You can tell it works – Experiences from using the VIPS practice model in primary healthcare

Dementia ◽  
2021 ◽  
pp. 147130122110539
Author(s):  
Marit Mjørud ◽  
Janne Røsvik
Keyword(s):  
Primary Healthcare ◽  
Qualitative Content Analysis ◽  
Clinical Work ◽  
Care Practice ◽  
Service Users ◽  
Next Of Kin ◽  
Practice Model ◽  
Frontline Staff ◽  
Care Plans ◽  
Care Services

Introduction Person-centred care is a philosophy rather than a method ready for implementation and utilization in daily clinical work. Internationally, few methods for person-centred care have been widely adopted in clinical dementia care practice. In Norway, the VIPS practice model is one that is commonly used for the implementation and use of person-centred care in primary healthcare. Method Nursing home physicians, managers and leaders in the municipalities, care institutions and domestic nursing care services were eligible for inclusion if their workplace had implemented and used the VIPS practice model for a minimum of 12 months. Individual interviews were conducted via Facetime, Skype or telephone and analysed with qualitative content analysis. Findings In all, 20 respondents were included: one manager of health and care services in the municipality, six managers and leaders working in domestic care or daytime activity centres and 10 managers/leaders and three physicians working in nursing homes. Two global categories emerged: category 1: Change in staff’s professional reasoning with two sub-categories: (a) an enhanced professional level in discussions and (b) a change in focus from task to person; and category 2: Changes in the clinical work, with three sub-categories: (a) effective interventions, (b) a person-centred work environment and (c) changes in cooperation between stakeholders. Conclusion Regular use of the VIPS practice model appeared to change the work culture for the benefit of both service users and frontline staff. Increased cooperation between frontline staff, nurses, physicians and next of kin was described. Staff were more focused on the needs of the service users, which resulted in care interventions tailored to the needs of the individual with dementia, loyalty to care plans and fewer complaints from next of kin.

scholarly journals ‘We must have a new VIPS meeting soon!’ Barriers and facilitators for implementing the VIPS practice model in primary health care

Dementia ◽  
2021 ◽  
pp. 147130122110074
Author(s):  
Janne Røsvik ◽  
Marit Mjørud
Keyword(s):  
Nursing Care ◽  
Implementation Process ◽  
Care Practice ◽  
Sufficient Information ◽  
Practice Model ◽  
Frontline Staff ◽  
Daily Work ◽  
Individual Interviews ◽  
Care Services ◽  
Manifest Content

Introduction Person-centred care is a philosophy of care rather than a method ready for implementation and utilisation in daily work. Internationally, few methods for the implementation of person-centred care have been widely adopted in clinical and care practice. In Norway, the VIPS practice model is a commonly used model for person-centred care implementation. Method Qualitative manifest content analysis was used. Managers and leaders in the municipalities, care institutions and domestic nursing care services were eligible for inclusion if their workplace had implemented the VIPS practice model and conducted the consensus meeting regularly for a minimum of 12 months. Seventeen respondents were included. Individual interviews were conducted either via FaceTime, Skype or telephone. Results Three global categories emerged describing the implementation process: (1) factors that impact the decision made at municipal level to implement person-centred care; (2) requirements for a good start at unit level and (3) factors that help to support the new routines in the unit. The categories were entwined; the results of one affected the results of the others. The informants from both domestic nursing care and institutions described the same factors as important for the implementation of the VIPS practice model. Conclusion To implement person-centred care by use of the VIPS practice model, the frontline staff need sufficient information about the rationale for implementing the model. The management’s vision and ethos of person-centred care must be followed by time set aside for staff training and regularly scheduled VIPS practice model consensus meetings. Head nurses are key to getting the new routines established and maintained and should be supported by the management.

scholarly journals Needs-Led Research: A Way of Employing User Involvement in Establishing Research Questions on the Trust Model Within Community Home-Based Health Care Services in Norway

2020 ◽  
Author(s):  
Ruth-Ellen Slåtsveen ◽  
Torunn Wibe ◽  
Liv Halvorsrud ◽  
Anne Lund
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Online Survey ◽  
User Involvement ◽  
Trust Model ◽  
Service Users ◽  
Next Of Kin ◽  
Care Services ◽  
Home Based ◽  
Research Questions

