scholarly journals Exploring the experiences of operating room health care professionals' from the challenges of the COVID-19 pandemic

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fateme Mohammadi ◽  
Banafsheh Tehranineshat ◽  
Mostafa Bijani ◽  
Khodayar Oshvandi ◽  
Zohreh Badiyepeymaiejahromi
Keyword(s):  
Health Care ◽  
Operating Room ◽  
Health Care Professionals ◽  
Clinical Performance ◽  
Standards Of Care ◽  
Structured Interviews ◽  
Health Care Professions ◽  
Professional Challenges ◽  
Operating Room Nurses ◽  
Efficient Planning

Abstract Background The operating room nurses have encountered several challenges during the current COVID-19 Pandemic, which subsequently impact their clinical performance. The present study aimed to investigate the experiences of operating room health care professionals' regarding the COVID-19 pandemic challenges in southern Iran. Methods This is a descriptive qualitative study. The required data were collected using in-depth and semi-structured interviews. Accordingly, 19 operating room health care professions were included in this study through purposive sampling. The data were collected from February 2020 to August 2021 and then analyzed using the Granheim and Lundman’s method. Results Three main themes and 9 sub-themes were presented in this study. They included: 1- Challenges of applying protocols and standards of care in the COVID-19 pandemic in the operating room (lack of specific guidelines regarding care protocols and standards for crisis management of Covid-19 in the operating room and impossibility of keeping social distance in the operating room). 2- Professional challenges (tedious and hard work, professional burnout, lack of adequate support by the managers and lack of personal protective equipment). 3-Psychological crises (indescribable anxiety and worry, parenting stress, and weakened resilience). Conclusion Based on the findings of the present study, it was indicated that lack of a specific guideline in the COVID-19 pandemic led to a sense of indecision and confusion among operating room staff. In this regard, performing tedious tasks, feelings of tiredness and exhaustion, lack of support by the authorities, and lack of access to adequate facilities and equipment were reported as the professional challenges of the healthcare staff in the current COVID-19 pandemic, which consequently affected the quality of care and patient’s safety. It seems that hospital officials can use the results reported in this study for efficient planning and effective management during the COVID-19 pandemic.

scholarly journals Implementation of the Operating Room Black Box Research Program at the Ottawa Hospital Through Patient, Clinical, and Organizational Engagement: Case Study (Preprint)

2019 ◽  
Author(s):  
Sylvain Boet ◽  
Nicole Etherington ◽  
Sandy Lam ◽  
Maxime Lê ◽  
Laurie Proulx ◽  
...  
Keyword(s):  
Health Care ◽  
Operating Room ◽  
Direct Observation ◽  
Health Care Professionals ◽  
Clinical Performance ◽  
Implementation Process ◽  
Black Box ◽  
Innovative Technology ◽  
Surgical Patient ◽  
Best Interest

BACKGROUND A large proportion of surgical patient harm is preventable; yet, our ability to systematically learn from these incidents and improve clinical practice remains limited. The Operating Room Black Box was developed to address the need for comprehensive assessments of clinical performance in the operating room. It captures synchronized audio, video, patient, and environmental clinical data in real time, which are subsequently analyzed by a combination of expert raters and software-based algorithms. Despite its significant potential to facilitate research and practice improvement, there are many potential implementation challenges at the institutional, clinician, and patient level. This paper summarizes our approach to implementation of the Operating Room Black Box at a large academic Canadian center. OBJECTIVE We aimed to contribute to the development of evidence-based best practices for implementing innovative technology in the operating room for direct observation of the clinical performance by using the case of the Operating Room Black Box. Specifically, we outline the systematic approach to the Operating Room Black Box implementation undertaken at our center. METHODS Our implementation approach included seeking support from hospital leadership; building frontline support and a team of champions among patients, nurses, anesthesiologists, and surgeons; accounting for stakeholder perceptions using theory-informed qualitative interviews; engaging patients; and documenting the implementation process, including barriers and facilitators, using the consolidated framework for implementation research. RESULTS During the 12-month implementation period, we conducted 23 stakeholder engagement activities with over 200 participants. We recruited 10 clinician champions representing nursing, anesthesia, and surgery. We formally interviewed 15 patients and 17 perioperative clinicians and identified key themes to include in an information campaign run as part of the implementation process. Two patient partners were engaged and advised on communications as well as grant and protocol development. Many anticipated and unanticipated challenges were encountered at all levels. Implementation was ultimately successful, with the Operating Room Black Box installed in August 2018, and data collection beginning shortly thereafter. CONCLUSIONS This paper represents the first step toward evidence-guided implementation of technologies for direct observation of performance for research and quality improvement in surgery. With technology increasingly being used in health care settings, the health care community should aim to optimize implementation processes in the best interest of health care professionals and patients.

