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Zhao Y, Fu Y, Zhang W, Zhao S, Li H. Evidence summary on management strategies for gastroesophageal reflux symptoms in patients following esophageal cancer surgery. Asia Pac J Oncol Nurs 2025; 12:100639. [PMID: 39811449 PMCID: PMC11732502 DOI: 10.1016/j.apjon.2024.100639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 12/05/2024] [Accepted: 12/05/2024] [Indexed: 01/16/2025] Open
Abstract
Objective This study aimed to summarize evidence-based strategies for the self-management of gastroesophageal reflux symptoms (GERS) at home among patients who have undergone esophageal cancer surgery, providing practical references for clinical practice. Methods A systematic evidence summary was conducted based on the reporting standards of the Fudan University Center for Evidence-based Nursing. Literature was retrieved from international and Chinese databases, including guidelines, expert consensus, systematic reviews, and original studies. The search covered the period from the inception of the databases to June 30, 2024. Two independent reviewers appraised the quality of evidence and synthesized recommendations across six domains: reflux symptoms, assessment, treatment, health education, follow-up, and outcome indicators. Results A total of 25 high-quality studies were included, comprising 10 guidelines, 10 expert consensus documents, two systematic reviews, and three original studies. Thirty-four evidence items were synthesized, emphasizing a combination of pharmacological treatments, lifestyle modifications, and health education to improve self-management outcomes. Conclusions This evidence synthesis highlights effective strategies for home-based self-management of GERS after esophageal cancer surgery. Future research should focus on culturally tailored interventions and large-scale studies to further enhance the applicability and reliability of these findings. Trial registration This study was registered at the Fudan University Center for Evidence-Based Nursing (Registration No. ES202446701).
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Affiliation(s)
- Yuqing Zhao
- Esophageal Oncology Department, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Yaxin Fu
- Esophageal Oncology Department, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Wei Zhang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shengjiang Zhao
- Nursing Department, Tianjin Second People’s Hospital, Tianjin, China
| | - Huixia Li
- Esophageal Oncology Department, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
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Wang QF, Guo SL, Tang HY, Wu Y. Effects of psychological intervention combined with education on psychological resilience and healthy behavior of patients with pulp disease. World J Psychiatry 2025; 15:100929. [DOI: 10.5498/wjp.v15.i4.100929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2024] [Revised: 01/15/2025] [Accepted: 02/21/2025] [Indexed: 03/25/2025] Open
Abstract
BACKGROUND The two-way, three-stage psychological intervention for patients with dental pulp disease offers a reference for nursing interventions in such cases.
AIM To examine the effects of a three-stage psychological intervention on psychological resilience and health behaviors.
METHODS A total of 114 patients with dental pulp disease treated between December 2022 and December 2023 were allocated into two groups according to the random lottery method, with 57 patients in each group. The control group adopted the teaching method, while the observation group used a three-stage psychological intervention combined with the teaching method. We compared psychological resilience, coping strategies, dental fear, health behavior habits, and stigma between the two groups.
RESULTS The intervention group showed significantly improved scores on the psychological resilience scale (Connor-Davidson Resilience Scale) (P < 0.05); positive and negative response scores also improved after the intervention (P < 0.05); significant differences were observed between the observation and control groups in the Chinese version of the Stouthard Dental Fear Scale (Dental Anxiety Inventory), the Social Impact Scale, and health behavior score (P < 0.05).
CONCLUSION Combining a three-stage psychological intervention with the back-teaching method effectively reduces dental fear and stigma in patients with dental pulp disease. It also improves psychological resilience, coping strategies, and health behavior habits, achieving significant results.
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Affiliation(s)
- Qing-Feng Wang
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing 210000, Jiangsu Province, China
| | - Shi-Liang Guo
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing 210000, Jiangsu Province, China
| | - Hai-Yan Tang
- Department of Medical Psychology, The Fourth People’s Hospital of Yancheng, Yancheng 224000, Jiangsu Province, China
| | - Ying Wu
- Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing University, Nanjing 210000, Jiangsu Province, China
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Lisai-Goldstein Y, Shaulov A. Medical Students' Experience of a Patient's Death and Their Coping Strategies: A Narrative Literature Review. Am J Hosp Palliat Care 2025; 42:413-420. [PMID: 38906091 PMCID: PMC11869511 DOI: 10.1177/10499091241264523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2024] Open
Abstract
The experience of a patient's death on medical students is powerful and may entail distress and anxiety. We review the experience of death and dying as perceived by medical students. Students are exposed to death and dying while dissecting cadavers in pre-clinical years, following patient death in clinical years, and commonly as a result of personal exposure. Students report sadness and anger in response to patient death, particularly following their first experience. The patient's identity and the student's past exposure to death were found to influence the way students experience death and dying. Coping methods may include conversation, reflection, and religion as well as detachment and avoidance. Although time and resources are invested in preparing students for a patient's death, many of them feel inadequately prepared. Greater understanding of and investment in processing medical students' experience of patient death may be helpful in their personal and professional development.
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Affiliation(s)
| | - Adir Shaulov
- Department of Hematology, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
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Pradelli L, Risoli C, Summer E, Bellini G, Mozzarelli F, Anderson G, Guasconi M, Artioli G, Bonacaro A, Sarli L. Healthcare professional perspective on barriers and facilitators of multidisciplinary team working in acute care setting: a systematic review and meta-synthesis. BMJ Open 2025; 15:e087268. [PMID: 40118478 PMCID: PMC11931918 DOI: 10.1136/bmjopen-2024-087268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 02/28/2025] [Indexed: 03/23/2025] Open
Abstract
OBJECTIVE A multidisciplinary team is essential to providing high-quality, patient-centred care. However, its effectiveness can be either hindered or facilitated by various factors, such as the need for rapid decision-making, which may compromise patient outcomes despite individual efforts. The aim of this study is to synthesise the factors that may act as barriers and facilitators to the work of multidisciplinary teams in managing labour within acute care settings. DESIGN A systematic qualitative review and meta-synthesis was conducted following the five-step methodology proposed by Sandelowski et al. DATA SOURCE Three databases (Medline, Embase and Scopus) were systematically searched without time restrictions up to 25 May 2024. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Qualitative studies exploring perspectives, experiences and other similar factors were included. These studies were assessed for methodological quality using the Critical Appraisal Skills Programme. DATA EXTRACTION AND SYNTHESIS The reviewers independently searched, screened and coded the results of the included studies. Data were synthesised using the method proposed by Thomas and Harden. RESULTS Seventeen studies were included in the meta-synthesis. Four key dimensions emerged, reflecting both the barriers and the facilitators of multidisciplinary team performances: (1) organisational variables, (2) individual variables, (3) collaborative variables and (4) role variables. A total of 36 variables were identified, which could function as barriers (n=6; eg, high staff turnover), facilitators (n=6; eg, strong listening skills) or both (n=24; eg, team climate), depending on the context. CONCLUSIONS This meta-synthesis identifies specific barriers and facilitators and variables that can act as both. Understanding these factors enables targeted interventions to enhance the performance of multidisciplinary teams in clinical practice, particularly in acute care settings. PROSPERO REGISTRATION NUMBER CRD42022297395.
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Affiliation(s)
| | | | - Elena Summer
- Fondazione Madonna della Bomba Scalabrini ETS, Piacenza, Italy
| | | | - Fabio Mozzarelli
- Azienda USL di Piacenza, Piacenza, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Gloria Anderson
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Massimo Guasconi
- Azienda USL di Piacenza, Piacenza, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giovanna Artioli
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Antonio Bonacaro
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Leopoldo Sarli
- Department of Medicine and Surgery, University of Parma, Parma, Italy
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Adi AAK, Harhara T, Oyoun Alsoud L, Elhag SA, Benani I, Ibrahim H. Perceptions of an acute medical unit in internal medicine on interprofessional collaboration. J Interprof Care 2025; 39:186-191. [PMID: 39575554 DOI: 10.1080/13561820.2024.2428967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 11/06/2024] [Accepted: 11/07/2024] [Indexed: 03/20/2025]
Abstract
We aimed to assess perceptions about interprofessional collaboration (IPC) of healthcare professionals working in an acute medical unit (AMU) in an internal medicine department in the United Arab Emirates. The AMU provides care during the initial 24 to 72 hours of admission and emphasizes interprofessional collaboration. Using the Assessment of Interprofessional Team Collaboration Scale II, the study measured partnership, cooperation, and coordination among team members. Between November 5, 2022, and January 5, 2023, 81 participants completed the survey, including physicians (n = 45; 55.5%), nurses (n = 18; 22.2%), and clinical and non-clinical allied health professionals (n = 18; 22.2%). On a Likert-type scale of one to five, most respondents perceived partnership, cooperation, and team coordination as good collaboration on the AMU, with mean scores of 4.29, 4.16, and 4.15, respectively. There was no significant difference between physicians' (4.18) and nurses' (4.45) perspectives of IPC on the AMU (p = .10), but physicians were less likely to notice collaborative practice changes compared to other professionals. Introducing IPC early in medical education might enhance future collaborative practice. This study sheds light on IPC in non-Western contexts and provides insights into how collaboration is perceived and practiced in diverse healthcare settings.
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Affiliation(s)
- Abd Al Kareem Adi
- Department of Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Thana Harhara
- Department of Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Leen Oyoun Alsoud
- Department of Medical Sciences, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
| | - Shahad Abasaeed Elhag
- Department of Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Imane Benani
- Department of Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Halah Ibrahim
- Department of Medical Sciences, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
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Paiva BSR, Trevizan FB, de Oliveira LC, da Costa Rosa KS, Betussi VA, Lourenço BM, Julião M, Paiva CE. Go Wish Card Game for Meaningful Conversations in the Oncology Healthcare Context: A Narrative Review. Cancers (Basel) 2025; 17:560. [PMID: 40002155 PMCID: PMC11853492 DOI: 10.3390/cancers17040560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Revised: 11/29/2024] [Accepted: 11/30/2024] [Indexed: 02/27/2025] Open
Abstract
The Go Wish Card Game (GWCG) is emerging as a valuable tool for facilitating end-of-life (EoL) discussions, particularly in oncology care where patients face complex treatment decisions. This review investigates the GWCG's intended use, its application in oncology settings, and best practices for introducing it to patients. It also addresses the challenges and barriers to its implementation in clinical practice. A search for scientific evidence revealed a significant gap in the literature: while various sources, including qualitative studies and reviews, were reviewed, only a small portion focused on intervention outcomes. This underscores the need for more comprehensive studies to evaluate the GWCG's effectiveness, especially in EoL care. Despite its potential to foster meaningful conversations and support informed decision-making, successful implementation requires overcoming barriers such as patient resistance and the need for a sensitive, gradual approach to EoL topics. Further research, particularly clinical trials, is essential to confirm its broader applicability and effectiveness.
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Affiliation(s)
- Bianca Sakamoto Ribeiro Paiva
- GPQual, Research Group on Palliative Care and Quality of Life, Teaching and Research Institute, Barretos Cancer Hospital, Barretos 14784-400, SP, Brazil;
| | - Fulvio Bergamo Trevizan
- GPQual, Research Group on Palliative Care and Quality of Life, Barretos Cancer Hospital, Barretos 14784-400, SP, Brazil; (F.B.T.); (L.C.d.O.); (K.S.d.C.R.); (V.A.B.); (B.M.L.)
| | - Lívia Costa de Oliveira
- GPQual, Research Group on Palliative Care and Quality of Life, Barretos Cancer Hospital, Barretos 14784-400, SP, Brazil; (F.B.T.); (L.C.d.O.); (K.S.d.C.R.); (V.A.B.); (B.M.L.)
- INCA—National Cancer Institute, Palliative Care Unit, Rio de Janeiro 20560-121, RJ, Brazil
| | - Karla Santos da Costa Rosa
- GPQual, Research Group on Palliative Care and Quality of Life, Barretos Cancer Hospital, Barretos 14784-400, SP, Brazil; (F.B.T.); (L.C.d.O.); (K.S.d.C.R.); (V.A.B.); (B.M.L.)
- INCA—National Cancer Institute, Palliative Care Unit, Rio de Janeiro 20560-121, RJ, Brazil
| | - Vitória Aparecida Betussi
- GPQual, Research Group on Palliative Care and Quality of Life, Barretos Cancer Hospital, Barretos 14784-400, SP, Brazil; (F.B.T.); (L.C.d.O.); (K.S.d.C.R.); (V.A.B.); (B.M.L.)
| | - Bruna Minto Lourenço
- GPQual, Research Group on Palliative Care and Quality of Life, Barretos Cancer Hospital, Barretos 14784-400, SP, Brazil; (F.B.T.); (L.C.d.O.); (K.S.d.C.R.); (V.A.B.); (B.M.L.)
| | - Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos da ULS, Sintra, 2720-276 Amadora, Portugal;
| | - Carlos Eduardo Paiva
- GPQual, Research Group on Palliative Care and Quality of Life, Teaching and Research Institute, Barretos Cancer Hospital, Barretos 14784-400, SP, Brazil;
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Soto-Schulz K, Herrera-Echenique R, Brito-Díaz R, Pérez-Romero N. Competencies required for the performance of primary health care managers: a systematic review. CAD SAUDE PUBLICA 2025; 41:e00092624. [PMID: 39879394 PMCID: PMC11774334 DOI: 10.1590/0102-311xen092624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 08/11/2024] [Accepted: 08/27/2024] [Indexed: 01/31/2025] Open
Abstract
This study aimed to identify the competencies required by primary health care managers for the effective performance of their functions. A systematic review was conducted according to PRISMA, in the databases PubMed, Scopus, Web of Science, and CINAHL, up to May 2023, in the last 10 years. The inclusion criteria were quantitative, qualitative, or mixed studies that evaluated the competencies required for primary health care managers and published in English, Spanish, or Portuguese. Methodological quality was assessed using the Mixed Methods Appraisal Tool. This article identified 171 studies, including six to the analysis. The importance of leadership, teamwork, and communication was highlighted. Furthermore, the need for disciplinary training in the health area, knowledge in administration, and use of management indicators, as well as an autonomous and flexible attitude to challenges were highlighted. The evaluation of methodological quality showed an overall good performance, except for some studies that do not report sufficient information to determine sample representativeness. Primary health care managers must possess specific competencies to effectively perform their roles, given the relevance of primary care in each country's health system. This study provides a general framework of the required competencies for managerial responsibilities in this area. However, it is necessary to consider the particularities and local contexts of each center to develop managerial profiles adapted to their specific needs.
