adverse events: a national questionnaire survey in Iran. BMC Nurs 2021; 20:60. [PMID: 33845822 PMCID: PMC8042945 DOI: 10.1186/s12912-021-00571-w] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 03/16/2021] [Indexed: 01/02/2023] Open
Abstract
Background Patient safety culture is an important factor in determining hospitals’ ability to address and reduce the occurrence of adverse events (AEs). However, few studies have reported on the impact of nurses’ perceptions of patient safety culture on the occurrence of AEs. Our study aimed to assess the association between nurses’ perception of patient safety culture and their perceived proportion of adverse events. Methods A cross-sectional survey was carried out among 2295 nurses employed in thirty-two teaching hospitals in Iran. Nurses completed the Persian version of the hospital survey of patients’ safety culture between October 2018 and September 2019. Results Positive Response Rates of overall patient safety culture was 34.1% and dimensions of patient safety culture varied from 20.9 to 43.8%. Also, nurses estimated that the occurrence of six adverse events varied from 51.2–63.0% in the past year. The higher nurses’ perceptions of “Staffing”, “Hospital handoffs and transitions”, “Frequency of event reporting”, “Non-punitive response to error”, “Supervisor expectation and actions promoting safety”, “Communication openness”, “Organizational learning continuous improvement”, “Teamwork within units”, and “Hospital management support patient safety” were significantly related to lower the perceived occurrence at least two out of six AEs (OR = 0.69 to 1.46). Conclusions Our findings demonstrated that nurses’ perception regarding patient safety culture was low and the perceived occurrence of adverse events was high. The research has also shown that the higher level of nurses’ perception of patient safety culture was associated with lowered occurrence of AEs. Hence, managers could provide prerequisites to improve patient safety culture and reduce adverse events through different strategies, such as encouraging adverse events’ reporting and holding training courses for nurses. However, further research is needed to assess how interventions addressing patient safety culture might reduce the occurrence of adverse events. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-021-00571-w.
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Affiliation(s)
- Edris Kakemam
- Department of Health Services Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hojatolah Gharaee
- District Health Center of Hamadan City, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Milad Nadernejad
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Khakdel
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.,Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Pouran Raeissi
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Rohollah Kalhor
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran. .,Health Services Management Department, School of Public Health, Qazvin University of Medical Sciences, Shahid Bahonar Blv, Qazvin, Iran.
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17
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Kerlin MP, Costa DK, Kahn JM. The Society of Critical Care Medicine at 50 Years: ICU Organization and Management. Crit Care Med 2021; 49:391-405. [PMID: 33555776 DOI: 10.1097/ccm.0000000000004830] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Meeta Prasad Kerlin
- Division of Pulmonary, Allergy, and Critical Care Medicine and Palliative and Advanced Illness Research Center, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Leonard Davis Institute, University of Pennsylvania, Philadelphia, PA
| | - Deena Kelly Costa
- Department of Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor, MI
- Institute for Healthcare Innovation & Policy, University of Michigan, Ann Arbor, MI
| | - Jeremy M Kahn
- Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
- Department of Health Policy & Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
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18
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Promes J, Barnason S. An Exploration of Factors Associated With Nurses' Perceptions of Decisional Involvement. J Nurs Adm 2021; 51:141-148. [PMID: 33570371 DOI: 10.1097/nna.0000000000000985] [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: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate nurses' perceptions of decisional involvement (DI). BACKGROUND Decisional involvement is a measure or gauge of nurses' perceived shared leadership. There has been limited research examining factors associated with actual and preferred DI. METHODS A descriptive, observational study design was used. A total of 189 RNs completed the Decisional Involvement Scale and Evidence-Based Practice Implementation Scale. Nurses' preferred DI (DI-P) and actual DI (DI-A) were analyzed, and DI total and subscale scores were compared based on nurses' demographic and clinical practice characteristics. RESULTS The DI-A and DI-P total scores were significantly different, including subscales for DI-A compared with DI-P score. Dissonance scores by subscale were highest for recruitment, governance, and support. Unit-based council (UBC) participants had significantly higher actual DI, compared with non-UBC participants. Nurses' perceptions of implementing evidence-based practice (EBP) was not significantly different by low versus high EBP implementation; nor were the scores significantly correlated with their DI-A or DI-P scores. CONCLUSIONS Findings indicate nurses' perceptions of DI-A and DI-P. This study provided further examination of the differences and interrelationships between DI and nurses' demographic and clinical practice characteristics. Dissonance DI scores provide opportunities for targeting interventions to engage nurses in shared leadership.
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Affiliation(s)
- Jennifer Promes
- Author Affiliations: Magnet Program Director (Ms Promes), Nurse Scientist (Dr Barnason), Nebraska Methodist Hospital, Omaha
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19
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Inter-Professional Collaboration and Patient Mortality: Protocol for a Systematic Review and Meta-Analysis. NURSING REPORTS 2020; 10:15-22. [PMID: 34968260 PMCID: PMC8608100 DOI: 10.3390/nursrep10010003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 11/17/2022] Open
Abstract
Inter-professional collaboration is a process in which health professionals from different disciplines work together, sharing their ideas and opinions to plan evidence-based care. Nurses and doctors spend most of their time providing direct patient care. Therefore, effective interprofessional collaboration may be important in ensuring safe and effective patient care. There are no systematic reviews that have evaluated the association between nurse–doctor collaboration and patient outcomes in medical and surgical settings. We will conduct a systematic search of five key databases MEDLINE, EMBASE, PsycInfo, CINAHL, and the Cochrane register. We will include observational and experimental research that tests the association between levels of inter-professional collaboration and medical and surgical inpatient mortality. Two reviewers will independently conduct title and abstract, full-text screening, and data extraction. The Effective Public Health Practice (EPHPP) tool will be used to determine the quality of the included studies. If sufficient studies are available, we will undertake a meta-analysis. The protocol is registered with the international prospective register of systematic reviews (PROSPERO-CRD42019133543).
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20
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Impact of hearing loss on clinical interactions between older adults and health professionals: a systematic review. Eur Geriatr Med 2020; 11:919-928. [DOI: 10.1007/s41999-020-00358-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
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21
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Cognitive aids with roles defined (CARD) for obstetrical crises: a multisite before-and-after cohort study. Can J Anaesth 2020; 67:970-980. [PMID: 32415478 DOI: 10.1007/s12630-020-01685-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 03/04/2020] [Accepted: 03/04/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE Patient outcome during an obstetrical emergency depends on prompt coordination of an interprofessional team. The cognitive aids with roles defined (CARD) is a cognitive aid that addresses the issue of teamwork in crisis management. This study evaluated the clinical impact of implementing the CARD cognitive aid during emergency Cesarean deliveries. METHODS We conducted a prospective before-and-after cohort trial at the maternity units of two Canadian academic hospital campuses. Both sites received didactic online training regarding teamwork during crises, which involved training on using CARD for the "CARD" campus (intervention) and no mention of CARD at the "no CARD" campus (control). The primary outcome was the total time to delivery after the call for an emergency Cesarean delivery. Secondary outcomes included specific intervals of time within the time to delivery and clinical outcomes for both the babies and mothers. RESULTS We analyzed data from 267 eligible emergency Cesarean deliveries that occurred between January 11 2014 and December 31 2017. The use of CARD did not significantly change the median [interquartile range] time to delivery of the baby during an emergency Cesarean delivery from the pre-intervention to the post-intervention time period (17 [12-28] vs 15 [13-20], respectively; median difference, 2; 95% confidence interval, -1 to 5; P = 0.36). The clinical outcomes for the baby or the mother and other secondary outcomes also did not change. CONCLUSIONS The CARD cognitive aid did not significantly improve time-based or clinical maternal and neonatal outcomes of emergency Cesarean delivery at our academic maternity unit.
