Did healthcare professional perspectives on the quality and safety environment in New Zealand public hospitals change from 2012 to 2017?

2020 ◽  
Vol 34 (7) ◽  
pp. 775-788
Author(s):  
Robin Gauld ◽  
Simon Horsburgh
Keyword(s):  
New Zealand ◽  
Patient Care ◽  
Health Professionals ◽  
Online Survey ◽  
Improve Patient Care ◽  
Public Hospitals ◽  
Quality And Safety ◽  
District Health ◽  
Content Type ◽  
Improve Patient

PurposeThe work environment is known to influence professional attitudes toward quality and safety. This study sought to measure these attitudes amongst health professionals working in New Zealand District Health Boards (DHBs), initially in 2012 and again in 2017.Design/methodology/approachThree questions were included in a national New Zealand health professional workforce survey conducted in 2012 and again in 2017. All registered health professionals employed with DHBs were invited to participate in an online survey. Areas of interest included teamwork amongst professionals; involvement of patients and families in efforts to improve patient care and ease of speaking up when a problem with patient care is perceived.FindingsIn 2012, 57% of respondents (58% in 2017) agreed health professionals worked as a team; 71% respondents (73% in 2017) agreed health professionals involved patients and families in efforts to improve patient care and 69% (65% in 2017) agreed it was easy to speak up in their clinical area, with none of these changes being statistically significant. There were some response differences by respondent characteristics.Practical implicationsWith no change over time, there is a demand for improvement. Also for leadership in policy, management and amongst health professionals if goals of improving quality and safety are to be delivered upon.Originality/valueThis study provides a simple three-question method of probing perceptions of quality and safety and an important set of insights into progress in New Zealand DHBs.

scholarly journals Healthcare professional perspectives on quality and safety in New Zealand public hospitals: findings from a national survey

2014 ◽  
Vol 38 (1) ◽  
pp. 109 ◽  
Author(s):  
Robin Gauld ◽  
Simon Horsburgh
Keyword(s):  
New Zealand ◽  
Patient Care ◽  
Health Professionals ◽  
Pearson Correlation ◽  
Public Hospitals ◽  
Health Board ◽  
Quality And Safety ◽  
District Health ◽  
Policy Makers ◽  
Clinical Leadership

Background Few studies have sought to measure health professional perceptions of quality and safety across an entire system of public hospitals. Therefore, three questions that gauge different aspects of quality and safety were included in a national New Zealand survey of clinical governance. Methods Three previously used questions were adapted. A total of 41040 registered health professionals employed in District Health Boards were invited to participate in an online survey. Analyses were performed using the R statistical environment. Proportional odds mixed models were used to quantify associations between demographic variables and responses on five-point scales. Relationships between other questions in the survey and the three quality and safety questions were quantified with the Pearson correlation coefficient. Results A 25% response rate delivered 10303 surveys. Fifty-seven percent of respondents (95% CI: 56–58%) agreed that health professionals in their District Health Board worked together as a team; 70% respondents (95% CI: 69–70%) agreed that health professionals involved patients and families in efforts to improve patient care; and 69% (95% CI: 68–70%) agreed that it was easy to speak up in their clinical area if they perceived a problem with patient care. Correlations showed links between perceptions of stronger clinical leadership and performances on the three questions, as well as with other survey items. The proportional mixed model also revealed response differences by respondent characteristics. Conclusions The findings suggest positive commitment to quality and safety among New Zealand health professionals and their employers, albeit with variations by district, profession, gender and age, but also scope for improvement. The study also contributes to the literature indicating that clinical leadership is an important contributor to quality improvement. What is known about the topic? Various studies have explored aspects of healthcare quality and safety, generally within a hospital or group of hospitals, using a lengthy tool such as the ‘safety climate survey’. What does this paper add? We used a simple three-question survey approach (derived from existing measures) to measuring healthcare professionals’ perceptions of quality and safety in New Zealand’s public hospitals. In doing so, we also collected the first such information on this. What are the implications for practitioners? New Zealand policy makers and health professionals can take some comfort in our findings, but also note that there is considerable scope for improvement. Our finding that more positive perceptions of quality and safety were related to perceptions of stronger clinical leadership adds to the international literature indicating the importance of this. Policy makers and hospital managers should support strong clinical leadership.