scholarly journals Embedded trials within national clinical audit programmes: A qualitative interview study of enablers and barriers

2021 ◽  
pp. 135581962110443
Author(s):  
Sarah Alderson ◽  
Tom A Willis ◽  
Su Wood ◽  
Fabiana Lorencatto ◽  
Jill Francis ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Audit Quality ◽  
Clinical Performance ◽  
Clinical Audit ◽  
Care Delivery ◽  
Audit And Feedback ◽  
Structured Interviews ◽  
Address Data ◽  
Qualitative Interview Study

Background Audit and feedback entails systematic documentation of clinical performance based on explicit criteria or standards which is then fed back to professionals in a structured manner. There are potential significant returns on investment from partnerships between existing clinical audit programmes in coordinated programmes of research to test ways of improving the effect of their feedback to drive greater improvements in health care delivery and population outcomes. We explored barriers to and enablers of embedding audit and feedback trials within clinical audit programmes. Methods We purposively recruited participants with varied experience in embedded trials in audit programmes. We conducted qualitative semi-structured interviews, guided by behavioural theory, with researchers, clinical audit programme staff and health care professionals. Recorded interviews were transcribed, and data coded and thematically analysed. Results We interviewed 31 participants (9 feedback researchers, 14 audit staff and 8 healthcare professionals, many having dual roles). We identified barriers and enablers for all 14 theoretical domains but no relationship between domains and participant role. We identified four optimal conditions for sustainable collaboration from the perspectives of stakeholders: resources, that is, recognition that audit programmes need to create capacity to participate in research, and research must be adapted to fit within each programme’s constraints; logistics, namely, that partnerships need to address data sharing and audit quality, while securing research funding to ensure operational success; leadership, that is, enthusiastic and engaged audit programme leaders must motivate their team and engage local stakeholders; and relationships, meaning that trust between researchers and audit programmes must be established over time by identifying shared priorities and meeting each partner’s needs. Conclusion Successfully embedding research within clinical audit programmes is likely to require compromise, logistical expertise, leadership and trusting relationships to overcome perceived risks and fully realise benefits.

scholarly journals Women, Exercise, and Eating Disorder Recovery: The Normal and the Pathological

2021 ◽  
pp. 104973232199204
Author(s):  
Hester Hockin-Boyers ◽  
Megan Warin
Keyword(s):  
Health Care ◽  
Eating Disorder ◽  
Affect Regulation ◽  
Health Care Professionals ◽  
Value Systems ◽  
Structured Interviews ◽  
Data Set ◽  
The United Kingdom ◽  
Theoretical Frame ◽  
Intensity Of Exercise

The appropriate form, regularity, and intensity of exercise for individuals recovering from eating disorders is not agreed upon among health care professionals or researchers. When exercise is permitted, it is that which is mindful, embodied, and non-competitive that is considered normative. Using Canguilhem’s concepts of “the normal and the pathological” as a theoretical frame, we examine the gendered assumptions that shape medical understandings of “healthy” and “dysfunctional” exercise in the context of recovery. The data set for this article comes from longitudinal semi-structured interviews with 19 women in the United Kingdom who engaged in weightlifting during their eating disorder recovery. We argue that women in recovery navigate multiple and conflicting value systems regarding exercise. Faced with aspects of exercise that are pathologized within the eating disorder literature (such as structure/routine, body transformations, and affect regulation), women re-inscribe positive value to these experiences, thus establishing exercise practices that serve them.

scholarly journals Leadership assumptions on implementation of patient involvement methods

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathrine Håland Jeppesen ◽  
Kirsten Frederiksen ◽  
Marianne Johansson Joergensen ◽  
Kirsten Beedholm
Keyword(s):  
Health Care ◽  
Organizational Learning ◽  
Health Care Professionals ◽  
Large Scale ◽  
Patient Involvement ◽  
Hospital Setting ◽  
Implementation Process ◽  
University Hospital ◽  
Structured Interviews ◽  
Implementation Processes

