Sharing psychosocial risk screening information with pediatric oncology healthcare providers: Service utilization and related factors

We assessed neuroticism, perceived stress, and work-related factors among obstetrician-gynecologists (ob-gyns), and examined the relationships between these variables. Surveys were sent to 500 physician members of the American College of Obstetricians and Gynecologists and we received 287 (57.4%) completed responses. Analyses included descriptive statistics and linear regressions. Ob-gyns reported high levels of perceived stress. After controlling for neuroticism, variables that significantly predicted stress levels included average hours worked, perception of working too many hours, colleague support for work–home balance, isolation due to gender/cultural differences, and perception of workplace control. Because these work-related factors are linked to stress even when controlling for neuroticism, administrators and physicians may consider whether any of these factors are modifiable to mitigate physician stress. This in turn may affect physicians' own health and the quality of care patients receive.

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#69: Improving Communication About the Care and Prevention of Infections in a Pediatric Oncology Unit by Using Patient Daily Goals in Multidisciplinary Rounds

Journal of the Pediatric Infectious Diseases Society ◽

10.1093/jpids/piaa170.069 ◽

2021 ◽

Vol 10 (Supplement_1) ◽

pp. S22-S22

Author(s):

Escobedo-Melendez Griselda ◽

Martinez-Albarran Manuel ◽

Magaña-Saldivar Isadora ◽

Jimenez Norma ◽

Gomez-Huerta Elizabeth ◽

...

Keyword(s):

Length Of Stay ◽

Pediatric Oncology ◽

Multidisciplinary Team ◽

Statistical Significance ◽

Healthcare Providers ◽

Multidisciplinary Teams ◽

Use Of Resources ◽

Multidisciplinary Rounds ◽

Prevention Of Infections ◽

Oncology Unit

Abstract Background In children with cancer infections are the most frequent complication, with fatal outcomes if not addressed promptly. Therefore, care and prevention of infections in these patients require multidisciplinary interventions, with effective communication among healthcare providers to reduce the morbidity, length of stay, and the inappropriate use of resources. We used the Institute of Healthcare Improvement (IHI) model for improving the communication among healthcare providers by using patient daily goals after the oncology pediatric unit multidisciplinary rounds. Methods A multidisciplinary team was identified in the pediatric oncology unit. The team received weekly coaching on the IHI methodology. The methodology used included the creation of a block diagram to understand the baseline processes and a key driver diagram. Then, after a literature review, a data collection plan and measures were identified. The team identified different ideas for changes and prioritized them using an impact-effort matrix. Finally, several rounds of Plan-Do-Study-Act (PDSA) cycles reached the desired changes that organized the patient daily goals for sharing in the form of a worksheet. This worksheet was shared with nurses and pharmacist staff, a chat group was created, and the routine use of the daily goals for patient management was taught and incorporated into the rest of the care team staff. The percentage of excellent communication among all multidisciplinary teams and outcomes (length of stay, intensive care unit admission, and mortality) were recorded at baseline and endline. We determined the statistical significance of the baseline vs. endline difference by using χ 2 and t-tests. Results A total of 105 patients with suspected infections were included over a 6-month period (June through November 2019). We found a significant increase per month in the percent of agreement in excellent communication in the patient daily goals between infectious diseases specialist faculty and fellows, nurses, pharmacist, and pediatric oncology faculty and fellows (33.3% vs. 91.3%) (P = 0.004). Length of stay decreased monthly after our interventions (baseline: mean 14.7 days [SD 12.4] vs. after intervention: mean 6.7 days [SD 2.7]) (P = 0.014). There were only one ICU admission and no deaths during the implementation period. Conclusions Our approach using patient daily goals improved communication among a multidisciplinary team, leading to decreased length of stay and supporting adequate outcomes.

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Magnitude of spontaneous preterm birth and its associated factors among preterm birth in NICU wards in Asella Teaching and Referral Hospital, Asella, Oromia, Ethiopia

Journal of International Medical Research ◽

10.1177/03000605211034693 ◽

2021 ◽

Vol 49 (8) ◽

pp. 030006052110346

Author(s):

Techane Sisay Tuji ◽

Addisu Dabi Wake ◽

Gezahegn Badeg Adere ◽

Aselefu Beka Wedajo ◽

Batu Dekeba Obole ◽

...