Improvements in neonatal care; using experience-based co-design

2014 ◽  
Vol 27 (5) ◽  
pp. 427-438 ◽  
Author(s):  
Susanne Maria Kristina Gustavsson
Keyword(s):  
Patient Care ◽  
Design Methodology ◽  
Healthcare Professionals ◽  
Improve Patient Care ◽  
Quality Improvements ◽  
Healthcare Staff ◽  
Content Type ◽  
Care Processes ◽  
Improve Patient ◽  
Practical Implications

Purpose – The purpose of this paper is to identify and improve patient care processes by collaborating patients, relatives and healthcare professionals. Design/methodology/approach – To identify and improve patient care processes by collaborating patients, relatives and healthcare professionals. Findings – Healthcare problems captured from collaboration between patients and healthcare professionals fall into simple, complicated and complex problems. Healthcare staff and patient experiences with patient processes differ, and a collaborative approach is needed to capture all areas needing improvement. Research limitations/implications – The conclusions are drawn from a project with few participants in a context that probably influenced the results. In contrast, other studies in the same area confirm the results. Practical implications – The study outcomes have direct implications for healthcare professionals who can learn from patients involved in quality improvements such as this experience-based co-design (EBCD) project. Originality/value – The paper contributes to limited studies on EBCD involving patients in healthcare quality improvements.

Knowledge, Attitudes, and Practices Regarding Antimicrobial Use and Stewardship Among Prescribers at Acute-Care Hospitals

2018 ◽  
Vol 39 (3) ◽  
pp. 316-322 ◽  
Author(s):  
Elizabeth Salsgiver ◽  
Daniel Bernstein ◽  
Matthew S. Simon ◽  
Daniel P. Eiras ◽  
William Greendyke ◽  
...  
Keyword(s):  
Patient Care ◽  
Acute Care ◽  
Online Survey ◽  
Improve Patient Care ◽  
Acute Care Hospitals ◽  
Convenience Sample ◽  
Attitudes And Practices ◽  
Antimicrobial Prescribing ◽  
Improve Patient ◽  
Knowledge Attitudes And Practices

OBJECTIVETo assess antimicrobial prescriber knowledge, attitudes, and practices (KAP) regarding antimicrobial stewardship (AS) and associated barriers to optimal prescribing.DESIGNCross-sectional survey.SETTINGOnline survey.PARTICIPANTSA convenience sample of 2,900 US antimicrobial prescribers at 5 acute-care hospitals within a hospital network.INTERVENTIONThe following characteristics were assessed with an anonymous, online survey in February 2015: attitudes and practices related to antimicrobial resistance, AS programs, and institutional AS resources; antimicrobial prescribing and AS knowledge; and practices and confidence related to antimicrobial prescribing.RESULTSIn total, 402 respondents completed the survey. Knowledge gaps were identified through case-based questions. Some respondents sometimes selected overly broad therapy for the susceptibilities given (29%) and some “usually” or “always” preferred using the most broad-spectrum empiric antimicrobials possible (32%). Nearly all (99%) reported reviewing antimicrobial appropriateness at 48–72 hours, but only 55% reported “always” doing so. Furthermore, 45% of respondents felt that they had not received adequate training regarding antimicrobial prescribing. Some respondents lacked confidence selecting empiric therapy using antibiograms (30%), interpreting susceptibility results (24%), de-escalating therapy (18%), and determining duration of therapy (31%). Postprescription review and feedback (PPRF) was the most commonly cited AS intervention (79%) with potential to improve patient care.CONCLUSIONSBarriers to appropriate antimicrobial selection and de-escalation of antimicrobial therapy were identified among front-line prescribers in acute-care hospitals. Prescribers desired more AS-related education and identified PPRF as the most helpful AS intervention to improve patient care. Educational interventions should be preceded by and tailored to local assessment of educational needs.Infect Control Hosp Epidemiol 2018;39:316–322

scholarly journals Pakistani Student Nurses’ perceptions of their hospital’s health professionals’ attitudes and suggested ways to improve patient care – An untainted view

2020 ◽  
Vol 36 (7) ◽  
Author(s):  
Sachal Aqeel Safdar ◽  
Humaira Zafar ◽  
Jawwad Ahmad ◽  
Rashid Qayyum ◽  
Sajid Nasim ◽  
...  
Keyword(s):  
Nursing Students ◽  
Patient Care ◽  
Health Professionals ◽  
Student Nurses ◽  
Improve Patient Care ◽  
Patient Counseling ◽  
Training Centre ◽  
Creative Commons ◽  
Nurses Perceptions ◽  
Improve Patient

