Examining Issues in Communicating Patient Care Information Across Shifts in a Critical Care Setting

2005 ◽  
Vol 49 (11) ◽  
pp. 1062-1066 ◽  
Author(s):  
Joseph Sharit ◽  
Lorgia McCane ◽  
Deborah M. Thevenin ◽  
Paul Barach
Keyword(s):  
Patient Care ◽  
Health Care Providers ◽  
Care Setting ◽  
Nurse Managers ◽  
Pediatric Intensive Care ◽  
Care Providers ◽  
Structured Interviews ◽  
Metropolitan Hospital ◽  
Care Information ◽  
Attending Physicians

This study addresses issues associated with sign-out reports occurring during shift changes in the pediatric intensive care unit of a large metropolitan hospital. The issues include the need for organizing our knowledge concerning the types of errors that providers are susceptible to during the sign-out process, the roles of personality, experience, and cultural factors, particularly as they may affect the incoming provider's inquisitiveness, and the potential impact on patient care of various different methods of performing sign-outs. We observed eight outgoing nurses and four residents who gave sign-out reports, and conducted eight semi-structured interviews with nurses, residents, nurse managers, and attending physicians. The results revealed important and intricate relationships among many of the variables that were investigated and suggested a number of interventions that might improve the sign-out process. Overall, our data on shift change sign-outs in an acute care setting confirmed the resiliency of health care providers and their capability for managing patient care under extremely demanding conditions.

scholarly journals Understanding Patient Expectations of Health Care: A Qualitative Study

2020 ◽  
Vol 7 (6) ◽  
pp. 1724-1731 ◽  
Author(s):  
Carlos El-Haddad ◽  
Iman Hegazi ◽  
Wendy Hu
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Patient Centered Care ◽  
Patient Expectations ◽  
Care Providers ◽  
Structured Interviews ◽  
Patient Centered ◽  
Measurement Tools ◽  
Metropolitan Hospital ◽  
Centered Care

Understanding and measuring patient expectations of health care is central to improving patient satisfaction and delivering patient-centered care. However, most empiric research in this field has focused on measuring patient expectations for specific diseases only. Patient expectations common to a variety of settings and clinical contexts need to be better understood to design measures with wider utility. We aimed to understand how patients express and conceptualize their expectations of health care across a range of clinical contexts and conditions. Semi-structured interviews were conducted with patients presenting to a major metropolitan hospital, informed by interpretive phenomenological analysis. Sampling continued until thematic saturation. Interview topics explored the illness experience, interactions with clinicians, how patients communicated and conceptualized their expectations of health care, and the nature of these expectations. The 26 participants conceptualized and described their expectations in 3 distinct domains: (1) health outcomes, (2) individual clinicians, and (3) the health-care system. Importantly, these domains were consistent across a variety of clinical contexts, participant demographics, and medical conditions. Despite variation in expectations due to individual patient circumstances, we identified 3 conceptual domains within which expectations consistently lie. When designing measurement tools for patient expectations, we suggest incorporating questions specifically addressing the 3 domains we have identified. With such measures, clinicians and health-care providers can be empowered to provide and monitor patient-centered care with outcomes tailored to what patients desire.

scholarly journals What Are the Perceptions, Experiences, and Behaviors of Health Care Providers After Implementation of a Comprehensive Smoke-Free Hospital Policy?

2018 ◽  
Vol 5 ◽  
pp. 233339361875677 ◽  
Author(s):  
Kerrie E. Luck ◽  
Shelley Doucet
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Providers ◽  
Hospital Setting ◽  
Hospital Environment ◽  
Care Providers ◽  
Structured Interviews ◽  
Staff Morale ◽  
Smoke Free Policy ◽  
And Behaviors

The aim of this study was to explore the perceptions, experiences, and behaviors of health care providers (HCPs) after the implementation of a comprehensive smoke-free policy. This qualitative descriptive study, using semi-structured interviews, was conducted with 28 HCPs working in a Canadian hospital. Four overarching themes emerged from the analysis including (a) greater support for tobacco reduction, (b) enhanced patient care and interactions, (c) improved staff morale, and (d) some barriers still exist. The main findings suggest a comprehensive smoke-free hospital environment can strengthen the tobacco-free workplace culture within a hospital setting among HCPs where support for tobacco reduction is amplified, patient care and interactions regarding tobacco dependence are improved, and staff morale is enhanced. While there are still some challenging barriers as well as opportunities for improvements, the implementation of a comprehensive smoke-free policy heightened the call-to-action among HCPs to take a more active role in tobacco reduction.

