The Unique Environmental Influences of Acute Care Settings on Patient and Physician Well-Being: A Call to Action

Abstract Background Restricted visitation policies in acute care settings because of the COVID-19 pandemic have negative consequences. The objective of this scoping review is to identify impacts of restricted visitation policies in acute care settings, and describe perspectives and mitigation approaches among patients, families, and healthcare professionals. Methods We searched Medline, Embase, PsycINFO, Healthstar, CINAHL, Cochrane Central Register of Controlled Trials on January 01/2021, unrestricted, for published primary research records reporting any study design. We included secondary (e.g., reviews) and non-research records (e.g., commentaries), and performed manual searches in web-based resources. We excluded records that did not report primary data. Two reviewers independently abstracted data in duplicate. Results Of 7810 citations, we included 155 records. Sixty-six records (43%) were primary research; 29 (44%) case reports or case series, and 26 (39%) cohort studies; 21 (14%) were literature reviews and 8 (5%) were expert recommendations; 54 (35%) were commentary, editorial, or opinion pieces. Restricted visitation policies impacted coping and daily function (n = 31, 20%) and mental health outcomes (n = 29, 19%) of patients, families, and healthcare professionals. Participants described a need for coping and support (n = 107, 69%), connection and communication (n = 107, 69%), and awareness of state of well-being (n = 101, 65%). Eighty-seven approaches to mitigate impact of restricted visitation were identified, targeting families (n = 61, 70%), patients (n = 51, 59%), and healthcare professionals (n = 40, 46%). Conclusions Patients, families, and healthcare professionals were impacted by restricted visitation polices in acute care settings during COVID-19. The consequences of this approach on patients and families are understudied and warrant evaluation of approaches to mitigate their impact. Future pandemic policy development should include the perspectives of patients, families, and healthcare professionals. Trial registration: The review was registered on PROSPERO (CRD42020221662) and a protocol peer-reviewed prior to data extraction.

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What Evidence Informs the Nursing Care of People with Class III Obesity in an Acute Care Setting? A Scoping Review.

10.21203/rs.3.rs-31488/v1 ◽

2020 ◽

Author(s):

Beverley Ewens ◽

Vivien Kemp ◽

Amanda Towel-Barnard ◽

Lisa Whitehead

Keyword(s):

Patient Care ◽

Acute Care ◽

Nursing Care ◽

Scoping Review ◽

Improve Patient Care ◽

Well Being ◽

Class Iii ◽

Inclusion Criteria ◽

Class Iii Obesity ◽

Acute Care Settings

Abstract Background: Obesity is a complex psycho-social construct which is strongly linked with health and well-being. The health and socioeconomic impacts of obesity on individuals and health care systems can be significant. The nursing care of people with Class III obesity needs careful attention to ensure the provision of appropriate care. This scoping review aims to synthesise available evidence on the nursing care of Class III obese patients in acute care settings. Methods : A scoping review informed by the Joanna Briggs Institute approach was undertaken. We searched CINAHL Plus, Medline, Scopus, Proquest Central, Web of Science and Embase databases for primary research articles relating to the nursing management of people classified as Class III obese in acute care settings. The methodological quality of all studies that met the inclusion criteria were assessed and data relating to methods and the findings extracted and synthesised into themes. Results : 3809 records were identified. Thirteen studies met the inclusion criteria and were included in the review. Three themes were generated from the synthesis of the findings: Access, knowledge and training related to equipment; Patient care; and Opportunities to improve care. Conclusions : The need for proactive planning to improve the nursing care provided to people classified as class III obese and admitted to acute care settings is vital. Access to appropriate equipment to support moving and handling and education on equipment use to prevent injury to both patients and staff is necessary. Education and support to promote engagement with patients, adapt nursing care practices and promote self-care have the potential to improve patient care and patient outcomes.

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An approach to develop a continuing professional development workshop for nurses to differentiate, delirium, dementia and depression among older adults

Journal of Nursing Education and Practice ◽

10.5430/jnep.v10n8p16 ◽

2020 ◽

Vol 10 (8) ◽

pp. 16

Author(s):

Hala Elansari ◽

Jessie Johnson ◽

Daniel Robert Kelly

Keyword(s):

Professional Development ◽

Older Adults ◽

Acute Care ◽

Quality Care ◽

Functional Decline ◽

Continuing Professional Development ◽

Health Care Expenditures ◽

Well Being ◽

Acute Care Settings ◽

Lack Of Knowledge

Delirium, dementia, and depression challenge nurses in acute care settings. They negatively impact older adult's health, well-being, and quality of life. Misdiagnosis of delirium, dementia, and depression is associated with higher mortality rate, functional decline, increased length of stay, higher admission and institutionalization rates, and higher health care expenditures. Nurses in acute care settings have a lack of knowledge about delirium, dementia, and depression. This lack of knowledge could have implication as necessary referrals to physicians is needed in order to ensure initiating of appropriate treatment. Continuing professional development is necessary to keep nurses abreast of the rapid changes in knowledge and technology needed to provide safe and high quality services. Providing an opportunity to participate in continuing professional development on this particular subject would go a long way to facilitate knowledge translation. As a result nurses will be equipped with the adequate knowledge and skills to meet the overall goal of providing quality care for older adults in different care settings.

