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Cardinaal EMM, Tjan MJH, Jeurissen PPT, Berden H. Academic medical centres in the Netherlands: muddling through or radical change? Front Public Health 2024; 11:1252977. [PMID: 38239804 PMCID: PMC10794299 DOI: 10.3389/fpubh.2023.1252977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/29/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction Academic medical centres (AMCs) are designed to perform multiple tasks within a single organisation. This institutional complexity gives rise to intricate governance challenges and promotes incrementalism and muddling. Method In this study, we hypothesised that radical change could provide a solution to the current incrementalism and we explored the conditions under which such changes could or could not be achieved. Results We conducted unstructured interviews with various high-level stakeholders and identified issues that negatively affected the governance of Dutch AMCs, which include: 1) negative undercurrents and unspoken issues due to conflicts of interests, 2) organisational complexity due to relationships with a university and academic medical specialists, 3) lack of sufficient government direction, 4) competition between AMCs due to perverse systemic incentives, 5) different interests, focus, and organisational culture, 6) concentration of care, which does not always lead to enhanced quality and efficiency as the provision of less complex care is of utmost importance for education and research, 7) the infeasibility of public and regional functions of an AMC, 8) the inefficiency of managing three core tasks within the same organisation and, 9) healthcare market regulation. Discussion Our hypothesis that radical change offers a solution to the current incrementalism in AMCs could not be adequately explored. Indeed, our exploration of the conditions under which radical change could potentially take place revealed that there are factors currently at play that make a substantive conversation between stakeholders about radical change difficult, if not impossible. The results also show that the government is in a position to take the lead and create conditions that foster mutual trust and common interests among AMCs, as well as between AMCs and other hospitals.
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Affiliation(s)
| | | | | | - Hubert Berden
- Radboud Institute of Health Sciences (RIHS), Nijmegen, Netherlands
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2
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Chateau L. [Organization of the emergency operating room]. Rev Infirm 2024; 73:19-20. [PMID: 38242614 DOI: 10.1016/j.revinf.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
The structure and organization of operating theatres vary from one healthcare facility to another. Some establishments have a multi-disciplinary operating theatre, with shared operating theatres and staff, while others have separate operating theatres, often divided by discipline. Emergencies are therefore dealt with in the operating theatres for scheduled surgery. However, some university hospitals also have emergency operating theatres.
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Affiliation(s)
- Lucas Chateau
- Institut de formation des infirmiers spécialisés de l'AP-HP, 47-83 boulevard de l'Hôpital, 75013 Paris, France.
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Ong KK, Yong YB, Kowitlawakul Y. Nurses' perceptions about bereavement care in critical care units: A qualitative study. Int Nurs Rev 2023; 70:527-534. [PMID: 37597199 DOI: 10.1111/inr.12872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 07/23/2023] [Indexed: 08/21/2023]
Abstract
AIM To explore critical care nurses' perceptions of bereavement nursing care in critical care settings at a tertiary hospital in Singapore. BACKGROUND Grief and bereavement are stressful life experiences associated with significant health problems. Critical care nurses play important roles in supporting bereaved family members, and their self-competence affects the quality of the care they deliver. Exploring critical care nurses' perceptions of bereavement nursing care is thus essential. METHODS An exploratory descriptive qualitative study design was adopted. A total of 16 nurses were recruited. One-on-one interviews were conducted using a semi-structured interview guide and were audio-recorded. The data collected were analysed using thematic analysis. This study was reported according to the Consolidated Criteria for Reporting Qualitative Research checklist. FINDINGS Five themes surfaced in the study, namely, family responses, holistic care, psychological impact, self-competence and organisational dynamics. CONCLUSION This study highlighted the key roles of critical care nurses in providing bereavement care, how their self-competence impacts care delivery and the significant impacts of organisational policies on their capacity to provide care. IMPLICATIONS FOR NURSING AND NURSING POLICY Nursing administrators should provide enhanced organisational support to critical care nurses who provide bereavement nursing care, and implement training work plans to ensure nurses are adequately prepared to provide culturally appropriate care. Strategies should be introduced to reduce administrative burden, expand the role of critical care nurses in providing bereavement nursing care, and establish and enlist role models as drivers of bereavement nursing care.
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Affiliation(s)
- Keh Kiong Ong
- Nursing Department, National University Hospital, National University Health System, Singapore, Singapore
| | - Ying Bing Yong
- Nursing Department, National University Hospital, National University Health System, Singapore, Singapore
| | - Yanika Kowitlawakul
- School of Nursing, College of Public Health, George Mason University, Virginia, USA
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Ioannou A. Mindfulness and technostress in the workplace: a qualitative approach. Front Psychol 2023; 14:1252187. [PMID: 38022994 PMCID: PMC10679397 DOI: 10.3389/fpsyg.2023.1252187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Information Technology (IT) has been vastly characterized as a double-edged sword, offering significant benefits to individuals but at the same time bringing certain negative consequences, such as technostress. Technostress can severely affect individuals in the workplace, causing fatigue, loss of motivation, inability to concentrate, dissatisfaction at work and reduced productivity among others; thus significantly affecting individual well-being work as well as increasing costs for organisations. Recently, studies have shown the beneficial role of mindfulness in reducing technostress experiences of individuals; however, the evidence that exists until today is very limited, and mostly focused on evaluating the impact of mindfulness on technostress and its negative consequences. As the current research stands, at the moment it is relatively unknown how mindfulness affects the underlying mechanisms of technostress experiences of individuals. Through semi-structured interviews with 10 knowledge workers, the current study explores how mindfulness alleviates technostress within the workplace, by investigating the experiences of more mindful employees and learning from their practices. Findings offer a deeper insight into the relationship of mindfulness and technostress, revealing a toolkit of the underlying strategies that more mindful and IT mindful individuals deploy as well as their perceptions during technostress experiences at work thus shedding light on the path between mindfulness and technostress. The study contributes both to academia and practice, offering important implications to managers and practitioners that strive to improve employee well-being within organisations.
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Affiliation(s)
- Athina Ioannou
- Surrey Business School, University of Surrey, Guildford, United Kingdom
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Raunkiær M, Shabnam J, Marsaa K, Kurita GP, Sjøgren P, Guldin MB. When and how to stop palliative antineoplastic treatment and to organise palliative care for patients with incurable cancer. Int J Palliat Nurs 2023; 29:499-506. [PMID: 37862155 DOI: 10.12968/ijpn.2023.29.10.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
BACKGROUND Improving the organisational aspects of the delivery of palliative care in order to support patients throughout their disease trajectory has received limited attention. AIM To investigate the opportunities and barriers related to organising palliation for people with terminal cancer and their families. METHODS An explorative interview study was conducted among 31 nurses and three physicians concerning an intervention facilitating a fast transition from treatment at a cancer centre at a university hospital to palliation at home. A thematic analysis was conducted. FINDINGS This article presents three out of seven themes: 1) improvement in the cessation of antineoplastic treatment in palliation; 2) improvement in organisations delivering palliation; and 3) improvement in multidisciplinary and cross-sectoral collaboration. CONCLUSIONS The results demonstrate the demand for flexible, family-centred and integrated palliation at all levels, from communication and the collaborative relationship between healthcare professionals and families to service sectors.
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Affiliation(s)
- Mette Raunkiær
- Danish Knowledge Centre of Rehabilitation and Palliative Care, Odense University Hospital, Denmark; Department of Clinical Research, University of Southern Denmark, Denmark
| | - Jahan Shabnam
- Danish Knowledge Centre of Rehabilitation and Palliative Care, Odense University Hospital, Denmark; Department of Clinical Research, University of Southern Denmark, Denmark
| | | | - Geana Paula Kurita
- Section of Palliative Medicine, Department of Oncology, Copenhagen University Hospital, Denmark; Department of Anaesthesiology, Pain and Respiratory Support, Neuroscience Centre-Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Per Sjøgren
- Section of Palliative Medicine, Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Denmark
| | - Mai-Britt Guldin
- Research Unit for General Practice, Aarhus, and Institute for Public Health, Aarhus University
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Svärd V, Jannas S. Organisational prerequisites for coordinating the return-to-work process for people with multimorbidity and psychosocial difficulties. Disabil Rehabil 2023; 45:2915-2924. [PMID: 36006799 DOI: 10.1080/09638288.2022.2114019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 06/24/2022] [Accepted: 08/11/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE The return-to-work (RTW) process for people with multimorbidity and psychosocial difficulties can be complicated. This study explores the organisational prerequisites for coordinating these patients' RTW processes from the perspective of coordinators in different clinical areas in Sweden. MATERIAL AND METHODS Six focus group interviews were conducted with 24 coordinators working in primary healthcare (PHC), psychiatric and orthopaedic clinics. The data were analysed thematically, inspired by organisation theory. RESULTS Coordinators described varying approaches to people with multimorbidity and psychosocial difficulties, with more hesitancy among PHC coordinators, who were perceived by other coordinators as hindering patient flows between clinical areas. Most organisational barriers to RTW were identified in the healthcare sector. These were long waiting times, physicians drawing up inadequate RTW plans, coordinators being involved late in the sickness absence process, and lack of rehabilitation programmes for people with multimorbidity. The barriers in relation to organisations such as Social Insurance Agency and Employment Services were caused by regulations and differing perspectives, priorities, and procedures. CONCLUSION Our findings indicate what is needed to improve the RTW process for patients with complex circumstances: better working conditions, steering, and guidelines; shorter waiting times; and a willingness among coordinators from different clinical areas to collaborate around patients. Implications for rehabilitationRTW coordinators need sufficient physical and psychosocial working conditions as well as clear leadership.In order to avoid inequalities in access to RTW support, better systems are needed to identify patients who would benefit from rehabilitation and RTW coordination.There is a need for multilevel collaboration between clinical areas so that patients with multiple healthcare contacts and prolonged sickness absence can obtain support during the RTW process.