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Affiliation(s)
- Katherine Soto-Schulz
- Facultad de Ciencias de la Rehabilitación, Universidad Andrés Bello, Santiago de Chile, Chile
- Programa de Doctorado en Derecho y Administración de Empresas, Universidad de Lleida, Lleida, España
| | | | | | - Nuria Pérez-Romero
- Facultad de Ciencias de la Rehabilitación, Universidad Andrés Bello, Santiago de Chile, Chile
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Spada F, Caruso R, Notarnicola I, Belloni S, De Maria M, Magon A, Conte G, Prendi E, Pata X, Duka B, Rocco G, Stievano A. Analyzing readiness for interprofessional education among health program students using hierarchical clustering. J Interprof Care 2025:1-8. [PMID: 39835532 DOI: 10.1080/13561820.2025.2452973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 12/21/2024] [Accepted: 01/08/2025] [Indexed: 01/22/2025]
Abstract
This study employs a clustering approach to assess the readiness for interprofessional education (IPE) among students enrolled in health-related study programs in Albania. Among a sample of 1470 students, complete data were available for 1383 participants, while 87 cases had missing data. Three distinct clusters were identified using hierarchical clustering analysis based on age and readiness domains: Teamwork (TW) and Professional Practice Identity (PPI). The average scores for TW and PPI were 4.4 ± 0.51 and 4.3 ± 0.51, respectively. Cluster A, consisting of 123 students, exhibited lower scores in both domains and a higher proportion of male students, while Clusters B (846 students) and C (414 students) demonstrated greater readiness for IPE and a higher representation of female students. These findings highlight varying perceptions and values associated with IPE across genders and health-related study programs, emphasizing the necessity for tailored and gender-aware IPE-enhancing interventions. Furthermore, our research underscores the importance of introducing IPE early in the healthcare curriculum and utilizing student clustering to tailor interventions, thus laying the foundation for broader research endeavors. Future studies are recommended to delve deeper into these results and assess the effectiveness of tailored interventions based on this approach in fostering readiness for IPE.
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Affiliation(s)
- Florian Spada
- Department of biomedical Sciences, Faculty of Medicine, University "Our Lady of the Good Counsel", Tirana, Albania
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Ippolito Notarnicola
- Center of Excellence for Nursing Culture and Research, Order of Nursing Professions of Rome, Rome, Italy
| | - Silvia Belloni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Maddalena De Maria
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Arianna Magon
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Gianluca Conte
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Emanuela Prendi
- Department of biomedical Sciences, Faculty of Medicine, University "Our Lady of the Good Counsel", Tirana, Albania
| | - Xhesika Pata
- Department of biomedical Sciences, Faculty of Medicine, University "Our Lady of the Good Counsel", Tirana, Albania
| | - Blerina Duka
- Department of biomedical Sciences, Faculty of Medicine, University "Our Lady of the Good Counsel", Tirana, Albania
| | - Gennaro Rocco
- Center of Excellence for Nursing Culture and Research, Order of Nursing Professions of Rome, Rome, Italy
- International Center for Nursing Research Montianum, University "Our Lady of the Good Counsel", Tirana, Albania
| | - Alessandro Stievano
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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9
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Javanmardi S, Rappelt L, Zangenberg S, Heinke L, Baumgart C, Niederer D, Freiwald J. Effectiveness of workplace health promotion programs for industrial workers: a systematic review. BMC Public Health 2025; 25:168. [PMID: 39815242 PMCID: PMC11736980 DOI: 10.1186/s12889-025-21365-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 01/07/2025] [Indexed: 01/18/2025] Open
Abstract
BACKGROUND Workplace health promotion is essential for individual and organisational well-being and disease prevention, also in industrial workers. As the transfer of the evidence on the effectiveness of such programs into practice is limited due to scattered effects, the need for a consolidation of the available studies is given. The purpose of this systematic review was to synthesise the evidence on the effectiveness of workplace health promotion programs for industrial workers. METHODS An electronic literature search was conducted in PubMed, Cochrane Library, Web of Science™, Scopus, and EBSCOHost until July 26th 2023. Studies investigated industrial workers who performed manual labour for at least 20 h per week were included. They had to receive a workplace health promotion intervention under any control condition. Outcomes were workplace health interventions' safety and corresponding health-related outcomes. The revised Cochrane risk-of-bias assessed the risk of bias (Rob 2) tool for randomised control trials (RCT) and cluster RCT. Quality assessment was performed using a modified Downs and Black Checklist. RESULTS Of the 25,555 studies initially identified, 39 were included. Generally, the mean quality of the studies was moderate, with most studies judged with a high overall risk of bias. Twenty-seven studies employed a behavioural approach, while one study adopted an organisational one. Ten studies utilised a multicomponent approach, and one intervention improved safety outcomes. The analysis of the results indicated an overall positive but heterogeneous effect across the different approaches. CONCLUSIONS The studies included in this review provide evidence that workplace health promotion can be effective. However, the overall findings are inconclusive due to the high risk of bias. Therefore, the results should be interpreted cautiously. Despite the considerable amount of research conducted in this field, additional well-designed studies are needed to fully confirm the effectiveness and determine the most promising types of interventions for improving and maintaining industrial health.
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Affiliation(s)
- Sasha Javanmardi
- Department of Movement and Training Science, University of Wuppertal, Wuppertal, Germany.
| | - Ludwig Rappelt
- Department of Movement and Training Science, University of Wuppertal, Wuppertal, Germany
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany
| | - Sascha Zangenberg
- Department of Movement and Training Science, University of Wuppertal, Wuppertal, Germany
| | - Lars Heinke
- Department of Movement and Training Science, University of Wuppertal, Wuppertal, Germany
| | - Christian Baumgart
- Department of Movement and Training Science, University of Wuppertal, Wuppertal, Germany
| | - Daniel Niederer
- Department of Movement and Training Science, University of Wuppertal, Wuppertal, Germany
- Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | - Jürgen Freiwald
- Department of Movement and Training Science, University of Wuppertal, Wuppertal, Germany
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10
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Shaker MS, Oppenheimer J, Verdi M, Anagnostou A, Abrams EM, Blatman KH, Hand M, Spergel JM, Lang DM. Teamwork in Clinical Medicine. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:3261-3268. [PMID: 39362486 DOI: 10.1016/j.jaip.2024.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Revised: 09/19/2024] [Accepted: 09/26/2024] [Indexed: 10/05/2024]
Abstract
Clinical teams are at the heart of healthcare value. Teamwork requires an appreciation of the unique geniuses of each team member as well as an understanding of team dynamics and larger organizational challenges. Effective teams leverage each member's unique talents within a culture of shared humility, service, and dedication. Although interpersonal communication is paramount, organizations that promote a culture of psychological safety to allow productive and necessary conflict are most effective at fostering shared commitment that allows real accountability and result-oriented, responsive systems. Healthy teams can serve to energize clinicians to provide outstanding service and high-value care.
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Affiliation(s)
- Marcus S Shaker
- Section of Allergy and Immunology, Dartmouth Hitchcock Medical Center, Lebanon, NH; Department of Medicine and Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH.
| | - John Oppenheimer
- Department of Internal Medicine, University of Medicine and Dentistry of New Jersey-Rutgers New Jersey Medical School, Newark, NJ
| | - Marylee Verdi
- Department of Medicine and Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH; Dartmouth College Student Health, Hanover, NH
| | - Aikaterini Anagnostou
- Department of Pediatrics, Division of Allergy and Immunology, Baylor College of Medicine, Houston, Texas
| | - Elissa M Abrams
- Section of Allergy and Immunology, University of Manitoba, Winnipeg, MB, Canada
| | - Karen Hsu Blatman
- Section of Allergy and Immunology, Dartmouth Hitchcock Medical Center, Lebanon, NH; Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Matthew Hand
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH; Section of Pediatric Nephrology, Dartmouth Hitchcock Medical Center, Lebanon, NH
| | - Jonathan M Spergel
- Division of Allergy and Immunology, Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa
| | - David M Lang
- Department of Allergy and Clinical Immunology, Cleveland Clinic, Cleveland, Ohio
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11
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Gilligan C, Bujnowska-Fedak MM, Essers G, Frerichs W, Brinke DJT, Junod Perron N, Kiessling C, Pype P, Tsimtsiou Z, Van Nuland M, Wilkinson TJ, Rosenbaum M. Assessment of communication skills in health professions education; Ottawa 2024 consensus statement. MEDICAL TEACHER 2024; 46:1593-1606. [PMID: 39418258 DOI: 10.1080/0142159x.2024.2413021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 10/02/2024] [Indexed: 10/19/2024]
Abstract
Despite the increasing inclusion of communication skills in accreditation standards and an increase in time dedicated to teaching these skills, communication is often regarded as a separate skill and is therefore, not consistently represented in overall systems of assessment in Health Professions Education (HPE). The ascendence of competency-based medical education, programmatic assessment, artificial intelligence, and widespread use of telehealth, alongside changing patient expectations warrant an update in thinking about the assessment of communication skills in health professions education. This consensus statement draws on existing literature, expert pinion, and emerging challenges to situate the assessment of communication skills in the contemporary health professions education context. The statement builds on previous work to offer an update on the topic and include new developments related to assessment, particularly: the challenges and opportunities associated with systems of assessment; patient and peer perspectives in assessment; assessment of interprofessional communication, cross-cultural communication, digital communication; and assessment using digital technologies. Consensus was reached through extensive discussion among the authors and other experts in HPE, exploration of the literature, and discussion during an Ottawa 2024 conference workshop. The statement puts forward a summary of available evidence with suggestions for what educators and curriculum developers should consider in their planning and design of the assessment of communication.
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Affiliation(s)
- Conor Gilligan
- Bond University, Robina, QLD, Australia
- EACH: International Association for Communication in Healthcare, Salisbury, UK
| | - Maria Magdalena Bujnowska-Fedak
- EACH: International Association for Communication in Healthcare, Salisbury, UK
- Department of Family Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Geurt Essers
- EACH: International Association for Communication in Healthcare, Salisbury, UK
- National Network for GP Training Programs, Utrecht, the Netherlands
| | - Wiebke Frerichs
- EACH: International Association for Communication in Healthcare, Salisbury, UK
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Desirée Joosten-Ten Brinke
- Department Educational Development and Research and the School of Health Professions Education, Maastricht University, Maastricht, Netherlands
| | - Noelle Junod Perron
- EACH: International Association for Communication in Healthcare, Salisbury, UK
- Geneva Faculty of medicine and University Hospitals, Geneva, Switzerland
| | - Claudia Kiessling
- EACH: International Association for Communication in Healthcare, Salisbury, UK
- Witten/Herdecke University, Faculty of Health, Chair for the Education of Personal and Interpersonal Competencies in Health Care, Witten, Germany
| | - Peter Pype
- EACH: International Association for Communication in Healthcare, Salisbury, UK
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
| | - Zoi Tsimtsiou
- EACH: International Association for Communication in Healthcare, Salisbury, UK
- Department of Hygiene, Social - Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Marc Van Nuland
- EACH: International Association for Communication in Healthcare, Salisbury, UK
- Department of Public Health and Primary Care, KU Leuven - University of Leuven, Leuven, Belgium
| | | | - Marcy Rosenbaum
- EACH: International Association for Communication in Healthcare, Salisbury, UK
- Department of Family Medicine, University of Iowa Carver College of Medicine, Iowa, US
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12
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Alquati S, Artioli G, Martucci G, Tanzi S. Training an infectious disease unit in palliative care during and post COVID-19: a qualitative longitudinal study. Front Public Health 2024; 12:1393770. [PMID: 39478742 PMCID: PMC11521919 DOI: 10.3389/fpubh.2024.1393770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 10/07/2024] [Indexed: 11/02/2024] Open
Abstract
Background To understand palliative care needs and their changes perceived by health professionals (HPs) of the Infectious Diseases Unit who participated in palliative care (PC) intensive training during the pandemic and behind/during the pandemic and one year after the outbreak. Methods A longitudinal qualitative study. Thematic analysis and meaning shift were two months after training to one year. This specific thematic approach enabled the researchers to fully understand the experiences of the HPs after they participated in the intensive PC training program during the pandemic. Participant validation meeting with the ward's staff one year after the end of the course was performed. The two last validation meetings were used as a triangulation source to plan the new education projects. Results From March 9 to 28, 2020, the Palliative Care Services (PCS) developed intensive experiential training. Thirty-one HPs of the Infectious Diseases Unit (physicians and nurses) who were facing the COVID-19 emergency participated in the training. We conducted eight semi-structured interviews with HPs who participated in intensive training during the first wave of the pandemic (T0), two months (T1) after training and after one year (T2), during the second wave. Two validation meetings were performed as suggested by the best practices in medical education. Twenty-two infectious disease staff members participated, 8 physicians and 14 nurses. Our data show a meaning shift on five overarching themes (defined within the sub-themes): (1) Recognizing patients' palliative care needs; (2) Responses to palliative care needs; (3) Increasing attention to intervention and care choices; (4) The suffering of health professionals; (5) Training evaluations and future expectations. At the end of Pandemic period, new training needs and acquisition have emerged. Palliative care needs changed over time: the COVID-19 themes are now far from their perception, and somehow the skills acquired during the intensive training are less present. Conclusion The pandemic led to a rapid acquisition of competencies and changes in the professionals' behaviors, maintenance of professionals' knowledge and competencies at two months and one year. COVID has improved relationships and increased interactions with the infectious world but that it has not been enough. The integration between PC and Infectious world needs models of integration to implement.
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Affiliation(s)
- Sara Alquati
- Palliative Care Unit, Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Giovanna Artioli
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | | | - Silvia Tanzi
- Palliative Care Unit, Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy
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13
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Grasto K, Leonardsen ACL. Interprofessional In Situ Simulation's Impact on Healthcare Personnel's Competence and Reported Need for Training in Cardiopulmonary Resuscitation-A Pilot Study in Norway. Healthcare (Basel) 2024; 12:2010. [PMID: 39408190 PMCID: PMC11475961 DOI: 10.3390/healthcare12192010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2024] [Revised: 10/07/2024] [Accepted: 10/08/2024] [Indexed: 10/20/2024] Open
Abstract
BACKGROUND/OBJECTIVES International guidelines recommend cardiopulmonary resuscitation [CPR] training every sixth month. However, research indicates that more training is needed to maintain CPR competence. The objectives of this pilot study were (a) to assess health personnel's self-reported competence and need for more training in CPR before and after interprofessional in situ CPR simulation and (b) to assess time since the last CPR course and respondent's reported need for more training. Also, we wanted a pilot to assess areas of improvement in a future, larger study. METHODS A questionnaire was administered to healthcare personnel in hospital wards receiving CPR training using a purposeful sampling strategy. RESULTS In total, 311 respondents answered the pre-intervention and 45 respondents answered the post-intervention survey. The respondents believed they had good knowledge, skills, and training in CPR, and about 2/3 of the respondents reported a need for more knowledge, skills, and training. There was a weak positive correlation between the time since the last CPR course and the perceived need for more training [p < 0.05]. There were no significant differences in self-reported competence or perceived need for more training pre- and post-intervention. The pilot detected several limitations that need improvement in a future study. CONCLUSIONS The authors suggest that regular training is important for maintaining competence in CPR. Also, in a future study, comparisons at an individual level, as well as assessments by experts and of non-technical skills, should be included.
