Predictors of fracture from falls reported in hospital and residential care facilities: a cross-sectional study

Abstract Background Nurse call systems (NCS) encompass all patients and nursing staff in healthcare facilities. Wireless NCSs offer increased mobility for all users and new affordances to patients unable to actively interact with such systems. Integrated technology potentially decrease response times and prevent alarm-fatigue, and thus increase patient safety and enhance nursing workflow. This study aimed to explore facilitators and barriers for implementation of wireless NCSs in residential care facilities. Methods The study had a cross-sectional descriptive design. Using a questionnaire, we collected data from care providers (n=98) based on the Measurement Instrument for Determinants of Innovations (MIDI) in five Norwegian residential care facilities during the first year of implementation of wireless NCSs. Descriptive statistics were used to explore participant characteristics and MIDI scores. MIDI items to which ≥20% of participants disagreed/totally disagreed were regarded as barriers and items to which ≥80% of participants agreed/totally agreed were regarded as facilitators for implementation. Results More facilitators (n=23) than barriers (n=6) were identified. No features of the technology itself were found to impede the implementation. The most salient barriers, reported by 37% of the care providers, were their lack of prior knowledge and that they found the wireless NCS difficult to learn. However, 87% became familiar with the systems during implementation. Respectively, 86% and 90% regarded themselves and their colleagues as competent users after the implementation. The greatest facilitators, reported by 98%, were firstly the normative belief of unit managers and secondly the expected outcomes of the NCSs: the importance and probability of achieving prompt call responses and increased safety. Conclusions The wireless NCSs were well received and the implementations were satisfactory executed. The barriers to implementation were addressed by training and practicing technological skills, facilitated by the influence and support by the manager and the colleagues within the residential care unit. Wireless NCSs offer a range of advanced applications and services, and further research is needed as more wireless NCS functionalities are implemented into residential care services.

Download Full-text

Nursing staff’s evaluation of facilitators and barriers during implementation of wireless nurse call systems in residential care facilities. A cross-sectional study.

10.21203/rs.2.12110/v3 ◽

2020 ◽

Author(s):

Janne Dugstad ◽

Vibeke Sundling ◽

Etty R. Nilsen ◽

Hilde Eide

Keyword(s):

Residential Care ◽

Measurement Instrument ◽

Implementation Process ◽

Cross Sectional Study ◽

Care Providers ◽

Cross Sectional ◽

Residential Care Facilities ◽

Care Facilities ◽

Facilitators And Barriers ◽

Expected Outcomes

Abstract Background: Traditional nurse call systems used in residential care facilities rely on patients to summon assistance for routine or emergency needs. Wireless nurse call systems (WNCS) offer new affordances for persons unable to actively or consciously engage with the system, allowing detection of hazardous situations, prevention and timely treatment, as well as enhanced nurse workflows. This study aimed to explore facilitators and barriers of implementation of WNCSs in residential care facilities. Methods: The study had a cross-sectional descriptive design. We collected data from care providers (n=98) based on the Measurement Instrument for Determinants of Innovation (MIDI) framework in five Norwegian residential care facilities during the first year of WNCS implementation. The self-reporting MIDI questionnaire was adapted to the contexts. Descriptive statistics were used to explore participant characteristics and MIDI item and determinant scores (D1-29). MIDI items to which ≥20% of participants disagreed/totally disagreed were regarded as barriers and items to which ≥80% of participants agreed/totally agreed were regarded as facilitators for implementation. Results: More facilitators (n=22) than barriers (n=6) were identified. The greatest facilitators, reported by 98% of the care providers, were the expected outcomes: the importance and probability of achieving prompt call responses and increased safety (D9 expected outcomes), and the normative belief of unit managers (D15 subjective norm). During the implementation process, 87% became familiar with the systems (D18 awareness of content), and 86% and 90%, respectively regarded themselves (D17 knowledge) and their colleagues (D14 descriptive norm) as competent users of the WNCS. The most salient barriers, reported by 37%, were their lack of prior knowledge (D17 knowledge) and that they found the WNCS difficult to learn (D8 personal drawback). No features of the technology were identified as barriers. Conclusions: Overall, the care providers gave a positive evaluation of the WNCS implementation. The barriers to implementation were addressed by training and practicing technological skills, facilitated by the influence and support by the manager and the colleagues within the residential care unit. WNCSs offer a range of advanced applications and services, and further research is needed as more WNCS functionalities are implemented into residential care services.