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Affiliation(s)
- Veronica Svärd
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
- Department of Social Work, Södertörn University, Huddinge, Sweden
- Medical Unit Social Work in Health, Karolinska University Hospital, Stockholm, Sweden
| | - Sandra Jannas
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institute, Stockholm, Sweden
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Zaluski S, Amzallag T, Bouchut P, Pinsard L, Theron JP, Tellouck-Morincomme J, Baffert S. Perioperative time and economic impact of an intracameral combination of mydriatics and anaesthetics in routine cataract surgery. Eur J Ophthalmol 2023; 33:239-246. [PMID: 35570572 DOI: 10.1177/11206721221101359] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE The aim of this study was to compare the perioperative time and economic impact of a licensed intracameral anaesthetic/mydriatic combination (Mydrane) during routine cataract surgery. METHODS A real-life, prospective, comparative study was performed in 3 clinical centres in France. Preoperative, surgical, and post-operative times were determined for two mydriasis strategies using conventional preoperative mydriatics/anaesthetics eye drops (control regimen) or Mydrane administered at time of surgery. Staff, surgery schedules and drugs utilisation were collected over 12 surgery half-days. The total cost of each strategy was estimated based on treatment cost and nursing costs. RESULTS The analysis included 112 routine cataract surgeries (57 surgeries using Mydrane and 55 using the topical regimen) without protocol deviations or complicated surgery. Overall, the mean time between administration of the first mydriatic eye drops or Mydrane and the end of the surgery was 27.4 ± 21.1 min in the Mydrane group vs. 90.3 ± 30.4 min in the control group (P < 0.0001). The total time of the procedure (from admission to discharge) was not significantly different between groups (P = 0.1611). On average, the extra cost of drugs per patient in the Mydrane group (€5.81) was almost balanced by the reduced nursing time (€5.57) with some variations between centres, due to different organisation including staff resource and consumable. CONCLUSIONS The Mydrane strategy produced perioperative nursing time saving and cost reduction provided that adaptation and reorganisation of routine cataract surgery are implemented.
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Affiliation(s)
- Serge Zaluski
- Polyclinique St Roch, Cabestany, France.,VISIS ophthalmological centre, Perpignan, France
| | | | | | - Loïc Pinsard
- Polyclinique St Roch, Cabestany, France.,VISIS ophthalmological centre, Perpignan, France
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Shahmari M, Nayeri ND, Palese A, Manookian A. Nurses' safety-related organisational challenges during the COVID-19 pandemic: A qualitative study. Int Nurs Rev 2022; 70:18-27. [PMID: 36515574 PMCID: PMC9877888 DOI: 10.1111/inr.12811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 11/08/2022] [Indexed: 12/15/2022]
Abstract
AIM To explore nurses' perspectives on and experiences of safety-related organisational challenges during the coronavirus disease 2019 (COVID-19) outbreak by Iranian nurses. BACKGROUND In different clinical contexts, nurses face numerous organisational challenges threatening their safety because of the COVID-19 pandemic. INTRODUCTION Exploring nurses' perceptions towards safety-oriented organisational challenges might inform nurse managers, healthcare managers, educators and policymakers on the priorities that should be considered to increase organisations' readiness and safety. METHODS This qualitative descriptive study is reported according to the Consolidated Criteria for Reporting Qualitative Research guidelines. Through purposeful sampling, 19 participants were involved. The research data were collected from March to August 2021 by conducting semi-structured interviews that were analysed through the content analysis approach. FINDINGS Three organisation-related safety challenges experienced were related to (1) human resource, (2) educational and (3) workforce protection issues. DISCUSSION Nurses experienced several safety issues related to the complexity faced by the health care organisations during the pandemic, exacerbated by previous frailties of the nursing system. CONCLUSION The three challenges that emerged might be considered a priority in building pandemic plans, transforming the experiences of nurses as a source of learning for all, capitalising on their suggestions and rendering healthcare facilities ready to deal safely with future crises. IMPLICATIONS FOR NURSING AND HEALTH POLICY Adopting appropriate measures to decrease human resource issues and that related to education, and promoting workforce health protection, are both recommended to improve nurses' work environment and satisfy their safety needs.
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Affiliation(s)
- Mehraban Shahmari
- Department of Medical‐SurgicalSchool of Nursing and MidwiferyTehran University of Medical SciencesTehranIran and USERN CARE (TUMS) OfficeSchool of Nursing and MidwiferyTehran University of Medical SciencesTehranIran
| | - Nahid Dehghan Nayeri
- Nursing and Midwifery Care Research CenterSchool of Nursing and MidwiferyTehran University of Medical SciencesTehranIran
| | - Alvisa Palese
- Department of Medical SciencesUniversity of UdineUdineItaly
| | - Arpi Manookian
- Department of Medical‐Surgical NursingSchool of Nursing and MidwiferyTehran University of Medical SciencesTehranIran
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Listorti E, Torbica A, Cella SG, Fiorini G, Corrao G, Franchi M. Healthcare Services for Undocumented Migrants: Organisation and Costs from the Italian NHS Perspective. Int J Environ Res Public Health 2022; 19:16447. [PMID: 36554329 PMCID: PMC9778250 DOI: 10.3390/ijerph192416447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/05/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
Based on the principle of health equity, the Italian National Health Service is known worldwide for being a universalistic system that guarantees healthcare services for all its population, among which there are undocumented migrants. A commitment for their health needs is further motivated by their lower utilisation rates of healthcare services, which becomes even more crucial when considering chronic conditions such as diabetes that require adherence and continuity of care. However, the need for more official data has resulted in little research documenting these healthcare usage patterns. For this reason, our objective has been to deepen, from the Italian NHS perspective, the quantity, costs, type, preventability and organisation of healthcare services directed to undocumented migrants. We used official healthcare data from the Lombardy Region, which enable the identification of people receiving the STP code (undocumented migrants) and of people with foreign citizenship (documented migrants). After quantifying the average annual amount and expenditure for healthcare services grouped by Italian citizens, documented migrants and undocumented migrants for all clinical conditions (quantity and costs), we performed three primary investigations where we enlightened differences between the three mentioned groups focusing on the diagnosis of diabetes: (i) mapping the types of healthcare services used and their characteristics (type); (ii) quantifying the impact of preventable hospital admissions (preventability); (iii) examining the healthcare patterns linking pharmaceutical prescriptions with hospital accesses (organisation). Our results reveal significant differences among the three groups, such as more urgent hospital admissions, more preventable complications, and a higher recurrence in terms of access and costs to hospital services rather than pharmaceutical prescriptions for undocumented migrants. These findings can represent the leverage to raise awareness toward the emerging challenges of the migrant health burden.
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Affiliation(s)
- Elisabetta Listorti
- Centre for Healthcare and Social Care Management (CERGAS), SDA Bocconi, 20136 Milan, Italy
| | - Aleksandra Torbica
- Centre for Healthcare and Social Care Management (CERGAS), SDA Bocconi, 20136 Milan, Italy
| | - Silvano G. Cella
- Laboratory of Pharmacology and Pharmacoepidemiology, Department of Clinical Sciences and Community Health, University of Milan, via Vanvitelli 32, 20129 Milan, Italy
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Gianfrancesco Fiorini
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
| | - Giovanni Corrao
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, 20126 Milan, Italy
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
| | - Matteo Franchi
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, 20126 Milan, Italy
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
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Lapierre N, Olatona O, Labrie D, Gagnon M, Paquette Raynard E, Mortenson WB, Routhier F. Providing community services for persons with disabilities during the COVID-19 pandemic: A scoping review. Health Soc Care Community 2022; 30:e3746-e3760. [PMID: 36168783 DOI: 10.1111/hsc.14050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 08/01/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
Community organisations and municipalities support people with disabilities by providing resources and services that are essential for their engagement in the community. Their services were particularly impacted by restrictions related to the COVID-19 pandemic. The aim of the study is to identify scientific literature that examines how community organisations and municipalities adapted services and resources provided to people with disabilities as a result of the COVID-19 pandemic. A scoping review was conducted by searching the databases Medline, Embase, CINAHL, PsycINFO and Web of Science Core Collection in January 2021. Fifteen studies were included from the initial search strategy of 7651 individual studies. Most of the studies were quantitative studies (73.3%; n = 11) and aimed at describing the adaptations put in place during the COVID-19 pandemic (66.7%; n = 10). Most services and resources involved some form of preventive healthcare (66.7%; n = 10). The adaptation of modalities for delivering resources and services varied widely across organisations (e.g. online or a combination of online and in-person) but mostly led to an improvement of the studied outcome (e.g. social skills, quality of life). Barriers (e.g. need for a reliable internet connection, lack of technology literacy from the member) and facilitators (e.g. flexibility and planning from the organisations) for these adaptations have been identified, but there is little information surrounding their cost. The results highlight that the delivery of online services has increased since the inception of the COVID-19 pandemic with valuable outcomes. However, further research is needed to better identify the barriers, facilitators and outcomes of remote services to better face future large-scale disasters like the COVID-19 pandemic and to better support individuals who cannot reach in-person services.
