Patient Safety Over Power Hierarchy: A Scoping Review of Healthcare Professionals' Speaking-up Skills Training

ObjectivesDespite training and the recognition that speaking up can mitigate harm to patients and save lives, healthcare professionals do not consistently speak up when they have patient safety concerns. The purpose of this study was to identify barriers to and facilitators of speaking up about patient safety concerns to inform the development of interventions that will increase this behaviour.DesignFrom October 2017 to February 2018, the study team conducted focus groups and interviews with nurses, advanced practice providers and physicians at three healthcare facilities. Participants were prompted to share their personal experiences with and perspectives on speaking up about patient safety concerns and to discuss strategies for communicating those concerns.SettingTertiary academic healthcare centre.Participants62 healthcare professionals participated in the study. Purposeful sampling was used to include participants of different health professions and experience levels.Main outcome measuresWe planned to answer questions about why more healthcare professionals do not consistently speak up when they have legitimate patient safety concerns and to identify ways to enhance current interventions on speaking up behaviours,ResultsTwelve focus group discussions and two interviews were conducted with 62 participants. We identified two recurring themes: (1) The predominantly hierarchical culture of medicine is a barrier to speaking up and (2) Institutional, interpersonal and individual factors can modulate the impact of medicine’s hierarchical culture on speaking up behaviours and inform the strategies employed.ConclusionsThe data highlighted the importance of moving beyond targeting front-line healthcare professionals for training in the skills of speaking up and engaging institutional leaders and systems to actively promote and reward speaking up behaviours.

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The effectiveness of scenario-based learning to develop patient safety behavior in first year nursing students

International Journal of Nursing Education Scholarship ◽

10.1515/ijnes-2020-0011 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Derya Uzelli Yilmaz ◽

Esra Akin Palandoken ◽

Burcu Ceylan ◽

Ayşe Akbiyik

Keyword(s):

Patient Safety ◽

Nursing Students ◽

Intramuscular Injection ◽

Skills Training ◽

First Year ◽

Safety Skills ◽

Safety Behavior ◽

Significant Difference ◽

Academic Year ◽

Nursing Course

AbstractThe aim of this study was to examine the effect of scenario-based learning (SBL) compared to traditional demonstration method on the development of patient safety behavior in first year nursing students. During the 2016–2017 academic year, the Fundamentals of Nursing course curriculum contained the teaching of demonstration method (n=168). In the academic year 2017–2018 was performed with SBL method in the same context (n=183). Objective Structured Clinical Examination (OSCE) that assesses the same three skills was implemented in both academic terms to provide standardization so that students could evaluated in terms of patient safety competency. It was found that students’ performance of some of the steps assessed were not consistently between the demonstration and SBL methods across the three skills. There was a statistically significant difference between demonstration method and SBL method for students’ performing the skill steps related to patient safety in intramuscular injection (p<0.05) Our results suggest that the integration of SBL into the nursing skills training may be used as a method of teaching in order to the development of patient safety skills.

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Education and skills training for care partners of hospitalised older adults: A scoping review

Health Education Journal ◽

10.1177/00178969211034192 ◽

2021 ◽

pp. 001789692110341

Author(s):

Madeline Carbery ◽

Samantha Schwartz ◽

Nicole Werner ◽

Beth Fields

Keyword(s):

Older Adults ◽

Hospital Admission ◽

Health Outcomes ◽

Older Adult ◽

Scoping Review ◽

Hospital Care ◽

Skills Training ◽

Individual Care ◽

Care Partners ◽

The Usa

Background: The care partners of hospitalised older adults often feel dissatisfied with the education and skills training provided to them, resulting in unpreparedness and poor health outcomes. Objective: This review aimed to characterise and identify gaps in the education and skills training used with the care partners of older adults in the hospital. Methods: We conducted a scoping review on the education and skills training practices used with the care partners of hospitalised older adults in the USA via sources identified in the PubMed, PsychINFO and CINAHL databases. Results: Twelve studies were included in this review. Results illustrate that nurses utilise multiple modes of delivery and frequently provide education and skills training tailored to the needs of care partners at the latter end of hospital care. The provision of education and skills training varies greatly, however, including who provides education, in what way information is conveyed, and how care partner outcomes are measured. Conclusion: This is the first scoping review to describe and synthesise the education and skills training practices used with care partners of hospitalised older adults. Findings highlight the need for education and skills training to be interprofessional, tailored to individual care partners’ needs and begin at, or even before, the hospital admission of older adult patients.

