Parent experience of HIE and hypothermia: A call for trauma informed care

2022 ◽  
Author(s):  
Anna Elizabeth Sagaser ◽  
Betsy Pilon ◽  
Annie Goeller ◽  
Monica Lemmon ◽  
Alexa Craig
Keyword(s):  
Parental Involvement ◽  
Neonatal Intensive Care ◽  
Parent Support ◽  
Face To Face ◽  
Trauma Informed Care ◽  
Parent Experience ◽  
Parent Role ◽  
Trauma Informed ◽  
E Mail

Purpose/Background: Therapeutic hypothermia (TH) is the standard treatment for hypoxic ischemic encephalopathy (HIE). We surveyed parents of infants treated with TH about their experiences of communication and parental involvement in the Neonatal Intensive Care Unit (NICU). Methods/Approach: A 29-question anonymous survey was posted on a parent support website (https://www.hopeforhie.org) and sent to members via e-mail. Responses from open-ended questions were analyzed using thematic analysis. Results: 165 respondents completed the survey and 108 (66%) infants were treated with TH. 79 (48%) respondents were dissatisfied/neutral regarding the quality of communication in the NICU, whereas 127 (77%) were satisfied/greatly satisfied with the quality of parental involvement in the NICU. 6 themes were identified: 1) Setting for communication: Parents preferred face to face meetings with clinicians. 2) Content and clarity of language: Parents valued clear language (use of layman’s terms) and being explicitly told the medical diagnosis of HIE. 3) Immediate and Longitudinal Emotional Support: Parents required support from clinicians to process the trauma of the birth experience and hypothermia treatment. 4) Clinician time and scheduling: Parents valued the ability to join rounds and other major conversations about infant care. 5) Valuing the Parent Role: Parents desired being actively involved in rounds, care times and decision making. 6) Physical Presence and Touch: Parents valued being physically present and touching their baby; this presence was limited by COVID-related restrictions. Conclusion: We highlight stakeholder views on parent involvement and parent-clinician communication in the NICU and note significant overlap with principles of Trauma Informed Care: safety (physical and psychological), trustworthiness and transparency, peer support, collaboration and mutuality, and empowerment, voice and choice. We propose that a greater understanding and implementation of these principles may allow the medical team to more effectively communicate with and involve parents in the care of infants with HIE in the NICU.

scholarly journals Education in Neurology Resident Documentation Using Payroll Simulation

2017 ◽  
Vol 9 (2) ◽  
pp. 231-236 ◽  
Author(s):  
John W. Liang ◽  
Vicki L. Shanker
Keyword(s):  
Medical Decision ◽  
Financial Loss ◽  
Income Loss ◽  
Face To Face ◽  
Number Of Patients ◽  
Specific Feedback ◽  
Didactic Lecture ◽  
E Mail

ABSTRACT Background Approaches for teaching neurology documentation include didactic lectures, workshops, and face-to-face meetings. Few studies have assessed their effectiveness. Objective To improve the quality of neurology resident documentation through payroll simulation. Methods A documentation checklist was created based on Medicaid and Medicare evaluation and management (E/M) guidelines. In the preintervention phase, neurology follow-up clinic charts were reviewed over a 16-week period by evaluators blinded to the notes' authors. Current E/M level, ideal E/M level, and financial loss were calculated by the evaluators. Ideal E/M level was defined as the highest billable level based on the documented problems, alongside a supporting history and examination. We implemented an educational intervention that consisted of a 1-hour didactic lecture, followed by e-mail feedback “paystubs” every 2 weeks detailing the number of patients seen, income generated, income loss, and areas for improvement. Follow-up charts were assessed in a similar fashion over a 16-week postintervention period. Results Ten of 11 residents (91%) participated. Of 214 charts that were reviewed preintervention, 114 (53%) had insufficient documentation to support the ideal E/M level, leading to a financial loss of 24% ($5,800). Inadequate documentation was seen in all 3 components: history (47%), examination (27%), and medical decision making (37%). Underdocumentation did not differ across residency years. Postintervention, underdocumentation was reduced to 14% of 273 visits (P < .001), with a reduction in the financial loss to 6% ($1,880). Conclusions Improved documentation and increased potential reimbursement was attained following a didactic lecture and a 16-week period in which individual, specific feedback to neurology residents was provided.

scholarly journals Trauma-informed knowledge, awareness, practice, competence and confidence of rural health staff: A descriptive study

