scholarly journals Implementing the Aseptic Non Touch Technique (ANTT®) clinical practice framework for aseptic technique: a pragmatic evaluation using a mixed methods approach in two London hospitals

2017 ◽  
Vol 19 (1) ◽  
pp. 6-15 ◽  
Author(s):  
Simon Clare ◽  
Stephen Rowley
Keyword(s):  
Clinical Practice ◽  
Mixed Methods ◽  
Infection Prevention ◽  
Self Report ◽  
Healthcare Associated Infection ◽  
Structured Interviews ◽  
Aseptic Technique ◽  
Mixed Methods Approach ◽  
Practice Framework ◽  
Mean Compliance

Background: Aseptic technique is an important infection prevention competency for protecting patients from healthcare-associated infection (HAI). Healthcare providers using the Aseptic Non Touch Technique (ANTT®) aseptic technique have demonstrated reduced variability and improved compliance with aseptic technique. Objectives: The primary aim of this study is to determine whether standardizing aseptic technique for invasive IV procedures, using the ANTT® - Clinical Practice Framework (CPF), increases staff compliance with the infection prevention actions designed to achieve a safe and effective aseptic technique, and whether this is sustainable over time. Methods: A pragmatic evaluation using a mixed-methods approach consisting of an observational audit of practice, a self-report survey and structured interviews with key stakeholders. Compliance with aseptic technique before and after the implementation of ANTT® was measured by observation of 49 registered healthcare professionals. Results: Mean compliance with competencies was 94%; each component of practice was improved over baseline: hand hygiene = 63% ( P ≤ 0.001); glove use = 14% ( P ≤ 0.037); Key-Part protection = 54% ( P ≤ 0.001); a non-touch technique = 45% ( P ≤ 0.001); Key-Part cleaning = 82% ( P ≤ 0.001); and aseptic field management = 80% ( P ≤ 0.001). Conclusions: Results show implementation of ANTT® improved compliance with the prerequisite steps for safe and effective aseptic technique as defined by the ANTT®-CPF. Improvements in compliance were sustained over four years.

Who Creates Microtransactions : The Production Context of Video Game Monetization

2021 ◽  
Author(s):  
Lies van Roessel ◽  
Jan Švelch
Keyword(s):  
Content Analysis ◽  
Mixed Methods ◽  
Data Analysis ◽  
Frequency Analysis ◽  
Video Game ◽  
Job Descriptions ◽  
Structured Interviews ◽  
Game Development ◽  
Mixed Methods Approach ◽  
Roles And Responsibilities

Despite a growing academic interest in in-game monetization, much less attention has been paid to the production context of microtransactions. With this chapter, we aim to address this gap by focusing on the roles and responsibilities related to video game monetization. We answer the titular question of this chapter using a mixed methods approach, combining semi-structured interviews, content analysis of job descriptions, and frequency analysis of in-game credits. Results suggest that monetization responsibilities are both being integrated into various existing roles, including game designers or product managers, but also spawn new dedicated roles of monetization specialists. Monetization as a game development task is closely related to data analysis and only inconsistently appears in in-game credits.

scholarly journals Exploring Health Literacy in Individuals with Alcohol Addiction: A Mixed Methods Clinical Study

2020 ◽  
Vol 17 (18) ◽  
pp. 6728
Author(s):  
Gabriela Rolova ◽  
Beata Gavurova ◽  
Benjamin Petruzelka
Keyword(s):  
Clinical Practice ◽  
Mixed Methods ◽  
Health Literacy ◽  
Health Information ◽  
Mixed Methods Research ◽  
Addiction Treatment ◽  
Alcohol Addiction ◽  
Structured Interviews ◽  
Literacy Survey ◽  
Health Related

This mixed methods research paper explores health literacy (HL) in individuals with alcohol addiction by using the 47-item version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47) and semi-structured interviews concerning health-related competencies (access, understand, appraise, and apply health information), and determines the limitations of the HLS-EU-Q47 when used under specific conditions of clinical practice. The questionnaire survey and the interviews were conducted with individuals of different health literacy levels who were undergoing inpatient alcohol addiction treatment. The findings indicate that individuals with alcohol addiction might require different types of health information according to their health literacy level in terms of quantity and quality of information to recover from alcohol addiction and improve their overall health. The implications for the clinical practice of addiction treatment as well as recommendations for national and regional policy are also discussed.