Abstract Background This article presents a user involvement process in Norway regarding the performance of the trust model within community home-based health care services. The process, referred to as needs-led research (NLR), is inspired by the James Lind Alliance (JLA) and focuses on bringing together service users, next of kin and clinicians, also referred to as stakeholders, on equal terms to explore research priorities in a priority-setting partnership.Method The following five-step process was followed, in which representatives from service users, next of kin and clinicians were involved in every step. Step 1: A meeting organised in the form of a workshop with service users, next of kin and clinicians to discuss and narrow the scope. Step 2: Steering group meeting. Step 3: Online survey to identify uncertainties regarding the scope. Step 4: Data review and interim prioritisation of research questions. Step 5: Online survey prioritising the final top 10 research questions.Results Almost 200 participants contributed during the five steps, 294 submissions were gathered, and 35 participants voted for the top 10 list. ConclusionThis NLR process was experienced as feasible, and the user involvement shows that it is appropriate and necessary to involve service users, next of kin and clinicians in creating research questions that are relevant to the field.

scholarly journals Needs-led research: a way of employing user involvement when devising research questions on the trust model in community home-based health care services in Norway

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Ruth-Ellen Slåtsveen ◽  
Torunn Wibe ◽  
Liv Halvorsrud ◽  
Anne Lund
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
User Involvement ◽  
Trust Model ◽  
Small Scale ◽  
Service Users ◽  
Next Of Kin ◽  
Care Services ◽  
Home Based ◽  
Research Questions

Abstract Background This paper presents a user involvement process, called needs-led research, conducted as a part of a doctoral degree project aiming to explore research priorities and, ultimately, to develop a final top 10 list of questions relevant to the field of research. There is evidence of a mismatch between what user groups within a research field find relevant to study and what is actually being done. User involvement is a method that can accommodate this, and there is a growing attention and amount of research in this field based on an understanding that people who receive health care services, and their next of kin and clinicians, are uniquely positioned to contribute to research in order to understand their experiences better and improve the services. This paper presents a user involvement process in a small-scale study, referred to as needs-led research, which concerns the ‘performance of the trust model in community home-based health care services’. The process was conducted as part of a doctoral degree project. Method The needs-led research process is inspired by the James Lind Alliance (JLA), which focuses on bringing together service users, next of kin and clinicians on equal terms to explore research priorities. The process consisted of five-steps, each of which involved representatives from service users, next of kin and clinicians: 1) narrowing down the theme; 2) steering group meeting; 3) gathering input through a survey; 4) data processing and interim priority setting; and 5) final priority setting. Results Almost 200 participants contributed during the five steps, 294 inputs were gathered, and 35 participants voted for the top 10 list. The top 10 list is presented. Conclusion This paper provides an example of how user involvement can be employed to devise research questions that are relevant for clinicians, service users, next of kin and service providers concerning the ‘performance of the trust model in home-based health care’. It also outlines some strengths and limitations of the process. The needs-led research process shows that user involvement in research is feasible for developing research questions in small-scale studies. We hope that the top 10 list presented will encourage future research to address issues of importance regarding the performance of the trust model in community home-based health care services.

scholarly journals Medication Monitoring for People with Dementia in Care Homes: The Feasibility and Clinical Impact of Nurse-Led Monitoring

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Sue Jordan ◽  
Marie Gabe ◽  
Louise Newson ◽  
Sherrill Snelgrove ◽  
Gerwyn Panes ◽  
...  
Keyword(s):  
Mental Health ◽  
Adverse Drug Reaction ◽  
Intervention Study ◽  
Clinical Impact ◽  
Care Homes ◽  
Service Users ◽  
Care Plans ◽  
Medication Monitoring ◽  
People With Dementia ◽  
Before And After