Download Full-text

Nursing staff’s evaluation of facilitators and barriers during implementation of wireless nurse call systems in residential care facilities. A cross-sectional study.

10.21203/rs.2.12110/v2 ◽

2019 ◽

Author(s):

Janne Dugstad ◽

Vibeke Sundling ◽

Etty R. Nilsen ◽

Hilde Eide

Keyword(s):

Residential Care ◽

Measurement Instrument ◽

Implementation Process ◽

Cross Sectional Study ◽

Care Providers ◽

Cross Sectional ◽

Residential Care Facilities ◽

Care Facilities ◽

Facilitators And Barriers ◽

Expected Outcomes

Abstract Background: Traditional nurse call systems used in residential care facilities rely on patients to summon assistance for routine or emergency needs. Wireless nurse call systems (WNCS) offer new affordances for persons unable to actively or consciously engage with the system, allowing detection of hazardous situations, prevention and timely treatment, as well as enhanced nurse workflows. This study aimed to explore facilitators and barriers of implementation of WNCSs in residential care facilities. Methods: The study had a cross-sectional descriptive design. We collected data from care providers (n=98) based on the Measurement Instrument for Determinants of Innovation (MIDI) framework in five Norwegian residential care facilities during the first year of WNCS implementation. The self-reporting MIDI questionnaire was adapted to the contexts. Descriptive statistics were used to explore participant characteristics and MIDI item and determinant scores (D1-29). MIDI items to which ≥20% of participants disagreed/totally disagreed were regarded as barriers and items to which ≥80% of participants agreed/totally agreed were regarded as facilitators for implementation. Results: More facilitators (n=22) than barriers (n=6) were identified. The greatest facilitators, reported by 98% of the care providers, were the expected outcomes: the importance and probability of achieving prompt call responses and increased safety (D9 expected outcomes), and the normative belief of unit managers (D15 subjective norm). During the implementation process, 87% became familiar with the systems (D18 awareness of content), and 86% and 90%, respectively regarded themselves (D17 knowledge) and their colleagues (D14 descriptive norm) as competent users of the WNCS. The most salient barriers, reported by 37%, were their lack of prior knowledge (D17 knowledge) and that they found the WNCS difficult to learn (D8 personal drawback). No features of the technology were identified as barriers. Conclusions: Overall, the care providers gave a positive evaluation of the WNCS implementation. The barriers to implementation were addressed by training and practicing technological skills, facilitated by the influence and support by the manager and the colleagues within the residential care unit. WNCSs offer a range of advanced applications and services, and further research is needed as more WNCS functionalities are implemented into residential care services.

Download Full-text

Nursing staff’s evaluation of facilitators and barriers during implementation of wireless nurse call systems in residential care facilities. A cross-sectional study.

10.21203/rs.2.12110/v4 ◽

2020 ◽

Author(s):

Janne Dugstad ◽

Vibeke Sundling ◽

Etty R. Nilsen ◽

Hilde Eide

Keyword(s):