2021 ◽  
Vol 11 (9) ◽  
pp. 1
Author(s):  
Kaye Ervin ◽  
Carol Reid ◽  
Tegan Podubinski ◽  
Jacquie Phillips
Keyword(s):  
Rural Health ◽  
Health Care Systems ◽  
Health Staff ◽  
Trauma History ◽  
Trauma Informed Care ◽  
Service Staff ◽  
Care Systems ◽  
Trauma Informed ◽  
Survey Results

Background and objective: By adopting a trauma-informed approach to care at the organisational and clinical levels, health care systems and providers can enhance the quality of care that they deliver and improve health outcomes for individuals with a trauma history. This study aimed to explore the trauma-related knowledge, attitudes awareness, practice, competence and confidence of health service staff from three small rural health services in Victoria, Australia, and examine their self-reported capacity to respond to clients with a trauma history.Methods: Staff from each site were invited to complete a paper-based survey. The survey included demographic information and questions related to knowledge and understanding of trauma, experience of trauma-informed care and confidence engaging in, and perceived importance of, trauma-informed practices. Results: The respondents were predominately nurses. Results showed that 16% of respondents had undertaken training in trauma-informed care and 44% disagreed that they had an understanding of trauma-informed practices. There were high levels of agreement for statements related to knowledge and understanding of trauma and low levels of agreement with statements related to experience of trauma-informed care. More than 70% of respondents reported that they had little knowledge of the principals of trauma-informed care, and little experiencing with practicing trauma-informed care.Discussion and conclusions: Overall, the survey results showed that staff were trauma-aware, but supported the need for more education and training in trauma-informed practices and improved organisational approaches to support trauma-informed approaches. It is important for organisations to shift from being trauma aware to being trauma-informed, by building foundational awareness of these practices and reinforcement through continuing education.

Information Integrity for CRM in a Virtual World

2011 ◽  
pp. 266-272
Author(s):  
Piyush Malik
Keyword(s):  
Customer Relationship ◽  
Quality Of Data ◽  
Face To Face ◽  
Internet Routers ◽  
Customer Preferences ◽  
Crm System ◽  
The Veil ◽  
Consistent Error ◽  
E Mail

As the Internet explosion has opened the doors to unprecedented avenues of e-Business for companies big and small, Customer Relationship Management (CRM) has taken a new meaning altogether, especially for virtual or e-customers. Virtual means of customer interactions via the Web, chat, e-mail, phone, fax and interactive voice recognition (IVR) systems are getting increasingly popular due to cost effectiveness as well as convenience. Companies no longer can rely on face-to-face interaction of their associates with their customers to know them better. As the customer is hidden behind the veil of IP addresses and Internet routers, it becomes increasingly apparent that companies lose the personal touch of yore in its customer interactions. The onus is on the company to provide all interaction capability that the e-customer demands and to “know” the customer by not only tracking and remembering all interactions across multiple touch points, but also be able to analyze customer interaction information to offer additional services such as personalization, security and communities of interest to attract and retain them. The quality and accuracy of data (i.e., customer, market, competitor, product and supplier data) in the CRM system will impact a consistent, error-free way to enhance the customer experience (Goldenberg, 2003). Challenges in understanding and formulating strategies for today’s virtual customers and prospects get accentuated when the quality of data collected and used is circumspect. Be it customer identity, customer preferences, privacy or misconstrued sales practices, these data issues can make or break the company’s future. Let’s take a closer look at the business scenarios for some of these.

scholarly journals A Case for TIC

2018 ◽  
Vol 5 (2) ◽  
pp. 1-12
Author(s):  
Steven Anthony Thirkle ◽  
Angela Kennedy ◽  
Petia Sice
Keyword(s):  
Human Services ◽  
Human Interaction ◽  
Interpersonal Neurobiology ◽  
Trauma Informed Care ◽  
Service Relationships ◽  
Trauma Informed ◽  
Organisational Structures ◽  
Successes And Challenges ◽  
Monitoring Change

Trauma Informed Care (TIC) is an approach to human services based on the understanding that most people in contact with services are more likely to have experienced some level of trauma, adversity and loss and this understanding needs to be held by those involved so that it is may permeate service relationships and delivery. This article reviews TIC literature and introduces a case example outlining the successes and challenges of TIC implementation in practice, i.e. staff awareness, knowledge and skills, communication and quality of human interaction, wellbeing and resilience, organisational structures and artefact, measurement and monitoring for success. Insights from complexity and interpersonal neurobiology are interpreted in the context of facilitating TIC implementation, i.e. parallel safe-to-fail interventions, managing constraints and boundary conditions, monitoring change through trusted sensor networks, maintaining awareness development practices.

