Comparing Physician and Nurse Opinions of Team and Individual Handoffs: Does Role Influence Preference?

2020 ◽  
Vol 64 (1) ◽  
pp. 613-617
Author(s):  
Emily Heuck ◽  
Abigail Wooldridge
Keyword(s):  
Intensive Care Unit ◽  
Safety Issue ◽  
Care Transitions ◽  
Intensive Care Unit Care ◽  
Sociotechnical System ◽  
Health Care Professions ◽  
Work System ◽  
Professional Needs ◽  
Future Work ◽  
System Designs

Care transitions are key to patient safety and remain a safety issue despite previous research. This study examines how the design of care transitions impacts different health care professions. Twenty-nine physicians and nurses were interviewed about operating room to intensive care unit care transitions. We compared relationships between work system elements in positive and negative opinions about two sociotechnical system designs: including team or individual handoffs. Nurses did not express positive opinions of individual handoffs or negative opinions of team handoffs, while physicians expressed positive and negative opinions of both. Relationships between work system elements varied by profession in the positive opinions about team handoffs and negative opinions about individual handoffs. Professional needs and culture may be related to the different perceptions of each handoff. Future work should continue to examine professional differences when developing a flexibly standardized process to ensure all users are considered.

scholarly journals Access to Intensive Care Unit Care for Elderly Patients with COVID-19 in Portugal

2020 ◽  
pp. 1-3
Author(s):  
Filipe S. Cardoso ◽  
André Borges ◽  
Isabel Botelho ◽  
André Real ◽  
Ana C. Araújo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Elderly Patients ◽  
Intensive Care Unit Care

scholarly journals Humanization and Macroergonomics: An Analysis in the Billing Sector of a University Hospital in Paraná

2020 ◽  
Author(s):  
Larissa de Oliveira Matia Leite ◽  
Alexandre Minoru Sasaki ◽  
Rosimeire Sedrez Bitencourt ◽  
Maria Lucia Miyake Okumura ◽  
Osiris Canciglieri Junior
Keyword(s):  
Health Workers ◽  
Work Organization ◽  
University Hospital ◽  
Participatory Ergonomics ◽  
Sociotechnical System ◽  
Work System ◽  
Organizational Constructs ◽  
Sociotechnical Analysis ◽  
Machine Systems ◽  
One Year

The humanization of organizations is a trend in companies that have a vision of the future aligned with the needs of the market. In the health area, this humanization should not be limited to its users, but include the employees involved in the work system. The human aspect and its relations with the work system is a focus of studying ergonomics, which in its macroergomic approach aims at integrating organization-man-machine systems into a sociotechnical and participatory context. This study aims to apply the macroergonomic approach with health workers in order to propose and implement improvements; evidencing the importance of their involvement in better acceptance of the proposed improvements generating greater satisfaction. To this end, a study was conducted in the Billing sector of a Brazilian Hospital. Ergonomic demands were identified in a participatory way through the Macroergonomic Analysis of Work (MAW) method, proposed in [1]. The results were tabulated and divided into constructs: Environment, Biomechanical, Cognitive, Work Organization, Risk, Company and Discomfort/Pain. After one year, a new macroergonomic evaluation was carried out and the improvements implemented included the concept of the sociotechnical system, which were: i) acquisition of new computers; ii) implementation of a new computational system and; iii) implementation of changes in the form of sector management. The results showed an increase of up to 40% in satisfaction with the improvements implemented in the Biomechanical and Organizational constructs, indicating that the application of participatory ergonomics and macroergonomics was fundamental for the changes made to increase satisfaction in aspects of the work performed by them. Finally, this research highlights the importance of employee involvement in sociotechnical analysis for the humanization of organizations and it is suggested for future studies the proposition of improvements related to the Environment and Cognitive constructs and pain/discomforts.

scholarly journals Risk and outcomes of coronavirus disease (COVID-19) in patients with inflammatory bowel disease: a systematic review and meta-analysis

2020 ◽  
pp. 205064062097260
Author(s):  
Anupam Kumar Singh ◽  
Anuraag Jena ◽  
Praveen Kumar-M ◽  
Vishal Sharma ◽  
Shaji Sebastian
Keyword(s):  
Ulcerative Colitis ◽  
Intensive Care Unit ◽  
Inflammatory Bowel Disease ◽  
Intensive Care ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
General Population ◽  
Bowel Disease ◽  
Intensive Care Unit Care ◽  
Inflammatory Bowel