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Affiliation(s)
- Kristina Grasto
- Faculty of Health, Welfare and Organization, Østfold University College, P.O. Box 700, 1757 Halden, Norway;
| | - Ann-Chatrin Linqvist Leonardsen
- Faculty of Health, Welfare and Organization, Østfold University College, P.O. Box 700, 1757 Halden, Norway;
- Department of Anesthesia, Østfold Hospital Trust, P.O. Box 300, 1714 Grålum, Norway
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14
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Raucci M, Díaz Crescitelli ME, Benati E, Borsari S, Lai M, Lombardi M, Mirra M, Giorgi V, Stoppazzoni S, Pedroni C, Di Leo S, Ghirotto L, Longo C. The care pathway experienced by cutaneous melanoma survivors: A qualitative longitudinal study. Eur J Oncol Nurs 2024; 72:102688. [PMID: 39303330 DOI: 10.1016/j.ejon.2024.102688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 08/19/2024] [Accepted: 08/20/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND The optimal management of cutaneous melanoma is based on implementing a multidisciplinary tumour board. No studies report cutaneous melanoma patients' perspective along the whole care pathway, taking us through their care experience longitudinally. AIMS To explore the patients' perspective on the cutaneous melanoma care journey in a skin cancers' tertiary referral centre. METHODS A longitudinal qualitative study was designed, using semi-structured interviews. Cutaneous melanoma patients were interviewed three times (T0, after diagnosis; T1, after the first postoperative visit; and T2, at the follow-up). Data were analysed using the inductive framework method. RESULTS Fifteen patients agreed to participate, and 8 completed all three interviews. We generated three themes describing how patients experienced the care pathway: (i) the evolving need for support during the care pathway, (ii) the development of emotions and expectations for the journey's end, (iii) the changing perceptions of hospital services, the care pathway itself, and the Skin Cancer Unit. We have emphasised the shifts in the experience of receiving assistance from the diagnosis to the follow-up stage. The more the care process progressed, the stronger the need for a relationship with healthcare professionals. The emotional impact of becoming a cancer survivor exacerbated the experience and reflected on patients' perceptions of the care pathway. CONCLUSIONS Adopting a relational approach to reassuring melanoma patients is essential. Our participants expressed needing a medical reference figure as a favourable element. When this is unfeasible, inter-professional training is desirable to help professionals cooperate in a multidisciplinary group and make this collaboration visible to patients.
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Affiliation(s)
- Margherita Raucci
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda USL-IRCCS di Reggio Emilia, Italy
| | | | - Elisa Benati
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda USL-IRCCS di Reggio Emilia, Italy
| | - Stefania Borsari
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda USL-IRCCS di Reggio Emilia, Italy
| | - Michela Lai
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda USL-IRCCS di Reggio Emilia, Italy; Department of Dermatology, University of Modena and Reggio Emilia, Italy; Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Italy
| | - Mara Lombardi
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda USL-IRCCS di Reggio Emilia, Italy
| | - Marica Mirra
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda USL-IRCCS di Reggio Emilia, Italy
| | - Valentina Giorgi
- Health Professions Department, Azienda USL-IRCSS di Reggio Emilia, Italy
| | - Simone Stoppazzoni
- Department with Integrated Activity of Mental Health and Pathological Dependencies, Azienda USL-IRCCS di Reggio Emilia, Italy
| | - Cristina Pedroni
- Health Professions Department, Azienda USL-IRCSS di Reggio Emilia, Italy
| | - Silvia Di Leo
- Psycho-oncology Unit, Azienda USL-IRCCS di Reggio Emilia, Italy
| | - Luca Ghirotto
- Qualitative Research Unit, Azienda USL-IRCCS di Reggio Emilia, Italy.
| | - Caterina Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda USL-IRCCS di Reggio Emilia, Italy; Department of Dermatology, University of Modena and Reggio Emilia, Italy
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15
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Malik RF, Azar P, Taimounti A, Buljac-Samardžić M, Hilders CGJM, Scheele F. How do cultural elements shape speak-up behavior beyond the patient safety context? An interprofessional perspective in an obstetrics and gynecology department. Front Med (Lausanne) 2024; 11:1345316. [PMID: 39296909 PMCID: PMC11409420 DOI: 10.3389/fmed.2024.1345316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 08/06/2024] [Indexed: 09/21/2024] Open
Abstract
Introduction Interprofessional working and learning thrives with speak-up behavior. Efforts to improve speak-up have mainly focused on isolated techniques and training programs within the patient safety scope, yet sustained improvement requires a cultural shift beyond this scope. This research investigates the influence of culture elements on speak-up behavior in interprofessional teams beyond the patient safety context. Methods An exploratory qualitative study design was used in a Dutch hospital's Obstetrics and Gynecology department. A representative sample of stakeholders was purposefully selected, resulting in semi-structured interviews with 13 professionals from different professional backgrounds (nurses, midwifes, managers, medical specialists, and residents). A speak-up pledge was developed by the research team and used to prime participants for discussion. Data analysis involved three-step coding, which led to the development of themes. Results This study has identified six primary cultural themes that enhance speak-up behavior. These themes encompass the importance of managing a shared vision, the role of functional hierarchy, the significance of robust interpersonal relationships, the formulation of a strategy delineating when to speak up and when to exercise restraint, the promotion of an open-minded professional mindset, and the integration of cultural practices in the context of interprofessional working and learning. Conclusion Six crucial cultural elements have been pinpointed to boost the practice of speaking up behavior in interprofessional working and learning. Remarkably, hierarchy should not be held responsible as the wrongdoer; instead, can be a great facilitator through respect and appreciation. We propose that employing transformational and humble leadership styles can provide guidance on effectively integrating the identified cultural elements into the workplace and provide an IMOI framework for effective interprofessional speak-up beyond patient safety.
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Affiliation(s)
- Romana F Malik
- Department of Research in Education, OLVG Hospital, Amsterdam, Netherlands
- Athena Institute, Faculty of Science, VU Amsterdam, Amsterdam, Netherlands
| | - Poyan Azar
- Department of Human Resources, Bunge, Zaandam, Netherlands
| | - Achraf Taimounti
- Faculty of Behavioral and Movement Sciences, VU Amsterdam, Amsterdam, Netherlands
| | | | - Carina G J M Hilders
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, Netherlands
- Reinier de Graaf Hospital, Delft, Netherlands
| | - Fedde Scheele
- Athena Institute, Faculty of Science, VU Amsterdam, Amsterdam, Netherlands
- Department of Research in Education, Amsterdam University Medical Centre, Amsterdam, Netherlands
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16
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Phelps KB, Pliakas M, Coughlin AK, McKissic D, Rappaport L, Carlton EF. Optimizing Pediatric Rapid Response Teams: Stakeholder Focus Groups. Hosp Pediatr 2024; 14:766-772. [PMID: 39183668 PMCID: PMC11358595 DOI: 10.1542/hpeds.2023-007468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 08/27/2024]
Abstract
OBJECTIVES Rapid response teams (RRTs) can improve outcomes in both adult and pediatric hospitals. Most pediatric hospitals have RRT-type systems; however, little is known about stakeholders' perspectives regarding how to optimize RRT quality and efficiency. We aimed to better understand multidisciplinary stakeholder perspectives on how to improve the RRT process. METHODS We held 4 stakeholder focus groups including floor nurses, pediatric trainees (interns and residents), pediatric hospitalists, and the responding PICU team (PICU fellows and nurses). We used deductive coding to identify potential solutions and subsequent themes. RESULTS Focus groups identified 10 potential solutions within 3 major themes. Themes included (1) the value of a standardized RRT workflow based on stages, (2) the benefit of promoting a safety culture, and (3) the need to implement ongoing RRT education. Stakeholders described a shared mental model of RRT workflow with important events or tasks occurring within each stage. These stages were coded as 1: trigger, 2: team arrival and information sharing, 3: intervention, and 4: disposition and follow-up. Additional proposed solutions included waiting for the entire team to arrive, a systematic information sharing process, and closed loop communication for follow-up plans for patients remaining on the general care floor. CONCLUSIONS RRT stakeholder focus groups provide valuable insight into efforts to optimize RRT events. Standardizing RRT workflow into a staged process may facilitate communication and information sharing. Promoting a culture of safety and implementing ongoing education may help reinforce RRT standardization.
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Affiliation(s)
- Kayla B. Phelps
- Louisiana State University Health Sciences Center, Children’s Hospital of New Orleans, New Orleans, Louisiana
| | | | | | - Devin McKissic
- Division of Neonatology, Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, Washington
| | - Leah Rappaport
- Division of Pediatric Hospital Medicine, Department of Pediatrics, Boston Children’s Hospital, Boston, Massachusetts
| | - Erin F. Carlton
- Division of Pediatric Critical Care Medicine
- Susan B. Meister Child Health Evaluation and Research Center, University of Michigan School of Medicine, Ann Arbor, Michigan
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17
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Cai M, Chen Y, Luo F, Zheng Y, Liu Y, Xiao B, Wang X, Sun L, Lin Y, Zeng X, Tan S, Liu K, Gu Y, Wang J, Ning X, Yuan J, Wen M, Cao J. Qualification rate and associated factors regarding COVID-19 clinical skills training based on scenario simulation teaching to medical staffs in China: a hospital-based cross-sectional study. BMC MEDICAL EDUCATION 2024; 24:774. [PMID: 39030541 PMCID: PMC11264940 DOI: 10.1186/s12909-024-05733-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 07/01/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND The coronavirus disease (COVID-19) pandemic has accentuated the need for effective clinical skills training in infectious diseases. This study aimed to explore the influencing factors of infectious disease clinical skills training based on scenario simulation teaching for medical staff in China. METHODS This hospital-based, cross-sectional study was conducted at the Third People's Hospital of Shenzhen between March and December 2022. Scenario simulation teaching was applied, and factors such as gender, educational level, professional background, and previous experience were examined to determine their impact on qualification outcomes. RESULTS The study included participants primarily between the ages of 20-40 years, with a higher proportion of women holding university degrees. Nurses and physicians were more likely to qualify, indicating the significance of professional backgrounds. Women showed a higher likelihood of qualifying than men and higher educational attainment correlated with better qualification rates. Prior experience with protective clothing in isolation wards was a significant determinant of successful qualification. Multivariate analysis underscored the influence of sex, education, and previous experience on training effectiveness. CONCLUSION Scenario simulation is an effective strategy for training clinical skills in treating infectious diseases. This study highlights the importance of considering sex, education, professional background, and prior experience when designing training programs to enhance the efficacy and relevance of infectious disease training.
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Affiliation(s)
- Manyuan Cai
- Department of Scientific Research and Teaching (Clinical Skills Simulation Training Center), Shenzhen Third People's Hospital and The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, 518112, China
| | - Yanping Chen
- Department of Difficult and Severe Liver Disease, Shenzhen Third People's Hospital and The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, 518112, China
| | - Fangting Luo
- Clinic, Shenzhen Third People's Hospital and The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, 518112, China
| | - Yanqun Zheng
- Department of Preventive Health Care and Hospital Infection Control, Shenzhen Third People's Hospital and The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, 518112, China
| | - Ying Liu
- Gastrointestinal Endoscopy Center, Shenzhen Third People's Hospital and The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, 518112, China
| | - Bing Xiao
- Clinic, Shenzhen Third People's Hospital and The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, 518112, China
| | - Xiaoyan Wang
- Department of Spine Surgery, Shenzhen Third People's Hospital and The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, 518112, China
| | - Lulu Sun
- Department of Pediatrics, Shenzhen Third People's Hospital and The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, 518112, China
| | - Yi Lin
- Two Department of Pulmonary Diseases, Shenzhen Third People's Hospital and The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, 518112, China
| | - Xianhu Zeng
- Department of Preventive Health Care and Hospital Infection Control, Shenzhen Third People's Hospital and The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, 518112, China
| | - Shuni Tan
- Department of Hepatitis and Cirrhosis, Shenzhen Third People's Hospital and The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, 518112, China
| | - Ke Liu
- Fever Clinic, Shenzhen Third People's Hospital and The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, 518112, China
| | - Yuanbo Gu
- Department of Scientific Research and Teaching (Clinical Skills Simulation Training Center), Shenzhen Third People's Hospital and The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, 518112, China
| | - Jinghua Wang
- Center of Clinical Epidemiology, Shenzhen Third People's Hospital and The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, 518112, China
| | - Xianjia Ning
- Center of Clinical Epidemiology, Shenzhen Third People's Hospital and The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, 518112, China
| | - Jing Yuan
- Department of Infectious disease, Shenzhen Third People's Hospital and The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, 518112, China
| | - Min Wen
- Department of Nursing, Shenzhen Third People's Hospital and The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, 29 Bulan Road, Longgang District, Shenzhen, Guangdong Province, 518112, China.
| | - Jing Cao
- Department of Nursing, Shenzhen Third People's Hospital and The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, 29 Bulan Road, Longgang District, Shenzhen, Guangdong Province, 518112, China.
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18
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Stuedemann A, Huston M, Saddler N, Schwend RM, Anderson J, Pierce E, Koivuniemi-Berg T, Fryatt J, Herman K. Implementing a Halo Gravity Traction Program: A Multidisciplinary Endeavor. Orthop Nurs 2024; 43:202-211. [PMID: 39047271 DOI: 10.1097/nor.0000000000001040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2024] Open
Abstract
Halo gravity traction (HGT) is a preoperative modality for children with severe spinal deformity used to optimize spine flexibility and balance while decreasing the likelihood of neurologic injury. HGT is a dependable solution for these challenging spinal deformities. Aligning treatment guidelines and providing resources, education, and training for staff are key components for a successful HGT program. The HGT program at Children's Mercy Hospital was then developed with a systems approach with the holistic goal of multidisciplinary collaboration with physical/occupational therapy, hospital medicine, pulmonology, psychology, nutrition, child life, and complex care management. Education, research, and national collaboration to standardize this therapy should improve patient safety and support quality improvement.