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23
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Vicente V, Johansson A, Ivarsson B, Todorova L, Möller S. The Experience of Using Video Support in Ambulance Care: An Interview Study with Physicians in the Role of Regional Medical Support. Healthcare (Basel) 2020; 8:healthcare8020106. [PMID: 32340339 PMCID: PMC7349766 DOI: 10.3390/healthcare8020106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/19/2020] [Accepted: 04/21/2020] [Indexed: 11/24/2022] Open
Abstract
Background: In order to facilitate more effective patient assessment and diagnostic support by improving the flow of information between ambulance nurses (AN) and physicians in the role of regional medical support (RMS), an application was developed for transmitting real-time video images. Objective: The objective of this study was to elucidate the physicians’ experiences using a video application to support the assessment and triage procedure in ambulance care, when patients are deemed to not have an urgent need for emergency care. Design: The design for this research was a qualitative interview study. Ten physicians, working as RMS in ambulance care, were purposively selected to participate. The telemedicine concept studied consisted of a real-time video image application, in addition to the currently used mobile phone. When a patient was deemed eligible for inclusion in the study, the ambulance nurse (AN) contacted the RMS via telephone to initiate a video consultation. To elucidate the RMS experience of using the application, a conventional content analysis was performed. Results: The main theme “a feeling of being satisfied through a sense of increased patient safety” emerged from the following two categories: adds value in diagnosing situations (three subcategories, i.e., support in diagnosing, usability, and technical weakness) and increase communication opportunities (four subcategories, i.e., assessing the level of care, patient dialogue, professional communication, and team learning). Conclusions: Physicians in the role of RMS experienced a positive impact using video image transmission in addition to the currently used mobile phone. This evaluation was derived from a sense of increased patient safety in the assessment situation when patients were considered to be triaged to self-care.
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Affiliation(s)
- Veronica Vicente
- The ambulance medical service (AISAB), 12118 Stockholm, Sweden
- Academic EMS, 12118 Stockholm, Sweden
- Karolinska Institute, Department of Clinical Science and Education at Södersjukhuset, 11861 Stockholm, Sweden
- Correspondence:
| | - Anders Johansson
- Office of Medical Services; Region Skåne, 20525 Malmö, Sweden; (A.J.); (B.I.); (L.T.); (S.M.)
- Department of Clinical Science, Lund University, 22185 Region Skane, Sweden
| | - Bodil Ivarsson
- Office of Medical Services; Region Skåne, 20525 Malmö, Sweden; (A.J.); (B.I.); (L.T.); (S.M.)
- Department of Clinical Science, Lund University, 22185 Region Skane, Sweden
- Department of Cardiothoracic surgery, IKVL, Lund University, 22185 Lund, Sweden
| | - Lizbet Todorova
- Office of Medical Services; Region Skåne, 20525 Malmö, Sweden; (A.J.); (B.I.); (L.T.); (S.M.)
- Department of Clinical Science, Lund University, 22185 Region Skane, Sweden
| | - Sebastian Möller
- Office of Medical Services; Region Skåne, 20525 Malmö, Sweden; (A.J.); (B.I.); (L.T.); (S.M.)
- Department of Clinical Science, Lund University, 22185 Region Skane, Sweden
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24
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Studying the effect of a supportive communication techniques program on the quality gap among women who gave birth in local childbirth outposts, south-east Iran. J Public Health (Oxf) 2020. [DOI: 10.1007/s10389-019-01059-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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25
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Randmaa M, Engström M, Mårtensson G, Leo Swenne C, Högberg H. Psychometric properties of an instrument measuring communication within and between the professional groups licensed practical nurses and registered nurses in anaesthetic clinics. BMC Health Serv Res 2019; 19:950. [PMID: 31823775 PMCID: PMC6905046 DOI: 10.1186/s12913-019-4805-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 12/02/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The most common cause of clinical incidents and adverse events in relation to surgery is communication error. There is a shortage of studies on communication between registered nurses and licenced practical nurses as well as of instruments to measure their perception of communication within and between the professional groups. The aim of the present study was to evaluate the psychometric properties of the Swedish version of the adapted ICU Nurse-Physician Questionnaire, designed to also measure communication within and between two professional groups: licensed practical nurses and registered nurses. Specifically, the aim was to examine the instrument's construct validity using confirmatory factor analysis and its internal consistency using Cronbach's Alpha. METHODS A cross-sectional and correlational design was used. The setting was anaesthetic clinics in two Swedish hospitals. A total of 316 questionnaires were delivered during spring 2011, of which 195 were analysed to evaluate the psychometric properties of the questionnaire. Construct validity was assessed using confirmatory factor analysis and internal consistency using Cronbach's Alpha. To assess items with missing values, we conducted a sensitivity analysis of two sets of data, and to assess the assumption of normally distributed data, we used Bayesian estimation. RESULTS The results support the construct validity and internal consistency of the adapted ICU Nurse-Physician Questionnaire. Model fit indices for the confirmative factor analysis were acceptable, and estimated factor loadings were reasonable. There were no large differences between the estimated factor loadings when comparing the two samples, suggesting that items with missing values did not alter the findings. The estimated factor loadings from Bayesian estimation were very similar to the maximum likelihood results. This indicates that confirmative factor analysis using maximum likelihood produced reliable factor loadings. Regarding internal consistency, alpha values ranged from 0.72 to 0.82. CONCLUSIONS The tests of the adapted ICU Nurse-Physician Questionnaire indicate acceptable construct validity and internal consistency, both of which need to be further tested in new settings and samples. TRIAL REGISTRATION Current controlled trials http://www.controlled-trials.com Communication and patient safety in anaesthesia and intensive care. Does implementation of SBAR make any differences? Identifier: ISRCTN37251313, retrospectively registered (assigned 08/11/2012).