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Affiliation(s)
- Nolwenn Lapierre
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Québec, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec City, Québec, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada
- Rehabilitation Research Program, GF Strong Rehabilitation Research Lab, Vancouver, British Columbia, Canada
| | - Olatioluwase Olatona
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada
- Rehabilitation Research Program, GF Strong Rehabilitation Research Lab, Vancouver, British Columbia, Canada
| | - Dylane Labrie
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Québec, Canada
| | | | | | - William Ben Mortenson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada
- Rehabilitation Research Program, GF Strong Rehabilitation Research Lab, Vancouver, British Columbia, Canada
| | - François Routhier
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Québec, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec City, Québec, Canada
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Alnes RE, Malmdal W, Nordtug B, Steinheim G, Blindheim K. Improving Everyday Life of People with Dementia living at home. Health care Professionals` Experiences. J Nurs Manag 2022; 30:3628-3636. [PMID: 36181254 PMCID: PMC10091963 DOI: 10.1111/jonm.13819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 09/01/2022] [Accepted: 09/25/2022] [Indexed: 11/27/2022]
Abstract
AIM This study investigates what healthcare professionals experience is important for improving everyday life of people with dementia living at home. BACKGROUND A prerequisite for living at home is that people with dementia and their relatives can handle everyday life together despite the challenges that dementia poses. METHODS This qualitative study conducted focus group interviews (n = 14), and the data were analysed using qualitative content analysis. RESULTS The analysis identified one theme - need for enhanced competence to develop and implement individual plans - and three categories: challenge in identifying cognitive decline; need to timeously facilitate an active and meaningful everyday life; need for consistency, continuity and coordination in dementia home care. CONCLUSION Increased expertise is needed among healthcare professionals to contribute to the development and implementation of individual plans in dementia home care. To achieve this, healthcare professionals' competence and how dementia home care is organised must be seen in conjunction. IMPLICATIONS FOR NURSING MANAGEMENT Routines should be established for identifying cognitive failure early and providing support and guidance at the beginning of the process. There is a need for nurse managers to facilitate increased advanced competence regarding dementia care for a professional home care service and to consider how home services can be organised to ensure continuity and security for people with dementia and their relatives. Creating and implementing an individual plan which can be a starting point for identifying individual needs and wishes and for coordinating an individual user's services.
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Affiliation(s)
- Rigmor Einang Alnes
- Department of Health Sciences, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Ålesund
| | - Wenche Malmdal
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim
| | - Bente Nordtug
- Faculty of Health Science, Nord University, Bodø, Norway
| | - Gunn Steinheim
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim
| | - Kari Blindheim
- Department of Health Sciences, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Ålesund.,Center for Care Research, Department of Health Sciences, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Gjøvik
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Merveille H, Bricaud M. [Outpatient psychiatric activity in the elderly]. Soins Gerontol 2022; 27:34-36. [PMID: 35926971 DOI: 10.1016/j.sger.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Outpatient psychiatry and its health action for the elderly has taken a certain boom in the 2010s. The health policies wanted undoubtedly to mitigate the will to close hospital beds, and to limit hospitalizations in a good way. Ambulatory teams and governments have often provided the means in terms of personnel and logistics to meet the demands in urban and rural areas. Probably, in the image of the clinical history, this ambulatory effort is necessary and positive for the patient, even if these actions will not be able to replace the hospital care in complex cases.
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Affiliation(s)
- Hervé Merveille
- Pôle interétablissement de psychiatrie adulte et de la personne âgée, centre hospitalier Esquirol de Limoges, 15 rue du Docteur-Raymond-Marcland, 87000 Limoges, France.
| | - Magali Bricaud
- Pôle interétablissement de psychiatrie adulte et de la personne âgée, centre hospitalier Esquirol de Limoges, 15 rue du Docteur-Raymond-Marcland, 87000 Limoges, France
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Zonneveld N, Glimmerveen L, Kenis P, Toro Polanco N, Johansen AS, Minkman MMN. Values Underpinning Integrated, People-Centred Health Services: Similarities and Differences among Actor Groups Across Europe. Int J Integr Care 2022; 22:6. [PMID: 36043027 DOI: 10.5334/ijic.6015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 07/27/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction: In addition to the functional aspects of healthcare integration, an understanding of its normative aspects is needed. This study explores the importance of values underpinning integrated, people-centred health services, and examines similarities and differences among the values prioritised by actors across Europe. Methods: Explorative cross-sectional design with quantitative analysis. A questionnaire of 18 values was conducted across Europe. A total of 1,013 respondents indicated the importance of each of the values on a nine-point scale and selected three most important values. Respondents were clustered in four actor groups, and countries in four European sub-regions. Results: The importance scores of values ranged from 7.62 to 8.55 on a nine-point scale. Statistically significant differences among actor groups were found for ten values. Statistically significant differences across European sub-regions were found for six values. Our analysis revealed two clusters of values: ‘people related’ and ‘governance and organisation’. Discussion and conclusion: The study found that all 18 values in the set are considered important by the respondents. Additionally, it revealed distinctions in emphasis among the values prioritised by actor groups and across sub-regions. The study uncovered two clusters of values that contribute to a conceptually based definition of integrated, people-centred health services.
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IJntema R, Barten DJ, Duits H, Tjemkes B, Veenhof C. Building and changing business models: a qualitative study among Dutch physiotherapy primary healthcare organisations. Prim Health Care Res Dev 2022; 23:e19. [PMID: 35314018 DOI: 10.1017/S1463423621000840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim: To gain insights into what business model-building and model-changing aspects make physiotherapy primary healthcare organisations (PTPHOs) attain and sustain superior performance in a changing environment, according to their managers. Background: Since 2006, the transition towards managed competition in the Dutch healthcare market has been intended to improve the performance of primary healthcare organisations like PTPHOs. In such a market, competition on efficiency with reimbursement system has been introduced. Consequently, performance entails achieving and sustaining quality, efficiency, and financial outcomes. Superior performance requires that PTPHOs continuously align their external environment and internal organisation. The business model literature suggests that business model-building and model-changing support this alignment process. Methods: This qualitative study had an explorative design. A pre-defined interview guide based on business model theory was applied. Semi-structured interviews were conducted with physiotherapy primary healthcare organisation managers and transcribed verbally. The transcripts were analysed using directed content analysis. Findings: The study results show, both verbally and graphically, that PTPHOs generate superior performance in a changing environment through business model-building and model-changing. Participating managers (n = 25) confirmed extant findings that business model-building consists of strategy and business model configuration. In addition, business model-building entails establishing interfaces to exploit external environment and internal organisation information. Also, these interfaces are evaluative techniques and tools, action, and process – make sense of knowledge and information. To sustain superior performance, it is essential to change the business model. This can be achieved through three change cycles: business model change, short-term change, and long-term change. Conclusion: Managers of both superior and lower performance organisations independently stress the importance of the same business model-building and model-changing aspects related to attainment and sustainment of superior performance. However, superior performance PTPHOs address building and changing business models in a more diversified and integrated way than their lower performance counterparts.
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Abstract
BACKGROUND Ethical sensitivity is a prerequisite for ethical nursing practices. Efforts to improve nurses' ethical sensitivity are required to correctly recognise ethical conflicts and for sound decision-making. Because an emerging infectious disease response involves complex ethical issues, it is important to understand the factors that influence public health nurses' ethical sensitivity while caring for patients with COVID-19, an emerging infectious disease. OBJECTIVES This study aims to identify the relationship between nursing professionalism, the organisation's ethical climate, and the ethical sensitivity of nurses who care for emerging infectious disease patients in Korean public health centres. Further, it sought to identify factors influencing ethical sensitivity and the mediating effect of the organisational ethical climate to inform guidelines and improve ethical sensitivity. RESEARCH DESIGN This was a cross-sectional descriptive study. PARTICIPANTS AND RESEARCH CONTEXT Data were collected from February 3 to 8 March 2021. Participants included 167 nurses caring for patients with COVID-19 in public health centres in South Korea. ETHICAL CONSIDERATION This study was approved by the Institutional Review Board of the Chung-Ang University and followed the principles of research ethics. RESULTS The factors influencing ethical sensitivity were working at a COVID-19 disease direct response department, nursing professionalism, and organisation's ethical climate. The organisation's ethical climate showed a partial mediating effect on the influence of nursing professionalism on ethical sensitivity. CONCLUSION Our findings show that nurses' ethical sensitivity can be improved by refining the organisation's ethical climate and nursing professionalism.
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Affiliation(s)
- Hyeji Seo
- Seoul Nurses Association, Seoul, Korea
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16
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L'Hotellier S. [Resuscitation and care organisation in the face of a pandemic]. Soins 2021; 66:32-35. [PMID: 34895570 DOI: 10.1016/j.soin.2021.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Resuscitation units, and the care practices they implement, require specific procedures and technologies, as well as particular and distinct knowledge, skills and human qualities within the care setting. Already facing tensions related to the challenges and vital issues of their mission, these resuscitation units have been destabilised by the influx of patients and the unprecedented complexity of the Covid-19 pandemic, which has forced them to rethink their organisation to a large extent and to envisage the future differently.
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Affiliation(s)
- Sylvie L'Hotellier
- Centre hospitalier universitaire de Strasbourg, 1 place de l'hôpital, BP 426, 67091 Strasbourg cedex, France.
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Orru K, Nero K, Nævestad T, Schieffelers A, Olson A, Airola M, Kazemekaityte A, Lovasz G, Scurci G, Ludvigsen J, de los Rios Pérez DA. Resilience in care organisations: challenges in maintaining support for vulnerable people in Europe during the Covid-19 pandemic. Disasters 2021; 45 Suppl 1:S48-S75. [PMID: 34874082 PMCID: PMC9300196 DOI: 10.1111/disa.12526] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The Covid-19 pandemic has challenged the resilience of care organisations (and those dependent on them), especially when services are stopped or restricted. This study focuses on the experiences of care organisations that offer services to individuals in highly precarious situations in 10 European countries. It is based on 32 qualitative interviews and three workshops with managers and staff. The four key types of organisations reviewed largely had the same adaptation patterns in all countries. The most drastic changes were experienced by day centres, which had to suspend or digitise services, whereas night shelters and soup kitchens had to reorganise broadly their work; residential facilities were minimally affected. Given the drastic surge in demand for services, reliance on an overburdened (volunteer) workforce, and a lack of crisis plans, the care organisations with long-term trust networks with clients and intra-organisational cooperation adapted easier. The outcomes were worse for new clients, migrants, psychologically vulnerable people, and those with limited communicative abilities.