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Affiliation(s)
- Anne Stuedemann
- Anne Stuedemann, MSN, RN, CPNP, Orthopaedic Surgery, Children's Mercy Kansas City, Kansas City, MO
- Michon Huston, PA-C, Children's Mercy Kansas City, Kansas City, MO
- Nicolette Saddler, MSN, APRN, FNP-C, Children's Mercy Kansas City, Kansas City, MO
- Richard M Schwend, MD FAAP FAOA, Children's Mercy Kansas City, Kansas City, MO
- John Anderson, MD, Children's Mercy Kansas City, Kansas City, MO
- Elizabeth Pierce, DPT, Children's Mercy Kansas City, Kansas City, MO
- Tiffany Koivuniemi-Berg, DPT, Children's Mercy Kansas City, Kansas City, MO
- Jamie Fryatt, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
- Katrina Herman, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
| | - Michon Huston
- Anne Stuedemann, MSN, RN, CPNP, Orthopaedic Surgery, Children's Mercy Kansas City, Kansas City, MO
- Michon Huston, PA-C, Children's Mercy Kansas City, Kansas City, MO
- Nicolette Saddler, MSN, APRN, FNP-C, Children's Mercy Kansas City, Kansas City, MO
- Richard M Schwend, MD FAAP FAOA, Children's Mercy Kansas City, Kansas City, MO
- John Anderson, MD, Children's Mercy Kansas City, Kansas City, MO
- Elizabeth Pierce, DPT, Children's Mercy Kansas City, Kansas City, MO
- Tiffany Koivuniemi-Berg, DPT, Children's Mercy Kansas City, Kansas City, MO
- Jamie Fryatt, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
- Katrina Herman, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
| | - Nicolette Saddler
- Anne Stuedemann, MSN, RN, CPNP, Orthopaedic Surgery, Children's Mercy Kansas City, Kansas City, MO
- Michon Huston, PA-C, Children's Mercy Kansas City, Kansas City, MO
- Nicolette Saddler, MSN, APRN, FNP-C, Children's Mercy Kansas City, Kansas City, MO
- Richard M Schwend, MD FAAP FAOA, Children's Mercy Kansas City, Kansas City, MO
- John Anderson, MD, Children's Mercy Kansas City, Kansas City, MO
- Elizabeth Pierce, DPT, Children's Mercy Kansas City, Kansas City, MO
- Tiffany Koivuniemi-Berg, DPT, Children's Mercy Kansas City, Kansas City, MO
- Jamie Fryatt, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
- Katrina Herman, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
| | - Richard M Schwend
- Anne Stuedemann, MSN, RN, CPNP, Orthopaedic Surgery, Children's Mercy Kansas City, Kansas City, MO
- Michon Huston, PA-C, Children's Mercy Kansas City, Kansas City, MO
- Nicolette Saddler, MSN, APRN, FNP-C, Children's Mercy Kansas City, Kansas City, MO
- Richard M Schwend, MD FAAP FAOA, Children's Mercy Kansas City, Kansas City, MO
- John Anderson, MD, Children's Mercy Kansas City, Kansas City, MO
- Elizabeth Pierce, DPT, Children's Mercy Kansas City, Kansas City, MO
- Tiffany Koivuniemi-Berg, DPT, Children's Mercy Kansas City, Kansas City, MO
- Jamie Fryatt, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
- Katrina Herman, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
| | - John Anderson
- Anne Stuedemann, MSN, RN, CPNP, Orthopaedic Surgery, Children's Mercy Kansas City, Kansas City, MO
- Michon Huston, PA-C, Children's Mercy Kansas City, Kansas City, MO
- Nicolette Saddler, MSN, APRN, FNP-C, Children's Mercy Kansas City, Kansas City, MO
- Richard M Schwend, MD FAAP FAOA, Children's Mercy Kansas City, Kansas City, MO
- John Anderson, MD, Children's Mercy Kansas City, Kansas City, MO
- Elizabeth Pierce, DPT, Children's Mercy Kansas City, Kansas City, MO
- Tiffany Koivuniemi-Berg, DPT, Children's Mercy Kansas City, Kansas City, MO
- Jamie Fryatt, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
- Katrina Herman, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
| | - Elizabeth Pierce
- Anne Stuedemann, MSN, RN, CPNP, Orthopaedic Surgery, Children's Mercy Kansas City, Kansas City, MO
- Michon Huston, PA-C, Children's Mercy Kansas City, Kansas City, MO
- Nicolette Saddler, MSN, APRN, FNP-C, Children's Mercy Kansas City, Kansas City, MO
- Richard M Schwend, MD FAAP FAOA, Children's Mercy Kansas City, Kansas City, MO
- John Anderson, MD, Children's Mercy Kansas City, Kansas City, MO
- Elizabeth Pierce, DPT, Children's Mercy Kansas City, Kansas City, MO
- Tiffany Koivuniemi-Berg, DPT, Children's Mercy Kansas City, Kansas City, MO
- Jamie Fryatt, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
- Katrina Herman, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
| | - Tiffany Koivuniemi-Berg
- Anne Stuedemann, MSN, RN, CPNP, Orthopaedic Surgery, Children's Mercy Kansas City, Kansas City, MO
- Michon Huston, PA-C, Children's Mercy Kansas City, Kansas City, MO
- Nicolette Saddler, MSN, APRN, FNP-C, Children's Mercy Kansas City, Kansas City, MO
- Richard M Schwend, MD FAAP FAOA, Children's Mercy Kansas City, Kansas City, MO
- John Anderson, MD, Children's Mercy Kansas City, Kansas City, MO
- Elizabeth Pierce, DPT, Children's Mercy Kansas City, Kansas City, MO
- Tiffany Koivuniemi-Berg, DPT, Children's Mercy Kansas City, Kansas City, MO
- Jamie Fryatt, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
- Katrina Herman, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
| | - Jamie Fryatt
- Anne Stuedemann, MSN, RN, CPNP, Orthopaedic Surgery, Children's Mercy Kansas City, Kansas City, MO
- Michon Huston, PA-C, Children's Mercy Kansas City, Kansas City, MO
- Nicolette Saddler, MSN, APRN, FNP-C, Children's Mercy Kansas City, Kansas City, MO
- Richard M Schwend, MD FAAP FAOA, Children's Mercy Kansas City, Kansas City, MO
- John Anderson, MD, Children's Mercy Kansas City, Kansas City, MO
- Elizabeth Pierce, DPT, Children's Mercy Kansas City, Kansas City, MO
- Tiffany Koivuniemi-Berg, DPT, Children's Mercy Kansas City, Kansas City, MO
- Jamie Fryatt, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
- Katrina Herman, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
| | - Katrina Herman
- Anne Stuedemann, MSN, RN, CPNP, Orthopaedic Surgery, Children's Mercy Kansas City, Kansas City, MO
- Michon Huston, PA-C, Children's Mercy Kansas City, Kansas City, MO
- Nicolette Saddler, MSN, APRN, FNP-C, Children's Mercy Kansas City, Kansas City, MO
- Richard M Schwend, MD FAAP FAOA, Children's Mercy Kansas City, Kansas City, MO
- John Anderson, MD, Children's Mercy Kansas City, Kansas City, MO
- Elizabeth Pierce, DPT, Children's Mercy Kansas City, Kansas City, MO
- Tiffany Koivuniemi-Berg, DPT, Children's Mercy Kansas City, Kansas City, MO
- Jamie Fryatt, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
- Katrina Herman, RN, BSN, CPN, Children's Mercy Kansas City, Kansas City, MO
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19
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Hyvärinen S, Jarva E, Mikkonen K, Karsikas E, Koivunen K, Kääriäinen M, Meriläinen M, Jounila-Ilola P, Tuomikoski A, Oikarinen A. Healthcare professionals' experience regarding competencies in specialized and primary stroke units: A qualitative study. JOURNAL OF VASCULAR NURSING 2024; 42:26-34. [PMID: 38555175 DOI: 10.1016/j.jvn.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/20/2023] [Accepted: 11/18/2023] [Indexed: 04/02/2024]
Abstract
AIM To describe healthcare professionals' experience of needed competence in patient stroke care within specialist and primary healthcare. BACKGROUND Healthcare professionals who provide stroke care need multifaceted, multi-professional skills; ongoing training is important for competent stroke care. DESIGN A descriptive qualitative study. METHODS Six focus group interviews with semi-structured interviews were conducted in October and November 2020. Healthcare professionals (n = 25) working in stroke care units in both specialist and primary healthcare settings were interviewed. The interviews were recorded, transcribed and analyzed inductively by content analysis. The study was conducted, and results were reported according to the Consolidated Criteria for Reporting Qualitative Research. RESULTS Five main categories were identified: clinical competence; multiprofessional networking competence; competence in interaction skills; emotional and psychoeducational support competence; and self-management and development competence. CONCLUSION Competence in stroke care includes both in-depth and wide-ranging professional competences that require ongoing development. Utilizing various education models and collaborative learning approaches can help meet the requirements for developing competence in stroke care. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Satu Hyvärinen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI- 90014 University of Oulu, Oulu, Finland.
| | - Erika Jarva
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI- 90014 University of Oulu, Oulu, Finland.
| | - Kristina Mikkonen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - Eevi Karsikas
- Oulu University Hospital, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
| | | | - Maria Kääriäinen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
| | - Merja Meriläinen
- Oulu University Hospital, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
| | | | | | - Anne Oikarinen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI- 90014 University of Oulu, Oulu, Finland.
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20
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KLEMENC-KETIŠ Z, ZAFOŠNIK U. Interprofessional Education with Simulations in Primary Care. Zdr Varst 2024; 63:1-4. [PMID: 38156341 PMCID: PMC10751883 DOI: 10.2478/sjph-2024-0001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/16/2023] [Indexed: 12/30/2023] Open
Abstract
The introduction of interprofessional primary care (IPC) as a model of collaborative patient care is increasingly vital in the context of complex healthcare systems and the growing needs of patients. Its benefits include improved patient outcomes, enhanced efficiency, and reduced costs. However, the successful implementation of IPC faces challenges due to the differences in training and backgrounds among healthcare professionals, emphasising the importance of effective teamwork and collaborative education. Educational approaches utilising simulations have gained prominence, particularly in addressing the challenges of interprofessional primary care. Notably, simulations facilitate team learning, enhancing team management and confidence, which ultimately leads to improved performance in real-life scenarios. They also contribute to patient safety by providing comprehensive training and creating a safe environment for professionals to practice and refine their skills without risking real patient harm. Moreover, simulations promote psychological safety, allowing healthcare workers to manage stress effectively and prepare for critical situations. Ethical considerations are met through simulation-based education, ensuring patient confidentiality, and creating a standardised and just learning environment for all students. Simulations contribute to promoting equity in medical education by providing equal access to high-quality training opportunities for all healthcare professionals. In conclusion, successful IPC implementation requires a comprehensive approach that includes interprofessional education and the integration of simulations as an essential component of the curriculum at all levels of healthcare education. This approach fosters effective communication, teamwork, and confidence among primary care teams, ultimately leading to improved patient care and outcomes.
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Affiliation(s)
- Zalika KLEMENC-KETIŠ
- Community Health Centre Ljubljana, Metelkova 9, 1000Ljubljana, Slovenia
- University of Maribor, Faculty of Medicine, Department of Family Medicine, Taborska 8, 2000Maribor, Slovenia
- University of Ljubljana, Faculty of Medicine, Department of Family Medicine, Poljanski nasip 58, 1000Ljubljana, Slovenia
| | - Uroš ZAFOŠNIK
- Community Health Centre Ljubljana, Metelkova 9, 1000Ljubljana, Slovenia
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21
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Stewart S, Totka JP, Hanrahan K. Ted Lasso and Team Science for Evidence-Based Practice Teamwork. J Perianesth Nurs 2024; 39:155-159. [PMID: 38099886 DOI: 10.1016/j.jopan.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 09/24/2023] [Indexed: 02/04/2024]
Affiliation(s)
- Stephanie Stewart
- Department of Nursing Services and Patient Care, University of Iowa Hospitals & Clinics, Iowa City, IA
| | - Joan P Totka
- College of Nursing, Marquette University, Milwaukee, WI; Department of Nursing Research and Evidence-Based Practice, Children's Wisconsin, Milwaukee, WI
| | - Kirsten Hanrahan
- Department of Nursing Services and Patient Care, University of Iowa Hospitals & Clinics, Iowa City, IA.
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22
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Seabrooke M, Seabrooke A. In situ clinical education of frontline healthcare providers in under-resourced areas: A rapid review. CANADIAN JOURNAL OF RURAL MEDICINE 2024; 29:20-29. [PMID: 38372264 DOI: 10.4103/cjrm.cjrm_95_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/15/2023] [Indexed: 02/20/2024]
Abstract
ABSTRACT Rural communities are geographically isolated from large urban areas, affecting access to definitive care, specialists and other health services that only service urban areas. Rural decision-makers are often faced with numerous challenges regarding the availability, capacity, sustainability and performance of health systems in rural and remote areas. We evaluated the current body of literature on educational initiatives being used in under-resourced areas to increase the knowledge or skills of healthcare workers. This rapid review followed the methods laid out by the Cochrane Rapid Reviews Methods Group and included published articles from any of three databases that described and evaluated an educational intervention, in which healthcare workers were the learners and which took place in an under-resourced area. Papers were excluded if they were deemed to be too resource intensive, were an opinion or concept paper or took place in an urban area. Results were synthesised descriptively. Ten studies were identified that contained information on educational initiatives in a variety of countries. The healthcare workers targeted in the studies varied from physicians, nurses and midwives to community health workers and students. The quality of studies also varied and included randomised control trials, systematic reviews and both prospective and retrospective studies. Initiatives involving simulation or point-of-care ultrasound were most common and showed the most benefit to a learner's knowledge and skill development. A limited body of literature exists on educational initiatives for healthcare workers in under-resourced areas. While simulation and hands-on learning showed positive results, the opportunity remains for a low-cost, high-yield educational initiative tailored to the unique needs of healthcare workers in under-resourced areas.Les communautés rurales sont géographiquement isolées des grandes zones urbaines, ce qui affecte l'accès à des soins définitifs, à des spécialistes et à d'autres services de santé qui ne desservent que les zones urbaines. Les décideurs ruraux sont souvent confrontés à de nombreux défis concernant la disponibilité, la capacité, la durabilité et la performance des systèmes de santé dans les zones rurales et éloignées. Nous avons évalué l'ensemble de la littérature actuelle sur les initiatives éducatives utilisées dans les zones sous-dotées pour améliorer les connaissances ou les compétences des travailleuses et travailleurs de la santé. Cette examen rapide a suivi les méthodes définies par le Cochrane Rapid Reviews Methods Group et a inclus des articles publiés dans l'une des trois bases de données qui décrivaient et évaluaient une intervention éducative dans laquelle les travailleuses et travailleurs de la santé étaient les apprenants et qui SE déroulait dans une zone manquant de ressources. Des articles jugés trop gourmands en ressources, des opinions, des documents conceptuels ou en lien avec des zones urbaines, ont été exclus. Les résultats ont été synthétisés de manière descriptive. 10 études ont été identifiées, contenant des informations sur des initiatives éducatives dans divers pays. Les travailleurs de la santé ciblés dans les études variaient des médecins, des infirmières et des sages-femmes aux travailleurs de la santé communautaire et aux étudiants. La qualité des études était également variable et comprenait des essais contrôlés randomisés, des revues systématiques et des études prospectives et rétrospectives. Les initiatives impliquant la simulation ou le POCUS étaient les plus courantes et présentaient le plus d'avantages pour le développement des connaissances et des compétences de l'apprenant. Il existe un nombre limité de documents sur les initiatives éducatives destinées aux travailleurs de la santé dans les zones sous-dotées. Bien que la simulation et l'apprentissage pratique aient donné des résultats positifs, il est toujours possible de mettre en place une initiative éducative peu coûteuse et à haut rendement, adaptée aux besoins spécifiques des travailleuses et travailleurs de la santé dans les zones sous-dotées.