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Affiliation(s)
- Maria Randmaa
- Faculty of Health and Occupational Studies, University of Gävle, S-801 76 Gävle, Sweden
| | - Maria Engström
- Faculty of Health and Occupational Studies, University of Gävle, S-801 76 Gävle, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Nursing Department, Medicine and Health College, Lishui University, Lishui, China
| | - Gunilla Mårtensson
- Faculty of Health and Occupational Studies, University of Gävle, S-801 76 Gävle, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Christine Leo Swenne
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Hans Högberg
- Faculty of Health and Occupational Studies, University of Gävle, S-801 76 Gävle, Sweden
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Brofidi K, Vlasiadis K, Philalithis A. Greek hospital environments. Int J Health Care Qual Assur 2019; 32:645-652. [PMID: 31018792 DOI: 10.1108/ijhcqa-05-2018-0102] [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: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is three-fold: first, to assess nurse satisfaction levels with working environment (known as favourability) in five Greek public hospitals using the practice environment scale (PES); second, to compare perceptions among nurses employed in surgical and medical departments; and third, to examine relationships between perceptions and nurse educational level and experience. DESIGN/METHODOLOGY/APPROACH In total, 532 nurses from five major public hospitals in Greece completed the PES. Descriptive statistics, t-tests and Spearman correlations were employed to analyse the data. FINDINGS Nurses perceived their work settings as unfavourable in all five hospitals, with collegial nurse-physician relations emerging as the only positive factor. Compared to medical wards, surgical departments emerged as slightly more positive working environments. Work department notwithstanding, in some cases, education and experience levels affected their perceptions on management, poor care quality, limited nurse involvement in hospital affairs and nursing shortage. PRACTICAL IMPLICATIONS Hospital managers do not provide sufficient support for Greek nurses in their working environments. ORIGINALITY/VALUE The authors attempted to evaluate nursing practice environments in Greek hospitals, viewed from nurse perspectives. The authors identified insufficient support for nurses' working in these hospitals.
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Mahboube L, Talebi E, Porouhan P, Orak RJ, Farahani MA. Comparing the attitude of doctors and nurses toward factor of collaborative relationships. J Family Med Prim Care 2019; 8:3263-3267. [PMID: 31742153 PMCID: PMC6857374 DOI: 10.4103/jfmpc.jfmpc_596_19] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/21/2019] [Accepted: 09/08/2019] [Indexed: 11/12/2022] Open
Abstract
Background and Objectives: Effective relationship and collaboration between doctors and nurses is considered the main factor in achieving positive medical results, which is the most important goal of the healthcare system. This study aims to compare attitude of doctors and nurses toward factors associated with doctor-nurse collaboration, including shared education and teamwork, caring as opposed to curing, physician's dominance, and nurses’ autonomy. Methods: In this cross sectional, descriptive-comparative study, the Jefferson Scale of Attitudes toward Physician-Nurse Collaboration was used to assess doctor–nurse collaboration in four domains, including shared education and teamwork, caring as opposed to curing, physician's dominance, and nurses’ autonomy. To this end, descriptive (mean, standard deviation) and inferential statistics including independent t test, Chi-square, and variance analysis were used. Results: According to the results obtained, compared to doctors, nurses showed a more positive attitude toward shared education and teamwork, caring as opposed to curing, and physicians’ dominance, but there was no significant difference between the two groups in nurses’ autonomy. Conclusion: With regard to doctor-nurse collaboration, it is essential that doctors and nurses be acculturated in the course of their academic education. Moreover, policies to change pattern of professional relationships from hierarchical to complementary can be effective in enhancing professional autonomy of nurses and reducing impaired professional interactions.
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Affiliation(s)
- Lari Mahboube
- Department of Nursing, College of Nursing and Midwifery, Karaj Branch Islamic Azad University, Karaj, Iran.,Clinical Cares and Health Promotion Research Center, Karaj Branch, Islamic Azad University, Karaj, Iran
| | - Elnaz Talebi
- Master of Science in Geriatric Nursing, Bahrami Children Hospital, Sabzevar, Iran
| | - Pejman Porouhan
- Department of Radiation Oncology, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Rohangiz J Orak
- Department of Statistics and Mathematics, School of Health Management and Information Sciences, International Campus Tehran University of Medical Sciences, Tehran, Iran
| | - Mansoure A Farahani
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences International Campus, Tehran, Iran
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Teague P, Kraeuter S, York S, Scott W, Furqan MM, Zakaria S. The Role of the Chaplain as a Patient Navigator and Advocate for Patients in the Intensive Care Unit: One Academic Medical Center's Experience. JOURNAL OF RELIGION AND HEALTH 2019; 58:1833-1846. [PMID: 31230162 PMCID: PMC6759628 DOI: 10.1007/s10943-019-00865-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Effective communication between intensive care unit (ICU) staff, and patients and their families, can help increase understanding, trust, and goals-of-care decisions. Many strategies focus on enhancing communication by increasing family meetings or adding patient navigators. In our ICU, we implemented both strategies, uniquely appointing a chaplain for the patient navigator role. We then surveyed ICU staff on their perceptions of the chaplain/patient navigator, which yielded several valuable insights. Although all staff supported a strong chaplaincy presence, many had concerns about the dual chaplain/patient navigator role. Based on our mixed results, we encourage further exploration to optimize the chaplain role in the ICU.
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Affiliation(s)
- Paula Teague
- Department of Spiritual Care and Chaplaincy, Johns Hopkins University, Baltimore, MD, USA.
- Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Baltimore, MD, 21224, USA.
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Susan Kraeuter
- Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Baltimore, MD, 21224, USA
| | - Sarah York
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Wayman Scott
- Department of Pastoral Counseling, Loyola University Maryland, Baltimore, MD, USA
| | - Muhammad M Furqan
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sammy Zakaria
- Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Baltimore, MD, 21224, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Torabizadeh C, Bahmani T, Molazem Z, Moayedi SA. Development and Psychometric Evaluation of a Professional Communication Questionnaire for the Operating Room. HEALTH COMMUNICATION 2019; 34:1313-1319. [PMID: 29902060 DOI: 10.1080/10410236.2018.1484268] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Effective communications play a significant role in environments where health care is provided. A review of the available literature did not yield a valid scale for evaluation of operating room nurse-doctor communication. Accordingly, the present study is an attempt at development and psychometric evaluation of a professional communication questionnaire for the operating room. The present study is a methodological work conducted in two steps. In the first stage of the study, 56 items on a 5-point Likert scale were developed according to the results of a review of relevant literature and several meetings with experts. Next, following a qualitative and quantitative evaluation of the face and content validity of the questionnaire, 41 items remained. An assessment of the construct validity of the questionnaire using factor analysis yielded six factors. In this stage, 410 operating room nurses and doctors who were randomly selected from six hospitals affiliated with the university participated. Cronbach's alpha for the internal homogeneity of the instrument was found to be .88; the results of the test-retest showed its consistency to be .91. The findings show that the developed instrument has enough validity and reliability to be used to evaluate professional communication in operating rooms.
