scholarly journals Empowering the patient? Medication communication during hospital discharge: a qualitative study at an internal medicines ward in Norway

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044850
Author(s):  
Stine Eidhammer Rognan ◽  
Sofia Kälvemark-Sporrong ◽  
Kajsa Rebecka Bengtsson ◽  
Helene Berg Lie ◽  
Yvonne Andersson ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Patient Empowerment ◽  
Study Data ◽  
University Hospital ◽  
Self Management ◽  
Healthcare Personnel ◽  
Power And Control ◽  
Core Elements ◽  
Patients Experience ◽  
And Control

ObjectiveEffective communication and patient empowerment before hospital discharge are important steps to ensure medication safety. Patients discharged from hospitals are often expected to assume self-management, frequently without healthcare personnel (HCP) having ensured patients’ knowledge, motivation and/or skills. In this substudy of a larger study, we explore how patients experience medication communication during encounters with HCPs and how they are empowered at hospital discharge.DesignThis is a qualitative case study. Data collection was done through qualitative observations of patient–HCP encounters, semistructured interviews with patients and drug reconciliation. Data were analysed using content analysis.SettingAn internal medicines ward at a university hospital in Norway.ParticipantsNine patients aged 49–90 years were included close to the day of discharge.ResultsThe analysis revealed the following themes: (1) patient-centred care (PCC), which included ‘understanding and involvement in the patient-as-person’, ‘establishment of a therapeutic alliance’, and ‘sharing power and responsibility’; and (2) biomedical (conventional) care, including the subthemes ‘HCPs in power and control’ and ‘optimising medical outcomes, following guidelines’. Even though the elements of PCC were observed in several encounters, overall communication was not sufficiently fostering patient empowerment. Spending time with patients and building relations based on mutual trust seemed undervalued.ConclusionsThe results provide a broader understanding of how patients experience medication communication at hospital discharge. Both the patients and the HCPs appear to be inculcated with biomedical traditions and are uncertain about the roles and opportunities associated with PCC. Attention should be paid to patient preferences and to the core elements of the PCC model from admission to discharge to empower patients in medication self-management.

scholarly journals Routine procedures and preventive measures in tissue banking and cell therapy during COVID-19 pandemic

2020 ◽  
Vol 3 (2) ◽  
pp. 50-55
Author(s):  
Marija Zekusic ◽  
Marina Bujic Mihica ◽  
Anamarija Jularic ◽  
Tamara Dolenec ◽  
Marija Skoko ◽  
...  
Keyword(s):  
Cell Therapy ◽  
Preventive Measures ◽  
Tissue Banking ◽  
Work Conditions ◽  
University Hospital ◽  
Healthcare Personnel ◽  
Rapid Spread ◽  
The Republic ◽  
And Control ◽  
Routine Procedures

Following the rapid spread of SARS-CoV-2 worldwide, this article describes routine procedures and preventive measures for tissue banking and cell therapy in University Hospital Centre “Sestre milosrdnice” in the Republic of Croatia. This paper describes our current practice for preventing contamination and microbiological environmental monitoring of cleanrooms, the protection of healthcare personnel as well as patients from SARS-CoV-2. These measures are based on the recommendations obtained from the Ministry of Health of the Republic of Croatia, the Croatian Institute of Public Health and the European Centre for Disease Prevention and Control. We also present data on samples collected and treated in this period in comparison to normal work conditions before COVID-19.

scholarly journals Barriers to control syphilis and HIV vertical transmission in the health care system in the city of Sao Paulo

2014 ◽  
Vol 17 (4) ◽  
pp. 887-898 ◽  
Author(s):  
Valdete Maria Ramos ◽  
Elisabeth Niglio de Figueiredo ◽  
Regina Célia de Menezes Succi
Keyword(s):  
Health Care ◽  
Prenatal Care ◽  
Pregnant Women ◽  
Hospital Discharge ◽  
Vertical Transmission ◽  
Health Care Professionals ◽  
Sao Paulo ◽  
University Hospital ◽  
Healthcare Personnel ◽  
São Paulo