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23
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Langford EC, Jain S. The importance of embedding an inclusive culture within healthcare teamwork education; an evaluation of implementation methods. Postgrad Med J 2023; 99:1027-1032. [PMID: 37130826 DOI: 10.1093/postmj/qgad032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/27/2023] [Accepted: 04/02/2023] [Indexed: 05/04/2023]
Abstract
Teamworking is a fundamental concept within most organisations and healthcare is no different. It is at the core of everything we do as professionals and has a multitude of impacts including on patient safety, the quality of care that we provide, and staff morale. This paper looks at why we should prioritize advancing teamwork education; argues the advantages of developing an all-encompassing, inclusive team training approach; and summarizes the different methods of how to implement teamwork education within your organisation. Key messages Good teamworking processes have significant effects on patient safety and staff well-being. Inclusive training has wide-reaching benefits for staff morale, fostering colleague relationships and breaking down hierarchies. Teamwork education should be embedded within all healthcare organisations with the method used depending on organisational culture, hierarchy gradient and learners' starting knowledge.
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Affiliation(s)
- Emily C Langford
- Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, United Kingdom
- Health Education England Yorkshire and the Humber, Leeds, LS1 4PL, United Kingdom
| | - Sunjay Jain
- Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, United Kingdom
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24
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Abahuje E, Diaz CM, Lin KA, Tesorero K, Bushara O, Yang S, Berry ABL, Rafferty MR, Johnson JK, Stey AM. A qualitative study of how team characteristics and leadership are associated with information sharing in multidisciplinary intensive care units. Surgery 2023; 174:350-355. [PMID: 37211509 PMCID: PMC11210940 DOI: 10.1016/j.surg.2023.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/14/2023] [Accepted: 03/17/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Better information sharing in intensive care units has been associated with lower risk-adjusted mortality. This study explored how team characteristics and leadership are associated with information sharing in 4 intensive care units in a single large urban, academic medical center. METHODS A qualitative study was conducted to understand how team characteristics and leadership are associated with information sharing. Qualitative data were conducted through ethnographic observations. One postdoctoral research fellow and one PhD qualitative researcher conducted nonparticipant observations of a Medical, Surgical, Neurological, and Cardiothoracic intensive care unit morning and afternoon rounds, as well as nurse and resident handoffs from May to September 2021. Field notes of observations were thematically analyzed using deductive reasoning anchored to the Edmondson Team Learning Model. This study included nurses, physicians (ie, intensivists, surgeons, fellows, and residents), medical students, pharmacists, respiratory therapists, dieticians, physical therapists, physician assistants, and nurse practitioners. RESULTS We conducted 50 person-hours of observations involving 148 providers. Three themes emerged from the qualitative analysis: (1) team leaders used variable leadership techniques to involve team members in discussions for information sharing related to patient care, (2) predefined tasks for team members allowed them to prepare for effective information sharing during intensive care unit rounds, and (3) a psychologically safe environment allowed team members to participate in discussions for information sharing related to patient care. CONCLUSION Inclusive team leadership is foundational in creating a psychologically safe environment for effective information sharing.
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Affiliation(s)
- Egide Abahuje
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL.
| | - Carmen M Diaz
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | - Kaithlyn Tesorero
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Omar Bushara
- Department of Surgery, University of Pennsylvania, Philadelphia, PA
| | - Sohae Yang
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Andrew B L Berry
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | - Julie K Johnson
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Anne M Stey
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
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25
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Pennestrì F, Villa G, Giannetta N, Sala R, Manara DF, Mordacci R. Training Ethical Competence in a World Growing Old: A Multimethod Ethical Round in Hospital and Residential Care Settings. JOURNAL OF BIOETHICAL INQUIRY 2023; 20:279-294. [PMID: 36959489 PMCID: PMC10035964 DOI: 10.1007/s11673-023-10236-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/20/2022] [Indexed: 06/18/2023]
Abstract
Ethical challenges are traditionally described in a negative light, even though moral conflict can express the individual ability to perceive when something is not working and promote change. The true question, therefore, is not to how to silence moral conflict but how to educate it. Although the need for ethical support of health- and social-care professionals in elderly care is clearly perceived, there is no universal method for providing effective interventions. The authors hypothesize that adequate training sessions can help care professionals enhance this skill, once clear goals and specific educational techniques are set. This research tests the hypothesis on twenty care professionals working in acute and residential care settings for the elderly, building on the ethics round method. Mixed methods drawn from literature and the experience of educators were adapted to meet different educational goals. Moral issues can hardly be removed from a context characterized by increasing demand and decreasing resources, but they can be recognized and addressed with common efforts, a critical attitude, and a growth mindset. Enhancing these skills in qualified workers can help them accept the reality of work, release pressure, and identify common team goals. Introducing these skills before graduation can help future workers avoid unreal expectations and reduce frustration and early job quit rates.
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Affiliation(s)
- Federico Pennestrì
- Faculty of Philosophy, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
| | - Giulia Villa
- Centre for Nursing Research and Innovation, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
| | - Noemi Giannetta
- Faculty of Philosophy, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
- Centre for Nursing Research and Innovation, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
| | - Roberta Sala
- Faculty of Philosophy, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
| | - Duilio Fiorenzo Manara
- Centre for Nursing Research and Innovation, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
| | - Roberto Mordacci
- Faculty of Philosophy, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
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Meglič J, Lisec A, Lepej D, Loboda T, Bertok S, Lešnik Musek P, Kreft Hausmeister I, Oštir M, Ponjević T, Meglič A. Challenges in establishing optimal pediatric palliative care at the university hospital in Slovenia. Eur J Pediatr 2023; 182:1393-1401. [PMID: 36680577 PMCID: PMC10023644 DOI: 10.1007/s00431-023-04806-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/19/2022] [Accepted: 01/03/2023] [Indexed: 01/22/2023]
Abstract
The integration of pediatric palliative care (PPC) should become a standard of care for all children with life-limiting and life-threatening illnesses. There are many barriers and misperceptions in pediatrics which hinder the early implementation of PPC. The aim of the study was to design starting points for the establishment of accessible PPC with early involvement of patients in a tertiary-level children's hospital. An intervention, presentation, and discussion on PPC were offered by the hospital PPC team to all employees in the hospital. A total of 237 participants (physicians 30.4%, nurses 49.4%, psychologists 8.4%, and others) completed a questionnaire before and after the intervention. The personnel's knowledge, self-assessment of their ability to perform PPC, attitude to participate in PPC, and their awareness and understanding of the need for PPC were evaluated. The results were analyzed using Pandas and SciPy libraries in Python. The knowledge, awareness, and attitude of the physicians, nurses, and other professionals improved significantly after the intervention. However, the self-assessment of their ability to perform PPC did not increase. Previous experience with the death of a patient has proven to be a stimulus for self-initiative in acquiring knowledge in PPC and was linked with a better attitude and higher awareness of the need for PPC.Conclusions: More education and practical work tailored to the different professional profiles are needed, with adjustments for specific subspecialist areas, especially where patients could be included in early PPC. Although additional studies are needed, we identified the main directions for the further implementation of PPC in clinical practice in our setting.
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Affiliation(s)
| | - Ajda Lisec
- University Medical Centre, Ljubljana, Slovenia.
| | - Dušanka Lepej
- Pediatric Palliative Team, University Children's Hospital, University Medical Centre, Ljubljana, Slovenia
| | - Tanja Loboda
- Pediatric Palliative Team, University Children's Hospital, University Medical Centre, Ljubljana, Slovenia
| | - Sara Bertok
- Pediatric Palliative Team, University Children's Hospital, University Medical Centre, Ljubljana, Slovenia
| | - Petra Lešnik Musek
- Pediatric Palliative Team, University Children's Hospital, University Medical Centre, Ljubljana, Slovenia
| | - Ivana Kreft Hausmeister
- Pediatric Palliative Team, University Children's Hospital, University Medical Centre, Ljubljana, Slovenia
| | - Majda Oštir
- Pediatric Palliative Team, University Children's Hospital, University Medical Centre, Ljubljana, Slovenia
| | - Tehvida Ponjević
- Pediatric Palliative Team, University Children's Hospital, University Medical Centre, Ljubljana, Slovenia
| | - Anamarija Meglič
- Pediatric Palliative Team, University Children's Hospital, University Medical Centre, Ljubljana, Slovenia
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27
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Fu BQ, Zhong CCW, Wong CHL, Ho FF, Nilsen P, Hung CT, Yeoh EK, Chung VCH. Barriers and Facilitators to Implementing Interventions for Reducing Avoidable Hospital Readmission: Systematic Review of Qualitative Studies. Int J Health Policy Manag 2023; 12:7089. [PMID: 37579466 PMCID: PMC10125127 DOI: 10.34172/ijhpm.2023.7089] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 01/04/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Avoidable hospital readmission is a major problem among health systems. Although there are effective peri-discharge interventions for reducing avoidable hospital readmission, successful implementation is challenging. This systematic review of qualitative studies aimed to identify barriers and facilitators to implementing peri-discharge interventions from providers' and service users' perspectives. METHODS We searched four databases for potentially eligible qualitative studies from databases' inception to March 2020, and updated literature search for studies published between January 2020 to October 2021. Barriers and facilitators to implementing peri-discharge interventions were identified and mapped onto the Consolidated Framework for Implementation Research (CFIR) constructs. Inductive analysis of the CFIR constructs was performed to yield thematic areas that illustrated the relationship between various facilitators and barriers, generating practical insights to key implementation issues. RESULTS Thirteen qualitative studies were included in this systematic review. Key issues were clustered in the CFIR constructs of Design Quality and Complexity of the intervention, strength of Network and Communication, being responsive to Patient Needs with sufficient Resource support, and External Incentives. The three thematic areas were rationality of the interventions, readiness and effort of multidisciplinary implementation teams, and influence of external stakeholders. Common barriers included (i) limited resources, (ii) poor communication among team members, (iii) incompatibility between the new intervention and existing work routine, (iv) complicated implementation process, (v) low practicality of supporting instruments, and (vi) lack of understanding about the content and effectiveness of the new interventions. Common facilitators were (i) information sharing via regular meetings on implementation issues, (ii) organizational culture that values quality and accountability, (iii) financial penalties for hospitals with high avoidable readmissions rates, (iv) external support offered via quality improvement programs and community resources, and (v) senior leadership support. CONCLUSION This study synthesized commonly-presenting barriers and facilitators to implementing peri-discharge interventions among different healthcare organizations. Findings may inform development of implementation strategies in different health systems after appropriate tailoring, based on a consensus-based formative research process.
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Affiliation(s)
- Becky Q Fu
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Claire CW Zhong
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Charlene HL Wong
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Fai Fai Ho
- School of Chinese Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Per Nilsen
- Department of Medicine, Health and Caring Sciences, Linköping University, Linköping, Sweden
| | - Chi Tim Hung
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Eng Kiong Yeoh
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Vincent CH Chung
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
- School of Chinese Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
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Santini TP, Muhlen ESV, Marchiori MRCT, Kruel CS, Backes DS. Best Practices in Maternal and Child Health from the Perspective of Healthcare Professionals. AQUICHAN 2023. [DOI: 10.5294/aqui.2023.23.1.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Objective: To understand healthcare professionals’ perception of best practices in maternal and child health. Materials and methods: This qualitative exploratory-descriptive study was conducted between December 2020 and March 2021. The study corpus consisted of 23 healthcare professionals from southern Brazil. Data were collected using a semi-structured script and coded based on Minayo’s thematic content analysis proposed. Results: Data analysis enabled the delimitation of two thematic categories: “best practices in maternal and child health: from idealization to accomplishment” and “strategies to qualify the maternal and child healthcare network.” Conclusions: Healthcare professionals recognize the relevance of best practices in maternal and child health, although this process must be expanded and consolidated. Continuing education, hospitality, ambiance, improved access, and the professional-user connection stand out among the qualifying strategies.
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Buléon C, Mattatia L, Minehart RD, Rudolph JW, Lois FJ, Guillouet E, Philippon AL, Brissaud O, Lefevre-Scelles A, Benhamou D, Lecomte F, group TSAWS, Bellot A, Crublé I, Philippot G, Vanderlinden T, Batrancourt S, Boithias-Guerot C, Bréaud J, de Vries P, Sibert L, Sécheresse T, Boulant V, Delamarre L, Grillet L, Jund M, Mathurin C, Berthod J, Debien B, Gacia O, Der Sahakian G, Boet S, Oriot D, Chabot JM. Simulation-based summative assessment in healthcare: an overview of key principles for practice. ADVANCES IN SIMULATION (LONDON, ENGLAND) 2022; 7:42. [PMID: 36578052 PMCID: PMC9795938 DOI: 10.1186/s41077-022-00238-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 11/30/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Healthcare curricula need summative assessments relevant to and representative of clinical situations to best select and train learners. Simulation provides multiple benefits with a growing literature base proving its utility for training in a formative context. Advancing to the next step, "the use of simulation for summative assessment" requires rigorous and evidence-based development because any summative assessment is high stakes for participants, trainers, and programs. The first step of this process is to identify the baseline from which we can start. METHODS First, using a modified nominal group technique, a task force of 34 panelists defined topics to clarify the why, how, what, when, and who for using simulation-based summative assessment (SBSA). Second, each topic was explored by a group of panelists based on state-of-the-art literature reviews technique with a snowball method to identify further references. Our goal was to identify current knowledge and potential recommendations for future directions. Results were cross-checked among groups and reviewed by an independent expert committee. RESULTS Seven topics were selected by the task force: "What can be assessed in simulation?", "Assessment tools for SBSA", "Consequences of undergoing the SBSA process", "Scenarios for SBSA", "Debriefing, video, and research for SBSA", "Trainers for SBSA", and "Implementation of SBSA in healthcare". Together, these seven explorations provide an overview of what is known and can be done with relative certainty, and what is unknown and probably needs further investigation. Based on this work, we highlighted the trustworthiness of different summative assessment-related conclusions, the remaining important problems and questions, and their consequences for participants and institutions of how SBSA is conducted. CONCLUSION Our results identified among the seven topics one area with robust evidence in the literature ("What can be assessed in simulation?"), three areas with evidence that require guidance by expert opinion ("Assessment tools for SBSA", "Scenarios for SBSA", "Implementation of SBSA in healthcare"), and three areas with weak or emerging evidence ("Consequences of undergoing the SBSA process", "Debriefing for SBSA", "Trainers for SBSA"). Using SBSA holds much promise, with increasing demand for this application. Due to the important stakes involved, it must be rigorously conducted and supervised. Guidelines for good practice should be formalized to help with conduct and implementation. We believe this baseline can direct future investigation and the development of guidelines.