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Virtual communities of practice to improve clinical outcomes in healthcare: protocol for a 10-year scoping review

BMJ Open ◽

10.1136/bmjopen-2020-046998 ◽

2021 ◽

Vol 11 (7) ◽

pp. e046998

Author(s):

Louise Shaw ◽

Dana Jazayeri ◽

Debra Kiegaldie ◽

Meg Morris

Keyword(s):

Communities Of Practice ◽

Scoping Review ◽

Virtual Communities ◽

Healthcare Professionals ◽

Falls Prevention ◽

Support Network ◽

Search Term ◽

Online Databases ◽

Relevant Stakeholder ◽

Virtual Communities Of Practice

IntroductionVirtual communities of practice (VCoPs) use a common online platform to provide healthcare professionals with the opportunity to access highly specialised knowledge, build a professional support network and promote the translation of research evidence into practice. There is limited reporting of how best to design and administer VCoPs within healthcare organisations. The primary aim of this scoping review is to identify the best methods used to establish and maintain VCoPs. Findings shall be used to develop a flexible framework to guide the establishment and facilitation of a VCoP for healthcare professionals to ensure the translation of falls prevention clinical guidelines into practice.Methods and analysisA five-stage scoping review process will be followed based on Arksey and O’Malley’s framework and refined by the Joanna Briggs Institute Methodology. An initial limited search of PubMed and Cumulative Index to Nursing and Allied Health Literature will identify relevant studies and assist with search term development. This will be followed by a search of five online databases to identify papers published from January 2010 until November 2020. Papers will be independently screened by two reviewers, and data extracted and analysed using a reporting framework. Qualitative data will be analysed thematically and numerical synthesis of the data will be conducted.Results and disseminationThe results of this scoping review will highlight the best ways to design and manage VCoPs in healthcare organisations. The findings will be presented at relevant stakeholder workshops, conferences and published in peer-reviewed journals.

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Ethical and culturally competent care of transgender patients: A scoping review

Nursing Ethics ◽

10.1177/0969733020988307 ◽

2021 ◽

pp. 096973302098830

Author(s):

Amara Sundus ◽

Sharoon Shahzad ◽

Ahtisham Younas

Keyword(s):

Scoping Review ◽

Healthcare Professionals ◽

Culturally Sensitive ◽

Culturally Competent ◽

Culturally Competent Care ◽

Individual Level ◽

Culturally Sensitive Care ◽

Healthcare Settings ◽

Ethical Approval ◽

Sensitive Issues

Background: Transgender individuals experience discrimination, stigmatization, and unethical and insensitive attitudes in healthcare settings. Therefore, healthcare professionals must be knowledgeable about the ways to deliver ethical and culturally competent care. Ethical considerations: No formal ethical approval was required. Aim: To synthesize the literature and identify gaps about approaches to the provision of ethical and culturally competent care to transgender populations. Design: A Scoping Review Literature Search: Literature was searched within CINAHL, Science Direct, PubMed, Google Scholar, EMBASE, and Scopus databases using indexed keywords such as “transgender,” “gender non-conforming,” “ethically sensitive care,” and “culturally sensitive care.” In total, 30 articles, which included transgender patients and their families and nurses, doctors, and health professionals who provided care to transgender patients, were selected for review. Data were extracted and synthesized using tabular and narrative summaries and thematic synthesis. Findings: Of 30 articles, 23 were discussion papers, 5 research articles, and 1 each case study and an integrative review. This indicates an apparent dearth of literature about ethical and culturally sensitive care of transgender individuals. The review identified that healthcare professionals should educate themselves about sensitive issues, become more self-aware, put transgender individual in charge during care interactions, and adhere to the principles of advocacy, confidentiality, autonomy, respect, and disclosure. Conclusions: The review identified broad approaches for the provision of ethical and culturally competent care. The identified approaches could be used as the baseline, and further research is warranted to develop and assess organizational and individual-level approaches.

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Adverse Effects of Personal Protective Equipment Among Intensive Care Unit Healthcare Professionals During the COVID-19 Pandemic: A Scoping Review

SAGE Open Nursing ◽

10.1177/23779608211026164 ◽

2021 ◽

Vol 7 ◽

pp. 237796082110261

Author(s):

Takeshi Unoki ◽

Hideaki Sakuramoto ◽

Ryuhei Sato ◽

Akira Ouchi ◽

Tomoki Kuribara ◽

...

Keyword(s):

Intensive Care ◽

Adverse Effects ◽

Scoping Review ◽

Personal Protective Equipment ◽

Healthcare Professionals ◽

World Health ◽

Protective Equipment ◽

Medical Database ◽

Publication Type ◽

Skin Injuries

Introduction To avoid exposure to SARS-COV-2, healthcare professionals use personal protective equipment (PPE) while treating COVID-19 patients. Prior studies have revealed the adverse effects (AEs) of PPE on healthcare workers (HCWs); however, no review has focused on the AEs of PPE on HCWs in intensive care units (ICUs). This review aimed to identify the AEs of PPE on HCWs working in ICUs during the COVID-19 pandemic. Methods A scoping review was conducted. MEDLINE, CINAHL, the World Health Organization (WHO) global literature on COVID-19, and Igaku-chuo-zasshi (a Japanese medical database), Google Scholar, medRxiv, and Health Research Board (HRB) open research were searched from January 25–28, 2021. The extracted data included author(s) name, year of publication, country, language, article title, journal name, publication type, study methodology, population, outcome, and key findings. Results The initial search identified 691 articles and abstracts. Twenty-five articles were included in the analysis. The analysis comprised four key topics: studies focusing on PPE-related headache, voice disorders, skin manifestations, and miscellaneous AEs of PPE. The majority of AEs for HCWs in ICUs were induced by prolonged use of masks. Conclusion The AEs of PPE among HCWs in ICUs included heat, headaches, skin injuries, chest discomfort, and dyspnea. Studies with a focus on specific diseases were on skin injuries. Moreover, many AEs were induced by prolonged use of masks.

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