The Introduction of an Electronic Patient Care Information System and Health Care Providers’ Job Stress

2012 ◽  
pp. 33-46 ◽  
Author(s):  
Jean E. Wallace ◽  
Steven P. Friesen ◽  
Deborah E. White ◽  
Janet G. Gilmour ◽  
Jane B. Lemaire
Keyword(s):  
Patient Care ◽  
Job Stress ◽  
Health Care Providers ◽  
Computer Use ◽  
Care Providers ◽  
Quality Of Patient Care ◽  
Care Information ◽  
Highly Correlated ◽  
Over Time

In this paper, the authors explore how the introduction of an electronic Patient Care Information System (PCIS) relates to changes in health care providers’ (HCPs’) perceptions of computer use, quality of patient care and job stress. Data were collected using a mixed-methods case study approach over a 20 month period following the introduction of this system. Initially stress levels appeared to increase, but over time declined significantly. After 3 months, the majority of HCPs reported they spent more time entering, retrieving and searching for patient information than before; however, these increases in computer use were unrelated to HCP stress. The potentially negative impact of the system on the quality of patient care was highly correlated with increased job stress. After 20 months, HCPs reported spending less time searching, entering and retrieving patient information, but these indicators of computer use were now highly correlated with stress. While some negative perceptions of the impact of the PCIS declined over time, HCPs reported ongoing stress related to concerns about quality of patient care even after 20 months of use.

Characterizing Citizens’ Preferences for Engagement in Patient Care and Research in Adult and Pediatric Intensive Care Units

2017 ◽  
Vol 35 (2) ◽  
pp. 170-178
Author(s):  
Karen E. A. Burns ◽  
Leena Rizvi ◽  
Anna Charteris ◽  
Samuel Laskey ◽  
Saima B. Bhatti ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Patient Care ◽  
Family Involvement ◽  
Health Care Providers ◽  
Pediatric Intensive Care ◽  
Care Providers ◽  
Patient Transfers ◽  
Facilitators And Barriers ◽  
Pediatric Icu

Rationale: Engagement promotes and supports the active participation of patients and families in health care and research to strengthen their influence on decision-making. We sought to characterize how citizens wish to be engaged in care and research in the intensive care unit (ICU). Methods: Interviewers administered questionnaires to visitors in 3 adult ICUs and 1 pediatric ICU. Results: We surveyed 202 (adult [n = 130] and pediatric [n = 72]) visitors. Adults and pediatric visitors prioritized 3 patient care topics (family involvement in rounds, improving communication between family members and health-care providers, and information transmission between health-care practitioners during patient transfers) and 2 research topics (evaluating prevention and recovery from critical illness). Preferred engagement activities included sharing personal experiences, identifying important topics and outcomes, and finding ways to make changes that respected their needs. Both respondent groups preferred to participate by completing electronic surveys or comment cards and answering questions on a website. Few respondents (<5%) wanted to participate in committees that met regularly. Although adult and pediatric respondents identified common facilitators and barriers to participation, they ranked them differently. Although both groups perceived engagement to be highly important, adult respondents were significantly less confident that their participation would impact care (7.6 ± 2.2 vs 8.3 ± 1.8; P = .01) and research (7.3 ± 2.4 vs 8.2 ± 2.0; P = .01) and were significantly less willing to participate in care (5.6 ± 2.9 vs 6.7 ± 3.0; P = .007) and research (4.7 ± 3.0 vs ± 5.8 ± 3.0; P = .02). Conclusions: Adult and pediatric visitors expressed comparable engagement preferences, identified similar facilitators and barriers, and rated engagement highly. Adult visitors were significantly less confident that their participation would be impactful and were significantly less willing to engage in care and research.

