‘It's a matter of patient safety’: understanding challenges in everyday clinical practice for achieving good care on the surgical ward - a qualitative study

Abstract Background Team training interventions to improve team effectiveness within healthcare are widely used. However, in-depth knowledge of how healthcare professionals experience such team training curricula and their implementation processes, as well as how contextual factors impact implementation, is currently missing. The aim of this study is therefore to describe healthcare professionals’ experiences with the implementation of a longitudinal interprofessional team training program in a surgical ward. Methods A descriptive design was applied based on qualitative semi-structured focus group interviews with 11 healthcare professionals. A convenience sample of physicians (n = 4), registered nurses (n = 4), and certified nursing assistants (n = 3) was divided into three professionally based focus groups, which were interviewed at three time intervals over a period of 1 year. Intervention The validated and evidence-based team training program Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) was implemented in a surgical ward at a hospital between January 2016 and June 2017. The team training program included three phases: 1) assessment and planning, 2) training and implementation, and 3) sustainment. Results Healthcare professionals’ experiences with the content of the team training program varied from valuing the different elements of it to seeing the challenges in implementing the elements in clinical practice. A one-day training course was found to be especially beneficial for interprofessional collaboration at the ward. Over time, the nursing staff seemed to maintain their motivation for the implementation of the tools and strategies, while the physicians became less actively involved. Contextual ward factors influenced the adoption and utilization of the tools and strategies of the program both positively and negatively. The healthcare professionals’ experienced the implementation of the team training program as positive for the patient safety culture at the ward in the forms of increased awareness of teamwork and open communication. Conclusions The study suggests that the implementation of a team training program in a surgical ward is dependent on a set of factors related to content, process, context, and impact. Knowledge on how and why a team training program work supports the transferability to clinical practice in further planning of team training measures. Trial registration The study is part of a larger research project with a study protocol that was registered retrospectively on 05.30.17, with the trial registration number ISRCTN13997367.

Download Full-text

Use of telemedicine by practising allergists before and during the SARS-CoV-2 pandemic

Allergo Journal International ◽

10.1007/s40629-021-00175-5 ◽

2021 ◽

Author(s):

Stephanie Dramburg ◽

Paolo Maria Matricardi ◽

Ingrid Casper ◽

Ludger Klimek

Keyword(s):

Clinical Practice ◽

Good Care ◽

Clinical Routine ◽

Everyday Clinical Practice ◽

Additional Qualification ◽

Exploratory Survey ◽

Outpatient Sector ◽

Inpatient And Outpatient Care ◽

To Receive

Summary Background The severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic presented unprecedented challenges to both inpatient and outpatient care. In order to maintain good care under necessary contact restrictions, especially in the outpatient sector, the use of telemedical applications was demanded and promoted. The exploratory survey among members of the Association of German Allergists (AeDA) was intended to show how these were received among allergists in private practice. Methods The survey was restricted to actively practising members of the AeDA who had previously given their consent to receive such surveys (n = 437). They were invited by email to participate in a survey on the topic of “Telemedicine in everyday clinical practice in allergology”. The survey included quantitative and qualitative questions on the use of telemedicine services before and during the pandemic and was conducted anonymously on the SoSci Survey platform. Participation was possible in the period from June to August 2020. Results In all, 76 specialists with additional qualification in allergology took part in the survey. Of these, 71 completed the full questionnaire. Before the start of the pandemic-related contact restrictions, 46.5% (33/71) stated that they had used telemedicine in their clinical practice. This number increased to 73.2% (52/71) after 31 January 2020. The largest increase (4.3% vs. 15.6%) was seen in the area of video consultations. Furthermore, 43/76 participants can imagine integrating telemedicine services into their daily clinical routine in the future. Conclusion The use of telemedical services, especially video consultations, increased significantly during the SARS-CoV‑2 pandemic in Germany. The majority of respondents perceive the implementation as positive and can imagine continuing to use telemedical methods after the end of the pandemic.

Download Full-text

Effects of age, gender, smoking and co-medication on the pharmacokinetics of venlafaxine and O-desmethylvenlafaxine in everyday clinical practice

Pharmacopsychiatry ◽

10.1055/s-0029-1240199 ◽

2009 ◽

Vol 42 (05) ◽

Author(s):

B Pfuhlmann ◽

C Greiner ◽

E Haen ◽

P Riederer ◽

J Deckert ◽

...

Keyword(s):

Clinical Practice ◽

Everyday Clinical Practice

Download Full-text

“Bridging Gaps – Improving Outcomes”: Problem domains in schizophrenia research, treatment and policy

Die Psychiatrie ◽

10.1055/s-0038-1669682 ◽

2016 ◽

Vol 13 (03) ◽

pp. 118-120

Author(s):

W. Wölwer ◽

W. Gaebel ◽

V. Toeller

Keyword(s):

Clinical Practice ◽

Mental Healthcare ◽

Knowledge Gaps ◽

Everyday Clinical Practice ◽

Treatment Gaps ◽

Different Types

Summary Background: The provision of mental healthcare for patients with schizophrenia is still characterized both by knowledge gaps and by treatment gaps in everyday clinical practice. Aim: This article discusses the different types of treatment gaps in schizophrenia and describes actions taken to overcome these gaps especially in Europe.

Download Full-text

Role of implantable loop recorder in the clinical diagnosis of syncope: Results of the introduction of an effective diagnostic tool

Orvosi Hetilap ◽

10.1556/oh.2015.30124 ◽

2015 ◽

Vol 156 (15) ◽

pp. 609-613

Author(s):

Miklós Somlói ◽

Emil Toldy-Schedel ◽

Zoltán Nényei ◽

Róbert Böszörményi ◽

János Tomcsányi

Keyword(s):

Clinical Practice ◽

Diagnostic Yield ◽

Diagnostic Algorithm ◽

Definitive Treatment ◽

Implantable Loop Recorder ◽

Everyday Clinical Practice ◽

Loop Recorder ◽

Early Application ◽

Electrocardiographic Monitoring ◽

The Everyday

Introduction: Extension of electrocardiographic monitoring via loop recorder implantation may increase the diagnostic yield of syncope work-up. Aim: In this retrospective observational study, the authors wanted to evaluate the diagnostic performance of implantable loop recorder in the everyday clinical practice. Method: The authors analyzed the electronically stored data of all patients who underwent loop recorder implantation between 2005 and 2014 in their cardiology department because of recurrent syncope of undetermined origin. Results: There were 52 loop recorder implantations within the study period. During the 167 (±136) days of monitoring, 36 (69.2%) diagnostic events occurred. In two-thirds of events, (46.2% of all monitored patients) a specific arrhythmia diagnosis was reached, allowing definitive treatment in these cases. In this selected population, there was no correlation between age, presence of known high-risk predictors, or accompanying trauma, and the mechanism of syncope. Conclusions: The high diagnostic rate of implantable loop recorder in the everyday clinical practice is in accordance with the findings in prospective clinical studies. This observation supports the early application of loop recorder in the diagnostic algorithm of syncope. Orv. Hetil., 2015, 156(15), 609–613.

Download Full-text