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Affiliation(s)
| | - Tayebeh Bahmani
- Student Research Committee, Shiraz University of Medical Sciences
| | - Zahra Molazem
- Department of Nursing, Shiraz University of Medical Sciences
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Schmutz JB, Meier LL, Manser T. How effective is teamwork really? The relationship between teamwork and performance in healthcare teams: a systematic review and meta-analysis. BMJ Open 2019; 9:e028280. [PMID: 31515415 PMCID: PMC6747874 DOI: 10.1136/bmjopen-2018-028280] [Citation(s) in RCA: 152] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES To investigate the relationship between teamwork and clinical performance and potential moderating variables of this relationship. DESIGN Systematic review and meta-analysis. DATA SOURCE PubMed was searched in June 2018 without a limit on the date of publication. Additional literature was selected through a manual backward search of relevant reviews, manual backward and forward search of studies included in the meta-analysis and contacting of selected authors via email. ELIGIBILITY CRITERIA Studies were included if they reported a relationship between a teamwork process (eg, coordination, non-technical skills) and a performance measure (eg, checklist based expert rating, errors) in an acute care setting. DATA EXTRACTION AND SYNTHESIS Moderator variables (ie, professional composition, team familiarity, average team size, task type, patient realism and type of performance measure) were coded and random-effect models were estimated. Two investigators independently extracted information on study characteristics in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS The review identified 2002 articles of which 31 were included in the meta-analysis comprising 1390 teams. The sample-sized weighted mean correlation was r=0.28 (corresponding to an OR of 2.8), indicating that teamwork is positively related to performance. The test of moderators was not significant, suggesting that the examined factors did not influence the average effect of teamwork on performance. CONCLUSION Teamwork has a medium-sized effect on performance. The analysis of moderators illustrated that teamwork relates to performance regardless of characteristics of the team or task. Therefore, healthcare organisations should recognise the value of teamwork and emphasise approaches that maintain and improve teamwork for the benefit of their patients.
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Affiliation(s)
- Jan B Schmutz
- Department of Communication Studies, Northwestern University, Evanston, Illinois, USA
| | - Laurenz L Meier
- Department of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Switzerland
| | - Tanja Manser
- FHNW School of Applied Psychology, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
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O'Connor P, Lydon S, Mongan O, Connolly F, Mcloughlin A, McVicker L, Byrne D. A mixed-methods examination of the nature and frequency of medical error among junior doctors. Postgrad Med J 2019; 95:583-589. [PMID: 31341038 DOI: 10.1136/postgradmedj-2018-135897] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 02/11/2019] [Accepted: 07/09/2019] [Indexed: 11/04/2022]
Abstract
PURPOSE OF THE STUDY To examine junior doctors' experience and perceptions of medical errors in which they had been involved. STUDY DESIGN A mixed-methods design, consisting of an error survey and critical incident technique (CIT) interviews, was used. The survey asked doctors in the first year of postgraduate training in Ireland whether they had made a medical error that had 'played on (their) mind', and if so, to identify factors that had contributed to the error. The participants in the CIT interviews were asked to describe a medical error in which they had been involved. RESULTS A total of 201 out of 332 (60.5%) respondents to the survey reported making an error that 'played on their mind'. 'Individual factors' were the most commonly identified group of factors (188/201; 93.5%), with 'high workload' (145/201; 72.1%) the most commonly identified contributory factor. Of the 28 CIT interviews which met the criteria for analysis, 'situational factors' (team, staff, task characteristics, and service user factors) were the most commonly identified group of contributory factors (24/28; 85.7%). A total of eight of the interviews were judged by subject matter experts (n=8) to be of medium risk to patients, and 20 to be of high-risk to patients. A significantly larger proportion of high-risk scenarios were attributed to 'local working conditions' than the medium-risk scenarios. CONCLUSIONS There is a need to prepare junior doctors to manage, and cope with, medical error and to ensure that healthcare professionals are adequately supported throughout their careers.
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Affiliation(s)
- Paul O'Connor
- Department of General Practice, National University of Ireland Galway, Galway, Ireland
| | - Sinéad Lydon
- School of Medicine, National University of Ireland Galway, Galway, Ireland.,Irish Centre for Applied Patient Safety and Simulation, National University of Ireland Galway, Galway, Ireland
| | - Orla Mongan
- School of Medicine, National University of Ireland Galway, Galway, Ireland.,Irish Centre for Applied Patient Safety and Simulation, National University of Ireland Galway, Galway, Ireland
| | - Fergal Connolly
- Department of Health Systems, University College Dublin, Dublin, Ireland
| | | | - Lyle McVicker
- Medicine, Galway University Hospital, Galway, Ireland
| | - Dara Byrne
- School of Medicine, National University of Ireland Galway, Galway, Ireland.,Irish Centre for Applied Patient Safety and Simulation, National University of Ireland Galway, Galway, Ireland
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O’Donovan R, Ward M, De Brún A, McAuliffe E. Safety culture in health care teams: A narrative review of the literature. J Nurs Manag 2019; 27:871-883. [DOI: 10.1111/jonm.12740] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 11/30/2018] [Accepted: 12/09/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Roisin O’Donovan
- School of Nursing, Midwifery & Health Systems, Health Sciences Centre University College Dublin Dublin Ireland
| | - Marie Ward
- School of Nursing, Midwifery & Health Systems, Health Sciences Centre University College Dublin Dublin Ireland
| | - Aoife De Brún
- School of Nursing, Midwifery & Health Systems, Health Sciences Centre University College Dublin Dublin Ireland
| | - Eilish McAuliffe
- School of Nursing, Midwifery & Health Systems, Health Sciences Centre University College Dublin Dublin Ireland
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Zangaro GA, Jones K. Practice Environment Scale of the Nursing Work Index: A Reliability Generalization Meta-Analysis. West J Nurs Res 2019; 41:1658-1684. [DOI: 10.1177/0193945918823779] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A healthy work environment is a critical factor in nurse satisfaction, retention, and patient outcomes. The Practice Environment Scale of the Nursing Work Index (PES-NWI) is the most commonly used instrument to measure the nursing practice environment. This study uses meta-analysis to examine the reliability generalization of the PES-NWI. A meta-analysis of 51 studies representing a total of 80,563 subjects was conducted. The mean score reliability for the PES-NWI based on 38 studies ( n = 68,278) was .922 ( p < .05). The Mean Weighted Effect Size was stronger for studies conducted in the United States versus non-U.S. (.946 vs. .907). For studies rated high and moderate quality, the mean score reliability was .911 and .946, respectively. Scores on the PES-NWI are reliable for measuring the nursing practice environment across samples in the United States and non-U.S. countries.