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Affiliation(s)
- Kati Orru
- Associate Professor in Sociology of Sustainability at the Institute of Social SciencesUniversity of TartuEstonia
| | - Kristi Nero
- PhD candidate at the Institute of Social SciencesUniversity of TartuEstonia
| | - Tor‐Olav Nævestad
- Chief Research Sociologist at the Transport Economics InstituteNorway
| | | | - Alexandra Olson
- Project Coordinator at the European Affairs OfficeSalvation ArmyBelgium
| | - Merja Airola
- Senior Scientist at the VTT Technical Research Centre of FinlandFinland
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18
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Abstract
The pre-hospital care process of a patient presenting a psychiatric emergency involves many pre-hospital and hospital personnel. Identifying such high-risk situations, allowing an initial approach that is adjusted and authorises care are often very delicate moments. An adapted management, concerted within a network, allows the safety of the patient, his entourage and the interveners. These situations are characterised by their polymorphism with major constants: training, anticipation and knowledge of organisations.
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Affiliation(s)
- Cédric Gil-Jardiné
- Service des urgences adultes, hôpital Pellegrin, centre hospitalo-universitaire de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France; Bordeaux Population Health, Inserm U1219, université de Bordeaux, Case 11, 146 rue Léo-Saignat, 33076 Bordeaux cedex, France.
| | - Coralie Gil
- Bordeaux Population Health, Inserm U1219, université de Bordeaux, Case 11, 146 rue Léo-Saignat, 33076 Bordeaux cedex, France
| | - Juliane Tortes Saint Jammes
- Bordeaux Population Health, Inserm U1219, université de Bordeaux, Case 11, 146 rue Léo-Saignat, 33076 Bordeaux cedex, France; Cellule d'urgence médico-psychologique zone de défense Sud-Ouest, centre hospitalier Charles-Perrens, 121 rue de la Béchade, 33076 Bordeaux, France
| | - Barbara Villoing
- Service d'accueil des urgences, Smur, centre-Université de Paris, hôpital Cochin Hôtel-Dieu, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Hugues Lefort
- Structure des urgences, hôpital d'instruction des armées Laveran, 4 boulevard Laveran, 13384 Marseille, France
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Uccella S, Garzon S, Lanzo G, Cromi A, Zorzato PC, Casarin J, Bosco M, Porcari I, Ciccarone F, Malzoni M, Ghezzi F, Scambia G, Franchi M. Practice changes in Italian Gynaecologic Units during the COVID-19 pandemic: a survey study. J OBSTET GYNAECOL 2021; 42:1268-1275. [PMID: 34581251 DOI: 10.1080/01443615.2021.1954149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The impact of Coronavirus disease 2019 pandemic on Italian Gynaecological Units practice and the compliance and satisfaction with available guidelines/recommendations is unknown. Therefore, a survey was conducted among all Italian Gynaecological Units Directors in April 2020. The response rate was 90% (135/150). 77.8% of centres performed surgery only for oncologic or not deferrable pathologies, and 9.6% was closed. 68.7% of directors were at least moderately satisfied by published guidelines/recommendations, but 94.8% of respondents identified limitations, mainly (83%) the absent definition of benign non-deferrable pathology. Responders considered as non-deferrable severe endometriosis (69.6%), endometriosis with organ failure/dysfunction (74.1%), and unresponsive symptomatic fibroids (89.6%). Despite guidelines/recommendations, respondents treated ovarian (77%) and endometrial (71.6%) cancer as usual. Only a minority of respondents reduced the laparoscopic approach (11.2%) and adopted all recommended surgical precautions (9.6%). Compliance with available guidelines/recommendations appears incomplete. Reconsidering guidelines/recommendations regarding oncological cases and specify non-deferrable benign pathologies would improve guidelines/recommendations compliance.Impact statementWhat is already known on this subject? The SARS-CoV-2 pandemic has profoundly influenced medical routine practice worldwide. Surgery units have been forced to reduce or even completely restrict their activity to re-allocate human resources. Many major international gynaecological societies have released statements and guidelines, providing various recommendations to guide practice changes. However, the impact of the SARS-CoV-2 pandemic on Italian Gynaecological Units practice and the compliance and satisfaction with available guidelines/recommendations is unknown.What do the results of this study add? Study results provide evidence showing how the SARS-CoV-2 pandemic has changed surgical activity in the Italian Gynaecological Units. Most centres reduced surgical activity, limiting surgery only for oncologic or not deferrable pathologies. Moreover, our research shows the level of compliance and satisfaction with available guidelines/recommendations and where they need to be improved. Most directors were at least moderately satisfied but identified different limitations. Guidelines/recommendations do not provide enough details, such as the absent definition of benign non-deferrable pathologies.What are the implications of these findings for clinical practice and/or further research? The limited compliance with available guidelines/recommendations and identified limitations suggest reconsidering guidelines/recommendations focussing on identified gaps. Provide more details, such as specifying non-deferrable benign pathologies, would improve guidelines/recommendations compliance.
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Affiliation(s)
- Stefano Uccella
- Department of Maternal, Neonatal and Infant Health, Division of Obstetrics and Gynaecology, ASL Biella, Biella, Italy.,Department of Obstetrics and Gynaecology, AOUI Verona, University of Verona, Verona, Italy
| | - Simone Garzon
- Department of Obstetrics and Gynaecology, AOUI Verona, University of Verona, Verona, Italy
| | - Gabriele Lanzo
- Department of Maternal, Neonatal and Infant Health, Division of Obstetrics and Gynaecology, ASL Biella, Biella, Italy
| | - Antonella Cromi
- Department of Obstetrics and Gynaecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Pier Carlo Zorzato
- Department of Maternal, Neonatal and Infant Health, Division of Obstetrics and Gynaecology, ASL Biella, Biella, Italy.,Department of Obstetrics and Gynaecology, AOUI Verona, University of Verona, Verona, Italy
| | - Jvan Casarin
- Department of Obstetrics and Gynaecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Mariachiara Bosco
- Department of Obstetrics and Gynaecology, AOUI Verona, University of Verona, Verona, Italy
| | - Irene Porcari
- Department of Obstetrics and Gynaecology, AOUI Verona, University of Verona, Verona, Italy
| | - Francesca Ciccarone
- Department of Obstetrics and Gynaecology, Catholic University of the Sacred Heart, Rome, Italy
| | - Mario Malzoni
- Endoscopica Malzoni-Center for Advanced Endoscopic Gynaecological Surgery, Avellino, Italy
| | - Fabio Ghezzi
- Department of Obstetrics and Gynaecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Giovanni Scambia
- Department of Obstetrics and Gynaecology, Catholic University of the Sacred Heart, Rome, Italy
| | - Massimo Franchi
- Department of Obstetrics and Gynaecology, AOUI Verona, University of Verona, Verona, Italy
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20
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Jourdier S, Annane D. [Application of the white plan in intensive care units during the covid-19 pandemic.]. Soins 2021; 66:37-41. [PMID: 34187653 DOI: 10.1016/s0038-0814(21)00162-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The deployment of the white plan in intensive care as part of the management of COVD-19 required a new organisation at every level of Raymond-Poincaré hospital in Garches. The closure of certain wards enabled equipment and staff to be pooled, and support services stepped up to the plate by reinventing themselves.
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Affiliation(s)
- Ségolène Jourdier
- Hôpital Raymond-Poincaré, groupe hospitalier universitaire, AP-HP Université Paris Saclay, 104 boulevard Raymond-Poincaré, 92380 Garches, France.
| | - Djillali Annane
- Hôpital Raymond-Poincaré, groupe hospitalier universitaire, AP-HP Université Paris Saclay, 104 boulevard Raymond-Poincaré, 92380 Garches, France; UFR Simone-Veil Santé, Université de Versailles -Saint-Quentin-en-Yvelines, Université Paris-Saclay, 2 avenue de la Source-de-la-Bièvre, 78180 Montigny-le-Bretonneux, France
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21
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Benhamed A, Barneoud-Rousset T, Wagenheim C, Tazarourte K, Lefort H, Gabilly L. [White plan and the organisation of emergency response services in France]. Soins 2021; 66:20-24. [PMID: 34187649 DOI: 10.1016/s0038-0814(21)00158-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The Eemergency plans for outside hospitals (ORSEC) and inside hospitals (white plan) are often linked and must be well structured in order to respond to the tensions created by exceptional health situations. They must be designed, used and updated like toolboxes. How is the chain of care organised? What is the role of the samu (emergency medical assistance service) in the preparation, activation and coordination of the white plan?
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Affiliation(s)
- Axel Benhamed
- Structure des urgences, Samu 69, Hôpital Édouard-Herriot, 5 place d'Arsonval, 69003 Lyon, France
| | - Thierry Barneoud-Rousset
- Structure des urgences, Samu 69, Hôpital Édouard-Herriot, 5 place d'Arsonval, 69003 Lyon, France
| | - Cédric Wagenheim
- Hôpital d'instruction des armées Legouest, 27 avenue de Plantières, BP 90001, 57077 Metz cedex, France
| | - Karim Tazarourte
- Structure des urgences, Samu 69, Hôpital Édouard-Herriot, 5 place d'Arsonval, 69003 Lyon, France
| | - Hugues Lefort
- Hôpital d'instruction des armées Legouest, 27 avenue de Plantières, BP 90001, 57077 Metz cedex, France
| | - Laurent Gabilly
- Hôpital d'instruction des armées Legouest, 27 avenue de Plantières, BP 90001, 57077 Metz cedex, France.