scholarly journals Evaluation of a Case Management to Support Families With Children Diagnosed With Spinal Muscular Atrophy—Protocol of a Controlled Mixed-Methods Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Jana Willems ◽  
Erik Farin-Glattacker ◽  
Thorsten Langer
Keyword(s):  
Mixed Methods ◽  
Case Management ◽  
Muscular Atrophy ◽  
Healthcare Providers ◽  
Structured Interviews ◽  
Mixed Methods Approach ◽  
Management Intervention ◽  
Care Integration ◽  
Case Management Intervention

Background: Spinal muscular atrophy (SMA) is a rare neuromuscular disease characterized by degeneration of the anterior horn cells in the spinal cord, resulting in muscle atrophy, and proximal muscle weakness. SMA presents with a wide range of symptoms requiring multiple clinical specialists and therapists. Integrating care between disciplines can be challenging due to the dynamic course of the disease, and great distances between specialist centers and local providers. Insufficient care integration can lead to suboptimal quality of care and more difficulties for patients and families. This study aims to improve care integration through a Case Management intervention, and taking a mixed-methods approach, to evaluate its impact.Methods: An exploratory, controlled, two-armed study with baseline, post- and follow-up measurement and process evaluation is conducted to evaluate our intervention compared to usual care. Through a multi-perspective state analysis, we investigate the experiences of caregivers and healthcare providers concerning the actual healthcare quality of patients with SMA I and II. Semi-structured interviews and care diaries are used. We apply that data to conceive a tailored Case Management intervention supplemented by a digital platform. The intervention's effect is examined in comparison to a control group taking a mixed-methods approach. As primary endpoints, we investigate the caregivers' health-related quality of life and the quality of care integration. Secondary endpoints are the use of healthcare services (patients and caregivers) and costs. We assess the process quality from the perspectives of caregivers and healthcare providers through semi-structured interviews.Discussion: This is an exploratory, controlled study to assess the impact of a tailored Case Management intervention to improve the care of patients with SMA I and II. After the evaluation, results on feasibility, expected effect sizes, and process quality will be available. On this basis, future randomized controlled trials can be planned. If demonstrated beneficial, the experience gained within this study may also be valuable for care strategies in other regions and other (non-pediatric) patient groups with rare diseases and/or chronic, complex conditions.Clinical Trial registration:https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00018778, identifier: DRKS00018778.

scholarly journals Mobile Health Features Supporting Self-Management Behavior in Patients With Chronic Arthritis: Mixed-Methods Approach on Patient Preferences (Preprint)

2018 ◽  
Author(s):  
Jonas Geuens ◽  
Luc Geurts ◽  
Thijs W Swinnen ◽  
Rene Westhovens ◽  
Vero Vanden Abeele
Keyword(s):  
Mixed Methods ◽  
Mobile Health ◽  
Disease Status ◽  
Chronic Arthritis ◽  
Adult Patients ◽  
Self Management ◽  
Structured Interviews ◽  
Management Behavior ◽  
Mixed Methods Approach ◽  
Related Data

BACKGROUND Patients with chronic arthritis (CA) ideally apply self-management behaviors between consultations. This enduring, tedious task of keeping track of disease-related parameters, adhering to medication schemes, and engaging in physical therapy may be supported by using a mobile health (mHealth) app. However, further research is needed to determine which self-management features are valued most by adult patients with CA patients. OBJECTIVE The aim of this study was to determine the preference of features for an mHealth app to support self-management behavior in patients with CA. In addition, we aimed to explore the motives behind these ratings. METHODS A mixed-methods approach was used to gather information from 31 adult patients (14 females), aged 23 to 71 years (mean 51 [SD 12.16]), with CA. Structured interviews were conducted to gather data pertaining to preferences of app features. Interviews were analyzed qualitatively, whereas ratings for each of the 28 features studied were analyzed quantitatively. RESULTS In general, patients with CA favored the use of features pertaining to supporting active and direct disease management, (eg, medication intake and detecting and alarming of bad posture), helping them to keep a close watch on their disease status and inform their health care professional (eg, providing a means to log and report disease-related data) and receiving personalized information (eg, offering tailored information based on the patient’s health data). Patients strongly disliked features that provide a means of social interaction or provide incentivization for disease-related actions (eg, being able to compare yourself with other patients, cooperating toward a common goal, and receiving encouragement from friends and/or family). Driving these evaluations is the finding that every patient with CA hurts in his/her own way, the way the disease unfolds over time and manifests itself in the patient and social environment is different for every patient, and patients with CA are well aware of this. CONCLUSIONS We have offered an insight into how patients with CA favor mHealth features for self-management apps. The results of this research can inform the design and development of prospective self-management apps for patients with CA.