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Affiliation(s)
| | - Kimmith Jones
- University of Maryland Medical Center, Baltimore, MD, USA
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Benham-Hutchins M, Carley KM, Brewer BB, Effken JA, Reminga J. Nursing Unit Communication During a US Public Health Emergency: Natural Experiment. JMIR Nurs 2018; 1:e11425. [PMID: 34345768 PMCID: PMC8279445 DOI: 10.2196/11425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 10/15/2018] [Accepted: 10/16/2018] [Indexed: 11/13/2022] Open
Abstract
Background In the second half of 2014, the first case of Ebola virus disease (EVD) was diagnosed in the United States. During this time period, we were collecting data for the Measuring Network Stability and Fit (NetFIT) longitudinal study, which used social network analysis (SNA) to study relationships between nursing staff communication patterns and patient outcomes. One of the data collection sites was a few blocks away from where the initial EVD diagnosis was made. The EVD public health emergency during the NetFIT data collection time period resulted in the occurrence of a natural experiment. Objective The objectives of the NetFIT study were to examine the structure of nursing unit decision-making and information-sharing networks, identify a parsimonious set of network metrics that can be used to measure the longitudinal stability of these networks, examine the relationship between the contextual features of a unit and network metrics, and identify relationships between key network measures and nursing-sensitive patient-safety and quality outcomes. This paper reports on unit communication and outcome changes that occurred during the EVD natural disaster time period on the 10 hospital units that had data collected before, during, and after the crisis period. Methods For the NetFIT study, data were collected from nursing staff working on 25 patient care units, in three hospitals, and at four data collection points over a 7-month period: Baseline, Month 1, Month 4, and Month 7. Data collection was staggered by hospital and unit. To evaluate the influence of this public health emergency on nursing unit outcomes and communication characteristics, this paper focuses on a subsample of 10 units from two hospitals where data were collected before, during, and after the EVD crisis period. No data were collected from Hospital B during the crisis period. Network data from individual staff were aggregated to the nursing unit level to create 24-hour networks and three unit-level safety outcome measures-fall rate, medication errors, and hospital-acquired pressure ulcers-were collected. Results This analysis includes 40 data collection points and 608 staff members who completed questionnaires. Participants (N=608) included registered nurses (431, 70.9%), licensed vocational nurses (3, 0.5%), patient care technicians (133, 21.9%), unit clerks (28, 4.6%), and monitor watchers (13, 2.1%). Changes in SNA metrics associated with communication (ie, average distance, diffusion, and density) were noted in units that had changes in patient safety outcome measures. Conclusions Units in the hospital site in the same city as the EVD case exhibited multiple changes in patient outcomes, network communication metrics, and response rates. Future research using SNA to examine the influence of public health emergencies on hospital communication networks and relationships to patient outcomes is warranted.
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Affiliation(s)
- Marge Benham-Hutchins
- School of Nursing University of Texas at Austin Austin, TX United States.,Center for Health Communication Moody College of Communication and Dell Medical School University of Texas at Austin Austin, TX United States
| | - Kathleen M Carley
- Institute for Software Research School of Computer Science Carnegie Mellon University Pittsburgh, PA United States
| | - Barbara B Brewer
- College of Nursing The University of Arizona Tucson, AZ United States
| | - Judith A Effken
- College of Nursing The University of Arizona Tucson, AZ United States
| | - Jeffrey Reminga
- Institute for Software Research School of Computer Science Carnegie Mellon University Pittsburgh, PA United States
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Wilkinson A, Muurlink O, Awan N, Townsend K. HRM and the health of hospitals. Health Serv Manage Res 2018; 32:89-102. [DOI: 10.1177/0951484818805369] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
While there is a plethora of research on people management and high-commitment management, most are focused on commercial enterprises. Even the high-commitment management literature on commercial organisations argues that we need to move beyond the confines of financial performance. There are relatively few studies of high-commitment management which focus on hospitals. This is despite the fact that human resources are a major cost and source of performance leverage in hospitals.
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Affiliation(s)
- Adrian Wilkinson
- Griffith University, Griffith Business School, Nathan, Queensland, Australia
| | - Olav Muurlink
- Central Queensland University Brisbane Campus, Brisbane, Queensland Australia
| | - Nabil Awan
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Keith Townsend
- Griffith University, Griffith Business School, Nathan, Queensland, Australia
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Brewer BB, Carley KM, Benham-Hutchins MM, Effken JA, Reminga J, Kowalchuck M. Relationship of Staff Information Sharing and Advice Networks to Patient Safety Outcomes. J Nurs Adm 2018; 48:437-444. [PMID: 30095687 PMCID: PMC6105471 DOI: 10.1097/nna.0000000000000646] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to compare information sharing and advice networks' relationships with patient safety outcomes. BACKGROUND Communication contributes to medical errors, but rarely is it clear what elements of communication are key. METHODS We investigated relationships of information-sharing and advice networks to patient safety outcomes in 24 patient care units from 3 hospitals over 7 months. Web-based questionnaires completed via Android tablets provided data to create 2 networks using ORA, a social network analysis application. Each hospital provided nurse-sensitive patient safety outcomes. RESULTS In both networks, medication errors correlated positively with node count and average distance and negatively with clustering coefficient. Density and weighted density negatively correlated with medication errors and falls in both networks. Eigenvector and total degree centrality correlated negatively with both safety outcomes, whereas betweenness centrality positively related to falls in the information-sharing network. CONCLUSION Technology-enabled social network analysis data collection is feasible and can provide managers actionable system-level information.
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Affiliation(s)
- Barbara B Brewer
- Author Affiliations: Associate Professor (Dr Brewer) and Professor Emeritus (Dr Effken), College of Nursing, The University of Arizona, Tucson; Professor (Dr Carley) and Senior Research Programmer (Mr Reminga and Mr Kowalchuck), Carnegie Mellon School of Computer Science, Carnegie Mellon University, Pittsburgh, Pennsylvania; and Assistant Professor (Dr Benham-Hutchins), School of Nursing, The University of Texas at Austin
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Leyenaar JK, Andrews CB, Tyksinski ER, Biondi E, Parikh K, Ralston S. Facilitators of interdepartmental quality improvement: a mixed-methods analysis of a collaborative to improve pediatric community-acquired pneumonia management. BMJ Qual Saf 2018; 28:215-222. [PMID: 30100566 DOI: 10.1136/bmjqs-2018-008065] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 06/22/2018] [Accepted: 07/22/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Emergency medicine and paediatric hospital medicine physicians each provide a portion of the initial clinical care for the majority of hospitalised children in the USA. While these disciplines share goals to increase quality of care, there are scant data describing their collaboration. Our national, multihospital learning collaborative, which aimed to increase narrow-spectrum antibiotic prescribing for paediatric community-acquired pneumonia, provided an opportunity to examine factors influencing the success of quality improvement efforts across these two clinical departments. OBJECTIVE To identify barriers to and facilitators of interdepartmental quality improvement implementation, with a particular focus on increasing narrow-spectrum antibiotic use in the emergency department and inpatient settings for children hospitalised with pneumonia. METHODS We used a mixed-methods design, analysing interviews, written reports and quality measures. To describe hospital characteristics and quality measures, we calculated medians/IQRs for continuous variables, frequencies for categorical variables and Pearson correlation coefficients. We conducted in-depth, semistructured interviews by phone with collaborative site leaders; interviews were transcribed verbatim and, with progress reports, analysed using a general inductive approach. RESULTS 47 US-based hospitals were included in this analysis. Qualitative analysis of 35 interview transcripts and 142 written reports yielded eight inter-related domains that facilitated successful interdepartmental quality improvement: (1) hospital leadership and support, (2) quality improvement champions, (3) evidence supporting the intervention, (4) national health system influences, (5) collaborative culture, (6) departments' structure and resources, (7) quality improvement implementation strategies and (8) interdepartmental relationships. CONCLUSIONS The conceptual framework presented here may be used to identify hospitals' strengths and potential barriers to successful implementation of quality improvement efforts across clinical departments.