Keyword(s):

Risk Factors ◽

Preterm Birth ◽

Healthcare Providers ◽

Preterm Births ◽

Cross Sectional Study ◽

Spontaneous Preterm Birth ◽

Related Factors ◽

Cross Sectional ◽

Bivariate Logistic Regression ◽

Associated Risk Factors

Objective To assess the prevalence of spontaneous preterm births and to identify the associated risk factors. Methods This single-centre cross-sectional study enrolled women that experienced a preterm birth as registered on the neonatal log-book between 30 December 2019 and 30 December 2020. A pre-tested structured checklist was used to collect data (sociodemographic characteristics; obstetric-related factors; medical history; and pregnancy-related factors). Bivariate logistic regression analyses were applied to identify factors associated with spontaneous preterm birth. A multivariate model identified significant independent risk factors. Results A total of 310 patients participated in the study. The prevalence of spontaneous preterm birth in this population was 67.1% (208 of 310; 95% confidence interval [CI] 61.5, 71.9). Patients without a partner (adjusted odds ratio [AOR] = 1.470, 95% CI 1.23, 4.42), patients residing in a rural area (AOR = 2.51, 95% CI 1.123, 5.513) and those with a history of PIH during their current pregnancy (AOR = 0.104, 95% CI 0.053, 0.014) were significantly more likely to have a spontaneous preterm birth. Conclusion The prevalence of spontaneous preterm birth in in this study was high. Healthcare providers and all stakeholders should focus on screening pregnant women at the risk of spontaneous preterm birth.

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Improving Psychosocial Risk Assessment and Service Provision for Craniofacial Team Patients: A Quality Improvement Project

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211043006 ◽

2021 ◽

pp. 105566562110430

Author(s):

Canice E. Crerand ◽

Meghan O’Brien ◽

Hillary M. Kapa ◽

Ari N. Rabkin ◽

Amanda Smith ◽

...

Keyword(s):

Risk Assessment ◽

Quality Improvement ◽

Service Provision ◽

Academic Medical Center ◽

Psychosocial Risk ◽

Secondary Outcome ◽

Risk Screening ◽

Improvement Project ◽

Psychosocial Services ◽

Psychosocial Risk Assessment

To improve psychosocial risk assessment and service provision for children with craniofacial conditions presenting for annual interdisciplinary team visits. Institute for Healthcare quality improvement model. U.S. pediatric academic medical center. Caregivers of children ages 0-17 years with craniofacial conditions presenting for 1692 team visits between August 2017 and July 2019. Key drivers included: (1) standardizing pre-visit triage processes; (2) administering the Psychosocial Assessment Tool-Craniofacial Version (PAT-CV); (3) utilizing PAT-CV scores in real time to add patients to psychosocial provider schedules; and (4) family education. Interventions included improving patient screening, increasing PAT-CV completion rate, altering clinic flow, providing patient and parent education about psychosocial services, and altering team member roles to fully integrate PAT-CV administration and scoring in the clinic. The primary outcome was the percentage of patients identified for psychosocial consultations via nurse triage, PAT-CV score, family or provider request who completed consultations. The secondary outcome was the percentage of patients completing needed psychosocial consultations based on elevated PAT-CV scores. Use of the PAT-CV resulted in an increase in the percentage of patients with elevated psychosocial risk who received a psychosocial consultation from 86.7% to 93.4%. The percentage of children receiving psychosocial consultation at their annual team visit due to elevated PAT-CV scores increased from 72% to 90%. Integrating a validated psychosocial risk screening instrument can improve risk identification and psychosocial consultation completion. A combination of risk screening approaches may be indicated to identify patients in need of psychosocial services.