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22
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Lacour F. [COVID-19 in care homes, a new organisation required]. Soins 2021; 66:41-3. [PMID: 34103134 DOI: 10.1016/S0038-0814(21)00129-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The unprecedented covid-19 health crisis required emergency measures to be put in place. The main aim was to prevent the pandemic from spreading within care homeof Côte Fleurie (14), while limiting the negative effects of the lockdown. It was also necessary to anticipate the support needed by residents receiving palliative care in a new and unique context.
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23
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Amouroux-Gorsse V. [Palliative care and COVID-19, a creative challenge]. Soins 2021; 66:37-38. [PMID: 34103132 DOI: 10.1016/s0038-0814(21)00127-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Faced with the covid-19 epidemic, palliative care professionals, working at home, in nursing homes or hospitals, have played an essential role. They have demonstrated their creativity and ability to adapt in order to change their organisation and continue their missions of supporting, training and guiding patients, their families and professionals in the field.
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Affiliation(s)
- Valérie Amouroux-Gorsse
- CHU Grenoble Alpes, Clinique de soins palliatifs, boulevard de la Chantourne, 38700 La Tronche, France.
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24
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Herling SF, Brix H, Andersen L, Jensen LD, Handesten R, Knudsen H, Bove DG. A qualitative study portraying nurses' perspectives on transitional care between intensive care units and hospitals wards. Scand J Caring Sci 2021; 36:947-956. [PMID: 33908642 DOI: 10.1111/scs.12990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 02/04/2021] [Accepted: 03/14/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The transition process from the intensive care unit (ICU) to hospital ward may impact the illness trajectory and compromise the continuity of safe care for ICU survivors. ICU and ward nurses are involved with the transition and are responsible for the quality of the transitional care. AIM The aim was to explore ICU and ward nurses' views on assignments in relation to patients' transition between ICU and hospital ward. METHODS We conducted a qualitative study with 20 semi-structured interviews with ICU nurses and ward nurses and analysed data by content analysis. SETTING A university hospital with 690 beds and an 11-bed mixed medical/surgical ICU. FINDINGS The overarching themes were (1) 'Ritual of hand over' with the categories: (a) 'Ready, able and willing', (b) 'Transfer of responsibility' and (c) 'Nice to know versus need to know' and (2) 'From lifesaving care to rehabilitative care' with the categories: (a) 'Complex care needs persist', (b) 'Fight or flight mode' and (c) '"Weaning" the family'. Nurses were highly focused on the ritual of the actual handover of the patient and discussed readiness as an indicator of quality and the feeling of passing on the responsibility. Nurses had different opinions on what useful knowledge was and thus necessary to communicate during handover. Although patients' complex care needs may not have been resolved when exiting the ICU, ward nurses had to receive patients in a setting where nurses were mostly comfortable within their own specialty - this was worrying for both type of nurses. Patients could enter the ward very exhausted and weak or in 'fight mode' and demand rehabilitation at a pace the ward was not capable of delivering. ICU nurses encouraged families to be demanding after the ICU stay, and ward nurses asked them to trust them and steep back.
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Affiliation(s)
- Suzanne Forsyth Herling
- Research Unit: ACES, Department of Anesthesiology, Copenhagen University Hospital Herlev Gentofte, Herlev, Denmark.,The Neuroscience Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen Ø, Denmark
| | - Helene Brix
- ICU, Department of Anesthesiology, Copenhagen University Hospital Herlev Gentofte, Herlev, Denmark
| | - Lise Andersen
- ICU, Department of Anesthesiology, Copenhagen University Hospital Herlev Gentofte, Herlev, Denmark
| | - Liz Daugaard Jensen
- ICU, Department of Anesthesiology, Copenhagen University Hospital Herlev Gentofte, Herlev, Denmark
| | - Rie Handesten
- ICU, Department of Anesthesiology, Copenhagen University Hospital Herlev Gentofte, Herlev, Denmark
| | - Heidi Knudsen
- ICU, Department of Anesthesiology, Copenhagen University Hospital Herlev Gentofte, Herlev, Denmark
| | - Dorthe Gaby Bove
- Emergency Department, Copenhagen University Hospital, Hillerød, Denmark
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Noyé S. [COVID-19, deployment of antigenic tests in EHPAD]. Soins Gerontol 2021; 26:24-26. [PMID: 34083011 DOI: 10.1016/j.sger.2021.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
During the second epidemic wave of COVID-19 in the fall of 2020, residents of accommodation facilities for dependent elderly people were not totally confined. They were able to continue to receive visits from their families under a strict health protocol. But these facilities are very fragile, and many have been affected. The marketing of rapid detection tests for severe acute respiratory syndrome coronavirus 2 using an antigenic method has made it possible to carry out massive screening campaigns for staff in these facilities since the beginning of November.
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Affiliation(s)
- Sébastien Noyé
- Établissement d'hébergement pour personnes âgées dépendantes Les Glycines, chemin de Fabreguette, 30460 Lasalle, France.
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26
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Trochet C. [Modalities of therapeutic patient education]. Rev Infirm 2021; 70:16-7. [PMID: 33742584 DOI: 10.1016/j.revinf.2021.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Today in France, one in three people live with an illness or disability throughout their lives. Due to the successive confinements linked to the health crisis, therapeutic patient education (TPE) programmes have often had to be adapted, notably through telephone follow-up and videoconferences. At the same time, the legislative framework has evolved, with the law of January 1st, 2021, which replaces the authorisation scheme for TPE programmes with a declaration scheme.
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Buist Y, Bekker M, Vaandrager L, Koelen M. Understanding Public Health Adaptation to Climate Change: An Explorative Study on the Development of Adaptation Strategies Relating to the Oak Processionary Moth in The Netherlands. Int J Environ Res Public Health 2021; 18:3080. [PMID: 33802715 PMCID: PMC8002434 DOI: 10.3390/ijerph18063080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/23/2021] [Accepted: 03/14/2021] [Indexed: 11/27/2022]
Abstract
Understanding of public health adaptation (PHA) to climate change and implementation is limited. This study therefore focuses on one specific PHA issue: adaptation to the oak processionary moth (OPM). The aim is to examine the development of OPM adaptation in order to offer a problem description of the complexities involved in OPM adaptation. In this explorative case study, we investigate adaptation strategies based on semi-structured interviews with 26 actors involved in OPM adaptation in The Netherlands. The results indicate that the context of OPM adaptation is relatively complex, given the involvement of many interdependent actors. OPM adaptation was developed with limited knowledge and strategies were based on ad hoc approaches in which there was ambiguity about tasks and expertise. In addition, different actors have different perceptions and values concerning health, sustainability, risks and responsibilities influencing decision-making processes, while also posing a challenge to collaboration and the development of a coordinated approach. The generation of knowledge and its translation into practical strategies calls for interdisciplinary cooperation in knowledge development. PHA adaptation involves more than technical and organisational solutions alone. It also entails the development of a shared problem perception and solution space in which citizens are also engaged.
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Affiliation(s)
- Yvette Buist
- Department of Social Sciences, Health and Society, Wageningen University & Research, P.O. Box 8130, Bode 60, 6700 EW Wageningen, The Netherlands; (M.B.); (L.V.); (M.K.)
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28
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Lissot C, Garnier V, Cerles M, Uhlenbusch S, Monfort E, Couturier P. [A TPE programme for patients with neurodegenerative diseases and their carers]. Rev Infirm 2021; 70:24-25. [PMID: 33742587 DOI: 10.1016/j.revinf.2021.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The team of the geriatric department of the Grenoble-Alpes (38) University Hospital Center has created the Accompagner therapeutic education program to meet the needs of patients suffering from neurocognitive disorders in the context of a neurodegenerative disease and their families. Presentation and current organization of the workshops.
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Affiliation(s)
- Clotilde Lissot
- Service universitaire de gériatrie et de gérontologie clinique, centre gérontologique sud, CHU Grenoble-Alpes, CS 10207, 38043 Grenoble cedex 9, France.
| | - Virginie Garnier
- Service universitaire de gériatrie et de gérontologie clinique, centre gérontologique sud, CHU Grenoble-Alpes, CS 10207, 38043 Grenoble cedex 9, France
| | - Mélanie Cerles
- Service universitaire de gériatrie et de gérontologie clinique, centre gérontologique sud, CHU Grenoble-Alpes, CS 10207, 38043 Grenoble cedex 9, France
| | - Sophie Uhlenbusch
- Unité transversale pour l'éducation des patients de l'Isère, CHU Grenoble-Alpes, CS 10207, 38043 Grenoble cedex 9, France
| | - Emmanuel Monfort
- Université Grenoble-Alpes, CNRS, TIMC-IMAG UMR5525, Domaine de la merci, 38706 La Tronche, France
| | - Pascal Couturier
- Service universitaire de gériatrie et de gérontologie clinique, centre gérontologique sud, CHU Grenoble-Alpes, CS 10207, 38043 Grenoble cedex 9, France; Université Grenoble-Alpes, CNRS, TIMC-IMAG UMR5525, Domaine de la merci, 38706 La Tronche, France
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Akerstrom M, Corin L, Severin J, Jonsdottir IH, Björk L. Can Working Conditions and Employees' Mental Health Be Improved via Job Stress Interventions Designed and Implemented by Line Managers and Human Resources on an Operational Level? Int J Environ Res Public Health 2021; 18:1916. [PMID: 33669481 PMCID: PMC7922402 DOI: 10.3390/ijerph18041916] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/08/2021] [Accepted: 02/12/2021] [Indexed: 11/17/2022]
Abstract
Organisational-level interventions are recommended for decreasing sickness absence, but knowledge of the optimal design and implementation of such interventions is scarce. We collected data on working conditions, motivation, health, employee turnover, and sickness absence among participants in a large-scale organisational-level intervention comprising measures designed and implemented by line managers and their human resources partners (i.e., operational-level). Information regarding the process, including the implementation of measures, was retrieved from a separate process evaluation, and the intervention effects were investigated using mixed-effects models. Data from reference groups were used to separate the intervention effect from the effects of other concurrent changes at the workplace. Overall, working conditions and motivation improved during the study for both the intervention and reference groups, but an intervention effect was only seen for two of 13 evaluated survey items: clearness of objectives (p = 0.02) and motivation (p = 0.06). No changes were seen in employees' perceived health, and there were no overall intervention effects on employee turnover or sickness absence. When using operational-level workplace interventions to improve working conditions and employees' health, efforts must be made to achieve a high measure-to-challenge correspondence; that is, the implemented measures must be a good match to the problems that they are intended to address.