Residential Care ◽

Measurement Instrument ◽

Implementation Process ◽

Cross Sectional Study ◽

Care Providers ◽

Cross Sectional ◽

Residential Care Facilities ◽

Care Services ◽

Care Facilities ◽

Facilitators And Barriers

Abstract Background: Traditional nurse call systems used in residential care facilities rely on patients to summon assistance for routine or emergency needs. Wireless nurse call systems (WNCS) offer new affordances for persons unable to actively or consciously engage with the system, allowing detection of hazardous situations, prevention and timely treatment, as well as enhanced nurse workflows. This study aimed to explore facilitators and barriers of implementation of WNCSs in residential care facilities. Methods: The study had a cross-sectional descriptive design. We collected data from care providers (n=98) based on the Measurement Instrument for Determinants of Innovation (MIDI) framework in five Norwegian residential care facilities during the first year of WNCS implementation. The self-reporting MIDI questionnaire was adapted to the contexts. Descriptive statistics were used to explore participant characteristics and MIDI item and determinant scores. MIDI items to which ≥20% of participants disagreed/totally disagreed were regarded as barriers and items to which ≥80% of participants agreed/totally agreed were regarded as facilitators for implementation. Results: More facilitators (n=22) than barriers (n=6) were identified. The greatest facilitators, reported by 98% of the care providers, were the expected outcomes: the importance and probability of achieving prompt call responses and increased safety, and the normative belief of unit managers. During the implementation process, 87% became familiar with the systems, and 86% and 90%, respectively regarded themselves and their colleagues as competent users of the WNCS. The most salient barriers, reported by 37%, were their lack of prior knowledge and that they found the WNCS difficult to learn. No features of the technology were identified as barriers. Conclusions: Overall, the care providers gave a positive evaluation of the WNCS implementation. The barriers to implementation were addressed by training and practicing technological skills, facilitated by the influence and support by the manager and the colleagues within the residential care unit. WNCSs offer a range of advanced applications and services, and further research is needed as more WNCS functionalities are implemented into residential care services.

Download Full-text

Competency of health workers in detecting and managing gestational hypertension, pre-eclampsia, severe pre-eclampsia and eclampsia during antenatal check-ups in primary care health facilities in Bangladesh: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-046638 ◽

2021 ◽

Vol 11 (7) ◽

pp. e046638

Author(s):

Sk Masum Billah ◽

Abdullah Nurus Salam Khan ◽

S M Rokonuzzaman ◽

Nafisa Lira Huq ◽

Marufa Aziz Khan ◽

...

Keyword(s):

Primary Care ◽

Health Workers ◽

Gestational Hypertension ◽

Cross Sectional Study ◽

P Value ◽

Sectional Study ◽

Hypertensive Disorders Of Pregnancy ◽

Cross Sectional ◽

Hypertensive Disorders ◽

Care Facilities

Study objectiveTo evaluate the competency of trained health workers in detecting and managing hypertensive disorders of pregnancy during routine antenatal check-ups (ANCs) at primary care facilities in Bangladesh.Study design and settingsCross-sectional study; conducted in 26 primary care facilities.Outcome measuresAccurate diagnosis of the hypertensive disorders of pregnancy.MethodIn total 1560 ANC consultations provided by primary health workers, known as Family Welfare Visitors (FWVs), were observed using a structured checklist between October 2017 and February 2018. All consultations were reassessed by study physicians for validation.ResultOf the ‘true’ cases of gestational hypertension (n=32), pre-eclampsia (n=29) and severe pre-eclampsia (n=16), only 3%, 7% and 25%, respectively, were correctly diagnosed by FWVs. Per cent agreement for the diagnosed cases of any hypertensive disorders of pregnancy was 9% and kappa statistics was 0.50 (p value 0.0125). For identification of any hypertensive disorders by FWVs, sensitivity and positive predictive values were 14% and 50%, respectively. There was a moderate positive correlation between the blood pressure measurements taken by FWVs and study physicians. Only 27% of those who had ‘some protein’ in urine were correctly identified by FWVs. Women diagnosed with any of the hypertensive disorders of pregnancy by FWVs were more likely to be counselled on at least one danger sign of pre-eclampsia (severe headache, blurring of vision and upper abdominal pain) than those without any such diagnosis (41% vs 19%, p value 0.008). All four cases of severe pre-eclampsia diagnosed by FWVs were given a loading dose of intramuscular magnesium sulphate and three among them were referred to a higher facility.ConclusionThe FWVs should be appropriately trained on risk assessment of pregnant women with particular emphasis on accurately assessing the diagnostic criteria of hypertensive disorders of pregnancy and its management.

Download Full-text