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White lie during patient care: A qualitative study of nurses’ perspectives

10.21203/rs.2.24636/v3 ◽

2020 ◽

Author(s):

Alireza Nikbakht nasrabadi ◽

soodabeh joolaee ◽

Elham Navab ◽

Maryam esmaeilie ◽

mahboobe shali

Keyword(s):

Qualitative Study ◽

Patient Care ◽

Healthcare Providers ◽

Cultural Knowledge ◽

Hospital Nurses ◽

Structured Interviews ◽

Related Factors ◽

Patient’S Rights ◽

Wide Range ◽

Data Saturation

Abstract Background: Keeping the patients well and fully informed about diagnosis, prognosis, and treatments is one of the patient’s rights in any healthcare system. Although all healthcare providers have the same viewpoint about rendering the truth in treatment process, sometimes the truth is not told to the patients; that is why the healthcare staff tell “white lie” instead. This study aimed to explore the nurses’ experience of white lies during patient care. Methods: This qualitative study was conducted from June to December 2018. Eighteen hospital nurses were recruited with maximum variation from ten state-run educational hospitals affiliated to Tehran University of Medical Sciences. Purposeful sampling was used and data were collected by semi-structured interviews that were continued until data saturation. Data were classified and analyzed by content analysis approach. Results: The data analysis in this study resulted in four main categories and eleven subcategories. The main categories included hope crisis, bad news, cultural diversity, and nurses’ limited professional competences. Conclusion: Results of the present study showed that, white lie told by nurses during patient care may be due to a wide range of patient, nurse and/or organizational related factors. Communication was the main factor that influenced information rendering. Nurses’ communication with patients should be based on mutual respect, trust and adequate cultural knowledge, and also nurses should provide precise information to patients, so that they can make accurate decisions regarding their health care.

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Lack of Awareness of the Impact of Improperly Disposed Of Medications and Associated Factors: A Cross-Sectional Survey in Indonesian Households

Frontiers in Pharmacology ◽

10.3389/fphar.2021.630434 ◽

2021 ◽

Vol 12 ◽

Author(s):

Sofa D. Alfian ◽

Widya N. Insani ◽

Eli Halimah ◽

Nabilla A. Qonita ◽

Siti S. Jannah ◽

...

Keyword(s):

Healthcare Providers ◽

Binary Logistic Regression ◽

Cross Sectional Survey ◽

Related Factors ◽

Cross Sectional ◽

Public Places ◽

Validated Questionnaire ◽

Unused Medications ◽

Medication Disposal ◽

The Impact

Introduction: Disposal of unused medications through environmentally unsafe routes is common in Indonesia. The lack of awareness of the impact of improperly disposed of medications is a significant contributing factor. The objectives of this study were to identify factors associated with lack of awareness of the impact of improperly disposed of unused medications and to assess the associations of awareness with medication disposal practices among the general population in Indonesia.Patients and methods: An observational cross-sectional survey was conducted using nonprobability sampling in Bandung, Indonesia, from November 2017 to January 2018 among respondents who were older than 18 years, had used any medication in the past, were literate, and had signed an informed consent document. Disposal practices and awareness regarding the impact of improperly disposed of unused medications were collected using an online- and a paper-based pre-validated questionnaire. The paper-based questionnaires were distributed to respondents in public places such as city center, markets, and religious places. Binary logistic regression was performed to assess associations of sociodemographic and other related factors with a lack of awareness. Odds ratios (ORs) with 95% confidence intervals (CIs) are reported.Results: Of 497 participating respondents, 433 and 64 respondents filled an online- or a paper-based questionnaire, respectively. Most respondents were female, aged between 18 and 30 years, and students/university students. Of 497 respondents, more than half (53.1%) were not aware that improper medication disposal could harm the environment and population health. Most respondents (79.5%) had never received information about proper medication disposal practices. The education level, the number of stored medications at home, and previous education about medication disposal practices were significantly associated with awareness of proper practices. In the multivariate analysis, only those with previous education about medication disposal practices were less likely to report a lack of awareness (OR: 0.043; 95% CI: 0.02–0.09). Respondents with a lack of awareness tended to dispose of their unused medications in the garbage or shared them with friends or relatives.Conclusion: There is a clear need to increase awareness of the importance of proper medication disposal practices, in particular among the student population of Bandung city, Indonesia. Healthcare providers can play an important role by educating this specific population on the proper disposal of unused medications.