OBJECTIVE: The objective of this study was to identify possible barriers to control vertical transmission of syphilis and HIV through the analysis of the orientation process of pregnant women from prenatal care to the obstetric center at an university hospital in Sao Paulo (Reference) and their return (with their exposed babies) for follow-up after hospital discharge (counter-reference). METHODS: It is a retrospective cross-sectional study including interviews with healthcare personnel. Pregnant women with syphilis and/or HIV-infection admitted for labor or miscarriage were identified from August 2006 to August 2007. Routine care for mothers and babies were analyzed. RESULTS: 56 pregnant women were identified: 43 were HIV-infected, 11 had syphilis and two were coinfected (syphilis/HIV); 22 health care professionals were interviewed. Prenatal care was identified in 91.1% of these women: 7/11 (63.6%) with syphilis; 44/45 (97.8%) HIV-infected or coinfected. The reference for delivery was satisfactory for 57.7% of the syphilis-infected women and 97.7% of the HIV-infected ones. The counter-reference was satisfactory for all babies and mothers at hospital discharge, besides the non-adherence to this recommendation. Interviews with health care professionals showed there are better routines for assisting and following-up pregnant women, puerperal women and HIV-infected or exposed babies than for those infected with syphilis. The epidemiological report and surveillance system are also better for HIV-infected patients. CONCLUSION: The difficulties in the reference and counter-reference system of these women and their babies are evident barriers to control the vertical transmission of these infectious diseases.

scholarly journals Self-management challenges following hospital discharge for patients with multimorbidity: a longitudinal qualitative study of a motivational interviewing intervention

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e046896
Author(s):  
Carina Brandberg ◽  
Mirjam Ekstedt ◽  
Maria Flink
Keyword(s):  
Qualitative Study ◽  
Motivational Interviewing ◽  
Hospital Discharge ◽  
Controlled Trial ◽  
Intervention Group ◽  
University Hospital ◽  
Self Management ◽  
Chronic Obstructive ◽  
Management Support ◽  
Post Discharge

ObjectivesThe aim of this study was to describe challenges in self-management activities among people with multimorbidity during a 4-week post-discharge period.DesignThis is a longitudinal qualitative study using data from a randomised controlled trial (RCT) of motivational interviewing (MI) sessions.SettingThe RCT was conducted at six wards in two hospitals—one university hospital and one general hospital in Stockholm, Sweden, during 2016–2018.ParticipantsSixteen participants from the intervention group, diagnosed with heart failure or chronic obstructive pulmonary disease and at least one other chronic condition, were purposively selected for this study.InterventionsEach participant had four or five post-discharge MI sessions with a trained social worker during a period of approximately 4 weeks. The sessions were recorded digitally and analysed using content analysis. Altogether, 70 recorded sessions were analysed.ResultsSelf-management after hospital discharge was a dynamic process with several shifting features that evolved gradually over time. Patients with multimorbidity experienced two major challenges with self-management in the first 4 weeks following hospital discharge: ‘Managing a system-centred care’ and ‘Handling the burden of living with multiple illnesses at home post-discharge’.ConclusionsSelf-management for patients with multimorbidity in the first post-discharge period does not equate to a fixed set of tasks, but varies over the post-discharge period. Self-management challenges include not only the burden of the disease itself, but also that of navigating and understanding the healthcare system. Hence, self-management support post-discharge involves both aiding patients with care coordination and meeting their gradually shifting disease-related needs.Trial registration numberNCT02823795.

Power and control: transferring energy when there is work to be done

2005 ◽  
pp. 29-30
Author(s):  
Naveen Sharma ◽  
William Stanley
Keyword(s):  
Power And Control ◽  
And Control

International Human Rights Law and Blockade

2018 ◽  
Author(s):  
Phillip Drew
Keyword(s):  
Human Rights ◽  
International Human Rights Law ◽  
Humanitarian Law ◽  
Human Rights Law ◽  
International Human Rights ◽  
European Court ◽  
Power And Control ◽  
International Human ◽  
Extraterritorial Jurisdiction ◽  
And Control

The years since the beginning of the twenty-first century have seen a significant incursion of international human rights law into the domain that had previously been the within the exclusive purview of international humanitarian law. The expansion of extraterritorial jurisdiction, particularly by the European Court of Human Rights, means that for many states, the exercise of physical power and control over an individual outside their territory may engage the jurisdiction of human rights obligations. Understanding the expansive tendencies of certain human rights tribunals, and the apparent disdain they have for any ambiguity respecting human rights, it is offered that the uncertain nature of the law surrounding humanitarian relief during blockades could leave blockading forces vulnerable to legal challenge under human rights legislation, particularly in cases in which starvation occurs as a result of a blockade.

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