Objectives. People with dementia are susceptible to adverse effects of medicines. However, they are not always closely monitored. We explored (1) feasibility and (2) clinical impact of nurse-led medication monitoring.Design. Feasibility “before-and-after” intervention study.Setting. Three care homes in Wales.Participants. Eleven service users diagnosed with dementia, taking at least one antipsychotic, antidepressant, or antiepileptic medicine.Intervention. West Wales Adverse Drug Reaction (ADR) Profile for Mental Health Medicines.Outcome Measures. (1) Feasibility: recruitment, retention, and implementation. (2) Clinical impact: previously undocumented problems identified and ameliorated, as recorded in participants’ records before and after introduction of the profile, and one month later.Results. Nurses recruited and retained 11 of 29 eligible service users. The profile took 20–25 minutes to implement, caused no harm, and supplemented usual care. Initially, the profile identified previously undocumented problems for all participants (mean 12.7 (SD 4.7)). One month later, some problems had been ameliorated (mean 4.9 (3.6)). Clinical gains included new prescriptions to manage pain (2 participants), psoriasis (1), Parkinsonian symptoms (1), rash (1), dose reduction of benzodiazepines (1), new care plans for oral hygiene, skin problems, and constipation.Conclusions. Participants benefited from structured nurse-led medication monitoring. Clinical trials of our ADR Profile are feasible and necessary.

scholarly journals Occupational Health and Safety Measures in German Outpatient Care Services during the COVID-19 Pandemic: A Qualitative Study

2021 ◽  
Vol 18 (6) ◽  
pp. 2987
Author(s):  
Mara Shirin Hetzmann ◽  
Natascha Mojtahedzadeh ◽  
Albert Nienhaus ◽  
Volker Harth ◽  
Stefanie Mache
Keyword(s):  
Occupational Health ◽  
Outpatient Care ◽  
Qualitative Content Analysis ◽  
Health And Safety ◽  
Occupational Health And Safety ◽  
Work Organisation ◽  
Safety Measures ◽  
Care Services ◽  
Health Threats ◽  
Company Doctor

Due to the coronavirus disease 2019 (COVID-19) pandemic, outpatient caregivers are exposed to new serious health threats at work. To protect their health, effective occupational health and safety measures (OHSM) are necessary. Outpatient caregivers (n = 15) participated in semi-structured telephone interviews in May/June 2020 (1) to examine the pandemic-related OHSM that have been implemented in their outpatient care services, as well as (2) to identify their corresponding unmet needs. Interviews were recorded, transcribed and analysed by using qualitative content analysis in accordance with Mayring. Available OHSM in outpatient care services described by outpatient caregivers mainly included personal protective equipment (PPE) and surface disinfection means after an initial shortage in the first peak of the pandemic. Further OHSM implied social distancing, increased hygiene regulations and the provision of pandemic-related information by the employer, as well as the possibility to consult a company doctor. Our study revealed that OHSM were largely adapted to the health threats posed by COVID-19, however an optimum has not yet been achieved. There is still a need for improvement in the qualitative and quantitative supply of PPE, as well as on the organisational level, e.g., with regard to the development of pandemic plans or in work organisation.

scholarly journals ‘They just came with the medication dispenser’- a qualitative study of elderly service users’ involvement and welfare technology in public home care services

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Heidi Snoen Glomsås ◽  
Ingrid Ruud Knutsen ◽  
Mariann Fossum ◽  
Kristin Halvorsen
Keyword(s):  
Qualitative Study ◽  
Home Care ◽  
Health Care Quality ◽  
Care Service ◽  
User Involvement ◽  
Home Care Services ◽  
Care Quality ◽  
Service Users ◽  
Care Services ◽  
Welfare Technology

Abstract Background Public home care for the elderly is a key area in relation to improving health care quality. It is an important political goal to increase elderly people’s involvement in their care and in the use of welfare technology. The aim of this study was to explore elderly service users’ experience of user involvement in the implementation and everyday use of welfare technology in public home care services. Method This qualitative study has an explorative and descriptive design. Sixteen interviews of service users were conducted in five different municipalities over a period of six months. The data were analysed using reflexive thematic analysis. Results Service users receiving public home care service are not a homogenous group, and the participants had different wishes and needs as regards user involvement and the use of welfare technology. The analysis led to four main themes: 1) diverse preferences as regards user involvement, 2) individual differences as regards information, knowledge and training, 3) feeling safe and getting help, and 4) a wish to stay at home for as long as possible. Conclusion The results indicated that user involvement was only to a limited extent an integral part of public home care services. Participants had varying insight into and interest in welfare technology, which was a challenge for user involvement. User involvement must be facilitated and implemented in a gentle way, highlighting autonomy and collaboration, and with the focus on respect, reciprocity and dialogue.