Background & Objectives: Feedback brings a fresh perspective and improvement in any organization. Health professionals (HPs) lose insight of the gaps in medical care. The views of student nurses can help improve systems. The objective of this study was to assess the views of our student nurses and how they perceive the way the doctors and HPs work in our hospital and comment on training, attitudes, care pathways, teamwork, and what needed to be improved. Methods: A proforma based qualitative study was carried out at the Nurses’ Training Centre of PAF Hospital and Fazaia Medical College, Islamabad, from January to March 2020. After approval, a semi-structured proforma with open and closed ended questions was administered, in English and Urdu. The results were analyzed by comparative numbers and percentages for each question and descriptive responses were grouped in recurring themes and analyzed for content and their constructive value. Results: Out of 85 nursing cadets, the proforma could be administered to 61(M=38(62.3%) and F=23(37.7%). Most were FSc with 26% graduates. Majority of the female students’ main reason for joining was to serve humanity, unlike most males. According to gender many responses were interestingly different. Majority of females thought male doctors were better (86%). Only 36% said the doctors were sincere in care of patients. Most thought that we needed to improve patient counseling. Most thought the seniors treated them unfairly, but bullying was negligible. They wanted the senior HPs to improve their attitudes and ensure adequate equipment in the wards. They were worried about personal security from patients and relatives. Dedicated mental health services to deal with stress of witnessing every day misery and death was suggested. Conclusions: Doctors need to improve their counseling skills and should talk more to the patients and their relatives. They should acknowledge the nursing students and improve teamwork. Belittling them in front of others harms their self-efficacy. Simple corrections like punctuality, ownership of their patients and improvement of equipment and systems can improve patient care. doi: https://doi.org/10.12669/pjms.36.7.3110 How to cite this:Safdar SA, Zafar H, Ahmad J, Qayyum R, Naseem S, Safdar CA. Pakistani Student Nurses’ perceptions of their hospital’s health professionals’ attitudes and suggested ways to improve patient care – An untainted view. Pak J Med Sci. 2020;36(7):---------.  doi: https://doi.org/10.12669/pjms.36.7.3110 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract 11119: Real-Time Nanopore Sequencing for Bacterial Pneumonia After Out-of-Hospital Cardiac Arrest, a Pilot Proof-of-Concept Study

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Alexandra Weissman ◽  
Mariam Bramah Lawani ◽  
Thomas Rohan ◽  
Clifton W CALLAWAY
Keyword(s):  
Patient Care ◽  
Pathogen Detection ◽  
Bacterial Pathogen ◽  
Improve Patient Care ◽  
Antibiotic Administration ◽  
Nanopore Sequencing ◽  
Proof Of Concept ◽  
Chi Square ◽  
Significant Difference ◽  
Improve Patient

Introduction: Pneumonia is common after OHCA but is difficult to diagnose in the first 72 hours following ROSC, this results in early untargeted antibiotic administration based on non-specific imaging and laboratory findings. Antibiotic resistance is rising, is influenced by untargeted antibiotic administration, and can increase patient morbidity and mortality as well as healthcare costs. Precision methods of bacterial pathogen detection in OHCA patients are needed to improve patient care. This proof-of-concept pilot study aimed to assess feasibility of bacterial pathogen sequencing and comparability of sequencing results to clinical culture after OHCA. Methods: Blood and bronchoalveolar lavage (BAL) were obtained from residual clinical specimens collected within 12 hours of ROSC. Bacterial DNA was extracted using the Qiagen PowerLyzer PowerSoil DNA kit, sequenced using the MinION nanopore sequencer, and analyzed with Oxford Nanopore Technologies’ EPI2ME bioinformatics software. Sequencing results were compared to culture results using McNemar’s chi-square statistic. Study-defined pneumonia was based on presence of at least two characteristics within 72 hours of ROSC: fever (temperature ≥38°C); persistent leukocytosis >15,000 or leukopenia <3,500 for 48 hours; persistent chest radiography infiltrates for 48 hours per clinical radiology read; bacterial pathogen cultured. Results: We enrolled 38 consecutive OHCA subjects: mean age 61.8 years (18.0); 16 (42%) female; 25 (66%) White, 7 (18%) Black, 6 (16%) “Other” race; 7 subjects (18%) survived and 31 (82%) died; 16 (42%) subjects had pneumonia. Sequencing results were available in 12 hours while culture results were available in 48-72 hours after collection. There was a non-significant difference in the proportion of the same pathogens identified for each method per McNemar’s chi-square: p = 0.38, difference of 0.095 (-0.095, 0.286). Conclusions: Nanopore sequencing detects pathogenic bacteria comparable to clinical microbiologic culture and in less time. This technology can produce a paradigm shift in early bacterial pathogen detection in OHCA survivors, which can improve patient care. The technology is applicable to other patient populations and for viral and fungal pathogens.

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