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Person-Centered Communication Between Health Care Professionals and COVID-19-Infected Older Adults in Acute Care Settings: Findings From Wuhan, China

The Journals of Gerontology Series B ◽

10.1093/geronb/gbaa190 ◽

2020 ◽

Author(s):

Juan Li ◽

Jing Wang ◽

Xiangjing Kong ◽

Tingting Gao ◽

Bei Wu ◽

...

Keyword(s):

Older Adults ◽

Health Care ◽

Acute Care ◽

Health Care Professionals ◽

Older Patients ◽

Well Being ◽

Direct Care ◽

Core Element ◽

Acute Care Settings ◽

Multiple Challenges

Abstract Objectives The current study aims to explore person-centered communication between health care professionals and COVID-19-infected older patients in acute care settings. Methods The current qualitative study explored the communication between professionals and COVID-19-infected older adults in the acute care setting through 2 rounds of interviews with physicians and nurses who provided direct care and treatment for COVID-19-infected older patients in Wuhan, China. We explored the possibilities and significance of facilitating effective communication despite multiple challenges in the pandemic. Conventional content analysis was adopted to analyze the rich data collected from our participants. Results It is possible and necessary to initiate and sustain person-centered communication despite multiple challenges brought by the pandemic. The achievement of person-centered communication can play significant roles in addressing challenges, building mutual trust, improving quality of care and relationships, and promoting treatment adherence and patients’ psychological well-being. Discussion It is challenging for health care professionals to provide care for COVID-19-infected older adults, especially for those with cognitive and sensory impairment, in acute care settings. Facilitating person-centered communication is a significant strategy in responding to the pandemic crisis and a core element of person-centered care.

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Improving Patient Safety and Patient–Provider Communication

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig12-2019-0021 ◽

2019 ◽

Vol 4 (5) ◽

pp. 1017-1027 ◽

Cited By ~ 1

Author(s):

Richard R. Hurtig ◽

Rebecca M. Alper ◽

Karen N. T. Bryant ◽

Krista R. Davidson ◽

Chelsea Bilskemper

Keyword(s):

Acute Care ◽

Augmentative And Alternative Communication ◽

Health Care Team ◽

Provider Communication ◽

Alternative Communication ◽

Patient Provider Communication ◽

Acute Care Settings ◽

Nurses Perceptions ◽

Communication Needs ◽

The Impact

Purpose Many hospitalized patients experience barriers to effective patient–provider communication that can negatively impact their care. These barriers include difficulty physically accessing the nurse call system, communicating about pain and other needs, or both. For many patients, these barriers are a result of their admitting condition and not of an underlying chronic disability. Speech-language pathologists have begun to address patients' short-term communication needs with an array of augmentative and alternative communication (AAC) strategies. Method This study used a between-groups experimental design to evaluate the impact of providing patients with AAC systems so that they could summon help and communicate with their nurses. The study examined patients' and nurses' perceptions of the patients' ability to summon help and effectively communicate with caregivers. Results Patients who could summon their nurses and effectively communicate—with or without AAC—had significantly more favorable perceptions than those who could not. Conclusions This study suggests that AAC can be successfully used in acute care settings to help patients overcome access and communication barriers. Working with other members of the health care team is essential to building a “culture of communication” in acute care settings. Supplemental Material https://doi.org/10.23641/asha.9990962

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Supplemental Material for Genetic and Environmental Influences on the Association Between Subjective Well-Being and Marital Adjustment

Couple and Family Psychology Research and Practice ◽

10.1037/cfp0000008.supp ◽

2013 ◽

Keyword(s):

Marital Adjustment ◽

Environmental Influences ◽

Well Being ◽

Subjective Well Being

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Highly sensitive adolescent benefits in positive school transitions: Evidence for vantage sensitivity in Japanese high-schoolers

10.31234/osf.io/kmxqs ◽

2020 ◽

Author(s):

Shuhei Iimura

Keyword(s):

High School ◽

Statistical Power ◽

Environmental Influences ◽

Differential Susceptibility ◽

School Transition ◽

Well Being ◽

Crossover Point ◽

Japanese Adolescents ◽

Highly Sensitive

Some researchers indicate that the transition to high school deflects adolescent developmental trajectories. Others assert it provides a new possibility for the promotion of adolescents’ socioemotional well-being. One critical view missing in such claims is that individual variabilities interact with environmental influences. We employed the framework of Differential Susceptibility Theory, which postulates that individual susceptibilities moderate external influences for better and for worse. In order to clarify the mechanism of adolescents’ differential adjustments, this paper investigated the role of sensory-processing sensitivity using the Japanese version of Highly Sensitive Child Scale for Adolescence (J-HSCS), and tested whether the diathesis-stress model or the differential susceptibility model best describes students’ socioemotional adjustment across their high school transition. The current paper used the two-wave data collected from Japanese adolescents aged from 14 to 15 years (n = 412, 50% girls). In Study 1, we investigated the replicability of psychometric properties of J-HSCS. The results supported previous findings, indicating its validity for the bifactor model. In Study 2, we utilized confirmatory competitive model testing, which maximizes statistical power by parameterizing the crossover point to allow a direct comparison of alternative models. The results indicated that neither the diathesis-stress nor the differential susceptibility models fitted the data. Rather, a strong vantage sensitivity model was revealed, suggesting that highly susceptible adolescents disproportionately benefitted from a positive school transition over their counterparts. This finding signified the role of adolescents’ sensitivity to environmental influences and the importance of considering its moderation under person x environment interactions.

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