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Affiliation(s)
- Clément Buléon
- grid.460771.30000 0004 1785 9671Department of Anesthesiology, Intensive Care and Perioperative Medicine, Caen Normandy University Hospital, 6th Floor, Caen, France ,grid.412043.00000 0001 2186 4076Medical School, University of Caen Normandy, Caen, France ,grid.419998.40000 0004 0452 5971Center for Medical Simulation, Boston, MA USA
| | - Laurent Mattatia
- grid.411165.60000 0004 0593 8241Department of Anesthesiology, Intensive Care and Perioperative Medicine, Nîmes University Hospital, Nîmes, France
| | - Rebecca D. Minehart
- grid.419998.40000 0004 0452 5971Center for Medical Simulation, Boston, MA USA ,grid.32224.350000 0004 0386 9924Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA USA ,grid.38142.3c000000041936754XHarvard Medical School, Boston, MA USA
| | - Jenny W. Rudolph
- grid.419998.40000 0004 0452 5971Center for Medical Simulation, Boston, MA USA ,grid.32224.350000 0004 0386 9924Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA USA ,grid.38142.3c000000041936754XHarvard Medical School, Boston, MA USA
| | - Fernande J. Lois
- grid.4861.b0000 0001 0805 7253Department of Anesthesiology, Intensive Care and Perioperative Medicine, Liège University Hospital, Liège, Belgique
| | - Erwan Guillouet
- grid.460771.30000 0004 1785 9671Department of Anesthesiology, Intensive Care and Perioperative Medicine, Caen Normandy University Hospital, 6th Floor, Caen, France ,grid.412043.00000 0001 2186 4076Medical School, University of Caen Normandy, Caen, France
| | - Anne-Laure Philippon
- grid.411439.a0000 0001 2150 9058Department of Emergency Medicine, Pitié Salpêtrière University Hospital, APHP, Paris, France
| | - Olivier Brissaud
- grid.42399.350000 0004 0593 7118Department of Pediatric Intensive Care, Pellegrin University Hospital, Bordeaux, France
| | - Antoine Lefevre-Scelles
- grid.41724.340000 0001 2296 5231Department of Emergency Medicine, Rouen University Hospital, Rouen, France
| | - Dan Benhamou
- grid.413784.d0000 0001 2181 7253Department of Anesthesiology, Intensive Care and Perioperative Medicine, Kremlin Bicêtre University Hospital, APHP, Paris, France
| | - François Lecomte
- grid.411784.f0000 0001 0274 3893Department of Emergency Medicine, Cochin University Hospital, APHP, Paris, France
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McAuliffe MJ, Gledhill SE. Enablers and barriers for mandatory training including Basic Life Support in an interprofessional environment: An integrative literature review. NURSE EDUCATION TODAY 2022; 119:105539. [PMID: 36327789 DOI: 10.1016/j.nedt.2022.105539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 08/12/2022] [Accepted: 09/04/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES It is vital health services have systems in place for staff mandatory training to meet safe quality health outcomes. The aim of this review is to identify enablers supporting staff attendance at mandatory training (including BLS) and barriers that pose challenges for staff participation in mandatory training that will be used to inform the development of a structured mandatory staff training program in an IPE environment. DESIGN An integrative literature review was sought to answer the question: What are the enablers and barriers that influence health professional attendance and successful completion of mandatory training (including BLS) in an IPE environment? DATA SOURCES An international literature search was undertaken using advance search of the databases: Medline, CINAHL, Google Scholar and Web of Science (WoS). English language, peer reviewed articles published from 2010 to 2022 were retrieved and screened for relevance. REVIEW METHODS An integrative review of papers included systematic reviews, a case study, quantitative and qualitative studies, RCT, mixed method studies and expert opinion papers. RESULTS Only 34 articles were eligible for inclusion in the review based on their relevance to staff attendance at mandatory training (including BLS). Analysis of literature identified four key themes: 'mandatory training' and 'certification'; 'knowledge and skills'; 'enablers' and 'barriers' for 'mandatory training (including BLS) attendance' and 'IPE'. The literature highlighted that IPE is an appropriate means of delivering a redesign education/training process that may increase attendance at mandatory training with recommendations for increased inclusivity and interactivity as well as providing useful logistic information. CONCLUSION The outcome of the review can inform development of an IPE Implementation Strategy in a health service aiming to improve staff attending and engaging in mandatory training. The findings are valuable to other health services seeking to improve and achieve mandatory and accreditation targets.
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Camacho-Rodríguez DE, Carrasquilla-Baza DA, Dominguez-Cancino KA, Palmieri PA. Patient Safety Culture in Latin American Hospitals: A Systematic Review with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14380. [PMID: 36361273 PMCID: PMC9658502 DOI: 10.3390/ijerph192114380] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/24/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Adverse events in hospitals are prevented through risk reduction and reliable processes. Highly reliable hospitals are grounded by a robust patient safety culture with effective communication, leadership, teamwork, error reporting, continuous improvement, and organizational learning. Although hospitals regularly measure their patient safety culture for strengths and weaknesses, there have been no systematic reviews with meta-analyses reported from Latin America. PURPOSE Our systematic review aims to produce evidence about the status of patient safety culture in Latin American hospitals from studies using the Hospital Survey on Patient Safety Culture (HSOPSC). METHODS This systematic review was guided by the JBI guidelines for evidence synthesis. Four databases were systematically searched for studies from 2011 to 2021 originating in Latin America. Studies identified for inclusion were assessed for methodological quality and risk of bias. Descriptive and inferential statistics, including meta-analysis for professional subgroups and meta-regression for subgroup effect, were calculated. RESULTS In total, 30 studies from five countries-Argentina (1), Brazil (22), Colombia (3), Mexico (3), and Peru (1)-were included in the review, with 10,915 participants, consisting primarily of nursing staff (93%). The HSOPSC dimensions most positive for patient safety culture were "organizational learning: continuous improvement" and "teamwork within units", while the least positive were "nonpunitive response to error" and "staffing". Overall, there was a low positive perception (48%) of patient safety culture as a global measure (95% CI, 44.53-51.60), and a significant difference was observed for physicians who had a higher positive perception than nurses (59.84; 95% CI, 56.02-63.66). CONCLUSIONS Patient safety culture is a relatively unknown or unmeasured concept in most Latin American countries. Health professional programs need to build patient safety content into curriculums with an emphasis on developing skills in communication, leadership, and teamwork. Despite international accreditation penetration in the region, there were surprisingly few studies from countries with accredited hospitals. Patient safety culture needs to be a priority for hospitals in Latin America through health policies requiring annual assessments to identify weaknesses for quality improvement initiatives.
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Affiliation(s)
- Doriam E. Camacho-Rodríguez
- Facultad de Enfermería, Universidad Cooperativa de Colombia, Santa Marta 470002, Colombia
- EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Lima 15023, Peru
| | - Deibys A. Carrasquilla-Baza
- Facultad de Enfermería, Universidad Cooperativa de Colombia, Santa Marta 470002, Colombia
- EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Lima 15023, Peru
| | - Karen A. Dominguez-Cancino
- EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Lima 15023, Peru
- Addiction Study Program, Université de Sherbrooke, 150, Place Charles-Le Moyne, Bureau 200, Longueuil, QC J4K 0A8, Canada
- Escuela de Salud Pública, Universidad de Chile, Av. Independencia 939, Independencia, Santiago de Chile 8380453, Chile
| | - Patrick A. Palmieri
- EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Lima 15023, Peru
- South American Center for Qualitative Research, Universidad Norbert Wiener, Av. Arequipa 444, Lima 15046, Peru
- College of Graduate Health Studies, A.T. Still University, 800 West Jefferson Street, Kirksville, MO 63501, USA
- Center for Global Nursing, Texas Woman’s University, 6700 Fannin St, Houston, TX 77030, USA
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Newman D, Hofstee F, Bowen K, Massey D, Penman O, Aggar C. A qualitative study exploring clinicians’ attitudes toward responding to and escalating care of deteriorating patients. J Interprof Care 2022; 37:541-548. [DOI: 10.1080/13561820.2022.2104231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Deb Newman
- Northern New South Wales Local Health District, Australia
| | - Fran Hofstee
- Northern New South Wales Local Health District, Australia
| | - Karen Bowen
- Northern New South Wales Local Health District, Australia
| | - Deb Massey
- School of Health & Human Sciences Southern Cross Drive, Southern Cross University, Lismore, Australia
| | - Olivia Penman
- School of Health & Human Sciences Southern Cross Drive, Southern Cross University, Lismore, Australia
| | - Christina Aggar
- Northern New South Wales Local Health District, Australia
- School of Health & Human Sciences Southern Cross Drive, Southern Cross University, Lismore, Australia
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Gordon D, Achuck K, Kempner D, Jaffe R, Papanagnou D. Toward Unity and Inclusion in the Clinical Workplace: An Evaluation of Healthcare Workforce Belonging During the COVID-19 Pandemic. Cureus 2022; 14:e29454. [PMID: 36312604 PMCID: PMC9595229 DOI: 10.7759/cureus.29454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction: In a challenging time for the healthcare workforce responding to the coronavirus disease 2019 (COVID-19) pandemic, it is critical to identify factors contributing to team members' feelings of “belonging” in the workplace. The Institute for Healthcare Improvement’s Quintuple Aim’s principle of improving healthcare worker well-being could be applied to explore the implications of the increased turnover and stress, which connect to components of belonging. This study applies a qualitative approach to the organizational issues impacting healthcare teams, particularly during a complex and uncertain time. Methods: To elucidate factors contributing to belonging, we conducted a series of semi-structured interviews with an interdisciplinary cross-sectional sample of healthcare workers. Interviews were conducted with 23 total staff members in two clinical settings, the emergency department and hospital medicine groups at a large urban teaching hospital, to evaluate team members’ perspectives of the work environment. Results: Participants discuss their degree of inclusion, excitement, challenges, and respective needs from the organization. Perspectives of workers representing varied professional roles of the healthcare team were gathered to provide robust and unique insights into initiatives that can enhance belonging in the clinical workplace. Conclusion: Our findings provide a preliminary framework to identify strategies that can potentially reinforce collective team member belonging and consequently improve staff well-being, morale, and retention.
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Italian Translation and Validation of the Readiness for Interprofessional Learning Scale (RIPLS) in an Undergraduate Healthcare Student Context. Healthcare (Basel) 2022; 10:healthcare10091698. [PMID: 36141309 PMCID: PMC9498412 DOI: 10.3390/healthcare10091698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/30/2022] [Accepted: 09/02/2022] [Indexed: 11/25/2022] Open
Abstract
Interprofessional education requires that two or more professionals learn from and with each other to allow effective collaboration and improve health outcomes. Thus far, the interprofessional collaboration of healthcare students might be assessed using the Readiness for Interprofessional Learning Scale (RIPLS), which is currently not available in its Italian version. This study aimed to provide the intercultural adaptation of the RIPLS in Italian (I-RIPLS) and assess its validity and reliability. A two-phase validation study was performed in 2020, using a single-centre approach in students enrolled in the medical degree, physiotherapy, nursing, and dentistry courses at an Italian-speaking university in Albania. The first phase of the study determined the cross-cultural adaptation of the items by involving two translators who followed a forward and backward translation process. In the second phase, a sample of 414 students was enrolled. The preliminary corrected item-total correlations showed that five items did not show significant item-to-total correlations. Even if their deletion was not mandatory for generating a suitable correlation matrix for factor analysis, the advantages of keeping only items contributing to a more stable measurement with a shorter scale represented the rationale for removing items with non-significant item-to-total correlation from the correlation matrix before testing the dimensionality of the I-RIPLS with factor analysis. The answers from the first 50% of responders (n = 207) were used to determine the most plausible dimensionality of the I-RIPLS by employing an exploratory factor analysis (EFA), and the second 50% were used to cross-validate the most plausible dimensionality derived from EFA by employing confirmatory factor analysis (CFA) models. The most plausible dimensionality from EFA, by acknowledging the interpretation of the scree plot, the eigenvalues greater than 1, a parallel analysis, and the previous theoretical dimensions of the tool had two factors with adequate internal consistency. The CFA confirmed the two-factor solutions and the internal consistency for each domain. The I-RIPLS has 14 items with adequate evidence of validity and reliability. Future research should revise the tool for pursuing cross-cultural multigroup measurement invariance.
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Willman A, Nilsson J, Bjuresäter K. PROFESSIONAL DEVELOPMENT AMONG NEWLY GRADUATED REGISTERED NURSES WORKING IN ACUTE CARE HOSPITAL SETTINGS ‐ A QUALITATIVE EXPLORATIVE STUDY. J Nurs Manag 2022; 30:3304-3312. [PMID: 35986496 PMCID: PMC10087153 DOI: 10.1111/jonm.13771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 07/26/2022] [Accepted: 08/19/2022] [Indexed: 11/28/2022]
Abstract
AIM To explore newly graduated registered nurses' perceptions of their work situation and management of nursing care in complex patient situations after 18 months of work experience. BACKGROUND Newly graduated registered nurses working in acute care hospital settings play a critical role in providing safe nursing care. METHODS An explorative qualitative design, with four focus group interviews with 14 newly graduated registered nurses working in acute care hospital settings. RESULTS One theme emerged: 'Clarity and security in one's own nursing role despite facing challenges that hinder professional development' and three categories: 'Independency due to one's own efforts and experience', 'Well-functioning teamwork' and 'Challenges in the work situation'. CONCLUSION After 18 months in the profession, the nurses were considered to be advanced beginners; at the same time, the most experienced nurses on their respective wards. They found it challenging and need to further develop competences concerning managing and organizing the nursing care of several complex patient situations or new patient groups, as well as supervising novice registered nurses and nursing students. IMPLICATION FOR NURSING MANAGEMENT Powerful and urgent action is needed to be taken by national healthcare policymakers as well a hospital and nurse managers to develop long-term strategies to improve working conditions for newly registered graduated nurses.