The Introduction of an Electronic Patient Care Information System and Health Care Providers’ Job Stress

2010 ◽  
Vol 5 (4) ◽  
pp. 35-48 ◽  
Author(s):  
Jean E. Wallace ◽  
Steven P. Friesen ◽  
Deborah E. White ◽  
Janet G. Gilmour ◽  
Jane B. Lemaire
Keyword(s):  
Patient Care ◽  
Job Stress ◽  
Health Care Providers ◽  
Computer Use ◽  
Care Providers ◽  
Quality Of Patient Care ◽  
Care Information ◽  
Highly Correlated ◽  
Over Time

In this paper, the authors explore how the introduction of an electronic Patient Care Information System (PCIS) relates to changes in health care providers’ (HCPs’) perceptions of computer use, quality of patient care and job stress. Data were collected using a mixed-methods case study approach over a 20 month period following the introduction of this system. Initially stress levels appeared to increase, but over time declined significantly. After 3 months, the majority of HCPs reported they spent more time entering, retrieving and searching for patient information than before; however, these increases in computer use were unrelated to HCP stress. The potentially negative impact of the system on the quality of patient care was highly correlated with increased job stress. After 20 months, HCPs reported spending less time searching, entering and retrieving patient information, but these indicators of computer use were now highly correlated with stress. While some negative perceptions of the impact of the PCIS declined over time, HCPs reported ongoing stress related to concerns about quality of patient care even after 20 months of use.

Acceptance of the HPV Vaccine in a Multiethnic Sample of Latinx Mothers

2021 ◽  
Vol 31 (3) ◽  
pp. 472-483
Author(s):  
Ana Cristina Lindsay ◽  
Madelyne J. Valdez ◽  
Denisse Delgado ◽  
Emily Restrepo ◽  
Yessica M. Guzmán ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Thematic Analysis ◽  
Hpv Vaccine ◽  
Female Adolescents ◽  
Future Research ◽  
Care Providers ◽  
Foreign Born ◽  
Structured Interviews ◽  
Direct Benefits ◽  
Multiethnic Sample

This descriptive qualitative study explored Latinx mothers’ acceptance of the human papillomavirus (HPV) vaccine for their adolescent children. Data were collected through individual, semi-structured interviews and analyzed using a hybrid method of thematic analysis that incorporated deductive and inductive approaches. Twenty-two ( n = 22), mostly foreign-born, Latinx mothers of male and female adolescents participated in the study. Three main themes and nine subthemes emerged from the analyses. Findings identified the need for increased efforts to raise awareness and knowledge among Latinx mothers of the direct benefits of the HPV vaccine for sons, including stressing prevention of HPV-associated cancers in males. Findings also underscore the need for improved health care providers’ communication and recommendation of the HPV vaccine for Latinx adolescent males. Future research should intervene upon the study’s findings to address barriers that remain and affect Latinx mothers’ acceptance and uptake of the HPV vaccine for their children, in particular their sons.

scholarly journals Care-seeking and managing diabetes in rural Bangladesh: a mixed methods study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hannah Maria Jennings ◽  
Joanna Morrison ◽  
Kohenour Akter ◽  
Hassan Haghparast-Bidgoli ◽  
Carina King ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Health Care Providers ◽  
Low Income ◽  
Diabetes Management ◽  
Local Health ◽  
Care Seeking ◽  
Care Providers ◽  
Structured Interviews ◽  
Rural Bangladesh

Abstract Background Type 2 diabetes mellitus poses a major health challenge worldwide and in low-income countries such as Bangladesh, however little is known about the care-seeking of people with diabetes. We sought to understand the factors that affect care-seeking and diabetes management in rural Bangladesh in order to make recommendations as to how care could be better delivered. Methods Survey data from a community-based random sample of 12,047 adults aged 30 years and above identified 292 individuals with a self-reported prior diagnosis of diabetes. Data on health seeking practices regarding testing, medical advice, medication and use of non-allopathic medicine were gathered from these 292 individuals. Qualitative semi-structured interviews and focus group discussions with people with diabetes and semi-structured interviews with health workers explored care-seeking behaviour, management of diabetes and perceptions on quality of care. We explore quality of care using the WHO model with the following domains: safe, effective, patient-centred, timely, equitable and efficient. Results People with diabetes who are aware of their diabetic status do seek care but access, particularly to specialist diabetes services, is hindered by costs, time, crowded conditions and distance. Locally available services, while more accessible, lack infrastructure and expertise. Women are less likely to be diagnosed with diabetes and attend specialist services. Furthermore costs of care and dissatisfaction with health care providers affect medication adherence. Conclusion People with diabetes often make a trade-off between seeking locally available accessible care and specialised care which is more difficult to access. It is vital that health services respond to the needs of patients by building the capacity of local health providers and consider practical ways of supporting diabetes care. Trial registration ISRCTN41083256. Registered on 30/03/2016.