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Affiliation(s)
- Magnus Akerstrom
- Region Västra Götaland, The Institute of Stress Medicine, 413 19 Gothenburg, Sweden; (L.C.); (J.S.); (I.H.J.); (L.B.)
- Occupational Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Linda Corin
- Region Västra Götaland, The Institute of Stress Medicine, 413 19 Gothenburg, Sweden; (L.C.); (J.S.); (I.H.J.); (L.B.)
- Department of Sociology and Work Science, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Jonathan Severin
- Region Västra Götaland, The Institute of Stress Medicine, 413 19 Gothenburg, Sweden; (L.C.); (J.S.); (I.H.J.); (L.B.)
| | - Ingibjörg H. Jonsdottir
- Region Västra Götaland, The Institute of Stress Medicine, 413 19 Gothenburg, Sweden; (L.C.); (J.S.); (I.H.J.); (L.B.)
- Social Medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Lisa Björk
- Region Västra Götaland, The Institute of Stress Medicine, 413 19 Gothenburg, Sweden; (L.C.); (J.S.); (I.H.J.); (L.B.)
- Department of Sociology and Work Science, University of Gothenburg, 405 30 Gothenburg, Sweden
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Abstract
Home dialysis is an effective and safe care strategy that promotes patients' quality of life. At the collective level, it responds to the medico-economic challenges of the French healthcare system. Although it has few contraindications, it remains under-used in France. Its implementation requires early information for patients and their families, as well as the organisation of personalised follow-up by a dedicated and trained team.
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Affiliation(s)
- Emmanuelle Hecquet
- Service de néphrologie, bâtiment de médecine,CH Dieppe, avenue Pasteur, 76200 Dieppe, France.
| | - Amélie Lecoq
- Service de néphrologie, bâtiment de médecine,CH Dieppe, avenue Pasteur, 76200 Dieppe, France
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Abstract
Caregivers put in place various mechanisms to manage their relationship with time. The time of silence and that of chronicity try to mask the confrontation with the finite nature of the human condition. Time in end-of-life care reminds them however that this life is finite.
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Affiliation(s)
- Françoise Daune
- Institut Jules-Bordet, clinique de psycho-oncologie, 1 rue Héger-Bordet, 1000 Bruxelles, Belgique.
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32
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Wade DT. The future of rehabilitation in the United Kingdom National Health Service: Using the COVID-19 crisis to promote change, increasing efficiency and effectiveness. Clin Rehabil 2020; 35:471-480. [PMID: 33167682 DOI: 10.1177/0269215520971145] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
THE PROBLEM Rehabilitation services in the UK are inadequate, with insufficient capacity or flexibility to meet the needs of patients after Covid-19. HISTORY Rehabilitation developed in a piecemeal way, focused on specific problems: spinal cord injury, burns, polio, stroke, back pain, equipment and adaptations etc. Rehabilitation is also provided using other names (e.g. intermediate care). Patients with complex needs do not fit easily within this system. SYSTEM FAILURE After Covid-19, patients have problems that cross existing condition-specific and/or treatment-specific services. Covid-19 has exposed the lack of any coherent organisational principle underlying development or commissioning of rehabilitation services. Consequently, in order to have their needs met, patients either have to engage with two or more separate services or they receive good management for some problems and sub-optimal management for other problems. THE GOALS The multitude of small specific services need to coalesce into an integrated service able to meet all the needs of any patient referred. Second, rehabilitation needs to be fully integrated into all healthcare services. A SOLUTION The purpose of healthcare is to 'improve our health and well-being . . . to stay as well as we can to the end of our lives'. (NHS constitution) All healthcare services need to consider patients holistically, giving equal attention to disease, disability, and distress. Rehabilitation, acute care, mental health and palliative care services need to work in parallel to achieve this purpose. Healthcare providers, supported by commissioners and rehabilitation experts, could achieve structural and organisational change, meeting the needs of patients.
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Affiliation(s)
- Derick T Wade
- Professor of Neurological Rehabilitation, OxINMAHR, and Movement Science Group, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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33
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Vigné C. [Crisis management, highlighting new opportunities for organisation management in psychiatry]. Soins Psychiatr 2020; 41:21-24. [PMID: 33357663 DOI: 10.1016/s0241-6972(20)30121-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The health crisis has radically changed psychiatric units. In order to react, a crisis unit was established, comprising the director, management team and medical staff. Its aim was to apply the necessary adaptation measures with regard to staff organisation and management. However, these measures have had a specifc and significant impact on patients' freedom to come and go, which must be medically justified. This crisis has highlighted more than ever the importance of coordination across the territory.
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Affiliation(s)
- Céline Vigné
- Centre de ressources Santea, 4 rue de Brest, 69002 Lyon, France.
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34
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Fleury C, Gateau V. [The philosophical clinical approach to burnout in caregivers in the light of Covid-19]. Soins 2020; 65:62-64. [PMID: 33160601 DOI: 10.1016/s0038-0814(20)30192-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The crisis caused by the Covid-19 pandemic has highlighted the risks of burnout in caregivers and more specifically the question of ethical suffering. A philosophical clinical approach to burnout enables it to be analysed as a form of existential suffering linked to our shared vulnerability, as well as to more socio-organisational failings.
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Affiliation(s)
- Cynthia Fleury
- Conservatoire national des arts et métiers, 292, rue Saint-Martin, 75141 Paris cedex 03, France; GHU Paris Psychiatrie et neurosciences, 1, rue Cabanis, 75014 Paris, France.
| | - Valérie Gateau
- GHU Paris Psychiatrie et neurosciences, 1, rue Cabanis, 75014 Paris, France
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35
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Marek J, Janoušek J, Tůma S. Eulogy: Professor Milan Šamánek, DrSc, FESC (*09.05.1931 †29.04.2020) - legend from the East. Cardiol Young 2020; 30:1374-5. [PMID: 32513330 DOI: 10.1017/S1047951120001547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This article is to commemorate and celebrate achievements of Professor Milan Šamánek who passed away on 29 April, 2020. Milan was an excellent and visionary paediatric cardiologist who helped to establish paediatric cardiology as a speciality in Czechoslovakia and several other east European countries in the late 1970s. Milan was also paramount for connecting the East and West, helping in no small way to establish the Association for European Paediatric Cardiology (AEPC) as the leading learned society in Europe.
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Batchelor P, Kingsland J. Improving the Health of the Homeless and How to Achieve It within the New NHS Architecture. Int J Environ Res Public Health 2020; 17:E4100. [PMID: 32521822 PMCID: PMC7312815 DOI: 10.3390/ijerph17114100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/29/2020] [Accepted: 06/03/2020] [Indexed: 12/20/2022]
Abstract
The publication of the National Health Service (NHS) Long Term Plan sees the creation of Primary Care Networks as the most appropriate solution to help improve overall health and address health inequalities. A key segment of society that suffers from poor health is the homeless. While the potential for the group to benefit from the NHS reform policy programme in England exists, it requires stronger collaborative working between the health and social care sectors Not least the new arrangements provide opportunities to tackle existing disease as well as the determinants of future ill health. However, if the policy vision is to be achieved, relations between the two sectors must occur and cross sector boundaries be broken down.
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Affiliation(s)
- Paul Batchelor
- School of Medicine, University of Central Lancashire, Preston PR1 2HE, UK
| | - James Kingsland
- School of Medicine, University of Central Lancashire, Preston PR1 2HE, UK
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Laamrani FZ, Chaibi A, Billah NM, Nassar I, Lasri FZ, Alaoui AA, Jroundi L, Madani N. Reorganization of the imaging units in the context of the COVID-19 pandemic: experience of the Ibn Sina University Hospital in Rabat. Pan Afr Med J 2020; 35:30. [PMID: 33623555 PMCID: PMC7875740 DOI: 10.11604/pamj.supp.2020.35.2.23239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 05/10/2020] [Indexed: 11/11/2022] Open
Abstract
The global health system is currently facing the new SARS-COV 2 pandemy. This exceptional situation requires, from our African health systems, to reorganize and readapt the usual protocols when they were carried out before the crisis and/or their urgent implementation otherwise. As imaging is one of the pillars of the diagnosis of infection with this emerging virus, it was essential to rethink the imaging department organization so as to dedicate a unit to COVID-19 activity while maintaining the usual emergency activity within the Ibn Sina university hospital in Rabat. The protection of exposed personnel and the bio-cleaning of radiology equipment and rooms also became an evidence. The active involvement of the administration, the Clinical Pharmacy Department and the Nosocomial Infections Control Committee is a key to the success of this reorganization.