Abstract Background From 2014 to 17, a large-scale project, ‘The User-involving Hospital’, was implemented at a Danish university hospital. Research highlights leadership as crucial for the outcome of change processes in general and for implementation processes in particular. According to the theory on organizational learning by Agyris and Schön, successful change requires organizational learning. Argyris and Schön consider that the assumptions of involved participants play an important role in organizational learning and processes. The purpose was to explore leaders’ assumptions concerning implementation of patient involvement methods in a hospital setting. Methods Qualitative explorative interview study with the six top leaders in the implementation project. The semi-structured interviews were conducted and analyzed in accordance with Kvale and Brinkmanns’ seven stages of interview research. Result The main leadership assumptions on what is needed in the implementation process are in line with the perceived elements in organizational learning according to the theory of Argyris and Schön. Hence, they argued that implementation of patient involvement requires a culture change among health care professionals. Two aspects on how to obtain success in the implementation process were identified based on leadership assumptions: “The health care professionals’ roles in the implementation process” and “The leaders’ own roles in the implementation process”. Conclusion The top leaders considered implementation of patient involvement a change process that necessitates a change in culture with health care professionals as crucial actors. Furthermore, the top leaders considered themselves important facilitators of this implementation process.

Nurses and Prescriptive Authority: A Legal and Economic Analysis

1989 ◽  
Vol 15 (2-3) ◽  
pp. 245-299 ◽  
Author(s):  
Elizabeth Harrison Hadley
Keyword(s):  
Health Care ◽  
Drug Therapy ◽  
Economic Efficiency ◽  
Health Care Professionals ◽  
Legal Authority ◽  
Economic Implications ◽  
Health Care Professions ◽  
Prescriptive Authority ◽  
Complementary Role ◽  
History Of

This article identifies twenty-six jurisdictions where nurses have been granted legal authority to prescribe drugs. The jurisdictions are divided into two groups: those where nurses have authority to prescribe without the supervision of a physician and can therefore function as substitutes for physicians; and those where nurses may prescribe only in collaboration with a supervising physician, and are thereby limited to functioning in a complementary role.The issue of prescriptive authority is discussed within the context of regulating the practice of nursing, and more generally, the health care professions. The article reviews the history of Nurse Practice Acts, focusing upon the Connecticut statute and the economic implications of this statutory approach. It is argued that the law should promote the use of nurses as substitutes for physicians whenever appropriate.The article concludes with a two-part proposal for reform: an “authorized prescriber” statute requiring health care professionals desiring to prescribe drugs to pass an examination testing their knowledge of pharmacology and drug therapy; and the elimination of the “unauthorized practice” provisions of the statutes regulating all health care professions. The proposal promotes economic efficiency by eliminating artificial constraints on the substitutability of labor in the provision of health services.

scholarly journals Surveillance, anticipation and firefighting: Perspectives of patient safety from a New Zealand case study

2020 ◽  
Author(s):  
J Wailling ◽  
Brian Robinson ◽  
M Coombs
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
New Zealand ◽  
Health Care Professionals ◽  
Nuclear Power ◽  
High Reliability ◽  
Health Care Systems ◽  
Tertiary Hospital ◽  
Structured Interviews

© 2018 John Wiley & Sons Ltd Aim: This study explored how doctors, nurses and managers working in a New Zealand tertiary hospital understand patient safety. Background: Despite health care systems implementing proven safety strategies from high reliability organisations, such as aviation and nuclear power, these have not been uniformly adopted by health care professionals with concerns raised about clinician engagement. Design: Instrumental, embedded case study design using qualitative methods. Methods: The study used purposeful sampling, and data was collected using focus groups and semi-structured interviews with doctors (n = 31); registered nurses (n = 19); and senior organisational managers (n = 3) in a New Zealand tertiary hospital. Results: Safety was described as a core organisational value. Clinicians appreciated proactive safety approaches characterized by anticipation and vigilance, where they expertly recognized and adapted to safety risks. Managers trusted evidence-based safety rules and approaches that recorded, categorized and measured safety. Conclusion and Implications for Nursing Management: It is important that nurse managers hold a more refined understanding about safety. Organisations are more likely to support safe patient care if cultural complexity is accounted for. Recognizing how different occupational groups perceive and respond to safety, rather than attempting to reinforce a uniform set of safety actions and responsibilities, is likely to bring together a shared understanding of safety, build trust and nurture safety culture.