scholarly journals Development of a Breech-Specific Integrated Care Pathway for Pregnant Women: Protocol for a Mixed Methods Study (Preprint)

2020 ◽  
Author(s):  
Sara Morris ◽  
Sadie Geraghty ◽  
Deborah Sundin
Keyword(s):  
Clinical Practice ◽  
Mixed Methods ◽  
Integrated Care ◽  
Western Australia ◽  
Delphi Study ◽  
Care Pathway ◽  
Breech Presentation ◽  
Mixed Methods Approach ◽  
Breech Birth ◽  
Integrated Care Pathway

BACKGROUND The development of an integrated care pathway with multidisciplinary input to standardize and streamline care for pregnant women experiencing breech presentation at 36 or more weeks of gestation poses several challenges because of the divisive and contentious nature of the phenomenon. Although many clinicians are interested in obtaining the skills required to safely support women desiring a vaginal breech birth, the primary trend in most health care facilities is to recommend a cesarean section. OBJECTIVE This paper aims to discuss the mixed methods approach used in a doctoral study conducted to generate new knowledge regarding women’s experiences of breech birth in Western Australia and professional recommendations regarding the care of women experiencing breech presentation close to or at term. This study was designed to inform the development of an integrated care pathway for women experiencing a breech presentation. This mixed methods approach situated within the pragmatic paradigm was determined to be the optimal way for incorporating multidisciplinary recommendations with current clinical practice guidelines and consumer feedback. METHODS A mixed methods study utilizing semistructured interviews, an electronic Delphi (e-Delphi) study, and clinical practice guideline appraisal was conducted to generate new data. The interviews were designed to provide insights and understanding of the experiences of women in Western Australia who are diagnosed with a breech presentation. The e-Delphi study explored childbirth professionals’ knowledge, opinions, and recommendations for the care of women experiencing breech presentation close to or at term. The clinical practice guideline appraisal will examine the current national and professional breech management and care guidelines. This study has the potential to highlight areas in practice that may need improvement and enable clinicians to better support women through what can be a difficult time. RESULTS Data collection for this study began in November 2018 and concluded in March 2020. Data analysis is currently taking place, and the results will be disseminated through publication when the analysis is complete. CONCLUSIONS The results of this study will guide the development of an integrated care pathway for women experiencing a breech presentation close to or at term, with the hope of moving toward standardized breech care for women in Western Australia. This study protocol has the potential to be used as a research framework for future studies of a similar nature. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/23514

scholarly journals Development of a Breech-Specific Integrated Care Pathway for Pregnant Women: Protocol for a Mixed Methods Study

10.2196/23514 ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. e23514 ◽  
Author(s):  
Sara Morris ◽  
Sadie Geraghty ◽  
Deborah Sundin
Keyword(s):  
Clinical Practice ◽  
Mixed Methods ◽  
Integrated Care ◽  
Western Australia ◽  
Delphi Study ◽  
Care Pathway ◽  
Breech Presentation ◽  
Mixed Methods Approach ◽  
Breech Birth ◽  
Integrated Care Pathway

Background The development of an integrated care pathway with multidisciplinary input to standardize and streamline care for pregnant women experiencing breech presentation at 36 or more weeks of gestation poses several challenges because of the divisive and contentious nature of the phenomenon. Although many clinicians are interested in obtaining the skills required to safely support women desiring a vaginal breech birth, the primary trend in most health care facilities is to recommend a cesarean section. Objective This paper aims to discuss the mixed methods approach used in a doctoral study conducted to generate new knowledge regarding women’s experiences of breech birth in Western Australia and professional recommendations regarding the care of women experiencing breech presentation close to or at term. This study was designed to inform the development of an integrated care pathway for women experiencing a breech presentation. This mixed methods approach situated within the pragmatic paradigm was determined to be the optimal way for incorporating multidisciplinary recommendations with current clinical practice guidelines and consumer feedback. Methods A mixed methods study utilizing semistructured interviews, an electronic Delphi (e-Delphi) study, and clinical practice guideline appraisal was conducted to generate new data. The interviews were designed to provide insights and understanding of the experiences of women in Western Australia who are diagnosed with a breech presentation. The e-Delphi study explored childbirth professionals’ knowledge, opinions, and recommendations for the care of women experiencing breech presentation close to or at term. The clinical practice guideline appraisal will examine the current national and professional breech management and care guidelines. This study has the potential to highlight areas in practice that may need improvement and enable clinicians to better support women through what can be a difficult time. Results Data collection for this study began in November 2018 and concluded in March 2020. Data analysis is currently taking place, and the results will be disseminated through publication when the analysis is complete. Conclusions The results of this study will guide the development of an integrated care pathway for women experiencing a breech presentation close to or at term, with the hope of moving toward standardized breech care for women in Western Australia. This study protocol has the potential to be used as a research framework for future studies of a similar nature. International Registered Report Identifier (IRRID) DERR1-10.2196/23514