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Affiliation(s)
- Anna Willman
- Department of Health Sciences, Faculty of Health, Science, and Technology Karlstad University Karlstad Sweden
| | - Jan Nilsson
- Department of Health Sciences, Faculty of Health, Science, and Technology Karlstad University Karlstad Sweden
- Department of Health Promotion Sciences Sophiahemmet University Stockholm Sweden
| | - Kaisa Bjuresäter
- Department of Health Sciences, Faculty of Health, Science, and Technology Karlstad University Karlstad Sweden
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Aziz Alimul Hidayat A, Chen WL, Nor RM, Uliyah M, Badriyah FL, Ubudiyah M. The determinants of patient care manager role and the implementation of COVID-19 clinical pathway: a cross-sectional study. PeerJ 2022; 10:e13764. [PMID: 35910779 PMCID: PMC9332306 DOI: 10.7717/peerj.13764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/30/2022] [Indexed: 01/17/2023] Open
Abstract
Objective This study aims to determine the factors associated with patient care manager role and the implementation of the clinical pathway among nurses in private hospitals. Methods This study was conducted from January-July 2021 using the cross-sectional approach. The sample consisted of 168 nurses working in a private hospital in Surabaya City, East Java, Indonesia. Meanwhile, the data were collected using the Patient Care Manager Role Scale (PCMRS) and analyzed by multiple logistic regression to find the correlation between the variables. Results A higher percentage of nurses namely 64.3% had compliance in COVID-19 clinical pathways with an average PCMRS score of 27.81 ± 2.43. Nurses with a high-level patient care manager role level had a significant compliance risk with odds ratio [OR] 440.137, 95% confidence interval [CI] [51.850-3736.184], and p-value = 0.000 compared to those with a low role. Conclusion The role of patient care manager and compliance with COVID-19 clinical pathways correlated significantly. Based on the results, several actions are needed for the early identification of patient service managers' roles to ensure compliance with COVID-19 clinical pathways and reduce the number of cases in Indonesia.
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Affiliation(s)
| | - Wen-Ling Chen
- Nursing, Kaohsiung Medical University Hospital, Kaohsiung, Kaohsiung, Taiwan
| | - Rahimah Mohd Nor
- Faculty of Health & Life Sciences, Management & Science University, Selangor, Selangor, Malaysia
| | - Musrifatul Uliyah
- Nursing, University Muhammadiyah of Surabaya, Surabaya, East Jawa, Indonesia
| | | | - Masunatul Ubudiyah
- Nursing, Universitas Muhammadiyah Lamongan, Lamongan, East Java, Indonesia
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Zhang Y, Mou Y, Zhang Y, Wang J, Kong F. Psychological experience and social reintegration needs of young stroke patients: a systematic review and meta-aggregation of qualitative studies. J Community Health Nurs 2022; 39:150-169. [PMID: 35653793 DOI: 10.1080/07370016.2022.2077074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The visible physical dysfunction and invisible psychological effects after stroke prevent young patients from returning to their pre-stroke roles and social activities. PURPOSE/AIM To comprehensively analyze the psychological experience and social reintegration needs of young stroke patients, which may be beneficial for improving quality of life and social reintegration after stroke. METHODS We conducted a comprehensive literature search of 10 databases. The screening and quality assessment of the included articles were performed by the Qualitative Assessment and Review Instrument (QARI). Meta-aggregation was conducted to synthesize the findings of the included studies. We summarized the certainty of confidence using the Confidence in Evidence from Reviews of Qualitative Research (CERQual) approach. RESULTS A total of 5506 studies were screened, of which 12 were included. Data synthesis suggested two new themes: (a) the self-growth process from denial of stroke to accepting stroke (high CERQual confidence), and (b) desire to regain pre-stroke normality, but having difficulty in the social reintegration process (high CERQual confidence). CONCLUSION Stroke, as a traumatic event, disrupts the life structure of young patients, and their needs of reintegration are not adequately considered. Interventions based on the principle of individuation should focus on this issue to restore continuity in life after stroke.
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Affiliation(s)
- Yongli Zhang
- Department of Neurology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, China.,College of Nursing, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Yating Mou
- Department of Neurology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, China.,College of Nursing, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Yunqian Zhang
- Department of Neurology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, China
| | - Jingmei Wang
- Department of Neurology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, China
| | - Fanyi Kong
- Department of Neurology, Affiliated Hospital of Yunnan University, Kunming, Yunnan, China
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Stassen P, Westerman D. Novice Doctors in the Emergency Department: A Scoping Review. Cureus 2022; 14:e26245. [PMID: 35898382 PMCID: PMC9308466 DOI: 10.7759/cureus.26245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 11/18/2022] Open
Abstract
In many emergency departments (EDs), young, inexperienced doctors treat patients who are critically ill. At the start of their career, these novice doctors are not sufficiently qualified to take care of these potentially critically ill patients in the highly demanding environment of an ED. This not only poses a threat to the well-being of the doctor, who feels inadequately prepared and experiences a lot of stress, but also to that of the patients, who may not receive optimal care. Lastly, young doctors may influence the efficiency of the organization, with longer throughput times, more orders of ancillary investigations, and more admissions. Training novice doctors with regard to simple or complex skills using simulation techniques is part of the solution. However, the transfer of newly learned skills to clinical practice remains unexplored, and not everything can be trained before the actual skill is required. Therefore, it is important to train young doctors in their learning abilities, for instance, teach them how to be adaptive and how to use their skills in new situations. Lastly, the way care is organized is essential. Good supervision, leaving room for the learning processes of young doctors, developing a team with more experienced professionals (paramedics, nurses, and doctors), and well-organized processes, aiming to reduce the complexity of the work, are ways to improve the quality of care, independent of the experience level of the novice doctor.
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Affiliation(s)
- Patricia Stassen
- Internal Medicine, Department of General Medicine, Section of Acute Medicine, Maastricht University Medical Centre, Maastricht, NLD
- General Practice, Maastricht University, Maastricht, NLD
- Optimising Patient Care, Care and Public Health Research Institute, Maastricht, NLD
| | - Dewa Westerman
- Internal Medicine, Department of General Medicine, Section of Acute Medicine, Maastricht University Medical Centre, Maastricht, NLD
- Health Professions Education, Maastricht School of Health Professions Education, Maastricht University, Maastricht, NLD
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Hsu HC, Lin MH. The impact of an educational program on nurses' shared decision making attitudes: A randomized controlled trial. Appl Nurs Res 2022; 65:151587. [DOI: 10.1016/j.apnr.2022.151587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/25/2022] [Accepted: 04/28/2022] [Indexed: 10/18/2022]
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Arku D, Almatruk Z, Warholak T, Axon DR. Evaluating the reliability and validity of a questionnaire used to measure experiences of teamwork among student pharmacists in a quality improvement course. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:552-560. [PMID: 35715095 DOI: 10.1016/j.cptl.2022.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 02/13/2022] [Accepted: 04/28/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The psychometric properties of instruments used to capture student pharmacists' perspectives of teamwork have not been well assessed. This study measured the reliability and validity of an instrument designed to assess teamwork experiences among student pharmacists in a quality improvement (QI) class at one United States pharmacy school. METHODS The psychometric properties of a previously conducted 17-item questionnaire (response options: "strongly agree," "agree," "disagree," or "strongly disagree") about second-year student pharmacists' teamworking experiences were assessed. A Rasch rating scale model was used to construct measures of teamwork experience. Principal component analysis (PCA) assessed unidimensionality. Item- and person-fit statistics were assessed. Construct and content validity and reliability were estimated utilizing student and item separation indices (SI) and reliability coefficients (RC). RESULTS Sixty student pharmacists were included. PCA conveyed a unidimensional construct. Four items with infit and outfit mean-squared values outside the suggested range were removed. Item responses "disagree" and "strongly disagree" were merged to improve scale functionality. The average person measure was 1.74 ± 2.03 logits. Student and item RC were 0.81 (SI = 2.04) and 0.97 (SI = 2.17), respectively. The easiest item endorsed was team's ability to reach consensus, while the most difficult item was interest to do collaborative work again. Mismatch of student experience and item difficulty level on the continuum scale suggested additional items are needed to match student teamwork experience. CONCLUSION The instrument demonstrated evidence of reliability and validity to measure student pharmacists' teamwork experience in a QI class, but additional instrument modifications are recommended.
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Affiliation(s)
- Daniel Arku
- University of Arizona College of Pharmacy, 1295 N. Martin Ave., PO Box 210202, Tucson, AZ 85721, United States.
| | - Ziyad Almatruk
- University of Arizona College of Pharmacy, 1295 N. Martin Ave., PO Box 210202, Tucson, AZ 85721, United States.
| | - Terri Warholak
- University of Arizona College of Pharmacy, 1295 N. Martin Ave., PO Box 210202, Tucson, AZ 85721, United States.
| | - David R Axon
- University of Arizona College of Pharmacy, 1295 N. Martin Ave., PO Box 210202, Tucson, AZ 85721, United States.
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Hu Y, Zheng B, Zhu L, Tang S, Lu Q, Song Q, Zhang N, Zhong Y. The effectiveness of emergency knowledge training of pediatric medical workers based on the knowledge, skills, simulation model: a quasi-experimental study. BMC MEDICAL EDUCATION 2022; 22:213. [PMID: 35351112 PMCID: PMC8966279 DOI: 10.1186/s12909-022-03267-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 03/16/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Basic life support and advanced life support are essential emergency management skills for medical workers, and pediatricians' first aid skills can be improved through emergency knowledge training. METHODS A controlled pre-post-intervention quasi-experimental study design was used. The study setting was a tertiary children's hospital in China. In November 2019, a KSS model of emergency knowledge learning was developed and tested, and pediatric medical workers (N = 1448) were trained with it. The outcome measures were based on an emergency knowledge questionnaire devised by the authors that measured the effectiveness of training by comparing the pre-and post-training scores of the particpants. RESULTS Pediatric medical workers scored significantly higher in total emergency knowledge after the training course than before [75.00 (62.50, 85.00) versus 100.00 (95.00, 100.00); P = 0.00]. Basic life support and advanced life support knowledge score significantly improved after training. Teamwork scores were significantly higher after the training than before [5.00 (5.00, 10.00) versus 10.00 (10.00, 10.00); P = 0.00]. Scores were significantly higher after the training (P < 0.001), especially for case analysis questions (P = 0.00). The attitudes of the medical workers towards the training were all positive and affirmative. CONCLUSION The KSS model was shown to be effective in improving the emergency knowledge of pediatric medical workers. Future research will be to explore the effectiveness of the model with different participants and at other hospitals or other institutions such as schools, encouraging more people to participate in and evaluate the model to promote its optimization. TRIAL REGISTRATION Hunan Children's Hospital, HCHLL-2018-03.
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Affiliation(s)
- Yaojia Hu
- Nursing Department, Hunan Children's Hospital, Changsha, China
| | - Bingya Zheng
- The School of Pediatrics, Hengyang Medical School, University of South China Hunan Children's Hospital, Changsha, China
| | - Lihui Zhu
- Nursing Department, Hunan Children's Hospital, Changsha, China
| | - Shuo Tang
- Medical Department Emergency Office, Hunan Children's Hospital, Changsha, China
| | - Qi Lu
- Medical Department Emergency Office, Hunan Children's Hospital, Changsha, China
| | - Qingqing Song
- Department of Cardiology, Hunan Children's Hospital, Changsha, China
| | - Na Zhang
- School of Nursing, Hunan University of Chinese Medicine, Changsha, China
| | - Yan Zhong
- Child Health Care Center, Hunan Children's Hospital, Changsha, China.
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Intention of Collaboration among Dental Students during the COVID-19 Pandemic. Dent J (Basel) 2022; 10:dj10030040. [PMID: 35323242 PMCID: PMC8947484 DOI: 10.3390/dj10030040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/15/2022] [Accepted: 03/02/2022] [Indexed: 11/29/2022] Open
Abstract
Interpersonal communication skills (ICS) are crucial for effective dental practice and interprofessional collaboration. The current study aimed to assess the attitudes of Greek dental undergraduate students towards team working and their cooperation abilities during the COVID-19 pandemic. One-hundred and twenty-seven fourth-semester dental students (N1 = 127) out of 145 (N0) filled in the online survey placed on Google forms. The “Dental Students Cooperation Questionnaire” (DSC) consisted of 49 questions and was available for completion for one week during April 2020. Bivariate (ANOVA) and linear regression analysis of data revealed that mean scores of the questionnaire increased as the parents’ educational level also increased. Data analysis showed that dental students had the required ICS and the intention to collaborate with each other. Many participants managed to achieve group goals, were willing to support other members to fulfill the project’s goals, and there was no competition among them. They acknowledged the importance of feedback, the reward at the end of a group project and social media as a tool for teamworking communication. The students reported that the most important characteristics of an academic teacher were patience, willingness to cooperate, friendliness, politeness, willingness to help, accessibility and availability. It is suggested that group work should be included in the curriculum of dental schools to enhance the integration and evolution of students’ ICS, and the DSC questionnaire can be an effective tool to assess these skills.
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Kennedy-Metz LR, Barbeito A, Dias RD, Zenati MA. Importance of high-performing teams in the cardiovascular intensive care unit. J Thorac Cardiovasc Surg 2022; 163:1096-1104. [PMID: 33931232 PMCID: PMC8481338 DOI: 10.1016/j.jtcvs.2021.02.098] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 12/14/2022]
Affiliation(s)
- Lauren R. Kennedy-Metz
- Department of Surgery, Harvard Medical School, Boston, Mass,Division of Cardiac Surgery, VA Boston Healthcare System, Boston, Mass
| | - Atilio Barbeito
- Anesthesiology Service, Durham VA Health Care System, Durham, NC,Department of Anesthesiology, Duke University, Durham, NC
| | - Roger D. Dias
- Department of Emergency Medicine, Harvard Medical School, Boston, Mass
| | - Marco A. Zenati
- Department of Surgery, Harvard Medical School, Boston, Mass,Division of Cardiac Surgery, VA Boston Healthcare System, Boston, Mass
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Setiawan E, Cotta MO, Abdul-Aziz MH, Sosilya H, Widjanarko D, Wardhani DK, Roberts JA. Indonesian healthcare providers' perceptions and attitude on antimicrobial resistance, prescription and stewardship programs. Future Microbiol 2022; 17:363-375. [PMID: 35212232 DOI: 10.2217/fmb-2021-0193] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: A successful antimicrobial stewardship program (ASP) is sustained through improving antimicrobial prescribing by changing prescribing behavior. This requires a better understanding of hospital stakeholders' views regarding antimicrobial resistance (AMR), antimicrobial use and participation in ASP activities. Objectives: Identify perceptions and attitudes among physicians and pharmacists in a public hospital toward AMR, prescription and ASP. Methods: A questionnaire consisting of 45 items was distributed to physicians and pharmacists in a 320-bed public hospital. All responses were formatted into the Likert scale. Results: A total of 78 respondents (73% response rate) completed the questionnaire. The majority of the respondents perceived AMR within hospital as less of a severe problem, and factors outside hospital were considered to be greater contributors to AMR. In addition, interprofessional conflict was identified as a serious concern in relation to implementing ASP. Conclusion: This finding indicates the need to address existing perceptions and attitudes toward ASP activities that may hamper its successful implementation in Indonesia.