scholarly journals Encountering suicide in primary healthcare rehabilitation: the experiences of physiotherapists

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Åse Lundin ◽  
Anna Bergenheim
Keyword(s):  
At Risk ◽  
Healthcare System ◽  
Primary Healthcare ◽  
Qualitative Content Analysis ◽  
Western Hemisphere ◽  
Mental Wellbeing ◽  
Healthcare Personnel ◽  
Public Health Issue ◽  
Structured Interviews ◽  
Patients At Risk

Abstract Background Suicide is a serious public health issue and one of the most common causes of death globally. Suicide has long-lasting impact on personal, relational, community and societal levels. Research has shown that patients often seek help in the primary healthcare system preceding a suicide. Studies exploring the experiences of encountering patients at risk for suicide have been performed among various categories of healthcare personnel, such as nurses and psychiatry residents as well as emergency room staff. There is a lack of research regarding primary healthcare rehabilitation staff, despite the fact that physiotherapists are the third largest health profession in the Western hemisphere and often work with patients experiencing mental health symptoms. The aim of this study was to explore the experiences of encountering patients at risk for suicide among physiotherapists working in a primary healthcare rehabilitation setting. Methods Semi-structured interviews were conducted with 13 physiotherapists working in primary healthcare rehabilitation clinics in the Gothenburg area, Sweden. The interviews were recorded on audio and transcribed into written text. A qualitative content analysis was performed on the material collected. Results The analysis of the material revealed an overarching theme, Through barriers and taboos – the physiotherapist finds a way, with five main categories: possibilities for identification, obstacles in meeting suicide, workplace environment matters, where does the patient belong? and education and experience are keys. Conclusions The present study indicates that physiotherapists in the primary healthcare system encounter patients experiencing suicidality, and they expressed a strong desire to care for both the physical and mental wellbeing of the patients. Despite reporting many barriers, the physiotherapists often found a way to form a meaningful therapeutic alliance with the patient and to ask about possible suicidality in their clinical practice. The result suggests that physiotherapists could play a larger role in working with patients experiencing suicidality in a primary healthcare setting and that they could be viewed as possible gatekeepers in identification as well as referral of these patients into other parts of the healthcare system.

scholarly journals What are the risk factors for avoidable transitions in the last year of life? A qualitative exploration of professionals’ perspectives for improving care in Germany

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alina Kasdorf ◽  
◽  
Gloria Dust ◽  
Vera Vennedey ◽  
Christian Rietz ◽  
...  
Keyword(s):  
Healthcare Professional ◽  
Healthcare Professionals ◽  
Qualitative Content Analysis ◽  
Individual Interviews ◽  
Information Power ◽  
Care Services ◽  
Healthcare Settings ◽  
Nursing Services ◽  
Value Based Care ◽  
Qualitative Exploration

Abstract Background Little is known about the nature of patients’ transitions between healthcare settings in the last year of life (LYOL) in Germany. Patients often experience transitions between different healthcare settings, such as hospitals and long-term facilities including nursing homes and hospices. The perspective of healthcare professionals can therefore provide information on transitions in the LYOL that are avoidable from a medical perspective. This study aims to explore factors influencing avoidable transitions across healthcare settings in the LYOL and to disclose how these could be prevented. Methods Two focus groups (n = 11) and five individual interviews were conducted with healthcare professionals working in hospitals, hospices and nursing services from Cologne, Germany. They were asked to share their observations about avoidable transitions in the LYOL. The data collection continued until the point of information power was reached and were audio recorded and analysed using qualitative content analysis. Results Four factors for potentially avoidable transitions between care settings in the LYOL were identified: healthcare system, organization, healthcare professional, patient and relatives. According to the participants, the most relevant aspects that can aid in reducing unnecessary transitions include timely identification and communication of the LYOL; consideration of palliative care options; availability and accessibility of care services; and having a healthcare professional taking main responsibility for care planning. Conclusions Preventing avoidable transitions by considering the multicomponent factors related to them not only immediately before death but also in the LYOL could help to provide more value-based care for patients and improving their quality of life.

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