The Perceptions of Nurses About the Behavioral Needs for Daylighting and View to the Outside in Inpatient Facilities

2019 ◽  
Vol 13 (1) ◽  
pp. 191-205
Author(s):  
Arsalan Gharaveis ◽  
Hamed Yekita ◽  
Gholamreza Shamloo
Keyword(s):  
Mixed Methods ◽  
Nursing Staff ◽  
Medical Error ◽  
Behavioral Responses ◽  
Structured Interviews ◽  
Mixed Methods Approach ◽  
Behavioral Needs ◽  
Extensive Body ◽  
Nurses Perceptions ◽  
The Impact

Objectives: This research aims to explore the perceptions of nursing staff regarding the effects of daylighting on behavioral factors including mood, stress, satisfaction, medical error, and efficiency. Background: In spite of an extensive body of literature seeking to investigate the impact of daylighting on patients, a limited number of studies have been done for the sake of nurses’ perceptions and behavioral responses. Method: A mixed-methods approach, comprised of qualitative explorations (structured interviews) and a validated survey, was applied and the results were compared and triangulated. Five nurses were interviewed and 156 nurses volunteered for a lighting survey from six departments of three inpatient facilities in Iran. Results: The findings of this study are consistent with the existing evidence that daylighting and view to the outside enhance nurses’ perceptions regarding satisfaction, mood, stress, medical error, and alertness, while reducing fatigue and stress. Conclusion: Patient rooms and work stations are the most crucial areas to provide daylighting from nurses’ perspectives.

scholarly journals Breast cancer specialists’ views on and use of risk prediction models in clinical practice: A mixed methods approach

2014 ◽  
Vol 54 (3) ◽  
pp. 361-367 ◽  
Author(s):  
Ellen G. Engelhardt ◽  
Arwen H. Pieterse ◽  
Nanny van Duijn-Bakker ◽  
Judith R. Kroep ◽  
Hanneke C. J. M. de Haes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Practice ◽  
Mixed Methods ◽  
Risk Prediction ◽  
Prediction Models ◽  
Risk Prediction Models ◽  
Mixed Methods Approach ◽  
Cancer Specialists

scholarly journals A Network-Based Mixed Methods Approach to Analyze Current Perspectives on Personalized Oncological Medicine in Austria

2020 ◽  
Vol 10 (4) ◽  
pp. 276
Author(s):  
Ines Viktoria Stelzer ◽  
Anna Sierawska ◽  
Alena Buyx ◽  
Judit Simon
Keyword(s):  
Mixed Methods ◽  
Network Theory ◽  
Practical Implementation ◽  
Structured Interviews ◽  
Mixed Methods Approach ◽  
Study Results ◽  
Long Time ◽  
Vienna General Hospital ◽  
The Individual ◽  
Medical University

Personalized medicine (PM) to tailor healthcare (HC) to the individual, is a promising but challenging concept. So far, no study exists investigating stakeholders’ perspectives on PM in oncology in Austria potentially hindering implementation, which was the aim of this study. We performed semi-structured interviews among experts (n = 14) and cancer patients (n = 2) of the Vienna General Hospital and the Medical University of Vienna and analyzed them by a mixed methods network theoretical approach. Study results show a great variety of topics addressed by the interviewees. Clear differences in the topic selection between patients and experts could be observed. Patient-doctor relationship was the most prominent theme among experts, whereas HC systems and public health in PM was more relevant for the patients. Although promising new molecular pathology methods were explicitly mentioned, the experts believed that their practical implementation and the implementation of PM in standard care will take a long time in Austria. A variety of concerns regarding PM were mentioned by the experts, including communication issues and knowledge gaps. Besides important insights into the current situation of PM in Austria, the study has shown that network theory is a powerful tool for analyzing qualitative interview data.

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