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Affiliation(s)
| | - Aicha Chaibi
- Clinical Pharmacy Department, Medicine and Pharmacy Faculty, Mohamed V University, Rabat, Morocco
| | | | - Ittimade Nassar
- Central Radiology Department, Ibn Sina Hospital, Rabat, Morocco
| | - Fatima Zahrae Lasri
- Clinical Pharmacy Department, Medicine and Pharmacy Faculty, Mohamed V University, Rabat, Morocco
| | - Amal Amrani Alaoui
- Clinical Pharmacy Department, Medicine and Pharmacy Faculty, Mohamed V University, Rabat, Morocco
| | - Laila Jroundi
- Emergency Radiology Depatrment, Ibn Sina Hospital, Rabat, Morocco
| | - Naoufel Madani
- Medical Emergencies Department, Nosocomial Infection Control Committee, Ibn Sina Hospital, Rabat, Morocco
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38
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Abstract
Internationally, clinical forensic medicine (CFM) is diverse in content and conduct, and forensic medical methods are not always evidence based. The first step towards evidence-based practice is to achieve a thorough knowledge of international diversity, which necessitates that CFM practitioners provide information about their national practice. This paper’s aim is to describe the organisation of CFM in Denmark, exemplified by the set-up in Eastern Denmark, and the types of assessments performed. In Denmark, forensic medicine is a board-certified specialty under the health authorities, with mandatory qualifications. The Danish Accreditation Fund accredits the Departments of Forensic Medicine as inspection bodies, according to an international European standard that is approved by Danish Standards. Mainly at police request, forensic doctors perform examinations of both victims and suspected perpetrators of perilous crimes. The examinations’ purposes are documentation and assessment of the findings and collection of biological evidence. The clinical forensic examinations do not include any treatment or medical follow-up. Thus, the forensic doctors must be neutral, objective and impartial. The clinical forensic examinations provide documentation of findings and conclusions not otherwise available for the police investigation and legal aftermath. Moreover, the accredited, standardised protocols ensure that the Departments of Forensic Medicine meet their obligations as inspection bodies, thus ensuring public confidence in the departments’ services.
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Affiliation(s)
| | | | - Niels Lynnerup
- Department of Forensic Medicine, University of Copenhagen, Denmark
| | - Jacob Steinmetz
- Trauma Centre and Department of Anaesthesia, HOC, Rigshospitalet, University of Copenhagen, Denmark
| | - Jytte Banner
- Department of Forensic Medicine, University of Copenhagen, Denmark
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39
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Isibor E, Kanmodi K, Adebayo O, Olaopa O, Igbokwe M, Adufe I, Oduyemi I, Adeniyi MA, Oiwoh SO, Omololu A, Egbuchulem IK, Kpuduwei SPK, Efuntoye O, Egwu O, Ogunsuji O, Grillo EO, Rereloluwa B. Exploring Issues and Challenges of Leadership among Early Career Doctors in Nigeria Using a Mixed-Method Approach: CHARTING Study. Eur J Investig Health Psychol Educ 2020; 10:441-454. [PMID: 34542496 PMCID: PMC8314232 DOI: 10.3390/ejihpe10010033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 02/01/2020] [Accepted: 02/10/2020] [Indexed: 11/16/2022] Open
Abstract
(1) Background: leadership behaviour is a poorly explored phenomenon among early-career doctors (ECDs). Good leadership is vital in maximising the effective management of patients in a clinical setting. While a good number of studies, though with small sample surveys, have researched the role of leadership in clinical setting quantitatively, qualitative investigations are yet to be done in Nigeria. This study aims to explore the attitudes, skills, and experience of ECDs in Nigeria on issues pertaining to leadership in a medical setting, using a mixed-method approach. (2) Methods: we conducted two sessions of key informant focus group discussion (FGD) that involved 14 ECD leaders in Nigeria, exploring their leadership experience in a clinical setting. Furthermore, we used a self-administered questionnaire to quantitatively survey 474 ECDs from seven Nigerian teaching hospitals to explore their attitudes, skills, and experience on issues pertaining to medical leadership. (3) Results: taking on leadership roles is a common phenomenon (52.7%) among the surveyed ECDs; however, the medical leadership position can be very challenging for ECDs in Nigeria. Despite the fact that many (91.1%) of the surveyed ECDs perceived leadership skills as essential skills needed by a doctr, many (44.1%) of them were yet to be formally trained on medical leadership. About three out of every 10 (23.6%) of surveyed ECDs that have ever held leadership positions in a medical setting experienced major leadership challenges while in such office due to their lack of training on leadership skills. Leadership skill acquisition programmes are highly recommended to become an integral part of medical training programmes in Nigeria. (4) Conclusion: there is a need for a structured leadership skill acquisition programme for ECDs in Nigeria. This programme will help in the robust delivery of highly effective healthcare services in Nigeria, as effective leadership is crucial to patient care services.
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Affiliation(s)
- Efosa Isibor
- Irrua Specialist Teaching Hospital, Irrua 310112, Nigeria
| | | | | | | | - Martin Igbokwe
- Obafemi Awolowo Teaching Hospital, Complex, Ile Ife 17153, Nigeria
| | - Iyanu Adufe
- University of Ibadan, Ibadan 200211, Nigeria
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40
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Moutel G, Suzat B, Grandazzi G. [The refusal of care, complex situations]. Rev Infirm 2020; 69:16-18. [PMID: 32327052 DOI: 10.1016/j.revinf.2020.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Over the last three decades, the evolution of medical care and the reorganization of our health care system have completely changed the relationship between health care professionals, patients and their families. The demand for patient participation in the healthcare process has been growing, raising the question of patients' freedom of choice and increasingly questioning the areas where this would be denied.
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Affiliation(s)
- Grégoire Moutel
- Équipe anticipe Inserm 1086, Université de Caen Normandie, esplanade de la Paix, 14032 Caen cedex 5, France; Service de médecine légale et droit de santé, CHU Caen, avenue de la Côte-de-Nacre, CS 30001, 14033 Caen cedex 9, France; Espace régional de réflexion éthique de Normandie, avenue de la Côte-de-Nacre, CS 30001, 14033 Caen cedex 9, France.
| | - Bertille Suzat
- Service de médecine légale et droit de santé, CHU Caen, avenue de la Côte-de-Nacre, CS 30001, 14033 Caen cedex 9, France
| | - Guillaume Grandazzi
- Espace régional de réflexion éthique de Normandie, avenue de la Côte-de-Nacre, CS 30001, 14033 Caen cedex 9, France
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41
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Millán Núñez-Cortés J. COVID-19 por SARS-Cov2 también ha afectado a la Educación Médica. Educacio´n Me´dica 2020; 21:261-264. [PMCID: PMC7301137 DOI: 10.1016/j.edumed.2020.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 06/17/2020] [Indexed: 08/30/2023]
Abstract
El virus, además de provocar una pandemia, con centenares de miles de enfermos y con decenas de miles de fallecidos, ha tenido la capacidad («el poder») de romper las prácticas educativas estándar. Esto ha tenido, o puede tener, un beneficio: reconsiderar lo que es realmente importante y lo que no lo es tanto. Y eso tiene un gran valor para el docente y para el discente. Y también ha servido para reconocer y encontrar formas alternativas con las que se puede transmitir el saber. En definitiva, el profesor ha tenido la oportunidad de contribuir a crear un modelo educativo capaz de impulsar el desarrollo de nuevas formas y métodos de aprendizaje. Ciertas técnicas y recursos educativos han podido ser reconocidos como «presentes» o «ausentes» de nuestro sistema educativo. Esto implica que ciertos recursos han de estar presentes, o que es preciso optimizar los que ya están disponibles para enseñar, para aprender, o para evaluar. La tecnologÃa permite facilitar el contacto «directo» entre profesor y alumno, entre profesores, y entre alumnos. Pero sobra decir que la tecnologÃa ha de estar disponible.
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Affiliation(s)
- Jesús Millán Núñez-Cortés
- Servicio de Medicina Interna, Hospital General Universitario Gregorio Marañón. Facultad de Medicina, Universidad Complutense, Madrid, España
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42
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Catherine Foulhy. Rétrospective et perspectives. Sages-Femmes 2020; 19. [ DOI: 10.1016/j.sagf.2020.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
L’épidémie de Covid-19 qui a déferlé sur le monde en mars 2020 a paralysé les sociétés et placé les professionnels de santé au premier plan, en ville comme à l’hôpital. Les acteurs de la périnatalité ont dû s’adapter pour répondre avec efficacité aux besoins des femmes et des enfants, en toute sécurité. Les soignants ont rencontré moult difficultés, mais ils ont également inventé de nouvelles façons de travailler et appris à mieux collaborer. De cette crise, il faut tirer les leçons pour bâtir l’avenir.
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Abstract
After a long process of negotiation, laws passed in 2018 mean that advanced practice has finally become a reality for nurses in French legislation. Benefits are expected for patients, doctors, caregivers, management, organisations and for the health system. However, it will be necessary to take into account certain limits, and practices are expected to evolve. This change highlights the evolution of nursing practices thanks to Evidence-Based Nursing. An interview with Christophe Debout, member of the advanced practice network training committee of the International Council of Nurses.
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Abstract
Dressings are a real challenge in the care of patients with thermal burns. They help to heal and prevent or treat possible skin infections. Paramedical teams must have a perfect strategy for organizing, managing pain and optimizing hygiene and asepsis rules. The purpose is to facilitate the understanding and implementation of this treatment by suggesting protocols that can be applied by all. It remains essential to mobilize specialized services to promote the evolution of burns.