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Mixed-method investigation of health consumers’ perception and experience of participation in patient safety activities

BMJ Open ◽

10.1136/bmjopen-2019-035831 ◽

2020 ◽

Vol 10 (3) ◽

pp. e035831

Author(s):

Nam-Ju Lee ◽

Shinae Ahn ◽

Miseon Lee

Keyword(s):

Patient Safety ◽

Focus Group ◽

Patient Participation ◽

Healthcare Providers ◽

Willingness To Participate ◽

Focus Group Interviews ◽

Related Factors ◽

Healthcare Environment ◽

Health Consumers ◽

Group Interviews

ObjectivesThis study aimed to examine the factors influencing patient safety behaviours and to explore health customers’ experiences of patient participation in the healthcare system.DesignA mixed-method sequential explanatory design was employed using a survey and focus group interviews with health consumers.SettingThe study was conducted in South Korea using an online survey tool.ParticipantsSurvey data were collected from 493 Korean adults, aged 19 years or older, who had visited hospitals within the most recent 1 year. Focus group interviews were conducted in two groups of six participants each among those of the survey participants who agreed to participate in focus groups.Main outcome measuresThe survey measured the recognition of the importance of participation, extent of willingness to participate and experience of engaging in patient safety activities using a 4-point Likert scale. Qualitative data were collected through focus group interviews to explore health consumers’ experience of patient participation in hospital care, and the data were analysed using content analysis.ResultsThe average score for experience of participation in patient safety behaviours (2.13±0.63) was found to be lower than those of recognition of the importance of participation (3.27±0.51) and willingness to participate (2.62±0.52). By integrating the results of the quantitative and qualitative data analysis, the factors associated with the experience of engaging in healthcare behaviour included patient-related factors, illness-related factors, factors involving relationship between patients and healthcare providers, and healthcare environment factors.ConclusionsTo improve patient participation, it is necessary to create a healthcare environment in which patients can speak comfortably and to provide an education programme reflecting the patients’ needs. Also, healthcare providers must consider patients as partners for patient safety. Shared decision-making procedures and patient-centred care and patient safety policies should be established in hospitals.

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Daily struggle to take antiretrovirals: a qualitative study in Papuans living with HIV and their healthcare providers

BMJ Open ◽

10.1136/bmjopen-2020-036832 ◽

2020 ◽

Vol 10 (9) ◽

pp. e036832

Author(s):

Elfride Irawati Sianturi ◽

Elmiawati Latifah ◽

Ari Probandari ◽

Christantie Effendy ◽

Katja Taxis

Keyword(s):

Qualitative Study ◽

Healthcare Providers ◽

Hiv Treatment ◽

Hiv Care ◽

Free Access ◽

Personal Factors ◽

Long Distance ◽

Related Factors ◽

Healthcare Environment ◽

Living With Hiv

ObjectiveThe aim of the study was to explore the experiences of Papuans living with HIV to take antiretroviral therapy (ART) from the patient and the healthcare providers (HCPs) perspective.DesignThis was a qualitative study covering all five tribes located in Papua Provinces one of two Indonesian provinces on Papua Island. Semistructured interviews were conducted with Papuans living with HIV and their HCPs. Interviews were transcribed verbatim and coded to find themes.ResultsOverall, we conducted interviews with 13 Papuans living with HIV (mean age: 33 years, 61% female) and 14 HCPs (mean age: 42 years, 64% female) within five customary areas. HCPs included three physicians, nine nurses, two others. Two main themes were identified: (1) personal factors and (2) healthcare environment-related factors. Personal factors were beliefs and knowledge of ART, stigma from family, community and HCPs as well as practical problems such as transportation because of long distance. Within the theme of healthcare environment, the competences and attitudes of HCPs were particularly relevant. The findings are important in refining HIV treatment strategies implemented in Papua, especially when extending HIV care provided by community centres.ConclusionsDespite free access to ART, Papuans living with HIV struggle to remain on treatment. Considering local culture and religion in strategies to reduce stigma should be a priority.

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