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Affiliation(s)
- JoAnna K Leyenaar
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Christine B Andrews
- Department of Pediatrics, Hasbro Children's Hospital, Providence, Rhode Island, USA
| | - Emily R Tyksinski
- Department of Nursing, Connecticut Children's Medical Center, Hartford, Connecticut, USA
| | - Eric Biondi
- Department of Pediatrics, Johns Hopkins Children's Center, Baltimore, Maryland, USA
| | - Kavita Parikh
- Division of Hospitalist Medicine, Children's National Health System, Washington, District of Columbia, USA
| | - Shawn Ralston
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
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Al-Hamdan Z, Banerjee T, Manojlovich M. Communication With Physicians as a Mediator in the Relationship Between the Nursing Work Environment and Select Nurse Outcomes in Jordan. J Nurs Scholarsh 2018; 50:714-721. [PMID: 30043513 DOI: 10.1111/jnu.12417] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To test whether communication mediated relationships among nurses' work environments and nurse outcomes of job satisfaction and intent to stay. DESIGN This study used a cross-sectional, quantitative survey design to query 650 nurses who worked in three hospitals in Jordan. METHODS We used Arabic versions of valid, reliable instruments measuring the nursing work environment, nurse perceptions of communication with physicians, intent to stay, and job satisfaction. Mediation analysis was used to test hypotheses. FINDINGS A total of 582 questionnaires were returned (89.5% response rate). Nurse perceptions of communication with physicians mediated the relationship between the nursing work environment and job satisfaction in medical, surgical, and critical care units. Nurse perceptions of communication with physicians mediated the relationship between the nursing work environment and intent to stay in all but maternity and "other" units. CONCLUSIONS Depending on the nurse outcome, communication was a significant mediator for various unit types. These results may be related to the type of work that is done in each unit and the influence of patient care. Communication is one of many mechanisms that can specify how a positive nursing work environment can contribute to nurses' job satisfaction and intent to stay. CLINICAL RELEVANCE A potential solution to the nursing shortage in Jordan emerges by identifying communication with physicians as a mediator in the relationship between the work environment and selected nurse outcomes.
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Affiliation(s)
- Zaid Al-Hamdan
- Jordan University of Science and Technology, Faculty of Nursing, Irbid, Jordan
| | - Tanima Banerjee
- University of Michigan, Institute of Healthcare Policy and Innovation Ann Arbor, MI, USA
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Wei H, Sewell KA, Woody G, Rose MA. The state of the science of nurse work environments in the United States: A systematic review. Int J Nurs Sci 2018; 5:287-300. [PMID: 31406839 PMCID: PMC6626229 DOI: 10.1016/j.ijnss.2018.04.010] [Citation(s) in RCA: 151] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 03/09/2018] [Accepted: 04/11/2018] [Indexed: 11/30/2022] Open
Abstract
A healthy nurse work environment is a workplace that is safe, empowering, and satisfying. Many research studies were conducted on nurse work environments in the last decade; however, it lacks an overview of these research studies. The purpose of this review is to identify, evaluate, and summarize the major foci of studies about nurse work environments in the United States published between January 2005 and December 2017 and provide strategies to improve nurse work environments. Databases searched included MEDLINE via PubMed, CINAHL, PsycINFO, Nursing and Allied Health, and the Cochrane Library. The literature search followed the PRISMA guideline. Fifty-four articles were reviewed. Five major themes emerged: 1) Impacts of healthy work environments on nurses' outcomes such as psychological health, emotional strains, job satisfaction, and retention; 2) Associations between healthy work environments and nurse interpersonal relationships at workplaces, job performance, and productivity; 3) Effects of healthy work environments on patient care quality; 4) Influences of healthy work environments on hospital accidental safety; and 5) Relationships between nurse leadership and healthy work environments. This review shows that nurses, as frontline patient care providers, are the foundation for patient safety and care quality. Promoting nurse empowerment, engagement, and interpersonal relationships at work is rudimental to achieve a healthy work environment and quality patient care. Healthier work environments lead to more satisfied nurses who will result in better job performance and higher quality of patient care, which will subsequently improve healthcare organizations' financial viability. Fostering a healthy work environment is a continuous effort.
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Affiliation(s)
- Holly Wei
- East Carolina University College of Nursing, Greenville, NC, USA
| | - Kerry A. Sewell
- Laupus Library, East Carolina University, Greenville, NC, USA
| | - Gina Woody
- East Carolina University College of Nursing, Greenville, NC, USA
| | - Mary Ann Rose
- East Carolina University College of Nursing, Greenville, NC, USA
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Blake N, Collins M. Importance of Healthy Work Environment Education in Nursing Schools. AACN Adv Crit Care 2018; 28:289-290. [PMID: 28847864 DOI: 10.4037/aacnacc2017511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Nancy Blake
- Nancy Blake is Director, Critical Care Services, Children's Hospital Los Angeles, 24719 Garland Dr, Valencia, CA 91355 . Mara Collins is Neonatal Intensive Care Unit Manager, Providence Holy Cross Medical Center, Mission Hills, California
| | - Mara Collins
- Nancy Blake is Director, Critical Care Services, Children's Hospital Los Angeles, 24719 Garland Dr, Valencia, CA 91355 . Mara Collins is Neonatal Intensive Care Unit Manager, Providence Holy Cross Medical Center, Mission Hills, California
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Welp A, Johnson A, Nguyen H, Perry L. The importance of reflecting on practice: How personal professional development activities affect perceived teamwork and performance. J Clin Nurs 2018; 27:3988-3999. [PMID: 29775493 DOI: 10.1111/jocn.14519] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 03/06/2018] [Accepted: 05/07/2018] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To examine the relationships between participation in personal professional development activities (e.g., coaching, mentoring), teamwork and performance; to investigate the mediating and moderating effects of reflective thinking and perceived usefulness of development activities. BACKGROUND Professional development is associated with better performance and attitudes towards one's work. This study adds to this research by focusing on understanding this effect and the conditions under which this occurs. DESIGN Cross-sectional survey study. METHODS Participants were 244 nurses working in a large, metropolitan acute public hospital. They completed a questionnaire consisting of validated measures and provided information on frequency of participation and perceived usefulness of personal professional development activities. We analysed data using regression-based moderated mediation analyses. RESULTS The relationship between frequency of participation in personal professional development activities and both perceived teamwork and performance was mediated by reflective thinking. Perceived usefulness of development activities moderated the relationship between frequency of participation in personal professional development activities and reflective thinking. CONCLUSION Our results highlight the importance of professional development activities that go beyond knowledge- or skill-based training. Activities that cater to nurses' personal professional development needs are also associated with more positively perceived teamwork and performance. Results provide insights into the mediating mechanisms: Participation in personal professional development activities encouraged reflective thinking, which was associated with better perceived teamwork and performance. This association between personal professional development activities and reflective thinking was even stronger where nurses perceived the activities as useful. RELEVANCE TO CLINICAL PRACTICE Personal professional development activities enhance reflection in and on practice as these activities were linked with higher perceived quality of care and teamworking. It is important to ensure that the positive effects of personal professional development activities should target nurses' professional development needs and need to be perceived as useful by those who undertake them.