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Affiliation(s)
- Célia Lucas
- Centre de traitement des brûlés, hôpital Saint-Louis, 1 avenue Claude-Vellefaux 75010 Paris, France.
| | - Marc Baudry
- Centre de traitement des brûlés, hôpital Saint-Louis, 1 avenue Claude-Vellefaux 75010 Paris, France
| | - Marc Chaouat
- Centre de traitement des brûlés, hôpital Saint-Louis, 1 avenue Claude-Vellefaux 75010 Paris, France
| | - Lauriane Gachie
- Centre de traitement des brûlés, hôpital Saint-Louis, 1 avenue Claude-Vellefaux 75010 Paris, France
| | - Hugues Lefort
- Structure des urgences, hôpital d'instruction des armées Legouest, 27 avenue de Plantieres57077 Metz cedex 3, France
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45
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Hong S, Yu P, Chen X, Qian S. Long-term care services and care workers in Hangzhou City, China: A cross-sectional survey. J Nurs Manag 2019; 27:1546-1553. [PMID: 31418968 DOI: 10.1111/jonm.12842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 08/12/2019] [Accepted: 08/13/2019] [Indexed: 11/30/2022]
Abstract
AIM This study aims to investigate the organisation and the workforce profile in long-term care facilities in Hangzhou City, China. BACKGROUND Population ageing calls for an increase in the number of high-quality, long-term care services. Therefore, there is a pressing need to understand how these services are organized and the qualifications of their workforce. METHODS A cross-sectional questionnaire survey was conducted among 293 care workers in 21 certified long-term care facilities in Hangzhou City, China. Comparison between government-owned and private facilities was conducted. RESULTS In total, there were 8,898 beds, 5,468 residents and 887 care workers in the facilities surveyed. As the total bed occupancy rate was 61.5%, there appeared to be adequate facilities in the city. The ratio of care workers to residents was similar in both the government-owned and private facilities, 1 care worker to 6.16 residents. For dependent residents, this ratio was 1-3.50. Organisation of the care services in terms of shift pattern, in-job training and care worker's insurance was significantly different between the two types of facilities. Despite the government-owned facilities being better organized than the private ones, both types of aged care facilities had a 24-hr-long shift. Although their monthly wage was similar, care workers in the government-owned facilities received better job-related insurance, were younger, had longer years of aged care work experience, were better educated and held more aged care certificates and received more frequent in-job training than their counterparts in the private facilities. CONCLUSION The shift arrangement needs to be improved. The low education level, long working hours and low remuneration of care workers were barriers for the development of the long-term care services. IMPLICATIONS FOR NURSING MANAGEMENT In order to improve the quality of long-term care services in China, the organisation of work, qualifications and payment of care workers need to be improved.
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Affiliation(s)
- Shaohua Hong
- Faculty of Nursing, Qianjiang College of Hangzhou Normal University, Hangzhou, China
| | - Ping Yu
- Centre for IT-enabled Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Xueping Chen
- Faculty of Nursing, Qianjiang College of Hangzhou Normal University, Hangzhou, China
| | - Shiyu Qian
- Centre for IT-enabled Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, NSW, Australia
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Castello C. [New governance and transformation of the hospital organisation]. Soins Pediatr Pueric 2019; 40:14-15. [PMID: 31331595 DOI: 10.1016/j.spp.2019.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The last decade has witnessed an increasing number of reforms of the French healthcare system. The main objectives are to control healthcare costs by reducing spending and pooling resources. This is not achieved without difficulties, the economic criteria sometimes overshadowing humanist and altruistic values. These changes influence the organisation of care, even in paediatrics.
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Affiliation(s)
- Christine Castello
- Établissement public départemental Le Charmeyran, 9 chemin Duhamel, 38700 La Tronche, France.
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Guillois B. [Evolution of practices in neonatology]. Soins Pediatr Pueric 2019; 40:16-21. [PMID: 31331596 DOI: 10.1016/j.spp.2019.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The care of newborns has benefited from significant progress over the last twenty years. The discovery of new treatments and technologies, the development of care centred on the infants and their family, ethical reflection, the organisation of support and training for professionals are just some examples. The place of the parents in decision-making processes however needs to be reinforced.
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Affiliation(s)
- Bernard Guillois
- Centre hospitalier universitaire de Caen, Service de néonatalogie, Avenue de la Côte de Nacre, 14000 Caen, France; Université Caen Normandie, UFR de médecine, 2 rue des Rochambelles, Caen, CS 14032, France.
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Audoin V, Faget J, Montagner V, Royal R. [Implementing isolation, reorganising care]. Rev Infirm 2019; 68:21-22. [PMID: 31147069 DOI: 10.1016/j.revinf.2019.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Isolation, protective or septic, requires firm commitment from the team and specific equipment. Pedagogical tools exist to train and inform the team. Communication with all the players, caregivers, patients and family, is essential. It cements the feeling of belonging to the department concerned. An internal medicine team from Auch general hospital shares its experience.
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Affiliation(s)
- Vanessa Audoin
- Centre hospitalier d'Auch, Allée Marie-Clarac, 80382, 32008, Auch cedex, France
| | - Julie Faget
- Centre hospitalier d'Auch, Allée Marie-Clarac, 80382, 32008, Auch cedex, France
| | - Virginie Montagner
- Centre hospitalier d'Auch, Allée Marie-Clarac, 80382, 32008, Auch cedex, France
| | - Régine Royal
- Médecine interne, rhumatologie, Centre hospitalier d'Auch, Allée Marie-Clarac, 80382, 32008, Auch cedex, France.
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Kaptain K, Ulsøe ML, Dreyer P. Surgical perioperative pathways-Patient experiences of unmet needs show that a person-centred approach is needed. J Clin Nurs 2019; 28:2214-2224. [PMID: 30786078 DOI: 10.1111/jocn.14817] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 02/05/2019] [Accepted: 02/09/2019] [Indexed: 11/30/2022]
Abstract
AIM To explore patients' and healthcare professionals' experiences of patients' surgical pathways in a perioperative setting. BACKGROUND Elective surgical pathways have improved over the past decades due to fast-track programmes, but patients desire more personalised and coordinated care and treatment. There is little knowledge of how healthcare professionals' collaboration and communication affect patients' pathways. DESIGN The overall framework was complex intervention method. A phenomenological-hermeneutic approach was used for data analyses. COREQ checklist was used as a guideline to secure accurate and complete reporting of the study. METHODS Field observations (120 hr) and semi-structured interviews (24 patients) were undertaken during 2016-2017. Healthcare professionals involved in the pathways were interviewed: (a) 13 single interviews and (b) 13 focus group interviews (37 healthcare professionals) were conducted. The Consolidated Criteria for Reporting Qualitative Research checklist was used. RESULTS Patients asked for individualised information adapted to their life and illness experiences. Furthermore, healthcare professionals need access to a quick overview of individual patients and their perioperative pathway in the electronic patient journal (EPJ). Agreements made with patients did not always reach the right receiver, there was poor interpersonal communication and the complex teamwork between many healthcare professionals made pathways incoherent and uncoordinated. Healthcare professionals who had the time to talk about other subjects than the disease with smiles and good humour gave patients a feeling of security. CONCLUSION Patients wanted to be treated as individuals, but often they received standard treatment. Healthcare professionals had the intention of treating patients individually, but the EPJ and information provided to patients were not easy to access. RELEVANCE TO CLINICAL PRACTICE Visible information about the patient's whole pathway could improve healthcare professionals' care and treatment. In addition, systematic feedback from patients' could make it possible to adjust information, care and treatment to achieve a more coherent pathway. Particular attention needs to be paid to how electronic healthcare systems can underpin relational coordination in pathways.
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Affiliation(s)
- Kirsten Kaptain
- Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus N, Denmark
| | - Marie-Louise Ulsøe
- Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus N, Denmark
| | - Pia Dreyer
- Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus N, Denmark.,Institute of Public Health, Section of Nursing, University of Aarhus, Aarhus C, Denmark
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Bauer A, Evans-Lacko S, Knapp M. Valuing recovery-oriented practice at the interface between mental health services and communities: The role of organisational characteristics and environments. Int J Soc Psychiatry 2019; 65:136-143. [PMID: 30808231 DOI: 10.1177/0020764019831319] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Implementing recovery-oriented mental health services is a policy priority in many countries. In addition, some governments have prioritised new forms of organising, financing and governing the provision of mental health services with a stronger focus on co-delivery and involving communities. Most research in the recovery field has focused on interventions. There is limited knowledge about the role of organisational characteristics and environments in which people experience recovery. AIM To understand the organisational characteristics of initiatives that implement recovery-oriented practice at the interface between mental health services and communities, as well as the mechanisms they employ to alter the conditions in which they operate. METHOD Semi-structured interviews and a focus group workshop with managers of five initiatives in England that implemented recovery-oriented practice at the interface between mental health services and communities. RESULTS Our cross-sector initiatives shared a range of characteristics and employed mechanisms that created favourable conditions for recovery-oriented practice: strong social value and process (rather than performance) orientation; participatory approaches and shared decision-making; flat hierarchies; creating and seizing business opportunities; utilising networking and (social) marketing opportunities; risk-taking; valuing and supporting all members of their organisations; entrepreneurial and value-driven leadership. CONCLUSION Recovery-oriented practice takes place in certain organisational environments that importantly influence an individual's recovery. Our research highlights the need to consider organisational characteristics when evaluating recovery interventions as well as a broader shift of research towards understanding the environments in which people experience recovery as members of society, and how those can be altered.
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Affiliation(s)
- Annette Bauer
- Personal Social Services Research Unit, The London School of Economics and Political Science, London, UK
| | - Sara Evans-Lacko
- Personal Social Services Research Unit, The London School of Economics and Political Science, London, UK
| | - Martin Knapp
- Personal Social Services Research Unit, The London School of Economics and Political Science, London, UK
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