scholarly journals What Affects Adoption of Specialty Palliative Care in Intensive Care Units?: A Qualitative Study

2020 ◽  
Author(s):  
M. Hua ◽  
L. Fonseca ◽  
A. Finkelstein ◽  
R.S. Morrison ◽  
H. Wunsch ◽  
...  
Keyword(s):  
Palliative Care ◽  
Intensive Care ◽  
Qualitative Study ◽  
Intensive Care Units

What Affects Adoption of Specialty Palliative Care in Intensive Care Units: A Qualitative Study

2021 ◽  
Author(s):  
May Hua ◽  
Laura D. Fonseca ◽  
R. Sean Morrison ◽  
Hannah Wunsch ◽  
Robert Fullilove ◽  
...  
Keyword(s):  
Palliative Care ◽  
Intensive Care ◽  
Qualitative Study ◽  
Intensive Care Units

Barriers of Palliative Care in Neonatal Intensive Care Units

2016 ◽  
Vol 34 (3) ◽  
pp. 205-211 ◽  
Author(s):  
Mansooreh Azzizadeh Forouzi ◽  
Marjan Banazadeh ◽  
Jila Soltan Ahmadi ◽  
Farideh Razban
Keyword(s):  
Palliative Care ◽  
Organizational Culture ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Attitude Scale ◽  
Neonatal Intensive Care Units ◽  
Cross Sectional ◽  
Neonatal Nurses ◽  
Eol Care

Objective: Neonatal nurses face numerous barriers in providing end-of-life (EOL) care for neonates and their families. Addressing neonatal nurses’ attitudes could provide insight into barriers that impede neonatal palliative care (NPC). This study thus conducted to examine neonatal nurses’ attitude toward barriers in providing NPC in Southeast Iran. Method: In this cross-sectional study, a translated modified version of Neonatal Palliative Care Attitude Scale was used to examine attitudes of 70 nurses toward barriers of palliative care in 3 neonatal intensive care units in Southeast Iran. Results: Findings indicated that overall 42.63% of nurses were strongly agreed or agreed with the proposed barriers in NPC. Among all categories, the highest and the lowest scores belonged to the categories of “insufficient resources” (3.42 ± 0.65) and “inappropriate personal and social attitudes” (2.33 ± 0.48), respectively. Neonatal nurses who had less education and study regarding NPC reported the presence of more barriers to NPC in the categories of “inappropriate organizational culture” and/or “inadequate nursing proficiency.” Also, younger nurses had more positive attitudes toward the category of inappropriate organizational culture as being a barrier to provision of NPC (4.62). Conclusion: The findings suggest that developing a context-based instrument is required to represent the barrier more precisely. Neonatal palliative care can be improved by establishing a special environment to focus on infants’ EOL care. This establishment requires standard palliative care guidelines and adequate NPC-trained nurses.

scholarly journals The challenges of using physical restraint in intensive care units in Iran: A qualitative study

2020 ◽  
pp. 175114371989278
Author(s):  
Zahra Salehi ◽  
Soodabeh Joolaee ◽  
Fatemeh Hajibabaee ◽  
Tahereh Najafi Ghezeljeh
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Qualitative Study ◽  
Intensive Care Units ◽  
Physical Restraint ◽  
Critical Care Nurses ◽  
Structured Interviews ◽  
Standard Equipment ◽  
Restraint Use ◽  
Ensure Patient Safety