Breastfeeding Experiences of Baccalaureate Nursing Students: A Qualitative Study

2020 ◽  
pp. 089033442097998
Author(s):  
Cheryl Langford ◽  
Marcella Gowan ◽  
Monica Haj
Keyword(s):  
Nursing Students ◽  
Health Care Providers ◽  
Baccalaureate Nursing ◽  
Community Support ◽  
Baccalaureate Nursing Students ◽  
Care Providers ◽  
Structured Interviews ◽  
Breastfeeding Support ◽  
Cross Sectional

Background Students returning to school who are breastfeeding face unique challenges. There is limited literature on breastfeeding university students. Several researchers have studied breastfeeding employees in the workplace. Institutions of higher education closely mimic the employment environment. Breastfeeding college students who express their milk while at school share similar challenges to employed mothers. A baccalaureate nursing program is rigorous and little is known about the challenges facing breastfeeding student nurses returning to classes. Research aim To explore the breastfeeding experience of baccalaureate nursing students. Methods Our study was a cross-sectional descriptive qualitative design. Purposive sampling was used to enroll participants ( N = 12). In depth, semi-structured interviews were conducted. Qualitative thematic analysis was used to analyze the data both manually and using Dedoose QDA software. Results An overarching theme of pervasive conflict between the role of the breastfeeding mother and the role of the student nurse surfaced. Three interrelated organizing themes also emerged; challenging, vulnerability, and resilience. Time constraints, self-care versus role demands, and structural accommodations contributed to the challenges. Only one participant indicated a knowledge of her breastfeeding rights. All of the participants expressed gratitude for faculty and community support, regardless of conflicts. Conclusion Breastfeeding participants were both vulnerable and resilient. Faculty may improve experiences through providing specific areas of support. A breastfeeding support policy outlining student rights and faculty responsibilities is needed to educate, guide, and enforce protections. Health care providers may enhance breastfeeding students’ experiences through anticipatory guidance, education, and continued support.

scholarly journals “What is the actual goal of the pathway?”: examining emergency department physician and nurse perspectives on the implementation of a pediatric concussion pathway using the theoretical domains framework

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anh Ly ◽  
Roger Zemek ◽  
Bruce Wright ◽  
Jennifer Zwicker ◽  
Kathryn Schneider ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Care Providers ◽  
Clinical Pathways ◽  
Theoretical Domains Framework ◽  
Local Context ◽  
Emergency Department Physician ◽  
Evidence Based ◽  
Care Providers ◽  
Structured Interviews ◽  
Pediatric Concussion

Abstract Background Multiple evidence-based clinical practice guidelines (CPGs) exist to guide the management of concussion in children, but few have been translated into clinical pathways (CP), which operationalize guidelines into accessible and actionable algorithms that can be more readily implemented by health care providers. This study aimed to identify the clinical behaviours, attitudinal factors, and environmental contexts that potentially influence the implementation of a clinical pathway for pediatric concussion. Methods Semi-structured interviews were conducted from October 2017 to January 2018 with 42 emergency department clinicians (17 physicians, 25 nurses) at five urban emergency departments in Alberta, Canada. A Theoretical Domains Framework (TDF)-informed interview guide contained open-ended questions intended to gather feedback on the proposed pathway developed for the study, as well as factors that could potentially influence its implementation. Results The original 14 domains of the TDF were collapsed into 6 clusters based on significant overlap between domains in the issues discussed by clinicians: 1) knowledge, skills, and practice; 2) professional roles and identity; 3) attitudes, beliefs, and motivations; 4) goals and priorities; 5) local context and resources; and 6) engagement and collaboration. The 6 clusters identified in the interviews each reflect 2–4 predominant topics that can be condensed into six overarching themes regarding clinicians’ views on the implementation of a concussion CP: 1) standardization in the midst of evolving research; 2) clarifying and communicating goals; 3) knowledge dissemination and alignment of information; 4) a team-oriented approach; 5) site engagement; and 6) streamlining clinical processes. Conclusion Application of a comprehensive, evidence-based, and theory-driven framework in conjunction with an inductive thematic analysis approach enabled six themes to emerge as to how to successfullly implement a concussion CP.

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