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Affiliation(s)
- Annalena Welp
- Work and Organisational Studies, University of Sydney Business School, Sydney, New South Wales, Australia
| | - Anya Johnson
- Work and Organisational Studies, University of Sydney Business School, Sydney, New South Wales, Australia
| | - Helena Nguyen
- Work and Organisational Studies, University of Sydney Business School, Sydney, New South Wales, Australia
| | - Lin Perry
- South Eastern Sydney Local Health District and Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Simulation of patient flow in multiple healthcare units using process and data mining techniques for model identification. J Biomed Inform 2018; 82:128-142. [PMID: 29753874 DOI: 10.1016/j.jbi.2018.05.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 04/05/2018] [Accepted: 05/09/2018] [Indexed: 01/02/2023]
Abstract
INTRODUCTION An approach to building a hybrid simulation of patient flow is introduced with a combination of data-driven methods for automation of model identification. The approach is described with a conceptual framework and basic methods for combination of different techniques. The implementation of the proposed approach for simulation of the acute coronary syndrome (ACS) was developed and used in an experimental study. METHODS A combination of data, text, process mining techniques, and machine learning approaches for the analysis of electronic health records (EHRs) with discrete-event simulation (DES) and queueing theory for the simulation of patient flow was proposed. The performed analysis of EHRs for ACS patients enabled identification of several classes of clinical pathways (CPs) which were used to implement a more realistic simulation of the patient flow. The developed solution was implemented using Python libraries (SimPy, SciPy, and others). RESULTS The proposed approach enables more a realistic and detailed simulation of the patient flow within a group of related departments. An experimental study shows an improved simulation of patient length of stay for ACS patient flow obtained from EHRs in Almazov National Medical Research Centre in Saint Petersburg, Russia. CONCLUSION The proposed approach, methods, and solutions provide a conceptual, methodological, and programming framework for the implementation of a simulation of complex and diverse scenarios within a flow of patients for different purposes: decision making, training, management optimization, and others.
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Krueger L, Ernstmeyer K, Kirking E. Impact of Interprofessional Simulation on Nursing Students' Attitudes Toward Teamwork and Collaboration. J Nurs Educ 2018; 56:321-327. [PMID: 28585979 DOI: 10.3928/01484834-20170518-02] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 01/19/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND The purpose of this study was to examine the influence of a multipatient, interprofessional simulation session on nursing students' attitudes toward nurse-physician collaboration using the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration. METHOD Final-semester nursing students, along with medical resident and students from other health programs, participated in a simulation exercise that included a period of prebriefing, simulation, and debriefing. Participants completed pre- and postsimulation surveys to assess the impact on collaboration. RESULTS In total, 268 nursing students completed the survey. Participants had a more positive attitude toward nurse-physician collaboration following the simulation event, compared with prior to it. Significant differences between male and female nursing students were found on mean postsimulation scores and for three of the four subscales of the tool. CONCLUSION Interprofessional simulation may be an effective way to enhance collaborative relationships, which ultimately may influence patient safety and quality of care. [J Nurs Educ. 2017;56(6):321-327.].
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Cubaka VK, Schriver M, Cotton P, Nyirazinyoye L, Kallestrup P. Providers' perceptions of communication with patients in primary healthcare in Rwanda. PLoS One 2018; 13:e0195269. [PMID: 29617429 PMCID: PMC5884556 DOI: 10.1371/journal.pone.0195269] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 03/19/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Delivery of effective healthcare is contingent on the quality of communication between the patient and the healthcare provider. Little is known about primary healthcare providers' perceptions of communication with patients in Rwanda. AIM To explore providers' perceptions of patient-provider communication (PPC) and analyse the ways in which providers present and reflect on communication practice and problems. METHODS Qualitative, in-depth, semi structured interviews with nine primary health care providers. An abductive analysis supplemented by the framework method was applied. A narrative approach allowed the emergence of archetypical narratives on PPC. RESULTS Providers shared rich reflections on the importance of proper communication with patients and appeared committed to making their interaction work optimally. Still, providers had difficulty critically analysing limitations of their communication in practice. Reported communication issues included lack of communication training as well as time and workload issues. Two archetypes of narratives on PPC issues and practice emerged and are discussed. CONCLUSION While providers' narratives put patients at the centre of care, there were indications that patient-provider communication training and practice need further development. In-depth exploration of highlighted issues and adapted strategies to tackle communication drawbacks are prerequisites to improvement. This study contributes to the advancement of knowledge related to communication between the patient and the provider in a resource-limited setting.
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Affiliation(s)
- Vincent Kalumire Cubaka
- School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda
- Centre for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Michael Schriver
- Centre for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Philip Cotton
- School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda
| | | | - Per Kallestrup
- Centre for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
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An Evaluation of Shared Mental Models and Mutual Trust on General Medical Units: Implications for Collaboration, Teamwork, and Patient Safety. J Patient Saf 2018; 13:237-242. [PMID: 25706910 DOI: 10.1097/pts.0000000000000151] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study examines nurse-physician teamwork and collaboration, a critical component in the delivery of safe patient care, on general medical units. To that end, we assess shared mental models and mutual trust, 2 coordinating mechanisms that help facilitate teamwork, among nurses and physicians working on general medical units. METHODS Data were collected from 37 nurses and 42 physicians at an urban teaching medical center in the Northeastern United States. Shared mental model questionnaire items were iteratively developed with experts' input to ensure content validity. Mutual trust items were adapted from an existing scale; items were reliable. Data were analyzed using χ and independent 2-tailed t tests. RESULTS Physicians and nurses reported significant differences in their perceptions of the professional responsible for a variety of roles (e.g., advocating for the patient [P = 0.0007], identifying a near miss/error [P = 0.003]). Medication reconciliation is only role for which nurses perceive less responsibility than physicians perceive nurses have. Regarding mutual trust, both groups reported significantly more trust within their own professions; both groups reported similar levels of trust in physicians, with physicians reporting significantly less trust in their nursing colleagues than nurses perceive (P < 0.0001). CONCLUSIONS Although many efforts have been directed at improving nurse-physician collaboration, more work is needed. To that end, we propose increasing knowledge about their respective roles, providing opportunities for nurse and physician collaboration through rounding or committee work and enhancing the preparedness and professionalism of interactions.