Education Research in German Non-Medical Health Care Professions compared to International Developments: a Bibliometric and Content-Related Publication Analysis

2020 ◽  
Author(s):  
Sandra Kuka ◽  
Jan P. Ehlers ◽  
Michaela Zupanic
Keyword(s):  
Health Care ◽  
Education Research ◽  
Health Care Professionals ◽  
Inclusion Criteria ◽  
Health Care Professions ◽  
Publication Analysis ◽  
Research Activities ◽  
German Health ◽  
Medical Health Care ◽  
Medical Health

Abstract Background In Germany academic degree programs for non-medical health care professions (nursing, physical, occupational and speech language therapy, midwifery) have been established only recently, even if they play a key role in today´s complex patient-centered health care. The aim of this study was to evaluate the development and current state of German education research in these professions as well as to conduct a comparison to international research activities in this field.Method To achieve these objectives a bibliometric and content-related publication analysis was performed from 2008 to 2017 in four international high-impact journals. Based on appropriate inclusion criteria (bibliographical and biographical criteria, focus on first and last author, original study) and their development into a coding scheme, articles were recorded systematically and results analyzed quantitatively and content-wise. Group comparisons between German and international health care professions as well as interdisciplinary comparisons between the individual professions were performed.Results On the whole, 11.891 articles were analyzed for participation of the respective target groups, either as first or as last author. Of these, 164 original studies met the inclusion criteria with 157 publications pertaining to international and only seven to German health care professionals. The majority of authors belonged to the discipline of nursing science (n=138). North America (36.63%), Australia (18.32%) and Asia (14.85%) rank among the regions that publish most frequently. Publications by German health care professionals are rare but showed an overall high level of quality.Conclusion International publication activities by non-medical health care professionals have been on the rise in recent years. Specific funding measures as well as transnational and interdisciplinary collaborations may be potential ways of strengthening and expanding education research in countries with only young academic experiences.

scholarly journals Where else would I look for it? A five-country qualitative study on purposes, strategies, and consequences of online health information seeking

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Nicola Diviani ◽  
Eva Haukeland Fredriksen ◽  
Corine S. Meppelink ◽  
Judy Mullan ◽  
Warren Rich ◽  
...  
Keyword(s):  
Health Care ◽  
Lived Experience ◽  
Health Information ◽  
Health Care Professionals ◽  
Information Seeking ◽  
The Body ◽  
Online Health Information ◽  
Structured Interviews ◽  
Ehealth Literacy ◽  
Digital Divides

Background. Online health information (OHI) is widely available and consulted by many people in Western countries to gain health advice. The main goal of the present study is to provide a detailed account of the experiences among people from various demographic backgrounds living in high-income countries, who have used OHI. Design and methods. Thematic analysis of 165 qualitative semi-structured interviews conducted among OHI users residing in Australia, Israel, the Netherlands, Norway, and Switzerland was performed. Results. The lived experience of people using OHI seem not to differ across countries. The interviews show that searches for OHI are motivated from curiosity, sharing of experiences, or affirmation for actions already taken. Most people find it difficult to appraise the information, leading them to cross-check sources or discuss OHI with others. OHI seems to impact mostly some specific types of health behaviors, such as changes in diet or physical activity, while it only plays a complementary role for more serious health concerns. Participants often check OHI before seeing their GP, but are reluctant to discuss online content with health care personnel due to expected negative reception. Conclusions. This study adds to the body of knowledge on eHealth literacy by demonstrating how OHI affects overall health behavior, strengthens patients’ ability to understand, live with, and prepare themselves for diverse health challenges. The increasing digitalization of health communication and health care calls for further research on digital divides and patient-professional relations. Health care professionals should acknowledge OHI seeking and engage in discussions with patients to enable them to appreciate OHI, and to support shared decision making in health care. The professionals can utilize patient’s desire to learn as a resource for health prevention, promotion or treatment, and empowerment.

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