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Affiliation(s)
- Eko Setiawan
- University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine, The University of Queensland, Brisbane, 4006, Australia.,Department of Clinical & Community Pharmacy, and Center for Medicines Information & Pharmaceutical Care (CMIPC), Faculty of Pharmacy, University of Surabaya, 60293, Surabaya, East Java, Indonesia
| | - Menino O Cotta
- University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine, The University of Queensland, Brisbane, 4006, Australia
| | - Mohd Hafiz Abdul-Aziz
- University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine, The University of Queensland, Brisbane, 4006, Australia
| | - Hernycane Sosilya
- Dr Mohamad Soewandhie Public Hospital, 60142, Surabaya, East Java, Indonesia
| | - Doddy Widjanarko
- Dr Mohamad Soewandhie Public Hospital, 60142, Surabaya, East Java, Indonesia.,Faculty of Medicine, Hang Tuah University, 60111, Surabaya, East Java, Indonesia
| | - Dian K Wardhani
- Dr Mohamad Soewandhie Public Hospital, 60142, Surabaya, East Java, Indonesia
| | - Jason A Roberts
- University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine, The University of Queensland, Brisbane, 4006, Australia.,Departments of Pharmacy & Intensive Care Medicine, Royal Brisbane & Women's Hospital, Brisbane, 4029, Australia.,Division of Anesthesiology Critical Care Emergency & Pain Medicine, Nîmes University Hospital, University of Montpellier, Nîmes, 30029, France
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Seibel K, Couné B, Mueller M, Boehlke C, Simon ST, Bausewein C, Becker G. Implementation of an acute palliative care unit for COVID-19 patients in a tertiary hospital: Qualitative data on clinician perspectives. Palliat Med 2022; 36:332-341. [PMID: 35176931 DOI: 10.1177/02692163211059690] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND During the COVID-19 pandemic, it has become apparent that palliative care has dynamically adapted to the care of dying patients with and without COVID-19 and has developed new forms of collaboration. Evaluation is needed to assess which innovations should be integrated into future pandemic management. AIM To explore the experiences of stakeholders and staff in implementing and operating an ad hoc unit delivering acute palliative care. What lessons were learned? DESIGN Qualitative interview study (German Clinical Trials Register; identifier 22,473) with qualitative content analysis. SETTING/PARTICIPANTS During the first wave of the pandemic, the University Medical Center Freiburg (Germany) established an ad hoc unit delivering acute palliative care for COVID-19 patients likely to die. Nurses from non-palliative areas and the specialist palliative care team formed a new team working together there. Twenty-nine individuals from management and staff of this unit were interviewed. RESULTS Patient care and teamwork were rated positively. Joint familiarization, bedside teaching, and team/management support were evaluated as core elements for success. Challenges for the nurses from non-palliative settings included adapting to palliative care routines and culture of care. The palliative care team had to adjust the high standards of palliative care to pandemic conditions. Due to sufficient hospital-wide capacity, only three COVID-19 patients were treated, significantly fewer than anticipated at planning. CONCLUSIONS Results show the feasibility of an ad hoc COVID-19 acute palliative care unit. In the event of capacity constraints, such a unit can be a viable part of future pandemic management.
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Affiliation(s)
- Katharina Seibel
- Department of Palliative Medicine, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bettina Couné
- Department of Palliative Medicine, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael Mueller
- Department of Palliative Medicine, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christopher Boehlke
- Department of Palliative Medicine, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Steffen T Simon
- Department of Palliative Medicine, University of Cologne, Faculty of Medicine and University Hospital, Cologne, Germany.,University of Cologne, Faculty of Medicine and University Hospital, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, Cologne, Germany
| | - Claudia Bausewein
- Department of Palliative Medicine, LMU Klinikum, Ludwig-Maximilians-University, Munich, Germany
| | - Gerhild Becker
- Department of Palliative Medicine, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Michael M, Griggs AC, Shields IH, Sadighi M, Hernandez J, Chan C, McHugh M, Nichols BE, Joshi K, Testa D, Raj S, Preble R, Lazzara EH, Greilich PE. Improving handover competency in preclinical medical and health professions students: establishing the reliability and construct validity of an assessment instrument. BMC MEDICAL EDUCATION 2021; 21:518. [PMID: 34600497 PMCID: PMC8487478 DOI: 10.1186/s12909-021-02943-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/15/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND As part of the worldwide call to enhance the safety of patient handovers of care, the Association of American Medical Colleges (AAMC) requires that all graduating students "give or receive a patient handover to transition care responsibly" as one of its Core Entrustable Professional Activities (EPAs) for Entering Residency. Students therefore require educational activities that build the necessary teamwork skills to perform structured handovers. To date, a reliable instrument designed to assess teamwork competencies, like structured communication, throughout their preclinical and clinical years does not exist. METHOD Our team developed an assessment instrument that evaluates both the use of structured communication and two additional teamwork competencies necessary to perform safe patient handovers. This instrument was utilized to assess 192 handovers that were recorded from a sample of 229 preclinical medical students and 25 health professions students who participated in a virtual course on safe patient handovers. Five raters were trained on utilization of the assessment instrument, and consensus was established. Each handover was reviewed independently by two separate raters. RESULTS The raters achieved 72.22 % agreement across items in the reviewed handovers. Krippendorff's alpha coefficient to assess inter-rater reliability was 0.6245, indicating substantial agreement among the raters. A confirmatory factor analysis (CFA) demonstrated the orthogonal characteristics of items in this instrument with rotated item loadings onto three distinct factors providing preliminary evidence of construct validity. CONCLUSIONS We present an assessment instrument with substantial reliability and preliminary evidence of construct validity designed to evaluate both use of structured handover format as well as two team competencies necessary for safe patient handovers. Our assessment instrument can be used by educators to evaluate learners' handoff performance as early as their preclinical years and is broadly applicable in the clinical context in which it is utilized. In the journey to optimize safe patient care through improved teamwork during handovers, our instrument achieves a critical step in the process of developing a validated assessment instrument to evaluate learners as they seek to accomplish this goal.
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Affiliation(s)
- Meghan Michael
- Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Mail Code 9068, Dallas, TX 75390 USA
| | - Andrew C. Griggs
- Department of Human Factors and Behavioral Neurobiology, Embry-Riddle Aeronautical University, 1 Aerospace Blvd, Daytona Beach, FL 32114 USA
| | - Ian H. Shields
- Office of Quality, Safety, and Outcomes Education, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390 USA
| | - Mozhdeh Sadighi
- Department of Undergraduate Medical Education, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390 USA
| | - Jessica Hernandez
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390 USA
| | - Chrissy Chan
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390 USA
| | - Mary McHugh
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390 USA
| | - Blake E. Nichols
- Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Mail Code 9063, Dallas, TX 75390 USA
| | - Kavita Joshi
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390 USA
| | - Daniel Testa
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390 USA
| | - Sonika Raj
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390 USA
| | - Richard Preble
- Office of Quality, Safety, and Outcomes Education, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390 USA
| | - Elizabeth H. Lazzara
- Department of Human Factors and Behavioral Neurobiology, Embry-Riddle Aeronautical University, 1 Aerospace Blvd, Daytona Beach, FL 32114 USA
| | - Philip E. Greilich
- Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Mail Code 9068, Dallas, TX 75390 USA
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Moral Distress in Community and Hospital Settings for the Care of Elderly People. A Grounded Theory Qualitative Study. Healthcare (Basel) 2021; 9:healthcare9101307. [PMID: 34682986 PMCID: PMC8544437 DOI: 10.3390/healthcare9101307] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/26/2021] [Accepted: 09/27/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Moral distress has frequently been investigated in single healthcare settings and concerning a single type of professional. This study aimed to describe the experience of moral distress in all the types of professionals providing daily care to elderly patients and residents. Methods: The Grounded Theory approach, developed by Corbin and Strauss, was used. This study included participants from hospital and nursing homes of northern Italy. Purposive and theoretical sampling was used. Between December 2020 and April 2021, semi-structured interviews were conducted. Results: Thirteen participants were included in the study. Four categories were derived from the data: talking and listening, care provider wellbeing, decision making, protective factors, and potential solutions. The core category identified was “sharing daily”. Interviewees confirm how hard it may be to communicate to the elderly, but at the same time, how adequate communication with the leader is a protective factor of moral distress. They also confirm how communication is key to managing or downsizing misunderstandings at all levels. Findings highlight the scarcity of operators as a fundamental trigger of moral distress. Conclusions: Many determinants of this phenomenon lie behind the direct control of professionals, but education can help them learn how to prevent, manage, or downsize the consequences.
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Maggio MG, Manuli A, Tripoli D, Calabrò RS. Paving the way to reduce work-stress in rehabilitation nurses: Promising results from a pilot study. Appl Nurs Res 2021; 61:151458. [PMID: 34544567 DOI: 10.1016/j.apnr.2021.151458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 03/22/2021] [Accepted: 05/12/2021] [Indexed: 11/15/2022]
Abstract
Work Stress (WS) negatively affects both nurses and the healthcare system. The aim of this exploratory study is to investigate the effect of a professional stress prevention program in order to reduce WS in nurses working in a Rehab Ward. Twenty-three nurses were enrolled in this pilot study. The professional stress prevention program was based on group meetings and individual support. At baseline, we found a high burnout risk in nurses. At the end of the meetings, we found a normalization in WS, with a higher sense of personal achievement and a greater use of functional coping strategies. Intervention on WS could be a useful way to reduce stress and anxiety, promoting more functional coping strategies to face work difficulties in nurses working in Rehab wards.
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Affiliation(s)
- Maria Grazia Maggio
- Studio di Psicoterapia Relazionale e Riabilitazione Cognitiva, viale Europa, 107, Messina, Italy
| | - Alfredo Manuli
- Azienda Sanitaria Provinciale di Ragusa, Piazza Igea, 1, 97100 Ragusa, Italy
| | - Daniele Tripoli
- Azienda Ospedaliera Papardo, Contrada Papardo, 98158 Messina, Italy
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Lauffer-Vogt SU, Maier J. Der Pneumonie keine Chance geben. Pflege 2021; 34:329-336. [PMID: 34445884 DOI: 10.1024/1012-5302/a000829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
No chance for pneumonia - A campaign for mobilization in the context of a practice project addressing pneumonia prevention Abstract. Background: Healthcare-associated infections (HAI) in inpatients are associated with complicated treatment. In Europe, 5.5 % of inpatients develop HAI. About half of these infections could be avoided. In the Clinic for traumatology of the university hospital Zurich, we developed interventions to reduce HAI. Thereby, we focused on non-ventilator-associated hospital-acquired pneumonia (nvHAP). Aim: Besides reducing nvHAP rates, we intended to improve patient mobility, to empower nurses, and to strengthen interprofessional collaboration. Methods: To achieve these aims, we performed a practice development project comprising inhouse training, workshops, information posters, structural changes and a mobilization campaign. Results: Patient mobilization increased by 40 %, duration of mobilization sessions by 46.5 %. The semi-annual comparison shows a sustainable improvement of 7.6 %. Nurses reported knowledge gain, considerably improved interprofessional collaboration and increased quality of caring. Discussion: Combining various methods and following an interprofessional approach resulted in sustainable effects. Limitations and transfer: Targeted practice development proves to be suitable for promoting patient mobility. Regular repetitions and physiotherapy services at off-peak times are essential to ensure sustainability.
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Affiliation(s)
| | - Jürgen Maier
- Klinik für Traumatologie, Universitätsspital Zürich
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Ballangrud R, Aase K, Vifladt A. Longitudinal team training program in a Norwegian surgical ward: a qualitative study of nurses' and physicians' experiences with implementation. BMC Health Serv Res 2021; 21:725. [PMID: 34294085 PMCID: PMC8299676 DOI: 10.1186/s12913-021-06732-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 07/06/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Team training interventions to improve team effectiveness within healthcare are widely used. However, in-depth knowledge of how healthcare professionals experience such team training curricula and their implementation processes, as well as how contextual factors impact implementation, is currently missing. The aim of this study is therefore to describe healthcare professionals' experiences with the implementation of a longitudinal interprofessional team training program in a surgical ward. METHODS A descriptive design was applied based on qualitative semi-structured focus group interviews with 11 healthcare professionals. A convenience sample of physicians (n = 4), registered nurses (n = 4), and certified nursing assistants (n = 3) was divided into three professionally based focus groups, which were interviewed at three time intervals over a period of 1 year. INTERVENTION The validated and evidence-based team training program Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) was implemented in a surgical ward at a hospital between January 2016 and June 2017. The team training program included three phases: 1) assessment and planning, 2) training and implementation, and 3) sustainment. RESULTS Healthcare professionals' experiences with the content of the team training program varied from valuing the different elements of it to seeing the challenges in implementing the elements in clinical practice. A one-day training course was found to be especially beneficial for interprofessional collaboration at the ward. Over time, the nursing staff seemed to maintain their motivation for the implementation of the tools and strategies, while the physicians became less actively involved. Contextual ward factors influenced the adoption and utilization of the tools and strategies of the program both positively and negatively. The healthcare professionals' experienced the implementation of the team training program as positive for the patient safety culture at the ward in the forms of increased awareness of teamwork and open communication. CONCLUSIONS The study suggests that the implementation of a team training program in a surgical ward is dependent on a set of factors related to content, process, context, and impact. Knowledge on how and why a team training program work supports the transferability to clinical practice in further planning of team training measures. TRIAL REGISTRATION The study is part of a larger research project with a study protocol that was registered retrospectively on 05.30.17, with the trial registration number ISRCTN13997367 .
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Affiliation(s)
- Randi Ballangrud
- Department of Health Sciences Gjøvik, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Teknologivn. 22, 2815 Gjøvik, Norway
| | - Karina Aase
- Department of Health Sciences Gjøvik, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Teknologivn. 22, 2815 Gjøvik, Norway
- Center for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Kjell Arholms hus, Kjell Arholms gate 43, 4021 Stavanger, Norway
| | - Anne Vifladt
- Department of Health Sciences Gjøvik, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Teknologivn. 22, 2815 Gjøvik, Norway
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