Background Physical restraint is widely used in intensive care units to ensure patient safety, manage agitated patients, and prevent the removal of medical equipment connected to them. However, physical restraint use is a major healthcare challenge worldwide. Aim This study aimed to explore nurses' experiences of the challenges of physical restraint use in intensive care units. Methods This qualitative study was conducted in 2018–2019. Twenty critical care nurses were purposively recruited from the intensive care units of four hospitals in Tehran, Iran. Data were collected via in-depth semi-structured interviews, concurrently analyzed via Graneheim and Lundman's conventional content analysis approach, and managed via MAXQDA software (v. 10.0). Findings Three main themes were identified (i) organizational barriers to effective physical restraint use (lack of quality educations for nurses about physical restraint use, lack of standard guidelines for physical restraint use, lack of standard physical restraint equipment), (ii) ignoring patients' wholeness (their health and rights), and (iii) distress over physical restraint use (emotional and mental distress, moral conflict, and inability to find an appropriate alternative for physical restraint). Conclusion Critical care nurses face different organizational, ethical, and emotional challenges in using physical restraint. Healthcare managers and authorities can reduce these challenges by developing standard evidence-based guidelines, equipping hospital wards with standard equipment, implementing in-service educational programs, supervising nurses' practice, and empowering them for finding and using alternatives to physical restraint. Nurses can also reduce these challenges through careful patient assessment, using appropriate alternatives to physical restraint, and consulting with their expert colleagues.

scholarly journals Palliative care in advanced coronavirus disease in intensive care units

2020 ◽  
Vol 10 (3) ◽  
pp. 340-340 ◽  
Author(s):  
Ali Esmaeili Vardanjani ◽  
Hossein Rafiei ◽  
Mostafa Mohammdi
Keyword(s):  
Palliative Care ◽  
Intensive Care ◽  
Intensive Care Units

Factors affecting nursing error communication in intensive care units: A qualitative study

2020 ◽  
pp. 096973302095210
Author(s):  
Tahereh Najafi Ghezeljeh ◽  
Mansoureh Ashghali Farahani ◽  
Fatemeh Kafami Ladani
Keyword(s):  
Intensive Care ◽  
Qualitative Study ◽  
Intensive Care Units ◽  
Organizational Factors ◽  
Public Hospitals ◽  
Ethical Challenges ◽  
Ethical Practice ◽  
Medical Sciences ◽  
Factors Affecting ◽  
Professional Characteristics

Background: Error communication includes both reporting errors to superiors and disclosing their consequences to patients and their families. It significantly contributes to error prevention and safety improvement. Yet, some errors in intensive care units are not communicated. Objectives: The aim of the present study was to explore factors affecting error communication in intensive care units. Design and participants: This qualitative study was conducted in 2019. Participants were 17 critical care nurses purposively recruited from the intensive care units of 2 public hospitals affiliated to Iran University of Medical Sciences, Tehran, Iran. Data were collected through in-depth semi-structured interviews and were analyzed through the conventional content analysis method proposed by Graneheim and Lundman. Ethical considerations: The Ethics Committee of Iran University of Medical Sciences, Tehran, Iran approved the study (code: IR.IUMS. REC.1397.792). Participants were informed about the study aim and methods and were ensured of data confidentiality. They were free to withdraw from the study at will. Written informed consent was obtained from all of them. Findings: Factors affecting error communication in intensive care units fell into four main categories, namely the culture of error communication (subcategories were error communication organizational atmosphere, clarity of processes and guidelines, managerial support for nurses, and learning organization), the consequences of errors for nurses and nursing (subcategories were fear over being stigmatized as incompetent, fear over punishment, and fear over negative judgments about nursing), the consequences of errors for patients (subcategories were monitoring the effects of errors on patients and predicting the effects of errors on patients), and ethical and professional characteristics (subcategories were ethical characteristics and inter-professional relationships). Discussion: The results of this study show many factors affect error communication, some facilitate and some prohibit it. Organizational factors such as the culture of error communication and the consequences of error communication for the nurse and the patient, as well as individual and professional characteristics, including ethical characteristics and interprofessional relationship, influence this process. Conclusion: Errors confront nurses with ethical challenges and make them assess error consequences and then, communicate or hide them based on the results of their assessments. Health authorities can promote nurses’ error communication through creating a supportive environment for them, developing clear error communication processes and guidelines, and providing them with education about the principles of ethical practice.

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