Background The risk of severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) infection and clinical outcomes of coronavirus disease (COVID-19) in inflammatory bowel disease are unclear. Methods We searched PubMed and Embase with the keywords: inflammatory bowel disease, Crohn’s disease, ulcerative colitis and COVID-19, novel coronavirus and SARS-CoV-2. We included studies reporting the frequency of COVID-19 infection and outcomes (hospitalisation, need for intensive care unit care and mortality) in patients with inflammatory bowel disease. We estimated the pooled incidence of COVID-19 in inflammatory bowel disease and comparative risk vis-a-vis the general population. We also estimated the pooled frequency of outcomes and compared them in patients who received and did not receive drugs for inflammatory bowel disease. Results Twenty-four studies were included. The pooled incidence rate of COVID-19 per 1000 patients of inflammatory bowel disease and the general population were 4.02 (95% confidence interval (CI) 1.44–11.17) and 6.59 (3.25–13.35), respectively, with no increase in relative risk (0.47, 0.18–1.26) in inflammatory bowel disease. The relative risk of the acquisition of COVID-19 was not different between ulcerative colitis and Crohn’s disease (1.03, 0.62–1.71). The pooled proportion of COVID-19-positive inflammatory bowel disease patients requiring hospitalisation and intensive care unit care was 27.29% and 5.33% while pooled mortality was 4.27%. The risk of adverse outcomes was higher in ulcerative colitis compared to Crohn’s disease. The relative risks of hospitalisation, intensive care unit admission and mortality were lower for patients on biological agents (0.34, 0.19–0.61; 0.49, 0.33–0.72 and 0.22, 0.13–0.38, respectively) but higher with steroids (1.99, 1.64–2.40; 3.41, 2.28–5.11 and 2.70, 1.61–4.55) or 5-aminosalicylate (1.59, 1.39–1.82; 2.38, 1.26–4.48 and 2.62, 1.67–4.11) use. Conclusion SARS-CoV-2 infection risk in patients with inflammatory bowel disease is comparable to the general population. Outcomes of COVID-19-positive inflammatory bowel disease patients are worse in ulcerative colitis, those on steroids or 5-aminosalicylates but outcomes are better with biological agents.

scholarly journals Student nurses’ ethical views on responses to the severe acute respiratory syndrome outbreak

2020 ◽  
Vol 27 (4) ◽  
pp. 924-934
Author(s):  
Joseph KM Kam ◽  
Eric Chan ◽  
Albert Lee ◽  
Vivian WI Wei ◽  
Kin On Kwok ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Resource Allocation ◽  
Intensive Care ◽  
Nursing Students ◽  
Severe Acute Respiratory Syndrome ◽  
Infectious Diseases ◽  
Health Workers ◽  
Intensive Care Unit Care ◽  
Central Research ◽  
Collateral Damage

Background Fifteen years have passed since the outbreak of severe acute respiratory syndrome in Hong Kong. At that time, there were reports of heroic acts among professionals who cared for these patients, whose bravery and professionalism were highly praised. However, there are concerns about changes in new generation of nursing professionals. Objective We aimed to examine the attitude of nursing students, should they be faced with severe acute respiratory syndrome patients during their future work. Research design A questionnaire survey was carried out to examine the attitude among final-year nursing students to three ethical areas, namely, duty of care, resource allocation, and collateral damage. Ethical considerations This study was carried out in accordance with the requirements and recommendations of the Central Research and Ethics Committee, School of Health Sciences at Caritas Institute of Higher Education. Findings Complete responses from 102 subjects were analyzed. The overwhelming majority (96.1%) did not agree to participate in the intubation of severe acute respiratory syndrome patients if protective measures, that is, N95 mask and gown, were not available. If there were insufficient N95 masks for all the medical, nursing, and allied health workers in the hospital (resource allocation), 37.3% felt that the distribution of N95 masks should be by casting lot, while the rest disagreed. When asked about collateral damage, more than three-quarters (77.5%) said that severe acute respiratory syndrome patients should be admitted to intensive care unit. There was sex difference in nursing students’ attitude toward severe acute respiratory syndrome care during pregnancy and influence of age in understanding intensive care unit care for these patients. Interestingly, 94.1% felt that there should be a separate intensive care unit for severe acute respiratory syndrome patients. Conclusion As infection control practice and isolation facilities improved over the years, relevant knowledge and nursing ethical issues related to infectious diseases should become part of nursing education and training programs, especially in preparation for outbreaks of infectious diseases or distress.

scholarly journals Engineering a foundation for partnership to improve medication safety during care transitions

2019 ◽  
Vol 24 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Yan Xiao ◽  
Ephrem Abebe ◽  
Ayse P Gurses
Keyword(s):  
Medication Safety ◽  
Medication Management ◽  
Care Transitions ◽  
System Thinking ◽  
Tool Support ◽  
Work Systems ◽  
Work System ◽  
Phone Calls ◽  
Hospital Stays ◽  
Engineer Work

There are major gaps and barriers for patients and caregivers after hospital discharge to achieve safe medication use. Patients and caregivers are often not ready to take on the responsibility for medication management when transitioned from inpatient care. Current approaches tend to focus on adding isolated strategies. A system thinking can enable a fundamental transformation to redesign professionals’ interactions with patients and caregivers with an explicit goal to develop patients and caregivers into true partners, with targeted roles, skills, attitude, knowledge, and tool support. We must recognize the fact that medication safety during care transition and, more so, at patient homes is the property of a “work system”, in which the patient and caregivers are at the center, with collaboration with health professionals. Innovative ideas are needed to engineer work system components by systematically examining professionals’ interactions with patients and caregivers, such as those during hospital stays and transitions (e.g. follow-up phone calls, community pharmacist consults, and home visits). Based on human factors principles, we describe a set of recommendations on engineering partnership with patients and their caregivers at different stages of a care episode, to enable productive interactions among work systems that are distributed and are often limited in their ability to exchange information and co-align their interests.

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