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Matthys E, Remmen R, Van Bogaert P. An overview of systematic reviews on the collaboration between physicians and nurses and the impact on patient outcomes: what can we learn in primary care? BMC FAMILY PRACTICE 2017; 18:110. [PMID: 29273023 PMCID: PMC5741858 DOI: 10.1186/s12875-017-0698-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 12/12/2017] [Indexed: 01/08/2023]
Abstract
Background Primary care needs to be strengthened in order to address the many societal challenges. Group practices in primary care foster collaboration with other health care providers, which encourages care co-ordination and leads to a higher quality of primary care. Nursing roles and responsibilities expanded over time and nurses have been found to often provide equal high-quality chronic patient care compared to physicians, even with higher patient satisfaction. Inter-professional collaboration between primary care physicians and nurses is a possible strategy to achieve the desired quality outcomes in a strengthened primary care system. The objective of this research is to synthesize the evidence presented in literature on the impact of collaboration between physicians and nurses on patient outcomes in primary care or in comparable care settings. Methods A systematic review of peer-reviewed reviews was performed in four databases: COCHRANE, MEDLINE, EMBASE and CINAHL. All studies from 1970 until May 22 2016 were included in the search strategy. Titles, abstracts and full texts were respectively reviewed. At least two of the three authors independently reviewed each of the 277 abstracts and 58 full texts retrieved in the searches to identify those which contained all the inclusion criteria. Two authors independently appraised the methodological quality of the reviews, using the AMSTAR quality appraisal tool. Results A total of eleven systematic reviews met all the inclusion criteria and almost fifty different patient outcomes were described. In most reviews, it was concluded that nurses do have added value. Blood pressure, patient satisfaction and hospitalization are patient outcomes where three or more systematic reviews concluded better results when physicians and nurses collaborated, compared to usual care. Colorectal screening, hospital length of stay and health-related quality of life are outcomes where collaboration appeared not to be effective. Conclusions Collaboration between physicians and nurses may have a positive impact on a number of patient outcomes and on a variety of pathologies. To address future challenges of primary care, there is a need for more integrated inter-professional collaboration care models with sufficiently educated nurses. Electronic supplementary material The online version of this article (10.1186/s12875-017-0698-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Evi Matthys
- University of Antwerp, Campus Drie Eiken DR334, Universiteitsplein 1, 2610, Wilrijk, Belgium.
| | - Roy Remmen
- University of Antwerp, Campus Drie Eiken DR334, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Peter Van Bogaert
- University of Antwerp, Campus Drie Eiken DR334, Universiteitsplein 1, 2610, Wilrijk, Belgium
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Monahan L, Sparbel K, Heinschel J, Rugen KW, Rosenberger K. Medical and pharmacy students shadowing advanced practice nurses to develop interprofessional competencies. Appl Nurs Res 2017; 39:103-108. [PMID: 29422142 DOI: 10.1016/j.apnr.2017.11.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 06/29/2017] [Accepted: 11/02/2017] [Indexed: 10/18/2022]
Abstract
AIM This article describes a job-shadowing project that partnered second-year medical and third-year pharmacy students with an advanced practice nurse (APN) for a four-hour job- shadowing experience. BACKGROUND In order to address the Interprofessional Education Collaborative (IPEC) Expert Panel core competencies of interprofessional communication, teamwork, and roles/responsibilities, this project implemented a job-shadowing experience to increase students' knowledge of APN roles and interprofessional collaborative team practices. METHODS Forty volunteer medical and pharmacy students were paired together and completed the job-shadowing activity with an APN. Assessment of knowledge was measured by pre- and post-project surveys. RESULTS Pre- and post-job-shadowing differences demonstrated statistical significance in the interprofessional domains of role awareness, collaboration and communication. These results suggest that an APN job-shadowing experience is effective in developing medical and pharmacy students' competencies in interprofessional collaborative practice. CONCLUSION Specific recommendations include creating enhanced job-shadowing experiences within the curriculums of medicine, pharmacy, and nursing students, and assessing for evidence of enhanced IPEC competencies as a result of these learning experiences.
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Affiliation(s)
- Laura Monahan
- Department of Nursing, Rockford University, Rockford, IL, United States.
| | - Kathleen Sparbel
- College of Nursing, University of Illinois at Chicago, Moline, IL, United States
| | - Judie Heinschel
- College of Nursing, University of Illinois at Chicago, Rockford, IL, United States
| | - Kathryn Wirtz Rugen
- College of Nursing, University of Illinois at Chicago, Chicago, IL, United States; Department of Veterans Affairs, Office of Academic Affiliations, WA, United States
| | - Kelly Rosenberger
- College of Nursing, University of Illinois at Chicago, Rockford, IL, United States
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Tatum JM, White T, Kang C, Ley EJ, Melo N, Bloom M, Alban RF. Prospective Trial of House Staff Time to Response and Intervention in a Surgical Intensive Care Unit: Pager vs. Smartphone. JOURNAL OF SURGICAL EDUCATION 2017; 74:851-856. [PMID: 28347663 DOI: 10.1016/j.jsurg.2017.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 03/01/2017] [Accepted: 03/06/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The objective of the study was to characterize house staff time to response and intervention when notified of a patient care issue by pager vs. smartphone. We hypothesized that smartphones would reduce house staff time to response and intervention. DESIGN Prospective study of all electronic communications was conducted between nurses and house staff between September 2015 and October 2015. The 4-week study period was randomly divided into two 2-week study periods where all electronic communications between intensive care unit nurses and intensive care unit house staff were exclusively by smartphone or by pager, respectively. Time of communication initiation, time of house staff response, and time from response to clinical intervention for each communication were recorded. Outcomes are time from nurse contact to house staff response and intervention. SETTING Single-center surgical intensive care unit of Cedars-Sinai Medical Center in Los Angeles, California, an academic tertiary care and level I trauma center. PARTICIPANTS All electronic communications occurring between nurses and house staff in the study unit during the study period were considered. During the study period, 205 nurse-house staff electronic communications occurred, 100 in the phone group and 105 in the pager group. RESULTS House staff response to communication time was significantly shorter in the phone group (0.5 [interquartile range = 1.7] vs. 2 [3]min, p < 0.001). Time to house staff intervention after response was also significantly more rapid in the phone group (0.8 [1.7] vs. 1 [2]min, p = 0.003). CONCLUSIONS Dedicated clinical smartphones significantly decrease time to house staff response after electronic nursing communications compared with pagers.
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Affiliation(s)
- James M Tatum
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California
| | - Terris White
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California
| | - Christopher Kang
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California
| | - Eric J Ley
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California
| | - Nicolas Melo
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California
| | - Matthew Bloom
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California
| | - Rodrigo F Alban
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California.
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Swiger PA, Patrician PA, Miltner RS(S, Raju D, Breckenridge-Sproat S, Loan LA. The Practice Environment Scale of the Nursing Work Index: An updated review and recommendations for use. Int J Nurs Stud 2017. [DOI: 10.1016/j.ijnurstu.2017.06.003] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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