Supporting Face-to-Face Birth Family Contact after Adoption from Care: Learning for Trauma-Sensitive Practice

2020 ◽  
Author(s):  
Mandi MacDonald
Keyword(s):  
Adult Child ◽  
Well Being ◽  
Adoptive Parents ◽  
Face To Face ◽  
Trauma Informed Care ◽  
Trauma Informed ◽  
Emotional Safety ◽  
Birth Family ◽  
Family Contact ◽  
And Control

Abstract There are recent calls to consider face-to-face birth family contact for more children adopted from care. Given that the threshold for this authoritative intervention is significant harm, post-adoption contact should be sensitive to the possible impact of early childhood trauma, and be adequately supported. This article draws on adopters’ reports of face-to-face contact with birth relatives, and their evaluation of social work support to suggest an approach to practice informed by principles of trauma-informed care. Twenty-six adoptive parents participated in focus groups, and seventy-three completed a web-based questionnaire, all from Northern Ireland where face-to-face post-adoption contact is expected. Findings are structured thematically around principles of trauma-informed care: trusting relationships; physical and emotional safety; choice and control; and narrative coherence. Most families had a social worker attending contact, and help with practical arrangements. Less common but important practices included: deliberate consideration of children’s perspectives; safeguarding their emotional well-being; and facilitating communication outside of visits. Findings suggest that visits are a context in which trauma-effects may surface, and social workers supporting contact should be sensitive to this possibility. This article suggests a systemic approach to helping all parties prepare for, manage and de-brief after contact, attending to both adult-to-adult and adult–child interactions.

Psychometric Evaluation of the TIC Grade, a Self-Report Measure to Assess Youth Perceptions of the Quality of Trauma-Informed Care They Received

2020 ◽  
pp. 107839032095389
Author(s):  
Nicole Boucher ◽  
Cynthia S. Darling-Fisher ◽  
Laura Sinko ◽  
Dana Beck ◽  
Josie Granner ◽  
...  
Keyword(s):  
Emerging Adults ◽  
Short Form ◽  
Psychometric Evaluation ◽  
Self Report ◽  
Clinical Practices ◽  
Trauma Informed Care ◽  
Trauma Informed ◽  
Training And Support ◽  
Report Measure

Background Agencies and clinical practices are beginning to provide trauma-informed care (TIC) to their clients. However, there are no measures to assess clients’ perceptions of and satisfaction with the TIC care they have received. A 20-item questionnaire, the TIC Grade, was developed, based on the National Center for Trauma-Informed Care principles of TIC, to assess the patient or client perception of the TIC provided in settings that serve adolescents and emerging adults. Objective The goal of this project was to evaluate the psychometric properties of the TIC Grade instrument and to make recommendations for use of the full measure and its short form—an overall letter grade. Study Design The TIC Grade questionnaire was administered to youth over the age of 18 years from four community partners providing care to vulnerable young adults. Potential participants were offered questionnaires at the end of their visit. Those interested in participating left their completed anonymous questionnaire in a locked box to maintain confidentiality. Questionnaires were collected from 100 respondents; 95 were complete enough to include in analyses for psychometric evaluation. Results The findings of this project support the reliability and usability of the 20-item TIC Grade measure to assess youth’s perceptions of the quality of TIC they received. Conclusions This TIC-specific, behaviorally worded client report measure can assist service delivery organizations to assess their success at implementing TIC and to identify areas where further staff training and support are needed.

Response Rates in Online Surveys With Affective Disorder Participants

2020 ◽  
Vol 228 (1) ◽  
pp. 14-24 ◽  
Author(s):  
Tanja Burgard ◽  
Michael Bošnjak ◽  
Nadine Wedderhoff
Keyword(s):  
Meta Analysis ◽  
Response Rates ◽  
Contact Mode ◽  
General Anxiety Disorder ◽  
General Anxiety ◽  
Face To Face ◽  
Survey Participation ◽  
The Mean ◽  
Design Characteristics ◽  
E Mail

Abstract. A meta-analysis was performed to determine whether response rates to online psychology surveys have decreased over time and the effect of specific design characteristics (contact mode, burden of participation, and incentives) on response rates. The meta-analysis is restricted to samples of adults with depression or general anxiety disorder. Time and study design effects are tested using mixed-effects meta-regressions as implemented in the metafor package in R. The mean response rate of the 20 studies fulfilling our meta-analytic inclusion criteria is approximately 43%. Response rates are lower in more recently conducted surveys and in surveys employing longer questionnaires. Furthermore, we found that personal invitations, for example, via telephone or face-to-face contacts, yielded higher response rates compared to e-mail invitations. As predicted by sensitivity reinforcement theory, no effect of incentives on survey participation in this specific group (scoring high on neuroticism) could be observed.

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